Physics Examination Research Articles

The Banach Fixed Point Theorem: selected topics from its hundred-year history

On June 24, 1920 Stefan Banach presented his doctoral dissertation titled O operacjach na zbiorach abstrakcyjnych i ich zastosowaniach do równañ całkowych (On operations on abstract sets and their applications to integral equations) to the Philosophy Faculty of Jan Kazimierz University in Lvov. He passed his PhD examinations in mathematics, physics and philosophy, and in January 1921 he became a doctor. A year later, he published the results of his doctorate in Fundamenta Mathematicae. Among them there was the theorem known today as the Banach Fixed Point Theorem or the Banach Contraction Principle. It is one of the most famous theorems in mathematics, one of many under the name of Banach. It concerns certain mappings (called contractions) of a complete metric space into itself and it gives the conditions sufficient for the existence and uniqueness of a fixed point of such mapping. In 2022 we had a centenary of publishing this theorem. In the paper, we want to present its most important modifications and generalizations, several contractive conditions, the converse theorems and some applications. It is not possible to provide complete information about what has been written during the last hundred years about the Banach Fixed Point Theorem and we are just trying to touch on some breakthrough moments in the development of the metric fixed point theory. The main purpose of this article is to organize the knowledge on this subject and to elaborate a broad bibliography which all interested persons can refer to.

Predictive value of bone turnover markers and thyroid indicators for bone metabolism in GD patients after treatment.

To investigate the relationship between bone turnover markers (BTMs) and thyroid indicators in Graves' disease (GD) and to further assess predictive value of changes in early stage retrospectively. We studied 435 patients with GD and 113 healthy physical examiners retrospectively and followed up these two groups of patients after 6 months. We investigated the correlations between BTMs and other 15 observed factors, and analyzed the predictive value of FT3 and FT4 before and after treatment (FT3-P/FT3-A, FT4-P/FT4-A) on whether BTMs recovered. The levels of thyroid hormones and BTMs in GD group were significantly higher than those in control group (P < 0.05) and decreased after 6 months of treatment. FT3, W, Ca and ALP were independent factors in predicting the elevation of OST. Duration of disease, FT3, TSH and ALP were independent factors in predicting the elevation of P1NP. Age, duration of disease, TRAb and ALP were independent factors in predicting the elevation of CTX-1. The AUC of FT3-P/FT3-A and FT4-P/FT4-A for predicting OST recovery were 0.748 and 0.705 (P < 0.05), respectively, and the cut-off values were 0.51 and 0.595. There was no predictive value for P1NP and CTX-1 recovery (P > 0.05). BTMs were abnormally elevated in GD and were significantly correlated with serum levels of FT3, FT4, TRAb, Ca, and ALP. FT3 decreased more than 51% and FT4 dropped more than 59.5% after 6 months of treatment were independent predictors for the recovery of BTMs in GD.

Clinical value of coagulation parameters in predicting the severity of severe fever with thrombocytopenia syndrome.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel bunyavirus infection with a high lethality rate. The purpose of this study was to investigate the changes in coagulation parameters in patients with SFTS, aiming to provide clinical evidence for early diagnosis, treatment, and disease analysis. A total of 40 patients with SFTS attended from April 1, 2020 to May 21, 2022 in Nanjing Drum Tower Hospital were selected and grouped according to the duration of the disease, mild and severe disease, cure and death, with 50 healthy physical examiners as controls, and the risk of severe and death disease was predicted using ROC curves. Comparison between the healthy, mild and severe groups revealed that PT, INR, APTT, TT, D-D and vWF levels were higher than those in the healthy control group, and FII, FIX, FX, FXI, FXII, PC and PS levels were lower than those in the healthy control group, the differences were statistically significant (p < 0.05). Comparing the results of SFTS patients with different course times, the results of Fib, FV, FVII, FVIII, FIX, FX, FXI were statistically significant (p < 0.05). Among the survived and deceased patients, the PT, INR, DD and PS results of the deceased patients were higher than those of the survived patients, and the FVIII, FIX, FXI, FXII and PC were lower than those of the survived patients. The area under the ROC curve showed that D-D had higher predictive ability for the risk of severe disease (AUROC 0.93, sensitivity and specificity at a Cut-off value of 1.50 mg/L were 90.0 and 86.5%, respectively) and the risk of death occurring (AUROC 0.84, sensitivity and specificity at a Cut-off value of 3.39 mg/L were 87.5 and 80.0%, respectively). The monitoring of the coagulation parameters in patients with SFTS is great significance for identifying the severity and death of the patient's condition, and it is of great clinical value to provide early attention, timely intervention and maximum reduction of the mortality rate for patients at risk of severe disease.

School-leaving examination in physics at the end of upper secondary school in the Czech Republic - Current state

The paper summarizes that the form and content of education in the Czech Republic is determined by the framework educational programmes (FEPs) and school educational programmes (SEPs). Analysis of these documents showed that the school-leaving examination (Maturita) in physics at the end of upper secondary education is not unified in any way on the national level. To map how the Maturita examination in physics looks like, the questionnaire survey was conducted. 366 gymnasiums and 32 schools with the study programme technical lyceum were proposed to participate in the survey. The return rate for the teacher questionnaire was approximately 28 %. The teacher questionnaire confirmed that the oral form of the Maturita examination in physics prevails in most schools and showed that the proportion of students choosing the Maturita examination in physics has been stable at around one-tenth of all school-leaving students with physics included in their curriculum. Students most often study for the exam on their own and as sources of information, use their own physics workbooks. As the easiest physics thematic area in terms of preparation for the exam is perceived mechanics, on the contrary, electricity and magnetism is considered to be the most difficult. The main reason to choose physics as one of the elective subjects in the Maturita exam appears to be students’ interest and enjoyment in physics.

A literature review of online exams in HE in Physics and Maths

During the COVID pandemic, universities around the globe had to move not only their content delivery online, but also their assessments. Due to COVID causing significant upheaval in Higher Education (HE), this enforced experiment also afforded an opportunity to reflect on traditional, invigilated, closed book exams (ICBE) resulting in research and advice in this area. A systematic review of this academic and grey literature was performed concentrating on maths heavy physics examinations to investigate what guidance is given to examination writers, educators who prepare students for exams and HE examinees themselves. The literature review results were divided into: Advice for examiners who need to provide an invigilated open book exam (UOBE), discussions on cheating, advice for students and case studies. It was found that ICBEs were good at examining lower order cognitive skills, e.g. recall and understanding, but higher order skills, such as analysing and synthesising, are better examined with access to a larger range of resources. Guidance on making academic misconduct more difficult also suggested using higher order thinking skills in exam questions as responses to these type of tasks are more individual and getting outside help may be more difficult in a time constrained UOBE. Furthermore, literature encouraged reflection on the motivation for cheating and suggested that overly demanding assessment may encourage students to seek inappropriate help. The advice for students highlighted the need to prepare as thoroughly for a UOBE as they would for a traditional exam. Probably the thrust should change from pure memorization to students preparing their notes so that they can efficiently access their material to locate relevant parts for synthesis during a UOBE. Some of the case studies used statistical methods to investigate comparability of grades between UOBEs and ICBEs and some of the studies found them comparable, so a large shift of results may be due to other factors rather than the exam type. Other studies describe their approach and include stakeholder reflections. The main recommendation to exclude lower cognitive skills can pose a problem for maths heavy exams as they mainly assess how well an examinee has mastered these skills before building on them. However, it seems advisable to climb higher up Bloom’s taxonomy if possible. Also, it may be conceivable to break up exams into shorter sections that require individual uploading before access to the next part is granted to reduce the possibility of outside help. Furthermore, individualised maths type problems could be achievable by using different data sets for a question. Student advice should highlight the differences between UOBEs and ICBEs so that they can prepare appropriately.

Diagnostic value of anti-Sa antibody and anti-carbamylated protein antibody for rheumatoid arthritis

Objective: To investigate the diagnostic value of anti-Sa antibody and anti-carbonylated protein (CarP) antibody for rheumatoid arthritis (RA). Methods: A retrospective selection of 180 patients with RA who came to Qinghai Provincial People's Hospital from September 2022 to February 2023. Grouped according to the Disease Activity Score of 28 joints (DAS28), 101 of them were patients with RA in high activity (RAH group), 24 males and 77 females, aged 18-79 (53.2±12.2), and 79 patients with RA in low activity (RAL group), 23 males and 56 females, aged 24-78 (49.0±12.9).A total of 90 patients with other autoimmune diseases in the hospital in the same period were choosed as the other immune disease group, and 90 healthy physical examiners were as the healthy control group. The levels of serum anti-Sa and anti-CarP antibodies were measured by ELISA, RF by immunoscattering turbidimetry, anti-CCP by chemiluminescence, and ESR by Weil's method in four groups of patients. The area under the subject operating characteristic (ROC) curve (AUC) was applied to assess the sensitivity and specificity of each index alone or in combination for the diagnosis of RA. Results: In the RAH group, RAL group, other immune disease group, and healthy control group, the RF levels were 117.6 (61.0, 161.1), 92.7 (48.1, 92.7), 10.1 (5.3, 24.6), and 8.1 (6.0, 12.8) U/ml, anti-CCP antibody levels were 202.7 (67.1, 594.4), 212.9 (98.3, 416.2), 9.4 (6.6, 11.8), 1.9 (0.8, 4.9) U/ml, anti-Sa antibody levels were 305.3 (120.4, 614.9), 235.8 (161.6, 336.9), 123.9 (41.8, 240.5), 165.1 (71.1, 237.5) U/ml, and anti-CarP antibody levels were 11.7 (7.9, 21.6), 5.2 (3.3, 7.7), 5.1 (3.9, 6.5), and 5.8 (3.8, 7.5) mg/L, respectively, and their differences were statistically significant (all P<0.001). The level of anti-CarP antibody was higher in the RAH group than in the RAL group (P<0.001), and the difference in anti-Sa antibody was not statistically significant (P>0.05). The critical value of anti-Sa antibody at 181.45 μg/L showed a sensitivity of 67.2%, specificity of 65.6% and AUC of 0.710 (95%CI: 0.645-0.775); The sensitivity was 52.8% and the specificity was 88.9% with an AUC of 0.706 (95%CI: 0.646-0.766) at a critical value of 7.98 U/ml for the anti-CarP antibody. The AUC for the combined RF, anti-CCP antibody and anti-CarP antibody assay was 0.986 (95%CI: 0.977-0.996). Conclusion: Anti-CarP antibody is clinically significant in distinguishing active RA. RF, anti-CCP, and anti-CarP antibodies can be detected together with high AUC results, suggesting the potential for developing an improved method for diagnosing RA.

Changes of Serum Pyruvate Kinase M2 Level in Patients with Sepsis and Its Clinical Value.

The glucose metabolic reprogramming is an important pathological mechanism in sepsis, which involves a series of enzymes including Pyruvate kinase M2 (PKM2). The purpose of this study is to explore the diagnostic and prognostic value of serum PKM2 in sepsis patients. This study recruited 143 sepsis patients, 91 non-sepsis patients, and 65 physical examiners, divided into sepsis group, non-sepsis group, and control group. Measure the serum PKM2 concentration of subjects, collect and analyze clinical and laboratory indicators of all subjects. Independent risk factors were selected by Logistic regression analysis. The area under curve (AUC) was calculated by plotting the receiver operating characteristic (ROC) curve to determine the diagnostic and prognostic value of biomarkers. Compared with non-sepsis and control groups, the serum PKM2 levels in the sepsis group were significantly increased (both P<0.001). PKM2 was an independent risk factor for sepsis and had the best diagnostic efficacy when combined with procalcitonin, with the AUC value of 0.9352. Patients with high levels of PKM2 were more likely to experience organ damage and had a higher incidence of septic shock. On the 1st and 3rd days of admission, the serum PKM2 levels in the septic shock group were higher than those in the sepsis group (both P<0.05), with AUC values of 0.7296 and 0.6247, respectively. On the 3rd and 7th days of admission, the serum PKM2 levels in the non-survival group were significantly higher than those in the survival group (both P<0.001), with AUC values of 0.7033 and 0.8732, respectively. The serum PKM2 levels in sepsis patients are significantly increased and correlated with disease severity and clinical outcomes. PKM2 may be a new diagnostic and prognostic biomarker for sepsis.

Gender bias in first-year multiple-choice physics examinations

Gender bias in first-year multiple-choice physics examinations

An auxiliary diagnostic tool for common fundus diseases based on fundus color photography and light-weight classification models.

To evaluate the performance of two lightweight neural network models in the diagnosis of common fundus diseases and make comparison to another two classical models. A total of 16,000 color fundus photography were collected, including 2000 each of glaucoma, diabetic retinopathy (DR), high myopia, central retinal vein occlusion (CRVO), age-related macular degeneration (AMD), optic neuropathy, and central serous chorioretinopathy (CSC), in addition to 2000 normal fundus. Fundus photography was obtained from patients or physical examiners who visited the Ophthalmology Department of Beijing Tongren Hospital, Capital Medical University. Each fundus photography has been diagnosed and labeled by two professional ophthalmologists. Two classical classification models (ResNet152 and DenseNet121), and two lightweight classification models (MobileNetV3 and ShufflenetV2), were trained. Area under the curve (AUC), sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were used to evaluate the performance of the four models. Compared with the classical classification model, the total size and number of parameters of the two lightweight classification models were significantly reduced, and the classification speed was sharply improved. Compared with the DenseNet121 model, the ShufflenetV2 model took 50.7% less time to make a diagnosis on a fundus photography. The classical models performed better than lightweight classification models, and Densenet121 showed highest AUC in five out of the seven common fundus diseases. However, the performance of lightweight classification models is satisfying. The AUCs using MobileNetV3 model to diagnose AMD, diabetic retinopathy, glaucoma, CRVO, high myopia, optic atrophy, and CSC were 0.805, 0.892, 0.866, 0.812, 0.887, 0.868, and 0.803, respectively. For ShufflenetV2model, the AUCs for the above seven diseases were 0.856, 0.893, 0.855, 0.884, 0.891, 0.867, and 0.844, respectively. The training of light-weight neural network models based on color fundus photography for the diagnosis of common fundus diseases is not only fast but also has a significant reduction in storage size and parameter number compared with the classical classification model, and can achieve satisfactory accuracy.

Prevalence of persistent symptoms after having COVID-19 in a cohort in Suriname.

To determine the prevalence of persistent symptoms after having coronavirus disease 2019 (COVID-19) in a cohort in Suriname, and assess the factors associated with long COVID. A sample of adults 18 years and older who were registered 3-4 months previously in a national database because of a positive COVID-19 test were selected. They were interviewed about socioeconomic characteristics, pre-COVID-19 health status and lifestyle, and symptoms during and after COVID-19. A subset of participants underwent a physical examination to determine body mass index, waist circumference, cardiovascular parameters, lung function, and functionality. A total of 106 participants (mean age 49 (standard deviation 15) years; 62.3% female) were interviewed, of whom 32 were physically examined. The greatest proportion of participants was of Hindustani descent (22.6%). Overall, 37.7% of participants were physically inactive, 26.4% had hypertension or diabetes mellitus, and 13.2% had been previously diagnosed with heart disease. Most participants (56.6%) had experienced mild COVID-19 and 14.2% had experienced severe COVID-19. A large proportion (39.6%) had experienced at least one persistent symptom after recovery from acute COVID-19 and more women were affected (47.0% of women versus 27.5% of men). Fatigue and alopecia were the most common symptoms, followed by dyspnea and sleep disturbance. Differences were observed between ethnic groups. Based on physical examination, 45.0% of the subset was obese and 67.7% had very high waist-circumference. About 40% of the cohort had at least one persistent symptom 3-4 months after having had COVID-19, with differences observed by sex and ethnic group.

Retrospective Study of Helminthiasis in Wild Sumatran Tiger (Panthera tigris sumatrae) Rescued by Dharmasraya Sumatran Tiger Rehabilitation Center

This study aims to determine the incidence of worm infection in wild Panthera tigris sumatrae rescued at Dharmasraya Sumatran Tiger Rehabilitation Center ARSARI based on physical and laboratory examination. The study used 12 Sumatran tigers, immediately after the tigers had been rescued. All Sumatran tigers were physically examined, followed by checking their blood and fecal for investigating the possibility of helminthiasis infections. The fecal examination method was carried out using qualitative methods (native, sedimentation, and flotation). The results of the physical examination found that 5 tigers didn’t show any clinical symptoms and 7 tigers were anemic and dehydrated with their blood profiles showing the presence of eosinophilia. The results also found that there were five types of worm eggs, namely Ancylostoma sp. (75%), Toxocara sp. (25%), Trichuris sp. (25%), Strongyloides sp. (8.3%) and Trichostrongylus sp. (8.3%) with a 100% helminthiasis incidence. These results of this retrospective study are expected to provide information on helminthiasis infection in wild P.t. sumatrae in their natural habitat. In conclusion, all of 12 rescued tigers suffering from helminthiasis with the main clinical symptoms being anemia, dehydration and eosinophilia .

Relationship between Angiotensin II, Vascular Endothelial Growth Factor, and Arteriosclerosis Obliterans.

To investigate the relationship between angiotensin II (Ang II), vascular endothelial growth factor (VEGF), and arteriosclerosis obliterans (ASO). 60 ASO patients diagnosed and treated from October 2019 to December 2021 were selected for the observation group while 30 healthy physical examiners were for the control group. The general information (gender, age, history of smoking, diabetes, and hypertension) and arterial blood pressure (systolic and diastolic blood pressure) of the two groups were collected, and parameters like disease site and duration, Fontaine stage, and ankle-brachial index (ABI) of ASO patients have been evaluated. Ang II, VEGF, uric acid (UA), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), and total cholesterol (TC) were also detected for the two groups. The variations in UA, LDL, HDL, TG, and TC among two groups along with levels of Ang II and VEGF in ASO patients in accordance to conditions like the general situation, disease duration, disease site, Fontaine stage, and ABI risk level have been studied to establish a correlation between Ang II and VEGF and ASO. (1) The proportion of males with a history of smoking, diabetes, and hypertension was higher (P < 0.05) among ASO patients in comparison to the control group. The diastolic blood pressure, LDL, TC, Ang II, and VEGF levels were found to be higher (P < 0.05) whereas HDL was low (P < 0.01). (2) The level of Ang II in male patients with ASO was significantly higher than that in female ASO patients (P < 0.05). In ASO patients, the levels of Ang II and VEGF increased not only with age (P < 0.01) but also with progression in Fontaine stages II, III, and IV (P < 0.01). (3) Logistic regression analysis revealed Ang II and VEGF as risk factors for ASO. (4) An AUC (area under the ROC (receiver operator characteristic) curve) for Ang II and VEGF for the diagnosis of ASO was 0.764 (good) and 0.854 (very good), respectively, while their combined AUC in diagnosing ASO was 0.901 (excellent). The AUC of Ang II and VEGF together in diagnosing ASO was greater than that of Ang II and VEGF alone along with higher specificity as well (all P < 0.05). Ang II and VEGF were correlated with the occurrence and development of ASO. The AUC analysis demonstrates that Ang II and VEGF were highly discriminative of ASO.

Gait analysis using physical examination and digital techniques

Gait examination is an important component of the patient assessment prior to movement therapy. With the advancement of video technology and computer science, digital analysis of gait has become possible. This research aims to physically examine gait and analyze video recordings using dedicated software. A voluntary group of 10 individuals diagnosed with coxarthrosis or gonarthrosis constituted the study group, while the control group comprised 10 individuals without lower limb musculoskeletal disorders. The mean age of the study group was 57 ±4.03 years, and the mean age of the control group was 54.2 ±3.16 years. The research involved conducting physical examinations of gait and recording walking sessions with body markers. The software facilitated the presentation of marker displacements on diagrams in both vertical and horizontal planes. Visual analysis and a two-sample t-test were employed. The physical musculoskeletal examination successfully identified causes of claudication. Significant differences were observed between the two groups across all kinematic gait indicators. The mean stance width in the test group was 17.65 ±3.09 cm, while the control group averaged 8.75 ±1.23 cm (p &lt; 0.001). The walking speed, assessed using a two-sample t-test, also yielded a significant difference (p &lt; 0.001). Key diagrams representing the groups during functional analysis were presented. Visual analysis revealed distinct variations in marker frequency and vertical and horizontal displacements between the groups. The study group exhibited notable deviations in the displacement diagrams on the affected side of the body. The average of the maximum and minimum points on the charts demonstrated a significant difference between the groups in terms of body displacement. The identified differences in gait between the two groups align with the results of the physical examination. The graphical representation of disparities in body displacement between the two halves of the body in the study group indicates the future potential of digital gait analysis for practical applications and monitoring the effectiveness of physiotherapy.

Exploring the Characteristics of Attribution and Countermeasures for Senior High School Students’ Success or Failure in Physics Examinations

Exploring the Characteristics of Attribution and Countermeasures for Senior High School Students’ Success or Failure in Physics Examinations

The blood monocyte to high density lipoprotein cholesterol ratio (MHR) is a possible marker of carotid artery plaque

BackgroundMHR is the ratio of monocyte to high-density lipoprotein cholesterol (HDL-C). It has been reported that MHR changes are associated with cardiovascular and cerebrovascular disease. Carotid plaque is a common vascular lesion of the carotid artery and is a manifestation of atherogenesis. This study investigated the relationships between the MHR and the incidence of carotid plaques.MethodsThe data of 3848 physical examiners were analyzed for retrospective analysis, which included 1428 patients with noncarotid plaque, 1133 patients with single carotid plaque, and 1287 patients with bilateral or multiple carotid plaques. Statistical analysis was performed on SPSS 22.0 0 software and statistical software R and its GAM package.ResultsThe difference was statistically significant in the levels of MHR, body mass index (BMI), high-sensitivity C-reactive protein (hs-CRP), blood lipids (HDL-C, low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (Tg)), blood glucose (Glu), hemoglobin A1c (HbA1c), renal function (urea, creatinine (Crea)), estimated glomerular filtration rate (eGFR), and uric acid (Ua) in the carotid plaque groups (P < 0.001, respectively). There was no significant difference between the sex (P = 0.635) and age (P = 0.063) in the different groups. MHR levels were positively correlated with BMI (r = 0.364, P < 0.001), hs-CRP (r = 0.320, P < 0.001), Tg (r = 0.417, P < 0.001), Crea (r = 0.323, P < 0.001), eGFR (r = − 0.248, P < 0.001), Ua (r = 0.383, P < 0.001) and HbA1c (r = 0.197, P < 0.001). Levels of TC, Glu, and urea were slightly correlated with the MHR level (r = − 0.150, P < 0.001; r = 0.187, P < 0.001; r = 0.137, P < 0.001, respectively). The MHR level increased with elevated severity of carotid plaque in subjects without hypertension or diabetes (P < 0.001). In adjusted models, with the rise of MHR level, the probability of occurrence of carotid plaque had a 1.871-fold (95% CI: 1.015–3.450, P = 0.045) increase; the probability of multiple occurrences of carotid plaques had a 2.896-fold (95% CI: 1.415–5.928, P < 0.001) increase. The GAM curve showed a nonlinear correlation between the normalized MHR and the probability of carotid plaque occurrence.ConclusionsMHR could be used as a possible marker for plaque formation and severity.

Objective-structured clinical examination in cardiovascular system for the assessment of internal medicine postgraduates amidst the Covid-19 pandemic.

Background The Covid-19 pandemic has posed a challenge to organizing a safe clinical assessment for postgraduate degree candidates completing the residency programmes in various specialties. Although minimizing the risk of Covid-19 transmission is a priority, fulfilling the objectives of the assessment is equally important. Methods We conducted this study in the Department of Internal Medicine at our institute. Instead of physically examining patients, case scenarios that included history, clinical and investigational data of the cardiovascular system (CVS) were presented to the candidates. Performance was scored by both the conventional and the CVS objective-structured clinical examination (CVS-OSCE) method and compared. Results Clinical assessment examination of 27 candidates for the degree of Doctor of Medicine showed that the median cumulative score gained in narrating and analysing various differential diagnoses was lower compared to the mean cumulative score gained in arriving at a single correct diagnosis (50% [interquartile range-IQR 39%-64%] v. 79% [IQR 64%-100%], p<0.01). Most of the candidates agreed that case scenarios were good alternatives to the conventional physical examination amidst the pandemic. Conclusion CVS-OSCE-based assessment using structured case scenarios is a feasible and effective alternative for clinical skill assessment in high-stake examinations.

Correlation between serum uric acid and creatinine ratio and metabolic syndrome based on physical examination population in Nantong area

To investigate the relationship between serum uric acid to creatinine ratio (SUA/Cr) and metabolic syndrome (MS) and other indexes on physical examination population in Nantong area. Using the method of cross-sectional study, 8 148 physical examiners in the physical examination center of the Affiliated Hospital of Nantong University from January 2017 to April 2020 were used as the research objects, and the clinical data and serum biochemical indicators such as smoking and alcohol addiction, physical examination and so on were collected. According to the standard diagnosis of MS of Diabetes Society of Chinese Medical Association, the patients were grouped according to the quartile of SUA/Cr and the clinical data of each group were compared. Pearson correlation analysis and logistic regression analysis were used to explore the correlation between SUA/Cr and clinical indicators and the relationship between SUA/Cr and the risk of MS. The results showed that UA and SUA/Cr were the lowest in normal metabolism group, followed by abnormal metabolism group and the highest in MS group, The difference between the two groups was statistically significant (H=919.21 and 629.34, P<0.001). According to the SUA/Cr quartile, the population was divided into four groups. After adjusting for gender, age, smoking history and drinking history, SUA/Cr in group Q1 was positively correlated with BMI and TG (r=0.061 and 0.080, P<0.05), but negatively correlated with HDL-C (r=-0.057, P<0.05). Multivariate logistic regression results showed that after adjusting for age, sex, smoking history and drinking history, the risk of MS for BMI, SBP, DBP, FBG, TG, HDL-C and SUA/Cr [OR (95%CI)] were: 1.44 (1.41-1.47), 1.07 (1.06-1.07), 1.10 (1.10-1.11), 1.83 (1.73-1.92), 1.89 (1.79-1.99), 0.08 (0.06-0.10) and 1.54 (1.47-1.62). Compared with SUA/Cr group Q1, the risk of MS in group Q2, Q3 and Q4 increased by 75%, 162% and 346%, respectively. In conclusion, there was an independent positive correlation between SUA/Cr and MS risk in Nantong area.

Cortex or cancellous-which is early for the decrease of bone content for vertebral body in health?

To obtain the cortex and cancellous parameter of the vertebral bone of healthy subjects using QCT. To explore which is earlier or faster for bone loss with age. 733 physical examiners underwent chest low-dose CT examination were recruited, from April 1, 2021 to October 1, 2021. QCT sequence was used to obtain the bone mineral density of T12-L2 vertebral body without additional radiation. The mass and area of vertebral cortex and cancellous at the central level of L2 vertebral body were measured. The age -related characteristics of vertebral cortex and cancellous between male and female was analyzed and compared. The vBMD of T12-L2 vertebral body decreased with age. Significant differences were found in volumetric bone mineral density (vBMD) of T12-L2 vertebral body. For female, significant differences were found in bone content involving cortical mass, cancellous mass, cortical area, cancellous area, cortical mass/cancellous mass and cortical area/cancellous area in different age groups, respectively. The cortical mass decreased with age in female. The cancellous mass of female increased and then decreased with peak at 31-40 y. The cortical area of female decreased gradually before 71 y. The cancellous area of female increased and then decreased with peak at 51-60 y. The values of mass ratio and area ratio in female showed a slowly downward trend with age. Significant differences of bone content between non-menopausal and menopausal women were found except the cancellous mass. For male, no significant differences were found in all parameters of bone content. The changes of vertebral BMD, bone content of cortex and cancellous have different characteristics in different age. The change of cortex in female maybe earlier and faster than that of cancellous, especially in menopausal women.

An Analysis of Students' Academic Performance in School – Based Assessment and Certificate Examinations in General Mathematics, Physics and Computer Science in Ondo state, Nigeria

An Analysis of Students' Academic Performance in School – Based Assessment and Certificate Examinations in General Mathematics, Physics and Computer Science in Ondo state, Nigeria

A structured multimodal teaching approach enhancing musculoskeletal physical examination skills among undergraduate medical students

ABSTRACT Current evidence indicates that undergraduate medical students display deficits in musculoskeletal physical examination skills (MPES). While various instructional methods are recommended for teaching clinical skills, effective methods for teaching MPES have not been established. This study compared the effectiveness of a multimodal teaching approach incorporating video-based learning, interactive small-group teaching, hands-on practicing, peer-assisted learning, formative assessment, and constructive feedback with traditional bedside teaching in developing undergraduate orthopedic MPES. Participants were 151 fifth-year medical students divided into two groups. One group received multimodal teaching, and the other received traditional bedside teaching. In both groups, the participants learned how to physically examine the knee and shoulder. The primary outcome was objective structured clinical examination (OSCE) scores, while the secondary outcomes included teaching sessions’ total durations, facilitator’s demonstration time, participants’ practice time, and proportion of students with passing checklist scores and global ratings-based assessments for the two teaching approaches. The multimodal teaching group had significantly higher OSCE scores (checklist scores, global ratings, and passing rates; p = 0.02, 0.02, 0.01, respectively) than the comparison group. Individual OSCE component assessments showed significant improvements in the special musculoskeletal physical examination test. The overall duration and amount of participants’ hands-on time were significantly longer for the multimodal than for the traditional bedside teaching group (p = 0.01 and 0.01, respectively), and the facilitator’s demonstration time was significantly shorter (p = 0.01). The multimodal learner-centered teaching approach evaluated in this study was effective for teaching MPES. It appeared to maximize learner engagement through enhancing interactions and providing increased time to engage in hands-on practice. This teaching approach improved MPES levels, maximized teaching efficiency for scenarios with limited instruction time and resources, and enhanced competency of undergraduate medical students in performing special musculoskeletal physical examinations compared to traditional bedside teaching.