Representative Cross Research Articles

Quantification of bedload transport in the Hungarian Danube using multiple analysis methods

While bedload transport is crucial to river morphodynamics, quantifying it in large rivers, such as the Danube, poses significant challenges. The current study focuses on the gravel-dominated section of the Danube River in Hungary, where multiple methods have been concurrently applied to evaluate bedload transport. In a representative cross section of the river, the following methods were applied: (i) point-wise direct physical sampling using a BfG-type pressure difference sampler, quality controlled with a video camera mounted on the sampler; (ii) indirect acoustic-based analysis with an Acoustic Doppler Current Profiler (ADCP), evaluating the Bottom Tracking signal; and (iii) indirect acoustic and imaging-based method utilizing Acoustic Mapping Velocimetry (AMV). The ADCP method is calibrated using results from the physical sampling, while the AMV method relies on bedform tracking and is entirely independent from the two other techniques. The results from a series of measurement campaigns, covering a wide range of flow regimes, suggest a robust bedload rating curve for the study section, enabling the estimation of bedload yields and its relation to morphological changes. In addition, the applicability conditions of the implemented methods are discussed.

Drivers of intention to engage in informal economy activities during maternity leave

PurposeThe present paper seeks to reveal the factors underlying the intentions of women on maternity leave to engage in informal economy activities.Design/methodology/approachA representative cross sectional survey of 417 women on maternity leave was selected as a main research approach. A structural equation modelling – partial equation modelling served as a research tool.FindingsThe study revealed that the most important determinants of intentions to become involved in informal economy activities during maternity leave are unsatisfactory financial situation, complicated legal regulation and fear of becoming uncompetitive in the labour market.Originality/valueTo the best of authors’ knowledge, it is the first scientific attempt to investigate the informal work/economy during maternal leave.

In‐vivo evaluation of corneal collagen fibrils pattern to detect Keratoconus

Aims/Purpose: The corneal stroma, is formed by fibrous connective tissue containing collagen fibrils that are super‐organized in lamellae. In keratoconus (KC), intra‐lamellar and inter‐lamellar disrupted organization causes a progressive thinning and corneal ectasia. The LUMAXIS is a new medical device specifically designed to evaluate the effects of the interaction between polarized light and corneal stroma. It identifies the orientation of collagen fibrils in the cornea, highlighting ultrastructural changes of the tissue. The purpose of this study was to employ the LUMAXIS to discriminate changes in the pattern of corneal collagen fibrils to detect keratoconus.Methods: Patients with KC and controls were included in this prospective study. Corneal tomography (Pentacam) was acquired as well as polarimetric interferometry (LUMAXIS, Phronema S.r.l., Bari, Italy). Custom software was developed to improve the visualization of the representative cross by extracting the histogram equalized luminance to provide a numerical outcome. We then fit a set of ellipses to the image in a semi‐automatic approach, aiming to capture the boundaries of the iris, pupil, each four quadrants of the cross, and eyelids. Combining this information, we are able to obtain a cross parameter. A correlation between cross outcome and Kmax was calculated.Results: A total of sixty eyes of sixty patients were included: 30 healthy subjects (including 60 eyes, mean age of 38.0 ± 13.2 years) and 30 patients with KC (60 eyes, mean age of 39.2 ± 12.9 years). Maximum keratometry value were 59.4 ± 11.2 D in the KC group and 45.3 ± 0.8 D in the healthy group. The cross parameter was 0.41 ± 0.028 in the KC group and 0.24 ± 0.055 in the healthy group. Using only measures taken from the cross resulting from the Lumaxis scan, we were able to distinguish between KC and healthy eyes.Conclusions: The interferometric analysis of diffractive and polarizing effects related to the birefringent properties provides new morphological information at corneal fibrils level. A different corneal pattern of corneal collagen fibrils can be recognized in keratoconus patients compared to healthy patients.

An extreme model of fertility in sheep demonstrates the basis of controversies surrounding antral follicle count and circulating concentrations of anti-Müllerian hormone as predictors of fertility in ruminants

Ovarian ultrasonography and measurement of circulating concentrations of anti-Müllerian hormone (AMH) have been used to estimate follicle number and predict fertility in mammalian females, but no study has evaluated follicle number and circulating concentrations of AMH in ewes known to differ in fertility. We tested the hypothesis that ewes that had failed to lamb (BARREN) in four consecutive annual breeding seasons of 21–35 d have fewer follicles and diminished circulating concentrations of AMH compared to closely matched ewes that consistently produced lambs (FERTILE) under the same breeding protocols. Once identified, BARREN ewes (n = 19) were paired by breed and sire to a FERTILE control ewe (n = 19) and reproductive tracts were recovered at necropsy. Visible antral follicles in both ovaries were counted and a representative cross section of one ovary was embedded for histological evaluation of pre-antral follicle numbers. Paired t-tests indicated that BARREN ewes had fewer antral follicles, fewer primordial follicles, and decreased circulating concentrations of AMH compared to FERTILE ewes (P ≤ 0.01), but there were ewes in each fertility classification that had ovarian phenotypes like the opposite fertility classification. The best technologies we have currently for estimating follicle numbers are ultrasonography and measurement of circulating concentrations of AMH, but no single technique is perfect for predicting fertility. A better understanding of the under-lying biological mechanisms linking AMH, folliculogenesis, and fertility is required to improve the use of measurements of follicle number for predicting fertility in livestock.

Representative deflection angle for the single-deflection method of direct simulation Monte Carlo.

The total cross sectionof binary collision is, in general, unbounded due to the long-range interations of molecules. It is conventional to truncate the small angle deflections of collisions. The present work suggests an alternative way of avoiding the difficulty of unboundedness. We employ the mean value theorem of definite integral over the deflection angle for the cross section. A series of numerical experiments were carried out to look for the representative collision cross sectionthrough which the single-angle simulation is amenable to the solution of the Boltzmann equation. Results show that the cross sectionshould be 〈Σ〉=Σ_{D}^{2}/(2Σ_{D}-Σ_{μ}), and the representative deflection for the single-angle simulation be cos〈χ〉=Σ_{μ}/Σ_{D}-1, where Σ_{D} is the diffusion cross sectionand Σ_{μ} is the viscosity cross section. The single-angle computations for the inverse power law and the Lennard-Jones force law perfectly reproduce the conventional scattering algorithms for one-dimensional (1D) simulations of transport coefficients and 1D shock thickness. The computation costs for Lennard-Jones molecules are comparable to the costs for inverse power-law models.

Evaluating the efficacy of alternative small scale test methodologies in deriving the mechanical properties of additive manufactured materials

With the continuous drive of the aerospace industry to implement additive manufactured (AM) components into the next generation of aero-engines, to benefit from the near net shape and weight saving potential that the technology has to offer, the requirement to understand their mechanical performance is also rising in parallel. This is further complicated by the highly localised and transient micro/macro structures that AM produced parts typically possess, raising a question mark over the suitability of more traditional mechanical test approaches where the bulk properties are heavily influenced by the presence of a single defect. As such, alternative experimental approaches, capable of establishing the properties of smaller more intricate structures and geometrically representative microstructures and cross sections, needs to be considered for process parameter down-selection. This paper will explore the suitability of several alternative mechanical test methodologies in characterising the mechanical behaviour of a nickel based superalloy, Inconel 718 (IN718), produced by laser powder bed fusion (LPBF), and establish which results correlate most favourably to those generated through more conventional means. For the first time, results will be presented from several mechanical test methodologies including small punch, shear punch, hardness, nano-indentation and profilometry based indentation plastometry experiments; a set of mechanical test approaches that have yet to be directly compared and discussed in a single study on an additively manufactured material. Findings will be supported by advanced microscopy in the form of field emission SEM and crystallographic texture maps produced through electron back-scattered diffraction.

Predicting the Early-Age Time-Dependent Behaviors of a Prestressed Concrete Beam by Using Physics-Informed Neural Network.

This paper proposes a physics-informed neural network (PINN) for predicting the early-age time-dependent behaviors of prestressed concrete beams. The PINN utilizes deep neural networks to learn the time-dependent coupling among the effective prestress force and the several factors that affect the time-dependent behavior of the beam, such as concrete creep and shrinkage, tendon relaxation, and changes in concrete elastic modulus. Unlike traditional numerical algorithms such as the finite difference method, the PINN directly solves the integro-differential equation without the need for discretization, offering an efficient and accurate solution. Considering the trade-off between solution accuracy and the computing cost, optimal hyperparameter combinations are determined for the PINN. The proposed PINN is verified through the comparison to the numerical results from the finite difference method for two representative cross sections of PSC beams.

Socio-demographic and environmental determinants of under-five child mortality in Ethiopia: using Ethiopian demographic and Health 2019 survey

BackgroundThe under-five mortality rate is a reliable indicator of a country’s general level of development and the wellbeing of its children. Life expectancy is a good indicator of a population’s standard of living.ObjectivesTo identify Socio-demographic and Environmental determinants of under-five child mortality in Ethiopia.MethodsA national representative cross sectional study and a quantitative study were conducted among 5753 households selected based on 2019 Mini-Ethiopian Demographic and Health Survey (EDHS-2019) data. The analysis was done using STATA version 14 statistical software. Bivariate and multivariate analyses were used. To assess the determinants of under-five child mortality in multivariate analysis, p values less than 0.05 were considered statistically significant, and odds ratios with 95% CI (confidence interval) were used.ResultsA total of 5,753 children were included in the study. Sex of the head of the household being female (AOR = 2:350, 95% CI: 1.310, 4.215), the U5CM for being their mother were currently married (AOR = 2:094, 95% CI: 1.076, 4.072), The odds of U5CM was less by 80% (AOR = 1.797, 95% CI: 1.159–2.782) with the number of under-five children at the household born 2-4th order as compared to those children born on the first order. For the mothers visit anti natal care four and above visit (AOR = 1:803, 95% CI: 1.032, 3.149), for the way of delivery (AOR = 0:478, 95% CI: 0.233, 0.982).ConclusionMultivariate logistic analysis reflected that way of delivery, mothers had being currently marred, sex of the head of the household and number of antenatal care visit were found to be significant predictors of under-five child mortality. So, government policy, nongovernmental organizations, and all concerned bodies should be focused on the major determinants of under-five child mortality and put in a lot more effort to reduce under-five child mortality.

Interplay between Crystal Structure and Optical Response in Plateau–Rayleigh Zn2GeO4/SnO2 Heterostructures

Hybrid semiconductor nanowire (NW) heterostructures are an ideal playground for cutting‐edge optoelectronic nanodevices. Among the several synthesis methods, Plateau–Rayleigh (PR) crystal growth is an effective route for producing decorated NWs with unprecedented properties. However, lateral variations in composition and/or crystal structure are postulated to play a central role in their optical response, but it is difficult to probe correlatively the elemental order, atomic organization, and light emission on length scales of tens to hundreds of nanometers. Usually, electron microscopies are applied to address the formation of clusters and imperfections in representative cross sections of the samples. Herein, a simultaneous spatially resolved nano‐analysis of the crystal symmetry, chemical composition, and optical properties of a whole Zn2GeO4/SnO2 NW heterostructure produced by PR instability is provided. The observations show the connection among Zn impurities, secondary phases, and asymmetrically distributed UV emissions present in the crystallites decorating the NW (Zn‐doped Sn1−xGexO2). The contributions of the elemental diffusion, crystal domains, and atomic site configurations to the light‐emission phenomena are disentangled in these hybrid architectures. The findings elucidate unknown underlying mechanisms that are critical to tailor emergent properties for rationally designing novel complex nanodevices based on 1D materials.

Determinants of Covid-19 vaccination: Evidence from the US pulse survey.

The Covid-19 disease is resurging across the United States and vaccine hesitancy remains a major obstacle to reaching the expected threshold for herd immunity. Using the nationally representative cross sectional Household Pulse Survey (HPS) Data published by the U.S. Census Bureau, this study identified demographic, socio-economic, and medical-psychological determinants of Covid-19 vaccination. Results revealed significant differences in Covid-19 vaccine uptake due to age, sex, sexual orientation, race or ethnicity, marital status, education, income, employment form, housing and living condition, physical illness, mental illness, Covid-19 illness, distrust of vaccines and beliefs about the efficacy of vaccines. Government policymakers need to be cognizant of these determinants of vaccine hesitancy when formulating policies to increase vaccine uptake and control the COVID-19 pandemic. The findings of this study suggest that segmented solutions to reach vulnerable groups like racial minorities and homeless people are needed to win the trust and optimize vaccine uptake.

Metabolically Active Zones Involving Fatty Acid Elongation Delineated by DESI-MSI Correlate with Pathological and Prognostic Features of Colorectal Cancer.

Colorectal cancer (CRC) is the second leading cause of cancer deaths. Despite recent advances, five-year survival rates remain largely unchanged. Desorption electrospray ionization mass spectrometry imaging (DESI) is an emerging nondestructive metabolomics-based method that retains the spatial orientation of small-molecule profiles on tissue sections, which may be validated by 'gold standard' histopathology. In this study, CRC samples were analyzed by DESI from 10 patients undergoing surgery at Kingston Health Sciences Center. The spatial correlation of the mass spectral profiles was compared with histopathological annotations and prognostic biomarkers. Fresh frozen sections of representative colorectal cross sections and simulated endoscopic biopsy samples containing tumour and non-neoplastic mucosa for each patient were generated and analyzed by DESI in a blinded fashion. Sections were then hematoxylin and eosin (H and E) stained, annotated by two independent pathologists, and analyzed. Using PCA/LDA-based models, DESI profiles of the cross sections and biopsies achieved 97% and 75% accuracies in identifying the presence of adenocarcinoma, using leave-one-patient-out cross validation. Among the m/z ratios exhibiting the greatest differential abundance in adenocarcinoma were a series of eight long-chain or very-long-chain fatty acids, consistent with molecular and targeted metabolomics indicators of de novo lipogenesis in CRC tissue. Sample stratification based on the presence of lympovascular invasion (LVI), a poor CRC prognostic indicator, revealed the abundance of oxidized phospholipids, suggestive of pro-apoptotic mechanisms, was increased in LVI-negative compared to LVI-positive patients. This study provides evidence of the potential clinical utility of spatially-resolved DESI profiles to enhance the information available to clinicians for CRC diagnosis and prognosis.

Deep-Seated Gravitational Slope Deformations in Molise region (Italy): novel inventory and main geomorphological features

ABSTRACT This paper focuses on Deep-Seated Gravitational Slope Deformations (DSGSDs) identified in the Molise region (Italy), along the central-southern sector of the Apennines chain. These phenomena were detected and mapped through a combination of aerial-photo interpretation, morphological analyses, and field surveys, integrated through satellite SAR interferometry (InSAR). The obtained general map is organized in different sections: inventory map with identification of DSGSDs and main geological and orographic features, geostructural scheme, representative cross sections, list and characteristics of DSGSDs, geomorphometric maps, landslides map, and seismotectonic setting. This study allowed us to realize a complete inventory of DSGSDs in the Molise region and define the main characteristics of each phenomenon. Through this research, it was possible to establish a general correlation between the analyzed deformations and the geological and geomorphological setting of the region as well as with its geodynamic context.

Abstract C127: Mental health and quality of care levels associated with race and socioeconomic status among cancer patients

Abstract Mental health and quality of cancer care are factors that significantly impact a cancer patient’s health outcomes. It is imperative that all patients, regardless of race or socio-economic status (SES), have equitable opportunities for optimal cancer survival. Recent reports suggest, African American (AA) cancer patients have the highest cancer mortality rates and lowest survival rates of any racial and ethnic group in the United States (U.S.). (cite) These alarming statistics, attributed in part to disparities in healthcare, can be linked to individual level stressors, modifiable risk factors, and structural characteristics of the health system. Recent studies suggest, AA’s and individuals of low SES in the U.S., are more likely to suffer disproportionately from social determinants of health (SDOH) that may contribute to chronic stress over the lifespan. Chronic stress is shown to have a negative impact on the mental health of a patient which can potentially contribute to progression of disease and effectiveness of cancer treatments. Quality of cancer care may even contribute to lower or higher rates of cancer patient stress. The complex interplay of mental health and quality of cancer care with race and SES can have a significant impact on the health outcomes of cancer patients. Methods Data for this study will be obtained from the National Cancer Institute’s Health Informational National Trends Survey (HINTS 5, CYCLE 4), a nationally representative cross sectional survey of American adults using telephone and postal mail. Secondary analysis of the dataset will be conducted using respondents. Participant characteristics and behaviors will be examined using weighted descriptive statistics. Bivariate chi square analyses will be conducted to examine the association between each independent variable (gender, race/ethnicity, age, level of education, level of income, and can afford treatment without it effecting finances) and the dependent variable as stress and distress scores and quality of care Multivariable logistic regression analyses will be used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (95% Cis) to determine whether race and socioeconomic status factors affect stress, distress scores, and quality of care. Results We will report findings relative to African American cancer patients of the same socio-economic status as White cancer patients and the association with lower quality of care and higher stress scores. Additional we will present findings relative to the association of African American cancer patients of lower socio-economic status with have higher stress scores and lower quality of care than African Americans of higher socio-economic status. Lastly, we will present data on the association of financial toxicity, race, SES, and stress score and quality of cancer care. Conclusion It is anticipated the findings from this study will inform future intervention strategies to address social determinants of health in clinical and non-clinical settings. Citation Format: Jamirah Y. Chevrin, Brian Rivers. Mental health and quality of care levels associated with race and socioeconomic status among cancer patients [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C127.

Parent's food literacy and adolescents nutrition literacy influence household's food security and adolescent's malnutrition and anemia: Findings from a national representative cross sectional study.

Food and nutrition literacy are widely fundamental to improve the food security and reduce the double burden of malnutrition and iron deficiency in low- and middle-income countries. This study aimed (1) to assess the nutrition literacy (NL) of Lebanese adolescents and their parents' food literacy (FL), (2) to investigate the impacts of adolescents' NL and parental FL on (a) the household food security, (b) the adolescents' self-reported food security, and (c) the adolescents' nutrition status with a focus on malnutrition and anemia. A national representative sample of 450 parent-adolescent dyads [parents: mean age ± standard deviation (SD) = 46.0 ± 7.0, mothers: 59.0%; adolescents: mean age ± SD = 15.0 ± 3.0, girls: 54.6%] were interviewed. Anthropometric and blood hemoglobin measurements were performed for adolescents. The Arab Family Food Security Scale and the Adolescent-Level Food Security Scale were used. Around 45.0% of the adolescents were nutritionally illiterate, and nearly half (47.8%) of parents had poor FL. Around 68.2 and 54.0% of the households and adolescents were food insecure, respectively. Moreover, 6.7, 4.7, 32.2, and 16.7% of the adolescents were stunted, thin, overweight/obese, and anemic, respectively. Poor parental FL increased the risk of household food insecurity (FI) by 2.7 times, p < 0.001. Adolescents' nutrition illiteracy increased their FI risk by 60.0% (p = 0.02). The number of offspring, household income, crowding status, and participants' residence also influenced the percentage of FI and malnutrition prevalence among households and adolescents. Improvements in FL and NL are promising to mitigate FI malnutrition in Lebanon.

Buganda Royal Music Revival

Buganda Royal Music Revival

Differentiated responsibilities of US citizens in the country’s sustainable dietary transition

If widely adopted, the ‘planetary health diet’ (PHD), proposed by the EAT-Lancet Commission, would help to meet ambitious sustainability goals currently jeopardised by excessive and resource intensive food demand. To date, convergence of nations to the PHD has been assessed using average food consumption patterns, overlooking the influence of different consumers within this context. Using self-reported dietary intake data from a snapshot survey of the US we reveal the differentiated responsibilities of US citizens within the country’s adoption of the PHD otherwise hidden by use of country averaged dietary intake data. We show how such a granular analysis of food consumption patterns is critical to identify levers in the sustainable food transition of nations. By combining 7418 individual food intake reports from a representative cross section of the United States (US) with commodity-level impact data we estimate the overshoot of US dietary patterns in relation to the PHD and their impacts across the climate, water and land system. The net environmental impacts of PHD adoption across the US population are quantified based on realistic dietary shifts. We estimate that US overshoot of the PHD is responsible for 70% of the US dietary greenhouse gas (GHG) footprint. However, over 60% of this burden could be eliminated by just 10% of the US population following the PHD. Although we estimate PHD adoption will more than half the US dietary GHG footprint and land footprint, we find it may have unintended consequences on water demand due to increased tree nut consumption. Across almost all food categories, we show that the food choices of the top tier of consumers in the US create, and must bridge the PHD gap. As such, actions by these consumers will be of major consequences to the speed and direction of the country’s sustainable dietary transition. To avoid environmental trade-offs, dietary policies must be scrutinised across multiple sustainability criteria.

Cranial suture morphometry and mechanical response to loading: 2D vs. 3D assumptions and characterization.

Cranial sutures are complex soft tissue structures whose mechanics are often studied due to their link with bone growth in the skull. Researchers will often use a cross-sectional two-dimensional slice to define suture geometry when studying morphometry and/or mechanical response to loading. However, using a single cross section neglects the full suture complexity and may introduce significant errors when defining their form. This study aims to determine trends in suture path variability through skull thickness in a swine model and the implications of using a 'representative' cross section on mechanical modeling. To explore these questions, a mixture of quantitative analysis of computed tomography images and finite element models was used. The linear interdigitation and width of coronal and sagittal sutures were analyzed on offset transverse planes through the skull thickness. It was found that sagittal suture width and interdigitation were largely consistent through the skull thickness, whereas the coronal suture showed significant variation in both. The finite element study found that average values of displacement and strain were similar between the two-dimensionally variable and three-dimensionally variable models. Larger ranges and more complex distributions of strain were found in the three-dimensionally variable model. Outcomes of this study indicate that the appropriateness of using a representative cross section to describe suture morphometry and predict mechanical response should depend on specific research questions and goals. Two-dimensional approximations can be sufficient for less-interdigitated sutures and when bulk site mechanics are of interest, while taking the true three-dimensional geometry into account is necessary when considering spatial variability and local mechanical response.

176 Are Ovarian Reserve Parameters Related to Reproductive Tract Development and Fertility in Ewes?

Abstract There are differences between cows and ewes in ovarian reserve parameters. No major genes influencing follicle numbers have been identified in cows, whereas several genes have variants reported to influence follicle numbers in ewes. In contrast, antral follicle count is associated with fertility in cows, and we reported that beef cows that failed to conceive in 2 consecutive years had fewer antral follicles and smaller reproductive tracts than cows that had never failed to conceive. In the current study, we tested the hypothesis that ewes that had failed to lamb (BARREN) in 4 consecutive annual breeding seasons of 21– 35 d with rams that had passed a breeding soundness exam have fewer follicles and smaller reproductive tracts than ewes that consistently produced lambs (FERTILE) under the same breeding protocols. BARREN ewes (n = 19) were paired by breed, age, and sire to a FERTILE control ewe (n = 19) and reproductive tracts were recovered at necropsy. All visible antral follicles in both ovaries were counted and a representative cross section of one ovary was embedded for histological evaluation of primordial follicle numbers. The reproductive tract was weighed, and ovulatory status was evaluated. Paired t-tests indicated that BARREN ewes had 25.6 ± 5.0 fewer antral follicles per pair of ovaries, 17.3 ± 4.4 fewer primordial follicles per histological section, and 54.5 ± 18.7 g lighter reproductive tracts than FERTILE ewes (P ≤ 0.01). The odds of FERTILE ewes being ovulatory at necropsy were 2.25 that of BARREN ewes, but this did not differ from expectation by McNemar’s test (P = 0.13). The results indicate that size of the ovarian reserve influences fertility in ewes as it does in cows. USDA is an equal opportunity provider and employer.

Pilot Testing a Series of Value-Based Care Training Courses.

PurposeThe US healthcare system currently emphasizes volume of services over value. To facilitate changing to a value-based care model, one managed care organization developed a series of online courses designed to teach clinicians value-based care principles and practices. A pilot test was conducted to obtain feedback regarding course content and design, so the courses could be revised prior to their launch.Patients and MethodsA representative cross section of the courses’ target audience (n = 50) was recruited to participate in the pilot test, and data were collected through an online survey. Descriptive statistics were calculated for responses to close-ended survey questions, and affinity analysis was performed on responses to open-ended survey questions. Issues identified were then categorized as urgent/not urgent with respect to course revision.ResultsNearly a quarter (24%) of respondents indicated that the course contained incorrect or misleading information. Other responses noted inconsistencies in course content, eg, misspelled or mispronounced words, slides that were hard to read, etc.ConclusionThis study demonstrates how a pilot test was used as part of a formative assessment to improve course content and design. During a pilot test, attention should be paid to making it easy for participants to provide feedback.

Editorial

Editorial