Evaluating the quality of the ontology-based auto-generated questions

An ontology is a knowledge representation structure which has been used in Virtual Learning Environments (VLEs) to describe educational courses by capturing the concepts and the relationships between them. Several ontology-based question generators used ontologies to auto-generate questions, which aimed to assess students' at different levels in Bloom's taxonomy. However, the evaluation of the questions was confined to measuring the qualitative satisfaction of domain experts and students. None of the question generators tested the questions on students and analysed the quality of the auto-generated questions by examining the question's difficulty, and the question's ability to discriminate between high ability and low ability students. The lack of quantitative analysis resulted in having no evidence on the quality of questions, and how the quality is a�affected by the ontology-based generation strategies, and the level of question in Bloom's taxonomy (determined by the question's stem templates). This paper presents an experiment carried out to address the drawbacks mentioned above by achieving two objectives. First, it assesses the auto-generated questions' difficulty, discrimination, and reliability using two statistical methods: Classical Test Theory (CTT) and Item Response Theory (IRT). Second, it studies the effect of the ontology-based generation strategies and the level of the questions in Bloom's taxonomy on the quality of the questions. This will provide guidance for developers and researchers working in the field of ontology-based question generators, and help building a prediction model using machine learning techniques

Induced sputum MMP-1, -3 & -8 concentrations during treatment of tuberculosis.

INTRODUCTION: Tuberculosis (TB) destroys lung tissues and this immunopathology is mediated in part by Matrix Metalloproteinases (MMPs). There are no data on the relationship between local tissue MMPs concentrations, anti-tuberculosis therapy and sputum conversion. MATERIALS AND METHODS: Induced sputum was collected from 68 TB patients and 69 controls in a cross-sectional study. MMPs concentrations were measured by Luminex array, TIMP concentrations by ELISA and were correlated with a disease severity score (TBscore). 46 TB patients were then studied longitudinally at the 2nd, 8th week and end of treatment. RESULTS: Sputum MMP-1,-2,-3,-8,-9 and TIMP-1 and -2 concentrations are increased in TB. Elevated MMP-1 and -3 concentrations are independently associated with higher TB severity scores (p<0.05). MMP-1, -3 and -8 concentrations decreased rapidly during treatment (p<0.05) whilst there was a transient increase in TIMP-1/2 concentrations at week 2. MMP-2, -8 and -9 and TIMP-2 concentrations were higher at TB diagnosis in patients who remain sputum culture positive at 2 weeks and MMP-3, -8 and TIMP-1 concentrations were higher in these patients at 2nd week of TB treatment. CONCLUSIONS: MMPs are elevated in TB patients and associate with disease severity. This matrix-degrading phenotype resolves rapidly with treatment. The MMP profile at presentation correlates with a delayed treatment response

Outcomes from patients with presumed drug resistant tuberculosis in five reference centers in Brazil

Background The implementation of rapid drug susceptibility testing (DST) is a current global priority for TB control. However, data are scarce on patient-relevant outcomes for presumptive diagnosis of drug-resistant tuberculosis (pDR-TB) evaluated under field conditions in high burden countries. Methods Observational study of pDR-TB patients referred by primary and secondary health units. TB reference centers addressing DR-TB in five cities in Brazil. Patients age 18 years and older were eligible if pDR-TB, culture positive results for Mycobacterium tuberculosis and, if no prior DST results from another laboratory were used by a physician to start anti-TB treatment. The outcome measures were median time from triage to initiating appropriate anti-TB treatment, empirical treatment and, the treatment outcomes. Results Between February,16th, 2011 and February, 15th, 2012, among 175 pDR TB cases, 110 (63.0%) confirmed TB cases with DST results were enrolled. Among study participants, 72 (65.5%) were male and 62 (56.4%) aged 26 to 45 years. At triage, empirical treatment was given to 106 (96.0%) subjects. Among those, 85 were treated with first line drugs and 21 with second line. Median time for DST results was 69.5 [interquartile - IQR: 35.7–111.0] days and, for initiating appropriate anti-TB treatment, the median time was 1.0 (IQR: 0–41.2) days. Among 95 patients that were followed-up during the first 6 month period, 24 (25.3%; IC: 17.5%–34.9%) changed or initiated the treatment after DST results: 16/29 MDRTB, 5/21 DR-TB and 3/45 DS-TB cases. Comparing the treatment outcome to DS-TB cases, MDRTB had higher proportions changing or initiating treatment after DST results (p = 0.01) and favorable outcomes (p = 0.07). Conclusions This study shows a high rate of empirical treatment and long delay for DST results. Strategies to speed up the detection and early treatment of drug resistant TB should be prioritized