Effects of vegetation degradation on soil microbial communities and ecosystem multifunctionality in a karst region, southwest China.

Vegetation degradation caused by intense human disturbances poses a significant challenge to the preservation and improvement of ecosystem functions and services in the karst region of southwest China. Soil microorganisms are major regulators of ecosystem multifunctionality (EMF). Currently, there is a dearth of knowledge regarding the effects of vegetation degradation on soil microbial communities and their corresponding multiple ecosystem functions in karst regions. In this study, we selected the vegetation degradation sequences of second natural forest (NF), agroforestry (AS) and cropland (CL) to investigate the diversity of bacterial, fungal and protistan communities, and their hierarchical co-occurrence network, and EMF to explore the relationships between them. Compared to the NF, the carbon cycling index, nitrogen cycling index, soil water regulation power, and the EMF were significantly decreased by 8.2%-50.6%, 48.7%-86.8%, 19.8%-24.5%, and 31.4%-69.5% in the AS and CL, respectively. The development of EMF can be explained by the fungal, protistan and microbial hierarchical ß-diversity, as well as the complexity (e.g. degree) of microbial hierarchical interactions during the process of vegetation degradation. Notably, correlations between the abundances of sensitive amplicon sequence variants (sASVs) for different karst vegetation types and EMF varied in distinct network modules, being positive in module 1 and negative in module 2. Moreover, the relative abundance of keystone taxa in fungal and protistan communities provided greater contributions to EMF than the bacterial communities. Additionally, random forest modeling showed that carbon and nitrogen sources, and soil water content, and trace elements (e.g. exchangeable magnesium, iron, manganese, and zinc) were identified as key driving factors of the EMF. Collectively, our findings demonstrate that vegetation degradation obviously alters soil microbial diversities and hierarchical interactions, emphasizing their key role in maintaining ecosystem functions and health in karst regions.

Development and Results of the First Certification Examination in the American Board of Medical Specialties Neurocritical Care Subspecialty.

This article reviews the development of the American Board of Medical Specialties subspecialty in neurocritical care (NCC) and describes the requirements for certification and the results of the first certification examination administered in October 2021. The American Board of Psychiatry and Neurology (ABPN) is the administrative board, and the sponsoring boards are the American Board of Anesthesiology (ABA), American Board of Emergency Medicine (ABEM), American Board of Internal Medicine (ABIM), and American Board of Neurological Surgery. The American Board of Medical Specialties approved the subspecialty in 2018, and the Accreditation Council for Graduate Medical Education developed and approved the training requirements in 2021. The fellowship programs are either 12 or 24 months in length and may become available in Academic Year 2022-2023. The first NCC examination was developed by a multispecialty group of subject matter experts following established test development procedures and was successfully administered to 1,011 candidates in October 2021. There were 406 (40.2%) ABIM candidates, 356 (35.2%) ABPN candidates, 208 (20.6%) ABA candidates, and 41 (4.1%) ABEM candidates. The end-of-test survey indicated that most examinees were satisfied with their test taking experience, and the .92 reliability index indicated that the test scores were reliable. An established process was also followed to set the criterion-referenced passing standard, and the resulting pass rate of 72.7% was judged to be reasonable. In summary, the combined efforts of representatives from the ABPN, ABA, ABEM, ABIM, and American Board of Neurological Surgery yielded a quality assessment instrument to identify physicians who possess the expertise required to be certified in NCC. The test development committee will continue to expand and improve the pool of test questions for the next examination, which is scheduled for October 2022.

An Article-Based Format for Medical Specialty and Subspecialty Maintenance of Certification.

INTRODUCTION: This article describes an article-based alternative for maintenance of certification that the American Board of Psychiatry and Neurology developed and began pilot testing in 2019. The rationale for and components of the pilot program are presented along with data on participant performance and feedback from the first year of implementation in three primary specialties (neurology, child neurology, and psychiatry) and one subspecialty (child and adolescent psychiatry). METHODS: Evaluation of the pilot program was guided by a widely used validity framework. Data were collected that addressed the five categories of validity evidence: content, response process, internal structure, relation to other variables, and consequences. RESULTS: Enrollment ranged from 66.7% for psychiatrists to 75.3% for child neurologists. For the 2019 cohort, the pass rates ranged from 92.6% for child and adolescent psychiatry to 98.7% for neurology, and very small numbers of diplomates failed or did not complete the process. For psychiatrists, there was a modest, but significant, relationship between performance on previous and subsequent maintenance of certification examinations. Ninety percent or more agreed that: the articles were easy to access and helpful to their practices; the mini-tests were a fair assessment of their understanding of the articles; and their test-taking experience was satisfactory. DISCUSSION: Most eligible diplomates participated in the article-based pilot project, and they strongly preferred this format to the traditional multiple-choice examinations. Most important, the pilot was perceived to be a meaningful and relevant learning activity that had a positive effect on patient care.

Analysis and Research on Human Movement in Sports Scene.

As a whole-body sport, skipping rope plays an increasingly important role in daily life. In rope-skipping education, due to the lack of professional teachers, the training efficiency of students is low. The rope-skipping monitoring device is heavy and expensive, and the cost of labor statistics and energy consumption are high. In order to quickly analyze the movement process of students and provide correct guidance, this article implements the movement analysis method of the human body movement process. The problem of limb posture analysis in rope skipping is transformed into a multilabel classification problem, a real-time human motion analysis method based on mobile vision is proposed, and the algorithm model is verified in the rope-skipping scene. The experimental results prove that this paper proposes the improved algorithm, which achieved the expected effect. In the analysis of rope-skipping action, the choice of hyperparameters during the experiment is introduced, and it is verified that the proposed ALSTM-LSTM can solve the problem of multilabel classification in the rope-skipping process. The accuracy rate reaches 95.1%, and it can provide the best in all indicators and good performance. It is of great significance for movement analysis and movement quality evaluation during exercise.

Performance of Certification and Recertification Examinees on Multiple Choice Test Items: Does Physician Age Have an Impact?

INTRODUCTION: The development of recertification programs (now referred to as Maintenance of Certification or MOC) by the members of the American Board of Medical Specialties provides the opportunity to study knowledge base across the professional lifespan of physicians. Research results to date are mixed with some studies finding negative associations between age and various measures of competency and others finding no or minimal relationships. METHODS: Four groups of multiple choice test items that were independently developed for certification and MOC examinations in psychiatry and neurology were administered to certification and MOC examinees within each specialty. Percent correct scores were calculated for each examinee. Differences between certification and MOC examinees were compared using unpaired t tests, and logistic regression was used to compare MOC and certification examinee performance on the common test items. RESULTS: Except for the neurology certification test items that addressed basic neurology concepts, the performance of the certification and MOC examinees was similar. The differences in performance on individual test items did not consistently favor one group or the other and could not be attributed to any distinguishable content or format characteristics of those items. DISCUSSION: The findings of this study are encouraging in that physicians who had recently completed residency training possessed clinical knowledge that was comparable to that of experienced physicians, and the experienced physicians' clinical knowledge was equivalent to that of recent residency graduates. The role testing can play in enhancing expertise is described.

Comparison of Certification and Recertification Examinee Performance on Multiple-Choice Items in Forensic Psychiatry.

Research on the association between age and performance on tests of medical knowledge has generally shown an inverse relationship, which is of concern because of the positive association between measures of knowledge and measures of clinical performance. Because the certification and maintenance of certification (MOC) examinations in the subspecialty of forensic psychiatry draw on a common item bank, performance of the two groups of examinees on the same items could be compared. In addition, the relationship between age and test performance was analyzed. Performance on items administered to certification and MOC examinees did not differ significantly, and the mean amount of time spent on each item was similar for the two groups. Although the majority (five of eight) of the correlations between age and test score on the certification and MOC examinations were negative, only three were significant, and the amount of variance explained by age was small. In addition, examination performance for those younger than 50 was similar to those 60 and older, and diplomates recertifying for the second time outperformed those doing so for the first time. These results indicate that in this subspecialty, there is no clear evidence of an age-related decline in knowledge as assessed by multiple-choice items.

The promise and challenge of including multimedia items in medical licensure examinations: some insights from an empirical trial.

BACKGROUND: The Comprehensive Osteopathic Medical Licensing Examination conducted a trial of multimedia items in the 2008-2009 Level 3 testing cycle to determine (1) if multimedia items were able to test additional elements of medical knowledge and skills and (2) how to develop effective multimedia items. METHOD: Forty-four content-matched multimedia and text multiple-choice items were randomly delivered to Level 3 candidates. Logistic regression and paired-samples t tests were used for pairwise and group-level comparisons, respectively. RESULTS: Nine pairs showed significant differences in either difficulty or/and discrimination. Content analysis found that, if text narrations were less direct, multimedia materials could make items easier. When textbook terminologies were replaced by multimedia presentations, multimedia items could become more difficult. Moreover, a multimedia item was found not uniformly difficult for candidates at different ability levels, possibly because multimedia and text items tested different elements of a same concept. CONCLUSIONS: Multimedia items may be capable of measuring some constructs different from what text items can measure. Effective multimedia items with reasonable psychometric properties can be intentionally developed.

A departmental outcome assessment to evaluate educational achievement.

Defining and addressing outcome objectives is a crucial process in medical science and education. One outcome objective of the Physiology/ Pharmacology Department at Des Moines University is to prepare students to successfully complete Part I of the national licensure examination. This study assesses the effectiveness of the departmental curriculum in helping the students achieve success on Part I of the licensure examination. Standardized discipline examinations were used as the comprehensive final examination for the physiology and pharmacology courses for the classes of 1997, 1998, and 2002 through 2005. The results were assessed by class year and specific topic area as determined by an item keyword description. Student performance on Part I of the National Podiatric Board examination was assessed for each class. Podiatric medical students' performance tended to be similar to or slightly lower than that of the national cohort on the discipline examinations. Topic analysis revealed areas of weakness, which were then addressed in the second-year courses. Student performance on Part I was generally acceptable yet showed marked improvement with the curricular interventions and changes. External assessments provide us with an unbiased means to evaluate the strengths and weaknesses of the curriculum through student performance and to make appropriate adjustments to enhance students' success.

Predictive validity of osteopathic medical licensing examinations for osteopathic medical knowledge measured by graduate written examinations.

The purpose of this study was to evaluate the predictive validity of osteopathic medical licensing examinations for osteopathic medical knowledge measured by graduate written medical examinations. Performances on the three osteopathic initial licensing examinations, the three osteopathic internal medicine in-service examinations, and the osteopathic internal medicine board certification examinations were analyzed for a cohort of the most recent osteopathic internal medicine board certification examination candidates (N = 82). Multiple regressions were performed for the predictive value of licensing examination scores for the late examination scores. Logistic regressions were used for the prediction of pass/fail status on the licensing examinations for that on the board certification. A longitudinal performance profile was constructed to assess the rank changes in decile on the examinations at different times. All correlation coefficients between the licensing examinations and other examinations were significant and higher than .70. The licensing examinations together predicted at least 60% of the variance of any of the other examination scores. The pass/fail status on the licensing examinations predicted 89% of the pass/fail status on the certification examination. Decile ranks since the first licensing examination were consistent and stable over at least 5 years. The osteopathic licensing examinations had high predictive validity for the late written osteopathic internal medicine examinations. Generalization of the findings to other disciplines needs a caution, as a specialty bias may exist for these types of studies.

Relationship of osteopathic medical licensure examinations with undergraduate admission measures and predictive value of identifying future performance in osteopathic principles and practice/osteopathic manipulative medicine courses and rotations.

Two hundred sixty-five students from four classes at one school of osteopathic medicine were studied to determine the correlation between several frequently used premedical admission criteria to predict performance on the early and current versions of the osteopathic medical licensure examinations. Further analysis evaluated the predictive value of the examination of the National Board of Osteopathic Medical Examiners (NBOME) and its successor, the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) in determining subsequent performance in the ascending levels of the examination sequence, as well as to predict performance in the courses and rotations of osteopathic principles and practice (OPP) and osteopathic manipulative medicine (OMM). This study also investigated the relationship between the early and later parts of the osteopathic medical licensure examinations. Analysis showed that of all premedical parameters, only the Medical College Aptitude Test score was positively correlated with performance on COMLEX-USA. In addition, a positive correlation was demonstrated between the performance in either Level 1 of COMLEX-USA or in the earlier form of the NBOME examination Part I and subsequent performance on the current Level 2 of COMLEX-USA or the old NBOME Part II. Finally, analysis indicated that COMLEX-USA predicted performance in OPP knowledge and skills.

Progress Testing for Postgraduate Medical Education: a Four-Year Experiment of American College of Osteopathic Surgeons Resident Examinations.

An experiment of progress testing for postgraduate medical education was evaluated for the psychometric properties and evaluation utilities of its outcome. Psychometric analysis emphasized reliability, construct validity, exam structure, and equating quality, while analysis of evaluation value focused on growth trajectories of several cohorts of residents. The analyses concluded that progress testing for postgraduate education was feasible. The value of progress testing for postgraduate medical education assessment was unique and promising.