BackgroundSingle Best Answer (SBA) questions are widely used in undergraduate and postgraduate medical examinations. Selection of the correct answer in SBA questions may be subject to cueing and therefore might not test the student’s knowledge. In contrast to this artificial construct, doctors are ultimately required to perform in a real-life setting that does not offer a list of choices. This professional competence can be tested using Short Answer Questions (SAQs), where the student writes the correct answer without prompting from the question. However, SAQs cannot easily be machine marked and are therefore not feasible as an instrument for testing a representative sample of the curriculum for a large number of candidates. We hypothesised that a novel assessment instrument consisting of very short answer (VSA) questions is a superior test of knowledge than assessment by SBA.MethodsWe conducted a prospective pilot study on one cohort of 266 medical students sitting a formative examination. All students were assessed by both a novel assessment instrument consisting of VSAs and by SBA questions. Both instruments tested the same knowledge base. Using the filter function of Microsoft Excel, the range of answers provided for each VSA question was reviewed and correct answers accepted in less than two minutes. Examination results were compared between the two methods of assessment.ResultsStudents scored more highly in all fifteen SBA questions than in the VSA question format, despite both examinations requiring the same knowledge base.ConclusionsValid assessment of undergraduate and postgraduate knowledge can be improved by the use of VSA questions. Such an approach will test nascent physician ability rather than ability to pass exams.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0793-z) contains supplementary material, which is available to authorized users.

The gastrointestinal tract is the largest endocrine organ in the body. It secretes more than 20 different peptide hormones, which serve both a local regulatory function and provide a means by which the gut can regulate appetite and satiety. As the worldwide prevalence of obesity reaches epidemic proportions, the importance of delineating the mechanisms which regulate food intake becomes even more urgent. There is now a substantial body of work in both rodent and human models demonstrating the effects of these peptides on appetite and work is underway to therapeutically manipulate the gut-brain axis for the treatment of obesity. In addition, it may also be possible to use our understanding of the entero-endocrine system to treat calorie-deficient states. Oral Diseases (2009) 15, 18-26

OBJECTIVEProkineticin 2 (PK2) is a hypothalamic neuropeptide expressed in central nervous system areas known to be involved in food intake. We therefore hypothesized that PK2 plays a role in energy homeostasis.RESEARCH DESIGN AND METHODSWe investigated the effect of nutritional status on hypothalamic PK2 expression and effects of PK2 on the regulation of food intake by intracerebroventricular (ICV) injection of PK2 and anti-PK2 antibody. Subsequently, we investigated the potential mechanism of action by determining sites of neuronal activation after ICV injection of PK2, the hypothalamic site of action of PK2, and interaction between PK2 and other hypothalamic neuropeptides regulating energy homeostasis. To investigate PK2's potential as a therapeutic target, we investigated the effect of chronic administration in lean and obese mice.RESULTSHypothalamic PK2 expression was reduced by fasting. ICV administration of PK2 to rats potently inhibited food intake, whereas anti-PK2 antibody increased food intake, suggesting that PK2 is an anorectic neuropeptide. ICV administration of PK2 increased c-fos expression in proopiomelanocortin neurons of the arcuate nucleus (ARC) of the hypothalamus. In keeping with this, PK2 administration into the ARC reduced food intake and PK2 increased the release of α-melanocyte–stimulating hormone (α-MSH) from ex vivo hypothalamic explants. In addition, ICV coadministration of the α-MSH antagonist agouti-related peptide blocked the anorexigenic effects of PK2. Chronic peripheral administration of PK2 reduced food and body weight in lean and obese mice.CONCLUSIONSThis is the first report showing that PK2 has a role in appetite regulation and its anorectic effect is mediated partly via the melanocortin system.

Salt-induced changes in growth, photosynthetic pigments, various gas exchange characteristics, relative membrane permeability (RMP), relative water content (RWC) and ion accumulation were examined in a greenhouse experiment on eight sunflower (Helianthus annuus L.) cultivars. Sunflower cultivars, namely Hysun-33, Hysun-38, M-3260, S-278, Alstar-Rm, Nstt-160, Mehran-II and Brocar were subjected to non-stress (0 mM NaCl) or salt stress (150 mM NaCl) in sand culture. On the basis of percent reduction in shoot biomass, cvs. Hysun-38 and Nstt-160 were found to be salt tolerant, cvs. Hysun-33, M-3260, S-278 and Mehran-II moderately tolerant and AlstarRm and Brocar salt sensitive. Salt stress markedly reduced growth, different gas exchange characteristics such as photosynthetic rate (A), water-use efficiency (WUE) calculated as A/E, transpiration rate (E), internal CO 2 concentration (C i ) and stomatal conductance (g s ) in all cultivars. The effect of 150 mM NaCl stress was non-significant on chlorophyll a and b contents, chlorophyll a/b ratio, RWC, RMP and leaf and root Cl -, K ? and P contents; however, salt stress markedly enhanced C i /C a ratio, free proline content and leaf and root Na ? concentrations in all sunflower cultivars. Of all cultivars, cv. Hysun-38 was higher in gas exchange characteristics, RWC and proline contents as compared with the other cultivars. Overall, none of the earlier-mentioned physiological attributes except leaf K ? /Na ? ratio was found to be effective in discriminating the eight sunflower cultivars as the response of each cultivar to salt stress appraised using various physiological attributes was cultivar-specific.