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Sample records for multiple choice diagnostic

  1. A Diagnostic Study of Pre-Service Teachers' Competency in Multiple-Choice Item Development

    Asim, Alice E.; Ekuri, Emmanuel E.; Eni, Eni I.

    2013-01-01

    Large class size is an issue in testing at all levels of Education. As a panacea to this, multiple choice test formats has become very popular. This case study was designed to diagnose pre-service teachers' competency in constructing questions (IQT); direct questions (DQT); and best answer (BAT) varieties of multiple choice items. Subjects were 88…

  2. A singular choice for multiple choice

    Frandsen, Gudmund Skovbjerg; Schwartzbach, Michael Ignatieff

    2006-01-01

    How should multiple choice tests be scored and graded, in particular when students are allowed to check several boxes to convey partial knowledge? Many strategies may seem reasonable, but we demonstrate that five self-evident axioms are sufficient to determine completely the correct strategy. We ...

  3. Student certainty answering misconception question: study of Three-Tier Multiple-Choice Diagnostic Test in Acid-Base and Solubility Equilibrium

    Ardiansah; Masykuri, M.; Rahardjo, S. B.

    2018-04-01

    Students’ concept comprehension in three-tier multiple-choice diagnostic test related to student confidence level. The confidence level related to certainty and student’s self-efficacy. The purpose of this research was to find out students’ certainty in misconception test. This research was quantitative-qualitative research method counting students’ confidence level. The research participants were 484 students that were studying acid-base and equilibrium solubility subject. Data was collected using three-tier multiple-choice (3TMC) with thirty questions and students’ questionnaire. The findings showed that #6 item gives the highest misconception percentage and high student confidence about the counting of ultra-dilute solution’s pH. Other findings were that 1) the student tendency chosen the misconception answer is to increase over item number, 2) student certainty decreased in terms of answering the 3TMC, and 3) student self-efficacy and achievement were related each other in the research. The findings suggest some implications and limitations for further research.

  4. ITER diagnostics: Design choices and solutions

    Costley, A.E.; Sugie, T.; Vayakis, G.; Malaquias, A.; Walker, C.

    2003-01-01

    An extensive diagnostic system will be installed on ITER to provide the measurements necessary to control, evaluate and optimise the plasma performance and to study burning plasma physics. Because of the harsh environment, diagnostic system selection and design has to cope with a range of phenomena not previously encountered in diagnostic implementation. In this paper, we describe the key problems encountered and give examples of the solutions that have been developed. A brief description of the scheme developed for integrating multiple systems into individual ports is also included. We conclude with an assessment of overall system performance. (author)

  5. Making the Most of Multiple Choice

    Brookhart, Susan M.

    2015-01-01

    Multiple-choice questions draw criticism because many people perceive they test only recall or atomistic, surface-level objectives and do not require students to think. Although this can be the case, it does not have to be that way. Susan M. Brookhart suggests that multiple-choice questions are a useful part of any teacher's questioning repertoire…

  6. Development and Application of a Two-Tier Multiple-Choice Diagnostic Test for High School Students' Understanding of Cell Division and Reproduction

    Sesli, Ertugrul; Kara, Yilmaz

    2012-01-01

    This study involved the development and application of a two-tier diagnostic test for measuring students' understanding of cell division and reproduction. The instrument development procedure had three general steps: defining the content boundaries of the test, collecting information on students' misconceptions, and instrument development.…

  7. Senior high school students’ need analysis of Three-Tier Multiple Choice (3TMC) diagnostic test about acid-base and solubility equilibrium

    Ardiansah; Masykuri, M.; Rahardjo, S. B.

    2018-05-01

    Students’ conceptual understanding is the most important comprehension to obtain related comprehension. However, they held their own conception. With this need analysis, we will elicit student need of 3TMC diagnostic test to measure students’ conception about acid-base and solubility equilibrium. The research done by a mixed method using questionnaire analysis based on descriptive of quantitative and qualitative. The research subject was 96 students from 4 senior high schools and 4 chemistry teachers chosen by random sampling technique. Data gathering used a questionnaire with 10 questions for student and 28 questions for teachers. The results showed that 97% of students stated that the development this instrument is needed. In addition, there were several problems obtained in this questionnaire include learning activity, teacher’s test and guessing. In conclusion, this is necessary to develop the 3TMC instrument that can diagnose and measure the student’s conception in acid-base and solubility equilibrium.

  8. Chemistry and biology by new multiple choice

    Seo, Hyeong Seok; Kim, Seong Hwan

    2003-02-01

    This book is divided into two parts, the first part is about chemistry, which deals with science of material, atom structure and periodic law, chemical combination and power between molecule, state of material and solution, chemical reaction and an organic compound. The second part give description of biology with molecule and cell, energy in cells and chemical synthesis, molecular biology and heredity, function on animal, function on plant and evolution and ecology. This book has explanation of chemistry and biology with new multiple choice.

  9. Can multiple-choice questions simulate free-response questions?

    Lin, Shih-Yin; Singh, Chandralekha

    2016-01-01

    We discuss a study to evaluate the extent to which free-response questions could be approximated by multiple-choice equivalents. Two carefully designed research-based multiple-choice questions were transformed into a free-response format and administered on the final exam in a calculus-based introductory physics course. The original multiple-choice questions were administered in another similar introductory physics course on final exam. Findings suggest that carefully designed multiple-choice...

  10. Multiple Choice Knapsack Problem: example of planning choice in transportation.

    Zhong, Tao; Young, Rhonda

    2010-05-01

    Transportation programming, a process of selecting projects for funding given budget and other constraints, is becoming more complex as a result of new federal laws, local planning regulations, and increased public involvement. This article describes the use of an integer programming tool, Multiple Choice Knapsack Problem (MCKP), to provide optimal solutions to transportation programming problems in cases where alternative versions of projects are under consideration. In this paper, optimization methods for use in the transportation programming process are compared and then the process of building and solving the optimization problems is discussed. The concepts about the use of MCKP are presented and a real-world transportation programming example at various budget levels is provided. This article illustrates how the use of MCKP addresses the modern complexities and provides timely solutions in transportation programming practice. While the article uses transportation programming as a case study, MCKP can be useful in other fields where a similar decision among a subset of the alternatives is required. Copyright 2009 Elsevier Ltd. All rights reserved.

  11. Genetic Algorithms for Multiple-Choice Problems

    Aickelin, Uwe

    2010-04-01

    This thesis investigates the use of problem-specific knowledge to enhance a genetic algorithm approach to multiple-choice optimisation problems.It shows that such information can significantly enhance performance, but that the choice of information and the way it is included are important factors for success.Two multiple-choice problems are considered.The first is constructing a feasible nurse roster that considers as many requests as possible.In the second problem, shops are allocated to locations in a mall subject to constraints and maximising the overall income.Genetic algorithms are chosen for their well-known robustness and ability to solve large and complex discrete optimisation problems.However, a survey of the literature reveals room for further research into generic ways to include constraints into a genetic algorithm framework.Hence, the main theme of this work is to balance feasibility and cost of solutions.In particular, co-operative co-evolution with hierarchical sub-populations, problem structure exploiting repair schemes and indirect genetic algorithms with self-adjusting decoder functions are identified as promising approaches.The research starts by applying standard genetic algorithms to the problems and explaining the failure of such approaches due to epistasis.To overcome this, problem-specific information is added in a variety of ways, some of which are designed to increase the number of feasible solutions found whilst others are intended to improve the quality of such solutions.As well as a theoretical discussion as to the underlying reasons for using each operator,extensive computational experiments are carried out on a variety of data.These show that the indirect approach relies less on problem structure and hence is easier to implement and superior in solution quality.

  12. The positive and negative consequences of multiple-choice testing.

    Roediger, Henry L; Marsh, Elizabeth J

    2005-09-01

    Multiple-choice tests are commonly used in educational settings but with unknown effects on students' knowledge. The authors examined the consequences of taking a multiple-choice test on a later general knowledge test in which students were warned not to guess. A large positive testing effect was obtained: Prior testing of facts aided final cued-recall performance. However, prior testing also had negative consequences. Prior reading of a greater number of multiple-choice lures decreased the positive testing effect and increased production of multiple-choice lures as incorrect answers on the final test. Multiple-choice testing may inadvertently lead to the creation of false knowledge.

  13. Evaluating multiple-choice exams in large introductory physics courses

    Gary Gladding; Tim Stelzer; Michael Scott

    2006-01-01

    The reliability and validity of professionally written multiple-choice exams have been extensively studied for exams such as the SAT, graduate record examination, and the force concept inventory. Much of the success of these multiple-choice exams is attributed to the careful construction of each question, as well as each response. In this study, the reliability and validity of scores from multiple-choice exams written for and administered in the large introductory physics courses at the Unive...

  14. Multiple sclerosis - etiology and diagnostic potential.

    Kamińska, Joanna; Koper, Olga M; Piechal, Kinga; Kemona, Halina

    2017-06-30

    Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease of autoimmune originate. The main agents responsible for the MS development include exogenous, environmental, and genetic factors. MS is characterized by multifocal and temporally scattered central nervous system (CNS) damage which lead to the axonal damage. Among clinical courses of MS it can be distinguish relapsing-remitting multiple sclerosis (RRMS), secondary progressive multiple sclerosis (SPSM), primary progressive multiple sclerosis (PPMS), and progressive-relapsing multiple sclerosis (RPMS). Depending on the severity of signs and symptoms MS can be described as benign MS or malignant MS. MS diagnosis is based on McDonald's diagnostic criteria, which link clinical manifestation with characteristic lesions demonstrated by magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, and visual evoked potentials. Among CSF laboratory tests used to the MS diagnosis are applied: Tibbling & Link IgG index, reinbegrams, and CSF isoelectrofocusing for oligoclonal bands detection. It should be emphasized, that despite huge progress regarding MS as well as the availability of different diagnostics methods this disease is still a diagnostic challenge. It may result from fact that MS has diverse clinical course and there is a lack of single test, which would be of appropriate diagnostic sensitivity and specificity for quick and accurate diagnosis.

  15. Evaluating Multiple-Choice Exams in Large Introductory Physics Courses

    Scott, Michael; Stelzer, Tim; Gladding, Gary

    2006-01-01

    The reliability and validity of professionally written multiple-choice exams have been extensively studied for exams such as the SAT, graduate record examination, and the force concept inventory. Much of the success of these multiple-choice exams is attributed to the careful construction of each question, as well as each response. In this study,…

  16. Assessing choice making among children with multiple disabilities.

    Sigafoos, J; Dempsey, R

    1992-01-01

    Some learners with multiple disabilities display idiosyncratic gestures that are interpreted as a means of making choices. In the present study, we assessed the validity of idiosyncratic choice-making behaviors of 3 children with multiple disabilities. Opportunities for each child to choose between food and drink were provided under two conditions. In one condition, the children were given the food or drink item corresponding to their prior choice. In the other condition, the teacher delivere...

  17. Multiple sclerosis - etiology and diagnostic potential

    Joanna Kamińska

    2017-06-01

    Full Text Available Multiple sclerosis (MS is a chronic inflammatory and demyelinating disease of autoimmune originate. The main agents responsible for the MS development include exogenous, environmental, and genetic factors. MS is characterized by multifocal and temporally scattered central nervous system (CNS damage which lead to the axonal damage. Among clinical courses of MS it can be distinguish relapsing-remitting multiple sclerosis (RRMS, secondary progressive multiple sclerosis (SPSM, primary progressive multiple sclerosis (PPMS, and progressive-relapsing multiple sclerosis (RPMS. Depending on the severity of signs and symptoms MS can be described as benign MS or malignant MS. MS diagnosis is based on McDonald’s diagnostic criteria, which link clinical manifestation with characteristic lesions demonstrated by magnetic resonance imaging (MRI, cerebrospinal fluid (CSF analysis, and visual evoked potentials. Among CSF laboratory tests used to the MS diagnosis are applied: Tibbling & Link IgG index, reinbegrams, and CSF isoelectrofocusing for oligoclonal bands detection. It should be emphasized, that despite huge progress regarding MS as well as the availability of differentdiagnostics methods this disease is still a diagnostic challenge. It may result from fact that MS has diverse clinical course and there is a lack of single test, which would be of appropriate diagnostic sensitivity and specificity for quick and accurate diagnosis.

  18. Discrete choice models with multiplicative error terms

    Fosgerau, Mogens; Bierlaire, Michel

    2009-01-01

    The conditional indirect utility of many random utility maximization (RUM) discrete choice models is specified as a sum of an index V depending on observables and an independent random term ε. In general, the universe of RUM consistent models is much larger, even fixing some specification of V due...

  19. Multiple choices of time in quantum cosmology

    Małkiewicz, Przemysław

    2015-01-01

    It is often conjectured that a choice of time function merely sets up a frame for the quantum evolution of the gravitational field, meaning that all choices should be in some sense compatible. In order to explore this conjecture (and the meaning of compatibility), we develop suitable tools for determining the relation between quantum theories based on different time functions. First, we discuss how a time function fixes a canonical structure on the constraint surface. The presentation includes both the kinematical and the reduced perspective, and the relation between them. Second, we formulate twin theorems about the existence of two inequivalent maps between any two deparameterizations, a formal canonical and a coordinate one. They are used to separate the effects induced by choice of clock and other factors. We show, in an example, how the spectra of quantum observables are transformed under the change of clock and prove, via a general argument, the existence of choice-of-time-induced semiclassical effects. Finally, we study an example, in which we find that the semiclassical discrepancies can in fact be arbitrarily large for dynamical observables. We conclude that the values of critical energy density or critical volume in the bouncing scenarios of quantum cosmology cannot in general be at the Planck scale, and always need to be given with reference to a specific time function. (paper)

  20. Airport choice model in multiple airport regions

    Claudia Muñoz

    2017-02-01

    Full Text Available Purpose: This study aims to analyze travel choices made by air transportation users in multi airport regions because it is a crucial component when planning passenger redistribution policies. The purpose of this study is to find a utility function which makes it possible to know the variables that influence users’ choice of the airports on routes to the main cities in the Colombian territory. Design/methodology/approach: This research generates a Multinomial Logit Model (MNL, which is based on the theory of maximizing utility, and it is based on the data obtained on revealed and stated preference surveys applied to users who reside in the metropolitan area of Aburrá Valley (Colombia. This zone is the only one in the Colombian territory which has two neighboring airports for domestic flights. The airports included in the modeling process were Enrique Olaya Herrera (EOH Airport and José María Córdova (JMC Airport. Several structure models were tested, and the MNL proved to be the most significant revealing the common variables that affect passenger airport choice include the airfare, the price to travel the airport, and the time to get to the airport. Findings and Originality/value: The airport choice model which was calibrated corresponds to a valid powerful tool used to calculate the probability of each analyzed airport of being chosen for domestic flights in the Colombian territory. This is done bearing in mind specific characteristic of each of the attributes contained in the utility function. In addition, these probabilities will be used to calculate future market shares of the two airports considered in this study, and this will be done generating a support tool for airport and airline marketing policies.

  1. THE MULTIPLE CHOICE PROBLEM WITH INTERACTIONS BETWEEN CRITERIA

    Luiz Flavio Autran Monteiro Gomes

    2015-12-01

    Full Text Available ABSTRACT An important problem in Multi-Criteria Decision Analysis arises when one must select at least two alternatives at the same time. This can be denoted as a multiple choice problem. In other words, instead of evaluating each of the alternatives separately, they must be combined into groups of n alternatives, where n = 2. When the multiple choice problem must be solved under multiple criteria, the result is a multi-criteria, multiple choice problem. In this paper, it is shown through examples how this problemcan be tackled on a bipolar scale. The Choquet integral is used in this paper to take care of interactions between criteria. A numerical application example is conducted using data from SEBRAE-RJ, a non-profit private organization that has the mission of promoting competitiveness, sustainable developmentand entrepreneurship in the state of Rio de Janeiro, Brazil. The paper closes with suggestions for future research.

  2. [Continuing medical education: how to write multiple choice questions].

    Soler Fernández, R; Méndez Díaz, C; Rodríguez García, E

    2013-06-01

    Evaluating professional competence in medicine is a difficult but indispensable task because it makes it possible to evaluate, at different times and from different perspectives, the extent to which the knowledge, skills, and values required for exercising the profession have been acquired. Tests based on multiple choice questions have been and continue to be among the most useful tools for objectively evaluating learning in medicine. When these tests are well designed and correctly used, they can stimulate learning and even measure higher cognitive skills. Designing a multiple choice test is a difficult task that requires knowledge of the material to be tested and of the methodology of test preparation as well as time to prepare the test. The aim of this article is to review what can be evaluated through multiple choice tests, the rules and guidelines that should be taken into account when writing multiple choice questions, the different formats that can be used, the most common errors in elaborating multiple choice tests, and how to analyze the results of the test to verify its quality. Copyright © 2012 SERAM. Published by Elsevier Espana. All rights reserved.

  3. Multiple-choice pretesting potentiates learning of related information.

    Little, Jeri L; Bjork, Elizabeth Ligon

    2016-10-01

    Although the testing effect has received a substantial amount of empirical attention, such research has largely focused on the effects of tests given after study. The present research examines the effect of using tests prior to study (i.e., as pretests), focusing particularly on how pretesting influences the subsequent learning of information that is not itself pretested but that is related to the pretested information. In Experiment 1, we found that multiple-choice pretesting was better for the learning of such related information than was cued-recall pretesting or a pre-fact-study control condition. In Experiment 2, we found that the increased learning of non-pretested related information following multiple-choice testing could not be attributed to increased time allocated to that information during subsequent study. Last, in Experiment 3, we showed that the benefits of multiple-choice pretesting over cued-recall pretesting for the learning of related information persist over 48 hours, thus demonstrating the promise of multiple-choice pretesting to potentiate learning in educational contexts. A possible explanation for the observed benefits of multiple-choice pretesting for enhancing the effectiveness with which related nontested information is learned during subsequent study is discussed.

  4. Evaluating multiple-choice exams in large introductory physics courses

    Gary Gladding

    2006-07-01

    Full Text Available The reliability and validity of professionally written multiple-choice exams have been extensively studied for exams such as the SAT, graduate record examination, and the force concept inventory. Much of the success of these multiple-choice exams is attributed to the careful construction of each question, as well as each response. In this study, the reliability and validity of scores from multiple-choice exams written for and administered in the large introductory physics courses at the University of Illinois, Urbana-Champaign were investigated. The reliability of exam scores over the course of a semester results in approximately a 3% uncertainty in students’ total semester exam score. This semester test score uncertainty yields an uncertainty in the students’ assigned letter grade that is less than 1 / 3 of a letter grade. To study the validity of exam scores, a subset of students were ranked independently based on their multiple-choice score, graded explanations, and student interviews. The ranking of these students based on their multiple-choice score was found to be consistent with the ranking assigned by physics instructors based on the students’ written explanations ( r>0.94 at the 95% confidence level and oral interviews (r=0.94−0.09+0.06 .

  5. Optimizing multiple-choice tests as tools for learning.

    Little, Jeri L; Bjork, Elizabeth Ligon

    2015-01-01

    Answering multiple-choice questions with competitive alternatives can enhance performance on a later test, not only on questions about the information previously tested, but also on questions about related information not previously tested-in particular, on questions about information pertaining to the previously incorrect alternatives. In the present research, we assessed a possible explanation for this pattern: When multiple-choice questions contain competitive incorrect alternatives, test-takers are led to retrieve previously studied information pertaining to all of the alternatives in order to discriminate among them and select an answer, with such processing strengthening later access to information associated with both the correct and incorrect alternatives. Supporting this hypothesis, we found enhanced performance on a later cued-recall test for previously nontested questions when their answers had previously appeared as competitive incorrect alternatives in the initial multiple-choice test, but not when they had previously appeared as noncompetitive alternatives. Importantly, however, competitive alternatives were not more likely than noncompetitive alternatives to be intruded as incorrect responses, indicating that a general increased accessibility for previously presented incorrect alternatives could not be the explanation for these results. The present findings, replicated across two experiments (one in which corrective feedback was provided during the initial multiple-choice testing, and one in which it was not), thus strongly suggest that competitive multiple-choice questions can trigger beneficial retrieval processes for both tested and related information, and the results have implications for the effective use of multiple-choice tests as tools for learning.

  6. Approaches to data analysis of multiple-choice questions

    Lin Ding; Robert Beichner

    2009-01-01

    This paper introduces five commonly used approaches to analyzing multiple-choice test data. They are classical test theory, factor analysis, cluster analysis, item response theory, and model analysis. Brief descriptions of the goals and algorithms of these approaches are provided, together with examples illustrating their applications in physics education research. We minimize mathematics, instead placing emphasis on data interpretation using these approaches.

  7. Approaches to Data Analysis of Multiple-Choice Questions

    Ding, Lin; Beichner, Robert

    2009-01-01

    This paper introduces five commonly used approaches to analyzing multiple-choice test data. They are classical test theory, factor analysis, cluster analysis, item response theory, and model analysis. Brief descriptions of the goals and algorithms of these approaches are provided, together with examples illustrating their applications in physics…

  8. Multiple-choice test of energy and momentum concepts

    Singh, Chandralekha; Rosengrant, David

    2016-01-01

    We investigate student understanding of energy and momentum concepts at the level of introductory physics by designing and administering a 25-item multiple choice test and conducting individual interviews. We find that most students have difficulty in qualitatively interpreting basic principles related to energy and momentum and in applying them in physical situations.

  9. Correcting Grade Deflation Caused by Multiple-Choice Scoring.

    Baranchik, Alvin; Cherkas, Barry

    2000-01-01

    Presents a study involving three sections of pre-calculus (n=181) at four-year college where partial credit scoring on multiple-choice questions was examined over an entire semester. Indicates that grades determined by partial credit scoring seemed more reflective of both the quantity and quality of student knowledge than grades determined by…

  10. Using the Multiple Choice Procedure to Measure College Student Gambling

    Butler, Leon Harvey

    2010-01-01

    Research suggests that gambling is similar to addictive behaviors such as substance use. In the current study, gambling was investigated from a behavioral economics perspective. The Multiple Choice Procedure (MCP) with gambling as the target behavior was used to assess for relative reinforcing value, the effect of alternative reinforcers, and…

  11. Optimizing Multiple-Choice Tests as Learning Events

    Little, Jeri Lynn

    2011-01-01

    Although generally used for assessment, tests can also serve as tools for learning--but different test formats may not be equally beneficial. Specifically, research has shown multiple-choice tests to be less effective than cued-recall tests in improving the later retention of the tested information (e.g., see meta-analysis by Hamaker, 1986),…

  12. Multiple choice questiones as a tool for assessment in medical ...

    Methods For this review, a PuBMed online search was carried out for English language ... Advantages and disadvantages of MCQs in medical education are ... multiple-choice question meets many of the educational requirements for an assessment method. The use of automation for grading and low costs makes it a viable ...

  13. Multiple choice questions in electronics and electrical engineering

    DAVIES, T J

    2013-01-01

    A unique compendium of over 2000 multiple choice questions for students of electronics and electrical engineering. This book is designed for the following City and Guilds courses: 2010, 2240, 2320, 2360. It can also be used as a resource for practice questions for any vocational course.

  14. Does Correct Answer Distribution Influence Student Choices When Writing Multiple Choice Examinations?

    Carnegie, Jacqueline A.

    2017-01-01

    Summative evaluation for large classes of first- and second-year undergraduate courses often involves the use of multiple choice question (MCQ) exams in order to provide timely feedback. Several versions of those exams are often prepared via computer-based question scrambling in an effort to deter cheating. An important parameter to consider when…

  15. Graded Multiple Choice Questions: Rewarding Understanding and Preventing Plagiarism

    Denyer, G. S.; Hancock, D.

    2002-08-01

    This paper describes an easily implemented method that allows the generation and analysis of graded multiple-choice examinations. The technique, which uses standard functions in user-end software (Microsoft Excel 5+), can also produce several different versions of an examination that can be employed to prevent the reward of plagarism. The manuscript also discusses the advantages of having a graded marking system for the elimination of ambiguities, use in multi-step calculation questions, and questions that require extrapolation or reasoning. The advantages of the scrambling strategy, which maintains the same question order, is discussed with reference to student equity. The system provides a non-confrontational mechanism for dealing with cheating in large-class multiple-choice examinations, as well as providing a reward for problem solving over surface learning.

  16. Approaches to data analysis of multiple-choice questions

    Lin Ding

    2009-09-01

    Full Text Available This paper introduces five commonly used approaches to analyzing multiple-choice test data. They are classical test theory, factor analysis, cluster analysis, item response theory, and model analysis. Brief descriptions of the goals and algorithms of these approaches are provided, together with examples illustrating their applications in physics education research. We minimize mathematics, instead placing emphasis on data interpretation using these approaches.

  17. Multiple diagnostic approaches to palpable breast mass

    Chin, Soo Yil; Kim, Kie Hwan; Moon, Nan Mo; Kim, Yong Kyu; Jang, Ja June [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    1985-12-15

    The combination of the various diagnostic methods of palpable breast mass has improved the diagnostic accuracy. From September 1983 to August 1985 pathologically proven 85 patients with palpable breast masses examined with x-ray mammography, ultrasonography, penumomammography and aspiration cytology at Korea Cancer Center Hospital were analyzed. The diagnostic accuracies of each methods were 77.6% of mammogram, 74.1% of ultrasonogram, 90.5% of penumomammogram and 92.4% of aspiration cytology. Pneumomammograms was accomplished without difficulty or complication and depicted more clearly delineated mass with various pathognomonic findings; air-ductal pattern in fibroadenoma (90.4%) and cystosarcoma phylloides (100%), air-halo in fibrocystic disease (14.2%), fibroadenoma (100%), cystosarcoma phylloides (100%), air-cystogram in cystic type of fibrocystic disease (100%) and vaculoar pattern or irregular air collection without retained peripheral gas in carcinoma.

  18. Multiple diagnostic approaches to palpable breast mass

    Chin, Soo Yil; Kim, Kie Hwan; Moon, Nan Mo; Kim, Yong Kyu; Jang, Ja June

    1985-01-01

    The combination of the various diagnostic methods of palpable breast mass has improved the diagnostic accuracy. From September 1983 to August 1985 pathologically proven 85 patients with palpable breast masses examined with x-ray mammography, ultrasonography, penumomammography and aspiration cytology at Korea Cancer Center Hospital were analyzed. The diagnostic accuracies of each methods were 77.6% of mammogram, 74.1% of ultrasonogram, 90.5% of penumomammogram and 92.4% of aspiration cytology. Pneumomammograms was accomplished without difficulty or complication and depicted more clearly delineated mass with various pathognomonic findings; air-ductal pattern in fibroadenoma (90.4%) and cystosarcoma phylloides (100%), air-halo in fibrocystic disease (14.2%), fibroadenoma (100%), cystosarcoma phylloides (100%), air-cystogram in cystic type of fibrocystic disease (100%) and vaculoar pattern or irregular air collection without retained peripheral gas in carcinoma

  19. Structured diagnostic imaging in patients with multiple trauma

    Linsenmaier, U.; Rieger, J.; Rock, C.; Pfeifer, K.J.; Reiser, M.; Kanz, K.G.

    2002-01-01

    Purpose. Development of a concept for structured diagnostic imaging in patients with multiple trauma.Material and methods. Evaluation of data from a prospective trial with over 2400 documented patients with multiple trauma. All diagnostic and therapeutic steps, primary and secondary death and the 90 days lethality were documented.Structured diagnostic imaging of multiple injured patients requires the integration of an experienced radiologist in an interdisciplinary trauma team consisting of anesthesia, radiology and trauma surgery. Radiology itself deserves standardized concepts for equipment, personnel and logistics to perform diagnostic imaging for a 24-h-coverage with constant quality.Results. This paper describes criteria for initiation of a shock room or emergency room treatment, strategies for documentation and interdisciplinary algorithms for the early clinical care coordinating diagnostic imaging and therapeutic procedures following standardized guidelines. Diagnostic imaging consists of basic diagnosis, radiological ABC-rule, radiological follow-up and structured organ diagnosis using CT. Radiological trauma scoring allows improved quality control of diagnosis and therapy of multiple injured patients.Conclusion. Structured diagnostic imaging of multiple injured patients leads to a standardization of diagnosis and therapy and ensures constant process quality. (orig.) [de

  20. Distance teaching using self-marking multiple choice questions.

    Poore, P

    1987-01-01

    In Papua New Guinea health extension officers receive a 3-year course of training in college, followed by a period of in-service training in hospital. They are then posted to a health center, where they are in charge of all health services within their district. While the health extension officers received an excellent basic training, and were provided with books and appropriate, locally produced texts, they often spent months or even years after graduation in remote rural health centers with little communication from colleagues. This paper describes an attempt to improve communication, and to provide support inexpensively by post. Multiple choice questions, with a system for self-marking, were sent by post to rural health workers. Multiple choice questions are used in the education system in Papua New Guinea, and all health extension officers are familiar with the technique. The most obvious and immediate result was the great enthusiasm shown by the majority of health staff involved. In this way a useful exchange of correspondence was established. With this exchange of information and recognition of each other's problems, the quality of patient care must improve.

  1. Benford's Law: textbook exercises and multiple-choice testbanks.

    Slepkov, Aaron D; Ironside, Kevin B; DiBattista, David

    2015-01-01

    Benford's Law describes the finding that the distribution of leading (or leftmost) digits of innumerable datasets follows a well-defined logarithmic trend, rather than an intuitive uniformity. In practice this means that the most common leading digit is 1, with an expected frequency of 30.1%, and the least common is 9, with an expected frequency of 4.6%. Currently, the most common application of Benford's Law is in detecting number invention and tampering such as found in accounting-, tax-, and voter-fraud. We demonstrate that answers to end-of-chapter exercises in physics and chemistry textbooks conform to Benford's Law. Subsequently, we investigate whether this fact can be used to gain advantage over random guessing in multiple-choice tests, and find that while testbank answers in introductory physics closely conform to Benford's Law, the testbank is nonetheless secure against such a Benford's attack for banal reasons.

  2. Benford's Law: textbook exercises and multiple-choice testbanks.

    Aaron D Slepkov

    Full Text Available Benford's Law describes the finding that the distribution of leading (or leftmost digits of innumerable datasets follows a well-defined logarithmic trend, rather than an intuitive uniformity. In practice this means that the most common leading digit is 1, with an expected frequency of 30.1%, and the least common is 9, with an expected frequency of 4.6%. Currently, the most common application of Benford's Law is in detecting number invention and tampering such as found in accounting-, tax-, and voter-fraud. We demonstrate that answers to end-of-chapter exercises in physics and chemistry textbooks conform to Benford's Law. Subsequently, we investigate whether this fact can be used to gain advantage over random guessing in multiple-choice tests, and find that while testbank answers in introductory physics closely conform to Benford's Law, the testbank is nonetheless secure against such a Benford's attack for banal reasons.

  3. Galactography: the diagnostic procedure of choice for nipple discharge

    Tabar, L.; Dean, P.B.; Pentek, Z.

    1983-01-01

    Galactogrpahy was performed in 204 women with a nipple discharge and the secretion confirmed histopathologically. All 116 intraductal tumors (papilloma, papillomatosis, carcinoma), which were associated with a serous or bloody discharge, were detected preoperatively. A palpable mass had little diagnostic significance, and exfoliative cytology was positive in only 11% (2/18) of the patients with carcinoma. The authors recommend that all patients with a spontaneous bloody or serous discharge from a single lactiferous orifice undergo galactography in addition to physical, cytological, and mammographic examination. Intraductal injection of methylene blue dye will demonstrate the affected duct system to the surgeon and can often make surgery less radical or even unnecessary

  4. Can Free-Response Questions Be Approximated by Multiple-Choice Equivalents?

    Lin, Shih-Yin; Singh, Chandralekha

    2016-01-01

    We discuss a study to evaluate the extent to which free-response questions can be approximated by multiple-choice equivalents. Two carefully designed research-based multiple-choice questions were transformed into a free-response format and administered on the final exam in a calculus-based introductory physics course. The original multiple-choice questions were administered in another, similar introductory physics course on the final exam. Our findings suggest that carefully designed multiple...

  5. Does Correct Answer Distribution Influence Student Choices When Writing Multiple Choice Examinations?

    Jacqueline A. Carnegie

    2017-03-01

    Full Text Available Summative evaluation for large classes of first- and second-year undergraduate courses often involves the use of multiple choice question (MCQ exams in order to provide timely feedback. Several versions of those exams are often prepared via computer-based question scrambling in an effort to deter cheating. An important parameter to consider when preparing multiple exam versions is that they must be equivalent in their assessment of student knowledge. This project investigated a possible influence of correct answer organization on student answer selection when writing multiple versions of MCQ exams. The specific question asked was whether the existence of a series of four to five consecutive MCQs in which the same letter represented the correct answer had a detrimental influence on a student’s ability to continue to select the correct answer as he/she moved through that series. Student outcomes from such exams were compared with results from exams with identical questions but which did not contain such series. These findings were supplemented by student survey data in which students self-assessed the extent to which they paid attention to the distribution of correct answer choices when writing summative exams, both during their initial answer selection and when transferring their answer letters to the Scantron sheet for correction. Despite the fact that more than half of survey respondents indicated that they do make note of answer patterning during exams and that a series of four to five questions with the same letter for the correct answer would encourage many of them to take a second look at their answer choice, the results pertaining to student outcomes suggest that MCQ randomization, even when it does result in short serial arrays of letter-specific correct answers, does not constitute a distraction capable of adversely influencing student performance. Dans les très grandes classes de cours de première et deuxième années, l

  6. The detection of cheating in multiple choice examinations

    Richmond, Peter; Roehner, Bertrand M.

    2015-10-01

    Cheating in examinations is acknowledged by an increasing number of organizations to be widespread. We examine two different approaches to assess their effectiveness at detecting anomalous results, suggestive of collusion, using data taken from a number of multiple-choice examinations organized by the UK Radio Communication Foundation. Analysis of student pair overlaps of correct answers is shown to give results consistent with more orthodox statistical correlations for which confidence limits as opposed to the less familiar "Bonferroni method" can be used. A simulation approach is also developed which confirms the interpretation of the empirical approach. Then the variables Xi =(1 -Ui) Yi +Ui Z are a system of symmetric dependent binary variables (0 , 1 ; p) whose correlation matrix is ρij = r. The proof is easy and given in the paper. Let us add two remarks. • We used the expression "symmetric variables" to reflect the fact that all Xi play the same role. The expression "exchangeable variables" is often used with the same meaning. • The correlation matrix has only positive elements. This is of course imposed by the symmetry condition. ρ12 0, thus violating the symmetry requirement. In the following subsections we will be concerned with the question of uniqueness of the set of Xi generated above. Needless to say, it is useful to know whether the proposition gives the answer or only one among many. More precisely, the problem can be stated as follows.

  7. Augmenting Fellow Education Through Spaced Multiple-Choice Questions.

    Barsoumian, Alice E; Yun, Heather C

    2018-01-01

    The San Antonio Uniformed Services Health Education Consortium Infectious Disease Fellowship program historically included a monthly short-answer and multiple-choice quiz. The intent was to ensure medical knowledge in relevant content areas that may not be addressed through clinical rotations, such as operationally relevant infectious disease. After completion, it was discussed in a small group with faculty. Over time, faculty noted increasing dissatisfaction with the activity. Spaced interval education is useful in retention of medical knowledge and skills by medical students and residents. Its use in infectious disease fellow education has not been described. To improve the quiz experience, we assessed the introduction of spaced education curriculum in our program. A pre-intervention survey was distributed to assess the monthly quiz with Likert scale and open-ended questions. A multiple-choice question spaced education curriculum was created using the Qstream(R) platform in 2011. Faculty development on question writing was conducted. Two questions were delivered every 2 d. Incorrectly and correctly answered questions were repeated after 7 and 13 d, respectively. Questions needed to be answered correctly twice to be retired. Fellow satisfaction was assessed at semi-annual fellowship reviews over 5 yr and by a one-time repeat survey. Pre-intervention survey of six fellows indicated dissatisfaction with the time commitment of the monthly quiz (median Likert score of 2, mean 6.5 h to complete), neutral in perceived utility, but satisfaction with knowledge retention (Likert score 4). Eighteen fellows over 5 yr participated in the spaced education curriculum. Three quizzes with 20, 39, and 48 questions were designed. Seventeen percentage of questions addressed operationally relevant topics. Fifty-nine percentage of questions were answered correctly on first attempt, improving to 93% correct answer rate at the end of the analysis. Questions were attempted 2,999 times

  8. Diagnostic radiology on multiple injured patients: interdisciplinary management

    Linsenmaier, U.; Pfeifer, K.J.; Kanz, K.G.; Mutschler, W.

    2001-01-01

    The presence of a radiologist within the admitting area of an emergency department and his capability as a member of the trauma team have a major impact on the role of diagnostic radiology in trauma care. The knowledge of clinical decision criteria, algorithms, and standards of patient care are essential for the acceptance within a trauma team. We present an interdisciplinary management concept of diagnostic radiology for trauma patients, which comprises basic diagnosis, organ diagnosis, radiological ABC, and algorithms of early clinical care. It is the result of a prospective study comprising over 2000 documented multiple injured patients. The radiologist on a trauma team should support trauma surgery and anesthesia in diagnostic and clinical work-up. The radiological ABC provides a structured approach for diagnostic imaging in all steps of the early clinical care of the multiple injured patient. Radiological ABC requires a reevaluation in cases of equivocal findings or difficulties in the clinical course. Direct communication of radiological findings with the trauma team enables quick clinical decisions. In addition, the radiologist can priority-oriented influence the therapy by using interventional procedures. The clinical radiologist is an active member of the interdisciplinary trauma team, not only providing diagnostic imaging but also participating in clinical decisions. (orig.) [de

  9. Ductal carcinoma in a multiple fibroadenoma: Diagnostic inaccuracies

    Rao Shalinee

    2010-01-01

    Full Text Available We present the diagnostic inaccuracies encountered in a case of multiple fibroadenoma with malignant transformation. A 30-year-old lady presented with lump in the right breast of one month duration which on clinical examination, X-ray mammogram, sonomammogram were suggestive of multiple fibroadenomas. Fine needle aspiration cytology of the largest lump revealed features of malignancy and a core biopsy showed pleomorphic cells that could not be categorized. Due to the clinical, radiological and pathological diagnostic ambiguity, lumpectomy was performed and frozen section showed features of only conventional fibroadenoma. Representative bits on routine processing showed only features of fibroadenoma. Hence, complete submission of all lumps was done, which revealed fibroadenoma with invasive ductal carcinoma in one. Patient underwent modified radical mastectomy which showed multiple fibroadenomas, focal fibrocystic disease with a focus of residual invasive tumor and metastatic deposit in one axillary lymph node. This case report highlights the diagnostic challenges in detecting malignancy in fibroadenoma and a need for extensive tissue sampling in multiple fibroadenomas to detect the rare occurrence of carcinoma.

  10. Ductal carcinoma in a multiple fibroadenoma: diagnostic inaccuracies.

    Rao, Shalinee; Latha, P Suvarna; Ravi, A; Thanka, J

    2010-01-01

    We present the diagnostic inaccuracies encountered in a case of multiple fibroadenoma with malignant transformation. A 30-year-old lady presented with lump in the right breast of one month duration which on clinical examination, X-ray mammogram, sonomammogram were suggestive of multiple fibroadenomas. Fine needle aspiration cytology of the largest lump revealed features of malignancy and a core biopsy showed pleomorphic cells that could not be categorized. Due to the clinical, radiological and pathological diagnostic ambiguity, lumpectomy was performed and frozen section showed features of only conventional fibroadenoma. Representative bits on routine processing showed only features of fibroadenoma. Hence, complete submission of all lumps was done, which revealed fibroadenoma with invasive ductal carcinoma in one. Patient underwent modified radical mastectomy which showed multiple fibroadenomas, focal fibrocystic disease with a focus of residual invasive tumor and metastatic deposit in one axillary lymph node. This case report highlights the diagnostic challenges in detecting malignancy in fibroadenoma and a need for extensive tissue sampling in multiple fibroadenomas to detect the rare occurrence of carcinoma.

  11. Using Module Analysis for Multiple Choice Responses: A New Method Applied to Force Concept Inventory Data

    Brewe, Eric; Bruun, Jesper; Bearden, Ian G.

    2016-01-01

    We describe "Module Analysis for Multiple Choice Responses" (MAMCR), a new methodology for carrying out network analysis on responses to multiple choice assessments. This method is used to identify modules of non-normative responses which can then be interpreted as an alternative to factor analysis. MAMCR allows us to identify conceptual…

  12. Learning Physics Teaching through Collaborative Design of Conceptual Multiple-Choice Questions

    Milner-Bolotin, Marina

    2015-01-01

    Increasing student engagement through Electronic Response Systems (clickers) has been widely researched. Its success largely depends on the quality of multiple-choice questions used by instructors. This paper describes a pilot project that focused on the implementation of online collaborative multiple-choice question repository, PeerWise, in a…

  13. Using a Classroom Response System to Improve Multiple-Choice Performance in AP[R] Physics

    Bertrand, Peggy

    2009-01-01

    Participation in rigorous high school courses such as Advanced Placement (AP[R]) Physics increases the likelihood of college success, especially for students who are traditionally underserved. Tackling difficult multiple-choice exams should be part of any AP program because well-constructed multiple-choice questions, such as those on AP exams and…

  14. Multiple-Choice and Short-Answer Exam Performance in a College Classroom

    Funk, Steven C.; Dickson, K. Laurie

    2011-01-01

    The authors experimentally investigated the effects of multiple-choice and short-answer format exam items on exam performance in a college classroom. They randomly assigned 50 students to take a 10-item short-answer pretest or posttest on two 50-item multiple-choice exams in an introduction to personality course. Students performed significantly…

  15. On the Equivalence of Constructed-Response and Multiple-Choice Tests.

    Traub, Ross E.; Fisher, Charles W.

    Two sets of mathematical reasoning and two sets of verbal comprehension items were cast into each of three formats--constructed response, standard multiple-choice, and Coombs multiple-choice--in order to assess whether tests with indentical content but different formats measure the same attribute, except for possible differences in error variance…

  16. Multiple Choice Testing and the Retrieval Hypothesis of the Testing Effect

    Sensenig, Amanda E.

    2010-01-01

    Taking a test often leads to enhanced later memory for the tested information, a phenomenon known as the "testing effect". This memory advantage has been reliably demonstrated with recall tests but not multiple choice tests. One potential explanation for this finding is that multiple choice tests do not rely on retrieval processes to the same…

  17. The Answering Process for Multiple-Choice Questions in Collaborative Learning: A Mathematical Learning Model Analysis

    Nakamura, Yasuyuki; Nishi, Shinnosuke; Muramatsu, Yuta; Yasutake, Koichi; Yamakawa, Osamu; Tagawa, Takahiro

    2014-01-01

    In this paper, we introduce a mathematical model for collaborative learning and the answering process for multiple-choice questions. The collaborative learning model is inspired by the Ising spin model and the model for answering multiple-choice questions is based on their difficulty level. An intensive simulation study predicts the possibility of…

  18. Using Multiple-Choice Questions to Evaluate In-Depth Learning of Economics

    Buckles, Stephen; Siegfried, John J.

    2006-01-01

    Multiple-choice questions are the basis of a significant portion of assessment in introductory economics courses. However, these questions, as found in course assessments, test banks, and textbooks, often fail to evaluate students' abilities to use and apply economic analysis. The authors conclude that multiple-choice questions can be used to…

  19. Teaching Critical Thinking without (Much) Writing: Multiple-Choice and Metacognition

    Bassett, Molly H.

    2016-01-01

    In this essay, I explore an exam format that pairs multiple-choice questions with required rationales. In a space adjacent to each multiple-choice question, students explain why or how they arrived at the answer they selected. This exercise builds the critical thinking skill known as metacognition, thinking about thinking, into an exam that also…

  20. Multiple Hub Network Choice in the Liberalized European Market

    Berechman, Joseph; deWit, Jaap

    1997-01-01

    airport slots, this is not a guarantee for a stable transport volume growth of individual airports. The more volatile the market is, the more vulnerable privatized airports become. Therefore, the main issue of this study is the analysis of the opportunities of major European airports to become a central hub as a result of the network choices made by the new European airlines in a completely liberalized market. In a previous study (Berechman and de Wit, 1996), we already explored the potential of Amsterdam Airport Schiphol of becoming the major West-European hub, once European aviation markets are deregulated. A major hindrance of that study was the use of a single hub-and-spoke network. For example that model could not analyze the viability of different combinations of European hubs within a multiple hub network of alternative airline alliances. In this study, we have formulated the model of a multi-hub network where two West-European airports are used for inter-continental and intra-European travel to enable a more realistic analysis of hub choice. Like the previous one also this multi-hub model is primarily used to assess the potential ability of Amsterdam Airport Schiphol for becoming a major West-European hub. Thus, in particular, the policy tests focus on this airport in a double hub network.

  1. Using automatic item generation to create multiple-choice test items.

    Gierl, Mark J; Lai, Hollis; Turner, Simon R

    2012-08-01

    Many tests of medical knowledge, from the undergraduate level to the level of certification and licensure, contain multiple-choice items. Although these are efficient in measuring examinees' knowledge and skills across diverse content areas, multiple-choice items are time-consuming and expensive to create. Changes in student assessment brought about by new forms of computer-based testing have created the demand for large numbers of multiple-choice items. Our current approaches to item development cannot meet this demand. We present a methodology for developing multiple-choice items based on automatic item generation (AIG) concepts and procedures. We describe a three-stage approach to AIG and we illustrate this approach by generating multiple-choice items for a medical licensure test in the content area of surgery. To generate multiple-choice items, our method requires a three-stage process. Firstly, a cognitive model is created by content specialists. Secondly, item models are developed using the content from the cognitive model. Thirdly, items are generated from the item models using computer software. Using this methodology, we generated 1248 multiple-choice items from one item model. Automatic item generation is a process that involves using models to generate items using computer technology. With our method, content specialists identify and structure the content for the test items, and computer technology systematically combines the content to generate new test items. By combining these outcomes, items can be generated automatically. © Blackwell Publishing Ltd 2012.

  2. Feedback enhances the positive effects and reduces the negative effects of multiple-choice testing.

    Butler, Andrew C; Roediger, Henry L

    2008-04-01

    Multiple-choice tests are used frequently in higher education without much consideration of the impact this form of assessment has on learning. Multiple-choice testing enhances retention of the material tested (the testing effect); however, unlike other tests, multiple-choice can also be detrimental because it exposes students to misinformation in the form of lures. The selection of lures can lead students to acquire false knowledge (Roediger & Marsh, 2005). The present research investigated whether feedback could be used to boost the positive effects and reduce the negative effects of multiple-choice testing. Subjects studied passages and then received a multiple-choice test with immediate feedback, delayed feedback, or no feedback. In comparison with the no-feedback condition, both immediate and delayed feedback increased the proportion of correct responses and reduced the proportion of intrusions (i.e., lure responses from the initial multiple-choice test) on a delayed cued recall test. Educators should provide feedback when using multiple-choice tests.

  3. Diagnostic value of ADC in patients with prostate cancer: influence of the choice of b values.

    Thörmer, Gregor; Otto, Josephin; Reiss-Zimmermann, Martin; Seiwerts, Matthias; Moche, Michael; Garnov, Nikita; Franz, Toni; Do, Minh; Stolzenburg, Jens-Uwe; Horn, Lars-Christian; Kahn, Thomas; Busse, Harald

    2012-08-01

    To evaluate the influence of the choice of b values on the diagnostic value of the apparent diffusion coefficient (ADC) for detection and grading of prostate cancer (PCa). Forty-one patients with biopsy-proven PCa underwent endorectal 3-T MRI before prostatectomy. Different combinations of b values (0-800 s/mm(2)) were used to calculate four representative ADC maps. Mean ADCs of tumours and non-malignant tissue were determined. Tumour appearance on different ADC maps was rated by three radiologists as good, fair or poor by assigning a visual score (VS) of 2, 1 or 0, respectively. Differences in the ADC values with the choice of b values were analysed using one-way ANOVA. Choice of b values had a highly (P < 0.001) significant influence on the absolute ADC in each tissue. Maps using b = [50, 800] and [0, 800] were rated best (VS= 1.6 ± 0.3) and second best (1.1 ± 0.3, P < 0.001), respectively. For low-grade carcinomas (Gleason score ≤ 6, 13/41 patients), only the former choice received scores better than fair (VS = 1.4 ± 0.3). Mean tumour ADCs showed significant negative correlation (Spearman's ρ -0.38 to -0.46, P < 0.05) with Gleason score. Absolute ADC values strongly depend on the choice of b values and therefore should be used with caution for diagnostic purposes. A minimum b value greater than zero is recommended for ADC calculation to improve the visual assessment of PCa in ADC maps. • Absolute ADC values are highly dependent on the choice of b values. • Absolute ADC thresholds should be used carefully to predict tumour aggressiveness. • Subjective ratings of ADC maps involving b = 0 s/mm ( 2 ) are poor to fair. • Minimum b value greater than 0 s/mm ( 2 ) is recommended for ADC calculation.

  4. Diagnostic value of ADC in patients with prostate cancer: influence of the choice of b values

    Thoermer, Gregor; Otto, Josephin; Reiss-Zimmermann, Martin; Seiwerts, Matthias; Moche, Michael; Garnov, Nikita; Kahn, Thomas; Busse, Harald [Leipzig University Hospital, Department of Diagnostic and Interventional Radiology, Leipzig (Germany); Franz, Toni; Do, Minh; Stolzenburg, Jens-Uwe [Leipzig University Hospital, Department of Urology, Leipzig (Germany); Horn, Lars-Christian [University of Leipzig, Institute of Pathology, Leipzig (Germany)

    2012-08-15

    To evaluate the influence of the choice of b values on the diagnostic value of the apparent diffusion coefficient (ADC) for detection and grading of prostate cancer (PCa). Forty-one patients with biopsy-proven PCa underwent endorectal 3-T MRI before prostatectomy. Different combinations of b values (0-800 s/mm{sup 2}) were used to calculate four representative ADC maps. Mean ADCs of tumours and non-malignant tissue were determined. Tumour appearance on different ADC maps was rated by three radiologists as good, fair or poor by assigning a visual score (VS) of 2, 1 or 0, respectively. Differences in the ADC values with the choice of b values were analysed using one-way ANOVA. Choice of b values had a highly (P < 0.001) significant influence on the absolute ADC in each tissue. Maps using b = [50, 800] and [0, 800] were rated best (VS = 1.6 {+-} 0.3) and second best (1.1 {+-} 0.3, P < 0.001), respectively. For low-grade carcinomas (Gleason score {<=} 6, 13/41 patients), only the former choice received scores better than fair (VS = 1.4 {+-} 0.3). Mean tumour ADCs showed significant negative correlation (Spearman's {rho} -0.38 to -0.46, P < 0.05) with Gleason score. Absolute ADC values strongly depend on the choice of b values and therefore should be used with caution for diagnostic purposes. A minimum b value greater than zero is recommended for ADC calculation to improve the visual assessment of PCa in ADC maps. (orig.)

  5. Diagnostic value of ADC in patients with prostate cancer: influence of the choice of b values

    Thoermer, Gregor; Otto, Josephin; Reiss-Zimmermann, Martin; Seiwerts, Matthias; Moche, Michael; Garnov, Nikita; Kahn, Thomas; Busse, Harald; Franz, Toni; Do, Minh; Stolzenburg, Jens-Uwe; Horn, Lars-Christian

    2012-01-01

    To evaluate the influence of the choice of b values on the diagnostic value of the apparent diffusion coefficient (ADC) for detection and grading of prostate cancer (PCa). Forty-one patients with biopsy-proven PCa underwent endorectal 3-T MRI before prostatectomy. Different combinations of b values (0-800 s/mm 2 ) were used to calculate four representative ADC maps. Mean ADCs of tumours and non-malignant tissue were determined. Tumour appearance on different ADC maps was rated by three radiologists as good, fair or poor by assigning a visual score (VS) of 2, 1 or 0, respectively. Differences in the ADC values with the choice of b values were analysed using one-way ANOVA. Choice of b values had a highly (P < 0.001) significant influence on the absolute ADC in each tissue. Maps using b = [50, 800] and [0, 800] were rated best (VS = 1.6 ± 0.3) and second best (1.1 ± 0.3, P < 0.001), respectively. For low-grade carcinomas (Gleason score ≤ 6, 13/41 patients), only the former choice received scores better than fair (VS = 1.4 ± 0.3). Mean tumour ADCs showed significant negative correlation (Spearman's ρ -0.38 to -0.46, P < 0.05) with Gleason score. Absolute ADC values strongly depend on the choice of b values and therefore should be used with caution for diagnostic purposes. A minimum b value greater than zero is recommended for ADC calculation to improve the visual assessment of PCa in ADC maps. (orig.)

  6. Simple model for multiple-choice collective decision making.

    Lee, Ching Hua; Lucas, Andrew

    2014-11-01

    We describe a simple model of heterogeneous, interacting agents making decisions between n≥2 discrete choices. For a special class of interactions, our model is the mean field description of random field Potts-like models and is effectively solved by finding the extrema of the average energy E per agent. In these cases, by studying the propagation of decision changes via avalanches, we argue that macroscopic dynamics is well captured by a gradient flow along E. We focus on the permutation symmetric case, where all n choices are (on average) the same, and spontaneous symmetry breaking (SSB) arises purely from cooperative social interactions. As examples, we show that bimodal heterogeneity naturally provides a mechanism for the spontaneous formation of hierarchies between decisions and that SSB is a preferred instability to discontinuous phase transitions between two symmetric points. Beyond the mean field limit, exponentially many stable equilibria emerge when we place this model on a graph of finite mean degree. We conclude with speculation on decision making with persistent collective oscillations. Throughout the paper, we emphasize analogies between methods of solution to our model and common intuition from diverse areas of physics, including statistical physics and electromagnetism.

  7. A diagnostic tree model for polytomous responses with multiple strategies.

    Ma, Wenchao

    2018-04-23

    Constructed-response items have been shown to be appropriate for cognitively diagnostic assessments because students' problem-solving procedures can be observed, providing direct evidence for making inferences about their proficiency. However, multiple strategies used by students make item scoring and psychometric analyses challenging. This study introduces the so-called two-digit scoring scheme into diagnostic assessments to record both students' partial credits and their strategies. This study also proposes a diagnostic tree model (DTM) by integrating the cognitive diagnosis models with the tree model to analyse the items scored using the two-digit rubrics. Both convergent and divergent tree structures are considered to accommodate various scoring rules. The MMLE/EM algorithm is used for item parameter estimation of the DTM, and has been shown to provide good parameter recovery under varied conditions in a simulation study. A set of data from TIMSS 2007 mathematics assessment is analysed to illustrate the use of the two-digit scoring scheme and the DTM. © 2018 The British Psychological Society.

  8. Survey of diagnostic and treatment practices for multiple sclerosis in Europe

    Fernández, O; Delvecchio, M; Edan, G

    2017-01-01

    BACKGROUND AND PURPOSE: Up-to-date information is needed on the extent to which neurologists treating multiple sclerosis (MS) in Europe are integrating rapidly evolving diagnostic criteria, disease-modifying therapies and recommendations for monitoring disease activity into their clinical practice...... syndrome (CIS), relapsing-remitting MS (RRMS) and RRMS with breakthrough disease. RESULTS: Multiple sclerosis neurologists from 11 European countries responded to survey 1 (n = 233) and survey 2 (n = 171). Respondents agreed that they would not treat the patients in the RIS or CIS cases but would treat...... a patient with a relatively mild form of RRMS. Choice of treatment was evenly distributed among first-line injectables and oral treatments for mild RRMS, and moved to second-line treatment as the RRMS case increased in severity. Additional results on RRMS with breakthrough disease are presented. CONCLUSIONS...

  9. Research priorities for the influence of gender on diagnostic imaging choices in the emergency department setting.

    Ashurst, John V; Cherney, Alan R; Evans, Elizabeth M; Kennedy Hall, Michael; Hess, Erik P; Kline, Jeffrey A; Mitchell, Alice M; Mills, Angela M; Weigner, Michael B; Moore, Christopher L

    2014-12-01

    Diagnostic imaging is a cornerstone of patient evaluation in the acute care setting, but little effort has been devoted to understanding the appropriate influence of sex and gender on imaging choices. This article provides background on this issue and a description of the working group and consensus findings reached during the diagnostic imaging breakout session at the 2014 Academic Emergency Medicine consensus conference "Gender-specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." Our goal was to determine research priorities for how sex and gender may (or should) affect imaging choices in the acute care setting. Prior to the conference, the working group identified five areas for discussion regarding the research agenda in sex- and gender-based imaging using literature review and expert consensus. The nominal group technique was used to identify areas for discussion for common presenting complaints to the emergency department where ionizing radiation is often used for diagnosis: suspected pulmonary embolism, suspected kidney stone, lower abdominal pain with a concern for appendicitis, and chest pain concerning for coronary artery disease. The role of sex- and gender-based shared decision-making in diagnostic imaging decisions is also raised. © 2014 by the Society for Academic Emergency Medicine.

  10. Joint Dynamic Pricing of Multiple Perishable Products Under Consumer Choice

    Yalç{\\i}n Akçay; Harihara Prasad Natarajan; Susan H. Xu

    2010-01-01

    In response to competitive pressures, firms are increasingly adopting revenue management opportunities afforded by advances in information and communication technologies. Motivated by these revenue management initiatives in industry, we consider a dynamic pricing problem facing a firm that sells given initial inventories of multiple substitutable and perishable products over a finite selling horizon. Because the products are substitutable, individual product demands are linked through consume...

  11. Acoustic Features Influence Musical Choices Across Multiple Genres.

    Barone, Michael D; Bansal, Jotthi; Woolhouse, Matthew H

    2017-01-01

    Based on a large behavioral dataset of music downloads, two analyses investigate whether the acoustic features of listeners' preferred musical genres influence their choice of tracks within non-preferred, secondary musical styles. Analysis 1 identifies feature distributions for pairs of genre-defined subgroups that are distinct. Using correlation analysis, these distributions are used to test the degree of similarity between subgroups' main genres and the other music within their download collections. Analysis 2 explores the issue of main-to-secondary genre influence through the production of 10 feature-influence matrices, one per acoustic feature, in which cell values indicate the percentage change in features for genres and subgroups compared to overall population averages. In total, 10 acoustic features and 10 genre-defined subgroups are explored within the two analyses. Results strongly indicate that the acoustic features of people's main genres influence the tracks they download within non-preferred, secondary musical styles. The nature of this influence and its possible actuating mechanisms are discussed with respect to research on musical preference, personality, and statistical learning.

  12. A Two-Tier Multiple Choice Questions to Diagnose Thermodynamic Misconception of Thai and Laos Students

    Kamcharean, Chanwit; Wattanakasiwich, Pornrat

    The objective of this study was to diagnose misconceptions of Thai and Lao students in thermodynamics by using a two-tier multiple-choice test. Two-tier multiple choice questions consist of the first tier, a content-based question and the second tier, a reasoning-based question. Data of student understanding was collected by using 10 two-tier multiple-choice questions. Thai participants were the first-year students (N = 57) taking a fundamental physics course at Chiang Mai University in 2012. Lao participants were high school students in Grade 11 (N = 57) and Grade 12 (N = 83) at Muengnern high school in Xayaboury province, Lao PDR. As results, most students answered content-tier questions correctly but chose incorrect answers for reason-tier questions. When further investigating their incorrect reasons, we found similar misconceptions as reported in previous studies such as incorrectly relating pressure with temperature when presenting with multiple variables.

  13. Comedy workshop: an enjoyable way to develop multiple-choice questions.

    Droegemueller, William; Gant, Norman; Brekken, Alvin; Webb, Lynn

    2005-01-01

    To describe an innovative method of developing multiple-choice items for a board certification examination. The development of appropriate multiple-choice items is definitely more of an art, rather than a science. The comedy workshop format for developing questions for a certification examination is similar to the process used by comedy writers composing scripts for television shows. This group format dramatically diminishes the frustrations faced by an individual question writer attempting to create items. The vast majority of our comedy workshop participants enjoy and prefer the comedy workshop format. It provides an ideal environment in which to teach and blend the talents of inexperienced and experienced question writers. This is a descriptive article, in which we suggest an innovative process in the art of creating multiple-choice items for a high-stakes examination.

  14. Primary progressive multiple sclerosis diagnostic criteria: a reappraisal.

    Montalban, X; Sastre-Garriga, J; Filippi, M; Khaleeli, Z; Téllez, N; Vellinga, M M; Tur, C; Brochet, B; Barkhof, F; Rovaris, M; Miller, D H; Polman, C H; Rovira, A; Thompson, A J

    2009-12-01

    The diagnostic criteria used in primary progressive (PP) and relapsing-remitting (RR) multiple sclerosis (MS) show substantial differences. This introduces complexity in the diagnosis of MS which could be resolved if these criteria could be unified in terms of the requirements for dissemination in space (DIS). The aim of this study was to assess whether a single algorithm may be used to demonstrate DIS in all forms of MS. Five sets of RRMS criteria for DIS were applied to a cohort of 145 patients with established PPMS (mean disease duration: 11 years - PPMS-1): C1: Barkhof-Tintoré (as in 2005 McDonald's criteria); C2: Swanton et al. (as in JNNP 2006); C3: presence of oligoclonal bands plus two lesions (as in McDonald's criteria); C4 and C5: a two-step approach was also followed (patients not fulfilling C1 or C2 were then assessed for C3). Two sets of PPMS criteria for DIS were applied: C6: Thompson et al. (as in 2001 McDonald's criteria); C7: 2005 McDonald criteria. A second sample of 55 patients with less than 5 years of disease duration (PPMS-2) was also analysed using an identical approach. For PPMS-1/PPMS-2, fulfilment was: C1:73.8%/66.7%; C2:72.1%/59.3%; C3:89%/79.2%; C4:96%/92.3%; C5:96%/85.7%; C6:85.8%/78.7%; C7:91%/80.4%. Levels of fulfilment suggest that the use of a single set of criteria for DIS in RRMS and PPMS might be feasible, and reinforce the added value of cerebrospinal fluid (CSF) findings to increase fulfilment in PPMS. Unification of the DIS criteria for both RRMS and PPMS could be considered in further revisions of the MS diagnostic criteria.

  15. Overview of the Beam diagnostics in the Medaustron Accelerator:Design choices and test Beam commissioning

    Osmic, F; Gyorgy, A; Kerschbaum, A; Repovz, M; Schwarz, S; Neustadt, W; Burtin, G

    2012-01-01

    The MedAustron centre is a synchrotron based accelerator complex for cancer treatment and clinical and non-clinical research with protons and light ions, currently under construction in Wiener Neustadt, Austria. The accelerator complex is based on the CERN-PIMMS study [1] and its technical implementation by the Italian CNAO foundation in Pavia [2]. The MedAustron beam diagnostics system is based on sixteen different monitor types (153 devices in total) and will allow measuring all relevant beam parameters from the source to the irradiation rooms. The monitors will have to cope with large intensities and energy ranges. Currently, one ion source, the low energy beam transfer line and the RFQ are being commissioned in the Injector Test Stand (ITS) at CERN. This paper gives an overview of all beam monitors foreseen for the MedAustron accelerator, elaborates some of the design choices and reports the first beam commissioning results from the ITS.

  16. Comparison of performance on multiple-choice questions and open-ended questions in an introductory astronomy laboratory

    Michelle M. Wooten; Adrienne M. Cool; Edward E. Prather; Kimberly D. Tanner

    2014-01-01

    When considering the variety of questions that can be used to measure students’ learning, instructors may choose to use multiple-choice questions, which are easier to score than responses to open-ended questions. However, by design, analyses of multiple-choice responses cannot describe all of students’ understanding. One method that can be used to learn more about students’ learning is the analysis of the open-ended responses students’ provide when explaining their multiple-choice response. I...

  17. FormScanner: Open-Source Solution for Grading Multiple-Choice Exams

    Young, Chadwick; Lo, Glenn; Young, Kaisa; Borsetta, Alberto

    2016-01-01

    The multiple-choice exam remains a staple for many introductory physics courses. In the past, people have graded these by hand or even flaming needles. Today, one usually grades the exams with a form scanner that utilizes optical mark recognition (OMR). Several companies provide these scanners and particular forms, such as the eponymous…

  18. The "None of the Above" Option in Multiple-Choice Testing: An Experimental Study

    DiBattista, David; Sinnige-Egger, Jo-Anne; Fortuna, Glenda

    2014-01-01

    The authors assessed the effects of using "none of the above" as an option in a 40-item, general-knowledge multiple-choice test administered to undergraduate students. Examinees who selected "none of the above" were given an incentive to write the correct answer to the question posed. Using "none of the above" as the…

  19. Consequences the extensive use of multiple-choice questions might have on student's reasoning structure

    Raduta, C. M.

    2013-01-01

    Learning physics is a context dependent process. I consider a broader interdisciplinary problem of where differences in understanding and reasoning arise. I suggest the long run effects a multiple choice based learning system as well as society cultural habits and rules might have on student reasoning structure.

  20. Student-Generated Content: Enhancing Learning through Sharing Multiple-Choice Questions

    Hardy, Judy; Bates, Simon P.; Casey, Morag M.; Galloway, Kyle W.; Galloway, Ross K.; Kay, Alison E.; Kirsop, Peter; McQueen, Heather A.

    2014-01-01

    The relationship between students' use of PeerWise, an online tool that facilitates peer learning through student-generated content in the form of multiple-choice questions (MCQs), and achievement, as measured by their performance in the end-of-module examinations, was investigated in 5 large early-years science modules (in physics, chemistry and…

  1. Validity and Reliability of Scores Obtained on Multiple-Choice Questions: Why Functioning Distractors Matter

    Ali, Syed Haris; Carr, Patrick A.; Ruit, Kenneth G.

    2016-01-01

    Plausible distractors are important for accurate measurement of knowledge via multiple-choice questions (MCQs). This study demonstrates the impact of higher distractor functioning on validity and reliability of scores obtained on MCQs. Freeresponse (FR) and MCQ versions of a neurohistology practice exam were given to four cohorts of Year 1 medical…

  2. Examining the Prediction of Reading Comprehension on Different Multiple-Choice Tests

    Andreassen, Rune; Braten, Ivar

    2010-01-01

    In this study, 180 Norwegian fifth-grade students with a mean age of 10.5 years were administered measures of word recognition skills, strategic text processing, reading motivation and working memory. Six months later, the same students were given three different multiple-choice reading comprehension measures. Based on three forced-order…

  3. Visual Attention for Solving Multiple-Choice Science Problem: An Eye-Tracking Analysis

    Tsai, Meng-Jung; Hou, Huei-Tse; Lai, Meng-Lung; Liu, Wan-Yi; Yang, Fang-Ying

    2012-01-01

    This study employed an eye-tracking technique to examine students' visual attention when solving a multiple-choice science problem. Six university students participated in a problem-solving task to predict occurrences of landslide hazards from four images representing four combinations of four factors. Participants' responses and visual attention…

  4. Multiple-Choice versus Constructed-Response Tests in the Assessment of Mathematics Computation Skills.

    Gadalla, Tahany M.

    The equivalence of multiple-choice (MC) and constructed response (discrete) (CR-D) response formats as applied to mathematics computation at grade levels two to six was tested. The difference between total scores from the two response formats was tested for statistical significance, and the factor structure of items in both response formats was…

  5. Retrieval practice with short-answer, multiple-choice, and hybrid tests.

    Smith, Megan A; Karpicke, Jeffrey D

    2014-01-01

    Retrieval practice improves meaningful learning, and the most frequent way of implementing retrieval practice in classrooms is to have students answer questions. In four experiments (N=372) we investigated the effects of different question formats on learning. Students read educational texts and practised retrieval by answering short-answer, multiple-choice, or hybrid questions. In hybrid conditions students first attempted to recall answers in short-answer format, then identified answers in multiple-choice format. We measured learning 1 week later using a final assessment with two types of questions: those that could be answered by recalling information verbatim from the texts and those that required inferences. Practising retrieval in all format conditions enhanced retention, relative to a study-only control condition, on both verbatim and inference questions. However, there were little or no advantages of answering short-answer or hybrid format questions over multiple-choice questions in three experiments. In Experiment 4, when retrieval success was improved under initial short-answer conditions, there was an advantage of answering short-answer or hybrid questions over multiple-choice questions. The results challenge the simple conclusion that short-answer questions always produce the best learning, due to increased retrieval effort or difficulty, and demonstrate the importance of retrieval success for retrieval-based learning activities.

  6. Constructing a multiple choice test to measure elementary school teachers' Pedagogical Content Knowledge of technology education.

    Rohaan, E.J.; Taconis, R.; Jochems, W.M.G.

    2009-01-01

    This paper describes the construction and validation of a multiple choice test to measure elementary school teachers' Pedagogical Content Knowledge of technology education. Pedagogical Content Knowledge is generally accepted to be a crucial domain of teacher knowledge and is, therefore, an important

  7. Multiple choice exams of medical knowledge with open books and web access? A validity study

    O'Neill, Lotte; Simonsen, Eivind Ortind; Knudsen, Ulla Breth

    2015-01-01

    Background: Open book tests have been suggested to lower test anxiety and promote deeper learning strategies. In the Aarhus University medical program, ¼ of the curriculum assess students’ medical knowledge with ‘open book, open web’ (OBOW) multiple choice examinations. We found little existing...

  8. The Incidence of Clueing in Multiple Choice Testbank Questions in Accounting: Some Evidence from Australia

    Ibbett, Nicole L.; Wheldon, Brett J.

    2016-01-01

    In 2014 Central Queensland University (CQU) in Australia banned the use of multiple choice questions (MCQs) as an assessment tool. One of the reasons given for this decision was that MCQs provide an opportunity for students to "pass" by merely guessing their answers. The mathematical likelihood of a student passing by guessing alone can…

  9. The Use of Management and Marketing Textbook Multiple-Choice Questions: A Case Study.

    Hampton, David R.; And Others

    1993-01-01

    Four management and four marketing professors classified multiple-choice questions in four widely adopted introductory textbooks according to the two levels of Bloom's taxonomy of educational objectives: knowledge and intellectual ability and skill. Inaccuracies may cause instructors to select questions that require less thinking than they intend.…

  10. Are Faculty Predictions or Item Taxonomies Useful for Estimating the Outcome of Multiple-Choice Examinations?

    Kibble, Jonathan D.; Johnson, Teresa

    2011-01-01

    The purpose of this study was to evaluate whether multiple-choice item difficulty could be predicted either by a subjective judgment by the question author or by applying a learning taxonomy to the items. Eight physiology faculty members teaching an upper-level undergraduate human physiology course consented to participate in the study. The…

  11. Impact of Answer-Switching Behavior on Multiple-Choice Test Scores in Higher Education

    Ramazan BAŞTÜRK

    2011-06-01

    Full Text Available The multiple- choice format is one of the most popular selected-response item formats used in educational testing. Researchers have shown that Multiple-choice type test is a useful vehicle for student assessment in core university subjects that usually have large student numbers. Even though the educators, test experts and different test recourses maintain the idea that the first answer should be retained, many researchers argued that this argument is not dependent with empirical findings. The main question of this study is to examine how the answer switching behavior affects the multiple-choice test score. Additionally, gender differences and relationship between number of answer switching behavior and item parameters (item difficulty and item discrimination were investigated. The participants in this study consisted of 207 upper-level College of Education students from mid-sized universities. A Midterm exam consisted of 20 multiple-choice questions was used. According to the result of this study, answer switching behavior statistically increase test scores. On the other hand, there is no significant gender difference in answer-switching behavior. Additionally, there is a significant negative relationship between answer switching behavior and item difficulties.

  12. Feasibility of a multiple-choice mini mental state examination for chronically critically ill patients.

    Miguélez, Marta; Merlani, Paolo; Gigon, Fabienne; Verdon, Mélanie; Annoni, Jean-Marie; Ricou, Bara

    2014-08-01

    Following treatment in an ICU, up to 70% of chronically critically ill patients present neurocognitive impairment that can have negative effects on their quality of life, daily activities, and return to work. The Mini Mental State Examination is a simple, widely used tool for neurocognitive assessment. Although of interest when evaluating ICU patients, the current version is restricted to patients who are able to speak. This study aimed to evaluate the feasibility of a visual, multiple-choice Mini Mental State Examination for ICU patients who are unable to speak. The multiple-choice Mini Mental State Examination and the standard Mini Mental State Examination were compared across three different speaking populations. The interrater and intrarater reliabilities of the multiple-choice Mini Mental State Examination were tested on both intubated and tracheostomized ICU patients. Mixed 36-bed ICU and neuropsychology department in a university hospital. Twenty-six healthy volunteers, 20 neurological patients, 46 ICU patients able to speak, and 30 intubated or tracheostomized ICU patients. None. Multiple-choice Mini Mental State Examination results correlated satisfactorily with standard Mini Mental State Examination results in all three speaking groups: healthy volunteers: intraclass correlation coefficient = 0.43 (95% CI, -0.18 to 0.62); neurology patients: 0.90 (95% CI, 0.82-0.95); and ICU patients able to speak: 0.86 (95% CI, 0.70-0.92). The interrater and intrarater reliabilities were good (0.95 [0.87-0.98] and 0.94 [0.31-0.99], respectively). In all populations, a Bland-Altman analysis showed systematically higher scores using the multiple-choice Mini Mental State Examination. Administration of the multiple-choice Mini Mental State Examination to ICU patients was straightforward and produced exploitable results comparable to those of the standard Mini Mental State Examination. It should be of interest for the assessment and monitoring of the neurocognitive

  13. Comparison between Two Assessment Methods; Modified Essay Questions and Multiple Choice Questions

    Assadi S.N.* MD

    2015-09-01

    Full Text Available Aims Using the best assessment methods is an important factor in educational development of health students. Modified essay questions and multiple choice questions are two prevalent methods of assessing the students. The aim of this study was to compare two methods of modified essay questions and multiple choice questions in occupational health engineering and work laws courses. Materials & Methods This semi-experimental study was performed during 2013 to 2014 on occupational health students of Mashhad University of Medical Sciences. The class of occupational health and work laws course in 2013 was considered as group A and the class of 2014 as group B. Each group had 50 students.The group A students were assessed by modified essay questions method and the group B by multiple choice questions method.Data were analyzed in SPSS 16 software by paired T test and odd’s ratio. Findings The mean grade of occupational health and work laws course was 18.68±0.91 in group A (modified essay questions and was 18.78±0.86 in group B (multiple choice questions which was not significantly different (t=-0.41; p=0.684. The mean grade of chemical chapter (p<0.001 in occupational health engineering and harmful work law (p<0.001 and other (p=0.015 chapters in work laws were significantly different between two groups. Conclusion Modified essay questions and multiple choice questions methods have nearly the same student assessing value for the occupational health engineering and work laws course.

  14. Radiological diagnosis in lung disease: factoring treatment options into the choice of diagnostic modality.

    Wielpütz, Mark O; Heußel, Claus P; Herth, Felix J F; Kauczor, Hans-Ulrich

    2014-03-14

    Chest X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) each have characteristic advantages and disadvantages that need to be considered in clinical decision-making. This point is discussed in reference to the main types of lung disease that are encountered in practice. A selective literature search was performed in the PubMed and Google Scholar databases. Existing clinical guidelines on the main types of lung disease and studies concerning radiological diagnosis were also con - sidered in this review. There have been no more than a few large-scale, controlled comparative trials of different radiological techniques. Chest X-ray provides general orientation as an initial diagnostic study and is especially useful in the diagnosis of pneumonia, cancer, and chronic obstructive pulmonary disease (COPD). Multi-detector CT affords nearly isotropic spatial resolution at a radiation dose of only 0.2-5 mSv, much lower than before. Its main indications, according to current guidelines, are tumors, acute pulmonary embolism, pulmonary hypertension, pulmonary fibrosis, advanced COPD, and pneumonia in a high-risk patient. MRI is used in the diagnosis of cystic fibrosis, pulmonary embolism, pulmonary hypertension, and bronchial carcinoma. The positive predictive value (PPV) of a chest X-ray in outpatients with pneumonia is only 27% (gold standard, CT); in contrast, an initial, non-randomized trial of MRI in nosocomial pneumonia revealed a PPV of 95%. For the staging of mediastinal lymph nodes in bronchial carcinoma, MRI has a PPV of 88% and positron emission tomography with CT (PET/CT) has a PPV of 79%, while CT alone has a PPV of 41% (gold standard, histology). The choice of radiologicalal technique for the detection, staging, follow-up, and quantification of lung disease should be based on the individual clinical options, so that appropriate treatment can be provided without excessive use of diagnostic testing.

  15. Survey of diagnostic and treatment practices for multiple sclerosis in Europe.

    Fernández, O; Delvecchio, M; Edan, G; Fredrikson, S; Gionvannoni, G; Hartung, H-P; Havrdova, E; Kappos, L; Pozzilli, C; Soerensen, P S; Tackenberg, B; Vermersch, P; Comi, G

    2017-03-01

    Up-to-date information is needed on the extent to which neurologists treating multiple sclerosis (MS) in Europe are integrating rapidly evolving diagnostic criteria, disease-modifying therapies and recommendations for monitoring disease activity into their clinical practice. A steering committee of MS neurologists used a modified Delphi process to develop case- and practice-based questions for two sequential surveys distributed to MS neurologists throughout Europe. Case-based questions were developed for radiologically isolated syndrome (RIS), clinically isolated syndrome (CIS), relapsing-remitting MS (RRMS) and RRMS with breakthrough disease. Multiple sclerosis neurologists from 11 European countries responded to survey 1 (n = 233) and survey 2 (n = 171). Respondents agreed that they would not treat the patients in the RIS or CIS cases but would treat a patient with a relatively mild form of RRMS. Choice of treatment was evenly distributed among first-line injectables and oral treatments for mild RRMS, and moved to second-line treatment as the RRMS case increased in severity. Additional results on RRMS with breakthrough disease are presented. Although there was general agreement on some aspects of treatment, responses to other management and clinical practice questions varied considerably. These results, which reflect current clinical practice patterns, highlight the need for additional MS treatment education and awareness and may help inform the development of MS practice guidelines in Europe. © 2017 EAN.

  16. Comparison of Performance on Multiple-Choice Questions and Open-Ended Questions in an Introductory Astronomy Laboratory

    Wooten, Michelle M.; Cool, Adrienne M.; Prather, Edward E.; Tanner, Kimberly D.

    2014-01-01

    When considering the variety of questions that can be used to measure students' learning, instructors may choose to use multiple-choice questions, which are easier to score than responses to open-ended questions. However, by design, analyses of multiple-choice responses cannot describe all of students' understanding. One method that can…

  17. The Relationship of Deep and Surface Study Approaches on Factual and Applied Test-Bank Multiple-Choice Question Performance

    Yonker, Julie E.

    2011-01-01

    With the advent of online test banks and large introductory classes, instructors have often turned to textbook publisher-generated multiple-choice question (MCQ) exams in their courses. Multiple-choice questions are often divided into categories of factual or applied, thereby implicating levels of cognitive processing. This investigation examined…

  18. [A factor analysis method for contingency table data with unlimited multiple choice questions].

    Toyoda, Hideki; Haiden, Reina; Kubo, Saori; Ikehara, Kazuya; Isobe, Yurie

    2016-02-01

    The purpose of this study is to propose a method of factor analysis for analyzing contingency tables developed from the data of unlimited multiple-choice questions. This method assumes that the element of each cell of the contingency table has a binominal distribution and a factor analysis model is applied to the logit of the selection probability. Scree plot and WAIC are used to decide the number of factors, and the standardized residual, the standardized difference between the sample, and the proportion ratio, is used to select items. The proposed method was applied to real product impression research data on advertised chips and energy drinks. Since the results of the analysis showed that this method could be used in conjunction with conventional factor analysis model, and extracted factors were fully interpretable, and suggests the usefulness of the proposed method in the study of psychology using unlimited multiple-choice questions.

  19. Dual processing theory and experts' reasoning: exploring thinking on national multiple-choice questions.

    Durning, Steven J; Dong, Ting; Artino, Anthony R; van der Vleuten, Cees; Holmboe, Eric; Schuwirth, Lambert

    2015-08-01

    An ongoing debate exists in the medical education literature regarding the potential benefits of pattern recognition (non-analytic reasoning), actively comparing and contrasting diagnostic options (analytic reasoning) or using a combination approach. Studies have not, however, explicitly explored faculty's thought processes while tackling clinical problems through the lens of dual process theory to inform this debate. Further, these thought processes have not been studied in relation to the difficulty of the task or other potential mediating influences such as personal factors and fatigue, which could also be influenced by personal factors such as sleep deprivation. We therefore sought to determine which reasoning process(es) were used with answering clinically oriented multiple-choice questions (MCQs) and if these processes differed based on the dual process theory characteristics: accuracy, reading time and answering time as well as psychometrically determined item difficulty and sleep deprivation. We performed a think-aloud procedure to explore faculty's thought processes while taking these MCQs, coding think-aloud data based on reasoning process (analytic, nonanalytic, guessing or combination of processes) as well as word count, number of stated concepts, reading time, answering time, and accuracy. We also included questions regarding amount of work in the recent past. We then conducted statistical analyses to examine the associations between these measures such as correlations between frequencies of reasoning processes and item accuracy and difficulty. We also observed the total frequencies of different reasoning processes in the situations of getting answers correctly and incorrectly. Regardless of whether the questions were classified as 'hard' or 'easy', non-analytical reasoning led to the correct answer more often than to an incorrect answer. Significant correlations were found between self-reported recent number of hours worked with think-aloud word count

  20. Do Students Behave Rationally in Multiple Choice Tests? Evidence from a Field Experiment

    María Paz Espinosa; Javier Gardeazabal

    2013-01-01

    A disadvantage of multiple choice tests is that students have incentives to guess. To discourage guessing, it is common to use scoring rules that either penalize wrong answers or reward omissions. In psychometrics, penalty and reward scoring rules are considered equivalent. However, experimental evidence indicates that students behave differently under penalty or reward scoring rules. These differences have been attributed to the different framing (penalty versus reward). In this paper, we mo...

  1. Cytogenetic Alterations in Multiple Myeloma: Prognostic Significance and the Choice of Frontline Therapy.

    Stella, Flavia; Pedrazzini, Estela; Agazzoni, Mara; Ballester, Oscar; Slavutsky, Irma

    2015-01-01

    Multiple myeloma tumor cells demonstrate multiple and often complex genetic lesions as evaluated by standard cytogenetic/FISH studies. Over the past decade, specific abnormalities have been associated with standard or high-risk clinical behavior and they have become strong prognostic indicators. Further, as evidenced by recent randomized clinical trials, the choice of front-line therapy (transplant vs. no transplant, inclusion of novel drugs such as bortezomib, thalidomide, and lenalidomide) may be able to overcome the adverse effect of high-risk genetic lesions.

  2. Psychometrics of Multiple Choice Questions with Non-Functioning Distracters: Implications to Medical Education.

    Deepak, Kishore K; Al-Umran, Khalid Umran; AI-Sheikh, Mona H; Dkoli, B V; Al-Rubaish, Abdullah

    2015-01-01

    The functionality of distracters in a multiple choice question plays a very important role. We examined the frequency and impact of functioning and non-functioning distracters on psychometric properties of 5-option items in clinical disciplines. We analyzed item statistics of 1115 multiple choice questions from 15 summative assessments of undergraduate medical students and classified the items into five groups by their number of non-functioning distracters. We analyzed the effect of varying degree of non-functionality ranging from 0 to 4, on test reliability, difficulty index, discrimination index and point biserial correlation. The non-functionality of distracters inversely affected the test reliability and quality of items in a predictable manner. The non-functioning distracters made the items easier and lowered the discrimination index significantly. Three non-functional distracters in a 5-option MCQ significantly affected all psychometric properties (p psychometrically as effective as 5-option items. Our study reveals that a multiple choice question with 3 functional options provides lower most limit of item format that has adequate psychometric property. The test containing items with less number of functioning options have significantly lower reliability. The distracter function analysis and revision of nonfunctioning distracters can serve as important methods to improve the psychometrics and reliability of assessment.

  3. Practical Usage of Multiple-Choice Questions as Part of Learning and Self-Evaluation

    Paula Kangasniemi

    2016-12-01

    Full Text Available The poster describes how the multiple-choice questions could be a part of learning, not only assessing. We often think of the role of questions only in order to test the student's skills. We have tested how questions could be a part of learning in our web-based course of information retrieval in Lapland University. In web-based learning there is a need for high-quality mediators. Mediators are learning promoters which trigger, support, and amplify learning. Mediators can be human mediators or tool mediators. The tool mediators are for example; tests, tutorials, guides and diaries. The multiple-choice questions can also be learning promoters which select, interpret and amplify objects for learning. What do you have to take into account when you are preparing multiple-choice questions as mediators? First you have to prioritize teaching objectives: what must be known and what should be known. According to our experience with contact learning, you can assess what the things are that students have problems with and need more guidance on. The most important addition to the questions is feedback during practice. The questions’ answers (wrong or right are not important. The feedback on the answers are important to guide students on how to search. The questions promote students’ self-regulation and self-evaluation. Feedback can be verbal, a screenshot or a video. We have added a verbal feedback for every question and also some screenshots and eight videos in our web-based course.

  4. How do STEM-interested students pursue multiple interests in their higher educational choice?

    Vulperhorst, Jonne Pieter; Wessels, Koen Rens; Bakker, Arthur; Akkerman, Sanne Floor

    2018-05-01

    Interest in science, technology, engineering and mathematics (STEM) has lately received attention in research due to a gap between the number of STEM students and the needs of the labour market. As interest seems to be one of the most important factors in deciding what to study, we focus in the present study on how STEM-interested students weigh multiple interests in making educational choices. A questionnaire with both open-ended and closed-ended items was administered to 91 STEM-interested students enrolled in a STEM programme of a Dutch University for secondary school students. Results indicate that students find it important that a study programme allows them to pursue multiple interests. Some students pursued multiple interests by choosing to enrol in two programmes at the same time. Most students chose one programme that enabled them to combine multiple interests. Combinations of pursued interests were dependent on the disciplinary range of interests of students. Students who were interested in diverse domains combined interests in an educational programme across academic and non-academic domains, whilst students who were mainly interested in STEM combined only STEM-focused interests. Together these findings stress the importance of taking a multiple interest perspective on interest development and educational choice.

  5. Magnetic resonance imaging in the diagnostics of multiple sclerosis

    Larsen, J.P.; Tjoerstad, K.; Kaass, B.; Oedegaard, H.

    1987-01-01

    Multiple sclerosis is an important and frequent neurological disease and the diagnosis might be difficult. The clinical criteria of multiple sclerosis and the role of laboratory examinations in the diagnosis of the disease are discussed. In particular the help offered by the magnetic resonance imaging method is the subject of this paper. Three patients are reported and discussed

  6. The value of diagnostic information to patients with suspected multiple sclerosis. Rochester-Toronto MRI Study Group.

    Mushlin, A I; Mooney, C; Grow, V; Phelps, C E

    1994-01-01

    To determine the value of diagnostic information to patients with suspected multiple sclerosis (MS). Because treatment choices would be only minimally affected by earlier diagnosis for most patients with this clinical problem, this study assessed the "nondecisional" value of diagnosis. Prospective survey of patients before and after diagnostic workup, including imaging with magnetic resonance scanning. We assessed the effect of diagnostic information on patients' sense of well-being, as well as direct measures of the utility of information (using time trade-off and willingness-to-pay techniques). Patients referred from primary care practices for diagnostic workup for suspected MS to neurology clinics and practices. Sixty-eight individuals, mean age 37.5 years, 53 female and 15 male. Thirty-one patients were classified as having "probable MS," and 37 were classified as having "possible MS" by the examining neurologist before workup. Present and future health perception, uncertainty about diagnosis-prognosis, and level of anxiety. Willingness to pay for diagnostic information, quality of life as measured by the time trade-off technique, and psychological state of the patient before and after diagnosis. Diagnostic uncertainty fell significantly as a result of the diagnostic workup. Most patients (59/62) said that they were better off having received diagnostic information. Although anxiety seemed to be reduced by testing, overall anxiety levels did not decrease as much as anticipated. Patients also became less optimistic about their future health after testing. On average, patients were willing to forgo 4.5 quality-adjusted life days to receive an earlier diagnosis and their quality of life after diagnosis improved slightly. Subgroups of patients differed in their response to diagnostic information. Those in whom no definitive diagnosis emerged tend to be more anxious rather than being reassured by the "negative" workup. Individuals with "positive" workups became less

  7. Malignant degeneration of multiple cartilaginous exostosis. Diagnostic significance of MRT

    Bair, H.J.; Schmitt, R.; Moos, P.; Fellner, F.; Dvorak, O.; Rupprecht, H.; Lenz, M.

    1997-01-01

    In summary it can be said that diagnostic radiology, and particularly MRT, for evaluation of malignant degeneration of cartilaginous extoses is of high importance, also because of the difficulties posed by a biopsy for verification of malignancy. Cases of malignant cartilaginous extosis have a good prognosis at the early stages of the disease, when the extosis still is restricted to the focal region. (Orig./AJ) [de

  8. Detecting Renibacterium salmoninarum in wild brown trout by use of multiple organ samples and diagnostic methods

    Guomundsdottir, S.; Applegate, Lynn M.; Arnason, I.O.; Kristmundsson, A.; Purcell, Maureen K.; Elliott, Diane G.

    2017-01-01

    Renibacterium salmoninarum, the causative agent of salmonid bacterial kidney disease (BKD), is endemic in many wild trout species in northerly regions. The aim of the present study was to determine the optimal R. salmoninarum sampling/testing strategy for wild brown trout (Salmo trutta L.) populations in Iceland. Fish were netted in a lake and multiple organs—kidney, spleen, gills, oesophagus and mid-gut—were sampled and subjected to five detection tests i.e. culture, polyclonal enzyme-linked immunosorbent assay (pELISA) and three different PCR tests. The results showed that each fish had encountered R. salmoninarum but there were marked differences between results obtained depending on organ and test. The bacterium was not cultured from any kidney sample while all kidney samples were positive by pELISA. At least one organ from 92.9% of the fish tested positive by PCR. The results demonstrated that the choice of tissue and diagnostic method can dramatically influence the outcome of R. salmoninarum surveys.

  9. Measuring and combining multiple diagnostic and prognostic sepsis biomarkers

    Kofoed, K.

    This PhD-thesis is based on work performed at Clinical Research Centre and Department of Infectious Diseases at Copenhagen University Hospital, Hvidovre, and includes a review, a method development study, and two clinical studies. The background of the thesis is, that timely and accurate diagnosis...... of sepsis is of great importance for choice of treatment, level of monitoring and prognosis. In this biomarkers could be a significant aid, and thus the search for and application of "new" sepsis biomarkers is of great importance. The thesis reviews the definitions and the epidemiology, and gives...

  10. Aufwandsanalyse für computerunterstützte Multiple-Choice Papierklausuren [Cost analysis for computer supported multiple-choice paper examinations

    Mandel, Alexander

    2011-11-01

    Full Text Available [english] Introduction: Multiple-choice-examinations are still fundamental for assessment in medical degree programs. In addition to content related research, the optimization of the technical procedure is an important question. Medical examiners face three options: paper-based examinations with or without computer support or completely electronic examinations. Critical aspects are the effort for formatting, the logistic effort during the actual examination, quality, promptness and effort of the correction, the time for making the documents available for inspection by the students, and the statistical analysis of the examination results.Methods: Since three semesters a computer program for input and formatting of MC-questions in medical and other paper-based examinations is used and continuously improved at Wuerzburg University. In the winter semester (WS 2009/10 eleven, in the summer semester (SS 2010 twelve and in WS 2010/11 thirteen medical examinations were accomplished with the program and automatically evaluated. For the last two semesters the remaining manual workload was recorded. Results: The cost of the formatting and the subsequent analysis including adjustments of the analysis of an average examination with about 140 participants and about 35 questions was 5-7 hours for exams without complications in the winter semester 2009/2010, about 2 hours in SS 2010 and about 1.5 hours in the winter semester 2010/11. Including exams with complications, the average time was about 3 hours per exam in SS 2010 and 2.67 hours for the WS 10/11. Discussion: For conventional multiple-choice exams the computer-based formatting and evaluation of paper-based exams offers a significant time reduction for lecturers in comparison with the manual correction of paper-based exams and compared to purely electronically conducted exams it needs a much simpler technological infrastructure and fewer staff during the exam.[german] Einleitung: Multiple-Choice

  11. Decision making under internal uncertainty: the case of multiple-choice tests with different scoring rules.

    Bereby-Meyer, Yoella; Meyer, Joachim; Budescu, David V

    2003-02-01

    This paper assesses framing effects on decision making with internal uncertainty, i.e., partial knowledge, by focusing on examinees' behavior in multiple-choice (MC) tests with different scoring rules. In two experiments participants answered a general-knowledge MC test that consisted of 34 solvable and 6 unsolvable items. Experiment 1 studied two scoring rules involving Positive (only gains) and Negative (only losses) scores. Although answering all items was the dominating strategy for both rules, the results revealed a greater tendency to answer under the Negative scoring rule. These results are in line with the predictions derived from Prospect Theory (PT) [Econometrica 47 (1979) 263]. The second experiment studied two scoring rules, which allowed respondents to exhibit partial knowledge. Under the Inclusion-scoring rule the respondents mark all answers that could be correct, and under the Exclusion-scoring rule they exclude all answers that might be incorrect. As predicted by PT, respondents took more risks under the Inclusion rule than under the Exclusion rule. The results illustrate that the basic process that underlies choice behavior under internal uncertainty and especially the effect of framing is similar to the process of choice under external uncertainty and can be described quite accurately by PT. Copyright 2002 Elsevier Science B.V.

  12. Effective choices for diagnostic imaging in clinical practice. Excerpts from a report of a WHO Scientific Group on Clinical Diagnostic Imaging

    1992-01-01

    There are so many different methods of diagnostic imaging that medical practitioners may need guidance to choose the best through the maze of options for each clinical problem. Advice may be required for more than just the first choice, because the first imaging procedure does not always give the desired answer and, depending on the results, further imaging may have to undertaken. The alternative is to submit the patient to a barrage of imaging and hope that one type, at least provides the diagnosis. This is a quite unacceptable way to practice medicine because of the cost and the risk of radiation damage from unnecessary examinations. The choice of the most effective imaging is often difficult and frequently controversial. The sequence to be followed vries with many factors: the equipment available, the skills of the practitioner, the expected quality of the results, the quality of interpretation, and conclusion which can be drawn

  13. Step by Step: Biology Undergraduates’ Problem-Solving Procedures during Multiple-Choice Assessment

    Prevost, Luanna B.; Lemons, Paula P.

    2016-01-01

    This study uses the theoretical framework of domain-specific problem solving to explore the procedures students use to solve multiple-choice problems about biology concepts. We designed several multiple-choice problems and administered them on four exams. We trained students to produce written descriptions of how they solved the problem, and this allowed us to systematically investigate their problem-solving procedures. We identified a range of procedures and organized them as domain general, domain specific, or hybrid. We also identified domain-general and domain-specific errors made by students during problem solving. We found that students use domain-general and hybrid procedures more frequently when solving lower-order problems than higher-order problems, while they use domain-specific procedures more frequently when solving higher-order problems. Additionally, the more domain-specific procedures students used, the higher the likelihood that they would answer the problem correctly, up to five procedures. However, if students used just one domain-general procedure, they were as likely to answer the problem correctly as if they had used two to five domain-general procedures. Our findings provide a categorization scheme and framework for additional research on biology problem solving and suggest several important implications for researchers and instructors. PMID:27909021

  14. Feedback-related brain activity predicts learning from feedback in multiple-choice testing.

    Ernst, Benjamin; Steinhauser, Marco

    2012-06-01

    Different event-related potentials (ERPs) have been shown to correlate with learning from feedback in decision-making tasks and with learning in explicit memory tasks. In the present study, we investigated which ERPs predict learning from corrective feedback in a multiple-choice test, which combines elements from both paradigms. Participants worked through sets of multiple-choice items of a Swahili-German vocabulary task. Whereas the initial presentation of an item required the participants to guess the answer, corrective feedback could be used to learn the correct response. Initial analyses revealed that corrective feedback elicited components related to reinforcement learning (FRN), as well as to explicit memory processing (P300) and attention (early frontal positivity). However, only the P300 and early frontal positivity were positively correlated with successful learning from corrective feedback, whereas the FRN was even larger when learning failed. These results suggest that learning from corrective feedback crucially relies on explicit memory processing and attentional orienting to corrective feedback, rather than on reinforcement learning.

  15. An intuitive graphical webserver for multiple-choice protein sequence search.

    Banky, Daniel; Szalkai, Balazs; Grolmusz, Vince

    2014-04-10

    Every day tens of thousands of sequence searches and sequence alignment queries are submitted to webservers. The capitalized word "BLAST" becomes a verb, describing the act of performing sequence search and alignment. However, if one needs to search for sequences that contain, for example, two hydrophobic and three polar residues at five given positions, the query formation on the most frequently used webservers will be difficult. Some servers support the formation of queries with regular expressions, but most of the users are unfamiliar with their syntax. Here we present an intuitive, easily applicable webserver, the Protein Sequence Analysis server, that allows the formation of multiple choice queries by simply drawing the residues to their positions; if more than one residue are drawn to the same position, then they will be nicely stacked on the user interface, indicating the multiple choice at the given position. This computer-game-like interface is natural and intuitive, and the coloring of the residues makes possible to form queries requiring not just certain amino acids in the given positions, but also small nonpolar, negatively charged, hydrophobic, positively charged, or polar ones. The webserver is available at http://psa.pitgroup.org. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Solving the redundancy allocation problem with multiple strategy choices using a new simplified particle swarm optimization

    Kong, Xiangyong; Gao, Liqun; Ouyang, Haibin; Li, Steven

    2015-01-01

    In most research on redundancy allocation problem (RAP), the redundancy strategy for each subsystem is assumed to be predetermined and fixed. This paper focuses on a specific RAP with multiple strategy choices (RAP-MSC), in which both active redundancy and cold standby redundancy can be selected as an additional decision variable for individual subsystems. To do so, the component type, redundancy strategy and redundancy level for each subsystem should be chosen subject to the system constraints appropriately such that the system reliability is maximized. Meanwhile, imperfect switching for cold standby redundancy is considered and a k-Erlang distribution is introduced to model the time-to-failure component as well. Given the importance and complexity of RAP-MSC, we propose a new efficient simplified version of particle swarm optimization (SPSO) to solve such NP-hard problems. In this method, a new position updating scheme without velocity is presented with stochastic disturbance and a low probability. Moreover, it is compared with several well-known PSO variants and other state-of-the-art approaches in the literature to evaluate its performance. The experiment results demonstrate the superiority of SPSO as an alternative for solving the RAP-MSC. - Highlights: • A more realistic RAP form with multiple strategy choices is focused. • Redundancy strategies are to be selected rather than fixed in general RAP. • A new simplified particle swarm optimization is proposed. • Higher reliabilities are achieved than the state-of-the-art approaches.

  17. The Instrument Implementation of Two-tier Multiple Choice to Analyze Students’ Science Process Skill Profile

    Sukarmin Sukarmin

    2018-01-01

    Full Text Available This research is aimed to analyze the profile of students’ science process skill (SPS by using instrument two-tier multiple choice. This is a descriptive research that describes the profile of students’ SPS. Subjects of the research were 10th-grade students from high, medium and low categorized school. Instrument two-tier multiple choice consists of 30 question that contains an indicator of SPS. The indicator of SPS namely formulating a hypothesis, designing experiment, analyzing data, applying the concept, communicating, making a conclusion. Based on the result of the research and analysis, it shows that: 1 the average of indicator achievement of science process skill at high categorized school on formulating hypothesis is 74,55%, designing experiment is 74,89%, analyzing data is 67,89%, applying concept is 52,89%, communicating is 80,22%, making conclusion is 76%, 2. the average of indicator achievement of science process skill at medium categorized school on formulating hypothesis is 53,47%, designing experiment is 59,86%, analyzing data is 42,22%, applying concept is 33,19%, communicating is 76,25%, making conclusion is 61,53%, 3 the average of indicator achievement of science process skill at low categorized school on formulating hypothesis is 51%, designing experiment is 55,17%, analyzing data is 39,17%, applying concept is 35,83%, communicating is 58,83%, making conclusion is 58%.

  18. Clinical diagnostic criteria of multiple sclerosis: the role of magnetic resonance imaging

    Belair, M.; Girard, M.

    2004-01-01

    The objective of this article is to summarize the diagnostic criteria recommended by the International Panel on the Diagnosis of Multiple Sclerosis in 2001. The recommendations of another working group, the Consortium of Multiple Sclerosis Centers Consensus Meeting, which met in Vancouver in 2001, concerning the diagnosis and follow-up of patients with multiple sclerosis are also presented in an effort to standardize the protocols for magnetic resonance imaging of these patients. (author)

  19. Multiple foci of splenic tissue autotransplantation: Splenosis in diagnostic imaging

    Laskowska, K.; Burzynska-Makuch, M.; Drewa, S.; Lasek, W.; Pilecki, S.; Junik, R.

    2005-01-01

    Splenosis is usually defined as an autotransplantation of lienal tissue in the abdomen or cest following trauma to the spleen and/or splenectomy. The authors present the case of patient 15 years after a splenectomy performed because of extensive abdominal trauma. A new computed tomographic (CT) scan of the abdomen revealed multiple homogenous nodules, different in size, spread in the abdomen. Their density was characteristic of spleen. Ultrasound examination revealed only the largest tumors, located close to the liver and apparently isoechogenic to it. Static scintigraphy and SPECT were performed to prove the presence of splenosis. After treating the patient with colloid sulfide, multiple foci of increased radioisotope accumulation were identified in the abdomen, extrahepatic at the same locations as the masses visible on the CT scans, which were comparable to splenic tissue. Nodules revealed during CT or abdominal US in patients previously treated by splenectomy require further imaging with static scintigraphy of the liver and spleen in order to confirm or exclude splenosis. (author)

  20. Radiological diagnostics of multiple myeloma; Radiologische Diagnostik des multiplen Myeloms

    D' Anastasi, M.; Grandl, S.; Reiser, M.F.; Baur-Melnyk, A. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany)

    2014-06-15

    Robust and reliable imaging methods are required to estimate the skeletal tumor load in multiple myeloma, as well as for the diagnosis of extraskeletal manifestations. Imaging also plays an essential role in the assessment of fracture risk and of vertebral fractures. The conventional skeletal survey has been the gold standard in the imaging of multiple myeloma for many years. Other modalities which have been investigated and are in use are whole-body computed tomography (WBCT), 18F-fluorodeoxyglucose positron emission tomography computed tomography (FDG PET-CT) and whole-body magnetic resonance imaging (WBMRI). These techniques are able to depict both mineralized bone and the bone marrow with a high sensitivity for myeloma lesions. Several studies have shown that cross-sectional imaging is superior to the skeletal survey in the detection of myeloma lesions and WBMRI has been shown to be significantly more sensitive than WBCT for the detection of focal myeloma lesions as well as for diffuse infiltration. The FDG PET-CT technique has a sensitivity comparable to WBMRI. Due to the higher sensitivity in the detection of myeloma lesions WBCT and WBMRI should replace the skeletal survey. A WBCT should be performed if there is suspicion of multiple myeloma. If no focal lesions are found WBMRI or at least MRI of the spine and pelvis should be additionally performed if available. If WBMRI has been initially performed and focal lesions are present, an additional WBCT may be performed to assess the extent of bone destruction and fracture risk. In cases of monoclonal gammopathy of undetermined significance (MGUS), solitary and smoldering myeloma, a WBMRI, if available, should be performed in addition to WBCT. (orig.) [German] Die Aufgabe der bildgebenden Diagnostik beim multiplen Myelom (MM) ist die zuverlaessige Erfassung der Tumorlast im Skelett sowie auch der extraskelettalen Manifestationen und der assoziierten Komplikationen (z. B. Wirbelkoerperfrakturen, Frakturgefahr

  1. The Effect of English Language on Multiple Choice Question Scores of Thai Medical Students.

    Phisalprapa, Pochamana; Muangkaew, Wayuda; Assanasen, Jintana; Kunavisarut, Tada; Thongngarm, Torpong; Ruchutrakool, Theera; Kobwanthanakun, Surapon; Dejsomritrutai, Wanchai

    2016-04-01

    Universities in Thailand are preparing for Thailand's integration into the ASEAN Economic Community (AEC) by increasing the number of tests in English language. English language is not the native language of Thailand Differences in English language proficiency may affect scores among test-takers, even when subject knowledge among test-takers is comparable and may falsely represent the knowledge level of the test-taker. To study the impact of English language multiple choice test questions on test scores of medical students. The final examination of fourth-year medical students completing internal medicine rotation contains 120 multiple choice questions (MCQ). The languages used on the test are Thai and English at a ratio of 3:1. Individual scores of tests taken in both languages were collected and the effect of English language on MCQ was analyzed Individual MCQ scores were then compared with individual student English language proficiency and student grade point average (GPA). Two hundred ninety five fourth-year medical students were enrolled. The mean percentage of MCQ scores in Thai and English were significantly different (65.0 ± 8.4 and 56.5 ± 12.4, respectively, p English was fair (Spearman's correlation coefficient = 0.41, p English than in Thai language. Students were classified into six grade categories (A, B+, B, C+, C, and D+), which cumulatively measured total internal medicine rotation performance score plus final examination score. MCQ scores from Thai language examination were more closely correlated with total course grades than were the scores from English language examination (Spearman's correlation coefficient = 0.73 (p English proficiency score was very high, at 3.71 ± 0.35 from a total of 4.00. Mean student GPA was 3.40 ± 0.33 from a possible 4.00. English language MCQ examination scores were more highly associated with GPA than with English language proficiency. The use of English language multiple choice question test may decrease scores

  2. Design and protocol of a randomized multiple behavior change trial: Make Better Choices 2 (MBC2).

    Pellegrini, Christine A; Steglitz, Jeremy; Johnston, Winter; Warnick, Jennifer; Adams, Tiara; McFadden, H G; Siddique, Juned; Hedeker, Donald; Spring, Bonnie

    2015-03-01

    Suboptimal diet and inactive lifestyle are among the most prevalent preventable causes of premature death. Interventions that target multiple behaviors are potentially efficient; however the optimal way to initiate and maintain multiple health behavior changes is unknown. The Make Better Choices 2 (MBC2) trial aims to examine whether sustained healthful diet and activity change are best achieved by targeting diet and activity behaviors simultaneously or sequentially. Study design approximately 250 inactive adults with poor quality diet will be randomized to 3 conditions examining the best way to prescribe healthy diet and activity change. The 3 intervention conditions prescribe: 1) an increase in fruit and vegetable consumption (F/V+), decrease in sedentary leisure screen time (Sed-), and increase in physical activity (PA+) simultaneously (Simultaneous); 2) F/V+ and Sed- first, and then sequentially add PA+ (Sequential); or 3) Stress Management Control that addresses stress, relaxation, and sleep. All participants will receive a smartphone application to self-monitor behaviors and regular coaching calls to help facilitate behavior change during the 9 month intervention. Healthy lifestyle change in fruit/vegetable and saturated fat intakes, sedentary leisure screen time, and physical activity will be assessed at 3, 6, and 9 months. MBC2 is a randomized m-Health intervention examining methods to maximize initiation and maintenance of multiple healthful behavior changes. Results from this trial will provide insight about an optimal technology supported approach to promote improvement in diet and physical activity. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Analyzing Multiple-Choice Questions by Model Analysis and Item Response Curves

    Wattanakasiwich, P.; Ananta, S.

    2010-07-01

    In physics education research, the main goal is to improve physics teaching so that most students understand physics conceptually and be able to apply concepts in solving problems. Therefore many multiple-choice instruments were developed to probe students' conceptual understanding in various topics. Two techniques including model analysis and item response curves were used to analyze students' responses from Force and Motion Conceptual Evaluation (FMCE). For this study FMCE data from more than 1000 students at Chiang Mai University were collected over the past three years. With model analysis, we can obtain students' alternative knowledge and the probabilities for students to use such knowledge in a range of equivalent contexts. The model analysis consists of two algorithms—concentration factor and model estimation. This paper only presents results from using the model estimation algorithm to obtain a model plot. The plot helps to identify a class model state whether it is in the misconception region or not. Item response curve (IRC) derived from item response theory is a plot between percentages of students selecting a particular choice versus their total score. Pros and cons of both techniques are compared and discussed.

  4. Solving the Single-Sink, Fixed-Charge, Multiple-Choice Transportation Problem by Dynamic Programming

    Christensen, Tue; Andersen, Kim Allan; Klose, Andreas

    2013-01-01

    This paper considers a minimum-cost network flow problem in a bipartite graph with a single sink. The transportation costs exhibit a staircase cost structure because such types of transportation cost functions are often found in practice. We present a dynamic programming algorithm for solving...... this so-called single-sink, fixed-charge, multiple-choice transportation problem exactly. The method exploits heuristics and lower bounds to peg binary variables, improve bounds on flow variables, and reduce the state-space variable. In this way, the dynamic programming method is able to solve large...... instances with up to 10,000 nodes and 10 different transportation modes in a few seconds, much less time than required by a widely used mixed-integer programming solver and other methods proposed in the literature for this problem....

  5. Solving the Single-Sink, Fixed-Charge, Multiple-Choice Transportation Problem by Dynamic Programming

    Rauff Lind Christensen, Tue; Klose, Andreas; Andersen, Kim Allan

    important aspects of supplier selection, an important application of the SSFCTP, this does not reflect the real life situation. First, transportation costs faced by many companies are in fact piecewise linear. Secondly, when suppliers offer discounts, either incremental or all-unit discounts, such savings......The Single-Sink, Fixed-Charge, Multiple-Choice Transportation Problem (SSFCMCTP) is a problem with versatile applications. This problem is a generalization of the Single-Sink, Fixed-Charge Transportation Problem (SSFCTP), which has a fixed-charge, linear cost structure. However, in at least two...... are neglected in the SSFCTP. The SSFCMCTP overcome this problem by incorporating a staircase cost structure in the cost function instead of the usual one used in SSFCTP. We present a dynamic programming algorithm for the resulting problem. To enhance the performance of the generic algorithm a number...

  6. Evaluation of five guidelines for option development in multiple-choice item-writing.

    Martínez, Rafael J; Moreno, Rafael; Martín, Irene; Trigo, M Eva

    2009-05-01

    This paper evaluates certain guidelines for writing multiple-choice test items. The analysis of the responses of 5013 subjects to 630 items from 21 university classroom achievement tests suggests that an option should not differ in terms of heterogeneous content because such error has a slight but harmful effect on item discrimination. This also occurs with the "None of the above" option when it is the correct one. In contrast, results do not show the supposedly negative effects of a different-length option, the use of specific determiners, or the use of the "All of the above" option, which not only decreases difficulty but also improves discrimination when it is the correct option.

  7. Searching for neurodegeneration in multiple sclerosis at clinical onset: Diagnostic value of biomarkers.

    Novakova, Lenka; Axelsson, Markus; Malmeström, Clas; Imberg, Henrik; Elias, Olle; Zetterberg, Henrik; Nerman, Olle; Lycke, Jan

    2018-01-01

    Neurodegeneration occurs during the early stages of multiple sclerosis. It is an essential, devastating part of the pathophysiology. Tools for measuring the degree of neurodegeneration could improve diagnostics and patient characterization. This study aimed to determine the diagnostic value of biomarkers of degeneration in patients with recent clinical onset of suspected multiple sclerosis, and to evaluate these biomarkers for characterizing disease course. This cross-sectional study included 271 patients with clinical features of suspected multiple sclerosis onset and was the baseline of a prospective study. After diagnostic investigations, the patients were classified into the following disease groups: patients with clinically isolated syndrome (n = 4) or early relapsing remitting multiple sclerosis (early RRMS; n = 93); patients with relapsing remitting multiple sclerosis with disease durations ≥2 years (established RRMS; n = 39); patients without multiple sclerosis, but showing symptoms (symptomatic controls; n = 89); and patients diagnosed with other diseases (n = 46). In addition, we included healthy controls (n = 51) and patients with progressive multiple sclerosis (n = 23). We analyzed six biomarkers of neurodegeneration: cerebrospinal fluid neurofilament light chain levels; cerebral spinal fluid glial fibrillary acidic protein; cerebral spinal fluid tau; retinal nerve fiber layer thickness; macula volume; and the brain parenchymal fraction. Except for increased cerebral spinal fluid neurofilament light chain levels, median 670 ng/L (IQR 400-2110), we could not find signs of early degeneration in the early disease group with recent clinical onset. However, the intrathecal immunoglobin G production and cerebral spinal fluid neurofilament light chain levels showed diagnostic value. Moreover, elevated levels of cerebral spinal fluid glial fibrillary acidic protein, thin retinal nerve fiber layers, and low brain parenchymal fractions were associated with

  8. Step by Step: Biology Undergraduates' Problem-Solving Procedures during Multiple-Choice Assessment.

    Prevost, Luanna B; Lemons, Paula P

    2016-01-01

    This study uses the theoretical framework of domain-specific problem solving to explore the procedures students use to solve multiple-choice problems about biology concepts. We designed several multiple-choice problems and administered them on four exams. We trained students to produce written descriptions of how they solved the problem, and this allowed us to systematically investigate their problem-solving procedures. We identified a range of procedures and organized them as domain general, domain specific, or hybrid. We also identified domain-general and domain-specific errors made by students during problem solving. We found that students use domain-general and hybrid procedures more frequently when solving lower-order problems than higher-order problems, while they use domain-specific procedures more frequently when solving higher-order problems. Additionally, the more domain-specific procedures students used, the higher the likelihood that they would answer the problem correctly, up to five procedures. However, if students used just one domain-general procedure, they were as likely to answer the problem correctly as if they had used two to five domain-general procedures. Our findings provide a categorization scheme and framework for additional research on biology problem solving and suggest several important implications for researchers and instructors. © 2016 L. B. Prevost and P. P. Lemons. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  9. Evaluating the quality of medical multiple-choice items created with automated processes.

    Gierl, Mark J; Lai, Hollis

    2013-07-01

    Computerised assessment raises formidable challenges because it requires large numbers of test items. Automatic item generation (AIG) can help address this test development problem because it yields large numbers of new items both quickly and efficiently. To date, however, the quality of the items produced using a generative approach has not been evaluated. The purpose of this study was to determine whether automatic processes yield items that meet standards of quality that are appropriate for medical testing. Quality was evaluated firstly by subjecting items created using both AIG and traditional processes to rating by a four-member expert medical panel using indicators of multiple-choice item quality, and secondly by asking the panellists to identify which items were developed using AIG in a blind review. Fifteen items from the domain of therapeutics were created in three different experimental test development conditions. The first 15 items were created by content specialists using traditional test development methods (Group 1 Traditional). The second 15 items were created by the same content specialists using AIG methods (Group 1 AIG). The third 15 items were created by a new group of content specialists using traditional methods (Group 2 Traditional). These 45 items were then evaluated for quality by a four-member panel of medical experts and were subsequently categorised as either Traditional or AIG items. Three outcomes were reported: (i) the items produced using traditional and AIG processes were comparable on seven of eight indicators of multiple-choice item quality; (ii) AIG items can be differentiated from Traditional items by the quality of their distractors, and (iii) the overall predictive accuracy of the four expert medical panellists was 42%. Items generated by AIG methods are, for the most part, equivalent to traditionally developed items from the perspective of expert medical reviewers. While the AIG method produced comparatively fewer plausible

  10. Delayed, but not immediate, feedback after multiple-choice questions increases performance on a subsequent short-answer, but not multiple-choice, exam: evidence for the dual-process theory of memory.

    Sinha, Neha; Glass, Arnold Lewis

    2015-01-01

    Three experiments, two performed in the laboratory and one embedded in a college psychology lecture course, investigated the effects of immediate versus delayed feedback following a multiple-choice exam on subsequent short answer and multiple-choice exams. Performance on the subsequent multiple-choice exam was not affected by the timing of the feedback on the prior exam; however, performance on the subsequent short answer exam was better following delayed than following immediate feedback. This was true regardless of the order in which immediate versus delayed feedback was given. Furthermore, delayed feedback only had a greater effect than immediate feedback on subsequent short answer performance following correct, confident responses on the prior exam. These results indicate that delayed feedback cues a student's prior response and increases subsequent recollection of that response. The practical implication is that delayed feedback is better than immediate feedback during academic testing.

  11. Analysis of Multiple Choice Tests Designed by Faculty Members of Kermanshah University of Medical Sciences

    Reza Pourmirza Kalhori

    2013-12-01

    Full Text Available Dear Editor Multiple choice tests are the most common objective tests in medical education which are used to assess the ind-ividual knowledge, recall, recognition and problem solving abilities. One of the testing components is the post-test analysis. This component includes; first, qualitative analysis of the taxonomy of questions based on the Bloom’s educational objectives and percentage of the questions with no structural problems; and second, the quantitative analysis of the reliability (KR-20 and indices of difficulty and differentiation (1. This descriptive-analytical study was aimed to qualitatively and quan-titatively investigate the multiple-choice tests of the faculty members at Kermanshah University of Medical Sciences in 2009-2010. The sample size comprised of 156 tests. Data were analyzed by SPSS-16 software using t-test, chi-squared test, ANOVA and Tukey multiple comparison tests. The mean of reliability (KR-20, difficulty index, and discrimination index were 0.68 (± 0.31, 0.56 (± 0.15 and 0.21 (± 0.15, respectively, which were acceptable. The analysis of the tests at Mashad University of Medical Sciences indicated that the mean for the reliability of the tests was 0.72, and 52.2% of the tests had inappropriate difficulty index and 49.2% of the tests did not have acceptable differentiation index (2. Comparison of the tests at Kermanshah University of Medical Sciences for the fields of anatomy, physiology, biochemistry, genetics, statistics and behavioral sciences courses at Malaysia Faculty of Medicine (3 and tests at Argentina Faculty of Medicine (4 showed that while difficulty index was acceptable in all three universities, but differentiation indices in Malaysia and Argentina Medical Faculties were higher than that in Kermanshah University of Medical Sciences. The mean for the questions with no structural flaws in all tests, taxonomy I, taxonomy II, and taxonomy III were 73.88% (± 14.88, 34.65% (± 15.78, 41.34% (± 13

  12. Force Concept Inventory-based multiple-choice test for investigating students’ representational consistency

    Pasi Nieminen

    2010-08-01

    Full Text Available This study investigates students’ ability to interpret multiple representations consistently (i.e., representational consistency in the context of the force concept. For this purpose we developed the Representational Variant of the Force Concept Inventory (R-FCI, which makes use of nine items from the 1995 version of the Force Concept Inventory (FCI. These original FCI items were redesigned using various representations (such as motion map, vectorial and graphical, yielding 27 multiple-choice items concerning four central concepts underpinning the force concept: Newton’s first, second, and third laws, and gravitation. We provide some evidence for the validity and reliability of the R-FCI; this analysis is limited to the student population of one Finnish high school. The students took the R-FCI at the beginning and at the end of their first high school physics course. We found that students’ (n=168 representational consistency (whether scientifically correct or not varied considerably depending on the concept. On average, representational consistency and scientifically correct understanding increased during the instruction, although in the post-test only a few students performed consistently both in terms of representations and scientifically correct understanding. We also compared students’ (n=87 results of the R-FCI and the FCI, and found that they correlated quite well.

  13. Diagnostic x-ray procedures and risk of leukemia, lymphoma, and multiple myeloma

    Boice, J.D. Jr.; Morin, M.M.; Glass, A.G.; Friedman, G.D.; Stovall, M.; Hoover, R.N.; Fraumeni, J.F. Jr.

    1991-01-01

    Exposure to diagnostic x-rays and the risk of leukemia, non-Hodgkin's lymphoma (NHL), and multiple myeloma were studied within two prepaid health plans. Adult patients with leukemia (n = 565), NHL (n = 318), and multiple myeloma (n = 208) were matched to controls (n = 1390), and over 25,000 x-ray procedures were abstracted from medical records. Dose response was evaluated by assigning each x-ray procedure a score based on estimated bone marrow dose. X-ray exposure was not associated with chronic lymphocytic leukemia, one of the few malignant conditions never linked to radiation (relative risk [RR], 0.66). For all other forms of leukemia combined (n = 358), there was a slight elevation in risk (RR, 1.17) but no evidence of a dose-response relationship when x-ray procedures near the time of diagnosis were excluded. Similarly, patients with NHL were exposed to diagnostic x-ray procedures more often than controls (RR, 1.32), but the RR fell to 0.99 when the exposure to diagnostic x-ray procedures within 2 years of diagnosis was ignored. For multiple myeloma, overall risk was not significantly high (RR, 1.14), but there was consistent evidence of increasing risk with increasing numbers of diagnostic x-ray procedures. These data suggest that persons with leukemia and NHL undergo x-ray procedures frequently just prior to diagnosis for conditions related to the development or natural history of their disease. There was little evidence that diagnostic x-ray procedures were causally associated with leukemia or NHL. The risk for multiple myeloma, however, was increased among those patients who were frequently exposed to x-rays

  14. Structured diagnostic imaging in patients with multiple trauma; Strukturierte radiologische Diagnostik beim Polytrauma

    Linsenmaier, U.; Rieger, J.; Rock, C.; Pfeifer, K.J.; Reiser, M. [Institut fuer Klinische Radiologie, Klinikum der Universitaet Muenchen, Innenstadt (Germany); Kanz, K.G. [Chirurgische Klinik, Klinikum der Universitaet Muenchen, Innenstadt (Germany)

    2002-07-01

    Purpose. Development of a concept for structured diagnostic imaging in patients with multiple trauma.Material and methods. Evaluation of data from a prospective trial with over 2400 documented patients with multiple trauma. All diagnostic and therapeutic steps, primary and secondary death and the 90 days lethality were documented.Structured diagnostic imaging of multiple injured patients requires the integration of an experienced radiologist in an interdisciplinary trauma team consisting of anesthesia, radiology and trauma surgery. Radiology itself deserves standardized concepts for equipment, personnel and logistics to perform diagnostic imaging for a 24-h-coverage with constant quality.Results. This paper describes criteria for initiation of a shock room or emergency room treatment, strategies for documentation and interdisciplinary algorithms for the early clinical care coordinating diagnostic imaging and therapeutic procedures following standardized guidelines. Diagnostic imaging consists of basic diagnosis, radiological ABC-rule, radiological follow-up and structured organ diagnosis using CT. Radiological trauma scoring allows improved quality control of diagnosis and therapy of multiple injured patients.Conclusion. Structured diagnostic imaging of multiple injured patients leads to a standardization of diagnosis and therapy and ensures constant process quality. (orig.) [German] Fragestellung. Entwicklung eines strukturierten Konzeptes zur radiologischen Diagnostik polytraumatisierter Patienten.Methodik. Die Datenevaluation erfolgte auf Basis einer prospektiven interdisziplinaere Polytraumastudie mit ueber 2400 Patienten. Alle diagnostischen und therapeutischen Schritte werden jeweils unter Angabe von Zeitpunkt und auftretenden Komplikationen erfasst, ein primaeres oder sekundaeres Versterben und die 90-Tage-Letalitaet werden dokumentiert.Die strukturierte radiologische Diagnostik von Mehrfachverletzen verlangt die Integration eines erfahrenen Radiologen in

  15. Learning from peer feedback on student-generated multiple choice questions: Views of introductory physics students

    Kay, Alison E.; Hardy, Judy; Galloway, Ross K.

    2018-06-01

    PeerWise is an online application where students are encouraged to generate a bank of multiple choice questions for their classmates to answer. After answering a question, students can provide feedback to the question author about the quality of the question and the question author can respond to this. Student use of, and attitudes to, this online community within PeerWise was investigated in two large first year undergraduate physics courses, across three academic years, to explore how students interact with the system and the extent to which they believe PeerWise to be useful to their learning. Most students recognized that there is value in engaging with PeerWise, and many students engaged deeply with the system, thinking critically about the quality of their submissions and reflecting on feedback provided to them. Students also valued the breadth of topics and level of difficulty offered by the questions, recognized the revision benefits afforded by the resource, and were often willing to contribute to the community by providing additional explanations and engaging in discussion.

  16. Fostering dental student self-assessment of knowledge by confidence scoring of multiple-choice examinations.

    McMahan, C Alex; Pinckard, R Neal; Jones, Anne Cale; Hendricson, William D

    2014-12-01

    Creating a learning environment that fosters student acquisition of self-assessment behaviors and skills is critically important in the education and training of health professionals. Self-assessment is a vital component of competent practice and lifelong learning. This article proposes applying a version of confidence scoring of multiple-choice questions as one avenue to address this crucial educational objective for students to be able to recognize and admit what they do not know. The confidence scoring algorithm assigns one point for a correct answer, deducts fractional points for an incorrect answer, but rewards students fractional points for leaving the question unanswered in admission that they are unsure of the correct answer. The magnitude of the reward relative to the deduction is selected such that the expected gain due to random guessing, even after elimination of all but one distractor, is never greater than the reward. Curricular implementation of this confidence scoring algorithm should motivate health professions students to develop self-assessment behaviors and enable them to acquire the skills necessary to critically evaluate the extent of their current knowledge throughout their professional careers. This is a professional development competency that is emphasized in the educational standards of the Commission on Dental Accreditation (CODA).

  17. Does Educator Training or Experience Affect the Quality of Multiple-Choice Questions?

    Webb, Emily M; Phuong, Jonathan S; Naeger, David M

    2015-10-01

    Physicians receive little training on proper multiple-choice question (MCQ) writing methods. Well-constructed MCQs follow rules, which ensure that a question tests what it is intended to test. Questions that break these are described as "flawed." We examined whether the prevalence of flawed questions differed significantly between those with or without prior training in question writing and between those with different levels of educator experience. We assessed 200 unedited MCQs from a question bank for our senior medical student radiology elective: an equal number of questions (50) were written by faculty with previous training in MCQ writing, other faculty, residents, and medical students. Questions were scored independently by two readers for the presence of 11 distinct flaws described in the literature. Questions written by faculty with MCQ writing training had significantly fewer errors: mean 0.4 errors per question compared to a mean of 1.5-1.7 errors per question for the other groups (P Educator experience alone had no effect on the frequency of flaws; faculty without dedicated training, residents, and students performed similarly. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  18. Benford’s Law: Textbook Exercises and Multiple-Choice Testbanks

    Slepkov, Aaron D.; Ironside, Kevin B.; DiBattista, David

    2015-01-01

    Benford’s Law describes the finding that the distribution of leading (or leftmost) digits of innumerable datasets follows a well-defined logarithmic trend, rather than an intuitive uniformity. In practice this means that the most common leading digit is 1, with an expected frequency of 30.1%, and the least common is 9, with an expected frequency of 4.6%. Currently, the most common application of Benford’s Law is in detecting number invention and tampering such as found in accounting-, tax-, and voter-fraud. We demonstrate that answers to end-of-chapter exercises in physics and chemistry textbooks conform to Benford’s Law. Subsequently, we investigate whether this fact can be used to gain advantage over random guessing in multiple-choice tests, and find that while testbank answers in introductory physics closely conform to Benford’s Law, the testbank is nonetheless secure against such a Benford’s attack for banal reasons. PMID:25689468

  19. Test of understanding of vectors: A reliable multiple-choice vector concept test

    Barniol, Pablo; Zavala, Genaro

    2014-06-01

    In this article we discuss the findings of our research on students' understanding of vector concepts in problems without physical context. First, we develop a complete taxonomy of the most frequent errors made by university students when learning vector concepts. This study is based on the results of several test administrations of open-ended problems in which a total of 2067 students participated. Using this taxonomy, we then designed a 20-item multiple-choice test [Test of understanding of vectors (TUV)] and administered it in English to 423 students who were completing the required sequence of introductory physics courses at a large private Mexican university. We evaluated the test's content validity, reliability, and discriminatory power. The results indicate that the TUV is a reliable assessment tool. We also conducted a detailed analysis of the students' understanding of the vector concepts evaluated in the test. The TUV is included in the Supplemental Material as a resource for other researchers studying vector learning, as well as instructors teaching the material.

  20. Pushing Critical Thinking Skills With Multiple-Choice Questions: Does Bloom's Taxonomy Work?

    Zaidi, Nikki L Bibler; Grob, Karri L; Monrad, Seetha M; Kurtz, Joshua B; Tai, Andrew; Ahmed, Asra Z; Gruppen, Larry D; Santen, Sally A

    2018-06-01

    Medical school assessments should foster the development of higher-order thinking skills to support clinical reasoning and a solid foundation of knowledge. Multiple-choice questions (MCQs) are commonly used to assess student learning, and well-written MCQs can support learner engagement in higher levels of cognitive reasoning such as application or synthesis of knowledge. Bloom's taxonomy has been used to identify MCQs that assess students' critical thinking skills, with evidence suggesting that higher-order MCQs support a deeper conceptual understanding of scientific process skills. Similarly, clinical practice also requires learners to develop higher-order thinking skills that include all of Bloom's levels. Faculty question writers and examinees may approach the same material differently based on varying levels of knowledge and expertise, and these differences can influence the cognitive levels being measured by MCQs. Consequently, faculty question writers may perceive that certain MCQs require higher-order thinking skills to process the question, whereas examinees may only need to employ lower-order thinking skills to render a correct response. Likewise, seemingly lower-order questions may actually require higher-order thinking skills to respond correctly. In this Perspective, the authors describe some of the cognitive processes examinees use to respond to MCQs. The authors propose that various factors affect both the question writer and examinee's interaction with test material and subsequent cognitive processes necessary to answer a question.

  1. Multiple-Choice Exams: An Obstacle for Higher-Level Thinking in Introductory Science Classes

    Stanger-Hall, Kathrin F.

    2012-01-01

    Learning science requires higher-level (critical) thinking skills that need to be practiced in science classes. This study tested the effect of exam format on critical-thinking skills. Multiple-choice (MC) testing is common in introductory science courses, and students in these classes tend to associate memorization with MC questions and may not see the need to modify their study strategies for critical thinking, because the MC exam format has not changed. To test the effect of exam format, I used two sections of an introductory biology class. One section was assessed with exams in the traditional MC format, the other section was assessed with both MC and constructed-response (CR) questions. The mixed exam format was correlated with significantly more cognitively active study behaviors and a significantly better performance on the cumulative final exam (after accounting for grade point average and gender). There was also less gender-bias in the CR answers. This suggests that the MC-only exam format indeed hinders critical thinking in introductory science classes. Introducing CR questions encouraged students to learn more and to be better critical thinkers and reduced gender bias. However, student resistance increased as students adjusted their perceptions of their own critical-thinking abilities. PMID:22949426

  2. Examining the Psychometric Quality of Multiple-Choice Assessment Items using Mokken Scale Analysis.

    Wind, Stefanie A

    The concept of invariant measurement is typically associated with Rasch measurement theory (Engelhard, 2013). Concerned with the appropriateness of the parametric transformation upon which the Rasch model is based, Mokken (1971) proposed a nonparametric procedure for evaluating the quality of social science measurement that is theoretically and empirically related to the Rasch model. Mokken's nonparametric procedure can be used to evaluate the quality of dichotomous and polytomous items in terms of the requirements for invariant measurement. Despite these potential benefits, the use of Mokken scaling to examine the properties of multiple-choice (MC) items in education has not yet been fully explored. A nonparametric approach to evaluating MC items is promising in that this approach facilitates the evaluation of assessments in terms of invariant measurement without imposing potentially inappropriate transformations. Using Rasch-based indices of measurement quality as a frame of reference, data from an eighth-grade physical science assessment are used to illustrate and explore Mokken-based techniques for evaluating the quality of MC items. Implications for research and practice are discussed.

  3. Identification of Misconceptions through Multiple Choice Tasks at Municipal Chemistry Competition Test

    Dušica D Milenković

    2016-01-01

    Full Text Available In this paper, the level of conceptual understanding of chemical contents among seventh grade students who participated in the municipal Chemistry competition in Novi Sad, Serbia, in 2013 have been examined. Tests for the municipal chemistry competition were used as a measuring instrument, wherein only multiple choice tasks were considered and analyzed. Determination of the level of conceptual understanding of the tested chemical contents was based on the calculation of the frequency of choosing the correct answers. Thereby, identification of areas of satisfactory conceptual understanding, areas of roughly adequate performance, areas of inadequate performance, and areas of quite inadequate performance have been conducted. On the other hand, the analysis of misconceptions was based on the analysis of distractors. The results showed that satisfactory level of conceptual understanding and roughly adequate performance characterize majority of contents, which was expected since only the best students who took part in the contest were surveyed. However, this analysis identified a large number of misunderstandings, as well. In most of the cases, these misconceptions were related to the inability to distinguish elements, compounds, homogeneous and heterogeneous mixtures. Besides, it is shown that students are not familiar with crystal structure of the diamond, and with metric prefixes. The obtained results indicate insufficient visualization of the submicroscopic level in school textbooks, the imprecise use of chemical language by teachers and imprecise use of language in chemistry textbooks.

  4. Automatic Generation System of Multiple-Choice Cloze Questions and its Evaluation

    Takuya Goto

    2010-09-01

    Full Text Available Since English expressions vary according to the genres, it is important for students to study questions that are generated from sentences of the target genre. Although various questions are prepared, it is still not enough to satisfy various genres which students want to learn. On the other hand, when producing English questions, sufficient grammatical knowledge and vocabulary are needed, so it is difficult for non-expert to prepare English questions by themselves. In this paper, we propose an automatic generation system of multiple-choice cloze questions from English texts. Empirical knowledge is necessary to produce appropriate questions, so machine learning is introduced to acquire knowledge from existing questions. To generate the questions from texts automatically, the system (1 extracts appropriate sentences for questions from texts based on Preference Learning, (2 estimates a blank part based on Conditional Random Field, and (3 generates distracters based on statistical patterns of existing questions. Experimental results show our method is workable for selecting appropriate sentences and blank part. Moreover, our method is appropriate to generate the available distracters, especially for the sentence that does not contain the proper noun.

  5. Ant system for reliability optimization of a series system with multiple-choice and budget constraints

    Nahas, Nabil; Nourelfath, Mustapha

    2005-01-01

    Many researchers have shown that insect colonies behavior can be seen as a natural model of collective problem solving. The analogy between the way ants look for food and combinatorial optimization problems has given rise to a new computational paradigm, which is called ant system. This paper presents an application of ant system in a reliability optimization problem for a series system with multiple-choice constraints incorporated at each subsystem, to maximize the system reliability subject to the system budget. The problem is formulated as a nonlinear binary integer programming problem and characterized as an NP-hard problem. This problem is solved by developing and demonstrating a problem-specific ant system algorithm. In this algorithm, solutions of the reliability optimization problem are repeatedly constructed by considering the trace factor and the desirability factor. A local search is used to improve the quality of the solutions obtained by each ant. A penalty factor is introduced to deal with the budget constraint. Simulations have shown that the proposed ant system is efficient with respect to the quality of solutions and the computing time

  6. Diagnostic Utility of Total IgE in Foods, Inhalant, and Multiple Allergies in Saudi Arabia.

    Al-Mughales, Jamil A

    2016-01-01

    Objective. To assess the diagnostic significance of total IgE in foods, inhalant, and multiple allergies. Methods. Retrospective review of the laboratory records of patients who presented with clinical suspicion of food or inhalant allergy between January 2013 and December 2014. Total IgE level was defined as positive for a value >195 kU/L; and diagnosis was confirmed by the detection of specific IgE (golden standard) for at least one food or inhalant allergen and at least two allergens in multiple allergies. Results. A total of 1893 (male ratio = 0.68, mean age = 39.0 ± 19.2 years) patients were included. Total IgE had comparable sensitivity (55.8% versus 59.6%) and specificity (83.9% versus 84.4%) in food versus inhalant allergy, respectively, but a superior PPV in inhalant allergy (79.1% versus 54.4%). ROC curve analysis showed a better diagnostic value in inhalant allergies (AUC = 0.817 (95% CI = 0.796-0.837) versus 0.770 (95% CI = 0.707-0.833)). In multiple allergies, total IgE had a relatively good sensitivity (78.6%), while negative IgE testing (allergies with 91.5% certitude. Conclusion. Total IgE assay is not efficient as a diagnostic test for foods, inhalant, or multiple allergies. The best strategy should refer to specific IgE testing guided by a comprehensive atopic history.

  7. An Australian Study Comparing the Use of Multiple-Choice Questionnaires with Assignments as Interim, Summative Law School Assessment

    Huang, Vicki

    2017-01-01

    To the author's knowledge, this is the first Australian study to empirically compare the use of a multiple-choice questionnaire (MCQ) with the use of a written assignment for interim, summative law school assessment. This study also surveyed the same student sample as to what types of assessments are preferred and why. In total, 182 undergraduate…

  8. Using a Fine-Grained Multiple-Choice Response Format in Educational Drill-and-Practice Video Games

    Beserra, Vagner; Nussbaum, Miguel; Grass, Antonio

    2017-01-01

    When using educational video games, particularly drill-and-practice video games, there are several ways of providing an answer to a quiz. The majority of paper-based options can be classified as being either multiple-choice or constructed-response. Therefore, in the process of creating an educational drill-and-practice video game, one fundamental…

  9. Effectiveness of Guided Multiple Choice Objective Questions Test on Students' Academic Achievement in Senior School Mathematics by School Location

    Igbojinwaekwu, Patrick Chukwuemeka

    2015-01-01

    This study investigated, using pretest-posttest quasi-experimental research design, the effectiveness of guided multiple choice objective questions test on students' academic achievement in Senior School Mathematics, by school location, in Delta State Capital Territory, Nigeria. The sample comprised 640 Students from four coeducation secondary…

  10. The Multiple-Choice Model: Some Solutions for Estimation of Parameters in the Presence of Omitted Responses

    Abad, Francisco J.; Olea, Julio; Ponsoda, Vicente

    2009-01-01

    This article deals with some of the problems that have hindered the application of Samejima's and Thissen and Steinberg's multiple-choice models: (a) parameter estimation difficulties owing to the large number of parameters involved, (b) parameter identifiability problems in the Thissen and Steinberg model, and (c) their treatment of omitted…

  11. Bayesian modeling and inference for diagnostic accuracy and probability of disease based on multiple diagnostic biomarkers with and without a perfect reference standard.

    Jafarzadeh, S Reza; Johnson, Wesley O; Gardner, Ian A

    2016-03-15

    The area under the receiver operating characteristic (ROC) curve (AUC) is used as a performance metric for quantitative tests. Although multiple biomarkers may be available for diagnostic or screening purposes, diagnostic accuracy is often assessed individually rather than in combination. In this paper, we consider the interesting problem of combining multiple biomarkers for use in a single diagnostic criterion with the goal of improving the diagnostic accuracy above that of an individual biomarker. The diagnostic criterion created from multiple biomarkers is based on the predictive probability of disease, conditional on given multiple biomarker outcomes. If the computed predictive probability exceeds a specified cutoff, the corresponding subject is allocated as 'diseased'. This defines a standard diagnostic criterion that has its own ROC curve, namely, the combined ROC (cROC). The AUC metric for cROC, namely, the combined AUC (cAUC), is used to compare the predictive criterion based on multiple biomarkers to one based on fewer biomarkers. A multivariate random-effects model is proposed for modeling multiple normally distributed dependent scores. Bayesian methods for estimating ROC curves and corresponding (marginal) AUCs are developed when a perfect reference standard is not available. In addition, cAUCs are computed to compare the accuracy of different combinations of biomarkers for diagnosis. The methods are evaluated using simulations and are applied to data for Johne's disease (paratuberculosis) in cattle. Copyright © 2015 John Wiley & Sons, Ltd.

  12. Isothermal multiple displacement amplification: a methodical approach enhancing molecular routine diagnostics of microcarcinomas and small biopsies

    Mairinger FD

    2014-08-01

    Full Text Available Fabian D Mairinger,1 Robert FH Walter,2 Claudia Vollbrecht,3 Thomas Hager,1 Karl Worm,1 Saskia Ting,1 Jeremias Wohlschläger,1 Paul Zarogoulidis,4 Konstantinos Zarogoulidis,4 Kurt W Schmid1 1Institute of Pathology, 2Ruhrlandklinik, West German Lung Center, University Hospital Essen, Essen, 3Institute of Pathology, University Hospital Cologne, Cologne, Germany; 4Pulmonary Department, Oncology Unit, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece Background and methods: Isothermal multiple displacement amplification (IMDA can be a powerful tool in molecular routine diagnostics for homogeneous and sequence-independent whole-genome amplification of notably small tumor samples, eg, microcarcinomas and biopsies containing a small amount of tumor. Currently, this method is not well established in pathology laboratories. We designed a study to confirm the feasibility and convenience of this method for routine diagnostics with formalin-fixed, paraffin-embedded samples prepared by laser-capture microdissection. Results: A total of 250 µg DNA (concentration 5 µg/µL was generated by amplification over a period of 8 hours with a material input of approximately 25 cells, approximately equivalent to 175 pg of genomic DNA. In the generated DNA, a representation of all chromosomes could be shown and the presence of elected genes relevant for diagnosis in clinical samples could be proven. Mutational analysis of clinical samples could be performed without any difficulty and showed concordance with earlier diagnostic findings. Conclusion: We established the feasibility and convenience of IMDA for routine diagnostics. We also showed that small amounts of DNA, which were not analyzable with current molecular methods, could be sufficient for a wide field of applications in molecular routine diagnostics when they are preamplified with IMDA. Keywords: isothermal multiple displacement amplification, isothermal, whole

  13. An update on the use of cerebrospinal fluid analysis as a diagnostic tool in multiple sclerosis.

    Gastaldi, Matteo; Zardini, Elisabetta; Franciotta, Diego

    2017-01-01

    Intrathecal B-lymphocyte activation is a hallmark of multiple sclerosis (MS), a multi-factorial inflammatory-demyelinating disease of the central nervous system. Such activation has a counterpart in the cerebrospinal fluid (CSF) oligoclonal IgG bands (OCB), whose diagnostic role in MS has been downgraded within the current McDonald's criteria. With a theoretico-practical approach, the authors review the physiopathological basis of the CSF dynamics, and the state-of-the-art of routine CSF analysis and CSF biomarkers in MS. Areas covered: The authors discuss pros and cons of CSF analysis, including critical evaluations of both well-established, and promising diagnostic and prognostic laboratory tools. New acquisitions on the CSF and cerebral interstitial fluid dynamics are also presented. The authors searched the PubMed database for English-language articles reported between January 2010 and June 2016, using the key words 'multiple sclerosis', 'cerebrospinal fluid', 'oligoclonal bands'. Reference lists of relevant articles were scanned for additional studies. Expert commentary: The availability of performing high-quality, routine CSF tests in specialized laboratories, the emerging potential of novel CSF biomarkers, and the trend for early treatments should induce a reappraisal of CSF analysis for diagnostic and prognostic purposes in MS. Further procedural and methodological improvements seem to be necessary in both research and translational diagnostic CSF settings.

  14. Imaging and diagnostic criteria for multiple sclerosis: are we there yet?

    Josey, Lawrence; Curley, Michael; Mousavi, Foroogh Jafari; Taylor, Bruce V.; Lucas, Robyn; Coulthard, Alan

    2012-01-01

    Excluding post traumatic injury, Multiple Sclerosis (MS) is the most common disabling neurological disorder of young adults. Although the effect on mortality is limited, the association of a young demographic and significant morbidity combine to make MS a devastating disease. Since MS was given its first detailed description in 1868, diagnostic criteria continue to evolve. Recently, there has been an international commitment to combine both clinical and paraclinical tests to arrive at an earlier diagnosis. Widespread acceptance of the use of MRI in diagnosis, monitoring and research has made the role of the radiologist more critical than ever in this disease. The primary diagnostic criteria for MS are the International Panel criteria, commonly referred to as the McDonald criteria and it is essential that the radiology community is aware of the work preceding these criteria, so that they are understood in the correct context and the importance acknowledged. Literature review utilising key word search to obtain the historical and current context of magnetic resonance imaging in the diagnosis of MS. A succinct description of the evolution of criteria for the diagnosis of MS. Radiologists must recognise that there are specific diagnostic criteria for MS that continue to evolve as a result of new research, improved technology and clinical experience and it is crucial that these criteria be applied in daily practice. It should be evident that diagnostic imaging criteria for MS will be most effective when combined with standardised MRI protocols such as those published by the international Consortium of Multiple Sclerosis Centres.

  15. Robust handling of dynamics and multiple failures in a diagnostic event analyzer

    Finch, F.E.; Kramer, M.A.

    1991-01-01

    MIDAS diagnoses malfunctions in continuous chemical and refinery processes using a plant-independent strategy based on qualitative and quantitative process models. MIDAS specifically addresses problems not treated in past systems, including: process dynamics with control system responses, multiple faults and induced failures, and out-of-order and false alarms. This paper discusses both the structure of the process models and the diagnostic reasoning strategies employed by MIDAS

  16. Isothermal multiple displacement amplification: a methodical approach enhancing molecular routine diagnostics of microcarcinomas and small biopsies.

    Mairinger, Fabian D; Walter, Robert Fh; Vollbrecht, Claudia; Hager, Thomas; Worm, Karl; Ting, Saskia; Wohlschläger, Jeremias; Zarogoulidis, Paul; Zarogoulidis, Konstantinos; Schmid, Kurt W

    2014-01-01

    Isothermal multiple displacement amplification (IMDA) can be a powerful tool in molecular routine diagnostics for homogeneous and sequence-independent whole-genome amplification of notably small tumor samples, eg, microcarcinomas and biopsies containing a small amount of tumor. Currently, this method is not well established in pathology laboratories. We designed a study to confirm the feasibility and convenience of this method for routine diagnostics with formalin-fixed, paraffin-embedded samples prepared by laser-capture microdissection. A total of 250 μg DNA (concentration 5 μg/μL) was generated by amplification over a period of 8 hours with a material input of approximately 25 cells, approximately equivalent to 175 pg of genomic DNA. In the generated DNA, a representation of all chromosomes could be shown and the presence of elected genes relevant for diagnosis in clinical samples could be proven. Mutational analysis of clinical samples could be performed without any difficulty and showed concordance with earlier diagnostic findings. We established the feasibility and convenience of IMDA for routine diagnostics. We also showed that small amounts of DNA, which were not analyzable with current molecular methods, could be sufficient for a wide field of applications in molecular routine diagnostics when they are preamplified with IMDA.

  17. Item Analysis of Multiple Choice Questions at the Department of Paediatrics, Arabian Gulf University, Manama, Bahrain

    Deena Kheyami

    2018-04-01

    Full Text Available Objectives: The current study aimed to carry out a post-validation item analysis of multiple choice questions (MCQs in medical examinations in order to evaluate correlations between item difficulty, item discrimination and distraction effectiveness so as to determine whether questions should be included, modified or discarded. In addition, the optimal number of options per MCQ was analysed. Methods: This cross-sectional study was performed in the Department of Paediatrics, Arabian Gulf University, Manama, Bahrain. A total of 800 MCQs and 4,000 distractors were analysed between November 2013 and June 2016. Results: The mean difficulty index ranged from 36.70–73.14%. The mean discrimination index ranged from 0.20–0.34. The mean distractor efficiency ranged from 66.50–90.00%. Of the items, 48.4%, 35.3%, 11.4%, 3.9% and 1.1% had zero, one, two, three and four nonfunctional distractors (NFDs, respectively. Using three or four rather than five options in each MCQ resulted in 95% or 83.6% of items having zero NFDs, respectively. The distractor efficiency was 91.87%, 85.83% and 64.13% for difficult, acceptable and easy items, respectively (P <0.005. Distractor efficiency was 83.33%, 83.24% and 77.56% for items with excellent, acceptable and poor discrimination, respectively (P <0.005. The average Kuder-Richardson formula 20 reliability coefficient was 0.76. Conclusion: A considerable number of the MCQ items were within acceptable ranges. However, some items needed to be discarded or revised. Using three or four rather than five options in MCQs is recommended to reduce the number of NFDs and improve the overall quality of the examination.

  18. Multiple-Choice Exams and Guessing: Results from a One-Year Study of General Chemistry Tests Designed to Discourage Guessing

    Campbell, Mark L.

    2015-01-01

    Multiple-choice exams, while widely used, are necessarily imprecise due to the contribution of the final student score due to guessing. This past year at the United States Naval Academy the construction and grading scheme for the department-wide general chemistry multiple-choice exams were revised with the goal of decreasing the contribution of…

  19. Reducing the number of options on multiple-choice questions: response time, psychometrics and standard setting.

    Schneid, Stephen D; Armour, Chris; Park, Yoon Soo; Yudkowsky, Rachel; Bordage, Georges

    2014-10-01

    Despite significant evidence supporting the use of three-option multiple-choice questions (MCQs), these are rarely used in written examinations for health professions students. The purpose of this study was to examine the effects of reducing four- and five-option MCQs to three-option MCQs on response times, psychometric characteristics, and absolute standard setting judgements in a pharmacology examination administered to health professions students. We administered two versions of a computerised examination containing 98 MCQs to 38 Year 2 medical students and 39 Year 3 pharmacy students. Four- and five-option MCQs were converted into three-option MCQs to create two versions of the examination. Differences in response time, item difficulty and discrimination, and reliability were evaluated. Medical and pharmacy faculty judges provided three-level Angoff (TLA) ratings for all MCQs for both versions of the examination to allow the assessment of differences in cut scores. Students answered three-option MCQs an average of 5 seconds faster than they answered four- and five-option MCQs (36 seconds versus 41 seconds; p = 0.008). There were no significant differences in item difficulty and discrimination, or test reliability. Overall, the cut scores generated for three-option MCQs using the TLA ratings were 8 percentage points higher (p = 0.04). The use of three-option MCQs in a health professions examination resulted in a time saving equivalent to the completion of 16% more MCQs per 1-hour testing period, which may increase content validity and test score reliability, and minimise construct under-representation. The higher cut scores may result in higher failure rates if an absolute standard setting method, such as the TLA method, is used. The results from this study provide a cautious indication to health professions educators that using three-option MCQs does not threaten validity and may strengthen it by allowing additional MCQs to be tested in a fixed amount

  20. Exploring Multiple Motivations on Urban Residents’ Travel Mode Choices: An Empirical Study from Jiangsu Province in China

    Jichao Geng

    2017-01-01

    Full Text Available People’s actions are always accompanied with multiple motives. How to estimate the role of the pro-environment motivation under the interference of other motivations will help us to better interpret human environmental behaviors. On the basis of classical motivation theories and travel mode choice research backgrounds, the concepts of pro-environmental and self-interested motivation were defined. Then based on survey data on 1244 urban residents in the Jiangsu Province in China, the multinomial logistic regression model was constructed to examine the effects of multiple motivations, government measures, and demographic characteristics on residents’ travel mode choice behaviors. The result indicates that compared to car use, pro-environmental motivation certainly has a significant and positive role in promoting green travel mode choices (walking, bicycling, and using public transport, but this unstable green behavior is always dominated by self-interested motivations rather than the pro-environmental motivation. In addition, the effects of gender, age, income, vehicle ownership, travel distance, and government instruments show significant differences among travel mode choices. The findings suggest that pro-environmental motivation needs to be stressed and highlighted to ensure sustainable urban transportation. However, policies aimed to only increase the public awareness of environment protection are not enough; tailored policy interventions should be targeted to specific groups having different main motivations.

  1. Diagnostic Criteria, Classification and Treatment Goals in Multiple Sclerosis: The Chronicles of Time and Space.

    Ntranos, Achilles; Lublin, Fred

    2016-10-01

    Multiple sclerosis (MS) is one of the most diverse human diseases. Since its first description by Charcot in the nineteenth century, the diagnostic criteria, clinical course classification, and treatment goals for MS have been constantly revised and updated to improve diagnostic accuracy, physician communication, and clinical trial design. These changes have improved the clinical outcomes and quality of life for patients with the disease. Recent technological and research breakthroughs will almost certainly further change how we diagnose, classify, and treat MS in the future. In this review, we summarize the key events in the history of MS, explain the reasoning behind the current criteria for MS diagnosis, classification, and treatment, and provide suggestions for further improvements that will keep enhancing the clinical practice of MS.

  2. Diagnostics

    Donné, A.J.H.; Costley, A.E.; Barnsley, R.

    2007-01-01

    of the measurements—time and spatial resolutions, etc—will in some cases be more stringent. Many of the measurements will be used in the real time control of the plasma driving a requirement for very high reliability in the systems (diagnostics) that provide the measurements. The implementation of diagnostic systems...... on ITER is a substantial challenge. Because of the harsh environment (high levels of neutron and gamma fluxes, neutron heating, particle bombardment) diagnostic system selection and design has to cope with a range of phenomena not previously encountered in diagnostic design. Extensive design and R......&D is needed to prepare the systems. In some cases the environmental difficulties are so severe that new diagnostic techniques are required. The starting point in the development of diagnostics for ITER is to define the measurement requirements and develop their justification. It is necessary to include all...

  3. Gender and Ethnicity Differences in Multiple-Choice Testing. Effects of Self-Assessment and Risk-Taking Propensity

    1993-05-01

    correctness of the response provides I some advantages. They are: i 1. Increased reliability of the test; 2. Examinees pay more attention to the multiple...their choice 3 of test date. Each sign up sheet was divided into four cells: Non-Hispanic males and females and Hispanic males and females. 3 I I I...certain prestige and financial rewards; or entering a conservatory of music for advanced training with a well-known pianist . Mr. H realizes that even

  4. Dual processing theory and experts' reasoning: exploring thinking on national multiple-choice questions

    Durning, S.J.; Dong, T.; Artino, A.R.; Vleuten, C. van der; Holmboe, E.; Schuwirth, L.

    2015-01-01

    BACKGROUND: An ongoing debate exists in the medical education literature regarding the potential benefits of pattern recognition (non-analytic reasoning), actively comparing and contrasting diagnostic options (analytic reasoning) or using a combination approach. Studies have not, however, explicitly

  5. Qualitätsverbesserung von MC Fragen [Quality assurance of Multiple Choice Questions

    Rotthoff, Thomas

    2006-08-01

    Full Text Available [english] Because of the missing relevance of graded examinations at the German medical faculties, there was no need to reflect the question quality in written examinations consistently. Through the new national legislation for medical education certification-relevant, faculty-internal examinations are prescribed. Until now, there is a lack of structures and processes which could lead to an improvement of the question quality. To reflect the different performance of the students, a different severity and a good selectivity of the test questions are necessary. For a interdisciplinary examination for fourth year undergraduate students at the University Hospital Duesseldorf, new Multiple choice (MC- questions which are application-orientated, clearly formulated and to a large extent free from formal errors should be developed. The implementation took place in the conception and performance of Workshops for the construction of MC-questions and the appointment of an interdisciplinary review-committee. It could be shown that an author training facilitates and accelerates the review-process for the committee and that a review process reflects itself in a high practise-orientation of the items. Prospectively, high-quality questions which are created in a review-process and metrological analysed could be read into inter-university databases. Therewith the initial expenditure of time could be reduced. The interdisciplinary constitution of the review-committee offers the possibility of an intensified discussion over content and relevance of the questions. [german] Wegen fehlender notenrelevanter Prüfungen an den Medizinischen Fakultäten in Deutschland bestand bisher keine Notwendigkeit, die Fragenqualität in schriftlichen Prüfungen konsequent zu reflektieren. Erst durch die neue Approbationsordnung sind zeugnisrelevante, fakultätsinterne Prüfungen vorgeschrieben. Es fehlen somit oftmals Strukturen und Prozesse, die zu einer Verbesserung der

  6. The axiom of multiple choice and models for constructive set theory

    van den Berg, B.; Moerdijk, I.

    2014-01-01

    We propose an extension of Aczel's constructive set theory CZF by an axiom for inductive types and a choice principle, and show that this extension has the following properties: it is interpretable in Martin-Löf's type theory (hence acceptable from a constructive and generalized-predicative

  7. Multiple Choice: How Public School Leaders in New Orleans' Saturated Market View Private School Competitors

    Jabbar, Huriya; Li, Dongmei M.

    2016-01-01

    School choice policies, such as charter schools and vouchers, are in part designed to induce competition between schools. While several studies have examined the impact of private school competition on public schools, few studies have explored school leaders' perceptions of private school competitors. This study examines the extent to which public…

  8. High Pressure Reform: Examining Urban Schools' Response to Multiple School Choice Policies

    Holme, Jennifer Jellison; Carkhum, Rian; Rangel, Virginia Snodgrass

    2013-01-01

    Over the past several decades, policymakers have sought to address the problem of school failure by exposing traditional public schools to competitive market forces. In this analysis, we examine how two traditional public schools in a "high pressure/high choice" urban school cluster in Texas responded to a number of overlapping choice…

  9. Interobserver agreement on Poser's and the new McDonald's diagnostic criteria for multiple sclerosis.

    Zipoli, V; Portaccio, E; Siracusa, G; Pracucci, G; Sorbi, S; Amato, M P

    2003-10-01

    We assessed the interobserver agreement on the diagnosis of multiple sclerosis (MS) in a study sample consisting of 41 MS (15 relapsing remitting, two secondary progressive, five primary progressive and 19 presenting their first clinical attack) and three non-MS cases. Clinical and paraclinical information was recorded in standardized forms. Four neurologists were asked to make a diagnosis using Poser's and McDonald's criteria and to assess MRI scans according to the McDonald's guidelines. In terms of the kappa statistic (kappa), we found a moderate agreement on the overall diagnosis using both Poser's and McDonald's criteria (kappa, respectively 0.57 and 0.52). As for distinct diagnostic categories, we observed a moderate to substantial agreement for the three McDonald categories (range of kappa values 0.49-0.64) and a fair to substantial agreement for the nine Poser categories (range of kappa values 0.37-0.67). Taking into account clinical information, the agreement on dissemination over time was substantially higher (kappa = 0.69) than that found on dissemination over space (kappa = 0.46). In contrast, for MRI assessment, the agreement for spatial dissemination was substantial (kappa = 0.74) compared with the fair agreement (kappa = 0.25) yielded by dissemination over time. The new McDonald's criteria yield a good overall diagnostic reliability, and compare favourably with Poser's classification in terms of agreement on distinct diagnostic categories.

  10. Diagnostic radiology on multiple injured patients: interdisciplinary management; Radiologische Diagnostik beim Polytrauma: interdisziplinaeres Management

    Linsenmaier, U.; Pfeifer, K.J. [Inst. fuer Radiologische Diagnostik, Klinikum der Univ. Muenchen (Germany); Kanz, K.G.; Mutschler, W. [Chirurgische Klinik Innenstadt, Klinikum der Univ. Muenchen, (Germany)

    2001-06-01

    The presence of a radiologist within the admitting area of an emergency department and his capability as a member of the trauma team have a major impact on the role of diagnostic radiology in trauma care. The knowledge of clinical decision criteria, algorithms, and standards of patient care are essential for the acceptance within a trauma team. We present an interdisciplinary management concept of diagnostic radiology for trauma patients, which comprises basic diagnosis, organ diagnosis, radiological ABC, and algorithms of early clinical care. It is the result of a prospective study comprising over 2000 documented multiple injured patients. The radiologist on a trauma team should support trauma surgery and anesthesia in diagnostic and clinical work-up. The radiological ABC provides a structured approach for diagnostic imaging in all steps of the early clinical care of the multiple injured patient. Radiological ABC requires a reevaluation in cases of equivocal findings or difficulties in the clinical course. Direct communication of radiological findings with the trauma team enables quick clinical decisions. In addition, the radiologist can priority-oriented influence the therapy by using interventional procedures. The clinical radiologist is an active member of the interdisciplinary trauma team, not only providing diagnostic imaging but also participating in clinical decisions. (orig.) [German] Die Anwesenheit des Radiologen im Schockraum und dessen Teamfaehigkeit bestimmen den Status der diagnostischen Radiologie in der Traumaversorgung. Voraussetzung zur Mitarbeit im interdisziplinaeren Traumateam ist die detaillierte Kenntnis der wesentlichen Entscheidungskriterien, Algorithmen und Behandlungsablaeufe. Das hier vorgestellte interdisziplinaere Managementkonzept der radiologischen Diagnostik beim Polytrauma mit Basisdiagnostik, Organdiagnostik, radiologischer ABC-Regel und Algorithmen zur fruehklinischen Behandlung beruht auf einer prospektiven Polytraumastudie mit

  11. RELATIONSHIP BETWEEN MOBILE NUMBER PORTABILITY AND CONSUMER CHOICE OF ACTIVE MULTIPLE MOBILE PHONE NUMBERS IN GHANA

    Solomon A. Keelson; Addo J. Odei

    2014-01-01

    The use of multiple mobile phone numbers in Ghana has become a dominate phenomenon in recent years. The introduction of mobile number portability (MNP) makes it possible for a subscriber to conveniently switch from one mobile network to another without losing his or her number. Because of mobile number portability, we expected that use of multiple numbers would become less attractive. This study examines how mobile number portability has affected the use of multiple phone numbers. We use top,...

  12. Item difficulty of multiple choice tests dependant on different item response formats – An experiment in fundamental research on psychological assessment

    KLAUS D. KUBINGER

    2007-12-01

    Full Text Available Multiple choice response formats are problematical as an item is often scored as solved simply because the test-taker is a lucky guesser. Instead of applying pertinent IRT models which take guessing effects into account, a pragmatic approach of re-conceptualizing multiple choice response formats to reduce the chance of lucky guessing is considered. This paper compares the free response format with two different multiple choice formats. A common multiple choice format with a single correct response option and five distractors (“1 of 6” is used, as well as a multiple choice format with five response options, of which any number of the five is correct and the item is only scored as mastered if all the correct response options and none of the wrong ones are marked (“x of 5”. An experiment was designed, using pairs of items with exactly the same content but different response formats. 173 test-takers were randomly assigned to two test booklets of 150 items altogether. Rasch model analyses adduced a fitting item pool, after the deletion of 39 items. The resulting item difficulty parameters were used for the comparison of the different formats. The multiple choice format “1 of 6” differs significantly from “x of 5”, with a relative effect of 1.63, while the multiple choice format “x of 5” does not significantly differ from the free response format. Therefore, the lower degree of difficulty of items with the “1 of 6” multiple choice format is an indicator of relevant guessing effects. In contrast the “x of 5” multiple choice format can be seen as an appropriate substitute for free response format.

  13. A forecast of household ownership and use of alternative fuel vehicles: A multiple discrete-continuous choice approach

    Ahn, Jiwoon [Korea Energy Economics Institute, Naeson 2-dong, Uiwang-si, Gyeonggi-do, 437-713 (Korea); Jeong, Gicheol [Technology Management, Economics and Policy Program, 37-402, College of Engineering, Seoul National University, San 56-1, Sillim-dong, Gwanak-gu, Seoul, 151-744 (Korea); Kim, Yeonbae [Technology Management, Economics and Policy Program, 37-318, College of Engineering, Seoul National University, San 56-1, Sillim-dong, Gwanak-gu, South Seoul, 151-744 (Korea)

    2008-09-15

    The paper analyzes how adding alternative fuel passenger cars to the market will affect patterns in demand for passenger cars. We use conjoint analysis and a multiple discrete-continuous choice model to estimate consumer preferences regarding alternative fuel vehicles, and based on the estimates we conduct a simulation to analyze changing rates of ownership and use of variously fueled passenger cars under the effect of the introduction of alternative fuel passenger cars. In addition, we estimate changes in overall fuel consumption and the emission of pollutants. The results show that gasoline-fueled cars will still be most consumers' first choice, but alternative fuel passenger cars will nevertheless compete and offer a substitute for the purchase and use of gasoline-fueled or diesel-fueled cars. Finally, results show that adding alternative fuel cars to the market would effectively lower gasoline and diesel fuel consumption and the emission of pollutants. (author)

  14. A forecast of household ownership and use of alternative fuel vehicles: A multiple discrete-continuous choice approach

    Ahn, Jiwoon; Jeong, Gicheol; Kim, Yeonbae

    2008-01-01

    The paper analyzes how adding alternative fuel passenger cars to the market will affect patterns in demand for passenger cars. We use conjoint analysis and a multiple discrete-continuous choice model to estimate consumer preferences regarding alternative fuel vehicles, and based on the estimates we conduct a simulation to analyze changing rates of ownership and use of variously fueled passenger cars under the effect of the introduction of alternative fuel passenger cars. In addition, we estimate changes in overall fuel consumption and the emission of pollutants. The results show that gasoline-fueled cars will still be most consumers' first choice, but alternative fuel passenger cars will nevertheless compete and offer a substitute for the purchase and use of gasoline-fueled or diesel-fueled cars. Finally, results show that adding alternative fuel cars to the market would effectively lower gasoline and diesel fuel consumption and the emission of pollutants. (author)

  15. NEUROPHYSIOLOGY PARAMETERS IN DIAGNOSTICS OF MULTIPLE SCLEROSIS AND ACUTE DISSEMINATED ENCEPHALOMYELITIS IN CHILDREN

    V. B. Voitenkov

    2017-01-01

    Full Text Available Our research objective was to evaluate the importance of neurophysiological methods in diagnosing the state of visual, somatosensory and motor pathways condition in the early stages of multiple sclerosis (MS and acute disseminated encephalomyelitis (ADEM in children.Materials and methods. Twenty-four children with a debut of multiple sclerosis, 15 children with debute of acute disseminated encephalomyelitis and 20 neurologically healthy children of the comparison group were examined. All patients were evaluated by neurologist, brain MRI and CSF analysis (isoelectrofocusing to oligoclonal IgG, oligoclonal bands test, visual evoked potentials (VEP, transcranial magnetic stimulation (TMS and somatosensory evoked potentials (SSEP.Results. In children with MS asymmetry of the conduction along the motor pathways on the spinal level was higher than in patients with ADEM and controls, functional state of somatosensory cortex neurons was lower and conduction along somatosensory pathways on the spinal level was slower – all differences significant. According to the visual evoked potentials, in more than half of the cases, there was an increase in the latency of the P100 peak. Also in MS group there was a significant disruption of the visual pathway in 54% of the cases. Neurophysiological changes in 58% of cases were demyelinating, and violations of the axonal type occurred in 37% of cases.Conclusions. Neurophysiological diagnostic methods such as transcranial magnetic stimulation, visual evoked potentials, somatosensory evoked potentials are highly informative for the differential diagnosis of multiple sclerosis and acute disseminated encephalomyelitis. More pronounced spinal lesions in early stages of MS than in ADEM in children may be the cause of the neurophysiologic differences, and prevalence of the sensory system involvement at this stage may be the reason behind more extended SSEP abnormalities comparing with TMS. VEP changes may reflect primary

  16. The development and validation of a two-tiered multiple-choice instrument to identify alternative conceptions in earth science

    Mangione, Katherine Anna

    This study was to determine reliability and validity for a two-tiered, multiple- choice instrument designed to identify alternative conceptions in earth science. Additionally, this study sought to identify alternative conceptions in earth science held by preservice teachers, to investigate relationships between self-reported confidence scores and understanding of earth science concepts, and to describe relationships between content knowledge and alternative conceptions and planning instruction in the science classroom. Eighty-seven preservice teachers enrolled in the MAT program participated in this study. Sixty-eight participants were female, twelve were male, and seven chose not to answer. Forty-seven participants were in the elementary certification program, five were in the middle school certification program, and twenty-nine were pursuing secondary certification. Results indicate that the two-tiered, multiple-choice format can be a reliable and valid method for identifying alternative conceptions. Preservice teachers in all certification areas who participated in this study may possess common alternative conceptions previously identified in the literature. Alternative conceptions included: all rivers flow north to south, the shadow of the Earth covers the Moon causing lunar phases, the Sun is always directly overhead at noon, weather can be predicted by animal coverings, and seasons are caused by the Earth's proximity to the Sun. Statistical analyses indicated differences, however not all of them significant, among all subgroups according to gender and certification area. Generally males outperformed females and preservice teachers pursuing middle school certification had higher scores on the questionnaire followed by those obtaining secondary certification. Elementary preservice teachers scored the lowest. Additionally, self-reported scores of confidence in one's answers and understanding of the earth science concept in question were analyzed. There was a

  17. Analysis of the residential location choice and household energy consumption behavior by incorporating multiple self-selection effects

    Yu Biying; Junyi Zhang; Fujiwara, Akimasa

    2012-01-01

    It is expected that the residential location choice and household energy consumption behavior might correlate with each other. Besides, due to the existence of self-selection effects, the observed inter-relationship between them might be the spurious result of the fact that some unobserved variables are causing both. These concerns motivate us to (1) consider residential location choice and household energy consumption behavior (for both in-home appliances and out-of-home cars) simultaneously and, (2) explicitly control self-selection effects so as to capture a relatively true effect of land-use policy on household energy consumption behavior. An integrated model termed as joint mixed Multinomial Logit-Multiple Discrete-Continuous Extreme Value model is presented here to identify the sensitivity of household energy consumption to land use policy by considering multiple self-selection effects. The model results indicate that land-use policy do play a great role in changing Beijing residents’ energy consumption pattern, while the self-selection effects cannot be ignored when evaluating the effect of land-use policy. Based on the policy scenario design, it is found that increasing recreational facilities and bus lines in the neighborhood can greatly promote household's energy-saving behavior. Additionally, the importance of “soft policy” and package policy is also emphasized in the context of Beijing. - Highlights: ► Representing residential choice and household energy consumption behavior jointly. ► Land use policy is found effective to control the household energy use in Beijing. ► Multiple self-selection effects are posed to get the true effect of land use policy. ► Significant self-selection effects call an attention to the soft policy in Beijing. ► The necessity of package policy on saving Beijing residents’ energy use is confirmed.

  18. Validation and analysis of the coupled multiple response Colorado upper-division electrostatics diagnostic

    Bethany R. Wilcox

    2015-11-01

    Full Text Available Standardized conceptual assessment represents a widely used tool for educational researchers interested in student learning within the standard undergraduate physics curriculum. For example, these assessments are often used to measure student learning across educational contexts and instructional strategies. However, to support the large-scale implementation often required for cross-institutional testing, it is necessary for these instruments to have question formats that facilitate easy grading. Previously, we created a multiple-response version of an existing, validated, upper-division electrostatics diagnostic with the goal of increasing the instrument’s potential for large-scale implementation. Here, we report on the validity and reliability of this new version as an independent instrument. These findings establish the validity of the multiple-response version as measured by multiple test statistics including item difficulty, item discrimination, and internal consistency. Moreover, we demonstrate that the majority of student responses to the new version are internally consistent even when they are incorrect and provide an example of how the new format can be used to gain insight into student difficulties with specific content in electrostatics.

  19. Complement or Contamination: A Study of the Validity of Multiple-Choice Items when Assessing Reasoning Skills in Physics

    Anders Jönsson; David Rosenlund; Fredrik Alvén

    2017-01-01

    The purpose of this study is to investigate the validity of using multiple-choice (MC) items as a complement to constructed-response (CR) items when making decisions about student performance on reasoning tasks. CR items from a national test in physics have been reformulated into MC items and students’ reasoning skills have been analyzed in two substudies. In the first study, 12 students answered the MC items and were asked to explain their answers orally. In the second study, 102 students fr...

  20. To Show or Not to Show: The Effects of Item Stems and Answer Options on Performance on a Multiple-Choice Listening Comprehension Test

    Yanagawa, Kozo; Green, Anthony

    2008-01-01

    The purpose of this study is to examine whether the choice between three multiple-choice listening comprehension test formats results in any difference in listening comprehension test performance. The three formats entail (a) allowing test takers to preview both the question stem and answer options prior to listening; (b) allowing test takers to…

  1. Diagnostic significance of combined detention of multiple tumour markers in lung cancer

    Chen Yanming; Qiu Jianming

    2003-01-01

    Objective: To explore the diagnostic value of combined detection of multiple markers in the determination of lung cancer. Methods: Using enzyme-linked immunosorbent assay (ELISA), the serum CEA, CA19-9, CA125, CA15-3 was determined in eighty-six lung cancer patients, thirty benign lung disease patients and thirty healthy persons. Results; Serum concentrations of CEA, CA19-9, CA125 and CA15-3 were significantly higher in patents with lung cancer than that in the patients with benign lung disease patients and healthy persons. The single test sensitivity of CEA, CA19-9, CA125 and CA15-3 for diagnosis of lung cancer is 41.9%, 37.2%, 48.9%, 36% respectively; the combined test sensitivity is 94.2%. Conclusions: Assessing several tumour markers can help differentiating various histological type of lung cancer and increase the sensitivity

  2. [Revision of McDonald's new diagnostic criteria for multiple sclerosis].

    Wiendl, H; Kieseier, B C; Gold, R; Hohlfeld, R; Bendszus, M; Hartung, H-P

    2006-10-01

    In 2001, an international panel suggested new diagnostic criteria for multiple sclerosis (MS). These criteria integrate clinical, imaging (MRI), and paraclinical results in order to facilitate diagnosis. Since then, these so-called McDonald criteria have been broadly accepted and widely propagated. In the meantime a number of publications have dealt with the sensitivity and specificity for MS diagnosis and with implementing these new criteria in clinical practice. Based on these empirical values and newer data on MS, an international expert group recently proposed a revision of the criteria. Substantial changes affect (1) MRI criteria for the dissemination of lesions over time, (2) the role of spinal cord lesions in the MRI and (3) diagnosis of primary progressive MS. In this article we present recent experiences with the McDonald and revised criteria.

  3. Cuttlefish dynamic camouflage: responses to substrate choice and integration of multiple visual cues.

    Allen, Justine J; Mäthger, Lydia M; Barbosa, Alexandra; Buresch, Kendra C; Sogin, Emilia; Schwartz, Jillian; Chubb, Charles; Hanlon, Roger T

    2010-04-07

    Prey camouflage is an evolutionary response to predation pressure. Cephalopods have extensive camouflage capabilities and studying them can offer insight into effective camouflage design. Here, we examine whether cuttlefish, Sepia officinalis, show substrate or camouflage pattern preferences. In the first two experiments, cuttlefish were presented with a choice between different artificial substrates or between different natural substrates. First, the ability of cuttlefish to show substrate preference on artificial and natural substrates was established. Next, cuttlefish were offered substrates known to evoke three main camouflage body pattern types these animals show: Uniform or Mottle (function by background matching); or Disruptive. In a third experiment, cuttlefish were presented with conflicting visual cues on their left and right sides to assess their camouflage response. Given a choice between substrates they might encounter in nature, we found no strong substrate preference except when cuttlefish could bury themselves. Additionally, cuttlefish responded to conflicting visual cues with mixed body patterns in both the substrate preference and split substrate experiments. These results suggest that differences in energy costs for different camouflage body patterns may be minor and that pattern mixing and symmetry may play important roles in camouflage.

  4. The impact of two multiple-choice question formats on the problem-solving strategies used by novices and experts.

    Coderre, Sylvain P; Harasym, Peter; Mandin, Henry; Fick, Gordon

    2004-11-05

    Pencil-and-paper examination formats, and specifically the standard, five-option multiple-choice question, have often been questioned as a means for assessing higher-order clinical reasoning or problem solving. This study firstly investigated whether two paper formats with differing number of alternatives (standard five-option and extended-matching questions) can test problem-solving abilities. Secondly, the impact of the alternatives number on psychometrics and problem-solving strategies was examined. Think-aloud protocols were collected to determine the problem-solving strategy used by experts and non-experts in answering Gastroenterology questions, across the two pencil-and-paper formats. The two formats demonstrated equal ability in testing problem-solving abilities, while the number of alternatives did not significantly impact psychometrics or problem-solving strategies utilized. These results support the notion that well-constructed multiple-choice questions can in fact test higher order clinical reasoning. Furthermore, it can be concluded that in testing clinical reasoning, the question stem, or content, remains more important than the number of alternatives.

  5. Force Concept Inventory-Based Multiple-Choice Test for Investigating Students' Representational Consistency

    Nieminen, Pasi; Savinainen, Antti; Viiri, Jouni

    2010-01-01

    This study investigates students' ability to interpret multiple representations consistently (i.e., representational consistency) in the context of the force concept. For this purpose we developed the Representational Variant of the Force Concept Inventory (R-FCI), which makes use of nine items from the 1995 version of the Force Concept Inventory…

  6. A multiple-choice knapsack based algorithm for CDMA downlink rate differentiation under uplink coverage restrictions

    Endrayanto, A.I.; Bumb, A.F.; Boucherie, Richardus J.

    2004-01-01

    This paper presents an analytical model for downlink rate allocation in Code Division Multiple Access (CDMA) mobile networks. By discretizing the coverage area into small segments, the transmit power requirements are characterized via a matrix representation that separates user and system

  7. Achievement, Motivation, and Educational Choices: A Longitudinal Study of Expectancy and Value Using a Multiplicative Perspective

    Guo, Jiesi; Parker, Philip D.; Marsh, Herbert W.; Morin, Alexandre J. S.

    2015-01-01

    Drawing on the expectancy-value model, the present study explored individual and gender differences in university entry and selection of educational pathway (e.g., science, technology, engineering, and mathematics [STEM] course selection). In particular, we examined the multiplicative effects of expectancy and task values on educational outcomes…

  8. Employee choice of a high-deductible health plan across multiple employers.

    Lave, Judith R; Men, Aiju; Day, Brian T; Wang, Wei; Zhang, Yuting

    2011-02-01

    To determine factors associated with selecting a high-deductible health plan (HDHP) rather than a preferred provider plan (PPO) and to examine switching and market segmentation after initial selection. Claims and benefit information for 2005-2007 from nine employers in western Pennsylvania first offering HDHP in 2006. We examined plan growth over time, used logistic regression to determine factors associated with choosing an HDHP, and examined the distribution of healthy and sick members across plan types. We linked employees with their dependents to determine family-level variables. We extracted risk scores, covered charges, employee age, and employee gender from claims data. We determined census-level race, education, and income information. Health status, gender, race, and education influenced the type of individual and family policies chosen. In the second year the HDHP was offered, few employees changed plans. Risk segmentation between HDHPs and PPOs existed, but it did not increase. When given a choice, those who are healthier are more likely to select an HDHP leading to risk segmentation. Risk segmentation did not increase in the second year that HDHPs were offered. © Health Research and Educational Trust.

  9. Coordinating supplier-retailer using multiple common replenishment epochs with retailers’ choices

    Juhwen Hwang

    2013-06-01

    Full Text Available Purpose: Provide a coordination strategy using multiple common replenishment epochs (MCRE for a single-supplier multi-retailer supply chain. Design/methodology/approach: The demand of a product occurs only with a group of heterogeneous and independent retailers with constant rates, whereas all their order requests are fulfilled by the supplier. The supplier decides a set of MCREs with general price and extra bonus to entice the retailers to join any one of the MCREs, or to let them remain with their original order time epochs. A retailer is willing to participate in a CRE as long as the retailer’s cost increase is within its tolerance. This paper provide a mixed integer programming to determine the MCRE strategies in order to minimize the total costs of the supplier. Findings: The results illustrate that MCRE model provided in the paper can generate a better replenishment coordination scheme than single CRE models. Practical implications: Replenishment coordination is one of the most important mechanisms to improve the efficiency in supply chains, e.g., chain convenience stores in the modern retail industry. Originality/value: This is a follow-up research on Joint Economic Lot Size (JELS models with a focus on multiple retailers with their replenishment coordination.

  10. When no choice of embryos exists, the multiple pregnancy risk is still high.

    Wong, V V

    2012-10-01

    Multiple pregnancies arising from assisted reproduction are known to be associated with increased medical, psychological, economical and social risks. If only two embryos develop after culture, how should the couple be counselled in relation to the risk of multiple pregnancy? We performed a retrospective review of all IVF\\/ICSI treatments performed between 1 January 2005 and 31 December 2007, that resulted in double embryos transfer (DET). We identified 623 cycles with a fortuitous DET (Group I) and 635 cycles with an elective DET (Group II). Group II were significantly more likely to have twins when compared with Group I, irrespective of age. Twin rates in Group I were higher in IVF compared with ICSI; 33.3% vs 16.6% in < 35 years old and 16.2% vs 7.6% in 35-40 years old. Therefore, single embryo transfer should be considered for IVF patients below 35 years old, even if only two good quality embryos are available.

  11. Development and Preliminary Testing of the Food Choice Priorities Survey (FCPS): Assessing the Importance of Multiple Factors on College Students' Food Choices.

    Vilaro, Melissa J; Zhou, Wenjun; Colby, Sarah E; Byrd-Bredbenner, Carol; Riggsbee, Kristin; Olfert, Melissa D; Barnett, Tracey E; Mathews, Anne E

    2017-12-01

    Understanding factors that influence food choice may help improve diet quality. Factors that commonly affect adults' food choices have been described, but measures that identify and assess food choice factors specific to college students are lacking. This study developed and tested the Food Choice Priorities Survey (FCPS) among college students. Thirty-seven undergraduates participated in two focus groups ( n = 19; 11 in the male-only group, 8 in the female-only group) and interviews ( n = 18) regarding typical influences on food choice. Qualitative data informed the development of survey items with a 5-point Likert-type scale (1 = not important, 5 = extremely important). An expert panel rated FCPS items for clarity, relevance, representativeness, and coverage using a content validity form. To establish test-retest reliability, 109 first-year college students completed the 14-item FCPS at two time points, 0-48 days apart ( M = 13.99, SD = 7.44). Using Cohen's weighted κ for responses within 20 days, 11 items demonstrated moderate agreement and 3 items had substantial agreement. Factor analysis revealed a three-factor structure (9 items). The FCPS is designed for college students and provides a way to determine the factors of greatest importance regarding food choices among this population. From a public health perspective, practical applications include using the FCPS to tailor health communications and behavior change interventions to factors most salient for food choices of college students.

  12. A simple test of choice stepping reaction time for assessing fall risk in people with multiple sclerosis.

    Tijsma, Mylou; Vister, Eva; Hoang, Phu; Lord, Stephen R

    2017-03-01

    Purpose To determine (a) the discriminant validity for established fall risk factors and (b) the predictive validity for falls of a simple test of choice stepping reaction time (CSRT) in people with multiple sclerosis (MS). Method People with MS (n = 210, 21-74y) performed the CSRT, sensorimotor, balance and neuropsychological tests in a single session. They were then followed up for falls using monthly fall diaries for 6 months. Results The CSRT test had excellent discriminant validity with respect to established fall risk factors. Frequent fallers (≥3 falls) performed significantly worse in the CSRT test than non-frequent fallers (0-2 falls). With the odds of suffering frequent falls increasing 69% with each SD increase in CSRT (OR = 1.69, 95% CI: 1.27-2.26, p = falls in people with MS. This test may prove useful in documenting longitudinal changes in fall risk in relation to MS disease progression and effects of interventions. Implications for rehabilitation Good choice stepping reaction time (CSRT) is required for maintaining balance. A simple low-tech CSRT test has excellent discriminative and predictive validity in relation to falls in people with MS. This test may prove useful documenting longitudinal changes in fall risk in relation to MS disease progression and effects of interventions.

  13. [Diagnostic and evolutionary profile of multiple myeloma in Senegal: monocentric study conducted from 2005 to 2016].

    Fall, Seynabou; Dieng, Fatma; Diouf, Coumba; Djiba, Boundia; Ndao, Awa Cheikh; Ndiaye, Fatou Samba Diago

    2017-01-01

    Accessibility to innovative multiple myeloma therapies is limited in sub-Saharan Africa. This study aimed to describe the diagnostic and evolutionary features observed during treatment of our patients with myeloma. We conducted a retrospective, descriptive, analytical study (2005 - 2016) of patients with myeloma included in the study based on International Myeloma Working Group (IMWG) Criteria (2003,2014) at the Hopital Aristide Le Dantec (Senegal). We collected data from 136 medical records (69 men, 67 women) of patients with an average age of 59 years ± 10.1 years, who were less than 65 years of age in 69.1% of cases. Tell-tale signs included bone pain (96.3%), renal failure (36.8%), infection (23.5%), pathological fracture (17.6%), spinal cord compression (16.9%) and malignant hypercalcaemia (16.2%). Isotopic antiglobulin test showed that anti-IgG could be detected in 61.3% of cases and Kappa in 65% of cases. Patients were classified stage III (59.4%) and I-II (40.6%)of the index staging system. The median survival of patients under conventional traitement (Méphalan-Prédnisone: 67.6%, innovative: 5.9%) was 20 months (1-78 months). Survival rates are better in the absence of neurological and infectious complications and for patients with score I-II of the index Staging System. In our study, multiple myeloma was frequently diagnosed before age 65, at advanced stage of tumor mass. Early detection and access to adequate therapies could improve overall survival.

  14. Comparing Item Performance on Three- Versus Four-Option Multiple Choice Questions in a Veterinary Toxicology Course.

    Royal, Kenneth; Dorman, David

    2018-06-09

    The number of answer options is an important element of multiple-choice questions (MCQs). Many MCQs contain four or more options despite the limited literature suggesting that there is little to no benefit beyond three options. The purpose of this study was to evaluate item performance on 3-option versus 4-option MCQs used in a core curriculum course in veterinary toxicology at a large veterinary medical school in the United States. A quasi-experimental, crossover design was used in which students in each class were randomly assigned to take one of two versions (A or B) of two major exams. Both the 3-option and 4-option MCQs resulted in similar psychometric properties. The findings of our study support earlier research in other medical disciplines and settings that likewise concluded there was no significant change in the psychometric properties of three option MCQs when compared to the traditional MCQs with four or more options.

  15. Use of flawed multiple-choice items by the New England Journal of Medicine for continuing medical education.

    Stagnaro-Green, Alex S; Downing, Steven M

    2006-09-01

    Physicians in the United States are required to complete a minimum number of continuing medical education (CME) credits annually. The goal of CME is to ensure that physicians maintain their knowledge and skills throughout their medical career. The New England Journal of Medicine (NEJM) provides its readers with the opportunity to obtain weekly CME credits. Deviation from established item-writing principles may result in a decrease in validity evidence for tests. This study evaluated the quality of 40 NEJM MCQs using the standard evidence-based principles of effective item writing. Each multiple-choice item reviewed had at least three item flaws, with a mean of 5.1 and a range of 3 to 7. The results of this study demonstrate that the NEJM uses flawed MCQs in its weekly CME program.

  16. A Novel Multiple Choice Question Generation Strategy: Alternative Uses for Controlled Vocabulary Thesauri in Biomedical-Sciences Education.

    Lopetegui, Marcelo A; Lara, Barbara A; Yen, Po-Yin; Çatalyürek, Ümit V; Payne, Philip R O

    2015-01-01

    Multiple choice questions play an important role in training and evaluating biomedical science students. However, the resource intensive nature of question generation limits their open availability, reducing their contribution to evaluation purposes mainly. Although applied-knowledge questions require a complex formulation process, the creation of concrete-knowledge questions (i.e., definitions, associations) could be assisted by the use of informatics methods. We envisioned a novel and simple algorithm that exploits validated knowledge repositories and generates concrete-knowledge questions by leveraging concepts' relationships. In this manuscript we present the development and validation of a prototype which successfully produced meaningful concrete-knowledge questions, opening new applications for existing knowledge repositories, potentially benefiting students of all biomedical sciences disciplines.

  17. The Prevalence of Multiple-Choice Testing in Registered Nurse Licensure-Qualifying Nursing Education Programs in New York State.

    Birkhead, Susan; Kelman, Glenda; Zittel, Barbara; Jatulis, Linnea

    The aim of this study was to describe nurse educators' use of multiple-choice questions (MCQs) in testing in registered nurse licensure-qualifying nursing education programs in New York State. This study was a descriptive correlational analysis of data obtained from surveying 1,559 nurse educators; 297 educators from 61 institutions responded (response rate [RR] = 19 percent), yielding a final cohort of 200. MCQs were reported to comprise a mean of 81 percent of questions on a typical test. Baccalaureate program respondents were equally likely to use MCQs as associate degree program respondents (p > .05) but were more likely to report using other methods of assessing student achievement to construct course grades (p < .01). Both groups reported little use of alternate format-type questions. Respondent educators reported substantial reliance upon the use of MCQs, corroborating the limited data quantifying the prevalence of use of MCQ tests in licensure-qualifying nursing education programs.

  18. Comparison between three option, four option and five option multiple choice question tests for quality parameters: A randomized study.

    Vegada, Bhavisha; Shukla, Apexa; Khilnani, Ajeetkumar; Charan, Jaykaran; Desai, Chetna

    2016-01-01

    Most of the academic teachers use four or five options per item of multiple choice question (MCQ) test as formative and summative assessment. Optimal number of options in MCQ item is a matter of considerable debate among academic teachers of various educational fields. There is a scarcity of the published literature regarding the optimum number of option in each item of MCQ in the field of medical education. To compare three options, four options, and five options MCQs test for the quality parameters - reliability, validity, item analysis, distracter analysis, and time analysis. Participants were 3 rd semester M.B.B.S. students. Students were divided randomly into three groups. Each group was given one set of MCQ test out of three options, four options, and five option randomly. Following the marking of the multiple choice tests, the participants' option selections were analyzed and comparisons were conducted of the mean marks, mean time, validity, reliability and facility value, discrimination index, point biserial value, distracter analysis of three different option formats. Students score more ( P = 0.000) and took less time ( P = 0.009) for the completion of three options as compared to four options and five options groups. Facility value was more ( P = 0.004) in three options group as compared to four and five options groups. There was no significant difference between three groups for the validity, reliability, and item discrimination. Nonfunctioning distracters were more in the four and five options group as compared to three option group. Assessment based on three option MCQs is can be preferred over four option and five option MCQs.

  19. Diagnostic mirrors for ITER: A material choice and the impact of erosion and deposition on their performance

    Litnovsky, A.; Wienhold, P.; Philipps, V.; Sergienko, G.; Schmitz, O.; Kirschner, A.; Kreter, A.; Droste, S.; Samm, U.; Mertens, Ph.; Donne, A.H.; Rudakov, D.; Allen, S.; Boivin, R.; McLean, A.; Stangeby, P.; West, W.; Wong, C.; Lipa, M.; Schunke, B.; De Temmerman, G.; Pitts, R.; Costley, A.; Voitsenya, V.; Vukolov, K.; Oelhafen, P.; Rubel, M.; Romanyuk, A.

    2007-01-01

    Metal mirrors will be implemented in about half of the ITER diagnostics. Mirrors in ITER will have to withstand radiation loads, erosion by charge-exchange neutrals, deposition of impurities, particle implantation and neutron irradiation. It is believed that the optical properties of diagnostic mirrors will be primarily influenced by erosion and deposition. A solution is needed for optimal performance of mirrors in ITER throughout the entire lifetime of the machine. A multi-machine research on diagnostic mirrors is currently underway in fusion facilities at several institutions and laboratories worldwide. Among others, dedicated investigations of ITER-candidate mirror materials are ongoing in Tore-Supra, TEXTOR, DIII-D, TCV, T-10 and JET. Laboratory studies are underway at IPP Kharkov (Ukraine), Kurchatov Institute (Russia) and the University of Basel (Switzerland). An overview of current research on diagnostic mirrors along with an outlook on future investigations is the subject of this paper

  20. Quantitative Analysis of Complex Multiple-Choice Items in Science Technology and Society: Item Scaling

    Ángel Vázquez Alonso

    2005-05-01

    Full Text Available The scarce attention to assessment and evaluation in science education research has been especially harmful for Science-Technology-Society (STS education, due to the dialectic, tentative, value-laden, and controversial nature of most STS topics. To overcome the methodological pitfalls of the STS assessment instruments used in the past, an empirically developed instrument (VOSTS, Views on Science-Technology-Society have been suggested. Some methodological proposals, namely the multiple response models and the computing of a global attitudinal index, were suggested to improve the item implementation. The final step of these methodological proposals requires the categorization of STS statements. This paper describes the process of categorization through a scaling procedure ruled by a panel of experts, acting as judges, according to the body of knowledge from history, epistemology, and sociology of science. The statement categorization allows for the sound foundation of STS items, which is useful in educational assessment and science education research, and may also increase teachers’ self-confidence in the development of the STS curriculum for science classrooms.

  1. Grey Matter Atrophy in Multiple Sclerosis: Clinical Interpretation Depends on Choice of Analysis Method.

    Veronica Popescu

    Full Text Available Studies disagree on the location of grey matter (GM atrophy in the multiple sclerosis (MS brain.To examine the consistency between FSL, FreeSurfer, SPM for GM atrophy measurement (for volumes, patient/control discrimination, and correlations with cognition.127 MS patients and 50 controls were included and cortical and deep grey matter (DGM volumetrics were performed. Consistency of volumes was assessed with Intraclass Correlation Coefficient/ICC. Consistency of patients/controls discrimination was assessed with Cohen's d, t-tests, MANOVA and a penalized double-loop logistic classifier. Consistency of association with cognition was assessed with Pearson correlation coefficient and ANOVA. Voxel-based morphometry (SPM-VBM and FSL-VBM and vertex-wise FreeSurfer were used for group-level comparisons.The highest volumetry ICC were between SPM and FreeSurfer for cortical regions, and the lowest between SPM and FreeSurfer for DGM. The caudate nucleus and temporal lobes had high consistency between all software, while amygdala had lowest volumetric consistency. Consistency of patients/controls discrimination was largest in the DGM for all software, especially for thalamus and pallidum. The penalized double-loop logistic classifier most often selected the thalamus, pallidum and amygdala for all software. FSL yielded the largest number of significant correlations. DGM yielded stronger correlations with cognition than cortical volumes. Bilateral putamen and left insula volumes correlated with cognition using all methods.GM volumes from FreeSurfer, FSL and SPM are different, especially for cortical regions. While group-level separation between MS and controls is comparable, correlations between regional GM volumes and clinical/cognitive variables in MS should be cautiously interpreted.

  2. Optimizing the diagnostic power with gastric emptying scintigraphy at multiple time points

    Gajewski Byron J

    2011-05-01

    Full Text Available Abstract Background Gastric Emptying Scintigraphy (GES at intervals over 4 hours after a standardized radio-labeled meal is commonly regarded as the gold standard for diagnosing gastroparesis. The objectives of this study were: 1 to investigate the best time point and the best combination of multiple time points for diagnosing gastroparesis with repeated GES measures, and 2 to contrast and cross-validate Fisher's Linear Discriminant Analysis (LDA, a rank based Distribution Free (DF approach, and the Classification And Regression Tree (CART model. Methods A total of 320 patients with GES measures at 1, 2, 3, and 4 hour (h after a standard meal using a standardized method were retrospectively collected. Area under the Receiver Operating Characteristic (ROC curve and the rate of false classification through jackknife cross-validation were used for model comparison. Results Due to strong correlation and an abnormality in data distribution, no substantial improvement in diagnostic power was found with the best linear combination by LDA approach even with data transformation. With DF method, the linear combination of 4-h and 3-h increased the Area Under the Curve (AUC and decreased the number of false classifications (0.87; 15.0% over individual time points (0.83, 0.82; 15.6%, 25.3%, for 4-h and 3-h, respectively at a higher sensitivity level (sensitivity = 0.9. The CART model using 4 hourly GES measurements along with patient's age was the most accurate diagnostic tool (AUC = 0.88, false classification = 13.8%. Patients having a 4-h gastric retention value >10% were 5 times more likely to have gastroparesis (179/207 = 86.5% than those with ≤10% (18/113 = 15.9%. Conclusions With a mixed group of patients either referred with suspected gastroparesis or investigated for other reasons, the CART model is more robust than the LDA and DF approaches, capable of accommodating covariate effects and can be generalized for cross institutional applications, but

  3. An Online National Archive of Multiple-Choice Questions for Astro 101 and the Development of the Question Complexity Rubric

    Cormier, S.; Prather, E.; Brissenden, G.

    2011-09-01

    We are developing a national archive of multiple-choice questions for use in the Astronomy 101 classroom. These questions are intended to supplement an instructor's implementation of Think-Pair-Share or for their assessment purposes (i.e., exams and homework). We are also developing the Question Complexity Rubric (QCR) to guide members of the Astro 101 teaching and learning community in assisting us with hierarchically ranking questions in this archive based on their conceptual complexity. Using the QCR, a score is assigned to differentiate each question based on the cognitive steps necessary to comprehensively explain the reasoning pathway to the correct answer. The lowest QCR score is given to questions with a reasoning pathway requiring only declarative knowledge. The highest QCR score is given to questions with a reasoning pathway that requires multiple connected cognitive steps. When completed, the online question archive will provide users with the utility to 1) use the QCR to score questions 2) search for and download questions based on topic and/or QCR score, and 3) add their own questions to the archive. Stop by our poster to test your skills at determining question complexity by trying out the QCR with our sample questions.

  4. "None of the above" as a correct and incorrect alternative on a multiple-choice test: implications for the testing effect.

    Odegard, Timothy N; Koen, Joshua D

    2007-11-01

    Both positive and negative testing effects have been demonstrated with a variety of materials and paradigms (Roediger & Karpicke, 2006b). The present series of experiments replicate and extend the research of Roediger and Marsh (2005) with the addition of a "none-of-the-above" response option. Participants (n=32 in both experiments) read a set of passages, took an initial multiple-choice test, completed a filler task, and then completed a final cued-recall test (Experiment 1) or multiple-choice test (Experiment 2). Questions were manipulated on the initial multiple-choice test by adding a "none-of-the-above" response alternative (choice "E") that was incorrect ("E" Incorrect) or correct ("E" Correct). The results from both experiments demonstrated that the positive testing effect was negated when the "none-of-the-above" alternative was the correct response on the initial multiple-choice test, but was still present when the "none-of-the-above" alternative was an incorrect response.

  5. An assessment of functioning and non-functioning distractors in multiple-choice questions: a descriptive analysis

    Mohammed Ahmed M

    2009-07-01

    Full Text Available Abstract Background Four- or five-option multiple choice questions (MCQs are the standard in health-science disciplines, both on certification-level examinations and on in-house developed tests. Previous research has shown, however, that few MCQs have three or four functioning distractors. The purpose of this study was to investigate non-functioning distractors in teacher-developed tests in one nursing program in an English-language university in Hong Kong. Methods Using item-analysis data, we assessed the proportion of non-functioning distractors on a sample of seven test papers administered to undergraduate nursing students. A total of 514 items were reviewed, including 2056 options (1542 distractors and 514 correct responses. Non-functioning options were defined as ones that were chosen by fewer than 5% of examinees and those with a positive option discrimination statistic. Results The proportion of items containing 0, 1, 2, and 3 functioning distractors was 12.3%, 34.8%, 39.1%, and 13.8% respectively. Overall, items contained an average of 1.54 (SD = 0.88 functioning distractors. Only 52.2% (n = 805 of all distractors were functioning effectively and 10.2% (n = 158 had a choice frequency of 0. Items with more functioning distractors were more difficult and more discriminating. Conclusion The low frequency of items with three functioning distractors in the four-option items in this study suggests that teachers have difficulty developing plausible distractors for most MCQs. Test items should consist of as many options as is feasible given the item content and the number of plausible distractors; in most cases this would be three. Item analysis results can be used to identify and remove non-functioning distractors from MCQs that have been used in previous tests.

  6. An assessment of functioning and non-functioning distractors in multiple-choice questions: a descriptive analysis.

    Tarrant, Marie; Ware, James; Mohammed, Ahmed M

    2009-07-07

    Four- or five-option multiple choice questions (MCQs) are the standard in health-science disciplines, both on certification-level examinations and on in-house developed tests. Previous research has shown, however, that few MCQs have three or four functioning distractors. The purpose of this study was to investigate non-functioning distractors in teacher-developed tests in one nursing program in an English-language university in Hong Kong. Using item-analysis data, we assessed the proportion of non-functioning distractors on a sample of seven test papers administered to undergraduate nursing students. A total of 514 items were reviewed, including 2056 options (1542 distractors and 514 correct responses). Non-functioning options were defined as ones that were chosen by fewer than 5% of examinees and those with a positive option discrimination statistic. The proportion of items containing 0, 1, 2, and 3 functioning distractors was 12.3%, 34.8%, 39.1%, and 13.8% respectively. Overall, items contained an average of 1.54 (SD = 0.88) functioning distractors. Only 52.2% (n = 805) of all distractors were functioning effectively and 10.2% (n = 158) had a choice frequency of 0. Items with more functioning distractors were more difficult and more discriminating. The low frequency of items with three functioning distractors in the four-option items in this study suggests that teachers have difficulty developing plausible distractors for most MCQs. Test items should consist of as many options as is feasible given the item content and the number of plausible distractors; in most cases this would be three. Item analysis results can be used to identify and remove non-functioning distractors from MCQs that have been used in previous tests.

  7. Measuring University students' understanding of the greenhouse effect - a comparison of multiple-choice, short answer and concept sketch assessment tools with respect to students' mental models

    Gold, A. U.; Harris, S. E.

    2013-12-01

    The greenhouse effect comes up in most discussions about climate and is a key concept related to climate change. Existing studies have shown that students and adults alike lack a detailed understanding of this important concept or might hold misconceptions. We studied the effectiveness of different interventions on University-level students' understanding of the greenhouse effect. Introductory level science students were tested for their pre-knowledge of the greenhouse effect using validated multiple-choice questions, short answers and concept sketches. All students participated in a common lesson about the greenhouse effect and were then randomly assigned to one of two lab groups. One group explored an existing simulation about the greenhouse effect (PhET-lesson) and the other group worked with absorption spectra of different greenhouse gases (Data-lesson) to deepen the understanding of the greenhouse effect. All students completed the same assessment including multiple choice, short answers and concept sketches after participation in their lab lesson. 164 students completed all the assessments, 76 completed the PhET lesson and 77 completed the data lesson. 11 students missed the contrasting lesson. In this presentation we show the comparison between the multiple-choice questions, short answer questions and the concept sketches of students. We explore how well each of these assessment types represents student's knowledge. We also identify items that are indicators of the level of understanding of the greenhouse effect as measured in correspondence of student answers to an expert mental model and expert responses. Preliminary data analysis shows that student who produce concept sketch drawings that come close to expert drawings also choose correct multiple-choice answers. However, correct multiple-choice answers are not necessarily an indicator that a student produces an expert-like correlating concept sketch items. Multiple-choice questions that require detailed

  8. Multiple Personality Domains in Relation to Occupational Choice and Performance among Established Teachers. Research Report. ETS RR-04-41

    Emmerich, Walter; Rock, Donald A.; Trapani, Catherine S.

    2004-01-01

    Does personality impact differently on occupational choice and occupational performance? In a study of established teachers, interests, the Five-Factor Model, and attributions were examined in relation to occupational choice and performance. Attributions were assessed using a new instrument designed for teachers. Choice of teaching specialty was…

  9. Efficiency of the Clinical Veterinary Diagnostic Practices and Drug Choices for Infectious Diseases in Livestock in Bangladesh

    Haider, Najmul; Khan, S. U.; Islam, A.

    2017-01-01

    ) and foot-and-mouth disease (FMD). We conducted the study from May 2009 to August 2010 in three government veterinary hospitals where veterinarians collected samples from sick livestock and recorded the presumptive diagnosis on the basis of clinical presentations. Samples were tested for PPR and FMD using...... competency of these veterinarians needs to be improved and access to laboratory diagnostic facilities could help veterinarians to improve the diagnostics and outcomes. The rational use of antibiotics by veterinarians in animals must be ensured....... validation process for PPR (kappa: 0.25) and FMD (kappa 0.36) indicated a poor performance of the presumptive diagnoses. Most of the animals (93%) were treated with antibiotics. Our findings indicate that veterinarians can detect animals not infected with FMD or PPR but miss the true cases. The clinical...

  10. The Question Complexity Rubric: Development and Application for a National Archive of Astro 101 Multiple-Choice Questions

    Cormier, Sebastien; Prather, E. E.; Brissenden, G.; Collaboration of Astronomy Teaching Scholars CATS

    2011-01-01

    For the last two years we have been developing an online national archive of multiple-choice questions for use in the Astro 101 classroom. These questions are intended to either supplement an instructor's implementation of Think-Pair-Share or be used for assessment purposes (i.e. exams and homework). In this talk we will describe the development, testing and implementation of the Question Complexity Rubric (QCR), which is designed to guide the ranking of questions in this archive based on their conceptual complexity. Using the QCR, a score is assigned to differentiate each question based on the cognitive steps necessary to comprehensively explain the reasoning pathway to the correct answer. The lowest QCR score is given to questions with a reasoning pathway requiring only declarative knowledge whereas the highest QCR score is given to questions that require multiple pathways of multi-step reasoning. When completed, the online question archive will provide users with the utility to 1) search for and download questions based on subject and average QCR score, 2) use the QCR to score questions, and 3) add their own questions to the archive. We will also discuss other potential applications of the QCR, such as how it informs our work in developing and testing of survey instruments by allowing us to calibrate the range of question complexity. This material is based upon work supported by the National Science Foundation under Grant No. 0715517, a CCLI Phase III Grant for the Collaboration of Astronomy Teaching Scholars (CATS). Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation.

  11. A comparative analysis of multiple-choice and student performance-task assessment in the high school biology classroom

    Cushing, Patrick Ryan

    This study compared the performance of high school students on laboratory assessments. Thirty-four high school students who were enrolled in the second semester of a regular biology class or had completed the biology course the previous semester participated in this study. They were randomly assigned to examinations of two formats, performance-task and traditional multiple-choice, from two content areas, using a compound light microscope and diffusion. Students were directed to think-aloud as they performed the assessments. Additional verbal data were obtained during interviews following the assessment. The tape-recorded narrative data were analyzed for type and diversity of knowledge and skill categories, and percentage of in-depth processing demonstrated. While overall mean scores on the assessments were low, elicited statements provided additional insight into student cognition. Results indicated that a greater diversity of knowledge and skill categories was elicited by the two microscope assessments and by the two performance-task assessments. In addition, statements demonstrating in-depth processing were coded most frequently in narratives elicited during clinical interviews following the diffusion performance-task assessment. This study calls for individual teachers to design authentic assessment practices and apply them to daily classroom routines. Authentic assessment should be an integral part of the learning process and not merely an end result. In addition, teachers are encouraged to explicitly identify and model, through think-aloud methods, desired cognitive behaviors in the classroom.

  12. The Social Attribution Task-Multiple Choice (SAT-MC): A Psychometric and Equivalence Study of an Alternate Form.

    Johannesen, Jason K; Lurie, Jessica B; Fiszdon, Joanna M; Bell, Morris D

    2013-01-01

    The Social Attribution Task-Multiple Choice (SAT-MC) uses a 64-second video of geometric shapes set in motion to portray themes of social relatedness and intentions. Considered a test of "Theory of Mind," the SAT-MC assesses implicit social attribution formation while reducing verbal and basic cognitive demands required of other common measures. We present a comparability analysis of the SAT-MC and the new SAT-MC-II, an alternate form created for repeat testing, in a university sample (n = 92). Score distributions and patterns of association with external validation measures were nearly identical between the two forms, with convergent and discriminant validity supported by association with affect recognition ability and lack of association with basic visual reasoning. Internal consistency of the SAT-MC-II was superior (alpha = .81) to the SAT-MC (alpha = .56). Results support the use of SAT-MC and new SAT-MC-II as equivalent test forms. Demonstrating relatively higher association to social cognitive than basic cognitive abilities, the SAT-MC may provide enhanced sensitivity as an outcome measure of social cognitive intervention trials.

  13. More than the Verbal Stimulus Matters: Visual Attention in Language Assessment for People with Aphasia Using Multiple-Choice Image Displays

    Heuer, Sabine; Ivanova, Maria V.; Hallowell, Brooke

    2017-01-01

    Purpose: Language comprehension in people with aphasia (PWA) is frequently evaluated using multiple-choice displays: PWA are asked to choose the image that best corresponds to the verbal stimulus in a display. When a nontarget image is selected, comprehension failure is assumed. However, stimulus-driven factors unrelated to linguistic…

  14. Incorporating Multiple-Choice Questions into an AACSB Assurance of Learning Process: A Course-Embedded Assessment Application to an Introductory Finance Course

    Santos, Michael R.; Hu, Aidong; Jordan, Douglas

    2014-01-01

    The authors offer a classification technique to make a quantitative skills rubric more operational, with the groupings of multiple-choice questions to match the student learning levels in knowledge, calculation, quantitative reasoning, and analysis. The authors applied this classification technique to the mid-term exams of an introductory finance…

  15. Dynamic Testing of Analogical Reasoning in 5- to 6-Year-Olds : Multiple-Choice Versus Constructed-Response Training Items

    Stevenson, C.E.; Heiser, W.J.; Resing, W.C.M.

    2016-01-01

    Multiple-choice (MC) analogy items are often used in cognitive assessment. However, in dynamic testing, where the aim is to provide insight into potential for learning and the learning process, constructed-response (CR) items may be of benefit. This study investigated whether training with CR or MC

  16. Predicting Social and Communicative Ability in School-Age Children with Autism Spectrum Disorder: A Pilot Study of the Social Attribution Task, Multiple Choice

    Burger-Caplan, Rebecca; Saulnier, Celine; Jones, Warren; Klin, Ami

    2016-01-01

    The Social Attribution Task, Multiple Choice is introduced as a measure of implicit social cognitive ability in children, addressing a key challenge in quantification of social cognitive function in autism spectrum disorder, whereby individuals can often be successful in explicit social scenarios, despite marked social adaptive deficits. The…

  17. Does the think-aloud protocol reflect thinking? Exploring functional neuroimaging differences with thinking (answering multiple choice questions) versus thinking aloud

    Durning, S.J.; Artino, A.R.; Beckman, T.J.; Graner, J.; Vleuten, C.P.M. van der; Holmboe, E.; Schuwirth, L.

    2013-01-01

    Background: Whether the think-aloud protocol is a valid measure of thinking remains uncertain. Therefore, we used functional magnetic resonance imaging (fMRI) to investigate potential functional neuroanatomic differences between thinking (answering multiple-choice questions in real time) versus

  18. Performance of Men and Women on Multiple-Choice and Constructed-Response Tests for Beginning Teachers. Research Report. ETS RR-04-48

    Livingston, Samuel A.; Rupp, Stacie L.

    2004-01-01

    Some previous research results imply that women tend to perform better, relative to men, on constructed-response (CR) tests than on multiple-choice (MC) tests in the same subjects. An analysis of data from several tests used in the licensing of beginning teachers supported this hypothesis, to varying degrees, in most of the tests investigated. The…

  19. Post-Graduate Student Performance in "Supervised In-Class" vs. "Unsupervised Online" Multiple Choice Tests: Implications for Cheating and Test Security

    Ladyshewsky, Richard K.

    2015-01-01

    This research explores differences in multiple choice test (MCT) scores in a cohort of post-graduate students enrolled in a management and leadership course. A total of 250 students completed the MCT in either a supervised in-class paper and pencil test or an unsupervised online test. The only statistically significant difference between the nine…

  20. Dynamic Testing of Analogical Reasoning in 5- to 6-Year-Olds: Multiple-Choice versus Constructed-Response Training Items

    Stevenson, Claire E.; Heiser, Willem J.; Resing, Wilma C. M.

    2016-01-01

    Multiple-choice (MC) analogy items are often used in cognitive assessment. However, in dynamic testing, where the aim is to provide insight into potential for learning and the learning process, constructed-response (CR) items may be of benefit. This study investigated whether training with CR or MC items leads to differences in the strategy…

  1. Multiple-Choice Testing Using Immediate Feedback--Assessment Technique (IF AT®) Forms: Second-Chance Guessing vs. Second-Chance Learning?

    Merrel, Jeremy D.; Cirillo, Pier F.; Schwartz, Pauline M.; Webb, Jeffrey A.

    2015-01-01

    Multiple choice testing is a common but often ineffective method for evaluating learning. A newer approach, however, using Immediate Feedback Assessment Technique (IF AT®, Epstein Educational Enterprise, Inc.) forms, offers several advantages. In particular, a student learns immediately if his or her answer is correct and, in the case of an…

  2. Measuring the Consistency in Change in Hepatitis B Knowledge among Three Different Types of Tests: True/False, Multiple Choice, and Fill in the Blanks Tests.

    Sahai, Vic; Demeyere, Petra; Poirier, Sheila; Piro, Felice

    1998-01-01

    The recall of information about Hepatitis B demonstrated by 180 seventh graders was tested with three test types: (1) short-answer; (2) true/false; and (3) multiple-choice. Short answer testing was the most reliable. Suggestions are made for the use of short-answer tests in evaluating student knowledge. (SLD)

  3. [The point-digital interpretation and the choice of the dermatoglyphic patterns on human fingers for diagnostics of consanguineous relationship].

    Zvyagin, V N; Rakitin, V A; Fomina, E E

    The objective of the present study was the development of the point-digital model for the scaless interpretation of the dermatoglyphic papillary patterns on human fingers that would allow to comprehensively describe, in digital terms, the main characteristics of the traits and perform the quantitative assessment of the frequency of their inheritance. A specially developed computer program, D.glyphic. 7-14 was used to mark the dermatoglyphic patterns on the fingerprints obtained from 30 familial triplets (father + mother + child).The values of all the studied traits for kinship diagnostics were found by calculating the ratios of the sums of differences between the traits in the parent-parent pairs to those in the respective parent-child pairs. The algorithms for the point marking of the traits and reading out the digital information about them have been developed. The traditional dermatoglyphic patterns were selected and the novel ones applied for the use in the framework of the point-digital model for the interpretation of the for diagnostics of consanguineous relationship. The present experimental study has demonstrated the high level of inheritance of the selected traits and the possibility to develop the algorithms and computation techniques for the calculation of consanguineous relationship coefficients based on these traits.

  4. Diagnostic value of multiple tumor markers for patients with esophageal carcinoma.

    Zhang, Jun; Zhu, Zhenli; Liu, Yan; Jin, Xueyuan; Xu, Zhiwei; Yu, Qiuyan; Li, Ke

    2015-01-01

    Various studies assessing the diagnostic value of serum tumor markers in patients with esophageal cancer remain controversial. This study aims to comprehensively and quantitatively summarize the potential diagnostic value of 5 serum tumour markers in esophageal cancer. We systematically searched PubMed, Embase, Chinese National Knowledge Infrastructure (CNKI) and Chinese Biomedical Database (CBM), through February 28, 2013, without language restriction. Studies were assessed for quality using QUADAS (quality assessment of studies of diagnostic accuracy). The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were pooled separately and compared with overall accuracy measures using diagnostic odds ratios (DORs) and symmetric summary receiver operating characteristic (SROC) curves. Of 4391 studies initially identified, 44 eligible studies including five tumor markers met the inclusion criteria for the meta-analysis, while meta-analysis could not be conducted for 12 other tumor markers. Approximately 79.55% (35/44) of the included studies were of relatively high quality (QUADAS score≥7). The summary estimates of the positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) for diagnosing EC were as follows: CEA, 5.94/0.76/9.26; Cyfra21-1, 12.110.59/22.27; p53 antibody, 6.71/0.75/9.60; SCC-Ag, 7.66/0.68/12.41; and VEGF-C, 0.74/0.37/8.12. The estimated summary receiver operating characteristic curves showed that the performance of all five tumor markers was reasonable. The current evidence suggests that CEA, Cyfra21-1, p53, SCC-Ag and VEGF-C have a potential diagnostic value for esophageal carcinoma.

  5. Item and test analysis to identify quality multiple choice questions (MCQS from an assessment of medical students of Ahmedabad, Gujarat

    Sanju Gajjar

    2014-01-01

    Full Text Available Background: Multiple choice questions (MCQs are frequently used to assess students in different educational streams for their objectivity and wide reach of coverage in less time. However, the MCQs to be used must be of quality which depends upon its difficulty index (DIF I, discrimination index (DI and distracter efficiency (DE. Objective: To evaluate MCQs or items and develop a pool of valid items by assessing with DIF I, DI and DE and also to revise/ store or discard items based on obtained results. Settings: Study was conducted in a medical school of Ahmedabad. Materials and Methods: An internal examination in Community Medicine was conducted after 40 hours teaching during 1 st MBBS which was attended by 148 out of 150 students. Total 50 MCQs or items and 150 distractors were analyzed. Statistical Analysis: Data was entered and analyzed in MS Excel 2007 and simple proportions, mean, standard deviations, coefficient of variation were calculated and unpaired t test was applied. Results: Out of 50 items, 24 had "good to excellent" DIF I (31 - 60% and 15 had "good to excellent" DI (> 0.25. Mean DE was 88.6% considered as ideal/ acceptable and non functional distractors (NFD were only 11.4%. Mean DI was 0.14. Poor DI (< 0.15 with negative DI in 10 items indicates poor preparedness of students and some issues with framing of at least some of the MCQs. Increased proportion of NFDs (incorrect alternatives selected by < 5% students in an item decrease DE and makes it easier. There were 15 items with 17 NFDs, while rest items did not have any NFD with mean DE of 100%. Conclusion: Study emphasizes the selection of quality MCQs which truly assess the knowledge and are able to differentiate the students of different abilities in correct manner.

  6. Dual process theory and intermediate effect: are faculty and residents' performance on multiple-choice, licensing exam questions different?

    Dong, Ting; Durning, Steven J; Artino, Anthony R; van der Vleuten, Cees; Holmboe, Eric; Lipner, Rebecca; Schuwirth, Lambert

    2015-04-01

    Clinical reasoning is essential for the practice of medicine. Dual process theory conceptualizes reasoning as falling into two general categories: nonanalytic reasoning (pattern recognition) and analytic reasoning (active comparing and contrasting of alternatives). The debate continues regarding how expert performance develops and how individuals make the best use of analytic and nonanalytic processes. Several investigators have identified the unexpected finding that intermediates tend to perform better on licensing examination items than experts, which has been termed the "intermediate effect." We explored differences between faculty and residents on multiple-choice questions (MCQs) using dual process measures (both reading and answering times) to inform this ongoing debate. Faculty (board-certified internists; experts) and residents (internal medicine interns; intermediates) answered live licensing examination MCQs (U.S. Medical Licensing Examination Step 2 Clinical Knowledge and American Board of Internal Medicine Certifying Examination) while being timed. We conducted repeated analysis of variance to compare the 2 groups on average reading time, answering time, and accuracy on various types of items. Faculty and residents did not differ significantly in reading time [F (1,35) = 0.01, p = 0.93], answering time [F (1,35) = 0.60, p = 0.44], or accuracy [F (1,35) = 0.24, p = 0.63] regardless of easy or hard items. Dual process theory was not evidenced in this study. However, this lack of difference between faculty and residents may have been affected by the small sample size of participants and MCQs may not reflect how physicians made decisions in actual practice setting. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  7. A comparative study of students' performance in preclinical physiology assessed by multiple choice and short essay questions.

    Oyebola, D D; Adewoye, O E; Iyaniwura, J O; Alada, A R; Fasanmade, A A; Raji, Y

    2000-01-01

    This study was designed to compare the performance of medical students in physiology when assessed by multiple choice questions (MCQs) and short essay questions (SEQs). The study also examined the influence of factors such as age, sex, O/level grades and JAMB scores on performance in the MCQs and SEQs. A structured questionnaire was administered to 264 medical students' four months before the Part I MBBS examination. Apart from personal data of each student, the questionnaire sought information on the JAMB scores and GCE O' Level grades of each student in English Language, Biology, Chemistry, Physics and Mathematics. The physiology syllabus was divided into five parts and the students were administered separate examinations (tests) on each part. Each test consisted of MCQs and SEQs. The performance in MCQs and SEQs were compared. Also, the effects of JAMB scores and GCE O/level grades on the performance in both the MCQs and SEQs were assessed. The results showed that the students performed better in all MCQ tests than in the SEQs. JAMB scores and O' level English Language grade had no significant effect on students' performance in MCQs and SEQs. However O' level grades in Biology, Chemistry, Physics and Mathematics had significant effects on performance in MCQs and SEQs. Inadequate knowledge of physiology and inability to present information in a logical sequence are believed to be major factors contributing to the poorer performance in the SEQs compared with MCQs. In view of the finding of significant association between performance in MCQs and SEQs and GCE O/level grades in science subjects and mathematics, it was recommended that both JAMB results and the GCE results in the four O/level subjects above may be considered when selecting candidates for admission into the medical schools.

  8. The Use of Case Based Multiple Choice Questions for Assessing Large Group Teaching: Implications on Student's Learning

    Christina Donnelly

    2014-06-01

    Full Text Available The practice of assessments in third level education is extremely important and a rarely disputed part of the university curriculum as a method to demonstrate a student’s learning. However, assessments to test a student’s knowledge and level of understanding are challenging to apply given recent trends which are showing that student numbers are increasing, student demographics are wide ranging and resources are being stretched. As a result of these emerging challenges, lecturers are required to develop a comprehensive assessment to effectively demonstrate student learning, whilst efficiently managing large class sizes. One form of assessment which has been used for efficient assessment is multiple choice questions (MCQs; however this method has been criticised for encouraging surface learning, in comparison to other methods such as essays or case studies. This research explores the impact of blended assessment methods on student learning. This study adopts a rigorous three-staged qualitative methodology to capture third level lecturers’ and students’ perception to (1 the level of learning when using MCQs; (2 the level of learning when blended assessment in the form of case based MCQs are used. The findings illuminate the positive impact of cased based MCQs as students and lecturers suggest that it leads to a higher level of learning and deeper information processing over that of MCQs without case studies. 2 The implications of this research is that this type of assessment contributes to the current thinking within literature on the use of assessments methods, as well as the blending of assessment methods to reach a higher level of learning. It further serves to reinforce the belief that assessments are the greatest influence on students’ learning, and the requirement for both universities and lecturers to reflect on the best form of assessment to test students’ level of understanding, whilst also balancing the real challenges of

  9. Will a Short Training Session Improve Multiple-Choice Item-Writing Quality by Dental School Faculty? A Pilot Study.

    Dellinges, Mark A; Curtis, Donald A

    2017-08-01

    Faculty members are expected to write high-quality multiple-choice questions (MCQs) in order to accurately assess dental students' achievement. However, most dental school faculty members are not trained to write MCQs. Extensive faculty development programs have been used to help educators write better test items. The aim of this pilot study was to determine if a short workshop would result in improved MCQ item-writing by dental school faculty at one U.S. dental school. A total of 24 dental school faculty members who had previously written MCQs were randomized into a no-intervention group and an intervention group in 2015. Six previously written MCQs were randomly selected from each of the faculty members and given an item quality score. The intervention group participated in a training session of one-hour duration that focused on reviewing standard item-writing guidelines to improve in-house MCQs. The no-intervention group did not receive any training but did receive encouragement and an explanation of why good MCQ writing was important. The faculty members were then asked to revise their previously written questions, and these were given an item quality score. The item quality scores for each faculty member were averaged, and the difference from pre-training to post-training scores was evaluated. The results showed a significant difference between pre-training and post-training MCQ difference scores for the intervention group (p=0.04). This pilot study provides evidence that the training session of short duration was effective in improving the quality of in-house MCQs.

  10. Diagnostic accuracy of full-body linear X-ray scanning in multiple trauma patients in comparison to computed tomography

    Joeres, A.P.W.; Heverhagen, J.T.; Bonel, H. [Inselspital - University Hospital Bern (Switzerland). Univ. Inst. of Diagnostic, Interventional and Pediatric Radiology; Exadaktylos, A. [Inselspital - University Hospital Bern (Switzerland). Dept. of Emergency Medicine; Klink, T. [Inselspital - University Hospital Bern (Switzerland). Univ. Inst. of Diagnostic, Interventional and Pediatric Radiology; Wuerzburg Univ. (Germany). Inst. of Diagnostic and Interventional Radiology

    2016-02-15

    The purpose of this study was to evaluate the diagnostic accuracy of full-body linear X-ray scanning (LS) in multiple trauma patients in comparison to 128-multislice computed tomography (MSCT). 106 multiple trauma patients (female: 33; male: 73) were retrospectively included in this study. All patients underwent LS of the whole body, including extremities, and MSCT covering the neck, thorax, abdomen, and pelvis. The diagnostic accuracy of LS for the detection of fractures of the truncal skeleton and pneumothoraces was evaluated in comparison to MSCT by two observers in consensus. Extremity fractures detected by LS were documented. The overall sensitivity of LS was 49.2%, the specificity was 93.3%, the positive predictive value was 91%, and the negative predictive value was 57.5%. The overall sensitivity for vertebral fractures was 16.7%, and the specificity was 100%. The sensitivity was 48.7% and the specificity 98.2% for all other fractures. Pneumothoraces were detected in 12 patients by CT, but not by LS.40 extremity fractures were detected by LS, of which 4 fractures were dislocated, and 2 were fully covered by MSCT. The diagnostic accuracy of LS is limited in the evaluation of acute trauma of the truncal skeleton. LS allows fast whole-body X-ray imaging, and may be valuable for detecting extremity fractures in trauma patients in addition to MSCT.

  11. The Diagnostic importance of clinical and radiologic features of the Multiple Cemento-osseous dysplasia

    Han, M. R.; Kim, Y. H.; Kang, B. C.

    1998-01-01

    This case was diagnosed as multiple cementoosseous dysplasia on the basis of clinical and radiological features but was diagnosed as ossifying fibroma on the basis of histopathological feature. The histopathologic features of the multiple cementoosseous dysplasia and cementoossifying fibroma have common features of cementum, fibrous network and bone. Multiple cementoosseous dysplasia is reactive lesion and shows restricted lesion size, occurred on anterior and posterior tooth of the mandible and needs no treatment except periodic follow up. But Cementoossifying fibroma is the true neoplasm and grows continuously and needs surgical removal. The final diagnosis of the multiple cementoosseous dysplasia requires good correlation of the clinical histopathological, and radiological features.

  12. A simple method to combine multiple molecular biomarkers for dichotomous diagnostic classification

    Amin Manik A

    2006-10-01

    Full Text Available Abstract Background In spite of the recognized diagnostic potential of biomarkers, the quest for squelching noise and wringing in information from a given set of biomarkers continues. Here, we suggest a statistical algorithm that – assuming each molecular biomarker to be a diagnostic test – enriches the diagnostic performance of an optimized set of independent biomarkers employing established statistical techniques. We validated the proposed algorithm using several simulation datasets in addition to four publicly available real datasets that compared i subjects having cancer with those without; ii subjects with two different cancers; iii subjects with two different types of one cancer; and iv subjects with same cancer resulting in differential time to metastasis. Results Our algorithm comprises of three steps: estimating the area under the receiver operating characteristic curve for each biomarker, identifying a subset of biomarkers using linear regression and combining the chosen biomarkers using linear discriminant function analysis. Combining these established statistical methods that are available in most statistical packages, we observed that the diagnostic accuracy of our approach was 100%, 99.94%, 96.67% and 93.92% for the real datasets used in the study. These estimates were comparable to or better than the ones previously reported using alternative methods. In a synthetic dataset, we also observed that all the biomarkers chosen by our algorithm were indeed truly differentially expressed. Conclusion The proposed algorithm can be used for accurate diagnosis in the setting of dichotomous classification of disease states.

  13. Imaging Characteristics and Prevalence of Pancreatic Carcinoma in Kosovo During 2011-2015 - Diagnostic Method as Choice.

    Dedushi, Kreshnike; Kabashi, Serbeze; Mucaj, Sefedin; Hasbahta, Gazmed; Ramadani, Naser; Hoxhaj, Astrit

    2016-06-01

    Pancreatic cancer is the 10(th)most common malignancy and the 4(th)largest cancer killer in adults. The purpose of this paper is to evaluate the number of cases presented with pancreatic carcinoma during the years 2011-2015, our experience of the imaging characteristics of pancreatic carcinoma. We evaluated prevalence of the pancreatic cancers, distant metastases and other local infiltration signs among the total cases of the pancreatic cancers diagnosed in the University Clinical Center of Kosovo, with the aim to compare these research findings to similar studies made in the developed countries. This is a retrospective research study done during the period of 2011-2015. This retrospective research study includes 362 patients recently diagnosed with pancreatic cancer, examined in the period of 2011-2015 at the University Clinical Center of Kosovo. The imaging diagnostics are performed with MSCT Sensation 64 Siemens, MSCT Emotion 6 Siemens, and 1.5T MRI Symphony Siemens, biopsy guide with MSCT Sensation 64 Siemens in the Radiologic Clinic of UCCK; while the histopathology diagnostics has been performed in Clinic of Pathology at UCCK and prevalence is taken from the number of cases Reported at the Institute of Oncology Institute of Statistics and NIPH (National Institute of Public Health of Kosovo). Out of a total of the 362 patients diagnosed with pancreas cancer, results is female 39.5% (n=143) and male 61.5% (n=219), report M: F (1: 1.6), 286 cases resulted in head and neck 79 % (n=286), 76 cases resulted in body and tail cancers (21%), distant metastases in first imaging modality were found in(n=155) patients 43 %, local infiltration was found in patients: gastric infiltration 15 % (n=54), duodenal and papilla infiltration 26% (n=94), local infiltration spleen 16% (n=57), local infiltration mesentery 43 % (n= 155), dilated biliary tree 34 % (n=123), regional lymph node infiltration 83 % (n= 300). Out of a total of the 362 patients diagnosed with pancreas cancer

  14. Diagnostic value of stool DNA testing for multiple markers of colorectal cancer and advanced adenoma: a meta-analysis.

    Yang, Hua; Xia, Bing-Qing; Jiang, Bo; Wang, Guozhen; Yang, Yi-Peng; Chen, Hao; Li, Bing-Sheng; Xu, An-Gao; Huang, Yun-Bo; Wang, Xin-Ying

    2013-08-01

    The diagnostic value of stool DNA (sDNA) testing for colorectal neoplasms remains controversial. To compensate for the lack of large-scale unbiased population studies, a meta-analysis was performed to evaluate the diagnostic value of sDNA testing for multiple markers of colorectal cancer (CRC) and advanced adenoma. The PubMed, Science Direct, Biosis Review, Cochrane Library and Embase databases were systematically searched in January 2012 without time restriction. Meta-analysis was performed using a random-effects model using sensitivity, specificity, diagnostic OR (DOR), summary ROC curves, area under the curve (AUC), and 95% CIs as effect measures. Heterogeneity was measured using the χ(2) test and Q statistic; subgroup analysis was also conducted. A total of 20 studies comprising 5876 individuals were eligible. There was no heterogeneity for CRC, but adenoma and advanced adenoma harboured considerable heterogeneity influenced by risk classification and various detection markers. Stratification analysis according to risk classification showed that multiple markers had a high DOR for the high-risk subgroups of both CRC (sensitivity 0.759 [95% CI 0.711 to 0.804]; specificity 0.883 [95% CI 0.846 to 0.913]; AUC 0.906) and advanced adenoma (sensitivity 0.683 [95% CI 0.584 to 0.771]; specificity 0.918 [95% CI 0.866 to 0.954]; AUC 0.946) but not for the average-risk subgroups of either. In the methylation subgroup, sDNA testing had significantly higher DOR for CRC (sensitivity 0.753 [95% CI 0.685 to 0.812]; specificity 0.913 [95% CI 0.860 to 0.950]; AUC 0.918) and advanced adenoma (sensitivity 0.623 [95% CI 0.527 to 0.712]; specificity 0.926 [95% CI 0.882 to 0.958]; AUC 0.910) compared with the mutation subgroup. There was no significant heterogeneity among studies for subgroup analysis. sDNA testing for multiple markers had strong diagnostic significance for CRC and advanced adenoma in high-risk subjects. Methylation makers had more diagnostic value than mutation

  15. Diagnostic accuracy of apparent diffusion coefficient and 123I-metaiodobenzylguanidine for differentiation of multiple system atrophy and Parkinson's disease.

    Atsushi Umemura

    Full Text Available BACKGROUND: It is often hard to differentiate Parkinson's disease (PD and parkinsonian variant of multiple system atrophy (MSA-P, especially in the early stages. Cardiac sympathetic denervation and putaminal rarefaction are specific findings for PD and MSA-P, respectively. PURPOSE: We investigated diagnostic accuracy of putaminal apparent diffusion coefficient (ADC test for MSA-P and (123I-metaiodobenzylguanidine (MIBG scintigram for PD, especially in early-stage patients. METHODS: The referral standard diagnosis of PD and MSA-P were the diagnostic criteria of the United Kingdom Parkinson's Disease Society Brain Bank Criteria and the second consensus criteria, respectively. Based on the referral standard criteria, diagnostic accuracy [area under the receiver-operator characteristic curve (AUC, sensitivity and specificity] of the ADC and MIBG tests was estimated retrospectively. Diagnostic accuracy of these tests performed within 3 years of symptom onset was also investigated. RESULTS: ADC and MIBG tests were performed on 138 patients (20 MSA and 118 PD. AUC was 0.95 and 0.83 for the ADC and MIBG tests, respectively. Sensitivity and specificity were 85.0% and 89.0% for MSA-P diagnosis by ADC test and 67.0% and 80.0% for PD diagnosis by MIBG test. When these tests were restricted to patients with disease duration ≤ 3 years, the sensitivity and specificity were 75.0% and 91.4% for the ADC test (MSA-P diagnosis and 47.7% and 92.3% for the MIBG test (PD diagnosis. CONCLUSIONS: Both tests were useful in differentiating between PD and MSA-P, even in the early stages. In early-stage patients, elevated putaminal ADC was a diagnostic marker for MSA-P. Despite high specificity of the MIBG test, careful neurological history and examinations were required for PD diagnosis because of possible false-negative results.

  16. Diagnostic accuracy of apparent diffusion coefficient and 123I-metaiodobenzylguanidine for differentiation of multiple system atrophy and Parkinson's disease.

    Umemura, Atsushi; Oeda, Tomoko; Hayashi, Ryutaro; Tomita, Satoshi; Kohsaka, Masayuki; Yamamoto, Kenji; Sawada, Hideyuki

    2013-01-01

    It is often hard to differentiate Parkinson's disease (PD) and parkinsonian variant of multiple system atrophy (MSA-P), especially in the early stages. Cardiac sympathetic denervation and putaminal rarefaction are specific findings for PD and MSA-P, respectively. We investigated diagnostic accuracy of putaminal apparent diffusion coefficient (ADC) test for MSA-P and (123)I-metaiodobenzylguanidine (MIBG) scintigram for PD, especially in early-stage patients. The referral standard diagnosis of PD and MSA-P were the diagnostic criteria of the United Kingdom Parkinson's Disease Society Brain Bank Criteria and the second consensus criteria, respectively. Based on the referral standard criteria, diagnostic accuracy [area under the receiver-operator characteristic curve (AUC), sensitivity and specificity] of the ADC and MIBG tests was estimated retrospectively. Diagnostic accuracy of these tests performed within 3 years of symptom onset was also investigated. ADC and MIBG tests were performed on 138 patients (20 MSA and 118 PD). AUC was 0.95 and 0.83 for the ADC and MIBG tests, respectively. Sensitivity and specificity were 85.0% and 89.0% for MSA-P diagnosis by ADC test and 67.0% and 80.0% for PD diagnosis by MIBG test. When these tests were restricted to patients with disease duration ≤ 3 years, the sensitivity and specificity were 75.0% and 91.4% for the ADC test (MSA-P diagnosis) and 47.7% and 92.3% for the MIBG test (PD diagnosis). Both tests were useful in differentiating between PD and MSA-P, even in the early stages. In early-stage patients, elevated putaminal ADC was a diagnostic marker for MSA-P. Despite high specificity of the MIBG test, careful neurological history and examinations were required for PD diagnosis because of possible false-negative results.

  17. Imaging Characteristics and Prevalence of Pancreatic Carcinoma in Kosovo During 2011-2015 - Diagnostic Method as Choice

    Dedushi, Kreshnike; Kabashi, Serbeze; Mucaj, Sefedin; Hasbahta, Gazmed; Ramadani, Naser; Hoxhaj, Astrit

    2016-01-01

    Introduction: Pancreatic cancer is the 10thmost common malignancy and the 4thlargest cancer killer in adults. Aim: The purpose of this paper is to evaluate the number of cases presented with pancreatic carcinoma during the years 2011-2015, our experience of the imaging characteristics of pancreatic carcinoma. We evaluated prevalence of the pancreatic cancers, distant metastases and other local infiltration signs among the total cases of the pancreatic cancers diagnosed in the University Clinical Center of Kosovo, with the aim to compare these research findings to similar studies made in the developed countries. This is a retrospective research study done during the period of 2011-2015. Materials and Methodology: This retrospective research study includes 362 patients recently diagnosed with pancreatic cancer, examined in the period of 2011-2015 at the University Clinical Center of Kosovo. The imaging diagnostics are performed with MSCT Sensation 64 Siemens, MSCT Emotion 6 Siemens, and 1.5T MRI Symphony Siemens, biopsy guide with MSCT Sensation 64 Siemens in the Radiologic Clinic of UCCK; while the histopathology diagnostics has been performed in Clinic of Pathology at UCCK and prevalence is taken from the number of cases Reported at the Institute of Oncology Institute of Statistics and NIPH (National Institute of Public Health of Kosovo). Results: Out of a total of the 362 patients diagnosed with pancreas cancer, results is female 39.5% (n=143) and male 61.5% (n=219), report M: F (1: 1.6), 286 cases resulted in head and neck 79 % (n=286), 76 cases resulted in body and tail cancers (21%), distant metastases in first imaging modality were found in(n=155) patients 43 %, local infiltration was found in patients: gastric infiltration 15 % (n=54), duodenal and papilla infiltration 26% (n=94), local infiltration spleen 16% (n=57), local infiltration mesentery 43 % (n= 155), dilated biliary tree 34 % (n=123), regional lymph node infiltration 83 % (n= 300). Out of a total

  18. Design and validation of realistic breast models for use in multiple alternative forced choice virtual clinical trials.

    Elangovan, Premkumar; Mackenzie, Alistair; Dance, David R; Young, Kenneth C; Cooke, Victoria; Wilkinson, Louise; Given-Wilson, Rosalind M; Wallis, Matthew G; Wells, Kevin

    2017-04-07

    A novel method has been developed for generating quasi-realistic voxel phantoms which simulate the compressed breast in mammography and digital breast tomosynthesis (DBT). The models are suitable for use in virtual clinical trials requiring realistic anatomy which use the multiple alternative forced choice (AFC) paradigm and patches from the complete breast image. The breast models are produced by extracting features of breast tissue components from DBT clinical images including skin, adipose and fibro-glandular tissue, blood vessels and Cooper's ligaments. A range of different breast models can then be generated by combining these components. Visual realism was validated using a receiver operating characteristic (ROC) study of patches from simulated images calculated using the breast models and from real patient images. Quantitative analysis was undertaken using fractal dimension and power spectrum analysis. The average areas under the ROC curves for 2D and DBT images were 0.51  ±  0.06 and 0.54  ±  0.09 demonstrating that simulated and real images were statistically indistinguishable by expert breast readers (7 observers); errors represented as one standard error of the mean. The average fractal dimensions (2D, DBT) for real and simulated images were (2.72  ±  0.01, 2.75  ±  0.01) and (2.77  ±  0.03, 2.82  ±  0.04) respectively; errors represented as one standard error of the mean. Excellent agreement was found between power spectrum curves of real and simulated images, with average β values (2D, DBT) of (3.10  ±  0.17, 3.21  ±  0.11) and (3.01  ±  0.32, 3.19  ±  0.07) respectively; errors represented as one standard error of the mean. These results demonstrate that radiological images of these breast models realistically represent the complexity of real breast structures and can be used to simulate patches from mammograms and DBT images that are indistinguishable from

  19. Analysis of the benefits of designing and implementing a virtual didactic model of multiple choice exam and problem-solving heuristic report, for first year engineering students

    Bennun, Leonardo; Santibanez, Mauricio

    2015-01-01

    Improvements in performance and approval obtained by first year engineering students from University of Concepcion, Chile, were studied, once a virtual didactic model of multiple-choice exam, was implemented. This virtual learning resource was implemented in the Web ARCO platform and allows training, by facing test models comparable in both time and difficulty to those that they will have to solve during the course. It also provides a feedback mechanism for both: 1) The students, since they c...

  20. Imaging diagnostics in ovarian cancer: magnetic resonance imaging and a scoring system guiding choice of primary treatment.

    Kasper, Sigrid M; Dueholm, Margit; Marinovskij, Edvard; Blaakær, Jan

    2017-03-01

    To analyze the ability of magnetic resonance imaging (MRI) and systematic evaluation at surgery to predict optimal cytoreduction in primary advanced ovarian cancer and to develop a preoperative scoring system for cancer staging. Preoperative MRI and standard laparotomy were performed in 99 women with either ovarian or primary peritoneal cancer. Using univariate and multivariate logistic regression analysis of a systematic description of the tumor in nine abdominal compartments obtained by MRI and during surgery plus clinical parameters, a scoring system was designed that predicted non-optimal cytoreduction. Non-optimal cytoreduction at operation was predicted by the following: (A) presence of comorbidities group 3 or 4 (ASA); (B) tumor presence in multiple numbers of different compartments, and (C) numbers of specified sites of organ involvement. The score includes: number of compartments involved (1-9 points), >1 subdiaphragmal location with presence of tumor (1 point); deep organ involvement of liver (1 point), porta hepatis (1 point), spleen (1 point), mesentery/vessel (1 point), cecum/ileocecal (1 point), rectum/vessels (1 point): ASA groups 3 and 4 (2 points). Use of the scoring system based on operative findings gave an area under the curve (AUC) of 91% (85-98%) for patients in whom optimal cytoreduction could not be achieved. The score AUC obtained by MRI was 84% (76-92%), and 43% of non-optimal cytoreduction patients were identified, with only 8% of potentially operable patients being falsely evaluated as suitable for non-optimal cytoreduction at the most optimal cut-off value. Tumor in individual locations did not predict operability. This systematic scoring system based on operative findings and MRI may predict non-optimal cytoreduction. MRI is able to assess ovarian cancer with peritoneal carcinomatosis with satisfactory concordance with laparotomic findings. This scoring system could be useful as a clinical guideline and should be evaluated and

  1. Multiple aneurysm of unknown aetiology in childhood: Complications and diagnostic possibilities

    Lanfermann, H.; Benz-Bohm, G.; Schaper, J.; Gross-Fengels, W.

    1990-01-01

    A 6,5-year old boy with already known multiple aneurysm of all major arteries presented with acute abdominal pain. As demonstrated by ultrasound a big aneurysm of the left renal artery thrombosed in the course of three days. As a result, the left kidney developed severe ischaemia. Although computed tomography and scintigraphy were applied, a plan for a definitive therapeutic procedere could be established only by arterial angiography. Both Ehlers-Danlos' syndrome and Kawasaki's syndrome were excluded. There were no facts suggesting an infective aetiology. Four other cases with multiple aneurysms of unknown aetiology in childhood have so far been described in literature. (orig.) [de

  2. Statistical models for quantifying diagnostic accuracy with multiple lesions per patient

    Zwinderman, Aeilko H.; Glas, Afina S.; Bossuyt, Patrick M.; Florie, Jasper; Bipat, Shandra; Stoker, Jaap

    2008-01-01

    We propose random-effects models to summarize and quantify the accuracy of the diagnosis of multiple lesions on a single image without assuming independence between lesions. The number of false-positive lesions was assumed to be distributed as a Poisson mixture, and the proportion of true-positive

  3. Improved localisation of neoclassical tearing modes by combining multiple diagnostic estimates

    Rapson, C. J.; Fischer, R.; Giannone, L.; Maraschek, M.; Reich, M.; Treutterer, W.; The ASDEX Upgrade Team

    2017-07-01

    Neoclassical tearing modes (NTMs) strongly degrade confinement in tokamaks, and are a leading cause of disruptions. They can be stabilised by targeted electron cyclotron current drive (ECCD), however the effectiveness of ECCD depends strongly on the accuracy or misalignment between ECCD and the NTM. The first step to ensure minimal misalignment is a good estimate of the NTM location. In previous NTM control experiments, three methods have been used independently to estimate the NTM location: the magnetic equilibrium, correlation between magnetic and spatially-resolved temperature fluctuations, and the amplitude response of the NTM to nearby ECCD. This submission describes an algorithm which has been designed to fuse these three estimates into one, taking into account many of the characteristics of each diagnostic. Although the method diverges from standard data fusion methods, results from simulation and experiment confirm that the algorithm achieves its stated goal of providing an estimate that is more reliable and accurate than any of the individual estimates.

  4. Diesel combustion and emissions formation using multiple 2-D imaging diagnostics

    Dec, J.E. [Sandia National Labs., Livermore, CA (United States)

    1997-12-31

    Understanding how emissions are formed during diesel combustion is central to developing new engines that can comply with increasingly stringent emission standards while maintaining or improving performance levels. Laser-based planar imaging diagnostics are uniquely capable of providing the temporally and spatially resolved information required for this understanding. Using an optically accessible research engine, a variety of two-dimensional (2-D) imaging diagnostics have been applied to investigators of direct-injection (DI) diesel combustion and emissions formation. These optical measurements have included the following laser-sheet imaging data: Mie scattering to determine liquid-phase fuel distributions, Rayleigh scattering for quantitative vapor-phase-fuel/air mixture images, laser induced incandescence (LII) for relative soot concentrations, simultaneous LII and Rayleigh scattering for relative soot particle-size distributions, planar laser-induced fluorescence (PLIF) to obtain early PAH (polyaromatic hydrocarbon) distributions, PLIF images of the OH radical that show the diffusion flame structure, and PLIF images of the NO radical showing the onset of NO{sub x} production. In addition, natural-emission chemiluminescence images were obtained to investigate autoignition. The experimental setup is described, and the image data showing the most relevant results are presented. Then the conceptual model of diesel combustion is summarized in a series of idealized schematics depicting the temporal and spatial evolution of a reacting diesel fuel jet during the time period investigated. Finally, recent PLIF images of the NO distribution are presented and shown to support the timing and location of NO formation hypothesized from the conceptual model.

  5. Comorbidity in multiple sclerosis is associated with diagnostic delays and increased mortality

    Thormann, Anja; Sorensen, Per Soelberg; Koch-Henriksen, Nils

    2017-01-01

    Objective: To investigate the effect of chronic comorbidity on the time of diagnosis of multiple sclerosis (MS) and on mortality in MS. Methods: We conducted a population-based, nationwide cohort study including all incident MS cases in Denmark with first MS symptom between 1980 and 2005. To inve......Objective: To investigate the effect of chronic comorbidity on the time of diagnosis of multiple sclerosis (MS) and on mortality in MS. Methods: We conducted a population-based, nationwide cohort study including all incident MS cases in Denmark with first MS symptom between 1980 and 2005.......007). Conclusions: An increased awareness of both the necessity of neurologic evaluation of new neurologic symptoms in persons with preexisting chronic disease and of optimum treatment of comorbidity in MS is critical....

  6. Comparing Multiple-Group Multinomial Log-Linear Models for Multidimensional Skill Distributions in the General Diagnostic Model. Research Report. ETS RR-08-35

    Xu, Xueli; von Davier, Matthias

    2008-01-01

    The general diagnostic model (GDM) utilizes located latent classes for modeling a multidimensional proficiency variable. In this paper, the GDM is extended by employing a log-linear model for multiple populations that assumes constraints on parameters across multiple groups. This constrained model is compared to log-linear models that assume…

  7. Peripheral (Seventh Nerve Palsy and Multiple Sclerosis: A Diagnostic Dilemma - A Case Report

    Christian Saleh

    2016-01-01

    Full Text Available During the last decades, only a few cases on the association between peripheral demyelinating diseases and multiple sclerosis (MS have been reported. We describe the case of a young man who was initially diagnosed with Bell's palsy, and only after performing a brain MRI was the diagnosis of MS made. We review the literature and discuss some pitfalls which may lead to missing the diagnosis of MS.

  8. Antinuclear antibodies giving the 'multiple nuclear dots' or the 'rim-like/membranous' patterns: diagnostic accuracy for primary biliary cirrhosis.

    Granito, A; Muratori, P; Muratori, L; Pappas, G; Cassani, F; Worthington, J; Guidi, M; Ferri, S; DE Molo, C; Lenzi, M; Chapman, R W; Bianchi, F B

    2006-12-01

    Serum antinuclear antibodies giving the 'multiple nuclear dots' or the 'rim-like/membranous' patterns are frequently detected by indirect immunofluorescence on HEp-2 cells in patients with primary biliary cirrhosis. To assess the accuracy of multiple nuclear dot and rim-like/membranous antinuclear antibodies for the diagnosis of primary biliary cirrhosis. Sera from 4371 consecutive patients referred to our laboratory were analysed under code for antinuclear antibodies testing by indirect immunofluorescence on HEp-2 cells. Review of the clinical records of the 4371 patients allowed identification of 101 patients with antimitochondrial antibody-positive primary biliary cirrhosis and 22 with antimitochondrial antibody-negative variant. Multiple nuclear dot and/or rim-like/membranous patterns were found in 59 (1.3%) of the 4371 patients: 31 antimitochondrial antibody-positive primary biliary cirrhosis, 17 antimitochondrial antibody-negative primary biliary cirrhosis and 11 non-primary biliary cirrhosis. The specificity for primary biliary cirrhosis of both the antinuclear antibodies pattern was 99%. Positive predictive value and likelihood ratio for a positive test were 86% (95% CI: 72.7-94) and 221 (95% CI: 91.7-544) for multiple nuclear dot, 79% (95% CI: 62.2-90.1) and 132 (95% CI: 56.8-312.7) for rim-like/membranous, respectively. Multiple nuclear dot and rim-like/membranous antinuclear antibodies are rare findings. Their positivity strongly suggests the diagnosis of primary biliary cirrhosis, irrespective of antimitochondrial antibody status. The high specificity for primary biliary cirrhosis makes them a useful diagnostic tool especially in antimitochondrial antibody-negative patients.

  9. Change in hippocampal theta oscillation associated with multiple lever presses in a bimanual two-lever choice task for robot control in rats.

    Norifumi Tanaka

    Full Text Available Hippocampal theta oscillations have been implicated in working memory and attentional process, which might be useful for the brain-machine interface (BMI. To further elucidate the properties of the hippocampal theta oscillations that can be used in BMI, we investigated hippocampal theta oscillations during a two-lever choice task. During the task body-restrained rats were trained with a food reward to move an e-puck robot towards them by pressing the correct lever, ipsilateral to the robot several times, using the ipsilateral forelimb. The robot carried food and moved along a semicircle track set in front of the rat. We demonstrated that the power of hippocampal theta oscillations gradually increased during a 6-s preparatory period before the start of multiple lever pressing, irrespective of whether the correct lever choice or forelimb side were used. In addition, there was a significant difference in the theta power after the first choice, between correct and incorrect trials. During the correct trials the theta power was highest during the first lever-releasing period, whereas in the incorrect trials it occurred during the second correct lever-pressing period. We also analyzed the hippocampal theta oscillations at the termination of multiple lever pressing during the correct trials. Irrespective of whether the correct forelimb side was used, the power of hippocampal theta oscillations gradually decreased with the termination of multiple lever pressing. The frequency of theta oscillation also demonstrated an increase and decrease, before and after multiple lever pressing, respectively. There was a transient increase in frequency after the first lever press during the incorrect trials, while no such increase was observed during the correct trials. These results suggested that hippocampal theta oscillations reflect some aspects of preparatory and cognitive neural activities during the robot controlling task, which could be used for BMI.

  10. Diagnostic evaluation of dysphagia in multiple sclerosis patients using a Persian version of DYMUS questionnaire.

    Pajouh, Sahar Danesh; Moradi, Negin; Shaterzadeh Yazdi, Mohammad Jafar; Latifi, Seyed Mahmoud; Mehravar, Mohammad; Majdinasab, Nastaran; Olapour, Ali Reza; Soltani, Majid; Khanchezar, Fatemeh

    2017-10-01

    Multiple sclerosis is a chronic neurological disease that may cause swallowing disorders. Dysphagia is a common problem, which patients with different levels of disability may encounter, but it is usually underestimated; therefore, effective assessments need to be performed before any serious complications. The aim of this study was to identify the frequency and characteristics of dysphagia in multiple sclerosis patients of Khuzestan MS society, using a Persian version of Dysphagia in Multiple Sclerosis (DYMUS) questionnaire. 105 consecutive MS patients (84 F and 21 M, mean age 33.8 ± 8.5 years, mean disease duration 3.5 ± 3.1 years, mean Expanded Disability Status Scale (EDSS) 1.8 ± 1.3) participated in the study and the DYMUS questionnaire was administered by a trained speech therapist. The results have shown that 55 MS patients (52.4%) had dysphagia and the dysphagia was significantly associated with the disease course of MS (p = 0.02). However, significant associations between DYMUS values and EDSS, disease duration, age, and gender were not observed. (Respectively, p = 0.4, p = 0.09, p = 0.1, p = 1.0). In the dysphagia group, based on dysphagia severity, 17.1% and 35.2% of patients had mild and alarming dysphagia, respectively. Although, the patients with alarming dysphagia had longer disease duration, higher EDSS score and more with SP, PP and PR disease course than the patients with mild dysphagia, these differences were not significant. The oropharyngeal dysphagia in MS patients is very common even in early stages of the disease; therefore, it is important to assess these patients carefully and to initiate a treatment program if needed. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Flow Cytometry Method as a Diagnostic Tool for Pleural Fluid Involvement in a Patient with Multiple Myeloma

    MUZAFFER KEKLIK

    2012-01-01

    Full Text Available

    Multiple myeloma is a malignant proliferation of plasma cells that mainly affects bone marrow. Pleural effusions secondary to pleural myelomatous involvement have rarely been reported in the literature. As it is rarely detected, we aimed to report a case in which pleural effusion of a multiple myeloma was confirmed as true myelomatous involvement by flow cytometry method. A 52-years old man presented to our clinic with chest and back pain lasting for 3 months. On the chest radiography, pleural fluid was detected in left hemithorax. Pleural fluid flow cytometry was performed. In the flow cytometry, CD56, CD38 and CD138 found to be positive, while CD19 was negative. True myelomatous pleural effusions are very uncommon, with fewer than 100 cases reported worldwide. Flow cytometry is a potentially useful diagnostic tool for clinical practice. We presented our case; as it has been rarely reported, although flow cytometer is a simple method for detection of pleural fluid involvement in multiple myeloma.

  12. Flow Cytometry Method as a Diagnostic Tool for Pleural Fluid Involvement in a Patient with Multiple Myeloma

    Muzaffer Keklik

    2012-10-01

    Full Text Available Multiple myeloma is a malignant proliferation of plasma cells that mainly affects bone marrow. Pleural effusions secondary to pleural myelomatous involvement have rarely been reported in the literature. As it is rarely detected, we aimed to report a case in which pleural effusion of a multiple myeloma was confirmed as true myelomatous involvement by flow cytometry method. A 52-years old man presented to our clinic with chest and back pain lasting for 3 months. On the chest radiography, pleural fluid was detected in left hemithorax. Pleural fluid flow cytometry was performed. In the flow cytometry, CD56, CD38 and CD138 found to be positive, while CD19 was negative. True myelomatous pleural effusions are very uncommon, with fewer than 100 cases reported worldwide. Flow cytometry is a potentially useful diagnostic tool for clinical practice. We presented our case; as it has been rarely reported, although flow cytometer is a simple method for detection of pleural fluid involvement in multiple myeloma.

  13. Diagnostic study of multiple double layer formation in expanding RF plasma

    Chakraborty, Shamik; Paul, Manash Kumar; Roy, Jitendra Nath; Nath, Aparna

    2018-03-01

    Intensely luminous double layers develop and then expand in size in a visibly glowing RF discharge produced using a plasma source consisting of a semi-transparent cylindrical mesh with a central electrode, in a linear plasma chamber. Although RF discharge is known to be independent of device geometry in the absence of magnetic field, the initiation of RF discharge using such a plasma source results in electron drift and further expansion of the plasma in the vessel. The dynamics of complex plasma structures are studied through electric probe diagnostics in the expanding RF plasma. The measurements made to study the parametric dependence of evolution of double layer structures are analyzed and presented here. The plasma parameter measurements suggest that the complex potential structures initially form with low potential difference between the layers and then gradually expand producing burst oscillations. The present study provides interesting information about the stability of plasma sheath and charge particle dynamics in it that are important to understand the underlying basic sheath physics along with applications in plasma acceleration and propulsion.

  14. Taeniasis-cysticercosis in Southern Ecuador: assessment of infection status using multiple laboratory diagnostic tools

    R Rodriguez-Hidalgo

    2006-11-01

    Full Text Available Taenia solium-taeniasis and cysticercosis were studied in the human and porcine populations of a rural community in the Southern Ecuadorian Andes. From the 1059 inhabitants, 800 serum samples and 958 stool samples could be collected. In addition, 646 from the estimated 1148 pigs were tongue inspected. Circulating antigen was detected by enzyme linked immunosorbent assay (Ag-ELISA in 2.25% of the human population, whereas intestinal taeniasis was detected in 1.46% by the formalin-ether technique. Following treatment and recovery of tapeworm fragments these were all identified as T. solium. Porcine cysticercosis was diagnosed in 3.56% of the pigs by tongue inspection. In addition, enzyme linked immunoelectrotransfer blot (EITB was performed on a subset group of 100 humans to confirm the results of the Ag-ELISA. One hundred serum samples from pigs were also analysed by EITB. It appeared that 43 and 74% of humans and pigs had antibodies against T. solium cysticerci, respectively. It is concluded that contrary to the high exposure of the human population to T. solium that is suggested by EITB, the number of active cysticercosis cases, diagnosed by Ag-ELISA, was low, which may indicate endemic stability. The further use of complementary diagnostic methods for a better understanding of the epidemiology of T. solium is suggested.

  15. Taeniasis-cysticercosis in Southern Ecuador: assessment of infection status using multiple laboratory diagnostic tools.

    Rodriguez-Hidalgo, R; Benitez-Ortiz, W; Praet, N; Saa, L R; Vercruysse, J; Brandt, J; Dorny, P

    2006-11-01

    Taenia solium-taeniasis and cysticercosis were studied in the human and porcine populations of a rural community in the Southern Ecuadorian Andes. From the 1059 inhabitants, 800 serum samples and 958 stool samples could be collected. In addition, 646 from the estimated 1148 pigs were tongue inspected. Circulating antigen was detected by enzyme linked immunosorbent assay (Ag-ELISA) in 2.25% of the human population, whereas intestinal taeniasis was detected in 1.46% by the formalin-ether technique. Following treatment and recovery of tapeworm fragments these were all identified as T. solium. Porcine cysticercosis was diagnosed in 3.56% of the pigs by tongue inspection. In addition, enzyme linked immunoelectrotransfer blot (EITB) was performed on a subset group of 100 humans to confirm the results of the Ag-ELISA. One hundred serum samples from pigs were also analysed by EITB. It appeared that 43 and 74% of humans and pigs had antibodies against T. solium cysticerci, respectively. It is concluded that contrary to the high exposure of the human population to T. solium that is suggested by EITB, the number of active cysticercosis cases, diagnosed by Ag-ELISA, was low, which may indicate endemic stability. The further use of complementary diagnostic methods for a better understanding of the epidemiology of T. solium is suggested.

  16. Application of multislice spiral CT (MSCT) in multiple injured patients and its effect on diagnostic and therapeutic algorithms

    Boehm, T.; Alkadhi, H.; Schertler, T.; Baumert, B.; Roos, J.; Marincek, B.; Wildermuth, S.

    2004-01-01

    The initial diagnostic work-up of trauma victims with multiple injuries is currently a combination of conventional radiography (CR), ultrasound (US), and computed tomography (CT). This article reviews the diagnostic quality of the different imaging modalities regarding detection and classification of injuries. CT performs better than US in detecting traumatic lesions of abdominal parenchymal organs. Furthermore, CT is better than CR in detecting therapeutically relevant chest and bone injuries. MSCT may replace CR and US under the condition that it is faster than or at least as fast as the conventional approach to diagnose lite threatening injuries. This can be achieved only by changing the work-flow for the entire trauma team including radiologist. Furthermore, certain prerequisites must be fulfilled including integration of a MSCT scanner into the emergency room. An optimized whole body CT protocol for the assessment of trauma victims using MSCT as well as a two-step algorithm for reporting the imaging findings depending on their clinical significance is presented. (orig.)

  17. Neural Dynamics of Multiple Object Processing in Mild Cognitive Impairment and Alzheimer's Disease: Future Early Diagnostic Biomarkers?

    Bagattini, Chiara; Mazza, Veronica; Panizza, Laura; Ferrari, Clarissa; Bonomini, Cristina; Brignani, Debora

    2017-01-01

    The aim of this study was to investigate the behavioral and electrophysiological dynamics of multiple object processing (MOP) in mild cognitive impairment (MCI) and Alzheimer's disease (AD), and to test whether its neural signatures may represent reliable diagnostic biomarkers. Behavioral performance and event-related potentials [N2pc and contralateral delay activity (CDA)] were measured in AD, MCI, and healthy controls during a MOP task, which consisted in enumerating a variable number of targets presented among distractors. AD patients showed an overall decline in accuracy for both small and large target quantities, whereas in MCI patients, only enumeration of large quantities was impaired. N2pc, a neural marker of attentive individuation, was spared in both AD and MCI patients. In contrast, CDA, which indexes visual short term memory abilities, was altered in both groups of patients, with a non-linear pattern of amplitude modulation along the continuum of the disease: a reduction in AD and an increase in MCI. These results indicate that AD pathology shows a progressive decline in MOP, which is associated to the decay of visual short-term memory mechanisms. Crucially, CDA may be considered as a useful neural signature both to distinguish between healthy and pathological aging and to characterize the different stages along the AD continuum, possibly becoming a reliable candidate for an early diagnostic biomarker of AD pathology.

  18. Application of 99mTc-MIBI for diagnostic evaluation of multiple myeloma and lymphoma

    Kostadinova, I.; Garcheva, M.; Petrov, T.

    1995-01-01

    An attempt is made to determine the stage of multiple myeloma (MM), Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) after applying 99 mTc-MIBI, as well as to proof the residual vital tissue after chemo- and radiotherapy. 15 patients with these diseases and 3 controls are examined. An increased tracer uptake was found at 7 of the patients along the bones (in MM) or focal intake at typical places (in HL and NHL) as a sign of an active disease. In comparison with X-ray and bone scintigraphy, the whole body examination with 99m Tc-MIBI allows visualization of more pathological sites. The preliminary results show that more patients with MM, HL and NHL can be examined in order to determine activity and stage of the disease and to differentiate between active and fibrous tissues after chemo and radio therapy. 6 refs., 2 figs. (author)

  19. Comparing diagnostic accuracy of bedside ultrasound and radiography for bone fracture screening in multiple trauma patients at the ED.

    Bolandparvaz, Shahram; Moharamzadeh, Payman; Jamali, Kazem; Pouraghaei, Mahboob; Fadaie, Maryam; Sefidbakht, Sepideh; Shahsavari, Kavous

    2013-11-01

    Long bone fractures are currently diagnosed using radiography, but radiography has some disadvantages (radiation and being time consuming). The present study compared the diagnostic accuracy of bedside ultrasound and radiography in multiple trauma patients at the emergency department (ED). The study assessed 80 injured patients with multiple trauma from February 2011 to July 2012. The patients were older than 18 years and triaged to the cardiopulmonary resuscitation ward of the ED. Bedside ultrasound and radiography were conducted for them. The findings were separately and blindly assessed by 2 radiologists. Sensitivity, specificity, the positive and negative predictive value, and κ coefficient were measured to assess the accuracy and validity of ultrasound as compared with radiography. The sensitivity of ultrasound for diagnosis of limb bone fractures was not high enough and ranged between 55% and 75% depending on the fracture site. The specificity of this diagnostic method had an acceptable range of 62% to 84%. Ultrasound negative prediction value was higher than other indices under study and ranged between 73% and 83%, but its positive prediction value varied between 33.3% and 71%. The κ coefficient for diagnosis of long bone fractures of upper limb (κ = 0.58) and upper limb joints (κ = 0.47) and long bones of lower limb (κ = 0.52) was within the medium range. However, the value for diagnosing fractures of lower limb joints (κ = 0.47) was relatively low. Bedside ultrasound is not a reliable method for diagnosing fractures of upper and lower limb bones compared with radiography. © 2013 Elsevier Inc. All rights reserved.

  20. Effect of response format on cognitive reflection: Validating a two- and four-option multiple choice question version of the Cognitive Reflection Test.

    Sirota, Miroslav; Juanchich, Marie

    2018-03-27

    The Cognitive Reflection Test, measuring intuition inhibition and cognitive reflection, has become extremely popular because it reliably predicts reasoning performance, decision-making, and beliefs. Across studies, the response format of CRT items sometimes differs, based on the assumed construct equivalence of tests with open-ended versus multiple-choice items (the equivalence hypothesis). Evidence and theoretical reasons, however, suggest that the cognitive processes measured by these response formats and their associated performances might differ (the nonequivalence hypothesis). We tested the two hypotheses experimentally by assessing the performance in tests with different response formats and by comparing their predictive and construct validity. In a between-subjects experiment (n = 452), participants answered stem-equivalent CRT items in an open-ended, a two-option, or a four-option response format and then completed tasks on belief bias, denominator neglect, and paranormal beliefs (benchmark indicators of predictive validity), as well as on actively open-minded thinking and numeracy (benchmark indicators of construct validity). We found no significant differences between the three response formats in the numbers of correct responses, the numbers of intuitive responses (with the exception of the two-option version, which had a higher number than the other tests), and the correlational patterns of the indicators of predictive and construct validity. All three test versions were similarly reliable, but the multiple-choice formats were completed more quickly. We speculate that the specific nature of the CRT items helps build construct equivalence among the different response formats. We recommend using the validated multiple-choice version of the CRT presented here, particularly the four-option CRT, for practical and methodological reasons. Supplementary materials and data are available at https://osf.io/mzhyc/ .

  1. Diagnosis of soil-transmitted helminthiasis in an Amazonic community of Peru using multiple diagnostic techniques.

    Machicado, Jorge D; Marcos, Luis A; Tello, Raul; Canales, Marco; Terashima, Angelica; Gotuzzo, Eduardo

    2012-06-01

    An observational descriptive study was conducted in a Shipibo-Conibo/Ese'Eja community of the rainforest in Peru to compare the Kato-Katz method and the spontaneous sedimentation in tube technique (SSTT) for the diagnosis of intestinal parasites as well as to report the prevalence of soil-transmitted helminth (STH) infections in this area. A total of 73 stool samples were collected and analysed by several parasitological techniques, including Kato-Katz, SSTT, modified Baermann technique (MBT), agar plate culture, Harada-Mori culture and the direct smear examination. Kato-Katz and SSTT had the same rate of detection for Ascaris lumbricoides (5%), Trichuris trichiura (5%), hookworm (14%) and Hymenolepis nana (26%). The detection rate for Strongyloides stercoralis larvae was 16% by SSTT and 0% by Kato-Katz, but 18% by agar plate culture and 16% by MBT. The SSTT also had the advantage of detecting multiple intestinal protozoa such as Blastocystis hominis (40%), Giardia intestinalis (29%) and Entamoeba histolytica/E. dispar (16%). The most common intestinal parasites found in this community were B. hominis, G. intestinalis, H. nana, S. stercoralis and hookworm. In conclusion, the SSTT is not inferior to Kato-Katz for the diagnosis of common STH infections but is largely superior for detecting intestinal protozoa and S. stercoralis larvae. Copyright © 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

  2. Social attribution test--multiple choice (SAT-MC) in schizophrenia: comparison with community sample and relationship to neurocognitive, social cognitive and symptom measures.

    Bell, Morris D; Fiszdon, Joanna M; Greig, Tamasine C; Wexler, Bruce E

    2010-09-01

    This is the first report on the use of the Social Attribution Task - Multiple Choice (SAT-MC) to assess social cognitive impairments in schizophrenia. The SAT-MC was originally developed for autism research, and consists of a 64-second animation showing geometric figures enacting a social drama, with 19 multiple choice questions about the interactions. Responses from 85 community-dwelling participants and 66 participants with SCID confirmed schizophrenia or schizoaffective disorders (Scz) revealed highly significant group differences. When the two samples were combined, SAT-MC scores were significantly correlated with other social cognitive measures, including measures of affect recognition, theory of mind, self-report of egocentricity and the Social Cognition Index from the MATRICS battery. Using a cut-off score, 53% of Scz were significantly impaired on SAT-MC compared with 9% of the community sample. Most Scz participants with impairment on SAT-MC also had impairment on affect recognition. Significant correlations were also found with neurocognitive measures but with less dependence on verbal processes than other social cognitive measures. Logistic regression using SAT-MC scores correctly classified 75% of both samples. Results suggest that this measure may have promise, but alternative versions will be needed before it can be used in pre-post or longitudinal designs. (c) 2009 Elsevier B.V. All rights reserved.

  3. More Than Just Accuracy: A Novel Method to Incorporate Multiple Test Attributes in Evaluating Diagnostic Tests Including Point of Care Tests.

    Thompson, Matthew; Weigl, Bernhard; Fitzpatrick, Annette; Ide, Nicole

    2016-01-01

    Current frameworks for evaluating diagnostic tests are constrained by a focus on diagnostic accuracy, and assume that all aspects of the testing process and test attributes are discrete and equally important. Determining the balance between the benefits and harms associated with new or existing tests has been overlooked. Yet, this is critically important information for stakeholders involved in developing, testing, and implementing tests. This is particularly important for point of care tests (POCTs) where tradeoffs exist between numerous aspects of the testing process and test attributes. We developed a new model that multiple stakeholders (e.g., clinicians, patients, researchers, test developers, industry, regulators, and health care funders) can use to visualize the multiple attributes of tests, the interactions that occur between these attributes, and their impacts on health outcomes. We use multiple examples to illustrate interactions between test attributes (test availability, test experience, and test results) and outcomes, including several POCTs. The model could be used to prioritize research and development efforts, and inform regulatory submissions for new diagnostics. It could potentially provide a way to incorporate the relative weights that various subgroups or clinical settings might place on different test attributes. Our model provides a novel way that multiple stakeholders can use to visualize test attributes, their interactions, and impacts on individual and population outcomes. We anticipate that this will facilitate more informed decision making around diagnostic tests.

  4. A Three-Tier Diagnostic Test to Assess Pre-Service Teachers' Misconceptions about Global Warming, Greenhouse Effect, Ozone Layer Depletion, and Acid Rain

    Arslan, Harika Ozge; Cigdemoglu, Ceyhan; Moseley, Christine

    2012-01-01

    This study describes the development and validation of a three-tier multiple-choice diagnostic test, the atmosphere-related environmental problems diagnostic test (AREPDiT), to reveal common misconceptions of global warming (GW), greenhouse effect (GE), ozone layer depletion (OLD), and acid rain (AR). The development of a two-tier diagnostic test…

  5. Towards single embryo transfer? Modelling clinical outcomes of potential treatment choices using multiple data sources: predictive models and patient perspectives.

    Roberts, Sa; McGowan, L; Hirst, Wm; Brison, Dr; Vail, A; Lieberman, Ba

    2010-07-01

    In vitro fertilisation (IVF) treatments involve an egg retrieval process, fertilisation and culture of the resultant embryos in the laboratory, and the transfer of embryos back to the mother over one or more transfer cycles. The first transfer is usually of fresh embryos and the remainder may be cryopreserved for future frozen cycles. Most commonly in UK practice two embryos are transferred (double embryo transfer, DET). IVF techniques have led to an increase in the number of multiple births, carrying an increased risk of maternal and infant morbidity. The UK Human Fertilisation and Embryology Authority (HFEA) has adopted a multiple birth minimisation strategy. One way of achieving this would be by increased use of single embryo transfer (SET). To collate cohort data from treatment centres and the HFEA; to develop predictive models for live birth and twinning probabilities from fresh and frozen embryo transfers and predict outcomes from treatment scenarios; to understand patients' perspectives and use the modelling results to investigate the acceptability of twin reduction policies. A multidisciplinary approach was adopted, combining statistical modelling with qualitative exploration of patients' perspectives: interviews were conducted with 27 couples at various stages of IVF treatment at both UK NHS and private clinics; datasets were collated of over 90,000 patients from the HFEA registry and nearly 9000 patients from five clinics, both over the period 2000-5; models were developed to determine live birth and twin outcomes and predict the outcomes of policies for selecting patients for SET or DET in the fresh cycle following egg retrieval and fertilisation, and the predictions were used in simulations of treatments; two focus groups were convened, one NHS and one web based on a patient organisation's website, to present the results of the statistical analyses and explore potential treatment policies. The statistical analysis revealed no characteristics that

  6. Multiple Diagnostic Imaging of a Patient with Solid Pseudopapillary Tumour of the Pancreas: EUS, CT and FDG PET/CT

    Chong, Ari; Ha, Jungmin; Kwon, Seong Young

    2014-01-01

    ). F-18 FDG PET/CT imaging findings of SPNP are rarely reported. Dong et al. reported varying SUVmax values ranging from 2.5 to 29.1 in eight patients with SPNP. They reported that tumours with high cellularity were associated with increased SUVmax. In our report, we described a patient with SPNP who was evaluated using multiple diagnostic imaging modalities, including PET/CT, CT, ultrasonography and endoscopic ultrasonography

  7. Exploring problem solving strategies on multiple-choice science items: Comparing native Spanish-speaking English Language Learners and mainstream monolinguals

    Kachchaf, Rachel Rae

    The purpose of this study was to compare how English language learners (ELLs) and monolingual English speakers solved multiple-choice items administered with and without a new form of testing accommodation---vignette illustration (VI). By incorporating theories from second language acquisition, bilingualism, and sociolinguistics, this study was able to gain more accurate and comprehensive input into the ways students interacted with items. This mixed methods study used verbal protocols to elicit the thinking processes of thirty-six native Spanish-speaking English language learners (ELLs), and 36 native-English speaking non-ELLs when solving multiple-choice science items. Results from both qualitative and quantitative analyses show that ELLs used a wider variety of actions oriented to making sense of the items than non-ELLs. In contrast, non-ELLs used more problem solving strategies than ELLs. There were no statistically significant differences in student performance based on the interaction of presence of illustration and linguistic status or the main effect of presence of illustration. However, there were significant differences based on the main effect of linguistic status. An interaction between the characteristics of the students, the items, and the illustrations indicates considerable heterogeneity in the ways in which students from both linguistic groups think about and respond to science test items. The results of this study speak to the need for more research involving ELLs in the process of test development to create test items that do not require ELLs to carry out significantly more actions to make sense of the item than monolingual students.

  8. A multiple choice testing program coupled with a year-long elective experience is associated with improved performance on the internal medicine in-training examination.

    Mathis, Bradley R; Warm, Eric J; Schauer, Daniel P; Holmboe, Eric; Rouan, Gregory W

    2011-11-01

    The Internal Medicine In-Training Exam (IM-ITE) assesses the content knowledge of internal medicine trainees. Many programs use the IM-ITE to counsel residents, to create individual remediation plans, and to make fundamental programmatic and curricular modifications. To assess the association between a multiple-choice testing program administered during 12 consecutive months of ambulatory and inpatient elective experience and IM-ITE percentile scores in third post-graduate year (PGY-3) categorical residents. Retrospective cohort study. One hundred and four categorical internal medicine residents. Forty-five residents in the 2008 and 2009 classes participated in the study group, and the 59 residents in the three classes that preceded the use of the testing program, 2005-2007, served as controls. A comprehensive, elective rotation specific, multiple-choice testing program and a separate board review program, both administered during a continuous long-block elective experience during the twelve months between the second post-graduate year (PGY-2) and PGY-3 in-training examinations. We analyzed the change in median individual percent correct and percentile scores between the PGY-1 and PGY-2 IM-ITE and between the PGY-2 and PGY-3 IM-ITE in both control and study cohorts. For our main outcome measure, we compared the change in median individual percentile rank between the control and study cohorts between the PGY-2 and the PGY-3 IM-ITE testing opportunities. After experiencing the educational intervention, the study group demonstrated a significant increase in median individual IM-ITE percentile score between PGY-2 and PGY-3 examinations of 8.5 percentile points (p ITE performance.

  9. THE RELIABILITY OF IDENTIFICATION EVIDENCE WITH MULTIPLE LINEUPS

    Nick J. Broers

    2013-01-01

    Full Text Available This study aimed to establish the diagnostic value of multiple lineup decisions made for portrait, body, and profile lineups, including multiple target/suspect choices, rejections, foil choices, and don’t know answers. A total of 192 participants identified a thief and a victim of theft from independent simultaneous target-present or target-absent 6-person portrait, body and profile lineups after watching one of two stimulus films. As hypothesized, multiple target/suspect choices had incriminating value whereas multiple rejections, foil choices, and don’t know answers had mostly exonerating value. For suspect choices, the combination of all three lineup modes consistently elicited high diagnosticities across targets. Combinations of non-suspect choices (rejections, foil choices, or don’t know answers were less successful and the different combinations showed less consistency in terms of diagnosticity. It was concluded that the use of multiple lineups, such as different facial poses and different aspects of a person should be particularly beneficial in three situations: if a witness only saw the perpetrator from a pose different than the frontal view normally used for lineups; if one or more witnesses saw the perpetrator from more than one perspective; and if different witnesses saw the perpetrator from different perspectives.

  10. Quality of Diagnosis and Treatment Plans After Using the 'Diagnostic Guideline for Anxiety and Challenging Behaviours' in People with Intellectual Disabilities: A Comparative Multiple Case Study Design.

    Pruijssers, Addy; van Meijel, Berno; Maaskant, Marian; Keeman, Noortje; van Achterberg, Theo

    2016-07-01

    People with intellectual disabilities often have a multitude of concurrent problems due to the combination of cognitive impairments, psychiatric disorders (particularly anxiety) and related challenging behaviours. Diagnoses in people with intellectual disabilities are complicated. This study evaluates the quality of the diagnoses and treatment plans after using a guideline that was developed to support professionals in their diagnostic tasks. A comparative multiple case study with an experimental and control condition, applying deductive analyses of diagnoses and treatment plans. The analyses revealed that the number of diagnostic statements and planned treatment actions in the experimental group was significantly larger and more differentiated than in the control condition. In the control group, consequential harm and protective factors were hardly mentioned in diagnoses and treatment plans. Working with the 'Diagnostic Guideline for Anxiety and CB' leads to improved diagnoses and treatment plans compared with care as usual. © 2015 John Wiley & Sons Ltd.

  11. Variation in type and frequency of diagnostic imaging during trauma care across multiple time points by patient insurance type

    Bell, Nathaniel; Repáraz, Laura; Fry, William R.; Smith, R. Stephen; Luis, Alejandro

    2016-01-01

    not-for-profit verified Level I Trauma Center receive fewer radiographic studies than patients with commercial indemnity plans, even after adjusting for clinical and demographic confounders. There is less disparity in care during the first 24-hours, which suggests that patient pathology is the determining factor for radiographic evaluation during the acute care phase. Results from this study offer initial evidence of disparity in diagnostic imaging across multiple insurance groups over different periods of trauma care

  12. Application of the 2012 revised diagnostic definitions for paediatric multiple sclerosis and immune-mediated central nervous system demyelination disorders

    van Pelt, E. Danielle; Neuteboom, Rinze F.; Ketelslegers, Immy A.; Boon, Maartje; Catsman-Berrevoets, Coriene E.; Hintzen, Rogier Q.

    Background Recently, the International Paediatric Multiple Sclerosis Study Group (IPMSSG) definitions for the diagnosis of immune-mediated acquired demyelinating syndromes (ADS) of the central nervous system, including paediatric multiple sclerosis (MS), have been revised. Objective To evaluate the

  13. Linking neuroscientific research on decision making to the educational context of novice students assigned to a multiple-choice scientific task involving common misconceptions about electrical circuits

    Patrice ePotvin

    2014-01-01

    Full Text Available Functional magnetic resonance imaging was used to identify the brain-based mechanisms of uncertainty and certainty associated with answers to multiple-choice questions involving common misconceptions about electric circuits. Twenty-two (22 scientifically novice participants (humanities and arts college students were asked, in an fMRI study, whether or not they thought the light bulbs in images presenting electric circuits were lighted up correctly, and if they were certain or uncertain of their answers. When participants reported that they were unsure of their responses, analyses revealed significant activations in brain areas typically involved in uncertainty (anterior cingulate cortex, anterior insula cortex, and superior/dorsomedial frontal cortex and in the left middle/superior temporal lobe. Certainty was associated with large bilateral activations in the occipital and parietal regions usually involved in visuospatial processing. Correct-and-certain answers were associated with activations that suggest a stronger mobilization of visual attention resources when compared to incorrect-and-certain answers. These findings provide insights into brain-based mechanisms of uncertainty that are activated when common misconceptions, identified as such by science education research literature, interfere in decision making in a school-like task. We also discuss the implications of these results from an educational perspective.

  14. [To what extent do reviewers of multiple-choice questions need to be trained? A comparison between handing out information sheets and brief workshop sessions].

    Öchsner, Wolfgang; Böckers, Anja

    2016-01-01

    A competent review process is crucial to ensure the quality of multiple-choice (MC) questions. However, the acquisition of reviewing skills should not cause any unnecessary additional burden for a medical staff that is already facing heavy workloads. 100 MC questions, for which an expert review existed, were presented to 12 novices. In advance, six participants received a specific information sheet covering critical information for high-calibre review; the other six participants attended a 2.5-hour workshop covering the same information. The review results of both groups were analysed with a licensed version of the IBM software SPSS 19.0 (SPSS Inc., Chicago, IL). The results of the workshop group were distinctly closer to the experts' results (gold standard) than those of the information sheet group. For the quantitatively important category of medium quality MC questions, the results of the workshop group did not significantly differ from the experts' results. In the information sheet group the results were significantly poorer than the experts', regardless of the quality of the questions. Distributing specific information sheets to MC question reviewers is not sufficient for ensuring the quality of the review so that - regardless of the increased effort involved - a recommendation to conduct specific workshops must be made. Copyright © 2014. Published by Elsevier GmbH.

  15. Optical Coherence Tomography-A New Diagnostic Tool to Evaluate Axonal Degeneration in Multiple Sclerosis: A Review

    Nilüfer Kale

    2010-09-01

    Full Text Available Multiple sclerosis is an inflammatory demyelinating disorder of the central nervous system with a wide spectrum of clinical signs and symptoms. Multiple sclerosis lesions have a predilection for the optic nerves, periventricular white matter, brainstem, spinal cord, and cerebellum. The mechanisms responsible for multiple sclerosis are complex and heterogeneous across patients and disease stages. No specific markers exist for the definite diagnosis and prognosis of multiple sclerosis. The afferent visual pathway, which extends from the retina to the primary visual cortex including the optic nerve, is one of the most commonly affected sites in multiple sclerosis (94-99%. Pathology of affected optic nerves exhibits inflammation, demyelination, gliosis, axonal injury, and thinning of the retinal nerve fiber layer (RNFL. The RNFL is composed of unmyelinated axons, and measuring RNFL thickness is a viable method to monitor axonal loss reflecting disease progression. Optical coherence tomography is a noninvasive and reproducible tool in assessing the impact of multiple sclerosis on the thickness of the RNFL. Assessment of the afferent visual pathway using clinical, imaging and electrophysiological methods provides insights into the pathophysiology of multiple sclerosis and may also serve a prognostic role in multiple sclerosis

  16. Lesion type and reader experience affect the diagnostic accuracy of breast MRI: A multiple reader ROC study

    Baltzer, Pascal A.T., E-mail: patbaltzer@gmail.com [Department of Biomedical Imaging and Imge-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna (Austria); Kaiser, Werner Alois [Department of Diagnostic and Interventional Radiology, University Hospital Jena, Erlanger Allee 101, 07740 Jena (Germany); Dietzel, Matthias, E-mail: dietzelmatthias2@hotmail.com [Department of Neuroradiology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen (Germany)

    2015-01-15

    Highlights: • The main findings of our study are, that reader experience and lesion type (i.e., mass versus non-mass enhancement) are independent predictors of the diagnostic accuracy of breast MRI. • Specifically, benign and malignant non-mass lesions cannot be differentiated with sufficient accuracy, especially if readers are not experienced. • We conclude that future research in breast MRI should focus on non-mass lesions, as these are the problem makers in modern breast MRI. - Abstract: Purpose: To evaluate the influence of lesion type (mass versus non-mass) and reader experience on the diagnostic performance of breast MRI (BMRI) in a non-screening setting. Materials and methods: Consecutive patients (mean age, 55 ± 12 years) with breast lesions that were verified by biopsy or surgery, and who had had BMRI as part of their diagnostic workup, were eligible for this retrospective single-center study. Cancers diagnosed by biopsy before BMRI were excluded to eliminate biological and interpretation bias due to biopsy or chemotherapy effects (n = 103). Six blinded readers (experience level, high (HE, n = 2); intermediate (IE, n = 2); and low (LE, n = 2)) evaluated all examinations and assigned independent MRI BI-RADS ratings. Lesion type (mass, non-mass, focal) was noted. Receiver operating characteristics (ROC) and logistic regression analysis was performed to compare diagnostic accuracies. Results: There were 259 histologically verified lesions (123 malignant, 136 benign) investigated. There were 169 mass (103 malignant, 66 benign) and 48 non-mass lesions (19 malignant, 29 benign). Another 42 lesions that met the inclusion criteria were biopsied due to conventional findings (i.e., microcalcifications, architectural distortions), but did not enhance on MRI (41 benign, one DCIS). ROC analysis revealed a total area under the curve (AUC) between 0.834 (LE) and 0.935 (HI). Logistic regression identified a significant effect of non-mass lesions (P < 0.0001) and

  17. Constructing food choice decisions.

    Sobal, Jeffery; Bisogni, Carole A

    2009-12-01

    Food choice decisions are frequent, multifaceted, situational, dynamic, and complex and lead to food behaviors where people acquire, prepare, serve, give away, store, eat, and clean up. Many disciplines and fields examine decision making. Several classes of theories are applicable to food decision making, including social behavior, social facts, and social definition perspectives. Each offers some insights but also makes limiting assumptions that prevent fully explaining food choice decisions. We used constructionist social definition perspectives to inductively develop a food choice process model that organizes a broad scope of factors and dynamics involved in food behaviors. This food choice process model includes (1) life course events and experiences that establish a food choice trajectory through transitions, turning points, timing, and contexts; (2) influences on food choices that include cultural ideals, personal factors, resources, social factors, and present contexts; and (3) a personal system that develops food choice values, negotiates and balances values, classifies foods and situations, and forms/revises food choice strategies, scripts, and routines. The parts of the model dynamically interact to make food choice decisions leading to food behaviors. No single theory can fully explain decision making in food behavior. Multiple perspectives are needed, including constructionist thinking.

  18. Noninvasive diagnostic test choices for the evaluation of coronary artery disease in women: a multivariate comparison of cardiac fluoroscopy, exercise electrocardiography and exercise thallium myocardial perfusion scintigraphy

    Hung, J.; Chaitman, B.R.; Lam, J.; Lesperance, J.; Dupras, G.; Fines, P.; Bourassa, M.G.

    1984-01-01

    Several diagnostic noninvasive tests to detect coronary and multivessel coronary disease are available for women. However, all are imperfect and it is not yet clear whether one particular test provides substantially more information than others. The aim of this study was to evaluate clinical findings, exercise electrocardiography, exercise thallium myocardial scintigraphy and cardiac fluoroscopy in 92 symptomatic women without previous infarction and determine which tests were most useful in determining the presence of coronary disease and its severity. Univariate analysis revealed two clinical, eight exercise electrocardiographic, seven myocardial scintigraphic and seven fluoroscopic variables predictive of coronary or multivessel disease with 70% or greater stenosis. The multivariate discriminant function analysis selected a reversible thallium defect, coronary calcification and character of chest pain syndrome as the variables most predictive of presence or absence of coronary disease. The ranked order of variables most predictive of multivessel disease were cardiac fluoroscopy score, thallium score and extent of ST segment depression in 14 electrocardiographic leads. Each provided statistically significant information to the model. The estimate of predictive accuracy was 89% for coronary disease and 97% for multivessel coronary disease. The results suggest that cardiac fluoroscopy or thallium scintigraphy provide significantly more diagnostic information than exercise electrocardiography in women over a wide range of clinical patient subsets

  19. The agony of choice in dermatophyte diagnostics-performance of different molecular tests and culture in the detection of Trichophyton rubrum and Trichophyton interdigitale.

    Kupsch, C; Ohst, T; Pankewitz, F; Nenoff, P; Uhrlaß, S; Winter, I; Gräser, Y

    2016-08-01

    Dermatophytosis caused by dermatophytes of the genera Trichophyton and Microsporum belong to the most frequent mycoses worldwide. Molecular detection methods proved to be highly sensitive and enable rapid and accurate detection of dermatophyte species from clinical specimens. For the first time, we compare the performance of different molecular methods with each other and with conventional diagnostics in the detection of dermatophytoses caused by Trichophyton rubrum and Trichophyton interdigitale in clinical specimens (nail, skin and hair). The compared molecular methods comprise two already published PCR-ELISAs, a published quantitative RT-PCR as well as a newly developed PCR-ELISA targeting the internal transcribed spacer region. We investigated the sensitivity of the assays by analysing 375 clinical samples. In 148 specimens (39.5%) a positive result was gained in at least one of the four molecular tests or by culture, but the number of detected agents differed significantly between some of the assays. The most sensitive assay, a PCR-ELISA targeting a microsatellite region, detected 81 T. rubrum infections followed by an internal transcribed spacer PCR-ELISA (60), quantitative RT-PCR (52) and a topoisomerase II PCR-ELISA (51), whereas cultivation resulted in T. rubrum identification in 37 samples. The pros and cons of all four tests in routine diagnostics are discussed. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  20. Synchronized multiple regression of diagnostic radiation-induced rather than spontaneous: disseminated primary intracranial germinoma in a woman: a case report

    Natsumeda Manabu

    2011-01-01

    Full Text Available Abstract Introduction Examples of the spontaneous regression of primary intracranial germinomas can be found in the literature. We present the case of a patient with disseminated lesions of primary intracranial germinoma which synchronously shrunk following diagnostic irradiation. We will discuss whether this regression was spontaneous or radiation-induced. Case presentation A 43-year-old Japanese woman presented to our hospital complaining of memory problems over a period of one year and blurred vision over a period of three months. Following magnetic resonance imaging, she was found to have a massive lesion in the third ventricle and small lesions in the pineal region, fourth ventricle, and in the anterior horn of the left lateral ventricle. Prior to an open biopsy to confirm the pathology of the lesions, she underwent a single cranial computed tomography scan and a single cranial digital subtraction angiography for a transcranial biopsy. Fourteen days after the first magnetic resonance image - 12 and eight days after the computed tomography scan and digital subtraction angiography, respectively - a pre-operative magnetic resonance image was taken, which showed a notable synchronous shrinkage of the third ventricle tumor, as well as shrinkage of the lesions in the pineal region and in the fourth ventricle. She did not undergo steroid administration until after a biopsy that confirmed the pathological diagnosis of pure germinoma. She then underwent whole craniospinal irradiation and went into a complete remission. Conclusions In our case report, we state that diagnostic radiation can induce the regression of germinomas; this is the most reasonable explanation for the synchronous multiple regression observed in this case of germinoma. Clinicians should keep this non-spontaneous regression in mind and monitor germinoma lesions with minimal exposure to diagnostic radiation before diagnostic confirmation, and also before radiation treatment with or

  1. Diagnostic grand rounds: A new teaching concept to train diagnostic reasoning

    Stieger, Stefan; Praschinger, Andrea; Kletter, Kurt; Kainberger, Franz

    2011-01-01

    Introduction: Diagnostic reasoning is a core skill in teaching and learning in undergraduate curricula. Diagnostic grand rounds (DGRs) as a subform of grand rounds are intended to train the students' skills in the selection of appropriate tests and in the interpretation of test results. The aim of this study was to test DGRs for their ability to improve diagnostic reasoning by using a pre-post-test design. Methods: During one winter term, all 398 fifth-year students (36.1% male, 63.9% female) solved 23 clinical cases presented in 8 DGRs. In an online questionnaire, a Diagnostic Thinking Inventory (DTI) with 41 items was evaluated for flexibility in thinking and structure of knowledge in memory. Results were correlated with those from a summative multiple-choice knowledge test and of the learning objectives in a logbook. Results: The students' DTI scores in the post-test were significantly higher than those reported in the pre-test. DTI scores at either testing time did not correlate with medical knowledge as assessed by a multiple-choice knowledge test. Abilities acquired during clinical clerkships as documented in a logbook could only account for a small proportion of the increase in the flexibility subscale score. This effect still remained significant after accounting for potential confounders. Conclusion: Establishing DGRs proofed to be an effective way of successfully improving both students' diagnostic reasoning and the ability to select the appropriate test method in routine clinical practice.

  2. Diagnostic grand rounds: A new teaching concept to train diagnostic reasoning

    Stieger, Stefan, E-mail: stefan.stieger@univie.ac.at [Department of Basic Psychological Research, School of Psychology, University of Vienna, Liebiggasse 5, A-1010 Vienna (Austria); Praschinger, Andrea, E-mail: andrea.praschinger@meduniwien.ac.at [Core Unit for Medical Education (BEMAW), Medical University of Vienna, Spitalgasse 23, BT87, P.O. 10, A-1097 Vienna (Austria); Kletter, Kurt, E-mail: kurt.kletter@meduniwien.ac.at [Department of Nuclear Medicine, General Hospital of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Kainberger, Franz, E-mail: franz.kainberger@meduniwien.ac.at [Department of Radiology, General Hospital of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    2011-06-15

    Introduction: Diagnostic reasoning is a core skill in teaching and learning in undergraduate curricula. Diagnostic grand rounds (DGRs) as a subform of grand rounds are intended to train the students' skills in the selection of appropriate tests and in the interpretation of test results. The aim of this study was to test DGRs for their ability to improve diagnostic reasoning by using a pre-post-test design. Methods: During one winter term, all 398 fifth-year students (36.1% male, 63.9% female) solved 23 clinical cases presented in 8 DGRs. In an online questionnaire, a Diagnostic Thinking Inventory (DTI) with 41 items was evaluated for flexibility in thinking and structure of knowledge in memory. Results were correlated with those from a summative multiple-choice knowledge test and of the learning objectives in a logbook. Results: The students' DTI scores in the post-test were significantly higher than those reported in the pre-test. DTI scores at either testing time did not correlate with medical knowledge as assessed by a multiple-choice knowledge test. Abilities acquired during clinical clerkships as documented in a logbook could only account for a small proportion of the increase in the flexibility subscale score. This effect still remained significant after accounting for potential confounders. Conclusion: Establishing DGRs proofed to be an effective way of successfully improving both students' diagnostic reasoning and the ability to select the appropriate test method in routine clinical practice.

  3. Multiple comorbidities of 21 psychological disorders and relationships with psychosocial variables: a study of the online assessment and diagnostic system within a web-based population.

    Al-Asadi, Ali M; Klein, Britt; Meyer, Denny

    2015-02-26

    While research in the area of e-mental health has received considerable attention over the last decade, there are still many areas that have not been addressed. One such area is the comorbidity of psychological disorders in a Web-based sample using online assessment and diagnostic tools, and the relationships between comorbidities and psychosocial variables. We aimed to identify comorbidities of psychological disorders of an online sample using an online diagnostic tool. Based on diagnoses made by an automated online assessment and diagnostic system administered to a large group of online participants, multiple comorbidities (co-occurrences) of 21 psychological disorders for males and females were identified. We examined the relationships between dyadic comorbidities of anxiety and depressive disorders and the psychosocial variables sex, age, suicidal ideation, social support, and quality of life. An online complex algorithm based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision, was used to assign primary and secondary diagnoses of 21 psychological disorders to 12,665 online participants. The frequency of co-occurrences of psychological disorders for males and females were calculated for all disorders. A series of hierarchical loglinear analyses were performed to examine the relationships between the dyadic comorbidities of depression and various anxiety disorders and the variables suicidal ideation, social support, quality of life, sex, and age. A 21-by-21 frequency of co-occurrences of psychological disorders matrix revealed the presence of multiple significant dyadic comorbidities for males and females. Also, for those with some of the dyadic depression and the anxiety disorders, the odds for having suicidal ideation, reporting inadequate social support, and poorer quality of life increased for those with two-disorder comorbidity than for those with only one of the same two disorders. Comorbidities of

  4. Molecular diagnostics of a single drug-resistant multiple myeloma case using targeted next-generation sequencing

    Ikeda H

    2015-10-01

    Full Text Available Hiroshi Ikeda,1 Kazuya Ishiguro,1 Tetsuyuki Igarashi,1 Yuka Aoki,1 Toshiaki Hayashi,1 Tadao Ishida,1 Yasushi Sasaki,1,2 Takashi Tokino,2 Yasuhisa Shinomura1 1Department of Gastroenterology, Rheumatology and Clinical Immunology, 2Medical Genome Sciences, Research Institute for Frontier Medicine, Sapporo Medical University, Sapporo, Japan Abstract: A 69-year-old man was diagnosed with IgG λ-type multiple myeloma (MM, Stage II in October 2010. He was treated with one cycle of high-dose dexamethasone. After three cycles of bortezomib, the patient exhibited slow elevations in the free light-chain levels and developed a significant new increase of serum M protein. Bone marrow cytogenetic analysis revealed a complex karyotype characteristic of malignant plasma cells. To better understand the molecular pathogenesis of this patient, we sequenced for mutations in the entire coding regions of 409 cancer-related genes using a semiconductor-based sequencing platform. Sequencing analysis revealed eight nonsynonymous somatic mutations in addition to several copy number variants, including CCND1 and RB1. These alterations may play roles in the pathobiology of this disease. This targeted next-generation sequencing can allow for the prediction of drug resistance and facilitate improvements in the treatment of MM patients. Keywords: multiple myeloma, drug resistance, genome-wide sequencing, semiconductor sequencer, target therapy

  5. Multiple primary malignancies of the liver and the colon: a complex diagnostic and decisional process with a final unanswered question.

    Portolani, Nazario; Baiocchi, Gianluca; Baronchelli, Carla; Gheza, Federico; Giulini, Stefano Maria

    2014-03-29

    We herein present the case of a 78-year-old man with an incidental finding of a solid hepatic mass without symptoms and only a laparotomic cholecystectomy for acute cholecystitis in the past surgical history. A colonoscopy, a magnetic resonance imaging scan, a positron emission tomography scan, and a computed tomography scan completed the preoperative workup: a neoplastic lesion 4.3×3 cm in size was diagnosed at segments IV and V, associated with a neoplastic involvement of the splenic flexure without signs of colonic occlusion. After colonic resection, a frozen section on a granulomatous-like tissue at gastric border suggested a diagnosis of an adenocarcinoma of bilio-pancreatic type, changing the surgical strategy to include gastric resection and hepatic pedicle node dissection. The discussion turns around the idea that a final diagnosis of colon cancer with regional nodal involvement (pT3N1) and metastatic gallbladder cancer with multiple peritoneal seedings cannot be excluded.

  6. Effects of phentermine and pentobarbital on choice processes during multiple probability learning (MPL) and decision processes manipulated by pay-off conditions

    Volkerts, ER; VanLaar, MW; Verbaten, MN; Mulder, G; Maes, RAA

    1997-01-01

    The primary research question in this investigation concerned whether arousal manipulation by a stimulant (phentermine 20 mg) and a depressant (pentobarbital 100 mg) will oppositely affect choice behaviour in a probability learning task and decision processes manipulated by pay-off. A 3-source

  7. Low field-low cost: Can low-field magnetic resonance systems replace high-field magnetic resonance systems in the diagnostic assessment of multiple sclerosis patients?

    Ertl-Wagner, B.B.; Reith, W.; Sartor, K.

    2001-01-01

    As low-field MR imaging is becoming a widely used imaging technique, we aimed at a prospective assessment of differences in imaging quality between low- and high-field MR imaging in multiple sclerosis patients possibly interfering with diagnostic or therapeutic decision making. Twenty patients with clinically proven multiple sclerosis were examined with optimized imaging protocols in a 1.5- and a 0.23-T MR scanner within 48 h. Images were assessed independently by two neuroradiologists. No statistically significant interrater discrepancies were observed. A significantly lower number of white matter lesions could be identified in low-field MR imaging both on T1- and on T2-weighted images (T2: high field 700, low field 481; T1: high field 253, low field 177). A total of 114 enhancing lesions were discerned in the high-field MR imaging as opposed to 45 enhancing lesions in low-field MR imaging. Blood-brain barrier disruption was identified in 11 of 20 patients in the high-field MR imaging, but only in 4 of 20 patients in low-field MR imaging. Since a significantly lower lesion load is identified in low-field MR imaging than in high-field MR imaging, and blood-brain barrier disruption is frequently missed, caution must be exercised in interpreting a normal low-field MR imaging scan in a patient with clinical signs of multiple sclerosis and in interpreting a scan without enhancing lesions in a patient with known multiple sclerosis and clinical signs of exacerbation. (orig.)

  8. Quantification of diagnostic biomarkers to detect multiple sclerosis lesions employing 1H-MRSI at 3T

    Vafaeyan, H.; Ebrahimzadeh, S.A.; Rahimian, N.; Harirchian, M.H.; Alavijeh, S. Karimi; Rad, H. Saligheh; Madadi, A.; Faeghi, F.

    2015-01-01

    Proton magnetic resonance spectroscopic imaging ( 1 H-MRSI) enables the quantification of metabolite concentration ratios in the brain. The major purpose of the current work is to characterize NAA/Cho, NAA/Cr and Myo/Cr in multiple sclerosis (MS) patients, and to estimate their reproducibility in healthy controls. Twelve MS patients and five healthy volunteers were imaged using 1 H-MRSI at 3T. Eddy current correction was performed using a single-voxel non-water suppressed acquisition on an external water phantom. Time-domain quantification was carried out using subtract-QUEST technique, and based on an optimal simulated metabolite database. Reproducibility was evaluated on the same quantified ratios in five normal subjects. An optimal database was created for the quantification of the MRSI data, consisting of choline (Cho), creatine (Cr), N-acetyl aspartate (NAA), lactate (Lac), lipids, myo-inositol (Myo) and glutamine + glutamate (Glx). Decreasing of NAA/Cr and NAA/Cho ratios, as well as an increase in Myo/Cr ratio were observed for MS patients in comparison with control group. Reproducibility of NAA/Cr, NAA/Cho and Myo/Cr in control group was 0.98, 0.87 and 0.64, respectively, expressed as the squared correlation coefficient R 2 between duplicate experiments. We showed that MRSI alongside the time-domain quantification of spectral ratios offers a sensitive and reproducible framework to differentiate MS patients from normals.

  9. Diagnostic performance of whole-body MRI for the detection of persistent or relapsing disease in multiple myeloma after stem cell transplantation

    Bannas, Peter; Hentschel, Hannah B.; Bley, Thorsten A.; Derlin, Thorsten; Yamamura, Jin; Adam, Gerhard; Weber, Christoph [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Treszl, Andras; Eulenburg, Christine [University Medical Center Hamburg-Eppendorf, Department of Medical Biometry and Epidemiology, Hamburg (Germany); Stuebig, Thomas; Kroeger, Nicolaus [University Medical Center Hamburg-Eppendorf, Department of Stem Cell Transplantation, Hamburg (Germany)

    2012-09-15

    To compare the diagnostic performance of whole-body MRI (WBMRI) with haematological parameters for detecting persistent or relapsing disease in patients with multiple myeloma after stem cell transplantation. Sixty-six WBMRI acquisitions were performed in 33 patients with multiple myeloma at two time points after stem cell transplantation. Extent of disease and inter-test dynamics of intra- and extramedullary myeloma manifestations were compared (kappa statistics) with Uniform Response Criteria, comprising haematological parameters. Using data from 66 sequential WBMRI acquisitions in 33 patients, 10 patients (30.3 %) were classified as having progressive disease and 23 (69.7 %) as being in remission. Eight (80 %) of the ten patients with progressive disease revealed intramedullary lesions, and two patients (20 %) had intra- and extramedullary lesions. WBMRI and laboratory tests were concordant in 26/33 (78.8 %) patients. We found an agreement of 51.2 %, 95 % confidence interval 19.8 %-82.6 %, between results from WBMRI and haematological parameters. WBMRI had a sensitivity of 63.6 %, specificity of 86.4 %, PPV of 70.0 %, NPV of 82.6 % and accuracy of 78.8 % for detection of remission. WBMRI allows the detection and exact localisation of intra- and extramedullary myeloma manifestations after stem cell transplantation, but shows only moderate agreement with routinely performed laboratory tests for determination of remission. (orig.)

  10. The Effect of Multiple Sulfatase Deficiency (MSD) on Dental Development: Can We Use the Teeth as an Early Diagnostic Tool?

    Zilberman, Uri; Bibi, Haim

    2016-01-01

    Multiple sulfatase deficiency (MSD) is a rare autosomal recessive inborn error of metabolism due to reduced catalytic activity of the different sulfatase. Affected individuals show neurologic deterioration with mental retardation, skeletal anomalies, organomegaly, and skin changes as in X-linked ichthyosis. The only organ that was not examined in MSD patients is the dentition. To evaluate the effect of the metabolic error on dental development in a patient with the intermediate severe late-infantile form of MSD (S155P). Histological and chemical study were performed on three deciduous and five permanent teeth from MSD patient and pair-matched normal patients. Tooth germ size and enamel thickness were reduced in both deciduous and permanent MSD teeth, and the scalloping feature of the DEJ was missing in MSD teeth causing enamel to break off from the dentin. The mineral components in the enamel and dentin were different. The metabolic error insults the teeth in the stage of organogenesis in both the deciduous and permanent dentition. The end result is teeth with very sharp cusp tips, thin hypomineralized enamel, and exposed dentin due to the break off of enamel. These findings are different from all other types of MPS syndromes.Clinically the phenotype of intermediate severe late-infantile form of MSD appeared during the third year of life. In children of parents that are carriers, we can diagnose the disease as early as birth using X-ray radiograph of the anterior upper region or as early as 6-8 months when the first deciduous tooth erupt and consider very early treatment to ameliorate the symptoms.

  11. Using Diagnostic Assessment to Help Teachers Understand the Chemistry of the Lead-Acid Battery

    Cheung, Derek

    2011-01-01

    Nineteen pre-service and in-service teachers taking a chemistry teaching methods course at a university in Hong Kong were asked to take a diagnostic assessment. It consisted of seven multiple-choice questions about the chemistry of the lead-acid battery. Analysis of the teachers' responses to the questions indicated that they had difficulty in…

  12. Gruppenleistungen beim Review von Multiple-Choice-Fragen - Ein Vergleich von face-to-face und virtuellen Gruppen mit und ohne Moderation [Review of multiple-choice-questions and group performance - A comparison of face-to-face and virtual groups with and without facilitation

    Schüttpelz-Brauns, Katrin

    2010-11-01

    Full Text Available [english] Background: Multiple choice questions (MCQs are often used in exams of medical education and need careful quality management for example by the application of review committees. This study investigates whether groups communicating virtually by email are similar to face-to-face groups concerning their review process performance and whether a facilitator has positive effects.Methods: 16 small groups of students were examined, which had to evaluate and correct MCQs under four different conditions. In the second part of the investigation the changed questions were given to a new random sample for the judgement of the item quality.Results: There was no significant influence of the variables “form of review committee” and “facilitation”. However, face-to-face and virtual groups clearly differed in the required treatment times. The test condition “face to face without facilitation” was generally valued most positively concerning taking over responsibility, approach to work, sense of well-being, motivation and concentration on the task.Discussion: Face-to-face and virtual groups are equally effective in the review of MCQs but differ concerning their efficiency. The application of electronic review seems to be possible but is hardly recommendable because of the long process time and technical problems.[german] Einleitung: Multiple-Choice-Fragen (MCF werden in vielen Prüfungen der medizinischen Ausbildung verwendet und bedürfen aus diesem Grund einer sorgfältigen Qualitätssicherung, beispielsweise durch den Einsatz von Review-Komitees. Anhand der vorliegenden empirischen Studie soll erforscht werden, ob virtuell per E-Mail kommunizierende Review-Komitees vergleichbar sind mit face-to-face Review-Komitees hinsichtlich ihrer Leistung beim Review-Prozess und ob sich Moderation positiv auswirkt.Methodik: 16 Kleingruppen von Psychologie-Studenten hatten die Aufgabe unter vier verschiedenen Versuchsbedingungen MCF zu bewerten und zu

  13. Vincent's Choice

    Stolwijk, Chris

    2003-01-01

    Official publication to accompany the important exhibition Vincent's Choice, Van Gogh's 'musee imaginaire' at the Van Gogh Museum, Amsterdam marking the 150th anniversary of the artist's birth. The exhibition runs from 14th February to 15th June 2003.Thanks to van Gogh's correspondence, it has been

  14. Diagnostic value of whole-body low-dose computed tomography (WBLDCT) in bone lesions detection in patients with multiple myeloma (MM)

    Ippolito, Davide, E-mail: davide.atena@tiscalinet.it [School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza (MB) (Italy); Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy); Besostri, Valeria, E-mail: valeriabesostri@gmail.com [School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza (MB) (Italy); Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy); Bonaffini, Pietro Andrea, E-mail: pa.bonaffini@gmail.com [School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza (MB) (Italy); Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy); Rossini, Fausto, E-mail: valeriabesostri@hotmail.it [Department of Hematology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy); Di Lelio, Alessandro, E-mail: valebeso@libero.it [Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy); Sironi, Sandro, E-mail: sandrosironi@libero.it [School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza (MB) (Italy); Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy)

    2013-12-01

    Purpose: To assess the role of whole-body low-dose computed tomography (WBLDCT) in the diagnosis and staging of patients with suspicion of multiple myeloma (MM). Materials and methods: A total of 138 patients (76 male and 62 female; mean age 63.5 years, range 50–81 years), with early MM, underwent WBLDCT protocol study, performed on 16-slice scanner (Brilliance, Philips Medical System, Eindhoven, The Netherlands): tube voltage 120 kV; tube current time product 40 mAs. Diagnosis of osteolytic lesions was performed on the basis of axial and multiplanar reformatted images, whereas the assessment of spinal misalignment and fracture was done by using multiplanar reformatted images. The overall dose delivered to each patient was 4.2 mSv. Every patient gave personal informed consent, as required by our institution guidelines. Results: The diagnosis was established either by histopathology or imaging follow-up (size increase of over a period time). In all 138 patients, image resolution was diagnostic, enabling correct classification of multiple myeloma patients. WBLDCT showed a total of 328 pathologic bone findings in 81/138 patients. CT scanning resulted in complete evaluation of the bone lesions in these areas of the skeleton: skull (42), humerus (15), femur (20), ribs (7), scapulae (13), pelvis (35), clavicle (13), sternum (10), cervical (39), dorsal (65), lombar (48) and sacral rachis (21). In 40/81 bone involvement detected by CT was the only CRAB criterion present. Furthermore, WBLDCT demonstrated pleuro-pulmonary lesions in 20 patients (11 infective, 9 as MM localizations) and 1 renal neoplasia. Conclusion: WBLDCT, detecting bone marrow localizations and demonstrating extra-osseous findings, with a fast scanning time and high resolution images, is a reliable imaging-based tool for a proper management of MM patients.

  15. Added diagnostic benefit of 16-row whole-body spiral CT in patients with multiple trauma differentiated by region and injury severity according to the ATLS registered concept

    Maurer, M.H.; Knopke, S.; Schroeder, R.J.

    2008-01-01

    Purpose: to determine the added diagnostic benefit of using MS-CT in multiple trauma patients differentiated by severity of injury and affected body region. Materials and methods: a retrospective analysis was performed of the 16-row whole-body spiral CT findings in 275 multiple trauma patients (73% men, 27% women; age 39.6 ± 18.9 years) with regard to additional findings and new findings obtained with CT compared to the findings obtained by conventional projection radiography and abdominal ultrasound in the emergency room. The additional and new findings were differentiated by body region (head, face, chest, pelvis, abdomen, spine) and the degree of severity according to the three classes of injuries distinguished by the ATLS registered concept (class 1: simple injury, class 2: potentially life threatening, class 3: immediately life threatening). Results: a total of 921 additional findings (findings potentially relevant for further diagnosis and therapy in addition to the findings obtained by conventional radiography or ultrasound) were obtained by MS-CT in all patients. The distribution by number of patients and body region was as follows: 22 neck, 76 face, 125 chest, 112 abdomen, 50 pelvis, and 91 spine. Most additional findings were categorized as potentially life threatening (ATLS class 2). In addition, there were 439 completely new findings, involving the head in 128 patients (mostly ATLS class 3), the face in 18, the chest in 47, the abdomen in 26, and the spine in 9 patients. Most new findings involving the face, abdomen, and spine were ATLS class 2 injuries. (orig.)

  16. Co-existence of Blau syndrome and NAID? Diagnostic challenges associated with presence of multiple pathogenic variants in NOD2 gene: a case report.

    Dziedzic, Magdalena; Marjańska, Agata; Bąbol-Pokora, Katarzyna; Urbańczyk, Anna; Grześk, Elżbieta; Młynarski, Wojciech; Kołtan, Sylwia

    2017-07-27

    Pediatric autoinflammatory diseases are rare and still poorly understood conditions resulting from defective genetic control of innate immune system, inter alia from anomalies of NOD2 gene. The product of this gene is Nod2 protein, taking part in maintenance of immune homeostasis. Clinical form of resultant autoinflammatory condition depends on NOD2 genotype; usually patients with NOD2 defects present with Blau syndrome, NOD2-associated autoinflammatory disease (NAID) or Crohn's disease. We present the case of a 7-year-old girl with co-existing symptoms of two rare diseases, Blau syndrome and NAID. Overlapping manifestations of two syndromes raised a significant diagnostic challenge, until next-generation molecular test (NGS) identified presence of three pathogenic variants of NOD2 gene: P268S, IVS8 +158 , 1007 fs, and established the ultimate diagnosis. Presence of multiple genetical abnormalities resulted in an ambiguous clinical presentation with overlapping symptoms of Blau syndrome and NAID. Final diagnosis of autoinflammatory disease opened new therapeutic possibilities, including the use of biological treatments.

  17. Survey of diagnostic and treatment practices for multiple sclerosis (MS) in Europe. Part 2: Progressive MS, paediatric MS, pregnancy and general management.

    Fernández, O; Delvecchio, M; Edan, G; Fredrikson, S; Giovannoni, G; Hartung, H-P; Havrdova, E; Kappos, L; Pozzilli, C; Soerensen, P S; Tackenberg, B; Vermersch, P; Comi, G

    2018-05-01

    The European Charcot Foundation supported the development of a set of surveys to understand current practice patterns for the diagnosis and management of multiple sclerosis (MS) in Europe. Part 2 of the report summarizes survey results related to secondary progressive MS (SPMS), primary progressive MS (PPMS), pregnancy, paediatric MS and overall patient management. A steering committee of MS neurologists developed case- and practice-based questions for two sequential surveys distributed to MS neurologists throughout Europe. Respondents generally favoured changing rather than stopping disease-modifying treatment (DMT) in patients transitioning from relapsing-remitting MS to SPMS, particularly with active disease. Respondents would not initiate DMT in patients with typical PPMS symptoms, although the presence of ≥1 spinal cord or brain gadolinium-enhancing lesion might affect that decision. For patients considering pregnancy, respondents were equally divided on whether to stop treatment before or after conception. Respondents strongly favoured starting DMT in paediatric MS with active disease; recommended treatments included interferon, glatiramer acetate and, in John Cunningham virus negative patients, natalizumab. Additional results regarding practice-based questions and management are summarized. Results of part 2 of the survey of diagnostic and treatment practices for MS in Europe largely mirror results for part 1, with neurologists in general agreement about the treatment and management of SPMS, PPMS, pregnancy and paediatric MS as well as the general management of MS. However, there are also many areas of disagreement, indicating the need for evidence-based recommendations and/or guidelines. © 2018 EAN.

  18. Dynamic Portfolio Choice with Frictions

    Garleanu, Nicolae; Heje Pedersen, Lasse

    2016-01-01

    We show how portfolio choice can be modeled in continuous time with transitory and persistent transaction costs, multiple assets, multiple signals predicting returns, and general signal dynamics. The objective function is derived from the limit of discrete-time models with endogenous transaction...

  19. Home care for children with multiple complex chronic conditions at the end of life: The choice of hospice versus home health.

    Lindley, Lisa C; Mixer, Sandra J; Mack, Jennifer W

    2016-01-01

    Families desire to bring their children home at end of life, and this creates a variety of unique care needs at home. This study analyzed the child and family factors associated with hospice versus home health care use in the last year of life among children with multiple complex chronic conditions. Using the Andersen Behavioral Healthcare Utilization Model, the predisposing, enabling, and need factors of the child and family were shown to be significant predictors of hospice and home health care use. Hospice and home health care have advantages, and families may wish to use the service that best fits their needs.

  20. Facilitating High School Students' Use of Multiple Representations to Describe and Explain Simple Chemical Reactions

    Chandrasegaran, A. L.; Treagust, David F.; Mocerino, Mauro

    2011-01-01

    This study involved the evaluation of the efficacy of a planned instructional program to facilitate understanding of the macroscopic, submicroscopic and symbolic representational systems when describing and explaining chemical reactions by sixty-five Grade 9 students in a Singapore secondary school. A two-tier multiple-choice diagnostic instrument…

  1. Choice & Consequence

    Khan, Azam

    to support hypothesis generation, hypothesis testing, and decision making. In addition to sensors in buildings, infrastructure, or the environment, we also propose the instrumentation of user interfaces to help measure performance in decision making applications. We show the benefits of applying principles...... between cause and effect in complex systems complicates decision making. To address this issue, we examine the central role that data-driven decision making could play in critical domains such as sustainability or medical treatment. We developed systems for exploratory data analysis and data visualization...... of data analysis and instructional interface design, to both simulation systems and decision support interfaces. We hope that projects such as these will help people to understand the link between their choices and the consequences of their decisions....

  2. Radiation risk to the patient: a case study involving multiple diagnostic X ray exposures given over a period of 25 years

    Rainbow, A.J.; McMaster Univ., Hamilton, ON; Roginski, P.; McGeen, W.

    1992-01-01

    The cumulative somatic dose index (SDI) for a number of diagnostic X ray examinations was made for a 60 year old male. The history of diagnostic X ray exposure for this patient from 1957 to 1983 showed 29 diagnostic X ray examinations including more than 100 films and 15 minutes of fluoroscopy. The total cumulative SDI to this patient was 214 mGy (about 21 rad). More than half this dose, 142 mGy, was contributed from upper GI and barium enema examinations which used fluoroscopy, with 88 mGy from the fluoroscopy alone. Using the recently revised risk coefficient for fatal cancer following whole-body irradiation of adult workers recommended by the International Commission on Radiological Protection in 1990, the authors estimate a 0.9% cancer morality risk to this patient resulting from the 29 diagnostic X ray examinations. (author)

  3. ¹⁸F-FDG PET/CT: a review of diagnostic and prognostic features in multiple myeloma and related disorders.

    Dammacco, Franco; Rubini, Giuseppe; Ferrari, Cristina; Vacca, Angelo; Racanelli, Vito

    2015-02-01

    Conventional radiographic skeletal survey has been for many years the gold standard to detect the occurrence of osteolytic lesions in patients with multiple myeloma (MM). However, the introduction of more sensitive imaging procedures has resulted in an updated anatomic and functional Durie and Salmon "plus" staging system and has remarkably changed the diagnostic and prognostic approach to this tumor. It is now established that (18)fluorine-fluorodeoxyglucose ((18)F-FDG) positron-emission tomography (PET) combined with low-dose computed tomography (CT), shortly designated PET/CT, exhibits a higher screening and diagnostic sensitivity and specificity over the skeleton X-ray. In patients with monoclonal gammopathy of undetermined significance and in those with smoldering MM, PET/CT is consistently unable to detect focal and/or diffuse marrow abnormalities. Conversely, based on a systematic review of 18 studies comprising almost 800 MM patients, PET/CT was able to detect MM osteolytic lesions with a sensitivity of approximately 80-90% and a specificity of 80-100%. Importantly, a poor degree of concordance has also been emphasized between PET/CT and whole-body magnetic resonance imaging (WB-MRI) in that when both techniques were applied to the same patients, double-positive results were recorded in approximately 30% of the cases, but in the majority of them, a higher number of lesions were revealed with PET/CT than with MRI. Double-negative results, on the other hand, were found in about 22% of the patients. Because PET/CT is able to identify tumor foci throughout the body, it can be usefully applied to the study of solitary bone plasmacytoma and extra-medullary plasmacytoma: In both conditions, the detection of additional, previously overlooked sites of skeletal involvement would falsify the diagnosis of single-district disease, upstage the tumor, and therefore require a different therapeutic approach. In addition, although PET/CT is poorly sensitive to diffuse bone

  4. Snapping wrist due to multiple accessory tendon of first extensor compartment

    S. Dhiyaneswaran Subramaniyam

    2018-01-01

    Conclusion: There are various causes for snapping wrist syndrome. Multiple accessory tendon can also cause snapping as shown in this case report. Moreover am presenting this case to highlight the diagnostic failure with non dynamic radiological investigation and to consider multiple accessory tendon as differential diagnosis for snapping wrist syndrome. Also suggest dynamic study could be a better choice of investigation to diagnosis snapping syndrome. First compartment tunnel release with few accessory tendon slip tenotomy gives good result.

  5. Multiple Primary Tumors

    2017-12-05

    Dec 5, 2017 ... Multiple primary tumors occur in clinical practice causing diagnostic dilemma. It is not very .... was estrogen receptor negative, progesterone receptor negative, and ... cervical, ovarian, and urinary bladder cancers. Multiple.

  6. Coupled Multiple-Response versus Free-Response Conceptual Assessment: An Example from Upper-Division Physics

    Wilcox, Bethany R.; Pollock, Steven J.

    2014-01-01

    Free-response research-based assessments, like the Colorado Upper-division Electrostatics Diagnostic (CUE), provide rich, fine-grained information about students' reasoning. However, because of the difficulties inherent in scoring these assessments, the majority of the large-scale conceptual assessments in physics are multiple choice. To increase…

  7. Choice Orientations, Discussions, and Prospects.

    Raywid, Mary Anne

    1992-01-01

    Examining the contemporary school choice debate yields arguments that are education, economics, governance, and policy driven. To "break the exclusive franchise," school districts are increasingly sponsoring school operation and education services supplied by multiple sources, and states are discussing sponsorship of schools by entities…

  8. Physical and Cognitive Functioning After 3 Years Can Be Predicted Using Information From the Diagnostic Process in Recently Diagnosed Multiple Sclerosis

    de Groot, V.; Beckerman, H.; Uitdehaag, B.M.J.; Hintzen, R.Q.; Minneboo, A.; Heymans, M.W.; Lankhorst, G.J.; Polman, C.H.; Bouter, L.M.

    2009-01-01

    de Groot V, Beckerman H, Uitdehaag BM, Hintzen RQ, Minneboo A, Heymans MW, Lankhorst GJ, Polman CH, Bouter LM, on behalf of the Functional Prognostication and Disability (FuPro) Study Group. Physical and cognitive functioning after 3 years can be predicted using information from the diagnostic

  9. The Multiple Choices of Sex Education

    Hamilton, Rashea; Sanders, Megan; Anderman, Eric M.

    2013-01-01

    Sex education in middle and high school health classes is critically important because it frequently comprises the primary mechanism for conveying information about sexual health to adolescents. Deliver evidence-based information on HIV and pregnancy prevention practices and they will be less likely to engage in risky sexual behaviors, the theory…

  10. Using module analysis for multiple choice responses

    Brewe, Eric; Bruun, Jesper; Bearden, Ian

    2016-01-01

    We describe a methodology for carrying out a network analysis of Force Concept Inventory (FCI) responses that aims to identify communities of incorrect responses. This method first treats FCI responses as a bipartite, student X response, network. We then use Locally Adaptive Network Sparsificatio...

  11. Choice certainty in Discrete Choice Experiments

    Uggeldahl, Kennet Christian; Jacobsen, Catrine; Lundhede, Thomas

    2016-01-01

    In this study, we conduct a Discrete Choice Experiment (DCE) using eye tracking technology to investigate if eye movements during the completion of choice sets reveal information about respondents’ choice certainty. We hypothesise that the number of times that respondents shift their visual...

  12. Integrated multi-choice goal programming and multi-segment goal programming for supplier selection considering imperfect-quality and price-quantity discounts in a multiple sourcing environment

    Chang, Ching-Ter; Chen, Huang-Mu; Zhuang, Zheng-Yun

    2014-05-01

    Supplier selection (SS) is a multi-criteria and multi-objective problem, in which multi-segment (e.g. imperfect-quality discount (IQD) and price-quantity discount (PQD)) and multi-aspiration level problems may be significantly important; however, little attention had been given to dealing with both of them simultaneously in the past. This study proposes a model for integrating multi-choice goal programming and multi-segment goal programming to solve the above-mentioned problems by providing the following main contributions: (1) it allows decision-makers to set multiple aspiration levels on the right-hand side of each goal to suit real-world situations, (2) the PQD and IQD conditions are considered in the proposed model simultaneously and (3) the proposed model can solve a SS problem with n suppliers where each supplier offers m IQD with r PQD intervals, where only ? extra binary variables are required. The usefulness of the proposed model is explained using a real case. The results indicate that the proposed model not only can deal with a SS problem with multi-segment and multi-aspiration levels, but also can help the decision-maker to find the appropriate order quantities for each supplier by considering cost, quality and delivery.

  13. Exploring undergraduates' understanding of photosynthesis using diagnostic question clusters.

    Parker, Joyce M; Anderson, Charles W; Heidemann, Merle; Merrill, John; Merritt, Brett; Richmond, Gail; Urban-Lurain, Mark

    2012-01-01

    We present a diagnostic question cluster (DQC) that assesses undergraduates' thinking about photosynthesis. This assessment tool is not designed to identify individual misconceptions. Rather, it is focused on students' abilities to apply basic concepts about photosynthesis by reasoning with a coordinated set of practices based on a few scientific principles: conservation of matter, conservation of energy, and the hierarchical nature of biological systems. Data on students' responses to the cluster items and uses of some of the questions in multiple-choice, multiple-true/false, and essay formats are compared. A cross-over study indicates that the multiple-true/false format shows promise as a machine-gradable format that identifies students who have a mixture of accurate and inaccurate ideas. In addition, interviews with students about their choices on three multiple-choice questions reveal the fragility of students' understanding. Collectively, the data show that many undergraduates lack both a basic understanding of the role of photosynthesis in plant metabolism and the ability to reason with scientific principles when learning new content. Implications for instruction are discussed.

  14. Pairwise Choice Markov Chains

    Ragain, Stephen; Ugander, Johan

    2016-01-01

    As datasets capturing human choices grow in richness and scale---particularly in online domains---there is an increasing need for choice models that escape traditional choice-theoretic axioms such as regularity, stochastic transitivity, and Luce's choice axiom. In this work we introduce the Pairwise Choice Markov Chain (PCMC) model of discrete choice, an inferentially tractable model that does not assume any of the above axioms while still satisfying the foundational axiom of uniform expansio...

  15. A CLINICAL CASE: DIAGNOSTICS OF SHERESHEVSKY TERNER SYNDROME WITH MULTIPLE CONGENITAL ANOMALIES IN MAIN ARTERIES OF A 4 YEAR OLD CHILD, SUFFERING FROM ARTERIAL HYPERTENSION

    A.N. Tsygin

    2007-01-01

    Full Text Available The article provides a substantiation for the differential diagnostics of the symptomatic arterial hypertension of a 4 year old child, suffering from the arterial hypertension of the presumably renoparenchymal origin. In the course of the clinical examination, the researchers found out coarctation of aorta and hypoplasia of the right renal artery as a part of Shereshevsky-Terner syndrome.Key words: arterial hypertension, Shereshevsky-Terner syndrome, coarctation of aorta, renovascular hypertension.

  16. Allocation of multiple, widely spread oil spills associated with one polluter : GC-MS fingerprinting and diagnostic ratios of spilled oil and oiled seabirds

    Hansen, A.B.; Avnskjold, J.

    2005-01-01

    In January 2005, a Cypriot cargo ship leaked about 5 tons of heavy fuel bunker oil in Kerteminde Bay in the Great Belt, Denmark. The ship was stopped to inspect and collect oil samples from its 2 damaged tanks for forensic oil spill identification by gas chromatography and mass spectrometry. Two weeks following the accident, a series of waterborne and stranded oil spills showed up in the Great Belt area, north and south of the vessel's route. Thousands of oiled seabirds on small islands and coastlines were affected. The Danish Coast Guard suspected that the vessel might be responsible for the observed spills. More than 50 oil samples were collected and sent for forensic analysis at the National Environmental Research Institute. Both waterborne and stranded spill samples showed an almost perfect match of diagnostic ratios and chromatograph with the potential responsible party (PRP) bunker. The spill samples therefore matched the reference oil and were allocated to the spill associated with the Cypriot cargo ship. One sample deviated significantly from the other samples and was not allocated to the ship's accidental spill. Oil samples collected from oiled seabirds showed larger variations between diagnostic ratios and the reference bunker oils. The variations can be attributed to weathering and biodegradation, but also to contamination by non-petrogenic material. It was concluded that the oiled seabirds represented non-match samples that cannot be allocated to the oil spill associated with the Cypriot cargo ship. 14 refs., 3 tabs., 4 figs

  17. Evaluation of Multiple Diagnostic Indicators in Comparison to the Intestinal Biopsy as the Golden Standard in Diagnosing Celiac Disease in Children

    Elisabet Hollén

    2016-11-01

    Full Text Available Celiac disease (CD is a chronic small intestinal enteropathy triggered by gluten in genetically predisposed individuals. The susceptibility is strongly associated with certain human leukocyte antigen (HLA-genes, but efforts are being made in trying to find non-HLA genes that are predictive for the disease. The criteria for diagnosing CD were previously based primarily on histologic evaluation of small intestinal biopsies, but nowadays are often based only on blood tests and symptoms. In this context, we elucidated the accuracy of three diagnostic indicators for CD, alone or in combination. Genetic analyses of HLA-type and nine single nucleotide polymorphisms (SNPs known to be associated with CD were performed in 177 children previously investigated for the suspicion of CD. CD was confirmed in 109 children, while 68 were considered non-celiacs. The antibodies and urinary nitrite/nitrate concentrations of all of them were measured. The combinations of all the variables used in the study would classify 93% of the study population in the correct diagnostic group. The single best predictors were antibodies (i.e., anti-endomysium immunoglobulin A (IgA (EMA and transglutaminase IgA (TGA, followed by HLA-type and nitric oxide (NO-metabolites. The nine SNPs used did not contribute to the right diagnoses. Although our control group consisted of children with mostly gastrointestinal symptoms, the presented methodology predicted a correct classification in more than 90% of the cases.

  18. The Diagnostic Drawing Series and the Tree Rating Scale: An Isomorphic Representation of Multiple Personality Disorder, Major Depression, and Schizophrenic Populations.

    Morris, Maureen Batza

    1995-01-01

    The tree drawings of 80 subjects, who were diagnosed with either multiple personality disorder, schizophrenia, or major depression, and a control group, were rated. Patterns were examined and graphs were used to depict results. Certain features were found to distinguish each category. The descriptive statistical findings were both consistent and…

  19. Cross-diagnostic validity of the SF-36 physical functioning scale in patients with stroke, multiple sclerosis and amyotrophic lateral sclerosis: a study using Rasch analysis

    Dallmeijer, Annet J.; de Groot, Vincent; Roorda, Leo D.; Schepers, Vera P. M.; Lindeman, Eline; van den Berg, Leonard H.; Beelen, Anita; Dekker, Joost

    2007-01-01

    The aim of this study was to investigate unidimensionality and differential item functioning of the SF-36 physical functioning scale (PF10) in patients with various neurological disorders. Patients: Patients post-stroke (n = 198), with multiple sclerosis (n = 151) and amyotrophic lateral sclerosis

  20. Physical and cognitive functioning after 3 years can be predicted using information from the diagnostic process in recently diagnosed multiple sclerosis

    de Groot, Vincent; Beckerman, Heleen; Uitdehaag, Bernard M.; Hintzen, Rogier Q.; Minneboo, Arjan; Heymans, Martijn W.; Lankhorst, Gustaaf J.; Polman, Chris H.; Bouter, Lex M.; IJzerman, Maarten Joost

    2009-01-01

    Objective To predict functioning after 3 years in patients with recently diagnosed multiple sclerosis (MS). Design Inception cohort with 3 years of follow-up. At baseline, predictors were obtained from medical history taking, neurologic examination, and magnetic resonance imaging (MRI). Setting

  1. Diagnostic planning in JT-60 project

    Matoba, Tohru; Suzuki, Yasuo; Funahashi, Akimasa; Itagaki, Tokiyoshi

    1977-08-01

    The diagnostic plans of JT-60 were made along with design of the main machine. Basic requirements of the diagnostic program are (1) multiple measurement of respective plasma parameters, (2) efficient usage of the discharge, (3) capable data acquisition system, (4) high reliability of the diagnostic equipments, and (5) systematic development of new diagnostic techniques. Dimensions of the diagnostic ports were determined in detailed design of the vacuum vessel, anticipating the possible diagnostic methods. The proposed diagnostic systems and the plans are shown in table and figures respectively. Problems in the diagnostics are also described. (auth.)

  2. Diagnostic performance of a multiple real-time PCR assay in patients with suspected sepsis hospitalized in an internal medicine ward.

    Pasqualini, Leonella; Mencacci, Antonella; Leli, Christian; Montagna, Paolo; Cardaccia, Angela; Cenci, Elio; Montecarlo, Ines; Pirro, Matteo; di Filippo, Francesco; Cistaro, Emma; Schillaci, Giuseppe; Bistoni, Francesco; Mannarino, Elmo

    2012-04-01

    Early identification of causative pathogen in sepsis patients is pivotal to improve clinical outcome. SeptiFast (SF), a commercially available system for molecular diagnosis of sepsis based on PCR, has been mostly used in patients hospitalized in hematology and intensive care units. We evaluated the diagnostic accuracy and clinical usefulness of SF, compared to blood culture (BC), in 391 patients with suspected sepsis, hospitalized in a department of internal medicine. A causative pathogen was identified in 85 patients (22%). Sixty pathogens were detected by SF and 57 by BC. No significant differences were found between the two methods in the rates of pathogen detection (P = 0.74), even after excluding 9 pathogens which were isolated by BC and were not included in the SF master list (P = 0.096). The combination of SF and BC significantly improved the diagnostic yield in comparison to BC alone (P < 0.001). Compared to BC, SF showed a significantly lower contamination rate (0 versus 19 cases; P < 0.001) with a higher specificity for pathogen identification (1.00, 95% confidence interval [CI] of 0.99 to 1.00, versus 0.94, 95% CI of 0.90 to 0.96; P = 0.005) and a higher positive predictive value (1.00, 95% CI of 1.00 to 0.92%, versus 0.75, 95% CI of 0.63 to 0.83; P = 0.005). In the subgroup of patients (n = 191) who had been receiving antibiotic treatment for ≥24 h, SF identified more pathogens (16 versus 6; P = 0.049) compared to BC. These results suggest that, in patients with suspected sepsis, hospitalized in an internal medicine ward, SF could be a highly valuable adjunct to conventional BC, particularly in patients under antibiotic treatment.

  3. Kinetics of aggregation with choice.

    Ben-Naim, E; Krapivsky, P L

    2016-12-01

    We generalize the ordinary aggregation process to allow for choice. In ordinary aggregation, two random clusters merge and form a larger aggregate. In our implementation of choice, a target cluster and two candidate clusters are randomly selected and the target cluster merges with the larger of the two candidate clusters. We study the long-time asymptotic behavior and find that as in ordinary aggregation, the size density adheres to the standard scaling form. However, aggregation with choice exhibits a number of different features. First, the density of the smallest clusters exhibits anomalous scaling. Second, both the small-size and the large-size tails of the density are overpopulated, at the expense of the density of moderate-size clusters. We also study the complementary case where the smaller candidate cluster participates in the aggregation process and find an abundance of moderate clusters at the expense of small and large clusters. Additionally, we investigate aggregation processes with choice among multiple candidate clusters and a symmetric implementation where the choice is between two pairs of clusters.

  4. Molecular Beacons in Diagnostics

    Tyagi, Sanjay; Kramer, Fred Russell

    2012-01-01

    Recent technical advances have begun to realize the potential of molecular beacons to test for diverse infections in clinical diagnostic laboratories. These include the ability to test for, and quantify, multiple pathogens in the same clinical sample, and to detect antibiotic resistant strains within hours. The design principles of molecular beacons have also spawned a variety of allied technologies.

  5. Choice Shifts in Groups

    Kfir Eliaz; Debraj Ray

    2004-01-01

    The phenomenon of "choice shifts" in group decision-making is fairly ubiquitous in the social psychology literature. Faced with a choice between a ``safe" and ``risky" decision, group members appear to move to one extreme or the other, relative to the choices each member might have made on her own. Both risky and cautious shifts have been identified in different situations. This paper demonstrates that from an individual decision-making perspective, choice shifts may be viewed as a systematic...

  6. Choice Probability Generating Functions

    Fosgerau, Mogens; McFadden, Daniel L; Bierlaire, Michel

    This paper considers discrete choice, with choice probabilities coming from maximization of preferences from a random utility field perturbed by additive location shifters (ARUM). Any ARUM can be characterized by a choice-probability generating function (CPGF) whose gradient gives the choice...... probabilities, and every CPGF is consistent with an ARUM. We relate CPGF to multivariate extreme value distributions, and review and extend methods for constructing CPGF for applications....

  7. Mining Diagnostic Assessment Data for Concept Similarity

    Madhyastha, Tara; Hunt, Earl

    2009-01-01

    This paper introduces a method for mining multiple-choice assessment data for similarity of the concepts represented by the multiple choice responses. The resulting similarity matrix can be used to visualize the distance between concepts in a lower-dimensional space. This gives an instructor a visualization of the relative difficulty of concepts…

  8. Cable Diagnostic Focused Initiative

    Hartlein, R.A.; Hampton, R.N.

    2010-12-30

    This report summarizes an extensive effort made to understand how to effectively use the various diagnostic technologies to establish the condition of medium voltage underground cable circuits. These circuits make up an extensive portion of the electric delivery infrastructure in the United States. Much of this infrastructure is old and experiencing unacceptable failure rates. By deploying efficient diagnostic testing programs, electric utilities can replace or repair circuits that are about to fail, providing an optimal approach to improving electric system reliability. This is an intrinsically complex topic. Underground cable systems are not homogeneous. Cable circuits often contain multiple branches with different cable designs and a range of insulation materials. In addition, each insulation material ages differently as a function of time, temperature and operating environment. To complicate matters further, there are a wide variety of diagnostic technologies available for assessing the condition of cable circuits with a diversity of claims about the effectiveness of each approach. As a result, the benefits of deploying cable diagnostic testing programs have been difficult to establish, leading many utilities to avoid the their use altogether. This project was designed to help address these issues. The information provided is the result of a collaborative effort between Georgia Tech NEETRAC staff, Georgia Tech academic faculty, electric utility industry participants, as well as cable system diagnostic testing service providers and test equipment providers. Report topics include: •How cable systems age and fail, •The various technologies available for detecting potential failure sites, •The advantages and disadvantages of different diagnostic technologies, •Different approaches for utilities to employ cable system diagnostics. The primary deliverables of this project are this report, a Cable Diagnostic Handbook (a subset of this report) and an online

  9. Molecular Diagnostics

    Choe, Hyonmin; Deirmengian, Carl A.; Hickok, Noreen J.; Morrison, Tiffany N.; Tuan, Rocky S.

    2015-01-01

    Orthopaedic infections are complex conditions that require immediate diagnosis and accurate identification of the causative organisms to facilitate appropriate management. Conventional methodologies for diagnosis of these infections sometimes lack accuracy or sufficient rapidity. Current molecular diagnostics are an emerging area of bench-to-bedside research in orthopaedic infections. Examples of promising molecular diagnostics include measurement of a specific biomarker in the synovial fluid...

  10. Choice probability generating functions

    Fosgerau, Mogens; McFadden, Daniel; Bierlaire, Michel

    2013-01-01

    This paper considers discrete choice, with choice probabilities coming from maximization of preferences from a random utility field perturbed by additive location shifters (ARUM). Any ARUM can be characterized by a choice-probability generating function (CPGF) whose gradient gives the choice...... probabilities, and every CPGF is consistent with an ARUM. We relate CPGF to multivariate extreme value distributions, and review and extend methods for constructing CPGF for applications. The choice probabilities of any ARUM may be approximated by a cross-nested logit model. The results for ARUM are extended...

  11. Institutional Choice and Recognition in Development

    Rutt, Rebecca Leigh

    Abstract This thesis concerns the role of local institutions in fostering development including natural resource management, and how this role is shaped by relations with higher scale institutions such as development agencies and national governments. Specifically, it examines the choice of local...... objective of this thesis was to contribute to understanding processes and outcomes of institutional choice and recognition. It employed mixed methods but primarily semi structured interviews in multiple sites across Nepal. In responding to specific objectives, namely to better understand: i) the rationales...... behind choices of local institutional counterparts, ii) the belonging and citizenship available with local institutions, iii) the dynamics and mutuality of recognition between higher and lower scale institutions, and iv) the social outcomes of choice and recognition, this thesis shows that the way choice...

  12. The diagnostic value of SE MRI and DWI of the spine in patients with monoclonal gammopathy of undetermined significance, smouldering myeloma and multiple myeloma

    Dutoit, Julie C.; Vanderkerken, Matthias A.; Dochy, Frederick; Verstraete, Koenraad L. [Ghent University Hospital, Department of Radiology, Ghent (Belgium); Anthonissen, Joris [Ghent University, Ghent (Belgium)

    2014-11-15

    To evaluate DWI of the bone marrow in the differentiation of monoclonal gammopathy of undetermined significance (MGUS), smouldering myeloma (SMM) and multiple myeloma (MM). The retrospective study includes 64 patients with MGUS, 27 with SMM, 64 with new MM and 12 controls. Signal intensity (SI) of spinal SE-MRI and DWI (b0-1000) as well as apparent diffusion coefficients (ADC) were measured in the T10 and L3. Qualitative assessment of b-images was performed by one experienced radiologist. ADC600 and ADC1000 are the best ADC values in differentiating patient groups (p < 0.030). SIT2, SIb1000 and ADC1000 are higher and SIT1 lower in L3 compared to T10 (p < 0.050). All quantitative parameters of L3 can differentiate significantly between MGUS and MM (p < 0.050) and between patients with percentage plasma cells (PC%) between 0-10 % compared to >50 % (p = 0.001). Only SIT2 for L3 can differentiate MGUS from SMM (p = 0.044) and PC%0-10 from PC%10-25 (p = 0.033). Qualitative interpretation of b1000 images allows differentiating MM patients from those with MGUS or SMM (p < 0.001). Spinal SE-MRI can differentiate among MGUS, SMM, MM and control subjects. DWI based on the SI on b1000 images and ADC values is increased in MM compared to MGUS and SMM. Qualitative assessment of b-images can differentiate MM from MGUS or SMM. (orig.)

  13. Mobile telecommunication networks choice among Ghanaians

    Boateng Henry

    2013-07-01

    Full Text Available The paper investigates the factors influencing customers choice of telecommunication network in Ghana. The survey design was employed to enable the researchers perform statistical analysis. Questionnaire consisting of Likert scale question was used to collect the primary data. Multiple regression analysis was performed to ascertain the factors influencing customers’ choice of telecommunication networks. The study found six factors that influence customers to choose a particular network. These factors include; brand awareness, brand image, perceived quality, price, convenience and brand loyalty. The study concludes that all the six factors contribute to the factors that drive consumer choice of telecommunications service in Ghana.

  14. Speakers' choice of frame in binary choice

    Marc van Buiten

    2009-02-01

    Full Text Available A distinction is proposed between extit{recommending for} preferred choice options and extit{recommending against} non-preferred choice options. In binary choice, both recommendation modes are logically, though not psychologically, equivalent. We report empirical evidence showing that speakers recommending for preferred options predominantly select positive frames, which are less common when speakers recommend against non-preferred options. In addition, option attractiveness is shown to affect speakers' choice of frame, and adoption of recommendation mode. The results are interpreted in terms of three compatibility effects, (i extit{recommendation mode---valence framing compatibility}: speakers' preference for positive framing is enhanced under extit{recommending for} and diminished under extit{recommending against} instructions, (ii extit{option attractiveness---valence framing compatibility}: speakers' preference for positive framing is more pronounced for attractive than for unattractive options, and (iii extit{recommendation mode---option attractiveness compatibility}: speakers are more likely to adopt a extit{recommending for} approach for attractive than for unattractive binary choice pairs.

  15. Companion diagnostics

    Jørgensen, Jan Trøst; Hersom, Maria

    2016-01-01

    of disease mechanisms, things are slowly changing. Within the last few years, we have seen an increasing number of predictive biomarker assays being developed to guide the use of targeted cancer drugs. This type of assay is called companion diagnostics and is developed in parallel to the drug using the drug-diagnostic...... co-development model. The development of companion diagnostics is a relatively new discipline and in this review, different aspects will be discussed including clinical and regulatory issues. Furthermore, examples of drugs, such as the ALK and PD-1/PD-L1 inhibitors, that have been approved recently....... Despite having discussed personalized medicine for more than a decade, we still see that most drug prescriptions for severe chronic diseases are largely based on 'trial and error' and not on solid biomarker data. However, with the advance of molecular diagnostics and a subsequent increased understanding...

  16. What counts as a choice? U.S. Americans are more likely than Indians to construe actions as choices.

    Savani, Krishna; Markus, Hazel Rose; Naidu, N V R; Kumar, Satishchandra; Berlia, Neha

    2010-03-01

    People everywhere select among multiple alternatives, but are they always making choices? In five studies, we found that people in U.S. American contexts, where the disjoint model of agency is prevalent, are more likely than those in Indian contexts to construe their own and other individuals' behaviors as choices, to construe ongoing behaviors and behaviors recalled from memory as choices, to construe naturally occurring and experimentally controlled behaviors as choices, to construe mundane and important actions as choices, and to construe personal and interpersonal actions as choices. Indians showed a greater tendency to construe actions as choices when these actions involved responding to other people than when they did not. These findings show that whether people construe actions as choices is significantly shaped by sociocultural systems of meanings and practices. Together, they suggest that the positive consequences associated with maximizing the availability of personal choice may not be universal and instead may be limited to North American contexts.

  17. Informed Food Choice

    Coff, Christian

    2014-01-01

    of informed food choice. An informed food choice is an enlightened food choice made by the individual based on the information made available. Food choices are made when shopping for food or when eating/drinking, and information is believed to give clarity to the options by increasing market transparency......Food production and consumption influence health, the environment, social structures, etc. For this reason consumers are increasingly interested in information about these effects. Disclosure of information about the consequences of food production and consumption is essential for the idea......, supporting rationality (the best choice), consumers’ self-governance (autonomy) and life coherence (integrity). On a practical level, informed food choice remains an ideal to strive for, as information on food often is inadequate....

  18. Promoting educated consumer choices

    Edinger, Wieke Willemijn Huizing

    2016-01-01

    Contemporary EU food information legislation combines and balances two main consumer interests, i.e., a consumer right to information and the freedom of choice, into one single protective standard: informed choice. Although the recent legislative measures quite openly establish a link between...... informed choice and the rather abstract societal norm of “what is good for the consumer,” this does not justify the conclusion that food information legislation has become overly meddlesome in relation to EU consumers and their choice of food. Rather, there has been a gradual maturing of the EU legislator......’s perception of its task from the mere provision of food information to ensuring educated consumer choices. This development is a logical and necessary consequence of the growing complexity of food choices....

  19. Newer diagnostic approaches to intestinal protozoa.

    van Lieshout, Lisette; Verweij, Jaco J

    2010-10-01

    To update the reader on the latest developments in the laboratory diagnosis of intestinal protozoa. Correct identification of a diarrhoea causing pathogens is essential for the choice of treatment in an individual patient as well as to map the aetiology of diarrhoea in a variety of patient populations. Classical diagnosis of diarrhoea causing protozoa by microscopic examination of a stool sample lacks both sensitivity and specificity. Alternative diagnostic platforms are discussed. Recent literature on the diagnosis of intestinal protozoa has focused mainly on nucleic acid-based assays, in particular the specific detection of parasite DNA in stool samples using real-time PCR. In addition, the trend has been moving from single pathogen detection to a multiplex approach, allowing simultaneous identification of multiple parasites. Different combinations of targets can be used within a routine diagnostic setting, depending on the patient population, such as children, immunocompromised individuals and those who have been travelling to tropical regions. Large-scale monitoring and evaluation of control strategies become feasible due to automation and high-throughput facilities. Improved technology also has become available for differentiating protozoa subspecies, which facilitates outbreak investigations and extensive research in molecular epidemiology.

  20. Choice, changeover, and travel

    Baum, William M.

    1982-01-01

    Since foraging in nature can be viewed as instrumental behavior, choice between sources of food, known as “patches,” can be viewed as choice between instrumental response alternatives. Whereas the travel required to change alternatives deters changeover in nature, the changeover delay (COD) usually deters changeover in the laboratory. In this experiment, pigeons were exposed to laboratory choice situations, concurrent variable-interval schedules, that were standard except for the introduction...

  1. Choice-impulsivity in children and adolescents with attention-deficit/hyperactivity disorder (ADHD): A meta-analytic review.

    Patros, Connor H G; Alderson, R Matt; Kasper, Lisa J; Tarle, Stephanie J; Lea, Sarah E; Hudec, Kristen L

    2016-02-01

    Impulsive behavior is a core DSM-5 diagnostic feature of attention-deficit/hyperactivity disorder (ADHD) that is associated with several pejorative outcomes. Impulsivity is multidimensional, consisting of two sub-constructs: rapid-response impulsivity and reward-delay impulsivity (i.e., choice-impulsivity). While previous research has extensively examined the presence and implications of rapid-response impulsivity in children with ADHD, reviews of choice-impulsive behavior have been both sparse and relatively circumscribed. This review used meta-analytic methods to comprehensively examine between-group differences in choice-impulsivity among children and adolescents with and without ADHD. Twenty-eight tasks (from 26 studies), consisting of 4320 total children (ADHD=2360, TD=1,960), provided sufficient information to compute an overall between-group effect size for choice-impulsivity performance. Results revealed a medium-magnitude between-group effect size (g=.47), suggesting that children and adolescents with ADHD exhibited moderately increased impulsive decision-making compared to TD children and adolescents. Further, relative to the TD group, children and adolescents with ADHD exhibited similar patterns of impulsive decision-making across delay discounting and delay of gratification tasks. However, the use of single-informant diagnostic procedures relative to multiple informants yielded larger between-group effects, and a similar pattern was observed across samples that excluded females relative to samples that included females. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Choice Neighborhood Grantees

    Department of Housing and Urban Development — Choice Neighborhoods grants transform distressed neighborhoods, public and assisted projects into viable and sustainable mixed-income neighborhoods by linking...

  3. Plasma Diagnostics

    Zaveryaev, V [Kurchatov Institute, Moscow (Russian Federation); others, and

    2012-09-15

    The success in achieving peaceful fusion power depends on the ability to control a high temperature plasma, which is an object with unique properties, possibly the most complicated object created by humans. Over years of fusion research a new branch of science has been created, namely plasma diagnostics, which involves knowledge of almost all fields of physics, from electromagnetism to nuclear physics, and up-to-date progress in engineering and technology (materials, electronics, mathematical methods of data treatment). Historically, work on controlled fusion started with pulsed systems and accordingly the methods of plasma parameter measurement were first developed for short lived and dense plasmas. Magnetically confined hot plasmas require the creation of special experimental techniques for diagnostics. The diagnostic set is the most scientifically intensive part of a plasma device. During many years of research operation some scientific tasks have been solved while new ones arose. New tasks often require significant changes in the diagnostic system, which is thus a very flexible part of plasma machines. Diagnostic systems are designed to solve several tasks. As an example here are the diagnostic tasks for the International Thermonuclear Experimental Reactor - ITER: (1) Measurements for machine protection and basic control; (2) Measurements for advanced control; (3) Additional measurements for performance evaluation and physics. Every new plasma machine is a further step along the path to the main goal - controlled fusion - and nobody knows in advance what new phenomena will be met on the way. So in the planning of diagnostic construction we should keep in mind further system upgrading to meet possible new scientific and technical challenges. (author)

  4. Diagnostic development

    Barnett, C.F.; Brisson, D.A.; Greco, S.E.

    1978-01-01

    During the past year the far-infrared or submillimeter diagnostic research program resulted in three major developments: (1) an optically pumped 0.385-μm D 2 O-laser oscillator-amplifier system was operated at a power level of 1 MW with a line width of less than 50 MHz; (2) a conical Pyrex submillimeter laser beam dump with a retention efficiency greater than 10 4 was developed for the ion temperature Thompson scattering experiment; and (3) a new diagnostic technique was developed that makes use of the Faraday rotation of a modulated submillimeter laser beam to determine plasma current profile. Measurements of the asymmetric distortion of the H/sub α/ (6563 A) spectral line profile show that the effective toroidal drift velocity, dv/sub two vertical bars i/dT/sub i/, may be used as an indicator of plasma quality and as a complement to other ion temperature diagnostics

  5. Resurgence as Choice.

    Shahan, Timothy A; Craig, Andrew R

    2017-08-01

    Resurgence is typically defined as an increase in a previously extinguished target behavior when a more recently reinforced alternative behavior is later extinguished. Some treatments of the phenomenon have suggested that it might also extend to circumstances where either the historic or more recently reinforced behavior is reduced by other non-extinction related means (e.g., punishment, decreases in reinforcement rate, satiation, etc.). Here we present a theory of resurgence suggesting that the phenomenon results from the same basic processes governing choice. In its most general form, the theory suggests that resurgence results from changes in the allocation of target behavior driven by changes in the values of the target and alternative options across time. Specifically, resurgence occurs when there is an increase in the relative value of an historically effective target option as a result of a subsequent devaluation of a more recently effective alternative option. We develop a more specific quantitative model of how extinction of the target and alternative responses in a typical resurgence paradigm might produce such changes in relative value across time using a temporal weighting rule. The example model does a good job in accounting for the effects of reinforcement rate and related manipulations on resurgence in simple schedules where Behavioral Momentum Theory has failed. We also discuss how the general theory might be extended to other parameters of reinforcement (e.g., magnitude, quality), other means to suppress target or alternative behavior (e.g., satiation, punishment, differential reinforcement of other behavior), and other factors (e.g., non- contingent versus contingent alternative reinforcement, serial alternative reinforcement, and multiple schedules). Copyright © 2016 Elsevier B.V. All rights reserved.

  6. School Choice Marches forward

    Butcher, Jonathan

    2013-01-01

    One year ago, the "Wall Street Journal" dubbed 2011 "the year of school choice," opining that "this year is shaping up as the best for reformers in a very long time." School-choice laws took great strides in 2011, both in the number of programs that succeeded across states and also in the size and scope of the adopted…

  7. Making Smart Food Choices

    ... turn JavaScript on. Feature: Healthy Aging Making Smart Food Choices Past Issues / Winter 2015 Table of Contents Everyday ... NIH www.nia.nih.gov/Go4Life Making Smart Food Choices To maintain a healthy weight, balance the calories ...

  8. Your Genes, Your Choices

    Table of Contents Your Genes, Your Choices describes the Human Genome Project, the science behind it, and the ethical, legal, and social issues that are ... Nothing could be further from the truth. Your Genes, Your Choices points out how the progress of ...

  9. Making Healthy Choices Easier

    Guldborg Hansen, Pelle; Skov, Laurits Rohden; Lund Skov, Katrine

    2016-01-01

    . However, integration and testing of the nudge approach as part of more comprehensive public health strategies aimed at making healthy choices easier is being threatened by inadequate understandings of its scientific character, relationship with regulation and its ethical implications. This article reviews...... working with or incorporating the nudge approach into programs or policies aimed at making healthy choices easier...

  10. Tough and easy choices

    Olsen, Søren Bøye; Lundhede, Thomas; Jacobsen, Jette Bredahl

    2011-01-01

    and the best alternative to that. We test this hypothesis using data from two independent Choice Experiments both focusing on nature values. In modelling respondents’ self-reported certainty in choice, we find evidence that the stated level of certainty increases significantly as utility difference in choice......Respondents in Stated Preference studies may be uncertain about their preferences for the good presented to them. Inspired by Wang (J Environ Econ Manag 32:219–232, 1997) we hypothesize that respondents’ stated certainty in choice increases with the utility difference between the alternative chosen...... sets increases. In addition, stated certainty increases with income. Furthermore, there is some evidence that male respondents are inherently more certain in their choices than females, and a learning effect may increase stated certainty. We find evidence of this in the first study where the good...

  11. Evaluating Secondary Students' Scientific Reasoning in Genetics Using a Two-Tier Diagnostic Instrument

    Tsui, Chi-Yan; Treagust, David

    2010-05-01

    While genetics has remained as one key topic in school science, it continues to be conceptually and linguistically difficult for students with the concomitant debates as to what should be taught in the age of biotechnology. This article documents the development and implementation of a two-tier multiple-choice instrument for diagnosing grades 10 and 12 students' understanding of genetics in terms of reasoning. The pretest and posttest forms of the diagnostic instrument were used alongside other methods in evaluating students' understanding of genetics in a case-based qualitative study on teaching and learning with multiple representations in three Western Australian secondary schools. Previous studies have shown that a two-tier diagnostic instrument is useful in probing students' understanding or misunderstanding of scientific concepts and ideas. The diagnostic instrument in this study was designed and then progressively refined, improved, and implemented to evaluate student understanding of genetics in three case schools. The final version of the instrument had Cronbach's alpha reliability of 0.75 and 0.64, respectively, for its pretest and the posttest forms when it was administered to a group of grade 12 students (n = 17). This two-tier diagnostic instrument complemented other qualitative data collection methods in this research in generating a more holistic picture of student conceptual learning of genetics in terms of scientific reasoning. Implications of the findings of this study using the diagnostic instrument are discussed.

  12. Diagnostic dilemma

    Feldt-Rasmussen, Ulla; Dobrovolny, Robert; Nazarenko, Irina

    2011-01-01

    Fabry disease, an X-linked lysosomal storage disorder, results from the deficient activity of a-galactosidase A (a-Gal A). In affected males, the clinical diagnosis is confirmed by the markedly decreased a-Gal A activity. However, in female heterozygotes, the a-Gal A activity can range from low t...... on enzyme replacement therapy. Thus, gene dosage analyses can detect large deletions (>50bp) in suspect heterozygotes for X-linked and autosomal dominant diseases that are "sequencing cryptic," resolving molecular diagnostic dilemmas....... to normal due to random X-chromosomal inactivation, and diagnostic confirmation requires identification of the family's a-Gal A gene mutation. In a young female who had occasional acroparesthesias, corneal opacities, and 15 to 50% of the lower limit of normal leukocyte a-Gal A activity, a-Gal A sequencing...... in two expert laboratories did not identify a confirmatory mutation, presenting a diagnostic dilemma. A renal biopsy proved diagnostic and renewed efforts to detect an a-Gal A mutation. Subsequent gene dosage analyses identified a large a-Gal A deletion confirming her heterozygosity, and she was started...

  13. Appropriate use of diagnostic imaging

    Palmer, P.E.S.; Cockshott, W.P.

    1984-11-16

    This article discusses ways in which more appropriate use can be made of roentgenography with a resulting decrease in radiation doses to the patient population. The authors recommend that fewer films be made and that traditional roentgenography be replaced with endoscopy, ultrasound, computerized tomography, or angiography where appropriate. They also recommend that medical schools and medical subspecialty groups study the World Health Organization document which provides indications for diagnostic imaging, the choice of procedure and the limitations of each.

  14. Digital assessments – challenges, choices and pitfalls

    Simonsen, Eivind Ortind

    assessments at the faculty of Health, Aarhus University. Today (2015) we have digitalized approximately 70 % of our assessments, including MCQ (multiple choice) and OSCE (objective structured clinical examination), with 7-800 students assessed each semester. We have developed our own systems...

  15. The axiom of choice

    Jech, Thomas J

    2008-01-01

    Comprehensive in its selection of topics and results, this self-contained text examines the relative strengths and consequences of the axiom of choice. Each chapter contains several problems, graded according to difficulty, and concludes with some historical remarks.An introduction to the use of the axiom of choice is followed by explorations of consistency, permutation models, and independence. Subsequent chapters examine embedding theorems, models with finite supports, weaker versions of the axiom, and nontransferable statements. The final sections consider mathematics without choice, cardin

  16. Choice probability generating functions

    Fosgerau, Mogens; McFadden, Daniel; Bierlaire, Michel

    2010-01-01

    This paper establishes that every random utility discrete choice model (RUM) has a representation that can be characterized by a choice-probability generating function (CPGF) with specific properties, and that every function with these specific properties is consistent with a RUM. The choice...... probabilities from the RUM are obtained from the gradient of the CPGF. Mixtures of RUM are characterized by logarithmic mixtures of their associated CPGF. The paper relates CPGF to multivariate extreme value distributions, and reviews and extends methods for constructing generating functions for applications....... The choice probabilities of any ARUM may be approximated by a cross-nested logit model. The results for ARUM are extended to competing risk survival models....

  17. Make Better Food Choices

    10 tips Nutrition Education Series make better food choices 10 tips for women’s health Fruits Grains Dairy Vegetables Protein Make yourself a priority and take time to care for yourself. ChooseMyPlate. gov ...

  18. Veterans Choice Program

    Department of Veterans Affairs — If you are already enrolled in VA health care, the Choice Program allows you to receive health care within your community. Using this program does NOT impact your...

  19. Neutron delayed choice experiments

    Bernstein, H.J.

    1986-01-01

    Delayed choice experiments for neutrons can help extend the interpretation of quantum mechanical phenomena. They may also rule out alternative explanations which static interference experiments allow. A simple example of a feasible neutron test is presented and discussed. (orig.)

  20. Consumer choice behaviour

    Hansen, Flemming; Percy, Larry; Hallum Hansen, Morten

    2004-01-01

    The paper is concerned with the measurement of emotions and the study of the role ofemotions in consumer choice. Contemporary neurological findings suggest that emotionsmay play a role in its own right, quite different from the way in which they have beenconsidered in traditional consumer choice ...... behaviour theory. A large-scale study including800 respondents, covering 64 brands, provide findings on emotional response tendenciesfor the brands, and relate these to involvement, type of need gratification, purchasingbehaviour, etc.......The paper is concerned with the measurement of emotions and the study of the role ofemotions in consumer choice. Contemporary neurological findings suggest that emotionsmay play a role in its own right, quite different from the way in which they have beenconsidered in traditional consumer choice...

  1. Occupational choice and values.

    Kantas, A.

    1985-01-01

    It is suggested that psychological and sociological approaches to occupational choice can be linked together by employment of three concepts: work salience, values and motivation. Employing Vroom's (1964) cognitive model of motivation occupational choice was examined as a value attainment process. The subjects were 225 male pupils of two different school complexes in Athens, Greece. They were asked to respond to a work salience questionnaire and to rank order a set of ...

  2. Consumer choice behaviour

    Hansen, Flemming; Percy, Larry; Hallum Hansen, Morten

    2004-01-01

    The paper is concerned with the measurement of emotions and the study of the role of emotions in consumer choice. Contemporary neurological findings suggest that emotions may play a role in its own right, quite different from the way in which they have been considered in traditional consumer choice behaviour theory. A large-scale study including 800 respondents, covering 64 brands, provide findings on emotional response tendencies for the brands, and relate these to involvement...

  3. Diagnostic criteria in MR neurography

    Baeumer, P.

    2017-01-01

    Peripheral neuropathies are frequent and can mostly be correctly diagnosed by clinical examination and electrophysiology; however, diagnostically difficult cases are sometimes encountered especially with respect to precise localization of nerve lesions. Imaging of the peripheral nervous system has been shown to provide additional useful diagnostic information. In addition to the more widely available nerve sonography, magnetic resonance neurography (MRN) is the method of choice in diagnostically complex cases. The most important pulse sequence is a T2-weighted fat-saturated pulse sequence with high in-plane resolution and detects increased T2-weighted signals of nerve fascicles as a highly sensitive sign for nerve lesions. Further established diagnostic criteria are nerve caliber and, less commonly used, contrast agent uptake. The spatial pattern of nerve lesions aids in the diagnostic classification of neuropathies. Functional imaging techniques, such as diffusion tensor imaging (DTI) and nerve perfusion are currently under examination with respect to the clinical potential. If all other diagnostic methods, including clinical examination, electrophysiology and nerve sonography do not arrive at an unambiguous diagnosis of a peripheral neuropathy, MRN should be used. The special value of MRN is demonstrated particularly in complex nerve lesions, such as traumatic plexopathies and in partial fascicular neuropathies and many other indications. (orig.) [de

  4. CT guided diagnostic foot injections

    Saifuddin, A.; Abdus-Samee, M.; Mann, C.; Singh, D.; Angel, J.C.

    2005-01-01

    AIM: To describe a CT technique for guiding diagnostic and therapeutic injections in the hind- and mid-foot. MATERIALS AND METHODS: Over a period of 50 months, 28 individuals were referred for diagnostic and therapeutic hind- and mid-foot injections before possible arthrodesis. A CT technique was developed that allowed entry into the various joints using a vertical approach. Numbers of joints injected were as follows: posterior subtalar, 21; talonavicular, 4; calcaneonavicular, calcaneocuboid, navicular-cuneiform and 5th metatarsocuboid joints, 1 each. RESULTS: All injections but one were technically successful. Significant relief of symptoms was noted by 16 participants, whereas for 9 there was no improvement and for 3 a partial response was achieved. CONCLUSION: CT is a simple and safe alternative to fluoroscopy for guiding diagnostic and therapeutic foot injections, and may be the technique of choice in cases of disordered anatomy

  5. Diagnostic radiology in the nearest future

    Lindenbraten, L.D.

    1984-01-01

    Basic trends of diagnostic radiology (DR) development in the nearest future are formulated. Possibilities of perspective ways and means of DR studies are described. The prohlems of strategy, tactics, organization of diagnostic radiological service are considered. An attempt has been made to outline the professional image of a specialist in the DR of the future. It is shown that prediction of the DR future development is the planning stage of the present, the choice of a right way of development

  6. How to appraise a diagnostic test

    Ramanitharan Manikandan

    2011-01-01

    Full Text Available Urologists frequently encounter problems in making a clinical diagnosis whose resolution requires the use of diagnostic tests. With an ever increasing choice of investigations being available, the urologist often has to decide which diagnostic test(s will best resolve the patient′s diagnostic problem. In this article, we aim to help the urologist understand how to critically appraise studies on diagnostic tests and make a rational choice. This article presents the guiding principles in scientifically assessing studies on diagnostic tests by proposing a clinical scenario. The authors describe a standardized protocol to assess the validity of the test and its relevance to the clinical problem that can help the urologist in decision making. The three important issues to be considered when evaluating the validity of the study are to identify how the study population was chosen, how the test was performed and whether there is a comparison to the gold standard test so as to confirm or refute the diagnosis. Then, the urologist would need to know the probability of the test in providing the correct diagnosis in an individual patient in order to decide about its utility in solving the diagnostic dilemma. By performing the steps described in this article, the urologist would be able to critically appraise diagnostic studies and draw meaningful conclusions about the investigations in terms of validity, results and its applicability to the patient′s problem. This would provide a scientific basis for using diagnostic tests for improving patient care.

  7. The choices before us.

    Streeten, P P

    1980-01-01

    This introduction is from the 16th World Conference of SID in Colombo, Sri Lanka, August 1979, which addressed the theme of development choices for the 1980's and beyond. Choices may refer to different political, ideological or social systems. Choices may refer to strategies and technical issues, e.g. agriculture vs. industry. A third meaning of choice is implicit in the idea of a Third World, or alternative, method of development. The third meaning implies a rejection of Western institutions, values, and standards. In the past, the transfer of Western or in this case Northern, institutions and standards has disappointed and created obstacles to development. The rapid rate of population growth forces choices of population control and resource management. Common themes of development have emerged from conference discussions: the need to build development efforts on indigenous values; the need for new institutions both at the sub-national and at the super-national level; and, the need to adjust to inevitable changes rationally and with foresight. The nation state is too large for many functions that are better decentralized and left to village or district administrations, yet it is too small to respond to global challenges and environmental risks like harvest failure, credit risks, marketing risks, failure of supplies. The interests of the state are not identical with those of society or particular groups in society.

  8. Isotope diagnostics apparatus

    Herrschaft, H.

    1976-01-01

    The invention relates to a measuring probe for an isotope diagnostics apparatus to determine the distribution of radioactive substances in a body by measuring the radiation emanating from this body by means of a multiplicity of measuring probes directed simultaneously towards areas of measuring surfae and carried in guidances of a holding block. The measuring results of the individual probes are recorded separately, thus allowing the possibility of being evaluated separately, too. Measuring probes of this kind are used in multi-channel measuring objects and are useful particularly for determining the regional cerebral blood flow. (orig./ORU) [de

  9. Contrast-Enhanced Ultrasonography in Crohn's Disease Diagnostics.

    Białecki, Marcin; Białecka, Agnieszka; Laskowska, Katarzyna; Liebert, Ariel; Kłopocka, Maria; Serafin, Zbigniew

    2015-06-01

    The chronic nature of Crohn's disease (CD) implicates necessity of multiple control assessments throughout patient's life. It is accepted that in patients with CD requiring disease monitoring, magnetic resonance enterography (MRE) and computed tomography enterography (CTE) are--apart from endoscopy--imaging studies of first choice. In practice, diagnostic imaging of patients with CD is troublesome, since MRE is an expensive and complicated study, and CTE exposes patients to high doses of ionizing radiation. Therefore, there is a need for new, both non-invasive and effective, methods of imaging in CD. Contrast-Enhanced Ultrasonography (CEUS) is a relatively new method using gas-filled microbubbles serving as contrast agent. It allows for detailed assessment of blood perfusion within intestine wall and peri-intestinal tissues, which enables detection and monitoring of inflammation and its qualitative assessment. The purpose of this paper is to describe CEUS examination technique and its clinical applications in patients with Crohn's disease.

  10. Towards a conceptual diagnostic survey in nuclear physics

    Kohnle, Antje; Mclean, Stewart; Aliotta, Marialuisa

    2011-01-01

    Understanding students' prior beliefs in nuclear physics is a first step towards improving nuclear physics instruction. This paper describes the development of a diagnostic survey in nuclear physics covering the areas of radioactive decay, binding energy, properties of the nuclear force and nuclear reactions, that was administered to students at two institutions in a pre- and post-test design. The pre-test was given in a free-text entry format, with responses being used to develop a multiple-choice version that was given as a post-test. We performed statistical tests to evaluate the reliability and discriminatory power. Students' reasoning comments and rated certainties in their responses were used to determine students' misconceptions. We give details of misconceptions in the areas of radioactive decay, binding energy and nuclear density, and discuss possible underlying reasons for these misconceptions.

  11. Comparison of Vehicle Choice Models

    Stephens, Thomas S. [Argonne National Lab. (ANL), Argonne, IL (United States); Levinson, Rebecca S. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Brooker, Aaron [National Renewable Energy Lab. (NREL), Golden, CO (United States); Liu, Changzheng [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Lin, Zhenhong [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Birky, Alicia [Energetics Incorporated, Columbia, MD (United States); Kontou, Eleftheria [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2017-10-31

    Five consumer vehicle choice models that give projections of future sales shares of light-duty vehicles were compared by running each model using the same inputs, where possible, for two scenarios. The five models compared — LVCFlex, MA3T, LAVE-Trans, ParaChoice, and ADOPT — have been used in support of the Energy Efficiency and Renewable Energy (EERE) Vehicle Technologies Office in analyses of future light-duty vehicle markets under different assumptions about future vehicle technologies and market conditions. The models give projections of sales shares by powertrain technology. Projections made using common, but not identical, inputs showed qualitative agreement, with the exception of ADOPT. ADOPT estimated somewhat lower advanced vehicle shares, mostly composed of hybrid electric vehicles. Other models projected large shares of multiple advanced vehicle powertrains. Projections of models differed in significant ways, including how different technologies penetrated cars and light trucks. Since the models are constructed differently and take different inputs, not all inputs were identical, but were the same or very similar where possible. Projections by all models were in close agreement only in the first few years. Although the projections from LVCFlex, MA3T, LAVE-Trans, and ParaChoice were in qualitative agreement, there were significant differences in sales shares given by the different models for individual powertrain types, particularly in later years (2030 and later). For example, projected sales shares of conventional spark-ignition vehicles in 2030 for a given scenario ranged from 35% to 74%. Reasons for such differences are discussed, recognizing that these models were not developed to give quantitatively accurate predictions of future sales shares, but to represent vehicles markets realistically and capture the connections between sales and important influences. Model features were also compared at a high level, and suggestions for further comparison

  12. Choosing health, constrained choices.

    Chee Khoon Chan

    2009-12-01

    In parallel with the neo-liberal retrenchment of the welfarist state, an increasing emphasis on the responsibility of individuals in managing their own affairs and their well-being has been evident. In the health arena for instance, this was a major theme permeating the UK government's White Paper Choosing Health: Making Healthy Choices Easier (2004), which appealed to an ethos of autonomy and self-actualization through activity and consumption which merited esteem. As a counterpoint to this growing trend of informed responsibilization, constrained choices (constrained agency) provides a useful framework for a judicious balance and sense of proportion between an individual behavioural focus and a focus on societal, systemic, and structural determinants of health and well-being. Constrained choices is also a conceptual bridge between responsibilization and population health which could be further developed within an integrative biosocial perspective one might refer to as the social ecology of health and disease.

  13. Thyroid diagnostics

    Scriba, P C; Boerner, W; Emrich, S; Gutekunst, R; Herrmann, J; Horn, K; Klett, M; Krueskemper, H L; Pfannenstiel, P; Pickardt, C R

    1985-03-01

    None of the in-vitro and in-vivo methods listed permits on unambiguous diagnosis when applied alone, owing to the fact that similar or even identical findings are obtained for various individual parameters in different thyroid diseases. Further, especially the in-vitro tests are also subject to extrathyroidal effects which may mask the typical findings. The limited and varying specificity and sensitivity of the tests applied, as well as the falsification of results caused by the patients' idiosyncracies and the methodology, make it necessary to interpret and evaluate the in-vivo and in-vitro findings only if the clinical situation (anamnesis and physical examination) is known. For maximum diagnostic quality of the tests, the initial probability of the assumed type of thyroid disease must be increased (formulation of the clinical problem). The concepts of exclusion diagnosis and identification must be distinguished as well as the diagnosis of functional disturbances on the one hand and of thyroid diseases on the other. Both of this requires a qualified, specific and detailed anamnesis and examination procedure, and the clinical examination remains the obligatory basis of clinical diagnostics. In case of inexplicable discrepancies between the clinical manifestations and the findings obtained with specific methods, or between the findings obtained with a specific method, the patient should be referred to an expert institution, or the expert institution should be consulted.

  14. Thyroid diagnostics

    Scriba, P.C.; Boerner, W.; Emrich, S.; Gutekunst, R.; Herrmann, J.; Horn, K.; Klett, M.; Krueskemper, H.L.; Pfannenstiel, P.; Pickardt, C.R.; Reiners, C.; Reinwein, D.; Schleusener, H.

    1985-01-01

    None of the in-vitro and in-vivo methods listed permits on unambiguous diagnosis when applied alone, owing to the fact that similar or even identical findings are obtained for various individual parameters in different thyroid diseases. Further, especially the in-vitro tests are also subject to extrathyroidal effects which may mask the typical findings. The limited and varying specificity and sensitivity of the tests applied, as well as the falsification of results caused by the patients' idiosyncracies and the methodology, make it necessary to interpret and evaluate the in-vivo and in-vitro findings only if the clinical situation (anamnesis and physical examination) is known. For maximum diagnostic quality of the tests, the initial probability of the assumed type of thyroid disease must be increased (formulation of the clinical problem). The concepts of exclusion diagnosis and identification must be distinguished as well as the diagnosis of functional disturbances on the one hand and of thyroid diseases on the other. Both of this requires a qualified, specific and detailed anamnesis and examination procedure, and the clinical examination remains the obligatory basis of clinical diagnostics. In case of inexplicable discrepancies between the clinical manifestations and the findings obtained with specific methods, or between the findings obtained with a specific method, the patient should be referred to an expert institution, or the expert institution should be consulted. (orig./MG) [de

  15. Ambient diagnostics

    Cai, Yang

    2014-01-01

    Part I. FundamentalsIntroductionWhat is Ambient Diagnostics?Diagnostic ModelsMultimedia IntelligenceCrowd SourcingSoft SensorsScience of SimplicityPersonal DiagnosesBasic AlgorithmsBasic ToolsSummaryProblemsTransformationEarly Discoveries of Heartbeat PatternsTransforms, Features, and AttributesSequential FeaturesSpatiotemporal FeaturesShape FeaturesImagery FeaturesFrequency Domain FeaturesMulti-Resolution FeaturesSummaryProblemsPattern RecognitionSimilarities and DistancesClustering MethodsClassification MethodsClassifier Accuracy MeasuresSummaryProblemsPart II. Multimedia IntelligenceSound RecognitionMicrophone AppsModern Acoustic Transducers (Microphones)Frequency Response CharacteristicsDigital Audio File FormatsHeart Sound SensingLung Sound SensingSnore MeterSpectrogram (STFT)Ambient Sound AnalysisSound RecognitionRecognizing Asthma SoundPeak ShiftFeature CompressionRegroupingNoise IssuesFuture ApplicationsSummaryProblemsColor SensorsColor SensingHuman Color VisionColor SensorsColor Matching ExperimentsC...

  16. Comparison of Vehicle Choice Models

    Stephens, Thomas S. [Argonne National Lab. (ANL), Argonne, IL (United States); Levinson, Rebecca S. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Brooker, Aaron [National Renewable Energy Lab. (NREL), Golden, CO (United States); Liu, Changzheng [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Lin, Zhenhong [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Birky, Alicia [Energetics Incorporated, Columbia, MD (United States); Kontou, Eleftheria [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2017-10-01

    Five consumer vehicle choice models that give projections of future sales shares of light-duty vehicles were compared by running each model using the same inputs, where possible, for two scenarios. The five models compared — LVCFlex, MA3T, LAVE-Trans, ParaChoice, and ADOPT — have been used in support of the Energy Efficiency and Renewable Energy (EERE) Vehicle Technologies Office in analyses of future light-duty vehicle markets under different assumptions about future vehicle technologies and market conditions. The models give projections of sales shares by powertrain technology. Projections made using common, but not identical, inputs showed qualitative agreement, with the exception of ADOPT. ADOPT estimated somewhat lower advanced vehicle shares, mostly composed of hybrid electric vehicles. Other models projected large shares of multiple advanced vehicle powertrains. Projections of models differed in significant ways, including how different technologies penetrated cars and light trucks. Since the models are constructed differently and take different inputs, not all inputs were identical, but were the same or very similar where possible.

  17. Diagnostic Criteria for Pediatric MS

    J Gordon Millichap

    2013-06-01

    Full Text Available Investigators at Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children’s Hospital of Chicago review the diagnostic criteria for pediatric multiple sclerosis, the differential diagnosis, the 2010 McDonald criteria, and Callen criteria.

  18. Saliva Preservative for Diagnostic Purposes

    Pierson, Duane L.; Mehta, Satish K.

    2012-01-01

    Saliva is an important body fluid for diagnostic purposes. Glycoproteins, glucose, steroids, DNA, and other molecules of diagnostic value are found in saliva. It is easier to collect as compared to blood or urine. Unfortunately, saliva also contains large numbers of bacteria that can release enzymes, which can degrade proteins and nucleic acids. These degradative enzymes destroy or reduce saliva s diagnostic value. This innovation describes the formulation of a chemical preservative that prevents microbial growth and inactivates the degradative enzymes. This extends the time that saliva can be stored or transported without losing its diagnostic value. Multiple samples of saliva can be collected if needed without causing discomfort to the subject and it does not require any special facilities to handle after it is collected.

  19. Producers' Complex Risk Management Choices

    Pennings, J.M.E.; Isengildina, O.; Irwin, S.H.; Garcia, P.; Good, D.L.

    2008-01-01

    Producers have a wide variety of risk management instruments available, making their choice(s) complex. The way producers deal with this complexity can vary and may influence the impact that the determinants, such as risk aversion, have on their choices. A recently developed choice bracketing

  20. Diagnostic accuracy of organ electrodermal diagnostics | Szopinski ...

    Objective. To estimate the diagnostic accuracy as well as the scope of utilisation of a new bio-electronic method of organ diagnostics. Design. Double-blind comparative study of the diagnostic results obtained by means of organ electrodermal diagnostics (OED) and clinical diagnoses, as a criterion standard. Setting.

  1. SNS Diagnostics

    Shea, T.J.; Cameron, P.; Doolittle, L.; Power, J.

    2000-01-01

    The Spallation Neutron Source (SNS) Project is a collaborative effort to build the next generation neutron science facility at Oak Ridge, TN. The facility will deliver a 2 MW proton beam to a liquid mercury target. Neutrons from this target will be moderated and sent to several state-of-the-art instruments. Six national laboratories are involved in SNS construction. Berkeley (LBNL) will build the front end that produces a 2.5 MeV, 52 mA H-beam. Los Alamos (LANL) is responsible for the 1 GeV linac with a superconducting section provided by Thomas Jefferson (JLab). Brookhaven (BNL) is building the transfer lines and accumulator ring. Oak Ridge (ORNL) and Argonne (ANL) have responsibility for the target and instruments. All activities are coordinated by the SNS project office at Oak Ridge. The high beam power, a desired availability of 95%, and an aggressive commissioning schedule lead to some interesting challenges in beam diagnostics

  2. Consumer rationality in choice

    Conlon, B.J.

    2001-01-01

    The dissertation concentrates on consumer choice and the ability of current modelling approaches to capture the underlying behaviour of the individual decision-makers. The standard assumption of a rational utility maximising individual and its implications for observed behaviour are examined and

  3. Households' portfolio choices

    Hochgürtel, S.

    1998-01-01

    This thesis presents four topics on households' portfolio choices. Empirically, households do not hold well-diversified wealth portfolios. In particular, they refrain from putting their savings into risky assets. We explore several ways that might help explaining this observation. Using Dutch

  4. Project Choice: Lessons Learned.

    Ewing Marion Kauffman Foundation, Kansas City, MO.

    Project Choice began with a simple goal: to increase the number of inner-city students who graduate from high school on time and become productive members of society. To that end, Ewing M. Kauffman, his Foundation, and associates designed and implemented a program that promised postsecondary education or training to some students in the Kansas…

  5. Angelina′s choice

    Nishu Singh Goel

    2013-01-01

    Full Text Available This is an opinion piece on how a celebrity′s personal choice to undergo prophylactic mastectomy on discovery of an aberrant gene, when publicly promoted, carries in itself the power to influence and impact healthcare trends and decisions. When celebrities advocate causes that are universally and uniformly acceptable and indisputable as the best in the realm of healthcare and cure (e.g. no smoking, it creates well-being and awareness in society at large. But those which are personal choices made out of a repertoire of other available and effective options may, because of celebrity preference, don the mantle of a norm. They thus run the danger of being blindly replicated by others without proper awareness and knowledge of the true potential of disease, risk factors, and other existing remedial or risk-reducing measures. Society should thus be encouraged to question, debate, and understand the validity, authenticity, and reason of the choices, especially those with a medical basis. This tempering of information with intelligence and rationale and making informed choices based on facts will serve humanity as a whole.

  6. Choices and Consequences.

    Thorp, Carmany

    1995-01-01

    Describes student use of Hyperstudio computer software to create history adventure games. History came alive while students learned efficient writing skills; learned to understand and manipulate cause, effect choice and consequence; and learned to incorporate succinct locational, climatic, and historical detail. (ET)

  7. Food choices in Ethiopia

    Bekele, Alemayehu Dekeba; Beuving, Joost; Ruben, Ruerd

    2016-01-01

    This article reports results from a framed market experiment conducted to examine whether milk choices are responsive to changes in the nutritional characteristics of milk products. Using a random-effect Tobit model, we analyzed experimental data collected from 160 participants in urban Ethiopia.

  8. Choices in Pension Management

    G.A.G. Alserda (Gosse)

    2017-01-01

    markdownabstractThe organization of pensions differs greatly across, and within, countries, and these differences affect the large number of stakeholders differently. The choices that underlie these differences tend to be very complicated, as they have to be balanced over the interests of different

  9. Small business development for molecular diagnostics.

    Anagostou, Anthanasia; Liotta, Lance A

    2012-01-01

    Molecular profiling, which is the application of molecular diagnostics technology to tissue and blood -specimens, is an integral element in the new era of molecular medicine and individualized therapy. Molecular diagnostics is a fertile ground for small business development because it can generate products that meet immediate demands in the health-care sector: (a) Detection of disease risk, or early-stage disease, with a higher specificity and sensitivity compared to previous testing methods, and (b) "Companion diagnostics" for stratifying patients to receive a treatment choice optimized to their individual disease. This chapter reviews the promise and challenges of business development in this field. Guidelines are provided for the creation of a business model and the generation of a marketing plan around a candidate molecular diagnostic product. Steps to commercialization are outlined using existing molecular diagnostics companies as learning examples.

  10. Molecular Diagnostic and Pathogenesis of Hereditary Hemochromatosis

    Paulo C. J. L. Santos

    2012-02-01

    Full Text Available Hereditary hemochromatosis (HH is an autosomal recessive disorder characterized by enhanced intestinal absorption of dietary iron. Without therapeutic intervention, iron overload leads to multiple organ damage such as liver cirrhosis, cardiomyopathy, diabetes, arthritis, hypogonadism and skin pigmentation. Most HH patients carry HFE mutant genotypes: homozygosity for p.Cys282Tyr or p.Cys282Tyr/p.His63Asp compound heterozygosity. In addition to HFE gene, mutations in the genes that encode hemojuvelin (HJV, hepcidin (HAMP, transferrin receptor 2 (TFR2 and ferroportin (SLC40A1 have been associated with regulation of iron homeostasis and development of HH. The aim of this review was to identify the main gene mutations involved in the pathogenesis of type 1, 2, 3 and 4 HH and their genetic testing indication. HFE testing for the two main mutations (p.Cys282Tyr and p.His63Asp should be performed in all patients with primary iron overload and unexplained increased transferrin saturation and/or serum ferritin values. The evaluation of the HJV p.Gly320Val mutation must be the molecular test of choice in suspected patients with juvenile hemochromatosis with less than 30 years and cardiac or endocrine manifestations. In conclusion, HH is an example that genetic testing can, in addition to performing the differential diagnostic with secondary iron overload, lead to more adequate and faster treatment.

  11. Search, Memory, and Choice Error: An Experiment.

    Sanjurjo, Adam

    2015-01-01

    Multiple attribute search is a central feature of economic life: we consider much more than price when purchasing a home, and more than wage when choosing a job. An experiment is conducted in order to explore the effects of cognitive limitations on choice in these rich settings, in accordance with the predictions of a new model of search memory load. In each task, subjects are made to search the same information in one of two orders, which differ in predicted memory load. Despite standard models of choice treating such variations in order of acquisition as irrelevant, lower predicted memory load search orders are found to lead to substantially fewer choice errors. An implication of the result for search behavior, more generally, is that in order to reduce memory load (thus choice error) a limited memory searcher ought to deviate from the search path of an unlimited memory searcher in predictable ways-a mechanism that can explain the systematic deviations from optimal sequential search that have recently been discovered in peoples' behavior. Further, as cognitive load is induced endogenously (within the task), and found to affect choice behavior, this result contributes to the cognitive load literature (in which load is induced exogenously), as well as the cognitive ability literature (in which cognitive ability is measured in a separate task). In addition, while the information overload literature has focused on the detrimental effects of the quantity of information on choice, this result suggests that, holding quantity constant, the order that information is observed in is an essential determinant of choice failure.

  12. Search, Memory, and Choice Error: An Experiment.

    Adam Sanjurjo

    Full Text Available Multiple attribute search is a central feature of economic life: we consider much more than price when purchasing a home, and more than wage when choosing a job. An experiment is conducted in order to explore the effects of cognitive limitations on choice in these rich settings, in accordance with the predictions of a new model of search memory load. In each task, subjects are made to search the same information in one of two orders, which differ in predicted memory load. Despite standard models of choice treating such variations in order of acquisition as irrelevant, lower predicted memory load search orders are found to lead to substantially fewer choice errors. An implication of the result for search behavior, more generally, is that in order to reduce memory load (thus choice error a limited memory searcher ought to deviate from the search path of an unlimited memory searcher in predictable ways-a mechanism that can explain the systematic deviations from optimal sequential search that have recently been discovered in peoples' behavior. Further, as cognitive load is induced endogenously (within the task, and found to affect choice behavior, this result contributes to the cognitive load literature (in which load is induced exogenously, as well as the cognitive ability literature (in which cognitive ability is measured in a separate task. In addition, while the information overload literature has focused on the detrimental effects of the quantity of information on choice, this result suggests that, holding quantity constant, the order that information is observed in is an essential determinant of choice failure.

  13. Diagnostic thoracoscopy

    Plavec Goran

    2002-01-01

    Full Text Available Diagnostic thoracoscopy in patients with pleural effusion of unclear origin mostly provides the correct diagnosis. Results from published reports of previous researches are not uniform. In 47 male and 20 female patients with pleural effusion of unknown etiology, after receiving negative results obtained from cytological finding of pleural effusion and percutaneous needle biopsy, thoracoscopy with biopsy of one or both pleurae was performed. Procedure was done in local anesthesia using Stortz rigid thoracoscope. In 37 patients with malignant disease (primary or metastatic diagnosis was confirmed histopathologically in 31 patient (81.12%. In 27 patients with inflammatory pleural disease diagnosis was confirmed histopathologically in 22 patients (81.4%. Among 11 patients with specific pleural effusions, tuberculosis was confirmed in 10 (90.91%. Normal finding in cases of spontaneous pneumothorax and pulmonary embolism was taken as a positive result. Total number of positive findings was 55 (82.10%. In one patient, the third spontaneous pneumothorax was the indication for thoracoscopy, and after numerous bullae were seen during the procedure, talcum powder pleurodesis was done. In four patients low intensity subcutaneous emphysema occurred one day after thoracoscopy. It can be concluded that thoracoscopy in local anesthesia out of the operating room is good and practical method for solving the unclear pleural effusions, with neglectable rate of complications.

  14. Mitigation diagnostics

    Hall, S.T.

    1990-01-01

    This paper reports that experience in the remediation of schools and other large buildings has shown the importance of the effects of both the location of geologic sources and HVAC-induced distribution of indoor radon. In general, elevated radon in areas of schools with evenly distributed HVAC pressures are correlated with maximum soil radon emanations. However, strong or unequal HVAC effects can redistribute indoor radon to areas away from the direct source. Effective remediation required a complete understanding of both contributions. In some schools, highest indoor radon levels were located near large return ducts and were attributed to proximity to negative HVAC pressure. Successful sub-slab depressurization systems were installed, however, in rooms with lower indoor but greatest sub-slab radon levels, closest to the source. This shows the inadequacy of using indoor radon levels alone as a basis for remediation. Wings of two other schools with radon problems have equivalent window fan coil units in rooms of equal size and no central HVAC system. Highest indoor radon levels correlated well with highest sub-slab radon levels due to the equivalent effects of the window units. Diagnostic tests in other schools have revealed: blockwall radon transport to upper floors; high blockwall radon adjacent to sub-slab sources; and elevated indoor radon over crawlspace being drawn upward by HVAC-induced negative pressure, determined from indoor to outdoor micromanometer measurements

  15. Feminist identity as a predictor of eating disorder diagnostic status.

    Green, Melinda A; Scott, Norman A; Riopel, Cori M; Skaggs, Anna K

    2008-06-01

    Passive Acceptance (PA) and Active Commitment (AC) subscales of the Feminist Identity Development Scale (FIDS) were examined as predictors of eating disorder diagnostic status as assessed by the Questionnaire for Eating Disorder Diagnoses (Q-EDD). Results of a hierarchical regression analysis revealed PA and AC scores were not statistically significant predictors of ED diagnostic status after controlling for diagnostic subtype. Results of a multiple regression analysis revealed FIDS as a statistically significant predictor of ED diagnostic status when failing to control for ED diagnostic subtype. Discrepancies suggest ED diagnostic subtype may serve as a moderator variable in the relationship between ED diagnostic status and FIDS. (c) 2008 Wiley Periodicals, Inc.

  16. Fuzzy social choice theory

    B Gibilisco, Michael; E Albert, Karen; N Mordeson, John; J Wierman, Mark; D Clark, Terry

    2014-01-01

    This book offers a comprehensive analysis of the social choice literature and shows, by applying fuzzy sets, how the use of fuzzy preferences, rather than that of strict ones, may affect the social choice theorems. To do this, the book explores the presupposition of rationality within the fuzzy framework and shows that the two conditions for rationality, completeness and transitivity, do exist with fuzzy preferences. Specifically, this book examines: the conditions under which a maximal set exists; the Arrow’s theorem;  the Gibbard-Satterthwaite theorem; and the median voter theorem.  After showing that a non-empty maximal set does exists for fuzzy preference relations, this book goes on to demonstrating the existence of a fuzzy aggregation rule satisfying all five Arrowian conditions, including non-dictatorship. While the Gibbard-Satterthwaite theorem only considers individual fuzzy preferences, this work shows that both individuals and groups can choose alternatives to various degrees, resulting in a so...

  17. The choice that disappeared

    Gjerris, Mickey; Saxe, Henrik

    2013-01-01

    This article criticise the notion that ethical consumerism can solve the ethical issues related to sustainability and food production through an analysis of the complexity of the concept of sustainability as related to food choices. The current trend of leaving the political discussion...... and regulation of the food area to the political consumer is shown to be problematic as shopping for sustainability might be much harder than initially believed due to the conflicting considerations entailed in the concept. Thus political consumerism may give way to fatalism as the complexity of choices become...... apparent and acts of citizenship increasingly are reduced to ethical consumerism supposed to be performed while shopping. The suggested solution is to let food policies be decided to a much higher degree through the political process engaging humans as citizens rather than consumers in the process....

  18. ParaChoice Model.

    Heimer, Brandon Walter [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Levinson, Rebecca Sobel [Sandia National Lab. (SNL-CA), Livermore, CA (United States); West, Todd H. [Sandia National Lab. (SNL-CA), Livermore, CA (United States)

    2017-12-01

    Analysis with the ParaChoice model addresses three barriers from the VTO Multi-Year Program Plan: availability of alternative fuels and electric charging station infrastructure, availability of AFVs and electric drive vehicles, and consumer reluctance to purchase new technologies. In this fiscal year, we first examined the relationship between the availability of alternative fuels and station infrastructure. Specifically, we studied how electric vehicle charging infrastructure affects the ability of EVs to compete with vehicles that rely on mature, conventional petroleum-based fuels. Second, we studied how the availability of less costly AFVs promotes their representation in the LDV fleet. Third, we used ParaChoice trade space analyses to help inform which consumers are reluctant to purchase new technologies. Last, we began analysis of impacts of alternative energy technologies on Class 8 trucks to isolate those that may most efficaciously advance HDV efficiency and petroleum use reduction goals.

  19. Food choices during Ramadan

    Thamina Rashid

    2017-03-01

    Full Text Available Few studies have assessed the dietary Practices of people with diabetes during Ramadan (1. A sub study of Ramadan prospective diabetes study (2 which was conducted at the outpatient department of Baqai Institute of Diabetology and endocrinology, Karachi Pakistan in 2009 analyzed the food choices of patients with diabetes during Ramadan. Several irregularities regarding dietary intake and food choices were noted among the study participants. Although, the patients were counseled regarding diet before Ramadan, many did not follow the dietary advice. All patients had taken food at Iftar but majority of them preferred fried items like samosas, pakoras (fried snack, chicken rolls etc. these deeply fried items can lead to post Iftar hyperglycemia. Patients were also opted for fruit chat, dahibara and chanachaat at Iftar, higher load of these items can also worsen glycemic control. The striking finding was almost absence of meat (protein intake at Iftar but study from India showed increment of all three macronutrients during Ramadan (3. This may result in higher intake of items from carbohydrate and fat groups resulting in hyperglycemia after iftar. Intake of vegetables at Iftar was also negligible and hence the diet was not well balanced. The food choices at sahoor included roti, paratha (fried bread, slices, khajla, pheni, meat, egg and milk. Though it is advisable to take complex carbohydrates, protein and fat at sahoor as these are slowly digestible and can prevent hypoglycemia during fasting but khajla pheni are extremely rich in fat and carbohydrate content and should be avoided (4. However, paratha in 2 teaspoon of oil can be taken at sahoor.Patients with diabetes who fast during the month of Ramadan should have pre Ramadan dietary guidance and counseling session in order to modify their food preferences and choices during the holy month of Ramadan (4.

  20. Constructive Consumer Choice Processes.

    Bettman, James R; Luce, Mary Frances; Payne, John W

    1998-01-01

    Consumer decision making has been a focal interest in consumer research, and consideration of current marketplace trends ( e.g., technological change, an information explosion) indicates that this topic will continue to be critically important. We argue that consumer choice is inherently constructive. Due to limited processing capacity, consumers often do not have well-defined existing preferences, but construct them using a variety of strategies contingent on task demands. After describing c...

  1. Leisure and Travel Choice

    María José Caride; Eduardo L. Giménez

    2003-01-01

    It is commonly recognized the relevance of transportation costs for studying recre- ational demand. However, these costs are related with travel and modal choice deci- sions. This paper o ers a theoretical explanation of the new generation of the demand for recreational goods at destiny after the introduction of a new transportation mode that is not the cheapest nor the fastest among the available modes. The main feature of the model deals with the transportation mode-dependent preferences. T...

  2. The impact of choice context on consumers' choice heuristics

    Mueller Loose, Simone; Scholderer, Joachim; Corsi, Armando M.

    2012-01-01

    Context effects in choice settings have received recent attention but little is known about the impact of context on choice consistency and the extent to which consumers apply choice heuristics. The sequence of alternatives in a choice set is examined here as one specific context effect. We compare...... how a change from a typical price order to a sensory order in wine menus affects consumer choice. We use pre-specified latent heuristic classes to analyse the existence of different choice processes, which begins to untangle the ‘black box’ of how consumers choose. Our findings indicate...... that in the absence of price order, consumers are less price-sensitive, pay more attention to visually salient cues, are less consistent in their choices and employ other simple choice heuristics more frequently than price. Implications for consumer research, marketing and consumer policy are discussed....

  3. Topological social choice

    1997-01-01

    The origins of this volume can be traced back to a conference on "Ethics, Economic and Business" organized by Columbia Busi­ ness School in March of 1993, and held in the splendid facilities of Columbia's Casa Italiana. Preliminary versions of several of the papers were presented at that meeting. In July 1994 the Fields Institute of Mathematical Sciences sponsored a workshop on "Geometry, Topology and Markets": additional papers and more refined versions of the original papers were presented there. They were published in their present versions in Social Choice and Wel­ fare, volume 14, number 2, 1997. The common aim of these workshops and this volume is to crystallize research in an area which has emerged rapidly in the last fifteen years, the area of topological approaches to social choice and the theory of games. The area is attracting increasing interest from social choice theorists, game theorists, mathematical econ­ omists and mathematicians, yet there is no authoritative collection of papers in the a...

  4. Beam diagnostic elements at the Laboratorio Nazionale del Sud

    Calabretta, L.; Cuttone, G.; Raia, G.

    1988-01-01

    The choice of the main beam diagnostic elements at the LNS has to take into account the future installation of the Milan Superconducting Cyclotron and its matching to the MP tandem in Catania. A diagnostic box, consisting of a home-made beam profile monitor, a pair of slits and a Faraday cup, has been designed according to these particular requirements. The main features of these diagnostic elements and preliminary results are described. (orig.)

  5. Diagnostic imaging of shoulder impingement

    Merl, T.; Weinhardt, H.; Oettl, G.; Lenz, M.; Riel, K.A.

    1996-01-01

    Magnetic resonance imaging is a method that has been advancing in the last few years to the modality of choice for diagnostic evaluation of the bone joints, as the method is capable of imaging not only the ossous but also the soft tissue components of the joint. MRI likewise has become an accepted method for diagnostic evaluation of syndromes of the shoulder, with high diagnostic accuracy in detecting rotator cuff lesions, or as an efficient MRI arthrography for evaluation of the instability or lesions of the labrocapsular complex. In the evaluation of early stages of shoulder impingement, the conventional MRI technique as a static technique yields indirect signs which in many cases do not provide the diagnostic certainty required in order to do justice to the functional nature of the syndrome. In these cases, functional MRI for imaging of the arm in abducted position and in rotational movement may offer a chance to early detect impingement and thus identify patients who will profit from treatment at an early stage [de

  6. Evoked Emotions Predict Food Choice

    Dalenberg, Jelle R.; Gutjar, Swetlana; ter Horst, Gert J.; de Graaf, Kees; Renken, Remco J.; Jager, Gerry

    2014-01-01

    In the current study we show that non-verbal food-evoked emotion scores significantly improve food choice prediction over merely liking scores. Previous research has shown that liking measures correlate with choice. However, liking is no strong predictor for food choice in real life environments.

  7. Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies

    Marincek, B. [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2002-09-01

    Common causes of acute abdominal pain include appendicitis, cholecystitis, bowel obstruction, urinary colic, perforated peptic ulcer, pancreatitis, diverticulitis, and nonspecific, nonsurgical abdominal pain. The topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique. The initial radiological evaluation often consists of plain abdominal radiography, despite significant diagnostic limitations. The traditional indications for plain films - bowel obstruction, pneumoperitoneum, and the search of ureteral calculi - are questioned by helical computed tomography (CT). Although ultrasonography (US) is in many centers the modality of choice for imaging the gallbladder and the pelvis in children and women of reproductive age, CT is considered to be one of the most valued tools for triaging patients with acute abdominal pain. CT is particularly beneficial in patients with marked obesity, unclear US findings, bowel obstruction, and multiple lesions. The introduction of multidetector row CT (MDCT) has further enhanced the utility of CT in imaging patients with acute abdominal pain. (orig.)

  8. Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies

    Marincek, B.

    2002-01-01

    Common causes of acute abdominal pain include appendicitis, cholecystitis, bowel obstruction, urinary colic, perforated peptic ulcer, pancreatitis, diverticulitis, and nonspecific, nonsurgical abdominal pain. The topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique. The initial radiological evaluation often consists of plain abdominal radiography, despite significant diagnostic limitations. The traditional indications for plain films - bowel obstruction, pneumoperitoneum, and the search of ureteral calculi - are questioned by helical computed tomography (CT). Although ultrasonography (US) is in many centers the modality of choice for imaging the gallbladder and the pelvis in children and women of reproductive age, CT is considered to be one of the most valued tools for triaging patients with acute abdominal pain. CT is particularly beneficial in patients with marked obesity, unclear US findings, bowel obstruction, and multiple lesions. The introduction of multidetector row CT (MDCT) has further enhanced the utility of CT in imaging patients with acute abdominal pain. (orig.)

  9. Overconfidence and Career Choice.

    Schulz, Jonathan F; Thöni, Christian

    2016-01-01

    People self-assess their relative ability when making career choices. Thus, confidence in their own abilities is likely an important factor for selection into various career paths. In a sample of 711 first-year students we examine whether there are systematic differences in confidence levels across fields of study. We find that our experimental confidence measures significantly vary between fields of study: While students in business related academic disciplines (Political Science, Law, Economics, and Business Administration) exhibit the highest confidence levels, students of Humanities range at the other end of the scale. This may have important implications for subsequent earnings and professions students select themselves in.

  10. Complex Strategic Choices

    Leleur, Steen

    to strategic decision making, Complex Strategic Choices presents a methodology which is further illustrated by a number of case studies and example applications. Dr. Techn. Steen Leleur has adapted previously established research based on feedback and input from various conferences, journals and students...... resulting in new material stemming from and focusing on practical application of a systemic approach. The outcome is a coherent and flexible approach named systemic planning. The inclusion of both the theoretical and practical aspects of systemic planning makes this book a key resource for researchers...

  11. Retirement Choice 2016

    2016-03-01

    MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR/MONITOR’S REPORT NUMBER(S) 12. DISTRIBUTION...retirement choice in 2016. We start by describing the $30,000 bonus as an early, partial cash -out of the servicemember’s retirement pension. This...30,000 cash -out will be “paid back” later in the form of reduced retirement checks. By providing information on how much this cash -out will cost in

  12. Overconfidence and Career Choice

    Schulz, Jonathan F.; Thöni, Christian

    2016-01-01

    People self-assess their relative ability when making career choices. Thus, confidence in their own abilities is likely an important factor for selection into various career paths. In a sample of 711 first-year students we examine whether there are systematic differences in confidence levels across fields of study. We find that our experimental confidence measures significantly vary between fields of study: While students in business related academic disciplines (Political Science, Law, Economics, and Business Administration) exhibit the highest confidence levels, students of Humanities range at the other end of the scale. This may have important implications for subsequent earnings and professions students select themselves in. PMID:26808273

  13. Computational mate choice: theory and empirical evidence.

    Castellano, Sergio; Cadeddu, Giorgia; Cermelli, Paolo

    2012-06-01

    The present review is based on the thesis that mate choice results from information-processing mechanisms governed by computational rules and that, to understand how females choose their mates, we should identify which are the sources of information and how they are used to make decisions. We describe mate choice as a three-step computational process and for each step we present theories and review empirical evidence. The first step is a perceptual process. It describes the acquisition of evidence, that is, how females use multiple cues and signals to assign an attractiveness value to prospective mates (the preference function hypothesis). The second step is a decisional process. It describes the construction of the decision variable (DV), which integrates evidence (private information by direct assessment), priors (public information), and value (perceived utility) of prospective mates into a quantity that is used by a decision rule (DR) to produce a choice. We make the assumption that females are optimal Bayesian decision makers and we derive a formal model of DV that can explain the effects of preference functions, mate copying, social context, and females' state and condition on the patterns of mate choice. The third step of mating decision is a deliberative process that depends on the DRs. We identify two main categories of DRs (absolute and comparative rules), and review the normative models of mate sampling tactics associated to them. We highlight the limits of the normative approach and present a class of computational models (sequential-sampling models) that are based on the assumption that DVs accumulate noisy evidence over time until a decision threshold is reached. These models force us to rethink the dichotomy between comparative and absolute decision rules, between discrimination and recognition, and even between rational and irrational choice. Since they have a robust biological basis, we think they may represent a useful theoretical tool for

  14. Lectures in plasma diagnostics

    Hutchinson, I.H.

    1990-06-01

    This paper discusses the following topics on plasma diagnostics: Electric probes in flowing and magnetized plasmas; Electron cyclotron emission absorption; Magnetic diagnostics; Spectroscopy; and Thomson Scattering

  15. Consensus definitions and application guidelines for control groups in cerebrospinal fluid biomarker studies in multiple sclerosis

    Teunissen, Charlotte; Menge, Til; Altintas, Ayse

    2013-01-01

    The choice of appropriate control group(s) is critical in cerebrospinal fluid (CSF) biomarker research in multiple sclerosis (MS). There is a lack of definitions and nomenclature of different control groups and a rationalized application of different control groups. We here propose consensus......). Furthermore, we discuss the application of these control groups in specific study designs, such as for diagnostic biomarker studies, prognostic biomarker studies and therapeutic response studies. Application of these uniform definitions will lead to better comparability of biomarker studies and optimal use...

  16. Diagnostic Technologies in Practice

    Steinberg, Malcolm; Kwag, Michael; Chown, Sarah A.; Doupe, Glenn; Trussler, Terry; Rekart, Michael; Gilbert, Mark

    2015-01-01

    Diagnosing HIV-positive gay men through enhanced testing technologies that detect acute HIV infection (AHI) or recent HIV infection provides opportunities for individual and population health benefits. We recruited 25 men in British Columbia who received an acute (n = 13) or recent (n = 12) HIV diagnosis to engage in a longitudinal multiple-methods study over one year or longer. Our thematic analysis of baseline qualitative interviews revealed insights within men’s accounts of technologically mediated processes of HIV discovery and diagnosis. Our analysis illuminated the dialectic of new HIV technologies in practice by considering the relationship between advances in diagnostics (e.g., nucleic acid amplification tests) and the users of these medical technologies in clinical settings (e.g., clients and practitioners). Technological innovations and testing protocols have shifted experiences of learning of one’s HIV-positive status; these innovations have created new diagnostic categories that require successful interpretation and translation to be rendered meaningful, to alleviate uncertainty, and to support public health objectives. PMID:25201583

  17. Shiva optical diagnostics

    Rienecker, F.; Kobierecki, M.; Ozarski, R.; Seppala, L.; Manes, K.; Merritt, B.

    1977-01-01

    In the laser fusion program at Lawrence Livermore Laboratory, no target experiment is complete unless it is complemented by careful measurements of the laser pulse that irradiates the target. For this purpose, an incident beam diagnostics (IBD) package has been designed for the Shiva laser. The package will furnish data on items such as the total energy and the focusable energy out of the laser chain, and the spatial and temporal energy and power distribution at the target plane. Understanding laser-plasma interactions requires knowledge of the amount of 1.06 μm light energy that is scattered in various directions from the target. The light energy that is scattered toward the beam focusing lens is analyzed by a reflected beam diagnostic (RBD) package containing a calorimeter, a multiple image camera and a TV camera. This paper describes the detailed design and operation of the IBD and RBD packages as tools to align spatial filters and targets, as well as to diagnose the laser beams and target reflectivity

  18. Climate Model Diagnostic Analyzer

    Lee, Seungwon; Pan, Lei; Zhai, Chengxing; Tang, Benyang; Kubar, Terry; Zhang, Zia; Wang, Wei

    2015-01-01

    The comprehensive and innovative evaluation of climate models with newly available global observations is critically needed for the improvement of climate model current-state representation and future-state predictability. A climate model diagnostic evaluation process requires physics-based multi-variable analyses that typically involve large-volume and heterogeneous datasets, making them both computation- and data-intensive. With an exploratory nature of climate data analyses and an explosive growth of datasets and service tools, scientists are struggling to keep track of their datasets, tools, and execution/study history, let alone sharing them with others. In response, we have developed a cloud-enabled, provenance-supported, web-service system called Climate Model Diagnostic Analyzer (CMDA). CMDA enables the physics-based, multivariable model performance evaluations and diagnoses through the comprehensive and synergistic use of multiple observational data, reanalysis data, and model outputs. At the same time, CMDA provides a crowd-sourcing space where scientists can organize their work efficiently and share their work with others. CMDA is empowered by many current state-of-the-art software packages in web service, provenance, and semantic search.

  19. Mexico's critical choices

    Marcos, E.

    1990-01-01

    In Mexico, the 1982 fall in international oil prices shook the national conscience and pushed the Mexican people in search of a new national image and toward the choices they must make to attain that image. But, according to the author of this paper, the country as a whole has already made critical choices for overall strategy and there are reasons for optimism. In the current economic environment of growing domestic demand and enhanced international competitiveness, the author sees PEMEX (the Mexican national oil company) facing not only the challenge of responding to the rapid changes taking place in the Mexican economy, but also making a significant contribution toward the solid and stable growth of the country. The relevant question is how PEMEX will live up to these expectations. This paper describes several steps PEMEX has taken already or is preparing to take in order to meet this challenge, including: investment in the domestic petrochemical industry; entry into the Eurobond market; development of new methods of project financing

  20. A Subjective Rational Choice

    Vinogradov, G. P.

    2017-01-01

    The problem of constructing a choice model of an agent with endogenous purposes of evolution is under debate. It is demonstrated that its solution requires the development of well-known methods of decision-making while taking into account the relation of action mode motivation to an agent’s ambition to implement subjectively understood interests and the environment state. The latter is submitted for consideration as a purposeful state situation model that exists only in the mind of an agent. It is the situation that is a basis for getting an insight into the agent’s ideas on the possible selected action mode results. The agent’s ambition to build his confidence in the feasibility of the action mode and the possibility of achieving the desired state requires him to use the procedures of forming an idea model based on the measured values of environment state. This leads to the gaming approach for the choice problem and its solution can be obtained on a set of trade-off alternatives.

  1. NAIMA as a solution for future GMO diagnostics challenges.

    Dobnik, David; Morisset, Dany; Gruden, Kristina

    2010-03-01

    In the field of genetically modified organism (GMO) diagnostics, real-time PCR has been the method of choice for target detection and quantification in most laboratories. Despite its numerous advantages, however, the lack of a true multiplexing option may render real-time PCR less practical in the face of future GMO detection challenges such as the multiplicity and increasing complexity of new transgenic events, as well as the repeated occurrence of unauthorized GMOs on the market. In this context, we recently reported the development of a novel multiplex quantitative DNA-based target amplification method, named NASBA implemented microarray analysis (NAIMA), which is suitable for sensitive, specific and quantitative detection of GMOs on a microarray. In this article, the performance of NAIMA is compared with that of real-time PCR, the focus being their performances in view of the upcoming challenge to detect/quantify an increasing number of possible GMOs at a sustainable cost and affordable staff effort. Finally, we present our conclusions concerning the applicability of NAIMA for future use in GMO diagnostics.

  2. Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management

    Chhabra, Avneesh; Belzberg, Allan J.; Rosson, Gedge D.; Shores, Jaimie T.; Deune, Gene; Thawait, Gaurav K.; Chalian, M.; Farahani, Sahar J.; Thawait, Shrey K.; Hashemi, Shar; Subhawong, Ty K.; Carrino, John A.

    2016-01-01

    To evaluate the impact of magnetic resonance neurography (MRN) on diagnostic thinking and therapeutic choices in patients with suspected peripheral neuropathy. IRB approval was obtained for this HIPAA-compliant study. Questionnaires were administered to six surgeons regarding the diagnosis and treatment in 85 patients suspected of having peripheral neuropathy, before (pretest) and after (posttest) MRN. Multiple outcome measures related to diagnostic confidence and surgical decision-making were assessed. The final cohort included 81 patients (30 men and 51 women, age 47 ± 17 years). The following changes were observed from pretest to posttest questionnaires: 23 % in nerve involvement (P < 0.05), 48 % in degree of confidence of nerve involvement (P < 0.01), 27 % in grade of injury (P < 0.05), 33 % in differential diagnosis (P < 0.05), 63 % in degree of confidence in need for surgery (P < 0.001), 41 % in timing of surgery (P < 0.01), 30 % in approach to surgery (P < 0.05), 58 % in degree of confidence in approach to surgery (P < 0.001), 30 % in estimated length of surgery (P < 0.05) and 27 % in length of incision (P < 0.05). The dichotomous decision regarding surgical or nonsurgical treatment changed from pro to con in 17 %. MRN results significantly influenced the diagnostic thinking and therapeutic recommendations of peripheral nerve surgeons. circle In patients with peripheral neuropathy, MRN significantly impacts diagnostic thinking. (orig.)

  3. Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management

    Chhabra, Avneesh [Southwestern Medical Center, Department of Radiology, Dallas, TX (United States); Johns Hopkins Hospital, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Belzberg, Allan J. [Johns Hopkins University School of Medicine, Department of Neurosurgery, Baltimore, MD (United States); Rosson, Gedge D.; Shores, Jaimie T.; Deune, Gene [Johns Hopkins University School of Medicine, Department of Plastic Surgery, Baltimore, MD (United States); Thawait, Gaurav K.; Chalian, M.; Farahani, Sahar J.; Thawait, Shrey K. [Johns Hopkins Hospital, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Hashemi, Shar [Dellon Institute, Towson, MD (United States); Subhawong, Ty K. [University of Miami Health System, Department of Radiology, Miami, FL (United States); Carrino, John A. [Weill Cornell Medical College, Hospital for Special Surgery, Department of Radiology and Imaging, New York, NY (United States)

    2016-05-15

    To evaluate the impact of magnetic resonance neurography (MRN) on diagnostic thinking and therapeutic choices in patients with suspected peripheral neuropathy. IRB approval was obtained for this HIPAA-compliant study. Questionnaires were administered to six surgeons regarding the diagnosis and treatment in 85 patients suspected of having peripheral neuropathy, before (pretest) and after (posttest) MRN. Multiple outcome measures related to diagnostic confidence and surgical decision-making were assessed. The final cohort included 81 patients (30 men and 51 women, age 47 ± 17 years). The following changes were observed from pretest to posttest questionnaires: 23 % in nerve involvement (P < 0.05), 48 % in degree of confidence of nerve involvement (P < 0.01), 27 % in grade of injury (P < 0.05), 33 % in differential diagnosis (P < 0.05), 63 % in degree of confidence in need for surgery (P < 0.001), 41 % in timing of surgery (P < 0.01), 30 % in approach to surgery (P < 0.05), 58 % in degree of confidence in approach to surgery (P < 0.001), 30 % in estimated length of surgery (P < 0.05) and 27 % in length of incision (P < 0.05). The dichotomous decision regarding surgical or nonsurgical treatment changed from pro to con in 17 %. MRN results significantly influenced the diagnostic thinking and therapeutic recommendations of peripheral nerve surgeons. circle In patients with peripheral neuropathy, MRN significantly impacts diagnostic thinking. (orig.)

  4. Proposed Diagnostic Criteria for Smartphone Addiction.

    Lin, Yu-Hsuan; Chiang, Chih-Lin; Lin, Po-Hsien; Chang, Li-Ren; Ko, Chih-Hung; Lee, Yang-Han; Lin, Sheng-Hsuan

    2016-01-01

    Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria. We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each participant was systematically assessed for smartphone-using behaviors by psychiatrist's structured diagnostic interview. The sensitivity, specificity, and diagnostic accuracy of the candidate symptom criteria were analyzed with reference to the psychiatrists' clinical global impression. The optimal model selection with its cutoff point of the diagnostic criteria differentiating the smartphone addicted subjects from non-addicted subjects was then determined by the best diagnostic accuracy. Six symptom criteria model with optimal cutoff point were determined based on the maximal diagnostic accuracy. The proposed smartphone addiction diagnostic criteria consisted of (1) six symptom criteria, (2) four functional impairment criteria and (3) exclusion criteria. Setting three symptom criteria as the cutoff point resulted in the highest diagnostic accuracy (84.3%), while the sensitivity and specificity were 79.4% and 87.5%, respectively. We suggested determining the functional impairment by two or more of the four domains considering the high accessibility and penetration of smartphone use. The diagnostic criteria of smartphone addiction demonstrated the core symptoms "impaired control" paralleled with substance related and addictive disorders. The functional impairment involved multiple domains provide a strict standard for clinical assessment.

  5. Ultimate explanations and suboptimal choice.

    Vasconcelos, Marco; Machado, Armando; Pandeirada, Josefa N S

    2018-07-01

    Researchers have unraveled multiple cases in which behavior deviates from rationality principles. We propose that such deviations are valuable tools to understand the adaptive significance of the underpinning mechanisms. To illustrate, we discuss in detail an experimental protocol in which animals systematically incur substantial foraging losses by preferring a lean but informative option over a rich but non-informative one. To understand how adaptive mechanisms may fail to maximize food intake, we review a model inspired by optimal foraging principles that reconciles sub-optimal choice with the view that current behavioral mechanisms were pruned by the optimizing action of natural selection. To move beyond retrospective speculation, we then review critical tests of the model, regarding both its assumptions and its (sometimes counterintuitive) predictions, all of which have been upheld. The overall contention is that (a) known mechanisms can be used to develop better ultimate accounts and that (b) to understand why mechanisms that generate suboptimal behavior evolved, we need to consider their adaptive value in the animal's characteristic ecology. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Motherhood as a choice.

    Mcfadden, P

    1994-06-01

    The choice of motherhood for women and women's rights have been forbidden in law by men, in religious doctrines by men, and within the medical system by men. Women in poverty have little say in determining whether to have children or not. When choice is exercised for abortion, poor women have unsafe and illegal abortions, which can be life-threatening. Rich women have safer options. Women historically have allowed their rights to be eroded by gender inequality and patriarchal manipulation. The religious right and the Roman Catholic church have been allowed to speak and decide for women. Abortion rights are not about western influences, but about maternal mortality. The right to make choices about one's life is the fundamental premise of the universal rights of all human beings. African governments have signed the UN Convention on elimination of all forms of discrimination against women, but the practice of human rights has not been implemented at the local and family level. Motherhood needs to be demystified. Motherhood is linked with the absence of personhood and bodily integrity. The rhetoric of moral obligations and the rights of the unborn child take precedence over the rights of women. The right of an African woman not to have children is not recognized in most Africa societies. The issue of AIDS creates an even more difficult milieu for women. The interests of the family and the interests of men overwhelm the interests of women to protect themselves. Motherhood is essential to validating one's heterosexuality and gaining stature, and females without a child are marginalized and unrecognized. Women whose babies do not survive are marginalized further than barren women. Men derive power from women's birthing. The terminology of male power is replete with expressions such as "pregnant with promise" and "miscarriage of justice's", no one says "uterus envy." Male psychologists only recognize "penis envy." Men need children for purposes of property, lineage, and

  7. Diagnostic use of angiotensin converting enzyme (ACE)-inhibited renal scintigraphy in the identification of selective renal artery stenosis in the presence of multiple renal arteries: A case report

    Morton, K.A.; Rose, S.C.; Haakenstad, A.O.; Handy, J.E.; Scuderi, A.J.; Datz, F.L.

    1990-01-01

    In patients with renovascular hypertension, it is unknown whether the angiotensin converting enzyme-(ACE) inhibited renal scan will identify stenosis of a segmental branch of a single renal artery or of an accessory artery where multiple renal arteries are present. Since multiple renal arteries may be present in approximately 25% of all individuals, it will be important to establish whether the ACE-inhibited renal scan is useful in this population. We report a case of stenosis involving a renal artery in a patient with multiple renal arteries, successfully identified by ACE-inhibited renal scintigraphy

  8. Biofuels: making tough choices

    Vermeulen, Sonja; Dufey, Annie; Vorley, Bill

    2008-02-15

    The jury is still out on biofuels. But one thing at least is certain: serious trade-offs are involved in the production and use of these biomass-derived alternatives to fossil fuels. This has not been lost on the European Union. The year kicked off with an announcement from the EU environment commissioner that it may be better for the EU to miss its target of reaching 10 per cent biofuel content in road fuels by 2020 than to compromise the environment and human wellbeing. The 'decision tree' outlined here can guide the interdependent processes of deliberation and analysis needed for making tough choices in national biofuels development.

  9. Attention and choice

    Orquin, Jacob Lund; Mueller Loose, Simone

    2013-01-01

    satisfaction models. Although most theories were confirmed with regard to certain predictions, none of the theories adequately accounted for the role of attention during decision making. Several observations emerged concerning the drivers and down-stream effects of attention on choice, suggesting......This paper reviews studies on eye movements in decision making, and compares their observations to theoretical predictions concerning the role of attention in decision making. Four decision theories are examined: rational models, bounded rationality, evidence accumulation, and parallel constraint...... that attention processes plays an active role in constructing decisions. So far, decision theories have largely ignored the constructive role of attention by assuming that it is entirely determined by heuristics, or that it consists of stochastic information sampling. The empirical observations reveal...

  10. Environment and fuel choice

    Ellerman, A.D.

    1992-01-01

    The efficacy of environmental regulation as a determinant of fossil fuel choice is examined, with a focus on coal and natural gas in the United States market. It is thought that with the current concern over greenhouse gas emissions, gas would become the fuel of choice and would benefit from measures such as emission trading and carbon taxes. In the USA, in spite of environmental regulations set forth in the Clean Air Act, coal consumption has not decreased with respect to gas because coal is successfully competing on an economic and environmental level. Coal mine productivity has increased over the past 15 years and significant progress has been made in both reducing the emission forming materials in coal through better processing and reducing stack emissions via pollution control devices. An economic analysis of the premium that should attach to natural gas as compared to coal for power generation shows that an emissions trading premium on gas is not sufficient to compensate for the lower cost of coal. The advantages of natural gas for power generation lie in the lower capital and operating costs for combined cycle generation technology and the good prospects for a low, long-term equilibrium price for natural gas. Lower wellhead prices and combined cycle technology will cause gas to have a larger share of the electric utility market than coal in areas where transport economics are favorable. However, the economics of existing coal-fired plants favor continued use of coal, and the increase in gas use will depend on the rate at which new plants are built. 4 figs

  11. Expanding the Nudge : Designing Choice Contexts and Choice Contents

    Grill, Kalle

    2014-01-01

    To nudge is to design choice contexts in order to improve choice outcomes. Richard Thaler and Cass Sunstein emphatically endorse nudging but reject more restrictive means. In contrast, I argue that the behavioral psychology that motivates nudging also motivates what may be called jolting—i.e. the design of choice content. I defend nudging and jolting by distinguishing them from the sometimes oppressive means with which they can be im- plemented, by responding to some common arguments against ...

  12. Roentgen signs in diagnostic imaging. Vol. 1

    Meschan, I.

    1988-01-01

    This book is a new edition under a different title of a part of the three-volume publication 'Analysis of X-ray pictures'. The book primarily deals with X-ray diagnostics and covers four chapters on the following subjects: plain radiographs of the abdomen, the urinary tract, obstetrics including gynaecology, and the biliary tract. Diagnostic ultrasonography is discussed in greater detail in the chapter on obstetrics and gynaecology as it is a method of first choice in this field. (MG) With 944 figs., 33 tabs [de

  13. Diagnostic reasoning strategies and diagnostic success.

    Coderre, S; Mandin, H; Harasym, P H; Fick, G H

    2003-08-01

    Cognitive psychology research supports the notion that experts use mental frameworks or "schemes", both to organize knowledge in memory and to solve clinical problems. The central purpose of this study was to determine the relationship between problem-solving strategies and the likelihood of diagnostic success. Think-aloud protocols were collected to determine the diagnostic reasoning used by experts and non-experts when attempting to diagnose clinical presentations in gastroenterology. Using logistic regression analysis, the study found that there is a relationship between diagnostic reasoning strategy and the likelihood of diagnostic success. Compared to hypothetico-deductive reasoning, the odds of diagnostic success were significantly greater when subjects used the diagnostic strategies of pattern recognition and scheme-inductive reasoning. Two other factors emerged as independent determinants of diagnostic success: expertise and clinical presentation. Not surprisingly, experts outperformed novices, while the content area of the clinical cases in each of the four clinical presentations demonstrated varying degrees of difficulty and thus diagnostic success. These findings have significant implications for medical educators. It supports the introduction of "schemes" as a means of enhancing memory organization and improving diagnostic success.

  14. Performing a Choice-Narrative

    Holmegaard, Henriette Tolstrup

    2015-01-01

    Students’ science choices have long attracted attention in both public and research. Recently there has been a call for qualitative studies to explore how choices create a sense of fit for individual students. Therefore, this paper aims to study how science students’ choices of higher education...... side articulated as not too predictable, and on the other side appearing realistic and adjusted to the students’ sense of self. Third, the choice-narratives were informed, validated and adjusted in the students’ social network providing the students with a repertoire of viable pathways. The study...... demonstrates how cultural discourses about how a proper choice is made set the scene for the students’ choices. The study raises some concerns for science education. Improving students’ interests in science alone might not lead to increased admission as several interests equally intervene. To attract more...

  15. Evoked Emotions Predict Food Choice

    Dalenberg, Jelle R.; Gutjar, Swetlana; ter Horst, Gert J.; de Graaf, Kees; Renken, Remco J.; Jager, Gerry

    2014-01-01

    In the current study we show that non-verbal food-evoked emotion scores significantly improve food choice prediction over merely liking scores. Previous research has shown that liking measures correlate with choice. However, liking is no strong predictor for food choice in real life environments. Therefore, the focus within recent studies shifted towards using emotion-profiling methods that successfully can discriminate between products that are equally liked. However, it is unclear how well ...

  16. Loci of Causality and Orientation in Occupational and Educational Choices

    Kalervo Friberg

    2013-06-01

    Full Text Available A student self-determination profile of occupational and educational choices was examined through the concepts of Locus of Causality and Locus of Orientation. Research questions associated with respondents’ certainty of occupation and orientation to vocational education were answered. The tested hypotheses were as follows: (a Independence, initiative, self-guidance, choice of discussion forums, and gender are related to certainty of future occupation choice and choice of vocational education; (b certainty of occupation relates to choosing vocational education; (c negatively biased media lessens interest in vocational education; and (d vocational education choices are related to gender. A survey of ninth-grade students in Finnish comprehensive school was conducted after implementation of a work-orientation program defined in the national comprehensive school curriculum. At the local school system level, 649 subjects of the mean ages of 16.0 years participated in an Internet survey in two school districts in southwestern Finland in 2008. The variables were inserted in Linear Multiple Regression Analysis in IBM SPSS. The means of vocational school choice and certainty of occupation, and vocational school choice and negative media image were compared in SPSS means. An independent-samples t test for vocational school choice and sex was conducted. Statistically significant regression models of loci of orientation and locus of causality were found. The more the respondents were certain of their occupation choice, the more they expressed their secondary education orientation to be vocational school. When students discussed their choices less at home, their orientation to vocational education weakened. A negative media image was not associated with vocational school choice in this data. The measured means for girls’ and boys’ orientations to vocational school did not show statistically significant differences.

  17. Discrete Choice and Rational Inattention

    Fosgerau, Mogens; Melo, Emerson; de Palma, André

    2017-01-01

    This paper establishes a general equivalence between discrete choice and rational inattention models. Matejka and McKay (2015, AER) showed that when information costs are modelled using the Shannon entropy, the result- ing choice probabilities in the rational inattention model take the multinomial...... logit form. We show that when information costs are modelled using a class of generalized entropies, then the choice probabilities in any rational inattention model are observationally equivalent to some additive random utility discrete choice model and vice versa. This equivalence arises from convex...

  18. Motherhood: From rights to choices

    Renata Salecl

    2010-01-01

    Full Text Available Motherhood has been perceived as choice in the developed world after the liberalisation of abortion. However, this choice can be extremely anxiety provoking for women, especially in times when the ideology of choice dominates our lives in all possible ways. The paper shows how psychotherapy and psychoanalysis look at this anxiety, it reflects on how family relations are often the traumatic kernel behind this choice, and how the changes that women experience in today's times contribute to the increase of anxiety related to reproduction.

  19. Intellectual property considerations for molecular diagnostic development with emphasis on companion diagnostics.

    Glorikian, Harry; Warburg, Richard Jeremy; Moore, Kelly; Malinowski, Jennifer

    2018-02-01

    The development of molecular diagnostics is a complex endeavor, with multiple regulatory pathways to consider and numerous approaches to development and commercialization. Companion diagnostics, devices which are "essential for the safe and effective use of a corresponding drug or diagnostic product" (see U.S. Food & Drug Administration, In Vitro Diagnostics - Companion Diagnostics, U.S. Dept. of Health & Human Services(2016), available at https://www.fda.gov/medicaldevices/productsandmedicalprocedures/invitrodiagnostics/ucm407297.htm ) and complementary diagnostics, which are more broadly associated with a class of drug, are becoming increasingly important as integral components of the implementation of precision medicine. Areas covered: The following article will highlight the intellectual property ('IP') considerations pertinent to molecular diagnostics development with special emphasis on companion diagnostics. Expert opinion/commentary Summary: For all molecular diagnostics, intellectual property (IP) concerns are of paramount concern, whether the device will be marketed only in the United States or abroad. Taking steps to protect IP at each stage of product development is critical to optimize profitability of a diagnostic product. Also the legal framework around IP protection of diagnostic technologies has been changing over the previous few years and can be expected to continue to change in the foreseeable near future, thus, a comprehensive IP strategy should take into account the fact that changes in the law can be expected.

  20. Addiction: Choice or compulsion?

    Edmund eHenden

    2013-08-01

    Full Text Available Normative thinking about addiction has traditionally been divided between, on the one hand, a medical model which sees addiction as a disease characterized by compulsive and relapsing drug use over which the addict has little or no control and, on the other, a moral model which sees addiction as a choice characterized by voluntary behaviour under the control of the addict. Proponents of the former appeal to evidence showing that regular consumption of drugs causes persistent changes in the brain structures and functions known to be involved in the motivation of behavior. On this evidence, it is often concluded that becoming addicted involves a transition from voluntary, chosen drug use to non-voluntary compulsive drug use. Against this view, proponents of the moral model provide ample evidence that addictive drug use involves voluntary chosen behaviour. In this article we argue that although they are right about something, both views are mistaken. We present a third model that neither rules out the view of addictive drug use as compulsive, nor that it involves voluntary chosen behavior.

  1. Addiction: Choice or Compulsion?

    Henden, Edmund; Melberg, Hans Olav; Røgeberg, Ole Jørgen

    2013-01-01

    Normative thinking about addiction has traditionally been divided between, on the one hand, a medical model which sees addiction as a disease characterized by compulsive and relapsing drug use over which the addict has little or no control and, on the other, a moral model which sees addiction as a choice characterized by voluntary behavior under the control of the addict. Proponents of the former appeal to evidence showing that regular consumption of drugs causes persistent changes in the brain structures and functions known to be involved in the motivation of behavior. On this evidence, it is often concluded that becoming addicted involves a transition from voluntary, chosen drug use to non-voluntary compulsive drug use. Against this view, proponents of the moral model provide ample evidence that addictive drug use involves voluntary chosen behavior. In this article we argue that although they are right about something, both views are mistaken. We present a third model that neither rules out the view of addictive drug use as compulsive, nor that it involves voluntary chosen behavior. PMID:23966955

  2. Probability and rational choice

    David Botting

    2014-05-01

    Full Text Available http://dx.doi.org/10.5007/1808-1711.2014v18n1p1 In this paper I will discuss the rationality of reasoning about the future. There are two things that we might like to know about the future: which hypotheses are true and what will happen next. To put it in philosophical language, I aim to show that there are methods by which inferring to a generalization (selecting a hypothesis and inferring to the next instance (singular predictive inference can be shown to be normative and the method itself shown to be rational, where this is due in part to being based on evidence (although not in the same way and in part on a prior rational choice. I will also argue that these two inferences have been confused, being distinct not only conceptually (as nobody disputes but also in their results (the value given to the probability of the hypothesis being not in general that given to the next instance and that methods that are adequate for one are not by themselves adequate for the other. A number of debates over method founder on this confusion and do not show what the debaters think they show.

  3. Diagnostic Imaging and Problems of Schizencephaly

    Stopa, Joanna; Kucharska-Miąsik, Iwona; Dziurzyńska-Białek, Ewa; Kostkiewicz, Agnieszka; Solińska, Anna; Zając-Mnich, Monika; Guz, Wiesław; Samojedny, Antoni

    2014-01-01

    Schizencephaly is a rare developmental malformation of the central nervous system associated with cell migration disturbances. Schizencephaly can be uni- or bilateral and is divided into two morphological types. The cleft is defined as type I (“closed lips”) if there are fused clefts in cerebral mantle. In type II (“open lips”) the clefts are separated and filled with cerebrospinal fluid connecting lateral ventricle with the subarachnoid space. We retrospectively analysed data of patients hospitalized in the Clinical Pediatric Neurology Department of Provincial Hospital No. 2 in Rzeszow between 1998–2011. Clinical data and imaging exams were analysed in the group of children with confirmed schizencephaly. Schizencephaly was recognized in 32 children. Diagnosis was made in children at the ages between 2 weeks and 15 years – the majority of older children were born before the year 2000. Diagnostic imaging, most often magnetic resonance imaging, was performed in all of the children. In most cases coexistence of other CNS malformations was discovered. In only one patient there were no neurological symptoms, most of the children presented different developmental disorders and neurological symptoms – most often cerebral palsy and epilepsy. In the group of children with bilateral and type II schizencephaly certain symptoms occurred more often. Schizencephaly is a rare central nervous system developmental disorder, which is very often associated with other severe brain malformations and in most of the cases subsequent multiple neurological symptoms. The method of choice in diagnosis of schizencephaly is magnetic resonance, which shows the degree and type of cleft, coexisting abnormalities and allows differential diagnosis. With the increased availability of this method it is possible to recognize schizencephaly more often and earlier

  4. Advanced statistics: linear regression, part II: multiple linear regression.

    Marill, Keith A

    2004-01-01

    The applications of simple linear regression in medical research are limited, because in most situations, there are multiple relevant predictor variables. Univariate statistical techniques such as simple linear regression use a single predictor variable, and they often may be mathematically correct but clinically misleading. Multiple linear regression is a mathematical technique used to model the relationship between multiple independent predictor variables and a single dependent outcome variable. It is used in medical research to model observational data, as well as in diagnostic and therapeutic studies in which the outcome is dependent on more than one factor. Although the technique generally is limited to data that can be expressed with a linear function, it benefits from a well-developed mathematical framework that yields unique solutions and exact confidence intervals for regression coefficients. Building on Part I of this series, this article acquaints the reader with some of the important concepts in multiple regression analysis. These include multicollinearity, interaction effects, and an expansion of the discussion of inference testing, leverage, and variable transformations to multivariate models. Examples from the first article in this series are expanded on using a primarily graphic, rather than mathematical, approach. The importance of the relationships among the predictor variables and the dependence of the multivariate model coefficients on the choice of these variables are stressed. Finally, concepts in regression model building are discussed.

  5. Diabetes and diet : food choices

    Niewind, A.C.

    1989-01-01

    This thesis reports on the food choices of diabetic patients. Two studies were undertaken considering the barriers these patients experience with the diabetic diet. Furthermore, the changes in food choices during the first years after the diagnosis of insulin-dependent diabetes as well as patients,

  6. Choice of pesticide fate models

    Balderacchi, Matteo; Trevisan, Marco; Vischetti, Costantino

    2006-01-01

    The choice of a pesticide fate model at field scale is linked to the available input data. The article describes the available pesticide fate models at a field scale and the guidelines for the choice of the suitable model as function of the data input requested [it

  7. Channel Choice: A Literature Review

    Østergaard Madsen, Christian; Kræmmergaard, Pernille

    2015-01-01

    The channel choice branch of e-government studies citizens’ and businesses’ choice of channels for interacting with government, and how government organizations can integrate channels and migrate users towards the most cost-efficient channels. In spite of the valuable contributions offered...

  8. Educational Choice. A Background Paper.

    Quality Education for Minorities Network, Washington, DC.

    This paper addresses school choice, one proposal to address parental involvement concerns, focusing on historical background, definitions, rationale for advocating choice, implementation strategies, and implications for minorities and low-income families. In the past, transfer payment programs such as tuition tax credits and vouchers were…

  9. Sex Education: Challenges and Choices

    MacKenzie, Alison; Hedge, Nicki; Enslin, Penny

    2017-01-01

    Noting public concern about sexual exploitation, abuse and sexualisation, we argue that sex education in the UK needs revision. Choice is a feature of current sex education policy and, acknowledging that choice can be problematic, we defend its place in an approach to sex education premised on informed deliberation, relational autonomy, a…

  10. PATERNAL INFLUENCE ON CAREER CHOICE.

    WERTS, CHARLES E.

    FATHER'S OCCUPATION WAS COMPARED WITH SON'S CAREER CHOICE FOR A SAMPLE OF 76,015 MALE, COLLEGE FRESHMEN. RESULTS INDICATED THAT CERTAIN TYPES OF FATHERS' OCCUPATIONS WERE ASSOCIATED WITH SIMILAR TYPES OF CAREER CHOICES BY SONS. BOYS WHOSE FATHERS WERE IN SCIENTIFIC OCCUPATIONS (ENGINEERS, MILITARY OFFICERS, ARCHITECTS, BIOLOGISTS, CHEMISTS, AND…

  11. Strategy-proof social choice

    Barberà, Salvador, 1946-

    2010-01-01

    This paper surveys the literature on strategy-proofness from a historical perspective. While I discuss the connections with other works on incentives in mechanism design, the main emphasis is on social choice models. This article has been prepared for the Handbook of Social Choice and Welfare, Volume 2, Edited by K. Arrow, A. Sen and K. Suzumura

  12. Substitution in recreation choice behavior

    George L. Peterson; Daniel J. Stynes; Donald H. Rosenthal; John F. Dwyer

    1985-01-01

    This review discusses concepts and theories of substitution in recreation choice. It brings together the literature of recreation research, psychology, geography, economics, and transportation. Parallel and complementary developments need integration into an improved theory of substitution. Recreation decision behavior is characterized as a nested or sequential choice...

  13. Perception bias in route choice

    Vreeswijk, Jacob Dirk; Thomas, Tom; van Berkum, Eric C.; van Arem, Bart

    2014-01-01

    Travel time is probably one of the most studied attributes in route choice. Recently, perception of travel time received more attention as several studies have shown its importance in explaining route choice behavior. In particular, travel time estimates by travelers appear to be biased against

  14. Optimal Portfolio Choice with Annuitization

    Koijen, R.S.J.; Nijman, T.E.; Werker, B.J.M.

    2006-01-01

    We study the optimal consumption and portfolio choice problem over an individual's life-cycle taking into account annuity risk at retirement. Optimally, the investor allocates wealth at retirement to nominal, inflation-linked, and variable annuities and conditions this choice on the state of the

  15. Multiple Perspectives / Multiple Readings

    Simon Biggs

    2005-01-01

    Full Text Available People experience things from their own physical point of view. What they see is usually a function of where they are and what physical attitude they adopt relative to the subject. With augmented vision (periscopes, mirrors, remote cameras, etc we are able to see things from places where we are not present. With time-shifting technologies, such as the video recorder, we can also see things from the past; a time and a place we may never have visited.In recent artistic work I have been exploring the implications of digital technology, interactivity and internet connectivity that allow people to not so much space/time-shift their visual experience of things but rather see what happens when everybody is simultaneously able to see what everybody else can see. This is extrapolated through the remote networking of sites that are actual installation spaces; where the physical movements of viewers in the space generate multiple perspectives, linked to other similar sites at remote locations or to other viewers entering the shared data-space through a web based version of the work.This text explores the processes involved in such a practice and reflects on related questions regarding the non-singularity of being and the sense of self as linked to time and place.

  16. Diagnosis of asthma: diagnostic testing.

    Brigham, Emily P; West, Natalie E

    2015-09-01

    Asthma is a heterogeneous disease, encompassing both atopic and non-atopic phenotypes. Diagnosis of asthma is based on the combined presence of typical symptoms and objective tests of lung function. Objective diagnostic testing consists of 2 components: (1) demonstration of airway obstruction, and (2) documentation of variability in degree of obstruction. A review of current guidelines and literature was performed regarding diagnostic testing for asthma. Spirometry with bronchodilator reversibility testing remains the mainstay of asthma diagnostic testing for children and adults. Repetition of the test over several time points may be necessary to confirm airway obstruction and variability thereof. Repeated peak flow measurement is relatively simple to implement in a clinical and home setting. Bronchial challenge testing is reserved for patients in whom the aforementioned testing has been unrevealing but clinical suspicion remains, though is associated with low specificity. Demonstration of eosinophilic inflammation, via fractional exhaled nitric oxide measurement, or atopy, may be supportive of atopic asthma, though diagnostic utility is limited particularly in nonatopic asthma. All efforts should be made to confirm the diagnosis of asthma in those who are being presumptively treated but have not had objective measurements of variability in the degree of obstruction. Multiple testing modalities are available for objective confirmation of airway obstruction and variability thereof, consistent with a diagnosis of asthma in the appropriate clinical context. Providers should be aware that both these characteristics may be present in other disease states, and may not be specific to a diagnosis of asthma. © 2015 ARS-AAOA, LLC.

  17. Contextual and social influences on valuation and choice.

    Engelmann, Jan B; Hein, Grit

    2013-01-01

    To survive in our complex environment, we have to adapt to changing contexts. Prior research that investigated how contextual changes are processed in the human brain has demonstrated important modulatory influences on multiple cognitive processes underlying decision-making, including perceptual judgments, working memory, as well as cognitive and attentional control. However, in everyday life, the importance of context is even more obvious during economic and social interactions, which often have implicit rule sets that need to be recognized by a decision-maker. Here, we review recent evidence from an increasing number of studies in the fields of Neuroeconomics and Social Neuroscience that investigate the neurobiological basis of contextual effects on valuation and social choice. Contrary to the assumptions of rational choice theory, multiple contextual factors, such as the availability of alternative choice options, shifts in reference point, and social context, have been shown to modulate behavior, as well as signals in task-relevant neural networks. A consistent picture that emerges from neurobiological results is that valuation-related activity in striatum and ventromedial prefrontal cortex is highly context dependent during both social and nonsocial choice. Alternative approaches to model and explain choice behavior, such as comparison-based choice models, as well as implications for future research are discussed. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Commitment-based action: Rational choice theory and contrapreferential choice

    Radovanović Bojana

    2014-01-01

    Full Text Available This paper focuses on Sen’s concept of contrapreferential choice. Sen has developed this concept in order to overcome weaknesses of the rational choice theory. According to rational choice theory a decision-maker can be always seen as someone who maximises utility, and each choice he makes as the one that brings to him the highest level of personal wellbeing. Sen argues that in some situations we chose alternatives that bring us lower level of wellbeing than we could achieve if we had chosen some other alternative available to us. This happens when we base our decisions on moral principles, when we act out of duty. Sen calls such action a commitment-based action. When we act out of commitment we actually neglect our preferences and thus we make a contrapreferential choice, as Sen argues. This paper shows that, contrary to Sen, a commitment-based action can be explained within the framework of rational choice theory. However, when each choice we make can be explained within the framework of rational choice theory, when in everything we do maximisation principle can be loaded, then the variety of our motives and traits is lost, and the explanatory power of the rational choice theory is questionable. [Projekat Ministarstva nauke Republike Srbije, br. 47009: Evropske integracije i društveno-ekonomske promene privrede Srbije na putu ka EU i br. 179015: Izazovi i perspektive strukturnih promena u Srbiji: Strateški pravci ekonomskog razvoja i usklađivanje sa zahtevima EU

  19. Procedures in diagnostic radiology

    Doyle, T.; Hare, W.S.C.; Thomson, K.; Tess, B.

    1989-01-01

    This book outlines the various procedures necessary for the successful practice of diagnostic radiology. Topics covered are: general principles, imaging of the urinary and gastrointestinal tracts, vascular radiology, arthrography, and miscellaneous diagnostic radiologic procedures

  20. Diagnostic Algorithm Benchmarking

    Poll, Scott

    2011-01-01

    A poster for the NASA Aviation Safety Program Annual Technical Meeting. It describes empirical benchmarking on diagnostic algorithms using data from the ADAPT Electrical Power System testbed and a diagnostic software framework.

  1. QTest: Quantitative Testing of Theories of Binary Choice.

    Regenwetter, Michel; Davis-Stober, Clintin P; Lim, Shiau Hong; Guo, Ying; Popova, Anna; Zwilling, Chris; Cha, Yun-Shil; Messner, William

    2014-01-01

    The goal of this paper is to make modeling and quantitative testing accessible to behavioral decision researchers interested in substantive questions. We provide a novel, rigorous, yet very general, quantitative diagnostic framework for testing theories of binary choice. This permits the nontechnical scholar to proceed far beyond traditionally rather superficial methods of analysis, and it permits the quantitatively savvy scholar to triage theoretical proposals before investing effort into complex and specialized quantitative analyses. Our theoretical framework links static algebraic decision theory with observed variability in behavioral binary choice data. The paper is supplemented with a custom-designed public-domain statistical analysis package, the QTest software. We illustrate our approach with a quantitative analysis using published laboratory data, including tests of novel versions of "Random Cumulative Prospect Theory." A major asset of the approach is the potential to distinguish decision makers who have a fixed preference and commit errors in observed choices from decision makers who waver in their preferences.

  2. Diagnostic radiography: A study in distancing

    Reeves, Pauline J.; Decker, Sola

    2012-01-01

    Aims: This article aims to explore the ways in which diagnostic radiographers use distancing as a tool for emotional management in radiography practice. Methods: This review utilises data from oral history interviews undertaken as part of a larger study documenting the oral history of the diagnostic radiography profession in the United Kingdom as recounted by 24 participants. Results: The results are presented as illustrative of various aspects of the role of the diagnostic radiographer including the initial choice of diagnostic radiography as a profession, the endemic use of particular terminology, the nature of the encounter in diagnostic radiography (including that of sectional imaging) and whether the role is really patient-centred. Conclusions: The article concludes by suggesting that distancing from the patient is mediated by the need for physical touch in order to position the patient for radiography and also makes the suggestion that those opting for diagnostic radiography as a career may do so because they want a profession which is more distanced from the patient and that, even where this is not the case initially, individuals are socialised into adopting the ‘feeling rules’ of the profession. The article concludes by outlining potential areas for further research.

  3. Diagnostic imaging in intensive care patients

    Afione, Cristina; Binda, Maria del C.

    2004-01-01

    Purpose: To determine the role of imaging diagnostic methods in the location of infection causes of unknown origin in the critical care patient. Material and methods: A comprehensive medical literature search has been done. Recommendations for the diagnostic imaging of septic focus in intensive care patients are presented for each case, with analysis based on evidence. The degree of evidence utilized has been that of Oxford Center for Evidence-based Medicine. Results: Nosocomial infection is the most frequent complication in the intensive care unit (25 to 33%) with high sepsis incidence rate. In order to locate the infection focus, imaging methods play an important role, as a diagnostic tool and to guide therapeutic procedures. The most frequent causes of infection are: ventilation associated pneumonia, sinusitis, intra-abdominal infections and an acute acalculous cholecystitis. This paper analyses the diagnostic imaging of hospital infection, with the evaluation of choice methods for each one and proposes an algorithm to assess the septic patient. Conclusion: There are evidences, with different degrees of recommendation, for the use of diagnostic imaging methods for infectious focuses in critical care patients. The studies have been selected based on their diagnostic precision, on the capacity of the medical team and on the availability of resources, considering the risk-benefit balance for the best safety of the patient. (author)

  4. Parental Choice of School, Class Strategies, and Educational Inequality: An Essay Review of "School Choice in China--A Different Tale?" (X. Wu, New York, NY: Routledge, 2014, 168 pp. ISBN 978-0-415-81769-1)

    Liu, Shuning; Apple, Michael W.

    2016-01-01

    Given the increasingly global nature of marketized school choice policies, this makes it even more crucial to investigate how the multiple scales, forms, and emphases of school choice in different countries are influenced by particular political, economic, and cultural conditions. While much of the critical research on school choice policies has…

  5. Veterinary Molecular Diagnostics

    Roest, H.I.J.; Engelsma, M.Y.; Weesendorp, E.; Bossers, A.; Elbers, A.R.W.

    2017-01-01

    In veterinary molecular diagnostics, samples originating from animals are tested. Developments in the farm animals sector and in our societal attitude towards pet animals have resulted in an increased demand for fast and reliable diagnostic techniques. Molecular diagnostics perfectly matches this

  6. Diagnostic imaging in focal epilepsy

    Zlatareva, D.

    2013-01-01

    Focal epilepsies account for 60% of all seizure disorders worldwide. In this review the classic and new classification system of epileptic seizures and syndromes as well as genetic forms are discussed. Magnetic resonance (MR) is the technique of choice for diagnostic imaging in focal epilepsy because of its sensitivity and high tissue contrast. The review is focused on the lack of consensus of imaging protocols and reported findings in refractory epilepsy. The most frequently encountered MRI findings in epilepsy are reported and their imaging characteristics are depicted. Diagnosis of hippocampal sclerosis and malformations of cortical development as two major causes of refractory focal epilepsy is described in details. Some promising new techniques as positron emission tomography computed tomography (PET/CT) and MR and PET/CT fusion are briefly discussed. Also the relevance of adequate imaging in focal epilepsy, some practical points in imaging interpretation and differential diagnosis are highlighted. (author)

  7. The retail market : competition choice and challenges

    Wiersma, J.

    2002-01-01

    This presentation includes a brief overview of the corporate structure of Veridian Corporation and discusses the concept of customer choice and competition regarding the electric power industry in Ontario. Pricing and price stability was also discussed with reference to the outlook of electricity retailing. The Veridian holding company employs a total of 149 employees within its corporate structure which includes Veridian Energy Inc., Veridian Connections Inc. (a local electric distribution company), and Firstsource Inc. (an energy retailing business). Veridian operates in the Ontario cities of Pickering, Ajax, Clarington, and Belleville. The author notes that true customer choice occurs when customers have accurate price information before they buy a product, or when they have choice regarding who they buy the product from. Likewise, true competition occurs when there are multiple suppliers, when there is sufficient supply, and when prices are determined by demand. Although the electricity market in Ontario was opened to competition on May 1, 2002, customers do not really have a choice, nor does true competition exist. The author suggests that the Pickering generating station must be brought back on-line, as well as an investment climate that will attract new investors in power generation to Ontario. It was noted that government intervention is not helpful in stimulating investment in the power system. Pricing and price stability was discussed with reference to current trends in the import/export balance. The volatility in prices is expected to get worse in the near future, which is particularly detrimental to large power users who are seeking the assurance of a fixed price so that they could predict their production costs. 2 tabs., 4 figs

  8. The retail market : competition choice and challenges

    Wiersma, J. [Veridian Corp., Ajax, ON (Canada)

    2002-07-01

    This presentation includes a brief overview of the corporate structure of Veridian Corporation and discusses the concept of customer choice and competition regarding the electric power industry in Ontario. Pricing and price stability was also discussed with reference to the outlook of electricity retailing. The Veridian holding company employs a total of 149 employees within its corporate structure which includes Veridian Energy Inc., Veridian Connections Inc. (a local electric distribution company), and Firstsource Inc. (an energy retailing business). Veridian operates in the Ontario cities of Pickering, Ajax, Clarington, and Belleville. The author notes that true customer choice occurs when customers have accurate price information before they buy a product, or when they have choice regarding who they buy the product from. Likewise, true competition occurs when there are multiple suppliers, when there is sufficient supply, and when prices are determined by demand. Although the electricity market in Ontario was opened to competition on May 1, 2002, customers do not really have a choice, nor does true competition exist. The author suggests that the Pickering generating station must be brought back on-line, as well as an investment climate that will attract new investors in power generation to Ontario. It was noted that government intervention is not helpful in stimulating investment in the power system. Pricing and price stability was discussed with reference to current trends in the import/export balance. The volatility in prices is expected to get worse in the near future, which is particularly detrimental to large power users who are seeking the assurance of a fixed price so that they could predict their production costs. 2 tabs., 4 figs.

  9. Making the EZ Choice

    2001-01-01

    Analytical Mechanics Associates, Inc. (AMA), of Hampton, Virginia, created the EZopt software application through Small Business Innovation Research (SBIR) funding from NASA's Langley Research Center. The new software is a user-friendly tool kit that provides quick and logical solutions to complex optimal control problems. In its most basic form, EZopt converts process data into math equations and then proceeds to utilize those equations to solve problems within control systems. EZopt successfully proved its advantage when applied to short-term mission planning and onboard flight computer implementation. The technology has also solved multiple real-life engineering problems faced in numerous commercial operations. For instance, mechanical engineers use EZopt to solve control problems with robots, while chemical plants implement the application to overcome situations with batch reactors and temperature control. In the emerging field of commercial aerospace, EZopt is able to optimize trajectories for launch vehicles and perform potential space station- keeping tasks. Furthermore, the software also helps control electromagnetic devices in the automotive industry.

  10. Exercise echocardiography or exercise SPECT imaging? - A meta-analysis of diagnostic test performance

    Fleischmann, KE; Hunink, MGM; Kuntz, KM; Douglas, PS

    1998-01-01

    Context.-Cardiac imaging has advanced rapidly, providing clinicians with several choices for evaluating patients with suspected coronary artery disease, but few studies compare modalities directly. .-To review the contemporary literature and to compare the diagnostic performance of exercise

  11. Multiple sclerosis

    ... indwelling catheter Osteoporosis or thinning of the bones Pressure sores Side effects of medicines used to treat the ... Daily bowel care program Multiple sclerosis - discharge Preventing pressure ulcers Swallowing problems Images Multiple sclerosis MRI of the ...

  12. School Choice: The Personal and the Political

    Shuls, James V.

    2018-01-01

    Enrollment in school choice programs is growing, so is overall support for school choice. Many have analyzed what demographic characteristics impact attitudes towards school choice. This article adds to the literature by exploring the interaction between personal decisions regarding school choice and broader support for school choice programs.…

  13. Improvement of diagnostic confidence for detection of multiple myeloma involvement of the ribs by a new CT software generating rib unfolded images: Comparison with 5- and 1-mm axial images

    Homann, Georg; Mustafa, Deedar Farhad; Nikolaou, Konstantin; Horger, Marius [Eberhard Karls University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Weisel, Katja [Eberhard Karls University Tuebingen, Department of Internal Medicine II, Tuebingen (Germany); Ditt, Hendrik [Healthcare Sector Imaging and Therapy Division, Siemens AG, Forchheim (Germany)

    2015-04-02

    To investigate the performance of a new CT software generating rib unfolded images for improved detection of rib osteolyses in patients with multiple myeloma. One hundred sixteen patients who underwent whole-body reduced-dose multidetector computed tomography (WBRD-MDCT) for multiple myeloma diagnosis and during follow-up were retrospectively evaluated. Nonenhanced CT scans with 5- and 1-mm slice thickness were interpreted by two readers with focus on detection of rib involvement (location, number, fracture). Image analysis of ''unfolded,'' 1-mm-based CT rib images was subsequently undertaken. We classified the number of lytic bone lesions into 0, 1, 2, <5, <10 and ≥10. For all three data sets the reading time was registered. An approximated sum of 6,727 myeloma-related rib lesions was found. On a patient-based analysis, CT (5 mm), CT (1 mm) and CT (1 mm ''unfolded rib'') yielded a sensitivity, specificity and accuracy of 79.7/94.7/87.1, 88.1/93/90.5 and 98.3/96.5/97.4, respectively. In a lesion-based analysis, the sensitivity, specificity and accuracy of the three evaluations were 69.7/87.2/70.5, 79.8/55.9/78 and 96.5/89.7/96.1. Mean reading time for 5 mm/1 mm axial images and unfolded images was 178.7/215.1/90.8 s, respectively. The generation of ''unfolded rib'' images improves detection of rib involvement in patients with multiple myeloma and significantly reduces reading time. (orig.)

  14. Connecting cognition and consumer choice.

    Bartels, Daniel M; Johnson, Eric J

    2015-02-01

    We describe what can be gained from connecting cognition and consumer choice by discussing two contexts ripe for interaction between the two fields. The first-context effects on choice-has already been addressed by cognitive science yielding insights about cognitive process but there is promise for more interaction. The second is learning and representation in choice where relevant theories in cognitive science could be informed by consumer choice, and in return, could pose and answer new questions. We conclude by discussing how these two fields of research stand to benefit from more interaction, citing examples of how interfaces of cognitive science with other fields have been illuminating for theories of cognition. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Modeling the dynamics of choice.

    Baum, William M; Davison, Michael

    2009-06-01

    A simple linear-operator model both describes and predicts the dynamics of choice that may underlie the matching relation. We measured inter-food choice within components of a schedule that presented seven different pairs of concurrent variable-interval schedules for 12 food deliveries each with no signals indicating which pair was in force. This measure of local choice was accurately described and predicted as obtained reinforcer sequences shifted it to favor one alternative or the other. The effect of a changeover delay was reflected in one parameter, the asymptote, whereas the effect of a difference in overall rate of food delivery was reflected in the other parameter, rate of approach to the asymptote. The model takes choice as a primary dependent variable, not derived by comparison between alternatives-an approach that agrees with the molar view of behaviour.

  16. Whole-body low-dose computed tomography in multiple myeloma staging: Superior diagnostic performance in the detection of bone lesions, vertebral compression fractures, rib fractures and extraskeletal findings compared to radiography with similar radiation exposure.

    Lambert, Lukas; Ourednicek, Petr; Meckova, Zuzana; Gavelli, Giampaolo; Straub, Jan; Spicka, Ivan

    2017-04-01

    The primary objective of the present prospective study was to compare the diagnostic performance of conventional radiography (CR) and whole-body low-dose computed tomography (WBLDCT) with a comparable radiation dose reconstructed using hybrid iterative reconstruction technique, in terms of the detection of bone lesions, skeletal fractures, vertebral compressions and extraskeletal findings. The secondary objective was to evaluate lesion attenuation in relation to its size. A total of 74 patients underwent same-day skeletal survey by CR and WBLDCT. In CR and WBLDCT, two readers assessed the number of osteolytic lesions at each region and stage according to the International Myeloma Working Group (IMWG) criteria. A single reader additionally assessed extraskeletal findings and their significance, the number of vertebral compressions and bone fractures. The radiation exposure was 2.7±0.9 mSv for WBLDCT and 2.5±0.9 mSv for CR (P=0.054). CR detected bone involvement in 127 out of 486 regions (26%; Prib fractures compared with CR (188 vs. 47; Pfractures, vertebral compressions and extraskeletal findings, which results in up- or downstaging in 24% patients according to the IMWG criteria. The attenuation of osteolytic lesions can be measured with the avoidance of the partial volume effect.

  17. New paradoxes in intertemporal choice

    Li-Lin Rao

    2011-02-01

    Full Text Available Similar to research on risky choice, the traditional analysis of intertemporal choice takes the view that an individual behaves so as to maximize the discounted sum of all future utilities. The well-known Allais paradox contradicts the fundamental postulates of maximizing the expected value or utility of a risky option. We describe a violation of the law of diminishing marginal utility as well as an intertemporal version of the Allais paradox.

  18. Evoked emotions predict food choice.

    Dalenberg, Jelle R; Gutjar, Swetlana; Ter Horst, Gert J; de Graaf, Kees; Renken, Remco J; Jager, Gerry

    2014-01-01

    In the current study we show that non-verbal food-evoked emotion scores significantly improve food choice prediction over merely liking scores. Previous research has shown that liking measures correlate with choice. However, liking is no strong predictor for food choice in real life environments. Therefore, the focus within recent studies shifted towards using emotion-profiling methods that successfully can discriminate between products that are equally liked. However, it is unclear how well scores from emotion-profiling methods predict actual food choice and/or consumption. To test this, we proposed to decompose emotion scores into valence and arousal scores using Principal Component Analysis (PCA) and apply Multinomial Logit Models (MLM) to estimate food choice using liking, valence, and arousal as possible predictors. For this analysis, we used an existing data set comprised of liking and food-evoked emotions scores from 123 participants, who rated 7 unlabeled breakfast drinks. Liking scores were measured using a 100-mm visual analogue scale, while food-evoked emotions were measured using 2 existing emotion-profiling methods: a verbal and a non-verbal method (EsSense Profile and PrEmo, respectively). After 7 days, participants were asked to choose 1 breakfast drink from the experiment to consume during breakfast in a simulated restaurant environment. Cross validation showed that we were able to correctly predict individualized food choice (1 out of 7 products) for over 50% of the participants. This number increased to nearly 80% when looking at the top 2 candidates. Model comparisons showed that evoked emotions better predict food choice than perceived liking alone. However, the strongest predictive strength was achieved by the combination of evoked emotions and liking. Furthermore we showed that non-verbal food-evoked emotion scores more accurately predict food choice than verbal food-evoked emotions scores.

  19. Choice, internal consistency, and rationality

    Aditi Bhattacharyya; Prasanta K. Pattanaik; Yongsheng Xu

    2010-01-01

    The classical theory of rational choice is built on several important internal consistency conditions. In recent years, the reasonableness of those internal consistency conditions has been questioned and criticized, and several responses to accommodate such criticisms have been proposed in the literature. This paper develops a general framework to accommodate the issues raised by the criticisms of classical rational choice theory, and examines the broad impact of these criticisms from both no...

  20. Can Free Choice Be Known?

    Itzhak Gilboa

    1993-01-01

    In this note we reconsider an argument, borrowed from causal decision theory, according to which rational and identical players should cooperate in a one-shot prisoner's dilemma. We argue that, regardless of how one views this type of reasoning, the example rpoints at a possible inconsistency in standard formulations of knowledge and decision. We suggest that when formalizing notions of "decision," "choice," and "rationality," care must be taken not to assume knowledge of one's own choice. Fi...

  1. Orbital phlebography for differentiation between multiple sclerosis and venous vasculitis in subacute blindness

    Hannerz, J.; Ericson, K.; Bergstrand, G.

    1988-01-01

    Thirteen consecutive patients with subacute unilateral loss of vision and periorbital pain but without pathology of the fundus or increased erythrocyte sedimentation rate, were investigated with visual evoked response, electrophoresis of serum and cerebrospinal fluid, and orbital phlebography. Seven of these patients were found to suffer from multiple sclerosis. The remaining 6 were considered to have venous vasculitis. There was a spontaneous recovery from visual impairment in all patients with multiple sclerosis, but not in patients with venous vasculitis. Of the latter patients, only two, who were treated with steroids within the first four days after onset of symptoms, regained vision. It appears that orbital phlebography is the diagnostic procedure of choice for proper management of patients with subacute loss of vision. (orig.)

  2. DEMO diagnostics and burn control

    Biel, Wolfgang, E-mail: w.biel@fz-juelich.de [Institute of Energy and Climate Research, Forschungszentrum Jülich GmbH, Jülich (Germany); Department of Applied Physics, Ghent University (Belgium); Baar, Marco de [FOM-Institute DIFFER, Nieuwegein (Netherlands); Eindhoven University of Technology (Netherlands); Dinklage, Andreas [Max-Planck-Institut für Plasmaphysik, Greifswald (Germany); Felici, Federico [Eindhoven University of Technology (Netherlands); König, Ralf [Max-Planck-Institut für Plasmaphysik, Greifswald (Germany); Meister, Hans; Treutterer, Wolfgang [Max-Planck-Institut für Plasmaphysik, Garching (Germany); Wenninger, Ronald [Max-Planck-Institut für Plasmaphysik, Garching (Germany); EFDA Power Plant Physics and Technology, Garching (Germany)

    2015-10-15

    Highlights: • An initial concept for the DEMO diagnostic and control system is presented. • A preliminary list of control functions and candidate diagnostics is developed. • Challenges regarding disruptions, power exhaust and radiation control are highlighted. • The need for introducing realistic control margins is emphasized. • On outline of the future R&D plan is presented. - Abstract: The development of the control system for a tokamak demonstration fusion reactor (DEMO) faces unprecedented challenges. First, the requirements for control reliability and accuracy are more stringent than on existing fusion devices: any loss of plasma control on DEMO may result in a disruption which could damage the inner wall of the machine, while operating the device with larger margins against the operational limits would lead to a reduction of the electrical output power. Second, the performance of DEMO control is limited by space restrictions for the implementation of components (optimization of the tritium breeding rate), by lifetime issues for the front-end parts (neutron and gamma radiation, erosion and deposition acting on all components) and by slow, weak and indirect action of the available actuators (plasma shaping, heating and fuelling). The European DEMO conceptual design studies include the development of a reliable control system, since the details of the achievable plasma scenario and the machine design may depend on the actual performance of the control system. In the first phase of development, an initial understanding of the prime choices of diagnostic methods applicable to DEMO, implementation and performance issues, the interrelation with the plasma scenario definition, and the planning of necessary future R&D have been obtained.

  3. Proposed Diagnostic Criteria for Smartphone Addiction.

    Yu-Hsuan Lin

    Full Text Available Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria.We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each participant was systematically assessed for smartphone-using behaviors by psychiatrist's structured diagnostic interview. The sensitivity, specificity, and diagnostic accuracy of the candidate symptom criteria were analyzed with reference to the psychiatrists' clinical global impression. The optimal model selection with its cutoff point of the diagnostic criteria differentiating the smartphone addicted subjects from non-addicted subjects was then determined by the best diagnostic accuracy.Six symptom criteria model with optimal cutoff point were determined based on the maximal diagnostic accuracy. The proposed smartphone addiction diagnostic criteria consisted of (1 six symptom criteria, (2 four functional impairment criteria and (3 exclusion criteria. Setting three symptom criteria as the cutoff point resulted in the highest diagnostic accuracy (84.3%, while the sensitivity and specificity were 79.4% and 87.5%, respectively. We suggested determining the functional impairment by two or more of the four domains considering the high accessibility and penetration of smartphone use.The diagnostic criteria of smartphone addiction demonstrated the core symptoms "impaired control" paralleled with substance related and addictive disorders. The functional impairment involved multiple domains provide a strict standard for clinical assessment.

  4. MULTIPLE OBJECTS

    A. A. Bosov

    2015-04-01

    Full Text Available Purpose. The development of complicated techniques of production and management processes, information systems, computer science, applied objects of systems theory and others requires improvement of mathematical methods, new approaches for researches of application systems. And the variety and diversity of subject systems makes necessary the development of a model that generalizes the classical sets and their development – sets of sets. Multiple objects unlike sets are constructed by multiple structures and represented by the structure and content. The aim of the work is the analysis of multiple structures, generating multiple objects, the further development of operations on these objects in application systems. Methodology. To achieve the objectives of the researches, the structure of multiple objects represents as constructive trio, consisting of media, signatures and axiomatic. Multiple object is determined by the structure and content, as well as represented by hybrid superposition, composed of sets, multi-sets, ordered sets (lists and heterogeneous sets (sequences, corteges. Findings. In this paper we study the properties and characteristics of the components of hybrid multiple objects of complex systems, proposed assessments of their complexity, shown the rules of internal and external operations on objects of implementation. We introduce the relation of arbitrary order over multiple objects, we define the description of functions and display on objects of multiple structures. Originality.In this paper we consider the development of multiple structures, generating multiple objects.Practical value. The transition from the abstract to the subject of multiple structures requires the transformation of the system and multiple objects. Transformation involves three successive stages: specification (binding to the domain, interpretation (multiple sites and particularization (goals. The proposed describe systems approach based on hybrid sets

  5. Classical diagnostic radiological features of Von Recklinghausen's ...

    ... and appropriately guiding management decisions. The patient presented is a 29- year old female who had presented with right orbital and periorbital masses, lisch nodules, multiple scalp and body nodules, cranial bony defect and complex kyphoscoliosis. She had three of the seven classical diagnostic features of NF-1 ...

  6. Protein nanomedicines for cancer diagnostics and therapy

    Nair, Shantikumar

    2012-01-01

    New results and applications of the work on anti-cancer therapy using nanomedicines at the Amrita Centre for Nanosciences are presented. Proteins have been selected as having good potential for clinical translation and are excellent carriers for drugs, provide good release kinetics and are also amenable for fluorescent tagging with multiple functionalities for diagnostic purposes. (author)

  7. Paradoxical choice in rats: Subjective valuation and mechanism of choice.

    Ojeda, Andrés; Murphy, Robin A; Kacelnik, Alex

    2018-07-01

    Decision-makers benefit from information only when they can use it to guide behavior. However, recent experiments found that pigeons and starlings value information that they cannot use. Here we show that this paradox is also present in rats, and explore the underlying decision process. Subjects chose between two options that delivered food probabilistically after a fixed delay. In one option ("info"), outcomes (food/no-food) were signaled immediately after choice, whereas in the alternative ("non-info") the outcome was uncertain until the delay lapsed. Rats sacrificed up to 20% potential rewards by preferring the info option, but reversed preference when the cost was 60%. This reversal contrasts with the results found with pigeons and starlings and may reflect species' differences worth of further investigation. Results are consistent with predictions of the Sequential Choice Model (SCM), that proposes that choices are driven by the mechanisms that control action in sequential encounters. As expected from the SCM, latencies to respond in single-option trials predicted preferences in choice trials, and latencies in choice trials were the same or shorter than in single-option trials. We argue that the congruence of results in distant vertebrates probably reflects evolved adaptations to shared fundamental challenges in nature, and that the apparently paradoxical overvaluing of information is not sub-optimal as has been claimed, even though its functional significance is not yet understood. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Diagnostic Development on NSTX

    A.L. Roquemore; D. Johnson; R. Kaita; et al

    1999-01-01

    Diagnostics are described which are currently installed or under active development for the newly commissioned NSTX device. The low aspect ratio (R/a less than or equal to 1.3) and low toroidal field (0.1-0.3T) used in this device dictate adaptations in many standard diagnostic techniques. Technical summaries of each diagnostic are given, and adaptations, where significant, are highlighted

  9. TFTR diagnostic vacuum controller

    Olsen, D.; Persons, R.

    1981-01-01

    The TFTR diagnostic vacuum controller (DVC) provides in conjunction with the Central Instrumentation Control and Data Acquisition System (CICADA), control and monitoring for the pumps, valves and gauges associated with each individual diagnostic vacuum system. There will be approximately 50 systems on TFTR. Two standard versions of the controller (A and B) wil be provided in order to meet the requirements of two diagnostic manifold arrangements. All pump and valve sequencing, as well as protection features, will be implemented by the controller

  10. 擇其所愛、愛其所擇:從自我決定理論看大學多元入學制度中學生的科系選擇與學習成果 The Application of Self-Determination Theory on Students’ Career Choice and Learning Outcomes under the Multiple College Admission System

    王秀槐 Hsiou-Huai Wang

    2010-06-01

    Full Text Available 近年來有關大學多元入學制度的研究已成高等教育領域重要議題,過去研究主題集中在探討學生家庭背景與學習成就的差異上,少有研究涉及學生科系選擇議題,也鮮少針對不同管道學生大學四年的學習情況與表現進行貫時性研究。本研究彙整「臺灣高等教育資料庫」九十二學年度大一新生、九十四學年度大三學生調查、九十五學年度應屆畢業生三次調查的貫時性資料,針對18,566 名九十二學年度年透過「甄選入學」與「分發入學」兩種管道入學的學生,探討其大一時的科系選擇、大三時的學業投入,以及大四時的學習成果與滿意程度。結果發現:甄選入學者較分發入學者傾向依據內在動機選擇科系、對科系選擇較為確定;在大學期間也較投入課業;畢業時的學習成果較佳,也對自我與學校環境較為滿意。這種「擇其所愛、愛其所擇」的現象可以自我決定理論予以詮釋與理解。此一研究結果為大學多元入學制度研究開啟新的視域,並且對多元入學政策深具啟示。 The multiple college admission system, one of the major recent educational reform policies in Taiwan, may exert a great impact on students’ career choices and learning processes. This study examined if differences existed in students’ career choices and learning outcomes when they were admitted through different admission channels. Utilizing the Taiwan Integrated Higher Education Database System, 18,566 students were traced from their entry to college in 2003, through their junior year in 2005 and on to their graduation in 2006. Statistical analysis including Chi-square test, ANOVA and MANOVA were conducted. The results showed that compared with their peers admitted through the “examination” channel, those admitted through the “application” channel tend to be more intrinsically motivated, more engaged

  11. The interpretation of diagnostic tests

    Lamk, M.; Lamki, M.D.

    1987-01-01

    The progress of nuclear and other diagnostic imaging is near rampant. With almost every issue of the major journals in this field, a new diagnostic test, or at least a new utility of an old test is described. Before we accept these innovations, we have to have a clear understanding of the clinical performance of the test. The major criteria are the sensitivity and the specificity of the test. From these derived other statistical parameters such as accuracy or efficiency of that test; also, the receiver operating characteristic (ROC) curves may then be evaluated and used in comparison of different tests. When we know the prevalence of the disease tested in the population we are investigating, we can then derive the predictive value of a positive or a negative result. This introduction tries to explain these parameters to help the reader understand the literature dealing with the subject of efficacy of imaging procedures. It is not intended as a critical review of the literature on the subject or a comprehensive overview of the subject matter. The benefit derived from explaination of statistical concepts to physicians is documented in a recent publication. Explaination of these basic statistical parameters will be followed by a demonstration of the utility of multiple testing with these parameters. The reader is thereby introduced to relevant statistical concepts that must be grasped for full comprehension of published results of a new diagnostic imaging modality, or before clinical decision making

  12. Diagnostic Utility of Alpha-fetoprotein and Des-gamma ...

    2018-02-07

    ] High DCP levels also reflect .... using the multiple logistic regression models. P < 0.05 was considered statistically significant. .... that C-reactive protein has significant diagnostic power in AFP-negative, HBV-related HCC.[23].

  13. Diagnostic evaluation of left-sided prosthetic heart valve dysfunction

    Habets, Jesse; Budde, Ricardo P.; Symersky, Petr; van den Brink, Renee B.; de Mol, Bas A.; Mali, Willem P.; van Herwerden, Lex A.; Chamuleau, Steven A.

    Prosthetic heart valve (PHV) dysfunction is a rare, but potentially life-threatening, complication. In clinical practice, PHV dysfunction poses a diagnostic dilemma. Echocardiography and fluoroscopy are the imaging techniques of choice and are routinely used in daily practice. However, these

  14. Diagnostic evaluation of left-sided prosthetic heart valve dysfunction

    Habets, Jesse; Budde, Ricardo P.; Symersky, Petr; van den Brink, Renee B.; de Mol, Bas A.; Mali, Willem P.; van Herwerden, Lex A.; Chamuleau, Steven A.

    2011-01-01

    Prosthetic heart valve (PHV) dysfunction is a rare, but potentially life-threatening, complication. In clinical practice, PHV dysfunction poses a diagnostic dilemma. Echocardiography and fluoroscopy are the imaging techniques of choice and are routinely used in daily practice. However, these

  15. Diagnostics of communication and information environment of pedagogical program means

    Елена Вадимовна Журавлёва

    2010-06-01

    Full Text Available The efficiency of pedagogical program means is considered through the correctness of a communication and information environment organization. The totality of pedagogical conditions is adduced; the communication and information environment answers these conditions. The main directions (didactic, psychological, ergonomic of analysis are determined and the methods choice for their diagnostics is grounded.

  16. The Environment Makes a Difference: The Impact of Explicit and Implicit Attitudes as Precursors in Different Food Choice Tasks.

    König, Laura M; Giese, Helge; Schupp, Harald T; Renner, Britta

    2016-01-01

    Studies show that implicit and explicit attitudes influence food choice. However, precursors of food choice often are investigated using tasks offering a very limited number of options despite the comparably complex environment surrounding real life food choice. In the present study, we investigated how the assortment impacts the relationship between implicit and explicit attitudes and food choice (confectionery and fruit), assuming that a more complex choice architecture is more taxing on cognitive resources. Specifically, a binary and a multiple option choice task based on the same stimulus set (fake food items) were presented to ninety-seven participants. Path modeling revealed that both explicit and implicit attitudes were associated with relative food choice (confectionery vs. fruit) in both tasks. In the binary option choice task, both explicit and implicit attitudes were significant precursors of food choice, with explicit attitudes having a greater impact. Conversely, in the multiple option choice task, the additive impact of explicit and implicit attitudes was qualified by an interaction indicating that, even if explicit and implicit attitudes toward confectionery were inconsistent, more confectionery was chosen than fruit if either was positive. This compensatory 'one is sufficient'-effect indicates that the structure of the choice environment modulates the relationship between attitudes and choice. The study highlights that environmental constraints, such as the number of choice options, are an important boundary condition that need to be included when investigating the relationship between psychological precursors and behavior.

  17. Voice and choice by delegation.

    van de Bovenkamp, Hester; Vollaard, Hans; Trappenburg, Margo; Grit, Kor

    2013-02-01

    In many Western countries, options for citizens to influence public services are increased to improve the quality of services and democratize decision making. Possibilities to influence are often cast into Albert Hirschman's taxonomy of exit (choice), voice, and loyalty. In this article we identify delegation as an important addition to this framework. Delegation gives individuals the chance to practice exit/choice or voice without all the hard work that is usually involved in these options. Empirical research shows that not many people use their individual options of exit and voice, which could lead to inequality between users and nonusers. We identify delegation as a possible solution to this problem, using Dutch health care as a case study to explore this option. Notwithstanding various advantages, we show that voice and choice by delegation also entail problems of inequality and representativeness.

  18. Choice Rules and Accumulator Networks

    2015-01-01

    This article presents a preference accumulation model that can be used to implement a number of different multi-attribute heuristic choice rules, including the lexicographic rule, the majority of confirming dimensions (tallying) rule and the equal weights rule. The proposed model differs from existing accumulators in terms of attribute representation: Leakage and competition, typically applied only to preference accumulation, are also assumed to be involved in processing attribute values. This allows the model to perform a range of sophisticated attribute-wise comparisons, including comparisons that compute relative rank. The ability of a preference accumulation model composed of leaky competitive networks to mimic symbolic models of heuristic choice suggests that these 2 approaches are not incompatible, and that a unitary cognitive model of preferential choice, based on insights from both these approaches, may be feasible. PMID:28670592

  19. Multiple primary cancer

    Jung, Gyu Sik; Lee, Ouk; Kim, So Sun; Kim, Ho Joon; Chun, Byung Hee; Joh, Young Duck

    1989-01-01

    It is rare for one human being to be afflicted with more than one cancer. However with further advances in therapeutic regimens, histopathologic observation, diagnostic modalities, and increased curiosity, there are increasing number of case reports of multiple primary cancer. The present study evaluates 25 histologically confirmed cases of multiple primary cancer from 1974 to 1988 at Kosin Medical Center. The most frequent site of the first primary cancer in male was stomach and in female, uterine cervix. The first primary cancer in female occurred in endocrine-related organs (breast, uterus and thyroid) in 63.6 percent. Synchronous cancers are diagnosed simultaneously or within an interval of about six months and synchronous cancers were 16 out of 25 cases. Metachronous cancers are diagnosed at interval of more than six months. There were 9 metachronous cancers and average interval between the first and second primary cancer was 22.8 months. The incidence of multiple primary cancer was 0.11 percent. The average age was 51.9 years at the time of the first primary cancer (53.1 years in male and 50.3 years in female). CT scan was most helpful in early detection of multiple primary cancers facilitating biopsy and surgery. Multiple primary cancers are beyond the medical curiosity. Early diagnosis of the disease and careful follow-up study, based on an awareness of the possibility of second cancers, will substantially increase the survival of these patients

  20. Psychologists' diagnostic processes during a diagnostic interview

    Groenier, Marleen; Beerthuis, Vos R.J.; Pieters, Julius Marie; Witteman, C.L.M.; Witteman, Cilia L.M.; Swinkels, Jan A.

    2011-01-01

    In mental health care, psychologists assess clients’ complaints, analyze underlying problems, and identify causes for these problems, to make treatment decisions. We present a study on psychologists’ diagnostic processes, in which a mixed-method approach was employed. We aimed to identify a common