The final examination in medicine : time for change?

Most medical programmes culminate in a final assessment, in order that participants may be tested and graded. In June 1995, at the University of Malta, a group of 53 medical students sat for their final examination; medicine was one of the three co-equal component subjects of this statutory qualifying examination. The scope of this paper is to analyze the results obtained in the final examination in medicine and to use this data to address such issues as aims of this examination, method and quality assurance of assessment. The result obtained by candidates in the final examination in medicine was correlated with their university entry qualifications. The composite mark for each candidate was split into its components and analysis took the form of description, correlation and clustering. Computation of Cronbach’s alpha facilitated anlaysis of reliability of each of the three parts of the examination. The findings of this paper suggest that there is room for improving the quality of assessment methods. A review of methods and procedures, with the dual purpose of decreasing bias and increasing specificity and sensitivity of this statutory examination will not only benefit candidates, but ultimately also the University of Malta. The final qualifying examination in medicine should have clearly defined objectives and methods of assessment should be aimed specifically at reaching them. It needs to be able to assess the ability to think critically about diagnosis and management and to ensure that the candidate has a satisfactory base of factual knowledge. It also needs to assess objectively the adequacy of basic clinical skills and candidates’ facility of communication.peer-reviewe

On the rough Gronwall lemma and its applications

We present a rough path analog of the classical Gronwall Lemma introduced recently by A. Deya, M. Gubinelli, M. Hofmanov\'a, S. Tindel in [arXiv:1604.00437] and discuss two of its applications. First, it is applied in the framework of rough path driven PDEs in order to establish energy estimates for weak solutions. Second, it is used in order to prove uniqueness for reflected rough differential equations

Concordance with the British Society of Rheumatology (BSR) 2010 recommendations on eligibility criteria for the first biologic agent

Aims: The aim of this study is to assess concordance with the British Society of Rheumatology (BSR) 2010 recommendations on the use of biologic therapy in Rheumatoid Arthritis (RA). The Disease Activity Score in 28 joints (DAS 28), a composite numerical score is included in these recommendations to assess disease activity and response to treatment. Methods: Clinical notes of fifty patients who were commenced on biologic treatment between March 2010 and June 2011 were reviewed for documentation of DAS 28 scores at baseline, after approximately 6 months of commencement of treatment and at approximately 6 monthly intervals during treatment. Results: Twenty two patients were eligible for this audit. Of these patients only half had a DAS 28 score performed prior to starting treatment, four patients had the score performed within 3-9 months of commencement of therapy and only 2 patients had continuous scores performed at six monthly intervals during treatment. Conclusions: This audit shows that we are not adhering to the BSR recommendations. In order to improve our adherence we plan to train all staff in contact with patients on biologic treatment to perform DAS 28 scores and have a DAS 28 calculator readily available at out patients. A proforma is being developed for patients on biologic therapy to ensure that DAS 28 scores are performed at baseline and during treatment.peer-reviewe

Malignant lymphoma of the intestine : a report of three cases

Tumours arising in the small intestine are uncommon; those of them originating in the lymphoid tissues are said to be even less frequent than adennocarcinomas. Three cases hereby are reported, outlining the respective diagnosis and treatment. All the three cases were diagnosed histologically as Lymphosarcoma. It is interesting to note that in published series, Lymphosarcomas and Reticulum Cell Sarcomas have been about equally represented, and together accounted for the vast majority of cases. Various gross features have been reported, the commonest being polypoid, annular, ulcerative and aneurismal. An important feature of these tumours is that they have little connective tissue stroma. This, together with infiltration of the muscle coat, is said to account for the aneurismal varieties of the growth. Age incidence studies show that most cases occur in the age group 45 to 60 years, but no age group is exempt. As for signs and symptoms, it is true to say that no definite syndrome is produced by this disease. In general, it may be said that cases have presented either as surgical emergencies or insidiously. There is general consensus regarding the value of post-operative radiotherapy in unresectable growths, and in those with regional lymph node metastasis. What is uncertain is the value of radiotherapy where no evidence of lymph node spread is present.peer-reviewe

Very low complexity convolutional neural network for quadtree structures

© 2018 Australasian Robotics and Automation Association. All rights reserved. In this paper, we present a Very Low Complexity Convolutional Neural Network (VLC-CNN) for the purpose of generating quadtree data structures for image segmentation. The use of quadtrees to encode images has applications including video encoding and robotic perception, with examples including the Coding Tree Unit in the High Efficiency Video Coding (HEVC) standard and Occupancy Grid Maps (OGM) as environment representations with variable grid-size. While some methods for determining quadtree structures include brute-force algorithms or heuristics, this paper describes the use of a Convolutional Neural Network (CNN) to predict the quadtree structure. CNNs traditionally require substantial computational and memory resources to operate, however, VLC-CNN exploits downsampling and integer-only quantised arithmetic to achieve minimal complexity. Therefore, VLC-CNN's minimal design makes it feasible for implementation in realtime or memory-constrained processing applications