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Moving towards a cleaner, greener, and more sustainable future, expanding electric vehicles (EVs) adoption is inevitable. However, uncontrolled charging of EVs, especially with their increased penetration among the utility grid, imposes several negative technical impacts, including grid instability and deteriorated power quality in addition to overloading conditions. Hence, smart and coordinated charging is crucial in EV electrification, where Vehicle-to-Grid (V2G) technology is gaining much interest. Owing to its inherited capability of bi-directional power flow, V2G is capable of enhancing grid stability and resilience, load balancing, and congestion alleviation, as well as supporting renewable energy sources (RESs) integration. However, as with most emerging technologies, there are still technical research gaps that need to be addressed. In addition to these technical impacts, other multidisciplinary factors must be investigated to promote EVs adoption and V2G implementation. This paper provides a detailed demonstration of the technical problems associated with EVs penetration in distribution networks along with quantifiable insights into these limitations and the corresponding mitigation schemes. In addition, it discusses V2G benefits for power systems and consumers, as well as explores their technical barriers and research directions to adequately regulate their services and encourage EV's owners to its embracement. Moreover, other factors, including regulatory, social, economic and environmental ones that affect EV market penetration are being studied and related challenges are analyzed to draw recommendations that aid market growth. [ABSTRACT FROM AUTHOR]

Background: There is clear evidence that prevalence of primary antibody deficiency (PAD) is higher in children with chronic rhinosinusitis (CRS) than in the general population. The purpose of this multi‐institutional and multidisciplinary evidence‐based review with recommendations (EBRR) is to thoroughly review the literature on rhinosinusitis with PAD, summarize the existing evidence, and provide recommendations on the evaluation and management of rhinosinusitis in children with PAD. Methods: The PubMed, Embase, and Cochrane databases were systematically reviewed from inception through December 2023. Studies on the evaluation and management of rhinosinusitis in PAD patients were included. An iterative review process was utilized in accordance with EBRR guidelines. Levels of evidence and recommendations on the evaluation and management principles for PAD were generated. Results: A total of 50 studies were included in this evidence‐based review. These studies were evaluated on the incidence of PAD in rhinosinusitis patients, the incidence of rhinosinusitis in PAD patients, and on the different treatment modalities used and their outcome. The aggregate quality of evidence varied across the reviewed domains. Conclusion: Based on the currently available evidence, the incidence of PAD in children with recalcitrant CRS can be significantly elevated. Despite the presence of multiple studies addressing rhinosinusitis and PAD, the level of evidence supporting different treatment options continues to be lacking. Optimal management requires a multidisciplinary approach through collaboration with clinical immunology. There is need for higher level studies that compare different treatments in children with PAD and rhinosinusitis. [ABSTRACT FROM AUTHOR]

Objective: Inappropriate use of short-acting beta2-agonists (SABA) in asthma has been associated with undesired outcomes. This national expert consensus was developed to increase awareness of SABA overuse and provide recommendations on the ways to eliminate SABA overprescription and overreliance in Malaysia. Data sources: This expert consensus was developed by searching the PubMed database, using index terms to identify SABA overuse-related burden and recommendations made in asthma guidelines. Consensus recommendations were made via the Delphi method, involving a Malaysian expert committee comprising 13 healthcare professionals (five pulmonologists, four family medicine specialists, two emergency medicine physicians and two pharmacists). Study selections: The articles reviewed include randomized controlled trials, systematic reviews, meta-analyses, observational studies, guidelines, and surveys, with abstracts in English and published up until June 2023. Relevant recommendations were also sourced from verified websites of medical organizations and societies. Results: Eleven consensus statements were developed, each statement achieving a priori agreement level of at least 70%. The statements reflect SABA overreliance in asthma care, as well as recommendations to eliminate SABA overprescription and overreliance in Malaysia. Supporting evidence in the literature as well as expert committee discussions leading to the development of the finalized statements were elaborated. Conclusion: This national expert consensus discussed the burden of SABA overreliance and made specific recommendations to eliminate SABA overprescription and overreliance in the Malaysian context. This consensus document is anticipated to impart better awareness among Malaysian healthcare providers and contribute to the continuous improvement of asthma care in the country. [ABSTRACT FROM AUTHOR]

• High level of agreement on the OASIS classification system. • High level of agreement on immediate management such as the site, choice of suture material, and need for adequate analgesia during the OASIS repair. • Differences in the recommended timing of OASIS repair, involvement of specialists, and use of prophylactic antibiotics. • Considerable variability in post-operative care and follow-up practices. To review and compare existing guidelines on the intrapartum management and postpartum follow-up of obstetric anal sphincter injuries (OASIS) We conducted a systematic review of clinical guidelines related to OASIS management, focusing on intrapartum care and postpartum follow-up. Searches were performed in July 2024 across multiple databases, including PubMed, Embase, and the Cochrane Library. Guidelines published after 2010 in English were included. Nine national guidelines were included. There was a consensus on OASIS classification and immediate management, particularly regarding suture techniques, materials, and the necessity of adequate analgesia. However, notable variations were identified in the timing of repair, specialist involvement, use of prophylactic antibiotics, and post-operative care protocols. Postpartum follow-up practices also varied, especially regarding the role of physiotherapy and the timing of specialist consultations, reflecting inconsistencies in long-term care recommendations. Significant variability existed in the guidelines for the management and follow-up of OASIS, particularly in postpartum care. This study underscored the need for standardized, evidence-based guidelines to ensure consistent and optimal care for women affected by OASIS. [ABSTRACT FROM AUTHOR]

This European Society of Clinical Microbiology and Infectious Diseases guideline provides evidence-based recommendations to support a selection of appropriate antibiotic use practices for patients seen in the emergency department (ED) and guidance for their implementation. The topics addressed in this guideline are (a) Do biomarkers or rapid pathogen tests improve antibiotic prescribing and/or clinical outcomes? (b) Does taking blood cultures in common infectious syndromes improve antibiotic prescribing and/or clinical outcomes? (c) Does watchful waiting without antibacterial therapy or with delayed antibiotic prescribing reduce antibiotic prescribing without worsening clinical outcomes in patients with specific infectious syndromes? (d) Do structured culture follow-up programs in patients discharged from the ED with cultures pending improve antibiotic prescribing? An expert panel was convened by European Society of Clinical Microbiology and Infectious Diseases and the guideline chair. The panel selected in consensus the four most relevant antimicrobial stewardship topics according to pre-defined relevance criteria. For each main question for the four topics, a systematic review was performed, including randomized controlled trials and observational studies. Both clinical outcomes and stewardship process outcomes related to antibiotic use were deemed relevant. The literature searches were conducted between May 2021 and March 2022. In April 2022, the panel members were formally asked to suggest additional studies that were not identified in the initial searches. Data were summarized in a meta-analysis if possible or otherwise summarized narratively. The certainty of the evidence was classified according to the Grading of Recommendations Assessment, Development and Evaluation criteria. The guideline panel reviewed the evidence per topic critically appraising the evidence and formulated recommendations through a consensus-based process. The strength of the recommendations was classified as strong or weak. To substantiate the implementation process, implementation trials or observational studies describing facilitators/barriers for implementation were identified from the same searches and were summarized narratively. The recommendations on the use of biomarkers and rapid pathogen diagnostic tests focus on the initiation of antibiotics in patients admitted through the ED. Their effect on the discontinuation or de-escalation of antibiotics during hospital stay was not reported, neither was their effect on hospital infection prevention and control practices. The recommendations on watchful waiting (i.e. withholding antibiotics with some form of follow-up) focus on specific infectious syndromes for which the primary care literature was also included. The recommendations on blood cultures focus on the indication in three common infectious syndromes in the ED explicitly excluding patients with sepsis or septic shock. Most recommendations are based on very low and low certainty of evidence, leading to weak recommendations or, when no evidence was available, to best practice statements. Implementation of these recommendations needs to be adapted to the specific settings and circumstances of the ED. The scarcity of high-quality studies in the area of antimicrobial stewardship in the ED highlights the need for future research in this field. [ABSTRACT FROM AUTHOR]

The Canadian Association of Radiologists supports equity, diversity, and inclusion (EDI) in employment. It is imperative that institutions implement recruitment and retention practices to ensure a diverse workforce. This requires considerable attention to each step in the process, including the job posting, candidate search, hiring committee composition, interviews, hiring decision, and retention and promotion. Job postings must be widely distributed and visible to underrepresented groups. The candidate search should be completed by a diverse committee with expertise in EDI. All committee members must complete EDI and anti-bias training and conduct a broad search that ensures underrepresented groups are encouraged to apply. Interviews must be offered to all candidates. The hiring decision must avoid the use of subjective criteria. Recruitment of members of underrepresented groups ensures a diverse workforce, and organizations should commit resources to the retention and promotion of these members. Mentorship programs must be implemented and incentives provided to faculty members to serve as mentors. Transparent guidelines for promotion made universally available on department or institution websites. Recruiting a diverse workforce in Medical Imaging will only be achieved if EDI are central to the organization's goals and strategic plan. All organizational policies, practices, and procedures must be reviewed with an intersectional lens to identify potential gaps, areas for improvement, and areas of strength in the recruitment and retention of members of underrepresented groups. [ABSTRACT FROM AUTHOR]

Purpose: To comprehensively evaluate and compare all the available reference guides for the safe use of drugs during pregnancy, with the goal of determining the scientificity and reliability of these reference guides. Methods: We searched PubMed, EMbase, CNKI, Wanfang Database, and VIP database to comprehensively identify the available reference guides. Moreover, we selected 103 drugs based on relevant literatures, and compared the recommendations of each drug from different reference guides. Results: A total of 14 available reference guides were identified. However, none of these reference guides assessed the risk of bias of original studies or the quality of current evidence. Seven reference guides adopted expert consensus method to formulate pregnancy recommendations, while the rest reference guides did not report the formation method. Moreover, 77.7% of the selected drugs had inconsistent recommendations among different reference guides. In addition, the referenced human and animal studies for the same drug differed among different reference guides. Conclusion: Our results indicate that current reference guides for the safe use of drugs during pregnancy are less scientific and reliable, and there are considerable discrepancies in recommendations from different reference guides concerning drug use during pregnancy. The reasons for the discrepancies in recommendations include ① the literature search in most reference guides was not comprehensive, ② none of the available reference guides assessed the risk of bias of original studies or the quality of current evidence, and ③ the method adopted by current reference guides to formulate recommendations had obvious subjectivity and lacked of scientificity. [ABSTRACT FROM AUTHOR]

Objective: To provide improved guidance for the consistent application of the Clavien-Dindo classification (CDC) and Comprehensive Complication Index (CCI®) in challenging clinical scenarios. Background: Standardized outcome reporting is key for the proper assessment of surgical procedures. A recent consensus conference recommended the CDC and the CCI® for assessing postoperative morbidity. Several challenging scenarios for grading complications still require evidence-based guidance, and the use of the 2 metrics in randomized controlled trials (RCTs) remains unexplored. Methods: We assessed the use of the CDC and CCI® as an outcome measure in a systematic literature search. In addition, we asked 163 international surgeons to critically evaluate and independently grade complications in 20 complex clinical scenarios. Finally, a Core Group of 5 experts used this information to develop consistent recommendations. Results: Until July 2023, 1327 RCTs selected the CDC and/or CCI® to assess morbidity. Annual use was steadily increasing with now over 200 new RCTs per year. However, only a third (n = 335) of published RCTs provided the complete range of CDC grades, including all subgrades. Eighty-nine out of 163 surgeons (response rate: 55%) completed the questionnaire that served as a basis for the recommendations: repetitive interventions that are required to treat one complication, complications followed by further complications, complications occurring before referral, and expected and unrelated complications to the original procedure should all be counted separately and included in the CCI®. Invasive blank diagnostic interventions should not be considered a complication. Conclusions: The increasing use of the CDC and CCI® in RCTs highlights the importance of their standardized application. The current consensus on various difficult scenarios may offer novel guidance for the consistent use of the CDC and CCI®, aiming to improve complication reporting and better quality control, ultimately benefiting all health care stakeholders and, first and foremost, all patients. [ABSTRACT FROM AUTHOR]

The service provided by hoteliers has a significant impact on the service experience of international Muslim tourists, which is also related to loyalty behaviour. Some hoteliers have noticed that they get less attention from international Muslim tourists because existing services may have failed to satisfy their needs. Therefore, there is a good opportunity, particularly for Malaysian hoteliers, to draw in the global Muslim tourist market by fulfilling their needs. Thus, the purpose of this paper is to investigate international tourists' visit experiences in terms of understanding their needs, as this is one of the factors that contribute to loyalty. Consequently, recommendations for improvement to meet these needs are also discussed. For this study, 15 international Muslim tourists were interviewed using a qualitative method. The data gathered was analysed using thematic content analysis. According to the analysis, the majority of foreign Muslim tourists prioritise cleanliness and accessibility to facilities when travelling. The participants also emphasized the need to enhance the services provided to meet their growing needs. These improvements include improving the hotels' facilities and amenities, improving cleanliness and quality of services provided, and taking action on customer feedback. This paper offers suggestions that hoteliers can undertake in order to satisfy guests and directly encourage their loyalty to the hotel for their travels, which will ultimately increase the hotels' profit and boost the country's tourism. [ABSTRACT FROM AUTHOR]

Rationale/purpose: While the International Olympic Committee has issued several guidelines and recommendations on the protection of athletes from harassment and abuse in sports, there exists very little research which documents the extent to which these recommendations are actually implemented in sports organizations across Europe and most importantly, the efficacy of such measures. Findings: Based on the results, a set of evidence-based guidelines for promoting compliance with the existing policies and measures of harassment and abuse are recommended, which include an Observatory of Harassment and Abuse in Sports, the ISO accreditation for all sports organizations, and a European Mobile phone application. Practical implications: With these findings, this study offers a standardized method of implementation of policies, which will enable future pan-European assessments of efficacy, thus narrowing the current gap in knowledge. Research contribution: This is the first study to recommend a remedy to the obstacles – identified in previous research – which hamper the implementation of Universal policies on harassment and abuse in sports. [ABSTRACT FROM AUTHOR]

Hypertension and diabetes are currently the most common, treatable, and controllable cardiovascular and metabolic risk factors for stroke, heart, and renal diseases in Cameroon. Hypertension affects 30% of adults aged ≥ 20 years with 90% as uncontrolled cases, while type 2 diabetes affects 6% of the same population, with 70% remaining underdiagnosed. Despite publication of the first Roadmap on raised blood pressure by the World Heart Federation in 2015, the Pan African Society of Cardiology Roadmap in 2017, and the technical package for cardiovascular disease management in primary health care (WHO-HEARTS) in 2020, very little progress has been made in improving the diagnosis, treatment, and control of cardiovascular risk factors and diseases in Cameroon. The Cameroon Cardiac Society and a dozen Cameroon non-communicable diseases societies, national organizations from the community and the civil society, along with researchers and members of academia and the health sector, came together under the patronage of representatives of the government to propose new strategies to improve hypertension and diabetes control and save lives in Cameroon. Two simple and practical algorithms for the management of hypertension and diabetes were developed. The ten recommendations tailored to be efficiently implemented in our country were summarized under the acronym 'A SMART VIEW' (Awareness, Screening, Manufacture, Activity, Research, Task-shifting, HIV/AIDS, Insurance, Education, and WHO-HEARTS). It is our hope that all stakeholders will further collaborate to remove barriers and enhance facilitators to deploy the proposed actions and reduce the burden of uncontrolled hypertension and untreated diabetes in Cameroon. Plain Language Summary: Hypertension and diabetes are very common, yet treatable, cardiovascular, and metabolic risk factors for stroke, heart, and renal diseases in Cameroon. One-third of all adults aged 20 years or more in Cameroon have hypertension, in most of whom it remains uncontrolled. In addition, while 6% of these adults have type 2 diabetes, more than two-thirds remain underdiagnosed. Despite efforts to improve the diagnosis, treatment, and control of cardiovascular risk factors and diseases in Cameroon, minimal progress has been made. The Cameroon Cardiac Society, supported by input from Cameroon non-communicable diseases societies, national institutions/organizations, and representatives from the community, research, academia, and the health sector, has now developed two practical algorithms and ten recommendations specific to the Cameroonian population in an attempt to improve the control of hypertension and diabetes in Cameroon. It is hoped that these stakeholders will further collaborate to ensure the efficient implementation of these recommendations across the country, with the ongoing aim of monitoring their effectiveness over the next five years. [ABSTRACT FROM AUTHOR]

This study examines the impact of employment background on the objectivity of profitability forecasts in the financial sector. We find that investment bank analysts provide relatively biased recommendations and less accurate forecasts than their counterparts at independent research firms (IRFs). The performance discrepancy is greater for bulge bracket banks and for firms involved in syndication with the analysts' employers. A closer look at analysts transitioning between IRFs and investment banks reveals that these biases stem from their affiliation with investment banks rather than personal bias. Our findings emphasize the critical influence of the work environment on analyst behavior. [ABSTRACT FROM AUTHOR]

The surge in applications necessitates a more intelligent and automated Higher Education Admission Management System (HEAMS). This research proposes a novel Deep Learning (DL)-based HEAMS utilizing a Cloud-Edge Architecture. The first step collects applicant data like transcripts, test scores, essays, and recommendations. Edge devices perform initial cleaning and preprocessing on these data to ensure quality and privacy. These preprocessed data using normalization and feature extraction using the Latent Dirichlet Allocation (LDA) are then transferred to the cloud where DL models, such as Convolutional Neural Networks (CNNs) for essays or Recurrent Neural Networks (RNNs) for transcripts, are trained. These models learn complex patterns from historical labeled data (admitted/not admitted) to predict an applicant’s success probability. During application evaluation, new data are fed through the trained models on the edge, generating probabilities for predefined classifications — high-potential, moderate, or low-potential. The cloud receives these probabilities and combines them with predefined admission criteria like minimum GPA. This combined analysis leads to a final classification using Novel Lite Convolutional Neural Network with Hybrid Leader-based Optimization (Lite CNN-HLO) for each applicant — admitted, waitlisted, or rejected and admission management system by refining admission decisions for admitted, waitlisted, and rejected applicants based on institutional priorities and constraints. The system not only generates classifications but also provides detailed model score breakdowns for transparency. This Cloud-Edge HEAMS offers improved efficiency, reduced workload for admissions staff, and potentially fairer decisions by mitigating bias through data-driven analysis. [ABSTRACT FROM AUTHOR]

Plain English Summary: Eating disorders (EDs) are common and can be deadly, yet treatment approaches are not currently meeting the needs of individuals in Canada requiring care. As noted in the existing literature, ED treatment is largely inaccessible in Canada and can be ineffective in facilitating long-term recovery. Recent research has suggested that improvement to publicly funded, hospital-based ED treatment for adults is necessary and that those in Canada with lived experience should be involved in the process of doing so. This paper is based on a study that set out to explore ED treatment and gather potential recommendations from eleven individuals in Canada with lived experience. Several recommendations were identified to improve ED treatment in Canada, while simultaneously addressing harmful stigma about people with lived experience with EDs. These recommendations included providing interim support, ensuring individualized care, offering dignified treatment, increasing resources, and directly targeting stigma. From this study, it is suggested that current ED treatment methods must change to improve health outcomes and reduce stigma, and exploring the perspectives of those with lived experience is a promising method for doing so. Background: Eating disorders (EDs) are increasingly common, affecting over one million individuals in Canada. Canadian adults (i.e., age 18+) requiring medical stabilization for their eating disorder (ED) may be referred to adult inpatient (IP) ED treatment for care. Recent Canadian publications have brought attention to the need for improved approaches to Canadian ED treatment; urging researchers to seek perspectives of people with lived experience to determine how to best do so. This study explored the perspectives of a sample of individuals in Canada with lived experience to identify recommendations for improvement of adult IP ED treatment programs and processes. Methods: Employing a transformative philosophical view and feminist standpoint theory, this study utilizes a qualitative hermeneutic phenomenological approach to fulfill the objectives. Eleven participants with lived adult IP ED treatment experiences from across Canada were interviewed individually, to discuss their experiences and recommendations regarding referral, transitions into and out of care, and treatment itself using an online video conference platform. Data were analyzed using interpretative phenomenological analysis. A comprehensive list of recommendations was drafted and brought back to participants for feedback. The feedback was implemented to create the final list of recommendations. Results: Several limitations of referral, transitions, and treatment, facilitated and exacerbated by stigma at individual and societal levels, were identified by participants. These included guilt and shame upon referral, lack of respect and trust from healthcare providers during transitions, and lack of consideration of social determinants of health during treatment. Participant-informed recommendations, which can be categorized as interim support, individualized care, dignified treatment, resources, and stigma, were identified to ameliorate the experiences of those in Canada with EDs while also combatting stigma. Conclusions: Adult IP ED treatment in Canada is in urgent need of significant change to meet the needs of those requiring care and to address harmful stigma. Implementing participant-informed recommendations may aid in achieving this goal. The meaningful inclusion of those with lived experience, particularly marginalized populations, will be paramount to the development of an approach to adult IP ED treatment that properly serves individuals in Canada who need it. [ABSTRACT FROM AUTHOR]

AbstractBackgroundAims/objectivesMaterials and methodsResultsConclusions and significance\nIMPLICATIONS FOR REHABILITATIONOccupational therapists have long been recognized for their expertise in welfare technology use, particularly in the context of dementia care. Despite this advanced training, however, there is often a gap between their knowledge of available technologies and the frequency with which they recommend these tools to individuals with dementia.This study explores the perspectives of occupational therapists on the recommendations of welfare technologies for individuals with dementia.A survey was created with the assistance of an expert group in a Swedish municipality. The survey consisted of 26 questions (demographics, background/workload, perceptions of welfare technologies, accessibility/information and knowledge on how and when to use, and initiation of contact and recommendation frequency) and was distributed to 60 occupational therapists within the selected municipality. We received a total of 29 responses. The responses were then analyzed qualitatively for meaningful insights across various themes. Using an encoding scheme, a statistical analysis of the responses was performed to uncover potential trends in the distribution of the responses.Results indicate positive perceptions of welfare technologies by occupational therapists, but a low frequency of recommendations for individuals with dementia.Based on the results, we find it important to advocate for more educational opportunities for occupational therapists regarding welfare technologies and improved organizational structures that promote their understanding and ultimately benefits of recommending welfare technologies to individuals with dementia.Occupational therapists generally hold positive perceptions of welfare technologies. However, this positivity does not correlate with the frequency of recommending these technologies to people with dementia and their relatives.Time seems to be a factor potentially hindering occupational therapists’ engagement in further educational opportunities.Contact with occupational therapists typically begins at a moderate level of dementia, which may impede the utilization of welfare technologies by people with dementia and their relatives.Despite their positive perceptions of welfare technologies for people with dementia, occupational therapists maintain a conservative approach, resulting in a low frequency of recommending these technologies.Occupational therapists generally hold positive perceptions of welfare technologies. However, this positivity does not correlate with the frequency of recommending these technologies to people with dementia and their relatives.Time seems to be a factor potentially hindering occupational therapists’ engagement in further educational opportunities.Contact with occupational therapists typically begins at a moderate level of dementia, which may impede the utilization of welfare technologies by people with dementia and their relatives.Despite their positive perceptions of welfare technologies for people with dementia, occupational therapists maintain a conservative approach, resulting in a low frequency of recommending these technologies. [ABSTRACT FROM AUTHOR]

Background: The relationship with the treating gastroenterologist has been shown to significantly influence the quality of life of patients with IBD (Inflammatory Bowel Disease). Still, the expectations of patients have not been studied in detail. This study aimed to explore the messages and recommendations of IBD patients towards their gastroenterologists who treat them. Methods: This qualitative study was conducted using the DIPEx method developed by the Health Experiences Research Group at Oxford University. Semi-structured interviews with 36 participants (19 with Crohn's disease and 17 with ulcerative colitis) were analysed using thematic analysis. Results: Three main areas emerged as relevant for patients: doctors' expertise, patient-physician relationships, and the organisation of the healthcare system. Participants underscored the importance of comprehensive information, symptom recognition, exceptional care, and addressing outcome disparities by their treating physicians. Patient-centeredness, including dignified treatment, collaborative management of embarrassment, and trust, was mentioned as crucial for a good patient-physician relationship. The patients stressed the importance of sufficient time for care and the incorporation of mental health interventions. They emphasised professionalism, expertise, and friendly rapport as crucial for building trust in treating the unpredictable nature of IBD. The study also highlights the systemic impact of these interactions on healthcare systems. Conclusions: Patients actively engaged in their treatment bring novel perspectives, underscoring the value of a collaborative, respectful, and patient-physician dynamic. The implementation of this approach requires systemic healthcare shifts. This qualitative study on patient expectations underscores factors for a robust patient-physician bond, including gastroenterologists' expertise, personalised care, and adequate time provision. [ABSTRACT FROM AUTHOR]

Low- and middle-income countries (LMICs) often struggle to provide adequate neurosurgical care due to poor governance and institutional efforts, making access to care difficult. Therefore, our review of literature aims to identify gaps in government, national, and institutional efforts to combat barriers to neurosurgical care of brain tumors in LMICs, to inform future policy and action planning. A comprehensive literature search was conducted using PubMed, Scopus, Google Scholar, and CINAHL without language restrictions from inception to October 20, 2022. After screening and data extraction, a thematic analysis based on the National Surgical, Obstetric, and Anesthesia Plan (NSOAP) systematically identified and classified notable themes, which were then quantified and presented as percentages. A total of 12 studies were included in the final analysis. The review highlighted some of the barriers to providing surgical care of brain tumors in LMICs, including political instability (14%), inadequate national budget for health care (43%), poor government support (14%), lack of support of hospital management (14%), and no coverage under national insurance plans (14%). Strategies that can be implemented to address the barriers include strengthening the local health system (17%), advocating for health ministry support (33%), developing national treatment guidelines (17%), making neurosurgery a part of the national surgical plan (17%), fostering collaborations across various levels of government (17%), changing national insurance policy to include neurosurgical care (17%), and advocating for more resources and changes in global care (33%). Effective governance plays a critical role in addressing challenges as it shapes the availability of resources and policies that affect the quality of care provided. Our study outlines key challenges and strategies reported within literature in an attempt to drive government attention and thereby policy to support the neurosurgical care of brain tumors, particularly in the developing world. [ABSTRACT FROM AUTHOR]

Health care in developing countries often lacks adequate bookkeeping and national cancer registries, means of information that have proven to impact disease research and care. The true burden of brain tumors therefore remains unchecked and so does the extent of the problem. Therefore, this study aims to explore the challenges and potential strategies related to information management of brain tumors in low- and middle-income countries (LMICs). A comprehensive literature search conducted using databases such as PubMed, Scopus, Google Scholar, and Cumulated Index in Nursing and Allied Health Literature, without any language restrictions, from inception to October 20, 2022. Following screening and extraction of data, themes were generated using the information management domain of the National Surgical, Obstetric, and Anesthesia Plan framework. The final analysis includes 23 studies that highlighted the challenges to managing information to the surgical care given to brain tumors in LMICs, including lack of proper hospital record system (43%), lack of national brain tumor registry (67%), lack of local management guidelines (10%), and low research output (33%). Some of the proposed strategies in the literature to address these barriers include improving data management systems (45%), developing a population-based brain tumor registry (64%), and formulating local treatment guidelines (9%) for the management of brain tumors. In LMICs, improving patient outcomes and quality of life postneurosurgical intervention for brain tumors requires coordinated efforts to enhance information systems. The support of the government and public health professionals is vital in implementing strategies to achieve this goal. [ABSTRACT FROM AUTHOR]

Aggression and violence against educators and school personnel have raised public health concerns that require attention from researchers, policymakers, and training providers in U.S. schools. School aggression and violence have negative effects on school personnel health and retention and on student achievement and development. In partnership with several national organizations, the American Psychological Association (APA) Task Force on Violence Against Educators and School Personnel administered two national, multi-informant, cross-sectional surveys. Time 1 data were collected in 2020–2021 from 14,966 respondents; participants reflected on their experiences of violence and aggression before COVID-19 and during COVID-19 restrictions in this survey. One year later, in 2022, 11,814 respondents completed the Time 2 survey after COVID-19 restrictions ended. Participants included teachers, school psychologists, social workers, counselors, staff members, and administrators from all 50 states and Puerto Rico. Rates of violence and aggression directed against educators by students, parents, colleagues, and administrators were substantial before COVID-19, were lower during COVID-19 restrictions, and returned to prepandemic levels or higher after COVID-19 restrictions. After COVID-19 restrictions, 22%–80% of respondents reported verbal or threatening aggression, and 2%–56% of respondents reported physical violence at least once during the year, varying by stakeholder role and aggressor. Rates of intentions to quit the profession ranged from 21% to 43% during COVID-19 restrictions (2020–2021) and from 23% to 57% after COVID-19 restrictions (2021–2022), varying by stakeholder role. Participants across roles reported substantial rates of anxiety and stress, especially during and after COVID-19 restrictions, and identified specific training needs. Implications for theory, research, training, and policy are presented. Public Significance Statement: Aggression and violence against educators and school personnel and educator shortages are public health and educational issues that require attention, particularly in the context of recent trends surrounding COVID-19. This study describes new results that highlight violence and aggression before the COVID-19 pandemic (2019–2020), during COVID-19 restrictions (2020–2021), and after COVID-19 restrictions (2021–2022) for teachers, school psychologists, school social workers, counselors, school staff members, and administrators. Recommendations are provided to promote school safety and advance the field in theory, research, training, and policy. [ABSTRACT FROM AUTHOR]

Background: Enhancing long-term support for post-stroke cognitive impairment is a top research priority. Addressing current gaps in UK post-stroke cognitive care provision requires a pragmatic and scalable intervention that can be integrated within the existing stroke care pathway. This study aimed to develop consensus on an initial set of core features for a UK-based monitoring and psychoeducational intervention for cognitive changes after stroke. Methods: An expert panel of UK healthcare professionals and researchers participated in an online modified Delphi survey. Candidate intervention features were identified from clinical guidelines, existing literature, research team/collaborator expertise, and PPI group lived experience. Survey participants indicated whether they agreed/disagreed/had no opinion about including each candidate feature in the intervention and free-text responses were invited. We analysed responses for consensus (≥ 75% agreement) using descriptive statistics, with items not reaching consensus carried into subsequent rounds. Template analysis was used to identify similarities/differences in viewpoints for items that did not reach consensus. Results: Three survey rounds were completed by 36, 29 and 26 participants, respectively. Participants agreed reviews should include a stroke-specific cognitive screen (97% agree) and assessment of other psychological changes (low mood, anxiety, fatigue: 94%, 90%, 89% agree, respectively). They agreed stroke survivors should be offered at least one review, regardless of their cognitive profile in hospital. They agreed on the importance of various cognition-focused psychoeducation topics, and formal (100% agree) and informal (79% agree) training for those conducting reviews. Consensus was not reached on the review mode (in person/remote options: 67% agree), offering reviews one-year post-discharge to patients without acute cognitive impairments (68% disagree), or including a dementia screen (63% disagree) and/or neuropsychological assessment battery (58% disagree). However, there were similarities in participant viewpoints. For example, participants emphasised the importance of onwards referral where clinically indicated. Conclusions: The UK-based post-stroke monitoring and psychoeducation intervention was originally conceptualised as a cognitive care pathway, but expert participants agreed on the importance of simultaneously addressing related psychological changes (e.g. low mood, anxiety). There was clear consensus on a minimum set of intervention features. Recommendations outlined here may usefully inform local service improvements. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic put unprecedented pressure on weight management services. These services were required to adapt to continue to provide care for people living with obesity. This study sought to develop consensus recommendations on the best practice solutions adopted by weight management services in the United Kingdom during the COVID‐19 pandemic. Methods: This study utilised a semi‐structured interview and a modified Delphi methodology to develop a consensus of best practice recommendations identified by specialist weight management services during the pandemic. Results: Twenty‐three healthcare professionals working in weight management service across the United Kingdom participated in the study. Analysis of interview transcripts identified four key thematic domains: outpatient, patient education and support, perioperative care and team working. Of the initial 43 unique recommendations, 30 reached consensus agreement. Outpatient recommendations focused on communication strategies, patient self‐monitoring and remote patient tracking. Patient education and support recommendations addressed the development of online educational resources and support groups. Perioperative care recommendations emphasised case prioritisation, waiting list support and postoperative care. Team working recommendations targeted the use of digital collaboration tools and strategies for effective teamwork. Conclusion: Developing consensus recommendations on best practice is a critical step for weight management and outpatient services to achieve higher standards of care. These recommendations provide a springboard for departmental discussions, paving the way for improved experiences for individuals living with obesity as they progress along their weight management journey. Key points: During times of crisis, healthcare providers in weight management services can rapidly adopt innovative digital solutions to support good patient care.Thirty expert consensus recommendations relating to outpatient management, patient education and support, perioperative care and team working were found.Collaborative research is key to further guideline development on obesity management in areas of outpatient care, patient education, perioperative care and team working. [ABSTRACT FROM AUTHOR]

• Systematic literature review & expert consensus to identify red flags for raising EGPA suspicion. • EGPA diagnosis is tricky due to its heterogeneity and its overlap with eosinophilic disorders. • Creating an evidence-based checklist with red flags to initiate EGPA diagnosis process. Eosinophilic granulomatosis with polyangiitis (EGPA), is a rare ANCA-associated systemic vasculitis. Its overlapping features with other vasculitic or eosinophilic diseases, and the wide and heterogeneous range of clinical manifestations, often result in a delay to diagnosis. To identify red flags that raise a suspicion of EGPA to prompt diagnostic testing and to present an evidence-based clinical checklist tool for use in routine clinical practice. Systematic literature review and expert consensus to identify a list of red flags based on clinical judgement. GRADE applied to generate a strength of recommendation for each red flag and to develop a checklist tool. 86 studies were included. 40 red flags were identified as relevant to raise a suspicion of EGPA and assessed by the experts as being clinically significant. Experts agreed that a diagnosis of EGPA should be considered in a patient aged ≥6 years with a blood eosinophil level >1000 cells/µL if untreated and >500 cells/µL if previously treated with any medication likely to have altered the blood eosinophil count. The presence of asthma and/or nasal polyposis should reinforce a suspicion of EGPA. Red flags of asthma, lung infiltrates, pericarditis, cardiomyopathy, polyneuropathy, biopsy with inflammatory eosinophilic infiltrates, palpable purpura, digital ischaemia and ANCA positivity, usually anti-myeloperoxidase, among others, were identified. The identification of a comprehensive set of red flags could be used to raise a suspicion of EGPA in patients with eosinophilia, providing clinicians with an evidence-based checklist tool that can be integrated into their practice. [ABSTRACT FROM AUTHOR]

Value addition is crucial for enhancing the market position of any agricultural product, improving its quality and branding, boosting income, and creating more employment opportunities. Social media marketing has become an essential tool for microenterprises, offering an affordable means to reach larger audiences and engage with customers. This study examines the obstacles when using social media to market value-added products at the microlevel by agripreneurs. These challenges include a lack of digital literacy, mistrust of social media, language barriers, supply chain complexity, seasonal demand fluctuations, limited internet access, restricted budgets, and time constraints. Employing a mixed-methods approach that combines quantitative surveys and qualitative interviews with microenterprise owners, the study identifies critical issues and proposes using the Garrett ranking and recommendations using word frequency in NVivo software. Training programs, suitable platform selection, and increased awareness among agripreneurs are some recommendations for using social media for marketing. This study provides valuable insights for policymakers and practitioners aiming to support this vital sector of the economy. [ABSTRACT FROM AUTHOR]

Given the great potential of Generation Y for the tourism industry, their perceptions, and opinions of family-run hotels, which dominate tourism, were explored through 20 semi-structured interviews. The study shows that Generation Y perceives the image of family-run hotels positively and emphasizes traditions, small-scale structures, authenticity, and trust while highlighting their hospitableness. Our results underline the assumption of responsibility to family firms, including the importance of word-of-mouth, in the communication between Generation Y and family firms. Based on organizational identity theory, family-run hotels can build on their core values to build family firm images, contributing to differentiation, and establishing customer relationships. This study relates Generation Y to the tourism industry context, which family firms mainly run. The findings suggest that Generation Y should be targeted as a segment for the family-run tourism industry and that research should be expanded. [ABSTRACT FROM AUTHOR]

Background: Low English language literacy is a common barrier to participation in clinical trials. Patient information leaflets (PILs) used in clinical trials are often lengthy, complex and have poor readability; this is a persistent and prevalent problem common to trials across the world. Simplifying the information provided in PILs can lead to improved understanding, comprehension and knowledge. The aim of this project was to develop recommendations for developing accessible PILs for clinical trials through a literature review of published and grey literature and co-working with marginalised communities, patients, and health and social care charities. Methods: A literature review of MEDLINE, Embase and online resources was conducted, and recommendations for developing accessible PILs were extracted from eligible published and grey literature. Grey literature which contained insights into more inclusive forms of communication was also identified and summarised. Meetings were held with two racially marginalised community groups, two groups involving autistic adults and/or adults with learning difficulties and a patient advisory group. Examples of accessible PILs were shared and discussions held about the content and format of the PILs and suggestions for changes/improvements. National Voices, a coalition of health and social care charities in England, held a national online workshop with charities and lived experience partners. Recommendations identified from the multiple sources were coded, collated and refined to develop an overarching framework of recommendations. Results: The framework consists of 74 recommendations for developing accessible PILs for clinical trials. Recommendations cover the five topics of formatting, information presentation, writing style, content and accessibility. Conclusions: This project has developed a comprehensive framework of recommendations to guide researchers in the development of accessible PILs for clinical trials. Findings from previous research and from co-working with marginalised communities, patients and health and social care charities were collated to ensure that a diverse range of voices and experiences informed the framework. These recommendations aim to support researchers to develop better study information to reduce English language literacy as a barrier to participation in clinical trials. [ABSTRACT FROM AUTHOR]

Background: Persons with disabilities (PwDs) experience various adverse sexual and reproductive health (SRH) outcomes. However, there is a paucity of evidence on the strategies to improve their SRH outcomes. This study, therefore, used a pluralistic approach to explore PwDs and healthcare providers' (HPs) perspectives on how to improve the SRH of PwDs in Ghana. Methods: In-depth interviews were conducted with 62 purposively selected stakeholders (37 PwDs and 25 HPs) in the Kumasi Metropolis and Offinso North District. The data was subjected to reflexive thematic analysis. Results: Six major themes were generated from the data: Training for disability-sensitive and inclusive healthcare, Healthcare inclusivity – 'nothing about us, without us', Raising awareness for accessibility and equity, Impactful continuous monitoring and evaluation, Vital empowerment for self-reliance and Educating for disability-inclusive healthcare environment. These recommendations were synthesised to develop the THRIVE model–a comprehensive data driven framework from stakeholders that emphasises the importance of factors such as Training for disability-sensitive and inclusive healthcare, Healthcare inclusivity – 'nothing about us, without us', Raising awareness for accessibility and equity, Impactful continuous monitoring and evaluation, Vital empowerment for self-reliance and Enforcement of physical accessibility to improve their SRH outcomes. Conclusion: Using the evidence based THRIVE model could facilitate the development and strengthening of existing interventions and policies including the disability Act 715 to improve the SRH access and outcomes of PwDs in Ghana and other low-and middle-income countries. [ABSTRACT FROM AUTHOR]

Causal directed acyclic graphs (DAGs) serve as intuitive tools to visually represent causal relationships between variables. While they find widespread use in guiding study design, data collection and statistical analysis, their adoption remains relatively rare in the domain of psychology. In this paper we describe the relevance of DAGs for health psychology, review guidelines for developing causal DAGs, and offer recommendations for their development. A scoping review searching for papers and resources describing guidelines for DAG development was conducted. Information extracted from the eligible papers and resources (n = 11) was categorised, and results were used to formulate recommendations. Most records focused on DAG development for data analysis, with similar steps outlined. However, we found notable variations on how to implement confounding variables (i.e., sequential inclusion versus exclusion). Also, how domain knowledge should be integrated in the development process was scarcely addressed. Only one paper described how to perform a literature search for DAG development. Key recommendations for causal DAG development are provided and discussed using an illustrative example. [ABSTRACT FROM AUTHOR]

Purpose: The article aims to verify whether the meetings industry is taking actions for sustainable development and, if so, what kind of projects they are. Implementation of sustainable development principles is currently a trend in management in every field, including the meetings industry. The meetings industry also recognises this problem's essence and implements sustainable development principles into its operations. Design/methodology/approach: To achieve the intended research goal, an in-depth search of literature and online sources and interviews with 21 industry representatives were used. The article discusses the following research problem: what actions are taken by the meetings industry for sustainable development; whether it implements a sustainable development strategy and policy; whether and how the idea of sustainable development is implemented in cooperation with partners; how the industry perceives sustainable development activities in the area of MICE and what is its opinion in terms of shaping the right conditions in this area; what actions are vital in shaping sustainable development by the meetings industry? Findings: Research has proven that the business tourism industry implements sustainability measures in its operations. Research limitations/implications: Research limitation is the amount of industry feedback obtained. Due to the inability to obtain a larger number of research questionnaires, a sample of only 20 interviews with experts was used. Practical implications: The utilitarian goal of the research is to provide useful guidelines for the meetings industry in implementing of ESG (Environmental, Social, and Corporate Governance) policies. Social implications: Research based on the issues it undertakes relates to and raises important social issues. Originality/value: Although the meetings industry implements activities in sustainable development, they are not sufficient, especially in the context of the European Commission's Directive on Corporate Sustainability Reporting (CSRD). The presented research and guidelines for the industry in this area are currently a critical topic. They are a scientific novelty, and, as such, a research approach has not been presented in the context of this industry so far. [ABSTRACT FROM AUTHOR]

Background: Ensuring diversity in clinical trials can be a challenge, which may be exacerbated when recruiting vulnerable populations, such as participants with mental health illness. As recruitment continues to be the major cause of trial delays, researchers are turning to online recruitment strategies, e.g. social media, to reach a wider population and reduce recruitment time and costs. There is mixed evidence for the use of online recruitment strategies; therefore, the REcruitment in Mental health trials: broadening the 'net', opportunities for INclusivity through online methoDs (RE-MIND) study aimed to identify evidence and provide guidance for use of online strategies in recruitment to mental health trials, with a focus on whether online strategies can enhance inclusivity. This commentary, as part of the RE-MIND study, focusses on providing recommendations for recruitment strategy selection in future research with the aim to improve trial efficiency. A mixed-methods approach was employed involving three work packages: (I) an evidence review of a cohort of 97 recently published randomised controlled trials/feasibility or pilot studies in mental health to assess the impact of online versus offline recruitment; (II) a qualitative study investigating the experiences of n = 23 key stakeholders on use of an online recruitment approach in mental health clinical trials; (III) combining the results of WP1 and WP2 to produce recommendations on the use of an online recruitment strategy in mental health clinical trials. The findings from WP1 and 2 have been published elsewhere; this commentary represents the results of the third work package. Conclusion: For external validity, clinical trial participants should reflect the populations that will ultimately receive the interventions being tested, if proven effective. To guide researchers on their options for inclusive recruitment strategies, we have developed a list of considerations and practical recommendations on how to maximise the use of online recruitment methods. [ABSTRACT FROM AUTHOR]

Pangenomics is a relatively new scientific field which investigates the union of all the genomes of a clade. The word pan means everything in ancient Greek; the term pangenomics originally regarded genomes of bacteria and was later intended to refer to human genomes as well. Modern bioinformatics offers several tools to analyze pangenomics data, paving the way to an emerging field that we can call computational pangenomics. Current computational power available for the bioinformatics community has made computational pangenomic analyses easy to perform, but this higher accessibility to pangenomics analysis also increases the chances to make mistakes and to produce misleading or inflated results, especially by beginners. To handle this problem, we present here a few quick tips for efficient and correct computational pangenomic analyses with a focus on bacterial pangenomics, by describing common mistakes to avoid and experienced best practices to follow in this field. We believe our recommendations can help the readers perform more robust and sound pangenomic analyses and to generate more reliable results. [ABSTRACT FROM AUTHOR]

Background: Oncological patients have high information needs that are often unmet. Patient versions of oncological clinical practice guidelines (PVG) translate clinical practice guidelines into laypersons' language and might help to address patients' information needs. Currently, 30 oncological PVG have been published in Germany and more are being developed. Following a large multi-phase project on oncological PVGs in Germany, recommendations to improve use and dissemination of PVG were adopted in a multi-stakeholder workshop. Methods: Organisations representing users of PVGs (patients, medical personnel, and multipliers), creators, initiators/funding organisations of PVGs, and organisations with methodological expertise in the development of clinical practice guidelines or in patient health information were invited to participate. The workshop included a World Café for discussion of pre-selected recommendations and structured consensus procedure for of all recommendations. Recommendations with agreement of > 75% were approved, and in case of ≤ 75% agreement, recommendations were rejected. Results: The workshop took place on 24th April 2023 in Cologne, Germany. Overall, 23 people from 24 organisations participated in the discussion. Of 35 suggested recommendations 28 recommendations reached consensus and were approved. The recommendations referred to the topics dissemination (N = 13), design and format (N = 7), (digital) links (N = 5), digitalisation (N = 4), up-to-dateness (N = 3), and use of the PVG in collaboration between healthcare providers and patients (N = 3). Conclusion: The practical recommendations consider various perspectives and can help to improve use and dissemination of oncological PVG in Germany. The inclusion of different stakeholders could facilitate the transfer of the results into practice. [ABSTRACT FROM AUTHOR]

Librarians across the country are experiencing unprecedented acts of censorship. This study examines the recommendations from librarians on handling censorship and information that librarians wished was commonplace for public understanding. The study asked the following two questions: What do you wish the public understood about cases of censorship? What recommendations do you have for others who might be facing a case of censorship in the library? The interview results were analyzed and coded. Librarians serve all members of their community. This study will give insight into recommendations for librarians and the profession of Library and Information Science best practice when dealing with censorship attempts. [ABSTRACT FROM AUTHOR]

Objective: Sleep disturbance is common among individuals with eating disorders (EDs), with approximately 50% of patients with EDs reporting sleep disturbance. Sleep problems may promote, exacerbate, or maintain ED symptoms through a variety of hypothesized mechanisms, such as impaired executive function, increased negative affect, and disruptions to appetitive rhythms. Although research investigating the role of sleep in EDs is growing, the current literature suffers from methodological limitations and inconsistencies, which reduce our ability to translate findings to improve clinical practice. The purpose of this forum is to propose a coordinated approach to more seamlessly integrate sleep research into ED research with particular emphasis on best practices in the definition and assessment of sleep characteristics. Methods: In this article, we will describe the current status of sleep‐related research and relevant gaps within ED research practices, define key sleep characteristics, and review common assessment strategies for these sleep characteristics. Throughout the forum, we also discuss study design considerations and recommendations for future research aiming to integrate sleep research into ED research. Results/Discussion: Given the potential role of sleep in ED maintenance and treatment, it is important to build upon preliminary findings using a rigorous and systematic approach. Moving forward as a field necessitates a common lens through which future research on sleep and EDs may be conducted, communicated, and evaluated. [ABSTRACT FROM AUTHOR]

Background: Newborn resuscitation algorithms have since the turn of the century been more evidence-based. In this review, we discuss the development of American Heart Association (AHA) and the International Liaison Committee on Resuscitation (ILCOR)'s algorithm for newborn resuscitation from 1992–2024. We have also aimed to identify the remaining gaps in non-evidenced practice. Summary: Of the 22 procedures reviewed in the 2020 ILCOR recommendations, the evidence was either low, very low, or non-existing. The strength of recommendation is weak or non-existing for most topics discussed. Several knowledge gaps are also summarized. The special challenge for low- and middle-income countries (LMIC) is discussed. Key Messages: Newborn resuscitation is still not evidence-based, although great progress has been achieved the recent years. We have identified several knowledge gaps which should be prioritized in future research. The challenge of obtaining evidence-based knowledge from LMIC should be focused on in future research. [ABSTRACT FROM AUTHOR]

Background: Young people with depression are met with stigma related to their mental health, which exacerbates loneliness, social isolation, and depression symptoms. While disclosing depression could improve one's mental health, stigma can also make social interactions more challenging and reduce the likelihood of receiving treatment. This research explored young people's experiences with stigma and recommendations for addressing it. Methods: Semi‐structured interviews conducted with N = 35 young people aged 18–25 years (Mage = 20.09) were analyzed with thematic analysis. Participants met the criteria for clinical depression using the Mood and Feelings Questionnaire (score >27) or had recently obtained a medical diagnosis (N = 18) of depression by a medical professional. Results: Participants faced stigma when deciding to disclose their depression, which fed into a vicious cycle influencing feelings of loneliness, social isolation, and withdrawal. Their recommendations for others to avoid this cycle can be summarized under three main themes: (1) Social affirmation: identify allies and build meaningful connections; (2) Self‐affirmation: build a constructive relationship with the self; and (3) Societal affirmation: structural changes are needed. Conclusions: The current research indicates that social, self‐, and societal affirmation are considered important for reducing the detrimental impacts of stigma. Policies and programs are needed that provide mental health support to young people, and public awareness campaigns that guide young people to appropriate resources (i.e., support and intervention) via governmental public health bodies. [ABSTRACT FROM AUTHOR]

Facioscapulohumeral muscular dystrophy (FSHD) is one of the most common genetically inherited myopathies in adults. It is characterized by incomplete penetrance and variable expressivity. Typically, FSHD patients display asymmetric weakness of facial, scapular, and humeral muscles that may progress to other muscle groups, particularly the abdominal and lower limb muscles. Early-onset patients display more severe muscle weakness and atrophy, resulting in a higher frequency of associated skeletal abnormalities. In these patients, multisystem involvement, including respiratory, ocular, and auditory, is more frequent and severe and may include the central nervous system. Adult-onset FSHD patients may also display some degree of multisystem involvement which mainly remains subclinical. In 95% of cases, FSHD patients carry a pathogenic contraction of the D4Z4 repeat units (RUs) in the subtelomeric region of chromosome 4 (4q35), which leads to the expression of DUX4 retrogene, toxic for muscles (FSHD1). Five percent of patients display the same clinical phenotype in association with a mutation in the SMCHD1 gene located in chromosome 18, inducing epigenetic modifications of the 4q D4Z4 repeated region and expression of DUX4 retrogene. This review highlights the complexities and challenges of diagnosing and managing FSHD, underscoring the importance of standardized approaches for optimal patient outcomes. It emphasizes the critical role of multidisciplinary care in addressing the diverse manifestations of FSHD across different age groups, from skeletal abnormalities in early-onset cases to the often-subclinical multisystem involvement in adults. With no current cure, the focus on alleviating symptoms and slowing disease progression through coordinated care is paramount. [ABSTRACT FROM AUTHOR]

The importance of health literacy in medical imaging is well recognized, yet the current landscape remains inadequately understood. This study aims to explore the extent of health literacy studies contextualized to medical imaging. Scoping review. A scoping review was conducted using three online bibliographic databases namely, PubMed, ScienceDirect, and CINAHL. We have adopted the concept of health literacy, as a clinical risk and personal asset, to guide this review. Of 311 unique articles, 39 met our selection criteria. Five themes (categories) were identified by the authors: appropriate communication with patients who receive medical imaging test results, appropriate usage of medical imaging, classes and characteristics of eHealth literacy, disease/deterioration prevention, and patient education. Additionally, 17 health literacy assessment tools were identified, including 11 original creations. Finally, 11 recommendations have emerged from this scoping review, offering valuable insights into methods, considerations, and strategies for promoting health literacy. Health literacy studies in medical imaging cover both clinical and public health perspectives, benefiting diverse populations, regardless of underlying medical conditions. Notably, the majority of assessment tools used in these studies were author-generated, hindering cross-study comparisons. Given the innate capacity of medical images to convey intuitive information, those images do not solely benefit the patients who are given medical imaging examinations, but they also hold significant potential to enhance public health literacy. Health literacy and medical imaging are closely associated and mutually reinforce each other. [ABSTRACT FROM AUTHOR]

In Europa sind circa 60% aller Erwachsenen übergewichtig/adipös, davon sind 23% adipös, die Prävalenz nimmt jährlich zu und damit auch die Folgekrankheiten. Adipositas ist seit dem Jahr 2000 von der Weltgesundheitsorganisation (WHO) als eine chronische Krankheit definiert. Seit 2020 ist Adipositas auch in Deutschland als Krankheit anerkannt worden. Körperliche Aktivität gehört zu den Basismaßnahmen der Therapie bei Übergewicht/Adipositas. Eine Kombination aus Ausdauer- und Krafttraining, eventuell unterstützt durch ein hoch intensives Intervall-Training wirkt sich metabolisch günstig aus. Das Körpergewicht reduziert sich insgesamt nur geringgradig durch alleinige körperliche Aktivitäten. Es kommt allerdings deutlicher zu einer Abnahme des Taillenumfangs und damit des viszeralen Fettgewebes, was die günstigen Stoffwechseleffekte durch Sport erklären könnte. In Europe, around 60% of all adults are overweight/obese, 23% of whom are obese. The prevalence is increasing every year and so are the secondary diseases. Obesity has been defined as a chronic disease by the World Health Organization (WHO) since 2000. Obesity has also been recognized as a disease in Germany since 2020. Physical activity is one of the basic therapeutic measures for overweight/obesity. A combination of endurance and strength training, possibly supported by high-intensity interval training, has a positive effect on the metabolism. Total body weight is only slightly reduced by physical activity alone, but there is a significant reduction in waist circumference and thus visceral fat tissue, which could explain the beneficial metabolic effects of exercise. [ABSTRACT FROM AUTHOR]

India being more focused on its agricultural development requires information on energy input requirements for agro-based industries, where most of the energy is consumed by post-harvest operations. This study evaluates energy consumption by both the conventional method and the non-conventional method of agro-processing of maize on a small scale with the objectives of effective management of the limited resources in the agriculture, finding energy and cost-saving solutions for the two most energy- and cost-intensive post-harvest processes, providing energy-saving recommendations with suggestions for minimizing the involved cost of operation by focusing on the use of eco-friendly renewables in the agro-processing sector. Energy auditing with the help of energy tools and experimentally collected data was used for the energy analysis of the processes, and break-even analysis was used to find out the new selling price of the product using alternate energy sources for processing. The net energy and cost savings obtained through solar drying and solar milling were 545.38 GJ/yr, 50,017.50 GJ/yr, and USD 7,146.68, and USD 3,880, respectively. The findings reveal that drying and milling when accomplished by using solar energy offer perfect solution to much of the problem for small farm holders as well as for the environment by reducing 39.8 kg of CO2 emission. This research work will help to understand the use of energy analysis and the ways of its implementation in agro-based industries for the development of sustainable agriculture strategy. Policy directions provided help to improve policy regarding the integration of renewable energy in post-harvest processing operations. [ABSTRACT FROM AUTHOR]

There is a critical, nation-wide teacher shortage. Exacerbating this shortage is declining enrollment in teacher preparation programs that serve as a pipeline to the profession. To help address this shortage, school districts and teacher preparation programs across the country are implementing a variety of strategies to recruit high school students to consider pursuing a career as a PreK-12 teacher. While such initiatives are growing in number, little research has been conducted to guide and inform these initiatives, and little is known about the extent to which they are successful. In response, the researchers used a single-case study design involving survey and interview data collected from high school student participants to investigate the influence of a two-day recruitment event on participant knowledge about and attitudes toward becoming a teacher. Results confirmed that well-planned recruitment events can have a positive influence on participant knowledge of the teaching profession and attitudes toward becoming a teacher and offered multiple recommendations to guide and inform future recruitment initiatives. [ABSTRACT FROM AUTHOR]

The use of pedestrian bridges is often ineffective as pedestrians tend to prefer crossing directly on the roadway, even though heavy traffic conditions increase the risk of accidents. This lowers the safety level of crossers and causes traffic problems. This study aims to evaluate the efficient use of pedestrian bridges and determine public perceptions of road crossing facilities. The research was conducted using geometric assessment and road performance evaluation methods that refer to the 2023 Indonesian Road Capacity Guidelines. In addition, crossing times were analyzed based on the traffic TCT distribution histogram, as well as pedestrian perceptions of crossing facilities. The evaluation results show that the effectiveness of road services falls into category A. Based on pedestrian perceptions, 60% of respondents prefer to cross directly on the roadway, with an average TCT of 1.2 m/sec. From the results of the CSI analysis, the level of respondents' satisfaction with the condition of the pedestrian bridge is 71.373%. Based on the results of the study, the use of pedestrian bridges will be effective in the next 15 years. Recommendations proposed to increase the effectiveness of the use of pedestrian bridges and the level of pedestrian safety is the use of guardrails. [ABSTRACT FROM AUTHOR]

Since 2002, Credit Union XYZ has been utilizing information technology in its lending operations. However, the utilization of IT governance has not been optimal due to various weaknesses, obstacles, and issues such as server problems, downtime for maintenance, system change requests, human resources, and recurring IT-related problems. This research aims to assess the current IT governance capabilities at Credit Union XYZ. The method used is the COBIT 5 standard with a focus on the APO and DSS domains tailored to the existing issues. Data were collected through questionnaires distributed to the IT team and relevant stakeholders. The selected COBIT 5 processes include APO06 (Manage budget and costs), APO07 (Manage human resources), DSS01 (Manage operations), DSS02 (Manage service requests and incidents), and DSS03 (Manage problems). The evaluation reveals a 1-level gap in IT governance capabilities, with the current level at level 2 in Credit Union XYZ, while the target is level 3 in the future. The researcher's recommendation to Credit Union XYZ is to align IT processes with the standards and regulations established by COBIT 5. [ABSTRACT FROM AUTHOR]

Introduction: Many preterm present somatic symptoms including aerodigestive and cardiorespiratory manifestations, in combination with irritability and/or distress, which are often attributed to gastroesophageal reflux (GER), albeit for unclear reasons. Areas Covered: We searched in PubMed, Google Scholar, and MEDLINE for guidelines, reviews, and randomized controlled trials up to March 2024. Expert opinion: The diagnosis of GER-disease (GERD) in preterm is challenging because manifestations are atypical and diagnostic investigations difficult and not devoid of risk for adverse events. In case of vomiting or regurgitation, GER as a consequence of anatomical or metabolic conditions should be considered. Although many preterm infants are treated with proton pump inhibitors, this is seldom needed. Low-quality evidence for alginates is available, but needs further evaluation. There is a need for an effective and safe prokinetic favoring esophageal clearance, increasing lower esophageal sphincter pressure and stimulating gastric emptying. Non-drug treatment such as feeding adaptations (volume, duration, and composition) and positional changes are insufficiently applied. Thickened formula is not indicated in preterm babies. In case none of the above recommendations did result in sufficient improvement, and if documentation of acid GER is not possible, a 2–4 week trial of a proton pump inhibitor is acceptable. [ABSTRACT FROM AUTHOR]

Background: The combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) constitutes the established standard of care for pseudomyxoma peritonei patients. However, the role of HIPEC lacks validation through randomized trials, leading to diverse proposed treatment protocols. This consensus seeks to standardize HIPEC regimens and identify research priorities for enhanced clarity. Methods: The steering committee applied the patient, intervention, comparator, and outcome method to formulate crucial clinical questions. Evaluation of evidence followed the Grading of Recommendations, Assessment, Development, and Evaluation system. Consensus on HIPEC regimens and research priorities was sought through a two-round Delphi process involving international experts. Results: Out of 90 eligible panelists, 71 (79%) participated in both Delphi rounds, resulting in a consensus on six out of seven questions related to HIPEC regimens. An overwhelming 84% positive consensus favored combining HIPEC with CRS, while a 70% weak positive consensus supported HIPEC after incomplete CRS. Specific HIPEC regimens also gained consensus, with 53% supporting Oxaliplatin 200 mg/m2 and 51% favoring the combination of cisplatin (CDDP) associated with mitomycin-C (MMC). High-dose MMC regimens received an 89% positive recommendation. In terms of research priorities, 61% of panelists highlighted the importance of studies comparing HIPEC regimens post CRS. The preferred regimens for such studies were the combination of CDDP/MMC and high-dose MMC. Conclusions: The consensus recommends the application of HIPEC following CRS based on the available evidence. The combination of CDDP/MMC and high-dose MMC regimens are endorsed for both current clinical practice and future research efforts. [ABSTRACT FROM AUTHOR]

Research on modern agri-food chains aims to enhance flexibility by analyzing supply chain aspects to identify improvement opportunities. A SWOT analysis of 39 agri-food sector organizations using a SWOT analysis organized using the PESTEL and MEETHS categories was conducted to evaluate the stakeholders' needs in this sector of activity in Northern Portugal. Logistic regressions were used to compute inferential statistics, which were complemented with a qualitative analysis. Cooperatives and primary sector companies often claim superior product quality without clear evidence, while corporations integrated into competitive national markets, like those with smoked products, adapt better to dietary trends. Small- and medium-sized enterprises struggle with competitive wages, leading to high turnover and difficulty retaining skilled workers. High costs hinder many organizations, particularly cooperatives, from adopting modern communication technologies affecting competitiveness. Challenges include identifying market opportunities and managing global competition for raw materials, like wild fish. Fishing and meat sectors depend heavily on modern distribution and are dominated by large retailers. Low labor costs boost competitiveness but reflect the struggle to add value. Larger organizations are more optimistic though many face challenges with the cost and volatility of key products, like pork and milk. This study offers the following key recommendations: invest in technology and innovation while balancing short-term gains with long-term sustainability; strengthen strategic planning and collaboration among corporations, cooperatives, associations, and academic institutions; and adapt to regulatory changes, invest in market and technological capabilities, and address resource limitations. Research and collaboration with policymakers and academic institutions will support tailored solutions, enabling the sector to anticipate challenges and capitalize on opportunities. [ABSTRACT FROM AUTHOR]

Abstract Moving towards a cleaner, greener, and more sustainable future, expanding electric vehicles (EVs) adoption is inevitable. However, uncontrolled charging of EVs, especially with their increased penetration among the utility grid, imposes several negative technical impacts, including grid instability and deteriorated power quality in addition to overloading conditions. Hence, smart and coordinated charging is crucial in EV electrification, where Vehicle-to-Grid (V2G) technology is gaining much interest. Owing to its inherited capability of bi-directional power flow, V2G is capable of enhancing grid stability and resilience, load balancing, and congestion alleviation, as well as supporting renewable energy sources (RESs) integration. However, as with most emerging technologies, there are still technical research gaps that need to be addressed. In addition to these technical impacts, other multidisciplinary factors must be investigated to promote EVs adoption and V2G implementation. This paper provides a detailed demonstration of the technical problems associated with EVs penetration in distribution networks along with quantifiable insights into these limitations and the corresponding mitigation schemes. In addition, it discusses V2G benefits for power systems and consumers, as well as explores their technical barriers and research directions to adequately regulate their services and encourage EV’s owners to its embracement. Moreover, other factors, including regulatory, social, economic and environmental ones that affect EV market penetration are being studied and related challenges are analyzed to draw recommendations that aid market growth.

Plain English Summary Eating disorders (EDs) are common and can be deadly, yet treatment approaches are not currently meeting the needs of individuals in Canada requiring care. As noted in the existing literature, ED treatment is largely inaccessible in Canada and can be ineffective in facilitating long-term recovery. Recent research has suggested that improvement to publicly funded, hospital-based ED treatment for adults is necessary and that those in Canada with lived experience should be involved in the process of doing so. This paper is based on a study that set out to explore ED treatment and gather potential recommendations from eleven individuals in Canada with lived experience. Several recommendations were identified to improve ED treatment in Canada, while simultaneously addressing harmful stigma about people with lived experience with EDs. These recommendations included providing interim support, ensuring individualized care, offering dignified treatment, increasing resources, and directly targeting stigma. From this study, it is suggested that current ED treatment methods must change to improve health outcomes and reduce stigma, and exploring the perspectives of those with lived experience is a promising method for doing so.

Abstract Background Enhancing long-term support for post-stroke cognitive impairment is a top research priority. Addressing current gaps in UK post-stroke cognitive care provision requires a pragmatic and scalable intervention that can be integrated within the existing stroke care pathway. This study aimed to develop consensus on an initial set of core features for a UK-based monitoring and psychoeducational intervention for cognitive changes after stroke. Methods An expert panel of UK healthcare professionals and researchers participated in an online modified Delphi survey. Candidate intervention features were identified from clinical guidelines, existing literature, research team/collaborator expertise, and PPI group lived experience. Survey participants indicated whether they agreed/disagreed/had no opinion about including each candidate feature in the intervention and free-text responses were invited. We analysed responses for consensus (≥ 75% agreement) using descriptive statistics, with items not reaching consensus carried into subsequent rounds. Template analysis was used to identify similarities/differences in viewpoints for items that did not reach consensus. Results Three survey rounds were completed by 36, 29 and 26 participants, respectively. Participants agreed reviews should include a stroke-specific cognitive screen (97% agree) and assessment of other psychological changes (low mood, anxiety, fatigue: 94%, 90%, 89% agree, respectively). They agreed stroke survivors should be offered at least one review, regardless of their cognitive profile in hospital. They agreed on the importance of various cognition-focused psychoeducation topics, and formal (100% agree) and informal (79% agree) training for those conducting reviews. Consensus was not reached on the review mode (in person/remote options: 67% agree), offering reviews one-year post-discharge to patients without acute cognitive impairments (68% disagree), or including a dementia screen (63% disagree) and/or neuropsychological assessment battery (58% disagree). However, there were similarities in participant viewpoints. For example, participants emphasised the importance of onwards referral where clinically indicated. Conclusions The UK-based post-stroke monitoring and psychoeducation intervention was originally conceptualised as a cognitive care pathway, but expert participants agreed on the importance of simultaneously addressing related psychological changes (e.g. low mood, anxiety). There was clear consensus on a minimum set of intervention features. Recommendations outlined here may usefully inform local service improvements.

Background Successful liberation from mechanical ventilation is one of the most crucial processes in critical care, because it is the first step through which a respiratory failure patient begins to transition out of the intensive care unit, and return to normal life. Therefore, when devising appropriate strategies for removing mechanical ventilation, it is essential to consider scientific and systematic approaches, as well as the individual experiences of healthcare professionals. Recently, numerous studies have investigated methods and tools to identify when mechanically ventilated patients are ready to breathe on their own. The Korean Society of Critical Care Medicine therefore provides these recommendations to clinicians for liberation from the ventilator. Methods Meta-analyses and comprehensive syntheses were used to thoroughly review, compile, and summarize the complete body of relevant evidence. All studies were meticulously assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method, and the outcomes were presented succinctly as evidence profiles. These evidence syntheses were discussed by a multidisciplinary committee of experts in mechanical ventilation, who then developed and approved the recommendations. Results Recommendations for nine questions on ventilator liberation about Population, Intervention, Comparator, and Outcome (PICO) are presented in this document. This guideline presents seven conditional recommendations, one expert consensus recommendation, and one conditional deferred recommendation. Conclusion We developed these clinical guidelines for mechanical ventilation liberation to provide meaningful recommendations. These guidelines reflect the best treatment for patients seeking liberation from mechanical ventilation.

Introduction. Glucocorticoid-induced osteoporosis (GIOP) is a bone metabolic disease that develops as a result of glucocorticoid (GC) use, is one of the most frequent causes of secondary osteoporosis, leads to an increase in the risk of low-energy fractures, disability and mortality of GC users. Despite the few stu­dies conducted in Ukraine on the epidemiology and treatment of GIOP, there have been no national recommendations for its ma­nagement until now, which has become the background for their creation. The purpose was to develop national guidelines for the diagnosis, prevention, and treatment of GIOP based on the analytical analysis of modern literary sources to improve the awareness of the medical community of Ukraine, improve management, and reduce the socio-economic burden of the disease. Materials and ­methods. A group of 18 experts, leading Ukrainian scientists in various fields, was created to develop the guideline. An analysis of current literary sources on epidemiology, risk factors, diagnosis, prevention and treatment of GIOP, and monitoring of the effectiveness and safety of its treatment was carried out. Evidence was synthesized ­using the GRADE system, and a critical assessment of the quality of the recommendations was carried out using the AGREE II tool. ­Results. The guideline consists of 12 provisions on screening, diagnosis, prevention, and treatment of GIOP. The authors emphasized the need to increase the awareness of the medical community of Ukraine regarding the problem, as well as patients regarding the possible side effects of GC. They presented the features of the clinical assessment of the osteoporotic fracture risk in GC users, as well as modern and available in Ukraine methods of diagnosis and treatment of GIOP. Conclusion. The first Ukrainian guideline for screening, diagnosis, prevention, and treatment of GIOP is an important national tool for its management, which is recommended by the Board of the Ukrainian Association of Osteoporosis for use in practical health care by doctors of various specialties.