Sample records for exam mlc reserved

  1. Radio frequency noise from an MLC: a feasibility study of the use of an MLC for linac-MR systems.

    PubMed

    Lamey, M; Yun, J; Burke, B; Rathee, S; Fallone, B G

    2010-02-21

    Currently several groups are actively researching the integration of a megavoltage teletherapy unit with magnetic resonance (MR) imaging for real-time image-guided radiotherapy. The use of a multileaf collimator (MLC) for intensity-modulated radiotherapy for linac-MR units must be investigated. The MLC itself will likely reside in the fringe field of the MR and the motors will produce radio frequency (RF) noise. The RF noise power spectral density from a Varian 52-leaf MLC motor, a Varian Millennium MLC motor and a brushless fan motor has been measured as a function of the applied magnetic field using a near field probe set. For the Varian 52-leaf MLC system, the RF noise produced by 13 of 52 motors is studied as a function of distance from the MLC. Data are reported in the frequency range suitable for 0.2-1.5 T linac-MR systems. Below 40 MHz the Millennium MLC motor tested showed more noise than the Varian 52-leaf motor or the brushless fan motor. The brushless motor showed a small dependence on the applied magnetic field. Images of a phantom were taken by the prototype linac-MR system with the MLC placed in close proximity to the magnet. Several orientations of the MLC in both shielded and non-shielded configurations were studied. For the case of a non-shielded MLC and associated cables, the signal-to-noise ratio (SNR) was reduced when 13 of 52 MLC leaves were moved during imaging. When the MLC and associated cables were shielded, the measured SNR of the images with 13 MLC leaves moving was experimentally the same as the SNR of the stationary MLC image. When the MLC and cables are shielded, subtraction images acquired with and without MLC motion contains no systematic signal. This study illustrates that the small RF noise produced by functioning MLC motors can be effectively shielded to avoid SNR degradation. A functioning MLC can be incorporated into a linac-MR unit.

  2. Radio frequency noise from an MLC: a feasibility study of the use of an MLC for linac-MR systems

    PubMed Central

    Lamey, M; Yun, J; Burke, B; Rathee, S; Fallone, B G

    2010-01-01

    Currently several groups are actively researching the integration of a megavoltage teletherapy unit with magnetic resonance (MR) imaging for real-time image-guided radiotherapy. The use of a multileaf collimator (MLC) for intensity-modulated radiotherapy for linac-MR units must be investigated. The MLC itself will likely reside in the fringe field of the MR and the motors will produce radio frequency (RF) noise. The RF noise power spectral density from a Varian 52-leaf MLC motor, a Varian Millennium MLC motor and a brushless fan motor has been measured as a function of the applied magnetic field using a near field probe set. For the Varian 52-leaf MLC system, the RF noise produced by 13 of 52 motors is studied as a function of distance from the MLC. Data are reported in the frequency range suitable for 0.2–1.5 T linac-MR systems. Below 40 MHz the Millennium MLC motor tested showed more noise than the Varian 52-leaf motor or the brushless fan motor. The brushless motor showed a small dependence on the applied magnetic field. Images of a phantom were taken by the prototype linac-MR system with the MLC placed in close proximity to the magnet. Several orientations of the MLC in both shielded and non-shielded configurations were studied. For the case of a non-shielded MLC and associated cables, the signal-to-noise ratio (SNR) was reduced when 13 of 52 MLC leaves were moved during imaging. When the MLC and associated cables were shielded, the measured SNR of the images with 13 MLC leaves moving was experimentally the same as the SNR of the stationary MLC image. When the MLC and cables are shielded, subtraction images acquired with and without MLC motion contains no systematic signal. This study illustrates that the small RF noise produced by functioning MLC motors can be effectively shielded to avoid SNR degradation. A functioning MLC can be incorporated into a linac-MR unit. PMID:20090187

  3. The transcription factor Mlc promotes Vibrio cholerae biofilm formation through repression of phosphotransferase system components.

    PubMed

    Pickering, Bradley S; Lopilato, Jane E; Smith, Daniel R; Watnick, Paula I

    2014-07-01

    The phosphoenol phosphotransferase system (PTS) is a multicomponent signal transduction cascade that regulates diverse aspects of bacterial cellular physiology in response to the availability of high-energy sugars in the environment. Many PTS components are repressed at the transcriptional level when the substrates they transport are not available. In Escherichia coli, the transcription factor Mlc (for makes large colonies) represses transcription of the genes encoding enzyme I (EI), histidine protein (HPr), and the glucose-specific enzyme IIBC (EIIBC(Glc)) in defined media that lack PTS substrates. When glucose is present, the unphosphorylated form of EIIBC(Glc) sequesters Mlc to the cell membrane, preventing its interaction with DNA. Very little is known about Vibrio cholerae Mlc. We found that V. cholerae Mlc activates biofilm formation in LB broth but not in defined medium supplemented with either pyruvate or glucose. Therefore, we questioned whether V. cholerae Mlc functions differently than E. coli Mlc. Here we have shown that, like E. coli Mlc, V. cholerae Mlc represses transcription of PTS components in both defined medium and LB broth and that E. coli Mlc is able to rescue the biofilm defect of a V. cholerae Δmlc mutant. Furthermore, we provide evidence that Mlc indirectly activates transcription of the vps genes by repressing expression of EI. Because activation of the vps genes by Mlc occurs under only a subset of the conditions in which repression of PTS components is observed, we conclude that additional inputs present in LB broth are required for activation of vps gene transcription by Mlc. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  4. Electromagnetic-Guided MLC Tracking Radiation Therapy for Prostate Cancer Patients: Prospective Clinical Trial Results.

    PubMed

    Keall, Paul J; Colvill, Emma; O'Brien, Ricky; Caillet, Vincent; Eade, Thomas; Kneebone, Andrew; Hruby, George; Poulsen, Per R; Zwan, Benjamin; Greer, Peter B; Booth, Jeremy

    2018-06-01

    To report on the primary and secondary outcomes of a prospective clinical trial of electromagnetic-guided multileaf collimator (MLC) tracking radiation therapy for prostate cancer. Twenty-eight men with prostate cancer were treated with electromagnetic-guided MLC tracking with volumetric modulated arc therapy. A total of 858 fractions were delivered, with the dose per fraction ranging from 2 to 13.75 Gy. The primary outcome was feasibility, with success determined if >95% of fractions were successfully delivered. The secondary outcomes were (1) the improvement in beam-target geometric alignment, (2) the improvement in dosimetric coverage of the prostate and avoidance of critical structures, and (3) no acute grade ≥3 genitourinary or gastrointestinal toxicity. All 858 planned fractions were successfully delivered with MLC tracking, demonstrating the primary outcome of feasibility (P < .001). MLC tracking improved the beam-target geometric alignment from 1.4 to 0.90 mm (root-mean-square error). MLC tracking improved the dosimetric coverage of the prostate and reduced the daily variation in dose to critical structures. No acute grade ≥3 genitourinary or gastrointestinal toxicity was observed. Electromagnetic-guided MLC tracking radiation therapy for prostate cancer is feasible. The patients received improved geometric targeting and delivered dose distributions that were closer to those planned than they would have received without electromagnetic-guided MLC tracking. No significant acute toxicity was observed. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. The β1 subunit of the Na,K-ATPase pump interacts with megalencephalic leucoencephalopathy with subcortical cysts protein 1 (MLC1) in brain astrocytes: new insights into MLC pathogenesis

    PubMed Central

    Brignone, Maria S.; Lanciotti, Angela; Macioce, Pompeo; Macchia, Gianfranco; Gaetani, Matteo; Aloisi, Francesca; Petrucci, Tamara C.; Ambrosini, Elena

    2011-01-01

    Megalencephalic leucoencephalopathy with subcortical cysts (MLC) is a rare congenital leucodystrophy caused by mutations in MLC1, a membrane protein of unknown function. MLC1 expression in astrocyte end-feet contacting blood vessels and meninges, along with brain swelling, fluid cysts and myelin vacuolation observed in MLC patients, suggests a possible role for MLC1 in the regulation of fluid and ion homeostasis and cellular volume changes. To identify MLC1 direct interactors and dissect the molecular pathways in which MLC1 is involved, we used NH2-MLC1 domain as a bait to screen a human brain library in a yeast two-hybrid assay. We identified the β1 subunit of the Na,K-ATPase pump as one of the interacting clones and confirmed it by pull-downs, co-fractionation assays and immunofluorescence stainings in human and rat astrocytes in vitro and in brain tissue. By performing ouabain-affinity chromatography on astrocyte and brain extracts, we isolated MLC1 and the whole Na,K-ATPase enzyme in a multiprotein complex that included Kir4.1, syntrophin and dystrobrevin. Because Na,K-ATPase is involved in intracellular osmotic control and volume regulation, we investigated the effect of hypo-osmotic stress on MLC1/Na,K-ATPase relationship in astrocytes. We found that hypo-osmotic conditions increased MLC1 membrane expression and favoured MLC1/Na,K-ATPase-β1 association. Moreover, hypo-osmosis induced astrocyte swelling and the reversible formation of endosome-derived vacuoles, where the two proteins co-localized. These data suggest that through its interaction with Na,K-ATPase, MLC1 is involved in the control of intracellular osmotic conditions and volume regulation in astrocytes, opening new perspectives for understanding the pathological mechanisms of MLC disease. PMID:20926452

  6. An experimental comparison of conventional two-bank and novel four-bank dynamic MLC tracking.

    PubMed

    Davies, G A; Clowes, P; McQuaid, D; Evans, P M; Webb, S; Poludniowski, G

    2013-03-07

    The AccuLeaf mMLC featuring four multileaf-collimator (MLC) banks has been used for the first time for an experimental comparison of conventional two-bank with novel four-bank dynamic MLC tracking of a two-dimensional sinusoidal respiratory motion. This comparison was performed for a square aperture, and for three conformal treatment apertures from clinical radiotherapy lung cancer patients. The system latency of this prototype tracking system was evaluated and found to be 1.0 s and the frequency at which MLC positions could be updated, 1 Hz, and therefore accurate MLC tracking of irregular patient motion would be difficult with the system in its current form. The MLC leaf velocity required for two-bank-MLC and four-bank-MLC tracking was evaluated for the apertures studied and a substantial decrease was found in the maximum MLC velocity required when four-banks were used for tracking rather than two. A dosimetric comparison of the two techniques was also performed and minimal difference was found between two-bank-MLC and four-bank-MLC tracking. The use of four MLC banks for dynamic MLC tracking is shown to be potentially advantageous for increasing the delivery efficiency compared with two-bank-MLC tracking where difficulties are encountered if large leaf shifts are required to track motion perpendicular to the direction of leaf travel.

  7. Impact of HESI Specialty Exams: the ninth HESI Exit Exam validity study.

    PubMed

    Zweighaft, Elizabeth L

    2013-01-01

    Using an ex post facto, nonexperimental design, this, the ninth validity study of Elsevier's HESI Exit Exam (E(2)), reexamined the predictive accuracy of the E(2). The value of administering HESI Specialty Exams within the nursing curriculum in terms of E(2) scores was also investigated. The sample was composed of nursing students (N = 3,790) from 63 randomly selected schools-26 baccalaureate, 31 associate degree, and 6 diploma programs-throughout the United States who took the E(2) between September 2008 and August 2009. As in the previous 8 studies, the E(2) was found to be highly accurate (96.61%) in predicting success on the National Council Licensure Examination for Registered Nurses (NCLEX-RN). Findings also indicated that students who took one or more HESI Specialty Exams during their nursing curriculum had a significantly higher mean E(2) score (P ≤ .0001) than students who did not take HESI Specialty Exams during their nursing curriculum. Of the 8 HESI Specialty Exams investigated, scores on the Critical Care, Pediatrics, and Medical-Surgical specialty exams were most predictive of NCLEX-RN success. Schools of nursing that used HESI Specialty Exams as course final exams had a significantly higher mean E(2) score (P < .01) than schools that used the exams for remediation and practice. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. The first patient treatment of electromagnetic-guided real time adaptive radiotherapy using MLC tracking for lung SABR.

    PubMed

    Booth, Jeremy T; Caillet, Vincent; Hardcastle, Nicholas; O'Brien, Ricky; Szymura, Kathryn; Crasta, Charlene; Harris, Benjamin; Haddad, Carol; Eade, Thomas; Keall, Paul J

    2016-10-01

    Real time adaptive radiotherapy that enables smaller irradiated volumes may reduce pulmonary toxicity. We report on the first patient treatment of electromagnetic-guided real time adaptive radiotherapy delivered with MLC tracking for lung stereotactic ablative body radiotherapy. A clinical trial was developed to investigate the safety and feasibility of MLC tracking in lung. The first patient was an 80-year old man with a single left lower lobe lung metastasis to be treated with SABR to 48Gy in 4 fractions. In-house software was integrated with a standard linear accelerator to adapt the treatment beam shape and position based on electromagnetic transponders implanted in the lung. MLC tracking plans were compared against standard ITV-based treatment planning. MLC tracking plan delivery was reconstructed in the patient to confirm safe delivery. Real time adaptive radiotherapy delivered with MLC tracking compared to standard ITV-based planning reduced the PTV by 41% (18.7-11cm 3 ) and the mean lung dose by 30% (202-140cGy), V20 by 35% (2.6-1.5%) and V5 by 9% (8.9-8%). An emerging technology, MLC tracking, has been translated into the clinic and used to treat lung SABR patients for the first time. This milestone represents an important first step for clinical real-time adaptive radiotherapy that could reduce pulmonary toxicity in lung radiotherapy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. The first clinical implementation of electromagnetic transponder-guided MLC tracking.

    PubMed

    Keall, Paul J; Colvill, Emma; O'Brien, Ricky; Ng, Jin Aun; Poulsen, Per Rugaard; Eade, Thomas; Kneebone, Andrew; Booth, Jeremy T

    2014-02-01

    We report on the clinical process, quality assurance, and geometric and dosimetric results of the first clinical implementation of electromagnetic transponder-guided MLC tracking which occurred on 28 November 2013 at the Northern Sydney Cancer Centre. An electromagnetic transponder-based positioning system (Calypso) was modified to send the target position output to in-house-developed MLC tracking code, which adjusts the leaf positions to optimally align the treatment beam with the real-time target position. Clinical process and quality assurance procedures were developed and performed. The first clinical implementation of electromagnetic transponder-guided MLC tracking was for a prostate cancer patient being treated with dual-arc VMAT (RapidArc). For the first fraction of the first patient treatment of electromagnetic transponder-guided MLC tracking we recorded the in-room time and transponder positions, and performed dose reconstruction to estimate the delivered dose and also the dose received had MLC tracking not been used. The total in-room time was 21 min with 2 min of beam delivery. No additional time was needed for MLC tracking and there were no beam holds. The average prostate position from the initial setup was 1.2 mm, mostly an anterior shift. Dose reconstruction analysis of the delivered dose with MLC tracking showed similar isodose and target dose volume histograms to the planned treatment and a 4.6% increase in the fractional rectal V60. Dose reconstruction without motion compensation showed a 30% increase in the fractional rectal V60 from that planned, even for the small motion. The real-time beam-target correction method, electromagnetic transponder-guided MLC tracking, has been translated to the clinic. This achievement represents a milestone in improving geometric and dosimetric accuracy, and by inference treatment outcomes, in cancer radiotherapy.

  10. The first clinical implementation of electromagnetic transponder-guided MLC tracking

    PubMed Central

    Keall, Paul J.; Colvill, Emma; O’Brien, Ricky; Ng, Jin Aun; Poulsen, Per Rugaard; Eade, Thomas; Kneebone, Andrew; Booth, Jeremy T.

    2014-01-01

    Purpose: We report on the clinical process, quality assurance, and geometric and dosimetric results of the first clinical implementation of electromagnetic transponder-guided MLC tracking which occurred on 28 November 2013 at the Northern Sydney Cancer Centre. Methods: An electromagnetic transponder-based positioning system (Calypso) was modified to send the target position output to in-house-developed MLC tracking code, which adjusts the leaf positions to optimally align the treatment beam with the real-time target position. Clinical process and quality assurance procedures were developed and performed. The first clinical implementation of electromagnetic transponder-guided MLC tracking was for a prostate cancer patient being treated with dual-arc VMAT (RapidArc). For the first fraction of the first patient treatment of electromagnetic transponder-guided MLC tracking we recorded the in-room time and transponder positions, and performed dose reconstruction to estimate the delivered dose and also the dose received had MLC tracking not been used. Results: The total in-room time was 21 min with 2 min of beam delivery. No additional time was needed for MLC tracking and there were no beam holds. The average prostate position from the initial setup was 1.2 mm, mostly an anterior shift. Dose reconstruction analysis of the delivered dose with MLC tracking showed similar isodose and target dose volume histograms to the planned treatment and a 4.6% increase in the fractional rectal V60. Dose reconstruction without motion compensation showed a 30% increase in the fractional rectal V60 from that planned, even for the small motion. Conclusions: The real-time beam-target correction method, electromagnetic transponder-guided MLC tracking, has been translated to the clinic. This achievement represents a milestone in improving geometric and dosimetric accuracy, and by inference treatment outcomes, in cancer radiotherapy. PMID:24506591

  11. The Mathematics and Computer Science Learning Center (MLC).

    ERIC Educational Resources Information Center

    Abraham, Solomon T.

    The Mathematics and Computer Science Learning Center (MLC) was established in the Department of Mathematics at North Carolina Central University during the fall semester of the 1982-83 academic year. The initial operations of the MLC were supported by grants to the University from the Burroughs-Wellcome Company and the Kenan Charitable Trust Fund.…

  12. A quantitative method to the analysis of MLC leaf position and speed based on EPID and EBT3 film for dynamic IMRT treatment with different types of MLC.

    PubMed

    Li, Yinghui; Chen, Lixin; Zhu, Jinhan; Wang, Bin; Liu, Xiaowei

    2017-07-01

    A quantitative method based on the electronic portal imaging system (EPID) and film was developed for MLC position and speed testing; this method was used for three MLC types (Millennium, MLCi, and Agility MLC). To determine the leaf position, a picket fence designed by the dynamic (DMLC) model was used. The full-width half-maximum (FWHM) values of each gap measured by EPID and EBT3 were converted to the gap width using the FWHM versus nominal gap width relationship. The algorithm developed for the picket fence analysis was able to quantify the gap width, the distance between gaps, and each individual leaf position. To determine the leaf speed, a 0.5 × 20 cm 2 MLC-defined sliding gap was applied across a 14 × 20 cm 2 symmetry field. The linacs ran at a fixed-dose rate. The use of different monitor units (MUs) for this test led to different leaf speeds. The effect of leaf transmission was considered in a speed accuracy analysis. The difference between the EPID and film results for the MLC position is less than 0.1 mm. For the three MLC types, twice the standard deviation (2 SD) is provided; 0.2, 0.4, and 0.4 mm for gap widths of three MLC types, and 0.1, 0.2, and 0.2 mm for distances between gaps. The individual leaf positions deviate from the preset positions within 0.1 mm. The variations in the speed profiles for the EPID and EBT3 results are consistent, but the EPID results are slightly better than the film results. Different speeds were measured for each MLC type. For all three MLC types, speed errors increase with increasing speed. The analysis speeds deviate from the preset speeds within approximately 0.01 cm s -1 . This quantitative analysis of MLC position and speed provides an intuitive evaluation for MLC quality assurance (QA). © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  13. Comparision of beam data requirements for MLC commissioning on a TPS

    NASA Astrophysics Data System (ADS)

    Solaiappan, Gopi; Singaravelu, Ganesan; Prakasarao, Aruna; Supe, Sanjay S.

    2008-01-01

    The treatment planning system (TPS) has become a key element in the radiotherapy process with the introduction of computer tomography (CT) based 3D conformal treatment planning. Commissioning of a MLC on a TPS either for conformal radiotherapy or intensity modulated radiation therapy (IMRT) requires beam data to be generated on a linear accelerator. Most of the TPS require these beam data to be generated with routine collimator jaws. However some TPS demand the data to be provided for MLC shaped fields. This prompted us to investigate whether beam data with jaws differ than that with MLC and whether the jaw based beam data would suffice for the commissioning of a MLC on a TPS. Beam data like percentage depth dose (PDD), cross beam profiles and output factors was acquired for jaws and MLC defined square fields for 6, 10 and 23 MV photon beams. Percentage depth dose and cross beam profiles were acquired with a radiation field analyzer RFA-200, CC13-S ion chambers with active volume of 0.13 cm3 and OmniPro-Accept software from Scanditronix-Wellhofer. A Medtec-TG51 water tank with Max-4000 electrometer and 0.6 cc PTW ionization chamber and a mini phantom from Standard Imaging was utilized for output measurements for millennium-120 MLC (Varian Medical Systems) and SRS diode detector (Scanditronix-Wellhofer) of 0.6 mm diameter of active area and 0.3 mm of active volume thickness for micro-MLC (BrainLab). The difference in PDD in the build-up region for millennium MLC was ±1.0% for 6 MV photons. For 10 MV photons the PDD difference was within ±4.0%. The difference in PDD for 23 MV photons ranged from 0% to 40.0%. PDD difference from build-up depth to about 28 cm was within ±1.0%. Difference in PDD crossed ±1.0% at 30 cm depth for 6 MV photons. The difference in PDD in the build-up region for mMLC was ±8.0% for 6 MV photons. For the smallest field size studied with micro-MLC i.e. 0.6 × 0.6 cm2 difference in PDD was more than ±1.0% in the build-up region and beyond a

  14. Evaluation of MLC leaf transmission on IMRT treatment plan quality of patients with advanced lung cancer.

    PubMed

    Chen, Jiayun; Fu, Guishan; Li, Minghui; Song, Yixin; Dai, Jianrong; Miao, Junjie; Liu, Zhiqiang; Li, Yexiong

    2017-12-14

    conventional fraction, hyperfraction, or stereotactic body radiotherapy (SBRT), the reduction on lung sparing is still essential because it is highly relevant to radiation pneumonitis (RP). It has potential to diminish incidence of RP and improve patient's quality of life after irradiation with lowered MLC transmission. Copyright © 2017 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  15. Fast regional readout CMOS Image Sensor for dynamic MLC tracking

    NASA Astrophysics Data System (ADS)

    Zin, H.; Harris, E.; Osmond, J.; Evans, P.

    2014-03-01

    Advanced radiotherapy techniques such as volumetric modulated arc therapy (VMAT) require verification of the complex beam delivery including tracking of multileaf collimators (MLC) and monitoring the dose rate. This work explores the feasibility of a prototype Complementary metal-oxide semiconductor Image Sensor (CIS) for tracking these complex treatments by utilising fast, region of interest (ROI) read out functionality. An automatic edge tracking algorithm was used to locate the MLC leaves edges moving at various speeds (from a moving triangle field shape) and imaged with various sensor frame rates. The CIS demonstrates successful edge detection of the dynamic MLC motion within accuracy of 1.0 mm. This demonstrates the feasibility of the sensor to verify treatment delivery involving dynamic MLC up to ~400 frames per second (equivalent to the linac pulse rate), which is superior to any current techniques such as using electronic portal imaging devices (EPID). CIS provides the basis to an essential real-time verification tool, useful in accessing accurate delivery of complex high energy radiation to the tumour and ultimately to achieve better cure rates for cancer patients.

  16. Saliva pH as a biomarker of exam stress and a predictor of exam performance.

    PubMed

    Cohen, Miri; Khalaila, Rabia

    2014-11-01

    Salivary pH is regulated by the sympathetic and parasympathetic nervous system; therefore, it may serve as a biomarker of stress. To assess the associations between the cognitive and emotional dimensions of exam stress and pH levels, and the predictability of salivary pH in relation to test performance. A prospective study. Eighty-three nursing students answered a questionnaire on stress appraisals, experienced stress, test anxiety (including worry and emotionality subscales) and health behaviors, and gave a saliva sample for measuring pH on the morning of their first term exam and three months later. Their performance on the test (grades) was also recorded. Levels of pH in saliva were higher (levels of acidity were lower) in the post exam compared to the exam period, in parallel to lower threat appraisal, experienced stress, and test anxiety levels post exam. Controlling for smoking, physical activity and working hours per week, pH levels at both time points were predicted by appraised threat regarding the exam situation, experienced stress, and the emotionality dimension of test anxiety. pH at Time 1 predicted performance on the exams and mediated the associations of experienced stress and emotionality subscale with test performance. the present study indicates that pH levels may serve as a reliable, accessible and inexpensive means by which to assess the degree of physiological reactions to exams and other naturalistic stressors. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. SU-E-T-501: Initial Orthovoltage Beam Profile Analysis of a Small Brass MLC

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Loughery, B; Snyder, M

    2015-06-15

    Purpose To create brass leaves for an orthovoltage MLC and take initial beam profile measurements. Methods The low-energy MLC was designed in previous work. Brass was chosen for its self-lubrication and low cost. Stock brass rectangles (30cm × 1.0cm × 0.5cm) were ordered with pre-cut gear rack along the topmost long edges. Leaf designs were translated into G-code, then cut with a Tormach CNC-1100 mill. Intense bowing was observed in the beam direction, which required straightening via an in-house jig. Straightened leaves were placed into MLC assembly and mounted to a 320 kVp orthovoltage tube. EDR2 film was irradiated inmore » four situations: MLC open so one edge was isocentric, and MLC open more than isocentric, completely closed MLC, and an open field shot with the MLC removed. The first two scans tested penumbra for our rectangular edges due to unfocused design. The final two scans tested transmission and interleaf leakage. All four experiments were set to 120 kVp and 10 mA for two minutes. Results Transmission and interleaf leakage were found to be zero. Interleaf leakage is faintly visible on film, but undetected by our film scanner despite high spatial resolution. Penumbra at isocenter was found to be 0.72mm, which matched the penumbras of true field edges. Penumbra off-isocenter was 1.1mm. Mechanically, leaves are moving smoothly once straightened. Conclusion Beam profiles through our brass MLC are acceptable. Leaves attenuate and move as designed. Looking forward, we intend to animate our MLC to deliver more complicated treatment plans.« less

  18. SU-F-T-530: Characterization of a 60-Leaf Motorized MLC Designed for Cobalt-60 Units

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Xu, L; Smith, L; Ciresianu, A

    2016-06-15

    Purpose: In a continuing effort to improve conformal radiation therapy with Cobalt-60 units, a 60-leaf MLC was designed, manufactured, and released to market. This work describes the physics measurements taken to characterize the clinical performance of this MLC. Methods: A 60 leaf MLC was custom designed with tungsten leaves of 4.5 cm height, single focused, achieving field size of 30×30 cm^2 when mounted on a 100cm SAD Cobalt-60 unit. Leakage and output factor measurements were performed using a single ion chamber in a solid water phantom. Penumbra and surface dose were measured using scanning chambers and diodes in a watermore » phantom. Radiation-light coincidence measurements were performed using radiographic films. Results: With MLC mounted, measured penumbras at all depths are smaller than with jaws only. Surface doses were not significantly affected by the presence of MLC, and remained below values recommended by regulatory bodies. Light-radiation coincidences were found to be better than 3 mm for all field sizes. Leakage through the MLC was found to be strongly dependent on field size, increasing from 1.0 % for a 10×10 cm field to 2.0% for a 30×30 cm field. Such results meet the requirements of IEC 60601-2-11. The MLC was found to have significant influence on the output factor, when field size defined by MLC is significantly smaller than field size defined by jaws. Such effect is also observed on linear accelerators, but it is more pronounced on Cobalt-60 units. A 10×10 “diamond” MLC shape inside a 14×14 cm jaw showed output factor that is 5.7% higher than 10×10 cm field defined by matching MLC and jaws. Conclusion: The MLC offers clinically acceptable performance in penumbra, surface dose, and light-radiation coincidence. Several units of this MLC have recently been installed and used clinically. Validation of Cobalt-60 based IMRT with this MLC is ongoing. The authors are employees of Best Theratrnics Ltd.« less

  19. Electron beam collimation with a photon MLC for standard electron treatments

    NASA Astrophysics Data System (ADS)

    Mueller, S.; Fix, M. K.; Henzen, D.; Frei, D.; Frauchiger, D.; Loessl, K.; Stampanoni, M. F. M.; Manser, P.

    2018-01-01

    Standard electron treatments are currently still performed using standard or molded patient-specific cut-outs placed in the electron applicator. Replacing cut-outs and electron applicators with a photon multileaf collimator (pMLC) for electron beam collimation would make standard electron treatments more efficient and would facilitate advanced treatment techniques like modulated electron radiotherapy (MERT) and mixed beam radiotherapy (MBRT). In this work, a multiple source Monte Carlo beam model for pMLC shaped electron beams commissioned at a source-to-surface distance (SSD) of 70 cm is extended for SSDs of up to 100 cm and validated for several Varian treatment units with field sizes typically used for standard electron treatments. Measurements and dose calculations agree generally within 3% of the maximal dose or 2 mm distance to agreement. To evaluate the dosimetric consequences of using pMLC collimated electron beams for standard electron treatments, pMLC-based and cut-out-based treatment plans are created for a left and a right breast boost, a sternum, a testis and a parotid gland case. The treatment plans consist of a single electron field, either alone (1E) or in combination with two 3D conformal tangential photon fields (1E2X). For each case, a pMLC plan with similar treatment plan quality in terms of dose homogeneity to the target and absolute mean dose values to the organs at risk (OARs) compared to a cut-out plan is found. The absolute mean dose to an OAR is slightly increased for pMLC-based compared to cut-out-based 1E plans if the OAR is located laterally close to the target with respect to beam direction, or if a 6 MeV electron beam is used at an extended SSD. In conclusion, treatment plans using cut-out collimation can be replaced by plans of similar treatment plan quality using pMLC collimation with accurately calculated dose distributions.

  20. Combining MLC and SVM Classifiers for Learning Based Decision Making: Analysis and Evaluations

    PubMed Central

    Zhang, Yi; Ren, Jinchang; Jiang, Jianmin

    2015-01-01

    Maximum likelihood classifier (MLC) and support vector machines (SVM) are two commonly used approaches in machine learning. MLC is based on Bayesian theory in estimating parameters of a probabilistic model, whilst SVM is an optimization based nonparametric method in this context. Recently, it is found that SVM in some cases is equivalent to MLC in probabilistically modeling the learning process. In this paper, MLC and SVM are combined in learning and classification, which helps to yield probabilistic output for SVM and facilitate soft decision making. In total four groups of data are used for evaluations, covering sonar, vehicle, breast cancer, and DNA sequences. The data samples are characterized in terms of Gaussian/non-Gaussian distributed and balanced/unbalanced samples which are then further used for performance assessment in comparing the SVM and the combined SVM-MLC classifier. Interesting results are reported to indicate how the combined classifier may work under various conditions. PMID:26089862

  1. Combining MLC and SVM Classifiers for Learning Based Decision Making: Analysis and Evaluations.

    PubMed

    Zhang, Yi; Ren, Jinchang; Jiang, Jianmin

    2015-01-01

    Maximum likelihood classifier (MLC) and support vector machines (SVM) are two commonly used approaches in machine learning. MLC is based on Bayesian theory in estimating parameters of a probabilistic model, whilst SVM is an optimization based nonparametric method in this context. Recently, it is found that SVM in some cases is equivalent to MLC in probabilistically modeling the learning process. In this paper, MLC and SVM are combined in learning and classification, which helps to yield probabilistic output for SVM and facilitate soft decision making. In total four groups of data are used for evaluations, covering sonar, vehicle, breast cancer, and DNA sequences. The data samples are characterized in terms of Gaussian/non-Gaussian distributed and balanced/unbalanced samples which are then further used for performance assessment in comparing the SVM and the combined SVM-MLC classifier. Interesting results are reported to indicate how the combined classifier may work under various conditions.

  2. Comparison of MLC error sensitivity of various commercial devices for VMAT pre-treatment quality assurance.

    PubMed

    Saito, Masahide; Sano, Naoki; Shibata, Yuki; Kuriyama, Kengo; Komiyama, Takafumi; Marino, Kan; Aoki, Shinichi; Ashizawa, Kazunari; Yoshizawa, Kazuya; Onishi, Hiroshi

    2018-05-01

    The purpose of this study was to compare the MLC error sensitivity of various measurement devices for VMAT pre-treatment quality assurance (QA). This study used four QA devices (Scandidos Delta4, PTW 2D-array, iRT systems IQM, and PTW Farmer chamber). Nine retrospective VMAT plans were used and nine MLC error plans were generated for all nine original VMAT plans. The IQM and Farmer chamber were evaluated using the cumulative signal difference between the baseline and error-induced measurements. In addition, to investigate the sensitivity of the Delta4 device and the 2D-array, global gamma analysis (1%/1, 2%/2, and 3%/3 mm), dose difference (1%, 2%, and 3%) were used between the baseline and error-induced measurements. Some deviations of the MLC error sensitivity for the evaluation metrics and MLC error ranges were observed. For the two ionization devices, the sensitivity of the IQM was significantly better than that of the Farmer chamber (P < 0.01) while both devices had good linearly correlation between the cumulative signal difference and the magnitude of MLC errors. The pass rates decreased as the magnitude of the MLC error increased for both Delta4 and 2D-array. However, the small MLC error for small aperture sizes, such as for lung SBRT, could not be detected using the loosest gamma criteria (3%/3 mm). Our results indicate that DD could be more useful than gamma analysis for daily MLC QA, and that a large-area ionization chamber has a greater advantage for detecting systematic MLC error because of the large sensitive volume, while the other devices could not detect this error for some cases with a small range of MLC error. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  3. SU-G-BRA-14: Dose in a Rigidly Moving Phantom with Jaw and MLC Compensation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chao, E; Lucas, D

    Purpose: To validate dose calculation for a rigidly moving object with jaw motion and MLC shifts to compensate for the motion in a TomoTherapy™ treatment delivery. Methods: An off-line version of the TomoTherapy dose calculator was extended to perform dose calculations for rigidly moving objects. A variety of motion traces were added to treatment delivery plans, along with corresponding jaw compensation and MLC shift compensation profiles. Jaw compensation profiles were calculated by shifting the jaws such that the center of the treatment beam moved by an amount equal to the motion in the longitudinal direction. Similarly, MLC compensation profiles weremore » calculated by shifting the MLC leaves by an amount that most closely matched the motion in the transverse direction. The same jaw and MLC compensation profiles were used during simulated treatment deliveries on a TomoTherapy system, and film measurements were obtained in a rigidly moving phantom. Results: The off-line TomoTherapy dose calculator accurately predicted dose profiles for a rigidly moving phantom along with jaw motion and MLC shifts to compensate for the motion. Calculations matched film measurements to within 2%/1 mm. Jaw and MLC compensation substantially reduced the discrepancy between the delivered dose distribution and the calculated dose with no motion. For axial motion, the compensated dose matched the no-motion dose within 2%/1mm. For transverse motion, the dose matched within 2%/3mm (approximately half the width of an MLC leaf). Conclusion: The off-line TomoTherapy dose calculator accurately computes dose delivered to a rigidly moving object, and accurately models the impact of moving the jaws and shifting the MLC leaf patterns to compensate for the motion. Jaw tracking and MLC leaf shifting can effectively compensate for the dosimetric impact of motion during a TomoTherapy treatment delivery.« less

  4. A clinically observed discrepancy between image-based and log-based MLC positions

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Neal, Brian, E-mail: bpn2p@virginia.edu; Ahmed, Mahmoud; Kathuria, Kunal

    2016-06-15

    Purpose: To present a clinical case in which real-time intratreatment imaging identified an multileaf collimator (MLC) leaf to be consistently deviating from its programmed and logged position by >1 mm. Methods: An EPID-based exit-fluence dosimetry system designed to prevent gross delivery errors was used to capture cine during treatment images. The author serendipitously visually identified a suspected MLC leaf displacement that was not otherwise detected. The leaf position as recorded on the EPID images was measured and log-files were analyzed for the treatment in question, the prior day’s treatment, and for daily MLC test patterns acquired on those treatment days.more » Additional standard test patterns were used to quantify the leaf position. Results: Whereas the log-file reported no difference between planned and recorded positions, image-based measurements showed the leaf to be 1.3 ± 0.1 mm medial from the planned position. This offset was confirmed with the test pattern irradiations. Conclusions: It has been clinically observed that log-file derived leaf positions can differ from their actual position by >1 mm, and therefore cannot be considered to be the actual leaf positions. This cautions the use of log-based methods for MLC or patient quality assurance without independent confirmation of log integrity. Frequent verification of MLC positions through independent means is a necessary precondition to trust log-file records. Intratreatment EPID imaging provides a method to capture departures from MLC planned positions.« less

  5. Automatic detection of MLC relative position errors for VMAT using the EPID-based picket fence test

    NASA Astrophysics Data System (ADS)

    Christophides, Damianos; Davies, Alex; Fleckney, Mark

    2016-12-01

    Multi-leaf collimators (MLCs) ensure the accurate delivery of treatments requiring complex beam fluences like intensity modulated radiotherapy and volumetric modulated arc therapy. The purpose of this work is to automate the detection of MLC relative position errors  ⩾0.5 mm using electronic portal imaging device-based picket fence tests and compare the results to the qualitative assessment currently in use. Picket fence tests with and without intentional MLC errors were measured weekly on three Varian linacs. The picket fence images analysed covered a time period ranging between 14-20 months depending on the linac. An algorithm was developed that calculated the MLC error for each leaf-pair present in the picket fence images. The baseline error distributions of each linac were characterised for an initial period of 6 months and compared with the intentional MLC errors using statistical metrics. The distributions of median and one-sample Kolmogorov-Smirnov test p-value exhibited no overlap between baseline and intentional errors and were used retrospectively to automatically detect MLC errors in routine clinical practice. Agreement was found between the MLC errors detected by the automatic method and the fault reports during clinical use, as well as interventions for MLC repair and calibration. In conclusion the method presented provides for full automation of MLC quality assurance, based on individual linac performance characteristics. The use of the automatic method has been shown to provide early warning for MLC errors that resulted in clinical downtime.

  6. Determination of MLC model parameters for Monaco using commercial diode arrays.

    PubMed

    Kinsella, Paul; Shields, Laura; McCavana, Patrick; McClean, Brendan; Langan, Brian

    2016-07-08

    Multileaf collimators (MLCs) need to be characterized accurately in treatment planning systems to facilitate accurate intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT). The aim of this study was to examine the use of MapCHECK 2 and ArcCHECK diode arrays for optimizing MLC parameters in Monaco X-ray voxel Monte Carlo (XVMC) dose calculation algorithm. A series of radiation test beams designed to evaluate MLC model parameters were delivered to MapCHECK 2, ArcCHECK, and EBT3 Gafchromic film for comparison. Initial comparison of the calculated and ArcCHECK-measured dose distributions revealed it was unclear how to change the MLC parameters to gain agreement. This ambiguity arose due to an insufficient sampling of the test field dose distributions and unexpected discrepancies in the open parts of some test fields. Consequently, the XVMC MLC parameters were optimized based on MapCHECK 2 measurements. Gafchromic EBT3 film was used to verify the accuracy of MapCHECK 2 measured dose distributions. It was found that adjustment of the MLC parameters from their default values resulted in improved global gamma analysis pass rates for MapCHECK 2 measurements versus calculated dose. The lowest pass rate of any MLC-modulated test beam improved from 68.5% to 93.5% with 3% and 2 mm gamma criteria. Given the close agreement of the optimized model to both MapCHECK 2 and film, the optimized model was used as a benchmark to highlight the relatively large discrepancies in some of the test field dose distributions found with ArcCHECK. Comparison between the optimized model-calculated dose and ArcCHECK-measured dose resulted in global gamma pass rates which ranged from 70.0%-97.9% for gamma criteria of 3% and 2 mm. The simple square fields yielded high pass rates. The lower gamma pass rates were attributed to the ArcCHECK overestimating the dose in-field for the rectangular test fields whose long axis was parallel to the long axis of the Arc

  7. TomoTherapy MLC verification using exit detector data

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chen Quan; Westerly, David; Fang Zhenyu

    2012-01-15

    Purpose: Treatment delivery verification (DV) is important in the field of intensity modulated radiation therapy (IMRT). While IMRT and image guided radiation therapy (IGRT), allow us to create more conformal plans and enables the use of tighter margins, an erroneously executed plan can have detrimental effects on the treatment outcome. The purpose of this study is to develop a DV technique to verify TomoTherapy's multileaf collimator (MLC) using the onboard mega-voltage CT detectors. Methods: The proposed DV method uses temporal changes in the MVCT detector signal to predict actual leaf open times delivered on the treatment machine. Penumbra and scatteredmore » radiation effects may produce confounding results when determining leaf open times from the raw detector data. To reduce the impact of the effects, an iterative, Richardson-Lucy (R-L) deconvolution algorithm is applied. Optical sensors installed on each MLC leaf are used to verify the accuracy of the DV technique. The robustness of the DV technique is examined by introducing different attenuation materials in the beam. Additionally, the DV technique has been used to investigate several clinical plans which failed to pass delivery quality assurance (DQA) and was successful in identifying MLC timing discrepancies as the root cause. Results: The leaf open time extracted from the exit detector showed good agreement with the optical sensors under a variety of conditions. Detector-measured leaf open times agreed with optical sensor data to within 0.2 ms, and 99% of the results agreed within 8.5 ms. These results changed little when attenuation was added in the beam. For the clinical plans failing DQA, the dose calculated from reconstructed leaf open times played an instrumental role in discovering the root-cause of the problem. Throughout the retrospective study, it is found that the reconstructed dose always agrees with measured doses to within 1%. Conclusions: The exit detectors in the TomoTherapy treatment

  8. Dynamic tumor tracking using the Elekta Agility MLC

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Fast, Martin F., E-mail: martin.fast@icr.ac.uk; Nill, Simeon, E-mail: simeon.nill@icr.ac.uk; Bedford, James L.

    2014-11-01

    Purpose: To evaluate the performance of the Elekta Agility multileaf collimator (MLC) for dynamic real-time tumor tracking. Methods: The authors have developed a new control software which interfaces to the Agility MLC to dynamically program the movement of individual leaves, the dynamic leaf guides (DLGs), and the Y collimators (“jaws”) based on the actual target trajectory. A motion platform was used to perform dynamic tracking experiments with sinusoidal trajectories. The actual target positions reported by the motion platform at 20, 30, or 40 Hz were used as shift vectors for the MLC in beams-eye-view. The system latency of the MLCmore » (i.e., the average latency comprising target device reporting latencies and MLC adjustment latency) and the geometric tracking accuracy were extracted from a sequence of MV portal images acquired during irradiation for the following treatment scenarios: leaf-only motion, jaw + leaf motion, and DLG + leaf motion. Results: The portal imager measurements indicated a clear dependence of the system latency on the target position reporting frequency. Deducting the effect of the target frequency, the leaf adjustment latency was measured to be 38 ± 3 ms for a maximum target speed v of 13 mm/s. The jaw + leaf adjustment latency was 53 ± 3 at a similar speed. The system latency at a target position frequency of 30 Hz was in the range of 56–61 ms for the leaves (v ≤ 31 mm/s), 71–78 ms for the jaw + leaf motion (v ≤ 25 mm/s), and 58–72 ms for the DLG + leaf motion (v ≤ 59 mm/s). The tracking accuracy showed a similar dependency on the target position frequency and the maximum target speed. For the leaves, the root-mean-squared error (RMSE) was between 0.6–1.5 mm depending on the maximum target speed. For the jaw + leaf (DLG + leaf) motion, the RMSE was between 0.7–1.5 mm (1.9–3.4 mm). Conclusions: The authors have measured the latency and geometric accuracy of the Agility MLC, facilitating its future use for

  9. SU-E-T-195: Gantry Angle Dependency of MLC Leaf Position Error

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ju, S; Hong, C; Kim, M

    Purpose: The aim of this study was to investigate the gantry angle dependency of the multileaf collimator (MLC) leaf position error. Methods: An automatic MLC quality assurance system (AutoMLCQA) was developed to evaluate the gantry angle dependency of the MLC leaf position error using an electronic portal imaging device (EPID). To eliminate the EPID position error due to gantry rotation, we designed a reference maker (RM) that could be inserted into the wedge mount. After setting up the EPID, a reference image was taken of the RM using an open field. Next, an EPID-based picket-fence test (PFT) was performed withoutmore » the RM. These procedures were repeated at every 45° intervals of the gantry angle. A total of eight reference images and PFT image sets were analyzed using in-house software. The average MLC leaf position error was calculated at five pickets (-10, -5, 0, 5, and 10 cm) in accordance with general PFT guidelines using in-house software. This test was carried out for four linear accelerators. Results: The average MLC leaf position errors were within the set criterion of <1 mm (actual errors ranged from -0.7 to 0.8 mm) for all gantry angles, but significant gantry angle dependency was observed in all machines. The error was smaller at a gantry angle of 0° but increased toward the positive direction with gantry angle increments in the clockwise direction. The error reached a maximum value at a gantry angle of 90° and then gradually decreased until 180°. In the counter-clockwise rotation of the gantry, the same pattern of error was observed but the error increased in the negative direction. Conclusion: The AutoMLCQA system was useful to evaluate the MLC leaf position error for various gantry angles without the EPID position error. The Gantry angle dependency should be considered during MLC leaf position error analysis.« less

  10. Gender differences in the regulation of MLC20 phosphorylation and smooth muscle contraction in rat stomach

    PubMed Central

    Al-Shboul, Othman A.; Al-Dwairi, Ahmed N.; Alqudah, Mohammad A.; Mustafa, Ayman G.

    2018-01-01

    Evidence of sex-related differences in gastrointestinal (GI) functions has been reported in the literature. In addition, various GI disorders have disproportionate prevalence between the sexes. An essential step in the initiation of smooth muscle contraction is the phosphorylation of the 20-kDa regulatory myosin light chain (MLC20) by the Ca2+/calmodulin-dependent myosin light chain kinase (MLCK). However, whether male stomach smooth muscle inherits different contractile signaling mechanisms for the regulation of MLC20 phosphorylation from that in females has not been established. The present study was designed to investigate sex-associated differences in the regulation of MLC20 phosphorylation and thus muscle contraction in gastric smooth muscle cells (GSMCs). Experiments were performed on GSMCs freshly isolated from male and female rats. Contraction of the GSMCs in response to acetylcholine (ACh), a muscarinic agonist, was measured via scanning micrometry in the presence or absence of the MLCK inhibitor, ML-7. Additionally, the protein levels of MLC20, MLCK and phosphorylated MLC20 were measured by ELISA. The protein levels of MLC20 and MLCK were indifferent between the sexes. ACh induced greater contraction (P<0.05) as well as greater MLC20 phosphorylation (P<0.05) in male GSMCs compared with female. Pretreatment of GSMCs with ML-7 significantly reduced the ACh-induced contraction (P<0.05) and MLC20 phosphorylation (P<0.05) in the male and female cells, and notably, abolished the contractile differences between the sexes. In conclusion, MLC20 phosphorylation and thus muscle contraction may be activated to a greater extent in male rat stomach compared with that in females. PMID:29599980

  11. Examining Exam Reviews: A Comparison of Exam Scores and Attitudes

    ERIC Educational Resources Information Center

    Hackathorn, Jana; Cornell, Kathryn; Garczynski, Amy M.; Solomon, Erin D.; Blankmeyer, Katheryn E.; Tennial, Rachel E.

    2012-01-01

    Instructors commonly use exam reviews to help students prepare for exams and to increase student success. The current study compared the effects of traditional, trivia, and practice test-based exam reviews on actual exam scores, as well as students' attitudes toward each review. Findings suggested that students' exam scores were significantly…

  12. SU-E-T-646: Quality Assurance of Truebeam Multi-Leaf Collimator Using a MLC QA Phantom

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zhang, J; Lu, J; Hong, D

    2015-06-15

    Purpose: To perform a routine quality assurance procedure for Truebeam multi-leaf collimator (MLC) using MLC QA phantom, verify the stability and reliability of MLC during the treatment. Methods: MLC QA phantom is a specialized phantom for MLC quality assurance (QA), and contains five radio-opaque spheres that are embedded in an “L” shape. The phantom was placed isocentrically on the Truebeam treatment couch for the tests. A quality assurance plan was setted up in the Eclipse v10.0, the fields that need to be delivered in order to acquire the necessary images, the MLC shapes can then be obtained by the images.more » The images acquired by the electronic portal imaging device (EPID), and imported into the PIPSpro software for the analysis. The tests were delivered twelve weeks (once a week) to verify consistency of the delivery, and the images are acquired in the same manner each time. Results: For the Leaf position test, the average position error was 0.23mm±0.02mm (range: 0.18mm∼0.25mm). The Leaf width was measured at the isocenter, the average error was 0.06mm±0.02mm (range: 0.02mm∼0.08mm) for the Leaf width test. Multi-Port test showed the dynamic leaf shift error, the average error was 0.28mm±0.03mm (range: 0.2mm∼0.35mm). For the leaf transmission test, the average inter-leaf leakage value was 1.0%±0.17% (range: 0.8%∼1.3%) and the average inter-bank leakage value was 32.6%±2.1% (range: 30.2%∼36.1%). Conclusion: By the test of 12 weeks, the MLC system of the Truebeam is running in a good condition and the MLC system can be steadily and reliably carried out during the treatment. The MLC QA phantom is a useful test tool for the MLC QA.« less

  13. NOTE: Reducing the number of segments in unidirectional MLC segmentations

    NASA Astrophysics Data System (ADS)

    Mellado, X.; Cruz, S.; Artacho, J. M.; Canellas, M.

    2010-02-01

    In intensity-modulated radiation therapy (IMRT), fluence matrices obtained from a treatment planning system are usually delivered by a linear accelerator equipped with a multileaf collimator (MLC). A segmentation method is needed for decomposing these fluence matrices into segments suitable for the MLC, and the number of segments used is an important factor for treatment time. In this work, an algorithm for reduction of the number of segments (NS) is presented for unidirectional segmentations, where there is no backtracking of the MLC leaves. It uses a geometrical representation of the segmentation output for searching the key values in a fluence matrix that complicate its decomposition. The NS reduction is achieved by performing minor modifications in these values, under the conditions of avoiding substantial modifications of the dose-volume histogram, and does not increase in average the total number of monitor units delivered. The proposed method was tested using two clinical cases planned with the PCRT 3D® treatment planning system.

  14. Disrupting MLC1 and GlialCAM and ClC-2 interactions in leukodystrophy entails glial chloride channel dysfunction

    NASA Astrophysics Data System (ADS)

    Hoegg-Beiler, Maja B.; Sirisi, Sònia; Orozco, Ian J.; Ferrer, Isidre; Hohensee, Svea; Auberson, Muriel; Gödde, Kathrin; Vilches, Clara; de Heredia, Miguel López; Nunes, Virginia; Estévez, Raúl; Jentsch, Thomas J.

    2014-03-01

    Defects in the astrocytic membrane protein MLC1, the adhesion molecule GlialCAM or the chloride channel ClC-2 underlie human leukoencephalopathies. Whereas GlialCAM binds ClC-2 and MLC1, and modifies ClC-2 currents in vitro, no functional connections between MLC1 and ClC-2 are known. Here we investigate this by generating loss-of-function Glialcam and Mlc1 mouse models manifesting myelin vacuolization. We find that ClC-2 is unnecessary for MLC1 and GlialCAM localization in brain, whereas GlialCAM is important for targeting MLC1 and ClC-2 to specialized glial domains in vivo and for modifying ClC-2’s biophysical properties specifically in oligodendrocytes (OLs), the cells chiefly affected by vacuolization. Unexpectedly, MLC1 is crucial for proper localization of GlialCAM and ClC-2, and for changing ClC-2 currents. Our data unmask an unforeseen functional relationship between MLC1 and ClC-2 in vivo, which is probably mediated by GlialCAM, and suggest that ClC-2 participates in the pathogenesis of megalencephalic leukoencephalopathy with subcortical cysts.

  15. Diabetes eye exams

    MedlinePlus

    Diabetic retinopathy - eye exams; Diabetes - eye exams; Glaucoma - diabetic eye exam; Macular edema - diabetic eye exam ... Ophthalmology Retina/Vitreous Panel. Preferred Practice Pattern ... www.aao.org/preferred-practice-pattern/diabetic-retinopathy- ...

  16. SU-F-T-650: The Comparison of Robotic Partial Breast Stereotactic Irradiation Using MLC Vs. Iris Cone

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ding, C; Timmerman, R; Jiang, S

    Purpose: To evaluate the dosimetric impact on treatment planning for partial breast stereotactic irradiation using Cyberknife with MLC versus Iris Cone. Methods: Ten patients whom underwent lumpectomy for DCIS or stage I invasive non-lobular epithelial breast cancer were included in this study. All patients were previously treated on the Cyberknife using Iris cone with the prescription dose of 37.5Gy in 5 fractions covering at least 95% of PTV on our phase I SBRT 5 fraction partial breast irradiation trial. Retrospectively, treatment planning was performed and compared using the new Cyberknife M6 MLC system for each patient. Using the same contoursmore » and critical organ constraints for both MLC and Iris cone plans, the dose on target and critical organs were analyzed accordingly. Results: Dose to critical organs such as ipsilateral lung, contralateral lung, heart, skin, ipsilateral breast, and rib were analyzed, as well as conformity index and high dose spillage of the target area. In 9 of 10 patients, the MLC plans had less total ipsilateral breast volume encompassing the 50% prescription isodose (mean:22.3±8.2% MLC vs. 31.6±8.0 Iris, p=0.00014) .The MLC plans mean estimated treatment delivery time was significantly less than the Iris plans (51±3.9min vs. 56.2±9min, p=0.03) Both MLC and Iris cone plans were able to meet all dose constraints and there was no statistical difference between those dose constraints. Conclusion: Both MLC and Iris Cone can deliver conformal dose to a partial breast target and satisfy the dose constraints of critical organs. The new Cyberknife with MLC can deliver a more conformal dose in the lower dose region and spare more ipsilateral breast tissue to the 50% prescription isodose. The treatment time for partial breast SBRT plans was also reduced using MLC. Project receives research support from Accuray Inc.« less

  17. Brushed permanent magnet DC MLC motor operation in an external magnetic field.

    PubMed

    Yun, J; St Aubin, J; Rathee, S; Fallone, B G

    2010-05-01

    Linac-MR systems for real-time image-guided radiotherapy will utilize the multileaf collimators (MLCs) to perform conformal radiotherapy and tumor tracking. The MLCs would be exposed to the external fringe magnetic fields of the linac-MR hybrid systems. Therefore, an experimental investigation of the effect of an external magnetic field on the brushed permanent magnet DC motors used in some MLC systems was performed. The changes in motor speed and current were measured for varying external magnetic field strengths up to 2000 G generated by an EEV electromagnet. These changes in motor characteristics were measured for three orientations of the motor in the external magnetic field, mimicking changes in motor orientations due to installation and/or collimator rotations. In addition, the functionality of the associated magnetic motor encoder was tested. The tested motors are used with the Varian 120 leaf Millennium MLC (Maxon Motor half leaf and full leaf motors) and the Varian 52 leaf MKII MLC (MicroMo Electronics leaf motor) including a carriage motor (MicroMo Electronics). In most cases, the magnetic encoder of the motors failed prior to any damage to the gearbox or the permanent magnet motor itself. This sets an upper limit of the external magnetic field strength on the motor function. The measured limits of the external magnetic fields were found to vary by the motor type. The leaf motor used with a Varian 52 leaf MKII MLC system tolerated up to 450 +/- 10 G. The carriage motor tolerated up to 2000 +/- 10 G field. The motors used with the Varian 120 leaf Millennium MLC system were found to tolerate a maximum of 600 +/- 10 G. The current Varian MLC system motors can be used for real-time image-guided radiotherapy coupled to a linac-MR system, provided the fringe magnetic fields at their locations are below the determined tolerance levels. With the fringe magnetic fields of linac-MR systems expected to be larger than the tolerance levels determined, some form of

  18. Quantitative measurement of MLC leaf displacements using an electronic portal image device

    NASA Astrophysics Data System (ADS)

    Yang, Yong; Xing, Lei

    2004-04-01

    The success of an IMRT treatment relies on the positioning accuracy of the MLC (multileaf collimator) leaves for both step-and-shoot and dynamic deliveries. In practice, however, there exists no effective and quantitative means for routine MLC QA and this has become one of the bottleneck problems in IMRT implementation. In this work we present an electronic portal image device (EPID) based method for fast and accurate measurement of MLC leaf positions at arbitrary locations within the 40 cm × 40 cm radiation field. The new technique utilizes the fact that the integral signal in a small region of interest (ROI) is a sensitive and reliable indicator of the leaf displacement. In this approach, the integral signal at a ROI was expressed as a weighted sum of the contributions from the displacements of the leaf above the point and the adjacent leaves. The weighting factors or linear coefficients of the system equations were determined by fitting the integral signal data for a group of pre-designed MLC leaf sequences to the known leaf displacements that were intentionally introduced during the creation of the leaf sequences. Once the calibration is done, the system can be used for routine MLC leaf positioning QA to detect possible leaf errors. A series of tests was carried out to examine the functionality and accuracy of the technique. Our results show that the proposed technique is potentially superior to the conventional edge-detecting approach in two aspects: (i) it deals with the problem in a systematic approach and allows us to take into account the influence of the adjacent MLC leaves effectively; and (ii) it may improve the signal-to-noise ratio and is thus capable of quantitatively measuring extremely small leaf positional displacements. Our results indicate that the technique can detect a leaf positional error as small as 0.1 mm at an arbitrary point within the field in the absence of EPID set-up error and 0.3 mm when the uncertainty is considered. Given its

  19. Development and evaluation of aperture-based complexity metrics using film and EPID measurements of static MLC openings

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Götstedt, Julia; Karlsson Hauer, Anna; Bäck, Anna, E-mail: anna.back@vgregion.se

    Purpose: Complexity metrics have been suggested as a complement to measurement-based quality assurance for intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). However, these metrics have not yet been sufficiently validated. This study develops and evaluates new aperture-based complexity metrics in the context of static multileaf collimator (MLC) openings and compares them to previously published metrics. Methods: This study develops the converted aperture metric and the edge area metric. The converted aperture metric is based on small and irregular parts within the MLC opening that are quantified as measured distances between MLC leaves. The edge area metricmore » is based on the relative size of the region around the edges defined by the MLC. Another metric suggested in this study is the circumference/area ratio. Earlier defined aperture-based complexity metrics—the modulation complexity score, the edge metric, the ratio monitor units (MU)/Gy, the aperture area, and the aperture irregularity—are compared to the newly proposed metrics. A set of small and irregular static MLC openings are created which simulate individual IMRT/VMAT control points of various complexities. These are measured with both an amorphous silicon electronic portal imaging device and EBT3 film. The differences between calculated and measured dose distributions are evaluated using a pixel-by-pixel comparison with two global dose difference criteria of 3% and 5%. The extent of the dose differences, expressed in terms of pass rate, is used as a measure of the complexity of the MLC openings and used for the evaluation of the metrics compared in this study. The different complexity scores are calculated for each created static MLC opening. The correlation between the calculated complexity scores and the extent of the dose differences (pass rate) are analyzed in scatter plots and using Pearson’s r-values. Results: The complexity scores calculated by the

  20. TH-AB-202-02: Real-Time Verification and Error Detection for MLC Tracking Deliveries Using An Electronic Portal Imaging Device

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    J Zwan, B; Central Coast Cancer Centre, Gosford, NSW; Colvill, E

    2016-06-15

    Purpose: The added complexity of the real-time adaptive multi-leaf collimator (MLC) tracking increases the likelihood of undetected MLC delivery errors. In this work we develop and test a system for real-time delivery verification and error detection for MLC tracking radiotherapy using an electronic portal imaging device (EPID). Methods: The delivery verification system relies on acquisition and real-time analysis of transit EPID image frames acquired at 8.41 fps. In-house software was developed to extract the MLC positions from each image frame. Three comparison metrics were used to verify the MLC positions in real-time: (1) field size, (2) field location and, (3)more » field shape. The delivery verification system was tested for 8 VMAT MLC tracking deliveries (4 prostate and 4 lung) where real patient target motion was reproduced using a Hexamotion motion stage and a Calypso system. Sensitivity and detection delay was quantified for various types of MLC and system errors. Results: For both the prostate and lung test deliveries the MLC-defined field size was measured with an accuracy of 1.25 cm{sup 2} (1 SD). The field location was measured with an accuracy of 0.6 mm and 0.8 mm (1 SD) for lung and prostate respectively. Field location errors (i.e. tracking in wrong direction) with a magnitude of 3 mm were detected within 0.4 s of occurrence in the X direction and 0.8 s in the Y direction. Systematic MLC gap errors were detected as small as 3 mm. The method was not found to be sensitive to random MLC errors and individual MLC calibration errors up to 5 mm. Conclusion: EPID imaging may be used for independent real-time verification of MLC trajectories during MLC tracking deliveries. Thresholds have been determined for error detection and the system has been shown to be sensitive to a range of delivery errors.« less

  1. Dosimetric comparison between cone/Iris-based and InCise MLC-based CyberKnife plans for single and multiple brain metastases.

    PubMed

    Jang, Si Young; Lalonde, Ron; Ozhasoglu, Cihat; Burton, Steven; Heron, Dwight; Huq, M Saiful

    2016-09-08

    We performed an evaluation of the CyberKnife InCise MLC by comparing plan qualities for single and multiple brain lesions generated using the first version of InCise MLC, fixed cone, and Iris collimators. We also investigated differences in delivery efficiency among the three collimators. Twenty-four patients with single or multiple brain mets treated previously in our clinic on a CyberKnife M6 using cone/Iris collimators were selected for this study. Treatment plans were generated for all lesions using the InCise MLC. Number of monitor units, delivery time, target coverage, conformity index, and dose falloff were compared between MLC- and clinical cone/Iris-based plans. Statistical analysis was performed using the non-parametric Wilcoxon-Mann-Whitney signed-rank test. The planning accuracy of the MLC-based plans was validated using chamber and film measurements. The InCise MLC-based plans achieved mean dose and target coverage comparable to the cone/Iris-based plans. Although the conformity indices of the MLC-based plans were slightly higher than those of the cone/Iris-based plans, beam delivery time for the MLC-based plans was shorter by 30% ~ 40%. For smaller targets or cases with OARs located close to or abutting target volumes, MLC-based plans provided inferior dose conformity compared to cone/Iris-based plans. The QA results of MLC-based plans were within 5% absolute dose difference with over 90% gamma passing rate using 2%/2 mm gamma criteria. The first version of InCise MLC could be a useful delivery modality, especially for clinical situations for which delivery time is a limiting factor or for multitarget cases. © 2016 The Authors.

  2. Will students pass a competitive exam that they failed in their dreams?

    PubMed

    Arnulf, Isabelle; Grosliere, Laure; Le Corvec, Thibault; Golmard, Jean-Louis; Lascols, Olivier; Duguet, Alexandre

    2014-10-01

    We tested whether dreams can anticipate a stressful exam and how failure/success in dreams affect next-day performance. We collected information on students' dreams during the night preceding the medical school entrance exam. Demographic, academic, sleep and dream characteristics were compared to the students' grades on the exam. Of the 719 respondents to the questionnaire (of 2324 total students), 60.4% dreamt of the exam during the night preceding it. Problems with the exam appeared in 78% of dreams and primarily involved being late and forgetting answers. Reporting a dream about the exam on the pre-exam night was associated with better performance on the exam (p=.01). The frequency of dreams concerning the exam during the first term predicted proportionally higher performance on the exam (R=0.1, p=.01). These results suggest that the negative anticipation of a stressful event in dreams is common and that this episodic simulation provides a cognitive gain. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. The sensitivity of patient specific IMRT QC to systematic MLC leaf bank offset errors.

    PubMed

    Rangel, Alejandra; Palte, Gesa; Dunscombe, Peter

    2010-07-01

    Patient specific IMRT QC is performed routinely in many clinics as a safeguard against errors and inaccuracies which may be introduced during the complex planning, data transfer, and delivery phases of this type of treatment. The purpose of this work is to evaluate the feasibility of detecting systematic errors in MLC leaf bank position with patient specific checks. 9 head and neck (H&N) and 14 prostate IMRT beams were delivered using MLC files containing systematic offsets (+/- 1 mm in two banks, +/- 0.5 mm in two banks, and 1 mm in one bank of leaves). The beams were measured using both MAPCHECK (Sun Nuclear Corp., Melbourne, FL) and the aS1000 electronic portal imaging device (Varian Medical Systems, Palo Alto, CA). Comparisons with calculated fields, without offsets, were made using commonly adopted criteria including absolute dose (AD) difference, relative dose difference, distance to agreement (DTA), and the gamma index. The criteria most sensitive to systematic leaf bank offsets were the 3% AD, 3 mm DTA for MAPCHECK and the gamma index with 2% AD and 2 mm DTA for the EPID. The criterion based on the relative dose measurements was the least sensitive to MLC offsets. More highly modulated fields, i.e., H&N, showed greater changes in the percentage of passing points due to systematic MLC inaccuracy than prostate fields. None of the techniques or criteria tested is sufficiently sensitive, with the population of IMRT fields, to detect a systematic MLC offset at a clinically significant level on an individual field. Patient specific QC cannot, therefore, substitute for routine QC of the MLC itself.

  4. SU-E-J-67: Evaluation of Adaptive MLC Morphing for Online Correction of Prostate Cancer Radiotherapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sandhu, R; Qin, A; Yan, D

    Purpose: Online adaptive MLC morphing is desirable over translational couch shifts to accommodate target position as well as anatomic changes. A reliable method of adaptive MLC segment to target during prostate cancer IMRT treatment is proposed and evaluated by comparison with daily online-image guidance (IGRT) correction and online-IMRT planning. Methods: The MLC adaptive algorithm involves following steps; move the MLC segments according to target translational shifts, and then morph the segment shape to maintain the spatial relationship between the planning-target contour and MLC segment. Efficacy of this method was evaluated retrospectively using daily-CBCT images on seven prostate patients treated withmore » seven-beam IMRT treatment to deliver 64Gy in 20 fractions. Daily modification was simulated with three approaches; daily-IGRT correction based on implanted radio-markers, adaptive MLC morphing, and online-IMRT planning, with no-residual variation. The selected dosimetric endpoints and nEUD (normalized equivalent uniform dose to online-IMRT planning) of each organ of interest were determined for evaluation and comparison. Results: For target(prostate), bladder and rectal-wall, the mean±sd of nEUD were 97.6%+3.2%, 103.9%±4.9% and 97.4%±1.1% for daily-IGRT correction; and 100.2%+0.2%, 108.9%±5.1% and 99.8%±1.2% for adaptive MLC morphing, respectively. For daily-IGRT correction, adaptive MLC morphing and online-IMRT planning, target D99 was <95% of the prescription dose in 30%, 0% and 0% of 140 fractions, respectively. For the rectal-wall, D5 exceeded 105% of the planned-D5 in 2.8%, 11.4% and 0% of 140 fractions, respectively. For the bladder, Dmax exceeded 105% of the planned-D5 in 2.8%, 5.6% and 0% of 140 fractions, respectively. D30 of bladder and rectal-wall were well within the planned-D30 for all three approaches. Conclusion: The proposed method of adaptive MLC morphing can be beneficial for the prostate patient population with large deformation

  5. SU-C-BRB-02: Symmetric and Asymmetric MLC Based Lung Shielding and Dose Optimization During Translating Bed TBI

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ahmed, S; Kakakhel, MB; Ahmed, SBS

    2015-06-15

    Purpose: The primary aim was to introduce a dose optimization method for translating bed total body irradiation technique that ensures lung shielding dynamically. Symmetric and asymmetric dynamic MLC apertures were employed for this purpose. Methods: The MLC aperture sizes were defined based on the radiological depth values along the divergent ray lines passing through the individual CT slices. Based on these RD values, asymmetrically shaped MLC apertures were defined every 9 mm of the phantom in superior-inferior direction. Individual MLC files were created with MATLAB™ and were imported into Eclipse™ treatment planning system for dose calculations. Lungs can be shieldedmore » to an optimum level by reducing the MLC aperture width over the lungs. The process was repeated with symmetrically shaped apertures. Results: Dose-volume histogram (DVH) analysis shows that the asymmetric MLC based technique provides better dose coverage to the body and optimum shielding of the lungs compared to symmetrically shaped beam apertures. Midline dose homogeneity is within ±3% with asymmetric MLC apertures whereas it remains within ±4.5% with symmetric ones (except head region where it drops down to −7%). The substantial over and under dosage of ±5% at tissue interfaces has been reduced to ±2% with asymmetric MLC technique. Lungs dose can be reduced to any desired limit. In this experiment lungs dose was reduced to 80% of the prescribed dose, as was desired. Conclusion: The novel asymmetric MLC based technique assures optimum shielding of OARs (e.g. lungs) and better 3-D dose homogeneity and body-dose coverage in comparison with the symmetric MLC aperture optimization. The authors acknowledge the financial and infrastructural support provided by Pakistan Institute of Engineering & Applied Sciences (PIEAS), Islamabad and Aga Khan University Hospital (AKUH), Karachi during the course of this research project. Authors have no conflict of interest with any national

  6. Real-time auto-adaptive margin generation for MLC-tracked radiotherapy

    NASA Astrophysics Data System (ADS)

    Glitzner, M.; Fast, M. F.; de Senneville, B. Denis; Nill, S.; Oelfke, U.; Lagendijk, J. J. W.; Raaymakers, B. W.; Crijns, S. P. M.

    2017-01-01

    In radiotherapy, abdominal and thoracic sites are candidates for performing motion tracking. With real-time control it is possible to adjust the multileaf collimator (MLC) position to the target position. However, positions are not perfectly matched and position errors arise from system delays and complicated response of the electromechanic MLC system. Although, it is possible to compensate parts of these errors by using predictors, residual errors remain and need to be compensated to retain target coverage. This work presents a method to statistically describe tracking errors and to automatically derive a patient-specific, per-segment margin to compensate the arising underdosage on-line, i.e. during plan delivery. The statistics of the geometric error between intended and actual machine position are derived using kernel density estimators. Subsequently a margin is calculated on-line according to a selected coverage parameter, which determines the amount of accepted underdosage. The margin is then applied onto the actual segment to accommodate the positioning errors in the enlarged segment. The proof-of-concept was tested in an on-line tracking experiment and showed the ability to recover underdosages for two test cases, increasing {{V}90 %} in the underdosed area about 47 % and 41 % , respectively. The used dose model was able to predict the loss of dose due to tracking errors and could be used to infer the necessary margins. The implementation had a running time of 23 ms which is compatible with real-time requirements of MLC tracking systems. The auto-adaptivity to machine and patient characteristics makes the technique a generic yet intuitive candidate to avoid underdosages due to MLC tracking errors.

  7. Standard eye exam

    MedlinePlus

    Standard ophthalmic exam; Routine eye examination; Eye exam - standard; Annual eye exam ... Comprehensive adult medical eye evaluation preferred practice pattern guidelines. Ophthalmology . 2016;123(1):209-236. PMID: 26581558 ...

  8. SU-E-T-784: Using MLC Log Files for Daily IMRT Delivery Verification

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Stathakis, S; Defoor, D; Linden, P

    2015-06-15

    Purpose: To verify daily intensity modulated radiation therapy (IMRT) treatments using multi-leaf collimator (MLC) log files. Methods: The MLC log files from a NovalisTX Varian linear accelerator were used in this study. The MLC files were recorded daily for all patients undergoing IMRT or volumetric modulated arc therapy (VMAT). The first record of each patient was used as reference and all records for subsequent days were compared against the reference. An in house MATLAB software code was used for the comparisons. Each MLC log file was converted to a fluence map (FM) and a gamma index (γ) analysis was usedmore » for the evaluation of each daily delivery for every patient. The tolerance for the gamma index was set to 2% dose difference and 2mm distance to agreement while points with signal of 10% or lower of the maximum value were excluded from the comparisons. Results: The γ between each of the reference FMs and the consecutive daily fraction FMs had an average value of 99.1% (ranged from 98.2 to 100.0%). The FM images were reconstructed at various resolutions in order to study the effect of the resolution on the γ and at the same time reduce the time for processing the images. We found that the comparison of images with the highest resolution (768×1024) yielded on average a lower γ (99.1%) than the ones with low resolution (192×256) (γ 99.5%). Conclusion: We developed an in-house software that allows us to monitor the quality of daily IMRT and VMAT treatment deliveries using information from the MLC log files of the linear accelerator. The information can be analyzed and evaluated as early as after the completion of each daily treatment. Such tool can be valuable to assess the effect of MLC positioning on plan quality, especially in the context of adaptive radiotherapy.« less

  9. On the suitability of Elekta’s Agility 160 MLC for tracked radiation delivery: closed-loop machine performance

    NASA Astrophysics Data System (ADS)

    Glitzner, M.; Crijns, S. P. M.; de Senneville, B. Denis; Lagendijk, J. J. W.; Raaymakers, B. W.

    2015-03-01

    For motion adaptive radiotherapy, dynamic multileaf collimator tracking can be employed to reduce treatment margins by steering the beam according to the organ motion. The Elekta Agility 160 MLC has hitherto not been evaluated for its tracking suitability. Both dosimetric performance and latency are key figures and need to be assessed generically, independent of the used motion sensor. In this paper, we propose the use of harmonic functions directly fed to the MLC to determine its latency during continuous motion. Furthermore, a control variable is extracted from a camera system and fed to the MLC. Using this setup, film dosimetry and subsequent γ statistics are performed, evaluating the response when tracking (MRI)-based physiologic motion in a closed-loop. The delay attributed to the MLC itself was shown to be a minor contributor to the overall feedback chain as compared to the impact of imaging components such as MRI sequences. Delay showed a linear phase behaviour of the MLC employed in continuously dynamic applications, which enables a general MLC-characterization. Using the exemplary feedback chain, dosimetry showed a vast increase in pass rate employing γ statistics. In this early stage, the tracking performance of the Agility using the test bench yielded promising results, making the technique eligible for translation to tracking using clinical imaging modalities.

  10. SU-D-201-04: Evaluation of Elekta Agility MLC Performance Using Statistical Process Control

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Meyers, SM; Balderson, MJ; Letourneau, D

    2016-06-15

    Purpose: to evaluate the performance and stability of the Elekta Agility MLC model using an automated quality control (QC) test in combination with statistical process control tools. Methods: Leaf positions were collected daily for 11 Elekta units over 5–19 months using the automated QC test, which analyzes 23 MV images to determine the location of MLC leaves relative to the radiation isocenter. The leaf positions are measured at 5 nominal positions, and images are acquired at collimator 0° and 180° to capture all MLC leaves in the field-of-view. Leaf positioning accuracy was assessed using individual and moving range control charts.more » Control limits were recomputed following MLC recalibration (occurred 1–2 times for 4 units). Specification levels of ±0.5, ±1 and ±1.5mm were tested. The mean and range of duration between out-of-control and out-of-specification events were determined. Results: Leaf position varied little over time, as confirmed by very tight individual control limits (mean ±0.19mm, range 0.09–0.44). Mean leaf position error was −0.03mm (range −0.89–0.83). Due to sporadic out-of-control events, the mean in-control duration was 3.3 days (range 1–23). Data stayed within ±1mm specification for 205 days on average (range 3–372) and within ±1.5mm for the entire date range. Measurements stayed within ±0.5mm for 1 day on average (range 0–17); however, our MLC leaves were not calibrated to this level of accuracy. Conclusion: The Elekta Agility MLC model was found to perform with high stability, as evidenced by the tight control limits. The in-specification durations support the current recommendation of monthly MLC QC tests with a ±1mm tolerance. Future work is on-going to determine if Agility performance can be optimized further using high-frequency QC test results to drive recalibration frequency. Factors that can affect leaf positioning accuracy, including beam spot motion, leaf gain calibration, drifting leaves, and

  11. SU-E-T-430: Modeling MLC Leaf End in 2D for Sliding Window IMRT and Arc Therapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Liang, X; Zhu, T

    2014-06-01

    Purpose: To develop a 2D geometric model for MLC accounting for leaf end dose leakage for dynamic IMRT and Rapidarc therapy. Methods: Leaf-end dose leakage is one of the problems for MLC dose calculation and modeling. Dosimetric leaf gap used to model the MLC and to count for leakage in dose calculation, but may not be accurate for smaller leaf gaps. We propose another geometric modeling method to compensate for the MLC round-shape leaf ends dose leakage, and improve the accuracy of dose calculation and dose verification. A triangular function is used to geometrically model the MLC leaf end leakagemore » in the leaf motion direction, and a step function is used in the perpendicular direction. Dose measurements with different leaf gap, different window width, and different window height were conducted, and the results were used to fit the analytical model to get the model parameters. Results: Analytical models have been obtained for stop-and-shoot and dynamic modes for MLC motion. Parameters a=0.4, lw'=5.0 mm for 6X and a=0.54, lw'=4.1 mm for 15x were obtained from the fitting process. The proposed MLC leaf end model improves the dose profile at the two ends of the sliding window opening. This improvement is especially significant for smaller sliding window openings, which are commonly used for highly modulated IMRT plans and arc therapy plans. Conclusion: This work models the MLC round leaf end shape and movement pattern for IMRT dose calculation. The theory, as well as the results in this work provides a useful tool for photon beam IMRT dose calculation and verification.« less

  12. Impact of the MLC on the MRI field distortion of a prototype MRI-linac

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kolling, Stefan; Keall, Paul; Oborn, Brad

    2013-12-15

    Purpose: To cope with intrafraction tumor motion, integrated MRI-linac systems for real-time image guidance are currently under development. The multileaf collimator (MLC) is a key component in every state-of-the-art radiotherapy treatment system, allowing for accurate field shaping and tumor tracking. This work quantifies the magnetic impact of a widely used MLC on the MRI field homogeneity for such a modality.Methods: The finite element method was employed to model a MRI-linac assembly comprised of a 1.0 T split-bore MRI magnet and the key ferromagnetic components of a Varian Millennium 120 MLC, namely, the leaves and motors. Full 3D magnetic field maps ofmore » the system were generated. From these field maps, the peak-to-peak distortion within the MRI imaging volume was evaluated over a 30 cm diameter sphere volume (DSV) around the isocenter and compared to a maximum preshim inhomogeneity of 300 μT. Five parametric studies were performed: (1) The source-to-isocenter distance (SID) was varied from 100 to 200 cm, to span the range of a compact system to that with lower magnetic coupling. (2) The MLC model was changed from leaves only to leaves with motors, to determine the contribution to the total distortion caused by MLC leaves and motors separately. (3) The system was configured in the inline or perpendicular orientation, i.e., the linac treatment beam was oriented parallel or perpendicular to the magnetic field direction. (4) The treatment field size was varied from 0 × 0 to 20×20 cm{sup 2}, to span the range of clinical treatment fields. (5) The coil currents were scaled linearly to produce magnetic field strengths B{sub 0} of 0.5, 1.0, and 1.5 T, to estimate how the MLC impact changes with B{sub 0}.Results: (1) The MLC-induced MRI field distortion fell continuously with increasing SID. (2) MLC leaves and motors were found to contribute to the distortion in approximately equal measure. (3) Due to faster falloff of the fringe field, the field

  13. Poster - 53: Improving inter-linac DMLC IMRT dose precision by fine tuning of MLC leaf calibration

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nakonechny, Keith; Tran, Muoi; Sasaki, David

    Purpose: To develop a method to improve the inter-linac precision of DMLC IMRT dosimetry. Methods: The distance between opposing MLC leaf banks (“gap size”) can be finely tuned on Varian linacs. The dosimetric effect due to small deviations from the nominal gap size (“gap error”) was studied by introducing known errors for several DMLC sliding gap sizes, and for clinical plans based on the TG119 test cases. The plans were delivered on a single Varian linac and the relationship between gap error and the corresponding change in dose was measured. The plans were also delivered on eight Varian 2100 seriesmore » linacs (at two institutions) in order to quantify the inter-linac variation in dose before and after fine tuning the MLC calibration. Results: The measured dose differences for each field agreed well with the predictions of LoSasso et al. Using the default MLC calibration, the variation in the physical MLC gap size was determined to be less than 0.4 mm between all linacs studied. The dose difference between the linacs with the largest and smallest physical gap was up to 5.4% (spinal cord region of the head and neck TG119 test case). This difference was reduced to 2.5% after fine tuning the MLC gap calibration. Conclusions: The inter-linac dose precision for DMLC IMRT on Varian linacs can be improved using a simple modification of the MLC calibration procedure that involves fine adjustment of the nominal gap size.« less

  14. The dosimetric impact of inversely optimized arc radiotherapy plan modulation for real-time dynamic MLC tracking delivery.

    PubMed

    Falk, Marianne; Larsson, Tobias; Keall, Paul; Chul Cho, Byung; Aznar, Marianne; Korreman, Stine; Poulsen, Per; Munck Af Rosenschold, Per

    2012-03-01

    Real-time dynamic multileaf collimator (MLC) tracking for management of intrafraction tumor motion can be challenging for highly modulated beams, as the leaves need to travel far to adjust for target motion perpendicular to the leaf travel direction. The plan modulation can be reduced by using a leaf position constraint (LPC) that reduces the difference in the position of adjacent MLC leaves in the plan. The purpose of this study was to investigate the impact of the LPC on the quality of inversely optimized arc radiotherapy plans and the effect of the MLC motion pattern on the dosimetric accuracy of MLC tracking delivery. Specifically, the possibility of predicting the accuracy of MLC tracking delivery based on the plan modulation was investigated. Inversely optimized arc radiotherapy plans were created on CT-data of three lung cancer patients. For each case, five plans with a single 358° arc were generated with LPC priorities of 0 (no LPC), 0.25, 0.5, 0.75, and 1 (highest possible LPC), respectively. All the plans had a prescribed dose of 2 Gy × 30, used 6 MV, a maximum dose rate of 600 MU/min and a collimator angle of 45° or 315°. To quantify the plan modulation, an average adjacent leaf distance (ALD) was calculated by averaging the mean adjacent leaf distance for each control point. The linear relationship between the plan quality [i.e., the calculated dose distributions and the number of monitor units (MU)] and the LPC was investigated, and the linear regression coefficient as well as a two tailed confidence level of 95% was used in the evaluation. The effect of the plan modulation on the performance of MLC tracking was tested by delivering the plans to a cylindrical diode array phantom moving with sinusoidal motion in the superior-inferior direction with a peak-to-peak displacement of 2 cm and a cycle time of 6 s. The delivery was adjusted to the target motion using MLC tracking, guided in real-time by an infrared optical system. The dosimetric results

  15. Pelvic Exam

    MedlinePlus

    ... of a routine physical exam to find possible signs of ovarian cysts, sexually transmitted infections, uterine fibroids or early-stage cancer. Pelvic exams are also commonly performed during pregnancy. There is a lot of debate among experts ...

  16. Challenges When Introducing Electronic Exam

    ERIC Educational Resources Information Center

    Kuikka, Matti; Kitola, Markus; Laakso, Mikko-Jussi

    2014-01-01

    Time pressures often necessitate the use of more efficient exam tools, such as electronic exams (e-exams), instead of traditional paper exams. However, teachers may face challenges when introducing e-exams in a higher education context. This paper describes what kinds of challenges teachers may face when introducing e-exams, based on experiences…

  17. SU-F-T-469: A Clinically Observed Discrepancy Between Image-Based and Log- Based MLC Position

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Neal, B; Ahmed, M; Siebers, J

    2016-06-15

    Purpose: To present a clinical case which challenges the base assumption of log-file based QA, by showing that the actual position of a MLC leaf can suddenly deviate from its programmed and logged position by >1 mm as observed with real-time imaging. Methods: An EPID-based exit-fluence dosimetry system designed to prevent gross delivery errors was used in cine mode to capture portal images during treatment. Visual monitoring identified an anomalous MLC leaf pair gap not otherwise detected by the automatic position verification. The position of the erred leaf was measured on EPID images and log files were analyzed for themore » treatment in question, the prior day’s treatment, and for daily MLC test patterns acquired on those treatment days. Additional standard test patterns were used to quantify the leaf position. Results: Whereas the log file reported no difference between planned and recorded positions, image-based measurements showed the leaf to be 1.3±0.1 mm medial from the planned position. This offset was confirmed with the test pattern irradiations. Conclusion: It has been clinically observed that log-file derived leaf positions can differ from their actual positions by >1 mm, and therefore cannot be considered to be the actual leaf positions. This cautions the use of log-based methods for MLC or patient quality assurance without independent confirmation of log integrity. Frequent verification of MLC positions through independent means is a necessary precondition to trusting log file records. Intra-treatment EPID imaging provides a method to capture departures from MLC planned positions. Work was supported in part by Varian Medical Systems.« less

  18. SU-F-T-366: Dosimetric Parameters Enhancement of 120-Leaf Millennium MLC Using EGSnrc and IAEA Phase-Space Data

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Haddad, K; Alopoor, H

    Purpose: Recently, the multileaf collimators (MLC) have become an important part of any LINAC collimation systems because they reduce the treatment planning time and improves the conformity. Important factors that affects the MLCs collimation performance are leaves material composition and their thickness. In this study, we investigate the main dosimetric parameters of 120-leaf Millennium MLC including dose in the buildup point, physical penumbra as well as average and end leaf leakages. Effects of the leaves geometry and density on these parameters are evaluated Methods: From EGSnrc Monte Carlo code, BEAMnrc and DOSXYZnrc modules are used to evaluate the dosimetric parametersmore » of a water phantom exposed to a Varian xi for 100cm SSD. Using IAEA phasespace data just above MLC (Z=46cm) and BEAMnrc, for the modified 120-leaf Millennium MLC a new phase space data at Z=52cm is produces. The MLC is modified both in leaf thickness and material composition. EGSgui code generates 521ICRU library for tungsten alloys. DOSXYZnrc with the new phase space evaluates the dose distribution in a water phantom of 60×60×20 cm3 with voxel size of 4×4×2 mm3. Using DOSXYZnrc dose distributions for open beam and closed beam as well as the leakages definition, end leakage, average leakage and physical penumbra are evaluated. Results: A new MLC with improved dosimetric parameters is proposed. The physical penumbra for proposed MLC is 4.7mm compared to 5.16 mm for Millennium. Average leakage in our design is reduced to 1.16% compared to 1.73% for Millennium, the end leaf leakage suggested design is also reduced to 4.86% compared to 7.26% of Millennium. Conclusion: The results show that the proposed MLC with enhanced dosimetric parameters could improve the conformity of treatment planning.« less

  19. Effect of MLC leaf width on treatment adaptation and accuracy for concurrent irradiation of prostate and pelvic lymph nodes

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shang Qingyang; Qi Peng; Ferjani, Samah

    2013-06-15

    Purpose: The aim of the study was to evaluate the impact of multileaf collimator (MLC) leaf width on treatment adaptation and delivery accuracy for concurrent treatment of the prostate and pelvic lymph nodes with intensity modulated radiation therapy (IMRT). Methods: Seventy-five kilovoltage cone beam CTs (KV-CBCT) from six patients were included for this retrospective study. For each patient, three different IMRT plans were created based on a planning CT using three different MLC leaf widths of 2.5, 5, and 10 mm, respectively. For each CBCT, the prostate displacement was determined by a dual image registration. Adaptive plans were created bymore » shifting selected MLC leaf pairs to compensate for daily prostate movements. To evaluate the impact of MLC leaf width on the adaptive plan for each daily CBCT, three MLC shifted plans were created using three different leaf widths of MLCs (a total of 225 adaptive treatment plans). Selective dosimetric endpoints for the tumor volumes and organs at risk (OARs) were evaluated for these adaptive plans. Using the planning CT from a selected patient, MLC shifted plans for three hypothetical longitudinal shifts of 2, 4, and 8 mm were delivered on the three linear accelerators to test the deliverability of the shifted plans and to compare the dose accuracy of the shifted plans with the original IMRT plans. Results: Adaptive plans from 2.5 and 5 mm MLCs had inadequate dose coverage to the prostate (D99 < 97%, or D{sub mean} < 99% of the planned dose) in 6%-8% of the fractions, while adaptive plans from 10 mm MLC led to inadequate dose coverage to the prostate in 25.3% of the fractions. The average V{sub 56Gy} of the prostate over the six patients was improved by 6.4% (1.6%-32.7%) and 5.8% (1.5%-35.7%) with adaptive plans from 2.5 and 5 mm MLCs, respectively, when compared with adaptive plans from 10 mm MLC. Pelvic lymph nodes were well covered for all MLC adaptive plans, as small differences were observed for D99, D{sub mean

  20. Effect of MLC leaf position, collimator rotation angle, and gantry rotation angle errors on intensity-modulated radiotherapy plans for nasopharyngeal carcinoma

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bai, Sen; Li, Guangjun; Wang, Maojie

    The purpose of this study was to investigate the effect of multileaf collimator (MLC) leaf position, collimator rotation angle, and accelerator gantry rotation angle errors on intensity-modulated radiotherapy plans for nasopharyngeal carcinoma. To compare dosimetric differences between the simulating plans and the clinical plans with evaluation parameters, 6 patients with nasopharyngeal carcinoma were selected for simulation of systematic and random MLC leaf position errors, collimator rotation angle errors, and accelerator gantry rotation angle errors. There was a high sensitivity to dose distribution for systematic MLC leaf position errors in response to field size. When the systematic MLC position errors weremore » 0.5, 1, and 2 mm, respectively, the maximum values of the mean dose deviation, observed in parotid glands, were 4.63%, 8.69%, and 18.32%, respectively. The dosimetric effect was comparatively small for systematic MLC shift errors. For random MLC errors up to 2 mm and collimator and gantry rotation angle errors up to 0.5°, the dosimetric effect was negligible. We suggest that quality control be regularly conducted for MLC leaves, so as to ensure that systematic MLC leaf position errors are within 0.5 mm. Because the dosimetric effect of 0.5° collimator and gantry rotation angle errors is negligible, it can be concluded that setting a proper threshold for allowed errors of collimator and gantry rotation angle may increase treatment efficacy and reduce treatment time.« less

  1. SU-E-T-01: 2-D Characterization of DLG Among All MLC Leaf Pairs

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kumaraswamy, L; Xu, Z; Podgorsak, M

    Purpose: The aim of this study is to evaluate the variation of dosimetric leaf-gap (DLG) along the travel path of each MLC leaf pair. This study evaluates whether the spatial variations in DLG could cause dose differences between TPS-calculated and measured dose. Methods: The 6MV DLG values were measured for all leaf pairs in the direction of leaf motion using a 2-D diode array and 0.6cc ion chamber. These measurements were performed on two Varian Linacs, employing the Millennium 120-leaf MLC and a 2-D-DLG variation map was created via in-house software. Several test plans were created with sweeping MLC fieldsmore » using constant gaps from 2mm to 10mm and corrected for 2-D variation utilizing in-house software. Measurements were performed utilizing the MapCHECK at 5.0cm depth for plans with and without the 2-D DLG correction and compared to the TPS calculated dose via gamma analysis (3%/3mm). Results: The measured DLGs for the middle 40 MLC leaf pairs (0.5cm width) were very similar along the central superior-inferior axis, with maximum variation of 0.2mm. The outer 20 MLC leaf pairs (1.0cm width) have DLG values from 0.32mm (mean) to 0.65mm (maximum) lower than the central leaf-pair, depending on off-axis distance. Gamma pass rates for the 2mm, 4mm, and 6mm sweep plans increased by 23.2%, 28.7%, and 26.0% respectively using the 2-D-DLG correction. The most improved dose points occur in areas modulated by the 1.0cm leaf-pairs. The gamma pass rate for the 10mm sweep plan increased by only 7.7%, indicating that the 2D variation becomes less significant for dynamic plans with larger MLC gaps. Conclusion: Fluences residing significantly off-axis with narrow sweeping gaps may exhibit significant variations from planned dose due to large differences between the true DLG exhibited by the 1.0cm leaf-pairs versus the constant DLG value utilized by the TPS for dose calculation.« less

  2. The effect of MLC speed and acceleration on the plan delivery accuracy of VMAT

    PubMed Central

    Park, J M; Wu, H-G; Kim, J H; Carlson, J N K

    2015-01-01

    Objective: To determine a new metric utilizing multileaf collimator (MLC) speeds and accelerations to predict plan delivery accuracy of volumetric modulated arc therapy (VMAT). Methods: To verify VMAT delivery accuracy, gamma evaluations, analysis of mechanical parameter difference between plans and log files, and analysis of changes in dose–volumetric parameters between plans and plans reconstructed with log files were performed with 40 VMAT plans. The average proportion of leaf speeds ranging from l to h cm s−1 (Sl–h and l–h = 0–0.4, 0.4–0.8, 0.8–1.2, 1.2–1.6 and 1.6–2.0), mean and standard deviation of MLC speeds were calculated for each VMAT plan. The same was carried out for accelerations in centimetre per second squared (Al–h and l–h = 0–4, 4–8, 8–12, 12–16 and 16–20). The correlations of those indicators to plan delivery accuracy were analysed with Spearman's correlation coefficient (rs). Results: The S1.2–1.6 and mean acceleration of MLCs showed generally higher correlations to plan delivery accuracy than did others. The highest rs values were observed between S1.2–1.6 and global 1%/2 mm (rs = −0.698 with p < 0.001) as well as mean acceleration and global 1%/2 mm (rs = −0.650 with p < 0.001). As the proportion of MLC speeds and accelerations >0.4 and 4 cm s−2 increased, the plan delivery accuracy of VMAT decreased. Conclusion: The variations in MLC speeds and accelerations showed considerable correlations to VMAT delivery accuracy. Advances in knowledge: As the MLC speeds and accelerations increased, VMAT delivery accuracy reduced. PMID:25734490

  3. SU-F-T-429: Craniospinal Irradiation by VMAT Technique: Impact of FFF Beam and High Resolution MLC On Plan Quality

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ganesh, T; Sarkar, B; Munshi, A

    2016-06-15

    Purpose: Objective of this study was to evaluate the impact of using flattening filter free (FFF) beam with 0.5 cm multileaf collimator (MLC) leaves over conventional flattened beam with 1 cm leaf width MLC on the treatment plan quality in cranio-spinal irradiation (CSI). Methods: For five medulloblastoma cases (3 males and 2 females), who were previously treated by volumetric modulated arc therapy (VMAT) technique using conventional flattened beam shaped by 1 cm width MLC leaves, four test plans were generated and compared against the delivered plan. These retrospective plans consisted of four different combinations of flattened and FFF beams frommore » Elekta’s Agility treatment head with 0.5 cm width MLC leaves. Sparing of organs at risks (OAR) in terms of dose to 5%, 50%, 75% and 90% volumes, mean and maximum dose were evaluated. Results: All plans satisfied the planning objective of covering 95% of PTV by at least 95% of prescription dose. Marginal variation of dose spillage was observed between different VMAT plans at very low dose range (1–5 Gy). Variation in dose statistics for PTVs and OARs were within 1% or 1 Gy. Amongst the five plans, the plan with flattened beam with 1 cm MLC had the highest number of MUs, 2.13 times higher than the plan with Agility MLC with FFF beam that had the least number of MUs. No statistically significant difference (p≥0.05) was observed between the reference plan and the retrospectively generated plans in terms of PTV coverage, cold spot, hot spot and organ at risk doses. Conclusion: In the treatment of CSI cases by VMAT technique, FFF beams and/or finer width MLC did not exhibit advantage over the flattened beams or wider MLC in terms of plan quality except for reduction in MUs.« less

  4. SU-E-T-479: IMRT Plan Recalculation in Patient Based On Dynalog Data and the Effect of a Single Failing MLC Motor

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Morcos, M; Mitrou, E

    2015-06-15

    Purpose: Using Linac dynamic logs (Dynalogs) we evaluate the impact of a single failing MLC motor on the deliverability of an IMRT plan by assessing the recalculated dose volume histograms (DVHs) taking the delivered MLC positions and beam hold-offs into consideration. Methods: This is a retrospective study based on a deteriorating MLC motor (leaf 36B) which was observed to be failing via Dynalog analysis. To investigate further, Eclipse-importable MLC files were generated from Dynalogs to recalculate the actual delivered dose and to assess the clinical impact through DVHs. All deliveries were performed on a Varian 21EX linear accelerator equipped withmore » Millennium-120 MLC. The analysis of Dynalog files and subsequent conversion to Eclipse-importable MLC files were all performed by in-house programming in Python. Effects on plan DVH are presented in the following section on a particular brain-IMRT plan which was delivered with a failing MLC motor which was then replaced. Results: Global max dose increased by 13.5%, max dose to the brainstem PRV increased by 8.2%, max dose to the optic chiasm increased by 7.6%, max dose to optic nerve increased by 8.8% and the mean dose to the PTV increased by 7.9% when comparing the original plan to the fraction with the failing MLC motor. The reason the dose increased was due to the failure being on the B-bank which is the lagging side on a sliding window delivery, therefore any failures on this side will cause an over-irradiation as the B-bank leaves struggles to keep the window from growing. Conclusion: Our findings suggest that a single failing MLC motor may jeopardize the entire delivery. This may be due to the bad MLC motor drawing too much current causing all MLCs on the same bank to underperform. This hypothesis will be investigated in a future study.« less

  5. Developing a prelicensure exam for Canada: an international collaboration.

    PubMed

    Hobbins, Bonnie; Bradley, Pat

    2013-01-01

    Nine previously conducted studies indicate that Elsevier's HESI Exit Exam (E(2)) is 96.36%-99.16% accurate in predicting success on the National Council Licensure Examination for Registered Nurses. No similar standardized exam is available in Canada to predict Canadian Registered Nurse Examination (CRNE) success. Like the E(2), such an exam could be used to evaluate Canadian nursing students' preparedness for the CRNE, and scores on the numerous subject matter categories could be used to guide students' remediation efforts so that, ultimately, they are successful on their first attempt at taking the CRNE. The international collaboration between a HESI test construction expert and a nursing faculty member from Canada, who served as the content expert, resulted in the development of a 180-item, multiple-choice/single-answer prelicensure exam (PLE) that was pilot tested with Canadian nursing students (N = 175). Item analysis data obtained from this pilot testing were used to develop a 160-item PLE, which includes an additional 20 pilot test items. The estimated reliability of this exam is 0.91, and it exhibits congruent validity with the CRNE because the PLE test blueprint mimics the CRNE test blueprint. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. 76 FR 4375 - In the Matter of Certain MLC Flash Memory Devices and Products Containing Same; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-25

    ... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-683] In the Matter of Certain MLC Flash Memory Devices and Products Containing Same; Notice of Commission Determination Not To Review an Initial... the United States after importation of certain MLC flash memory devices and products containing same...

  7. Digital rectal exam

    MedlinePlus

    Skip navigation U.S. National Library of Medicine The navigation menu has been collapsed. Menu ... exam URL of this page: //medlineplus.gov/ency/article/007069.htm Digital rectal exam To use the sharing features ...

  8. SU-E-T-122: Dosimetric Comparison Between Cone, HDMLC and MicroMLC for the Treatment of Trigeminal Neuralgia

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vacca, N; Caussa, L; Filipuzzi, M

    2014-06-01

    Purpose: The purpose of this work was to evaluate the dosimetric characteristics of three collimation systems, 5mm circular cone (Brainlab) and square fields of 5mm with HDMLC (Varian) and microMLC Moduleaf, Siemens) for trigeminal neuralgia treatment. Methods: A TPS Iplan v4.5 BrainLAB was used to do treatment plans for each collimations system in a square solid water phantom with isocenter at 5cm depth. Single field and treatment plan including 11 arcs with fix field and 100° gantry range was made for each collimation systems. EBT3 films were positioned at isocenter in a coronal plane to measured dose distribution for allmore » geometries. Films were digitized with a Vidar DosimetryPro Red scanner with a resolution of 89dpi and RIT113v6.1 software was used for analysis. Penumbra region (80%–20%), FWHM and dose percentage at 5mm and 10mm from CAX were determined. All profiles were normalized at CAX. Results: For single beam the penumbra (FWHM) was 1.5mm (5.3mm) for the cone, 1.9mm (5.5mm) for HDMLC and 1.8mm (5.4mm) for the microMLC. Dose percentage at 5mm was 6.9% for cone, 12.5% for HDMLC and 8.7% for the microMLC. For treatment plan the penumbra (FWHM) was 2.58mm (5.47mm) for the cone, 2.8mm (5.84mm) for HDMLC and 2.58mm (6.09mm) for the microMLC. Dose perecentage at 5mm was 13.1% for cone, 16.1% for HDMLC, 15.2% for the microMLC. Conclusion: The cone has a dose falloff larger than the microMLC and HDMLC, by its reduced penumbra, this translates into better protection of surrounding healthy tissue, however, the microMLC and HDMLC have similar accuracy to cone.« less

  9. Behavioral economics and diabetic eye exams.

    PubMed

    Williams, Andrew M; Liu, Peggy J; Muir, Kelly W; Waxman, Evan L

    2018-07-01

    Diabetic retinopathy is a common microvascular complication of diabetes mellitus and is the leading cause of new blindness among working-age adults in the United States. Timely intervention to prevent vision loss is possible with early detection by regular eye examinations. Unfortunately, adherence to recommended annual diabetic eye exams is poor. Public health interventions have targeted traditional barriers to care, such as cost and transportation, with limited success. Behavioral economics provides an additional framework of concepts and tools to understand low screening rates and to promote regular diabetic eye exams for populations at risk. In particular, behavioral economics outlines biases and heuristics that affect decision-making and underlie pervasive barriers to care, such as not viewing diabetic eye exams as a priority or perceiving oneself as too healthy to need an examination. In this review, we examine the literature on the use of behavioral economics interventions to promote regular diabetic eye exams. From the results of the included studies, we outline how concepts from behavioral economics can improve eye examination rates. In particular, the default bias, present bias, and self-serving bias play a significant role in precluding regular diabetic eye examinations. Potential tools to mitigate these biases include leveraging default options, using reminder messages, providing behavioral coaching, applying commitment contracts, offering financial incentives, and personalizing health messages. When combined with traditional public health campaigns, insights from behavioral economics can improve understanding of pervasive barriers to care and offer additional strategies to promote regular preventive eye care for patients with diabetes. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. Exams: The Secret Ingredients

    ERIC Educational Resources Information Center

    DiJulio, Betsy

    2012-01-01

    This year, many high-school teachers in the district where the author teaches experienced exam anxiety because midterms--as they had come to know and love them--were no more. For a variety of reasons, the semester exam schedule looked very different. More to the point is the new philosophy about exam content and format that underpinned the…

  11. Fast leaf-fitting with generalized underdose/overdose constraints for real-time MLC tracking

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Moore, Douglas, E-mail: douglas.moore@utsouthwestern.edu; Sawant, Amit; Ruan, Dan

    2016-01-15

    Purpose: Real-time multileaf collimator (MLC) tracking is a promising approach to the management of intrafractional tumor motion during thoracic and abdominal radiotherapy. MLC tracking is typically performed in two steps: transforming a planned MLC aperture in response to patient motion and refitting the leaves to the newly generated aperture. One of the challenges of this approach is the inability to faithfully reproduce the desired motion-adapted aperture. This work presents an optimization-based framework with which to solve this leaf-fitting problem in real-time. Methods: This optimization framework is designed to facilitate the determination of leaf positions in real-time while accounting for themore » trade-off between coverage of the PTV and avoidance of organs at risk (OARs). Derived within this framework, an algorithm is presented that can account for general linear transformations of the planned MLC aperture, particularly 3D translations and in-plane rotations. This algorithm, together with algorithms presented in Sawant et al. [“Management of three-dimensional intrafraction motion through real-time DMLC tracking,” Med. Phys. 35, 2050–2061 (2008)] and Ruan and Keall [Presented at the 2011 IEEE Power Engineering and Automation Conference (PEAM) (2011) (unpublished)], was applied to apertures derived from eight lung intensity modulated radiotherapy plans subjected to six-degree-of-freedom motion traces acquired from lung cancer patients using the kilovoltage intrafraction monitoring system developed at the University of Sydney. A quality-of-fit metric was defined, and each algorithm was evaluated in terms of quality-of-fit and computation time. Results: This algorithm is shown to perform leaf-fittings of apertures, each with 80 leaf pairs, in 0.226 ms on average as compared to 0.082 and 64.2 ms for the algorithms of Sawant et al., Ruan, and Keall, respectively. The algorithm shows approximately 12% improvement in quality-of-fit over the Sawant et

  12. Do Collaborative Exams Really Promote Learning?

    NASA Astrophysics Data System (ADS)

    Miller, Scott; James, C. Renee

    2018-01-01

    Collaborative, two-stage exams are becoming more popular in physics and astronomy courses, and their supposed benefits in terms of collaborative learning have been reported in the field of physics. In a collaborative, two-stage exam, students first complete an exam individually. Once that portion of the exam is over, students then retake all or part of the exam within a group, where they are able to discuss the questions with their peers and arrive at a common answer. While there are a number of papers that discuss the purported benefits of this method from a collaborative point of view, few, if any discuss the actual benefits in terms of student learning. One paper found that when students were presented with previous exam questions a few weeks later, they performed better on questions covered previously in the group portion of the exam compared to similar questions which were tested but not part of the group portion. But, when students were retested on exam questions which were administered earlier, roughly six to seven weeks beforehand, no difference was found in their performance on the two sets of questions.We present preliminary findings comparing student performance levels on multiple sets of exam questions administered to students in an introductory astronomy course where two-stage exams are administered. Questions were administered first in an exam during the course of the semester, then again during a final exam. During the semester exams, one set of questions was also contained within the group portion of the exam, while questions similar in concept and difficulty were not. A comparison of student performance on these two sets of questions are compared to evaluate the usefulness of collaborative exams to promote learning.

  13. Evaluation of dosimetric effect caused by slowing with multi-leaf collimator (MLC) leaves for volumetric modulated arc therapy (VMAT)

    PubMed Central

    Wang, Iris Z.; Kumaraswamy, Lalith K.; Podgorsak, Matthew B.

    2016-01-01

    Background This study is to report 1) the sensitivity of intensity modulated radiation therapy (IMRT) QA method for clinical volumetric modulated arc therapy (VMAT) plans with multi-leaf collimator (MLC) leaf errors that will not trigger MLC interlock during beam delivery; 2) the effect of non-beam-hold MLC leaf errors on the quality of VMAT plan dose delivery. Materials and methods. Eleven VMAT plans were selected and modified using an in-house developed software. For each control point of a VMAT arc, MLC leaves with the highest speed (1.87-1.95 cm/s) were set to move at the maximal allowable speed (2.3 cm/s), which resulted in a leaf position difference of less than 2 mm. The modified plans were considered as ‘standard’ plans, and the original plans were treated as the ‘slowing MLC’ plans for simulating ‘standard’ plans with leaves moving at relatively lower speed. The measurement of each ‘slowing MLC’ plan using MapCHECK®2 was compared with calculated planar dose of the ‘standard’ plan with respect to absolute dose Van Dyk distance-to-agreement (DTA) comparisons using 3%/3 mm and 2%/2 mm criteria. Results All ‘slowing MLC’ plans passed the 90% pass rate threshold using 3%/3 mm criteria while one brain and three anal VMAT cases were below 90% with 2%/2 mm criteria. For ten out of eleven cases, DVH comparisons between ‘standard’ and ‘slowing MLC’ plans demonstrated minimal dosimetric changes in targets and organs-at-risk. Conclusions For highly modulated VMAT plans, pass rate threshold (90%) using 3%/3mm criteria is not sensitive in detecting MLC leaf errors that will not trigger the MLC leaf interlock. However, the consequential effects of non-beam hold MLC errors on target and OAR doses are negligible, which supports the reliability of current patient-specific IMRT quality assurance (QA) method for VMAT plans. PMID:27069458

  14. [Why are some high achievers on the course final exam unsuccessful on the proficiency exam in English?].

    PubMed

    Matsunuma, Mitsuyasu

    2009-04-01

    This study examined why some high achievers on the course final exam were unsuccessful on the proficiency exam in English. We hypothesized that the learning motives and learning behaviors (learning strategy, learning time) had different effects on the outcomes of the exams. First, the relation between the variables was investigated using structural equation modeling. Second, the learning behaviors of students who got good marks on both exams were compared with students who did well only on the course final exam. The results were as follows. (a) Learning motives influenced test performance via learning behaviors. (b) Content-attached motives influenced all variables concerning learning behaviors. (c) Content-detached motives influenced all variables concerning learning behaviors that were related only to the course final exam. (d) The students who got good marks on both exams performed the learning behaviors that were useful on the proficiency exam more frequently than the students who did well only on the course final exam.

  15. SU-G-JeP2-03: Automatic Quantification of MLC Positional Accuracy in An MRI Guided Radiotherapy System

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Li, X; Studenski, M; Yang, F

    Purpose: MRI-guided-radiotherapy (MRIGRT) systems lack many features of traditional Linac based RT systems and specialized tests need to be developed to evaluate MLC performance. This work describes automatic tools for the analysis of positional accuracy of an MLC equipped MRIGRT system. Methods: This MLC analysis tool was developed for the MRIdian™ RT system which has three Co-60 equipped treatment heads each with a double focused MLC containing 30 leaf pairs, leaf thickness is 1.05cm defined at isocenter (SAD 105 cm). For MLC positional analysis a picket fence test was performed using a 25.4cm × 25.4cm Gafchromic™ RTQA2 film placed betweenmore » 5cm solidwater and a 30cm × 30cm × 1cm jigwire phantom with seven embedded parallel metal strips 4cm apart. A plan was generated to deliver 2Gy per field and seven 23.1cm × 2cm fields centered over each wire in the phantom. For each leaf pair the center of the radiation profile was determined by fitting the horizontal profile with a Gaussian model and determining the center of the FWHM. This was compared with the metal strip location to determine any deviation. The following metrics were used to evaluate the deviations per gantry angle including maximum, minimum, mean, Kurtosis, and skewness. Results: The identified maximum/mean leaf deviations are, 1.32/0.55 mm for gantry 0°, 1.59/0.76 mm for gantry 90°, and 1.19/0.39 mm for gantry 270°. The percentage of leaf deviation less than 1mm are 90.0% at 0°, 74.6% at 90°, and 97.0% at 270°. Kurtosis/skewness of the leaf deviation are 2.41/0.14 at 0°, 2.53/0.23 at 90°, 3.33/0.83 at 270°, respectively. Conclusion: This work presents an automatic tool for evaluation of the MLC position accuracy of the MRIdian™ radiotherapy system which can be used to benchmark the performance of the MLC system for each treatment head and track the results longitudinally.« less

  16. Treatment plan comparison between helical tomotherapy and MLC-based IMRT using radiobiological measures

    NASA Astrophysics Data System (ADS)

    Mavroidis, Panayiotis; Costa Ferreira, Brigida; Shi, Chengyu; Lind, Bengt K.; Papanikolaou, Nikos

    2007-07-01

    The rapid implementation of advanced treatment planning and delivery technologies for radiation therapy has brought new challenges in evaluating the most effective treatment modality. Intensity-modulated radiotherapy (IMRT) using multi-leaf collimators (MLC) and helical tomotherapy (HT) are becoming popular modes of treatment delivery and their application and effectiveness continues to be investigated. Presently, there are several treatment planning systems (TPS) that can generate and optimize IMRT plans based on user-defined objective functions for the internal target volume (ITV) and organs at risk (OAR). However, the radiobiological parameters of the different tumours and normal tissues are typically not taken into account during dose prescription and optimization of a treatment plan or during plan evaluation. The suitability of a treatment plan is typically decided based on dosimetric criteria such as dose-volume histograms (DVH), maximum, minimum, mean and standard deviation of the dose distribution. For a more comprehensive treatment plan evaluation, the biologically effective uniform dose ({\\bar{\\bar{D}}}) is applied together with the complication-free tumour control probability (P+). Its utilization is demonstrated using three clinical cases that were planned with two different forms of IMRT. In this study, three different cancer types at different anatomical sites were investigated: head and neck, lung and prostate cancers. For each cancer type, a linac MLC-based step-and-shoot IMRT plan and a HT plan were developed. The MLC-based IMRT treatment plans were developed on the Philips treatment-planning platform, using the Pinnacle 7.6 software release. For the tomotherapy HiArt plans, the dedicated tomotherapy treatment planning station was used, running version 2.1.2. By using {\\bar{\\bar{D}}} as the common prescription point of the treatment plans and plotting the tissue response probabilities versus {\\bar{\\bar{D}}} for a range of prescription doses

  17. SU-C-BRB-04: Characteristics and Performance Evaluation of the First Commercial MLC for a Robotic Delivery System

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Fuerweger, C; European Cyberknife Center Munich, Munich, DE; Prins, P

    Purpose: To assess characteristics and performance of the “Incise™” MLC (41 leaf pairs, 2.5mm width, FFF linac) mounted on the robotic SRS/SBRT platform “CyberKnife M6™” in a pre-clinical 5 months (11/2014–03/2015) test period. Methods: Beam properties were measured with unshielded diodes and EBT3 film. The CyberKnife workspace for MLC was analyzed by transforming robot node coordinates (cranial / body paths) into Euler geometry. Bayouth tests for leaf / bank position accuracy were performed in standard (A/P) and clinically relevant non-standard positions, before and after exercising the MLC for 10+ minutes. Total system and delivery accuracy were assessed in End-to-End testsmore » and dosimetric verification of exemplary plans. Stability over time was evaluated in Picket-Fence-and adapted Winston-Lutz-tests (AQA) for different collimator angles. Results: Penumbrae (80–20%, with 100%=2*dose at inflection point; SAD 80cm; 10cm depth) parallel / perpendicular to leaf motion were 2.87/2.64mm for the smallest (0×76×0.75cm{sup 2}) and 5.34/4.94mm for the largest (9.76×9.75cm{sup 2}) square field. MLC circular field penumbrae exceeded fixed cones by 10–20% (e.g. 60mm: 4.0 vs. 3.6mm; 20mm: 3.6 vs. 2.9mm). Interleaf leakage was <0.5%. Clinically accessible workspace with MLC covered (non-coplanar) gantry angles of [-113°;+112°] (cranial) and [-108°;+102°] (body), and collimator angles of [-100°;+107°] (cranial) and [-91°;+100°] (body). Average leaf position offsets were ≤0.2mm in 14 standard A/P Bayouth tests and ≤0.6mm in 8 non-standard direction tests. Pre-test MLC exercise increased jaggedness (range ±0.3mm vs. ±0.5mm) and allowed to identify one malfunctioning leaf motor. Total system accuracy with MLC was 0.39±0.06mm in 6 End-to-End tests. Picket-Fence and AQA showed no adverse trends during the test period. Conclusion: The Incise™ MLC for CyberKnife M6™ displayed high accuracy and mechanical stability over the test period

  18. Isolation and characterization of ventricular-like cells derived from NKX2-5eGFP/w and MLC2vmCherry/w double knock-in human pluripotent stem cells.

    PubMed

    Yamauchi, Kaori; Li, Junjun; Morikawa, Kumi; Liu, Li; Shirayoshi, Yasuaki; Nakatsuji, Norio; Elliott, David A; Hisatome, Ichiro; Suemori, Hirofumi

    2018-01-01

    Human pluripotent stem cell (hPSC)-derived cardiomyocytes (CMs) are a promising source for cell transplantation into the damaged heart, which has limited regenerative ability. Many methods have been developed to obtain large amounts of functional CMs from hPSCs for therapeutic applications. However, during the differentiation process, a mixed population of various cardiac cells, including ventricular, atrial, and pacemaker cells, is generated, which hampers the proper functional analysis and evaluation of cell properties. Here, we established NKX2-5 eGFP/w and MLC2v mCherry/w hPSC double knock-ins that allow for labeling, tracing, purification, and analysis of the development of ventricular cells from early to late stages. As with the endogenous transcriptional activities of these genes, MLC2v-mCherry expression following NKX2-5-eGFP expression was observed under previously established culture conditions, which mimic the in vivo cardiac developmental process. Patch-clamp and microelectrode array electrophysiological analyses showed that the NKX2-5 and MLC2v double-positive cells possess ventricular-like properties. The results demonstrate that the NKX2-5 eGFP/w and MLC2v mCherry/w hPSCs provide a powerful model system to capture region-specific cardiac differentiation from early to late stages. Our study would facilitate subtype-specific cardiac development and functional analysis using the hPSC-derived sources. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Preparing Students for the AP Psychology Exam

    ERIC Educational Resources Information Center

    Whitlock, Kristin

    2013-01-01

    The Advanced Placement Psychology exam is one of the fastest growing exams offered by the College Board. The average percent of change in the number of students taking this exam over the past five years is 12.4%. With 238,962 students taking the exam in 2013, the AP Psychology exam is the sixth largest exam, surpassing AP Biology and AP World…

  20. Technical Note: A novel leaf sequencing optimization algorithm which considers previous underdose and overdose events for MLC tracking radiotherapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wisotzky, Eric, E-mail: eric.wisotzky@charite.de, E-mail: eric.wisotzky@ipk.fraunhofer.de; O’Brien, Ricky; Keall, Paul J., E-mail: paul.keall@sydney.edu.au

    2016-01-15

    Purpose: Multileaf collimator (MLC) tracking radiotherapy is complex as the beam pattern needs to be modified due to the planned intensity modulation as well as the real-time target motion. The target motion cannot be planned; therefore, the modified beam pattern differs from the original plan and the MLC sequence needs to be recomputed online. Current MLC tracking algorithms use a greedy heuristic in that they optimize for a given time, but ignore past errors. To overcome this problem, the authors have developed and improved an algorithm that minimizes large underdose and overdose regions. Additionally, previous underdose and overdose events aremore » taken into account to avoid regions with high quantity of dose events. Methods: The authors improved the existing MLC motion control algorithm by introducing a cumulative underdose/overdose map. This map represents the actual projection of the planned tumor shape and logs occurring dose events at each specific regions. These events have an impact on the dose cost calculation and reduce recurrence of dose events at each region. The authors studied the improvement of the new temporal optimization algorithm in terms of the L1-norm minimization of the sum of overdose and underdose compared to not accounting for previous dose events. For evaluation, the authors simulated the delivery of 5 conformal and 14 intensity-modulated radiotherapy (IMRT)-plans with 7 3D patient measured tumor motion traces. Results: Simulations with conformal shapes showed an improvement of L1-norm up to 8.5% after 100 MLC modification steps. Experiments showed comparable improvements with the same type of treatment plans. Conclusions: A novel leaf sequencing optimization algorithm which considers previous dose events for MLC tracking radiotherapy has been developed and investigated. Reductions in underdose/overdose are observed for conformal and IMRT delivery.« less

  1. Airborne particulate matter in vitro exposure induces cytoskeleton remodeling through activation of the ROCK-MYPT1-MLC pathway in A549 epithelial lung cells.

    PubMed

    Chirino, Yolanda I; García-Cuellar, Claudia María; García-García, Carlos; Soto-Reyes, Ernesto; Osornio-Vargas, Álvaro Román; Herrera, Luis A; López-Saavedra, Alejandro; Miranda, Javier; Quintana-Belmares, Raúl; Pérez, Irma Rosas; Sánchez-Pérez, Yesennia

    2017-04-15

    Airborne particulate matter with an aerodynamic diameter ≤10μm (PM 10 ) is considered a risk factor for the development of lung cancer. Little is known about the cellular mechanisms by which PM 10 is associated with cancer, but there is evidence that its exposure can lead to an acquired invasive phenotype, apoptosis evasion, inflammasome activation, and cytoskeleton remodeling in lung epithelial cells. Cytoskeleton remodeling occurs through actin stress fiber formation, which is partially regulated through ROCK kinase activation, we aimed to investigate if this protein was activated in response to PM 10 exposure in A549 lung epithelial cells. Results showed that 10μg/cm 2 of PM 10 had no influence on cell viability but increased actin stress fibers, cytoplasmic ROCK expression, and phosphorylation of myosin phosphatase-targeting 1 (MYPT1) and myosin light chain (MLC) proteins, which are targeted by ROCK. The inhibition of ROCK prevented actin stress fiber formation and the phosphorylation of MYPT1 and MLC, suggesting that PM 10 activated the ROCK-MYPT1-MLC pathway in lung epithelial cells. The activation of ROCK1 has been involved in the acquisition of malignant phenotypes, and its induction by PM 10 exposure could contribute to the understanding of PM 10 as a risk factor for cancer development through the mechanisms associated with invasive phenotype. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Physics Exams That Promote Collaborative Learning

    ERIC Educational Resources Information Center

    Wieman, Carl E.; Rieger, Georg W.; Heiner, Cynthia E.

    2014-01-01

    The two-stage exam is a relatively simple way to introduce collaborative learning and formative assessment into an exam. Their use is rapidly growing in the physics department at the University of British Columbia, as both students and faculty find them rewarding. In a two-stage exam students first complete and turn in the exam individually, and…

  3. Monte Carlo modeling and simulations of the High Definition (HD120) micro MLC and validation against measurements for a 6 MV beam

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Borges, C.; Zarza-Moreno, M.; Heath, E.

    2012-01-15

    Purpose: The most recent Varian micro multileaf collimator (MLC), the High Definition (HD120) MLC, was modeled using the BEAMNRC Monte Carlo code. This model was incorporated into a Varian medical linear accelerator, for a 6 MV beam, in static and dynamic mode. The model was validated by comparing simulated profiles with measurements. Methods: The Varian Trilogy (2300C/D) accelerator model was accurately implemented using the state-of-the-art Monte Carlo simulation program BEAMNRC and validated against off-axis and depth dose profiles measured using ionization chambers, by adjusting the energy and the full width at half maximum (FWHM) of the initial electron beam. Themore » HD120 MLC was modeled by developing a new BEAMNRC component module (CM), designated HDMLC, adapting the available DYNVMLC CM and incorporating the specific characteristics of this new micro MLC. The leaf dimensions were provided by the manufacturer. The geometry was visualized by tracing particles through the CM and recording their position when a leaf boundary is crossed. The leaf material density and abutting air gap between leaves were adjusted in order to obtain a good agreement between the simulated leakage profiles and EBT2 film measurements performed in a solid water phantom. To validate the HDMLC implementation, additional MLC static patterns were also simulated and compared to additional measurements. Furthermore, the ability to simulate dynamic MLC fields was implemented in the HDMLC CM. The simulation results of these fields were compared with EBT2 film measurements performed in a solid water phantom. Results: Overall, the discrepancies, with and without MLC, between the opened field simulations and the measurements using ionization chambers in a water phantom, for the off-axis profiles are below 2% and in depth-dose profiles are below 2% after the maximum dose depth and below 4% in the build-up region. On the conditions of these simulations, this tungsten-based MLC has a density of

  4. Investigating the Written Exam Scores' Prediction Power of TEOG Exam Scores

    ERIC Educational Resources Information Center

    Kontas, Hakki; Özpolat, Esen Turan

    2017-01-01

    The purpose of this study was to investigate exam scores' predicting Transition from Primary to Secondary Education (TEOG) exam scores. The research data were obtained from the records of 1035 students studying at the first term of eighth grade in 2015-2016 academic year in e-school system. The research was on relational screening model. Linear…

  5. Drastic increase of myosin light chain MLC-2 in senescent skeletal muscle indicates fast-to-slow fibre transition in sarcopenia of old age.

    PubMed

    Gannon, Joan; Doran, Philip; Kirwan, Anne; Ohlendieck, Kay

    2009-11-01

    The age-dependent decline in skeletal muscle mass and function is believed to be due to a multi-factorial pathology and represents a major factor that blocks healthy aging by increasing physical disability, frailty and loss of independence in the elderly. This study has focused on the comparative proteomic analysis of contractile elements and revealed that the most striking age-related changes seem to occur in the protein family representing myosin light chains (MLCs). Comparative screening of total muscle extracts suggests a fast-to-slow transition in the aged MLC population. The mass spectrometric analysis of the myofibril-enriched fraction identified the MLC2 isoform of the slow-type MLC as the contractile protein with the most drastically changed expression during aging. Immunoblotting confirmed an increased abundance of slow MLC2, concomitant with a switch in fast versus slow myosin heavy chains. Staining of two-dimensional gels of crude extracts with the phospho-specific fluorescent dye ProQ-Diamond identified the increased MLC2 spot as a muscle protein with a drastically enhanced phosphorylation level in aged fibres. Comparative immunofluorescence microscopy, using antibodies to fast and slow myosin isoforms, confirmed a fast-to-slow transformation process during muscle aging. Interestingly, the dramatic increase in slow MLC2 expression was restricted to individual senescent fibres. These findings agree with the idea that aged skeletal muscles undergo a shift to more aerobic-oxidative metabolism in a slower-twitching fibre population and suggest the slow MLC2 isoform as a potential biomarker for fibre type shifting in sarcopenia of old age.

  6. Verification of dosimetric accuracy on the TrueBeam STx: rounded leaf effect of the high definition MLC.

    PubMed

    Kielar, Kayla N; Mok, Ed; Hsu, Annie; Wang, Lei; Luxton, Gary

    2012-10-01

    The dosimetric leaf gap (DLG) in the Varian Eclipse treatment planning system is determined during commissioning and is used to model the effect of the rounded leaf-end of the multileaf collimator (MLC). This parameter attempts to model the physical difference between the radiation and light field and account for inherent leakage between leaf tips. With the increased use of single fraction high dose treatments requiring larger monitor units comes an enhanced concern in the accuracy of leakage calculations, as it accounts for much of the patient dose. This study serves to verify the dosimetric accuracy of the algorithm used to model the rounded leaf effect for the TrueBeam STx, and describes a methodology for determining best-practice parameter values, given the novel capabilities of the linear accelerator such as flattening filter free (FFF) treatments and a high definition MLC (HDMLC). During commissioning, the nominal MLC position was verified and the DLG parameter was determined using MLC-defined field sizes and moving gap tests, as is common in clinical testing. Treatment plans were created, and the DLG was optimized to achieve less than 1% difference between measured and calculated dose. The DLG value found was tested on treatment plans for all energies (6 MV, 10 MV, 15 MV, 6 MV FFF, 10 MV FFF) and modalities (3D conventional, IMRT, conformal arc, VMAT) available on the TrueBeam STx. The DLG parameter found during the initial MLC testing did not match the leaf gap modeling parameter that provided the most accurate dose delivery in clinical treatment plans. Using the physical leaf gap size as the DLG for the HDMLC can lead to 5% differences in measured and calculated doses. Separate optimization of the DLG parameter using end-to-end tests must be performed to ensure dosimetric accuracy in the modeling of the rounded leaf ends for the Eclipse treatment planning system. The difference in leaf gap modeling versus physical leaf gap dimensions is more pronounced in

  7. An MLC-based linac QA procedure for the characterization of radiation isocenter and room lasers' position.

    PubMed

    Rosca, Florin; Lorenz, Friedlieb; Hacker, Fred L; Chin, Lee M; Ramakrishna, Naren; Zygmanski, Piotr

    2006-06-01

    We have designed and implemented a new stereotactic linac QA test with stereotactic precision. The test is used to characterize gantry sag, couch wobble, cone placement, MLC offsets, and room lasers' positions relative to the radiation isocenter. Two MLC star patterns, a cone pattern, and the laser line patterns are recorded on the same imaging medium. Phosphor plates are used as imaging medium due to their sensitivity to red light. The red light of room lasers erases some of the irradiation information stored on the phosphor plates enabling accurate and direct measurements for the position of room lasers and radiation isocenter. Using film instead of the phosphor plate as imaging medium is possible, however, it is less practical. The QA method consists of irradiating four phosphor plates that record the gantry sag between the 0 degrees and 180 degrees gantry angles, the position and stability of couch rotational axis, the sag between the 90 degrees and 270 degrees gantry angles, the accuracy of cone placement on the collimator, the MLC offsets from the collimator rotational axis, and the position of laser lines relative to the radiation isocenter. The estimated accuracy of the method is +/- 0.2 mm. The observed reproducibility of the method is about +/- 0.1 mm. The total irradiation/ illumination time is about 10 min per image. Data analysis, including the phosphor plate scanning, takes less than 5 min for each image. The method characterizes the radiation isocenter geometry with the high accuracy required for the stereotactic radiosurgery. In this respect, it is similar to the standard ball test for stereotactic machines. However, due to the usage of the MLC instead of the cross-hair/ball, it does not depend on the cross-hair/ball placement errors with respect to the lasers and it provides more information on the mechanical integrity of the linac/couch/laser system. Alternatively, it can be used as a highly accurate QA procedure for the nonstereotactic machines

  8. SU-E-T-312: Dosimetric Consideration for the Agility MLC When Planning Rotational SRT/SBRT Treatments

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kong, X; Harris, J; Spitznagel, D

    2015-06-15

    Purpose: To analyze the radiation transmission of the Agility MLC and make recommendation based on the MLC dosimetric characteristics for SRT, SBRT and VMAT planning Method and Materials: Agility MLC is the newest model from Elekta and has no back up diaphragm behind leaves for this generation. Leaves are single focused with rounded end; composed of leafs each 0.5cm wide, 9cm thick, constructed from tungsten alloy and provide low transmission <0.5%. Total radiation transmission from leaves and diaphragm is <0.13%. A 360degree arc was generated using iCom tools; leaves were programmed closed while keeping the diaphragm fully open to maximizemore » the MLC transmission effect. Gafchromic EBT films were sandwiched between 4cm of solid water and situated at midplane to take dose measurement. 5000MU was delivered using 6MV VersaHD, various collimator angles, and a 5cm central axis offset was tested also. Films were scanned with Epson 10000XL scanner and analyzed using DoseLab Pro. Results: Due to the rounded leaf end and nature of rotation therapy, dose accumulation through the leaf gap is significant. By offsetting the leaf gap from central axis, this accumulation can be greatly reduced. There are dark bands showing accumulation of interleaf transmission which is improved by increasing collimator angle from 0 to 45dgree. However for 45 degree, in most cases, there are larger volumes sweeping under MLC alone, which needs considered planning. Conclusions: While inter-leaf leakage is minimized by using collimator angles greater than 0 degrees, the location of the leaf gap must also be managed. The leaf gap position becomes critically important when the treatment area is off axis such is the case when more than one PTV is being treated. With VMAT for SRT, SBRT becoming a more popular planning technique, special attention needs to be paid when initially setting up the field geometry.« less

  9. Mlc Is a Transcriptional Activator with a Key Role in Integrating Cyclic AMP Receptor Protein and Integration Host Factor Regulation of Leukotoxin RNA Synthesis in Aggregatibacter actinomycetemcomitans

    PubMed Central

    Childress, Catherine; Feuerbacher, Leigh A.; Phillips, Linda; Burgum, Alex

    2013-01-01

    Aggregatibacter actinomycetemcomitans, a periodontal pathogen, synthesizes leukotoxin (LtxA), a protein that helps the bacterium evade the host immune response. Transcription of the ltxA operon is induced during anaerobic growth. The cyclic AMP (cAMP) receptor protein (CRP) indirectly increases ltxA expression, but the intermediary regulator is unknown. Integration host factor (IHF) binds to and represses the leukotoxin promoter, but neither CRP nor IHF is responsible for the anaerobic induction of ltxA RNA synthesis. Thus, we have undertaken studies to identify other regulators of leukotoxin transcription and to demonstrate how these proteins work together to modulate leukotoxin synthesis. First, analyses of ltxA RNA expression from defined leukotoxin promoter mutations in the chromosome identify positions −69 to −35 as the key control region and indicate that an activator protein modulates leukotoxin transcription. We show that Mlc, which is a repressor in Escherichia coli, functions as a direct transcriptional activator in A. actinomycetemcomitans; an mlc deletion mutant reduces leukotoxin RNA synthesis, and recombinant Mlc protein binds specifically at the −68 to −40 region of the leukotoxin promoter. Furthermore, we show that CRP activates ltxA expression indirectly by increasing the levels of Mlc. Analyses of Δmlc, Δihf, and Δihf Δmlc strains demonstrate that Mlc can increase RNA polymerase (RNAP) activity directly and that IHF represses ltxA RNA synthesis mainly by blocking Mlc binding. Finally, a Δihf Δmlc mutant still induces ltxA during anaerobic growth, indicating that there are additional factors involved in leukotoxin transcriptional regulation. A model for the coordinated regulation of leukotoxin transcription is presented. PMID:23475968

  10. X-Ray Exam: Hip

    MedlinePlus

    ... Staying Safe Videos for Educators Search English Español X-Ray Exam: Hip KidsHealth / For Parents / X-Ray Exam: Hip What's in this article? What ... Have Questions Print What It Is A hip X-ray is a safe and painless test that ...

  11. X-Ray Exam: Forearm

    MedlinePlus

    ... Staying Safe Videos for Educators Search English Español X-Ray Exam: Forearm KidsHealth / For Parents / X-Ray Exam: Forearm What's in this article? What ... Have Questions Print What It Is A forearm X-ray is a safe and painless test that ...

  12. X-Ray Exam: Ankle

    MedlinePlus

    ... Staying Safe Videos for Educators Search English Español X-Ray Exam: Ankle KidsHealth / For Parents / X-Ray Exam: Ankle What's in this article? What ... Have Questions Print What It Is An ankle X-ray is a safe and painless test that ...

  13. X-Ray Exam: Foot

    MedlinePlus

    ... Staying Safe Videos for Educators Search English Español X-Ray Exam: Foot KidsHealth / For Parents / X-Ray Exam: Foot What's in this article? What ... Have Questions Print What It Is A foot X-ray is a safe and painless test that ...

  14. X-Ray Exam: Wrist

    MedlinePlus

    ... Staying Safe Videos for Educators Search English Español X-Ray Exam: Wrist KidsHealth / For Parents / X-Ray Exam: Wrist What's in this article? What ... Have Questions Print What It Is A wrist X-ray is a safe and painless test that ...

  15. X-Ray Exam: Finger

    MedlinePlus

    ... Staying Safe Videos for Educators Search English Español X-Ray Exam: Finger KidsHealth / For Parents / X-Ray Exam: Finger What's in this article? What ... Have Questions Print What It Is A finger X-ray is a safe and painless test that ...

  16. X-Ray Exam: Pelvis

    MedlinePlus

    ... Staying Safe Videos for Educators Search English Español X-Ray Exam: Pelvis KidsHealth / For Parents / X-Ray Exam: Pelvis What's in this article? What ... Have Questions Print What It Is A pelvis X-ray is a safe and painless test that ...

  17. Improving the preparticipation exam process.

    PubMed

    Reed, F E

    2001-08-01

    The Preparticipation Exam for too long has been a mandatory yearly athletic exam and not the base from which a process of continuous athletic care took place. The purpose of this article is not only to introduce improvements in the exam itself but to also describe some extensions of the process that allow us to improve athletic care in South Carolina. It is hoped that a software scanning program will allow compiling of demographic data from individual and group examinations and thus support the method of exam preferred by all physicians in our state. Standard forms will also facilitate communication within the Athletic Care Unit and between physicians involved in athletic care.

  18. My Favorite Exam Question

    ERIC Educational Resources Information Center

    Styer, Dan

    2015-01-01

    My favorite exam question comes from the final exam in an introductory mechanics course: "A rolling 31 ton railroad boxcar collides with a stationary flatcar. The coupling mechanism activates so the cars latch together and roll down the track attached. Of the initial kinetic energy, 38% dissipates as heat, sound, vibrations, mechanical…

  19. Are Online Exams an Invitation to Cheat?

    ERIC Educational Resources Information Center

    Harmon, Oskar R.; Lambrinos, James; Kennedy, Peter, Ed.

    2008-01-01

    In this study, the authors use data from two online courses in principles of economics to estimate a model that predicts exam scores from independent variables of student characteristics. In one course, the final exam was proctored, and in the other course, the final exam was not proctored. In both courses, the first three exams were unproctored.…

  20. Dose-to-water conversion for the backscatter-shielded EPID: A frame-based method to correct for EPID energy response to MLC transmitted radiation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zwan, Benjamin J., E-mail: benjamin.zwan@uon.edu.au; O’Connor, Daryl J.; King, Brian W.

    2014-08-15

    Purpose: To develop a frame-by-frame correction for the energy response of amorphous silicon electronic portal imaging devices (a-Si EPIDs) to radiation that has transmitted through the multileaf collimator (MLC) and to integrate this correction into the backscatter shielded EPID (BSS-EPID) dose-to-water conversion model. Methods: Individual EPID frames were acquired using a Varian frame grabber and iTools acquisition software then processed using in-house software developed inMATLAB. For each EPID image frame, the region below the MLC leaves was identified and all pixels in this region were multiplied by a factor of 1.3 to correct for the under-response of the imager tomore » MLC transmitted radiation. The corrected frames were then summed to form a corrected integrated EPID image. This correction was implemented as an initial step in the BSS-EPID dose-to-water conversion model which was then used to compute dose planes in a water phantom for 35 IMRT fields. The calculated dose planes, with and without the proposed MLC transmission correction, were compared to measurements in solid water using a two-dimensional diode array. Results: It was observed that the integration of the MLC transmission correction into the BSS-EPID dose model improved agreement between modeled and measured dose planes. In particular, the MLC correction produced higher pass rates for almost all Head and Neck fields tested, yielding an average pass rate of 99.8% for 2%/2 mm criteria. A two-sample independentt-test and fisher F-test were used to show that the MLC transmission correction resulted in a statistically significant reduction in the mean and the standard deviation of the gamma values, respectively, to give a more accurate and consistent dose-to-water conversion. Conclusions: The frame-by-frame MLC transmission response correction was shown to improve the accuracy and reduce the variability of the BSS-EPID dose-to-water conversion model. The correction may be applied as a

  1. Dynamic-MLC leaf control utilizing on-flight intensity calculations: a robust method for real-time IMRT delivery over moving rigid targets.

    PubMed

    McMahon, Ryan; Papiez, Lech; Rangaraj, Dharanipathy

    2007-08-01

    An algorithm is presented that allows for the control of multileaf collimation (MLC) leaves based entirely on real-time calculations of the intensity delivered over the target. The algorithm is capable of efficiently correcting generalized delivery errors without requiring the interruption of delivery (self-correcting trajectories), where a generalized delivery error represents anything that causes a discrepancy between the delivered and intended intensity profiles. The intensity actually delivered over the target is continually compared to its intended value. For each pair of leaves, these comparisons are used to guide the control of the following leaf and keep this discrepancy below a user-specified value. To demonstrate the basic principles of the algorithm, results of corrected delivery are shown for a leading leaf positional error during dynamic-MLC (DMLC) IMRT delivery over a rigid moving target. It is then shown that, with slight modifications, the algorithm can be used to track moving targets in real time. The primary results of this article indicate that the algorithm is capable of accurately delivering DMLC IMRT over a rigid moving target whose motion is (1) completely unknown prior to delivery and (2) not faster than the maximum MLC leaf velocity over extended periods of time. These capabilities are demonstrated for clinically derived intensity profiles and actual tumor motion data, including situations when the target moves in some instances faster than the maximum admissible MLC leaf velocity. The results show that using the algorithm while calculating the delivered intensity every 50 ms will provide a good level of accuracy when delivering IMRT over a rigid moving target translating along the direction of MLC leaf travel. When the maximum velocities of the MLC leaves and target were 4 and 4.2 cm/s, respectively, the resulting error in the two intensity profiles used was 0.1 +/- 3.1% and -0.5 +/- 2.8% relative to the maximum of the intensity profiles

  2. Comparison of secondary neutron dose in proton therapy resulting from the use of a tungsten alloy MLC or a brass collimator system.

    PubMed

    Diffenderfer, Eric S; Ainsley, Christopher G; Kirk, Maura L; McDonough, James E; Maughan, Richard L

    2011-11-01

    To apply the dual ionization chamber method for mixed radiation fields to an accurate comparison of the secondary neutron dose arising from the use of a tungsten alloy multileaf collimator (MLC) as opposed to a brass collimator system for defining the shape of a therapeutic proton field. Hydrogenous and nonhydrogenous ionization chambers were constructed with large volumes to enable measurements of absorbed doses below 10(-4) Gy in mixed radiation fields using the dual ionization chamber method for mixed-field dosimetry. Neutron dose measurements were made with a nominal 230 MeV proton beam incident on a closed tungsten alloy MLC and a solid brass block. The chambers were cross-calibrated against a (60)Co-calibrated Farmer chamber in water using a 6 MV x-ray beam and Monte Carlo simulations were performed to account for variations in ionization chamber response due to differences in secondary neutron energy spectra. The neutron and combined proton plus γ-ray absorbed doses are shown to be nearly equivalent downstream from either a closed tungsten alloy MLC or a solid brass block. At 10 cm downstream from the distal edge of the collimating material the neutron dose from the closed MLC was (5.3 ± 0.4) × 10(- 5) Gy/Gy. The neutron dose with brass was (6.4 ± 0.7) × 10(- 5) Gy/Gy. Further from the secondary neutron source, at 50 cm, the neutron doses remain close for both the MLC and brass block at (6.9 ± 0.6) × 10(- 6) Gy/Gy and (6.3 ± 0.7) × 10(- 6) Gy/Gy, respectively. The dual ionization chamber method is suitable for measuring secondary neutron doses resulting from proton irradiation. The results of measurements downstream from a closed tungsten alloy MLC and a brass block indicate that, even in an overly pessimistic worst-case scenario, secondary neutron production in a tungsten alloy MLC leads to absorbed doses that are nearly equivalent to those seen from brass collimators. Therefore, the choice of tungsten alloy

  3. Exit Exam as Academic Performance Indicator

    ERIC Educational Resources Information Center

    Al Ahmad, Mahmoud; Al Marzouqi, Ali H.; Hussien, Mousa

    2014-01-01

    This paper focuses on the impact of exit exams on different elements of the educational process, namely: curriculum development, students and instructors. A 50-question multiple-choice Exit Exam was prepared by Electrical Engineering (EE) faculty members covering a poll of questions from EE core courses. A copy of the Exit Exam applied during each…

  4. Experimental verification of a Monte Carlo-based MLC simulation model for IMRT dose calculations in heterogeneous media

    NASA Astrophysics Data System (ADS)

    Tyagi, N.; Curran, B. H.; Roberson, P. L.; Moran, J. M.; Acosta, E.; Fraass, B. A.

    2008-02-01

    IMRT often requires delivering small fields which may suffer from electronic disequilibrium effects. The presence of heterogeneities, particularly low-density tissues in patients, complicates such situations. In this study, we report on verification of the DPM MC code for IMRT treatment planning in heterogeneous media, using a previously developed model of the Varian 120-leaf MLC. The purpose of this study is twofold: (a) design a comprehensive list of experiments in heterogeneous media for verification of any dose calculation algorithm and (b) verify our MLC model in these heterogeneous type geometries that mimic an actual patient geometry for IMRT treatment. The measurements have been done using an IMRT head and neck phantom (CIRS phantom) and slab phantom geometries. Verification of the MLC model has been carried out using point doses measured with an A14 slim line (SL) ion chamber inside a tissue-equivalent and a bone-equivalent material using the CIRS phantom. Planar doses using lung and bone equivalent slabs have been measured and compared using EDR films (Kodak, Rochester, NY).

  5. Potential of discrete Gaussian edge feathering method for improving abutment dosimetry in eMLC-delivered segmented-field electron conformal therapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Eley, John G.; Hogstrom, Kenneth R.; Matthews, Kenneth L.

    2011-12-15

    Purpose: The purpose of this work was to investigate the potential of discrete Gaussian edge feathering of the higher energy electron fields for improving abutment dosimetry in the planning volume when using an electron multileaf collimator (eMLC) to deliver segmented-field electron conformal therapy (ECT). Methods: A discrete (five-step) Gaussian edge spread function was used to match dose penumbras of differing beam energies (6-20 MeV) at a specified depth in a water phantom. Software was developed to define the leaf eMLC positions of an eMLC that most closely fit each electron field shape. The effect of 1D edge feathering of themore » higher energy field on dose homogeneity was computed and measured for segmented-field ECT treatment plans for three 2D PTVs in a water phantom, i.e., depth from the water surface to the distal PTV surface varied as a function of the x-axis (parallel to leaf motion) and remained constant along the y-axis (perpendicular to leaf motion). Additionally, the effect of 2D edge feathering was computed and measured for one radially symmetric, 3D PTV in a water phantom, i.e., depth from the water surface to the distal PTV surface varied as a function of both axes. For the 3D PTV, the feathering scheme was evaluated for 0.1-1.0-cm leaf widths. Dose calculations were performed using the pencil beam dose algorithm in the Pinnacle{sup 3} treatment planning system. Dose verification measurements were made using a prototype eMLC (1-cm leaf width). Results: 1D discrete Gaussian edge feathering reduced the standard deviation of dose in the 2D PTVs by 34, 34, and 39%. In the 3D PTV, the broad leaf width (1 cm) of the eMLC hindered the 2D application of the feathering solution to the 3D PTV, and the standard deviation of dose increased by 10%. However, 2D discrete Gaussian edge feathering with simulated eMLC leaf widths of 0.1-0.5 cm reduced the standard deviation of dose in the 3D PTV by 33-28%, respectively. Conclusions: A five-step discrete

  6. Implementation of hospital examination reservation system using data mining technique.

    PubMed

    Cha, Hyo Soung; Yoon, Tae Sik; Ryu, Ki Chung; Shin, Il Won; Choe, Yang Hyo; Lee, Kyoung Yong; Lee, Jae Dong; Ryu, Keun Ho; Chung, Seung Hyun

    2015-04-01

    New methods for obtaining appropriate information for users have been attempted with the development of information technology and the Internet. Among such methods, the demand for systems and services that can improve patient satisfaction has increased in hospital care environments. In this paper, we proposed the Hospital Exam Reservation System (HERS), which uses the data mining method. First, we focused on carrying clinical exam data and finding the optimal schedule for generating rules using the multi-examination pattern-mining algorithm. Then, HERS was applied by a rule master and recommending system with an exam log. Finally, HERS was designed as a user-friendly interface. HERS has been applied at the National Cancer Center in Korea since June 2014. As the number of scheduled exams increased, the time required to schedule more than a single condition decreased (from 398.67% to 168.67% and from 448.49% to 188.49%; p < 0.0001). As the number of tests increased, the difference between HERS and non-HERS increased (from 0.18 days to 0.81 days). It was possible to expand the efficiency of HERS studies using mining technology in not only exam reservations, but also the medical environment. The proposed system based on doctor prescription removes exams that were not executed in order to improve recommendation accuracy. In addition, we expect HERS to become an effective system in various medical environments.

  7. Evaluation of a novel scoring and grading model for VP-based exams in postgraduate nurse education.

    PubMed

    Forsberg, Elenita; Ziegert, Kristina; Hult, Håkan; Fors, Uno

    2015-12-01

    For Virtual Patient-based exams, several scoring and grading methods have been proposed, but none have yet been validated. The aim of this study was to evaluate a new scoring and grading model for VP-based exams in postgraduate paediatric nurse education. The same student group of 19 students performed a VP-based exam in three consecutive courses. When using the scoring and grading assessment model, which contains a deduction system for unnecessary or unwanted actions, a progression was found in the three courses: 53% of the students passed the first exam, 63% the second and 84% passed the final exam. The most common reason for deduction of points was due to students asking too many interview questions or ordering too many laboratory tests. The results showed that the new scoring model made it possible to judge the students' clinical reasoning process as well as their progress. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Medical Student Dissection of Cadavers Improves Performance on Practical Exams but not on the NBME Anatomy Subject Exam.

    PubMed

    Sargent Jones, Leslie; Paulman, Lance E; Thadani, Raj; Terracio, Louis

    2001-12-01

    We have examined whether cadaver dissection by first year medical students (MIs) affected their performance in two test measures: the NBME Gross Anatomy and Embryology Subject Exam (dissection-relevant questions only), and practical exams given at the end of each major section within the course. The dissections for the entire course were divided into 18 regional dissection units and each student was assigned to dissect one third of the regional units; the other two-thirds of the material was learned from the partner-prosected cadavers. Performance for each student on the exams was then assessed as a function of the regions those students actually dissected. While the results indicated a small performance advantage for MIs answering questions on material they had dissected on the NBME Subject Exam questions relevant to dissection (78-88% of total exam), the results were not statistically significant. However, a similar, small performance advantage on the course practical exams was highly significant.

  9. SU-G-BRB-10: New Generation of High Frame-Rate and High Spatial-Resolution EPID QA System for Full-Body MLC-Based Robotic Radiosurgery

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Han, B; Xing, L; Wang, L

    Purpose: To systematically investigate an ultra-high spatial-resolution amorphous silicon flat-panel electronic portal imaging device (EPID) for MLC-based full-body robotic radiosurgery geometric and dosimetric quality assurance (QA). Methods: The high frame-rate and ultra-high spatial resolution EPID is an outstanding detector for measuring profiles, MLC-shaped radiosurgery field aperture verification, and small field dosimetry. A Monte Carlo based technique with a robotic linac specific response and calibration is developed to convert a raw EPID-measured image of a radiosurgery field into water-based dose distribution. The technique is applied to measure output factors and profiles for 6MV MLC-defined radiosurgery fields with various sizes ranging frommore » 7.6mm×7.7mm to 100mm×100.1mm and the results are compared with the radiosurgery diode scan measurements in water tank. The EPID measured field sizes and the penumbra regions are analyzed to evaluate the MLC positioning accuracy. Results: For all MLC fields, the EPID measured output factors of MLC-shaped fields are in good agreement with the diode measurements. The mean output difference between the EPID and diode measurement is 0.05±0.87%. The max difference is −1.33% for 7.6mm×7.7mm field. The MLC field size derived from the EPID measurements are in good agreement comparing to the diode scan result. For crossline field sizes, the mean difference is −0.17mm±0.14mm with a maximum of −0.35mm for the 30.8mm×30.8mm field. For inline field sizes, the mean difference is +0.08mm±0.18mm with a maximum of +0.45mm for the 100mm×100.1mm field. The high resolution EPID is able to measure the whole radiation field, without the need to align the detector center perfectly at field center as diode or ion chamber measurement. The setup time is greatly reduced so that the whole process is possible for machine and patient-specific QA. Conclusion: The high spatial-resolution EPID is proved to be an accurate and

  10. Eye Exam

    MedlinePlus

    ... may use a variety of instruments, shine bright lights directly at your eyes and request that you ... exam is complete, as daylight or other bright lights may be uncomfortable or cause blurred vision. Also, ...

  11. Clinic exam room design: present and future.

    PubMed

    Freihoefer, Kara; Nyberg, Gary; Vickery, Christine

    2013-01-01

    This article aims to deconstruct various design qualities and strategies of clinic exam rooms, and discuss how they influence users' interaction and behavior in the space. Relevant literature supports the advantages and disadvantages of different design strategies. Annotated exam room prototypes illustrate the design qualities and strategies discussed. Advancements in technology and medicine, along with new legislative policies, are influencing the way care providers deliver care and ultimately clinic exam room designs. The patient-centered medical home model has encouraged primary care providers to make patients more active leaders of their health plan which will influence the overall functionality and configuration of clinic exam rooms. Specific design qualities discussed include overall size, location of doors and privacy curtains, positioning of exam tables, influence of technology in the consultation area, types of seating, and placement of sink and hand sanitizing dispensers. In addition, future trends of exam room prototypes are presented. There is a general lack of published evidence to support design professionals' design solutions for outpatient exam rooms. Future research should investigate such topics as the location of exam tables and privacy curtains as they relate to patient privacy; typical size and location of consultation table as it relates to patient connection and communication; and placement of sinks and sanitization dispensers as they relate to frequency and patterns of usage. Literature review, outpatient, technology, visual privacy.

  12. A dosimetric evaluation of the Eclipse AAA algorithm and Millennium 120 MLC for cranial intensity-modulated radiosurgery

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Calvo Ortega, Juan Francisco, E-mail: jfcdrr@yahoo.es; Moragues, Sandra; Pozo, Miquel

    2014-07-01

    The aim of this study is to assess the accuracy of a convolution-based algorithm (anisotropic analytical algorithm [AAA]) implemented in the Eclipse planning system for intensity-modulated radiosurgery (IMRS) planning of small cranial targets by using a 5-mm leaf-width multileaf collimator (MLC). Overall, 24 patient-based IMRS plans for cranial lesions of variable size (0.3 to 15.1 cc) were planned (Eclipse, AAA, version 10.0.28) using fixed field-based IMRS produced by a Varian linear accelerator equipped with a 120 MLC (5-mm width on central leaves). Plan accuracy was evaluated according to phantom-based measurements performed with radiochromic film (EBT2, ISP, Wayne, NJ). Film 2Dmore » dose distributions were performed with the FilmQA Pro software (version 2011, Ashland, OH) by using the triple-channel dosimetry method. Comparison between computed and measured 2D dose distributions was performed using the gamma method (3%/1 mm). Performance of the MLC was checked by inspection of the DynaLog files created by the linear accelerator during the delivery of each dynamic field. The absolute difference between the calculated and measured isocenter doses for all the IMRS plans was 2.5% ± 2.1%. The gamma evaluation method resulted in high average passing rates of 98.9% ± 1.4% (red channel) and 98.9% ± 1.5% (blue and green channels). DynaLog file analysis revealed a maximum root mean square error of 0.46 mm. According to our results, we conclude that the Eclipse/AAA algorithm provides accurate cranial IMRS dose distributions that may be accurately delivered by a Varian linac equipped with a Millennium 120 MLC.« less

  13. Helping Struggling Students: The Impact of Three Instructional Interventions on College Students' Exam Scores and Exam-Skipping Behavior

    ERIC Educational Resources Information Center

    Thomas, Nichole Gibbs; Thomas, Antonio Lamar

    2018-01-01

    Whether instructional-communication feedback sent to struggling students and succeeding students following course exams would significantly increase their exam scores and significantly decrease their exam-skipping behavior relative to students in the control group was investigated. An experimenter-blind study utilizing feedback and the…

  14. Cognitive Difficulty and Format of Exams Predicts Gender and Socioeconomic Gaps in Exam Performance of Students in Introductory Biology Courses

    PubMed Central

    Wright, Christian D.; Eddy, Sarah L.; Wenderoth, Mary Pat; Abshire, Elizabeth; Blankenbiller, Margaret; Brownell, Sara E.

    2016-01-01

    Recent reform efforts in undergraduate biology have recommended transforming course exams to test at more cognitively challenging levels, which may mean including more cognitively challenging and more constructed-response questions on assessments. However, changing the characteristics of exams could result in bias against historically underserved groups. In this study, we examined whether and to what extent the characteristics of instructor-generated tests impact the exam performance of male and female and middle/high- and low-socioeconomic status (SES) students enrolled in introductory biology courses. We collected exam scores for 4810 students from 87 unique exams taken across 3 yr of the introductory biology series at a large research university. We determined the median Bloom’s level and the percentage of constructed-response questions for each exam. Despite controlling for prior academic ability in our models, we found that males and middle/high-SES students were disproportionately favored as the Bloom’s level of exams increased. Additionally, middle/high-SES students were favored as the proportion of constructed-response questions on exams increased. Given that we controlled for prior academic ability, our findings do not likely reflect differences in academic ability level. We discuss possible explanations for our findings and how they might impact how we assess our students. PMID:27252299

  15. Optimal Weighting for Exam Composition

    ERIC Educational Resources Information Center

    Ganzfried, Sam; Yusuf, Farzana

    2018-01-01

    A problem faced by many instructors is that of designing exams that accurately assess the abilities of the students. Typically, these exams are prepared several days in advance, and generic question scores are used based on rough approximation of the question difficulty and length. For example, for a recent class taught by the author, there were…

  16. Breast Exam

    MedlinePlus

    ... can cause changes in your breasts, including breast cancer. A breast self-exam for breast awareness isn't a reliable way to screen for ... instructions and technique with your doctor. The American Cancer Society recommends ... have their techniques periodically evaluated by their doctors. ...

  17. Development of an iterative reconstruction method to overcome 2D detector low resolution limitations in MLC leaf position error detection for 3D dose verification in IMRT.

    PubMed

    Visser, R; Godart, J; Wauben, D J L; Langendijk, J A; Van't Veld, A A; Korevaar, E W

    2016-05-21

    The objective of this study was to introduce a new iterative method to reconstruct multi leaf collimator (MLC) positions based on low resolution ionization detector array measurements and to evaluate its error detection performance. The iterative reconstruction method consists of a fluence model, a detector model and an optimizer. Expected detector response was calculated using a radiotherapy treatment plan in combination with the fluence model and detector model. MLC leaf positions were reconstructed by minimizing differences between expected and measured detector response. The iterative reconstruction method was evaluated for an Elekta SLi with 10.0 mm MLC leafs in combination with the COMPASS system and the MatriXX Evolution (IBA Dosimetry) detector with a spacing of 7.62 mm. The detector was positioned in such a way that each leaf pair of the MLC was aligned with one row of ionization chambers. Known leaf displacements were introduced in various field geometries ranging from  -10.0 mm to 10.0 mm. Error detection performance was tested for MLC leaf position dependency relative to the detector position, gantry angle dependency, monitor unit dependency, and for ten clinical intensity modulated radiotherapy (IMRT) treatment beams. For one clinical head and neck IMRT treatment beam, influence of the iterative reconstruction method on existing 3D dose reconstruction artifacts was evaluated. The described iterative reconstruction method was capable of individual MLC leaf position reconstruction with millimeter accuracy, independent of the relative detector position within the range of clinically applied MU's for IMRT. Dose reconstruction artifacts in a clinical IMRT treatment beam were considerably reduced as compared to the current dose verification procedure. The iterative reconstruction method allows high accuracy 3D dose verification by including actual MLC leaf positions reconstructed from low resolution 2D measurements.

  18. SU-F-T-629: Effect of Multi-Leaf Collimator (MLC) Width On Plan Quality of Single-Isocenter VMAT Intracranial Stereotactic Radiosurgery for Multiple Metastases

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kraus, J; Thomas, E; Wu, X

    2016-06-15

    Purpose: Single-isocenter VMAT has been shown able to create high quality plans for complex intracranial multiple metastasis SRS cases. Linacs capable of the technique are typically outfitted with an MLC that consists of a combination of 5 mm and 10 mm leaves (standard) or 2.5 mm and 5 mm leaves (high-definition). In this study, we test the hypothesis that thinner collimator leaves are associated with improved plan quality. Methods: Ten multiple metastasis cases were identified and planned for VMAT SRS using a 10 MV flattening filter free beam. Plans were created for a standard (std) and a high-definition (HD) MLC.more » Published values for leaf transmission factor and dosimetric leaf gap were utilized. All other parameters were invariant. Conformity (plan and individual target), moderate isodose spill (V50%), and low isodose spill (mean brain dose) were selected for analysis. Results: Compared to standard MLC, HD-MLC improved overall plan conformity (median: Paddick CI-HD = 0.83, Paddick CI-std = 0.79; p = 0.004 and median: RTOG CI-HD =1.18, RTOG CI-std =1.24; p = 0.01 ), improved individual lesion conformity (median: Paddick CI-HD,i =0.77, Paddick CI-std,i =0.72; p < 0.001 and median: RTOG CI-HD,i = 1.28, RTOG CI-std,i =1.35; p < 0.001), improved moderate isodose spill (median: V50%-HD = 37.0 cc, V50%-std = 45.7 cc; p = 0.002), and improved low dose spill (median: dmean-HD = 2.90 Gy, dmean-std = 3.19 Gy; p = 0.002). Conclusion: For the single-isocenter VMAT SRS of multiple metastasis plans examined, use of HD-MLC modestly improved conformity, moderate isodose, and low isodose spill compared to standard MLC. However, in all cases we were able to generate clinically acceptable plans with the standard MLC. More work is need to further quantify the difference in cases with higher numbers of small targets and to better understand any potential clinical significance. This research was supported in part by Varian Medical Systems.« less

  19. TH-AB-202-03: A Novel Tool for Computing Deliverable Doses in Dynamic MLC Tracking Treatments

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Fast, M; Kamerling, C; Menten, M

    2016-06-15

    Purpose: In tracked dynamic multi-leaf collimator (MLC) treatments, segments are continuously adapted to the target centroid motion in beams-eye-view. On-the-fly segment adaptation, however, potentially induces dosimetric errors due to the finite MLC leaf width and non-rigid target motion. In this study, we outline a novel tool for computing the 4d dose of lung SBRT plans delivered with MLC tracking. Methods: The following automated workflow was developed: A) centroid tracking, where the initial segments are morphed to each 4dCT phase based on the beams-eye-view GTV shift (followed by a dose calculation on each phase); B) re-optimized tracking, in which all morphedmore » initial plans from (A) are further optimised (“warm-started”) in each 4dCT phase using the initial optimisation parameters but phase-specific volume definitions. Finally, both dose sets are accumulated to the reference phase using deformable image registration. Initial plans were generated according to the RTOG-1021 guideline (54Gy, 3-Fx, equidistant 9-beam IMRT) on the peak-exhale (reference) phase of a phase-binned 4dCT. Treatment planning and delivery simulations were performed in RayStation (research v4.6) using our in-house segment-morphing algorithm, which directly links to RayStation through a native C++ interface. Results: Computing the tracking plans and 4d dose distributions via the in-house interface takes 5 and 8 minutes respectively for centroid and re-optimized tracking. For a sample lung SBRT patient with 14mm peak-to-peak motion in sup-inf direction, mainly perpendicular leaf motion (0-collimator) resulted in small dose changes for PTV-D95 (−13cGy) and GTV-D98 (+18cGy) for the centroid tracking case compared to the initial plan. Modest reductions of OAR doses (e.g. spinal cord D2: −11cGy) were achieved in the idealized tracking case. Conclusion: This study presents an automated “1-click” workflow for computing deliverable MLC tracking doses in RayStation. Adding a non

  20. SU-F-T-271: Comparing IMRT QA Pass Rates Before and After MLC Calibration

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mazza, A; Perrin, D; Fontenot, J

    Purpose: To compare IMRT QA pass rates before and after an in-house MLC leaf calibration procedure. Methods: The MLC leaves and backup jaws on four Elekta linear accelerators with MLCi2 heads were calibrated using the EPID-based RIT Hancock Test as the means for evaluation. The MLCs were considered to be successfully calibrated when they could pass the Hancock Test with criteria of 1 mm jaw position tolerance, and 1 mm leaf position tolerance. IMRT QA results were collected pre- and postcalibration and analyzed using gamma analysis with 3%/3mm DTA criteria. AAPM TG-119 test plans were also compared pre- and post-calibration,more » at both 2%/2mm DTA and 3%/3mm DTA. Results: A weighted average was performed on the results for all four linear accelerators. The pre-calibration IMRT QA pass rate was 98.3 ± 0.1%, compared with the post-calibration pass rate of 98.5 ± 0.1%. The TG-119 test plan results showed more of an improvement, particularly at the 2%/2mm criteria. The averaged results were 89.1% pre and 96.1% post for the C-shape plan, 94.8% pre and 97.1% post for the multi-target plan, 98.6% pre and 99.7% post for the prostate plan, 94.7% pre and 94.8% post for the head/neck plan. Conclusion: The patient QA results did not show statistically significant improvement at the 3%/3mm DTA criteria after the MLC calibration procedure. However, the TG-119 test cases did show significant improvement at the 2%/2mm level.« less

  1. Oral Exams as a Tool for Teaching and Assessment

    ERIC Educational Resources Information Center

    Sayre, Eleanor C.

    2014-01-01

    Oral exams are a fruitful and practical alternative to written exams in small-enrolment Science classes. In an oral exam, the instructor can assess conceptual understanding, problem-solving, scientific communication skills, and a student's philosophy of science. In contrast, a written exam gives a much poorer picture of how students learn and…

  2. Sleep and Final Exam Performance in Introductory Physics

    NASA Astrophysics Data System (ADS)

    Coletta, Vincent; Wikholm, Colin; Pascoe, Daniel

    2018-03-01

    Most physics instructors believe that adequate sleep is important in order for students to perform well on problem solving, and many instructors advise students to get plenty of sleep the night before an exam. After years of giving such advice to students at Loyola Marymount University (LMU), one of us decided to find out how many hours students actually do sleep the night before an exam, and how that would relate to their performance. The effect of inadequate sleep on exam performance was explored in a second-semester introductory physics course. At the end of the final exam, students reported the number of hours they slept the night before. Sleep deprivation corresponded to lower final exam scores. The main purpose of this study is to provide evidence that instructors can provide to their students to convince them that their time is better spent sleeping rather than studying all night before an exam.

  3. Physical exam frequency

    MedlinePlus

    How often you need a physical exam; Health maintenance visit; Health screening; Checkup ... illness Recommendations are based on sex and age: Health screening -- women -- age 18 to 39 Health screening -- ...

  4. SU-E-T-347: Effect of MLC Leaf Position Inaccuracy On Dose Distribution for Spinal SBRT with Different Energies and Dose Rates

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    You, T; Dang, J; Dai, C

    2015-06-15

    Purpose: To evaluate dosimetric impact of spinal SBRT when MLC leaf positions deviate from planning positions for different energies and doserates. Methods and Materials: 18 localized spinal metastases patients were selected for SBRT using IMRT planning with 9 posterior beams delivered at gantry angles ranging between 100°–260°. A modern linear accelerator(Varian Turebeam STX with HDMLC 2.5 mm thick leaf at isocenter) IMRT plans were generated using both 6X and 6X-FFF(Flattening filter free) beams with a nominal prescription dose of 6 Gy/fraction to PTV. Doserates ranging from 200–600 MU/min for 6X and 400–1400 MU/min for 6X-FFF, with 200 increments were examined.more » A fixed amount(0.3, 0.5, 1, and 2 mm) of MLC-leaf position deviation was simulated to each plan under following conditions: 1)only along X1 collimator; 2)with increments at both X1 and X2 collimator directions;3)with reductions at both X1 and X2 collimator directions. Dose was recalculated for each modified plans. Both original and modified plans were delivered using Turebeam STX machine and measured using both portal dosimetry and a 3D dosimeter(Delta4 of ScandiDos). Each field’s Result were compared using following three parameters: the 95% iso-dose level Conformal Index(95%CI), the spinal cord maximum dose(SCDmax), and the planned target volume(PTV) mean dose. Results: Dosimetric impacts on the 95%CI, SCDmax and the PTV mean dose are: 1)negligible if MLC-leaf position deviation only along a single collimator direction ≥1.0 mm,2)substantial if MLC-leaf position increment along both collimator directions ≥0.3 mm(95% CI decreases while SCDmax and PTV mean-dose increase), 3)substantial if MLC-leaf position reduction along both collimator directions ≥0.3 mm(95% CI first increases and then decreases while SCDmax and PTV mean-dose decrease). Different energies and doserates demonstrated comparable dosimetric impacts. Conclusion: Substantial dose deviations could happen for spinal SBRT

  5. X-Ray Exam: Neck (For Parents)

    MedlinePlus

    ... Staying Safe Videos for Educators Search English Español X-Ray Exam: Neck KidsHealth / For Parents / X-Ray Exam: Neck What's in this article? What ... español Radiografía: cuello What It Is A neck X-ray is a safe and painless test that ...

  6. The Provision of Diabetes-Monitoring Exams to Older Latinos

    PubMed Central

    Herrera, Angelica P.; Lee Smith, Matthew; Ory, Marcia G.; Rodriguez, Hector P.; Warre, Ruth; Thompson, Wesley K.; Azcue, Annette; Romero, Jairo A.

    2012-01-01

    Objectives To explore factors associated with the provision of diabetes-monitoring practices among older Latinos with type 2 diabetes. Method Data from 547 Latinos (≥55 years) were analyzed from the 2007 California Health Interview Survey. Multivariate logistic regression modeled the relationship between health status and sociodemographic factors and the receipt of semiannual HbA1c tests, annual foot exams, and annual retinal exams. Results The majority of older Latino diabetics received foot exams (87%) and retinal exams (77%), but the provision of semiannual HbA1c tests (30%) was low. Higher English-language proficiency and health insurance coverage were associated with the provision of HbA1c tests and foot exams, but not retinal exams. Insulin therapy was positively associated with semiannual HbA1c testing, but negatively associated with foot exams. Discussion There are considerable missed opportunities in the provision of diabetes monitoring for older Latinos, particularly those with limited English proficiency, less comprehensive insurance, and noninsulin therapy. PMID:21948771

  7. Giving bonus points based on oral exams

    NASA Astrophysics Data System (ADS)

    Ehrlich, Robert

    2007-04-01

    A pedagogical experiment of giving bonus points based on oral exams in an introductory physics course is described. The orals covered the questions on a written exam that had just been graded and returned to the class. Although the performance of most students on the oral exams was fair at best, the value of bonus point orals would appear to be considerable, even though it may not be applicable to large classes and have other important disadvantages.

  8. Cognitive Difficulty and Format of Exams Predicts Gender and Socioeconomic Gaps in Exam Performance of Students in Introductory Biology Courses.

    PubMed

    Wright, Christian D; Eddy, Sarah L; Wenderoth, Mary Pat; Abshire, Elizabeth; Blankenbiller, Margaret; Brownell, Sara E

    2016-01-01

    Recent reform efforts in undergraduate biology have recommended transforming course exams to test at more cognitively challenging levels, which may mean including more cognitively challenging and more constructed-response questions on assessments. However, changing the characteristics of exams could result in bias against historically underserved groups. In this study, we examined whether and to what extent the characteristics of instructor-generated tests impact the exam performance of male and female and middle/high- and low-socioeconomic status (SES) students enrolled in introductory biology courses. We collected exam scores for 4810 students from 87 unique exams taken across 3 yr of the introductory biology series at a large research university. We determined the median Bloom's level and the percentage of constructed-response questions for each exam. Despite controlling for prior academic ability in our models, we found that males and middle/high-SES students were disproportionately favored as the Bloom's level of exams increased. Additionally, middle/high-SES students were favored as the proportion of constructed-response questions on exams increased. Given that we controlled for prior academic ability, our findings do not likely reflect differences in academic ability level. We discuss possible explanations for our findings and how they might impact how we assess our students. © 2016 C. D. Wright, S. L. Eddy, et al. 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. Breast self-exam

    MedlinePlus

    Self-examination of the breast; BSE; Breast cancer - BSE; Breast cancer screening - self exam ... chap 15. US Preventive Services Task Force website. Breast cancer: screening. www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast- ...

  10. Ocular Health (OH) Fundoscope Exam

    NASA Image and Video Library

    2013-06-05

    ISS036-E-006520 (5 June 2013) --- NASA astronaut Karen Nyberg, Expedition 36 flight engineer, conducts an ocular health exam on herself in the Destiny laboratory of the Earth-orbiting International Space Station. NASA astronaut Chris Cassidy, flight engineer, nearby but out of frame, assisted in the testing, part of a suite of eye exams carried out over a two-day period on various crew members to gather information on intraocular pressure and eye anatomy.

  11. Determination of the optimal tolerance for MLC positioning in sliding window and VMAT techniques

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hernandez, V., E-mail: vhernandezmasgrau@gmail.com; Abella, R.; Calvo, J. F.

    2015-04-15

    Purpose: Several authors have recommended a 2 mm tolerance for multileaf collimator (MLC) positioning in sliding window treatments. In volumetric modulated arc therapy (VMAT) treatments, however, the optimal tolerance for MLC positioning remains unknown. In this paper, the authors present the results of a multicenter study to determine the optimal tolerance for both techniques. Methods: The procedure used is based on dynalog file analysis. The study was carried out using seven Varian linear accelerators from five different centers. Dynalogs were collected from over 100 000 clinical treatments and in-house software was used to compute the number of tolerance faults as amore » function of the user-defined tolerance. Thus, the optimal value for this tolerance, defined as the lowest achievable value, was investigated. Results: Dynalog files accurately predict the number of tolerance faults as a function of the tolerance value, especially for low fault incidences. All MLCs behaved similarly and the Millennium120 and the HD120 models yielded comparable results. In sliding window techniques, the number of beams with an incidence of hold-offs >1% rapidly decreases for a tolerance of 1.5 mm. In VMAT techniques, the number of tolerance faults sharply drops for tolerances around 2 mm. For a tolerance of 2.5 mm, less than 0.1% of the VMAT arcs presented tolerance faults. Conclusions: Dynalog analysis provides a feasible method for investigating the optimal tolerance for MLC positioning in dynamic fields. In sliding window treatments, the tolerance of 2 mm was found to be adequate, although it can be reduced to 1.5 mm. In VMAT treatments, the typically used 5 mm tolerance is excessively high. Instead, a tolerance of 2.5 mm is recommended.« less

  12. Enhanced Security for Online Exams Using Group Cryptography

    ERIC Educational Resources Information Center

    Jung, I. Y.; Yeom, H. Y.

    2009-01-01

    While development of the Internet has contributed to the spread of online education, online exams have not been widely adopted. An online exam is defined here as one that takes place over the insecure Internet, and where no proctor is in the same location as the examinees. This paper proposes an enhanced secure online exam management environment…

  13. Exit Exams: Decreases or Increases the Dropout Rate

    ERIC Educational Resources Information Center

    Barnes, Teresa A.

    2009-01-01

    The purpose of this paper was to examine the impact of exit exams on the dropout rate. Data was gathered from several research articles. The most impressionable research revealed exit exams have a negative effect on minorities, especially black males. Results indicate by 2012, that exit exams in 25 states will affect 81 percent of minority high…

  14. Does Pelvic Exam in the Emergency Department Add Useful Information?

    PubMed Central

    Brown, Jeremy; Fleming, Rita; Aristzabel, Jamie; Gishta, Rocksolana

    2011-01-01

    Objective: Physicians are taught that the pelvic exam is a key part of the evaluation of a woman presenting with abdominal pain or vaginal bleeding. However, the exam is time consuming and invasive, and its use in the emergency department (ED) has not been prospectively evaluated. We evaluated how often the findings of the pelvic exam changed management in a cohort of consecutive female patients presenting with acute abdominal pain or vaginal bleeding. Methods: We enrolled women who required a pelvic exam together with the providers caring for them in an academic ED from September 2004 to August 2005. We collected the results of the general history and physical exam. The provider was asked to predict the findings of the pelvic exam, and these were compared with the actual findings of the exam. Results: One hundred eighty-three patients were prospectively entered into the study. When compared with predicted findings, the pelvic exam was as expected in 131 patients (72%). In a further 40 patients (22%), the findings of the pelvic exam were not as predicted, but resulted in no change in the clinical plan. In 12 cases (6%) the exam revealed a finding that was both unexpected and changed the clinical plan. Only one of these patients was admitted. Of the 24 patients who were admitted, four had a pelvic exam that revealed unexpected results, but only one of these cases caused the physician to change the care planned for the patient. Conclusion: In 94% of women with acute abdominal pain or vaginal bleeding, the results of the pelvic exam were either predictable or had no effect on the clinical plan. This suggests that there may be a subset of women with abdominal pain or vaginal bleeding in whom a pelvic exam may safely be deferred. PMID:21691528

  15. TH-AB-202-05: BEST IN PHYSICS (JOINT IMAGING-THERAPY): First Online Ultrasound-Guided MLC Tracking for Real-Time Motion Compensation in Radiotherapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ipsen, S; Bruder, R; Schweikard, A

    Purpose: While MLC tracking has been successfully used for motion compensation of moving targets, current real-time target localization methods rely on correlation models with x-ray imaging or implanted electromagnetic transponders rather than direct target visualization. In contrast, ultrasound imaging yields volumetric data in real-time (4D) without ionizing radiation. We report the first results of online 4D ultrasound-guided MLC tracking in a phantom. Methods: A real-time tracking framework was installed on a 4D ultrasound station (Vivid7 dimension, GE) and used to detect a 2mm spherical lead marker inside a water tank. The volumetric frame rate was 21.3Hz (47ms). The marker wasmore » rigidly attached to a motion stage programmed to reproduce nine tumor trajectories (five prostate, four lung). The 3D marker position from ultrasound was used for real-time MLC aperture adaption. The tracking system latency was measured and compensated by prediction for lung trajectories. To measure geometric accuracy, anterior and lateral conformal fields with 10cm circular aperture were delivered for each trajectory. The tracking error was measured as the difference between marker position and MLC aperture in continuous portal imaging. For dosimetric evaluation, 358° VMAT fields were delivered to a biplanar diode array dosimeter using the same trajectories. Dose measurements with and without MLC tracking were compared to a static reference dose using a 3%/3 mm γ-test. Results: The tracking system latency was 170ms. The mean root-mean-square tracking error was 1.01mm (0.75mm prostate, 1.33mm lung). Tracking reduced the mean γ-failure rate from 13.9% to 4.6% for prostate and from 21.8% to 0.6% for lung with high-modulation VMAT plans and from 5% (prostate) and 18% (lung) to 0% with low modulation. Conclusion: Real-time ultrasound tracking was successfully integrated with MLC tracking for the first time and showed similar accuracy and latency as other methods while holding the

  16. SU-F-T-574: MLC Based SRS Beam Commissioning - Minimum Target Size Investigation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zakikhani, R; Able, C

    2016-06-15

    Purpose: To implement a MLC accelerator based SRS program using small fields down to 1 cm × 1 cm and to determine the smallest target size safe for clinical treatment. Methods: Computerized beam scanning was performed in water using a diode detector and a linac-head attached transmission ion chamber to characterize the small field dosimetric aspects of a 6 MV photon beam (Trilogy-Varian Medical Systems, Inc.). The output factors, PDD and profiles of field sizes 1, 2, 3, 4, and 10 cm{sup 2} were measured and utilized to create a new treatment planning system (TPS) model (AAA ver 11021). Staticmore » MLC SRS treatment plans were created and delivered to a homogeneous phantom (Cube 20, CIRS, Inc.) for a 1.0 cm and 1.5 cm “PTV” target. A 12 field DMLC plan was created for a 2.1 cm target. Radiochromic film (EBT3, Ashland Inc.) was used to measure the planar dose in the axial, coronal and sagittal planes. A micro ion chamber (0.007 cc) was used to measure the dose at isocenter for each treatment delivery. Results: The new TPS model was validated by using a tolerance criteria of 2% dose and 2 mm distance to agreement. For fields ≤ 3 cm{sup 2}, the max PDD, Profile and OF difference was 0.9%, 2%/2mm and 1.4% respectively. The measured radiochromic film planar dose distributions had gamma scores of 95.3% or higher using a 3%/2mm criteria. Ion chamber measurements for all 3 test plans effectively met our goal of delivering the dose accurately to within 5% when compared to the expected dose reported by the TPS (1 cm plan Δ= −5.2%, 1.5 cm plan Δ= −2.0%, 2 cm plan Δ= 1.5%). Conclusion: End to end testing confirmed that MLC defined SRS for target sizes ≥ 1.0 cm can be safely planned and delivered.« less

  17. Exam anxiety in the undergraduate medical students of Taibah University.

    PubMed

    Khoshhal, Khalid I; Khairy, Gamal A; Guraya, Salman Y; Guraya, Shaista S

    2017-04-01

    Assessment is perceived to create highly stressful environment among medical students. Several studies have reported exam-related anxiety symptoms but the contributing factors seem to differ across institutions. This study aimed to determine the prevalence of exam anxiety, gender differences and the variables that moderate exam anxiety among students of a Saudi medical school. A cross-section study was done on 5th year medical students by administering a 12-statement self-administered questionnaire. The degree of exam anxiety was gauged by a visual analog scale. Of 125 students, 111 responded (response rate 89%). About 65% students experienced exam anxiety due to various reasons. Studying all night before exam (28 students; 25.2%) and extensive course load (26 students; 23.4%) were the major confounding factors. Female students experienced more stress due to extensive course load as compared with male students (p = .00). The data about the identified risk factors for exam anxiety can help medical educators to deeply understand the reasons for exam anxiety. There is a need to reassess the amount of study material in undergraduate medical curricula and students need to organize their time management skills to cope with exam anxiety.

  18. SU-E-T-613: Dosimetric Consequences of Systematic MLC Leaf Positioning Errors

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kathuria, K; Siebers, J

    2014-06-01

    Purpose: The purpose of this study is to determine the dosimetric consequences of systematic MLC leaf positioning errors for clinical IMRT patient plans so as to establish detection tolerances for quality assurance programs. Materials and Methods: Dosimetric consequences were simulated by extracting mlc delivery instructions from the TPS, altering the file by the specified error, reloading the delivery instructions into the TPS, recomputing dose, and extracting dose-volume metrics for one head-andneck and one prostate patient. Machine error was simulated by offsetting MLC leaves in Pinnacle in a systematic way. Three different algorithms were followed for these systematic offsets, and aremore » as follows: a systematic sequential one-leaf offset (one leaf offset in one segment per beam), a systematic uniform one-leaf offset (same one leaf offset per segment per beam) and a systematic offset of a given number of leaves picked uniformly at random from a given number of segments (5 out of 10 total). Dose to the PTV and normal tissue was simulated. Results: A systematic 5 mm offset of 1 leaf for all delivery segments of all beams resulted in a maximum PTV D98 deviation of 1%. Results showed very low dose error in all reasonably possible machine configurations, rare or otherwise, which could be simulated. Very low error in dose to PTV and OARs was shown in all possible cases of one leaf per beam per segment being offset (<1%), or that of only one leaf per beam being offset (<.2%). The errors resulting from a high number of adjacent leaves (maximum of 5 out of 60 total leaf-pairs) being simultaneously offset in many (5) of the control points (total 10–18 in all beams) per beam, in both the PTV and the OARs analyzed, were similarly low (<2–3%). Conclusions: The above results show that patient shifts and anatomical changes are the main source of errors in dose delivered, not machine delivery. These two sources of error are “visually complementary” and

  19. TH-AB-202-04: Auto-Adaptive Margin Generation for MLC-Tracked Radiotherapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Glitzner, M; Lagendijk, J; Raaymakers, B

    Purpose: To develop an auto-adaptive margin generator for MLC tracking. The generator is able to estimate errors arising in image guided radiotherapy, particularly on an MR-Linac, which depend on the latencies of machine and image processing, as well as on patient motion characteristics. From the estimated error distribution, a segment margin is generated, able to compensate errors up to a user-defined confidence. Method: In every tracking control cycle (TCC, 40ms), the desired aperture D(t) is compared to the actual aperture A(t), a delayed and imperfect representation of D(t). Thus an error e(t)=A(T)-D(T) is measured every TCC. Applying kernel-density-estimation (KDE), themore » cumulative distribution (CDF) of e(t) is estimated. With CDF-confidence limits, upper and lower error limits are extracted for motion axes along and perpendicular leaf-travel direction and applied as margins. To test the dosimetric impact, two representative motion traces were extracted from fast liver-MRI (10Hz). The traces were applied onto a 4D-motion platform and continuously tracked by an Elekta Agility 160 MLC using an artificially imposed tracking delay. Gafchromic film was used to detect dose exposition for static, tracked, and error-compensated tracking cases. The margin generator was parameterized to cover 90% of all tracking errors. Dosimetric impact was rated by calculating the ratio between underexposed points (>5% underdosage) to the total number of points inside FWHM of static exposure. Results: Without imposing adaptive margins, tracking experiments showed a ratio of underexposed points of 17.5% and 14.3% for two motion cases with imaging delays of 200ms and 300ms, respectively. Activating the margin generated yielded total suppression (<1%) of underdosed points. Conclusion: We showed that auto-adaptive error compensation using machine error statistics is possible for MLC tracking. The error compensation margins are calculated on-line, without the need of assuming motion

  20. FLEX: A Modular Software Architecture for Flight License Exam

    NASA Astrophysics Data System (ADS)

    Arsan, Taner; Saka, Hamit Emre; Sahin, Ceyhun

    This paper is about the design and implementation of an examination system based on World Wide Web. It is called FLEX-Flight License Exam Software. We designed and implemented flexible and modular software architecture. The implemented system has basic specifications such as appending questions in system, building exams with these appended questions and making students to take these exams. There are three different types of users with different authorizations. These are system administrator, operators and students. System administrator operates and maintains the system, and also audits the system integrity. The system administrator can not be able to change the result of exams and can not take an exam. Operator module includes instructors. Operators have some privileges such as preparing exams, entering questions, changing the existing questions and etc. Students can log on the system and can be accessed to exams by a certain URL. The other characteristic of our system is that operators and system administrator are not able to delete questions due to the security problems. Exam questions can be inserted on their topics and lectures in the database. Thus; operators and system administrator can easily choose questions. When all these are taken into consideration, FLEX software provides opportunities to many students to take exams at the same time in safe, reliable and user friendly conditions. It is also reliable examination system for the authorized aviation administration companies. Web development platform - LAMP; Linux, Apache web server, MySQL, Object-oriented scripting Language - PHP are used for developing the system and page structures are developed by Content Management System - CMS.

  1. What students learn when studying physics practice exam problems

    NASA Astrophysics Data System (ADS)

    Fakcharoenphol, Witat; Potter, Eric; Stelzer, Timothy

    2011-06-01

    We developed a web-based tool to provide students with access to old exam problems and solutions. By controlling the order in which students saw the problems, as well as their access to solutions, we obtained data about student learning by studying old exam problems. Our data suggest that in general students learn from doing old exam problems, and that having access to the problem solutions increases their learning. However, the data also suggest the depth of learning may be relatively shallow. In addition, the data show that doing old exam problems provides important formative assessment about the student’s overall preparedness for the exam and their particular areas of strength and weakness.

  2. SU-G-BRB-03: Assessing the Sensitivity and False Positive Rate of the Integrated Quality Monitor (IQM) Large Area Ion Chamber to MLC Positioning Errors

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Boehnke, E McKenzie; DeMarco, J; Steers, J

    2016-06-15

    Purpose: To examine both the IQM’s sensitivity and false positive rate to varying MLC errors. By balancing these two characteristics, an optimal tolerance value can be derived. Methods: An un-modified SBRT Liver IMRT plan containing 7 fields was randomly selected as a representative clinical case. The active MLC positions for all fields were perturbed randomly from a square distribution of varying width (±1mm to ±5mm). These unmodified and modified plans were measured multiple times each by the IQM (a large area ion chamber mounted to a TrueBeam linac head). Measurements were analyzed relative to the initial, unmodified measurement. IQM readingsmore » are analyzed as a function of control points. In order to examine sensitivity to errors along a field’s delivery, each measured field was divided into 5 groups of control points, and the maximum error in each group was recorded. Since the plans have known errors, we compared how well the IQM is able to differentiate between unmodified and error plans. ROC curves and logistic regression were used to analyze this, independent of thresholds. Results: A likelihood-ratio Chi-square test showed that the IQM could significantly predict whether a plan had MLC errors, with the exception of the beginning and ending control points. Upon further examination, we determined there was ramp-up occurring at the beginning of delivery. Once the linac AFC was tuned, the subsequent measurements (relative to a new baseline) showed significant (p <0.005) abilities to predict MLC errors. Using the area under the curve, we show the IQM’s ability to detect errors increases with increasing MLC error (Spearman’s Rho=0.8056, p<0.0001). The optimal IQM count thresholds from the ROC curves are ±3%, ±2%, and ±7% for the beginning, middle 3, and end segments, respectively. Conclusion: The IQM has proven to be able to detect not only MLC errors, but also differences in beam tuning (ramp-up). Partially supported by the Susan Scott

  3. From Exam to Education: The Math Exam/Education Resources

    ERIC Educational Resources Information Center

    Bruni, Carmen; Koch, Christina; Konrad, Bernhard; Lindstrom, Michael; Moyles, Iain; Thompson, Will

    2016-01-01

    The Math Exam/Education Resources (MER) is an open online learning resource hosted at The University of British Columbia (UBC), aimed at providing mathematics education resources for students and instructors at UBC. In this paper, there will be a discussion of the motivation for creating this resource on the MediaWiki platform, key features of the…

  4. Tailoring the Preparticipation Exam to Female Athletes.

    ERIC Educational Resources Information Center

    Johnson, Mimi D.

    1992-01-01

    Discusses the basics of the preparticipation exam, focusing on aspects specific to females, such as menstrual dysfunction, disordered eating, and orthopedic problems such as scoliosis and patellofemoral pain. Health history questionnaire and other parts of the exam are included in six tables. (SM)

  5. The evaluation of eye pain with a normal ocular exam.

    PubMed

    Lee, Andrew G; Brazis, Paul W

    2003-12-01

    Eye pain with or without associated head or face pain is a common complaint to the ophthalmologist. The ocular exam may reveal the etiology (e.g., corneal disease, angle closure glaucoma) but typically the exam is normal. This paper reviews the evaluation and management of eye pain with a "normal" ocular exam, including: 1) subtle findings on ocular exam; 2) transient findings on exam, and 3) no abnormal ocular findings. Ophthalmologists should be aware of the various etiologies for eye pain and the specific and distinctive features that make the diagnosis.

  6. Evaluation of the dose calculation accuracy for small fields defined by jaw or MLC for AAA and Acuros XB algorithms.

    PubMed

    Fogliata, Antonella; Lobefalo, Francesca; Reggiori, Giacomo; Stravato, Antonella; Tomatis, Stefano; Scorsetti, Marta; Cozzi, Luca

    2016-10-01

    Small field measurements are challenging, due to the physical characteristics coming from the lack of charged particle equilibrium, the partial occlusion of the finite radiation source, and to the detector response. These characteristics can be modeled in the dose calculations in the treatment planning systems. Aim of the present work is to evaluate the MU calculation accuracy for small fields, defined by jaw or MLC, for anisotropic analytical algorithm (AAA) and Acuros XB algorithms, relative to output measurements on the beam central axis. Single point output factor measurement was acquired with a PTW microDiamond detector for 6 MV, 6 and 10 MV unflattened beams generated by a Varian TrueBeam STx equipped with high definition-MLC. Fields defined by jaw or MLC apertures were set; jaw-defined: 0.6 × 0.6, 0.8 × 0.8, 1 × 1, 2 × 2, 3 × 3, 4 × 4, 5 × 5, and 10 × 10 cm 2 ; MLC-defined: 0.5 × 0.5 cm 2 to the maximum field defined by the jaw, with 0.5 cm stepping, and jaws set to: 2 × 2, 3 × 3, 4 × 4, 5 × 5, and 10 × 10 cm 2 . MU calculation was obtained with 1 mm grid in a virtual water phantom for the same fields, for AAA and Acuros algorithms implemented in the Varian eclipse treatment planning system (version 13.6). Configuration parameters as the effective spot size (ESS) and the dosimetric leaf gap (DLG) were varied to find the best parameter setting. Differences between calculated and measured doses were analyzed. Agreement better than 0.5% was found for field sizes equal to or larger than 2 × 2 cm 2 for both algorithms. A dose overestimation was present for smaller jaw-defined fields, with the best agreement, averaged over all the energies, of 1.6% and 4.6% for a 1 × 1 cm 2 field calculated by AAA and Acuros, respectively, for a configuration with ESS = 1 mm for both X and Y directions for AAA, and ESS = 1.5 and 0 mm for X and Y directions for Acuros. Conversely, a calculated dose underestimation was found for small MLC-defined fields, with the

  7. Investigating the Effects of Exam Length on Performance and Cognitive Fatigue

    PubMed Central

    Jensen, Jamie L.; Berry, Dane A.; Kummer, Tyler A.

    2013-01-01

    This study examined the effects of exam length on student performance and cognitive fatigue in an undergraduate biology classroom. Exams tested higher order thinking skills. To test our hypothesis, we administered standard- and extended-length high-level exams to two populations of non-majors biology students. We gathered exam performance data between conditions as well as performance on the first and second half of exams within conditions. We showed that lengthier exams led to better performance on assessment items shared between conditions, possibly lending support to the spreading activation theory. It also led to greater performance on the final exam, lending support to the testing effect in creative problem solving. Lengthier exams did not result in lower performance due to fatiguing conditions, although students perceived subjective fatigue. Implications of these findings are discussed with respect to assessment practices. PMID:23950918

  8. TU-AB-BRC-04: Commissioning of a New MLC Model for the GEPTS Monte Carlo System: A Model Based On the Leaf and Interleaf Effective Density

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chibani, O; Tahanout, F; Ma, C

    2016-06-15

    Purpose: To commission a new MLC model for the GEPTS Monte Carlo system. The model is based on the concept of leaves and interleaves effective densities Methods: GEPTS is a Monte Carlo system to be used for external beam planning verification. GEPTS incorporates detailed photon and electron transport algorithms (Med.Phys. 29, 2002, 835). A new GEPTS model for the Varian Millennium MLC is presented. The model accounts for: 1) thick (1 cm) and thin (0.5 cm) leaves, 2) tongue-and-groove design, 3) High-Transmission (HT) and Low-Transmission (LT) interleaves, and 4) rounded leaf end. Leaf (and interleaf) height is set equal tomore » 6 cm. Instead of modeling air gaps, screw holes, and complex leaf heads, “effective densities” are assigned to: 1) thin leaves, 2) thick leaves, 3) HT-, and 4) LT-interleaves. Results: The new MLC model is used to calculate dose profiles for Closed-MLC and Tongue-and-Groove fields at 5 cm depth for 6, 10 and 15 MV Varian beams. Calculations are compared with 1) Pin-point ionization chamber transmission ratios and 2) EBT3 Radiochromic films. Pinpoint readings were acquired beneath thick and thin leaves, and HT and LT interleaves. The best fit of measured dose profiles was obtained for the following parameters: Thick-leaf density = 16.1 g/cc, Thin-leaf density = 17.2 g/cc; HT Interleaf density = 12.4 g/cc, LT Interleaf density = 14.3 g/cc; Interleaf thickness = 1.1 mm. Attached figures show comparison of calculated and measured transmission ratios for the 3 energies. Note this is the only study where transmission profiles are compared with measurements for 3 different energies. Conclusion: The new MLC model reproduces transmission measurements within 0.1%. The next step is to implement the MLC model for real plans and quantify the improvement in dose calculation accuracy gained using this model for IMRT plans with high modulation factors.« less

  9. Developing On-line Exams.

    ERIC Educational Resources Information Center

    Hartsell, Taralynn S.; Yuen, Steve Chi-Yin

    2003-01-01

    Discusses advantages and limitations of online exams, describes available software tools for creating computer-based tests (CGI, JavaScript, commercial programs, course authoring tools), and offers suggestions for implementation. (JOW)

  10. Marshburn performs Tonometry Eye Exam on Hadfield

    NASA Image and Video Library

    2013-01-21

    ISS034-E-035949 (21 Jan. 2013) --- NASA astronaut Tom Marshburn (right), Expedition 34 flight engineer, performs a Tonometry eye exam on Canadian Space Agency astronaut Chris Hadfield, flight engineer, in the Columbus laboratory of the International Space Station. The purpose of this exam is to measure intraocular eye pressure.

  11. SU-F-T-465: Two Years of Radiotherapy Treatments Analyzed Through MLC Log Files

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Defoor, D; Kabat, C; Papanikolaou, N

    Purpose: To present treatment statistics of a Varian Novalis Tx using more than 90,000 Varian Dynalog files collected over the past 2 years. Methods: Varian Dynalog files are recorded for every patient treated on our Varian Novalis Tx. The files are collected and analyzed daily to check interfraction agreement of treatment deliveries. This is accomplished by creating fluence maps from the data contained in the Dynalog files. From the Dynalog files we have also compiled statistics for treatment delivery times, MLC errors, gantry errors and collimator errors. Results: The mean treatment time for VMAT patients was 153 ± 86 secondsmore » while the mean treatment time for step & shoot was 256 ± 149 seconds. Patient’s treatment times showed a variation of 0.4% over there treatment course for VMAT and 0.5% for step & shoot. The average field sizes were 40 cm2 and 26 cm2 for VMAT and step & shoot respectively. VMAT beams contained and average overall leaf travel of 34.17 meters and step & shoot beams averaged less than half of that at 15.93 meters. When comparing planned and delivered fluence maps generated using the Dynalog files VMAT plans showed an average gamma passing percentage of 99.85 ± 0.47. Step & shoot plans showed an average gamma passing percentage of 97.04 ± 0.04. 5.3% of beams contained an MLC error greater than 1 mm and 2.4% had an error greater than 2mm. The mean gantry speed for VMAT plans was 1.01 degrees/s with a maximum of 6.5 degrees/s. Conclusion: Varian Dynalog files are useful for monitoring machine performance treatment parameters. The Dynalog files have shown that the performance of the Novalis Tx is consistent over the course of a patients treatment with only slight variations in patient treatment times and a low rate of MLC errors.« less

  12. SU-E-T-425: Spherical Dose Distributions for Radiosurgery Using a Standardized MLC Plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Popple, R; Brezovich, I; Wu, X

    2014-06-01

    Purpose: To investigate a standardized MLC treatment plan to generate small spherical dose distributions. Methods: The static virtual cone plan comprised six table positions with clockwise and counterclockwise arcs having collimator angles 45 and 135 degrees, respectively, at each position. The central two leaves of a 2.5 mm leaf width MLC were set to a constant gap. Control points were weighted proportional to the sine of the gantry angle. Plans were created for the 10 MV flattening-filter-free beam of a TrueBeam STx (Varian Medical Systems) with gaps of 1, 1.5, 2, and 3 mm and were delivered to a phantommore » containing radiochromic film. Dose was calculated using the Eclipse AAA (Varian Medical Systems). A dynamic plan in which the table and gantry moved simultaneously with 1.5 mm gap was also created and delivered using the TrueBeam developer mode. Results: The full-width-half-max (FWHM) varied with leaf gap, ranging from 5.2 to 6.2 mm. Calculated FWHM was smaller than measured by 0.7 mm for the 1 mm gap and ≤ 0.4 mm for the larger gaps. The measured-to-calculated dose ratio was 0.93, 0.96, 1.01, and 0.99 for 1 mm, 1.5 mm, 2 mm, and 3 mm gaps, respectively. The dynamic results were the same as the static. The position deviations between the phantom target position and the center of the dose distribution were < 0.4 mm. Conclusion: The virtual cone can deliver spherical dose distributions suitable for radio surgery of small targets such as the trigeminal nerve. The Eclipse AAA accurately calculates the expected dose, particularly for leaf gap ≥ 1.5 mm. The measured dose distribution is slightly larger than the calculation, which is likely due to systematic leaf position error, isocenter variation due to gantry sag and table eccentricity, and inaccuracy in MLC leaf end modeling.« less

  13. Class A and Class B UST Operator Exams

    EPA Pesticide Factsheets

    Learn about exams developed by EPA to help underground storage tank system owners and operators in Indian country meet the 2015 federal UST regulation requirement that designated operators demonstrate knowledge and pass an exam.

  14. Exam Question Sequencing Effects and Context Cues

    ERIC Educational Resources Information Center

    Davis, Doris Bitler

    2017-01-01

    Providing two or more versions of multiple-choice exams has long been a popular strategy for reducing the opportunity for students to engage in academic dishonesty. While the results of studies comparing exam scores under different question-order conditions have been inconclusive, the potential importance of contextual cues to aid student recall…

  15. Performing pediatric eye exams in primary care.

    PubMed

    Martin, Elaine F

    2017-08-17

    Early vision care is critical for all children. If undetected, eye disorders such as amblyopia and strabismus may result in permanent vision loss. Vision exams should include a careful history and physical including fix and follow, red reflex, and cover/uncover testing. Photo screening and visual acuity exams should be administered whenever possible.

  16. Investigation into the need for ingesting foreign imaging exams into local systems and evaluation of the design challenges of Foreign Exam Management (FEM)

    NASA Astrophysics Data System (ADS)

    Milovanovic, Lazar; Agrawal, Arun; Bak, Peter; Bender, Duane; Koff, David

    2015-03-01

    The deployment of regional and national Electronic Health Record solutions has been a focus of many countries throughout the past decade. Most of these deployments have taken the approach of "sharing" imaging exams via portals and web-based viewers. The motivation of portal/web-based access is driven by a) the perception that review of imaging exams via portal methods is satisfactory to all users and b) the perceived complexity of ingesting foreign exams into local systems. This research project set out to objectively evaluate who really needs foreign exams within their local systems, what those systems might be and how often this is required. Working on the belief that Foreign Exam Management (FEM) is required to support clinical workflow, the project implemented a FEM capability within an XDSI. b domain to identify the design challenges and nuances associated with FEM.

  17. Experimental investigation of a moving averaging algorithm for motion perpendicular to the leaf travel direction in dynamic MLC target tracking.

    PubMed

    Yoon, Jai-Woong; Sawant, Amit; Suh, Yelin; Cho, Byung-Chul; Suh, Tae-Suk; Keall, Paul

    2011-07-01

    In dynamic multileaf collimator (MLC) motion tracking with complex intensity-modulated radiation therapy (IMRT) fields, target motion perpendicular to the MLC leaf travel direction can cause beam holds, which increase beam delivery time by up to a factor of 4. As a means to balance delivery efficiency and accuracy, a moving average algorithm was incorporated into a dynamic MLC motion tracking system (i.e., moving average tracking) to account for target motion perpendicular to the MLC leaf travel direction. The experimental investigation of the moving average algorithm compared with real-time tracking and no compensation beam delivery is described. The properties of the moving average algorithm were measured and compared with those of real-time tracking (dynamic MLC motion tracking accounting for both target motion parallel and perpendicular to the leaf travel direction) and no compensation beam delivery. The algorithm was investigated using a synthetic motion trace with a baseline drift and four patient-measured 3D tumor motion traces representing regular and irregular motions with varying baseline drifts. Each motion trace was reproduced by a moving platform. The delivery efficiency, geometric accuracy, and dosimetric accuracy were evaluated for conformal, step-and-shoot IMRT, and dynamic sliding window IMRT treatment plans using the synthetic and patient motion traces. The dosimetric accuracy was quantified via a tgamma-test with a 3%/3 mm criterion. The delivery efficiency ranged from 89 to 100% for moving average tracking, 26%-100% for real-time tracking, and 100% (by definition) for no compensation. The root-mean-square geometric error ranged from 3.2 to 4.0 mm for moving average tracking, 0.7-1.1 mm for real-time tracking, and 3.7-7.2 mm for no compensation. The percentage of dosimetric points failing the gamma-test ranged from 4 to 30% for moving average tracking, 0%-23% for real-time tracking, and 10%-47% for no compensation. The delivery efficiency of

  18. Prior-to-Exam: What Activities Enhance Performance?

    ERIC Educational Resources Information Center

    Rhoads, C. J.; Healy, Therese

    2013-01-01

    Can instructors impact their student performance by recommending an activity just prior to taking an exam? In this study, college students were randomly assigned to one of three treatment groups (study, exercise, or meditation) or a control group. Each group was given two different types of tests; a traditional concept exam, and a non-traditional…

  19. SU-E-T-627: Precision Modelling of the Leaf-Bank Rotation in Elekta’s Agility MLC: Is It Necessary?

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vujicic, M; Belec, J; Heath, E

    Purpose: To demonstrate the method used to determine the leaf bank rotation angle (LBROT) as a parameter for modeling the Elekta Agility multi-leaf collimator (MLC) for Monte Carlo simulations and to evaluate the clinical impact of LBROT. Methods: A detailed model of an Elekta Infinity linac including an Agility MLC was built using the EGSnrc/BEAMnrc Monte Carlo code. The Agility 160-leaf MLC is modelled using the MLCE component module which allows for leaf bank rotation using the parameter LBROT. A precise value of LBROT is obtained by comparing measured and simulated profiles of a specific field, which has leaves arrangedmore » in a repeated pattern such that one leaf is opened and the adjacent one is closed. Profile measurements from an Agility linac are taken with gafchromic film, and an ion chamber is used to set the absolute dose. The measurements are compared to Monte Carlo (MC) simulations and the LBROT is adjusted until a match is found. The clinical impact of LBROT is evaluated by observing how an MC dose calculation changes with LBROT. A clinical Stereotactic Body Radiation Treatment (SBRT) plan is calculated using BEAMnrc/DOSXYZnrc simulations with different input values for LBROT. Results: Using the method outlined above, the LBROT is determined to be 9±1 mrad. Differences as high as 4% are observed in a clinical SBRT plan between the extreme case (LBROT not modeled) and the nominal case. Conclusion: In small-field radiation therapy treatment planning, it is important to properly account for LBROT as an input parameter for MC dose calculations with the Agility MLC. More work is ongoing to elucidate the observed differences by determining the contributions from transmission dose, change in field size, and source occlusion, which are all dependent on LBROT. This work was supported by OCAIRO (Ontario Consortium of Adaptive Interventions in Radiation Oncology), funded by the Ontario Research Fund.« less

  20. Cognitive Difficulty and Format of Exams Predicts Gender and Socioeconomic Gaps in Exam Performance of Students in Introductory Biology Courses

    ERIC Educational Resources Information Center

    Wright, Christian D.; Eddy, Sarah L.; Wenderoth, Mary Pat; Abshire, Elizabeth; Blankenbiller, Margaret; Brownell, Sara E.

    2016-01-01

    Recent reform efforts in undergraduate biology have recommended transforming course exams to test at more cognitively challenging levels, which may mean including more cognitively challenging and more constructed-response questions on assessments. However, changing the characteristics of exams could result in bias against historically underserved…

  1. COAMFTE accreditation and California MFT licensing exam success.

    PubMed

    Caldwell, Benjamin E; Kunker, Shelly A; Brown, Stephen W; Saiki, Dustin Y

    2011-10-01

    Professional accreditation of graduate programs in marital and family therapy (MFT) is intended to ensure the strength of the education students receive. However, there is great difficulty in assessing the real-world impact of accreditation on students. Only one measure is applied consistently to graduates of all MFT programs, regardless of accreditation status: licensure examinations. Within California, COAMFTE-accredited, regionally (WASC) accredited, and state-approved programs all may offer degrees qualifying for licensure. Exam data from 2004, 2005, and 2006 (n = 5,646 examinees on the Written Clinical Vignette exam and n = 3,408 first-time examinees on the Standard Written Exam) were reviewed to determine the differences in exam success among graduates of programs at varying levels of accreditation. Students from COAMFTE-accredited programs were more successful on both California exams than were students from other WASC-accredited or state-approved universities. There were no significant differences between (non-COAMFTE) WASC-accredited universities and state-approved programs. Differences could be related to selection effects, if COAMFTE programs initially accept students of higher quality. Implications for therapist education and training are discussed. © 2011 American Association for Marriage and Family Therapy.

  2. Experience with Online and Open-Web Exams

    ERIC Educational Resources Information Center

    Gehringer, Edward F.; Peddycord, Barry W., III

    2013-01-01

    As homework and other aspects of education migrate to a computer-based format, on-paper exams are beginning to seem like an anachronism. Online delivery is attractive, but comes with a myriad of implications not apparent at first glance. It affects the kinds of questions that can be asked and complicates administration of the exam, but it may make…

  3. Exams disadvantage women in introductory biology

    PubMed Central

    Cotner, Sehoya

    2017-01-01

    The gender gap in STEM fields has prompted a great deal of discussion, but what factors underlie performance deficits remain poorly understood. We show that female students underperformed on exams compared to their male counterparts across ten large introductory biology course sections in fall 2016 (N > 1500 students). Females also reported higher levels of test anxiety and course-relevant science interest. Results from mediation analyses revealed an intriguing pattern: for female students only, and regardless of their academic standing, test anxiety negatively impacted exam performance, while interest in the course-specific science topics increased exam performance. Thus, instructors seeking equitable classrooms can aim to decrease test anxiety and increase student interest in science course content. We provide strategies for mitigating test anxiety and suggestions for alignment of course content with student interest, with the hope of successfully reimagining the STEM pathway as one that is equally accessible to all. PMID:29049334

  4. An electronic safety screening process during inpatient computerized physician order entry improves the efficiency of magnetic resonance imaging exams.

    PubMed

    Schneider, Erika; Ruggieri, Paul; Fromwiller, Lauren; Underwood, Reginald; Gurland, Brooke; Yurkschatt, Cynthia; Kubiak, Kevin; Obuchowski, Nancy A

    2013-12-01

    Delays between order and magnetic resonance (MR) exam often result when using the conventional paper-based MR safety screening process. The impact of an electronic MR safety screening process imbedded in a computerized physician order entry (CPOE) system was evaluated. Retrospective chart review of 4 months of inpatient MR exam orders and reports was performed before and after implementation of electronic MR safety documentation. Time from order to MR exam completion, time from MR exam completion to final radiology report, and time from first order to final report were analyzed by exam anatomy. Length of stay (LOS) and date of service within the admission were also analyzed. We evaluated 1947 individual MR orders in 1549 patients under an institutional review board exemption and a waiver of informed consent. Implementation of the electronic safety screening process resulted in a significant decrease of 1.1 hours (95% confidence interval 1.0-1.3 hours) in the mean time between first order to final report and a nonsignificant decrease of 0.8 hour in the median time from first order to exam end. There was a 1-day reduction (P = .697) in the time from admission to the MR exam compared to the paper process. No significant change in LOS was found except in neurological intensive care patients imaged within the first 24 hours of their admission, where a mean 0.9-day decrease was found. Benefits of an electronic process for MR safety screening include enabling inpatients to have decreased time to MR exams, thus enabling earlier diagnosis and treatment and reduced LOS. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

  5. Exam Question Exchange.

    ERIC Educational Resources Information Center

    Alexander, John J., Ed.

    1978-01-01

    Two exam questions are presented. One suitable for advanced undergraduate or beginning graduate courses in organic chemistry, is on equivalent expressions for the description of several pericyclic reactions. The second, for general chemistry students, asks for an estimation of the rate of decay of a million-year-old Uranium-238 sample. (BB)

  6. Validation of Dosimetric Leaf Gap (DLG) prior to its implementation in Treatment Planning System (TPS): TrueBeam™ millennium 120 leaf MLC.

    PubMed

    Shende, Ravindra; Patel, Ganesh

    2017-01-01

    Objective of present study is to determine optimum value of DLG and its validation prior to being incorporated in TPS for Varian TrueBeam™ millennium 120 leaves MLC. Partial transmission through the rounded leaf ends of the Multi Leaf Collimator (MLC) causes a conflict between the edges of the light field and radiation field. Parameter account for this partial transmission is called Dosimetric Leaf Gap (DLG). The complex high precession technique, such as Intensity Modulated Radiation Therapy (IMRT), entails the modeling of optimum value of DLG inside Eclipse Treatment Planning System (TPS) for precise dose calculation. Distinct synchronized uniformed extension of sweeping dynamic MLC leaf gap fields created by Varian MLC shaper software were use to determine DLG. DLG measurements performed with both 0.13 cc semi-flex ionization chamber and 2D-Array I-Matrix were used to validate the DLG; similarly, values of DLG from TPS were estimated from predicted dose. Similar mathematical approaches were employed to determine DLG from delivered and TPS predicted dose. DLG determined from delivered dose measured with both ionization chamber (DLG Ion ) and I-Matrix (DLG I-Matrix ) compared with DLG estimate from TPS predicted dose (DLG TPS ). Measurements were carried out for all available 6MV, 10MV, 15MV, 6MVFFF and 10MVFFF beam energies. Maximum and minimum DLG deviation between measured and TPS calculated DLG was found to be 0.2 mm and 0.1 mm, respectively. Both of the measured DLGs (DLG Ion and DLG I-Matrix ) were found to be in a very good agreement with estimated DLG from TPS (DLG TPS ). Proposed method proved to be helpful in verifying and validating the DLG value prior to its clinical implementation in TPS.

  7. Effect of Paper Color and Question Order on Exam Performance

    ERIC Educational Resources Information Center

    Tal, Ilanit R.; Akers, Katherine G.; Hodge, Gordon K.

    2008-01-01

    To deter cheating, teachers commonly use exams printed on differently colored paper or with varied question orders. Previous studies, however, reported that paper color and question order affect exam performance and suggested that teachers should adjust students' scores accordingly and discontinue the use of alternate exam forms. We conducted 2…

  8. Does Question Structure Affect Exam Performance in the Geosciences?

    NASA Astrophysics Data System (ADS)

    Day, E. A.; D'Arcy, M. K.; Craig, L.; Streule, M. J.; Passmore, E.; Irving, J. C. E.

    2015-12-01

    The jump to university level exams can be challenging for some students, often resulting in poor marks, which may be detrimental to their confidence and ultimately affect their overall degree class. Previous studies have found that question structure can have a strong impact on the performance of students in college level exams (see Gibson et al., 2015, for a discussion of its impact on physics undergraduates). Here, we investigate the effect of question structure on the exam results of geology and geophysics undergraduate students. Specifically, we analyse the performance of students in questions that have a 'scaffolded' framework and compare them to their performance in open-ended questions and coursework. We also investigate if observed differences in exam performance are correlated with the educational background and gender of students, amongst other factors. It is important for all students to be able to access their degree courses, no matter what their backgrounds may be. Broadening participation in the geosciences relies on removing systematic barriers to achievement. Therefore we recommend that exams are either structured with scaffolding in questions at lower levels, or students are explicitly prepared for this transition. We also recommend that longitudinal studies of exam performance are conducted within individual departments, and this work outlines one approach to analysing performance data.

  9. Research participation improves student's exam performance.

    PubMed

    Gil-Gómez de Liaño, Beatriz; León, Orfelio G; Pascual-Ezama, David

    2012-07-01

    Although there have been several attempts to explore for beneficial effects of research participation in social sciences, most of them have mainly explored satisfaction and students learning perceptions (e.g., Bowman & Waite, 2003). Very few works have studied learning by measuring exam performance. Moreover, participation has been usually conceptualized as a mixture of active and passive participation, including in the same measure different practices such as filling up questionnaires, running experiments or reading and answering questions about a journal article or a scientific conference. The present work tries to determine if there is an advantage due to research participation comparing exam performance, satisfaction and perceived learning of the matter Research Methods in Psychology, in three different groups (non-participating, passive and active participating). As we can see in the results, the mere participation benefits exam performance. Results are discussed in terms of the use of research participation as a new powerful active method in education.

  10. Providing Opportunities for Argumentation in Science Exam Settings

    ERIC Educational Resources Information Center

    Swanson, Lauren; Solorza, Ruben; Fissore, Cinzia

    2018-01-01

    This article explores undergraduates' efforts to engage in scientific argumentation during exam settings. Thirteen undergraduate students enrolled in an environmental science course completed exams with questions linked around a central theme. Three types of questions were used, including those that prompted students to construct scientific…

  11. [Centrally and non-centrally designed exams in nursing: Comparisons of the final exams in 2008 to 2013 in Berlin focusing on different concepts of professional nursing education].

    PubMed

    Strube-Lahmann, Sandra; Vogler, Christine; Friedrich, Kai; Dassen, Theo; Kottner, Jan

    2016-12-01

    In Germany, nursing education ends with a final written, oral and practical exam. In the federal state of Berlin, Germany, all nursing students take centrally standardized written exams, while the practical and oral exams are developed by each individual nursing school or university and conducted without standardized protocols (non-central). Comparability might be seriously limited by this procedure. Since there is no official statistics available, the objective of this study is to compare the results of the final written, oral and practical exams of different nursing education institutions with an additional focus on different educational concepts. In a secondary data analysis, the final grades (written, oral, practical) of 4,342 nursing students in all 16 educational institutions in Berlin from 2008 to 2013 were analyzed. The mean (SD) of all written, oral and practical exams taken was 2.9 (0.7), 2.6 (1.1) and 2.2 (1.0), respectively. In each type of exam, the trend in grades was stable over the observation period. There was a statistically significant increase in the prevalence of initially failed exams from 2008 (7.9 %) to 2013 (12.0 %). In institutions following a traditional concept of education, the difference in grades between oral/practical exams on the one hand and written exams on the other ranged from 0.1 to 0.9, while in generalist (academic) institutions it ranged between -0.1 and 0.3 (-0.1 to 0). In nursing schools with a traditional approach to education, there was a big difference in grades between written and oral/practical exams. Standardization of oral and practical exams should be initiated to ensure greater comparability between different educational institutions. Copyright © 2016. Published by Elsevier GmbH.

  12. Comparative Analysis of Different Measurement Techniques for MLC Characterization: Preliminary Results

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Larraga-Gutierrez, J. M.; Ballesteros-Zebadua, P.; Garcia-Garduno, O. A.

    2008-08-11

    Radiation transmission, leakage and beam penumbra are essential dosimetric parameters related to the commissioning of a multileaf collimation system. This work shows a comparative analysis of commonly used film detectors: X-OMAT V2 and EDR2 radiographic films, and GafChromic EBT registered radiochromic film. The results show that X-OMAT over-estimates radiation leakage and 80-20% beam penumbra. However, according to the reference values reported by the manufacturer for these dosimetric parameters, all three films are adequate for MLC dosimetric characterization, but special care must be taken when X-OMAT V2 film is used due to its low energy photon dependence.

  13. Even after Thirteen Class Exams, Students Are Still Overconfident: The Role of Memory for Past Exam Performance in Student Predictions

    ERIC Educational Resources Information Center

    Foster, Nathaniel L.; Was, Christopher A.; Dunlosky, John; Isaacson, Randall M.

    2017-01-01

    Students often are overconfident when they predict their performance on classroom examinations, and their accuracy often does not improve across exams. One contributor to overconfidence may be that students did not have enough experience, and another is that students may under-use their knowledge of prior exam performance to predict performance on…

  14. X-Ray Exam: Bone Age Study (For Parents)

    MedlinePlus

    ... for Educators Search English Español X-Ray Exam: Bone Age Study KidsHealth / For Parents / X-Ray Exam: Bone Age Study What's in this article? What It ... de la edad ósea What It Is A bone age study helps doctors estimate the maturity of ...

  15. Nursing students collaborating to develop multiple-choice exam revision questions: A student engagement study.

    PubMed

    Craft, Judy A; Christensen, Martin; Shaw, Natasha; Bakon, Shannon

    2017-12-01

    Nursing students find bioscience subjects challenging. Bioscience exams pose particular concerns for these students, which may lead to students adopting a surface-approach to learning. To promote student collective understanding of bioscience, improve their confidence for the final exam, and improve deeper understanding of bioscience. In order to address exam anxiety, and improve student understanding of content, this student engagement project involved nursing students collaborating in small groups to develop multiple-choice questions and answers, which became available to the entire student cohort. This study was conducted at two campuses of an Australian university, within a first year bioscience subject as part of the undergraduate nursing programme. All students enrolled in the subject were encouraged to attend face-to-face workshops, and collaborate in revision question writing. Online anonymous questionnaires were used to invite student feedback on this initiative; 79 respondents completed this feedback. Students collaborated in groups to write revision questions as part of in-class activities. These questions were made available on the student online learning site for revision. An online feedback survey was deployed at the conclusion of all workshops for this subject, with questions rated using a Likert scale. Participants indicated that they enjoyed the opportunity to collaborate in this activity, and almost all of these respondents used these questions in their exam preparation. There was strong agreement that this activity improved their confidence for the final exam. Importantly, almost two-thirds of respondents agreed that writing questions improved their understanding of content, and assisted in their active reflection of content. Overall, this initiative revealed various potential benefits for the students, including promoting bioscience understanding and confidence. This may improve their long-term understanding of bioscience for nursing practice

  16. The Cognitive Abilities of Children: Reflections from an Entrance Exam

    ERIC Educational Resources Information Center

    Cil, Emine; Cepni, Salih

    2012-01-01

    The basic determiner for the school in which the children who completed their primary education will in at an upper education level in Turkey is the entrance exam carried out nationwide. The items of national exam, called as LDE (Level Determination Exam) which the primary education pupils (aged between 12 and 15) will participate in Turkey were…

  17. Validity, Reliability and Difficulty Indices for Instructor-Built Exam Questions

    ERIC Educational Resources Information Center

    Jandaghi, Gholamreza; Shaterian, Fatemeh

    2008-01-01

    The purpose of the research is to determine college Instructor's skill rate in designing exam questions in chemistry subject. The statistical population was all of chemistry exam sheets for two semesters in one academic year from which a sample of 364 exam sheets was drawn using multistage cluster sampling. Two experts assessed the sheets and by…

  18. [International family medicine certification exam in Venezuela: the physician's experience].

    PubMed

    Ledesma-Solaeche, Flor Maria; Romero, Nerio Enrique; Atencio, Carlos Miguel; Pineda, Francisco; Fernández, Miguel Angel

    2006-01-01

    To present opinions of physicians participating in a pilot certification exam in the specialty of Family Medicine implemented in Venezuela, in December 2004, by the Mexican Board of Certification of Family Medicine A.C. Descriptive, transversal. Participant physicians (n:37) completed semi-structured questionnaries: one or two weeks before the exam, and immediately after it. 60% of participants were 41-50 years old and 80% women. All of them were practicing physicians; 49% had 5-10 year experience in family medicine. Main motivation to participate in the exam: the need for continuing learning (83%). Results showed their participation motivated continuing education (46%). Books were the most frequently utilized resource when preparing for the exam (54%). 94% were willing to take the exam again in the future, and all would recommend it to their colleagues. 49% said that examination should be taken every 3-4 years and should be voluntary (54%). 86% considered the content of the exam pertinent to their practice while 54% mentioned it was well adapted to their country's reality. Time for the exam was enough according to 71%, and number of questions was considered excessive by 89%. After the exam, 43% estimated to have personal prognosis for excellent or good outcomes. CONCLUSIONS. The international examination was satisfactory, stimulated desires of update, and the participants would repeat and recommend it in the future. The Mexican experience offers an example to put into practice, and the international collaboration would be a valid option to extend the certification processes in Latin America.

  19. MO-FG-BRA-06: Electromagnetic Beacon Insertion in Lung Cancer Patients and Resultant Surrogacy Errors for Dynamic MLC Tumour Tracking

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hardcastle, N; Booth, J; Caillet, V

    Purpose: To assess endo-bronchial electromagnetic beacon insertion and to quantify the geometric accuracy of using beacons as a surrogate for tumour motion in real-time multileaf collimator (MLC) tracking of lung tumours. Methods: The LIGHT SABR trial is a world-first clinical trial in which the MLC leaves move with lung tumours in real time on a standard linear accelerator. Tracking is performed based on implanted electromagnetic beacons (CalypsoTM, Varian Medical Systems, USA) as a surrogate for tumour motion. Five patients have been treated and have each had three beacons implanted endo-bronchially under fluoroscopic guidance. The centre of mass (C.O.M) has beenmore » used to adapt the MLC in real-time. The geometric error in using the beacon C.O.M as a surrogate for tumour motion was measured by measuring the tumour and beacon C.O.M in all phases of the respiratory cycle of a 4DCT. The surrogacy error was defined as the difference in beacon and tumour C.O.M relative to the reference phase (maximum exhale). Results: All five patients have had three beacons successfully implanted with no migration between simulation and end of treatment. Beacon placement relative to tumour C.O.M varied from 14 to 74 mm and in one patient spanned two lobes. Surrogacy error was measured in each patient on the simulation 4DCT and ranged from 0 to 3 mm. Surrogacy error as measured on 4DCT was subject to artefacts in mid-ventilation phases. Surrogacy error was a function of breathing phase and was typically larger at maximum inhale. Conclusion: Beacon placement and thus surrogacy error is a major component of geometric uncertainty in MLC tracking of lung tumours. Surrogacy error must be measured on each patient and incorporated into margin calculation. Reduction of surrogacy error is limited by airway anatomy, however should be taken into consideration when performing beacon insertion and planning. This research is funded by Varian Medical Systems via a collaborative research

  20. Medication competency of nurses according to theoretical and drug calculation online exams: A descriptive correlational study.

    PubMed

    Sneck, Sami; Saarnio, Reetta; Isola, Arja; Boigu, Risto

    2016-01-01

    Medication administration is an important task of registered nurses. According to previous studies, nurses lack theoretical knowledge and drug calculation skills and knowledge-based mistakes do occur in clinical practice. Finnish health care organizations started to develop a systematic verification processes for medication competence at the end of the last decade. No studies have yet been made of nurses' theoretical knowledge and drug calculation skills according to these online exams. The aim of this study was to describe the medication competence of Finnish nurses according to theoretical and drug calculation exams. A descriptive correlation design was adopted. Participants and settings All nurses who participated in the online exam in three Finnish hospitals between 1.1.2009 and 31.05.2014 were selected to the study (n=2479). Quantitative methods like Pearson's chi-squared tests, analysis of variance (ANOVA) with post hoc Tukey tests and Pearson's correlation coefficient were used to test the existence of relationships between dependent and independent variables. The majority of nurses mastered the theoretical knowledge needed in medication administration, but 5% of the nurses struggled with passing the drug calculation exam. Theoretical knowledge and drug calculation skills were better in acute care units than in the other units and younger nurses achieved better results in both exams than their older colleagues. The differences found in this study were statistically significant, but not high. Nevertheless, even the tiniest deficiency in theoretical knowledge and drug calculation skills should be focused on. It is important to identify the nurses who struggle in the exams and to plan targeted educational interventions for supporting them. The next step is to study if verification of medication competence has an effect on patient safety. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Effect of tertiary multileaf collimator (MLC) on foetal dose during three-dimensional conformal radiation therapy (3DCRT) of a brain tumour during pregnancy.

    PubMed

    Sharma, Dayananda S; Jalali, Rakesh; Tambe, Chandrashekhar M; Animesh; Deshpande, Deepak D

    2004-01-01

    The aim of this work was to measure the dose to foetus both in vivo and in vitro during three-dimensional conformal radiation therapy (3DCRT) in a pregnant patient with a pituitary adenoma. The study was then extended to assess the components contributing to the foetal dose such as collimator scatter, internal scatter, head leakage, wedge scatter and multileaf collimator (MLC) effect. A 30-year-old pregnant woman with a non-functioning pituitary macroadenoma was planned for 3DCRT with 6MV X-ray using four equally weighted MLC-shaped non-coplanar wedged portals. In vivo dosimetry was carried out using thermoluminescent (TL) phosphor powder, which was placed at different positions on the patient, corresponding to different locations in the uterus and also at external os. In vitro measurements were also performed on a simulated phantom using the same set-up parameters and beam arrangement to verify the in vivo measured dose. Experiments were carried out to measure the respective contributions of different components towards peripheral dose. In vitro measured dose to foetus was found to be slightly more than that of in vivo measurement with a maximum of 0.044% of the prescribed dose of 45Gy, which corresponded to 0.0199+/-0.0008Gy. Thermoluminescence dosimeter (TLD) kept at the external os of the patient showed a dose of 0.031% of the prescribed dose. Among the various components of the peripheral dose (foetal dose) measured, head leakage was found to be the leading cause contributing 52%, followed by wedge scatter (31%), collimator scatter (14%) and internal scatter (13%). The use of MLC reduced not only the volume of normal brain irradiation as compared to open fields but also the peripheral dose by 10%. Radiotherapy of brain tumours during pregnancy poses a unique clinical situation and decisions to deliver radiotherapy should be taken after detailed in vitro and in vivo dosimetric measurements. Our findings suggest that the beam arrangement using 3-4-fields

  2. Exam 2 Strategy

    ERIC Educational Resources Information Center

    Cummings, Richard G.; Gruber, Robert A.

    2006-01-01

    After students take their first exam in an accounting course, tax accounting and intermediate accounting in this case, their reactions to their test scores may be varied. This is their first major assessment of how they have performed in the class. The students in the class near the high end of the grading scale are going to be satisfied with…

  3. A Pilot Study of an Electronic Exam System at an Australian University

    ERIC Educational Resources Information Center

    Wibowo, Santoso; Grandhi, Srimannarayana; Chugh, Ritesh; Sawir, Erlenawati

    2016-01-01

    This study sought academic staff and students' views of electronic exams (e-exams) system and the benefits and challenges of e-exams in general. The respondents provided useful feedback for future adoption of e-exams at an Australian university and elsewhere too. The key findings show that students and academic staff are optimistic about the…

  4. Comparison of two Classification methods (MLC and SVM) to extract land use and land cover in Johor Malaysia

    NASA Astrophysics Data System (ADS)

    Rokni Deilmai, B.; Ahmad, B. Bin; Zabihi, H.

    2014-06-01

    Mapping is essential for the analysis of the land use and land cover, which influence many environmental processes and properties. For the purpose of the creation of land cover maps, it is important to minimize error. These errors will propagate into later analyses based on these land cover maps. The reliability of land cover maps derived from remotely sensed data depends on an accurate classification. In this study, we have analyzed multispectral data using two different classifiers including Maximum Likelihood Classifier (MLC) and Support Vector Machine (SVM). To pursue this aim, Landsat Thematic Mapper data and identical field-based training sample datasets in Johor Malaysia used for each classification method, which results indicate in five land cover classes forest, oil palm, urban area, water, rubber. Classification results indicate that SVM was more accurate than MLC. With demonstrated capability to produce reliable cover results, the SVM methods should be especially useful for land cover classification.

  5. Final Exam Weighting as Part of Course Design

    ERIC Educational Resources Information Center

    Franke, Matthew

    2018-01-01

    The weighting of a final exam or a final assignment is an essential part of course design that is rarely discussed in pedagogical literature. Depending on the weighting, a final exam or assignment may provide unequal benefits to students depending on their prior performance in the class. Consequently, uncritical grade weighting can discount…

  6. Gender Differences in STEM Related Advanced Placement Exams

    ERIC Educational Resources Information Center

    Morris, Jill B.

    2013-01-01

    Purpose: The purpose of this study was to examine differences between boys and girls in their performance on STEM related AP exams. Specifically, gender differences were examined for the following STEM related AP exams: Calculus AB, Calculus BC, Physics B, Physics C: Electricity and Magnetism, Physics C: Mechanics, Chemistry, and Computer Science…

  7. Catabolic regulation analysis of Escherichia coli and its crp, mlc, mgsA, pgi and ptsG mutants

    PubMed Central

    2011-01-01

    Background Most bacteria can use various compounds as carbon sources. These carbon sources can be either co-metabolized or sequentially metabolized, where the latter phenomenon typically occurs as catabolite repression. From the practical application point of view of utilizing lignocellulose for the production of biofuels etc., it is strongly desirable to ferment all sugars obtained by hydrolysis from lignocellulosic materials, where simultaneous consumption of sugars would benefit the formation of bioproducts. However, most organisms consume glucose prior to consumption of other carbon sources, and exhibit diauxic growth. It has been shown by fermentation experiments that simultaneous consumption of sugars can be attained by ptsG, mgsA mutants etc., but its mechanism has not been well understood. It is strongly desirable to understand the mechanism of metabolic regulation for catabolite regulation to improve the performance of fermentation. Results In order to make clear the catabolic regulation mechanism, several continuous cultures were conducted at different dilution rates of 0.2, 0.4, 0.6 and 0.7 h-1 using wild type Escherichia coli. The result indicates that the transcript levels of global regulators such as crp, cra, mlc and rpoS decreased, while those of fadR, iclR, soxR/S increased as the dilution rate increased. These affected the metabolic pathway genes, which in turn affected fermentation result where the specific glucose uptake rate, the specific acetate formation rate, and the specific CO2 evolution rate (CER) were increased as the dilution rate was increased. This was confirmed by the 13C-flux analysis. In order to make clear the catabolite regulation, the effect of crp gene knockout (Δcrp) and crp enhancement (crp+) as well as mlc, mgsA, pgi and ptsG gene knockout on the metabolism was then investigated by the continuous culture at the dilution rate of 0.2 h-1 and by some batch cultures. In the case of Δcrp (and also Δmlc) mutant, TCA cycle and

  8. Ocular Health (OH) Fundoscope Exam

    NASA Image and Video Library

    2013-06-05

    Astronaut Karen Nyberg and Astronaut Chris Cassidy (partially visible), both Expedition 37 flight engineers, perform an Ocular Health (OH) Fundoscope Exam in the Destiny laboratory of the International Space Station

  9. Observing and Deterring Social Cheating on College Exams

    ERIC Educational Resources Information Center

    Fendler, Richard J.; Yates, Michael C.; Godbey, Johnathan M.

    2018-01-01

    This research introduces a unique multiple choice exam design to observe and measure the degree to which students copy answers from their peers. Using data collected from the exam, an empirical experiment is conducted to determine whether random seat assignment deters cheating relative to a control group of students allowed to choose their seats.…

  10. Examining ethics - developing a comprehensive exam for a bioethics master's program.

    PubMed

    Schonfeld, Toby; Stoddard, Hugh; Labrecque, Cory Andrew

    2014-10-01

    Assessing mastery of bioethics in a graduate program requires careful attention not simply to the content knowledge and skill development of students but also to the principles of sound assessment processes. In this article, we describe the rationale, development process, and features of the comprehensive exam we created as a culminating experience of a master's program in bioethics. The exam became the students' opportunity to demonstrate the way they were able to integrate course, textual, and practical knowledge gained throughout the experience of the program. Additionally, the exam assessed students' proficiency in the field of bioethics and their ability to critically and constructively analyze bioethical issues. In this article, we offer tips to other exam creators regarding our experiences with question and answer development, scoring of the exam, and relationships between coursework and exam preparation and completion. We also include a sample rubric for others to see how we determined which student answers were satisfactory.

  11. Performance Analysis of Exam Gloves Used for Aseptic Rodent Surgery

    PubMed Central

    LeMoine, Dana M; Bergdall, Valerie K; Freed, Carrie

    2015-01-01

    Aseptic technique includes the use of sterile surgical gloves for survival surgeries in rodents to minimize the incidence of infections. Exam gloves are much less expensive than are surgical gloves and may represent a cost-effective, readily available option for use in rodent surgery. This study examined the effectiveness of surface disinfection of exam gloves with 70% isopropyl alcohol or a solution of hydrogen peroxide and peracetic acid (HP–PA) in reducing bacterial contamination. Performance levels for asepsis were met when gloves were negative for bacterial contamination after surface disinfection and sham ‘exertion’ activity. According to these criteria, 94% of HP–PA-disinfected gloves passed, compared with 47% of alcohol-disinfected gloves. In addition, the effect of autoclaving on the integrity of exam gloves was examined, given that autoclaving is another readily available option for aseptic preparation. Performance criteria for glove integrity after autoclaving consisted of: the ability to don the gloves followed by successful simulation of wound closure and completion of stretch tests without tearing or observable defects. Using this criteria, 98% of autoclaved nitrile exam gloves and 76% of autoclaved latex exam gloves met performance expectations compared with the performance of standard surgical gloves (88% nitrile, 100% latex). The results of this study support the use of HP–PA-disinfected latex and nitrile exam gloves or autoclaved nitrile exam gloves as viable cost-effective alternatives to sterile surgical gloves for rodent surgeries. PMID:26045458

  12. Performance analysis of exam gloves used for aseptic rodent surgery.

    PubMed

    LeMoine, Dana M; Bergdall, Valerie K; Freed, Carrie

    2015-05-01

    Aseptic technique includes the use of sterile surgical gloves for survival surgeries in rodents to minimize the incidence of infections. Exam gloves are much less expensive than are surgical gloves and may represent a cost-effective, readily available option for use in rodent surgery. This study examined the effectiveness of surface disinfection of exam gloves with 70% isopropyl alcohol or a solution of hydrogen peroxide and peracetic acid (HP-PA) in reducing bacterial contamination. Performance levels for asepsis were met when gloves were negative for bacterial contamination after surface disinfection and sham 'exertion' activity. According to these criteria, 94% of HP-PA-disinfected gloves passed, compared with 47% of alcohol-disinfected gloves. In addition, the effect of autoclaving on the integrity of exam gloves was examined, given that autoclaving is another readily available option for aseptic preparation. Performance criteria for glove integrity after autoclaving consisted of: the ability to don the gloves followed by successful simulation of wound closure and completion of stretch tests without tearing or observable defects. Using this criteria, 98% of autoclaved nitrile exam gloves and 76% of autoclaved latex exam gloves met performance expectations compared with the performance of standard surgical gloves (88% nitrile, 100% latex). The results of this study support the use of HP-PA-disinfected latex and nitrile exam gloves or autoclaved nitrile exam gloves as viable cost-effective alternatives to sterile surgical gloves for rodent surgeries.

  13. Should the MCAT exam be used for medical school admissions in Canada?

    PubMed

    Eskander, Antoine; Shandling, Maureen; Hanson, Mark D

    2013-05-01

    In light of the structural and content changes to the Medical College Admission Test (MCAT) to be implemented in 2015 and the recent diversity- and social-accountability-based recommendations of the Future of Medical Education in Canada (FMEC) project, the authors review and reexamine the use of the MCAT exam in Canadian medical school admissions decisions.This Perspective article uses a point-counterpoint format to discuss three main advantages and disadvantages of using the MCAT exam in the medical school admissions process, from a Canadian perspective. The authors examine three questions regarding the FMEC recommendations and the revised MCAT exam: (1) Is the MCAT exam equal and useful in Canadian admissions? (2) Does the MCAT exam affect matriculant diversity? and (3) Is the MCAT exam a strong predictor of future performance? They present the most recent arguments and evidence for and against use of the MCAT exam, with the purpose of summarizing these different perspectives for readers.

  14. Exit Exams Face Pinch in Common-Core Push

    ERIC Educational Resources Information Center

    Ujifusa, Andrew

    2012-01-01

    With many states crafting assessments based on the common-core standards--and an increasing emphasis on college and career readiness--some are rethinking the kind of tests high school students must pass to graduate, or whether to use such exit exams at all. Twenty-five states, enrolling a total of 34.1 million students, make exit exams a…

  15. SU-G-TeP4-07: Automatic EPID-Based 2D Measurement of MLC Leaf Offset as a Quality Control Tool

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ritter, T; Moran, J; Schultz, B

    Purpose: The MLC dosimetric leaf gap (DLG) and transmission are measured parameters which impact the dosimetric accuracy of IMRT and VMAT plans. This investigation aims to develop an efficient and accurate routine constancy check of the physical DLG in two dimensions. Methods: The manufacturer’s recommended DLG measurement method was modified by using 5 fields instead of 11 and by utilizing the Electronic Portal Imaging Device (EPID). Validations were accomplished using an ion chamber (IC) in solid water and a 2D IC array. EPID data was collected for 6 months on multiple TrueBeam linacs using both Millennium and HD MLCs atmore » 5 different clinics in an international consortium. Matlab code was written to automatically analyze the images and calculate the 2D results. Sensitivity was investigated by introducing deliberate leaf position errors. MLC calibration and initialization history was recorded to allow quantification of their impact. Results were analyzed using statistical process control (SPC). Results: The EPID method took approximately 5 minutes. Due to detector response, the EPID measured DLG and transmission differed from the IC values but were reproducible and consistent with changes measured using the ICs. For the Millennium MLC, the EPID measured DLG and transmission were both consistently lower than IC results. The EPID method was implemented as leaf offset and transmission constancy tests (LOC and TC). Based on 6 months of measurements, the initial leaf-specific action thresholds for changes from baseline were set to 0.1 mm. Upper and lower control limits for variation were developed for each machine. Conclusion: Leaf offset and transmission constancy tests were implemented on Varian HD and Millennium MLCs using an EPID and found to be efficient and accurate. The test is effective for monitoring MLC performance using dynamic delivery and performing process control on the DLG in 2D, thus enhancing dosimetric accuracy. This work was supported by a

  16. Patient preferences for physician gender in the male genital/rectal exam.

    PubMed

    Heaton, C J; Marquez, J T

    1990-01-01

    This paper presents the results of a descriptive survey assessing male patients' past experience, current preferences, and concerns regarding the gender of the physician performing the male genital/rectal exam. The sample consists of 72 male patients seen at a university-based family practice clinic located in a small rural community in Michigan. Patient age and physician gender preference were the main independent variables of interest. This study found that 51.5% of all male patients in the sample indicated a preference for a male physician to perform the genital exam while 48.5% indicated no preference for physician gender. In contrast, for the rectal exam, 61.5% of all male patients indicated no preference for physician gender while 38.5% did express a preference for a male physician. No one expressed a preference for a female physician for either the genital or rectal exams. Further analysis revealed that male patients over the age of 40 who prefer a male physician do so, at least in part, because it would be embarrassing to have a female physician perform the exam. Few, however, would refuse to allow a female physician to perform the exam. Respondents preferred certain positions for the exam and these are a means of minimizing potential embarrassment in the older patient.

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

    ERIC Educational Resources Information Center

    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…

  18. Hispanic Student Performance on Advanced Placement Exams: A Multiyear, National Investigation

    ERIC Educational Resources Information Center

    Jara, Teresa Dianne

    2013-01-01

    Purpose: The purpose of this study was to analyze the Advanced Placement exams that Hispanic students complete and to compare their overall performance with the performance of White students from 2000 to 2012. A second purpose was to determine which Advanced Placement exams were the most difficult exams for Hispanic students and which Advanced…

  19. Assessing Conceptual and Algorithmic Knowledge in General Chemistry with ACS Exams

    ERIC Educational Resources Information Center

    Holme, Thomas; Murphy, Kristen

    2011-01-01

    In 2005, the ACS Examinations Institute released an exam for first-term general chemistry in which items are intentionally paired with one conceptual and one traditional item. A second-term, paired-questions exam was released in 2007. This paper presents an empirical study of student performances on these two exams based on national samples of…

  20. Relationships between Preclinical Course Grades and Standardized Exam Performance

    ERIC Educational Resources Information Center

    Hu, Yinin; Martindale, James R.; LeGallo, Robin D.; White, Casey B.; McGahren, Eugene D.; Schroen, Anneke T.

    2016-01-01

    Success in residency matching is largely contingent upon standardized exam scores. Identifying predictors of standardized exam performance could promote primary intervention and lead to design insights for preclinical courses. We hypothesized that clinically relevant courses with an emphasis on higher-order cognitive understanding are most…

  1. Expedition 50 Qualification Exams

    NASA Image and Video Library

    2016-10-25

    Expedition 50 crew members NASA astronaut Peggy Whitson, left, Russian cosmonaut Oleg Novitskiy of Roscosmos, center, and ESA astronaut Thomas Pesquet laugh together as they prepare for their final qualification exams, Tuesday, Oct. 25, 2016, at the Gagarin Cosmonaut Training Center (GCTC) in Star City, Russia. Photo Credit: (NASA/Bill Ingalls)

  2. The Preparatory Workshop: A Partial Solution to an English Compulsory Exam Failure Rate.

    ERIC Educational Resources Information Center

    Naugle, Helen; McGuire, Peter

    Georgia Institute of Technology has created a preparatory workshop that avoids focusing composition courses on the state competency exam while helping its students pass the exam. In checking the exams of students who had failed, three problems appeared: lack of motivation, lack of awareness of the standards for grading the exam, and an inability…

  3. SU-G-BRA-16: Target Dose Comparison for Dynamic MLC Tracking and Mid- Ventilation Planning in Lung Radiotherapy Subject to Intrafractional Baseline Drifts

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Menten, MJ; Fast, MF; Nill, S

    Purpose: Lung tumor motion during radiotherapy can be accounted for by expanded treatment margins, for example using a mid-ventilation planning approach, or by localizing the tumor in real-time and adapting the treatment beam with multileaf collimator (MLC) tracking. This study evaluates the effect of intrafractional changes in the average tumor position (baseline drifts) on these two treatment techniques. Methods: Lung stereotactic treatment plans (9-beam IMRT, 54Gy/3 fractions, mean treatment time: 9.63min) were generated for three patients: either for delivery with MLC tracking (isotropic GTV-to-PTV margin: 2.6mm) or planned with a mid-ventilation approach and delivered without online motion compensation (GTV-to-PTV margin:more » 4.4-6.3mm). Delivery to a breathing patient was simulated using DynaTrack, our in-house tracking and delivery software. Baseline drifts in cranial and posterior direction were simulated at a rate of 0.5, 1.0 or 1.5mm/min. For dose reconstruction, the corresponding 4DCT phase was selected for each time point of the delivery. Baseline drifts were accounted for by rigidly shifting the CT to ensure correct relative beam-to-target positioning. Afterwards, the doses delivered to each 4DCT phase were accumulated deformably on the mid-ventilation phase using research RayStation v4.6 and dose coverage of the GTV was evaluated. Results: When using the mid-ventilation planning approach, dose coverage of the tumor deteriorated substantially in the presence of baseline drifts. The reduction in D98% coverage of the GTV in a single fraction ranged from 0.4-1.2, 0.6-3.3 and 4.5-6.2Gy, respectively, for the different drift rates. With MLC tracking the GTV D98% coverage remained unchanged (+/− 0.1Gy) regardless of drift. Conclusion: Intrafractional baseline drifts reduce the tumor dose in treatments based on mid-ventilation planning. In rare, large target baseline drifts tumor dose coverage may drop below the prescription, potentially affecting

  4. Washback Effect of University Entrance exams in Applied Mathematics to Social Sciences.

    PubMed

    Rodríguez-Muñiz, Luis J; Díaz, Patricia; Mier, Verónica; Alonso, Pedro

    2016-01-01

    Curricular issues of subject Applied Mathematics to Social Sciences are studied in relation to university entrance exams performed in several Spanish regions between 2009-2014. By using quantitative and qualitative analyses, it has been studied how these exams align with curriculum and how they produce a washback on curriculum and teachers' work. Additionally, one questionnaire about teachers' practices has been performed, in order to find out how the exams are influencing teaching methodology development. Main results obtained show that evaluation is producing a bias on the official curriculum, substantially simplifying the specific orientation that should guide applied mathematics. Furthermore, teachers' practices are influenced by the exams, and they usually approach their teaching methodology to the frequent types of exams. Also, slight differences among the teachers lead to distinguish two behavioral subgroups. Results can also be useful in an international context, because of the importance of standardized exit exams in OECD countries.

  5. Peer-led instruction for a qualifying exam preparatory course or: How I learned to stop worrying and love the PhD Qualifying Exam

    NASA Astrophysics Data System (ADS)

    Christensen, Warren; Engelhardt, Larry

    2006-04-01

    In the spring of 2004, the authors were charged with the task of creating and administering a qualifying exam preparation curriculum that would strive to assist graduate students studying for their comprehensive physics exam. We incorporated many pedagogical techniques that have been proven effective at nearly all levels of instruction by leading researchers in the field of physics education. Our primary focus was on peer-led instruction and time-on-task doing actual problems from previous qualifying exams. After a brief but precise lecture covering essential ideas over a particular subject matter, students spend most of class time working in small groups and presenting worked problems at the board. At all times, the focus was on student explanations concerning the fundamental concepts behind a specific problem, as well as contemplating variations to broaden understanding and challenge students to think on their feet. We found that students who attended and participated regularly in class could be correlated with those students who achieved high marks on the exam.

  6. Redesigning the MCAT exam: balancing multiple perspectives.

    PubMed

    Schwartzstein, Richard M; Rosenfeld, Gary C; Hilborn, Robert; Oyewole, Saundra Herndon; Mitchell, Karen

    2013-05-01

    The authors of this commentary discuss the recently completed review of the current Medical College Admission Test (MCAT), which has been used since 1991, and describe the blueprint for the new test that will be introduced in 2015. The design of the MCAT exam reflects changes in medical education, medical science, health care delivery, and the needs of the populations served by graduates of U.S. and Canadian medical schools. The authors describe how balancing the ambitious goals for the new exam and the varying priorities of the testing program's many stakeholders made blueprint design complex. They discuss the tensions and trade-offs that characterized the design process as well as the deliberations and data that shaped the blueprint.The blueprint for the MCAT exam balances the assessment of a broad range of competencies in the natural, social, and behavioral sciences and critical analysis and reasoning skills that are essential to entering students' success in medical school. The exam will include four sections: Biological and Biochemical Foundations of Living Systems; Chemical and Physical Foundations of Biological Systems; Psychological, Social, and Biological Foundations of Behavior; and Critical Analysis and Reasoning Skills.The authors also offer recommendations for admission committees, advising them to review applicants' test scores, course work, and other academic, personal, and experiential credentials as part of a holistic admission process and in relation to their institutions' educational, scientific, clinical, and service-oriented goals.

  7. Investigating the Variables in a Mock Exam Study Session Designed to Improve Student Exam Performance in an Undergraduate Behavior Modification and Therapy Course

    ERIC Educational Resources Information Center

    Dotson, Wesley H.

    2010-01-01

    The purpose of the present study was to identify components of an optional mock exam review session (e.g. requiring students to write answers, providing students grading keys for questions) responsible for improvements in student performance on application-based short-essay exams in an undergraduate behavior modification course. Both…

  8. Washback Effect of University Entrance exams in Applied Mathematics to Social Sciences

    PubMed Central

    Díaz, Patricia; Mier, Verónica; Alonso, Pedro

    2016-01-01

    Curricular issues of subject Applied Mathematics to Social Sciences are studied in relation to university entrance exams performed in several Spanish regions between 2009–2014. By using quantitative and qualitative analyses, it has been studied how these exams align with curriculum and how they produce a washback on curriculum and teachers’ work. Additionally, one questionnaire about teachers’ practices has been performed, in order to find out how the exams are influencing teaching methodology development. Main results obtained show that evaluation is producing a bias on the official curriculum, substantially simplifying the specific orientation that should guide applied mathematics. Furthermore, teachers’ practices are influenced by the exams, and they usually approach their teaching methodology to the frequent types of exams. Also, slight differences among the teachers lead to distinguish two behavioral subgroups. Results can also be useful in an international context, because of the importance of standardized exit exams in OECD countries. PMID:27936103

  9. EFL Teachers' Formal Assessment Practices Based on Exam Papers

    ERIC Educational Resources Information Center

    Kiliçkaya, Ferit

    2016-01-01

    This study reports initial findings from a small-scale qualitative study aimed at gaining insights into English language teachers' assessment practices in Turkey by examining the formal exam papers. Based on the technique of content analysis, formal exam papers were analyzed in terms of assessment items, language skills tested as well as the…

  10. [What happens when medical students set their own exam papers?].

    PubMed

    Baerheim, A; Meland, E

    2001-10-20

    In the section for general practice at the University of Bergen, Norway, we want to emphasise learning more than control in our work with students. As a step in this direction we invited students to come up with proposals for exam papers, papers that usually include six to nine multiple steps for clinical reasoning. We guaranteed that one out of three proposals would be included as a paper in the written examination, possibly slightly modified. This article is an evaluation of the consequences of letting medical students set some of their own exam papers. The process was evaluated using 1) grades given, 2) students' assessment of whether this mode of setting papers influenced their exam preparations, and 3) students' free-text comments on the process. 57 out of 64 students (89%) took part in the evaluation. All knew that their fellow students had set one of the exam papers, but only 34 (60%) reported that this knowledge had changed the way they prepared for the exam. The mean grade was 9.9 (range 5-12, on a scale from 1 to 12, 6 being the lowest pass grade) for the paper set by students, and 9.5 (range 5-11) for all papers combined. Mean difference in score was 0.32 (95% confidence interval 0.08-0.64). Students' free-text comments showed that they specifically prepared for the three known paper topics. They drew comfort from knowing at least one of the papers set, and the student-set papers were found relevant for general practice. Letting medical students set one of the exam papers makes them feel more confident. Student-set papers were seen as relevant for clinical practice. The control function of the exam seemed to have been preserved.

  11. Improving Patient Safety: Avoiding Unread Imaging Exams in the National VA Enterprise Electronic Health Record.

    PubMed

    Bastawrous, Sarah; Carney, Benjamin

    2017-06-01

    In the current digital and filmless age of radiology, rates of unread radiology exams remain low, however, may still exist in unique environments. Veterans Affairs (VA) health care systems may experience higher rates of unread exams due to coexistence of Veterans Health Information Systems and Technology Architecture (VistA) imaging and commercial picture archiving and communication systems (PACS). The purpose of this patient safety initiative was to identify any unread exams and causes leading to unread exams. Following approval by departmental quality assurance committee, a comprehensive review was performed of all radiology exams within VistA imaging from July 1, 2009 to June 30, 2014 to identify unread radiology exams. Over the 5-year period, the total unread exam rate was calculated to be 0.17%, with the highest yearly unread exam rate of 0.25%. The leading majority of unread exam type was plain radiographs. Analysis revealed unfinished dictations, unassociated accession numbers, technologist errors, and inefficient radiologist work lists as top contributors to unread exams. Once unread radiology exams were discovered and the causes identified, valuable process changes were implemented within our department to ensure simultaneous tracking of all unread exams in VistA imaging as well as the commercial PACS.

  12. Preparing Students to Take SOA/CAS Exam FM/2

    ERIC Educational Resources Information Center

    Marchand, Richard J.

    2014-01-01

    This paper provides suggestions for preparing students to take the actuarial examination on financial mathematics, SOA/CAS Exam FM/2. It is based on current practices employed at Slippery Rock University, a small public liberal arts university. Detailed descriptions of our Theory of Interest course and subsequent Exam FM/2 prep course are provided…

  13. MO-F-204-00: Preparing for the ABR Diagnostic and Nuclear Medical Physics Exams

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and

  14. MO-F-204-02: Preparing for Part 2 of the ABR Diagnostic Physics Exam

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Szczykutowicz, T.

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and

  15. MO-F-204-03: Preparing for Part 3 of the ABR Diagnostic Physics Exam

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zambelli, J.

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and

  16. MO-F-204-01: Preparing for Part 1 of the ABR Diagnostic Physics Exam

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    McKenney, S.

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and

  17. WE-D-213-00: Preparing for the ABR Diagnostic and Nuclear Medicine Physics Exams

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging

  18. WE-D-213-01: Preparing for Part 1 of the ABR Diagnostic Physics Exam

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Simiele, S.

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging

  19. WE-D-213-03: Preparing for Part 3 of the ABR Diagnostic Physics Exam

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bevins, N.

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging

  20. WE-D-213-02: Preparing for Part 2 of the ABR Diagnostic Physics Exam

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zambelli, J.

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging

  1. An Exploration into Improving Examinees' Acceptance of Participation in an Online Exam

    ERIC Educational Resources Information Center

    Liu, I-Fan; Chen, Ruey-Shin; Lu, Hao-Chun

    2015-01-01

    With the rapid development of the Internet and information technology, the issues related to online exams have become the concern of an increasing number of researchers. At present, the biggest challenges for the integration of web communication technology into online exams are the ability to detect cheating behaviors during the exam, and the…

  2. Evaluation of virtual environment as a form of interactive resuscitation exam

    NASA Astrophysics Data System (ADS)

    Leszczyński, Piotr; Charuta, Anna; Kołodziejczak, Barbara; Roszak, Magdalena

    2017-10-01

    There is scientific evidence confirming the effectiveness of e-learning within resuscitation, however, there is not enough research on modern examination techniques within the scope. The aim of the pilot research is to compare the exam results in the field of Advanced Life Support in a traditional (paper) and interactive (computer) form as well as to evaluate satisfaction of the participants. A survey was conducted which meant to evaluate satisfaction of exam participants. Statistical analysis of the collected data was conducted at a significance level of α = 0.05 using STATISTICS v. 12. Final results of the traditional exam (67.5% ± 15.8%) differed significantly (p < 0.001) from the results of the interactive exam (53.3% ± 13.7%). However, comparing the number of students who did not pass the exam (passing point at 51%), no significant differences (p = 0.13) were observed between the two types exams. The feedback accuracy as well as the presence of well-prepared interactive questions could influence the evaluation of satisfaction of taking part in the electronic test. Significant differences between the results of a traditional test and the one supported by Computer Based Learning system showed the possibility of achieving a more detailed competence verification in the field of resuscitation thanks to interactive solutions.

  3. Anxiety and Piano Exams: Turkish Prospective Music Teachers' Experiences

    ERIC Educational Resources Information Center

    Güven, Elif

    2016-01-01

    The purpose of this study is to determine the test anxiety levels of prospective music teachers and their opinions regarding anxiety in piano exams. Test Anxiety Inventory (TAI) and semi-structured interviews were used to meet the purpose. Interviews were conducted with students prior to and after the piano exam. As a result of the study it was…

  4. The Management Skills of Exam Process for Undergraduate Students

    ERIC Educational Resources Information Center

    Cetin, Filiz; Cetin, Saban

    2017-01-01

    This study aims to identify to what degree undergraduate students are able to manage the exam process to be successful in exams. The study group of the research, which utilizes the survey model, consists of 350 students in total, 185 female and 165 male, attending 4 different teaching programs in Faculty of Education, Gazi University. "The…

  5. Independent Monte-Carlo dose calculation for MLC based CyberKnife radiotherapy

    NASA Astrophysics Data System (ADS)

    Mackeprang, P.-H.; Vuong, D.; Volken, W.; Henzen, D.; Schmidhalter, D.; Malthaner, M.; Mueller, S.; Frei, D.; Stampanoni, M. F. M.; Dal Pra, A.; Aebersold, D. M.; Fix, M. K.; Manser, P.

    2018-01-01

    This work aims to develop, implement and validate a Monte Carlo (MC)-based independent dose calculation (IDC) framework to perform patient-specific quality assurance (QA) for multi-leaf collimator (MLC)-based CyberKnife® (Accuray Inc., Sunnyvale, CA) treatment plans. The IDC framework uses an XML-format treatment plan as exported from the treatment planning system (TPS) and DICOM format patient CT data, an MC beam model using phase spaces, CyberKnife MLC beam modifier transport using the EGS++ class library, a beam sampling and coordinate transformation engine and dose scoring using DOSXYZnrc. The framework is validated against dose profiles and depth dose curves of single beams with varying field sizes in a water tank in units of cGy/Monitor Unit and against a 2D dose distribution of a full prostate treatment plan measured with Gafchromic EBT3 (Ashland Advanced Materials, Bridgewater, NJ) film in a homogeneous water-equivalent slab phantom. The film measurement is compared to IDC results by gamma analysis using 2% (global)/2 mm criteria. Further, the dose distribution of the clinical treatment plan in the patient CT is compared to TPS calculation by gamma analysis using the same criteria. Dose profiles from IDC calculation in a homogeneous water phantom agree within 2.3% of the global max dose or 1 mm distance to agreement to measurements for all except the smallest field size. Comparing the film measurement to calculated dose, 99.9% of all voxels pass gamma analysis, comparing dose calculated by the IDC framework to TPS calculated dose for the clinical prostate plan shows 99.0% passing rate. IDC calculated dose is found to be up to 5.6% lower than dose calculated by the TPS in this case near metal fiducial markers. An MC-based modular IDC framework was successfully developed, implemented and validated against measurements and is now available to perform patient-specific QA by IDC.

  6. SU-E-T-418: Explore the Sensitive of the Planar Quality Assurance to the MLC Error with Different Beam Complexity in Intensity-Modulate Radiation Therapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wang, J; Peng, J; Xie, J

    2015-06-15

    Purpose: The purpose of this study is to investigate the sensitivity of the planar quality assurance to MLC errors with different beam complexities in intensity-modulate radiation therapy. Methods: sixteen patients’ planar quality assurance (QA) plans in our institution were enrolled in this study, including 10 dynamic MLC (DMLC) IMRT plans measured by Portal Dosimetry and 6 static MLC (SMLC) IMRT plans measured by Mapcheck. The gamma pass rate was calculated using vender’s software. The field numbers were 74 and 40 for DMLC and SMLC, respectively. A random error was generated and introduced to these fields. The modified gamma pass ratemore » was calculated by comparing the original measured fluence and modified fields’ fluence. A decreasing gamma pass rate was acquired using the original gamma pass rate minus the modified gamma pass rate. Eight complexity scores were calculated in MATLAB based on the fluence and MLC sequence of these fields. The complexity scores include fractal dimension, monitor unit of field, modulation index, fluence map complexity, weighted average of field area, weighted average of field perimeter, and small aperture ratio ( <5cm{sup 2} and <50cm{sup 2}). The Spearman’s rank correlation coefficient was implemented to analyze the correlation between these scores and decreasing gamma rate. Results: The relation between the decreasing gamma pass rate and field complexity was insignificant for most complexity scores. The most significant complexity score was fluence map complexity for SMLC, which have ρ =0.4274 (p-value=0.0063). For DMLC, the most significant complex score was fractal dimension, which have ρ=−0.3068 (p-value=0.0081). Conclusions: According to the primarily Result of this study, the sensitivity gamma pass rate was not strongly relate to the field complexity.« less

  7. Analysis of Low Appropriateness Score Exam Trends in Decision Support-based Radiology Order Entry System.

    PubMed

    Gupta, Supriya; Klein, Kandace; Singh, Anand H; Thrall, James H

    2017-05-01

    Awareness of imaging utilization increased after implementation of Radiology Order Entry with decision support systems (ROE-DS). Our hypothesis is few exams with low Clinical Appropriateness Score (CAS) on ROE-DS are performed. Clinical indications of exams with CAS less than 3 (9-point scale) were re-reviewed and reports analyzed. Structured Query Language-based query retrieved exams with CAS less than 3 in ROE-DS from January 2007 to December 2011. Reasons provided by physicians for ordering these exams and reports of exams performed were analyzed. For each indication, number of exams ordered and performed was calculated. Statistical significance was assessed using Student's t test and χ 2 analysis (P < .05). From 445,984 exams, 12,615 exams (2.8%) had CAS less than 3, and 7,956 exams (63%) were performed. Reasons for ordering of 12,615 low CAS exams were as follows: Requests by physician specialists without further explanation (4,516 = 35.8%), notation of special clinical circumstances (2,877 = 22.8%), requests by nonphysician staff without further explanation (1,383 = 10.9%), absence of suspected finding on previous modality (1,099 = 8.7%), patient preference (737 = 5.8%), and requests based on radiologists' recommendations (706 = 5.6%). Difference between male and female (male < female) preferences for low CAS exams was statistically significant (P < .01). Imaging outcome was highest for extremity MRI cases (66.7%; P < .01). Less than 3% of exams ordered had low CAS and about two-thirds of these were performed. Most common indication for ordering these exams was physician specialist request based on opinion of medical necessity without specification. Extremity MRI constituted the highest positive findings for low CAS exams performed. Published by Elsevier Inc.

  8. Estimation of the collective ionizing dose in the Portuguese population for the years 2011 and 2012, due to nuclear medicine exams.

    PubMed

    Costa, F; Teles, P; Nogueira, A; Barreto, A; Santos, A I; Carvalho, A; Martins, B; Oliveira, C; Gaspar, C; Barros, C; Neves, D; Costa, D; Rodrigues, E; Godinho, F; Alves, F; Cardoso, G; Cantinho, G; Conde, I; Vale, J; Santos, J; Isidoro, J; Pereira, J; Salgado, L; Rézio, M; Vieira, M; Simãozinho, P; Almeida, P; Castro, R; Parafita, R; Pintão, S; Lúcio, T; Reis, T; Vaz, P

    2015-01-01

    In 2009-2010 a Portuguese consortium was created to implement the methodologies proposed by the Dose Datamed II (DDM2) project, aiming to collect data from diagnostic X-ray and nuclear medicine (NM) procedures, in order to determine the most frequently prescribed exams and the associated ionizing radiation doses for the Portuguese population. The current study is the continuation of this work, although it focuses only on NM exams for the years 2011 and 2012. The annual frequency of each of the 28 selected NM exams and the average administered activity per procedure was obtained by means of a nationwide survey sent to the 35 NM centres in Portugal. The results show a reduction of the number of cardiac exams performed in the last two years compared with 2010, leading to a reduction of the annual average effective dose of Portuguese population due to NM exams from 0.08 mSv ± 0.017 mSv/caput to 0.059 ± 0.011 mSv/caput in 2011 and 0.054 ± 0.011 mSv/caput in 2012. Portuguese total annual average collective effective dose due to medical procedures was estimated to be 625.6 ± 110.9 manSv in 2011 and 565.1 ± 117.3 manSv in 2012, a reduction in comparison with 2010 (840.3 ± 183.8 manSv). The most frequent exams and the ones that contributed the most for total population dose were the cardiac and bone exams, although a decrease observed in 2011 and in 2012 was verified. The authors intend to perform this study periodically to identify trends in the annual Portuguese average effective dose and to help to raise awareness about the potential dose optimization. Copyright © 2014 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  9. Auricular Acupuncture for Exam Anxiety in Medical Students—A Randomized Crossover Investigation

    PubMed Central

    Klausenitz, Catharina; Hacker, Henriette; Hesse, Thomas; Kohlmann, Thomas; Endlich, Karlhans; Hahnenkamp, Klaus; Usichenko, Taras

    2016-01-01

    Auricular acupuncture (AA) is effective in the treatment of preoperative anxiety. The aim was to investigate whether AA can reduce exam anxiety as compared to placebo and no intervention. Forty-four medical students were randomized to receive AA, placebo, or no intervention in a crossover manner and subsequently completed three comparable oral anatomy exams with an interval of 1 month between the exams/interventions. AA was applied using indwelling fixed needles bilaterally at points MA-IC1, MA-TF1, MA-SC, MA-AT1 and MA-TG one day prior to each exam. Placebo needles were used as control. Levels of anxiety were measured using a visual analogue scale before and after each intervention as well as before each exam. Additional measures included the State-Trait-Anxiety Inventory, duration of sleep at night, blood pressure, heart rate and the extent of participant blinding. All included participants finished the study. Anxiety levels were reduced after AA and placebo intervention compared to baseline and the no intervention condition (p < 0.003). AA was better at reducing anxiety than placebo in the evening before the exam (p = 0.018). Participants were able to distinguish between AA and placebo intervention. Both AA and placebo interventions reduced exam anxiety in medical students. The superiority of AA over placebo may be due to insufficient blinding of participants. PMID:28033320

  10. Introducing Computer-Based Testing in High-Stakes Exams in Higher Education: Results of a Field Experiment.

    PubMed

    Boevé, Anja J; Meijer, Rob R; Albers, Casper J; Beetsma, Yta; Bosker, Roel J

    2015-01-01

    The introduction of computer-based testing in high-stakes examining in higher education is developing rather slowly due to institutional barriers (the need of extra facilities, ensuring test security) and teacher and student acceptance. From the existing literature it is unclear whether computer-based exams will result in similar results as paper-based exams and whether student acceptance can change as a result of administering computer-based exams. In this study, we compared results from a computer-based and paper-based exam in a sample of psychology students and found no differences in total scores across the two modes. Furthermore, we investigated student acceptance and change in acceptance of computer-based examining. After taking the computer-based exam, fifty percent of the students preferred paper-and-pencil exams over computer-based exams and about a quarter preferred a computer-based exam. We conclude that computer-based exam total scores are similar as paper-based exam scores, but that for the acceptance of high-stakes computer-based exams it is important that students practice and get familiar with this new mode of test administration.

  11. Combined Online and In-Class Pretesting Improves Exam Performance in General Psychology

    ERIC Educational Resources Information Center

    Glass, Arnold Lewis; Brill, Gary; Ingate, Margaret

    2008-01-01

    This study examined the effect of distributed questioning on learning and retention in a college lecture course. A total of 48 question pairs were presented over four exams. The 16 question pairs associated with each of the three blocks of the course appeared on the block exams, and all 48 appeared on the final exam. The two questions in each pair…

  12. How Does Student Performance on Formative Assessments Relate to Learning Assessed by Exams?

    ERIC Educational Resources Information Center

    Smith, Gary

    2007-01-01

    A retrospective analysis examines the relationships between formative assessments and exam grades in two undergraduate geoscience courses. Pair and group-work grades correlate weakly with individual exam grades. Exam performance correlates to individual, weekly online assessments. Student attendance and use of assessment feedback are also…

  13. Expedition 50 Qualification Exams

    NASA Image and Video Library

    2016-10-25

    ESA Flight Surgeon Dr. Brigitte Godard, seated left, NASA Flight ‎Surgeon Jennifer Law, center, talk with Expedition 50 NASA astronaut Peggy Whitson ahead of the final qualification exams with Whitson and her fellow crew mates Russian cosmonaut Oleg Novitskiy of Roscosmos and ESA astronaut Thomas Pesquet, Tuesday, Oct. 25, 2016, at the Gagarin Cosmonaut Training Center (GCTC) in Star City, Russia. Photo Credit: (NASA/Bill Ingalls)

  14. The Red Effect, Anxiety, and Exam Performance: A Multistudy Examination

    ERIC Educational Resources Information Center

    Smajic, Adnan; Merritt, Stephanie; Banister, Christina; Blinebry, Amanda

    2014-01-01

    Laboratory studies have established a negative relationship between the color red and academic performance. This research examined whether this effect would generalize to classroom performance and whether anxiety and negative affect might mediate the effect. In two studies, students taking classroom exams were randomly assigned an exam color. We…

  15. Diagnosis of Alzheimer’s disease in Brazil: Supplementary exams

    PubMed Central

    Caramelli, Paulo; Teixeira, Antonio Lúcio; Buchpiguel, Carlos Alberto; Lee, Hae Won; Livramento, José Antônio; Fernandez, Liana Lisboa; Anghinah, Renato

    2011-01-01

    This article presents a review of the recommendations on supplementary exams employed for the clinical diagnosis of Alzheimer’s disease (AD) in Brazil published in 2005. A systematic assessment of the consensus reached in other countries, and of articles on AD diagnosis in Brazil available on the PUBMED and LILACS medical databases, was carried out. Recommended laboratory exams included complete blood count, serum creatinine, thyroid stimulating hormone (TSH), albumin, hepatic enzymes, Vitamin B12, folic acid, calcium, serological reactions for syphilis and serology for HIV in patients aged younger than 60 years with atypical clinical signs or suggestive symptoms. Structural neuroimaging, computed tomography or – preferably – magnetic resonance exams, are indicated for diagnostic investigation of dementia syndrome to rule out secondary etiologies. Functional neuroimaging exams (SPECT and PET), when available, increase diagnostic reliability and assist in the differential diagnosis of other types of dementia. The cerebrospinal fluid exam is indicated in cases of pre-senile onset dementia with atypical clinical presentation or course, for communicant hydrocephaly, and suspected inflammatory, infectious or prion disease of the central nervous system. Routine electroencephalograms aid the differential diagnosis of dementia syndrome with other conditions which impair cognitive functioning. Genotyping of apolipoprotein E or other susceptibility polymorphisms is not recommended for diagnostic purposes or for assessing the risk of developing the disease. Biomarkers related to the molecular alterations in AD are largely limited to use exclusively in research protocols, but when available can contribute to improving the accuracy of diagnosis of the disease. PMID:29213741

  16. The scare tactic: do fear appeals predict motivation and exam scores?

    PubMed

    Putwain, David; Remedios, Richard

    2014-12-01

    Prior to high-stakes exams, teachers use persuasive messages that highlight to students the possible consequences of failure. Such messages are known as fear appeals. This study examined whether fear appeals relate to self- and non-self-determined motivation and academic performance. Data were collected in 3 waves. Self-report data pertaining to perceived fear appeals were collected in the first wave, self-report data pertaining to self-determined motivation were collected in the second wave, and exam scores were collected in the third wave. An increased frequency of fear appeals and the appraisal of fear appeals as threatening predicted lower self-determined motivation but were largely unrelated to non-self-determined motivation. An increased frequency of fear appeals and the appraisal of fear appeals as threatening predicted lower examination performance that was partly mediated by lower self-determined motivation. These findings support a position derived from self-worth theory that the negative consequences of fear appeals arise from their focus on avoiding failure rather than their focus on extrinsic consequences. We suggest that teachers and instructors need to be aware how seemingly motivational statements can unwittingly promote lower self-determined motivation. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  17. Asymmetric programming: a highly reliable metadata allocation strategy for MLC NAND flash memory-based sensor systems.

    PubMed

    Huang, Min; Liu, Zhaoqing; Qiao, Liyan

    2014-10-10

    While the NAND flash memory is widely used as the storage medium in modern sensor systems, the aggressive shrinking of process geometry and an increase in the number of bits stored in each memory cell will inevitably degrade the reliability of NAND flash memory. In particular, it's critical to enhance metadata reliability, which occupies only a small portion of the storage space, but maintains the critical information of the file system and the address translations of the storage system. Metadata damage will cause the system to crash or a large amount of data to be lost. This paper presents Asymmetric Programming, a highly reliable metadata allocation strategy for MLC NAND flash memory storage systems. Our technique exploits for the first time the property of the multi-page architecture of MLC NAND flash memory to improve the reliability of metadata. The basic idea is to keep metadata in most significant bit (MSB) pages which are more reliable than least significant bit (LSB) pages. Thus, we can achieve relatively low bit error rates for metadata. Based on this idea, we propose two strategies to optimize address mapping and garbage collection. We have implemented Asymmetric Programming on a real hardware platform. The experimental results show that Asymmetric Programming can achieve a reduction in the number of page errors of up to 99.05% with the baseline error correction scheme.

  18. Asymmetric Programming: A Highly Reliable Metadata Allocation Strategy for MLC NAND Flash Memory-Based Sensor Systems

    PubMed Central

    Huang, Min; Liu, Zhaoqing; Qiao, Liyan

    2014-01-01

    While the NAND flash memory is widely used as the storage medium in modern sensor systems, the aggressive shrinking of process geometry and an increase in the number of bits stored in each memory cell will inevitably degrade the reliability of NAND flash memory. In particular, it's critical to enhance metadata reliability, which occupies only a small portion of the storage space, but maintains the critical information of the file system and the address translations of the storage system. Metadata damage will cause the system to crash or a large amount of data to be lost. This paper presents Asymmetric Programming, a highly reliable metadata allocation strategy for MLC NAND flash memory storage systems. Our technique exploits for the first time the property of the multi-page architecture of MLC NAND flash memory to improve the reliability of metadata. The basic idea is to keep metadata in most significant bit (MSB) pages which are more reliable than least significant bit (LSB) pages. Thus, we can achieve relatively low bit error rates for metadata. Based on this idea, we propose two strategies to optimize address mapping and garbage collection. We have implemented Asymmetric Programming on a real hardware platform. The experimental results show that Asymmetric Programming can achieve a reduction in the number of page errors of up to 99.05% with the baseline error correction scheme. PMID:25310473

  19. Introducing Computer-Based Testing in High-Stakes Exams in Higher Education: Results of a Field Experiment

    PubMed Central

    Boevé, Anja J.; Meijer, Rob R.; Albers, Casper J.; Beetsma, Yta; Bosker, Roel J.

    2015-01-01

    The introduction of computer-based testing in high-stakes examining in higher education is developing rather slowly due to institutional barriers (the need of extra facilities, ensuring test security) and teacher and student acceptance. From the existing literature it is unclear whether computer-based exams will result in similar results as paper-based exams and whether student acceptance can change as a result of administering computer-based exams. In this study, we compared results from a computer-based and paper-based exam in a sample of psychology students and found no differences in total scores across the two modes. Furthermore, we investigated student acceptance and change in acceptance of computer-based examining. After taking the computer-based exam, fifty percent of the students preferred paper-and-pencil exams over computer-based exams and about a quarter preferred a computer-based exam. We conclude that computer-based exam total scores are similar as paper-based exam scores, but that for the acceptance of high-stakes computer-based exams it is important that students practice and get familiar with this new mode of test administration. PMID:26641632

  20. Industry Supplied CAD Curriculum: Case Study on Passing Certification Exams

    ERIC Educational Resources Information Center

    Webster, Rustin; Dues, Joseph; Ottway, Rudy

    2017-01-01

    Students who successfully pass professional certification exams while in school are often targeted first by industry for internships and entry level positions. Over the last decade, leading industry suppliers of computer-aided design (CAD) software have developed and launched certification exams for many of their product offerings. Some have also…

  1. [Difference analysis among majors in medical parasitology exam papers by test item bank proposition].

    PubMed

    Jia, Lin-Zhi; Ya-Jun, Ma; Cao, Yi; Qian, Fen; Li, Xiang-Yu

    2012-04-30

    The quality index among "Medical Parasitology" exam papers and measured data for students in three majors from the university in 2010 were compared and analyzed. The exam papers were formed from the test item bank. The alpha reliability coefficients of the three exam papers were above 0.70. The knowledge structure and capacity structure of the exam papers were basically balanced. But the alpha reliability coefficients of the second major was the lowest, mainly due to quality of test items in the exam paper and the failure of revising the index of test item bank in time. This observation demonstrated that revising the test items and their index in the item bank according to the measured data can improve the quality of test item bank proposition and reduce the difference among exam papers.

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

    ERIC Educational Resources Information Center

    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…

  3. Impact of implementing an EMR on physical exam documentation by ambulance personnel.

    PubMed

    Katzer, R; Barton, D J; Adelman, S; Clark, S; Seaman, E L; Hudson, K B

    2012-01-01

    Georgetown University has a student run Emergency Medical Services (EMS) organization with over 100 emergency medical technicians (EMTs). We set out to determine whether implementing an electronic patient care report (ePCR) system was associated with improved physical exam documentation. This study evaluated documentation of the physical exam on prehospital patient care reports (PCRs). An ePCR system was implemented. ePCR documentation was compared to that of the previously used paper PCRs. This study looked retrospectively at 154 PCRs. 77 were hand written PCRs from before the electronic system. The PCRs involved chief complaints that were primarily respiratory, neurologic, or both. 77 ePCRs of matching chief complaint categories were used for comparison. Each chart was reviewed for completion of certain physical exam findings. The mean percentage of documented components from the ePCRs was compared to that of the hand written PCRs. The null hypothesis was that the absolute increase in the mean was not more than 20 percent. The two exclusion criteria were PCRs completed by study investigators after the design of the project and partially or completely missing PCRs. The absolute increase in mean physical exam component documentation was 36% (95% CI = 29-43%). A weighted kappa of 0.894 showed very good agreement between chart reviewers. This study rejected the null hypothesis that the ePCR system was associated with a mean increase of no more than 20%. It observed increase in physical exam documentation. Limitations of this study included the inability to determine whether documentation of physical exam findings reflected performance of the physical exam, and what components of the ePCR system bundle were responsible for the increase in physical exam component documentation.

  4. Impact of implementing an EMR on physical exam documentation by ambulance personnel

    PubMed Central

    Katzer, R.; Barton, D.J.; Adelman, S.; Clark, S.; Seaman, E.L.; Hudson, K.B.

    2012-01-01

    Objectives Georgetown University has a student run Emergency Medical Services (EMS) organization with over 100 emergency medical technicians (EMTs). We set out to determine whether implementing an electronic patient care report (ePCR) system was associated with improved physical exam documentation. Methods This study evaluated documentation of the physical exam on prehospital patient care reports (PCRs). An ePCR system was implemented. ePCR documentation was compared to that of the previously used paper PCRs. This study looked retrospectively at 154 PCRs. 77 were hand written PCRs from before the electronic system. The PCRs involved chief complaints that were primarily respiratory, neurologic, or both. 77 ePCRs of matching chief complaint categories were used for comparison. Each chart was reviewed for completion of certain physical exam findings. The mean percentage of documented components from the ePCRs was compared to that of the hand written PCRs. The null hypothesis was that the absolute increase in the mean was not more than 20 percent. The two exclusion criteria were PCRs completed by study investigators after the design of the project and partially or completely missing PCRs. Results The absolute increase in mean physical exam component documentation was 36% (95% CI = 29–43%). A weighted kappa of 0.894 showed very good agreement between chart reviewers. Conclusions This study rejected the null hypothesis that the ePCR system was associated with a mean increase of no more than 20%. It observed increase in physical exam documentation. Limitations of this study included the inability to determine whether documentation of physical exam findings reflected performance of the physical exam, and what components of the ePCR system bundle were responsible for the increase in physical exam component documentation. PMID:23646077

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

    PubMed Central

    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

  6. Air Force Health Care Providers Incidence of Performing Testicular Exams and Instruction of Testicular Self-Exam

    DTIC Science & Technology

    1999-05-01

    Misener & Fuller,1995; Singer, Tichler , Orvieto, Finestone, & Moskowitz,1993; Sladden & Dickinson, 1995). This continues despite the American Cancer...175. Shaffner, R.J. (1995). Knowledge of testicular self exam. Nurse Practitioner, 20, (8), 10-11. Singer, A.J., Tichler , T., Orvieto, R., Finestone

  7. Air Force Health Care Providers Incidence of Performing Testicular Exams and Instruction of Testicular Self-Exam

    DTIC Science & Technology

    1999-06-01

    or discussing TSE with patients (Misener & Fuller, 1995; Singer, Tichler , Orvieto, Finestone, & Moskowitz, 1993; Sladden & Dickinson, 1995). This...Clinicians, 43, 3, 151-175. Shaffner, R.J. (1995). Knowledge of testicular self exam. Nurse Practitioner, 20, (8), 10-11. Singer, A.J., Tichler , T

  8. Two-argument total scatter factor for small fields simultaneously collimated by MLC and jaws: application to stereotactic radiosurgery and radiotherapy

    NASA Astrophysics Data System (ADS)

    Han, Zhaohui; Friesen, Scott; Hacker, Fred; Zygmanski, Piotr

    2018-01-01

    Direct use of the total scatter factor (S tot) for independent monitor unit (MU) calculations can be a good alternative approach to the traditional separate treatment of head/collimator scatter (S c) and phantom scatter (S p), especially for stereotactic small fields under the simultaneous collimation of secondary jaws and tertiary multileaf collimators (MLC). We have carried out the measurement of S tot in water for field sizes down to 0.5  ×  0.5 cm2 on a Varian TrueBeam STx medical linear accelerator (linac) equipped with high definition MLCs. Both the jaw field size (c) and MLC field size (s) significantly impact the linac output factors, especially when c \\gg s and s is small (e.g. s  <  5 cm). The combined influence of MLC and jaws gives rise to a two-argument dependence of the total scatter factor, S tot(c,s), which is difficult to functionally decouple. The (c,s) dependence can be conceived as a set of s-dependent functions (‘branches’) defined on domain [s min, s max  =  c] for a given jaw size of c. We have also developed a heuristic model of S tot to assist the clinical implementation of the measured S tot data for small field dosimetry. The model has two components: (i) empirical fit formula for the s-dependent branches and (ii) interpolation scheme between the branches. The interpolation scheme preserves the characteristic shape of the measured branches and effectively transforms the measured trapezoidal domain in (c,s) plane to a rectangular domain to facilitate easier two-dimensional interpolation to determine S tot for arbitrary (c,s) combinations. Both the empirical fit and interpolation showed good agreement with experimental validation data.

  9. Test anxiety levels of board exam going students in Tamil Nadu, India.

    PubMed

    Mary, Revina Ann; Marslin, Gregory; Franklin, Gregory; Sheeba, Caroline J

    2014-01-01

    The latest report by the National Crime Records Bureau has positioned Tamil Nadu as the Indian state with highest suicide rate. At least in part, this is happening due to exam pressure among adolescents, emphasizing the imperative need to understand the pattern of anxiety and various factors contributing to it among students. The present study was conducted to analyze the level of state anxiety among board exam attending school students in Tamil Nadu, India. A group of 100 students containing 50 boys and 50 girls from 10th and 12th grades participated in the study and their state anxiety before board exams was measured by Westside Test Anxiety Scale. We found that all board exam going students had increased level of anxiety, which was particularly higher among boys and 12th standard board exam going students. Analysis of various demographic variables showed that students from nuclear families presented higher anxiety levels compared to their desired competitive group. Overall, our results showing the prevalence of state anxiety among board exam going students in Tamil Nadu, India, support the recent attempt taken by Tamil Nadu government to improve student's academic performance in a healthier manner by appointing psychologists in all government schools.

  10. Test Anxiety Levels of Board Exam Going Students in Tamil Nadu, India

    PubMed Central

    Ann Mary, Revina; Marslin, Gregory; Franklin, Gregory; Sheeba, Caroline J.

    2014-01-01

    The latest report by the National Crime Records Bureau has positioned Tamil Nadu as the Indian state with highest suicide rate. At least in part, this is happening due to exam pressure among adolescents, emphasizing the imperative need to understand the pattern of anxiety and various factors contributing to it among students. The present study was conducted to analyze the level of state anxiety among board exam attending school students in Tamil Nadu, India. A group of 100 students containing 50 boys and 50 girls from 10th and 12th grades participated in the study and their state anxiety before board exams was measured by Westside Test Anxiety Scale. We found that all board exam going students had increased level of anxiety, which was particularly higher among boys and 12th standard board exam going students. Analysis of various demographic variables showed that students from nuclear families presented higher anxiety levels compared to their desired competitive group. Overall, our results showing the prevalence of state anxiety among board exam going students in Tamil Nadu, India, support the recent attempt taken by Tamil Nadu government to improve student's academic performance in a healthier manner by appointing psychologists in all government schools. PMID:25143938

  11. Pick-N Multiple Choice-Exams: A Comparison of Scoring Algorithms

    ERIC Educational Resources Information Center

    Bauer, Daniel; Holzer, Matthias; Kopp, Veronika; Fischer, Martin R.

    2011-01-01

    To compare different scoring algorithms for Pick-N multiple correct answer multiple-choice (MC) exams regarding test reliability, student performance, total item discrimination and item difficulty. Data from six 3rd year medical students' end of term exams in internal medicine from 2005 to 2008 at Munich University were analysed (1,255 students,…

  12. Challenges in Creating Online Exercises and Exams in Organic Chemistry.

    PubMed

    Jaun, Bernhard; Thilgen, Carlo

    2018-02-01

    e-Learning has become increasingly important in chemical education and online exams can be an attractive alternative to traditional exams written on paper, particularly in classes with a large number of students. Ten years ago, we began to set up an e-course complementing our lecture courses Organic Chemistry I and II within the open-source e-learning environment Moodle. In this article, we retrace a number of decisions we took over time, thereby illustrating the challenges one faces when creating online exercises and exams in (organic) chemistry. Special emphasis is put on the development of MOSFECCS (MOlecular Structural Formula Editor and Calculator of Canonical SMILES), our new editor for drawing structural formulae and converting them to alphanumeric SMILES codes that can be submitted as answers to e-problems. Convinced that the possibility for structure input is essential to set up sensible chemistry quizzes and exams, and realising that existing tools present major flaws in an educational context, we decided to embark on the implementation of MOSFECCS which takes into account a number of didactic aspects.

  13. Psychological and physiological responses during an exam and their relation to personality characteristics.

    PubMed

    Spangler, G

    1997-08-01

    The aim of the study was to compare emotional and physiological responses to real and control examinations and to assess their relation to personality characteristics. Emotional responses were assessed by state anxiety and perceived stress. The assessment of physiological responses included the activity of the cardiac system (heart periods, vagal tone), the adrenocortical system (cortisol) and the immune system (immune globulin A, sIgA). Emotional and physiological responses of 23 students (12 males, 11 females) were assessed during an oral exam at the end of a basic course in psychology which was a prerequisite for the students' final exams. For the control condition physiological responses were assessed one week before the examination during a memory test. The findings of the study demonstrate different emotional and physiological response patterns to examinations as compared to the control condition. Heightened anxiety was observed only before the exam. Whereas within-situation physiological responses (higher heart periods, cortisol, and sIgA; lower vagal tone) were observed both under the exam and control condition, responses to exam condition indicated pre-exam anticipatory activation and post-exam restricted recovery responses. With regard to personality characteristics subjects with high ego-resiliency showed more flexible adaptation than subjects with low ego-resiliency both on the emotional level (anxiety down-regulation after exam) and on the physiological level (situation-specific responses, quick recovery). Subjects with high ego-control exhibited a lower physiological reactivity under both conditions, i.e. they seemed to maintain longer their control also on a physiological level independent of the type of situation.

  14. Teaching Materials and Strategies for the AP Music Theory Exam

    ERIC Educational Resources Information Center

    Lively, Michael T.

    2017-01-01

    Each year, many students take the Advanced Placement (AP) Music Theory Exam, and the majority of these students enroll in specialized AP music theory classes as part of the preparation process. For the teachers of these AP music theory classes, a number of challenges are presented by the difficulty and complexity of the exam subject material as…

  15. Reworking Exams to Teach Chemistry Content and Reinforce Student Learning

    ERIC Educational Resources Information Center

    Risley, John M.

    2007-01-01

    One meaningful approach to demonstrate to students the value of reworking exams is to offer an incentive to do so. This paper describes the strategy and effects of offering partial credit to students who rework answers originally answered incorrectly on an exam. This has proved largely successful for the last 10 years in several classes at the…

  16. Approaches to Studying and Academic Performance in Short Essay Exams

    ERIC Educational Resources Information Center

    Minbashian, Amirali; Huon, Gail F.; Bird, Kevin D.

    2004-01-01

    Previous research has generally failed to find a relation between the way students approach the task of studying and their exam grades. The present study investigated why it is that a deep approach to studying, which has been shown to result in a higher quality of learning, does not consistently result in higher exam grades. The participants in…

  17. Crib Sheets and Exam Performance in a Data Structures Course

    ERIC Educational Resources Information Center

    Hamouda, Sally; Shaffer, Clifford A.

    2016-01-01

    In this paper, we study the relationship between the use of "crib sheets" or "cheat sheets" and performance on in-class exams. Our extensive survey of the existing literature shows that it is not decisive on the questions of when or whether crib sheets actually help students to either perform better on an exam or better learn…

  18. Going Green and Using Less Paper to Print Exams: Student Performance, Completion Time, and Preference

    ERIC Educational Resources Information Center

    O'Connor, Kevin J.

    2014-01-01

    Two studies measured the impact on student exam performance and exam completion time of strategies aimed to reduce the amount of paper used for printing multiple-choice course exams. Study 1 compared single-sided to double-sided printed exams. Study 2 compared a single-column arrangement of multiple-choice answer options to a space (and paper)…

  19. Introducing Standardized EFL/ESL Exams

    ERIC Educational Resources Information Center

    Laborda, Jesus Garcia

    2007-01-01

    This article presents the features, and a brief comparison, of some of the most well-known high-stakes exams. They are classified in the following fashion: tests that only include multiple-choice questions, tests that include writing and multiple-choice questions, and tests that include speaking questions. The tests reviewed are: BULATS, IELTS,…

  20. The Odds of Success: Predicting Registered Health Information Administrator Exam Success

    PubMed Central

    Dolezel, Diane; McLeod, Alexander

    2017-01-01

    The purpose of this study was to craft a predictive model to examine the relationship between grades in specific academic courses, overall grade point average (GPA), on-campus versus online course delivery, and success in passing the Registered Health Information Administrator (RHIA) exam on the first attempt. Because student success in passing the exam on the first attempt is assessed as part of the accreditation process, this study is important to health information management (HIM) programs. Furthermore, passing the exam greatly expands the graduate's job possibilities because the demand for credentialed graduates far exceeds the supply of credentialed graduates. Binary logistic regression was utilized to explore the relationships between the predictor variables and success in passing the RHIA exam on the first attempt. Results indicate that the student's cumulative GPA, specific HIM course grades, and course delivery method were predictive of success. PMID:28566994

  1. Radiation Exposure from Medical Exams and Procedures

    MedlinePlus

    Fact Sheet Adopted: January 2010 Health Physics Society Specialists in Radiation Safety Radiation Exposure from Medical Exams and Procedures Ionizing radiation is used daily in hospitals and clinics ...

  2. English-Spanish Verbatim Translation Exam.

    ERIC Educational Resources Information Center

    Stansfield, Charles W.; And Others

    The development and validation of the English-Spanish Verbatim Translation Exam (ESVTE) is described. The test is for use by the Federal Bureau of Investigation (FBI) in the selection of applicants for the positions of Language Specialist or Contract Linguist. The report is divided into eight sections. Section 1 describes the need for the test,…

  3. Sleep quality during exam stress: the role of alcohol, caffeine and nicotine.

    PubMed

    Zunhammer, Matthias; Eichhammer, Peter; Busch, Volker

    2014-01-01

    Academic exam stress is known to compromise sleep quality and alter drug consumption in university students. Here we evaluated if sleeping problems and changes in legal drug consumption during exam stress are interrelated. We used the Pittsburgh Sleep Quality Index (PSQI) to survey sleep quality before, during, and after an academic exam period in 150 university students in a longitudinal questionnaire study. Self-reports of alcohol, caffeine, and nicotine consumption were obtained. The Perceived Stress Questionnaire (PSQ-20) was used as a measure of stress. Sleep quality and alcohol consumption significantly decreased, while perceived stress and caffeine consumption significantly increased during the exam period. No significant change in nicotine consumption was observed. In particular, students shortened their time in bed and showed symptoms of insomnia. Mixed model analysis indicated that sex, age, health status, as well as the amounts of alcohol and caffeine consumed had no significant influence on global sleep quality. The amount of nicotine consumed and perceived stress were identified as significant predictors of diminished sleep quality. Nicotine consumption had a small-to-very-small effect on sleep quality; perceived stress had a small-to-moderate effect. In conclusion, diminished sleep quality during exam periods was mainly predicted by perceived stress, while legal drug consumption played a minor role. Exam periods may pose an interesting model for the study of stress-induced sleeping problems and their mechanisms.

  4. Sleep Quality during Exam Stress: The Role of Alcohol, Caffeine and Nicotine

    PubMed Central

    Zunhammer, Matthias; Eichhammer, Peter; Busch, Volker

    2014-01-01

    Academic exam stress is known to compromise sleep quality and alter drug consumption in university students. Here we evaluated if sleeping problems and changes in legal drug consumption during exam stress are interrelated. We used the Pittsburgh Sleep Quality Index (PSQI) to survey sleep quality before, during, and after an academic exam period in 150 university students in a longitudinal questionnaire study. Self-reports of alcohol, caffeine, and nicotine consumption were obtained. The Perceived Stress Questionnaire (PSQ-20) was used as a measure of stress. Sleep quality and alcohol consumption significantly decreased, while perceived stress and caffeine consumption significantly increased during the exam period. No significant change in nicotine consumption was observed. In particular, students shortened their time in bed and showed symptoms of insomnia. Mixed model analysis indicated that sex, age, health status, as well as the amounts of alcohol and caffeine consumed had no significant influence on global sleep quality. The amount of nicotine consumed and perceived stress were identified as significant predictors of diminished sleep quality. Nicotine consumption had a small-to-very-small effect on sleep quality; perceived stress had a small-to-moderate effect. In conclusion, diminished sleep quality during exam periods was mainly predicted by perceived stress, while legal drug consumption played a minor role. Exam periods may pose an interesting model for the study of stress-induced sleeping problems and their mechanisms. PMID:25279939

  5. The Coordinators of Psychiatric Education (COPE) Residency In-Training Exam: A Preliminary Psychometric Assessment

    ERIC Educational Resources Information Center

    Montgomery, Gregory P. J.; Crockford, David N.; Hecker, Kent

    2010-01-01

    Objective: The Coordinators of Psychiatric Education (COPE) Residency In-Training Exam is a formative exam for Canadian psychiatric residents that was reconstructed using assessment best practices. An assessment of psychometric properties was subsequently performed on the exam to ensure preliminary validity and reliability. Methods: An exam…

  6. SU-E-T-774: Use of a Scintillator-Mirror-Camera System for the Measurement of MLC Leakage Radiation with the CyberKnife M6 System

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Goggin, L; Kilby, W; Noll, M

    2015-06-15

    Purpose: A technique using a scintillator-mirror-camera system to measure MLC leakage was developed to provide an efficient alternative to film dosimetry while maintaining high spatial resolution. This work describes the technique together with measurement uncertainties. Methods: Leakage measurements were made for the InCise™ MLC using the Logos XRV-2020A device. For each measurement approximately 170 leakage and background images were acquired using optimized camera settings. Average background was subtracted from each leakage frame before filtering the integrated leakage image to replace anomalous pixels. Pixel value to dose conversion was performed using a calibration image. Mean leakage was calculated within an ROImore » corresponding to the primary beam, and maximum leakage was determined by binning the image into overlapping 1mm x 1mm ROIs. 48 measurements were performed using 3 cameras and multiple MLC-linac combinations in varying beam orientations, with each compared to film dosimetry. Optical and environmental influences were also investigated. Results: Measurement time with the XRV-2020A was 8 minutes vs. 50 minutes using radiochromic film, and results were available immediately. Camera radiation exposure degraded measurement accuracy. With a relatively undamaged camera, mean leakage agreed with film measurement to ≤0.02% in 92% cases, ≤0.03% in 100% (for maximum leakage the values were 88% and 96%) relative to reference open field dose. The estimated camera lifetime over which this agreement is maintained is at least 150 measurements, and can be monitored using reference field exposures. A dependency on camera temperature was identified and a reduction in sensitivity with distance from image center due to optical distortion was characterized. Conclusion: With periodic monitoring of the degree of camera radiation damage, the XRV-2020A system can be used to measure MLC leakage. This represents a significant time saving when compared to the

  7. TU-C-17A-05: Dose Domain Optimization of MLC Leaf Patterns for Highly Complicated 4Ï€ IMRT Plans

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nguyen, D; Yu, V; Ruan, D

    Purpose: Highly conformal non-coplanar 4π radiotherapy plans typically require more than 20 intensity-modulated fields to deliver. A novel method to calculate multileaf collimator (MLC) leaf patterns is introduced to maximize delivery efficiency, accuracy and plan quality. Methods: 4 GBM patients, with a prescription dose of 59.4 Gy or 60 Gy, were evaluated using the 4π algorithm using 20 beams. The MLC calculation utilized a least square minimization of the dose distribution, with an anisotropic total variation regularization term to encourage piecewise continuity in the fluence maps. Transforming the fluence to the dose domain required multiplying the fluence with a sparsemore » matrix. Exploiting this property made it feasible to solve the problem using CVX, a MATLAB-based convex modeling framework. The fluence was stratified into even step sizes, and the MLC segments, limited to 300, were calculated. The patients studied were replanned using Eclipse with the same beam angles. Results: Compared to the original 4π plan, the stratified 4π plan increased the maximum/mean dose for, in Gy, by 1.0/0.0 (brainstem), 0.5/0.2 (chiasm), 0.0/0.0 (spinal cord), 1.9/0.3 (L eye), 0.7/0.2 (R eye), 0.4/0.4 (L lens), 0.3/0.3 (R lens), 1.0/0.8 (L Optical Nerve), 0.5/0.3 (R Optical Nerve), 0.3/0.2 (L Cochlea), 0.1/0.1 (R Cochlea), 4.6/0.2 (brain), 2.4/0.1 (brain-PTV), 5.1/0.9 (PTV). Compared to Eclipse, which generated an average of 607 segments, the stratified plan reduced (−) or increased (+) the maximum/mean dose, in Gy, by −10.2/−4.1 (brainstem), −10.5/−8.9 (chiasm), +0.0/−0.1 (spinal cord), −4.9/−3.4 (L eye), −4.1/−2.5 (R eye), −2.8/−2.7 (L lens), −2.1/−1.9 (R lens), −7.6/−6.5 (L Optical Nerve), −8.9/−6.1 (R Optical Nerve), −1.3/−1.9 (L Cochlea), −1.8/−1.8 (R Cochlea), +1.7/−2.1 (brain), +3.2/−2.6 (brain-PTV), +1.8/+0.3 Gy (PTV. The stratified plan was also more homogeneous in the PTV. Conclusion: This novel solver can

  8. Undergraduate range management exam: 1999-2014

    USDA-ARS?s Scientific Manuscript database

    The Undergraduate Range Management Exam (URME) has been administered to undergraduate students at the Annual Meeting of the Society for Range Management since 1983, with students demonstrating their higher order learning skills and synthesis knowledge of the art and science of rangeland management. ...

  9. Database trial impact on graduate nursing comprehensive exams

    PubMed Central

    Pionke, Katharine; Huckstadt, Alicia

    2015-01-01

    While the authors were doing a test period of databases, the question of whether or not databases affect outcomes of graduate nursing comprehensive examinations came up. This study explored that question through using citation analysis of exams that were taken during a database trial and exams that were not. The findings showed no difference in examination pass/fail rates. While the pass/fail rates did not change, a great deal was learned in terms of citation accuracy and types of materials that students used, leading to discussions about changing how citation and plagiarism awareness were taught. PMID:26512218

  10. MO-F-204-04: Preparing for Parts 2 & 3 of the ABR Nuclear Medicine Physics Exam

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    MacDougall, R.

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and

  11. WE-D-213-04: Preparing for Parts 2 & 3 of the ABR Nuclear Medicine Physics Exam

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    MacDougall, R.

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging

  12. 46 CFR 10.304 - General medical exam.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... impairs cognitive ability, judgment, or reaction time. The Coast Guard will provide guidance on the... medical exam, but must obtain a statement from a licensed physician, physician assistant, or nurse...

  13. The AP Calculus Exam Reading Experience: Implications for Teacher Classroom Practice and Student Comprehension

    ERIC Educational Resources Information Center

    Corcoran, Mimi

    2017-01-01

    This dissertation explores the views and experiences of high school calculus teachers and college mathematics professors on the professional development which occurs at the annual national AP Calculus exam grading. This professional development experience comes in several forms: the exam briefing sessions, the actual reading of the exams, the…

  14. Accuracy of a technology-assisted eye exam in evaluation of referable diabetic retinopathy and concomitant ocular diseases.

    PubMed

    Conlin, Paul R; Asefzadeh, Baharak; Pasquale, Louis R; Selvin, Gerald; Lamkin, Rebecca; Cavallerano, Anthony A

    2015-12-01

    Digital retinal imaging using store-and-forward technology is used to screen for diabetic retinopathy (DR). Its usefulness in detecting non-diabetic eye diseases is uncertain. We determined the level of agreement between teleretinal imaging supplemented with visual acuity and intraocular pressure (IOP) measurements (ie, technology-assisted eye (TAE) exam) and a comprehensive eye exam in evaluation for DR and non-diabetic ocular conditions. We conducted a prospective, observational study with two parallel evaluations. Patients with diabetes (n=317) had a TAE exam and a comprehensive eye exam on the same day. A subset of participants with normal baseline exams (n=72) had follow-up exams 1 year later. We measured the level of agreement for referable ocular findings. Agreement for referable ocular findings was moderate (n=389, agreement: 77%; κ: 0.55), due in part to ungradable exams (22%). However, about half of the ungradable exams had findings that warranted referral. There was substantial agreement for follow-up exams (n=72, agreement: 93%; κ: 0.63). Among all gradable exams (n=303), the TAE exam had 86% sensitivity and 84% specificity for referable ocular findings, with high agreement (≥94%) for DR and other major ocular diagnoses. There was moderate-to-substantial agreement between a TAE exam and a comprehensive eye exam for referable ocular findings in patients with diabetes. Ungradable exams were a frequent marker of ocular pathology. Teleretinal imaging may be a useful evaluation for both diabetic and non-diabetic ocular conditions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. Strange non-chaotic attractors in a state controlled-cellular neural network-based quasiperiodically forced MLC circuit

    NASA Astrophysics Data System (ADS)

    Ezhilarasu, P. Megavarna; Inbavalli, M.; Murali, K.; Thamilmaran, K.

    2018-07-01

    In this paper, we report the dynamical transitions to strange non-chaotic attractors in a quasiperiodically forced state controlled-cellular neural network (SC-CNN)-based MLC circuit via two different mechanisms, namely the Heagy-Hammel route and the gradual fractalisation route. These transitions were observed through numerical simulations and hardware experiments and confirmed using statistical tools, such as maximal Lyapunov exponent spectrum and its variance and singular continuous spectral analysis. We find that there is a remarkable agreement of the results from both numerical simulations as well as from hardware experiments.

  16. Prognostic Factors and Pattern of Long-Term Recovery with MLC601 (NeuroAiD™) in the Chinese Medicine NeuroAiD Efficacy on Stroke Recovery - Extension Study.

    PubMed

    Venketasubramanian, Narayanaswamy; Lee, Chun Fan; Young, Sherry H; Tay, San San; Umapathi, Thirugnanam; Lao, Annabelle Y; Gan, Herminigildo H; Baroque Ii, Alejandro C; Navarro, Jose C; Chang, Hui Meng; Advincula, Joel M; Muengtaweepongsa, Sombat; Chan, Bernard P L; Chua, Carlos L; Wijekoon, Nirmala; de Silva, H Asita; Hiyadan, John Harold B; Suwanwela, Nijasri C; Wong, K S Lawrence; Poungvarin, Niphon; Eow, Gaik Bee; Chen, Christopher L H

    2017-01-01

    The Chinese Medicine NeuroAiD Efficacy on Stroke recovery - Extension (CHIMES-E) study is among the few acute stroke trials with long-term outcome data. We aimed to evaluate the recovery pattern and the influence of prognostic factors on treatment effect of MLC601 over 2 years. The CHIMES-E study evaluated the 2 years outcome of subjects aged ≥18 years with acute ischemic stroke, National Institutes of Health Stroke Scale (NIHSS) score 6-14, pre-stroke modified Rankin Scale (mRS) score ≤1 included in a multicenter, randomized, double-blind, placebo-controlled trial of MLC601 for 3 months. Standard stroke care and rehabilitation were allowed during follow-up with mRS score being assessed in-person at month (M) 3 and by telephone at M1, M6, M12, M18 and M24. Data from 880 subjects were analyzed. There was no difference in baseline characteristics between treatment groups. The proportion of subjects with mRS score 0-1 increased over time in favor of MLC601 most notably from M3 to M6, thereafter remaining stable up to M24, while the proportion deteriorating to mRS score ≥2 remained low at all time points. Older age (p < 0.01), female sex (p = 0.06), higher baseline NIHSS score (p < 0.01) and longer onset to treatment time (OTT; p < 0.01) were found to be predictors of poorer outcome at M3. Greater treatment effect, with more subjects improving on MLC601 than placebo, was seen among subjects with 2 or more prognostic factors (OR 1.65 at M3, 1.78 at M6, 1.90 at M12, 1.65 at M18, 1.39 at M24), especially in subjects with more severe stroke or longer OTT. The sustained benefits of MLC601 over 2 years were due to more subjects improving to functional independence at M6 and beyond compared to placebo. Selection of subjects with poorer prognosis, particularly those with more severe NIHSS score and longer OTT delay, as well as a long follow-up period, may improve the power of future trials investigating the treatment effect of neuroprotective or neurorestorative

  17. The Road to Redemption: Reclaiming the Value in Assessment Retention Exams

    ERIC Educational Resources Information Center

    Stohlman, Trey

    2015-01-01

    A good assessment plan combines many direct and indirect measures to validate the collected data. One often controversial assessment measure comes in the form of retention exams. Although assessment retention exams may come with faults, others advocate for their inclusion in program assessment. Objective-based tests may offer insight to…

  18. Cheating on Multiple-Choice Exams: Monitoring, Assessment, and an Optional Assignment

    ERIC Educational Resources Information Center

    Nath, Leda; Lovaglia, Michael

    2009-01-01

    Academic dishonesty is unethical. Exam cheating is viewed as more serious than most other forms (Pincus and Schmelkin 2003). The authors review the general cheating problem, introduce a program to conservatively identify likely cheaters on multiple-choice exams, and offer a procedure for handling likely cheaters. Feedback from students who confess…

  19. Principal Licensure Exams and Future Job Performance: Evidence from the School Leaders Licensure Assessment

    ERIC Educational Resources Information Center

    Grissom, Jason A.; Mitani, Hajime; Blissett, Richard S. L.

    2017-01-01

    Many states require prospective principals to pass a licensure exam to obtain an administrative license, but we know little about the potential effects of principal licensure exams on the pool of available principals or whether scores predict later job performance. We investigate the most commonly used exam, the School Leaders Licensure Assessment…

  20. Do You Prefer to Have the Text or a Sheet with Your Physics Exams?

    ERIC Educational Resources Information Center

    Hamed, Kastro M.

    2008-01-01

    Many high school and introductory college physics instructors ponder the choice between "open text" exams versus "facts and formulae sheet" exams. Other alternatives are closed book/closed notes exams or an instructor-prepared sheet of facts and relevant formulas. There is no agreement on merit. Rehfuss strongly opposes allowing students to use…

  1. The Value of Analysis of Standardized Placement Exams: A Case Study of Cell Structure.

    ERIC Educational Resources Information Center

    Blystone, Robert V.

    This study focused on potential pedagological uses of standardized placement exams. A sample of 250 exams of the May 1984 Biology Advanced Placement (AP) exam was obtained and student responses to the question on cell structure were analyzed. The frequency of particular responses to the question is listed and trends and patterns in the responses…

  2. The Effect of School Size on Exam Performance in Secondary Schools.

    ERIC Educational Resources Information Center

    Bradley, Steve; Taylor, Jim

    1998-01-01

    Examines the effects of school size on exam performance for pupils in their final year of compulsory education in England. Background information about English secondary schools and the determinants of exam performance are discussed along with a description of the variables used in the econometric analysis and their expected effects on exam…

  3. Do Exam Wrappers Increase Metacognition and Performance? A Single Course Intervention

    ERIC Educational Resources Information Center

    Soicher, Raechel N.; Gurung, Regan A. R.

    2017-01-01

    Previous research has indicated that an intervention called "exam wrappers" can improve students' metacognition when they are using wrappers in more than one course per academic term. In this study, we tested if exam wrappers would improve students' metacognition and academic performance when used in only one course per academic term. A…

  4. Writing Proficiency Exams and the Internationalization of U.S. Higher Education

    ERIC Educational Resources Information Center

    Mott-Smith, Jennifer A.

    2012-01-01

    In the U.S., writing proficiency exams (WPEs) often employ a construct of writing proficiency that is based on U.S. English and essay-text literacy. As universities internationalize, they should reconsider whether such exams reflect the literacy requirements of a globalizing world. Since the ways in which universities respond to international…

  5. An innovative addition to team-based-learning pedagogy to enhance teaching and learning: Students' perceptions of team exams.

    PubMed

    Khansari, Parto S; Coyne, Leanne

    The study investigates students' perceptions of the value of implementing a team exam to enhance learning prior to a summative assessment. Team exams are similar to midterm exams, except that answering questions is a team effort. Data was collected from second year pharmacy students at California Northstate University College of Pharmacy (CNUCOP) through a self-administered online survey. The survey questions included closed-ended questions to evaluate students' perception on preparedness for a summative assessment and to rank advantages and disadvantages of the team exams. Of the 40 students who completed the survey (38% response rate), 100% of participants agreed that having a team exam prior to a major exam made them feel more prepared for a major summative exam. Ninety-seven percent of students believed that the team exam helped them to identify gaps in their knowledge and 85% agreed that taking a team exam reinforced their knowledge by teaching other students. The survey results did not identify any major disadvantages to holding a team exam. Students perceived that taking a team exam prior to a midterm exam is an effective approach to review the course contents and identify areas of improvement. Copyright © 2017. Published by Elsevier Inc.

  6. Students' Attitudes towards Group-Based Project Exams in Two Engineering Programmes

    ERIC Educational Resources Information Center

    Dahl, Bettina; Kolmos, Anette

    2015-01-01

    At Aalborg University, engineering students spend half the time each semester in groups working on projects in a problem-based learning (PBL) curriculum. The projects are assessed through group exams, except for between 2007 and 2013 when the law forbade group-based project exams. Prior to 2007, a survey showed that students preferred the…

  7. Effects of Online Testing on Student Exam Performance and Test Anxiety

    ERIC Educational Resources Information Center

    Stowell, Jeffrey R.; Bennett, Dan

    2010-01-01

    Increased use of course management software to administer course exams online for face-to-face classes raises the question of how well test anxiety and other emotions generalize from the classroom to an online setting. We hypothesized that administering regular course exams in an online format would reduce test anxiety experienced at the time of…

  8. AK State Profile. Alaska: Alaska High School Graduation Qualifying Exam (HSGOE)

    ERIC Educational Resources Information Center

    Center on Education Policy, 2010

    2010-01-01

    This paper provides information about Alaska High School Graduation Qualifying Exam (HSGQE), a comprehensive standards-based exam. Its purpose is to meet a state mandate. A bill to remove the HSGQE as a graduation requirement by July 1, 2011 was presented to the state legislature as SB 109. However, it did not pass both houses of the legislature.…

  9. Using the First Exam for Student Placement in Beginning Chemistry Courses

    ERIC Educational Resources Information Center

    Mills, Pamela; Sweeney, William; Bonner, Sarah M.

    2009-01-01

    The first exam in a typical first-semester general chemistry course is used to identify students at risk of failing the course. The performance at Hunter College of 667 students on the first exam in general chemistry in seven different classes between fall 2000 and fall 2005 was correlated with the students' final score in the course. The…

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

    NASA Astrophysics Data System (ADS)

    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 "Scantron." OMR scanners combine hardware and software—a scanner and OMR program—to read and grade student-filled forms.

  11. Correlation of the NBME advanced clinical examination in EM and the national EM M4 exams.

    PubMed

    Hiller, Katherine; Miller, Emily S; Lawson, Luan; Wald, David; Beeson, Michael; Heitz, Corey; Morrissey, Thomas; House, Joseph; Poznanski, Stacey

    2015-01-01

    Since 2011 two online, validated exams for fourth-year emergency medicine (EM) students have been available (National EM M4 Exams). In 2013 the National Board of Medical Examiners offered the Advanced Clinical Examination in Emergency Medicine (EM-ACE). All of these exams are now in widespread use; however, there are no data on how they correlate. This study evaluated the correlation between the EM-ACE exam and the National EM M4 Exams. From May 2013 to April 2014 the EM-ACE and one version of the EM M4 exam were administered sequentially to fourth-year EM students at five U.S. medical schools. Data collected included institution, gross and scaled scores and version of the EM M4 exam. We performed Pearson's correlation and random effects linear regression. 305 students took the EM-ACE and versions 1 (V1) or 2 (V2) of the EM M4 exams (281 and 24, respectively) [corrected].The mean percent correct for the exams were as follows: EM-ACE 74.9 (SD-9.82), V1 83.0 (SD-6.39), V2 78.5 (SD-7.70) [corrected]. Pearson's correlation coefficient for the V1/EM-ACE was 0.53 (0.43 scaled) and for the V2/EM-ACE was 0.58 (0.41 scaled) [corrected]. The coefficient of determination for V1/ EM-ACE was 0.73 and for V2/EM-ACE 0.71 (0.65 and .49 for scaled scores) [ERRATUM]. The R-squared values were 0.28 and 0.30 (0.18 and 0.13 scaled), respectively [corrected]. There was significant cluster effect by institution. There was moderate positive correlation of student scores on the EM-ACE exam and the National EM M4 Exams.

  12. Clinical breast exam screening by trained laywomen in Malawi integrated with other health services

    PubMed Central

    Gutnik, Lily; Lee, Clara; Msosa, Vanessa; Moses, Agnes; Stanley, Christopher; Mzumara, Suzgo; Liomba, N. George; Gopal, Satish

    2016-01-01

    Background Breast cancer awareness and early detection are limited in sub-Saharan Africa. Resource limitations make screening mammography or clinical breast exam (CBE) by physicians or nurses impractical in many settings. We aimed to assess feasibility and performance of CBE by laywomen in urban health clinics in Malawi. Methods Four laywomen were trained to deliver breast cancer educational talksand conduct CBE. After training, screening was implemented in diverse urbanhealth clinics. Eligible women were ≥30 years, with no prior breast cancer or breast surgery, and clinic attendance for reasons other than abreast concern. Wo men with abnormal CBE were referred to a study surgeon. All palpable masses confirmed by surgeon exam were pathologically sampled. Patients with abnormal screening CBE but normal surgeon exam underwentbreast ultrasound con firmation. Additionally, 50 randomly selected women with normal screening CBE underwent breast ultrasound, and 45 different women with normal CBE were randomly assigned to surgeon exam. Results Among 1,220 eligible women, 1,000 (82%) agreed to CBE. Lack of time (69%) was the commonest reason for refusal. Educational talk attendance was associated with higher CBE participation (83% vs 77%, p=0.012). Among 1,000 women screened, 7% had abnormal CBE. Of 45 women with normal CBE randomized to physician exam, 43 had normal exams and two had axillary lymphadenopathy not detected by CBE. Sixty of 67 women (90%) with abnormal CBE attended the referral visit. Of these, 29 (48%) had concordant abnormal physician exam. Thirty-one women (52%) had discordant normal physician exam, all of whom also had normal breast ultrasounds. Compared to physician exam, sensitivity for CBE by laywomen was 94% (CI 79-99%), specificity 58% (CI 46-70%), positive predictive value 48% (CI 35-62%), and negative predictive value 96% (CI 85-100%). Of 13 women who underwent recommended pathologic sampling of a breast lesion, two had cytologic dysplasia and all

  13. Academic Achievement by Graduates from For-Profit and Nonprofit Institutions: Evidence from CPA Exam Performance

    ERIC Educational Resources Information Center

    Mittelstaedt, H. Fred; Morris, Michael H.

    2017-01-01

    This study shows that graduates from nonprofit educational institutions outperform graduates from for-profit institutions on the four sections of the certified public accountant (CPA) exam. Specifically, it (1) documents univariate differences in CPA exam scores, score distributions, pass rates, and time to complete the CPA exam; (2) investigates…

  14. [Docimologic analysis of 4th-year preclinical exam questions].

    PubMed

    Gnagne-Agnero, Koffi N; Zinsou, E M; Assoumou, N M; Adiko, E F

    2003-12-01

    Operative Dentistry and Endodontics' Department of the School of Dentistry of Abidjan experienced pre-clinical exam in fourth year of dentistry with MCQ following guided courses which aim was to lead student to be correctly in charge of the patients when they start their first clinical performance. The objective off his this work is to show how one's can analyse exams questions efficiently. In this work the authors present et discuss the results of the evaluation of this preclinical exam performed through calculation of index of success (Ir) which gives us information on the difficulty of a question for all the students who answered, the discriminative index (Id) which allow to determine when a question is selective enough to distinguish weak to strong students in a group. The mean to evaluate is well chosen because the questions asked has a Ir between 46% et 80% (satisfying Ir) and the average Id is between 0.30 and 0.53 (Id discriminates well among 0.30 et 1). This methodology allows an evaluation of a high number of students by stocked questions.

  15. Evaluation of Performance and Perceptions of Electronic vs. Paper Multiple-Choice Exams

    ERIC Educational Resources Information Center

    Washburn, Shannon; Herman, James; Stewart, Randolph

    2017-01-01

    In the veterinary professional curriculum, methods of examination in many courses are transitioning from the traditional paper-based exams to electronic-based exams. Therefore, a controlled trial to evaluate the impact of testing methodology on examination performance in a veterinary physiology course was designed and implemented. Formalized…

  16. Durability of the beneficial effect of MLC601 (NeuroAiD™) on functional recovery among stroke patients from the Philippines in the CHIMES and CHIMES-E studies.

    PubMed

    Navarro, Jose C; Chen, Christopher Lh; Lee, Chun F; Gan, Herminigildo H; Lao, Annabelle Y; Baroque, Alejandro C; Hiyadan, John Harold B; Chua, Carlos L; San Jose, Ma Cristina; Advincula, Joel M; Venketasubramanian, Narayanaswamy

    2017-04-01

    Background and Aim A pre-specified country analysis of subjects from the Philippines in the CHInese Medicine NeuroAiD Efficacy on Stroke recovery (CHIMES) Study showed significantly improved functional and neurological outcomes on MLC601 at month (M) 3. We aimed to assess these effects on long-term functional recovery in the Filipino cohort. Methods The CHIMES-E (extension) Study evaluated subjects who completed three months of randomized placebo-controlled treatment in CHIMES up to two years. Blinding of treatment allocation was maintained and all subjects received standard stroke care and rehabilitation. Modified Rankin Score (mRS) and Barthel Index (BI) were assessed in-person at M3 and by telephone at M6, M12, M18, M24. Odds ratios (OR) with corresponding 95% confidence intervals (CI) for functional recovery using ordinal analysis of mRS and for achieving functional independence (mRS 0-1 or BI ≥ 95) at each time point were calculated, adjusting for age, sex, baseline National Institute of Health Stroke Scale (NIHSS), onset-to-treatment time (OTT) and pre-stroke mRS. Results The 378 subjects (MLC601 192, placebo 186) included in CHIMES-E from the Philippines (mean age 60.2 ± 11.1) had more women ( p < 0.001), worse baseline NIHSS ( p < 0.001) and longer onset to treatment time ( p = 0.002) compared to other countries. Baseline characteristics were similar between treatment groups. The treatment effect of MLC601 seen at M3 peaked at M6 with OR for mRS shift of 1.53 (95% CI 1.05-2.22), mRS dichotomy 0-1 of 1.77 (95% CI 1.10-2.83), and BI ≥ 95 of 1.87 (95% CI 1.16-3.02). The beneficial effect persisted up to M24. Conclusion The beneficial effect of MLC601 seen at M3 in the Filipino cohort is durable up to two years after stroke.

  17. Evaluating outcomes of computer-based classroom testing: Student acceptance and impact on learning and exam performance.

    PubMed

    Zheng, Meixun; Bender, Daniel

    2018-03-13

    Computer-based testing (CBT) has made progress in health sciences education. In 2015, the authors led implementation of a CBT system (ExamSoft) at a dental school in the U.S. Guided by the Technology Acceptance Model (TAM), the purposes of this study were to (a) examine dental students' acceptance of ExamSoft; (b) understand factors impacting acceptance; and (c) evaluate the impact of ExamSoft on students' learning and exam performance. Survey and focus group data revealed that ExamSoft was well accepted by students as a testing tool and acknowledged by most for its potential to support learning. Regression analyses showed that perceived ease of use and perceived usefulness of ExamSoft significantly predicted student acceptance. Prior CBT experience and computer skills did not significantly predict acceptance of ExamSoft. Students reported that ExamSoft promoted learning in the first program year, primarily through timely and rich feedback on examination performance. t-Tests yielded mixed results on whether students performed better on computerized or paper examinations. The study contributes to the literature on CBT and the application of the TAM model in health sciences education. Findings also suggest ways in which health sciences institutions can implement CBT to maximize its potential as an assessment and learning tool.

  18. Language Placement and Beyond: Guidelines for the Design and Implementation of a Computerized Spanish Heritage Language Exam

    ERIC Educational Resources Information Center

    Beaudrie, Sara M.; Ducar, Cynthia

    2012-01-01

    This paper outlines the design, implementation, and analysis of a computerized Spanish heritage language (SHL) placement exam. The exam created by the authors exemplifies how to design a simple yet effective placement exam with limited resources. It is suggested that an SHL placement exam should be developed in-house due not only to the diversity…

  19. Developing an evidence base of best practices for integrating computerized systems into the exam room: a systematic review.

    PubMed

    Patel, Minal R; Vichich, Jennifer; Lang, Ian; Lin, Jessica; Zheng, Kai

    2017-04-01

    The introduction of health information technology systems, electronic health records in particular, is changing the nature of how clinicians interact with patients. Lack of knowledge remains on how best to integrate such systems in the exam room. The purpose of this systematic review was to (1) distill "best" behavioral and communication practices recommended in the literature for clinicians when interacting with patients in the presence of computerized systems during a clinical encounter, (2) weigh the evidence of each recommendation, and (3) rank evidence-based recommendations for electronic health record communication training initiatives for clinicians. We conducted a literature search of 6 databases, resulting in 52 articles included in the analysis. We extracted information such as study setting, research design, sample, findings, and implications. Recommendations were distilled based on consistent support for behavioral and communication practices across studies. Eight behavioral and communication practices received strong support of evidence in the literature and included specific aspects of using computerized systems to facilitate conversation and transparency in the exam room, such as spatial (re)organization of the exam room, maintaining nonverbal communication, and specific techniques that integrate the computerized system into the visit and engage the patient. Four practices, although patient-centered, have received insufficient evidence to date. We developed an evidence base of best practices for clinicians to maintain patient-centered communications in the presence of computerized systems in the exam room. Further work includes development and empirical evaluation of evidence-based guidelines to better integrate computerized systems into clinical care. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  20. Experience using radio frequency laptops to access the electronic medical record in exam rooms.

    PubMed Central

    Dworkin, L. A.; Krall, M.; Chin, H.; Robertson, N.; Harris, J.; Hughes, J.

    1999-01-01

    Kaiser Permanente, Northwest, evaluated the use of laptop computers to access our existing comprehensive Electronic Medical Record in exam rooms via a wireless radiofrequency (RF) network. Eleven of 22 clinicians who were offered the laptops successfully adopted their use in the exam room. These clinicians were able to increase their exam room time with the patient by almost 4 minutes (25%), apparently without lengthening their overall work day. Patient response to exam room computing was overwhelmingly positive. The RF network response time was similar to the hardwired network. Problems cited by some laptop users and many of the eleven non-adopters included battery issues, different equipment layout and function, and inadequate training. IT support needs for the RF laptops were two to four times greater than for hardwired desktops. Addressing the reliability and training issues should increase clinician acceptance, making a successful general roll-out for exam room computing more likely. PMID:10566458

  1. Learning during a Collaborative Final Exam

    ERIC Educational Resources Information Center

    Dahlstrom, Orjan

    2012-01-01

    Collaborative testing has been suggested to serve as a good learning activity, for example, compared to individual testing. The aim of the present study was to measure learning at different levels of knowledge during a collaborative final exam in a course in basic methods and statistical procedures. Results on pre- and post-tests taken…

  2. Beta-Blockers for Exams Identify Students at High Risk of Psychiatric Morbidity.

    PubMed

    Butt, Jawad H; Dalsgaard, Søren; Torp-Pedersen, Christian; Køber, Lars; Gislason, Gunnar H; Kruuse, Christina; Fosbøl, Emil L

    2017-04-01

    Beta-blockers relieve the autonomic symptoms of exam-related anxiety and may be beneficial in exam-related and performance anxiety, but knowledge on related psychiatric outcomes is unknown. We hypothesized that beta-blocker therapy for exam-related anxiety identifies young students at risk of later psychiatric events. Using Danish nationwide administrative registries, we studied healthy students aged 14-30 years (1996-2012) with a first-time claimed prescription for a beta-blocker during the exam period (May-June); students who were prescribed a beta-blocker for medical reasons were excluded. We matched these students on age, sex, and time of year to healthy and study active controls with no use of beta-blockers. Risk of incident use of antidepressants, incident use of other psychotropic medications, and suicide attempts was examined by cumulative incidence curves for unadjusted associations and multivariable cause-specific Cox proportional hazard analyses for adjusted hazard ratios (HRs). We identified 12,147 healthy students with exam-related beta-blocker use and 12,147 matched healthy students with no current or prior use of beta-blockers (median age, 19 years; 80.3% women). Among all healthy students, 0.14% had a first-time prescription for a beta-blocker during the exam period with the highest proportion among students aged 19 years (0.39%). Eighty-one percent of the students filled only that single prescription for a beta-blocker during follow-up. During follow-up, 2225 (18.3%) beta-blocker users and 1400 (11.5%) nonbeta-blocker users were prescribed an antidepressant (p < 0.0001); 1225 (10.1%) beta-blocker users and 658 (5.4%) nonbeta-blocker users were prescribed a psychotropic drug (p < 0.0001); and 16 (0.13%) beta-blocker users and 6 (0.05%) nonbeta-blocker users attempted suicide (p = 0.03). Exam-related beta-blocker use was associated with an increased risk of antidepressant use (adjusted HRs, 1.68 [95% confidence intervals (CIs), 1

  3. The Role of Frequent Short Exams in Improving Student Performance in Hybrid Global Business Classes

    ERIC Educational Resources Information Center

    Nakos, George; Whiting, Anita

    2018-01-01

    The authors investigate whether frequent in class exams can improve the performance of students in hybrid global business courses. An experiment was conducted in three hybrid sections of a global business course exposing students to short in class exams. The expectation of a short exam forces students to watch the online lectures and study the…

  4. Improving consistency in large laboratory courses: a design for a standardized practical exam.

    PubMed

    Chen, Xinnian; Graesser, Donnasue; Sah, Megha

    2015-06-01

    Laboratory courses serve as important gateways to science, technology, engineering, and mathematics education. One of the challenges in assessing laboratory learning is to conduct meaningful and standardized practical exams, especially for large multisection laboratory courses. Laboratory practical exams in life sciences courses are frequently administered by asking students to move from station to station to answer questions, apply knowledge gained during laboratory experiments, interpret data, and identify various tissues and organs using various microscopic and gross specimens. This approach puts a stringent time limit on all questions regardless of the level of difficulty and also invariably increases the potential risk of cheating. To avoid potential cheating in laboratory courses with multiple sections, the setup for practical exams is often changed in some way between sections. In laboratory courses with multiple instructors or teaching assistants, practical exams may be handled inconsistently among different laboratory sections, due to differences in background knowledge, perceptions of the laboratory goals, or prior teaching experience. In this article, we describe a design for a laboratory practical exam that aims to align the assessment questions with well-defined laboratory learning objectives and improve the consistency among all laboratory sections. Copyright © 2015 The American Physiological Society.

  5. Students' Attitudes and Perceptions about the Use of Cooperative Exams in an Introductory Leadership Class

    ERIC Educational Resources Information Center

    Moore, Lori L.

    2010-01-01

    This study sought to examine student perceptions related to the use of cooperative exams in an introductory leadership class. In this study, cooperative exams were used as a collaborative learning activity in which students took class exams individually first and then as a peer group. The majority of students (n = 41, 61.4%) had not previously…

  6. Red vs. green: Does the exam booklet color matter in higher education summative evaluations? Not likely.

    PubMed

    Arthur, Winfred; Cho, Inchul; Muñoz, Gonzalo J

    2016-10-01

    We examined the so-called "red effect" in the context of higher education summative exams under the premise that unlike the conditions or situations where this effect typically has been obtained, the totality of factors, such as higher motivation, familiarity with exam material, and more reliance on domain knowledge that characterize high-stakes testing such as those in operational educational settings, are likely to mitigate any color effects. Using three naturally occurring archival data sets in which students took exams on either red or green exam booklets, the results indicated that booklet color (red vs. green) did not affect exam performance. From a scientific perspective, the results suggest that color effects may be attenuated by factors that characterize high-stakes assessments, and from an applied perspective, they suggest that the choice of red vs. green exam booklets in higher education summative evaluations is likely not a concern.

  7. Cheating in a Dental Practical Exam

    ERIC Educational Resources Information Center

    Currie, Wendy; Dracopoulos, Susie; Hendry, Graham

    2017-01-01

    There is increasing attention given to academic integrity across university education and dental schools are not immune to this problem (Andrews et al. J Dent Educ 71; 1027-1039, 2007; Ford & Hughes Eur J Dent Educ 16(1):e180-e186, 2012). While there has been an increasing concern about academic dishonesty in written exams and assignments,…

  8. Inference on cancer screening exam accuracy using population-level administrative data.

    PubMed

    Jiang, H; Brown, P E; Walter, S D

    2016-01-15

    This paper develops a model for cancer screening and cancer incidence data, accommodating the partially unobserved disease status, clustered data structures, general covariate effects, and dependence between exams. The true unobserved cancer and detection status of screening participants are treated as latent variables, and a Markov Chain Monte Carlo algorithm is used to estimate the Bayesian posterior distributions of the diagnostic error rates and disease prevalence. We show how the Bayesian approach can be used to draw inferences about screening exam properties and disease prevalence while allowing for the possibility of conditional dependence between two exams. The techniques are applied to the estimation of the diagnostic accuracy of mammography and clinical breast examination using data from the Ontario Breast Screening Program in Canada. Copyright © 2015 John Wiley & Sons, Ltd.

  9. Alone in the Crowd: I Failed the ABGC Certification Exam.

    PubMed

    Colón, Christine

    2016-08-01

    The American Board of Genetic Counseling (ABGC) certification examination (often referred to as "the board exam") has become a milestone within the field of genetic counseling. For many, it is the final standardized test taken and indicates the examinee has met "the standards of minimal competence to practice as a genetic counselor" (Bulletin 2015). Although voluntary, certification is strongly encouraged, and in some employment situations, required. Although recent statistics indicate the majority of those who take the test pass, each year there are those who sit for the test unsuccessfully. Despite this fact, exam failure and tools for dealing with this experience are not often broached in the literature. This essay recalls my experiences with a failed exam attempt and the subsequent emotional turmoil. It also aims to start the conversation regarding the difficulty of coping with the "secret" shame of public, professional failure, and suggests there is room for further discussion and resource development in this area.

  10. Helping Students Prepare for Qualifying Exams; A Summary of WCRA Institute III.

    ERIC Educational Resources Information Center

    Parmer, Lorraine

    This paper describes several learning laboratory program approaches to teaching students how to prepare for professional school admission exams. That these exams are true aptitude tests is a myth repeatedly deflated when students study for the tests and manage to score significantly higher on a second testing. Factors in addition to intelligence…

  11. Does Failing a Placement Exam Discourage Underprepared Students from Going to College?

    ERIC Educational Resources Information Center

    Martorell, Paco; McFarlin, Isaac, Jr.; Xue, Yu

    2015-01-01

    About one third of college students are required to take remedial courses. Assignment to remediation is generally made on the basis of performance on a placement exam. When students are required to take a placement exam "prior" to enrolling in college-level courses, assignment to remediation may dissuade students from actually going to…

  12. The Impact of Assessment Policy on Learning: Replacement Exams or Grade Dropping

    ERIC Educational Resources Information Center

    MacDermott, Raymond J.

    2013-01-01

    Instructors often debate the merits of alternate grading policies such as dropping the lowest exam or offering an additional exam to replace the lowest score. To date, there has been little research conducted on the impact of these policies on performance. In this study, the author investigates student performance in intermediate macroeconomics…

  13. Changes in Student Attributions Due to the Implementation of Central Exit Exams

    ERIC Educational Resources Information Center

    Oerke, Britta; Maag Merki, Katharina; Holmeier, Monika; Jager, Daniela J.

    2011-01-01

    The central aim of standardized exit exams is to motivate students and teachers to work harder on critical subject matters and thus increase student achievement. However, the effects of the implementation of central exams on student motivation have not been analyzed in a longitudinal section until now. In the present study, the consequences of…

  14. Providing the Answers Does Not Improve Performance on a College Final Exam

    ERIC Educational Resources Information Center

    Glass, Arnold Lewis; Sinha, Neha

    2013-01-01

    In the context of an upper-level psychology course, even when students were given an opportunity to refer to text containing the answers and change their exam responses in order to improve their exam scores, their performance on these questions improved slightly or not at all. Four experiments evaluated competing explanations for the students'…

  15. Can formative quizzes predict or improve summative exam performance?*

    PubMed Central

    Zhang, Niu; Henderson, Charles N.R.

    2015-01-01

    Objective Despite wide use, the value of formative exams remains unclear. We evaluated the possible benefits of formative assessments in a physical examination course at our chiropractic college. Methods Three hypotheses were examined: (1) Receiving formative quizzes (FQs) will increase summative exam (SX) scores, (2) writing FQ questions will further increase SE scores, and (3) FQs can predict SX scores. Hypotheses were tested across three separate iterations of the class. Results The SX scores for the control group (Class 3) were significantly less than those of Classes 1 and 2, but writing quiz questions and taking FQs (Class 1) did not produce significantly higher SX scores than only taking FQs (Class 2). The FQ scores were significant predictors of SX scores, accounting for 52% of the SX score. Sex, age, academic degrees, and ethnicity were not significant copredictors. Conclusion Our results support the assertion that FQs can improve written SX performance, but students producing quiz questions didn't further increase SX scores. We concluded that nonthreatening FQs may be used to enhance student learning and suggest that they also may serve to identify students who, without additional remediation, will perform poorly on subsequent summative written exams. PMID:25517737

  16. MLC Libraries--A School Library's Journey with Students, Staff and Web 2.0 Technologies: Blogs, Wikis and E-Books--Where Are We Going Next?

    ERIC Educational Resources Information Center

    Viner, Jane; Lucas, Amanda; Ricchini, Tracey; Ri, Regina

    2010-01-01

    This workshop paper explores the Web 2.0 journey of the MLC Libraries' teacher-librarians, librarian, library and audio visual technicians. Our journey was initially inspired by Will Richardson and supported by the School Library Association of Victoria (SLAV) Web 2.0 professional development program. The 12 week technological skills program…

  17. Factors Affecting Success in the Professional Entry Exam for Accountants in Brazil

    ERIC Educational Resources Information Center

    Lima Rodrigues, Lúcia; Pinho, Carlos; Bugarim, Maria Clara; Craig, Russell; Machado, Diego

    2018-01-01

    This paper explores factors that have affected the success of candidates in the professional entry exam conducted by Brazil's Federal Council of Accounting. We analyse results of 18,948 candidates who sat for the exam in 2012, using a logistic regression model and the key indicators used by government to monitor the performance of higher education…

  18. Does Eating Breakfast Affect the Performance of College Students on Biology Exams?

    ERIC Educational Resources Information Center

    Phillips, Gregory W.

    2005-01-01

    This study examined the breakfast eating habits of 1,259 college students over an eleven year period to determine if eating breakfast had an impact upon their grade on a General Biology exam. The study determined that there was a significant difference in the performance on the exam with a higher percent of the participants, who had eaten…

  19. High School Exit Exams and Dropout in an Era of Increased Accountability

    ERIC Educational Resources Information Center

    Hemelt, Steven W.; Marcotte, Dave E.

    2013-01-01

    A key form of student-level accountability is the requirement for students to pass high school exit exams (HSEEs) in order to receive a diploma. In this paper, we examine the impact of HSEEs on dropout during a period when these exams became more common and rigorous. Further, we study whether offering alternate pathways to graduation for students…

  20. The Effect of Tutoring on Math Scores for the Praxis I Exam

    ERIC Educational Resources Information Center

    Longwell-Grice, Robert; McIlheran, Janine; Schroeder, Mark; Scheele, Steve

    2013-01-01

    The Praxis test is one of a series of national teacher certification exams written and administered by the Education Testing Service (ETS) since 1947. Currently, forty states now require some form of the Praxis Series (Educational Testing Service, 2011). Using pre- and post-tests similar to the Praxis I math exam, this study examined the affect…

  1. The Integrated Skin Exam film: an educational intervention to promote early detection of melanoma by medical students.

    PubMed

    Garg, Amit; Wang, Joyce; Reddy, Shalini B; Powers, Jennifer; Jacob, Reza; Powers, Michael; Biello, Katie; Cayce, Rachael; Savory, Stephanie; Belazarian, Leah; Domingues, Erik; Korzenko, Adam; Wilson, Lindsay; Grant-Kels, Jane M; George, Paul; Robinson-Bostom, Leslie; Trotter, Shannon C; Geller, Alan C

    2014-01-01

    Knowledge of the skin cancer examination (SCE) and its practice remain relevant competency gaps among medical students. We elaborate on a method of SCE known as the Integrated Skin Exam and discuss the development of an instructional film that illustrates its principles. We assess the tool's effect on knowledge, attitudes, and perceptions related to the SCE. Second-year students among 8 randomized schools viewed the film and completed pre-post questionnaires. After viewing The Integrated Skin Exam film, students demonstrated improved melanoma knowledge, including identification of high-risk demographic groups (61% vs 42.9%, P < .001), high-risk anatomic sites in women (88.6% vs 46.5%, P < .001) and men (92.1% vs 34.8%, P < .001), and the ABCDEs of melanoma (98.4% vs 91.2%, P < .001). Students demonstrated increased confidence in the SCE (66.93% vs 16.40%, P < .001) and augmented intentions to practice it (99.05% vs 13.9%, P < .001). A greater proportion (70.4% vs 41.9%, P < .001) of students thought less than 3 minutes were required to integrate SCE into the routine examination. Longitudinal impact of the film was not assessed. The Integrated Skin Exam film introduces an integrated approach to the SCE that addresses knowledge gaps, mitigates perceived barriers, and augments intention related to practice of the SCE. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  2. Improving Consistency in Large Laboratory Courses: A Design for a Standardized Practical Exam

    ERIC Educational Resources Information Center

    Chen, Xinnian; Graesser, Donnasue; Sah, Megha

    2015-01-01

    Laboratory courses serve as important gateways to science, technology, engineering, and mathematics education. One of the challenges in assessing laboratory learning is to conduct meaningful and standardized practical exams, especially for large multisection laboratory courses. Laboratory practical exams in life sciences courses are frequently…

  3. High-Stakes, Minimum-Competency Exams: How Competent Are They for Evaluating Teacher Competence?

    ERIC Educational Resources Information Center

    Goodman, Gay; Arbona, Consuelo; Dominguez de Rameriz, Romilia

    2008-01-01

    Increasingly, teacher educators recommend authentic, performance-related measures for evaluating teacher candidates. Nevertheless, more states are requiring teachers to pass high-stakes, minimum-competency exams. This study examined the relation between teacher candidate scores on authentic measures and their scores on certification exams required…

  4. Flip-chip replacement within the constraints imposed by multilayer ceramic (MLC) modules

    NASA Astrophysics Data System (ADS)

    Puttlitz, Karl J.

    1984-01-01

    Economics often dictates that suitable module rework procedures be established to replace solder bump devices (flip chips) reflowed to multichip carriers. These operations are complicated, owing to various constraints such as the substrate's physical and mechanical properties, close proximity of surface features, etc. This paper describes the constraints and the methods to circumvent them. An order of preference based upon the degree of constraint is recommended to achieve device removal and subsequent site dress of the residual solder left on the substrate. It has been determined that rework (device replacement) can be successfully achieved in even highly constricted situations. This is illustrated by the example of utilizing a localized heating technique, hot gas, to remove solder from microsockets from which chips were previously removed. Microsockets are areas to which chips are reflowed to the top surface of IBM's densely populated multilayer ceramic (MLC) modules, thus forming the so-called controlled collapse chip connection or C-4. The microsocket patterns are thus identical to the chip footprint.

  5. Realisation of the guidelines for faculty-internal exams at the Department of General Medicine at the University of Munich: Pushing medical exams one step ahead with IMSm.

    PubMed

    Boeder, Niklas; Holzer, Matthias; Schelling, Jörg

    2012-01-01

    Graded exams are prerequisites for the admission to the medical state examination. Accordingly the exams must be of good quality in order to allow benchmarking with the faculty and between different universities. Criteria for good quality need to be considered - namely objectivity, validity and reliability. The guidelines for the processing of exams published by the GMA are supposed to help maintaining those criteria. In 2008 the Department of General Medicine at the University of Munich fulfils only 14 of 18 items. A review process, appropriate training of the staff and the introduction of the IMSm software were the main changes that helped to improve the 'GMA-score' to 30 fulfilled items. We see the introduction of the IMSm system as our biggest challenge ahead. IMSm helps to streamline the necessary workflow and improves their quality (e.g. by the detection of cueing, item analysis). Overall, we evaluate the steps to improve the exam process as very positive. We plan to engage co-workers outside the department to assist in the various review processes in the future. Furthermore we think it might be of value to get into contact with other departments and faculties to benefit from each other's question pools.

  6. TH-AB-207A-03: Skin Dose to Patients Receiving Multiple CTA and CT Exams of the Head

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nawfel, RD; Young, G

    Purpose: To measure patient skin dose from CT angiography (CTA) and CT exams of the head, and determine if patients having multiple exams could receive cumulative doses that approach or exceed deterministic thresholds. Methods: This study was HIPAA compliant and conducted with IRB approval. Patient skin doses were measured over a 4 month period using nanoDot OSL dosimeters placed on the head of 52 patients for two CT scanners. On each scanner, 26 patients received CT exams (scanner 1: 10 females, 16 males, mean age 64.2 years; scanner 2: 18 females, 8 males, mean age 61.2 years). CT exam dosemore » metrics, CTDIvol and dose-length product (DLP) were recorded for each exam. Additionally, skin dose was measured on an acrylic skull phantom in each scanner and on a neuro-interventional imaging system using clinical protocols. Measured dose data was used to estimate peak skin dose (PSD) for 4 patients receiving multiple exams including CTA, head CT, and cerebral angiography. Results: For scanner 1, the mean PSD for CTA exams (98.9 ± 5.3 mGy) and for routine head CT exams (39.2 ± 3.7 mGy) agreed reasonably well with the PSD measured on the phantom, 105.4 mGy and 40.0 mGy, respectively. Similarly for scanner 2, the mean PSD for CTA exams (98.8 ± 7.4 mGy) and for routine head CT exams (42.9 ± 9.4 mGy) compared well with phantom measurements, 95.2 mGy and 37.6 mGy, respectively. In addition, the mean PSD was comparable between scanners for corresponding patient exams, CTA and routine head CT respectively. PSD estimates ranged from 1.9 – 4.5 Gy among 4 patients receiving multiple exams. Conclusion: Patients having several exams including both CTA and routine head CT may receive cumulative doses approaching or exceeding the threshold for single dose deterministic effects.« less

  7. Does Missing Classes Decelerate Student Exam Performance Progress? Empirical Evidence and Policy Implications

    ERIC Educational Resources Information Center

    Lin, Tin-Chun

    2014-01-01

    A total of 389 business students in undergraduate introductory microeconomics classes in spring 2007, 2009, and 2011, and fall 2012 participated in an exam performance progress study. Empirical evidence suggested that missing classes decelerates and hampers high-performing students' exam performance progress. Nevertheless, the evidence does…

  8. Using colposcopy in the rape exam: health care, forensic, and criminal justice issues.

    PubMed

    Sommers, Marilyn Sawyer; Fisher, Bonnie S; Karjane, Heather M

    2005-01-01

    In the setting of a forensic examination following rape, colposcopy allows practitioners to identify and photograph genital injury not readily visible to the unaided eye, thereby clarifying the location and extent of injury as well as providing evidence for court proceedings. Since the 1980s, the technique once reserved for victims of child abuse has been used across the lifespan and has been shown to identify genital injury in up to 87% of women who have been raped. The role of colposcopic findings as evidence in court testimony, however, remains controversial. This paper explores the history of colposcopy in the rape exam and describes the epidemiology of genital injury in consensual sex as well as rape.

  9. Doppler ultrasound exam of an arm or leg

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/003775.htm Doppler ultrasound exam of an arm or leg To use ... this page, please enable JavaScript. This test uses ultrasound to look at the blood flow in the ...

  10. [Relieving pre-exam anxiety syndrome with wrist-ankle acupuncture: a randomized controlled trial].

    PubMed

    Shu, Shi; Li, Tong-ming; Fang, Fan-fu; He, Hou-luo; Zhou, Qing-hui; Gu, Wei; Zhou, Shuang

    2011-06-01

    Pre-exam anxiety syndrome is a common condition occurring in pre-exam students and directly affects their examination performance and physical state. Wrist-ankle acupuncture has significant therapeutic effects in treating mental disorders and may also relieve the symptoms of pre-exam anxiety syndrome. To assess the therapeutic effect of wrist-ankle acupuncture on pre-exam anxiety syndrome. A total of 60 students who met the inclusion criteria of pre-exam anxiety syndrome were enrolled from a university in Shanghai and they were randomly divided into treatment group and control group. There were 30 cases in each group, and no case failed to follow-up. In the treatment group, wrist-ankle acupuncture was adopted to point upper 1 bilaterally (impression between flexor carpi ulnaris tendon and ulnar margin), and there was no requirement for Deqi (arrival of qi). In the control group, sham acupuncture was adopted. The treatment was applied 3 times totally in both groups one week before the exam, once every other day, each time with the needles retained for 30 min. The therapeutic effects were compared between two groups. Before and after 3 treatments, Sarason Test Anxiety Scale (TAS) and Expectation and Treatment Credibility Scale (ETCS) were measured and evaluated. The therapeutic effect experienced by the treatment group was better than that of the control group (P<0.05). There were no statistically significant differences in TAS and ETCS before treatment between the two groups. The scores of TAS after treatment in two groups were higher than those before treatment (P<0.05, P<0.01). There were statistical differences in TAS absolute difference and TAS relative difference between the two groups and the treatment group had better results (P<0.05, P<0.01). After treatment, patients in the treatment group had higher scores in ETCS than those in the control group (P<0.05, P<0.01). No adverse reaction was reported. Wrist-ankle acupuncture can relieve the symptoms of pre-exam

  11. Minocycline Promotes Neurite Outgrowth of PC12 Cells Exposed to Oxygen-Glucose Deprivation and Reoxygenation Through Regulation of MLCP/MLC Signaling Pathways.

    PubMed

    Tao, Tao; Feng, Jin-Zhou; Xu, Guang-Hui; Fu, Jie; Li, Xiao-Gang; Qin, Xin-Yue

    2017-04-01

    Minocycline, a semi-synthetic second-generation derivative of tetracycline, has been reported to exert neuroprotective effects both in animal models and in clinic trials of neurological diseases. In the present study, we first investigated the protective effects of minocycline on oxygen-glucose deprivation and reoxygenation-induced impairment of neurite outgrowth and its potential mechanism in the neuronal cell line, PC12 cells. We found that minocycline significantly increased cell viability, promoted neurite outgrowth and enhanced the expression of growth-associated protein-43 (GAP-43) in PC12 cells exposed to oxygen-glucose deprivation/reoxygenation injury. In addition, immunoblots revealed that minocycline reversed the overexpression of phosphorylated myosin light chain (MLC) and the suppression of activated extracellular signal-regulated kinase 1/2 (ERK1/2) caused by oxygen-glucose deprivation/reoxygenation injury. Moreover, the minocycline-induced neurite outgrowth was significantly blocked by Calyculin A (1 nM), an inhibitor of myosin light chain phosphatase (MLCP), but not by an ERK1/2 inhibitor (U0126; 10 μM). These findings suggested that minocycline activated the MLCP/MLC signaling pathway in PC12 cells after oxygen-glucose deprivation/reoxygenation injury, which resulted in the promotion of neurite outgrowth.

  12. Do You Prefer to Have the Text or a Sheet with Your Physics Exams?

    NASA Astrophysics Data System (ADS)

    Hamed, Kastro M.

    2008-05-01

    Many high school and introductory college physics instructors ponder the choice between "open text" exams versus "facts and formulae sheet" exams. Other alternatives are closed book/closed notes exams or an instructor-prepared sheet of facts and relevant formulas. There is no agreement on merit. Rehfuss strongly opposes allowing students to use formula sheets while taking physics exams despite acknowledging that such use is common practice. Cone2 responded to Rehfuss by defending the use of such sheets and outlining the benefits of a "cheat sheet." Debate over the use of a "cheat sheet" or other resources during exams is not limited to the physics community. Skidmore and Aagaard3 studied the relationship between testing conditions and student test scores for students in teacher education. Two decades earlier Boniface,4 Dorsal and Cundiff,5 and Hindman6 published papers on the use of texts and/or sheets during examinations in psychology and education. Others, such as Pullen et al.7 focused on studying the discarded cheat sheets themselves. Humorously, in October 2005 The New York Times8 reported an unusual museum exhibit of "cheat sheets" and the different ways students had cheated at a particular university.

  13. A three-day anatomy revision course taught by senior peers effectively prepares junior students for their national anatomy exam.

    PubMed

    Rengier, Fabian; Rauch, Philipp Julian; Partovi, Sasan; Kirsch, Joachim; Nawrotzki, Ralph

    2010-12-20

    this study examines whether peer-teaching, in the setting of a three-day revision course in anatomy, is effective in preparing medical students for their national anatomy exam. the anatomy course was designed for candidates taking the first part of the German national medical exam. Increase of knowledge during the course was assessed by tests before and after the course (group A). To test equivalence, two control groups participated in the pre-test (group B) or in the course and in the post-test (group C). Participants anonymously rated 14 feedback items on a five-point Likert scale ranging from 1 (full agreement) to 5 (full disagreement). group A students' performance improved significantly during the course with a mean increase of 7.15 points (11.9% improvement; p<0.001). Equivalence testing showed that performance of group A students in the pre-/post-tests was equal to those of group B pre-tests and group C post-tests, respectively. Agreement on the 14 feedback items was highly significant (p<0.001 for all items), with a global median of 1. this study shows that a three-day anatomy revision course is effective and highly appreciated by medical students in their preparation for the national exam. Moreover, peer-teaching is reliable at this stage of the medical curriculum. 2010 Elsevier GmbH. All rights reserved.

  14. Reading Quizzes Improve Exam Scores for Community College Students.

    PubMed

    Pape-Lindstrom, Pamela; Eddy, Sarah; Freeman, Scott

    2018-06-01

    To test the hypothesis that adding course structure may encourage self-regulated learning skills resulting in an increase in student exam performance in the community college setting, we added daily preclass online, open-book reading quizzes to an introductory biology course. We compared three control terms without reading quizzes and three experimental terms with online, open-book reading quizzes; the instructor of record, class size, and instructional time did not vary. Analyzing the Bloom's taxonomy level of a random sample of exam questions indicated a similar cognitive level of high-stakes assessments across all six terms in the study. To control for possible changes in student preparation or ability over time, we calculated each student's grade point average in courses other than biology during the term under study and included it as a predictor variable in our regression models. Our final model showed that students in the experimental terms had significantly higher exam scores than students in the control terms. This result shows that online reading quizzes can boost achievement in community college students. We also comment on the importance of discipline-based education research in community college settings and the structure of our community college/4-year institution collaboration.

  15. Democracy in the Israeli Education System: The Case of the English Matriculation Exam

    ERIC Educational Resources Information Center

    Zaher, Rana

    2012-01-01

    This research investigates the extent to which indices of social justice and democratic rights are expressed in Israel in the crucial national English matriculation exam, as perceived by Palestinian Arab high school pupils studying for these exams and their English teachers. The research employed Critical Theory as a paradigm, case study as a…

  16. A stimulus control intervention in the gynecological exam with sexual abuse survivors.

    PubMed

    Smith, M S; Smith, M T

    1999-01-01

    The effectiveness of a new examination gown, as a stimulus control intervention designed to reduce distress during the pelvic exam, was investigated in a sample of sexual abuse survivors and women without abuse histories. Sixty-nine participants from a women's health ambulatory center and a private practice in gynecology were randomly assigned to the experimental gown condition or the paper drape control group. One-third of the sample reported a history of childhood sexual abuse. Survivors reported higher anxiety during exams than did women without abuse histories. Women who wore the experimental gown reported more positive emotional and physical experiences of the exam. Further research is required to examine the trend showing that survivors who wore the experimental gown reported less anxiety during the examination than survivors who wore the control drape.

  17. Automatic Assessment of 3D Modeling Exams

    ERIC Educational Resources Information Center

    Sanna, A.; Lamberti, F.; Paravati, G.; Demartini, C.

    2012-01-01

    Computer-based assessment of exams provides teachers and students with two main benefits: fairness and effectiveness in the evaluation process. This paper proposes a fully automatic evaluation tool for the Graphic and Virtual Design (GVD) curriculum at the First School of Architecture of the Politecnico di Torino, Italy. In particular, the tool is…

  18. Efficacy of Cognitive Training in Older Adults with and without Subjective Cognitive Decline Is Associated with Inhibition Efficiency and Working Memory Span, Not with Cognitive Reserve.

    PubMed

    López-Higes, Ramón; Martín-Aragoneses, María T; Rubio-Valdehita, Susana; Delgado-Losada, María L; Montejo, Pedro; Montenegro, Mercedes; Prados, José M; de Frutos-Lucas, Jaisalmer; López-Sanz, David

    2018-01-01

    The present study explores the role of cognitive reserve, executive functions, and working memory (WM) span, as factors that might explain training outcomes in cognitive status. Eighty-one older adults voluntarily participated in the study, classified either as older adults with subjective cognitive decline or cognitively intact. Each participant underwent a neuropsychological assessment that was conducted both at baseline (entailing cognitive reserve, executive functions, WM span and depressive symptomatology measures, as well as the Mini-Mental State Exam regarding initial cognitive status), and then 6 months later, once each participant had completed the training program (Mini-Mental State Exam at the endpoint). With respect to cognitive status the training program was most beneficial for subjective cognitive decline participants with low efficiency in inhibition at baseline (explaining a 33% of Mini-Mental State Exam total variance), whereas for cognitively intact participants training gains were observed for those who presented lower WM span.

  19. Ethnic and Gender Differences in Advanced Placement Exam Performance: A Multiyear National Analysis

    ERIC Educational Resources Information Center

    Holmes, Maria Alexander

    2013-01-01

    Purpose: The purpose of this study was to analyze ethnic and gender differences in Advanced Placement (AP) exam performance of U.S. high school students. Specifically, the extent to which differences exist in overall AP exam performance scores within and between four ethnic groups (i.e., Asian, Black, Hispanic, and White) was investigated. Within…

  20. Training Children with Autism Spectrum Disorders to Be Compliant with a Physical Exam

    ERIC Educational Resources Information Center

    Cuvo, Anthony J.; Reagan, Amanda Law; Ackerlund, Julie; Huckfeldt, Rachel; Kelly, Cheri

    2010-01-01

    The purpose of this study was to train children with autism spectrum disorders to be compliant with a 10-component physical examination. After a physician assistant administered an exam pretest, noncompliance on steps of the exam were considered with respect to a skill deficit and escape from aversive stimuli. A package of training procedures was…

  1. The ACS Exams Institute Undergraduate Chemistry Anchoring Concepts Content Map I: General Chemistry

    ERIC Educational Resources Information Center

    Holme, Thomas; Murphy, Kristen

    2012-01-01

    To provide tools for programmatic assessment related to the use of ACS Exams in undergraduate chemistry courses, the ACS Exams Institute has built a content map that applies to the entire undergraduate curriculum. At the top two levels, the grain size of the content classification is large and spans the entire undergraduate curriculum. At the…

  2. Do Resit Exams Promote Lower Investments of Study Time? Theory and Data from a Laboratory Study

    PubMed Central

    Nieuwenstein, Mark R.; de Jong, Ritske; Lorist, Monicque M.

    2016-01-01

    Although many educational institutions allow students to resit exams, a recently proposed mathematical model suggests that this could lead to a dramatic reduction in study-time investment, especially in rational students. In the current study, we present a modification of this model in which we included some well-justified assumptions about learning and performance on multiple-choice tests, and we tested its predictions in two experiments in which participants were asked to invest fictional study time for a fictional exam. Consistent with our model, the prospect of a resit exam was found to promote lower investments of study time for a first exam and this effect was stronger for participants scoring higher on the cognitive reflection test. We also found that the negative effect of resit exams on study-time investment was attenuated when access to the resit was made uncertain by making it probabilistic or dependent on obtaining a minimal, non-passing grade for the first attempt. Taken together, these results suggest that offering students resit exams may compromise the achievement of learning goals, and they raise the more general implication that second chances promote risky behavior. PMID:27711140

  3. Do Resit Exams Promote Lower Investments of Study Time? Theory and Data from a Laboratory Study.

    PubMed

    Nijenkamp, Rob; Nieuwenstein, Mark R; de Jong, Ritske; Lorist, Monicque M

    2016-01-01

    Although many educational institutions allow students to resit exams, a recently proposed mathematical model suggests that this could lead to a dramatic reduction in study-time investment, especially in rational students. In the current study, we present a modification of this model in which we included some well-justified assumptions about learning and performance on multiple-choice tests, and we tested its predictions in two experiments in which participants were asked to invest fictional study time for a fictional exam. Consistent with our model, the prospect of a resit exam was found to promote lower investments of study time for a first exam and this effect was stronger for participants scoring higher on the cognitive reflection test. We also found that the negative effect of resit exams on study-time investment was attenuated when access to the resit was made uncertain by making it probabilistic or dependent on obtaining a minimal, non-passing grade for the first attempt. Taken together, these results suggest that offering students resit exams may compromise the achievement of learning goals, and they raise the more general implication that second chances promote risky behavior.

  4. The importance of the anal exam in neurologic classification of spinal cord injury.

    PubMed

    Donovan, William H

    2018-01-01

    The examination of the sensation of the anal orifice and the contraction of the external anal sphincter, either voluntarily or reflexly, has always been an integral part of the International Standards for Neurologic Classification of Spinal Cord Injury (ISNCSCI). Yet the importance of this component has been defended and challenged. This paper compares these two points of view as expressed by Previnaire and Marino, respectively. Both authors make important points but as the papers do not address the same aspect of the anal exam, room for further refinement of ISNCSCI both regarding the details of the exam and the use of components of the exam for prognostication of neurologic recovery is apparent.

  5. Determinants of Student Attitudes toward Team Exams

    ERIC Educational Resources Information Center

    Reinig, Bruce A.; Horowitz, Ira; Whittenburg, Gene

    2014-01-01

    We examine how student attitudes toward their group, learning method, and perceived development of professional skills are initially shaped and subsequently evolve through multiple uses of team exams. Using a Tobit regression model to analyse a sequence of 10 team quizzes given in a graduate-level tax accounting course, we show that there is an…

  6. Relationships between Self-Regulating Behaviors and Predictor Exam Scores for Senior Nursing Students

    ERIC Educational Resources Information Center

    Gillespie, Maria

    2012-01-01

    Low pass rates on the National Council Licensure Exam for Registered Nurses have directed nursing faculty to examine how to predict the readiness of the nursing student. Exit exam testing that predicts readiness has become one way to assess the nursing student's readiness. Nursing students at the research site's school of nursing are…

  7. Including an Exam P/1 Prep Course in a Growing Actuarial Science Program

    ERIC Educational Resources Information Center

    Wakefield, Thomas P.

    2014-01-01

    The purpose of this article is to describe the actuarial science program at our university and the development of a course to enhance students' problem solving skills while preparing them for Exam P/1 of the Society of Actuaries (SOA) and the Casualty Actuary Society (CAS). The Exam P/1 prep course, formally titled Mathematical Foundations of…

  8. The Elite Illusion: Achievement Effects at Boston and New York Exam Schools. NBER Working Paper No. 17264

    ERIC Educational Resources Information Center

    Abdulkadiroglu, Atila; Angrist, Joshua D.; Pathak, Parag A.

    2011-01-01

    Talented students compete fiercely for seats at Boston and New York exam schools. These schools are characterized by high levels of peer achievement and a demanding curriculum tailored to each district's highest achievers. While exam school students clearly do very well in school, the question of whether an exam school education adds value…

  9. Analysis of placenta vascularization in patients with uterine altered artery Doppler flow velocity exams.

    PubMed

    Gilio, Daniel Bruno; Miranda Corrêa, Rosana Rosa; Souza de Oliveira Guimarães, Camila; Peres, Luiz Cesar; Marques Salge, Ana Karina; Cavellani, Camila Lourencini; de Paula Antunes Teixeira, Vicente; Costa da Cunha Castro, Eumenia

    2009-08-01

    One of the frequent questions in obstetric practice is to determine placental vascular changes that may account for abnormal Doppler flow velocity alterations in maternal uterine vessels from women and fetuses without pregnancy pathology. A retrospective morphometric study was realized using 27 placentas from patients submitted for Doppler flow velocity exam during pregnancy. The placentas were morphologically examined using hematoxylin-eosin staining. Measurements of villi were made with the use of a video camera coupled to a common light microscope and a computer with automatic image analyzing software. Of the 27 placentas, 13 (48%) were of patients showing unaltered Doppler and 14 (52%) showing altered Doppler. The number of stem villi vessels was significantly larger in the placentas of patients with Doppler exam alterations (P = 0.003). This group also presented greater stem villi vessel thickness, although without significant difference. The number of intermediary and terminal villi vessels was greater in the placentas of patients with altered Doppler exams (P < 0.001), and a greater terminal villi area was observed in these cases (P < 0.001). The morphological proof that uterine artery Doppler flow velocity exam alterations are associated with placental vascular alterations demonstrates the importance of this exam during prenatal care, even in the absence of maternal-fetal alterations.

  10. Assessment of Learning Gains Associated with Independent Exam Analysis in Introductory Biology

    PubMed Central

    William, Adrienne E.; Aguilar-Roca, Nancy M.; Tsai, Michelle; Wong, Matthew; Beaupré, Marin Moravec; O’Dowd, Diane K.

    2011-01-01

    This study evaluates the impact of an independent postmidterm question analysis exercise on the ability of students to answer subsequent exam questions on the same topics. It was conducted in three sections (∼400 students/section) of introductory biology. Graded midterms were returned electronically, and each student was assigned a subset of questions answered incorrectly by more than 40% of the class to analyze as homework. The majority of questions were at Bloom's application/analysis level; this exercise therefore emphasized learning at these higher levels of cognition. Students in each section answered final exam questions matched by topic to all homework questions, providing a within-class control group for each question. The percentage of students who correctly answered the matched final exam question was significantly higher (p < 0.05) in the Topic Analysis versus Control Analysis group for seven of 19 questions. We identified two factors that influenced activity effectiveness: 1) similarity in topic emphasis of the midterm–final exam question pair and 2) quality of the completed analysis homework. Our data suggest that this easy-to-implement exercise will be useful in large-enrollment classes to help students develop self-regulated learning skills. Additional strategies to help introductory students gain a broader understanding of topic areas are discussed. PMID:22135369

  11. Assessment of learning gains associated with independent exam analysis in introductory biology.

    PubMed

    Williams, Adrienne E; William, Adrienne E; Aguilar-Roca, Nancy M; Tsai, Michelle; Wong, Matthew; Beaupré, Marin Moravec; O'Dowd, Diane K

    2011-01-01

    This study evaluates the impact of an independent postmidterm question analysis exercise on the ability of students to answer subsequent exam questions on the same topics. It was conducted in three sections (∼400 students/section) of introductory biology. Graded midterms were returned electronically, and each student was assigned a subset of questions answered incorrectly by more than 40% of the class to analyze as homework. The majority of questions were at Bloom's application/analysis level; this exercise therefore emphasized learning at these higher levels of cognition. Students in each section answered final exam questions matched by topic to all homework questions, providing a within-class control group for each question. The percentage of students who correctly answered the matched final exam question was significantly higher (p < 0.05) in the Topic Analysis versus Control Analysis group for seven of 19 questions. We identified two factors that influenced activity effectiveness: 1) similarity in topic emphasis of the midterm-final exam question pair and 2) quality of the completed analysis homework. Our data suggest that this easy-to-implement exercise will be useful in large-enrollment classes to help students develop self-regulated learning skills. Additional strategies to help introductory students gain a broader understanding of topic areas are discussed.

  12. Does exam-targeted training help village doctors pass the certified (assistant) physician exam and improve their practical skills? A cross-sectional analysis of village doctors' perspectives in Changzhou in Eastern China.

    PubMed

    Li, Xiaohong; Shen, Jay J; Yao, Fang; Jiang, Chunxin; Chang, Fengshui; Hao, Fengfeng; Lu, Jun

    2018-05-11

    Quality of health care needs to be improved in rural China. The Chinese government, based on the 1999 Law on Physicians, started implementing the Rural Doctor Practice Regulation in 2004 to increase the percentage of certified physicians among village doctors. Special exam-targeted training for rural doctors therefore was launched as a national initiative. This study examined these rural doctors' perceptions of whether that training helps them pass the exam and whether it improves their skills. Three counties were selected from the 4 counties in Changzhou City in eastern China, and 844 village doctors were surveyed by a questionnaire in July 2012. Chi-square test and Fisher exact test were used to identify differences of attitudes about the exam and training between the rural doctors and certified (assistant) doctors. Longitudinal annual statistics (1980-2014) of village doctors were further analyzed. Eight hundred and forty-four village doctors were asked to participate, and 837 (99.17%) responded. Only 14.93% of the respondents had received physician (assistant) certification. Only 49.45% of the village doctors thought that the areas tested by the certification exam were closely related to the healthcare needs of rural populations. The majority (86.19%) felt that the training program was "very helpful" or "helpful" for preparing for the exam. More than half the village doctors (61.46%) attended the "weekly school". The village doctors considered the most effective method of learning was "continuous training (40.36%)" . The majority of the rural doctors (89.91%) said they would be willing to participate in the training and 96.87% stated that they could afford to pay up to 2000 yuan for it. The majority of village doctors in Changzhou City perceived that neither the certification exam nor the training for it are closely related to the actual healthcare needs of rural residents. Policies and programs should focus on providing exam-preparation training for selected

  13. Somatic symptoms evoked by exam stress in university students: the role of alexithymia, neuroticism, anxiety and depression.

    PubMed

    Zunhammer, Matthias; Eberle, Hanna; Eichhammer, Peter; Busch, Volker

    2013-01-01

    The etiology of somatization is incompletely understood, but could be elucidated by models of psychosocial stress. Academic exam stress has effectively been applied as a naturalistic stress model, however its effect on somatization symptoms according to ICD-10 and DSM-IV criteria has not been reported so far. Baseline associations between somatization and personality traits, such as alexithymia, have been studied exhaustively. Nevertheless, it is largely unknown if personality traits have an explanatory value for stress induced somatization. This longitudinal, quasi-experimental study assessed the effects of university exams on somatization - and the reversal of effects after an exam-free period. Repeated-observations were obtained within 150 students, measuring symptom intensity before, during and after an exam period, according to the Screening for Somatoform Symptoms 7-day (SOMS-7d). Additionally, self-reports on health status were used to differentiate between medically explained and medically unexplained symptoms. Alexithymia, neuroticism, trait-anxiety and baseline depression were surveyed using the Toronto-Alexithymia Scale (TAS-20), the Big-Five Personality Interview (NEO-FFI), the State Trait Anxiety Inventory (STAI) and Beck's Depression Inventory (BDI-II). These traits were competitively tested for their ability to explain somatization increases under exam stress. Somatization significantly increased across a wide range of symptoms under exam stress, while health reports pointed towards a reduction in acute infections and injuries. Neuroticism, alexithymia, trait anxiety and depression explained variance in somatization at baseline, but only neuroticism was associated with symptom increases under exam stress. Exam stress is an effective psychosocial stress model inducing somatization. A comprehensive quantitative description of bodily symptoms under exam stress is supplied. The results do not support the stress-alexithymia hypothesis, but favor

  14. Somatic Symptoms Evoked by Exam Stress in University Students: The Role of Alexithymia, Neuroticism, Anxiety and Depression

    PubMed Central

    Zunhammer, Matthias; Eberle, Hanna; Eichhammer, Peter; Busch, Volker

    2013-01-01

    Objective The etiology of somatization is incompletely understood, but could be elucidated by models of psychosocial stress. Academic exam stress has effectively been applied as a naturalistic stress model, however its effect on somatization symptoms according to ICD-10 and DSM-IV criteria has not been reported so far. Baseline associations between somatization and personality traits, such as alexithymia, have been studied exhaustively. Nevertheless, it is largely unknown if personality traits have an explanatory value for stress induced somatization. Methods This longitudinal, quasi-experimental study assessed the effects of university exams on somatization — and the reversal of effects after an exam-free period. Repeated-observations were obtained within 150 students, measuring symptom intensity before, during and after an exam period, according to the Screening for Somatoform Symptoms 7-day (SOMS-7d). Additionally, self-reports on health status were used to differentiate between medically explained and medically unexplained symptoms. Alexithymia, neuroticism, trait-anxiety and baseline depression were surveyed using the Toronto-Alexithymia Scale (TAS-20), the Big-Five Personality Interview (NEO-FFI), the State Trait Anxiety Inventory (STAI) and Beck’s Depression Inventory (BDI-II). These traits were competitively tested for their ability to explain somatization increases under exam stress. Results Somatization significantly increased across a wide range of symptoms under exam stress, while health reports pointed towards a reduction in acute infections and injuries. Neuroticism, alexithymia, trait anxiety and depression explained variance in somatization at baseline, but only neuroticism was associated with symptom increases under exam stress. Conclusion Exam stress is an effective psychosocial stress model inducing somatization. A comprehensive quantitative description of bodily symptoms under exam stress is supplied. The results do not support the stress

  15. A history and overview of the certification exam for medical dosimetrists

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pusey, Damien; Smith, Lisette; Zeman, Elaine M.

    2005-06-30

    During the last century, the creation and implementation of board certification has had a powerful impact on the medical community. Board certification has helped to shape the scope and practice of medical professionals and the care they provide, as well as to influence the way the health insurance industry sets standards for reimbursement. One profession that offers board certification to its members is medical dosimetry. The Medical Dosimetrist Certification Board exam has been administered since 1988 and its content covers a broad spectrum of information from the radiation therapy sciences. The exam has strict application requirements and is rather difficultmore » to pass. Those who pass the exam can then call themselves Certified Medical Dosimetrists. For data purposes of this study, several members of the dosimetry community were solicited to participate in a survey regarding the exam's content and history, and to provide relevant statistical data. Currently 2,177 medical dosimetrists are board certified, with an additional 1,500 estimated to be working without certification. Although board certification is not currently required to practice medical dosimetry, new legislation known as the CARE Bill could change this. The CARE Bill, if passed, would mandate nationwide compulsory licensure and/or certification for medical dosimetrists and other medical professionals who want to work in radiation-related health care. Health maintenance organizations and other insurance carriers may likewise require certification for reimbursement purposes.« less

  16. Spanish-English Verbatim Translation Exam. Final Report.

    ERIC Educational Resources Information Center

    Stansfield, Charles W.; And Others

    The development and validation of the Spanish-English Verbatim Translation Exam (SEVTE) is described. The test is for use by the Federal Bureau of Investigation (FBI) in the selection of applicants for the positions of Language Specialist or Contract Linguist. The report is divided into eight sections. Section 1 describes the need for the test,…

  17. An algorithm for calculating exam quality as a basis for performance-based allocation of funds at medical schools.

    PubMed

    Kirschstein, Timo; Wolters, Alexander; Lenz, Jan-Hendrik; Fröhlich, Susanne; Hakenberg, Oliver; Kundt, Günther; Darmüntzel, Martin; Hecker, Michael; Altiner, Attila; Müller-Hilke, Brigitte

    2016-01-01

    The amendment of the Medical Licensing Act (ÄAppO) in Germany in 2002 led to the introduction of graded assessments in the clinical part of medical studies. This, in turn, lent new weight to the importance of written tests, even though the minimum requirements for exam quality are sometimes difficult to reach. Introducing exam quality as a criterion for the award of performance-based allocation of funds is expected to steer the attention of faculty members towards more quality and perpetuate higher standards. However, at present there is a lack of suitable algorithms for calculating exam quality. In the spring of 2014, the students' dean commissioned the "core group" for curricular improvement at the University Medical Center in Rostock to revise the criteria for the allocation of performance-based funds for teaching. In a first approach, we developed an algorithm that was based on the results of the most common type of exam in medical education, multiple choice tests. It included item difficulty and discrimination, reliability as well as the distribution of grades achieved. This algorithm quantitatively describes exam quality of multiple choice exams. However, it can also be applied to exams involving short assay questions and the OSCE. It thus allows for the quantitation of exam quality in the various subjects and - in analogy to impact factors and third party grants - a ranking among faculty. Our algorithm can be applied to all test formats in which item difficulty, the discriminatory power of the individual items, reliability of the exam and the distribution of grades are measured. Even though the content validity of an exam is not considered here, we believe that our algorithm is suitable as a general basis for performance-based allocation of funds.

  18. Will I Do as Well on the Final Exam as I Expect? An Examination of Students' Expectations

    ERIC Educational Resources Information Center

    Burns, David J.

    2008-01-01

    Immediately prior to an exam, it is common to hear students commenting on whether they anticipate doing as well on the exam as they expect (or, in other words, whether they anticipate performing as well on the exam as the standard at which they believe they should be performing). These anticipations have received little past research attention. In…

  19. SU-E-T-119: Dosimetric and Mechanical Characteristics of Elekta Infinity LINAC with Agility MLC

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Park, J; Xu, Q; Xue, J

    2014-06-01

    Purpose: Elekta Infinity is the one of the latest generation LINAC with unique features. Two Infinity LINACs are recently commissioned at our institution. The dosimetric and mechanical characteristics of the machines are presented. Methods: Both Infinity LINACs with Agility MLC (160 leaves with 0.5 cm leaf width) are configured with five electron energies (6, 9, 12, 15, and 18 MeV) and two photon energies (6 and 15 MV). One machine has additional photon energy (10 MV). The commissioning was performed by following the manufacturer's specifications and AAPM TG recommendations. Beam data of both electron and photon beams are measured withmore » scanning ion chambers and linear diode array. Machines are adjusted to have the dosimetrically equivalent characteristics. Results: The commissioning of mechanical and imaging system meets the tolerances by TG recommendations. The PDD{sub 10} of various field sizes for 6 and 15 MV shows < 0.5% difference between two machines. For each electron beams, R{sub 80} matches with < 0.4 mm difference. The symmetry and flatness agree within 0.8% and 0.9% differences for photon beams, respectively. For electron beams, the differences of the symmetry and flatness are within 1.2% and 0.8%, respectively. The mean inline penumbras for 6, 10, and 15 MV are respectively 5.1±0.24, 5.6±0.07, and 5.9±0.10 mm for 10x10 cm at 10 cm depth. The crossline penumbras are larger than inline penumbras by 2.2, 1.4, and 1.0 mm, respectively. The MLC transmission factor with interleaf leakage is 0.5 % for all photon energies. Conclusion: The dosimetric and mechanical characteristics of two Infinity LINACs show good agreements between them. Although the Elekta Infinity has been used in many institutions, the detailed characteristics of the machine have not been reported. This study provides invaluable information to understand the Infinity LINAC and to compare the quality of commissioning data for other LINACs.« less

  20. Like Climbing Jacob's Ladder: An Art-Based Exploration of the Comprehensive Exam Process

    ERIC Educational Resources Information Center

    Shields, Sara Scott

    2015-01-01

    The comprehensive exam process is a rite of passage in the scholarly world, and as such the movements of this process often feel like a guarded secret to graduate students. As a PhD candidate, I left the comprehensive exam process feeling both initiated and inundated. This article is an attempt to uncover the secret that is the comprehensive exam…

  1. The educational and financial impact of using patient educators to teach introductory physical exam skills.

    PubMed

    Allen, Sharon S; Miller, Jane; Ratner, Edward; Santilli, Jamie

    2011-01-01

    Physical exam skills are essential to core competencies for physicians in training. It is increasingly difficult to secure time and funding for physician faculty to teach these critical skills. This study was designed to determine whether Patient Educators (PE) (non-physician instructors) in an introductory clinical medicine (ICM) course (1) were as effective as physician faculty in teaching the physical exam, (2) impacted consistency of student performance on a final practical exam, and (3) whether this model was cost effective. PE were introduced into an ICM course at the University of Minnesota from 2006 to 2008. Each year, students' physical exam competencies were evaluated by a performance-based head-to-toe examination and 6 months later by an objective structured clinical examination (OSCE). Differences in test scores between years and variability (i.e., consistency) among yearly scores were assessed. The cost per student was calculated by considering a stable compensation cost per hour for the required number of physician faculty, standardized patients, and PE in each year. Mean student performance was statistically lower with PE, but only by two percentage points. The amount of variation within the medical student classes' physical exam skills remained stable as the use of PE expanded. Total educator salary costs per student declined from $449 in 2006 to $196 in 2008. In terms of sustainability and student performance, the use of trained lay educators has equivalent outcomes and is less costly for physical exam instruction in the pre-clinical years.

  2. A Study of the Technological, Instructional, and Motivational Factors Affecting PHR Certification Exam Outcomes

    ERIC Educational Resources Information Center

    Bonner, David M.

    2012-01-01

    Although previous studies have considered the factors affecting other certification exam outcomes, they have not examined those that are related to performance on the Professional in Human Resources (PHR) exam. In response to that need, this study specifically investigates technology and training factors that affect self-efficacy and self-set…

  3. OHS Redecorates Exam Rooms to Educate Patients | Poster

    Cancer.gov

    Occupational Health Services interns are educating patients during their visits via updated exam rooms that now display health-related “themes” like cancer, general health, mental health, and travel safety. They hope the vibrant designs and intriguing facts they’ve displayed will attract attention and benefit patients.

  4. Teacher-Generated Final Exams in High School Science: Content, Rigor, and Assessment Literacy

    NASA Astrophysics Data System (ADS)

    Lach, Michael

    This study investigates a large collection of teacher-generated end-of-semester final exams from Chicago Public School high school science classrooms in order to explore the depth and breadth of content that students learn in science classrooms. Teachers focus on a specific set of scientific content that is driven by district guidelines and popular textbooks but not particularly aligned to standards. To most teachers, rigor means coverage instead of intellectual press. The assessments, while unsophisticated, seem to be delivering what is expected of them---a way to mimic the most basic format of the ACT exam quickly. There was little variation among high poverty and low poverty schools, matching national data and indicating issues that are more due to a particular culture of science teaching and learning than driven by particular contexts. The study identifies implications for the observed homogeneity of final exam rigor and content, identifies gaps between how the routine of final exams are design and implemented in schools, and discusses similar methodological efforts that could enhance the ability of schools and districts to access useful information about the technical core of instruction.

  5. The association between school exam grades and subsequent development of bipolar disorder.

    PubMed

    Pedersen, Steffie Damgaard; Østergaard, Søren Dinesen; Petersen, Liselotte

    2018-03-13

    Prior studies have indicated that both high and low school grades are associated with development of bipolar disorder (BD), but these studies have not adjusted for parental history of mental disorder, which is a likely confounder. Furthermore, the association between school grades and bipolar I disorder (BD-I) has not been studied. Therefore, we aimed to study the association between school exam grades and subsequent development of BD and BD-I while adjusting for parental history of mental disorder. We conducted a register-based nationwide cohort study following 505 688 individuals born in Denmark between 1987 and 1995. We investigated the association between school exam grades and development of BD or BD-I with a Cox model adjusting for family history of mental disorder and other potential confounders. During follow-up, 900 individuals were diagnosed with BD and 277 of these with BD-I. The risk for BD and BD-I was significantly increased for individuals not having completed the exams at term [adjusted hazard ratio (aHR) for BD (aHR=1.71, 95% CI: 1.43-2.04) and for BD-I (aHR=1.57, 95% CI: 1.13-2.19)]. Also, having low exam grades in mathematics was associated with increased risk of both BD (aHR=2.41, 95% CI: 1.27-4.59) and BD-I (aHR=2.71, 95% CI: 1.41-5.21). Females with very high exam grades in Danish (percentile group>97.7) had a significantly increased risk of BD-I (aHR=2.49, 95% CI: 1.19-5.23). The potential to develop BD seems to affect the school results of individuals negatively even before BD is diagnosed - with females having the potential to develop BD-I as a possible exception.

  6. Expedition 43 Crew Final Exams in Russia

    NASA Image and Video Library

    2015-03-13

    NASA Video File of ISS Expedition 43 final exams in Russia on March 5, 2015 with crewmembers Scott Kelly, Gennady Padalka, and Mikhail Kornienko; and backup crew Jeff Williams, Sergei Volkov and Alexei Ovchinin. Includes footage of final qualification training at the Gagarin Cosmonaut Training Center (GCTC); interview with Emily Nelson, ISS Expedition 46 Lead Flight Director; and scenes from the qualification training.

  7. Influence of Preparatory Workshops on Dental Students' Academic Performance and Stress on Their First Operative Dentistry Psychomotor Exam.

    PubMed

    Dilbone, Deborah A; Feng, Xiaoying; Su, Yu; Xirau-Probert, Patricia; Behar-Horenstein, Linda S; Nascimento, Marcelle M

    2018-06-01

    Predoctoral dental psychomotor examinations are known to generate high levels of stress among dental students, which may compromise their academic performance. At one U.S. dental school, all 93 first-year dental students were invited to attend a series of three workshop sessions prior to enrollment in their initial operative dentistry course. The workshops were developed to facilitate academic transition from the dental anatomy course to the operative dentistry course; provide early exposure to materials, instruments, and laboratory techniques; support the early development of psychomotor and self-assessment skills; and lessen students' stress and anxiety levels regarding psychomotor examinations. The aim of this study was to assess the impact of the workshops on the students' academic performance and self-reported stress and preparedness. All students who attended the workshop sessions and all who did not were asked to complete a pre-exam survey (immediately preceding the exam) and a post-exam survey (immediately after the exam) on the day of their first operative dentistry psychomotor exam. Of the 93 students, 21 attended one, 34 attended two, and 25 attended three workshop sessions, while 13 students did not attend any. Response rates for the pre- and post-exam surveys were 100% and 98.9%, respectively. Students who attended all three workshop sessions reported being significantly less stressed about taking the exam than the other groups. The mean exam grade of students who attended the workshop sessions was significantly higher than that of students who did not attend the sessions. These findings support the development and implementation of preparatory workshops to improve academic performance and decrease the stress levels of dental students prior to the first operative dentistry psychomotor exam.

  8. A Valid and Reliable Instrument for Cognitive Complexity Rating Assignment of Chemistry Exam Items

    ERIC Educational Resources Information Center

    Knaus, Karen; Murphy, Kristen; Blecking, Anja; Holme, Thomas

    2011-01-01

    The design and use of a valid and reliable instrument for the assignment of cognitive complexity ratings to chemistry exam items is described in this paper. Use of such an instrument provides a simple method to quantify the cognitive demands of chemistry exam items. Instrument validity was established in two different ways: statistically…

  9. A Study of the Relationship between Student Final Exam Performance and Simulation Game Participation.

    ERIC Educational Resources Information Center

    Whiteley, T. R.; Faria, A. J.

    1989-01-01

    Describes study that investigated the relationship between participation in a business simulation game and performance on a final exam in a principles of marketing course. Past research on business games is reviewed; the use of midterm exam performance level as a pretest variable is explained; and question classification is described. (44…

  10. The CPA Exam as a Postcurriculum Accreditation Assessment

    ERIC Educational Resources Information Center

    Barilla, Anthony G.; Jackson, Robert E.; Mooney, J. Lowell

    2008-01-01

    Business schools often attain accreditation to demonstrate program efficacy. J. A. Marts, J. D. Baker, and J. M. Garris (1988) hypothesized that candidates from Association to Advance Collegiate Schools of Business International (AACSB)-accredited accounting programs perform better on the CPA exam than do candidates from non-AACSB-accredited…

  11. Preparticipation Exams: How to Detect a Teenage Crisis.

    ERIC Educational Resources Information Center

    Donahue, Parnell

    1990-01-01

    Sport-specific preparticipation examinations do not address social problems (drug abuse, suicide, murder, accidents, and sex) epidemic among teenagers, but they are often the only contact these youth have with a physician. This article discusses these risk factors and presents methods for assessing them during preparticipation exams. (SM)

  12. Psychosocial Factors Associated with Skin Self-Exam Performance

    ERIC Educational Resources Information Center

    Jensen, Jakob D.; Moriarty, Cortney M.

    2008-01-01

    Objective: The authors examined psychosocial factors associated with skin self-exam (SSE) performance by young adults. Participants and Methods: The authors administered surveys to 218 US college students (aged 18-26 years) attending a large midwestern university. Results: Contrary to prior research, men (44%) and women (49%) were relatively…

  13. Influence of a revision course and the gender of examiners on the grades of the final ENT exam – a retrospective review of 3961 exams

    PubMed Central

    Grasl, Matthäus C.; Seemann, Rudolf; Hanisch, Michael; Heiduschka, Gregor; Kremser, Karl; Thurnher, Dietmar

    2015-01-01

    Revision courses should repeat already acquired knowledge and skills and mostly provide a basis for passing the following exam. Aim: The aim of the study is to investigate the influence of a previously attended revision course on the grades achieved in a final exam (Ear, Nose and Throat Diseases). Additionally we ask the question whether the gender of the examiners plays a role concerning the marks or not. Methods: 3961 exams at the Department of Ear, Nose and Throat (ENT) Diseases in Vienna were investigated, 725 with revision course (experimental group) and 3236 without previous revision course (comparison group). The revision courses were performed in a standardized way concerning form and content, interactive and case based. Both groups were examined uniform in regard to topics and time duration. 16 male and 6 female examiners were involved. The grading followed a five–level scale. The examination marks were calculated in the arithmetic mean and median value for the entire sample, gender dependence was calculated according to the Wilcoxon-Mann-Whitney-Test. The inferential statistics included single- and multiple factorial analyses of variance as well as uni- and multivariate regression models. Results: The experimental group achieved a grade average of 2.54 compared with 2.46 for the comparison group. Splitting up into male and female examiners, an average of 2.54 and 2.58 resp. for the experimental group and 2.44 and 2.61 resp. for the comparison group resulted. Female examiner marked significantly lower grades in comparison to their male colleagues (P= 0.001926). Conclusions: The ENT revision course did not improve the grade averages of the final ENT exam. Female examiners grade stricter than male examiners. There was no difference concerning grades 4 (pass) and 5 (fail) but female examiners grade less with mark 1. PMID:26483851

  14. Effects of High School Exit Exams on Dropout Rates: Summary of a Panel Discussion.

    ERIC Educational Resources Information Center

    Chudowsky, Naomi; Gayler, Keith

    This paper summarizes a panel discussion that addressed exit-exam policies and dropout issues. It presents the panel members' conclusions about existing research and their recommendations on what kinds of further work are needed. Research on how exit exams affect dropout rates is limited and inconclusive, so policies continue to be made in the…

  15. Assessment of the Assessment Tool: Analysis of Items in a Non-MCQ Mathematics Exam

    ERIC Educational Resources Information Center

    Khoshaim, Heba Bakr; Rashid, Saima

    2016-01-01

    Assessment is one of the vital steps in the teaching and learning process. The reported action research examines the effectiveness of an assessment process and inspects the validity of exam questions used for the assessment purpose. The instructors of a college-level mathematics course studied questions used in the final exams during the academic…

  16. Additional Support for the Information Systems Analyst Exam as a Valid Program Assessment Tool

    ERIC Educational Resources Information Center

    Carpenter, Donald A.; Snyder, Johnny; Slauson, Gayla Jo; Bridge, Morgan K.

    2011-01-01

    This paper presents a statistical analysis to support the notion that the Information Systems Analyst (ISA) exam can be used as a program assessment tool in addition to measuring student performance. It compares ISA exam scores earned by students in one particular Computer Information Systems program with scores earned by the same students on the…

  17. Intensity- and energy-modulated electron radiotherapy by means of an xMLC for head and neck shallow tumors

    NASA Astrophysics Data System (ADS)

    Salguero, Francisco Javier; Arráns, Rafael; Atriana Palma, Bianey; Leal, Antonio

    2010-03-01

    The purpose of this paper is to assess the feasibility of delivering intensity- and energy-modulated electron radiation treatment (MERT) by a photon multileaf collimator (xMLC) and to evaluate the improvements obtained in shallow head and neck (HN) tumors. Four HN patient cases covering different clinical situations were planned by MERT, which used an in-house treatment planning system that utilized Monte Carlo dose calculation. The cases included one oronasal, two parotid and one middle ear tumors. The resulting dose-volume histograms were compared with those obtained from conventional photon and electron treatment techniques in our clinic, which included IMRT, electron beam and mixed beams, most of them using fixed-thickness bolus. Experimental verification was performed with plane-parallel ionization chambers for absolute dose verification, and a PTW ionization chamber array and radiochromic film for relative dosimetry. A MC-based treatment planning system for target with compromised volumes in depth and laterally has been validated. A quality assurance protocol for individual MERT plans was launched. Relative MC dose distributions showed a high agreement with film measurements and absolute ion chamber dose measurements performed at a reference point agreed with MC calculations within 2% in all cases. Clinically acceptable PTV coverage and organ-at-risk sparing were achieved by using the proposed MERT approach. MERT treatment plans, based on delivery of intensity-modulated electron beam using the xMLC, for superficial head and neck tumors, demonstrated comparable or improved PTV dose homogeneity with significantly lower dose to normal tissues. The clinical implementation of this technique will be able to offer a viable alternative for the treatment of shallow head and neck tumors.

  18. The Effect of Online Chapter Quizzes on Exam Performance in an Undergraduate Social Psychology Course

    PubMed Central

    Johnson, Bethany C.; Kiviniemi, Marc T.

    2009-01-01

    Assigned textbook readings are a common requirement in undergraduate courses, but students often do not complete reading assignments or do not do so until immediately before an exam. This may have detrimental effects on learning and course performance. Regularly scheduled quizzes on reading material may increase completion of reading assignments and therefore course performance. This study examined the effectiveness of compulsory, mastery-based, weekly reading quizzes as a means of improving exam and course performance. Completion of reading quizzes was related to both better exam and course performance. The discussion includes recommendations for the use of quizzes in undergraduate courses. PMID:20046908

  19. A real-time dynamic-MLC control algorithm for delivering IMRT to targets undergoing 2D rigid motion in the beam's eye view.

    PubMed

    McMahon, Ryan; Berbeco, Ross; Nishioka, Seiko; Ishikawa, Masayori; Papiez, Lech

    2008-09-01

    An MLC control algorithm for delivering intensity modulated radiation therapy (IMRT) to targets that are undergoing two-dimensional (2D) rigid motion in the beam's eye view (BEV) is presented. The goal of this method is to deliver 3D-derived fluence maps over a moving patient anatomy. Target motion measured prior to delivery is first used to design a set of planned dynamic-MLC (DMLC) sliding-window leaf trajectories. During actual delivery, the algorithm relies on real-time feedback to compensate for target motion that does not agree with the motion measured during planning. The methodology is based on an existing one-dimensional (ID) algorithm that uses on-the-fly intensity calculations to appropriately adjust the DMLC leaf trajectories in real-time during exposure delivery [McMahon et al., Med. Phys. 34, 3211-3223 (2007)]. To extend the 1D algorithm's application to 2D target motion, a real-time leaf-pair shifting mechanism has been developed. Target motion that is orthogonal to leaf travel is tracked by appropriately shifting the positions of all MLC leaves. The performance of the tracking algorithm was tested for a single beam of a fractionated IMRT treatment, using a clinically derived intensity profile and a 2D target trajectory based on measured patient data. Comparisons were made between 2D tracking, 1D tracking, and no tracking. The impact of the tracking lag time and the frequency of real-time imaging were investigated. A study of the dependence of the algorithm's performance on the level of agreement between the motion measured during planning and delivery was also included. Results demonstrated that tracking both components of the 2D motion (i.e., parallel and orthogonal to leaf travel) results in delivered fluence profiles that are superior to those that track the component of motion that is parallel to leaf travel alone. Tracking lag time effects may lead to relatively large intensity delivery errors compared to the other sources of error investigated

  20. Uncovering an Existential Barrier to Breast Self-exam Behavior

    PubMed Central

    Goldenberg, Jamie L.; Arndt, Jamie; Hart, Joshua; Routledge, Clay

    2008-01-01

    The present research applies an analysis derived from terror management theory to the health domain of breast examination, and in doing so uncovers previously unrecognized factors that may contribute to women’s reluctance to perform breast self-examinations (BSEs). In Study 1, when concerns about mortality were primed, reminders of human beings’ physical nature (i.e., creatureliness) reduced intentions to conduct BSEs compared to reminders of humans’ uniqueness. In Study 2, women conducted shorter exams on a breast model (an experience found to increase death-thought accessibility) when creatureliness was primed compared to a uniqueness and no essay condition. In Study 3, after a creatureliness prime, women performed shorter BSEs when a placebo did not provide an alternative explanation for their discomfort compared to when it did. Advances for theory and breast self-exam promotion are discussed. PMID:19255593

  1. Scanner Based Assessment in Exams Organized with Personalized Thesis Randomly Generated via Microsoft Word

    ERIC Educational Resources Information Center

    Teneqexhi, Romeo; Qirko, Margarita; Sharko, Genci; Vrapi, Fatmir; Kuneshka, Loreta

    2017-01-01

    Exams assessment is one of the most tedious work for university teachers all over the world. Multiple choice theses make exams assessment a little bit easier, but the teacher cannot prepare more than 3-4 variants; in this case, the possibility of students for cheating from one another becomes a risk for "objective assessment outcome." On…

  2. Skipping Class in College and Exam Performance: Evidence from a Regression Discontinuity Classroom Experiment

    ERIC Educational Resources Information Center

    Dobkin, Carlos; Gil, Ricard; Marion, Justin

    2010-01-01

    In this paper we estimate the effect of class attendance on exam performance by implementing a policy in three large economics classes that required students scoring below the median on the midterm exam to attend class. This policy generated a large discontinuity in the rate of post-midterm attendance at the median of the midterm score. We…

  3. Assessment of Validity, Reliability and Difficulty Indices for Teacher-Built Physics Exam Questions in First Year High School

    ERIC Educational Resources Information Center

    Jandaghi, Gholamreza

    2010-01-01

    The purpose of the research is to determine high school teachers' skill rate in designing exam questions in physics subject. The statistical population was all of physics exam shits for two semesters in one school year from which a sample of 364 exam shits was drawn using multistage cluster sampling. Two experts assessed the shits and by using…

  4. Oral Exam System at Teacher Appointments in Turkey

    ERIC Educational Resources Information Center

    Colak, Ismail; Demir, Selcuk Besir

    2017-01-01

    Many systems have been developed on teacher selection and appointments procedures throughout history in Turkey. Latest teacher appointments and selection systems in Turkey is Oral Exam Evaluation. This new system is discussed in detail in this study. Basically, the study is to analysis what the positive and negative reflections of the system might…

  5. Disorders of Sex Development: Pediatric Psychology and the Genital Exam.

    PubMed

    Tishelman, Amy C; Shumer, Daniel E; Nahata, Leena

    2017-06-01

    To provide suggestions for clinical care of youth with disorders of sex development (DSD) and their families, by drawing on preexisting pediatric psychology literature with a particular focus on child sexual abuse (CSA) genital exams. Relevant peer-reviewed papers published since 1990 in the CSA literature were systematically reviewed, as well as an illustrative sample of general pediatric psychology papers. Empirical research from the CSA literature provided information on prevalence of distress and the impact of provider behavior, the importance of preparation, and proposed interventions. Expert recommendations from CSA literature and general findings gleaned from pediatric psychology also address these issues. Psychological findings in the CSA pediatric population suggest that fears and anxieties are not universal and can be linked to a number of variables. Based on this review, we make a number of recommendations for potential interventions for youth with DSD and their families, emphasizing the need for further clinical research. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  6. Predictors of Academic Success for the National Board Dental Hygiene Examination and the Southern Regional Testing Agency Clinical Exam

    ERIC Educational Resources Information Center

    Efurd, Melissa G.

    2012-01-01

    The purpose for conducting this study was to investigate and describe the relationship between applicant criteria for a dental hygiene program and subsequent outcomes on credentialing exams: the National Board Dental Hygiene Exam and the Southern Regional Testing Agency clinical exam. Because admission criteria play a crucial role in applicant…

  7. Why do some women refuse to allow male residents to perform pelvic exams?

    PubMed

    Rifkin, Julie I; Shapiro, Howard; Regensteiner, Judith G; Stotler, Jeanne K; Schmidt, Betty

    2002-10-01

    Many women who receive medical care in residency training clinics refuse to allow male residents to perform their pelvic exams. This study was conducted to identify which women were most likely to refuse and to learn their reasons for refusing. From January to March 1997, a questionnaire was given to all women entering a Tri-County Health office and a Planned Parenthood clinic, both in the Denver, Colorado, metropolitan area, who consented to participate in the study. Data from the questionnaire were analyzed using a statistical software package. A total of 1,437 women entered the clinics during the study period. Of these patients, 1,078 consented to complete the questionnaire. Seven of these 1,078 women did not complete the questionnaire. Women who did not know the training level of the resident performing the pelvic exam were more likely to refuse than were women who knew the training level of the resident (p =.001), but many women preferred a female physician regardless of the physician's training level. Fifty-eight percent said they would allow a male resident to observe a female attending physician perform the exam, compared with 36% who said they would allow a male resident to observe if the attending physician was a man. Common statements from those who would refuse were: "I am just more comfortable with a female," "Women do not want men to examine their private body parts," and "Women explain things better." A woman's knowledge of the resident's training level correlates with her willingness to have a pelvic exam performed by a male resident. Women who said they would refuse a pelvic exam performed by a male resident gave specific reasons for their decision.

  8. Verbal Final Exam in Introductory Biology Yields Gains in Student Content Knowledge and Longitudinal Performance

    ERIC Educational Resources Information Center

    Luckie, Douglas B.; Rivkin, Aaron M.; Aubry, Jacob R.; Marengo, Benjamin J.; Creech, Leah R.; Sweeder, Ryan D.

    2013-01-01

    We studied gains in student learning over eight semesters in which an introductory biology course curriculum was changed to include optional verbal final exams (VFs). Students could opt to demonstrate their mastery of course material via structured oral exams with the professor. In a quantitative assessment of cell biology content knowledge,…

  9. Pattern recognition as a concept for multiple-choice questions in a national licensing exam.

    PubMed

    Freiwald, Tilo; Salimi, Madjid; Khaljani, Ehsan; Harendza, Sigrid

    2014-11-14

    Multiple-choice questions (MCQ) are still widely used in high stakes medical exams. We wanted to examine whether and to what extent a national licensing exam uses the concept of pattern recognition to test applied clinical knowledge. We categorized all 4,134 German National medical licensing exam questions between October 2006 and October 2012 by discipline, year, and type. We analyzed questions from the four largest disciplines: internal medicine (n = 931), neurology (n = 305), pediatrics (n = 281), and surgery (n = 233), with respect to the following question types: knowledge questions (KQ), pattern recognition questions (PRQ), inverse PRQ (IPRQ), and pseudo PRQ (PPRQ). A total 51.1% of all questions were of a higher taxonomical order (PRQ and IPRQ) with a significant decrease in the percentage of these questions (p <0.001) from 2006 (61.5%) to 2012 (41.6%). The proportion of PRQs and IPRQs was significantly lower (p <0.001) in internal medicine and surgery, compared to neurology and pediatrics. PRQs were mostly used in questions about diagnoses (71.7%). A significantly higher (p <0.05) percentage of PR/therapy questions was found for internal medicine compared with neurology and pediatrics. The concept of pattern recognition is used with different priorities and to various extents by the different disciplines in a high stakes exam to test applied clinical knowledge. Being aware of this concept may aid in the design and balance of MCQs in an exam with respect to testing clinical reasoning as a desired skill at the threshold of postgraduate medical education.

  10. Sleep and Final Exam Performance in Introductory Physics

    ERIC Educational Resources Information Center

    Coletta, Vincent; Wikholm, Colin; Pascoe, Daniel

    2018-01-01

    Most physics instructors believe that adequate sleep is important in order for students to perform well on problem solving, and many instructors advise students to get plenty of sleep the night before an exam. After years of giving such advice to students at Loyola Marymount University (LMU), one of us decided to find out how many hours students…

  11. Assessing first year radiology resident competence pre-call: development and implementation of a computer-based exam before and after the 12 month training requirement.

    PubMed

    Khan, Rihan; Krupinski, Elizabeth; Graham, J Allen; Benodin, Les; Lewis, Petra

    2012-06-01

    Whether first-year radiology residents are ready to start call after 6 or 12 months has been a subject of much debate. The purpose of this study was to establish an assessment that would evaluate the call readiness of first-year radiology residents and identify any individual areas of weakness using a comprehensive computerized format. Secondarily, we evaluated for any significant differences in performance before and after the change in precall training requirement from 6 to 12 months. A list of >140 potential emergency radiology cases was given to first-year radiology residents at the beginning of the academic year. Over 4 years, three separate versions of a computerized examination were constructed using hyperlinked PowerPoint presentations and given to both first-year and second-year residents. No resident took the same version of the exam twice. Exam score and number of cases failed were assessed. Individual areas of weakness were identified and remediated with the residents. Statistical analysis was used to evaluate exam score and the number of cases failed, considering resident year and the three versions of the exam. Over 4 years, 17 of 19 (89%) first-year radiology residents passed the exam on first attempt. The two who failed were remediated and passed a different version of the exam 6 weeks later. Using the oral board scoring system, first-year radiology residents scored an average of 70.7 with 13 cases failed, compared to 71.1 with eight cases failed for second-year residents who scored statistically significantly higher. No significant difference was found in first-year radiology resident scoring before and after the 12-month training requirement prior to call. An emergency radiology examination was established to aid in the assessment of first-year radiology residents' competency prior to starting call, which has become a permanent part of the first-year curriculum. Over 4 years, all first-year residents were ultimately judged ready to start call. Of

  12. Should I Do a Breast Self-Exam? (For Teens)

    MedlinePlus

    ... growing and changing. The reason women do breast self-exams is to learn what's normal for their breasts. But during the teen years, what's "normal" can change based on where a girl is in her development. To make things more confusing, your breasts can ...

  13. 76 FR 37200 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... Small Business/Self Employed Correspondence Exam Practitioner Engagement Project Committee AGENCY... Taxpayer Advocacy Panel Small Business/ Self Employed Correspondence Exam Practitioner Engagement Project... Act, 5 U.S.C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Small Business/Self...

  14. 76 FR 10942 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-28

    ... Small Business/Self Employed Correspondence Exam Practitioner Engagement Project Committee AGENCY... Taxpayer Advocacy Panel Small Business/ Self Employed Correspondence Exam Practitioner Engagement Project... Act, 5 U.S.C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Small Business/Self...

  15. 76 FR 46897 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-03

    ... Small Business/Self Employed Correspondence Exam Practitioner Engagement Project Committee AGENCY... Taxpayer Advocacy Panel Small Business/ Self Employed Correspondence Exam Practitioner Engagement Project... Advisory Committee Act, 5 U.S.C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Small...

  16. 76 FR 6189 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-03

    ... Small Business/Self Employed Correspondence Exam Practitioner Engagement Project Committee AGENCY... Taxpayer Advocacy Panel Small Business/ Self Employed Correspondence Exam Practitioner Engagement Project... Act, 5 U.S.C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Small Business/Self...

  17. 76 FR 22170 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-20

    ... Small Business/Self Employed Correspondence Exam Practitioner Engagement Project Committee AGENCY... Taxpayer Advocacy Panel Small Business/ Self Employed Correspondence Exam Practitioner Engagement Project... Act, 5 U.S.C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Small Business/Self...

  18. 76 FR 56879 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... Small Business/Self Employed Correspondence Exam Practitioner Engagement Project Committee AGENCY... Taxpayer Advocacy Panel Small Business/ Self Employed Correspondence Exam Practitioner Engagement Project... Advisory Committee Act, 5 U.S.C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Small...

  19. 76 FR 63715 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-13

    ... Small Business/Self Employed Correspondence Exam Practitioner Engagement Project Committee AGENCY... Taxpayer Advocacy Panel Small Business/ Self Employed Correspondence Exam Practitioner Engagement Project... Advisory Committee Act, 5 U.S.C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Small...

  20. The importance of the first ultrasonic exam of newborn hips.

    PubMed

    Grubor, Predrag; Asotic, Mithat; Biscevic, Mirza; Grubor, Milan

    2012-01-01

    Developmental hip disorder (DHD) is a disorder in development of the acetabulum which remains abrupt (dysplasia) and probably consequential cranialisation of the femur head (luxation). The aim of this paper is to establish the total number of DHD and its subtypes at the first clinical and ultrasound exam of newborns in a retrospective-prospective study made in the period from 1st Jan 2006 through to 31 Dec 2010 at the Clinic for orthopaedics and traumatology in Banja Luka. In total 6132 patients were examined and 99 cases diagnosed with DHD (dysplasia and luxation). Ultrasonic exam was done by means of electronic probe of 5-12 MHz according to standard method after Graph. Girls were significantly more present (96%). Positive family anamnesis on DHD was present with 7.8% examinee, mainly with primiparas, and/ or with 77.8% children with DHD. Dominant intrauterine risk factors for DHD were: mal position of foetus in uterus (78.6%), oligoamnion (17.9%), malformation of the spinal column of the pregnant woman (3.6%), whereas with 38.4% of children with a certain form of DHD the following were found: breech presentation, caesarean section or twin pregnancy. The clinical exam indicated DHD with 8.87% examinee, out of which hip looseness was found with 5% examinees. Ultrasonic finding was positive with 99 examinee, that is with 1.61% of them (deficient and badly formed acetabulum, sleeked protrusion; 8 luxations and 91 dysplasia). Prophylactic measures were requested by 58.6% children (abductive bending and exercises), whereas 41.4 % needed non-intervention therapeutic measures (traction, Pavlik's straps, Graph's knickers, plastering), after which there were no children needing surgical correction of DHD. These data indicate that clinical exam is unreliable for DHD diagnostics, and that Ultrasonic diagnostics and treatment of DHD should start as early as possible applying atraumatic helping devices and procedures in the period when all structures are elastic, flexible and

  1. Resources Used to Teach the Physical Exam to Preclerkship Medical Students: Results of a National Survey.

    PubMed

    Uchida, Toshiko; Achike, Francis I; Blood, Angela D; Boyle, Mary; Farnan, Jeanne M; Gowda, Deepthiman; Hojsak, Joanne; Ovitsh, Robin K; Park, Yoon Soo; Silvestri, Ronald

    2018-05-01

    To examine resources used in teaching the physical exam to preclerkship students at U.S. medical schools. The Directors of Clinical Skills Courses developed a 49-question survey addressing resources and pedagogical methods employed in preclerkship physical exam curricula. The survey was sent to all 141 Liaison Committee on Medical Education-accredited medical schools in October 2015. Results were averaged across schools, and data were weighted by class size. Results from 106 medical schools (75% response rate) identified a median of 59 hours devoted to teaching the physical exam. Thirty-eight percent of time spent teaching the physical exam involved the use of standardized patients, 30% used peer-to-peer practice, and 25% involved examining actual patients. Approximately half of practice time with actual patients was observed by faculty. At 48% of schools (51), less than 15% of practice time was with actual patients, and at 20% of schools (21) faculty never observed students practicing with actual patients. Forty-eight percent of schools (51) did not provide compensation for their outpatient clinical preceptors. There is wide variation in the resources used to teach the physical examination to preclerkship medical students. At some schools, the amount of faculty observation of students examining actual patients may not be enough for students to achieve competency. A significant percentage of faculty teaching the physical exam remain uncompensated for their effort. Improving faculty compensation and increasing use of senior students as teachers might allow for greater observation and feedback and improved physical exam skills among students.

  2. Two-Stage Exams Improve Student Learning in an Introductory Geology Course: Logistics, Attendance, and Grades

    ERIC Educational Resources Information Center

    Knierim, Katherine; Turner, Henry; Davis, Ralph K.

    2015-01-01

    Two-stage exams--where students complete part one of an exam closed book and independently and part two is completed open book and independently (two-stage independent, or TS-I) or collaboratively (two-stage collaborative, or TS-C)--provide a means to include collaborative learning in summative assessments. Collaborative learning has been shown to…

  3. Research and Teaching: Correcting Missed Exam Questions as a Learning Tool in a Physiology Course

    ERIC Educational Resources Information Center

    Rozell, Timothy G.; Johnson, Jessica; Sexten, Andrea; Rhodes, Ashley E.

    2017-01-01

    Students in a junior- and senior-level Anatomy and Physiology course have the opportunity to correct missed exam questions ("regrade") and earn up to half of the original points missed. The three objectives of this study were to determine if: (a) performance on the regrade assignment was correlated with scores on subsequent exams, (b)…

  4. Lack of Follow-Up Exams after Failed School Vision Screenings: An Investigation of Contributing Factors

    ERIC Educational Resources Information Center

    Kimel, Linda S.

    2006-01-01

    Programs to facilitate professional eye exams after failed school vision screenings often are based on the assumption that funding and access to services are major obstacles to care. Despite such programs, many children do not receive professional exams. The purpose of this study was to identify additional barriers to follow-up eye care. School…

  5. Validating the Use of AP® Exam Scores for College Course Placement. Research Report 2013-2

    ERIC Educational Resources Information Center

    Patterson, Brian F.; Ewing, Maureen

    2013-01-01

    The Advanced Placement Program® (AP®) was created to provide access to rigorous, college-level curricula to motivated and prepared high school students. This study evaluated whether the AP Exam scores from the summative exams associated with 10 courses were valid for the placement of students into higher-level college courses in the subject area…

  6. 76 FR 2193 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-12

    ... Small Business/Self Employed Correspondence Exam Practitioner Engagement AGENCY: Internal Revenue... Small Business/ Self Employed Correspondence Exam Practitioner Engagement will be conducted. The...: Notice is hereby given pursuant to Section 10(a)(2) of the Federal Advisory Committee Act, 5 U.S.C. App...

  7. 76 FR 17995 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-31

    ... Small Business/Self Employed Correspondence Exam Practitioner Engagement Project Committee AGENCY... Taxpayer Advocacy Panel Small Business/ Self Employed Correspondence Exam Practitioner Engagement Project... Section 10(a)(2) of the Federal Advisory Committee Act, 5 U.S.C. App. (1988) that an open meeting of the...

  8. 46 CFR 71.50-3 - Drydock examination, internal structural examination, underwater survey, and alternate hull exam...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., underwater survey, and alternate hull exam intervals. 71.50-3 Section 71.50-3 Shipping COAST GUARD...-3 Drydock examination, internal structural examination, underwater survey, and alternate hull exam... wooden hulls must undergo two drydock and two internal structural examinations within any five year...

  9. Advanced Placement[R] Exam-Taking and Performance: Relationships with First-Year Subject Area College Grades. Research Report 2011-4

    ERIC Educational Resources Information Center

    Patterson, Brian F.; Packman, Sheryl; Kobrin, Jennifer L.

    2011-01-01

    The purpose of this study was to examine the effects of Advanced Placement[R] (AP[R]) exam participation and performance on college grades for courses taken in the same subject area as students' AP Exam(s). Students' first-year college subject area grade point averages (SGPAs) were examined in nine subject areas: mathematics, computer science,…

  10. The Challenges of Using the WebCAPE Placement Exam in an Advanced Spanish Grammar Class

    ERIC Educational Resources Information Center

    Turner, Robert L., III

    2017-01-01

    This study attempts to ascertain if the WebCAPE placement exam can be used to measure improvement in an upper division grammar course. The WebCAPE online placement exam is a widely used instrument designed to help university language programs place students into the basic language course best corresponding to their proficiency level. This is done…

  11. Development of a testlet generator in re-engineering the Indonesian physics national-exams

    NASA Astrophysics Data System (ADS)

    Mindyarto, Budi Naini; Mardapi, Djemari; Bastari

    2017-08-01

    The Indonesian Physics national-exams are end-of-course summative assessments that could be utilized to support the assessment for learning in physics educations. This paper discusses the development and evaluation of a testlet generator based on a re-engineering of Indonesian physics national exams. The exam problems were dissected and decomposed into testlets revealing the deeper understanding of the underlying physical concepts by inserting a qualitative question and its scientific reasoning question. A template-based generator was built to facilitate teachers in generating testlet variants that would be more conform to students' scientific attitude development than their original simple multiple-choice formats. The testlet generator was built using open source software technologies and was evaluated focusing on the black-box testing by exploring the generator's execution, inputs and outputs. The results showed the correctly-performed functionalities of the developed testlet generator in validating inputs, generating testlet variants, and accommodating polytomous item characteristics.

  12. The Grass Isn’t Always Greener: Perceptions of and Performance on Open-Note Exams

    PubMed Central

    Sato, Brian K.; He, Wenliang; Warschauer, Mark; Kadandale, Pavan

    2015-01-01

    Undergraduate biology education is often viewed as being focused on memorization rather than development of students’ critical-thinking abilities. We speculated that open-note testing would be an easily implemented change that would emphasize higher-order thinking. As open-note testing is not commonly used in the biological sciences and the literature on its effects in biology education is sparse, we performed a comprehensive analysis of this intervention on a primary literature–based exam across three large-enrollment laboratory courses. Although students believed open-note testing would impact exam scores, we found no effect on performance, either overall or on questions of nearly all Bloom’s levels. Open-note testing also produced no advantage when examined under a variety of parameters, including research experience, grade point average, course grade, prior exposure to primary literature–focused laboratory courses, or gender. Interestingly, we did observe small differences in open- and closed-note exam performance and perception for students who experienced open-note exams for an entire quarter. This implies that student preparation or in-test behavior can be altered by exposure to open-note testing conditions in a single course and that ­increased experience may be necessary to truly understand the impact of this intervention. PMID:25828402

  13. [The touched masculinity: a discussion about the digital rectal exam for prostate cancer prevention].

    PubMed

    Gomes, Romeu; do Nascimento, Elaine Ferreira; Rebello, Lúcia Emília Figueiredo de Sousa; de Araújo, Fábio Carvalho

    2008-01-01

    The present study aims at analyzing the meanings attributed to the digital rectal exam, seeking to problematize questions underlying the masculine discourse on the basis of aspects of the hegemonic masculinity model. Semi-structured interviews were held with 28 men in the city of Rio de Janeiro, in 2004. Among the main results is the idea that the digital rectal exam is something that violates an interdicted space, something that compromises the current understanding of masculinity, shall say, the digital rectal exam does not only affect the prostate, it also affects the masculinity, puts it to shame. We conclude that for understanding and problematizing the questions related to the prostate cancer prevention in special, and to the question of taking care of oneself from the masculine perspective in general, we need to consider the structural and symbolic aspects that underlie these questions.

  14. Assessment Drives Learning: The Effect of Central Exit Exams on Curricular Knowledge and Mathematical Literacy

    ERIC Educational Resources Information Center

    Jurges, Hendrik; Schneider, Kerstin; Senkbeil, Martin; Carstensen, Claus H.

    2012-01-01

    In this paper, we use data from the German PISA 2003 sample to study the effects of central exit examinations on student performance and student attitudes. Unlike earlier studies we use (i) a value-added measure to pin down the effect of central exit exams on learning in the last year before the exam and (ii) separate test scores for mathematical…

  15. Pathologic C-spine fracture with low risk mechanism and normal physical exam.

    PubMed

    Hunter, Andrew; McGreevy, Jolion; Linden, Judith

    2017-09-01

    Cervical spinal fracture is a rare, but potentially disabling complication of trauma to the neck. Clinicians often rely on clinical decision rules and guidelines to decide whether or not imaging is necessary when a patient presents with neck pain. Validated clinical guidelines include the Canadian C-Spine Rule and the Nexus criteria. Studies suggest that the risks of a pathologic fracture from a simple rear end collision are negligible. We present a case of an individual who presented to an emergency department (ED) after a low speed motor vehicle collision complaining of lateral neck pain and had multiple subsequent visits for the same complaint with negative exam findings. Ultimately, he was found to have a severely pathologic cervical spine fracture with notable cord compression. Our objective is to discuss the necessity to incorporate clinical decision rules with physician gestalt and the need to take into account co-morbidities of a patient presenting after a minor MVC. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Implementation of the Hammersmith Infant Neurological Exam in a High-Risk Infant Follow-Up Program

    PubMed Central

    Maitre, Nathalie L; Chorna, Olena; Romeo, Domenico M; Guzzetta, Andrea

    2017-01-01

    Background High-Risk Infant Follow-Up (HRIF) programs provide early identification and referral for treatment of neurodevelopmental delays and impairments. In these programs, a standardized neurological exam is a critical component of evaluation for clinical and research purposes. Implementation To address primary challenges of provider educational diversity and standardized documentation, we designed an approach to training and implementation of the Hammersmith Infant Neurological Exam (HINE) with pre-course materials, a workshop model and adaptation of the electronic medical record. Conclusions Provider completion and documentation of a neurologic exam were evaluated before and after HINE training. Standardized training and implementation of the HINE in a large HRIF is feasible and effective and allows for quantitative evaluation of neurological findings and developmental trajectories. PMID:27765470

  17. The Use of a Comprehensive Multiple Choice Final Exam in the Macroeconomics Principles Course: An Assessment.

    ERIC Educational Resources Information Center

    Petrowsky, Michael C.

    This paper analyzes the results of a pilot study at Glendale Community College (Arizona) to assess the effectiveness of a comprehensive multiple choice final exam in the macroeconomic principles course. The "pilot project" involved the administration of a 50-question multiple choice exam to 71 students in three macroeconomics sections.…

  18. Knowledge Assessment of Food Safety Managers in Utah and Its Implications on the Exam and Instruction

    ERIC Educational Resources Information Center

    Nummer, Brian A.; Guy, Stanley M.; Bentley, Joanne P. H.

    2010-01-01

    Food Safety Manager's Certification is offered through a state-local Extension partnership in Utah using an online course management system. Exams and course materials were created by an Extension Specialist at Utah State Univ. Extension Agents provide exam and curriculum facilitation in each county. This form of distance education enables access…

  19. Exam High Schools and Academic Achievement: Evidence from New York City. NBER Working Paper No. 17286

    ERIC Educational Resources Information Center

    Dobbie, Will; Fryer, Roland G., Jr.

    2011-01-01

    Publicly funded exam schools educate many of the world's most talented students. These schools typically contain higher achieving peers, more rigorous instruction, and additional resources compared to regular public schools. This paper uses a sharp discontinuity in the admissions process at three prominent exam schools in New York City to provide…

  20. Reading Quizzes Improve Exam Scores for Community College Students

    ERIC Educational Resources Information Center

    Pape-Lindstrom, Pamela; Eddy, Sarah; Freeman, Scott

    2018-01-01

    To test the hypothesis that adding course structure may encourage self-regulated learning skills resulting in an increase in student exam performance in the community college setting, we added daily preclass online, open-book reading quizzes to an introductory biology course. We compared three control terms without reading quizzes and three…

  1. Student-Produced Videos for Exam Review in Mathematics Courses

    ERIC Educational Resources Information Center

    Hulsizer, Heidi

    2016-01-01

    Videos have been used in classrooms for decades, but student-produced video has recently become a viable, economical option to enhance learning. Students were asked to create videos to be used for their exam review in two different undergraduate mathematics courses: Differential Equation and Complex Analysis. Students were then surveyed about…

  2. Interteaching: The Effects of Quality Points on Exam Scores

    ERIC Educational Resources Information Center

    Saville, Bryan K.; Zinn, Tracy E.

    2009-01-01

    Although previous studies have found interteaching to be an effective alternative to traditional methods of instruction, few studies have examined which of its components contribute to its effectiveness. In the current study, we examined whether manipulating quality points had an effect on our students' exam scores. In two sections of an…

  3. Evaluation of Simulated Clinical Breast Exam Motion Patterns Using Marker-Less Video Tracking

    PubMed Central

    Azari, David P.; Pugh, Carla M.; Laufer, Shlomi; Kwan, Calvin; Chen, Chia-Hsiung; Yen, Thomas Y.; Hu, Yu Hen; Radwin, Robert G.

    2016-01-01

    Objective This study investigates using marker-less video tracking to evaluate hands-on clinical skills during simulated clinical breast examinations (CBEs). Background There are currently no standardized and widely accepted CBE screening techniques. Methods Experienced physicians attending a national conference conducted simulated CBEs presenting different pathologies with distinct tumorous lesions. Single hand exam motion was recorded and analyzed using marker-less video tracking. Four kinematic measures were developed to describe temporal (time pressing and time searching) and spatial (area covered and distance explored) patterns. Results Mean differences between time pressing, area covered, and distance explored varied across the simulated lesions. Exams were objectively categorized as either sporadic, localized, thorough, or efficient for both temporal and spatial categories based on spatiotemporal characteristics. The majority of trials were temporally or spatially thorough (78% and 91%), exhibiting proportionally greater time pressing and time searching (temporally thorough) and greater area probed with greater distance explored (spatially thorough). More efficient exams exhibited proportionally more time pressing with less time searching (temporally efficient) and greater area probed with less distance explored (spatially efficient). Just two (5.9 %) of the trials exhibited both high temporal and spatial efficiency. Conclusions Marker-less video tracking was used to discriminate different examination techniques and measure when an exam changes from general searching to specific probing. The majority of participants exhibited more thorough than efficient patterns. Application Marker-less video kinematic tracking may be useful for quantifying clinical skills for training and assessment. PMID:26546381

  4. Advanced Placement® Exam-Taking and Performance: Relationships with First-Year Subject Area College Grades. Research Report No. 2011-4

    ERIC Educational Resources Information Center

    Patterson, Brian F.; Packman, Sheryl; Kobrin, Jennifer L.

    2011-01-01

    The purpose of this study was to examine the effects of Advanced Placement (AP) exam participation and performance on college grades for courses taken in the same subject area as students' AP Exam(s). Students' first-year college subject area grade point averages (SGPAs) were examined in nine subject areas: mathematics, computer science,…

  5. TH-C-18A-09: Exam and Patient Parameters Affecting the DNA Damage Response Following CT Studies

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Elgart, S; Adibi, A; Bostani, M

    Purpose: To identify exam and patient parameters affecting the biological response to CT studies using in vivo and ex vivo blood samples. Methods: Blood samples were collected under IRB approval from 16 patients undergoing clinically-indicated CT exams. Blood was procured prior to, immediately after and 30minutes following irradiation. A sample of preexam blood was placed on the patient within the exam region for ex vivo analysis. Whole blood samples were fixed immediately following collection and stained for γH2AX to assess DNA damage response (DDR). Median fluorescence of treated samples was compared to non-irradiated control samples for each patient. Patients weremore » characterized by observed biological kinetic response: (a) fast — phosphorylation increased by 2minutes and fell by 30minutes, (b) slow — phosphorylation continued to increase to 30minutes and (c) none — little change was observed or irradiated samples fell below controls. Total dose values were normalized to exam time for an averaged dose-rate in dose/sec for each exam. Relationships between patient biological responses and patient and exam parameters were investigated. Results: A clearer dose response at 30minutes is observed for young patients (<61yoa; R2>0.5) compared to old patients (>61yoa; R{sup 2}<0.11). Fast responding patients were significantly younger than slow responding patients (p<0.05). Unlike in vivo samples, age did not significantly affect the patient response ex vivo. Additionally, fast responding patients received exams with significantly smaller dose-rate than slow responding patients (p<0.05). Conclusion: Age is a significant factor in the biological response suggesting that DDR may be more rapid in a younger population and slower as the population ages. Lack of an agerelated response ex vivo suggests a systemic response to radiation not present when irradiated outside the body. Dose-rate affects the biological response suggesting that patient response may be

  6. 76 FR 46897 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam Toll...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-03

    ... Small Business/Self Employed Correspondence Exam Toll Free Project Committee AGENCY: Internal Revenue... Panel Small Business/ Self Employed Correspondence Exam Toll Free Project Committee will be conducted....C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Small Business/Self Employed...

  7. 76 FR 37893 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam Toll...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-28

    ... Small Business/Self Employed Correspondence Exam Toll Free Project Committee AGENCY: Internal Revenue... Panel Small Business/ Self Employed Correspondence Exam Toll Free Project Committee will be conducted....C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Small Business/Self Employed...

  8. 76 FR 6190 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam Toll...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-03

    ... Small Business/Self Employed Correspondence Exam Toll Free Project Committee AGENCY: Internal Revenue... Panel Small Business/ Self Employed Correspondence Exam Toll Free Project Committee will be conducted....C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Small Business/Self Employed...

  9. 76 FR 10942 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam Toll...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-28

    ... Small Business/Self Employed Correspondence Exam Toll Free Project Committee AGENCY: Internal Revenue... Panel Small Business/ Self Employed Correspondence Exam Toll Free Project Committee will be conducted....C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Small Business/Self Employed...

  10. Rumor Has It: Investigating Teacher Licensure Exam Advice Networks

    ERIC Educational Resources Information Center

    Baker-Doyle, Kira; Petchauer, Emery

    2015-01-01

    In many countries, including the United States, England, Korea, Hong Kong, and Japan, individuals must pass some form of examination for entry into or completion of a teacher education program (Wang, Coleman, Coley, & Phelps, 2003). These exams are meant to act as gatekeeping mechanisms for teacher quality. In the majority of the countries…

  11. Factors Distinguishing Exceptional Performance on the Uniform CPA Exam.

    ERIC Educational Resources Information Center

    Ashbaugh, Donald L.; Thompson, A. Frank

    1993-01-01

    Analysis of data from 234 Certified Public Accountant (CPA) candidates (98 of whom failed at least 1 part of the exam) showed that higher grades in the CPA review course correlated with passing the first time. Higher high school class rank and larger high school class size influenced exceptional test performance. (SK)

  12. Regression Effects in Angoff Ratings: Examples from Credentialing Exams

    ERIC Educational Resources Information Center

    Wyse, Adam E.

    2018-01-01

    This article discusses regression effects that are commonly observed in Angoff ratings where panelists tend to think that hard items are easier than they are and easy items are more difficult than they are in comparison to estimated item difficulties. Analyses of data from two credentialing exams illustrate these regression effects and the…

  13. Naringin attenuates MLC phosphorylation and NF-κB activation to protect sepsis-induced intestinal injury via RhoA/ROCK pathway.

    PubMed

    Li, Zhiling; Gao, Ming; Yang, Bingchang; Zhang, Huali; Wang, Kangkai; Liu, Zuoliang; Xiao, Xianzhong; Yang, Mingshi

    2018-07-01

    Sepsis is commonly associated with excessive stimulation of host immune system and result in multi-organ failure dysfunction. Naringin has been reported to exhibit a variety of biological effects. The present study aimed to investigate the protective effect of naringin on sepsis-induced injury of intestinal barrier function in vivo and in vitro. Mice were randomly divided into 4 groups named sham (n = 20), CLP + vehicle (n = 20), CLP + NG (30 mg/kg) (n = 20) and CLP + NG (60 mg/kg) (n = 20) groups. Sepsis was induced by cecal ligation and puncture (CLP). H&E staining and transmission electron microscopy (TEM) were performed to observe intestinal mucosal morphology. ELISA was used to determine the intestinal permeability and inflammatory response in vivo and in vitro. Western blot and RhoA activity assay were performed to determine the levels of tight junction proteins and the activation of indicated signaling pathways. MTT assay was used to determine cell viability. Naringin improved survival rate of CLP mice and alleviated sepsis-induced intestinal mucosal injury. Furthermore, naringin improved impaired intestinal permeability and inhibited the release of TNF-α and IL-6, while increased IL-10 level in CLP mice and lipopolysaccharide (LPS)-stimulated MODE-K cells in a dose-dependent manner. Naringin increased the expression of tight junction proteins ZO-1 and claudin-1 via RhoA/ROCK/NF-κB/MLCK/MLC signaling pathway in vivo and in vitro. Naringin improved sepsis-induced intestinal injury via RhoA/ROCK/NF-κB/MLCK/MLC signaling pathway in vivo and in vitro. Copyright © 2018. Published by Elsevier Masson SAS.

  14. Assessment of the relationship between stress and temporomandibular joint disorder in female students before university entrance exam (Konkour exam).

    PubMed

    Mottaghi, Ahmad; Razavi, S Mohammad; Pozveh, Elham Zamani; Jahangirmoghaddam, Milad

    2011-12-01

    Temporomandibular joint is one of the most complicated joints of the body and plays an important role in the head and neck system. One of the factors affecting the temporomandibular joint and lead to temporomandibular disorder is anxiety with all the events causing it. The aim of this study was to determine a relationship between anxiety and temporomandibular disorders. In this prospective study, subjects were randomly selected. One hundred and thirty pre-university students in Isfahan were evaluated with Ketel's test of anxiety, exam stress test and temporomandibular disorder questionnaires. The evaluation was done in two stages 10 months and 1 month prior to the university entrance exam (Konkour), clinical assessments consisted of masticatory muscles and sternocleidomastoid muscle palpation, temporomandibular joint palpation for pain and noise and its movement, and mouth opening limitations. The Wilcoxon rank test and paired t-test were used to analyze the data and the P value under 0.05 was considered significant. The level of anxiety and occurrence of temporomandibular disorders were increased between two stages and had the highest level in the second stage. There was a significant increase between two stages (P<0.001). The parallel increase of temporomandibular disorders and anxiety between the two stages can suggest a possible relationship between anxiety and temporomandibular disorders. Therefore, the effect of anxiety in triggering temporomandibular disorder symptoms is probable.

  15. What Does a Student Know Who Earns a Top Score on the Advanced Placement Chemistry Exam?

    ERIC Educational Resources Information Center

    Claesgens, Jennifer; Daubenmire, Paul L.; Scalise, Kathleen M.; Balicki, Scott; Gochyyev, Perman; Stacy, Angelica M.

    2014-01-01

    This paper compares the performance of students at a high-performing U.S. public school (n = 64) on the advanced placement (AP) chemistry exam to their performance on the ChemQuery assessment system. The AP chemistry exam was chosen because, as the National Research Council acknowledges, it is the "perceived standard of excellence and school…

  16. Objective structured clinical examination "Death Certificate" station - Computer-based versus conventional exam format.

    PubMed

    Biolik, A; Heide, S; Lessig, R; Hachmann, V; Stoevesandt, D; Kellner, J; Jäschke, C; Watzke, S

    2018-04-01

    is a cost-efficient and standardised format for examination that yields results comparable to those from a conventional format exam. Moreover, the examination results also indicate the need to optimize both the test itself (adjusting the degree of difficulty of the case vignettes) and the corresponding instructional and learning methods (including, for example, the use of computer programmes to complete the death certificate in small group formats in the SkillsLab). Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  17. USER MANUAL FOR EXPRESS, THE EXAMS-PRZM EXPOSURE SIMULATION SHELL

    EPA Science Inventory

    The Environmental Fate and Effects Division (EFED) of EPA's Office of Pesticide Programs(OPP) uses a suite of ORD simulation models for the exposure analysis portion of regulatory risk assessments. These models (PRZM, EXAMS, AgDisp) are complex, process-based simulation codes tha...

  18. Acute vocal fold hemorrhage caught on video during office exam.

    PubMed

    Carroll, Thomas L; Smith, Libby J

    2009-03-01

    This article presents a unique video of a laryngeal exam during which a vocal fold hemorrhage occurs. This patient had likely been suffering from intermittent vocal fold hemorrhages for the last decade due to a persistent vascular lesion and an underlying chronic cough.

  19. Lack of follow-up exams after failed school vision screenings: an investigation of contributing factors.

    PubMed

    Kimel, Linda S

    2006-06-01

    Programs to facilitate professional eye exams after failed school vision screenings often are based on the assumption that funding and access to services are major obstacles to care. Despite such programs, many children do not receive professional exams. The purpose of this study was to identify additional barriers to follow-up eye care. School nurses in an urban, midwestern public school district identified elementary school students who had not received follow-up eye exams after failed school vision screenings. Parents of these students were interviewed during the summer to determine financial, logistical, social/family, and perceptual barriers to care. Family issues, parental perceptions of vision problems, and difficulty planning ahead were found to be significant factors. Strategies to increase follow-up compliance and recommendations for overcoming barriers to care were also identified.

  20. How Much Is that Exam Grade Really Worth? An Estimation of Student Risk Aversion to Their Unknown Final College Course Grades

    ERIC Educational Resources Information Center

    Nalley, Lanier; McKenzie, Andrew

    2011-01-01

    This study created an experimental design with which students can empirically assess their risk behavior with respect to exam grades within an expected utility framework. Specifically, the authors analyzed students' risk preferences associated with taking exams and earning a "risky" unknown grade versus not taking exams and instead…

  1. Tablet computer enhanced training improves internal medicine exam performance.

    PubMed

    Baumgart, Daniel C; Wende, Ilja; Grittner, Ulrike

    2017-01-01

    Traditional teaching concepts in medical education do not take full advantage of current information technology. We aimed to objectively determine the impact of Tablet PC enhanced training on learning experience and MKSAP® (medical knowledge self-assessment program) exam performance. In this single center, prospective, controlled study final year medical students and medical residents doing an inpatient service rotation were alternatingly assigned to either the active test (Tablet PC with custom multimedia education software package) or traditional education (control) group, respectively. All completed an extensive questionnaire to collect their socio-demographic data, evaluate educational status, computer affinity and skills, problem solving, eLearning knowledge and self-rated medical knowledge. Both groups were MKSAP® tested at the beginning and the end of their rotation. The MKSAP® score at the final exam was the primary endpoint. Data of 55 (tablet n = 24, controls n = 31) male 36.4%, median age 28 years, 65.5% students, were evaluable. The mean MKSAP® score improved in the tablet PC (score Δ + 8 SD: 11), but not the control group (score Δ- 7, SD: 11), respectively. After adjustment for baseline score and confounders the Tablet PC group showed on average 11% better MKSAP® test results compared to the control group (p<0.001). The most commonly used resources for medical problem solving were journal articles looked up on PubMed or Google®, and books. Our study provides evidence, that tablet computer based integrated training and clinical practice enhances medical education and exam performance. Larger, multicenter trials are required to independently validate our data. Residency and fellowship directors are encouraged to consider adding portable computer devices, multimedia content and introduce blended learning to their respective training programs.

  2. Tablet computer enhanced training improves internal medicine exam performance

    PubMed Central

    Wende, Ilja; Grittner, Ulrike

    2017-01-01

    Background Traditional teaching concepts in medical education do not take full advantage of current information technology. We aimed to objectively determine the impact of Tablet PC enhanced training on learning experience and MKSAP® (medical knowledge self-assessment program) exam performance. Methods In this single center, prospective, controlled study final year medical students and medical residents doing an inpatient service rotation were alternatingly assigned to either the active test (Tablet PC with custom multimedia education software package) or traditional education (control) group, respectively. All completed an extensive questionnaire to collect their socio-demographic data, evaluate educational status, computer affinity and skills, problem solving, eLearning knowledge and self-rated medical knowledge. Both groups were MKSAP® tested at the beginning and the end of their rotation. The MKSAP® score at the final exam was the primary endpoint. Results Data of 55 (tablet n = 24, controls n = 31) male 36.4%, median age 28 years, 65.5% students, were evaluable. The mean MKSAP® score improved in the tablet PC (score Δ + 8 SD: 11), but not the control group (score Δ- 7, SD: 11), respectively. After adjustment for baseline score and confounders the Tablet PC group showed on average 11% better MKSAP® test results compared to the control group (p<0.001). The most commonly used resources for medical problem solving were journal articles looked up on PubMed or Google®, and books. Conclusions Our study provides evidence, that tablet computer based integrated training and clinical practice enhances medical education and exam performance. Larger, multicenter trials are required to independently validate our data. Residency and fellowship directors are encouraged to consider adding portable computer devices, multimedia content and introduce blended learning to their respective training programs. PMID:28369063

  3. Teachers' Interpretations of Exit Exam Scores and College Readiness

    ERIC Educational Resources Information Center

    McIntosh, Shelby

    2013-01-01

    This study examined teachers' interpretations of Virginia's high school exit exam policy through the teachers' responses to a survey. The survey was administered to teachers from one school district in Northern Virginia. The teachers selected for the survey taught a subject in which students must pass a Standards of Learning (SOL) test in order to…

  4. Thinking out of the Exams Box: Assessment through Talk?

    ERIC Educational Resources Information Center

    Coultas, Valerie

    2017-01-01

    This article examines the abandonment of talk-based assessment in favour of written exams, even when writing results in less valid assessment. It points to substantial experience of assessment through talk in English and media studies and points to its potential use in other subjects. It is followed by an example, originally designed by the…

  5. WE-A-304-01: Strategies and Technologies for Cranial Radiosurgery Planning: MLC-Based Linac

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kim, G.

    2015-06-15

    The high fractional doses, stringent requirements for accuracy and precision, and surgical perspective characteristic of intracranial radiosurgery create considerations for treatment planning which are distinct from most other radiotherapy procedures. This session will introduce treatment planning techniques specific to two popular intracranial SRS modalities: Gamma Knife and MLC-based Linac. The basic treatment delivery characteristics of each device will be reviewed with a focus on how those characteristics determine the paradigm used for treatment planning. Basic techniques for treatment planning will be discussed, including considerations such as isodose selection, target and organ-at-risk definition, quality indices, and protection of critical structures. Futuremore » directions for SRS treatment planning will also be discussed. Learning Objectives: Introduce the basic physical principles of intracranial radiosurgery and how they are realized in the treatment planning paradigms for Gamma Knife and Linac radiosurgery. Demonstrate basic treatment planning techniques. Discuss metrics for evaluating SRS treatment plan quality. Discuss recent and future advances in SRS treatment planning. D. Schlesinger receives research support from Elekta, AB.« less

  6. Levels of Music Performance Anxiety and Test Anxiety of Turkish Prospective Music Teachers in Piano Exams

    ERIC Educational Resources Information Center

    Guven, Elif

    2017-01-01

    The purpose of this study was to determine the anxiety of prospective music teachers (N = 129) during piano exams and to examine the effects of peer and self-assessments on anxiety and exam achievement of individuals with high performance and test anxiety (n = 5). Female students were more anxious compared to males, students of the fourth class…

  7. Photographic art in exam rooms may reduce white coat hypertension.

    PubMed

    Harper, Michael B; Kanayama-Trivedi, Stacy; Caldito, Gloria; Montgomery, David; Mayeaux, E J; DelRosso, Lourdes M

    2015-12-01

    Blood pressure (BP) elevation in medical office settings in patients who are normotensive in nonmedical settings is an effect known as 'white coat hypertension'. This phenomenon is thought to be due to situational anxiety caused by the experience of visiting a doctor and the anxiety-inducing nature of the medical office. Our study was designed to determine if carefully selected photographic art could counter the anxiety that causes white coat hypertension and lead to lower BP recordings in some patients. 117 adults, non-pregnant patients from the Louisiana State University Health Sciences Center Family Medicine Resident Clinic participated in this study. After the triage nurse measured the BP, the patients were randomly placed in either an exam room with standard medical posters (control room) or in an exam room with photographic art (photo room). The BP was measured in the exam room. After the medical visit, the patients switched rooms and the BP was measured a third time. The patients were asked to fill out a questionnaire to identify room preference. On average, the BP obtained in the control rooms was higher than that obtained in the photo rooms. There was a statistically significant difference between the mean arterial pressure, systolic BP and diastolic BP between the control room and the photo room. Landscape photographic art may have the beneficial effect of reducing BP in medical office examination rooms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. 76 FR 17996 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam Toll...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-31

    ... Small Business/Self Employed Correspondence Exam Toll Free Project Committee AGENCY: Internal Revenue... Small Business/ Self Employed Correspondence Exam Toll Free Project Committee will be conducted. The... Act, 5 U.S.C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Small Business/Self...

  9. 76 FR 22170 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam Toll...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-20

    ... Small Business/Self Employed Correspondence Exam Toll Free Project Committee AGENCY: Internal Revenue... Small Business/ Self Employed Correspondence Exam Toll Free Project Committee will be conducted. The... hereby given pursuant to Section 10(a)(2) of the Federal Advisory Committee Act, 5 U.S.C. App. (1988...

  10. SU-E-T-605: Performance Evaluation of MLC Leaf-Sequencing Algorithms in Head-And-Neck IMRT

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jing, J; Lin, H; Chow, J

    2015-06-15

    Purpose: To investigate the efficiency of three multileaf collimator (MLC) leaf-sequencing algorithms proposed by Galvin et al, Chen et al and Siochi et al using external beam treatment plans for head-and-neck intensity modulated radiation therapy (IMRT). Methods: IMRT plans for head-and-neck were created using the CORVUS treatment planning system. The plans were optimized and the fluence maps for all photon beams determined. Three different MLC leaf-sequencing algorithms based on Galvin et al, Chen et al and Siochi et al were used to calculate the final photon segmental fields and their monitor units in delivery. For comparison purpose, the maximum intensitymore » of fluence map was kept constant in different plans. The number of beam segments and total number of monitor units were calculated for the three algorithms. Results: From results of number of beam segments and total number of monitor units, we found that algorithm of Galvin et al had the largest number of monitor unit which was about 70% larger than the other two algorithms. Moreover, both algorithms of Galvin et al and Siochi et al have relatively lower number of beam segment compared to Chen et al. Although values of number of beam segment and total number of monitor unit calculated by different algorithms varied with the head-and-neck plans, it can be seen that algorithms of Galvin et al and Siochi et al performed well with a lower number of beam segment, though algorithm of Galvin et al had a larger total number of monitor units than Siochi et al. Conclusion: Although performance of the leaf-sequencing algorithm varied with different IMRT plans having different fluence maps, an evaluation is possible based on the calculated number of beam segment and monitor unit. In this study, algorithm by Siochi et al was found to be more efficient in the head-and-neck IMRT. The Project Sponsored by the Fundamental Research Funds for the Central Universities (J2014HGXJ0094) and the Scientific Research Foundation

  11. Does patient gender impact resident physicians' approach to the cardiac exam?

    PubMed

    Chakkalakal, Rosette J; Higgins, Stacy M; Bernstein, Lisa B; Lundberg, Kristina L; Wu, Victor; Green, Jacqueline; Long, Qi; Doyle, Joyce P

    2013-04-01

    Physical examination remains an important part of the initial evaluation of patients presenting with chest pain but little is known about the effect of patient gender on physician performance of the cardiovascular exam. To determine if resident physicians are less likely to perform five key components of the cardiovascular exam on female versus male standardized patients (SPs) presenting with acute chest pain. Videotape review of SP encounters during Objective Structured Clinical Examinations (OSCEs) administered by the Emory University Internal Medicine Residency Program in 2006 and 2007. Encounters were reviewed to assess residents' performance of five cardiac exam skills: auscultation of the aortic, pulmonic, tricuspid, and mitral valve areas and palpation for the apical impulse. One hundred forty-nine incoming residents. Residents' performance for each skill was classified as correct, incorrect, or unknown. One hundred ten of 149 (74 %) of encounters were available for review. Residents were less likely to correctly perform each of the five skills on female versus male SPs. This difference was statistically significant for auscultation of the tricuspid (p = 0.004, RR = 0.62, 95 % CI 0.46-0.83) and mitral (p = 0.007, RR = 0.58, 95 % CI = 0.41-0.83) valve regions and palpation for the apical impulse (p < 0.001, RR = 0.27, 95 % CI = 0.16-0.47). Male residents were less likely than female residents to correctly perform each maneuver on female versus male SPs. The interaction of SP gender and resident gender was statistically significant for auscultation of the mitral valve region (p = 0.006) and palpation for the apical impulse (p = 0.01). We observed significant differences in the performance of key elements of the cardiac exam for female versus male SPs presenting with chest pain. This observation represents a previously unidentified but potentially important source of gender bias in the evaluation of patients presenting

  12. Internal quality control indicators of cervical cytopathology exams performed in laboratories monitored by the External Quality Control Laboratory.

    PubMed

    Ázara, Cinara Zago Silveira; Manrique, Edna Joana Cláudio; Tavares, Suelene Brito do Nascimento; de Souza, Nadja Lindany Alves; Amaral, Rita Goreti

    2014-09-01

    To evaluate the impact of continued education provided by an external quality control laboratory on the indicators of internal quality control of cytopathology exams. The internal quality assurance indicators for cytopathology exams from 12 laboratories monitored by the External Quality Control Laboratory were evaluated. Overall, 185,194 exams were included, 98,133 of which referred to the period preceding implementation of a continued education program, while 87,061 referred to the period following this intervention. Data were obtained from the Cervical Cancer Database of the Brazilian National Health Service. Following implementation of the continued education program, the positivity index (PI) remained within recommended limits in four laboratories. In another four laboratories, the PI progressed from below the limits to within the recommended standards. In one laboratory, the PI remained low, in two laboratories, it remained very low, and in one, it increased from very low to low. The percentage of exams compatible with a high-grade squamous intraepithelial lesion (HSIL) remained within the recommended limits in five laboratories, while in three laboratories it progressed from below the recommended levels to >0.4% of the total number of satisfactory exams, and in four laboratories it remained below the standard limit. Both the percentage of atypical squamous cells of undetermined significance (ASC-US) in relation to abnormal exams, and the ratio between ASC-US and intraepithelial lesions remained within recommended levels in all the laboratories investigated. An improvement was found in the indicators represented by the positivity index and the percentage of exams compatible with a high-grade squamous intraepithelial lesion, showing that the role played by the external quality control laboratory in providing continued education contributed towards improving laboratory staff skills in detecting cervical cancer precursor lesions.

  13. Low Levels of Evidence on the Plastic Surgery In-Service Training Exam.

    PubMed

    Silvestre, Jason; Bilici, Nadir; Serletti, Joseph M; Chang, Benjamin

    2016-06-01

    The Plastic Surgery In-Service Training Exam is written by the American Society of Plastic Surgeons. Examinees reasonably infer that tested material reflects the Society's vision for the core curriculum in plastic surgery. The purpose of this study was to determine the levels of evidence on which credited answers to the examination questions are based. Two recent Plastic Surgery In-Service Training Exams (2014 and 2015) were analyzed. Questions were categorized using a taxonomy model. Recommended journal article references for Level III (decision-making) questions were assigned a level of evidence. Exam sections were analyzed for differences in question taxonomy distribution and level of evidence. To look for studies with higher levels of evidence, a PubMed search was conducted for a random sample of 10 questions from each section. One hundred three Level I (25.8 percent), 138 Level II (34.5 percent), and 159 Level III (39.8 percent) questions were analyzed (p < 0.001). The hand and lower extremity section had the highest percentage of Level III questions (50.0 percent; p = 0.005). Journal articles had a mean level of evidence of 3.9 ± 0.7. The number of articles with a low level of evidence (IV and V) (p = 0.624) and the percentage of questions supported by articles with a high level of evidence (I and II) (p = 0.406) did not vary by section. The PubMed search revealed no instances of a higher level of evidence than the recommended reading list. A significant percentage of Plastic Surgery In-Service Training Exam questions test clinical management, but most are supported with a low level of evidence. Although that is consistent with low level of evidence of plastic surgery literature, educators should recognize the potential for biases of question writers.

  14. Time to Say Goodbye to High School Exit Exams

    ERIC Educational Resources Information Center

    Bracey, Gerald W.

    2009-01-01

    In recent years, a concatenation of fears, pressures, and agendas has produced a new round of testing in the form of high school exit examinations. There has not, however, been an accompanying rush to see whether the exams do any good. No state has attempted to validate its test against external criteria: given the hyperbole surrounding the tests…

  15. State High School Exit Exams: A Policy in Transition

    ERIC Educational Resources Information Center

    McIntosh, Shelby

    2012-01-01

    Since 2002, the Center on Education Policy (CEP) at The George Washington University, a national advocate for public education and improving public schools, has been studying state high school exit examinations--tests students must pass to receive a high school diploma. This year marks the 11th year CEP has reported on exit exams in order to help…

  16. 76 FR 2196 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam Toll...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-12

    ... Small Business/Self Employed Correspondence Exam Toll Free AGENCY: Internal Revenue Service (IRS.../ Self Employed Correspondence Exam Toll Free will be conducted. The Taxpayer Advocacy Panel is... pursuant to Section 10(a)(2) of the Federal Advisory Committee Act, 5 U.S.C. App. (1988) that an open...

  17. 76 FR 56880 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam Toll...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... Small Business/Self Employed Correspondence Exam Toll Free Project Committee AGENCY: Internal Revenue... Small Business/ Self Employed Correspondence Exam Toll Free Project Committee will be conducted. The...: Notice is hereby given pursuant to Section 10(a)(2) of the Federal Advisory Committee Act, 5 U.S.C. App...

  18. 76 FR 63716 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Correspondence Exam Toll...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-13

    ... Small Business/Self Employed Correspondence Exam Toll Free Project Committee AGENCY: Internal Revenue... Small Business/ Self Employed Correspondence Exam Toll Free Project Committee will be conducted. The...: Notice is hereby given pursuant to Section 10(a)(2) of the Federal Advisory Committee Act, 5 U.S.C. App...

  19. Perceptions and practices of U.S. dental schools regarding curriculum integrated format and traditional format licensure exams.

    PubMed

    Desai, Shamik; Allareddy, Veerasathpurush; Donoff, R Bruce; Howell, T Howard; Karimbux, Nadeem Y

    2013-08-01

    The dental licensure exam in the United States has evolved over the past ten years, and two formats-the traditional format and curriculum integrated format-are now available for students to satisfy licensure requirements. The objective of this study was to examine the differences and relative merits of the two formats. A twenty-five-question survey was distributed to the fifty-seven U.S. dental schools at the time. The survey included both quantitative and discrete variables and followed a strategic sequential order. The first set of questions sought to determine what type of board preparatory/mock exam each dental school offered, and the next set of questions asked which licensure exam each school formally offered. The final questions were qualitative in nature and aimed to determine the school representatives' opinions about the curriculum integrated format versus traditional format. Of the fifty-seven schools contacted, thirty-seven agreed to participate (response rate=64.9 percent). Fourteen schools reported that they administer the traditional format only and twelve administer the curriculum integrated format only, while eleven offer both. Thirty-two schools offered mock board exams to their graduating students, and twenty-four of those said their mock exams were identical in format to the actual qualifying clinical exams offered at their institution. The respondents reported no significant advantage to preparing for the curriculum integrated format examination as compared to the traditional format examination with regards to number of clock hours taken from regular curriculum time. In reporting on this study, this article provides an overview of the relative advantages and disadvantages of the two examination formats used for the dental licensure process in the United States.

  20. Variation of semen parameters in healthy medical students due to exam stress.

    PubMed

    Lampiao, Fanuel

    2009-12-01

    This study was aimed at investigating semen parameters that vary most in samples of healthy donors undergoing stressful examination period. Samples were left to liquefy in an incubator at 37 degrees C, 5% CO2 for 30 minutes before volume was measured. Concentration and motility parameters were measured by means of computer assisted semen analysis (CASA) using Sperm Class Analyzer (Microptic S.L, Madrid, Spain). Sperm concentration was significantly decreased in samples donated close to the exam period as well as samples donated during the exam period when compared to samples donated at the beginning of the semester. Stress levels of donors might prove to be clinically relevant and important when designing experiment protocols.

  1. Evaluation of Hands-On Clinical Exam Performance Using Marker-less Video Tracking.

    PubMed

    Azari, David; Pugh, Carla; Laufer, Shlomi; Cohen, Elaine; Kwan, Calvin; Chen, Chia-Hsiung Eric; Yen, Thomas Y; Hu, Yu Hen; Radwin, Robert

    2014-09-01

    This study investigates the potential of using marker-less video tracking of the hands for evaluating hands-on clinical skills. Experienced family practitioners attending a national conference were recruited and asked to conduct a breast examination on a simulator that simulates different clinical presentations. Videos were made of the clinician's hands during the exam and video processing software for tracking hand motion to quantify hand motion kinematics was used. Practitioner motion patterns indicated consistent behavior of participants across multiple pathologies. Different pathologies exhibited characteristic motion patterns in the aggregate at specific parts of an exam, indicating consistent inter-participant behavior. Marker-less video kinematic tracking therefore shows promise in discriminating between different examination procedures, clinicians, and pathologies.

  2. Role of RhoA and its effectors ROCK and mDia1 in the modulation of deformation-induced FAK, ERK, p38, and MLC motogenic signals in human Caco-2 intestinal epithelial cells

    PubMed Central

    Chaturvedi, Lakshmi S.; Marsh, Harold M.

    2011-01-01

    Repetitive deformation enhances intestinal epithelial migration across tissue fibronectin. We evaluated the contribution of RhoA and its effectors Rho-associated kinase (ROK/ROCK) and mammalian diaphanous formins (mDia1) to deformation-induced intestinal epithelial motility across fibronectin and the responsible focal adhesion kinase (FAK), extracellular signal-regulated kinase (ERK), p38, and myosin light chain (MLC) signaling. We reduced RhoA, ROCK1, ROCK2, and mDia1 by smart-pool double-stranded short-interfering RNAs (siRNA) and pharmacologically inhibited RhoA, ROCK, and FAK in human Caco-2 intestinal epithelial monolayers on fibronectin-coated membranes subjected to 10% repetitive deformation at 10 cycles/min. Migration was measured by wound closure. Stimulation of migration by deformation was prevented by exoenzyme C3, Y27632, or selective RhoA, ROCK1, and ROCK2 or mDia1 siRNAs. RhoA, ROCK inhibition, or RhoA, ROCK1, ROCK2, mDia1, and FAK reduction by siRNA blocked deformation-induced nuclear ERK phosphorylation without preventing ERK phosphorylation in the cytoplasmic protein fraction. Furthermore, RhoA, ROCK inhibition or RhoA, ROCK1, ROCK2, and mDia1 reduction by siRNA also blocked strain-induced FAK-Tyr925, p38, and MLC phosphorylation. These results suggest that RhoA, ROCK, mDia1, FAK, ERK, p38, and MLC all mediate the stimulation of intestinal epithelial migration by repetitive deformation. This pathway may be an important target for interventions to promote mechanotransduced mucosal healing during inflammation. PMID:21849669

  3. Verbal Final Exam in Introductory Biology Yields Gains in Student Content Knowledge and Longitudinal Performance

    PubMed Central

    Luckie, Douglas B.; Rivkin, Aaron M.; Aubry, Jacob R.; Marengo, Benjamin J.; Creech, Leah R.; Sweeder, Ryan D.

    2013-01-01

    We studied gains in student learning over eight semesters in which an introductory biology course curriculum was changed to include optional verbal final exams (VFs). Students could opt to demonstrate their mastery of course material via structured oral exams with the professor. In a quantitative assessment of cell biology content knowledge, students who passed the VF outscored their peers on the medical assessment test (MAT), an exam built with 40 Medical College Admissions Test (MCAT) questions (66.4% [n = 160] and 62% [n = 285], respectively; p < 0.001);. The higher-achieving students performed better on MCAT questions in all topic categories tested; the greatest gain occurred on the topic of cellular respiration. Because the VF focused on a conceptually parallel topic, photosynthesis, there may have been authentic knowledge transfer. In longitudinal tracking studies, passing the VF also correlated with higher performance in a range of upper-level science courses, with greatest significance in physiology, biochemistry, and organic chemistry. Participation had a wide range but not equal representation in academic standing, gender, and ethnicity. Yet students nearly unanimously (92%) valued the option. Our findings suggest oral exams at the introductory level may allow instructors to assess and aid students striving to achieve higher-level learning. PMID:24006399

  4. Verbal final exam in introductory biology yields gains in student content knowledge and longitudinal performance.

    PubMed

    Luckie, Douglas B; Rivkin, Aaron M; Aubry, Jacob R; Marengo, Benjamin J; Creech, Leah R; Sweeder, Ryan D

    2013-01-01

    We studied gains in student learning over eight semesters in which an introductory biology course curriculum was changed to include optional verbal final exams (VFs). Students could opt to demonstrate their mastery of course material via structured oral exams with the professor. In a quantitative assessment of cell biology content knowledge, students who passed the VF outscored their peers on the medical assessment test (MAT), an exam built with 40 Medical College Admissions Test (MCAT) questions (66.4% [n = 160] and 62% [n = 285], respectively; p < 0.001);. The higher-achieving students performed better on MCAT questions in all topic categories tested; the greatest gain occurred on the topic of cellular respiration. Because the VF focused on a conceptually parallel topic, photosynthesis, there may have been authentic knowledge transfer. In longitudinal tracking studies, passing the VF also correlated with higher performance in a range of upper-level science courses, with greatest significance in physiology, biochemistry, and organic chemistry. Participation had a wide range but not equal representation in academic standing, gender, and ethnicity. Yet students nearly unanimously (92%) valued the option. Our findings suggest oral exams at the introductory level may allow instructors to assess and aid students striving to achieve higher-level learning.

  5. Feasibility of a longitudinal study of women anticipating first pregnancy and assessed by multiple pelvic exams: recruitment and retention challenges.

    PubMed

    Zielinski, Ruth; Ackerson, Kelly; Misiunas, Ruta B; Miller, Janis M

    2010-11-01

    To better understand the relationship between childbirth and pelvic floor disorders the ideal study design would begin with data collection prior to but close in time to first pregnancy and follow participants through postpartum. We conducted a feasibility study to determine the following: a) whether women desiring to get pregnant would agree to pre-pregnancy data collection including a one-time urethral catheter measure and repeat pelvic exams to ascertain a baseline within 6 months of pregnancy; b) effectiveness of various recruitment and retention methods, c) number achieving pregnancy, and then d) number expressing willingness to continue follow-up through pregnancy and postpartum. Advertising included newspaper ads, targeted emails and flyers. Post-enrollment, four data collection visits were scheduled and occurred every 6 months or until pregnant. If pregnancy occurred, women were asked to indicate their willingness to continue assessments. The most successful advertising strategy for both recruitment and retention was local newspaper ads. Ninety-four women inquired about the study, 30 enrolled. Post-baseline retention was 23 women at 6 months, 17 at 12 months, and 13 at 18 months. Nine of the 30 women achieved pregnancy; two remained eligible and willing to participate through pregnancy and postpartum. This study provides data on feasibility of recruiting women to establish near-pregnancy clinical baseline measures that include pelvic exams. Close to 30% reached pregnancy within 2 years of study start and within 6 months of most recent pelvic exam measure. Of those who became pregnant, 22% expressed willingness to continue follow-up into the childbearing year. Copyright © 2010 Elsevier Inc. All rights reserved.

  6. 76 FR 73021 - Agency Information Collection (Exam for Housebound Status or Permanent Need for Regular Aid and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-28

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0721] Agency Information Collection (Exam for... with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), this notice announces that the... INFORMATION: Title: Exam for Housebound Status or Permanent Need for Regular Aid and Attendance, VA Form 21...

  7. A Qualitative Evaluation of Instructors' Exam Questions at a Primary Education Department in Terms of Certain Variables

    ERIC Educational Resources Information Center

    Demir, Mehmet Kaan; Eryaman, Mustafa Yunus

    2012-01-01

    The purpose of this qualitative research study is to analyze instructors' exam questions at a Primary Education Department in terms of the exam's period, the comprehensibility of the instructions, cognitive level, and the appropriateness to the critical thinking. This qualitative study is based on document analysis method. 100 randomly selected…

  8. How to pass exams on the run.

    PubMed

    Atkinson, J

    1988-09-17

    Yes, dear friends of my youth, it is I - he who left school with two 'O' levels, o music CSE [Illegible Word] a budgerigar; consolidating this by failing his SRN three times, finally getting on the only refresher course in England and passing in October 1979- the very last occasion to take an SRN for the fourth time. Have I got a cheek to write about passing exams? These experiences hove had their effect! I come to academic life late and have developed a hectic domestic, social and professional life meanwhile.

  9. Who Does Not Cut Down? Comparing Characteristics and Drinking Motives of Drinkers and Abstainers during the Exam Periods

    ERIC Educational Resources Information Center

    Van Damme, Joris; Hublet, Anne; De Clercq, Bart; Kuntsche, Emmanuel; Maes, Lea; Clays, Els

    2017-01-01

    Objective: Drinking alcohol during the exams can affect academic performance and future career options, but is rarely investigated. Drinking motives, sociodemographics and personality characteristics are investigated in nonabstainers and weekly drinkers during the exams. Participants: 7,181 Belgian university students who anonymously responded to…

  10. Testing the methodology for dosimetry audit of heterogeneity corrections and small MLC-shaped fields: Results of IAEA multi-center studies.

    PubMed

    Izewska, Joanna; Wesolowska, Paulina; Azangwe, Godfrey; Followill, David S; Thwaites, David I; Arib, Mehenna; Stefanic, Amalia; Viegas, Claudio; Suming, Luo; Ekendahl, Daniela; Bulski, Wojciech; Georg, Dietmar

    2016-07-01

    The International Atomic Energy Agency (IAEA) has a long tradition of supporting development of methodologies for national networks providing quality audits in radiotherapy. A series of co-ordinated research projects (CRPs) has been conducted by the IAEA since 1995 assisting national external audit groups developing national audit programs. The CRP 'Development of Quality Audits for Radiotherapy Dosimetry for Complex Treatment Techniques' was conducted in 2009-2012 as an extension of previously developed audit programs. The CRP work described in this paper focused on developing and testing two steps of dosimetry audit: verification of heterogeneity corrections, and treatment planning system (TPS) modeling of small MLC fields, which are important for the initial stages of complex radiation treatments, such as IMRT. The project involved development of a new solid slab phantom with heterogeneities containing special measurement inserts for thermoluminescent dosimeters (TLD) and radiochromic films. The phantom and the audit methodology has been developed at the IAEA and tested in multi-center studies involving the CRP participants. The results of multi-center testing of methodology for two steps of dosimetry audit show that the design of audit procedures is adequate and the methodology is feasible for meeting the audit objectives. A total of 97% TLD results in heterogeneity situations obtained in the study were within 3% and all results within 5% agreement with the TPS predicted doses. In contrast, only 64% small beam profiles were within 3 mm agreement between the TPS calculated and film measured doses. Film dosimetry results have highlighted some limitations in TPS modeling of small beam profiles in the direction of MLC leave movements. Through multi-center testing, any challenges or difficulties in the proposed audit methodology were identified, and the methodology improved. Using the experience of these studies, the participants could incorporate the auditing

  11. The licensure exam in nursing degree courses: a survey in the four universities of the Lazio Region.

    PubMed

    Marchetti, A; Virgolesi, M; Pulimeno, A M L; Rocco, G; Stievano, A; Venturini, G; De Marinis, M G

    2014-01-01

    In recent years, the nursing licensure exam is at the centre of a national and international wide debate. This debate regards the planning of the nursing licensure exam in many Universities and the competences that this exam must certify to ensure quality, effectiveness, and ethics of nursing care from newly-graduated nurses to general public. The aim of this study was to describe the practical tests used for the licensure exam in the four Universities of the Lazio Region. The researchers analyzed the type of practical tests used and the field of competences assessed according to the degrees of performance defined by the Dublin Descriptors. The data were collected through semi-structured interviews to Presidents, Directors and Lecturers of nursing degree courses and through direct retrieval of the written texts of the licensure exam. Two researchers analyzed the practical tests. A special lecture-grid divided into three different sections to interpret the data was created. Statistical analysis was carried out by means of Epi-info 3.5.1/2008. Analysis of data showed that the most used tests were Discussion of theoretical and practical aspects in context (33.6%), followed by the Test with open and/or closed questions (23,9%). Psychomotor and relational skills tests were little used. The most valued field of competence was the cognitive one (85,5%) that assessed, above all, the storage of the concept. The ability to interpret data and solve problems was less valued. The study showed the high discrepancy in the types of tests used in the four Universities of the Lazio Region. Universities found it difficult to assess psychomotor and relational skills of the students. Most of the cognitive tests utilized omitted the evaluation of mastery of complex competences. Therefore, there is the necessity of a new planning of the nursing licensure exam to overcome these critical issues.

  12. Using Self-Efficacy Beliefs to Understand How Students in a General Chemistry Course Approach the Exam Process

    ERIC Educational Resources Information Center

    Willson-Conrad, Angela; Kowalske, Megan Grunert

    2018-01-01

    Retention of students who major in STEM continues to be a major concern for universities. Many students cite poor teaching and disappointing grades as reasons for dropping out of STEM courses. Current college chemistry courses often assess what a student has learned through summative exams. To understand students' experiences of the exam process,…

  13. Analysis of Factors that Affect the Teacher Certification Exam Results in a University System in Puerto Rico

    ERIC Educational Resources Information Center

    Garofalo, Jorge H.

    2009-01-01

    The purpose of this study was to analyze the factors that affect a teacher preparation exam results within a University System in Puerto Rico. Using Bertalanffy's System Theory as theoretical framework, this mixed methods study examined factors in the university system that could have affected student's preparation for a teacher exam (PCMAS by its…

  14. Using Oral Exams to Assess Communication Skills in Business Courses

    ERIC Educational Resources Information Center

    Burke-Smalley, Lisa A.

    2014-01-01

    Business, like many other fields in higher education, continues to rely largely on conventional testing methods for assessing student learning. In the current article, another evaluation approach--the oral exam--is examined as a means for building and evaluating the professional communication and oral dialogue skills needed and utilized by…

  15. From Exam Factories to Communities of Discovery: The Democratic Route

    ERIC Educational Resources Information Center

    Coffield, Frank; Williamson, Bill

    2011-01-01

    "From Exam Factories to Communities of Discovery" passionately calls for educators to challenge the dominant market-led model of education and instead build a more democratic one, better able to face threats such as environmental damage; intensified global competition; corrosive social inequalities in and between nations in the world;…

  16. Strategies Instruction to Improve the Preparation for English Oral Exams

    ERIC Educational Resources Information Center

    Abad, José Vicente; Alzate, Paula Andrea

    2016-01-01

    This article presents the results of an inter-institutional research study that assessed the impact of strategies instruction on students' preparation for and performance in oral exams. Two teacher-researchers at different universities trained 26 students in their respective B1-English-level courses in using language learning strategies. The study…

  17. Residency Applicants Misinterpret Their United States Medical Licensing Exam Scores

    ERIC Educational Resources Information Center

    Jones, Roger C.; Desbiens, Norman A.

    2009-01-01

    Proper interpretation of the results of the United States Medical Licensing Exam (USMLE) is important for program directors, residents, and faculty who advise applicants about applying for residency positions. We suspected that applicants often misinterpreted their performance in relationship to others who took the same examination. In 2005, 54…

  18. The TRIPSE: A Process-Oriented Exam for Large Undergraduate Classes

    ERIC Educational Resources Information Center

    Nastos, Stash; Rangachari, P. K.

    2013-01-01

    The TRIPSE (tri-partite problem solving exercise), a process-oriented exam that mimics the scientific process, was used previously in small classes (15-25). Provided limited data, students frame explanations and design experimental tests that they later revise with additional information. Our 6-year experience using it with larger numbers…

  19. The Management Challenge: Handling Exams Involving Large Quantities of Students, on and off Campus--A Design Concept

    ERIC Educational Resources Information Center

    Larsson, Ken

    2014-01-01

    This paper looks at the process of managing large numbers of exams efficiently and secure with the use of a dedicated IT support. The system integrates regulations on different levels, from national to local, (even down to departments) and ensures that the rules are employed in all stages of handling the exams. The system has a proven record of…

  20. Decrease in the Number of People Taking the CPA Exam Not Due to the 150-Hour Requirement

    ERIC Educational Resources Information Center

    Metinko, Teresa R.; Gray, Dahli

    2010-01-01

    This paper reports the results of a study that examined the association of the 120/150-hour education requirement with the number of CPA exam candidates during 1998 and 2008. Data gathered from the NASBA Candidate Performance Reports 1999 and 2009 found no relationship between the number of CPA exam candidates and the education requirements in…

  1. 3-Hydroxyflavone inhibits human osteosarcoma U2OS and 143B cells metastasis by affecting EMT and repressing u-PA/MMP-2 via FAK-Src to MEK/ERK and RhoA/MLC2 pathways and reduces 143B tumor growth in vivo.

    PubMed

    Lu, Ko-Hsiu; Chen, Pei-Ni; Hsieh, Yi-Hsien; Lin, Chin-Yin; Cheng, Fu-Yuan; Chiu, Peng-Chou; Chu, Shu-Chen; Hsieh, Yih-Shou

    2016-11-01

    Many natural flavonoids have cytostatic and apoptotic properties; however, we little know whether the effect of synthetic 3-hydroxyflavone on metastasis and tumor growth of human osteosarcoma. Here, we tested the hypothesis that 3-hydroxyflavone suppresses human osteosarcoma cells metastasis and tumor growth. 3-hydroxyflavone, up to 50 μM without cytotoxicity, inhibited U2OS and 143B cells motility, invasiveness and migration by reducing matrix metalloproteinase (MMP)-2 and urokinase-type plasminogen activator (u-PA) and also impaired cell adhesion to gelatin. 3-hydroxyflavone significantly reduced p-focal adhesion kinase (FAK) Tyr397, p-FAK Tyr925, p-steroid receptor coactivator (Src), p-mitogen/extracellular signal-regulated kinase (MEK)1/2, p-myosin light chain (MLC)2 Ser19, epithelial cell adhesion molecule, Ras homolog gene family (Rho)A and fibronectin expressions. 3-hydroxyflavone also affected the epithelial-mesenchymal transition (EMT) by down-regulating expressions of Vimentin and α-catenin with activation of the transcription factor Slug. In nude mice xenograft model and tail vein injection model showed that 3-hydroxyflavone reduced 143B tumor growth and lung metastasis. 3-hydroxyflavone possesses the anti-metastatic activity of U2OS and 143B cells by affecting EMT and repressing u-PA/MMP-2 via FAK-Src to MEK/ERK and RhoA/MLC2 pathways and suppresses 143B tumor growth in vivo. This may lead to clinical trials of osteosarcoma chemotherapy to confirm the promising result in the future. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Geographic information systems for mapping the National Exam Result of Junior High School in 2014 at West Java Province

    NASA Astrophysics Data System (ADS)

    Setiawan Abdullah, Atje; Nurani Ruchjana, Budi; Rejito, Juli; Rosadi, Rudi; Candra Permana, Fahmi

    2017-10-01

    National Exam level of schooling is implemented by the Ministry of Education and Culture for the development of education in Indonesia. The national examinations are centrally evaluated by the National Education Standards Agency, and the expected implementation of the national exams can describe the successful implementation of education at the district, municipal, provincial, or national level. In this study, we evaluate, analyze, and explore the implementation of the national exam database of the results of the Junior High School in 2014, with the Junior High School (SMP/MTs) as the smallest unit of analysis at the district level. The method used in this study is a data mining approach using the methodology of Knowledge Discovery in Databases (KDD) using descriptive analysis and spatial mapping of national examinations. The results of the classification of the data mining process to national exams of Junior High School in 2014 using data 6,878 SMP/MTs in West Java showed that 81.01 % were at moderate levels. While the results of the spatial mapping for SMP/MTs in West Java can be explained 36,99 % at the unfavorable level. The evaluation results visualization in graphic is done using ArcGIS to provide position information quality of education in municipal, provincial or national level. The results of this study can be used by management to make decision to improve educational services based on the national exam database in West Java. Keywords: KDD, spatial mapping, national exam.

  3. How Should I Study for the Exam? Self-Regulated Learning Strategies and Achievement in Introductory Biology

    PubMed Central

    Sebesta, Amanda J.; Bray Speth, Elena

    2017-01-01

    In college introductory science courses, students are challenged with mastering large amounts of disciplinary content while developing as autonomous and effective learners. Self-regulated learning (SRL) is the process of setting learning goals, monitoring progress toward them, and applying appropriate study strategies. SRL characterizes successful, “expert” learners, and develops with time and practice. In a large, undergraduate introductory biology course, we investigated: 1) what SRL strategies students reported using the most when studying for exams, 2) which strategies were associated with higher achievement and with grade improvement on exams, and 3) what study approaches students proposed to use for future exams. Higher-achieving students, and students whose exam grades improved in the first half of the semester, reported using specific cognitive and metacognitive strategies significantly more frequently than their lower-achieving peers. Lower-achieving students more frequently reported that they did not implement their planned strategies or, if they did, still did not improve their outcomes. These results suggest that many students entering introductory biology have limited knowledge of SRL strategies and/or limited ability to implement them, which can impact their achievement. Course-specific interventions that promote SRL development should be considered as integral pedagogical tools, aimed at fostering development of students’ lifelong learning skills. PMID:28495934

  4. The effect of ankle position on the exam for first ray mobility.

    PubMed

    Grebing, Brett R; Coughlin, Michael J

    2004-07-01

    The clinical assessment of first ray motion in the sagittal plane, as originally described by Morton, is difficult to quantify. Different reports have shown inconsistent values and variability between the manual exam and examination using an external measuring device. The authors hypothesize that when performing a manual examination for evidence of increased first ray motion, the magnitude of first ray mobility varies as the position of ankle dorsiflexion/plantarflexion varies. Using an external caliper (a modified Klaue device), the authors quantified first ray motion in reference to variable ankle positions in a group of normal patients, a group of patients with untreated moderate and severe hallux valgus, a group who had undergone a successful metatarsophalangeal joint arthrodesis for hallux valgus, and a small group who had previously undergone a plantar fasciectomy. A total of 119 feet (109 patients) were measured. In addition to first ray motion, radiographic data were compared between groups. With the ankle in the neutral dorsiflexion position, the mean first ray motion was 4.9 mm for the control group, 7.0 mm for the hallux valgus group, 4.4 mm for the metatarsophalangeal fusion group, and 7.7 mm for the plantar fasciectomy group. There was a significant decrease (p < .05) in first ray motion when the ankle was moved to the dorsiflexed position for all four groups. There was a significant increase in first ray motion when the ankle was moved to the plantarflexed position (p < .01) for all groups except the plantar fasciectomy group. No significant difference in first ray motion was observed for the plantar fasciectomy group between the neutral and plantarflexed ankle positions (p < .05). The exam for first ray mobility is influenced by the position of the ankle and may explain the discrepancy between the manual exam and measurement with an external device. Recommendations for the manual exam of first ray mobility are given.

  5. Breast-feeding, self-exam, and exercise practices before and after reduction mammoplasty.

    PubMed

    Brown, Jennifer R; Holton, Luther H; Chung, Thomas L; Slezak, Sheri

    2008-10-01

    The current indications for reduction mammoplasty include the relief of painful physical symptoms of macromastia. Numerous studies have demonstrated not only improvement in physical symptoms following reduction mammoplasty, but postoperative psychological benefits as well, including increased ability to participate in physical activity as a result of pain relief and decreased breast mass. Reduction mammoplasty may have additional effects on the patient's ability to breast-feed and perform breast self-exam. The present study is a retrospective study of the effects of reduction mammoplasty on breast-feeding, breast self-exam, physical symptoms, and physical activity. One-hundred and forty-one patients who underwent reduction mammoplasty at our institution between the years 1996-2005 agreed to participate in the study. Each was asked a series of questions in order to assess changes in symptoms and behaviors including breast-feeding and breast self-exam practices before and after the surgery. Patients were also asked questions regarding their pain symptoms and physical activity profiles. Ninety-seven percent of the participants claimed to have back, neck, and/or shoulder pain that was either significantly improved or completely resolved. Moreover, 100% of patients report that physical activity such as exercise was easier following reduction mammoplasty. Ninety-three percent of participants reported that performing breast self-exam following surgery was either the same (68%) or easier (25%) as a result of having less breast tissue. Eighty-nine percent of participants had no children following surgery, therefore effects on breast-feeding practices following reduction mammoplasty were not statistically significant. However, we suggest that when patients are seen in consultation or in the perioperative period, there is an opportunity to teach patients about the benefits of breast-feeding, and to assure patients that a pedicle flap reduction will likely allow breastfeeding

  6. Computer Modeling of the Instructionally Insensitive Nature of the Texas Assessment of Knowledge and Skills (TAKS) Exam

    NASA Astrophysics Data System (ADS)

    Pham, Vinh Huy

    Stakeholders of the educational system assume that standardized tests are transparently about the subject content being tested and therefore can be used as a metric to measure achievement in outcome-based educational reform. Both analysis of longitudinal data for the Texas Assessment of Knowledge and Skills (TAKS) exam and agent based computer modeling of its underlying theoretical testing framework have yielded results that indicate the exam only rank orders students on a persistent but uncharacterized latent trait across domains tested as well as across years. Such persistent rank ordering of students is indicative of an instructionally insensitive exam. This is problematic in the current atmosphere of high stakes testing which holds teachers, administrators, and school systems accountable for student achievement.

  7. Two layers LSTM with attention for multi-choice question answering in exams

    NASA Astrophysics Data System (ADS)

    Li, Yongbin

    2018-03-01

    Question Answering in Exams is typical question answering task that aims to test how accurately the model could answer the questions in exams. In this paper, we use general deep learning model to solve the multi-choice question answering task. Our approach is to build distributed word embedding of question and answers instead of manually extracting features or linguistic tools, meanwhile, for improving the accuracy, the external corpus is introduced. The framework uses a two layers LSTM with attention which get a significant result. By contrast, we introduce the simple long short-term memory (QA-LSTM) model and QA-LSTM-CNN model and QA-LSTM with attention model as the reference. Experiment demonstrate superior performance of two layers LSTM with attention compared to other models in question answering task.

  8. Validating Performance Level Descriptors (PLDs) for the AP® Environmental Science Exam

    ERIC Educational Resources Information Center

    Reshetar, Rosemary; Kaliski, Pamela; Chajewski, Michael; Lionberger, Karen

    2012-01-01

    This presentation summarizes a pilot study conducted after the May 2011 administration of the AP Environmental Science Exam. The study used analytical methods based on scaled anchoring as input to a Performance Level Descriptor validation process that solicited systematic input from subject matter experts.

  9. Cheat Sheet or Open-Book? A Comparison of the Effects of Exam Types on Performance, Retention, and Anxiety

    ERIC Educational Resources Information Center

    Gharib, Afshin; Phillips, William; Mathew, Noelle

    2012-01-01

    The differences between open-book, cheat sheet, and closed-book exams were examined in two different types of psychology courses. A total of 297 students enrolled in eight sections of Introductory Psychology and 99 students enrolled in four sections of Statistics participated in this study. Exam types were counterbalanced across sections of the…

  10. Transnational English Language Learners Fighting on an Unlevel Playing Field: High School Exit Exams, Accommodations, and ESL Status

    ERIC Educational Resources Information Center

    Alexander, Mariko Mizuno

    2017-01-01

    Though previous research addresses the negative impact of state-mandated high school exit exams on English language learners' (ELLs) educational experiences, less attention has been given to how college-oriented ELLs, especially those who attended school in their home countries before coming to the US, handle rigorous exams or gain access to…

  11. Voluntary peer-led exam preparation course for international first year students: Tutees' perceptions.

    PubMed

    Huhn, Daniel; Eckart, Wolfgang; Karimian-Jazi, Kianush; Amr, Ali; Herzog, Wolfgang; Nikendei, Christoph

    2015-06-18

    While the number of international students has increased over the last decade, such students face diverse challenges due to language and cultural barriers. International medical students suffer from personal distress and a lack of support. Their performance is significantly lower than non-international peers in clinical examinations. We investigated whether international students benefit from a peer-led exam preparation course. An exam preparation course was designed, and relevant learning objectives were defined. Two evaluations were undertaken: Using a qualitative approach, tutees (N = 10) were asked for their thoughts and comments in a semi-structured interview at the end of the semester. From a quantitative perspective, all participants (N = 22) were asked to complete questionnaires at the end of each course session. International students reported a range of significant benefits from the course as they prepared for upcoming exams. They benefited from technical and didactic, as well as social learning experiences. They also considered aspects of the tutorial's framework helpful. Social and cognitive congruence seem to be the key factors to success within international medical students' education. If tutors have a migration background, they can operate as authentic role models. Furthermore, because they are still students themselves, they can offer support using relevant and understandable language.

  12. Alzheimer’s and Cognitive Reserve

    PubMed Central

    Roe, Catherine M.; Mintun, Mark A.; D’Angelo, Gina; Xiong, Chengjie; Grant, Elizabeth A.; Morris, John C.

    2009-01-01

    Objective To evaluate the cognitive reserve hypothesis by examining whether individuals of greater educational attainment have better cognitive function than individuals with less education in the presence of elevated fibrillar brain amyloid. Design, Setting, and Participants Uptake of N-methyl-[11C]2-(4′-methylaminophenyl)-6-hydroybenzothiazole, or [11C]PIB for “Pittsburgh Compound-B,” was measured for participants assessed between August 15, 2003 and January 8, 2008 at the Washington University Alzheimer’s Disease Research Center and diagnosed either as nondemented (N=161) or with dementia of the Alzheimer type (N=37). Multiple regression was used to determine whether [11C]PIB uptake interacted with level of educational attainment to predict cognitive function. Main Outcome Measures Scores on the Clinical Dementia Rating - Sum of Boxes (CDR-SB), Mini-Mental State Exam (MMSE), and Short Blessed Test (SBT), and individual measures from a psychometric battery. Results [11C]PIB uptake interacted with years of education in predicting scores on the CDR-SB (p=.003), the MMSE (p<.001), the SBT (p=.03) and a measure of verbal abstract reasoning and conceptualization (p=.02), such that performance on these measures increased with increasing education for participants with elevated PIB uptake. Education was unrelated to global cognitive functioning scores among those with lower PIB uptake. Conclusions These results support the hypothesis that cognitive reserve influences the association between Alzheimer disease pathology and cognition. PMID:19001165

  13. Comparative Racial Analysis of Enlisted Advancement Exams: Item- Difficulty.

    DTIC Science & Technology

    1975-07-01

    11cm-ana lysis Promotion Racial comparison Equal opportunity 1 20. ABSTRACT (Continue on reveree aide 11 neceeemry mnd Identity by block...improving equal oppor- tunity in career growth for minority groups. The study of exam item- difficulty levels is the first of a series of technical reports...under Exploratory Development Task Area PF55.521.032 (Contemporary Social Issues). J. J. CLARKIN Commanding Officer SUMMARY Purpose A number of

  14. MO-F-201-00: PANEL DISCUSSION: Preparing for Parts 2 and 3 of the ABR Therapy Medical Physics Exam

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    The goal of this session is to provide guidance to medical physicists undergoing the American Board of Radiology certification process in therapeutic medical physics. This panel discussion will focus on parts 2 (computer-based) and 3 (oral) of the examination. Unlike the latter portions of the exam which are specialty-driven, part 1 is universal for all medical physics fields and will not be addressed. This session is structured into different topics that aim to guide the participants on how to successfully prepare for the board exams. The subjects of discussion will include timing and strategies for exam preparation, crucial differences inmore » preparing for the clinical computer-based exam versus the oral exam, what study tools are currently available for each, etc. The panel discussion format will allow the speakers to collectively present their experience and advice relating to each topic and foment audience participation. Learning Objectives: Know the main differences between what is expected for parts 2 and 3 Know different resources for test preparation Know how to formulate a plan to best study for each part based on the specific skill set the two parts require Know how to best present his/her answers during the oral examination – demeanor, answer structure, etc.« less

  15. SU-F-T-402: The Effect of Extremely Narrow MLC Leaf Width On the Plan Quality of VMAT for Prostate Cancer

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kim, J; Park, S; Kim, J

    2016-06-15

    Purpose: To investigate the effect of multi-leaf collimators (MLCs) with leaf width of 1.25 mm on the plan quality of volumetric modulated arc therapy (VMAT) for prostate cancer. Methods: A total of 20 patients with prostate cancer were retrospectively selected. Using a high definition MLC (HD MLC), primary and boost VMAT plans with two full arcs were generated for each patient (original plan). After that, by shifting patient CT images by 1.25 mm in the cranio-caudal direction between the 1st and the 2nd arc, we simulated fluences made with MLCs with leaf width of 1.25 mm. After shifting, primary andmore » boost plans were generated for each patient (shifted plan). A sum plan was generated by summation of the primary and boost plan for each patient. Dose-volumetric parameters were calculated and compared. Results: Both homogeneity index (HI) and conformity index (CI) of the shifted plans were better than those of the original plans in primary plans (HI = 0.044 vs. 0.040 with p < 0.001 and CI = 1.056 vs. 1.044 with p = 0.006). Similarly, the shifted plans for boost target volume showed better homogeneity and conformity than did the original plans (HI = 0.042 vs. 0.037 with p = 0.006 and CI = 1.015 vs. 1.009 with p < 0.001). The total body volumes of the original plans irradiated by the prescription dose were larger than those of the shifted plans in sum plans (60.9 cc vs. 49.0 cc with p = 0.007). Conclusion: Use of extremely narrow MLCs could increase dose homogeneity and conformity of the target volume for prostate VMAT. This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (No. 2015R1C1A1A02036331).« less

  16. Should Live Patient Licensing Examinations in Dentistry Be Discontinued? Two Viewpoints: Viewpoint 1: Alternative Assessment Models Are Not Yet Viable Replacements for Live Patients in Clinical Licensure Exams and Viewpoint 2: Ethical and Patient Care Concerns About Live Patient Exams Require Full Acceptance of Justifiable Alternatives.

    PubMed

    Chu, Tien-Min Gabriel; Makhoul, Nicholas M; Silva, Daniela Rodrigues; Gonzales, Theresa S; Letra, Ariadne; Mays, Keith A

    2018-03-01

    This Point/Counterpoint article addresses a long-standing but still-unresolved debate on the advantages and disadvantages of using live patients in dental licensure exams. Two contrasting viewpoints are presented. Viewpoint 1 supports the traditional use of live patients, arguing that other assessment models have not yet been demonstrated to be viable alternatives to the actual treatment of patients in the clinical licensure process. This viewpoint also contends that the use of live patients and inherent variances in live patient treatment represent the realities of daily private practice. Viewpoint 2 argues that the use of live patients in licensure exams needs to be discontinued considering those exams' ethical dilemmas of exposing patients to potential harm, as well as their lack of reliability and validity and limited scope. According to this viewpoint, the current presence of viable alternatives means that the risk of harm inherent in live patient exams can finally be eliminated and those exams replaced with other means to confirm that candidates are qualified for licensure to practice.

  17. Awarding Credit Where Credit Is Due: Effective Practices for the Implementation of Credit by Exam. Adopted Spring 2014

    ERIC Educational Resources Information Center

    Academic Senate for California Community Colleges, 2014

    2014-01-01

    Credit by Exam is a mechanism employed in the California community colleges as a means of granting credit for student learning outside of the traditional classroom. In some instances, credit by exam is the means used to award college credit for structured learning experiences in a secondary educational setting, while in other instances knowledge…

  18. Assessing the Key Attributes of Low Utilization of Mammography Screening and Breast-self Exam among African-American Women

    PubMed Central

    Chowdhury, Rupak; David, Nganwa; Bogale, Asseged; Nandy, Shami; Habtemariam, T.; Tameru, Berhanu

    2016-01-01

    PURPOSE: African-American (AA) women living in four Black Belt Counties (BBC) of Alabama; consisting of Barbour, Macon, Green and Wilcox are known to have lower mammogram utilization and breast self-exam rates when compared to their white female counterparts. The influence of socioeconomic and demographic factors on these disparities has not been clearly defined so far. Our study was designed to determine whether these observed disparities can be predicted with the socioeconomic and other demographic attributes. METHODS: Health Disparity Questionnaires data (n = 516) for BBC of Alabama was analyzed using a logistic regression model to examine the association of breast cancer screening rates and breast self-exam with income, the level of education, family doctor, type of health insurance, obesity, and age. RESULTS: Income, education, family doctor, age and health insurance were independent predictors for the low utilization rate of mammography and breast self-exam (BSE). CONCLUSION: Improving socioeconomic conditions such as level of education and availability of health care are essential to increase the rates of breast cancer screening test and breast self-exam in the BBC of Alabama. PMID:26958089

  19. An Innovative Excel Application to Improve Exam Reliability in Marketing Courses

    ERIC Educational Resources Information Center

    Keller, Christopher M.; Kros, John F.

    2011-01-01

    Measures of survey reliability are commonly addressed in marketing courses. One statistic of reliability is "Cronbach's alpha." This paper presents an application of survey reliability as a reflexive application of multiple-choice exam validation. The application provides an interactive decision support system that incorporates survey item…

  20. Teaching to the Test…or Testing to Teach: Exams Requiring Higher Order Thinking Skills Encourage Greater Conceptual Understanding

    ERIC Educational Resources Information Center

    Jensen, Jamie L.; McDaniel, Mark A.; Woodard, Steven M.; Kummer, Tyler A.

    2014-01-01

    In order to test the effect of exam-question level on fostering student conceptual understanding, low-level and high-level quizzes and exams were administered in two sections of an introductory biology course. Each section was taught in a high-level inquiry based style but was assigned either low-level questions (memory oriented) on the quizzes…