bluuebunny/crossref_metadata_2025_split huggingface dataset:
Faculty development participants' experiences of working with change in clinical settings
Authors: Elmberger Agnes , Blitz Julia , Björck Erik , Nieminen Juha , Bolander Laksov Klara 
Published: November 2022

AbstractObjectivesMany universities offer faculty development to support teachers in developing and improving clinical education in the health professions. Although research shows outcomes on individual levels after faculty development, little is known about its contribution to change within the organisation. To advance current faculty development and ensure that it can support wider educational change in healthcare organisations, a better understanding of educational change practices in these settings is needed. This study therefore explores the experiences of working with educational change in clinical workplaces from the perspective of clinical educators that have undergone faculty development training. The study adopts perspectives on change as influenced by context to include the impact from clinical workplaces on individuals' change work.MethodsA collective case study design with a multi‐institutional approach was applied and individual interviews with 14 clinical educators from two universities, one in Sweden and one in South Africa, were conducted. Data were analysed separately before a cross‐case analysis was performed, synthesising the findings from both sites.FindingsParticipants shared experiences of having limited opportunities to work with educational change beyond their own individual teaching practices within their clinical workplaces. Also, participants appeared to refrain from leading change and rather pursued change on their own or relied on indirect approaches to change. They described several workplace aspects influencing their work, including the organisation and management of teaching, the resources and incentives for teaching and the attitudes and beliefs about teaching within the clinical community.ConclusionsThe study shows that clinical educators are part of communities and contexts that shape their approaches to educational change and influence which changes are feasible and which ones are not. It thus adds to the understanding of change as contextual and dynamic and contributes with implications for how to advance faculty development to better support change in practice.
Spatiotemporal matching method for tracking pavement distress using high‐frequency detection data
Authors: Pan Ning , Liu Hao , Wu Difei , Liu Chenglong , Du Yuchuan 
Published: November 2022

AbstractVarious algorithms based on deep learning have achieved promising results in pavement distress detection. However, the detected distresses are not tracked throughout the life cycle. In long‐term application scenarios, pavement distresses may take on different forms due to image acquisition mode, distress development, and environmental change, which make tracking distresses a tough question. We present in this study a spatiotemporal matching method based on high‐frequency real pavement distress datasets. Pavement distresses of fixed routes were collected 30 times over 5 months, and distresses with spatiotemporal information were obtained at time series. We apply image rectification, stitching and distress class, and bounding box generation algorithms for pre‐processing to align the collected images to the same‐detail level and angle. A four‐step spatiotemporal matching module is designed, including global positioning system (GPS) filtering, class filtering, relative position filtering, and distress feature filtering. The results reveal that the comprehensive rank‐3 hit rate of the matching method reaches 88.73%, and the method is robust to environmental factors, which helps show performance decay of distresses and the effect of maintenance operations. It is concluded that the spatiotemporal matching method is convenient to operate, and it lays the foundation for an agency to track distress evolution and make timely treatment of distresses in the life cycle.
Spatial and temporal zoning of watershed resilience using a multidimensional composition approach
Authors: Farzi Parisa , Sadeghi Seyed Hamidreza , Jomehpour Mahmoud 
Published: November 2022

AbstractThe present initiative study has been planned to develop a conceptual model for watershed resilience for which rare documents have been reported yet, particularly in developing countries where such studies are necessary. In this vein, different ecological, social, economic, and infrastructural and cultural key domains were applied for the modeling processes of watershed resilience for the Shazand Watershed in Iran. To this end, watershed resilience was firstly conceptualized according to the prevailing conditions for three periods 1986–1998, 1999–2008, and 2009–2016. Accordingly, the watershed health index was used for the ecological dimension, and 13, 8, and 13 criteria were consequently considered for social, economic, and infrastructural and cultural dimensions, respectively. The whole data required for the last three dimensions were collected through the distribution of questionnaires among the stockholders of the Shazand Watershed. The principal component analysis (PCA) method was used to weighting and prioritize the criteria and dimensions. The overall resilience index was ultimately calculated by aggregating all four dimensions using a geometric mean. The effect of each dimension on resilience was also assessed by applying multivariable regression. According to the resilience map of the period 2009–2016, 40%, 9%, 34%, and 17% of the Shazand Watershed has been classified as very low and low resilience, moderate, high, and very high resilience. This study showed that the resilience of the Shazand Watershed has improved over time. The necessity of resilience modeling for practical and integrated management of watersheds was also confirmed during the present research.
Comparison of reflectance confocal microscopy and line‐field optical coherence tomography for the identification of keratinocyte skin tumours
Authors: Cinotti Elisa , Bertello Martina , Cartocci Alessandra , Fiorani Diletta , Tognetti Linda , Solmi Valentina , Cappilli Simone , Peris Ketty , Perrot Jean Luc , Suppa Mariano , Del Marmol Veronique , Rubegni Pietro 
Published: November 2022

AbstractBackgroundReflectance confocal microscopy (RCM) and line‐field confocal optical coherence tomography (LC‐OCT) are non‐invasive imaging devices that can help in the clinical diagnosis of actinic keratosis (AK) and cutaneous squamous cell carcinoma (SCC). No studies are available on the comparison between these two technologies for the identification of the different features of keratinocyte skin tumours.ObjectivesTo compare RCM and LC‐OCT findings in AK and SCC.MethodsA retrospective multicenter study was conducted. Tumours were imaged with RCM and LC‐OCT devices before surgery, and the diagnosis was confirmed by histological examinations. LC‐OCT and RCM criteria for AK/SCC were identified, and their presence/absence was evaluated in all study lesions. Gwet AC1 concordance index was calculated to compare RCM and LC‐OCT.ResultsWe included 52 patients with 33 AKs and 19 SCCs. Irregular epidermis was visible in most tumours and with a good degree of agreement between RCM and LC‐OCT (Gwet's AC1 0.74). Parakeratosis, dyskeratotic keratinocytes and both linear dilated and glomerular vessels were better visible at LC‐OCT than RCM (p < 0.001). Erosion/ulceration was identified with both methods in more than half of the cases with a good degree of agreement (Gwet AC1 0.62).ConclusionsOur results suggest that both LC‐OCT and hand‐held RCM can help clinicians in the identification of AK and SCC, providing an in vivo and non‐invasive identification of an irregular epidermis. LC‐OCT proved to be more effective in identifying parakeratosis, dyskeratotic keratinocytes and vessels in this series.
Infrastructure and intra‐regional trade in Africa
Authors: Tandrayen‐Ragoobur Verena , Ongono Patrice , Gong Jiong 
Published: November 2022

AbstractThis study examines the impact of infrastructural development on bilateral trade flows using a panel of 51 African countries from 2003 to 2015. An infrastructure‐augmented gravity model was estimated with different indicators of infrastructural development. Three aggregate indicators were computed namely: (i) a soft infrastructure index, (ii) a hard infrastructure measure, and (iii) an effective infrastructure index combining both soft and hard infrastructure components. The soft and hard infrastructure indices were constructed using the principal component analysis. Disaggregated hard infrastructural development indices for transport, information and communication technologies (ICT), and electricity were also used to assess their differential effects on intra‐African trade. By adopting the Pseudo Poisson Maximum Likelihood estimator with High Dimension Fixed Effects, the results confirm that both hard and soft infrastructures matter for trade in Africa. A disaggregation of the hard infrastructure index reveals that the electricity composite index has a greater impact on trade flows relative to transport and ICT infrastructures. Importantly, there is evidence that soft infrastructure matters most and complements hard infrastructure in the region. Targeted policies and resources should be channelled towards improving energy infrastructure and soft infrastructure in terms of streamlining trading rules and procedures to better propel and maximise the benefits of intra‐African trade.
Assessment of statistical methods for converting biochemical oxygen demand and carbonaceous biochemical oxygen demand to total organic carbon in wastewater
Authors: Brose Dominic A. , Pluth Thaís Bremm , Grunwald Paul , Jesernik Ashley 
Published: November 2022

AbstractThe 5‐day biochemical oxygen demand (BOD5) and carbonaceous BOD5 (CBOD5) tests are widely used parameters for monitoring wastewater. Total organic carbon (TOC) has many advantages over these tests. Wastewater utilities have conducted studies to modify National Pollutant Discharge Elimination System (NPDES) permits to allow TOC analysis; however, statistical methods vary across studies. This study examined parametric and nonparametric correlation and parametric, nonparametric, and nonlinear regression methods for analysing BOD5, CBOD5, and TOC concentrations collected for 1 year from seven wastewater treatment plants from the Metropolitan Water Reclamation District of Greater Chicago. Spearman ρ correlation and Theil–Sen regression on log‐transformed concentrations were the most appropriate methods. Correlation coefficients were 0.83 or greater and regression residuals were as small as or smaller than the other two methods. This study demonstrated that nonparametric methods performed best for analysing non‐normal data in seeking to incorporate TOC analysis into NPDES reporting.
Neuropathic arthropathy of the wrist revealing a syringomyelia
Authors: Masmoudi Karim , Feki Afef , Akrout Rim , Baklouti Sofien 
Published: November 2022

Syringomyelia is uncommonly revealed by a neuropathic arthropathy (Charcot joint) and characterised by its slow progression with late neurological symptoms. In this particular field, neuropathic arthropathies mainly affect the shoulders and the elbows.We report a new case of neuropathic arthropathy of the wrist caused by syringomyelia, because of the rarity of this condition as well as its uncommon location.Neuropathic arthropathy caused by syringomyelia is poorly published in the literature. This atypical entity should be considered in case of Charcot arthropathy associated with neurological loss, especially when it affects the upper limbs.
Predicting 60–4 visual field tests using 3D facial reconstruction
Authors: Jamali Dogahe Sepideh , Garmany Armin , Sadegh Mousavi Seyedmostafa , Khanna Cheryl L 
Published: November 2022

BackgroundDespite, the potential clinical utility of 60–4 visual fields, they are not frequently used in clinical practice partly, due to the purported impact of facial contour on field defects. The purpose of this study was to design and test an artificial intelligence-driven platform to predict facial structure-dependent visual field defects on 60–4 visual field tests.MethodsSubjects with no ocular pathology were included. Participants were subject to optical coherence tomography, 60–4 Swedish interactive thresholding algorithm visual field tests and photography. The predicted visual field was compared with observed 60–4 visual field results in subjects. Average and point-specific sensitivity, specificity, precision, negative predictive value, accuracy, and F1-scores were primary outcome measures.Results30 healthy were enrolled. Three-dimensional facial reconstruction using a convolution neural network (CNN) was able to predict facial contour-dependent 60–4 visual field defects in 30 subjects without ocular pathology. Overall model accuracy was 97%±3% and 96%±3% and the F1-score, dependent on precision and sensitivity, was 58%±19% and 55%±15% for the right eye and left eye, respectively. Spatial-dependent model performance was observed with increased sensitivity and precision within the far inferior nasal field reflected by an average F1-score of 76%±20% and 70%±29% for the right eye and left eye, respectively.ConclusionsThis pilot study reports the development of a CNN-enhanced platform capable of predicting 60–4 visual field defects in healthy controls based on facial contour. Further study with this platform may enhance understanding of the influence of facial contour on 60–4 visual field testing.
Optical coherence tomography angiography for the characterisation of retinal microvasculature alterations in pregnant patients with anaemia: a nested case‒control study
Authors: Wu Yuxuan , Wang Dongyu , Wu Xiaohang , Shen Lixia , Zhao Lanqin , Wang Wei , Xiao Hui , Wang Xun , Liu Lixue , Lin Zhenzhe , Yang Jingyuan , Lin Xiaohong , Yun Dongyuan , Iao Wai Cheng , Wu Yi , Xu Miaohong , Song Kexin , Xu Zemeihong , Huang Yihong , Shi Shaole , Zhang Mo , Zhou Junling , Yang Zhuofan , Wang Zilian , Lin Haotian 
Published: November 2022

AimsTo characterise retinal microvascular alterations in the eyes of pregnant patients with anaemia (PA) and to compare the alterations with those in healthy controls (HC) using optical coherence tomography angiography (OCTA).MethodsThis nested case‒control study included singleton PA and HC from the Eye Health in Pregnancy Study. Fovea avascular zone (FAZ) metrics, perfusion density (PD) in the superficial capillary plexus, deep capillary plexus and flow deficit (FD) density in the choriocapillaris (CC) were quantified using FIJI software. Linear regressions were conducted to evaluate the differences in OCTA metrics between PA and HC. Subgroup analyses were performed based on comparisons between PA diagnosed in the early or late trimester and HC.ResultsIn total, 99 eyes of 99 PA and 184 eyes of 184 HC were analysed. PA had a significantly reduced FAZ perimeter (βcoefficient=−0.310, p<0.001), area (βcoefficient=−0.121, p=0.001) and increased circularity (βcoefficient=0.037, p<0.001) compared with HC. Furthermore, higher PD in the central (βcoefficient=0.327, p=0.001) and outer (βcoefficient=0.349, p=0.007) regions were observed in PA. PA diagnosed in the first trimester had more extensive central FD (βcoefficient=4.199, p=0.003) in the CC, indicating impaired perfusion in the CC.ConclusionIt was found that anaemia during pregnancy was associated with macular microvascular abnormalities, which differed in PA as pregnancy progressed. The results suggest that quantitative OCTA metrics may be useful for risk evaluation before clinical diagnosis.Trial registration numbers2021KYPJ098 and ChiCTR2100049850.
Transform-Us! cluster RCT: 18-month and 30-month effects on children’s physical activity, sedentary time and cardiometabolic risk markers
Authors: Salmon Jo , Arundell Lauren , Cerin Ester , Ridgers Nicola Dawn , Hesketh Kylie D , Daly Robin M , Dunstan David , Brown Helen , Della Gatta Jacqui , Della Gatta Paul , Chinapaw Mai J M , Shepphard Lauren , Moodie Marj , Hume Clare , Brown Vicki , Ball Kylie , Crawford David 
Published: November 2022

ObjectiveTo test the efficacy of theTransform-Us!school- and home-based intervention on children’s physical activity (PA), sedentary behaviour (SB) and cardiometabolic risk factor profiles.MethodsA 30-month 2×2 factorial design cluster randomised controlled trial delivered in 20 primary schools (148 Year 3 classes) in Melbourne, Australia (2010–2012), that used pedagogical and environmental strategies to reduce and break up SB, promote PA or a combined approach, compared with usual practice. Primary outcomes (accelerometry data; n=348) were assessed at baseline, 18 and 30 months. Secondary outcomes included body mass index (BMI) and waist circumference (WC) (n=564), blood pressure (BP) (n=537) and biomarkers (minimum n=206). Generalised linear mixed models estimated the interactive effects of the PA and SB interventions on the outcomes. If there was no interaction, the main effects were assessed.ResultsAt 18 months, there were intervention effects on children’s weekday SB (−27 min, 95% CI: −47.3 to −5.3) for the PA intervention, and on children’s average day PA (5.5 min, 95% CI: 0.1 to 10.8) for the SB intervention. At 30 months, there was an intervention effect for children’s average day SB (−33.3 min, 95% CI: −50.6 and −16.0) for the SB intervention. Children’s BMI (PA and SB groups) and systolic BP (combined group) were lower, and diastolic BP (PA group) was higher. There were positive effects on WC at both time points (SB intervention) and mixed effects on blood parameters.ConclusionsTheTransform-Us!PA and SB interventions show promise as a pragmatic approach for reducing children’s SB and adiposity indicators; but achieving substantial increases in PA remains challenging.Trial registrationISRCTN83725066; ACTRN12609000715279.
Alcohol use and its associated factors among Ethiopian military personnel
Authors: Fida Alemu Tesfahun , Kaba M , Worku A 
Published: November 2022

BackgroundStudies indicate that alcohol use is more prevalent in the military and that such use is related to coping mechanisms for stress. Alcohol use could result in health and social problems. However, little is known about alcohol use in Ethiopian military personnel.ObjectiveTo assess the level of alcohol use and its associated factors in the Ethiopian military.MethodsA cross-sectional study including participants from the Ground and Air Forces of the Ethiopian National Defence Forces was conducted from February to June 2021. A representative sample of 502 military personnel from the two forces participated in the study. A structured questionnaire was developed to assess the individual level of alcohol use and its associated factors. The Alcohol Use Disorder Identification Test (AUDIT) was used to identify likely problematic alcohol use (AUDIT score ≥8). Hierarchical multivariable logistic regression models were run to identify associated factors with alcohol consumption.ResultsApproximately half of the respondents (49.8%, 95% CI 45.4% to 54.0%) were alcohol drinkers. Of the current alcohol users, 142 (63.1 %) were infrequent users; 60 (26.7 %) were moderate drinkers; and 23 (10.2 %) were heavy drinkers. Based on the AUDIT composite score, 71 (33.0%) of male participants were classified as having a score indicative of hazardous and harmful drinking and possible alcohol dependence behaviours. After adjusting for covariates, alcohol drinking was statistically significantly associated with higher odds of being: male, younger age, part of the Ground Force, smoker and high risk-taker.ConclusionsThis study provides an initial step to addressing patterns of harmful and hazardous alcohol use in the Ethiopian National Defence Forces. Findings indicate the need to integrate alcohol abuse prevention into existing health education and behaviour change efforts of the Ethiopian National Defence Forces.
Uric acid in advanced heart failure: relation to central haemodynamics and outcome
Authors: Deis Tania , Rossing Kasper , Ersbøll Mads Kristian , Wolsk Emil , Gustafsson Finn 
Published: November 2022

ObjectiveThe role of hyperuricaemia as a prognostic maker has been established in chronic heart failure (HF) but limited information on the association between plasma uric acid (UA) levels and central haemodynamic measurements is available.MethodsA retrospective study on patients with advanced HF referred for right heart catherisation. Regression analyses were constructed to investigate the association between UA and haemodynamic variables. Cox models were created to investigate if UA was a significant predictor of adverse outcome where log1.1(UA) was used to estimate the effect on outcome associated with a 10% increase in UA levels.ResultsA total of 228 patients were included (77% males, age 49±12 years, mean left ventricular ejection fraction (LVEF) of 17%±8%). Median UA was 0.48 (0.39–0.61) mmol/L. UA level was associated to pulmonary capillary wedge pressure (PCWP) and cardiac index (CI) in univariable (both p<0.001) and multivariable regression analysis (p<0.004 and p=0.025 for PCWP and CI). When constructing multivariable Cox models including PCWP, CI, central venous pressure, age, estimated glomerular filtration rate (eGFR), use of loop diuretics and LVEF, log1.1(UA) independently predicted the combined endpoint (left ventricular assist device, total artificial heart implantation, heart transplantation or all-cause mortality) (hazard ratio (HR): 1.10 (1.03–1.17), p=0.004) as well as all-cause mortality (HR: 1.15 (1.06–1.25), p=0.001).ConclusionsElevated UA is associated with greater haemodynamic impairment in advanced HF. In adjusted Cox models (age, eGFR, LVEF and haemodynamics), UA predicts the combined endpoint and all-cause mortality in long-term follow-up.
Haemostasis and fibrinolysis after regular high-intensity interval training in patients with coronary artery disease: a randomised controlled trial
Authors: Kristiansen Jacobina , Grove Erik Lerkevang , Sjúrðarson Tórur , Rasmussen Jan , Mohr Magni , Kristensen Steen Dalby , Hvas Anne-Mette 
Published: November 2022

IntroductionPatients with coronary artery disease (CAD) have prothrombotic changes compared with healthy individuals. Regular exercise reduces cardiovascular mortality in patients with stable CAD. However, the underlying mechanism for the beneficial effect is unknown. We investigated whether regular exercise would inhibit platelet aggregation and thrombin generation and increase fibrinolysis in patients with CAD.Materials and methodsPatients with CAD were randomised 1:1 to a supervised high-intensity exercise training programme or standard care for 12 weeks. Blood samples were obtained at baseline and after 6 and 12 weeks. Platelet aggregation was evaluated with the Multiplate Analyser, thrombin generation using the calibrated automated thrombogram and fibrinolysis employing a clot lysis assay.ResultsA total of 169 stable patients with CAD were randomised, and 142 patients (67±9 years, 83% males) completed the study; 64 in the exercise group and 78 in the standard care group. All but one patients received single antiplatelet therapy. From baseline to 12 weeks postintervention (Δ), no significant between-group differences were found in adenosine diphosphate-induced platelet aggregation (Δ−15 aggregation units (AU), AU×min, 95% CI −70 to 40 in the exercise group and Δ−26 AU×min, 95% CI −77 to 26 in the standard care group, p=0.44); endogenous thrombin potential (medians: Δ−5%, 95% CI −12 to 3 in the exercise group and Δ−6%, 95% CI −13 to 1 in the standard care group, p=0.26); nor in 50% clot lysis time (medians: Δ−9%, 95% CI −23 to 7 in the exercise group and Δ−17%, 95% CI −29 to −3 in the standard care group, p=0.60).ConclusionsTwelve weeks of high-intensity whole-body endurance exercise did not affect platelet aggregation, thrombin generation or fibrinolysis in patients with stable CAD.Trial registration numberNCT04268992.