Biennial Review Research Articles

Introduction to the biennial review of pain

Introduction to the biennial review of pain

2024 Systematic Review of Evidence-Based Guidelines for Prehospital Care

ABSTRACT Objectives Evidence-based guidelines (EBGs) are widely recognized as valuable tools to aggregate and translate scientific knowledge into clinical care. High-quality EBGs can also serve as important components of dissemination and implementation efforts focused on educating emergency medical services (EMS) clinicians about current evidence-based prehospital clinical care practices and operations. We aimed to perform the third biennial systematic review of prehospital EBGs to identify and assess the quality of prehospital EBGs published since 2021. Methods We systematically searched Ovid Medline and EMBASE from January 1, 2021, to June 6, 2023, for publications relevant to prehospital care, based on an organized review of the literature, and focused on providing recommendations for clinical care or operations. Included guidelines were appraised using the National Academy of Medicine (NAM) criteria for high-quality guidelines and scored using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Tool. Results We identified 33 new guidelines addressing clinical and operational topics of EMS medicine. The most addressed EMS core content areas were time-life critical conditions (n = 17, 51.5%), special clinical considerations (n = 15, 45%), and injury (n = 12, 36%). Seven (21%) guidelines included all elements of the National Academy of Medicine (NAM) criteria for high-quality guidelines, including the full reporting of a systematic review of the evidence. Guideline appraisals by the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool demonstrated modest compliance to reporting recommendations and similar overall quality compared to previously identified guidelines (mean overall domain score 67%, SD 12%), with Domain 5 (“Applicability”) scoring the lowest of the six AGREE II domains (mean score of 53%, SD 13%). Conclusions This updated systematic review identified and appraised recent guidelines addressing prehospital care and identifies important targets for education of EMS personnel. Continued opportunities exist for prehospital guideline developers to include comprehensive evidence-based reporting into guideline development to facilitate widespread implementation of high-quality EBGs in EMS systems and incorporate the best available scientific evidence into initial education and continued competency activities.

Poverty, policies, and politics: a rights-based approach to food insecurity in Africa

Food and nutrition insecurity remain serious African concerns, reflecting government failure to meet global and regional human rights obligations to assure food availability, accessibility, utilisation, stability, sustainability, and agency. According to recent data, more than one-third of people facing severe food insecurity around the world live in Africa. The numbers may continue to rise in the absence of deliberate and human rightscentred solutions. The second biennial review report of the African Union on the Malabo Declaration on Accelerated Agricultural Growth and Transformation for Shared Prosperity and Improved Livelihoods conceded that the continent is not on track to meet the targets set out in the Declaration to end food insecurity and improve nutrition. This article investigates and advocates for a human rights-based approach to food andnutrition security. It highlights the critical links between the six main elements of food security, namely, availability, access, utilisation, stability, agency, and sustainability, and the normative obligations of states on the right to food and its interdependence with other fundamental human rights. It critically analyses the available legal frameworks on addressing foodinsecurity and its challenges, and proposes a human rights-based approach.

Application of multi-criteria decision analysis techniques and decision support framework for informing plant select agent designation and decision making.

The United States Department of Agriculture (USDA) Division of Agricultural Select Agents and Toxins (DASAT) established a list of biological agents (Select Agents List) that threaten crops of economic importance to the United States and regulates the procedures governing containment, incident response, and the security of entities working with them. Every 2years the USDA DASAT reviews their select agent list, utilizing assessments by subject matter experts (SMEs) to rank the agents. We explored the applicability of multi-criteria decision analysis (MCDA) techniques and a decision support framework (DSF) to support the USDA DASAT biennial review process. The evaluation includes both current and non-select agents to provide a robust assessment. We initially conducted a literature review of 16 pathogens against 9 criteria for assessing plant health and bioterrorism risk and documented the findings to support this analysis. Technical review of published data and associated scoring recommendations by pathogen-specific SMEs was found to be critical for ensuring accuracy. Scoring criteria were adopted to ensure consistency. The MCDA supported the expectation that select agents would rank high on the relative risk scale when considering the agricultural consequences of a bioterrorism attack; however, application of analytical thresholds as a basis for designating select agents led to some exceptions to current designations. A second analytical approach used agent-specific data to designate key criteria in a DSF logic tree format to identify pathogens of low concern that can be ruled out for further consideration as select agents. Both the MCDA and DSF approaches arrived at similar conclusions, suggesting the value of employing the two analytical approaches to add robustness for decision making.

Application of multi-criteria decision analysis techniques and decision support framework for informing select agent designation for agricultural animal pathogens.

The United States Department of Agriculture (USDA), Division of Agricultural Select Agents and Toxins (DASAT) established a list of biological agents and toxins (Select Agent List) that potentially threaten agricultural health and safety, the procedures governing the transfer of those agents, and training requirements for entities working with them. Every 2years the USDA DASAT reviews the Select Agent List, using subject matter experts (SMEs) to perform an assessment and rank the agents. To assist the USDA DASAT biennial review process, we explored the applicability of multi-criteria decision analysis (MCDA) techniques and a Decision Support Framework (DSF) in a logic tree format to identify pathogens for consideration as select agents, applying the approach broadly to include non-select agents to evaluate its robustness and generality. We conducted a literature review of 41 pathogens against 21 criteria for assessing agricultural threat, economic impact, and bioterrorism risk and documented the findings to support this assessment. The most prominent data gaps were those for aerosol stability and animal infectious dose by inhalation and ingestion routes. Technical review of published data and associated scoring recommendations by pathogen-specific SMEs was found to be critical for accuracy, particularly for pathogens with very few known cases, or where proxy data (e.g., from animal models or similar organisms) were used to address data gaps. The MCDA analysis supported the intuitive sense that select agents should rank high on the relative risk scale when considering agricultural health consequences of a bioterrorism attack. However, comparing select agents with non-select agents indicated that there was not a clean break in scores to suggest thresholds for designating select agents, requiring subject matter expertise collectively to establish which analytical results were in good agreement to support the intended purpose in designating select agents. The DSF utilized a logic tree approach to identify pathogens that are of sufficiently low concern that they can be ruled out from consideration as a select agent. In contrast to the MCDA approach, the DSF rules out a pathogen if it fails to meet even one criteria threshold. Both the MCDA and DSF approaches arrived at similar conclusions, suggesting the value of employing the two analytical approaches to add robustness for decision making.

An introduction to the biennial review of pain.

An introduction to the biennial review of pain.

The value of monitoring amended reports in cytopathology quality programs: A biennial review.

Quality and safety are the foundation of the practice of cytopathology. Review of key performance indicator (KPI) data can shine a light on laboratory vulnerabilities and potential areas for targeted improvement. The rate and content of amendment reports is a frequently monitored KPI in anatomic pathology, but few have studied its value in cytopathology. The goal of this study was to examine the frequency, classification, and outcome of amendments for a large cytopathology laboratory. All amendment reports issued for cases during a 2-year period from July 2019 to June 2021 were included in the study. Amendments were classified into three error type root causes: Specimen Identification Error, General Report Defects, and Diagnostic Error. A total of 202 amendment reports were issued equating to a rate of 0.275%. A total of 83 (41.1%) were gynecologic cases and 119 (58.9%) were nongynecologic cases. Within the gynecologic cases, 13 (15.7%) cases were due to Specimen Identification Error, 13 (15.7%) cases were due to Diagnostic Error, and 57 (68.7%) cases were due to General Report Defects. Within the nongynecologic cases, 15 (12.6%) cases were due to Specimen Identification Error, 30 (25.2%) cases were due to General Report Defects, and 74 (62.2%) cases were due to Diagnostic Error with 32 of these due to true diagnostic change. Discovery methods included following re-review after additional clinical information was provided, reinterpretation after additional ancillary testing was performed, or conference review. There was no correlation with years in practice. Studying amendment reports is an underrecognized and valuable quality assurance tool. Amendments can help provide information about types of errors, monitor laboratory processes, and help guide quality improvement endeavors.

Application of Multi-Criteria Decision Analysis Techniques for Informing Select Agent Designation and Decision Making.

The Centers for Disease Control and Prevention (CDC) Select Agent Program establishes a list of biological agents and toxins that potentially threaten public health and safety, the procedures governing the possession, utilization, and transfer of those agents, and training requirements for entities working with them. Every 2 years the Program reviews the select agent list, utilizing subject matter expert (SME) assessments to rank the agents. In this study, we explore the applicability of multi-criteria decision analysis (MCDA) techniques and logic tree analysis to support the CDC Select Agent Program biennial review process, applying the approach broadly to include non-select agents to evaluate its generality. We conducted a literature search for over 70 pathogens against 15 criteria for assessing public health and bioterrorism risk and documented the findings for archiving. The most prominent data gaps were found for aerosol stability and human infectious dose by inhalation and ingestion routes. Technical review of published data and associated scoring recommendations by pathogen-specific SMEs was found to be critical for accuracy, particularly for pathogens with very few known cases, or where proxy data (e.g., from animal models or similar organisms) were used to address data gaps. Analysis of results obtained from a two-dimensional plot of weighted scores for difficulty of attack (i.e., exposure and production criteria) vs. consequences of an attack (i.e., consequence and mitigation criteria) provided greater fidelity for understanding agent placement compared to a 1-to-n ranking and was used to define a region in the upper right-hand quadrant for identifying pathogens for consideration as select agents. A sensitivity analysis varied the numerical weights attributed to various properties of the pathogens to identify potential quantitative (x and y) thresholds for classifying select agents. The results indicate while there is some clustering of agent scores to suggest thresholds, there are still pathogens that score close to any threshold, suggesting that thresholding “by eye” may not be sufficient. The sensitivity analysis indicates quantitative thresholds are plausible, and there is good agreement of the analytical results with select agent designations. A second analytical approach that applied the data using a logic tree format to rule out pathogens for consideration as select agents arrived at similar conclusions.

Curation of a list of chemicals in biosolids from EPA National Sewage Sludge Surveys & Biennial Review Reports

Section 405(d) of the Clean Water Act requires the US Environmental Protection Agency to review sewage sludge regulations every two years to identify any additional pollutants that may occur in biosolids and to set regulations for pollutants identified in biosolids if sufficient scientific evidence shows they may harm human health or the environment. To date, EPA has conducted eight biennial reviews to identify chemical and microbial pollutants and three national sewage sludge surveys to identify pollutants and obtain concentration data for chemicals found in biosolids. Prior to 2021, there was inconsistent reporting of chemicals identified and EPA did not cumulatively track chemicals in biosolids. Through the efforts presented here, EPA produced a list of 726 chemicals and structure-based classes found in biosolids based on biennial reviews and national sewage sludge surveys. Summary statistics of concentration data are also reported for the 484 chemicals found in the three national sewage sludge surveys. The creation of the Biosolids List supports EPA in assessing the potential risk of chemical pollutants found in biosolids.

Six priorities to advance the science and practice of coral reef restoration worldwide

Coral reef restoration is a rapidly growing movement galvanized by the accelerating degradation of the world's tropical coral reefs. The need for concerted and collaborative action focused on the recovery of coral reef ecosystems coalesced in the creation of the Coral Restoration Consortium (CRC) in 2017. In March 2020, the CRC leadership team met for a biennial review of international coral reef restoration efforts and a discussion of perceived knowledge and implementation bottlenecks that may impair scalability and efficacy. Herein we present six priorities wherein the CRC will foster scientific advancement and collaboration to: (1) increase restoration efficiency, focusing on scale and cost‐effectiveness of deployment; (2) scale up larval‐based coral restoration efforts, emphasizing recruit health, growth, and survival; (3) ensure restoration of threatened coral species proceeds within a population‐genetics management context; (4) support a holistic approach to coral reef ecosystem restoration; (5) develop and promote the use of standardized terms and metrics for coral reef restoration; and (6) support coral reef restoration practitioners working in diverse geographic locations. These priorities are not exhaustive nor do we imply that accomplishing these tasks alone will be sufficient to restore coral reefs globally; rather these are topics where we feel the CRC community of practice can make timely and significant contributions to facilitate the growth of coral reef restoration as a practical conservation strategy. The goal for these collective actions is to provide tangible, local‐scale advancements in reef condition that offset declines resulting from local and global stressors including climate change.

The EU’s Environmental Implementation Review: An Emerging Tool for Supervising Policy Delivery.

The aim of this short article is to provide a brief overview and reflections on theUnion’s relatively recent introduction of a biennial Environmental Implementation Review (EIR) cycle as part of its activities in monitoring EU Member States’ (MS) implementation of Union environmental law and policy. The EIR reflects an increased level of interest on the part of the Union in seeking to identify ways in which MS may improve upon their track records in implementing EU environmental legislative requirements at national level. Notably, it envisages a more intense form of engagement and dialogue on the part of the European Commission with MS authorities on identifying strengths and weaknesses in terms of individual MS performance as well as identifying common challenges at national level. The article assesses what key outcomes may have emerged thus far with the two EIR cycles that have been completed and how the EIR relates to the other principal supranational supervisory tool used by the EU for the purpose overseeing compliance with the EU environmental acquis, namely the use of law enforcement action via infringement proceedings. Ultimately, the article posits the view that the tools of EIR and law enforcement may be best seen to be in a complementary and mutually supportive relationship, each needing the other to be able to make a sufficient impression and impact on MS in terms of inducing them to address the subject of implementation with the degree of importance and urgency it deserves. Environmental Implementation Review, supranational supervision, implementation, infringements, compliance assurance, European Commission, Court of Justice of the European Union.

Technology readiness assessment of materials for DEMO in-vessel applications

A dedicated procedure was developed to categorize the technology readiness of materials for specific DEMO in-vessel fusion reactor applications. This methodology was employed to assess the technological maturity of materials under development within the EUROfusion materials work package (WPMAT). This covers materials intended for structural, high heat flux, optical and dielectric applications in the European DEMO fusion reactor (breeder materials and barrier coatings are not covered here). The baseline materials have been assigned DEMO Material Technology Readiness Levels (MTRLs) of 4 (EUROFER97), 3 (conventional tungsten) and 4 (Copper-Chromium-Zirconium). In addition, a further 28 candidate materials (and groups of materials) were also assessed. These were generally assigned DEMO MTRLs in the range of 2-3. This process has highlighted the wide range of materials under development within WPMAT. However, it has also brought into focus the many challenges facing DEMO materials development. While the lack of technologically ready materials is clearly a source of risk to DEMO, the introduction of a biennial review of technology readiness within WPMAT is intended to facilitate more effective planning and targeted materials development, in line with the strategic plans of EUROfusion. This paper highlights the methodologies for fusion specific material technology readiness levels, their application for EU-DEMO and the effectiveness of these in strategic materials development.

An introduction to the Biennial Review of Pain.

aScientific Programme Committee Chair, 18th World Congress on Pain bEditor in Chief, PAIN *Corresponding author. Address: Pain Research Group, Department of Surgery and Cancer, Faculty of Medicine, Imperial College, Chelsea and Westminster Hospital campus, 369 Fulham Road, London SW10 9NH, United Kingdom. E-mail address: [email protected] (A.S.C. Rice). Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Improving Data Quality for the CAADP Biennial Review: A Partnership Initiative Piloted in Five Countries

This paper presents results of a data partnership framework for strengthening evidence-based planning and implementation that was initiated in 2019 in five selected African countries (Kenya, Malawi, Mozambique, Senegal, and Togo) during the second round of the CAADP biennial review (BR) process. It analyzes the effect of the activities conducted on the data reporting rate and the quality of data reported in the five pilot countries, compared with what was achieved in like-pilot countries. The like-pilot countries are non-pilot countries that have characteristics like the pilot countries at the baseline which affect selection into the pilot or the data reporting and quality outcomes. Different methods (standard deviations, propensity score matching, and two-stage weighted regression) are used to identify the like-pilot countries, and a difference-in-difference method is used to estimate the effect of the pilot activities on the outcomes. The capacity-strengthening activities focused on working with the country Biennial Review (BR) team to: assess the inaugural or 2018 BR process and identify the data gaps; constitute and train members of data clusters to compile and check the data for the 2020 BR; and then validate and submit the data. The findings show that the activities helped the pilot countries to improve their performance in the data reporting rate and the quality of data reported in the 2020 BR. The largest improvement is observed in Togo and Senegal, followed by Kenya and Malawi, and then Mozambique. The average increase in the data reporting rate between 2018 and 2020 BRs for the pilot countries is greater than the average progress made in the like-pilot countries by about 6 to 9 % pts. This derives mostly from improvements in the data reporting rate for the indicators under theme 3 on ending hunger. Regarding the quality of data reported (measured as the percent of the data reported that have issues) too, the pilot countries on average performed better than the like-pilot countries, especially with respect to the data reported under themes 2 on investment in agriculture and 3 on ending hunger. But most of the estimated differences have low or no statistical significance. Implications for sustaining the progress made in the pilot countries, as well as for extending the activities to other countries, for the next rounds of the BR are discussed.

The Literature of American Library History, 2016–2017

This biennial review of the writings on the history of libraries, librarianship, and information surveys about two hundred publications that were published in 2016 and 2017. The essay is divided into a number of sections, including academic and public libraries, biography, technical services, and the history of reading and publishing. It also contains a brief list of theses and dissertations that were completed in 2016 and 2017.

Flemish breast cancer screening programme: 15\u2009years of key performance indicators (2002\u20132016)

BackgroundWe examined 15 years of key performance indicators (KPIs) of the population-based mammography screening programme (PMSP) in Flanders, Belgium.MethodsIndividual screening data were linked to the national cancer registry to obtain oncological follow-up. We benchmarked crude KPI results against KPI-targets set by the European guidelines and KPI results of other national screening programmes. Temporal trends were examined by plotting age-standardised KPIs against the year of screening and estimating the Average Annual Percentage Change (AAPC).ResultsPMSP coverage increased significantly over the period of 15 years (+ 7.5% AAPC), but the increase fell to + 1.6% after invitation coverage was maximised. In 2016, PMSP coverage was at 50.0% and opportunistic coverage was at 14.1%, resulting in a total coverage by screening of 64.2%. The response to the invitations was 49.8% in 2016, without a trend. Recall rate decreased significantly (AAPC -1.5% & -5.0% in initial and subsequent regular screenings respectively) while cancer detection remained stable (AAPC 0.0%). The result was an increased positive predictive value (AAPC + 3.8%). Overall programme sensitivity was stable and was at 65.1% in 2014.In initial screens of 2015, the proportion of DCIS, tumours stage II+, and node negative invasive cancers was 18.2, 31.2, and 61.6% respectively. In subsequent regular screens of 2015, those proportions were 14.0, 24.8, and 65.4% respectively. Trends were not significant.ConclusionBesides a suboptimal attendance rate, most KPIs in the Flemish PMSP meet EU benchmark targets. Nonetheless, there are several priorities for further investigation such as a critical evaluation of strategies to increase screening participation, organising a biennial radiological review of interval cancers, analysing the effect that preceding opportunistic screening has on the KPI for initial screenings, and efforts to estimate the impact on breast cancer mortality.

An introduction to the Biennial Review of Pain

An introduction to the Biennial Review of Pain

Biennial Review of Planar Chromatography: 2015-2017.

The most important advances in planar chromatography published between November 1, 2015, and November 1, 2017, are reviewed in this paper. Included are an introduction to the current status of the field; student experiments and reviews; apparatus and techniques for sample preparation and TLC separations; detection and identification of separated zones; quantitative analysis; preparative layer chromatography; and thin-layer radiochromatography. Selected applications are given in the various sections of the review.

The importance of qualitative and quantitative regional wall motion abnormality assessment at rest in pediatric coronary allograft vasculopathy.

CAV remains one of the main limiting factors for survival in children after heart transplantation. In this study, we explored the incremental value of routine CMR for evaluation and detection of CAV using qualitative and quantitative analysis of regional and global myocardial function and strain. This was a prospective imaging biomarker validation trial. Twenty-two patients (11 male), aged between 10 and 17years (median 14years) post-heart transplantation, were prospectively enrolled and underwent CMR in addition to their biennial review workup with Echo, angiography, and IVUS. Nine healthy control patients were enrolled to undergo CMR alone. Echo was used to analyze WMAs and systolic function. CMR images were analyzed qualitatively for RWMA and quantitatively for volumetric analysis, S and SR. All results were compared to IVUS and angiography assessments. Qualitatively, CMR detected RWMA corresponding to angiographic disease in 3 patients that were not detected on Echo. However, quantitative strain analysis suggested RWMA in an extra 9 patients. Detection of regional wall motion abnormality using quantitative strain analysis was associated with a higher mean stenosis grade (P=.04) and reduced graft survival (P=.04) compared to those with no quantitative wall motion abnormality. Overall, only longitudinal stain was abnormal in patients compared with controls, but there was no correlation between any of the global indices of S or SR and IVUS measurements. CMR is more sensitive than Echo for the visual detection of significant WMAs. Quantitative CMR strain analysis at rest may give additional information to discriminate those at greatest risk.

Is regulation preventing the development of therapeutics that may prevent future coronavirus pandemics?

Is regulation preventing the development of therapeutics that may prevent future coronavirus pandemics?