Basis Of Consensus Research Articles

Quel bilan anatomo-pathologique ?

The WHO classification of lung tumours on which pathologists base their diagnosis was revised in 2015 on the basis of an international consensus established in 2011 between clinicians, radiologists and pathologists. This resulted in a histo-molecular and prognostic classification of adenocarcinomas. The use of immunohistochemistry for the classification of poorly differentiated non-small cell carcinomas and a new classification adapted to small specimens were defined. These concepts are still relevant today, as the management of small specimens is a key point in the collaboration between the sampling physician and the pathologist.This classification was revised in 2021 and remains broadly the same except for the appearance of new entities: SMARCA4-defident undifferentiated thoracic tumour; bron-chiolar adenoma / muconodular ciliated papillar tumour. Although rare, these lesions have histopathological, clinical and/or molecular appearances that merit their presence as new entities.For invasive adenocarcinomas, the 5 architectural patterns are maintained but the IASLC proposes a grading system which has shown a prognostic impact for early stages.Some clarifications regarding the diagnosis of neuroendocrine tumours/carcinomas were provided.Regarding pleural pathology, mesothelioma in situ is defined and characterised. 1877-1203/© 2024 SPLF. Published by Elsevier Masson SAS. All rights reserved.

An open-source tool for automated human-level circling behavior detection

Quantitatively relating behavior to underlying biology is crucial in life science. Although progress in keypoint tracking tools has reduced barriers to recording postural data, identifying specific behaviors from this data remains challenging. Manual behavior coding is labor-intensive and inconsistent, while automatic methods struggle to explicitly define complex behaviors, even when they seem obvious to the human eye. Here, we demonstrate an effective technique for detecting circling in mice, a form of locomotion characterized by stereotyped spinning. Despite circling's extensive history as a behavioral marker, there currently exists no standard automated detection method. We developed a circling detection technique using simple postprocessing of keypoint data obtained from videos of freely-exploring (Cib2−/−;Cib3−/−) mutant mice, a strain previously found to exhibit circling behavior. Our technique achieves statistical parity with independent human observers in matching occurrence times based on human consensus, and it accurately distinguishes between videos of wild type mice and mutants. Our pipeline provides a convenient, noninvasive, quantitative tool for analyzing circling mouse models without the need for software engineering experience. Additionally, as the concepts underlying our approach are agnostic to the behavior being analyzed, and indeed to the modality of the recorded data, our results support the feasibility of algorithmically detecting specific research-relevant behaviors using readily-interpretable parameters tuned on the basis of human consensus.

Development of a Smart Home Modification Program: A Delphi Survey of Multidisciplinary Health Care Experts.

There is a critical gap between the potential of smart home technologies to enhance the lives of people with physical disabilities (PwPD) and their limited use because of complex interfaces, high costs, technical issues, and insufficient institutional support. To bridge this gap and ensure that PwPD can fully benefit from smart home advancements to improve their daily living and quality of life by developing a smart home modification program. A Delphi survey involving three rounds was conducted with experts in disability and smart home technologies. Online survey. Thirty multidisciplinary health care experts. Experts rated the level of relevance in smart home modification with each survey. Consensus was set at ≥75%, content validity (CVR) was ≥.33, and convergence was ≤.5. The first Delphi result selected 26 items, and the second included 59 items after adjusting for values that fell below a CVR of .33. In the third Delphi survey, 59 items were selected. The final Delphi study had an average CVR of .96 and a coefficient of variation of .10. The last survey's consensus point was .92, indicating a high level of agreement among participants. On the basis of expert consensus, the study provides a validated framework for smart home modifications to aid PwPD. Plain-Language Summary: This research highlights the role of smart home adaptations to promote responsible, independent living for people with physical disabilities. There is a critical gap between the potential of smart home technologies to improve the lives of people with physical disabilities and their limited use because of complex interfaces, high costs, technical issues, and insufficient institutional support. The study authors developed a smart home modification program with the goal of closing this gap and to ensure that people with physical disabilities can fully benefit from smart home advancements to improve their daily living and quality of life. Based on expert ratings, the study findings provide a validated framework that occupational therapists can use to recommend smart home modifications to help people with physical disabilities. The framework can also be used by occupational therapists to identify people who may need more extensive environmental modifications and interventions.

Diagnosis and treatment of venous leg ulcers: S2k Guideline of the German Society of Phlebology and Lymphology (DGPL) e.V.

This S2k guideline on venous leg ulcers was created on the initiative and under the leadership of the German Society of Phlebology and Lymphology (DGPL). The guideline group also consisted of representatives from the German Society for Phlebology and Lymphology, German Dermatological Society, German Society for General Medicine, German Society for Angiology, German Society for Vascular Surgery and Vascular Medicine, German Society for Surgery, German Society for Dermatosurgery, German Society for Wound Healing and Wound Treatment, Professional Association of Phlebologists and Lymphologists and Initiative Chronische Wunden. The aim of this guideline is to combine the different approaches and levels of knowledge of the respective professional groups on the basis of consensus, so that a basic concept for the best possible treatment of patients with venous leg ulcers can be provided. A total of 70 specific recommendations were formulated and agreed upon, divided into the subject areas of diagnostics, therapy, prevention of recurrences, and everyday challenges. The guideline thus reflects the current state of scientific knowledge and is intended to be widely used as the best available document for the treatment of patients with venous leg ulcers in everyday clinical practice.

Cardiometabolic health in people with HIV: expert consensus review.

To develop consensus data statements and clinical recommendations to provide guidance for improving cardiometabolic health outcomes in people with HIV based on the knowledge and experience of an international panel of experts. A targeted literature review including 281 conference presentations, peer-reviewed articles, and background references on cardiometabolic health in adults with HIV published between January 2016 and April 2022 was conducted and used to develop draft consensus data statements. Using a modified Delphi method, an international panel of 16 experts convened in workshops and completed surveys to refine consensus data statements and generate clinical recommendations. Overall, 10 data statements, five data gaps and 14 clinical recommendations achieved consensus. In the data statements, the panel describes increased risk of cardiometabolic health concerns in people with HIV compared with the general population, known risk factors, and the potential impact of antiretroviral therapy. The panel also identified data gaps to inform future research in people with HIV. Finally, in the clinical recommendations, the panel emphasizes the need for a holistic approach to comprehensive care that includes regular assessment of cardiometabolic health, access to cardiometabolic health services, counselling on potential changes in weight after initiating or switching antiretroviral therapy and encouraging a healthy lifestyle to lower cardiometabolic health risk. On the basis of available data and expert consensus, an international panel developed clinical recommendations to address the increased risk of cardiometabolic disorders in people with HIV to ensure appropriate cardiometabolic health management for this population.

Expert consensus on immunoprophylaxis of childhood rotavirus gastroenteritis (2024 version)

Rotavirus gastroenteritis (RVGE) is a global public health challenge that seriously threatens the health of children under 5 years of age. In China, the burden associated with RVGE is substantial and its prevention and control are difficult. On the basis of Expert Consensus on Immunoprophylaxis of Childhood Rotavirus Gastroenteritis (2020 Version) and Rotavirus Vaccines: WHO Position Paper-July 2021, in this updated consensus we systematically review advances in RVGE epidemiological research; safety, effectiveness/efficacy, and immune persistence of post-marketing rotavirus (RV) vaccines; and RV immunization strategies. We also provide guidance for RVGE diagnosis and treatment. Following the principles of prioritizing prevention and integrating medical and preventive approaches, we aim to facilitate the implementation of comprehensive prevention and control measures focusing on RV vaccination to reduce the childhood RVGE disease burden and provide reference for professionals working for disease control and prevention, vaccination, clinical diagnosis and treatment, and related fields.

Consensus to identify the dangerous drugs risks in hospital pharmacy services

ObjectiveTo identify the hazards and define the theoretical occupational risks arising from the process of handling hazard drugs in hospital pharmacy services on the basis of expert consensus. MethodAn expert consensus was conducted (nominal group and documentary techniques) using a mixed method of two face-to-face rounds (meeting of participants and approval of proposals) and three masked rounds (individualized review). The analysis was applied to the field of hospital pharmacy. The stages of the process were designed using the standardized graphical Business Process Model and Notation. ResultsA specific flowchart was obtained for the management and traceability of hazardous drugs. All general process phases were characterized. A management chart included operations addressing the reception and storage, compounding, conservation, and dispensation of hazardous drugs in hospital pharmacy services. This chart provides a description of the chemical hazards and exposure routes. ConclusionsThe hazardous drug process should be integrated in a standard management system to improve the safety of patients and healthcare professionals. Efficiency can maximized and procedural incidents minimized, thereby ensuring the quality and the safety of hazardous drugs handling in hospital pharmacy services.Once hazards are identified, risk assessment should be implemented using a systematic and preventative methodology to minimize the risk and severity of any adverse event.

Matrix measure-based event-triggered consensus of multi-agent systems with hybrid time delays

Considering that there are many systems with limited energy resources in reality, this paper mainly concentrates on researching the leader-following consensus issue for an array of nonlinear multi-agent systems with hybrid time delays. The purpose of this article is to reduce the load of communication and controller updates for multi-agent systems on the basis of consensus achieving, a novel distributed event-triggered impulsive control strategy is therefore proposed to realize the global and exponential leader-following consensus. By jointly utilizing the matrix measure protocol, the comparison principle and the parameter variation formula method, sufficient conditions for the realization of leader-following consensus are successfully obtained. Moreover, the convergence rate is precisely estimated and the Zeno behavior is proved not exist in closed-loop systems. Eventually, a numerical example is given to demonstrate the effectiveness of proposed control strategy and the rightness of theoretical analysis.

Social Risk Factors are Associated with Risk for Hospitalization in Home Health Care: A Natural Language Processing Study

ObjectiveThis study aimed to develop a natural language processing (NLP) system that identified social risk factors in home health care (HHC) clinical notes and to examine the association between social risk factors and hospitalization or an emergency department (ED) visit. DesignRetrospective cohort study. Setting and ParticipantsWe used standardized assessments and clinical notes from one HHC agency located in the northeastern United States. This included 86,866 episodes of care for 65,593 unique patients. Patients received HHC services between 2015 and 2017. MethodsGuided by HHC experts, we created a vocabulary of social risk factors that influence hospitalization or ED visit risk in the HHC setting. We then developed an NLP system to automatically identify social risk factors documented in clinical notes. We used an adjusted logistic regression model to examine the association between the NLP-based social risk factors and hospitalization or an ED visit. ResultsOn the basis of expert consensus, the following social risk factors emerged: Social Environment, Physical Environment, Education and Literacy, Food Insecurity, Access to Care, and Housing and Economic Circumstances. Our NLP system performed “very good” with an F score of 0.91. Approximately 4% of clinical notes (33% episodes of care) documented a social risk factor. The most frequently documented social risk factors were Physical Environment and Social Environment. Except for Housing and Economic Circumstances, all NLP-based social risk factors were associated with higher odds of hospitalization and ED visits. Conclusions and ImplicationsHHC clinicians assess and document social risk factors associated with hospitalizations and ED visits in their clinical notes. Future studies can explore the social risk factors documented in HHC to improve communication across the health care system and to predict patients at risk for being hospitalized or visiting the ED.

Self-stabilizing Byzantine fault-tolerant repeated reliable broadcast

We study a well-known communication abstraction called Byzantine Reliable Broadcast (BRB). This abstraction is central in the design and implementation of fault-tolerant distributed systems, as many fault-tolerant distributed applications require communication with provable guarantees on message deliveries. Our study focuses on fault-tolerant implementations for message-passing systems that are prone to process-failures, such as crashes and malicious behavior.At PODC 1983, Bracha and Toueg, in short, BT, solved the BRB problem. BT has optimal resilience since it can deal with t<n/3 Byzantine processes, where n is the number of processes. The present work aims to design an even more robust solution than BT by expanding its fault-model with self-stabilization, a vigorous notion of fault-tolerance. In addition to tolerating Byzantine and communication failures, self-stabilizing systems can recover after the occurrence of arbitrary transient-faults. These transient faults allow the model to represent temporary deviations from the assumptions on which the system was originally designed to operate (provided that the algorithm code remains intact).We propose, to the best of our knowledge, the first self-stabilizing Byzantine fault-tolerant (BFT) solution for repeated BRB in signature-free message-passing systems (that follows BT's problem specifications). Our contribution includes a self-stabilizing variation on BT that solves a single-instance BRB for asynchronous systems. We also consider the problem of recycling instances of single-instance BRB. Our self-stabilizing BFT recycling for time-free systems facilitates the concurrent handling of a predefined number of BRB invocations and, in this way, can serve as the basis for self-stabilizing BFT consensus.

Reforms and Responses to the Internal Governance Structure of Primary and Secondary School in the Context of High-Quality Development in Mainland China

In the wake of the focus on improving the quality of education in the international community, the development of the cause of education in mainland China has entered the stage of high-quality development. Currently, the construction of internal governance structures for primary and secondary schools in mainland China exhibits three areas of difficulties and problems: In vertical governance structures, the configurations are overly hierarchical, and there is a high cost of communication and coordination, and difficulty forwarding reforms and innovations; in horizontal governance structures, professional organizations do not have high status, there is a low degree of coordination, and efforts for oversight and assurance are inadequate; in integrated network governance structures, there is a weak basis for consensus and low responsiveness, and the degree of coupling needs improvement. In order to adapt to the needs of high-quality development, primary and secondary schools in mainland China must make reforms to and tackle several aspects of their internal governance structures, vertically adhering to the logic of management reform, to improve the rationality of decision-making and promote flattening of vertical structures; horizontally adhering to the logic of intrinsic development, to improve the status, authority and influence of a school’s professional organizations; and integratively abiding by the logic of systems integration, to build deliberative democratic network governance structures on the foundation of a consensus of ideas.

Regulating Antarctic Tourism: The Challenge of Consensus-Based Decision Making

AbstractIn the 2022–2023 season, more than 104,000 tourists visited Antarctica. This represents an increase of more than 40 percent compared to the 2019–2020 pre-pandemic season. This Current Development discusses this trend and the limits of the Antarctic Treaty Consultative Parties, which govern on the basis of consensus, in responding with regulatory action. Options for strengthening regulation in this area are also considered.

Unexplained Acute Distal Pancreatitis: Association With Subsequent Diagnosis of Pancreatic Cancer.

BACKGROUND. Distal pancreatitis is an atypical imaging subtype of acute pancreatitis involving only the pancreatic body and tail, the head being spared. If no cause is identified, suspicion of a small imaging-occult cancer may be warranted. OBJECTIVE. The purpose of this study was to determine the frequency of subsequently diagnosed pancreatic cancer in patients with unexplained acute distal pancreatitis and to compare this frequency to that found in patients with unexplained nondistal pancreatitis. METHODS. This retrospective study included patients who underwent contrast-enhanced CT between January 1, 2019, and December 31, 2020, that showed acute pancreatitis without identifiable explanation. Studies were classified as showing distal or nondistal acute pancreatitis on the basis of consensus. The Fisher exact test was used to compare the frequency of subsequent histologic diagnosis of pancreatic cancer between groups. Negative classification required 6 or more months of imaging follow-up and/or 12 or more months of clinical follow-up. Interreader agreement among seven readers of varying experience was assessed by Fleiss kappa. RESULTS. Among 215 patients with acute pancreatitis, 116 (54%) had no identifiable explanation and formed the study sample. A total of 100 of 116 (86%) patients (59 men, 41 women; mean age, 57 ± 18 [SD] years) had nondistal acute pancreatitis; 16 of 116 (14%) patients (10 men, six women; mean age, 66 ± 14 years) had distal acute pancreatitis. Among patients with nondistal pancreatitis, none were subsequently diagnosed with pancreatic cancer; 62 had sufficient follow-up (median, 2.5 years) to be classified as having negative follow-up for pancreatic cancer. Among patients with distal pancreatitis, nine were subsequently diagnosed with pancreatic cancer (median interval to suspected cancer on subsequent CT, 174 days); five had sufficient follow-up (median, 3.1 years) to be classified as having negative follow-up for pancreatic cancer. The frequency of pancreatic cancer was higher (p < .001) in patients with distal pancreatitis (9/14 [64%; 95% CI, 35-87%]) than in with those with nondistal pancreatitis (0/62 [0%; 95% CI, 0-6%]). Interreader agreement on classification of distal versus nondistal pancreatitis was almost perfect (κ = 0.81). CONCLUSION. Distal pancreatitis without identifiable cause on CT is an uncommon but unique imaging subtype of acute pancreatitis that is associated with a high frequency of pancreatic cancer. CLINICAL IMPACT. In patients with acute distal pancreatitis without identifiable cause, endoscopic ultrasound-guided biopsy should be considered to evaluate for an underlying small cancer.

Impact of, Factors for the Success of, and Concerns Regarding Transplant Patients' Skin Cancer Campaigns: Observational Study.

Due to rising health care costs, patients have sought alternative ways of addressing medical expenses. In particular, transplant patients have complex and expensive medical needs-including skin cancer surveillance-that may not be fully covered by insurance. One such method of financing medical costs is by crowdsourcing through web-based platforms, most notably GoFundMe. Previous work identified factors associated with GoFundMe campaigns' fundraising success for dermatologic diseases. We sought to characterize these factors in transplant recipients' campaigns for funds raised for covering skin cancer-related costs. These factors include demographics, campaign traits, and subjective themes. From January to April 2022, we analyzed GoFundMe campaigns using the following search terms chosen on the basis of author consensus: "transplant skin cancer," "transplant basal cell," "transplant squamous," "transplant melanoma," and "dermatologist transplant." Demographic data were coded from campaign text or subjectively coded based on author consensus. Campaigns were read completely by 2 independent coders and associated with up to 3 different themes. Linear regression was performed to examine the qualities associated with success, which was defined as funds raised when controlling for campaign goals. Logistic regression was used to examine qualities associated with extremely successful campaigns, defined as those raising funds over 1.5 times the IQR. Across 82 campaigns, we identified several factors that were associated with fundraiser success. Patients who experienced complications during infectious disease treatment, those who received a pancreas transplant, or those who died from their disease raised significantly more money. Patients older than 61 years raised significantly less money. Extremely successful campaigns (>US $20,177) were associated with campaigners who emphasized a disability from their disease, those who were reluctant to ask for help, or those who died due to their disease. Demographic and thematic factors are associated with transplant patients' skin cancer-related fundraising success, favoring those who are younger, in more extreme situations, and appear reluctant to ask for help; these findings are consistent with those of previous studies. Additionally, transplant patients have complex and expensive dermatologic needs that may not be fully covered by insurance, as reflected in their GoFundMe campaigns. The most commonly mentioned reasons for fundraising included living expenses or loss of income, inadequate or no insurance, and end-of-life costs. Our findings may inform transplant patients how to maximize the success of their campaigns and highlight gaps in health care coverage for skin cancer-related costs. Limitations include the possibility for misclassification due to the data abstraction process and limiting data collection to fundraisers available on GoFundMe while excluding those on other websites. Further research should investigate the ethical implications of crowdfunding, financial needs of this patient population, and potential ways to improve access to routine skin cancer surveillance among patients receiving transplants.

Legal Socialization in the Context of Global Transformations

This article is devoted to the problem of legal socialization in the context of changes in the global social reality, and the analysis of a set of measures of citizenship legal education as a priority factor of proper legal socialization in modern conditions. The authors’ methodological basis of the research consists of a set of key approaches (synergetic, interdisciplinary, humanistic, cosmopolitan-sociological) and a three-level system of methods: philosophical, general scientific and special scientific methods. The legal statistical method is used for a comprehensive analysis and establishment of certain patterns based on statistical processing of quantitative material collected as a result of the study (certain data from UN and EUROSTAT official documents and publications were used). It is proved that legal socialization conceptualizes two processes for achieving compliance both on the basis of consensus and coercion. Therefore, the task of proper legal policy is the formation of such a mechanism of law-making, law-enforcement and law-interpreting guarantees that take into account the latest requirements of social reality and the classic moral and ethical patterns of existence of civilized nations. It is generalized that the manifestations of the transformation of legal globalization affecting the legal socialization of the individual are manifested in the following: systematic, continuous, rapid renewal of legal knowledge; obtaining legal information through the latest and classic channels; complexity of legal knowledge and practical skills of implementation, interpretation of legal norms; integrativeness; and multiculturalism of legal communication. It is pointed out that citizenship legal education is a priority means of proper legal socialization and a set of legal guarantees to ensure the proper level of proposed citizenship education.

Diffuse Large B-Cell Lymphoma and Related Entities.

Diffuse large B-cell lymphoma (DLBCL) is the most common malignant B-cell neoplasm, with an incidence of 5.6 per 100 000 persons per year and a mean age of onset of approximately 65 years. It is an aggressive type of non-Hodgkin's lymphoma requiring urgent treatment with curative intent. Evidence-based guidelines have not been available to date. For this first international evidence-based DLBCL-specific guideline, various systematic literature searches were performed. 5 systematic reviews, 21 randomized controlled trials (RCTs), and 36 non-randomized studies were used to formulate 42 recommendations. 142 were formulated on the basis of expert consensus. All recommendations were approved in a structured consensus-finding process. For staging, combined positron emission tomography and computed tomography (PET/CT) should be performed (evidence: a prospective registry study). For all patients with a new diagnosis of DLBCL and without contraindications, R-CHOP based immunochemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) should be initiated with curative intent (evidence: RCTs). The individual treatment strategy is tailored to the patient's age and risk constellation. Once immunochemotherapy has been completed, PET/CT should be performed again to check for remission. Patients with PET-positive residual disease that is amenable to radiotherapy should be treated with consolidating irradiation (evidence: retrospective cohort study). This clinical practice guideline on the diagnosis, treatment, and followup of patients with DLBCL and related entities provides a standardized clinical management approach, identifies areas where improvement would be desirable, and can serve as a basis for the development of further studies.

Imaging of Right Lower Quadrant Pain in Children and Adolescents: AJR Expert Panel Narrative Review.

Right lower quadrant (RLQ) pain is a common clinical presentation in children, and accurate clinical diagnosis remains challenging given that this nonspecific presentation is associated with numerous surgical and nonsurgical conditions. The broad differential diagnosis varies by patient age and sex. Important considerations in the selection of a diagnostic imaging strategy include the sequencing, performance, and cost of tests. This article provides a comprehensive narrative review of the diagnostic imaging of RLQ pain in children and adolescents, including a discussion of the complementary roles of ultrasound, CT, and MRI; description of key imaging findings based on available evidence; and presentation of salient differential diagnoses. Subspecialized pediatric emergency medicine and surgical perspectives are also provided as further clinical insight into this common, but often challenging, scenario. Finally, the current status of imaging of RLQ pain in children and adolescents is summarized on the basis of expert consensus.

Bone fragility, sarcopenia and cardiac calcifications in an elderly population: a preliminary study

Cardiovascular disease, osteoporosis and sarcopenia are very common age-related conditions. This study aimed at investigating the relationships of cardiac calcifications, as assessed by using GCCS with BMD, fragility fractures and sarcopenia in elderly subjects. In a cohort of 106 subjects (age 70.4 ± 5.8 yrs) we measured lumbar (BMD-LS), femoral BMD (femoral neck: BMD-FN, total femur: BMD-TH) and body composition (BMD-WB) with Dual-energy X-ray Absorptiometry (DXA) method. We also evaluated the presence of sarcopenia on the basis of the EWGSOP Consensus. All subjects, simultaneously, underwent to a transthoracic color doppler echocardiography exam to assess the presence of cardiac calcifications. The degree of non coronaric cardiac calcifications was evaluated using the Global Cardiac Calcium Score (GCCS). The degree of cardiac calcification assessed by GCCS was significantly higher in osteoporotic patients (p < 0.001). Furthermore, an inverse correlation emerged between BMD and GCCS, statistical significance was found at lumbar spine and femoral sub-regions in female population (p < 0.01). Moreover by dividing population according to the presence of fragility fractures, we observed that GCCS values were significantly higher in subjects with fractures in respect of non-fractured ones (p < 0.05). Multiple regression models showed that BMD-LS and BMD-FT were independently associated with cardiac calcification. GCCS values were significantly associated with BMI and ASMM in women (p < 0.01 and p < 0.05, respectively) and with handgrip strength in men (p < 0.05). Our data confirm the presence of a relationship between cardiac calcifications and decreased BMD values. It's also the first study that relates sarcopenia and valvular calcifications.

Research on 3D Phenotypic Reconstruction and Micro-Defect Detection of Green Plum Based on Multi-View Images

Rain spots on green plum are superficial micro-defects. Defect detection based on a two-dimensional image is easily influenced by factors such as placement position and light and is prone to misjudgment and omission, which are the main problems affecting the accuracy of defect screening of green plum. In this paper, using computer vision technology, an improved structure from motion (SFM) and patch-based multi-view stereo (PMVS) algorithm based on similar graph clustering and graph matching is proposed to perform three-dimensional sparse and dense reconstruction of green plums. The results show that, compared with the traditional algorithm, the running time of this algorithm is lower, at only 26.55 s, and the mean values of camera optical center error and pose error are 0.019 and 0.631, respectively. This method obtains a higher reconstruction accuracy to meet the subsequent plum micro-defect detection requirements. Aiming at the dense point cloud model of green plums, through point cloud preprocessing, the improved adaptive segmentation algorithm based on the Lab color space realizes the effective segmentation of the point cloud of green plum micro-defects. The experimental results show that the average running time of the improved adaptive segmentation algorithm is 2.56 s, showing a faster segmentation speed and better effect than the traditional K-means and K-means++ algorithms. After clustering the micro-defect point cloud, the micro-defect information of green plums was extracted on the basis of random sample consensus (RANSAC) plane fitting, which provides a theoretical model for further improving the accuracy of sorting the appearance quality of green plums.

Health in All Education: A Transdisciplinary Learning Outcomes Framework

Historical and recent population health issues necessitate the goal of educating and preparing a transdisciplinary workforce with population health knowledge and competence to be able to develop, implement, and evaluate innovative and feasible solutions that not only address multifaceted community health problems downstream but also to be able to predict and prevent those factors that contribute to an inequitable health burden upstream. To identify where population health education is already shared among multiple disciplines, the Centers for Disease Control and Prevention's Academic Partnerships to Improve Health program conceptualized the Health In All Education initiative that was implemented in partnership with the Association for Prevention Teaching and Research. The purpose of the initiative was to (1) show the importance of integrating population health principles into higher-education transdisciplinary practices; (2) discuss examples of Centers for Disease Control and Prevention collaboration with disciplines related to public health (i.e., economics, environmental engineering, health informatics, health law and policy, social work, liberal education in general education); and (3) explore opportunities to promote transdisciplinary learning to prepare for collaborative, interprofessional practice in population health. This article introduces the Health in All Education Learning Outcomes Framework, a set of shared population health concepts identified on the basis of discipline-representative consensus. The following domains were identified as having transdisciplinary applicability on the basis of established public health curricula, competency, and learning outcome models: determinants of health, evidence-based approaches, population health focus, interprofessional practice, community collaboration, environmental health, occupational health, global health, diversity/cultural competence, health systems, finance and budgeting, and health law and policy.