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Fiona Elizabeth van Zyl-Bonk, Sibylle Lange, Antoinette Leonarda Maria Lagro-Janssen, Theodora Alberta Maria Teunissen Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, the NetherlandsCorrespondence: Theodora Alberta Maria Teunissen, Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Geert Grooteplein 21, Postbus 9101, Nijmegen, 6500 HB, the Netherlands, Tel +31 24 3618181, Email doreth.teunissen@radboudumc.nlPurpose: Sexual abuse is a health issue with many consequences. Recognizing and discussing past sexual abuse has proven to be challenging for health care professionals. To improve overall quality of health care for sexual abuse victims, health care professionals need to be properly trained. The aim of this paper is to provide an overview of training methods for health care professionals and to report on their effectiveness.Methods: A scoping review was conducted. A broad search was executed in six databases in December 2022. Study selection was performed by two independent reviewers, followed by quality assessment and data extraction.Results: After screening of titles and abstracts and later full-text assessment for quality appraisal, seven articles were selected, consisting mostly of non-randomized trials, performed among a total of 1299 health care professionals. All studies were assessed to be of moderate to poor quality. The participants attended training courses with a wide variety of durations, settings, formats and methods. The outcomes showed improvements in self-perceived or measured knowledge, skills and confidence to discuss sexual violence. Changes in clinical practice were scarcely investigated. Training courses were most effective when a mix of didactic passive methods, such as lectures and videos, and active participatory strategies, such as discussions and roleplay, were applied. Timely iteration to reinforce retention of gained knowledge and skills also contributed to effectiveness. Participants most enjoyed incorporating opportunities for receiving feedback in small settings and sharing personal experiences.Conclusion: This scoping review summarizes on how to effectively train health care professionals. Flaws and difficulties in measuring the effectiveness of training courses were discussed. Recognition and discussion of past sexual abuse by health care providers can be effectively trained using an alternating mix of multiple active and passive training methods with room for feedback and personal experiences.Keywords: sexual violence, disclosure, recognition, medical education, post-graduate training

Arctic lowlands are characterized by large numbers of small waterbodies, which are known to affect surface energy budgets and the global carbon cycle. Statistical analysis of their size distributions has been hindered by the shortage of observations at sufficiently high spatial resolutions. This situation has now changed with the high-resolution (

Marion Jarczok,1,* Stephanie Lange,1,* Matthias Domhardt,2 Harald Baumeister,2 Andreas Jud1,3 1Department of Child and Adolescent Psychiatry/Psychotherapy, University Medical Center Ulm, Ulm, Germany; 2Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany; 3School of Social Work, Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland*These authors contributed equally to this workCorrespondence: Marion Jarczok, Department of Child and Adolescent, Psychiatry/Psychotherapy, University Medical Center Ulm, Steinhövelstraße 5, Ulm, BW, 89075, Germany, Tel +49 731 500-61610, Fax +49 731 500-61602, Email marion.jarczok@uni-ulm.dePurpose: Child maltreatment may be linked with long-term sleeping disorders and limited coping with stress. Yet, the potential relationships are only marginally studied.Patients and Methods: Based on a sample of young adults (n = 312) this study aims at exploring the effects of child maltreatment and the experience of threat to personal safety and life in childhood on sleep disturbances in early adulthood. Data were collected at the two study sites, Ulm University and Bielefeld University, by an online survey. For both risk factors, child maltreatment and the experience of threat to personal safety and life in childhood, a direct impact on sleep disturbances and an indirect path via psychological distress were tested using Structural Equation Modelling (SEM).Results: In these models, the direct path to sleep disturbances turned out to be significant for the experience of threat to personal safety and life (Path C: b = 0.18, p = 0.013), but not for child maltreatment (Path C: b = 0.05, p = 0.491). However, the current level of psychological distress was found to have a mediating effect on sleep disturbances for both risk factors, thereby confirming indirect significant effects.Conclusion: Considering that the etiological pathway of child maltreatment on sleeping disturbances is mediated via psychological distress, this provides a venue to test in future research whether stress reduction interventions can reduce the negative consequences of child maltreatment on sleep disorders.Keywords: sleep disorders, child maltreatment, stress, unsafety, structural equation modelling

Objectives: Supplemental MRI screening improves early breast cancer detection and reduces interval cancers in women with extremely dense breasts in a cost-effective way. Recently, the European Society of Breast Imaging recommended offering MRI screening to women with extremely dense breasts, but the debate on whether to implement it in breast cancer screening programs is ongoing. Insight into the participant experience and willingness to re-attend is important for this discussion. Methods: We calculated the re-attendance rates of the second and third MRI screening rounds of the DENSE trial. Moreover, we calculated age-adjusted odds ratios (ORs) to study the association between characteristics and re-attendance. Women who discontinued MRI screening were asked to provide one or more reasons for this. Results: The re-attendance rates were 81.3% (3458/4252) and 85.2% (2693/3160) in the second and third MRI screening round, respectively. A high age (> 65 years), a very low BMI, lower education, not being employed, smoking, and no alcohol consumption were correlated with lower re-attendance rates. Moderate or high levels of pain, discomfort, or anxiety experienced during the previous MRI screening round were correlated with lower re-attendance rates. Finally, a plurality of women mentioned an examination-related inconvenience as a reason to discontinue screening (39.1% and 34.8% in the second and third screening round, respectively). Conclusions: The willingness of women with dense breasts to re-attend an ongoing MRI screening study is high. However, emphasis should be placed on improving the MRI experience to increase the re-attendance rate if widespread supplemental MRI screening is implemented. Clinical relevance statement: For many women, MRI is an acceptable screening method, as re-attendance rates were high — even for screening in a clinical trial setting. To further enhance the (re-)attendance rate, one possible approach could be improving the overall MRI experience. Key Points: • The willingness to re-attend in an ongoing MRI screening study is high. • Pain, discomfort, and anxiety in the previous MRI screening round were related to lower re-attendance rates. • Emphasis should be placed on improving MRI experience to increase the re-attendance rate in supplemental MRI screening. [ABSTRACT FROM AUTHOR]

Ponds and lakes are abundant in Arctic permafrost lowlands. They play an important role in Arctic wetland ecosystems by regulating carbon, water, and energy fluxes and providing freshwater habitats. However, ponds, i.e., waterbodies with surface areas smaller than 1. 0 × 104ĝ€m2, have not been inventoried on global and regional scales. The Permafrost Region Pond and Lake (PeRL) database presents the results of a circum-Arctic effort to map ponds and lakes from modern (2002-2013) high-resolution aerial and satellite imagery with a resolution of 5ĝ€m or better. The database also includes historical imagery from 1948 to 1965 with a resolution of 6ĝ€m or better. PeRL includes 69 maps covering a wide range of environmental conditions from tundra to boreal regions and from continuous to discontinuous permafrost zones. Waterbody maps are linked to regional permafrost landscape maps which provide information on permafrost extent, ground ice volume, geology, and lithology. This paper describes waterbody classification and accuracy, and presents statistics of waterbody distribution for each site. Maps of permafrost landscapes in Alaska, Canada, and Russia are used to extrapolate waterbody statistics from the site level to regional landscape units. PeRL presents pond and lake estimates for a total area of 1. 4 × 106ĝ€km2 across the Arctic, about 17ĝ€% of the Arctic lowland ( < ĝ€300ĝ€mĝ€a.s.l.) land surface area. PeRL waterbodies with sizes of 1. 0 × 106ĝ€m2 down to 1. 0 × 102ĝ€m2 contributed up to 21ĝ€% to the total water fraction. Waterbody density ranged from 1. 0 × 10 to 9. 4 × 101ĝ€kmĝ'2. Ponds are the dominant waterbody type by number in all landscapes representing 45-99ĝ€% of the total waterbody number. The implementation of PeRL size distributions in land surface models will greatly improve the investigation and projection of surface inundation and carbon fluxes in permafrost lowlands. Waterbody maps, study area boundaries, and maps of regional permafrost landscapes including detailed metadata are available at https://doi.pangaea.de/10.1594/PANGAEA.868349.

Geometric characteristics of subaqueous bedforms, such as height, length and leeside angle, are crucial for determining hydraulic form roughness and interpreting sedimentary records. Traditionally, bedform existence and geometry predictors are primarily based on uniform, cohesionless sediments. However, mixtures of sand, silt and clay are common in deltaic, estuarine, and lowland river environments, where bedforms are ubiquitous. Therefore, we investigate the impact of fine sand and silt in sand‐silt mixtures on bedform geometry, based on laboratory experiments conducted in a recirculating flume. We systematically varied the fraction of sand and silt for different discharges, and utilized an acoustic Doppler velocimeter to measure flow velocity profiles. The final bed geometry was captured using a line laser scanner. Our findings reveal that the response of bedforms to an altered fine sediment percentage is ambiguous, and likely depends on, among others, bimodality‐driven bed mobility and sediment cohesiveness. When fine, non‐cohesive material (fine sand or coarse silt) is mixed with the base material (medium sand), an increased dune height and length is observed, possibly caused by the hiding‐exposure effect, resulting in enhanced mobility of the coarser material. However, weakly cohesive fine silt suppresses dune height and length, possibly caused by reduced sediment mobility. Finally, in the transition from dunes to upper stage plane bed, there are indications that the bed becomes unstable and dune heights vary over time. The composition of the bed material does not significantly impact the hydraulic roughness, but mainly affects roughness via the bed morphology, especially the leeside angle. Plain Language Summary: Underwater bedforms, such as dunes, are often found on the bed of rivers and deltas. These rhythmic undulations have specific shapes and sizes, and they affect how water flows. When the bed of the river is made up of sand, we can predict the dune height and length. However, mixtures of different‐sized sediments are common in rivers, and it is unknown how this impacts the geometry of the dunes. Therefore, we did experiments in a flume, a laboratory facility to simulate a river, and we tested different sediment bed mixtures. We found that replacing part of the base material with non‐cohesive fine particles leads to longer dunes, likely caused by increased mobility of the base material. However, for weakly cohesive fine particles, the effect was the opposite, and the dunes became shorter, probably due to the limited mobility of the sediment. Finally, we observed that under high flow conditions, the bed became unstable and different dune shapes occurred. We found that the friction the water experiences is not directly impacted by the sediment bed mixtures, but is mostly affected by the shape of the bedforms. Key Points: An increased dune length due to a larger fraction of finer, non‐cohesive material in a sand bed, implies an increased mobility of the sandA decreased dune size due to a larger fraction of finer, weakly cohesive silt in a sand bed, implies a decreased mobility of the sandSediment bed composition indirectly affects hydraulic roughness by altering bedform geometry [ABSTRACT FROM AUTHOR]

Experimentally generated and simulated soft x-ray plasma images and spectra from 1064 nm-driven laser-produced plasmas from slab tin are presented. Produced are small, micrometer-scale emission volumes with principle imaged emission lying between 1.2 and 2.5 nm. Experimental images of the soft x-ray emission of these plasmas are generated using a pinhole imaging system, which enables spatial characterization of the plasmas, and a simple transmission grating spectrometer with a 100 nm pitch grating is used to facilitate the spectral characterization of these plasmas. Plasmas are simulated under similar experimental conditions to those used with the single-fluid, single-temperature radiation-hydrodynamics code RALEF-2D. Coupling the simulation output with optical modeling methods demonstrates its promise as a capability for modeling the spatial and spectral behavior of soft x-ray-emitting tin plasmas at such scales and laser energies. [ABSTRACT FROM AUTHOR]

In deltas and estuaries throughout the world, a fluvial‐to‐tidal transition zone (FTTZ) exists where both the river discharge and the tidal motion drive the flow. It is unclear how dune characteristics are impacted by changes in tidal flow strength, and how this is reflected in the hydraulic roughness. To understand dune geometry and variability in the FTTZ and possible impacts on hydraulic roughness, we assess dune variability from multibeam bathymetric surveys, and we use a calibrated 2D hydrodynamic model (Delft3D‐FM) of a sand‐bedded lowland river (Fraser River, Canada). We focus on a period of low river discharge during which tidal impact is strong. We find that the fluvial‐tidal to tidal regime change is not directly reflected in dune height, but local patterns of increasing and decreasing dune height are present. The fluvial‐to‐tidal regime change is reflected in dune shape, where dunes have lower leeside angles and are more symmetrical in the tidal regime. The calibrated model allows to estimate local patterns of dune heights using tidally averaged values of bed shear stress. However, the spatially variable dune morphology hampers local dune height estimation. Changes in dune shape do not significantly impact the reach‐scale roughness, and estimated dune roughness using dune height and length is similar to the dune roughness inferred from model calibration. Hydraulic model performance with a calibrated, constant roughness is not improved by implementing dune‐derived bed roughness. Instead, the data analysis revealed that large‐scale river morphology may explain differences in model roughness and corresponding estimates from dune predictors. Plain Language Summary: Where rivers meet the sea, the flow will often be driven by tides from the sea and by river flow, resulting in a fluvial‐to‐tidal transition zone. The transition can be abrupt or gradual, which might influence the bed of the river, which is covered by dunes. Dune geometry is important in understanding the degree of friction in the river, which in turn determines water levels. It is unclear how bedform characteristics and the related friction are impacted by change in tidal flow strength. This study of the Fraser River in Canada used survey data of the river bed and a computer model of the river flow to study the geometry of dunes and the corresponding friction in this transitional region. We find that dune height and length vary considerably, but they are is unrelated to the fluvial‐tidal regime change. Instead, only the dune leeside, that is, the downstream facing side, was impacted. The difference in leeside angle before and after the regime change, did not result in a different friction produced by the dunes. Using the friction produced by dunes in the model, instead of a constant friction, does not improve model performance. Instead, large‐scale river morphology determines roughness variations. Key Points: Hydraulic roughness in the fluvial‐to‐tidal transition zone estimated from dune geometry agrees with calibrated model roughnessVariation in dune asymmetry and leeside angle across a fluvial‐to‐tidal transition zone has little impact on reach‐scale hydraulic roughnessEstimated spatial bedform patterns from modeled shear stress match measured bedform patterns, but absolute dune heights do not [ABSTRACT FROM AUTHOR]

Accurate particle size distribution (PSD) measurements of suspended particulate matter (SPM) composed of flocs and aggregates are important to improve understanding of ecological and geomorphological processes, and for environmental engineering applications. PSDs can be measured in situ (in the field) using a submersible sensor, or ex situ (in the laboratory) using samples. The methodological choice is often guided by logistical factors, and the differences in PSDs acquired by in situ and ex situ measurements is of concern. In this study, a laser‐diffraction instrument (the LISST‐200X) was used to compare in situ and ex situ PSD measurements. Samples measured ex situ were stored for three consecutive weeks and measured each week in a laboratory using different stirrer speeds. We observed that ex situ measurements display a higher D50 (median particle size) than in situ measurements of the same sample (up to 613% larger, 112% on average). Our experiments show that the difference between in situ and ex situ measurements can be explained by flocculation of the riverine sediments during the first week of storage. During the subsequent ex situ measurements, the stirring results in a significantly lower D50. Ex situ measurements are therefore unsuitable for flocculated SPM. This study provides recommendations for optimizing PSD measurements by calculating the measurement times required to obtain robust PSD measurements (exceeding 3 min per sample), which are larger for field samples with coarser particles and wider PSDs. Plain Language Summary: Measurements of the size of particles suspended in a water column are important for understanding many processes related to river ecology and morphology. It is possible to measure these particles directly in the field using a submersible sensor (in situ), or by taking samples and transporting them to a laboratory (ex situ). The choice between these options often depends on logistics, with little recognition of the impact that this choice can have on the measurements. In this research, the differences between in situ and ex situ measurements are explored. We find that ex situ measured particle sizes are on average 112% larger than in situ measurements, which can be related to flocculation of the riverine particles. Flocs are a combination of mineral particles (such as silt or clay) and organic particles, forming larger aggregates. Our results show that flocs grow when a sample is taken to the laboratory and stored. During ex situ measurements, which involve stirring, they break apart. Ex situ measurements are therefore unsuitable for determining the natural particle size. We show how long a measurement should last to give a representative particle size. In situ, longer measurement periods are needed. Key Points: The D50, a generic way to parametrize particle size distributions (PSDs), is not an absolute number, but depends on the measurement methodDifferences between in situ and ex situ measured PSDs are caused by the ex situ alteration of flocculated particlesA robust PSD measurement with laser diffraction takes longer for coarser field samples with a wider distribution [ABSTRACT FROM AUTHOR]