Assessment Methods Research Articles

A Systematic Review of Simulation in Burn Care: Education, Assessment, and Management.

Assessment and management of burns require nuanced, timely interventions in high-stake settings, creating challenges for trainees. Simulation-based education has become increasingly popular in surgical and nonsurgical subspecialties to supplement training without compromising patient safety. This study aimed to systematically review the literature on existing burn management-related simulations. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles describing burn-specific surgical and nonsurgical simulation models were included. The model type, study description, simulated skills, assessment methods, fidelity, cost, and outcomes were collected. Of 3,472 articles, 31 met inclusion criteria. The majority of simulations were high-fidelity (n=17, 54.8%). Most were immersive (n=17, 54.8%) and used synthetic benchtop models (n=13, 41.9%), whereas none were augmented/virtual reality. Simulations of acute and early surgical intervention techniques (n=16, 51.6%) and burn wound assessments (n=15, 48.4%) were the most common, whereas burn reconstruction was the least common (n=3, 9.7%). Technical skills were taught more often (n=29, 93.5%) than non-technical skills (n=15, 48.4%). Subjective assessments (n=18, 58.1%) were used more often than objective assessments (n=23, 74.2%). Of the studies that reported costs, 91.7% (n=11) reported low costs. This review identified the need to expand burn simulator options, especially for burn reconstruction, and highlighted the paucity of animal, cadavers, and augmented/virtual reality models. Developing validated, accessible burn simulations to supplement training may improve education, patient safety, and outcomes.

Osteosarcopenia and Mortality in Older Adults Undergoing Transcatheter Aortic Valve Replacement.

Osteosarcopenia is an emerging geriatric syndrome characterized by age-related deterioration in muscle and bone. Despite the established relevance of frailty and sarcopenia among older adults undergoing transcatheter aortic valve replacement (TAVR), osteosarcopenia has yet to be investigated in this setting. To determine the association between osteosarcopenia and adverse outcomes following TAVR. This is a post hoc analysis of the Frailty in Aortic Valve Replacement (FRAILTY-AVR) prospective multicenter cohort study and McGill extension that enrolled patients aged 70 years or older undergoing TAVR from 2012 through 2022. FRAILTY-AVR was conducted at 14 centers in Canada, the United States, and France between 2012 and 2016, and patients at the McGill University-affiliated center in Montreal, Québec, Canada, were enrolled on an ongoing basis up to 2022. Osteosarcopenia as measured on computed tomography (CT) scans prior to TAVR. Clinically indicated CT scans acquired prior to TAVR were analyzed to quantify psoas muscle area (PMA) and vertebral bone density (VBD). Osteosarcopenia was defined as a combination of low PMA and low VBD according to published cutoffs. The primary outcome was 1-year all-cause mortality. Secondary outcomes were 30-day mortality, hospital length of stay, disposition, and worsening disability. Multivariable logistic regression was used to adjust for potential confounders. Of the 605 patients (271 [45%] female) in this study, 437 (72%) were octogenarian; the mean (SD) age was 82.6 (6.2) years. Mean (SD) PMA was 22.1 (4.5) cm2 in men and 15.4 (3.5) cm2 in women. Mean (SD) VBD was 104.8 (35.5) Hounsfield units (HU) in men and 98.8 (34.1) HU in women. Ninety-one patients (15%) met the criteria for osteosarcopenia and had higher rates of frailty, fractures, and malnutrition at baseline. One-year mortality was highest in patients with osteosarcopenia (29 patients [32%]) followed by those with low PMA alone (18 patients [14%]), low VBD alone (16 patients [11%]), and normal bone and muscle status (21 patients [9%]) (P < .001). Osteosarcopenia, but not low VBD or PMA alone, was independently associated with 1-year mortality (odds ratio [OR], 3.18; 95% CI, 1.54-6.57) and 1-year worsening disability (OR, 2.11; 95% CI, 1.19-3.74). The association persisted in sensitivity analyses adjusting for the Essential Frailty Toolset, Clinical Frailty Scale, and geriatric conditions such as malnutrition and disability. The findings suggest that osteosarcopenia detected using clinical CT scans could be used to identify frail patients with a 3-fold increase in 1-year mortality following TAVR. This opportunistic method for osteosarcopenia assessment could be used to improve risk prediction, support decision-making, and trigger rehabilitation interventions in older adults.

Uncertain pedestrian load modeling for structural vibration assessment in footbridge design

The request of material savings in bridge constructions leads to the development towards slender and lightweight structures, which are more sensitive to human-induced vibrations caused by walking pedestrians. The resulting accelerations do not endanger the structural safety, but can be perceived as unpleasant for the user and must therefore be restricted within the limit state of serviceability. For this purpose, the guidelines define acceleration intervals, called as “comfort levels” (CL), which evaluate the comfort of the pedestrians, given the maximum acceleration of the bridge. The model for human-induced loads in the design guideline is based on conservative and deterministic simplifications. In particular, the uncertainties in the human gait parameters are neglected. The main objective of this paper is to develop an uncertain load model for walking pedestrians based on Fourier series. The aleatory and epistemic uncertainties in the human gait parameters are quantified with appropriate uncertainty models relying on available data. In a dynamical finite element analysis, the model is used to simulate groups of pedestrians randomly walking over a bridge to calculate the resulting acceleration amplitudes. The approach is applied to a single span beam and to a real world footbridge using a 3D finite element model. The results are then evaluated within the CLs, enabling new assessment methods.

Comparison of multi-task ergonomic assessment methods for risk of upper extremity and low back musculoskeletal disorders

Work-related musculoskeletal disorder of upper extremity multi-task assessment methods (Revised Strain Index [RSI], Distal Upper Extremity Tool [DUET]) and manual handling multi-task assessment methods (Revised NIOSH Lifting Equation [RNLE], Lifting Fatigue Failure Tool [LiFFT]) were compared. RSI and DUET showed a strong correlation (rs = 0.933, p < 0.001) where increasing risk factor exposure resulted in increasing outputs for both methods. RSI and DUET demonstrated fair agreement (κ = 0.299) in how the two methods classified outputs into risk categories (high, moderate or low) when assessing the same tasks. The RNLE and LiFFT showed a strong correlation (rs = 0.903, p = 0.001) where increasing risk factor exposure resulted in increasing outputs, and moderate agreement (κ = 0.574) in classifying the outputs into risk categories (high, moderate or low) when assessing the same tasks. The multi-task assessment methods provide consistent output magnitude rankings in terms of increasing exposure, however some differences exist between how different methods classify the outputs into risk categories.

Translational risk-adapted approaches to de-escalated radiation for human papillomavirus-positive oropharyngeal cancer: Past, present, and future

Interest in the use of de-escalated radiation to treat patients with newly diagnosed human papillomavirus (HPV)-positive oropharyngeal cancer has grown dramatically with the publication of prospective trials demonstrating the efficacy of such an approach. While the rationale for de-escalation--- namely to decrease treatment-related toxicity while maintaining the excellent rates of disease control historically observed in patients with this disease—is inherently obvious, uncertainty exists regarding how to best select patients for de-escalation. Consequently, risk-adapted strategies using a variety of translational and clinical platforms have been increasingly popularized to better refine treatment. These have integrated contemporary methods of mid-treatment response assessment using advanced technologies and molecular assays to customize the radiation dose. By monitoring the response as patients actively proceed through treatment, risk-adapted protocols have the potential to provide insight into the biological behavior of tumors and make individualized therapy possible. The purpose of this review is to summarize the evidence to date on risk-adapted approaches to de-escalated radiation-- highlighting the clinical, radiological, and biological data which may ultimately help usher the principles of precision medicine into practice for patients with HPV-positive oropharyngeal cancer.

Non-Contact Blood Pressure Estimation from Radar Signals by a Stacked Deformable Convolution Network.

This study introduces a contactless blood pressure monitoring approach that combines conventional radar signal processing with novel deep learning architectures. During the preprocessing phase, datasets suitable for synchronization are created by integrating Kalman filtering, multiscale bandpass filters, and a periodic extraction method in the time domain. These data comprise data on chest micro variations, encapsulating a complex array of physiological and biomedical information reflective of cardiac micromotions. The Radar-based Stacked Deformable convolution Network (RSD-Net) integrates channel and spatial self attention mechanisms within a deformable convolutional framework to enhance feature extraction from radar signals. The network architecture systematically employs deformable convolutions for initial deep feature extraction from individual signals. Subsequently, continuous blood pressure estimation is conducted using self attention mechanisms on feature map from single source coupled with multi-feature map channel attention. The performance of model is corroborated via the open-source dataset procured using a non-invasive 24GHz six-port continuous wave radar system. The dataset, encompassing readings from 30 healthy individuals subjected to diverse conditions including rest, the Valsalva maneuver, apnea, and tilt-table examinations. It serves to substantiate the validity and resilience of the proposed method in the non-contact assessment of continuous blood pressure. Evaluation metrics reveal Pearson correlation coefficients of 0.838 for systolic and 0.797 for diastolic blood pressure predictions. The Mean Error (ME) and Standard Deviation (SD) for systolic and diastolic blood pressure measurements are -0.32 ±6.14mmHg and -0.20 ±5.50mmHg, respectively. The ablation study assesses the contribution of different structural components of the RSD-Net, validating their significance in the overall of model performance.

Identifying Core Issues for Basin Management: The Issue Generating Assessment (IGA) Methodology.

Effective stakeholder engagement is essential for basin management, requiring structured approaches to foster collaboration and consensus. This paper applies the Issue Generating Assessment (IGA) method, which identifies core issues for stakeholder discussion, to basin management. Focusing on the Israeli part of the Hadera Basin, we identify the core issues that should be discussed by stakeholders using the IGA method. To this end 39 participants across 14 sectors evaluating three generic basin management strategies were asked to qualitatively explain their evaluations. By analyzing these explanations utilizing the IGA method, four core issues emerged: (1) Managing uncertainty: addressing climate change and land use impacts on stream flow; (2) Mutual impacts management: handling interactions between the stream and its surroundings; (3) Integration of uses: balancing various stream utilization priorities; (4) Defining natural system functions: determining the role of natural systems. For each core issue, we proposed questions to guide stakeholder discussions. The IGA method is thus found to be useful, and has the potential to foster meaningful dialogue in structured stakeholder meetings, thereby focusing discussions and allowing understandings among stakeholders to be reached as a basis for basin management plans. Such early understandings may contribute to the development of strategies for sustainable basin management.

The largest European forest carbon sinks are in the Dinaric Alps old-growth forests: comparison of direct measurements and standardised approaches

BackgroundCarbon (C) sink and stock are among the most important ecosystem services provided by forests in climate change mitigation policies. In this context, old-growth forests constitute an essential reference point for the development of close-to-nature silviculture, including C management techniques. Despite their small extent in Europe, temperate old-growth forests are assumed to be among the most prominent in terms of biomass and C stored. However, monitoring and reporting of C stocks is still poorly understood. To better understand the C stock amount and distribution in temperate old-growth forests, we estimated the C stock of two old-growth stands in the Dinaric Alps applying different assessment methods, including direct and indirect approaches (e.g., field measurements and allometric equations vs. IPCC standard methods). This paper presents the quantification and the distribution of C across the five main forest C pools (i.e., aboveground, belowground, deadwood, litter and soil) in the study areas and the differences between the applied methods.ResultsWe report a very prominent C stock in both study areas (507 Mg C ha− 1), concentrated in a few large trees (36% of C in 5% of trees). Moreover, we found significant differences in C stock estimation between direct and indirect methods. Indeed, the latter tended to underestimate or overestimate depending on the pool considered.ConclusionsComparison of our results with previous studies and data collected in European forests highlights the prominence of temperate forests, among which the Dinaric Alps old-growth forests are the largest. These findings provide an important benchmark for the development of future approaches to the management of the European temperate forests. However, further and deeper research on C stock and fluxes in old-growth stands is of prime importance to understand the potential and limits of the climate mitigation role of forests.

Comparison of cardiac output estimates obtained from the Antares oscillometric pulse wave analysis algorithm and from Doppler transthoracic echocardiography.

In cardiology, cardiac output (CO) is an important parameter for assessing cardiac function. While invasive thermodilution procedures are the gold standard for CO assessment, transthoracic Doppler echocardiography (TTE) has become the established method for routine CO assessment in daily clinical practice. However, a demand persists for non-invasive approaches, including oscillometric pulse wave analysis (PWA), to enhance the accuracy of CO estimation, reduce complications associated with invasive procedures, and facilitate its application in non-intensive care settings. Here, we aimed to compare the TTE and oscillometric PWA algorithm Antares for a non-invasive estimation of CO. Non-invasive CO data obtained by two-dimensional TTE were compared with those from an oscillometric blood pressure device (custo med GmbH, Ottobrunn, Germany) using the integrated algorithm Antares (Redwave Medical GmbH, Jena, Germany). In total, 59 patients undergoing elective cardiac catheterization for clinical reasons (71±10 years old, 76% males) were included. Agreement between both CO measures were assessed by Bland-Altman analysis, Student's t-test, and Pearson correlations. The mean difference in CO was 0.04 ± 1.03 l/min (95% confidence interval for the mean difference: -0.23 to 0.30 l/min) for the overall group, with lower and upper limits of agreement at -1.98 and 2.05 l/min, respectively. There was no statistically significant difference in means between both CO measures (P = 0.785). Statistically significant correlations between TTE and Antares CO were observed in the entire cohort (r = 0.705, P<0.001) as well as in female (r = 0.802, P<0.001) and male patients (r = 0.669, P<0.001). The oscillometric PWA algorithm Antares and established TTE for a non-invasive estimation of CO are highly correlated in male and female patients, with no statistically significant difference between both approaches. Future validation studies of the Antares CO are necessary before a clinical application can be considered.

Semi-TSGAN: Semi-Supervised Learning for Highlight Removal Based on Teacher-Student Generative Adversarial Network

Despite recent notable advancements in highlight image restoration techniques, the dearth of annotated data and the lightweight deployment of highlight removal networks pose significant impediments to further advancements in the field. In this paper, to the best of our knowledge, we first propose a semi-supervised learning paradigm for highlight removal, merging the fusion version of a teacher–student model and a generative adversarial network, featuring a lightweight network architecture. Initially, we establish a dependable repository to house optimal predictions as pseudo ground truth through empirical analyses guided by the most reliable No-Reference Image Quality Assessment (NR-IQA) method. This method serves to assess rigorously the quality of model predictions. Subsequently, addressing concerns regarding confirmation bias, we integrate contrastive regularization into the framework to curtail the risk of overfitting on inaccurate labels. Finally, we introduce a comprehensive feature aggregation module and an extensive attention mechanism within the generative network, considering a balance between network performance and computational efficiency. Our experimental evaluations encompass comprehensive assessments on both full-reference and non-reference highlight benchmarks. The results demonstrate conclusively the substantive quantitative and qualitative enhancements achieved by our proposed algorithm in comparison to state-of-the-art methodologies.

G2NPAN: GAN-guided nuance perceptual attention network for multimodal medical fusion image quality assessment

Multimodal medical fusion images (MMFI) are formed by fusing medical images of two or more modalities with the aim of displaying as much valuable information as possible in a single image. However, due to the different strategies of various fusion algorithms, the quality of the generated fused images is uneven. Thus, an effective blind image quality assessment (BIQA) method is urgently required. The challenge of MMFI quality assessment is to enable the network to perceive the nuances between fused images of different qualities, and the key point for the success of BIQA is the availability of valid reference information. To this end, this work proposes a generative adversarial network (GAN) -guided nuance perceptual attention network (G2NPAN) to implement BIQA for MMFI. Specifically, we achieve the blind evaluation style via the design of a GAN and develop a Unique Feature Warehouse module to learn the effective features of fused images from the pixel level. The redesigned loss function guides the network to perceive the image quality. In the end, the class activation mapping supervised quality assessment network is employed to obtain the MMFI quality score. Extensive experiments and validation have been conducted in a database of medical fusion images, and the proposed method is superior to the state-of-the-art BIQA method.

Study on the Environmental Impact and Benefits of Incorporating Humus Composites in Anaerobic Co-Digestion Treatment

This study evaluated the environmental impact and overall benefits of incorporating humus composites in the anaerobic co-digestion of kitchen waste and residual sludge. The life cycle assessment method was used to quantitatively analyze the environmental impact of the entire anaerobic co-digestion treatment process of waste, including garbage collection, transportation, and final product utilization. Moreover, the comprehensive assessment of the environmental impact, energy-saving and emission-reduction abilities, and economic cost of using humus composites in the anaerobic co-digestion treatment process was conducted using a benefit analysis method. The results showed that the anaerobic co-digestion of kitchen waste and residual sludge significantly contributed to the mitigation of global warming potential (GWP), reaching −19.76 kgCO2-eq, but had the least impact on the mitigation of acidification potential (AP), reaching −0.10 kgSO2-eq. In addition, the addition of humus composites significantly increased the production of biogas. At a concentration of 5 g/L, the biogas yield of the anaerobic co-digestion process was 70.76 m3, which increased by 50.62% compared with the blank group. This amount of biogas replaces ~50.52 kg of standard coal, reducing CO2 emissions by 13.74 kg compared with burning the same amount of standard coal. Therefore, the anaerobic co-digestion treatment of kitchen waste and residual sludge brings considerable environmental benefits.

Optimization of photon counting CT for cardiac imaging in patients with left ventricular assist devices: An in-depth assessment of metal artifacts.

Photon counting CT (PCCT) holds promise for mitigating metal artifacts and can produce virtual mono-energetic images (VMI), while maintaining temporal resolution, making it a valuable tool for characterizing the heart. This study aimed to evaluate and optimize PCCT for cardiac imaging in patients during left ventricular assistance device (LVAD) therapy by conducting an in-depth objective assessment of metal artifacts and visual grading. Various scan and reconstruction settings were tested on a phantom and further evaluated on a patient acquisition to identify the optimal protocol settings. The phantom comprised an empty thoracic cavity, supplemented with heart and lungs from a cadaveric lamb. The heart was implanted with an LVAD (HeartMate 3) and iodine contrast. Scans were performed on a PCCT (NAEOTOM Alpha, Siemens Healthcare). Metal artifacts were assessed by three objective methods: Hounsfield units (HU)/SD measurements (DiffHU and SDARTIFACT), Fourier analysis (AmplitudeLowFreq), and depicted LVAD volume in the images (BloomVol). Radiologists graded metal artifacts and the diagnostic interpretability in the LVAD lumen, cardiac tissue, lung tissue, and spinal cord using a 5-point rating scale. Regression and correlation analysis were conducted to determine the assessment method most closely associated with acquisition and reconstruction parameters, as well as the objective method demonstrating the highest correlation with visual grading. Due to blooming artifacts, the LVAD volume fluctuated between 27.0 and 92.7 cm3. This variance was primarily influenced by kVp, kernel, keV, and iMAR (R2=0.989). Radiologists favored pacemaker iMAR, 3mm slice thickness, and T3D keV and kernel Bv56f for minimal metal artifacts in cardiac tissue assessment, and 110keV and Qr40f for lung tissue interpretation. The model adequacy for DiffHU SDARTIFACT, AmplitueLowFreq, and BloomVol was 0.28, 0.76, 0.29, and 0.99 respectively for phantom data, and 0.95, 0.98, 1.00, and 0.99 for in-vivo data. For in-vivo data, the correlation between visual grading (VGSUM) and DiffHU SDARTIFACT, AmplitueLowFreq, and BloomVol was -0.16, -0.01, -0.48, and -0.40 respectively. We found that optimal scan settings for LVAD imaging involved using 120 kVp and IQ level 80. Employing T3D with pacemaker iMAR, the sharpest allowed vascular kernel (Bv56f), and VMI at 110keV with kernel Qr40 yields images suitable for cardiac imaging during LVAD-therapy. Volumetric measurements of the LVAD for determination of the extent of blooming artifacts was shown to be the best objective method to assess metal artifacts.

Not All Frailty Assessments Are Created Equal: Comparability of Electronic Health Data-Based Frailty Assessments in Assessing Older People in Residential Care.

Objectives: To evaluate the comparability of frailty assessment tools - the electronic frailty index (eFI), retrospective electronic frailty index (reFI), and clinical frailty scale (CFS) - in older residents of care facilities. Methods: Data from 813 individuals aged 65 or older, with frailty and co-morbidities, collected between 2022 and 2023, were analysed using various statistical methods. Results: The results showed significant differences in frailty classification among the tools: 78.3% were identified as moderately to severely frail by eFI, 59.6% by reFI, and 92.1% by CFS. Statistical tests confirmed significant differences (p < .05) in their assessments, indicating variability in measurement methods. Discussion: This study advances the understanding of frailty assessment within aged-care settings, highlighting the differences in the efficacy of these assessment tools. It underscores the challenges in frailty assessments and emphasizes the need for continuous refinement of assessment methods to address the diverse facets of frailty in aged care.

An exergy-ecology assessment method and its application for basic building heating schemes

ABSTRACT Building heating is the main type of heating consumption in China. At present, there is a lack of attention given to the assessment of ecological cost or impact considering energy depreciation for various heating schemes. In this work, a method of exergy-ecology assessment is proposed to evaluate the energy and ecological characteristics of four basic building heating schemes. The solar-equivalent joule was adopted as the unified quantitative value of ecological impact by converting exergy, material, and cost flows. The exergy-ecology balance was established for each scheme, and a series of indexes were proposed and calculated through two strategies. The results show that the objective exergy efficiency of Scheme 3 heat pump is the highest (53.87%) and that of Scheme 2 electric heater is the lowest (17.58%). Larger difference of energy grade between energy providing side (0.83 for gas fuel and 1 for electricity) and receiving side (0.18 for output water) connects with lower exergy efficiency. Scheme 3 heat pump has the highest eco-exergy efficiency under both assessment strategies (71.89% and 53.86%), followed by Schemes 4 solar collector (61.52% and 36.34%). This method proves that the thermodynamics perfectness of system is positively correlated with ecological sustainability and can be used to assess other energy systems.

Quantitative risk assessment of gas leakage and explosion in open kitchens and partitioned kitchens

ABSTRACT In recent years, natural gas companies have faced more and more gas supply applications for open kitchens in China. However, natural gas cannot be utilized in open kitchens according to the current compulsory regulations. The numerical models for three typical open kitchen layouts and the corresponding partition kitchen layouts were developed, respectively. The experimental setup of gas leakage and explosion, like a residential kitchen, was established based on the similarity theory. The accuracy and reliability of numerical models have been validated by three sets of experiments. An innovative quantitative risk assessment method was proposed to quantify the integrated risks for the open kitchen layout and the partition kitchen layout. The effectiveness of the proposed risk reduction measures was assessed using a modified LOPA (i.e. Layer Of Protection Analysis). The results show that the integrated risk for the open kitchen layout in different apartments is 1.37 ~ 4.65 times than that for the partition kitchen layouts. The integrated risk of gas leakage explosion in three open kitchen layout arrangements was reduced by 94.8%, 50%, and 94.5%, respectively, by setting two layers of protection. Meanwhile, the increased expense of ¥400 can be generally acceptable for the majority of residential users. The achievements could provide theoretical and technological guidance for gas safety supply in open kitchens.

Evaluating student performance assessment methods in Objective Structured Clinical Exam: perspectives and comparisons.

This study aims to evaluate how student performance and perspectives changed when the Objective Structured Clinical Exam (OSCE) assessment system was changed from a composite score to discipline-specific grading at the Harvard School of Dental Medicine. The retrospective study population consisted of all students (n=349) who completed three OSCEs (OSCE 1, 2, and 3) as part of the predoctoral program during the years 2014-2023. Data on the students' OSCE scores were obtained from the Office of Dental Education, and data on students' race/ethnicity and gender were obtained from their admissions data. The likelihood of a student failing the OSCE after the assessment system change significantly increased with an adjusted odds ratio of 20.12. After the change, the number of failed subjects per student decreased with an adjusted mean ratio of 0.48. Students perceived the OSCE as being less useful after the change. Independent of the grading change, OSCEs 1 and 2 were seen as more useful compared to OSCE 3, which is administered in the last year of the Doctor of Dental Medicine program. The discipline-specific nature of the new assessment system helps focus on specific areas of remediation, rather than blanket remediation used previously, in order to isolate the actual areas of deficiency and to focus remediation efforts so that students can align their learning needs appropriately.Therefore, although the actual number of fails identified increased for the course, the assessment change has allowed for more directed, actionable information to be gained from the OSCE to prepare students to work toward competency standards.

Challenges and Opportunities for School-Based Teacher Training in Zanzibar

This research delves into the Challenges and Opportunities for School-Based Teacher Training in Zanzibar, employing a comprehensive mixed-methods approach. The study engages both quantitative and qualitative methodologies, incorporating questionnaires and interviews to gather insights from 110 participants. The sample comprises teachers actively participating in the program, head teachers, and program facilitators, selected through random and purposive sampling methods. Utilizing interviews for head teachers and facilitators, and questionnaires for teachers, the data collection process was meticulous. The quantitative data underwent analysis through statistical software, while qualitative analysis deciphered insights from the interviews. The results underscore overwhelmingly positive perceptions regarding the program's impact, as 95.6% of respondents expressed strong support. Significantly, 51.1% highlighted the imperative to prioritize teaching methodology and assessment methods, while 45.5% advocated for the integration of ICT into teaching practices. However, the research also unveiled challenges faced by the program, including financial constraints, inadequate teaching aids and equipment, and deficiencies in facilitator skills. The study puts forth actionable recommendations, emphasizing the necessity for needs-based training programs, continuous development for facilitators, and augmented budget allocation for materials, technology, and participant allowances. These improvements aim to fortify the efficacy and sustainability of school-based teacher training programs in Zanzibar.

Studying eruption patterns of mandibular third molars for forensic age assessment: Introducing current reference data from a population of black South Africans.

Evaluation of the eruption of mandibular third molars in orthopantomograms (OPGs) is a method of forensic age assessment. The objective of our study was to provide valid reference data for this trait within a population of black South Africans. The study was guided by the criteria for reference studies in age assessment. A study population from Pretoria, South Africa comprising 670 OPGs obtained from 338 black females and 332 black males aged between 15.00 and 25.97 years was analysed. All OPGs were performed for medical indication during the period from 2011 to 2022 and were retrospectively evaluated. From the 670 OPGs, a total of 1021 mandibular third molars were evaluated. The assessment of mandibular third molars was conducted using the staging scale presented by Olze et al. in 2012. Two experienced dentists evaluated the OPGs independently of each other. If the two examiners diverged in their assessments, a consensus stage was assigned. As expected, the mean, median and minimal age increased with higher stages for both teeth and both sexes. The minimum age recorded for stage D, indicating complete tooth eruption, was 15.79 years in females and 16.62 years in males. As it is the case for previous reference studies in other countries, placing exclusive reliance on the evaluation of mandibular third molar eruption is inadequate for ascertaining the age of majority among Black South Africans. Future studies need to examine if our results are transferable to other countries in Sub-Saharan Africa.

Deep Learning Method for Precise Landmark Identification and Structural Assessment of Whole-Spine Radiographs

Deep Learning Method for Precise Landmark Identification and Structural Assessment of Whole-Spine Radiographs