Training Sites Research Articles

Geological (Dis)orientations: Training Sites, Storytelling, and Fieldwork in the Chilean Andes

This article explores place-based geological storytelling by examining the role of training sites in the geoscientific learning process. Based on ethnographic work conducted with geoscientists in the Liquiñe-Ofqui Geological Fault, I illustrate how sites located in the Chilean Andes have historically been used to practice geoscientific storytelling and to learn the language and theory of plate tectonics. Building on scholarship in STS and the history of science which has documented how plate tectonics and the associated paradigm shift changed the authority of field geology, I show how, rather than replacing fieldwork, place-based observations still play a central role in helping students gain a professional vision in geology. Reflecting on fieldwork training sites and geoscientists’ negotiated attempts to tell geological stories, this article speaks to the question: from where are the stories of the earth told?

Serving up Success: Assessing and Improving Tennis Athlete Development Pathways

The primary purpose of this study was to look into what makes tennis players develop and succeed, as well as the most significant problems and obstacles they face on their way to becoming better. Using a mix of methods, numeric and qualitative data were gathered from 526 tennis players from various school programs and levels of experience. The quantitative data was technical, primarily training, tactical skills, mental preparation, competitive experience, teaching, and support networks. On the other hand, the qualitative conversations looked into how athletes felt about these things on a deeper level and perceptions of the coaches on their view of the current development of atheletes and how they could be improved were also the focus of this study. Meanwhile, the players who answered were male and female, from various school backgrounds, and most of them had competed for one to two years. The study found that athletes liked all parts of training but needed more access to expert coaches. These training sites required to be updated had more chances to compete and had trouble balancing their athletic and academic obligations. Qualitative results showed more problems, such as mental stress from high-level racing and not enough help for recovering from injuries. Results showed that there are significant holes in the current growth paths for tennis players. It stressed the importance of making it easier for them to get tools, mental health support, and up-to-date training devices. Based on these results, a complete program was created to remove these obstacles and improve athletic growth.

Measuring Amazon Rainfall Intensity With Sound Recorders

AbstractGround weather observations are scarce in many parts of the globe, hampering effective climate monitoring and disaster management. In the Amazon basin, this occurs due to its remoteness and the challenging measurement of rainfall within the forest. Innovative rainfall estimation methods are thus requested to fill this gap. Here we present an approach to estimate rainfall based on sound measurements. We identified the best frequency range to estimate rainfall occurrence and intensity, trained classification and regression models with sound and rain gauge data collected in the Central Amazon during 9 months. By training a random forest classifier/regression model based on power spectrum values it was possible to identify and satisfactorily estimate hourly rainfall rates in two vegetation environments distinct from the training site, located 30 km from it. The proposed method is a promising approach for future weather monitoring in remote tropical areas.

Design and Implementation of Unity-based Special Unmanned Vehicle Operating Simulator

Special unmanned vehicles can replace personnel to perform military tasks with high risk coefficients, such as long-distance reconnaissance, guided irradiation, and weapons strikes. In order to ensure that the special unmanned vehicle can quickly and accurately complete the established task action, the operator should carry out a large number of trainings in advance for the task content, if the training is directly used in the early stage of the training to manipulate the training, which has the security risks, it’s easy to increase the operator's psychological pressure, and the actual training site can't realistically restore the task scene, the training effect is also single. In view of the above problems, this paper designs a special unmanned vehicle control simulator, which enables the trainers to intuitively understand the task content and key points, and at the same time can control the unmanned vehicle in the virtual task environment to carry out the established task training and result review and analysis, so as to rapidly improve the control level of the trainers and ensure the successful completion of the established task.

Probabilistic surrogate modeling of damage equivalent loads on onshore and offshore wind turbines using mixture density networks

Abstract. The use of load surrogates in offshore wind turbine site assessment has gained attention as a way to speed up the lengthy and costly siting process. We propose a novel probabilistic approach using mixture density networks to map 10 min average site conditions to the corresponding load statistics. The probabilistic framework allows for the modeling of the uncertainty in the loads as a response to the stochastic inflow conditions. We train the data-driven model on the OpenFAST simulations of the IEA 10 MW reference wind turbine (IEA-10MW-RWT) and compare the predictions to the widely used Gaussian process regression. We show that mixture density networks can recover the accurate mean response in all load channels with values for the coefficient of determination (R2) greater than 0.95 on the test dataset. Mixture density networks completely outperform Gaussian process regression in predicting the quantiles, showing an excellent agreement with the reference. We compare onshore and offshore sites for training to conclude the need for a more extensive training dataset in offshore cases due to the larger feature space and more noise in the data.

Large, but Dispersal-Limited Populations of the Marsh Fritillary Euphydryas aurinia Persist on Abandoned Military Training Areas Three Decades After the End of the Cold War.

Military training areas can host important biodiversity, due to the preservation of diverse, nutrient-poor historical cultural landscapes and an insect-friendly disturbance regime. In Europe, many training areas were abandoned after the end of the cold war in 1991 and the withdrawal of the Allied and Soviet forces. Many of these are now protected areas, and current management strategies vary from rewilding to active habitat management such as grazing or mowing. In a capture-release-recapture approach, marking 2418 individuals, we assessed the population size and movement patterns of the dry ecotype of the Marsh Fritillary Euphydryas aurinia Rottemburg 1775 on three former military training areas in Germany that varied in size and management (natural succession, mowing, and sheep-/goat grazing). Euphydryas aurinia is a rare and declining butterfly species listed in Annex II of the European Union Habitats Directive. Jolly-Seber models revealed a large population of ca. 19,000 individuals on the largest study site and a smaller population at a second site, whereas recapture rates were too low to predict the population size reliably at a third site. Population densities were 190-194 butterflies ha-1 at the unmanaged, large site and 56-71 butterflies ha-1 at a smaller site grazed with sheep. Thirty-nine percent of the recapture events occurred within the same 1-ha-study plot. The average minimum flight distance between the study plots was 313 m for males and 328 m for females. The maximum lifetime flight distance was 1237 m within 3 days. No dispersal was detected between study sites. Thirty years after cessation of the military use, the large former training site still held what likely is one of the largest populations of the species dry ecotype in Central Europe, including in areas where management ceased already in 1991. This suggests remarkable persistence of the species in areas without regular management, contrary to current opinion. However, regular flight distances seem not to be sufficient to connect the isolated habitat patches. It remains unknown how long the large population at the abandoned military area will persist without active habitat management. Careful, but active habitat management and restoration of habitat connectivity should thus be considered.

Service delivery in postpandemic period for routine childhood immunization in Assam following capacity building with BRIDGE IPC Skill tool

ABSTRACT Background: For COVID-19 pandemic and associated factors, around 25 million children missed routine immunization in 2021. NFHS-5 for Assam reported 67% coverage with routine immunization in 2019–21 which is below national average (77%) and lowest among Indian States/UTs. Lack of knowledge and skill among provider can reduce coverage. To address vaccine hesitancy and demand generation for routine immunization, BRIDGE IPC Skills (Boosting Routine Immunization Demand Generation) training in routine immunization for frontline workers considered an effective tool. Objectives: To estimate the service delivery in postpandemic period for routine childhood immunization in Assam following capacity building with a BRIDGE IPC Skill tool. Materials and Methods: This cross-sectional comparative study was conducted among immunization service providers from April 2022 to March 2023, where training coverage of service providers on BRIDGE IPC Skill was assessed. Comparison was made between functionalities of trained services by service providers with untrained ones. Results: A total of 2312 session sites were visited, of which 67.7% of frontline workers were trained, while 32.3% were not trained. Alternate vaccine delivery was present in 58.5%. Updated due list was present in 64.1% vs 29.8% in trained and untrained sites. Significant association was found between delivery of key message and status of frontline worker on BRIDGE IPC Skill training. Conclusion: Capacity building of frontline workers on BRIDGE IPC Skill can boost efficiency of frontline workers and may facilitate in addressing gaps that EXIST between health care system and community.

Skin Biopsies and Diagnostic Outcomes at a Multisite Family Medicine Residency Network.

Physicians other than dermatologists evaluate nearly 60% of all skin diseases, and 22% of these physicians are family physicians. Dermatology education is therefore an important aspect of Family Medicine training. Dermatologic procedural training in Family Medicine residency is not standardized, however, so family physicians graduate with highly variable skills. This study describes the scope and diagnostic outcomes of skin biopsies performed by residents at a multisite Family Medicine residency network in comparison with those performed by attendings at a Family Medicine faculty community practice. We performed a retrospective chart review of patients evaluated at eight Family Medicine residency training sites and one Family Medicine faculty community practice within a regional academic health system between January 2020 and October 2022. Patients with a skin finding who underwent at least one skin biopsy during their visit were included in the study. Among all of the skin findings, the incidence of skin biopsy was 3.6% (258/7104) for residents and 1.8% (175/9917) for attendings (P < 0.001). Family Medicine residents performed fewer shave biopsies (57.8% vs 77.7%, P < 0.001) and more punch biopsies (25.6% vs 11.4%, P < 0.001) compared with attendings. Most biopsies performed by residents and attendings were benign, although residents biopsied significantly more benign (79.1% vs 64.6%, P < 0.001) and malignant lesions (11.2% vs 5.7%, P = 0.049). Attendings biopsied significantly more low-to-moderate-grade dysplastic (22.3% vs 5.0%, P < 0.001) and high-grade atypical lesions (4.0% vs 0.8%, P = 0.034). Family Medicine residents at this residency network receive training in a variety of skin biopsy types. Distinct skin biopsy practices and outcomes between residents and attendings may reflect differences in patient populations, clinical expertise, and dermatology referral patterns.

Effects of 4 weeks of device-induced normobaric intermittent hypoxia/hyperoxia training on the performance of elite cyclists: A pilot study

Introduction &amp; Purpose Classic altitude training and other forms of hypoxia are regularly used in endurance training (Mujika et al., 2019). Due to corona exit restrictions in 2019-2020, device-induced normobaric hypoxia/hyperoxia was suggested as an alternative to classic altitude training. Intermittent hypoxia/hyperoxia training (IHHT) has been studied and used in various forms since the 1940s (Serebrovskaya, 2002) with the advantage to be used at the athlete’s training site (Burtscher, 2005). The aim of this pilot study was to test the effects of a IHHT intervention on aerobic performance, hematological parameters and hypoxia-induced factor-1α (HIF-1α). Method A total of 11 athletes (2 women) from the U23 and elite national squads of the Austrian Cycling Federation completed 16 IHHT units in addition to their normal training program over a period of 4 weeks as part of a randomized cross over intervention study (control – IHHT, IHHT – control). The IHHT units were carried out on a Cellgym CellAir® Gecko Plus device at rest without exercise following a predetermined protocol (Sessions 1-8: 5 min of hypoxia (12.0% oxygen) followed by 3 min of hyperoxia (34.0% oxygen) repeated five times. Sessions 9-16): 6 min of hypoxia (11.0% oxygen) followed by 3 min of hyperoxia (34.0% oxygen). During the 4 weeks of control period, participants should maintain their training schedule. Aerobic performance was determined before and after the intervention by spiroergometry. As secondary outcomes, changes in hematological parameters and protein levels of HIF-1α were determined from venous blood which was processed immediately after collection. Serum was stored at -80 °C until HIF-1 α determination by ELISA technique. Results Eleven out of 13 athletes took part in the pre – post IHHT measurements, but only three of them managed to participate in the measurements planned for the control period, making it impossible to compare the two conditions. Replacement was not possible due to the availability of candidates and the ongoing preparation for the season. After 4 weeks of intervention with 16 IHHT training sessions, no significant changes were observed in performance parameters such as VO2peak, relative VO2max, maximum power (watts) or threshold values (p &gt; 0.05). There were also no significant changes in blood enzymes, lipid and iron metabolism (p &gt; 0.05). However, a tendency towards increased values of haemoglobin (z = 1.738; p = 0.082) and a significant increase of erythrocyte counts (z = 2.193; p = 0.028) were detected. Other haematological parameters and HIF-1α did not change significantly (p &gt; 0.05). Discussion &amp; Conclusion In summary, four weeks of device-induced normobaric IHHT had a modest effect on haematological parameters, but with no detectable transfer to maximal or submaximal endurance performance in highly trained athletes. Although various studies have shown that the difference between normobaric and hypobaric hypoxia exposure is not limited to the partial pressure of oxygen, but Mounier and Brugniaux state that the physiological responses are in fact equivalent (Mounier &amp; Brugniaux, 2012). However, due to the limitations of the competitive setting and the low sample size, the final interpretation of the study remains difficult. References Burtscher, M. (2005). Intermittierende Hypoxie: Höhenvorbereitung, Training, Therapie [Intermittent hypoxia: altitude preparation, training, therapy]. Schweizerische Zeitschrift für Sportmedizin und Sporttraumatologie, 53(2), 61-67. Serebrovskaya, T. V. (2002). Intermittent hypoxia research in the former Soviet Union and the commonwealth of independent states: History and review of the concept and selected applications. High Altitude Medicine &amp; Biology, 3(2), 205-221. https://doi.org/10.1089/15270290260131939 Mounier, R., &amp; Brugniaux, J. V. (2012). Counterpoint: Hypobaric hypoxia does not induce different responses from normobaric hypoxia. Journal of Applied Physiology, 112(10), 1784-1786. https://doi.org/10.1152/japplphysiol.00067.2012a Mujika, I., Sharma, A. P., &amp; Stellingwerff, T. (2019). Contemporary periodization of altitude training for elite endurance athletes: A narrative review. Sports Medicine, 49, 1651-1669. https://doi.org/10.1007/s40279-019-01165-y

Training a rural oral health workforce: Effects of rural background on dentist practice choice

AbstractPurposeThe Regional Initiatives in Dental Education (RIDE) program is an educational track of the University of Washington School of Dentistry that aims to produce leaders who practice in rural areas of the Pacific Northwest. This study assesses outcomes of the first 10 years of the RIDE program. The hypothesis tested is that rural background is the most important predictor of long‐term rural dental practice.MethodsThis descriptive study assessed existing data including graduates' location of practice, demographics, rurality of origin, parental occupation, and practice type over time. Subjects are all graduates of the RIDE program from 2012 to 2021 (N = 80), and range in age from 25 to 50 years. Statistical analyses were utilized to explore associations.ResultsWithin the study sample 78% of graduates practiced in a rural and/or underserved area, 32.5% of graduates pursued post‐graduate dental training, 40% participated in Medicaid, and 78% practiced in the Pacific Northwest at the time of analysis (March 2023). Statistical analysis demonstrated a strong association and medium to large effect sizes between both rural upbringing and training sites and established dental practice in a rural region.ConclusionsGraduates of the RIDE program practice in rural areas in greater proportion compared to the general population of practicing dentists. RIDE graduates from the study period tended to be male, and white, and practice in a health professional shortage area or rural site. The rurality of origin analysis was confounded by the substantial number of graduates from Spokane, Washington, an urban area surrounded by extensive rural territory.

Assessing Academic Preferential Hiring Practices in Highly Ranked Otolaryngology Departments.

Objective: To assess whether preferential hiring practices, particularly self-hiring, are present in academic otolaryngology departments. Setting: A list of academic Otolaryngology-Head and Neck Surgery (O-HNS) departments ranked #1-40 was generated from the Doximity 2021 rankings. The educational background and training information of clinical faculty members and departmental leadership was extracted from each department's online directories. Methods: Descriptive statistics were used to examine inter/intradepartmental relationships and affiliations of included clinical faculty and departmental leadership based on current employment and medical training sites. A "prior affiliation ratio" was calculated to assess the degree of self-hiring and account for multiple possible prior affiliations (medical school, residency, and fellowship) by dividing all prior self-hired affiliations of faculty by the total number of faculty at each department. Results: A total of 1344 clinical faculty were identified, and 596 (44.35%) had at least 1 prior affiliation with their department. The overall prior affiliation ratio was 0.6, and 7 departments had a value >0.8, with the highest being 1.27 (>1.0 indicating multiple prior affiliations per individual such as both residency and fellowship). A network map of departments #1-10 showed heavy intradepartmental faculty recruitment with 24% of faculty having completed a #1-10 residency, 24% a #11-20 residency, 13% a #21-30 residency, and 11% a #31-40 residency. Totaling this data, 76% of faculty at departments ranked #1-10 had completed training at a program ranked #1-40. Furthermore, our data shows high rates of self-hiring among departmental leadership, (40% of Departmental Chairs and 62.5% of Program Directors) though rates are not significantly higher than self-hiring among faculty overall. Conclusion: The top 40 ranked O-HNS departments have high rates of self-hiring, relying on prestige of training programs and prior affiliation in hiring decisions. The effect on departmental productivity and training is unclear.

Spectral induced polarization (SIP) measurements across a PFAS-contaminated source zone

There is a need to develop field-scale, in situ screening technologies for assessing variations in aqueous film-forming foam (AFFF) concentrations in soils at former fire training and storage sites. Field-scale Spectral Induced Polarization (SIP) geophysical measurements were acquired on a transect crossing an AFFF source zone. Soil samples were acquired to determine variations in poly- and per-fluoroalkyl substances (PFAS) concentrations in soils, characterize soil texture, and create triplicate soil columns for laboratory SIP measurements. Field and laboratory observations show that SIP measurements are sensitive to the concentration of AFFF constituents associated with soil pore surface area. The specific polarizability and the phase of the SIP measurements for the laboratory samples were linearly correlated with total soil-sorbed PFAS concentration. The phase from the field SIP measurements was highest over the location of maximum PFAS concentration measured on the laboratory samples. However, a significant correlation between field-measured phase and laboratory-measured total PFAS concentration still needs to be established. These observations, along with the demonstrated sensitivity of the SIP response to the removal of soil PFAS using a methanol wash procedure, support the case for SIP characterization of AFFF source zones.

SP1.14 - Advancing Surgical Education: A Pilot Study Evaluating the Impact of Augmented Reality in Post-Graduate Surgical Skill Training

Abstract Aim The landscape of post-graduate surgical education, influenced by the clinical pressures of the COVID-19 pandemic, has prompted a shift towards prioritizing patient safety and embracing simulated technology for skill development and assessment. This study aims to evaluate the influence of (LapAR™) simulation on the acquisition of surgical skills and the overall training experience for junior surgical trainees. Methods 15 trainees and 2 consultants were recruited across five training sites. Participants used (LapAR™) at home to perform ten appendicectomies, interspersed with LapPass tasks. Objective metrics, including completion time and distance, were quantified, followed by comprehensive interviews. Results Junior surgical trainees demonstrated improvements in completion time, distance travelled, smoothness, acceleration, and ambidexterity during repeated laparoscopic appendicectomies. It is of interest that trainees were meeting consultant benchmarks across all modalities. Qualitative analysis emphasized the relevance of Augmented Reality in early surgical training, advocating for its mandatory integration. Participants sought prolonged access to (LapAR™), acknowledging its value for list preparation, skill acquisition, and knowledge enhancement. Home-based training offered flexibility, contrast to the pressures of traditional surgical environments. Despite technical challenges, (LapAR™) delivered realistic educational benefits. Conclusion (LapAR™) presents a scalable and transformative approach to enhancing surgical skills while addressing common challenges faced by trainees. This study validates its efficacy through improved skills aligned with objective metrics, positive evaluations of educational content, and unanimous agreement on the realism of the simulation. Augmented Reality bridges the gap between surgical training and practice, offering a scalable solution to elevate the standards of surgical education.

How to establish a new medical school? A scoping review of the key considerations.

Establishing new medical schools in medically under-served regions is suggested as part of the solution to the problem of doctor shortages and maldistributions. Establishing a new medical school is, however, a complex undertaking with high financial and political stakes. Critically, the evidence-base for this significant activity has not previously been elucidated. This paper presents the first scoping review on this vitally important, yet under-researched aspect of medical education and health workforce planning. To better understand the process of new medical school establishment, this review posed two research questions: (1) What is the nature of the available literature on establishing a new medical school?; (2) What are the key factors to be considered when establishing a new medical school? Five databases and grey literature were searched in 2015 and 2021 for English-language articles, using search terms related to new medical schools and their establishment. Inclusion and exclusion criteria were based on relevance and suitability in answering the research questions. Seventy-eight articles were analysed both structurally and thematically to understand the nature of the literature and the key considerations involved. Structurally, most articles were descriptive pieces outlining personal and institutional experiences and did not make use of research methodologies nor theory. Thematically, thirteen key considerations were identified including reasons for establishment; location choices; leadership and governance; costs and funding; partnerships; staffing; student numbers; student recruitment; curriculum design and implementation; clinical training sites; buildings and facilities; information and technology resources; and accreditation. Significant gaps in the literature included how to obtain the initial permission from governing authorities and the personal costs and burnout experienced by founding leaders and staff. Although, the literature on new medical school establishment is empirically and theoretically under-developed, it is still useful and reveals a number of important considerations that could assist founding leaders and teams to maximise the outcomes and impact of their establishment efforts. Critically, the evidence-base underpinning this complex undertaking needs to be better informed by theory and research.

Bridging oral health and nutrition: Assessing produce prescription programs in pediatric dental clinics serving low-income communities.

This study assesses the needs and feasibility of conducting a produce prescription (produce Rx) program in a pediatric dental clinic setting serving low-income patients. We conducted a cross-sectional quantitative survey examining several household characteristics including demographics, benefits received, fruit and vegetable intake patterns, food security, feasibility of a produce Rx program, and respondents' answers to questions based on social cognitive theory constructs. The survey was administered at the University of Nebraska Medical Center (UNMC) pediatric dental clinic, a pediatric dental residency clinical training site. One hundred adult respondents with low income completed a 36-item questionnaire during their child's dental appointment. Almost half of respondents reported experiencing food insecurity (45%). Respondents who were food insecure experienced higher levels of nutrition insecurity (p = 0.012), less confidence in choosing fruits and vegetables (FVs) (p = 0.026), difficulty in purchasing FVs in their neighborhood (p = 0.012), and more concern that FVs cost too much (p < 0.001) when compared to respondents who were food secure. Notwithstanding the barriers they face, almost all respondents reported that they eat FVs because of health benefits (95%) and to set a good example for their family (91%). Additionally, most respondents expressed an interest in produce Rx programs (80%) and nutrition education activities (81%). This study demonstrated the potential for produce Rx program uptake in a pediatric dental clinic setting through positive caregiver-reported need and interest. Future studies should explore how produce Rx programs can be adapted most effectively in this novel setting.

Radiography students' knowledge, attitude and practice relating to infection prevention and control in the use of contrast media injectors in computed tomography.

Radiography students complete professional placements in various clinical settings and must adhere to distinct infection prevention and control (IPC) protocols. The aim of this study was to explore radiography students' training, knowledge, attitudes, and practice (KAP) relating to IPC in the use of contrast media injectors in computed tomography (CT). An online survey study was undertaken with radiography students enrolled at two Australian universities. Survey questions related to contrast media training and KAP regarding IPC in CT. Data was summarised using descriptive statistics, with comparisons between experience in public and private practice. One free-text response question focused on non-adherence to IPC best practice, analysed using content analysis. In total, 40 students completed the survey (9% response rate). Reports of IPC and contrast media equipment training was high, with disposition for further training. Regarding IPC knowledge, 65% of students responded correctly to all 'knowledge' items (individual scores range: 60-100%). Low consensus was observed regarding whether gloves replace the need for hand hygiene and if CT contrast tubing poses risk to healthcare workers (85% each). Mean scores ranged from 41% to 100% regarding identification of sterile syringe and tubing components. Responses to the open-ended question were categorised into four themes: 'High non-adherence risk working conditions', 'attitudes and practice', 'knowledge', and 'prioritise good IPC practice'. Radiography students demonstrate varied comprehension of IPC regarding contrast media equipment, and results suggest need for collaborative efforts between academic institutions and clinical training sites to integrate IPC protocols into curricula and on-site training.

Resident and Fellow Perspectives on Family Planning and Building During Training

Physicians, especially surgeons, delay family building, and face age-related complications of pregnancy. To explore factors that are associated with family building decisions among residents and fellows and to understand their thoughts on accessing family building supports, workplace culture, and attitudes toward family planning. This qualitative study was conducted from May to August 2022 at postgraduate training sites across Ontario, Canada. Participants included 29 postgraduate learners. Purposive sampling from 80 eligible trainees was used to ensure diverse demographics, including sex, specialty, and institution. Semi-structured individual interviews lasting 30 to 90 minutes were conducted over a virtual platform. Participants were asked to share their thoughts and experiences on family planning in a medical career, family building goals, the role of mentorship, and knowledge of current family planning supports. Themes associated with residents' perception of family planning within the context of a medical career. Twenty-nine trainees, ages 25 to 37 years old (22 [75.9%] were female, 26 [89.7%] were heterosexual; median [range] age, 30 [25-37] years) from various institutions took part in this study. The participants included both 24 residents (82.8%) and 5 fellows (17.2%) and 8 (27.6%) were from surgical specialties, 3 (10.3%) from pediatrics and subspecialties, 4 (13.8%) from internal medicine and subspecialties, 2 (6.9%) from obstetrics and gynecology, 3 (10.3%) family medicine, 2 (6.9%) from anesthesia, and 7 (24.1%) other medical specialties. Four themes were identified: (1) tension between role as a physician and role as a parent; (2) impact of role models and mentorship on family planning choices; (3) family building is discouraged during training, especially in surgical specialties; and (4) need for tangible family planning supports in training. In this qualitative study of residents' and fellows' perspectives on family building, trainees did not perceive residency and fellowship programs as supportive for individuals who want to family build during training leading to personal and professional dissonance. Trainees identified that more tangible supports, transparent information, and mentorship may improve a trainees' feeling of support.

SiMix: A domain generalization method for cross-site brain MRI harmonization via site mixing

Brain magnetic resonance imaging (MRI) is widely used in clinical practice for disease diagnosis. However, MRI scans acquired at different sites can have different appearances due to the difference in the hardware, pulse sequence, and imaging parameter. It is important to reduce or eliminate such cross-site variations with brain MRI harmonization so that downstream image processing and analysis is performed consistently. Previous works on the harmonization problem require the data acquired from the sites of interest for model training. But in real-world scenarios there can be test data from a new site of interest after the model is trained, and training data from the new site is unavailable when the model is trained. In this case, previous methods cannot optimally handle the test data from the new unseen site. To address the problem, in this work we explore domain generalization for brain MRI harmonization and propose Site Mix (SiMix). We assume that images of travelling subjects are acquired at a few existing sites for model training. To allow the training data to better represent the test data from unseen sites, we first propose to mix the training images belonging to different sites stochastically, which substantially increases the diversity of the training data while preserving the authenticity of the mixed training images. Second, at test time, when a test image from an unseen site is given, we propose a multiview strategy that perturbs the test image with preserved authenticity and ensembles the harmonization results of the perturbed images for improved harmonization quality. To validate SiMix, we performed experiments on the publicly available SRPBS dataset and MUSHAC dataset that comprised brain MRI acquired at nine and two different sites, respectively. The results indicate that SiMix improves brain MRI harmonization for unseen sites, and it is also beneficial to the harmonization of existing sites.

An efficient and generalisable approach for mapping paddy rice fields based on their unique spectra during the transplanting period leveraging the CIE colour space

As one of the most important staple foods globally, rice sustains nearly half of the world's population. Accurate and timely paddy rice mapping is, thus, essential for rice-related policy-making to ensure food security in the context of anthropogenic, environmental and climate changes. However, paddy rice mapping remains a challenging task since it usually has similar spectral characteristics to other land covers. In this research, for the first time, an entirely new approach, called RiceTColour, was proposed for mapping rice fields within the Commission Internationale de l'Eclairage (CIE) colour space based on their unique spectra during the rice transplanting period as observed in remotely sensed imagery. We demonstrate that transplanted rice fields, representing a mixture of soil, water and rice seedlings, consistently exhibit relatively low spectral values in both SWIR and NIR bands across various geographical locations, leading to their unique dark green colours in the false-colour image composed of SWIR, NIR and Red bands. Based upon this, we transformed these three spectral bands into the CIE colour space where paddy rice was found to be readily and completely separated from the other land covers. Straightforward, but specific classification criteria were established within the CIE colour space to differentiate paddy rice from the other land covers. The proposed RiceTColour, thus, represents a new approach for paddy rice identification, that is mapping paddy rice using the CIE colour space based upon the previous underexplored remotely sensed spectra of paddy fields during the transplanting season. The effectiveness of the proposed method was investigated over five rice-planting regions distributed across different geographical regions, characterised by different climates, rice cropping intensities, irrigation schemes and cultural practices. Specifically, the mapping criteria established in a training site (S1) were directly generalised to the other four sites (S2 to S5) for paddy rice mapping. Experimental results demonstrated that the RiceTColour method consistently achieved the most accurate and balanced classifications across all five sites compared with four benchmark comparators: a SAR-based method, an index-based method and two supervised classifier-based methods. In particular, the RiceTColour method performed relatively stable, producing an overall accuracy exceeding 95% in the training site (S1) as well as the four generalised sites (S2 to S5), which is an encouraging result. Such efficient yet stable rice mapping results across various rice-planting regions suggest a very strong generalisation capability of the proposed RiceTColour method. In consideration of the relatively large planting area of paddy rice fields globally, the proposed parameter-free, efficient, and generalisable RiceTColour method, thus, holds great potential for widespread application in various rice-planting areas worldwide.

Platform Design for Optical Screening and Conditioning for Injury Resilience.

Musculoskeletal injuries (MSKIs) among active duty soldiers result in more than 10 million limited duty days each year and account for more than 70% of the medically nondeployable population. Overuse injuries in lower limbs from running, foot marching long distances with heavy loads, and lifting heavy objects are the most common types of injuries in the military. Physical training and rehabilitation exercises for greater resiliency through aerobic, muscle strength, endurance, and agility conditioning programs can prevent or reduce the effects of MSKIs if Soldiers adhere to proper biomechanics and training techniques. We are introducing a three-dimensional (3D) camera-based platform for Optical Screening and Conditioning for Injury Resilience (OSCIR) that is designed to identify and correct high-risk movement patterns based on quantifiable biomechanical measurements in clinical or field settings. Our goal is to improve resilience to MSKI by offering greater access to quality of movement skills in warfighters through an autonomous device that can be used in Sports Medicine and Reconditioning Team (SMART) clinics and High-Intensity Tactical Training (HITT) sites. OSCIR fuses four pairs of Kinect Azure cameras into a concise footprint to achieve suitable sampling rates and an unobstructed field of view for accurate dynamic movement tracking using a custom point cloud solution. We designed a unique multistage 3D joint tracking algorithm architecture to methodically isolate the human body point cloud from the background, identify individual limb segments, and perform iterative joint optimization at the global and local joint levels. We evaluated the feasibility of our prototype system among N = 12 control participants (6 M/6 F; 21-37 years) in compliance with the Western Institutional Review Board (Tracking #20225920, approved on November 4, 2022). Five task-specific MSKI outcome metrics identified by end-user physical therapists and athletic trainers as indicators for movement quality were assessed across 7 lower-extremity exercises derived from standardized MSK assessment/conditioning batteries used in the military. Data were recorded concurrently by OSCIR and a reference standard Vicon motion capture system for validating system accuracy. Task-specific MSKI indicators for knee flexion and hip flexion range of motion achieved an average error of 4.05 ± 2.34°, while 3D position-based postural outcomes of left-right foot distance, left-right hand distance, and step length obtained mean absolute errors of 2.58 ± 2.30 cm. Results support the feasibility of our system in achieving outcomes that are comparable to currently accepted laboratory standards. Our study describes the integration process for a 3D camera-based clinical system for MSKI conditioning and rehabilitation. The impact of our system will enable key stakeholders in the military to manage MSKIs in warfighters by automating key assessment and rehabilitation test batteries; making tests more readily accessible, and interpretations more accurate by providing objective biomechanical measures. OSCIR is undergoing turn-key design features to serve as a screening tool for warfighters to readily assess susceptibility to MSKI or as a training platform to help guide exercise techniques to achieve resiliency against future injuries.