Test Scores Research Articles

Increased serum IL‑41 associated with acute exacerbation of chronic obstructive pulmonary disease.

Interleukin (IL)-41 is a novel immunomodulatory cytokine involved in the pathogenesis of several inflammatory and metabolic illnesses. However, it remains unclear how IL-41 contributes to the pathogenesis of chronic obstructive pulmonary disease (COPD). Therefore, the aim of the present study was to explore the correlation between the expression level of IL-41 and acute exacerbation of COPD (AECOPD). In total, 107 patients with COPD and 56 healthy controls were recruited from the First Affiliated Hospital of Ningbo University (Ningbo, China). Serum IL-41, IL-6, and matrix metalloproteinase-2 (MMP-2) levels were evaluated using enzyme-linked immunosorbent assay. Serum amyloid A (SAA) and C-reactive protein (CRP) levels were assessed in the hospital laboratory. The levels of IL-41 were higher in the AECOPD group than in the stable COPD (SCOPD) and control groups (P<0.0001). IL-6, SAA and CRP levels, the percentage of neutrophils, as well as neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were higher in the AECOPD group than those in the SCOPD and control groups. The smoking index was positively correlated with serum IL-41, CRP and SAA levels. The expression level of IL-41 was correlated with the number of acute exacerbations, severity of the exacerbations, and COPD assessment test scores in the AECOPD group. Examination of the receiver operating characteristic (ROC) curves showed that IL-41, especially when combined with other inflammatory factors, had a specific diagnostic value for AECOPD. According to the ROC curve analysis, the area under the curve (AUC) for IL-41 was 0.742 (P=0.051), and the AUC for IL-41 combined with other inflammatory factors was 0.925 (P=0.030). Increased serum IL-41 levels were associated with AECOPD and may play a role in the monitoring and evaluation of COPD.

Enhancing English and accounting skills through a VOCABING-based technology program for MSMEs in Kediri

Digital economic transformation which is the impact of technological development changes the perspective of Indonesian on economic behavior. The use of technology in economics activity is increasing nowadays. It impacts on the development of the economic sectors. Macro, Small and Medium Enterprises (MSME) one of the business roles in Indonesia have to do some innovation for its existing in today's trading world. The strategy that can be implemented for facing that case is by adapting the technology use and enhancing the quality of human resources through increasing competence and skills. Considering that the performance of an organization is determined by the human resources it has. Community service program through Integrated Training; Vocabulary Building &amp; Accounting (VOCABING)-Based Technology needs to be held for MSMEs in Kediri. These activities include training in English and the Use of Accounting Technology for improving MSMEs skill. it is based on vocabulary mastery which influence the ability to understand the complex information and instructions. The activity held two days series through four steps; planning, implementation, evaluations, and reporting. For proving the training’s goals, it used tests and assessment. The results showed that there was an increase of 12.5% in the final English test score and participants completed the work instruction assessment correctly.

Cognitive profile, neuroimaging and fluid biomarkers in post-acute COVID-19 syndrome

We aimed to characterize the cognitive profile of post-acute COVID-19 syndrome (PACS) patients with cognitive complaints, exploring the influence of biological and psychological factors. Participants with confirmed SARS-CoV-2 infection and cognitive complaints ≥ 8 weeks post-acute phase were included. A comprehensive neuropsychological battery (NPS) and health questionnaires were administered at inclusion and at 1, 3 and 6 months. Blood samples were collected at each visit, MRI scan at baseline and at 6 months, and, optionally, cerebrospinal fluid. Cognitive features were analyzed in relation to clinical, neuroimaging, and biochemical markers at inclusion and follow-up. Forty-nine participants, with a mean time from symptom onset of 10.4 months, showed attention-executive function (69%) and verbal memory (39%) impairment. Apathy (64%), moderate-severe anxiety (57%), and severe fatigue (35%) were prevalent. Visual memory (8%) correlated with total gray matter (GM) and subcortical GM volume. Neuronal damage and inflammation markers were within normal limits. Over time, cognitive test scores, depression, apathy, anxiety scores, MRI indexes, and fluid biomarkers remained stable, although fewer participants (50% vs. 75.5%; p = 0.012) exhibited abnormal cognitive evaluations at follow-up. Altered attention/executive and verbal memory, common in PACS, persisted in most subjects without association with structural abnormalities, elevated cytokines, or neuronal damage markers.

Probiotics relieve perioperative postoperative cognitive dysfunction induced by cardiopulmonary bypass through the kynurenine metabolic pathway

Postoperative cognitive dysfunction (POCD) has become the popular critical post-operative consequences, especially cardiopulmonary bypass surgery, leading to an increased risk of mortality. However, no therapeutic effect about POCD. Probiotics are beneficial bacteria living in the gut and help to reduce the risk of POCD. However, the detailed mechanism is still not entirely known. Therefore, our research aims to uncover the effect and mechanism of probiotics in relieving POCD and to figure out the possible relationship between kynurenine metabolic pathway. 36 rats were grouped into three groups: sham operated group (S group, n = 12), Cardiopulmonary bypass group (CPB group, n = 12), and probiotics+CPB (P group, n = 12). After CPB model preparation, water maze test and Garcia score scale was performed to identify the neurological function. Immunofluorescence and Hematoxylin and eosin staining has been used for hippocampal neurons detection. Brain injury related proteins, oxidative stress factors, and inflammatory factors were detected using enzyme-linked immunosorbent assays (ELISA). Neuronal apoptosis was detected by TdT-mediated dUTP nick end-labeling (TUNEL) staining and western blot. High-performance liquid chromatography/mass spectrometry (HPLC/MS) was performed to detect the key factors of the kynurenine metabolic pathway. Our results demonstrated that probiotics improved neurological function of post-CPB rats. The administration of probiotics ameliorated memory and learning in spatial terms CPB rats (P < 0.05). Hematoxylin and eosin (H&E) staining data, S‐100β and neuron-specific enolase (NSE) data convinced that probiotics agonists reduced brain damage in CPB rats (P < 0.05). Moreover, probiotics regulated inflammatory factors, meanwhile attenuated hippocampal neuronal apoptosis. Probiotics alleviated POCD in rats with CPB through regulation of kynurenine metabolic signaling pathway.

English in the internationalization of higher education and international student mobility

Abstract In this article, we discuss the significance of English in the internationalization of higher education and international student mobility, using Kachru’s (1985) Three Circles Model of World English. As education is one of the major forms of migration (Liu-Farrer, 2022; Borlongan, 2023) in the so-called ‘age of migration’ (cf. de Haas, Castles, &amp; Miller, 2020), more and more students are motivated to study abroad to complete their tertiary education. First, we discuss motivating factors both for the internationalization of higher education and international student mobility. Second, we point out how English has been playing a very central role in the internationalization of higher education institutions and international student mobility (Philipson, 2010; Jenkins, 2017) among these factors. Then, we present the dynamics of international student mobility by looking at their global flow, English-medium programs, and English language proficiency requirements. While Inner Circle countries are still the most attractive destinations for most international students, Expanding Circle countries, where English is not an institutionalized medium of instruction in higher education, also value English by expanding English-medium degree programs and requiring English proficiency test scores to admission. Finally, we end the article by reiterating the dominance and utility of English in the internationalization of higher education and international student mobility and its stable position as the language of educational migration.

Occupational exposure to pesticides and neurobehavioral outcomes. Impact of different original and recalled exposure measures on the associations.

Several measures of occupational exposure to pesticides have been used to study associations between exposure to pesticides and neurobehavioral outcomes. This study assessed the impact of different exposure measures for glyphosate and mancozeb on the association with neurobehavioral outcomes based on original and recalled self-reported data with 246 smallholder farmers in Uganda. The association between the 6 exposure measures and 6 selected neurobehavioral test scores was investigated using linear multivariable regression models. Exposure measures included original exposure measures for the previous year in 2017: (i) application status (yes/no), (ii) number of application days, (iii) average exposure-intensity scores (EIS) of an application and (iv) number of EIS-weighted application days. Two additional measures were collected in 2019: (v) recalled application status and (vi) recalled EIS for the respective periods in 2017. Recalled applicator status and EIS were between 1.2 and 1.4 times more frequent and higher for both pesticides than the original application status and EIS. Adverse associations between the different original measures of exposure to glyphosate and 4 neurobehavioral tests were observed. Glyphosate exposure based on recalled information and all mancozeb exposure measures were not associated with the neurobehavioral outcomes. The relation between the different original self-reported glyphosate exposure measures and neurobehavioral test scores appeared to be robust. When based on recalled exposure measures, associations observed with the original exposure measures were no longer present. Therefore, future epidemiological studies on self-reported exposure should critically evaluate the potential bias towards the null in observed exposure-response associations.

Long-term effects of early life rainfall shocks on foundational cognitive skills: Evidence from Peru

Global warming is changing precipitation patterns, particularly harming communities in low-and-middle income countries (LMICs). Whilst the long-term effects of being exposed to rainfall shocks early in life on school-achievement tests are well-established, there is little population-based evidence from LMICs on the mechanisms through which these shocks operate. Executive functions (EFs) are key for children’s learning abilities. This paper analyses the effects of early exposure to rainfall shocks on four foundational cognitive skills (FCSs), including EFs that have been found to be key predictors of educational success. These skills were measured via a series of tablet-based tasks administered in Peru as part of the Young Lives longitudinal study (YLS). We combine the YLS data with gridded data on monthly precipitation to generate monthly, community-level rainfall shock estimates. The key identification strategy relies on temporary climatic shocks being uncorrelated with other latent determinants of FCSs development. Our results show significant negative effects of early life exposure to rainfall shocks on EFs—especially, on working memory—measured in later childhood. We also find evidence of rainfall shocks decreasing households’ abilities to invest in human capital, which may affect both FCSs and domain-specific test scores. Finally, there is suggestive, but not conclusive, evidence that a conditional-cash-transfer program providing poor households with additional financial resources might partially offset the effects of the rainfall shocks.

Exploring Clinical Remission in Moderate Asthma - Perspectives from Asia, the Middle East, and South America.

Clinical remission is a relatively new concept in asthma but recent research initiatives suggest it could be an ambitious and achievable therapeutic target for patients with asthma. In this modified Delphi study (comprising two online surveys, completed either side of a virtual scientific workshop), the opinions of a panel of respiratory physicians were evaluated to summarize perspective statements on key therapeutic outcomes and criteria for on-treatment clinical remission in patients with moderate asthma. An agreement threshold was pre-defined as agreement by ≥ 75% of participants. Surveys 1 and 2 were completed by 20 and 18 participants, respectively. Most participants (95%) agreed with the concept of clinical remission in moderate asthma and that this should be a desirable treatment goal (90%). Based on a composite measure of 4-6 desirable therapeutic outcomes, current understanding of clinical remission was considered as 12months with no exacerbations, no oral corticosteroids, no daytime or night-time asthma symptoms (Asthma Control Test score ≥ 20 or Asthma Control Questionnaire score ≤ 0.75), stable lung function, and no treatment-related adverse events. No agreement was reached on the role of relievers in defining therapeutic outcomes or on the wider use of biomarkers and airway hyperresponsiveness for defining asthma remission in clinical practice. In line with recent consensus statements from the United States and Europe, there was a high level of agreement on the elements of clinical remission among a panel of respiratory physicians from Asia, the Middle East, and South America. Extension of the concept of clinical remission to patients with moderate asthma was considered aligned with the potential of clinical remission as a goal of therapy.

Cognitive improvement in late-life depression treated with vortioxetine and duloxetine in an eight-week randomized controlled trial: The role of age at first onset and change in depressive symptoms

BackgroundAge at first onset of depression as a clinical factor affecting cognitive improvement in late life depression was investigated. MethodsThis is a secondary analysis of an eight-week randomized controlled trial involving 452 elderly patients treated by vortioxetine, duloxetine or placebo (1:1:1). Patients were subcategorized into early-onset (LLD-EO) and late-onset (LLD-LO) groups divided by onset age of 50. Cognitive performance was assessed by composite score of Digit Symbol Substitution Test (DSST) and the Rey Auditory Verbal Learning Test (RAVLT) tasks, while depressive symptoms were assessed by Montgomery–Åsberg Depression Rating Scale (MADRS). ResultsVortioxetine and duloxetine exhibited advantages versus placebo in improving cognitive performance in the LLD-LO group, yet not in the LLD-EO group after eight weeks. Patients in the LLD-EO group showed overall advantage to placebo in depressive symptoms before endpoint (week 8) of treatment, while patients in the LLO-LO group showed no advantage until endpoint. Path analysis suggested a direct effect of vortioxetine (B = 0.656, p = .036) and duloxetine (B = 0.726, p = .028) on improving cognition in the LLD-LO group, yet in all-patients treated set both medications improved cognition indirectly through changes of depressive symptoms. LimitationReliability of clinical history could raise caution as it was collected by subjective recall of patients. ConclusionAge at first onset might affect cognitive improvement as well as change in depressive symptoms and its mediation towards cognitive improvement in late life depression treated with vortioxetine and duloxetine.

Development and Validation of a Bedside Scale for Assessing Upper Limb Function Following Stroke: A Methodological Study.

Background Numerous tools are available for evaluation of upper limb (UL) functions among stroke survivors. Despite the excellent psychometric properties, many require considerable amount of time, are resource-intensive, and often impractical for bedside evaluation. Objectives To develop and concurrently validate a simple, resource-efficient, and time-efficient bedside tool for evaluating UL function in stroke survivors. Methods Relevant literature review was carried out to conceptualize and define the theoretical framework of day-to-day UL movement tasks. Subsequently, an item pool of 18 UL movements was developed. A mini-Delphi method was employed to verify content validity. During the iterative rounds, 18-items were revised and refined to a 12-items scale. The final bedside upper limb evaluation tool (BUFET) scale underwent concurrent validation by correlating the scores with Wolf Motor Function Test (WMFT) scores using Spearman’s correlation coefficient. Internal consistency was evaluated through Cronbach’s alpha. Results Concurrent validity and internal consistency of the scale were supported by a high correlation coefficient (r = 0.937; p&lt;0.001) with WMFT and high Cronbach’s alpha (0.948). Conclusions Newly developed BUFET was found to be a valid and reliable bedside tool in the evaluation of upper limb functions and can be administered in a resource and time-efficient manner.

Subgroups of mild cognitive impairment based on cognitive function among Chinese older adults

Abstract Background: Due to the heterogeneity of mild cognitive impairment (MCI), the key points for non-pharmaceutical therapies cannot be determined. Examining impairment characteristics among different MCI subgroups would therefore be beneficial to the development of non-pharmaceutical therapies. Objective: To characterize the subgroups of older Chinese with MCI, and examine factors associated with the membership of distinct subgroups. Methods: This cross-sectional study was conducted between October 2018 and June 2022 in Fujian, East China, with 1017 older adults with MCI deemed eligible. Exclusion criteria included any diagnosis of other neurological or psychiatric conditions that could affect cognition. Participants underwent a neuropsychological test that assessed memory, language, attention, and executive function(s), and completed a questionnaire collecting their socioeconomic and clinical variables. Neuropsychological test scores were transformed to z-scores, which were then examined using latent class analysis. Associations between socioeconomic and clinical variables, and MCI subgroups were assessed using multinomial logistic regression analysis. Results: Three MCI subgroups were identified: G1 “Minimally impairment” (56.64%), G2 “Moderate impairment” (36.28%) and G3 “Worst impairment” (7.08%). Age, place of residence, marriage status, living status, and participation in intellectual activities differed significantly across the three MCI subgroups (P&lt;0.05). Compared with the Minimally impairment group, participants with Worst impairment were less likely to participate in intellectual activity and more likely to live in a nursing home. Conclusions: Cognitive function is a suitable foundation for establishing classifications among individuals with MCI. Non-pharmalogical therapies may target older adults at higher risk of moderate or worst impairment.

Effect of Self-Training Using Virtual Reality Head-Mounted Display Simulator on the Acquisition of Holmium Laser Enucleation of the Prostate Surgical Skills.

We aimed to evaluate the effect of self-training using a virtual reality head-mounted display simulator on the acquisition of surgical skills for holmium laser enucleation surgery. Thirteen medical students without surgical skills for holmium laser enucleation of the prostate were trained using multimedia to learn the technique via simulator manipulation. Thereafter, participants performed the technique on a virtual benign prostatic hyperplasia model A (test A). After a 1-week wash-out period, they underwent self-training using a simulator and performed the technique on model B (test B). Subsequently, participants were asked to respond to Training Satisfaction Questions. Video footage of hand movements and endoscope view were recorded during tests A and B for later review by 2 expert surgeons. A 20-step Assessment Checklist, 6-domain Global Rating Scale, and a Pass Rating were used to compare performance on tests A and B. Thirteen participants completed both tests A and B. The 20-step Assessment Checklist and 6-domain Global Rating Scale evaluation results showed significantly improved scores in test B than in test A (P<0.05). No evaluator rated participants as passed after test A, but 11 participants (84.6%) passed after test B. Ten participants (76.9%) indicated that the simulator was helpful in acquiring surgical skills for holmium laser enucleation of the prostate. The virtual reality head-mounted display holmium laser enucleation of the prostate simulator was effective for surgical skill training. This simulator may help to shorten the learning curve of this technique in real clinical practice in the future.

Implementation of hematology oncology lecture series for nursing staff.

e21005 Background: Westchester Medical Center has an oncology unit that provides care for hundreds of patients annually. Inpatient cancer patients often have especially complex medical treatment plans that require interdisciplinary collaboration and specialized knowledge of oncologic conditions. There is a need to implement formal teaching tailored to nursing staff devoted to topics in hematology and oncology. Our goal was to develop a monthly lecture series for nursing that deepened their understanding of cancer treatments, enabling them to assess and monitor patients with greater expertise. Methods: Topics were chosen based on relevance and are listed in the table. Speakers included full-time faculty, fellows and residents, pharmacists, and medical students. Ten lectures were completed and scheduled approximately once monthly in the mornings just prior to sign out for nursing shift change. Nursing staff were asked to complete a set of questions prior to each lecture (Pre-Test) They were given the same set of questions after each lecture (Post-Test) to determine whether there was an improvement in understanding of the topic. Informational handouts were distributed at the end of each lecture to provide participants with a summary of key points. A survey administered at the conclusion of the lecture series was collected to assess attitudes towards the lectures. Results: Overall test scores improved after each lecture was given, as demonstrated in the table: Pre and Post Lecture Test Scores. Additionally, feedback regarding the lectures was positive. 100% agreed that they gained a better understanding of topics related to hematology oncology and 92% agreed that participation in these lectures has improved their ability to function collaboratively on interprofessional healthcare teams. Conclusions: A didactic lecture series is a valuable component of hematology oncology education for nursing staff and will improve quality of care of the oncology service. Some limitations of this lecture series concerned nursing staff scheduling conflicts and their availability for lecture attendance. Possible interventions in the future may include setting aside time dedicated for monthly lectures and scheduling lectures for afternoons to avoid conflicts with shift changes and morning rounds. Nevertheless, our findings highlight the value of continued education in empowering nursing staff to deliver quality care to hematology oncology patients.[Table: see text]

Efficacy of Parent Training Programme in Enhancing Quality of Home and Community Living of Individuals with Intellectual Disability in Haryana (India)

Intellectual Disabled (ID) person has a right to live and received recognition and importance. There is a strong need to strengthen the social, emotional, physical and personal support systems among the families of these ID people and the society at large. The purpose of the study was to assess the effectiveness of parents training program in quality of life of children with ID on its dimension Quality of Home &amp; Community Living. Binet-Kamat Test of Intelligence and Quality of Life Scale for Persons with Disabilities was applied. Analysis of covariance (ANCOVA) was applied on the pre test scores and post test scores obtained by the participants in the experimental and control group before and after the Parent Training Programme. Parent training programme of individual with intellectual disability is effective and important interventional approach for enhancing better quality of life of parents as well as person with ID.

Long-term Outcomes of Multiligament Knee Injuries in American Football Players.

Long-term outcomes for isolated anterior cruciate ligament (ACL) reconstructions in competitive American football athletes are well reported in the literature, but little data currently exist regarding multiligament knee injury (MLKI) reconstruction outcomes. To examine patient-reported and return-to-sport outcomes of competitive American football athletes who underwent primary, single-staged, multiligament knee reconstruction. Case series; Level of evidence, 4. We identified patients from our institution's prospectively collected data repository between 2001 and 2020 who underwent single-staged surgical reconstruction of an MLKI sustained during competitive participation in American football. We assessed patient-reported outcomes at a minimum of 2 years after surgery using the International Knee Documentation Committee (IKDC) Subjective Knee Form and questions regarding surgical satisfaction and return to sport. Successful return to sport was defined as a return to preinjury level of competition. We summarized all outcome data and compared outcomes between 2-ligament and >2-ligament groups and between ACL-only MLKI injury and bicruciate MLKI injury groups using independent t test for IKDC scores and chi-square test for return to sport. Additionally, we evaluated predictors of postoperative IKDC scores using linear regression and predictors of return to sport using logistic regression. Outcome data were successfully collected for 53 of 73 total eligible patients (73%; mean follow-up time, 7.7 ± 4.0 years; all male; mean age at surgery, 18.1 ± 2.7 years). The mean postoperative IKDC score was 84 ± 16. The most common level of preinjury competition was high school (n = 36; 68%), followed by college (n = 10; 19%). Seven patients did not return to sport competition at any level due to limitations from their knee surgery, and 82% of patients that attempted to return to preinjury level of sport were able to do so. A total of 50 patients (94%) were satisfied or very satisfied with their surgical outcome. The 2-ligament (n = 39) and >2-ligament (n = 14) groups did not significantly differ in IKDC scores (P = .96) or proportions with successful return to sport (P = .77). Similarly, the ACL-MLKI injury (n = 39) and bicruciate MLKI injury (n = 14) groups did not significantly differ in IKDC scores (P = .89) or proportions with successful return to sport (P = .77). Age and body mass index were not significantly associated with IKDC scores or successful return to sport at follow-up (all P > .05). This study may represent the largest cohort of competitive American football athletes evaluated for longitudinal outcomes after multiligament knee reconstruction. Despite the severity of these injuries, we found good knee-related function and that the large majority of athletes who attempted to return to sport were successful. The majority of athletes (94%) were satisfied with their operative treatment.

Effectiveness of Balance Exercise and Brisk Walking on Alleviating Nonmotor and Motor Symptoms in People With Mild-to-Moderate Parkinson Disease: A Randomized Clinical Trial With 6-Month Follow-up

ObjectiveTo investigate the effects of balance exercise and brisk walking on nonmotor and motor symptoms, balance and gait functions, walking capacity, and balance confidence in Parkinson disease (PD) at posttraining and 6-month follow-up. DesignTwo-arm, assessor-blinded randomized controlled trial SettingUniversity research laboratory and the community ParticipantsNinety-nine eligible individuals with mild-to-moderate PD InterventionsParticipants were randomized to balance and brisk walking group (B&B, n=49) or active control group (n=50). B&B received ten 90-minute sessions of balance exercises and brisk walking supervised by physical therapists for 6 months (week 1-6: weekly, week 7-26: monthly), whereas control practiced whole-body flexibility and upper limb strength exercise at same dosage (180 min/wk). Both groups performed unsupervised home exercises 2-3 times/wk during intervention and continued at follow-up. Main Outcome MeasuresPrimary outcomes were Movement Disorder Society Unified Parkinson Disease Rating Scale nonmotor (MDS-UPDRS-I) and motor (MDS-UPRDS-III) scores. Secondary outcomes were mini-Balance Evaluation Systems Test (mini-BEST) score, comfortable gait speed (CGS), 6-minute walk test (6MWT), dual-task timed-Up-and-Go (DTUG) time, and Activities-Specific Balance Confidence Scale score. ResultsEighty-three individuals completed the 6-month intervention with no severe adverse effects. The mean between-group (95% CI) difference for the MDS-UPDRS nonmotor score was 1.50 (0.19-2.81) at 6 months and 1.09 (−0.66 to 2.85) at 12 months. The mean between-group (95% CI) difference for the MDS-UPDRS motor score was 3.75 (0.69-6.80) at 6 months and 4.57 (1.05-8.01) at 12 months. At 6 and 12 months, there were significant between-group improvements of the B&B group in mini-BEST score, CGS, 6MWT, and DTUG time. ConclusionsThis combined balance and brisk walking exercise program alleviates nonmotor and motor symptoms and improves walking capacity, balance, and gait functions posttraining, with positive carryover effects for all except nonmotor outcomes, at 6-month follow-up in mild-to-moderate PD.

Effect of Olfactory Rehabilitation on the Recovery of Post-Coronavirus Disease Olfactory Dysfunction: A Randomized Controlled Trial.

Introduction Persistent olfactory dysfunction was seen in many patients upon coronavirus disease 2019 (COVID-19) infection recovery. However, research on its management was very limited, especially among the Southeast Asian population. Objectives We aim to investigate the role of olfactory rehabilitation and topical corticosteroids among post-COVID-19 olfactory dysfunction patients in Malaysia, and at the same timeto determine factors leading to olfactory recovery post-COVID-19 infection. Methods Adult Malaysians with persistent olfactory dysfunction one month post-COVID-19 recovery were recruited. Thirty-one patients were randomly assigned into three groups with 10 patients being given olfactory training (Group 1), another 10 being given mometasone furoate nasal spray/olfactory training (Group 2), and 11 patients being assigned to the control group (Group 3). All groups were followed up for an average duration of six months. Olfactory function was evaluated by Top International Biotech Smell Identification Test (TIBSIT) scores and Olfactory Disorder Questionnaire (eODQ) prior to randomization, at three and six months after recruitment. Results The baseline characteristics of patients were similar in all groups. Generally, patients of all three groups showed a statistically significant improvement in the TIBSIT scores after six months. The TIBSIT scores for Group 2 were statistically significantly higher than the control at three months but not at six months. As for Group 1, no statistically significant differences in TIBSIT scores at both three and six months were noted when compared to control. Statistically significant improvements were seen in the eODQ scores in all three groups. Conclusion No superiority of intervention for post-COVID-19 olfactory dysfunction was seen compared to control.

Phân tích đề thi trắc nghiệm khách quan học phần/Module của sinh viên ngành Ykhoa năm thứ 3 tại Trường Đại học Y Dược Thái Bình

Objective: To evaluate the score spectrum of the test, difficulty, and discriminability of questions in the objective multiple-choice tests. Method: Use spectrum analysis for each module. Determining the difficulty of a multiple-choice question is the percentage of students who answered correctly compared to the total number of students participating in answering that question; Discriminability of test questions is the ability of multiple-choice questions to classify students into groups of different levels (good, very good groups and average-weak- poor group). Results: Spectrum of test scores: the average score or higher accounted for 66,93%, of which, good and excellent scores accounted for 30.47%. The score spectrum is also relatively even between classes. There are 35.03% of exam questions with medium difficulty, 41.66% of the exam questions are at the easy level, the questions at the difficult level and the relatively difficult level account for 15.18 and 8.11%, respectively. There are 25.24% of exam questions with low discriminatory level; The levels of good, and average are equivalent with the rate of 15.47% and 15.13% respectively; Questions with a very good level of discrimination account for an overall rate of 43.16%. Conclusion: Determining the score spectrum of the test and assessing the difficulty and discriminability of the questions for the objective multiple-choice test is essential to build a good-quality test, and at the same time help to improve the question bank and eliminate inappropriate multiple-choice questions.

Brain functional specialization and cooperation in Alzheimer's disease.

Cerebral specialization and interhemispheric cooperation are two vital features of the human brain. Their dysfunction may be associated with disease progression in patients with Alzheimer's disease (AD), which is featured as progressive cognitive degeneration and asymmetric neuropathology. This study aimed to examine and define two inherent properties of hemispheric function in patients with AD by utilizing resting-state functional magnetic resonance imaging (rs-fMRI). Sixty-four clinically diagnosed AD patients and 52 age- and sex-matched cognitively normal subjects were recruited and underwent MRI and clinical evaluation. We calculated and compared brain specialization (autonomy index, AI) and interhemispheric cooperation (connectivity between functionally homotopic voxels, CFH). In comparison to healthy controls, patients with AD exhibited enhanced AI in the left middle occipital gyrus. This increase in specialization can be attributed to reduced functional connectivity in the contralateral region, such as the right temporal lobe. The CFH of the bilateral precuneus and prefrontal areas was significantly decreased in AD patients compared to controls. Imaging-cognitive correlation analysis indicated that the CFH of the right prefrontal cortex was marginally positively related to the Montreal Cognitive Assessment score in patients and the Auditory Verbal Learning Test score. Moreover, taking abnormal AI and CFH values as features, support vector machine-based classification achieved good accuracy, sensitivity, specificity, and area under the curve by leave-one-out cross-validation. This study suggests that individuals with AD have abnormal cerebral specialization and interhemispheric cooperation. This provides new insights for further elucidation of the pathological mechanisms of AD.

Desigualdade educacional nos exames de larga escala e a jornadas escolares extendidas: uma análise da rede pública de ensino médio de Pernambuco (Brasil)

Abstract This paper analyzes the relationship between full-time journeys and schooling inequality in Pernambuco, Brazil. Using standardized test scores on the school level, we tested the inverted u-curve hypothesis proposed initially by Simon Kuznets in 1955 and adapted with a focus on schooling expansion and inequality by Rati Ram in 1990. We build a panel data analysis to perform the test, with data aggregated by region and scores on standardized tests as the output variable. Initially, the hypotheses described an inverted U-curve correlating schooling effectiveness and inequality. However, we have found that the relationship follows a regular U shape. It is also inferable that the equity of the result is more connected to the effects of the diversity of school typology, the location of schools, and the way the region is developed.