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Background: Network meta-analyses (NMAs) are statistical techniques used to synthesize data from multiple studies and compare the effectiveness of different interventions for a particular disease or condition. They have gained popularity in recent years as a tool for evidence-based decision making in healthcare. Whether publications in NMAs have an increasing trend is still unclear. This study aimed to investigate the trends in the number of NMA articles over the past 10 years when compared to non-NMA articles., Methods: The study utilized data from the Web of Science database, specifically searching for articles containing the term "meta-analysis" published between 2013 and 2022. The analysis examined the annual number of articles, as well as the countries, institutions, departments, and authors associated with the articles and the journals in which they were published. Ten different visualization techniques, including line charts, choropleth maps, chord diagrams, circle packing charts, forest plots, temporal heatmaps, impact beam plots, pyramid plots, 4-quadrant radar plots, and scatter plots, were employed to support the hypothesis that the number of NMA-related articles has increased (or declined) over the past decade when compared to non-NMA articles., Results: Our findings indicate that there was no difference in mean citations or publication trends between NMA and non-NMA; the United States, McMaster University (Canada), medical schools, Dan Jackson from the United Kingdom, and the Journal of Medicine (Baltimore) were among the leading entities; NMA ranked highest on the coword analysis, followed by heterogeneity, quality, and protocol, with weighted centrality degrees of 32.51, 30.84, 29.43, and 24.26, respectively; and the number of NMA-related articles had increased prior to 2020 but experienced a decline in the past 3 years, potentially due to being overshadowed by the intense academic focus on COVID-19., Conclusion: It is evident that the number of NMA articles increased rapidly between 2013 and 2019 before leveling off in the years following. For researchers, policymakers, and healthcare professionals who are interested in evidence-based decision making, the visualizations used in this study may be useful., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Targeted metabolite assays that measure tens or hundreds of pre-selected metabolites, typically using liquid chromatography-mass spectrometry, are increasingly being developed and applied to metabolic phenotyping studies. These are used both as standalone phenotyping methods and for the validation of putative metabolic biomarkers obtained from untargeted metabolomics studies. However, there are no widely accepted standards in the scientific community for ensuring reliability of the development and validation of targeted metabolite assays (referred to here as 'targeted metabolomics'). Most current practices attempt to adopt, with modifications, the strict guidance provided by drug regulatory authorities for analytical methods designed largely for measuring drugs and other xenobiotic analytes. Here, the regulatory guidance provided by the European Medicines Agency, US Food and Drug Administration and International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use are summarized. In this Perspective, we have adapted these guidelines and propose a less onerous 'tiered' approach to evaluate the reliability of a wide range of metabolomics analyses, addressing the need for community-accepted, harmonized guidelines for tiers other than full validation. This 'fit-for-purpose' tiered approach comprises four levels-discovery, screening, qualification and validation-and is discussed in the context of a range of targeted and untargeted metabolomics assays. Issues arising with targeted multiplexed metabolomics assays, and how these might be addressed, are considered. Furthermore, guidance is provided to assist the community with selecting the appropriate degree of reliability for a series of well-defined applications of metabolomics., (© 2023. Springer Nature Limited.)

The recent clearance by the United States Food and Drug Administration of Tidepool Loop sets an important precedent within the medical device landscape. For the first time, an automated insulin delivery mobile application-based on an algorithm initially designed and developed by users -has been recognised as safe and effective by a regulatory body. The aim of this paper is twofold: firstly, we map out the regulatory pathways and processes that were navigated by Tidepool, the non-profit behind Tidepool Loop, in order to make this landmark moment possible. Secondly, we set out potential approvals processes in the European Union and United Kingdom with a view to examining the challenges to obtaining regulatory clearance for Tidepool Loop in these jurisdictions. In so doing, we highlight the significant differences, not only between the United States and European systems but also between the European Union and Great Britain systems. We conclude by arguing that the complexity encountered when seeking to introduce an innovative solution in different regulatory systems has the potential to act as a disincentive to open source developers from seeking regulatory approvals for such technologies in the future., (© 2023 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.)

Objectives: In celebration of the journal's 50th anniversary, the aim of the study was to review the whole collection of Community Dentistry and Oral Epidemiology (CDOE) publications from 1973 to 2022 and provide a complete overview of the main publication characteristics., Methods: The study used bibliometric techniques such as performance and science mapping analysis of 3428 articles extracted from the Scopus database. The data were analysed using the 'Bibliometrix' package in R. The journal's scientific production was examined, along with the yearly citation count, the distribution of publications based on authors, the corresponding author's country and affiliation and citation count, citing source and keywords. Bibliometric network maps were constructed to determine the conceptual, intellectual and social collaborative structure over the past 50 years. The trending research topics and themes were identified., Results: The total number of articles and average citations has increased over the years. D Locker, AJ Spencer, A Sheiham and WM Thomson were the most frequently published authors, and PE Petersen, GD Slade and AI Ismail published papers with the highest citations. The most published countries were the United States, United Kingdom, Brazil and Canada, frequently engaging in collaborative efforts. The most common keywords used were 'dental caries', 'oral epidemiology' and 'oral health'. The trending topics were healthcare and health disparities, social determinants of health, systematic review and health inequalities. Epidemiology, oral health and disparities were highly researched areas., Conclusion: This bibliometric study reviews CDOE's significant contribution to dental public health by identifying key research trends, themes, influential authors and collaborations. The findings provide insights into the need to increase publications from developing countries, improve gender diversity in authorship and broaden the scope of research themes., (© 2023 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.)

On December 19, 1846, at the London home of Francis Boott, dentist James Robinson administered the vapor of diethyl ether to a young female patient named Miss Lonsdale. This was the earliest known attempt in England to provide painless operating conditions for a dental extraction, and it was successful. Many authors have since written much about Boott and Robinson, but scarcely anything is known about Miss Lonsdale. In contemporaneous accounts of the event, Robinson referred to his patient as a "young person" and a "young lady"; Boott, however, named her, suggesting that she was publicly recognizable. Our initial attempt to identify Miss Lonsdale was based on genealogical, United Kingdom Census, and other public records, using selection criteria based on age, name recognition, familial relationships, and London addresses. This produced 7 possible candidates from publicly recognizable families, though none was notable in her own right. Our second attempt was based primarily on contemporaneous newspaper records, among which were published 2 private letters in which Boott referred to Robinson's patient as a "girl." We found that "Miss Lonsdale" was the publicly recognizable name of 2 young stage-performing sisters, Adeline Lonsdale, a danseuse, and Annie Lonsdale, an actor-comedienne. Both subsequently emigrated to the United States where they were well-known stage performers. Accordingly, we suggest that both are highly probable candidates for that etherized patient, with the younger sister Adeline then more publicly recognizable. However, no records were found that directly associated any of the Miss Lonsdale candidates with that first dental anesthetic in England., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 International Anesthesia Research Society.)

Motivating effortful behaviour is a problem employers, governments and nonprofits face globally. However, most studies on motivation are done in Western, educated, industrialized, rich and democratic (WEIRD) cultures. We compared how hard people in six countries worked in response to monetary incentives versus psychological motivators, such as competing with or helping others. The advantage money had over psychological interventions was larger in the United States and the United Kingdom than in China, India, Mexico and South Africa (N = 8,133). In our last study, we randomly assigned cultural frames through language in bilingual Facebook users in India (N = 2,065). Money increased effort over a psychological treatment by 27% in Hindi and 52% in English. These findings contradict the standard economic intuition that people from poorer countries should be more driven by money. Instead, they suggest that the market mentality of exchanging time and effort for material benefits is most prominent in WEIRD cultures., (© 2024. The Author(s).)

Document Reviewers: Rudolf A. de Boer (CPG Review Coordinator) (Netherlands), P. Christian Schulze (CPG Review Coordinator) (Germany), Magdy Abdelhamid (Egypt), Victor Aboyans (France), Stamatis Adamopoulos (Greece), Stefan D. Anker (Germany), Elena Arbelo (Spain), Riccardo Asteggiano (Italy), Johann Bauersachs (Germany), Antoni Bayes-Genis (Spain), Michael A. Borger (Germany), Werner Budts (Belgium), Maja Cikes (Croatia), Kevin Damman (Netherlands), Victoria Delgado (Netherlands), Paul Dendale (Belgium), Polychronis Dilaveris (Greece), Heinz Drexel (Austria), Justin Ezekowitz (Canada), Volkmar Falk (Germany), Laurent Fauchier (France), Gerasimos Filippatos (Greece), Alan Fraser (United Kingdom), Norbert Frey (Germany), Chris P. Gale (United Kingdom), Finn Gustafsson (Denmark), Julie Harris (United Kingdom), Bernard Iung (France), Stefan Janssens (Belgium), Mariell Jessup (United States of America), Aleksandra Konradi (Russia), Dipak Kotecha (United Kingdom), Ekaterini Lambrinou (Cyprus), Patrizio Lancellotti (Belgium), Ulf Landmesser (Germany), Christophe Leclercq (France), Basil S. Lewis (Israel), Francisco Leyva (United Kingdom), AleVs Linhart (Czech Republic), Maja-Lisa Løchen (Norway), Lars H. Lund (Sweden), Donna Mancini (United States of America), Josep Masip (Spain), Davor Milicic (Croatia), Christian Mueller (Switzerland), Holger Nef (Germany), Jens-Cosedis Nielsen (Denmark), Lis Neubeck (United Kingdom), Michel Noutsias (Germany), Steffen E. Petersen (United Kingdom), Anna Sonia Petronio (Italy), Piotr Ponikowski (Poland), Eva Prescott (Denmark), Amina Rakisheva (Kazakhstan), Dimitrios J. Richter (Greece), Evgeny Schlyakhto (Russia), Petar Seferovic (Serbia), Michele Senni (Italy), Marta Sitges (Spain), Miguel Sousa-Uva (Portugal), Carlo G. Tocchetti (Italy), Rhian M. Touyz (United Kingdom), Carsten Tschoepe (Germany), Johannes Waltenberger (Germany/Switzerland) All experts involved in the development of these guidelines have submitted declarations of interest. These have been compiled in a report and published in a supplementary document simultaneously to the guidelines. The report is also available on the ESC website www.escardio.org/guidelines For the Supplementary Data which include background information and detailed discussion of the data that have provided the basis for the guidelines see European Heart Journal online., (© 2022 European Society of Cardiology This article has been co-published with permission in European Heart Journal (published by Oxford University Press on behalf of European Society of Cardiology) and European Journal of Heart Failure (published by John Wiley & Sons Ltd on behalf of European Society of Cardiology).)

The Covid-19 crises in the United Kingdom and the United States show how democracies may struggle to confront disasters that are increasingly impinging on the Global North. This paper highlights the extent to which disasters are now 'coming home' to Western democracies and it looks at some of the principal reasons why democracy has not been especially protective, at least in the case of the UK and the US. These include: reconceptualising disaster as a good thing (via 'herd immunity'); the influence of neoliberalism; and the limitations in the circulation of information. A key pandemic-related danger is the conclusion that democracy itself is discredited. Disasters, though, call for a reinvigoration of democracy, not a knee-jerk invocation of autocratic 'emergency' rule. A fundamental problem in the UK and US is that these countries were not democratic enough. The paper underlines the risk of a move towards a disaster-producing system that is self-reinforcing rather than self-correcting., (© 2021 The Authors Disasters © 2021 Overseas Development Institute.)

We overwhelmingly utilize (partially) informed consent for, and debriefing of, human research participants. Also common is the practice of reconsent, particularly where changes in study protocols (or in participants themselves) occur midstream - participants consent again to remaining in the project or to having their data included. Worryingly under-discussed is post-debriefing reconsent, wherein participants can withdraw their data after learning more fully of the study's goals and methods. Yet, major ethics bodies in Canada, the United States and the United Kingdom promote such practice, with vague and potentially problematic guidelines. Here, the author provides examples involving such reconsent practice, highlighting potentially serious problems that are scientific (e.g. threats to internal and external validity) and ethical (i.e. to the participant, their peers, the researcher and society) in nature. Particularly, problematic is the introduction, by design, of unknowable bias in our research findings. For example, highly prejudiced participants could withdraw data from a discrimination study after learning of the study's hypotheses and goals. The practice may arguably contradict an Open Science goal of increasing research transparency. This call for discussion about the direction of psychological science methods aims to engage a broader discussion in the research community., (© 2022 The British Psychological Society.)

With the globalization of clinical trials, regulators have increased collaboration to evaluate the adequacy of clinical trial conduct and to optimize regulatory oversight. The 2020 joint Good Clinical Practice (GCP) symposium of the US Food and Drug Administration and the UK Medicines and Healthcare products Regulatory Agency provided the agencies' perspectives on the challenges in ensuring data quality in novel clinical trial designs and the importance of the management and documentation of protocol deviations, sponsor oversight of clinical trials, and use of electronic source data, including electronic health records. This paper summarizes considerations of both agencies on these topics, along with case examples. This paper touches upon considerations when using real-world data to support regulatory decisions. It also discusses the impact of the coronavirus disease 2019 (COVID-19) pandemic on clinical trial conduct and underscores the importance of well-designed, resilient, and adaptable systems for GCP compliance and data integrity., (© 2021 Crown copyright. Clinical Pharmacology & Therapeutics © 2021 American Society for Clinical Pharmacology and Therapeutics. This article is published with the permission of the Controller of HMSO and the Queen's Printer for Scotland. This article has been contributed to by US Government employees and their work is in the public domain in the USA.)

Aim: To examine the diagnostic reasoning skills of two nurse practitioner student cohorts., Introduction: Nurse practitioners continue to play a pivotal role in health care provision. Diagnostic reasoning is a core skill of advanced practice. A comparative diagnostic reasoning study between two student cohorts was undertaken between 2018 and 2019., Methods: A validated diagnostic reasoning scale was completed by nurse practitioner students in the United Kingdom and the United States of America at the beginning and end of their clinical placements. The study utilized descriptive quantitative statistics from the data submitted by 22 survey respondents from an online survey., Results: Analysis of the diagnostic reasoning skills suggested there was a difference in the structural memory scores when compared with the beginning of their clinical placements and the final semester of their clinical placements., Conclusion: Diagnostic reasoning skills are a core skill of advanced practice. As students progress through their training, these skills improve. Despite the statistical difference in diagnostic reasoning scores, caution should be made in determining any larger implications due to the small number of participants in this study. Further study is needed in this area., (© 2022 John Wiley & Sons Australia, Ltd.)

It has been shown that disadvantaged groups who endorse system-justifying beliefs tend to internalize their state of inferiority by expressing ingroup derogation and opposing collective action for change. In the present research, we recruited women - as disadvantaged group - from different countries (the United States, the United Kingdom, Italy) and examined whether their moral conviction against gender inequality, as an absolute stance that does not tolerate any violation, may interact with and overpower system-justifying beliefs. Results from three studies provided support for our hypotheses. First, when women held strong moral conviction, they expressed higher identification with their disadvantaged ingroup and, in turn, higher collective action intentions, independent of system-justifying beliefs. Second, when women held weak moral conviction, higher system-justifying beliefs reduced women's ingroup identification and, in turn, undermined their collective action intentions. This support is found across different contexts of gender inequality (the gender leadership gap, the gender pay gap, and the gender power imbalance), using different methodological approaches (online survey, online experiment, laboratory experiment). Implications, limits, and future directions are discussed., (© 2021 The British Psychological Society.)

Health economics uses quality adjusted life years (QALYs) to help healthcare decision makers. However, unlike life expectancy for which age- and sex-dependent national life tables are available, no general population norms exist to use as a benchmark against which to compare observed or modeled projections of QALYs in sub-populations or patients. We developed a 2-state Markov model to generate QALY population norms for the USA, UK, China and Australia. Annual age- and sex-specific probabilities of all-cause mortality were taken from life tables combined with general population country-specific age- and sex-specific health state utilities for the EQ-5D-3L (all countries); and SF-6D (Australia) multi-attribute utility instruments (MAUI). To validate our QALY benchmark model we found that the model closely predicted population life expectancies. Using EQ-5D-3L, undiscounted QALYs for males/females aged 18 years ranged 54.62/58.90 (USA), 55.55/60.21 (China), 57.11/60.16 (Australia), and 58.01/61.43 (UK) years. SF-6D benchmark QALYs for Australia were consistently lower than those generated from the EQ-5D-3L. The gap in undiscounted QALYs between the UK (highest) and the USA (lowest) was 2.53 QALYs in women and 3.39 QALYs in men aged 18 years. Our model's QALY population norms can be used for internal validation of future health economic models for the country-specific value sets for the instruments that we adopted, and when quantifying burden of disease in terms of QALYs lost due to illness compared to the general population. We have created a publicly available repository to continuously include QALY benchmarks that use country-specific value sets for other MAUIs and life expectancies., (© 2021 John Wiley & Sons Ltd.)

Meme-making is an effective method for engaging students and enhancing the learning environment. Memes are a social media cultural phenomenon that the majority of those in Higher Education are exposed to on an almost daily occurrence. This research examined the use of meme-making within the forensic sciences to allow students to reflect on their knowledge. Students studying modules in forensic science across six universities in the UK and USA participated in the study. At the end of a teaching session, students produced a meme (using Meme Generator) to reflect on what they had learned; memes were then shared with the class anonymously via Padlet. This allowed all class members to see and engage with the memes created. At the end of the activity students were anonymously surveyed on their experience using Microsoft Forms and analysis of the results were undertaken using SPSS software. Meme-making was found to be an inclusive learning activity with no limitations, including age (part-time, distance learning and visually impaired students were not part of the study parameters). Results showed that not only did students find the practice fun, but it also helped with the retention of the class content suggesting that the meme-making process is an effective way to enhance the learning environment while engaging students. Student feedback suggests that to maximise participation the educator should stress reflection and learning as the key purpose of generating a meme, rather than being witty or entertaining. The forensic science educator should be mindful of selecting appropriate subject matter for this often-humorous activity., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Purpose of Review: The goal of this paper was to highlight the degree to which sleep, behavioral health, and leader involvement were interrelated using data from militaries in five English-speaking countries: Australia, Canada, New Zealand, the UK, and the United States., Recent Findings: Many service members reported sleeping fewer than the recommended 7 h/night: 34.9%, 67.2%, and 77.2% of respondents from New Zealand, Canada, and the United States, respectively. Countries reporting shorter sleep duration also reported fewer insomnia-related difficulties, likely reflecting higher sleep pressure from chronic sleep loss. Across all countries, sleep problems were positively correlated with behavioral health symptoms. Importantly, leader promotion of healthy sleep was positively correlated with more sleep and negatively correlated with sleep problems and behavioral health symptoms. Insufficient sleep in the military is ubiquitous, with serious implications for the behavioral health and functioning of service members. Leaders should attend to these risks and examine ways to promote healthy sleep in service members., (© 2024. His Majesty the King in Right of Canada as represented by the Minister of National Defence.)

Objectives: This research aimed to identify the characteristics of strong midwifery leaders and explore how strong midwifery leadership may be enabled from the perspective of midwives and nurse-midwives globally., Design: In this appreciative inquiry, we collected qualitative and demographic data using a cross-sectional online survey between February and July 2022., Setting: Responses were received from many countries (n = 76), predominantly the United Kingdom (UK), Australia, the United States of America (USA), Canada, Uganda, Saudi Arabia, Tanzania, Rwanda, India, and Kenya., Participants: An international population (n = 429) of English-speaking, and ethnically diverse midwives (n = 211) and nurse-midwives (n = 218)., Measurements: Reflexive thematic analysis was used to make sense of the qualitative data collected. Identified characteristics of strong midwifery leadership were subsequently deductively mapped to established leadership styles and leadership theories. Demographic data were analysed using descriptive statistics., Findings: Participants identified strong midwifery leaders as being mediators, dedicated to the profession, evidence-based practitioners, effective decision makers, role models, advocates, visionaries, resilient, empathetic, and compassionate. These characteristics mapped to compassionate, transformational, servant, authentic, and situational leadership styles. To enable strong midwifery leadership, participants identified a need for investment in midwives' clear professional identity, increased societal value placed upon the midwifery profession, ongoing research, professional development in leadership, interprofessional collaborations, succession planning and increased self-efficacy., Key Conclusions and Implications for Practice: This study contributes to understandings of trait, behavioural, situational, transformational and servant leadership theory in the context of midwifery. Investing in the development of strong midwifery leadership is essential as it has the potential to elevate the profession and improve perinatal outcomes worldwide. Findings may inform the development of both existing and new leadership models, frameworks, and validated measurement tools., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Equitable representation is key for successful clinical and research work. Inequalities in gender, skin colour, and education have been found among professionals in many medical, surgical and academic fields, but have not been examined yet in the current UK neurologists' workforce. This cross-sectional study examined whether there are disparities in gender, perceived skin colour, education, academic productivity, and career progression among UK neurologists. The names of consultant neurologists working in the UK anytime between December 2021 and March 2022 were found via an online search. Online data were collected regarding education, research activity, academic productivity, impact and progression. A total of 1010 consultant neurologists were found to be working in the UK. There was predominance of men at consultant level, with a university affiliation, and with a full professor position. All 24 female full professors had white skin colour. There were no skin colour or gender disparities in currently being affiliated with a top university, obtaining a Master's degree, or duration between medical degree obtainment and becoming full professors. However, less black or brown neurologists had obtained a PhD, were consultants, andit took them a longer time from medical school graduation until becoming consultants.Less females were currently affiliated with a university and had obtained their medical degree from a top university. There were also skin colour and gender disparities in bibliometrics. In conclusion, this study revealed that there are gender, skin colour, education, academic productivity, and career progression gaps among UK consultant neurologists, which need to be addressed., Competing Interests: Declaration of competing interest The author declares that she has no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Aim: To present a bibliometric overview of pedagogical research from Nurse Education in Practice from its inception in 2001 up until 2023., Background: Bibliometric methods are useful in analysing and understanding the characteristics of scientific publications in a particular field and the influence of specific journals. However, no bibliometric analysis of a nurse education journal has been undertaken to date which would highlight important research trends in this area of nursing and midwifery., Methods: A total of 2231 publications (articles and reviews only) from Nursing Education in Practice were retrieved from the Scopus database between 2001 and 2023. Several software applications including Microsoft Excel and VOSviewer were used to undertake bibliometric analysis on this dataset. Publication trends such as country analysis, author analysis, keywords analyses (cluster, content and trend analysis) were generated to help understand the volume and scope of pedagogical nursing and midwifery research in this journal., Results: There has been a steady increase in pedagogical research from Nurse Education in Practice since its launch in 2001 up until 2018, with a dip in publications in 2022 most likely due to the impact of restrictions during the coronavirus pandemic. The most prolific institutions publishing in the journal are mainly from the United Kingdom, Australia and the United States, with over eighty countries represented demonstrating its global reach and impact. Nursing students, nursing education, simulation and learning are some of the most frequent author keywords., Conclusion: The diversity of pedagogies in nursing and midwifery education, clinical learning and supervision in practice environments, and competence and confidence when transitioning to practice are the most popular research areas in Nurse Education in Practice. This study informs nurse and midwife educators and scholars about the volume and scope of pedagogical research in nursing and midwifery. It also makes recommendations on how to improve aspects of scholarship in education and areas for future pedagogical research., Competing Interests: Declaration of Competing Interest The author declares that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The school nurse has a crucial role in the United States and the United Kingdom and has their own expertise dedicated to school assistance for children, families, school staff, and the community. This study aims to identify the role and skills of the school nurse and understand the effects of COVID-19 on nursing skills in the following countries: The United States, the United Kingdom, and Italy. A Scoping Review was conducted following the JBI methodology for scoping reviews, following the PRISMA-ScR guidelines. Three databases were consulted: PubMed, Cinahl, and Scopus. In all, 58 studies met the eligibility criteria and were included. 93.1% of the studies were carried out in the United States, 5.2% in the United Kingdom, and 1.7% in Italy. 34.5% of the articles were published in 2020, 15.5% in 2021, 31% in 2022, and 19% in 2023. 22.4% of the studies included in the review concerned health promotion and education. Regarding the methodology of the studies, 41.5% of the studies were commentary papers, 15.5% were observational studies, and 12% were cross-sectional studies. Considering the effects of the school nurse in the United States and the United Kingdom, it is possible to reflect on how the systematic presence of a nurse could also have benefits in Italy., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: Hardly any value frameworks exist that are focused on provider-facing digital health technologies (DHTs) for managing chronic disease with diverse stakeholder participation in their creation. Our study aimed to 1) understanding different stakeholder opinions on where value lies in provider-facing technologies and 2) create a comprehensive value assessment framework for DHT assessment., Methods: Mixed-methods comprising both primary and secondary evidence were used. A scoping review enabled a greater understanding of the evidence base and generated the initial indicators. Thirty-four indicators were proposed within 6 value domains: health inequalities (3), data rights and governance (6), technical and security characteristics (6), clinical characteristics (7), economic characteristics (9), and user preferences (3). Subsequently, a 3-round Web-Delphi was conducted to rate the indicators' importance in the context of technology assessment and determine whether there was consensus., Results: The framework was adapted to 45 indicators based on participant contributions in round 1 and delivered 16 stable indicators with consensus after rounds 2 and 3. Twenty-nine indicators showed instability and/or dissensus, particularly the data rights domain, in which all 5 indicators were unstable, showcasing the novelty of the concept of data rights. Significant instability between important and very important ratings was present within stakeholder groups, particularly clinicians and policy experts, indicating they were unsure how different aspects should be valued., Conclusions: Our study provides a comprehensive value assessment framework for assessing provider-facing DHTs incorporating diverse stakeholder perspectives. Instability for specific indicators was expected due to the novelty of data and analytics integration in health technologies and their assessment. Further work is needed to ensure that, across all types of stakeholders, there is a clear understanding of the potential impacts of provider-facing DHTs., Highlights: Current health technology assessment (HTA) methods may not be well suited for evaluating digital health technologies (DHTs) because of their complexity and wide-ranging impact on the health system.This article adds to the literature by exploring a wide range of stakeholder opinions on the value of provider-facing DHTs, creating a holistic value framework for these technologies, and highlighting areas in which further discussions are needed to align stakeholders on DHTs' value attributes.A Web-based Delphi co-creation approach was used involving key stakeholders from throughout the digital health space to generate a widely applicable value framework for assessing provider-facing DHTs. The stakeholders include patients, health care professionals, supply-side actors, decision makers, and academia from the United States, United Kingdom, and Germany.High levels of instability among stakeholders and value domains are demonstrated, indicating the novelty of assessing provider-facing DHTs and their impact on the health system., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Financial support for this paper was provided by a contract with Sanofi S.A. The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report.

Quantifying tumor-infiltrating lymphocytes (TILs) in breast cancer tumors is a challenging task for pathologists. With the advent of whole slide imaging that digitizes glass slides, it is possible to apply computational models to quantify TILs for pathologists. Development of computational models requires significant time, expertise, consensus, and investment. To reduce this burden, we are preparing a dataset for developers to validate their models and a proposal to the Medical Device Development Tool (MDDT) program in the Center for Devices and Radiological Health of the U.S. Food and Drug Administration (FDA). If the FDA qualifies the dataset for its submitted context of use, model developers can use it in a regulatory submission within the qualified context of use without additional documentation. Our dataset aims at reducing the regulatory burden placed on developers of models that estimate the density of TILs and will allow head-to-head comparison of multiple computational models on the same data. In this paper, we discuss the MDDT preparation and submission process, including the feedback we received from our initial interactions with the FDA and propose how a qualified MDDT validation dataset could be a mechanism for open, fair, and consistent measures of computational model performance. Our experiences will help the community understand what the FDA considers relevant and appropriate (from the perspective of the submitter), at the early stages of the MDDT submission process, for validating stromal TIL density estimation models and other potential computational models. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA., (© 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.)

Objectives: The objectives of the study were: 1) Describe the thematic structure and evolution of the field of physical therapy; 2) identify the main research producers (i.e. countries and institutions); and 3) compare their research output and citation impact., Methods: Papers related to physical therapy indexed in Web of Science (2000-2018) were identified to delineate the field, using keywords, journals, and citation networks. VOSviewer software, advanced bibliometric text mining, and visualization techniques were used to evaluate the thematic structure. We collected data about the country and institutional affiliation of all the authors and calculated production and citation impact indicators., Results: 85,697 papers were analyzed. Eleven thematic clusters were identified: 1) "health care and education"; 2) "biomechanics"; 3) "psychosocial, chronic pain and quality of life outcomes"; 4) "evidence-based physical therapy research methods"; 5) "traumatology and orthopedics"; 6) "neurological rehabilitation"; 7) "psychometrics and cross-cultural adaptation"; 8) "gait-balance analysis and Parkinson's disease"; 9) "exercise"; 10) "respiratory physical therapy"; and 11) "back pain." The United States, the United Kingdom, and Australia were the most productive countries. Netherlands, Norway, and Sweden had the highest citation impact., Conclusions: Our bibliometric visualization approach makes it possible to comprehensively study the thematic structure of physical therapy. The ranking of producers has evolved and now includes China and Brazil. High research production does not imply a high citation impact.

Background: Preparing nursing students for practice is supported by developing a global perspective of health care delivery models. However, many schools of nursing and students lack the resources for study abroad., Method: Using a virtual stay-in place model, 42 international students applied an evidenced-based approach to study statistics, research, transitions in care, and elder care models that supported collaboration among peers from Austria, Switzerland, Chile, the United Kingdom, and the United States. Students explored social, economic, and reimbursement factors not encountered in the typical classroom., Results: Student beliefs and perspectives changed after completing a program with global peers. Survey results and themes in reflection papers indicated increased ability to conceptualize content in new ways, including holistic elder care, cultural practices and reimbursement options, and effects on future practice., Conclusion: Virtual international learning experiences are an effective education innovation that allows student to connect and learn from one another using a stay-in place model. [ J Nurs Educ . 2023;62(11):647-649.] .

Background: One of the most difficult challenges in healthcare involves equitable allocation of resources. Our review aimed to identify international funding models in Organisation for Economic Co-operation and Development (OECD) countries for government-funded public hospitals and evidence underpinning their efficacy, via review of the peer-reviewed and grey literature., Methods: Ovid-Medline, Ovid Embase, Scopus, and PubMed were searched for peer-reviewed literature. Advanced Google searches and targeted hand searches of relevant organisational websites identified grey literature. Inclusion criteria were: English language, published between 2011 and 2022, and that the article: (1) focused on healthcare funding; (2) reported on or identified specific factors, indexes, algorithms or formulae associated with healthcare funding; and (3) referred to countries that are members of the OECD, excluding the United States (US)., Results: For peer-reviewed literature 1189 abstracts and 35 full-texts were reviewed; six articles met the inclusion criteria. For grey literature, 2996 titles or abstracts and 37 full-texts were reviewed; five articles met the inclusion criteria. Healthcare funding arrangements employed in 15 OECD countries (Australia, Belgium, Canada, Finland, France, Germany, Israel, Italy, the Netherlands, New Zealand, Norway, Spain, Sweden, Switzerland, and the United Kingdom [UK; specifically, England, Scotland, Wales and Northern Ireland]) were identified, but papers reported population-based funding arrangements for specific regions rather than hospital-specific models., Conclusions: While some models adjusted for deprivation and ethnicity factors, none of the identified documents reported on health systems that adjusted funding allocation for social determinants such as health literacy levels., (© 2023 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.)

Older job seekers dropping out of the active workforce is a major challenge for individuals, organizations, and society, resulting in the need to protect and extend their working lives. Based on the discouraged workers approach, this study used career construction theory to study how past experiences can discourage older job seekers and make them withdraw from the job search. Specifically, we explored how age discrimination is connected to lower levels of older job seekers' occupational future time perspective (i.e., remaining time and future opportunities) and how it results in less career exploration and higher retirement intentions. Using a three-wave design, we followed 483 older job seekers in two countries (the United Kingdom and the United States) over a total period of two months. Results of structural equation modeling showed that perceived age discrimination decreased older job seekers' remaining time and future opportunities. Further, remaining time was negatively linked to retirement intentions, whereas future opportunities were positively linked to career exploration. Furthermore, results revealed two indirect effects of age discrimination on (1) retirement intentions via remaining time and (2) career exploration via future opportunities. These results show how damaging age discrimination can be in the job search context and we call for the search of potential moderators that can buffer the negative impact of age discrimination. Practitioners should work on protecting older job seekers' occupational future time perspective to keep them active instead of losing them to early retirement., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Only rigorous evaluation of competence will result in the production of safe surgeons that are able to provide the best care for patients. The development of competency-based assessment should ultimately be evidence driven., Objectives: Explore the volume of existing evidence pertaining to the different objective assessment methods reported in the literature., Eligibility Criteria: Studies describing objective assessment of postgraduate general surgical trainees within the last 20 years., Sources of Evidence: PubMed, Ovid Medline and Web of Sciences., Charting Methods: A data chart proforma was designed and data were extracted into tables. Basic numerical analysis of extracted data and narrative synthesis of charted data., Results: A total of 343 papers were reviewed. 26 were eligible for inclusion. 92% of articles were published from 2008 onwards. 50% have been published in the last five years. The articles originated from 6 different countries, predominantly the United Kingdom (42%), followed by the United States of America (38%). In addition, a small number were published from Canada (8%), Japan (4%), Germany (4%) and Australia (4%). UK publications were predominantly between 2008 and 2014 while the USA had a later predominance between 2015 and 2018. 42% were based on quantitative methodology, 27% had a qualitative approach while 31% had mixed analysis. There were sixteen assessment methods presented. The most common type of assessment was Objective Structured Assessments (27%), which included Objective Structured Assessment of Technical Skill (OSATS) (23%) and Objective Structured Assessment of Non-Technical Skill (4%). Procedure Based Assessment (PBA) (23%) and Entrustability Scales (23%) were also prevalent., Conclusions: This scoping review has identified a range of different assessment methods. The assessment methods with a higher volume and level of supporting evidence were OSATS, PBAs and Entrustability Scales. There was a lower volume and level of supporting evidence found within this review for the remaining assessment methods., Competing Interests: Declaration of competing interest There are no competeing interests. In addition there was no external funding provided in the course of this research., (Crown Copyright © 2022. Published by Elsevier Ltd. All rights reserved.)

A large body of literature suggests that children living with two married, biological parents on average have fewer behavior problems than those who do not. What is less clear is why this occurs. Competing theories suggest that resource deficiencies and parental selectivity play a part. We suggest that examining different contexts can help adjudicate among different theoretical explanations as to how family structure relates to child behavior problems. In this paper, we use data from the Growing Up in Australia: Longitudinal Study of Australian Children (LSAC), the UK Millennium Cohort Study (MCS), and the US Early Childhood Longitudinal Study (ECLS-K) to examine the relationship between family structure and child behavior problems. Specifically, we look at how living in several configurations of biological and social parents may relate to child behavior problems. Findings suggest both similarities and differences across the three settings, with explanations in the UK results favoring selectivity theories, US patterns suggesting that there is a unique quality to family structure that can explain outcomes, and the Australian results favoring resource theories.

There is a long history of regarding marginalised groups as unfit to parent and of eugenic policies targeting those with 'undesirable' bodily conditions or behaviours. This is part of a broader pattern of stratified reproduction - structural conditions that enable or discourage certain groups from reproducing - that often brings about and exacerbates injustices. This paper critically assesses the US and UK social and medical literature on applying pressure to marginalised groups, or those who have behaved 'irresponsibly', to use long-acting reversible contraception (LARC). Targeting young people for LARC fails to recognise that social inequality is the context for teenage pregnancy, not the result of it. Provider pressure on women of colour to use LARC is linked to institutional racism, whilst policy for those with physical and intellectual disabilities is shaped by disability discrimination. Other groups to be targeted include so-called 'welfare mothers', substance users, those who have had children put into care and offenders. Particularly controversial are cases in which LARC has been ordered by courts. LARC policy incorporating these kind of discriminatory practices needs to stop; future policy should focus on person-centred care that bolsters reproductive justice.

International research and collaboration has been a part of the National Cancer Institute's (NCI) mission since its creation in 1937. Early on, efforts were limited to international exchange of information to ensure that US cancer patients could benefit from advances in other countries. As NCI's research grant portfolio grew in the 1950s, it included a modest number of grants to foreign institutions, primarily in the United Kingdom and Europe. In the 1960s, the development of geographic pathology, which aimed to study cancer etiology through variations in cancer incidence and risk factors, led to an increase in NCI-funded international research, including research in low- and middle-income countries. In this paper, we review key international research programs, focusing particularly on the first 50 years of NCI history. The first NCI-led overseas research programs, established in the 1960s in Ghana and Uganda, generated influential research but also struggled with logistical challenges and political instability. The 1971 National Cancer Act was followed by the creation of a number of bilateral agreements with foreign governments, including China, Japan, and Russia, to support cooperation in technology and medicine. Although these agreements were broad without specific scientific goals, they provided an important mechanism for sustained collaborations in specific areas. With the creation of the NCI Center for Global Health in 2011, NCI's global cancer research efforts gained sustained focus. Because the global cancer burden has evolved over time, increasingly impacting low- and middle-income countries, NCI's role in global cancer research remains more important than ever., (Published by Oxford University Press 2022. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

In January 2019, the United States National Academy of Medicine initiated a comprehensive study of the status of current knowledge and clinical practices associated with temporomandibular disorders (TMDs). The National Academy of Sciences, which includes the National Academy of Medicine, was chartered by the US Government in the late 1800s as a non-profit institution working outside of government in order to provide unbiased, objective opinions on matters including healthcare. In this brief paper, we will discuss the open access 2020 report Temporomandibular disorders: priorities for research and care, available online. While the main focus of this report was the situation of TMDs in the US, the evidence base, authorship, expertise and literature scope was international and the findings therefore are at least in part generalisable to and important for the UK.The authors of this commentary were directly involved in the National Academy process, with RO a panel member, JD a consultant and CG one of 15 reviewers of the draft report. There was a wide variety of clinical and research fields involved in gathering the evidence and constructing the report. In addition, there was extensive involvement from affected patients with TMDs and their families, which is critical because their perspective is typically omitted in textbooks and professional consensus meetings., (© 2022. The Author(s), under exclusive licence to the British Dental Association.)

Dyslexia is a disorder characterized by an impaired ability to understand written and printed words or phrases. Epidemiological longitudinal data show that dyslexia is highly prevalent, affecting 10-20% of the population regardless of gender. This study aims to provide a detailed overview of research status and development characteristics of dyslexia from types of articles, years, countries, institutions, journals, authors, author keywords, and highly cited papers. A total of 9,166 publications have been retrieved from the Social Sciences Citation Index (SSCI) and Science Citation Index Expanded (SCI-E) from 2000 to 2021. The United States of America, United Kingdom, and Germany were the top three most productive countries in terms of the number of publications. China, Israel, and Japan led the Asia research on dyslexia. University of Oxford had the most publications and won first place in terms of h-index. Dyslexia was the most productive journal in this field and Psychology was the most used subject category. Keywords analysis indicated that "developmental dyslexia," "phonological awareness," children and fMRI were still the main research topics. "Literacy," "rapid automatized naming (RAN)," "assessment," "intervention," "meta-analysis," "Chinese," "executive function," "morphological awareness," "decoding," "dyscalculia," "EEG," "Eye tracking," "rhythm," "bilingualism," and "functional connectivity" might become the new research hotspots., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wu, Cheng, Yang, Yu and Wan.)

Background: A recent meta-analysis suggested that the majority of young people in contact with the criminal justice system have cognitive and/or communication impairments. Over the past 20 years, recognition of these complex needs has resulted in support measures being put in place in courtrooms across the globe. It is therefore timely to review evidence for the efficacy of these measures., Aims: This scoping review evaluates evidence on support measures employed to facilitate access to court proceedings for individuals with cognition and communication impairments, and considers how this evidence might inform future research and practice., Methods: Research databases were searched for studies that: directly or indirectly involved a population with a form of functional impairment and/or diagnosed neurodevelopmental disorder; and refer to support delivered to remove barriers or support access to courtroom processes., Results: Searches identified 3,318 distinct articles. Following review, 37 papers were identified for inclusion. The papers were published between 1993 and 2019, with the majority being published since 2010 (n = 23). The majority of papers were from the United Kingdom (n = 26); other countries represented were Australia (n = 1), Canada (n = 3), New Zealand (n = 2), UK papers don't necessarily state which countries involved (n = 2) Scotland specifically state Scotland only and the United States (n = 3). No papers met the criteria for an experimental research design., Conclusions: Whilst the high level of need in this population is well established, which support measures are most effective in enabling engagement in court processes is not currently clear. More robust evaluative research is therefore required to establish the most effective methods of support. Despite this lack of evidence regarding outcomes, both young people and professionals generally view support measures favourably. There is an increasing onus on professionals to adapt their practice rather than to support/enhance the cognition and communication skills of young people., (© 2022 The Authors. Criminal Behaviour and Mental Health published by John Wiley & Sons Ltd.)

This paper compares health policy responses to COVID-19 in Canada, Ireland, the United Kingdom and United States of America (US) from January to November 2020, with the aim of facilitating cross-country learning. Evidence is taken from the COVID-19 Health System Response Monitor, a joint initiative of the European Observatory on Health Systems and Policies, the WHO Regional Office for Europe, and the European Commission, which has documented country responses to COVID-19 using a structured template completed by country experts. We show all countries faced common challenges during the pandemic, including difficulties in scaling-up testing capacity, implementing timely and appropriate containment measures amid much uncertainty and overcoming shortages of health and social care workers, personal protective equipment and other medical technologies. Country responses to address these issues were similar in many ways, but dissimilar in others, reflecting differences in health system organization and financing, political leadership and governance structures. In the US, lack of universal health coverage have created barriers to accessing care, while political pushback against scientific leadership has likely undermined the crisis response. Our findings highlight the importance of consistent messaging and alignment between health experts and political leadership to increase the level of compliance with public health measures, alongside the need to invest in health infrastructure and training and retaining an adequate domestic health workforce. Building on innovations in care delivery seen during the pandemic, including increased use of digital technology, can also help inform development of more resilient health systems longer-term., (Copyright © 2021. Published by Elsevier B.V.)

This paper primarily aims to provide a citation-based method for exploring the scholarly network of artificial intelligence (AI)-related research in the information science (IS) domain, especially from Global North (GN) and Global South (GS) perspectives. Three research objectives were addressed, namely (1) the publication patterns in the field, (2) the most influential articles and researched keywords in the field, and (3) the visualization of the scholarly network between GN and GS researchers between the years 2010 and 2020. On the basis of the PRISMA statement, longitudinal research data were retrieved from the Web of Science and analyzed. Thirty-two AI-related keywords were used to retrieve relevant quality articles. Finally, 149 articles accompanying the follow-up 8838 citing articles were identified as eligible sources. A co-citation network analysis was adopted to scientifically visualize the intellectual structure of AI research in GN and GS networks. The results revealed that the United States, Australia, and the United Kingdom are the most productive GN countries; by contrast, China and India are the most productive GS countries. Next, the 10 most frequently co-cited AI research articles in the IS domain were identified. Third, the scholarly networks of AI research in the GN and GS areas were visualized. Between 2010 and 2015, GN researchers in the IS domain focused on applied research involving intelligent systems (e.g., decision support systems); between 2016 and 2020, GS researchers focused on big data applications (e.g., geospatial big data research). Both GN and GS researchers focused on technology adoption research (e.g., AI-related products and services) throughout the investigated period. Overall, this paper reveals the intellectual structure of the scholarly network on AI research and several applications in the IS literature. The findings provide research-based evidence for expanding global AI research., Competing Interests: The authors have declared that no competing interests exist.

Fatality rates such as fatalities per full-time equivalent workers are officially used to compare the risk level of the construction industry among various countries. However, each country evaluates the fatality rate using different conditions. This paper presents the comparison of fatality rates of various countries using conventional (national data) and pair (equivalent condition) methods through a time-series approach. The research was conducted in three stages. The risk level was evaluated in order in South Korea (1.54), Japan (0.84), Mexico (0.83), China (0.70), United Kingdom (0.15), and Singapore (0.13) in terms of national data. However, the risk level was re-evaluated in order in China (2.27), South Korea (2.05), Mexico (1.23), Singapore (0.98), Japan (0.80), and United Kingdom (0.47) in terms of equivalent conditions. The risk level of each can be changed when the fatality rate is compared under given equivalent conditions.

Objective: This study aimed to analyze the progression and trends of multimorbidity in the elderly in China and internationally from a bibliometric perspective, and compare their differences on hotspots and research fronts., Methods: Publications between January 2001 and August 2021 were retrieved from WOS and CNKI databases. Endnote 20 and VOSviewer 1.6.8 were used to summarize bibliometric features, including publication years, journals, and keywords, and the co-occurrence map of countries, institutions, and keywords was drawn., Results: 3857 research papers in English and 664 research papers in Chinese were included in this study. The development trends of multimorbidity in the elderly are fully synchronized in China and other countries. They were divided into germination period, development period, and prosperity period. Research literature in English was found to be mainly focused on public health, and the IF of the literature is high; In China, however, most research papers are in general medicine and geriatrics with fewer core journals. Co-occurrence analysis based on countries and institutions showed that the most productive areas were the United States, Canada, the United Kingdom, and Australia, while the Chinese researchers have made little contribution. The clustering analysis of high-frequency keywords in China and around the globe shows that the hotspots have shifted from individual multimorbidity to group multimorbidity management. Sorting out the top 10 highly cited articles and highly cited authors, Barnett, K's article published in Lancet in 2012 is regarded as a milestone in the field., Conclusion: Multimorbidity in the elderly leads to more attention in the world. Although China lags behind global research the research fronts from disease-centered to patient-centered, and individual management to population management is consistent.

This paper provides a narrative review of the existing literature on differences in demographic and biological features of breast cancer at time of diagnosis between Black and White women in Canada, the United Kingdom and the United States. Electronic database searches for published peer-reviewed articles on this topic were conducted, and 78 articles were included in the final narrative review. Differences between Black and White women were compared for eight categories including age, tumour stage, size, grade, lymph node involvement, and hormone status. Black women were significantly more likely to present with less favourable tumour features at the time of diagnosis than White women. Significant differences were reported in age at diagnosis, tumour stage, size, grade and hormone status, particularly triple negative breast cancer. Limitations on the generalizability of the review findings are discussed, as well as the implications of these findings on future research, especially within the Canadian context., (© 2021. The Author(s).)

Electric vehicles (EVs) can substantially decrease atmospheric pollutant emissions, thereby improving air quality, decreasing global warming, and improving human health. In this study, we performed a comprehensive bibliometric analysis using Web of Science to understand the research developments and future perspectives in EVs between 1974 and 2021. The analysis of indicators such as research trends, publication growth, and keywords revealed that most research in the selected timeframe was focused on applying and optimizing the existing technologies of different types of EVs to decrease air pollution and mortality. The changes in air quality owing to such electrification received special attention, with approximately 441 publications preferably in the English language. Among all the retrieved documents, research articles were most common (n = 295; 66.89% of the global output), dominated by the research domains of environmental sciences, followed by energy fuels and transportation science technology. Journal analysis revealed that Sustainability (n = 19, 4.30%) was the leading journal, followed by Journal of Cleaner Production and Science of the Total Environment. The most frequently used keywords were "electric vehicles," "air quality," and "air pollution." The most highly impactful article was published by Jacobson et al. (2005) in Science, with 620 total citations and 38.82 average annual citations. Furthermore, the United States (n = 118; 26.75% of the global output) had the highest publication rate, followed by China and the United Kingdom. The leading institutions were Tsinghua University (n = 16; 3.62% of the global research output) in China, followed by the University of Michigan and Cornell University in the United States. The current analysis warrants more focus on comprehensive analysis employing transport and chemistry modeling and using the latest technology for long life and sustainable batteries. This study provides a basis for future studies on improving air quality through innovative work in the electrification of vehicles., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Introduction: This paper reviews the potential legal ramifications of prescribing or dispensing generics for people with epilepsy (PWE) and the international perspective., Special Considerations: Anti-seizure medications (ASM) control ~70% of seizures. Generic alternatives must respect -20% to +25% of the bioequivalence of the 'parent' medication but are not tested, one against another. The first generic may reflect -20% and the next +25%, almost halving or doubling the bioequivalence. While doctors in some countries, prescribing ASM, have the option to deny generic substitution, this may not always be respected by the 'learned intermediary'. Use of trade name, be it of a specific generic or the parent compound, obviates the potential for substitution, especially if prohibiting substitution., Legal Consequences Attached to Brand Substitution: Patients given a generic substitute, without warning of potential risks who experience serious consequences, may litigate for medical negligence. This responsibility rests with the provision and failure to warn, be it doctor, pharmacist or institution. Where a pharmacist ignores a doctor's instruction, there is also the potential of professional misconduct., International Perspective: In the USA, litigation against manufacturers failed but litigating against prescribers or dispensers remains possible. While generic substitution is preferred, US doctors retain the right to reject brand substitution. Other jurisdictions likewise advocate generics, some mandating the same, but most offer the option to refuse brand substitution., Conclusions: Generic substitution, particularly for PWE, has the potential for serious harm. There is a duty of care to warn of such risks. It is the responsibility of the provider to so warn, thereby achieving informed consent., (Copyright © 2021. Published by Elsevier Ltd.)

Research has shown that stress impacts on people's religious beliefs. However, several aspects of this effect remain poorly understood, for example regarding the role of prior religiosity and stress-induced anxiety. This paper explores these aspects in the context of the recent coronavirus pandemic (COVID-19). The latter has impacted dramatically on many people's well-being; hence it can be considered a highly stressful event. Through online questionnaires administered to UK (n = 140) and USA (n = 140) citizens professing either Christian faith or no religion, this paper examines the impact of the coronavirus crisis upon common people's religious beliefs. Anxiety about the coronavirus and prior religiosity showed an interaction effect upon change in religious beliefs (t(276) = 2.27, p = .024): for strong believers higher anxiety about coronavirus was associated with increased strengthening of religious beliefs (r = .249), while for non-believers higher anxiety about coronavirus was associated with increased scepticism towards religious beliefs (r = - .157). These observations are consistent with the notion that stress-induced anxiety enhances support for an individual's existing ideology already embraced before a stressful event occurs. This study sheds light on the psychological and cultural implications of the coronavirus crisis, which represents one of the most serious health emergencies in recent times., (© 2021. The Author(s).)

Objective: Internationally, primary care practice had to transform in response to the COVID pandemic. Informatics issues included access, privacy, and security, as well as patient concerns of equity, safety, quality, and trust. This paper describes progress and lessons learned., Methods: IMIA Primary Care Informatics Working Group members from Australia, Canada, United Kingdom and United States developed a standardised template for collection of information. The template guided a rapid literature review. We also included experiential learning from primary care and public health perspectives., Results: All countries responded rapidly. Common themes included rapid reductions then transformation to virtual visits, pausing of non-COVID related informatics projects, all against a background of non-standardized digital development and disparate territory or state regulations and guidance. Common barriers in these four and in less-resourced countries included disparities in internet access and availability including bandwidth limitations when internet access was available, initial lack of coding standards, and fears of primary care clinicians that patients were delaying care despite the availability of televisits., Conclusions: Primary care clinicians were able to respond to the COVID crisis through telehealth and electronic record enabled change. However, the lack of coordinated national strategies and regulation, assurance of financial viability, and working in silos remained limitations. The potential for primary care informatics to transform current practice was highlighted. More research is needed to confirm preliminary observations and trends noted., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (IMIA and Thieme. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

A transition toward environmentally conscious business practices is underway in many sectors. For healthcare, the topic is both concerning and tragically ironic as hospitals have substantial environmental footprints, which are now known to contribute to significant health problems that the system itself was designed to treat. The human medical field has been proactive in taking steps to reduce waste and carbon emissions by identifying best practices to minimize such impacts. Characterization of needs and gaps has been addressed through reviews of the literature regarding environmental sustainability in the context of human hospitals. Our objective was to replicate methods used in a recent review of environmental sustainability in human hospitals to summarize information available to clinical veterinarians. Two search algorithms were used across 8 databases, however only 3 peer-reviewed opinion articles specific to veterinary medicine were identified. These papers included 1 on anesthesia and 2 on production animals. Interestingly, all articles were written by United Kingdom-based authors and none were specific to companion animal practice, the largest sector in the veterinary industry in the United States. Results of this review highlight need for research and communication that supports veterinary clinics in adopting more environmentally sustainable practices. Proposed starting points informed from research in other sectors, including 5 physical themes of energy efficiency, water, waste, sustainable procurement, and transportation, and human behavior changes on the individual, group, and organizational levels, are discussed. Additional work is needed to support veterinarians and other animal health professionals to practice medicine in a way that upholds the veterinary profession's oath to promote the health of animals, the public, and the environment we all share., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Background and Objectives: Black, African, and Caribbean (BAC) families are disproportionately affected by dementia but engage less with services. Studies reporting their experiences of dementia have tended to aggregate people from diverse backgrounds, without considering the impact of this diversity, or researchers' ethnicities. We investigated participants' and researchers' ethnic identities, exploring how this relates to findings., Research Design and Methods: We searched electronic databases in September 2018, for qualitative studies exploring how participants of Black ethnicity understand and experience dementia and dementia care. We reported participants' and researchers' ethnicities, and meta-synthesized qualitative findings regarding how ethnicity influences experiences and understanding of dementia., Results: Twenty-eight papers reported 25 studies; in United States (n = 17), United Kingdom (n = 7), and Netherlands (n = 1). 350/492 (71%) of participants were in U.S. studies and described as African American; participants in U.K. studies as Caribbean (n = 45), African/Caribbean (n = 44), African (n = 28), Black British (n = 7), or Indo-Caribbean (n = 1); and in Netherlands as Surinamese Creole (n = 17). 6/25 (24%) of studies reported involving recruiters/interviewers matching participants' ethnicity; and 14/25 (56%) involved an author/advisor from a BAC background during analysis/procedures. We identified four themes: Dementia does not relate to me; Inappropriate and disrespectful services; Kinship and responsibility; Importance of religion., Discussion and Implications: Studies were mostly from a U.S. African American perspective, by researchers who were not of BAC background. Themes of dementia diagnosis and services feeling less relevant to participants than the majority population resonated across studies. We caution against the racialization of these findings, which can apply to many differing minority groups., (© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America.)

This paper maps key regulatory, governance and legal challenges associated with the UK's withdrawal from the European Union (EU) in terms of convergent and divergent pressures within the global pharmaceutical sector. These include (i) convergent regulatory pressures associated with the European framework for pre-market licensing; (ii) convergent and divergent industry pressures with regard to drug discovery and manufacturing; and (iii) divergent and convergent market pressures associated with the supply, pricing and assessment of medicines. The UK's sovereign ambitions risk a loss of influence over the licensing and surveillance of pharmaceuticals under convergent regulatory and industry pressures to engage in unilateral participation in the European regime. Further, they also risk a loss of influence over processes for pricing and assessing the effectiveness of new treatment regimens under divergent market pressures from larger pharmaceutical markets outside the EU, notably the United States.

Using the extended science citation index database (SCI) and social science citation index (SSCI) databases, this paper analyzed the characteristics of publications, research foundations, research hotspots, and the evolutionary tracks of studies in the field of energy, environment, and climate change from 1990 to 2019 using a bibliometric method. This method is useful because it involves the quantitative analysis of large amounts of literature, using mathematical and statistical method. The results showed that the United States (US), the United Kingdom (UK), and China were the countries with the most published papers in the field. The US plays a key role in the cooperation between international institutions. An assessment conducted by the Intergovernmental Panel on Climate Change (IPCC) created the standard scientific reference for the research on climate change and its consequences. From 2006 to 2016, a large number of co-cited papers laid a solid foundation for research in the field. During this period, the research focused on the impact of climate change on the ecological environment, began to propose different countermeasures, and formed a set of mature research methods. From 2017 to 2019, there was an acceleration in the growth rate of the number of published articles. Strategies to address climate change, including renewable energy and energy transition, were the focus during this phase. Future studies are expected to focus on climate change mitigation strategies and energy policies. The findings provide a reference for researchers and can help policy makers balance economic development with environmental protection., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Discrete choice experiment (DCE) as a tool that can measure medical stakeholders' preferences especially patients recently has been increasingly applied in health care. Objective: The aim of this study was to examine the hotspots and trends of the application of DCE in health care and to provide reference and direction for further development of DCE in the future. Method: A bibliometric method was implemented using the Web of Science (WoS) Core Collection for the period from the database established to December 8, 2020. The data files are imported into CiteSpace and Excel to analyze and visualize the annual volume of productive, authors, countries, cited journals, cited articles, and keywords. Results: A total of 1,811 articles were retrieved, then we read the abstract of each paper one by one, and 1,562 articles were included after screening, with an exponential increase in publication volume. John F. P. Bridges contributed to 40 publications and ranked first, followed by F. Reed Johnson ( n = 37), Julie Ratcliffe ( n = 36). The majority of the papers were conducted in the United States ( n = 513) and the United Kingdom ( n = 433). The top three cited journals were " Health Economics " ( n = 981), " Value in Health " ( n = 893), and " Pharmaceutical Economics " ( n = 774), and the top three articles were "Constructing experimental designs for discrete-choice experiments: report of the ISPOR Conjoint Analysis Experimental Design Good Research Practices Task Force," "Conjoint analysis applications in health-a checklist: a report of the ISPOR Good Research Practices for Conjoint Analysis Task Force," and "Discrete choice experiments in health economics: a review of the literature." The research hotspots and trends included "health technology assessment," "survival," "preference based measure," and "health state valuation." Conclusion: The size of the literature about DCE studies in health care showed a noticeable increase in the past decade. The application of DCE in health care remains in an early growth phase, and "health technology assessment," "survival," "preference based measure," and "health state valuation" reflected the latest research hotpots and future trends., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Wang, Wang, Wang, Li, Pang and Wang.)

This paper aimed to explore the characteristics of the top-100 cited articles on the biomarkers in the depression field and strive to find the future trend. The top-100 cited articles were selected from the Web of Science Core Collection database. Excel 2016 and VOSviewer 1.6.9 were used to analyze the information. Forty-six journals contributed to these 100 articles, and Biological Psychiatry published the largest number of articles (n = 18). Holsboer F (n = 4) contributed the most, and Maes M (n = 118) was the most co-cited author. Twenty-six countries and 220 organizations contributed to the top-100 articles, respectively. The USA (n = 48) was the main contributor. NIMH and Kings Coll London both participated in seven articles. Major depression (n = 62), depression (n = 38) and biomarker (n = 31) were the top three keywords. These results indicated that articles published in journals with higher impact factors are more likely to spread. Compared with developing countries, developed countries have contributed more to these articles. It is suggested that cooperation should be strengthened between developed countries and developing counties in the future. More research on biomarkers in the depression field may still mainly focus on major depression. Abbreviation: WoS = Web of Science; JCR = Journal Citation Reports; UK = United Kingdom; NIMH = The National Institute of Mental Health; UCL = University College London; IF = Impact factor; BDNF = brain-derived neurotrophic factor; USA = United States.

This paper studies the interplay between social distancing and the spread of the COVID-19 disease-a global pandemic that has affected most of the world's population. Our goals are to (1) to observe the correlation between the strictness of social distancing policies and the spread of disease and (2) to determine the optimal adoption level of social distancing policies. The earliest instances of the virus were found in China, and the virus has reached the United States with devastating consequences. Other countries severely affected by the pandemic are Brazil, Russia, the United Kingdom, Spain, India, Italy, and France. Although it is impossible to stop it, it is possible to slow down its spread to reduce its impact on the society and economy. Governments around the world have deployed various policies to reduce the virus spread in response to the pandemic. To assess the effectiveness of these policies, the system's dynamics of the society needs to be analyzed, which is generally not possible with mathematical linear equations or Monte Carlo methods because human society is a complex adaptive system with continuous feedback loops. Because of the challenges with the other methods, we chose agent-based methods to conduct our study. Moreover, recent agent-based modeling studies for the COVID-19 pandemic show significant promise in assisting decision-makers in managing the crisis by applying policies such as social distancing, disease testing, contact tracing, home isolation, emergency hospitalization, and travel prevention to reduce infection rates. Based on modeling studies conducted in Imperial College, increasing levels of interventions could slow the spread of disease and infection. We ran the model with six different percentages of social distancing while keeping the other parameters constant. The results show that social distancing affects the spread of COVID-19 significantly, in turn decreasing the spread of disease and infection rates when implemented at higher levels. We also validated these results by using the behavior space tool with ten experiments with varying social distancing levels. We conclude that applying and increasing social distancing policy levels leads to a significant reduction in infection spread and the number of deaths. Both experiments show that infection rates are reduced drastically when social distancing intervention is implemented between 80% to 100%.

This review paper examines the extent of employer, worker, and labour union concerns to occupational health hazard exposure, as a function of previously reported and investigated complaints. Consequently, an online literature search was conducted, encompassing publicly available reports resulting from investigations, regulatory inspection, and enforcement activities conducted by relevant government structures from South Africa, the United Kingdom, and the United States. Of the three countries' government structures, the United States' exposure investigative activities conducted by the National Institute for Occupational Safety and Health returned literature search results aligned to the study design, in the form of health hazard evaluation reports reposited on its online database. The main initiators of investigated exposure cases were employers, workers, and unions at 86% of the analysed health hazard evaluation reports conducted between 2000 and 2020. In the synthesised literature, concerns to exposure from chemical and physical hazards were substantiated by occupational hygiene measurement outcomes confirming excessive exposures above regulated health and safety standards in general. Recommendations to abate the confirmed excessive exposures were made in all cases, highlighting the scientific value of occupational hygiene measurements as a basis for exposure control, informing risk and hazard perception. Conclusively, all stakeholders at the workplace should have adequate risk perception to trigger abatement measures.