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The paper is focused on the practical use of infrared thermography (IRT) in the diagnosis of clinical or subclinical forms of equine inflammation. The aim of the study was to verify the suitability of IRT for the early detection of areas with the potential existence of inflammation. The verification of findings was carried out through veterinary data (medical reports, radiographs). The study claimed the suitability of the IRT method for practical monitoring and detection of health problems, especially limb diseases – hooves, tendons, muscles (13 horses) as well as dermatological diseases (3 horses). The results showed that the most frequent occurrence of the disease, manifested by muscle and tendon overload and inflammatory processes, is on the limbs. The results claimed a significant difference between the measured temperatures and the typical temperatures of a healthy horse.

Abstract The study aimed to explore the potential use of coal-fired power plant bottom ashes in Pleurotus ostreatus cultivation using spent coffee grounds. The study analyzed five compositions of growth substrate for mushrooms: pure coffee grounds (I) as a control sample; coffee grounds substrate with the addition of 1% (II); 5% (III); 10% (IV) bottom ash; and bottom ash alone (V). The study revealed that compared to the control sample (I), the addition of 1% bottom ash (II) did not affect the time of mycelium growth but slowed fruiting body growth by 4 days. With 5% addition (III), mycelium growth slowed by 6 days, and fruiting body growth by 7 days. At 10% (IV), growth was completely inhibited. Compared to sample (I), fruiting bodies grown on sample (II) had higher phosphorus, copper, and zinc accumulation, while chromium, nickel, and lead levels were lower in fruiting bodies grown on samples (II) and (III). Additionally, fruiting bodies grown on samples (II) and (III) contained less iron, silicon, selenium, aluminum, calcium, and magnesium. The results presented in the article regarding the levels of contamination in the cultivated mushrooms and in the substrate after cultivation, indicate the potential for their further management.

Abstract Background The emergence of virtual reality (VR) for medical education enables a range of new teaching opportunities. Skills and competences can be trained that cannot be demonstrated in any other way due to physical or ethical limitations. Immersion and presence may play an important role for learning in this context. This study investigates whether this VR-based, immersive software is an effective tool for assessing medical learning objectives by comparing behavioral outcomes in VR and actor-based simulations, and examines how these behaviors relate to immersion levels and their impact on learning success. Methods To evaluate the effectiveness of the new teaching method, objective behavioral outcomes were identified as part of a dermatological learning unit and VR as a method was compared with actor-based simulation training. In addition, subjective questionnaires were collected to compare the levels of immersion in both concepts. Results It was shown that primary learning objectives can be addressed well in VR. However, secondary learning objectives that fall into the field of basic skills seem to be delivered better in the actor-based training than in VR. This appears to be an effect of weaker immersion measured in VR training. Conclusions It can be said that the implementation of basic skills training depends largely on the level of immersion in the teaching method used. While primary learning subjectives can be trained and assessed well, at present, it does not appear to be fully possible to train secondary skills with the technical status quo in VR. However, the observation of secondary learning objectives can serve as an indicator for the assessment of immersion in the future.

The aim of this paper is to investigate the possibility of using two different methods together to detect more accurately and to evaluate thermal defects in the envelope of agricultural buildings. The structure of heated agricultural buildings is significantly influenced by the characteristics of the indoor environment (aggressive gaseous and liquid substances, high humidity, higher heating temperatures, etc.). In this study, research has been conducted that synergistically combines two methods for the evaluation of thermal defects, where the structure is evaluated using infrared thermography and at the same time described as a numerical model for a more detailed identification of envelope defects and thermal bridges. The study confirmed that in agricultural building structures, thermal defects are most commonly found in the areas of window lintels, ceiling and bracing structures, window and door joints, and foundation and floor joints, while the proposed combination of the two methods for assessing thermal defects in structures demonstrated superior performance in terms of accuracy and detail of results obtained compared to the standard partial use of only one of these methods.

Domestic hot water storage tanks (HWST) are widely used devices, and their daily operation can generate significant annual heat losses to the environment. Previous studies concerning HWST have mainly focused on the impact of insulation quality and thickness, stratification, and tank operation on total heat losses. Some studies have addressed these losses concerning different parts of the tank, including upper, lower, and side walls. However, the influence of insulating additional tank elements, such as connectors, on heat loss has not been analyzed.Therefore, experimental studies were conducted as a reference for the temperature distribution and heat loss from an insulated HWST equipped with 12 connectors. Then, CFD numerical calculations of heat loss were performed for various variants: an insulated HWST without connectors, a tank with connectors insulated in five different ways, and an uninsulated tank.It was found that, in extreme cases of poor insulation of the tank connectors, the heat loss increased by 92.5 % and 147.6 %, respectively, compared to the reference loss. This means an increase in heat loss streams by 62.0 W and 98.9 W compared to the reference case. The latter value corresponds to an annual heat loss of approximately 3 GJ. The study also showed that insulating the bottom of the tank is crucial. With proper insulation, heat losses from this part account for less than 10 % of the total heat loss.The results highlight the critical role of proper connector insulation in minimizing standby heat losses in water storage systems.

Background The decision to discontinue intensive care unit (ICU) treatment during the end-of-life stage has recently become a significant concern in Korea, with an observed increase in life-sustaining treatment (LST) withdrawal. There is a growing demand for evidence-based support for patients, families, and clinicians in making LST decisions. This study aimed to identify factors influencing LST decisions in ICU inpatients and to analyze their impact on healthcare utilization. Methods We retrospectively reviewed medical records of ICU patients with neurological disorders, infectious disorders, or cancer who were treated at a single university hospital between January 1, 2019 and July 7, 2021. Factors influencing the decision to withdraw LST were compared between those who withdrew LST and those who did not. Results Among 54,699 hospital admissions, LST was withdrawn in 550 cases (1%). Cancer was the most common diagnosis, followed by pneumonia and cerebral infarction. Among ICU inpatients, LST was withdrawn from 215 (withdrawal group). The withdrawal group was older (78 vs. 75 years, P=0.002), had longer total hospital stays (16 vs. 11 days, P

Numerous studies have explored the cooling and energy-saving effects of vegetation and reflective materials under extreme heat conditions in urban residential areas. However, few have explored the synergistic effects of vegetation and albedo, particularly in low-rise, high-density residential areas. Therefore, this study selected six typical low-rise, high-density residential areas in Gyeonggi-do, South Korea, based on the neighborhood characteristics. This study investigated the cooling effects and energy-saving potential of vegetation and cooling materials through the development of five simulation scenarios. These included original conditions, the application of highly reflective cooling materials, increased vegetation cover, the removal of vegetation cover, and a comprehensive strategy combining cooling materials with enhanced vegetation. These scenarios were analyzed using ENVI-met and DesignBuilder to evaluate their impact on the microclimate and building energy consumption. The results reveal the following: (1) Cooling materials can lower air temperatures by 1.9 °C, saving 10.37% in energy consumption during the summer, demonstrating a greater efficiency in reducing air temperature and energy use. (2) Vegetation slightly reduces daytime air temperatures but hampers nighttime cooling in dense low-rise areas, increasing energy demand. Shrubs or grass are preferable to tall trees. (3) Cooling materials had a stronger correlation with energy consumption reduction compared to vegetation. Hence, combining cooling materials with strategically placed vegetation and controlling vegetation size maximized cooling and energy-saving benefits. This study provides valuable insights for urban planners and designers, offering guidance for improving urban microclimates, reducing building energy use, and achieving carbon neutrality goals.

Background: Numerous studies have shown the presence of multiple defence factors in placental tissue, although their role is partially understood; therefore, the aim of this study was to evaluate the expression of nuclear factor-kappa B (NF-κB); human beta-defensin 2, 3, and 4 (HBD-2,3,4); cathelicidine (LL-37); heat shock protein 60 (HSP60); and interleukin 10 (IL-10) in dissimilar gestational week placental tissue and display correlations between immunoreactive cells. Methods: A total of 15 human placental tissue samples were acquired from mothers with different gestational weeks: 28, 31, and 40. Routine staining and immunohistochemistry for the samples were executed. The evaluation of data was performed with semi-quantitative methods, and, for statistical analysis, the Kruskal–Wallis test was used. Spearman’s rank correlation was used for calculating correlations. Results: NF-κB, HBD- 2,3,4, HSP60, and IL-10 expression were discovered in every examined placental tissue cell type. LL-37 expression was found only in Hofbauer cells. A rise in expression with higher gestational weeks was noted in LL-37-positive Hofbauer cells (p = 0.03), HBD-3-positive cytotrophoblasts (p = 0.007), endothelial cells (p = 0.024), extraembryonic mesodermal cells (p = 0.004), and HBD-4-positive endothelial cells (p = 0.001). Numerous statistically significant moderate and strong positive correlations between defence factors were discovered. Conclusions: The persistence of Hofbauer cell accumulations underlines the growing significance of placental macrophages in placental protection. The expression of positive defence factors and a rise in expression in tissue protection factors (HBD-3, LL-37, HBD-4) in higher gestational weeks may indicate these factors as the most significant protectors of the placenta in ontogenetic aspects. The high number of statistically significant positive and negative correlations between positive cells show a strong network to sustain distressed placental growth and therefore pregnancy.

The Korean heliospheric community, led by the Korea Astronomy and Space Science Institute (KASI), is currently assessing the viability of deploying a spacecraft at the Sun-Earth Lagrange Point L4 in collaboration with National Aeronautics and Space Administration (NASA). The aim of this mission is to utilize a combination of remote sensing and in situ instruments for comprehensive observations, complementing the capabilities of the L1 and L5 observatories. The paper outlines longterm scientific objectives, underscoring the significance of multi-point in-situ observations to better understand critical heliospheric phenomena. These include coronal mass ejections, magnetic flux ropes, heliospheric current sheets, kinetic waves and instabilities, suprathermal electrons and solar energetic particle events, as well as remote detection of solar radiation phenomena. Furthermore, the mission’s significance in advancing space weather prediction and space radiation exposure assessment models through the integration of L4 observations is discussed. This article is concluded with an emphasis on the potential of L4 observations to propel advancements in heliospheric science.

The aim of the study was to investigate the effects of a once weekly, online video bodyweight resistance exercise training on body mass, muscle strength, and quality of life in middle-aged men (age 40–50 years) during a 20-week coronavirus (COVID-19) pandemic period. The participants were 30 healthy men, and the intervention lasted from June 2021 to September 2021. The participants were randomly assigned in two groups: an exercise group (n = 15) and a congrol group (n = 15). The exercise group participated in a 45-minute program including warm-up, resistance exercise, and recovery once per week for 20 weeks. The participants in the exercise group showed significantly reduced body mass (76.08 ± 8.80 kg), body mass index (BMI, 25.23 ± 2.39 kg·m−2), body fat mass (14.93 ± 4.97 kg), body fat percentage (19.42 ± 5.31%), and waist circumference (91.40 ± 6.13 cm) and increased handgrip strength (right: 48.49 ± 6.98 kg and left: 44.44 ± 6.39 kg) and quality of life (total score: 25.80 ± 2.651). Meanwhile, the control group showed increased body mass (77.06 ± 9.04 kg) and body fat mass (19.10 ± 4.95 kg) and decreased quality of life (total score: 24.60 ± 3.180). The once-weekly online video bodyweight resistance exercise program could be beneficial for body mass, muscular strength, and quality of life among middle-aged men.

Abstract The hydrologic connectivity of non-floodplain wetlands (NFWs) with downstream water (DW) has gained increased importance, but connectivity via groundwater (GW) is largely unknown owing to the high complexity of hydrological processes and climatic seasonality. In this study, a causal inference method, convergent cross mapping (CCM), was applied to detect the hydrologic causality between upland NFW and DW through GW. CCM is a nonlinear inference method for detecting causal relationships among environmental variables with weak or moderate coupling in nonlinear dynamical systems. We assumed that causation would exist when the following conditions were observed: (1) the presence of two direct causal (NFW → GW and GW → DW) and one indirect causal (NFW → DW) relationship; (2) a nonexistent opposite causal relationship (DW → NFW); (3) the two direct causations with shorter lag times relative to indirect causation; and (4) similar patterns not observed with pseudo DW. The water levels monitored by a well and piezometer represented NFW and GW measurements, respectively, and the DW was indicated by the baseflow at the outlet of the drainage area, including NFW. To elucidate causality, the DW taken at the adjacent drainage area with similar climatic seasonality was also tested as pseudo DW. The CCM results showed that the water flow from NFW to GW and then DW was only present, and any opposite flows did not exist. In addition, direct causations had shorter lag time than indirect causation, and 3-day lag time was shown between NFW and DW. Interestingly, the results with pseudo DW did not show any lagged interactions, indicating non-causation. These results provide the signals for the hydrologic connectivity of NFW and DW with GW. Therefore, this study would support the importance of NFW protection and management.

Congenital abdominal adhesions are a rare condition that can result in a small bowel obstruction at any age, more frequently in pediatric populations. The cause remains unknown, and the importance of aberrant congenital bands is related to the difficulty of diagnosis, and cases of death with late detection have been documented. This research examines the expression of Caudal Type Homeobox 1 (CDX1), Indian Hedgehog (IHH), Sonic Hedgehog (SHH), GATA Binding Protein 4 (GATA4), Forkhead Box A2 (FOXA2) and Forkhead Box F1 (FOXF1) gene expression in human abdominal congenital adhesion fibroblast and endothelium cells by chromogenic in situ hybridization, with the aim of elucidating their potential association with the etiology of congenital intra-abdominal adhesion band development. The potential genes’ signals were examined using a semi-quantitative approach. Significant correlations were observed between the expression of CDX1 (p

PURPOSE This study aimed to examine the effects of an 8-week gluteus medius strengthening exercise on back pain, balance, and strength in female office workers with low back pain. METHODS The participants of this study were female office workers aged 30 to 48 years old who reported low back pain on a visual analogue scale (VAS) ranging from 3 to 7. Twenty-six participants were randomly assigned to the exercise (n=13) and control (n=13) groups. The study applied a gluteus medius strengthening program to the exercise group for 8 weeks, three times a week, and 60 minutes per session. The participants in the control group were asked to maintain their normal life patterns during the period of intervention. Data collected from the test were analyzed through repeated two-way ANOVA, paired t-test, and independent t-test. RESULTS First, there has been a significant decrease in the pain level, as evidenced by VAS and Korean oswestry disability index (KODI) scores. Second, there was a statistically significant improvement in both static and dynamic balance capabilities. Last, back strength also significantly improved. CONCLUSIONS Application of the gluteus medius strengthening exercise appears to be effective for low back pain, static and dynamic balance capabilities, and back strength.

Objective Extraocular muscles have complex development processes. The present study aimed to analyze the presence of myosin, dystrophin, and collagen IV in the strabismus-affected extraocular muscle. Methods This research was an observational case–control study. Myosin, dystrophin, and collagen IV were detected by histological and immunohistochemical analyses of extraocular muscle samples from concomitant strabismus patients and controls. A semi-quantitative grading method and statistical analysis were used. Results In the strabismus-affected extraocular muscle, morphological analysis demonstrated different-sized muscle fibers. Immature muscle fibers and an increased amount of connective tissue were also noted. Strong positive correlations were identified between myosin and collagen IV and between dystrophin and collagen IV. Conclusions The presence of newly formed muscle fibers, increased connective tissue, and variable diameters of skeletal striated muscle fibers indicate the decreased quality of extraocular muscles in strabismus cases. Reduced levels of myosin and dystrophin and a near absence of collagen IV in strabismus-affected skeletal striated muscle fibers characterized the muscular dystrophy of strabismus. Adjuvant therapy aimed at normalizing the metabolism of these muscles may be appropriate alongside concomitant strabismus treatment.

Abstract The growth of aquaculture sector in Kenya has been anchored on farmed Nile tilapia Oreochromis niloticus. Different strains of the species exist in Kenya with unknown quality due to lack of stock improvement programmes coupled by variations in breeding and management practices in different hatcheries. The seeds supplied to farmers have not exhibited good performance and resilience to changing climate. There is need to validate the quality of strains supplied to fish farmers in Kenya. This study sought to compare the growth performance of three strains of farmed Nile tilapia; Sagana strain (SAG‐F8) produced through selective breeding, super YY strain (KAM‐YY) from Kamuthanga fish farm and the local strain (LOC‐T) obtained from Siaya County. The fish were stocked in fertilised earthen ponds measuring 300 m2 in triplicates at 3 fish/m2. The fish were fed on 35% crude protein diet for 180 days at Bukani Aquapark located in Busia County, Kenya. There was no significant difference in mean weight gain (MWG) between SAG‐F8 and LOC‐T strain exhibiting 159.786 ± 6.76 g and 158.623 ± 4.67 g, respectively. However, under similar conditions, the KAM‐YY strain had a significantly lower MWG (131.74 ± 4.75 g) compared to the two strains. Food conversion ratio (FCR), specific growth rate (SGR) did not demonstrate any significant difference among the different strains. The body protein content in the SAG‐F8 fish strain was higher (65.40 ± 0.20%) followed by LOC‐T strain (61.23 ± 2.34%) and lastly KAM‐YY strain had the lowest (60.37 ± 0.89%). In this study, the impact of genetic improvement has been demonstrated to influence growth and feed efficiency as well as body composition. These improved strains will substantially increase fish production and productivity, hence, a positive impact on the fish farmers' livelihoods when supplied to the farmers and seed multipliers.

The aim is to apply the principles of valuation of intangible assets - goodwill using the Weighted Average Return on Asset (WARA) method to enterprises in the agricultural sector in the Czech Republic in 2016-2020 agricultural sector and what is the value of goodwill of the average enterprise in the agricultural sector in the Czech Republic in the years 2016 - 2020 determined by the WARA method. The calculation is performed from data from the CRIBIS database of the company Crif - Czech Credit Bureau, s.r.o., specifically according to the classification of economic activities CZ NACE section A for the period 2016 - 2020, from which the analysis is subsequently performed. The average company in the industry is determined for the calculation. An average agricultural enterprise's goodwill is determined using the capitalised net income method and property valuation. Subsequently, the goodwill is further multiplied by the WARA percentage value, and the resulting goodwill value determined using the WARA method is determined.

Numerous studies have explored the cooling and energy-saving effects of vegetation and reflective materials under extreme heat conditions in urban residential areas. However, few have explored the synergistic effects of vegetation and albedo, particularly in low-rise, high-density residential areas. Therefore, this study selected six typical low-rise, high-density residential areas in Gyeonggi-do, South Korea, based on the neighborhood characteristics. This study investigated the cooling effects and energy-saving potential of vegetation and cooling materials through the development of five simulation scenarios. These included original conditions, the application of highly reflective cooling materials, increased vegetation cover, the removal of vegetation cover, and a comprehensive strategy combining cooling materials with enhanced vegetation. These scenarios were analyzed using ENVI-met and DesignBuilder to evaluate their impact on the microclimate and building energy consumption. The results reveal the following: (1) Cooling materials can lower air temperatures by 1.9 °C, saving 10.37% in energy consumption during the summer, demonstrating a greater efficiency in reducing air temperature and energy use. (2) Vegetation slightly reduces daytime air temperatures but hampers nighttime cooling in dense low-rise areas, increasing energy demand. Shrubs or grass are preferable to tall trees. (3) Cooling materials had a stronger correlation with energy consumption reduction compared to vegetation. Hence, combining cooling materials with strategically placed vegetation and controlling vegetation size maximized cooling and energy-saving benefits. This study provides valuable insights for urban planners and designers, offering guidance for improving urban microclimates, reducing building energy use, and achieving carbon neutrality goals. [ABSTRACT FROM AUTHOR]

As artificial intelligence (AI) increasingly drives decision-making in the financial sector, ensuring fairness in machine-learning models has become critical. Bias in AI models can lead to discriminatory practices, undermining public trust and restricting access to essential financial services. While existing financial services leverage AI to enhance efficiency and accuracy, these systems can inadvertently produce unfair outcomes for specific groups defined by sensitive attributes, such as gender and race. This study addresses the challenge of mitigating bias in loan-approval models by applying fairness-aware machine-learning techniques. We investigate two distinct constraint-based strategies for bias mitigation: fairness- and accuracy-constrained models. These strategies are evaluated using logistic regression (LR) and a large-scale, contemporary financial dataset from the Korea Credit Information Services. The results demonstrate that fairness-constrained models achieve a superior balance between fairness and accuracy compared to a conventional LR model. Furthermore, we highlight the importance of tailored data preprocessing and carefully selecting relevant sensitive attributes (e.g., gender, age, nationality) in enhancing fairness outcomes. The findings underscore the necessity of integrating fairness considerations into every stage of the AI model development lifecycle within finance, ensuring equitable outcomes without compromising predictive performance. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have shown the presence of multiple defence factors in placental tissue, although their role is partially understood; therefore, the aim of this study was to evaluate the expression of nuclear factor-kappa B (NF-κB); human beta-defensin 2, 3, and 4 (HBD-2,3,4); cathelicidine (LL-37); heat shock protein 60 (HSP60); and interleukin 10 (IL-10) in dissimilar gestational week placental tissue and display correlations between immunoreactive cells. Methods: A total of 15 human placental tissue samples were acquired from mothers with different gestational weeks: 28, 31, and 40. Routine staining and immunohistochemistry for the samples were executed. The evaluation of data was performed with semi-quantitative methods, and, for statistical analysis, the Kruskal–Wallis test was used. Spearman's rank correlation was used for calculating correlations. Results: NF-κB, HBD- 2,3,4, HSP60, and IL-10 expression were discovered in every examined placental tissue cell type. LL-37 expression was found only in Hofbauer cells. A rise in expression with higher gestational weeks was noted in LL-37-positive Hofbauer cells (p = 0.03), HBD-3-positive cytotrophoblasts (p = 0.007), endothelial cells (p = 0.024), extraembryonic mesodermal cells (p = 0.004), and HBD-4-positive endothelial cells (p = 0.001). Numerous statistically significant moderate and strong positive correlations between defence factors were discovered. Conclusions: The persistence of Hofbauer cell accumulations underlines the growing significance of placental macrophages in placental protection. The expression of positive defence factors and a rise in expression in tissue protection factors (HBD-3, LL-37, HBD-4) in higher gestational weeks may indicate these factors as the most significant protectors of the placenta in ontogenetic aspects. The high number of statistically significant positive and negative correlations between positive cells show a strong network to sustain distressed placental growth and therefore pregnancy. [ABSTRACT FROM AUTHOR]

Pc1 pulsations are infrequently observed at mid-latitude ground stations. Previous studies have shown that these pulsations near the ground are commonly observed during dawn and geomagnetic storms, particularly in the storm recovery phase. However, few studies have directly compared the characteristics of Pc1 pulsations during storm and non-storm times using long-term ground-based data. In this study, we conducted a comparative analysis of storm-related and non-storm-related Pc1 pulsations detected at a mid-latitude ground station located at Bohyun mountain in Korea (BOH, L~1.34). Our findings reveal notable distinctions between the two groups. Pc1 pulsations during the non-storm period exhibit a sharper peak in the local time distribution of the occurrence, relatively well indicating daytime wave power attenuation during propagation. Additionally, during the non-storm period, Pc1 pulsations show relatively lower frequencies (0.6~1 Hz) with predominantly linear polarization. In contrast, storm-related Pc1 pulsations exhibit higher and broader frequencies (up to 3 Hz) with more frequent left-handed polarization. These results suggest that storm-related Pc1 pulsations might originate from a more diverse range of spatial sources.

Abstract Background The Education and Training Centre for Public Healthcare of the National Medical Centre plays a key role in providing continuing professional development (CPD) to 221 public health and medical institutions in South Korea. To assess the realization of the Centre’s core value and the intended changes, program evaluations are required. The context, input, process, and product (CIPP) model is particularly suitable for evaluating CPD in the public sector, as it allows for recognizing the dynamic nature of the program environment. Methods This research applied the CIPP model to the evaluation of CPD programs, particularly abdominal and thoracic ultrasound programs implemented in 2017 and 2018. Data were collected from 2017 to 2019. The program and its feedback were reviewed in the context evaluation. Based on this, a subsequent program strategy was established for the input evaluation. Observing the program in real time and recording its progress was followed in process evaluation. Finally, the outcomes and impacts of the program were reviewed and compared with baseline data in the product evaluation. Results In context evaluation, the educational needs of the Centre’s CPD program recipients, impediments that inhibit participation in education, and resources that the Centre can utilize were identified through an online survey, focus group interviews and expert consultation. Through input evaluation, we identified the best alternative that satisfied all pre-selected criteria, which were responsiveness to priority system needs, potential effectiveness, fit with existing services, affordability, and administrative feasibility. Observing the program in real time and recording its progress were conducted in process evaluation, demonstrating that the augmented program went as planned, and even had to be expanded due to increased demand. The impact of the program was measured, interpreted, and assessed in the product evaluation. The review committee decided that the intended change had been occurred, thus the Centre decided to maintain the program. Conclusion A thorough evaluation is necessary to determine the potential benefits of CPD. The CIPP methodology is valuable for executing formative and summative evaluations. The CIPP model is particularly useful for securing accountability data for large-scale nationwide educational programs supplied by public funds.

Background: Medical students need to be prepared for various situations in clinical decision-making that cannot be systematically trained with real patients without risking their health or integrity. To target system-related limitations of actor-based training, digital learning methods are increasingly used in medical education, with virtual reality (VR)- training seeming to have high potential. Virtually generated training scenarios allow repetitive training of highly relevant clinical skills within a protected, realistic learning environment. Thanks to Artificial Intelligence (AI), face-to-face interaction with virtual agents is feasible. Combining this technology with VR-simulations offers a new way of situated context-based, first-person training for medical students.Project goal and method: The authors’ aim is to develop a modular digital training platform for medical education with virtual, interactable agents and to integrate this platform into the medical curriculum. The medical tr.AI.ning platform will provide veridical simulation of clinical scenarios with virtual patients, augmented with highly realistic medical pathologies within a customizable, realistic situational context. Medical tr.AI.ning is scaled to four complementary developmental steps with different scenarios that can be used separately and so each outcome can successively be integrated early within the project. Every step has its own focus (visual, movement, communication, combination) and extends an author toolbox through its modularity. The modules of each step will be specified and designed together with medical didactics experts. Perspective: To ensure constant improvement of user experience, realism, and medical validity, the authors will perform regular iterative evaluation rounds.Furthermore, integration of medical tr.AI.ning into the medical curriculum will enable long-term and large-scale detection of benefits and limitations of this approach, providing enhanced alternative teaching paradigms for VR technology.

In Republic of Korea, pronounced seasonal precipitation variability poses substantial challenges for stream water quality management and the effective utilization of water resources. Ecologically degraded streams are particularly vulnerable to these fluctuations, which can exacerbate their already fragile condition. We assessed the resilience of reference and impaired streams in response to rainfall through water quality system performance (WQSP). The WQSP is quantified as the concentration of BOD, T-N, and T-P, which represent streams’ eutrophication and anaerobic conditions and respond quickly to disturbances. Reference and impaired streams are classified according to the biological condition and habitat environment of the streams in the Han River watershed of Republic of Korea. The resilience of the stream ecosystem was estimated using WQSP, the linear multiple regression model, and the generalized additive model for rainfall and WQSP. The WQSP reference streams have a lower sensitivity to disturbance and recover more quickly from the influence of rainfall; therefore, they have higher resilience than impaired streams to rainfall events. This study facilitates understanding changes in stream ecosystems of varying conditions in response to rainfall for ensuring long-term stability and adaptability.