External validation of multidimensional prognostic indices (ADO, BODEx and DOSE) in a primary care international cohort (PROEPOC/COPD cohort)

Background: Due to the heterogeneous and systemic nature of the chronic obstructive pulmonary disease (COPD), the new guidelines are oriented toward individualized attention. Multidimensional scales could facilitate its proper clinical and prognostic assessment, but not all of them were validated in an international primary care cohort, different from the original ones used for model development. Therefore, our main aim is to assess the prognostic capacity of the ADO, BODEx and DOSE indices in primary care for predicting mortality in COPD patients and to validate the models obtained in subgroups of patients, classified by revised Global Initiative for Chronic Obstructive Lung Disease (2011) and updated Spanish Guideline (2014). Besides, we want to confirm that the prognostic capacity of all indices increases if the number of exacerbations is substituted by the interval between them and to assess the impact on health of the patient''s lifestyle, social network and adherence to treatment. Methods: Design: External validation of scales, open and prospective cohort study in primary care. Setting: 36 health centres in 6 European high, medium and low income countries. Subjects: 477 patients diagnosed with COPD, captured in clinical visit by their General Practitioner/Nurse. Predictors: Detailed patient history, exacerbations, lung function test and questionnaires at baseline. Outcomes: Exacerbations, all-cause mortality and specific mortality, within 5 years of recruitment. Analysis: Multivariate logistic regression and Cox regression will be used. Possible non-linear effect of the indices will be studied by using Structured Additive Regression models with penalised splines. Subsequently, we will assess different aspects of the regression models: discrimination, calibration and diagnostic precision. Clinical variables modulated in primary care and the interval between exacerbations will be considered and incorporated into the analysis. Discussion: The Research Agenda for General Practice/Family Medicine highlights that the evidence on predictive values of prognostic indices in primary care is scarce. A prospective cohort like that of PROEPOC/COPD provides good opportunities for research into COPD and make communication easier between family practitioners, nursing staff, pneumologists and other professionals, supporting a multi-disciplinary approach to the treatment of these patients. Trial registration:ISRCTN52402811. Date: 15/01/2015. Prospectively registered

Mediterranean winter rainfall in phase with African monsoons during the past 1.36 million years

Mediterranean climates are characterized by strong seasonal contrasts between dry summers and wet winters. Changes in winter rainfall are critical for regional socioeconomic development, but are difficult to simulate accurately1 and reconstruct on Quaternary timescales. This is partly because regional hydroclimate records that cover multiple glacial–interglacial cycles2,3 with different orbital geometries, global ice volume and atmospheric greenhouse gas concentrations are scarce. Moreover, the underlying mechanisms of change and their persistence remain unexplored. Here we show that, over the past 1.36 million years, wet winters in the northcentral Mediterranean tend to occur with high contrasts in local, seasonal insolation and a vigorous African summer monsoon. Our proxy time series from Lake Ohrid on the Balkan Peninsula, together with a 784,000-year transient climate model hindcast, suggest that increased sea surface temperatures amplify local cyclone development and refuel North Atlantic low-pressure systems that enter the Mediterranean during phases of low continental ice volume and high concentrations of atmospheric greenhouse gases. A comparison with modern reanalysis data shows that current drivers of the amount of rainfall in the Mediterranean share some similarities to those that drive the reconstructed increases in precipitation. Our data cover multiple insolation maxima and are therefore an important benchmark for testing climate model performance

ICDP workshop on the Lake Tanganyika Scientific Drilling Project: a late Miocene–present record of climate, rifting, and ecosystem evolution from the world's oldest tropical lake

The Neogene and Quaternary are characterized by enormous changes in global climate and environments, including global cooling and the establishment of northern high-latitude glaciers. These changes reshaped global ecosystems, including the emergence of tropical dry forests and savannahs that are found in Africa today, which in turn may have influenced the evolution of humans and their ancestors. However, despite decades of research we lack long, continuous, well-resolved records of tropical climate, ecosystem changes, and surface processes necessary to understand their interactions and influences on evolutionary processes. Lake Tanganyika, Africa, contains the most continuous, long continental climate record from the mid-Miocene (∼10 Ma) to the present anywhere in the tropics and has long been recognized as a top-priority site for scientific drilling. The lake is surrounded by the Miombo woodlands, part of the largest dry tropical biome on Earth. Lake Tanganyika also harbors incredibly diverse endemic biota and an entirely unexplored deep microbial biosphere, and it provides textbook examples of rift segmentation, fault behavior, and associated surface processes. To evaluate the interdisciplinary scientific opportunities that an ICDP drilling program at Lake Tanganyika could offer, more than 70 scientists representing 12 countries and a variety of scientific disciplines met in Dar es Salaam, Tanzania, in June 2019. The team developed key research objectives in basin evolution, source-to-sink sedimentology, organismal evolution, geomicrobiology, paleoclimatology, paleolimnology, terrestrial paleoecology, paleoanthropology, and geochronology to be addressed through scientific drilling on Lake Tanganyika. They also identified drilling targets and strategies, logistical challenges, and education and capacity building programs to be carried out through the project. Participants concluded that a drilling program at Lake Tanganyika would produce the first continuous Miocene–present record from the tropics, transforming our understanding of global environmental change, the environmental context of human origins in Africa, and providing a detailed window into the dynamics, tempo and mode of biological diversification and adaptive radiations.© Author(s) 2020. This open access article is distributed under the Creative Commons Attribution 4.0 License

Use of Sentinel-2 for land cover classification on Shar Planina, North Macedonia

Providing information on the spatial distribution of habitat groups through land cover classification is useful for a wide range of environmental studies, especially those monitoring and managing succession and land cover change. While Corine Land Cover is widely used in standardised land cover comparisons, its strength is primarily its use in coarse scale analyses over large extent. Recently available Sentinel-2 combined with wide availability of open-source remote sensing software allows customised fine-scale land cover classifications to suit research projects applied over a smaller extent. In this regard, this study aims to test the suitability of Sentinel-2 imagery in providing a customised land cover classification for Shar Planina mountain range in North Macedonia, hoping that the results will serve as a background for assessment of its landscape visual quality as part of the ongoing PhD study (Jovanovska, D. 2018-2021). The results show that use of Sentinel-2 multiband high resolution images allows customized medium-large scale image classification that yields great accuracy results. Furthermore, frequent updating of Sentinel-2 database allows comparability and standardised land cover change analysis for the purpose of environmental monitoring. The resulting land cover data classification is uploaded as an .ASCII file accompanied with corresponding .lyr file and can serve as a background for subsequent environmental studies in the region. Finally, any further improvements of the final output, as well as trials on its suitability in studies with different aim and scope are encouraged and welcomed

Use of Sentinel-2 for land cover classification on Shar Planina, North Macedonia

Providing information on the spatial distribution of habitat groups through land cover classification is useful for a wide range of environmental studies, especially those monitoring and managing succession and land cover change. While Corine Land Cover is widely used in standardised land cover comparisons, its strength is primarily its use in coarse scale analyses over large extent. Recently available Sentinel-2 combined with wide availability of open-source remote sensing software allows customised fine-scale land cover classifications to suit research projects applied over a smaller extent. In this regard, this study aims to test the suitability of Sentinel-2 imagery in providing a customised land cover classification for Shar Planina mountain range in North Macedonia, hoping that the results will serve as a background for assessment of its landscape visual quality as part of the ongoing PhD study (Jovanovska, D. 2018-2021). The results show that use of Sentinel-2 multiband high resolution images allows customized medium-large scale image classification that yields great accuracy results. Furthermore, frequent updating of Sentinel-2 database allows comparability and standardised land cover change analysis for the purpose of environmental monitoring. The resulting land cover data classification is uploaded as an .ASCII file accompanied with corresponding .lyr file and can serve as a background for subsequent environmental studies in the region. Finally, any further improvements of the final output, as well as trials on its suitability in studies with different aim and scope are encouraged and welcomed

Use of Sentinel-2 for land cover classification on Shar Planina, North Macedonia

Providing information on the spatial distribution of habitat groups through land cover classification is useful for a wide range of environmental studies, especially those monitoring and managing succession and land cover change. While Corine Land Cover is widely used in standardised land cover comparisons, its strength is primarily its use in coarse scale analyses over large extent. Recently available Sentinel-2 combined with wide availability of open-source remote sensing software allows customised fine-scale land cover classifications to suit research projects applied over a smaller extent. In this regard, this study aims to test the suitability of Sentinel-2 imagery in providing a customised land cover classification for Shar Planina mountain range in North Macedonia, hoping that the results will serve as a background for assessment of its landscape visual quality as part of the ongoing PhD study (Jovanovska, D. 2018-2021). The results show that use of Sentinel-2 multiband high resolution images allows customized medium-large scale image classification that yields great accuracy results. Furthermore, frequent updating of Sentinel-2 database allows comparability and standardised land cover change analysis for the purpose of environmental monitoring. The resulting land cover data classification is uploaded as an .ASCII file accompanied with corresponding .lyr file and can serve as a background for subsequent environmental studies in the region. Finally, any further improvements of the final output, as well as trials on its suitability in studies with different aim and scope are encouraged and welcomed

A study in university students on the applied methods of transferring information through integrated teaching of anatomy

Ten years ago we introduced an integrated method in the teaching of Anatomy at a university level. It incorporates not only the classical methods of teaching, but also the use of electronic devices. The surveyed students are from five different courses. Despite their various specialization and qualification goals, they all share an insufficient amount of academic lessons on the difficult subject of Anatomy. The aim of this study is to improve the teaching practice, using the method of student feedback. We proposed a short survey to the students, after they completed their Anatomy course. The results were organized into tables and consequently were statistically analyzed. The following report is an analysis of the received data on the importance of the individual teaching methods in the context of integrated teaching. During the study the principle of voluntary participation was explicitly used.

Betreuung von Online-Studierenden in der Hochschulweiterbildung - Annäherung an ein weites Themenfeld

Neben Forschung und Lehre erweitern mittlerweile auch Weiterbildungsangebote das Leistungsspektrum deutscher Universitäten und Fachhochschulen. Mit dem Bund-Länder-Wettbewerb „Aufstieg durch Bildung: offene Hochschulen“ wird seit dem Jahr 2011 das Lebenslange Lernen an Hochschulen durch den Aufbau neuer berufsbegleitender Studienangebote gefördert. Ziel dieser Qualifizierungsinitiative ist es, neuen Zielgruppen einen Zugang zu einer Hoch- und Fachhochschule zu ermöglichen (Hanft et al. 2016). Im Rahmen dieser Initiative sollten hauptsächlich für heterogene Zielgruppen neue Studiengangsformate (z.B. Online-Studiengänge) etabliert werden. Eine besondere Rolle nehmen dabei die berufstätigen Studierenden ein, die als hervorgehobener Ziel-adressat in dem Bund-Länder-Wettbewerb identifiziert worden sind (Hanft et al. 2013). Insbesondere für diese Zielgruppe wurden neue Weiterbildungsangebote konzipiert und erprobt, die meist ein Blended-Learning-Format oder sogar 100 Prozent online für ihre Form der Wissensvermittlung und Lehr-Lern-Interaktion nutzen