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Landslide events cause significant financial losses, human casualties, and irreversible changes in the natural landscape. In this paper, we have addressed the mapping of landslides zones using the extracted Cartosat-1 Digital Elevation Model (DEM) and a knowledge-based numerical rating system. The main objective of the study is to use the Weight of Evidence (WoE) technique to produce a Landslide Hazards Zonation (LHZ) map and a Landslide Susceptible Map (LSM) to establish a relationship between landslide causality factors and past landslide locations. For the prediction and generation of the LSM, accurate DEM is extracted using the noise-free stereo images of the Cartosat-1 sensor. This research proposed a prediction model for landslide susceptibility mapping based on the combination of a knowledge-based numerical rating system, remote sensing, and the WoE technique. The WoE technique and information value method are used to calculate the weightage and ranking of each landslide causality factor. The sum of the landslide causality factor products calculates the Landslide Susceptible Index (LSI) value for every pixel. The area under concern was classified into five susceptibility classes based on the derived LSI, ranging from very low to scars. The overall prediction and forecast accuracy of the LSM generated using the WoE technique is 92.68%.

Different methods to incorporate research training during residency are suggested, however, long-term impact is not studied well. This study reports development of a research curriculum with milestones, a long-term outcome and sustainability, and its impact on the overall departmental research culture. The research curriculum that included a research seminar for resident preparation, annual milestones, and structured research mentoring was implemented in our hybrid program in 2012. The research output for five-year period before and after the implementation was evaluated as peer-reviewed publications, presentations, and grant submissions. Further, secondary effects on faculty and medical student research was evaluated. Following implementation, we observed a significant increase in the number of resident presentations (p < 0.05) and higher trends for publications and grant submissions. Medical student research increased significantly in terms of both presentations and publications (p < 0.05). Consequently, we observed a significant improvement in the overall department research productivity. Our resident research curriculum was associated with improved long-term research productivity. It allowed residents to work closely with faculty and medical students leading to more collaboration resulting in an enhanced scholarly environment. •Structured research curriculum and milestones could be implemented and are sustainable over a long period of time.•Proposed curriculum increases surgery residents’ research outcomes and enhances their overall research experiences.•It could become a foundation for improved collaboration among residents, faculty, and students leading to a cultural shift.

Perception of a surgeon based on physical attributes in the operating room (OR) environment has not been assessed, which was our primary goal. A common OR scenario was simulated using 8 different actors as a lead surgeon with combinations of age (<40 vs. >55), race (white vs. black), and gender (male vs. female). One video scenario with a survey was electronically distributed to surgeons, residents, and OR nurses/staff. The overall rating, assessment, and perception of the lead surgeon were assessed. Of 974 respondents, 64.5% were females. There were significant differences in the rating and assessment based upon surgeon's age (p = .01) favoring older surgeons. There were significant differences in the assessments of surgeons by the study group (p = .03). The positive assessments as well as perceptions trended highest towards male, older, and white surgeons, especially in the stressful situation. While perception of gender bias may be widespread, age and race biases may also play a role in the OR. Inter-professional education training for OR teams could be developed to help alleviate such biases. •In addition to widespread phenomenon of gender bias, age bias may also play a role in the operative environment.•Perception towards the lead surgeon changes in operating room especially when situation gets stressful.•Assessment and perception of the surgeon from fellow surgeons vs. OR staff varies significantly; staff being more negative.

Background Limited work has been done in predicting discharge disposition in trauma patients; most studies use single institutional data and have limited generalizability. This study develops and validates a model to predict, at admission, trauma patients’ discharge disposition using NTDB, transforms the model into an easy-to-use score, and subsequently evaluates its generalizability on institutional data. Methods NTDB data were used to build and validate a binary logistic regression model using derivation-validation (ie, train-test) approach to predict patient disposition location (home vs non-home) upon admission. The model was then converted into a trauma disposition score (TDS) using an optimization-based approach. The generalizability of TDS was evaluated on institutional data from a single Level I trauma center in the U.S. Results A total of 614 625 patients in the NTDB were included in the study; 212 684 (34.6%) went to a non-home location. Patients with a non-home disposition compared to home had significantly higher age (69 ± 19.7 vs 48.3 ± 20.3) and ISS (11.2 ± 8.2 vs 8.2 ± 6.3); P < .001. Older age, female sex, higher ISS, comorbidities (cancer, cardiovascular, coagulopathy, diabetes, hepatic, neurological, psychiatric, renal, substance abuse), and Medicare insurance were independent predictors of non-home discharge. The logistic regression model’s AUC was 0.8; TDS achieved a correlation of 0.99 and performed similarly well on institutional data (n = 3161); AUC = 0.8. Conclusion We developed a score based on a large national trauma database that has acceptable performance on local institutions to predict patient discharge disposition at the time of admission. TDS can aid in early discharge preparation for likely-to-be non-home patients and may improve hospital efficiency.

Purpose The transition of USMLE Step1 to pass/fail has brought many questions and uncertainties for medical students and residency programs. This study assesses the perceptions of both students and faculty on this policy change and residency matching. Methods An IRB-approved survey was distributed to our medical students and faculty, who participate in residency interviews and ranking of residency applicants of different specialties; general surgery, orthopedic and plastic surgery, ob-gyn, dermatology, emergency medicine, and psychiatry. The survey included both open- and closed-ended questions. Data were analyzed descriptively and qualitatively. Results A total of 36.2% (181/500) students responded; 68.0% were interested in highly competitive specialties. The response rate for faculty was 40.3% (23/57). A higher number of students (58.6%) were in favor of pass/fail, primary reason being less pressure and stress; 73.9% of faculty were opposed, the primary reason being an inability to stratify applicants. Students believed that Step2 scores (92.5%), clerkship honors (74.4%), and research (77.5%) would be more important for residency applications. While faculty members agreed with clerkship honors (66.6%) and Step 2 scores (60.0%), they included away rotations (53.3%) as one of the factors influencing their ranking list. Students (70.0%) feared that their school’s name/prestige would carry higher weight on interview offers and rank list; only 33.33% of faculty agreed. Faculty suggested students prepare a sincere personal statement, get excellent recommendations, and perform high-quality research to stand out. Conclusions While students and faculty disagreed on favoring pass/fail Step 1, they shared common concerns on resulting stress and difficulties for students interested in highly competitive specialties and/or from less prestigious schools. Both groups stated that Step 2 score and clerkship honors could now play a major role but warranted further clarification on the stratification of the residency selection process.

Sleep stage analysis plays an imperative role in sleep disorder analysis to diagnose a person’s mental and physical health. In the past, various techniques were presented for a sleep stage analysis which suffered from class imbalance problem, poor performance for multi-class sleep stage analysis, lower inter-class, and larger intra-class difference in raw electroencephalogram (EEG) features. This study presents Convolutional Neural Network (CNN) for a sleep stage analysis using an EEG signal. To surmount the problem of class imbalance, Generative Adversarial Network (GAN) is presented for data augmentation. Further, proposed Fire Hawk Optimization based Wavelet Packet Transform (FHO-WPT) based soft thresholding-based EEG enhancement technique is used to minimize the effect of noise and artifacts. The FHO is used to tune to hyper-parameters of the WPT to tackle the problem of manual selection of the WPT based soft thresholding. The results are presented for sleep stage classification on (i) original and enhanced sleep signals and (ii) augmented data to illustrate the effectiveness of the suggested framework. The results of the system are estimated on sleep-EDF database on the basis of accuracy, recall, precision and F1-score and it is found that the proposed framework minimizes data scarcity problem and improves the efficacy of the system.

Falls that occur within a hospital setting are difficult to predict, however, are preventable adverse events with the potential to negatively impact patient care. Falls have the potential to cause serious or fatal injuries and may increase patient morbidity. Many hospitals utilize fall “predictor tools” to categorize a patient's fall risk, however, these tools are primarily studied within in-patient units. The emergency department (ED) presents a unique environment with a distinct patient population and demographic. The Memorial Emergency Department Fall Risk Assessment Tool (MEDFRAT) has shown to be effective with predicting a patient's fall risk in the ED. This IRB-approved study aims to assess the predictive validity of the MEDFRAT by evaluating the sensitivity and specificity for predicting a patient's fall risk in an emergency department at a level 1 trauma center. A retrospective cohort analysis was conducted using an electronic medical record (EMR) for patients who met study inclusion criteria at a level 1 trauma center ED. Extracted data includes MEDFRAT components, demographic information, and data from the Moving Safely Risk Assessment (MSRA) Tool, our institution's current fall assessment tool. A receiver operating characteristic (ROC) curve was constructed to determine the best cutoff for identifying any fall risk. Sensitivity, specificity, accuracy, positive likelihood ratio (LR+) and negative LR (LR-), with 95% CIs were then calculated for the cutoff value determined from the ROC curve. To compare overall tool performance, the areas under the ROC curves (AUC) were determined and compared with a z-test. The MEDFRAT had a significantly higher sensitivity compared to the MSRA (83.1% vs. 66.1%, p = 0.002), while the MSRA had a significantly higher specificity (84.5% vs. 69.0%, p = 0.012). For identifying any level of fall risk, ROC curve analysis showed that the cutoff providing the best trade-off between sensitivity and specificity for the MEDFRAT was a score of ≥1. Additionally, area under the curve was determined for the MEDFRAT and MSRA (0.817 vs. 0.737). This study confirms the validity of the MEDFRAT as an acceptable tool to predict in-hospital falls in a level 1 trauma center ED. Accurate identification of patients at a high risk of falling is critical for decreasing healthcare costs and improving health outcomes and patient safety. •Majority of fall risk assessment tools are not developed for emergency department.•Falls increase patients' risk for poor health outcomes and costs.•Memorial Emergency Department Fall Risk Assessment Tool is a valid fall risk tool.

Introduction Public health investigations, including research, in refugee populations are necessary to inform evidence-based interventions and care. The unique challenges refugees face (displacement, limited political protections, economic hardship) can make them especially vulnerable to harm, burden, or undue influence. Acute survival needs, fear of stigma or persecution, and history of trauma may present challenges to ensuring meaningful informed consent and establishing trust. We examined the recently published literature to understand the application of ethics principles in investigations involving refugees. Methods We conducted a preliminary review of refugee health literature (research and non-research data collections) published from 2015 through 2018 available in PubMed. Article inclusion criteria were: participants were refugees, topic was health-related, and methods used primary data collection. Information regarding type of investigation, methods, and reported ethics considerations was abstracted. Results We examined 288 articles. Results indicated 33% of investigations were conducted before resettlement, during the displacement period (68% of these were in refugee camps). Common topics included mental health (48%) and healthcare access (8%). The majority (87%) of investigations obtained consent. Incentives were provided less frequently (23%). Most authors discussed the ways in which community stakeholders were engaged (91%), yet few noted whether refugee representatives had an opportunity to review investigational protocols (8%). Cultural considerations were generally limited to gender and religious norms, and 13% mentioned providing some form of post-investigation support. Conclusions Our analysis is a preliminary assessment of the application of ethics principles reported within the recently published refugee health literature. From this analysis, we have proposed a list of best practices, which include stakeholder engagement, respect for cultural norms, and post-study support. Investigations conducted among refugees require additional diligence to ensure respect for and welfare of the participants. Development of a refugee-specific ethics framework with ethics and refugee health experts that addresses the need for stakeholder involvement, appropriate incentive use, protocol review, and considerations of cultural practices may help guide future investigations in this population.

[...]this study was planned to evaluate the awareness of general practitioners (GPs) with respect to the latest Indian guidelines for the treatment of malaria and simultaneously assess their treatment practices regarding malaria. In spite of regular reminders and calls to more than 300 GP, only 40 responses were received by the end of 3 months. [...]due to insufficient number of responses, doctors were approached physically after the end of national lockdown. Section A - Five questions of the questionnaire collected data about the demographic details of the participants - age, years of practice, qualification, monthly number of malaria patients treated, and whether or not they had attended any Continuing Medical Education (CME) regarding treatment of infections. RESULTS The study was conducted in March 2020; a total of 93 GP participated in this study - 18 were MBBS doctors, 39 were homeopathy doctors (Bachelor of Homeopathic Medicine and Surgery [BHMS]), and 36 were Ayurveda specialists (Bachelor in Ayurvedic Medicine and Surgery [BAMS]); all of them prescribed allopathy drugs [Figure 1], Comparatively, BHMS and BAMS doctors were well informed about malaria treatment guidelines in comparison to MBBS doctors [Table 1].