An Item Analysis of Written Multiple-Choice Questions: Kashan University of Medical Sciences

Background: Multiple Choice Questions (MCQs) are one of the most common types of exams used in evaluation of students in any educational setting. The question items making up these exams need to be examined if they are to meaningfully contribute to the student scores. Such characteristics are amenable to examination by item analysis. Objectives: The purpose of this research was to examine the quality of MCQs used in Nursing and Midwifery Faculty and to compare the results with the other faculties in Kashan University of Medical Science in the academic year 2008-2009. Materials and Methods: In this cross-sectional study, 101 multiple-choice exams were randomly chosen for the study, and 37 exams were selected from the faculty of nursing and midwifery. The difficulty, discrimination indices and Cronbach’s Alpha were calculated for every exam and then mean values for each index were calculated by LERTAL 5.0 software purchased from Assessment Systems Corporation of the United States. Results: A total of 7062 MCQs in the university and 1793 items in the faculty of nursing and midwifery presented to the students by different instructors were analyzed. The average of difficulty index of the faculty of nursing was 0.5. The discrimination index was 0.36, and the average of Alpha-Cronbach was 0.82 in the faculty of nursing. All the values were significantly better in the faculty of nursing and midwifery compared to the rest of the university. Conclusions: The difficulty index, the discrimination index and the Alpha-Cronbach values in the faculty of nursing were within the acceptable range recommended by experts in the field of educational measurement. However, some of the tests had values less than the recommended

An epidemiological study of obsessive-compulsive disorder among high school students and its relationship with religious attitudes

Background/Objective: Considering the importance of mental health in adolescents, we studied the prevalence of obsessive-compulsive disorder (OCD) in this age group and determined its relationship with their religious attitudes. Methods: In this survey, 293 students at different grades were selected using a multiphasic cluster sampling method. Subjects were asked to complete demographic, Yale-Brown scale, and religious attitude questionnaires. Those with scores higher than the cutoff value were interviewed by a psychiatrist, based on the DSM-IV criteria. Data were analyzed by �2 and Student's t-test. Results: The prevalence of OCD was 8.87 (5.1 in boys and 3.75 in girls). The majority of patients with OCD were from urban regions and had a positive family history in their first- or second-degree relatives. Nonetheless, there was no relationship between OCD and religious attitudes. Conclusion: The prevalence of OCD found in our study was higher than many of those reported earlier. Religious attitudes could only affect the contents of obsession and compulsion

Contralateral Axillary Lymph Node Metastasis in Breast Cancer, an Unusual Clinical Scenario: A Case Report and Review of the Literature

Background: Contralateral axillary metastasis (CAM) is a rare entity in patients with breast cancer which can occur during the primary breast cancer or its follow-up. Different treatment modalities include surgery, radiotherapy, and chemotherapy, but there is no agreement on them. In our review, we found 12 series with available data, 82 patients with synchronous or metachronous contralateral axillary node involvement with no primary cancer in the contralateral breast. Case Presentation: Our patient was a 50-year-old woman who presented with locally advanced right breast cancer with no distant metastasis. After treatment including neoadjuvant chemotherapy, MRM, and radiotherapy, her contralateral axillary lymph node was involved with metastatic carcinoma compatible with ductal carcinoma of the breast with similar IHC results. Evaluation of the contralateral breast was negative for occult lesions and metastatic workups were negative for malignancy. We assumed this presentation as a CAM and planned the treatment accordingly. Conclusion: CAM without systemic metastasis might be considered a regional disease because in many cases the spread is lymphatic and not hematogenous. The new concept of lymphatic invasion instead of hematogenous spread has changed the intent of palliative to curative treatment. According to our study, CAM patients were mostly managed with chemotherapy (96%), ALND (45%), contralateral breast and axillary radiation (35%). The prognosis of CAM is usually poor with a high relapse rate (>60%) and a mortality rate of 15% in our review after 14-43 months follow-up, but it is better than the prognosis of the patients with systemic metastasis

Psychological and personality characteristics of young addicted subjects in Kashan, 1379

Background: Addiction is a worldwide problem usually affecting young adults. Different environmental, psychological and social factors may aggravate the situation. The present study was conducted to determine psychological and personality characteristics of young addicted subjects in Kashan in 1379.Materials and methods: For this descriptive study, 100 young addicted subjects aged 15-30 years were included. A demographic questionnaire as well as Minnesota Multiphasic Personality Inventory (MMPI) was completed for all subjects. Finally, the psychologic profile of the candidate was drawn according to his score and an interview achieved by a psychiatrist. The role psychological and personality factors were determined.Results: Anxiety(43) and depression(34) were the most common psychological problems followed by antisocial personality(31) and schizoid (30). Married subjects were more likely to develop anxiety, however, single subjects developed depression.Conclusion: With respect to the high prevalence of anxiety and depression in addicted subjects, further studies are highly recommended to treat the affected subjects

A beacon analysis-based RFID reader anti-collision protocol for dense reader environments

Radio-frequency identification (RFID) is one of the major technologies for auto-identification in many applications. When multiple readers work together to improve the read rate and reliability, a dense RFID network is created. One of the most important issues to be considered in such environments is reader collision, which leads to reduced throughput. Although different schemes have been proposed to reduce reader collision, they often either require additional hardware or do not use network resources efficiently, or are not consistent with international laws and standards. In this paper, by managing and analyzing beacon messages, a new centralized scheme, which is consistent with European standards and laws, is proposed to reduce collisions and increase throughput. In the proposed scheme, by sending a priority code via a beacon message and making decisions based on the beacon messages received by readers, the available resources are used optimally, and the maximum number of readers is activated in one round. Additionally, in the proposed scheme, the priority code is initialized in such a manner that the readers access the channel fairly. The simulation results and comparison of the proposed scheme with other protocols indicate that throughput increased. Because of the increased throughput and fairness of the proposed scheme, the delay reduced compared with other schemes, and overall, the proposed scheme was superior to other centralized schemes. © 201

An efficient resource allocation scheme in a dense RFID network based on cellular learning automata

Radio-frequency identification (RFID) is a wireless communication technology. Radio frequencies can cause interference in a dense RFID system, thus decreasing efficiency. In recent years, many protocols have been proposed to reduce reader collisions based on multiple-access techniques. The main weakness of Time Division Multiple Access (TDMA)-based schemes is the random selection of resources. Additionally, they do not consider the distance between the interfering readers. Therefore, the likelihood of interference in an RFID system will be increased. To address this problem, we propose a new scheme for allocating resources to readers using a learning technique. The proposed scheme takes into account the distance between interfering readers, and these readers acquire the necessary knowledge to select new resources based on the results of the previous selection of neighboring readers using cellular learning automata. This approach leads to reduced interference in an RFID system. The proposed scheme is fully distributed and operates without hardware redundancy. In this scheme, the readers select new resources without exchanging information with each other. The simulation results show that the percentage of kicked readers decreased by more than 20, and the proposed scheme also provides higher throughput than do state-of-the-art schemes for dense reader environments and leads to further recognition of tags. © 2018 John Wiley & Sons, Ltd

Vitamin D supplementation affects the beck depression inventory, insulin resistance, and biomarkers of oxidative stress in patients with major depressive disorder: A randomized, controlled clinical trial

Background: Vitamin D may decrease depression symptoms through its beneficial effects on neurotransmitters, metabolic profiles, biomarkers of inflammation, and oxidative stress. Objective: This study was designed to assess whether vitamin D supplementation can reduce symptoms of depression, metabolic profiles, serum high-sensitivity C-reactive protein (hs-CRP), and biomarkers of oxidative stress in patients with major depressive disorder (MDD). Methods: This randomized, double-blind, placebo-controlled clinical trial was performed in 40 patients between 18 and 65 y of age with a diagnosis of MDD based on criteria from the Diagnostic and Statistical Manual of Mental Disorders. Patients were randomly assigned to receive either a single capsule of 50 kIU vitamin D/wk (n = 20) or placebo (n = 20) for 8 wk. Fasting blood samples were taken at baseline and postintervention to quantify relevant variables. The primary Beck Depression Inventory (BDI), which examines depressive symptoms and secondary (glucose homeostasis variables, lipid profiles, hs-CRP, and biomarkers of oxidative stress) outcomes were assessed. Results: Baseline concentrations of mean serum 25-hydroxy vitamin D were significantly different between the 2 groups (9.2 ± 6.0 and 13.6 ± 7.9 mg/L in the placebo and control groups, respectively, P = 0.02). After 8 wk of intervention, changes in serum 25-hydroxyvitamin D concentrations were significantly greater in the vitamin D group (+20.4 mg/L) than in the placebo group (20.9 mg/L, P < 0.001). A trend toward a greater decrease in the BDI was observed in the vitamin D group than in the placebo group (-8.0 and -3.3, respectively, P = 0.06). Changes in serum insulin (23.6 compared with +2.9 μIU/mL, P = 0.02), estimated homeostasis model assessment of insulin resistance (-1.0 compared with +0.6, P = 0.01), estimated homeostasis model assessment of β cell function (-13.9 compared with +10.3, P = 0.03), plasma total antioxidant capacity (+63.1 compared with -23.4 mmol/L, P = 0.04), and glutathione (+170 compared with -213 μmol/L, P = 0.04) in the vitamin D group were significantly different from those in the placebo group. Conclusion: Overall, vitamin D supplementation of patients with MDD for 8 wk had beneficial effects on the BDI, indicators of glucose homeostasis, and oxidative stress. This trial was registered at www.irct.ir as IRCT201412065623N29. © 2016 American Society for Nutrition