Expert Committee Research Articles

2024 American Heart Association and American Academy of Pediatrics Focused Update on Special Circumstances: Resuscitation Following Drowning: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

Drowning is the third leading cause of death from unintentional injury worldwide, accounting for 7% of all injury-related deaths. In the United States, drowning is the leading cause of death in children 1 to 4 years of age and second leading cause of death due to unintentional injury in those aged 5 to 14 years. Drowning generally progresses from initial respiratory arrest due to submersion-related hypoxia to cardiac arrest; thus, it can be challenging to distinguish respiratory arrest from cardiac arrest because pulses are difficult to accurately palpate within the recommended 10-second window. Therefore, resuscitation from cardiac arrest due to this specific circumstance must focus on restoring breathing as much as it does circulation. Resuscitation from drowning may begin with in-water rescue breathing when safely provided by rescuers trained in the technique and should continue with chest compressions, in keeping with basic life support guidelines, once the drowned individual and the rescuer are in a safe environment (eg, dry land, boat). This focused update incorporates systematic reviews from 2021 to 2023 performed by the International Liaison Committee on Resuscitation related to the resuscitation of drowning. These clinical guidelines are the product of a committee of experts representing the American Academy of Pediatrics and the American Heart Association. The writing group reviewed the recent International Liaison Committee on Resuscitation systematic reviews, including updated literature searches, prior guidelines related to resuscitation from cardiac arrest following drowning, and other drowning-related publications from the American Academy of Pediatrics and the American Heart Association. The writing group used these reviews to update its recommendations aimed at resuscitation from cardiac arrest following drowning in children.

2024 American Heart Association and American Academy of Pediatrics Focused Update on Special Circumstances: Resuscitation Following Drowning: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

Drowning is the third leading cause of death from unintentional injury worldwide, accounting for 7% of all injury-related deaths. The World Health Organization estimates that there are ≈236 000 deaths due to drowning worldwide each year. Significant efforts have focused on creating systems to prevent drowning, but an average of 4000 fatal and 8000 nonfatal drownings still occur annually in the United States-likely an underestimate. Drowning generally progresses from initial respiratory arrest due to submersion-related hypoxia to cardiac arrest; thus, it can be challenging to distinguish respiratory arrest from cardiac arrest because pulses are difficult to accurately palpate within the recommended 10-second window. Therefore, resuscitation from cardiac arrest attributable to this specific circumstance must focus on restoring breathing as much as it does circulation. Resuscitation from drowning may begin with in-water rescue breathing when safely provided by rescuers trained in the technique and should continue with chest compressions, in keeping with basic life support guidelines, once the drowned individual and the rescuer are in a safe environment (eg, dry land, a boat). This focused update incorporates systematic reviews from 2021 to 2023 performed by the International Liaison Committee on Resuscitation related to the resuscitation of drowning. These clinical guidelines are the product of a committee of experts representing the American Heart Association and the American Academy of Pediatrics. The writing group reviewed the recent International Liaison Committee on Resuscitation systematic reviews, including updated literature searches, prior guidelines related to resuscitation from cardiac arrest following drowning, and other drowning-related publications from the American Heart Association and American Academy of Pediatrics. The writing group used these reviews to update its recommendations aimed at resuscitation of cardiac arrest following drowning in adults and children.

Translation and cross-cultural adaptation of the self evaluation of breathing questionnaire (SEBQ) into Danish

ABSTRACT Background and Purpose Dysfunctional breathing (DB) with or without an underlying medical condition is associated with impaired quality of life. DB-related symptoms can be measured with the 25-item Self Evaluation of Breathing Questionnaire (SEBQ). However, the SEBQ is not available in Danish.The aim of the present study was to translate and cross-culturally adapt the SEBQ into Danish and to assess the face validity of the Danish version of the questionnaire in individuals with DB-related symptoms. Materials and Methods The SEBQ was translated and cross-culturally adapted into Danish using an internationally acknowledged six-step forward-backward translation guideline in an interactive process with an expert committee of clinicians, translators, methodologists and the SEBQ developer. Face validity was explored through semi-structured interviews with 24 adult individuals with DB-related symptoms (age 20–70 years, female n = 14). Results The SEBQ was successfully translated and cross-culturally adapted into Danish. Three major modifications were made following the translation process and participant interviews. First, an introductory paragraph, including a recall period of the previous seven days, was added. Second, the administration of the questionnaire was changed from a paper to an electronic version. Finally, adaptations regarding semantic equivalence, especially concerning being ‘breathless’ and ‘short of breath’, were performed. The participants expressed that the final version of the SEBQ embraced their DB-related symptoms, was understandable, and easy to complete. Conclusion The SEBQ is the first available Danish questionnaire to measure DB-related symptoms, following an internationally acknowledged cross-cultural adaptation and face validity evaluation approach. This promising validation should be followed by an assessment of measurement properties in individuals with DB-related symptoms to investigate the adequacy of the SEBQ in a Danish context.

Management of fever and associated symptoms in children and adults: an Italian national survey

An advisory committee of Italian experts conducted a national, cross-sectional, web-based survey in June 2024 to describe the current management of fever and associated symptoms in different settings, including primary care, emergency departments, and hospital wards in pediatric and adult patients. The survey covered two domains: participants’ features and questions about the main drugs prescribed to treat fever and associated symptoms. A total of 832 questionnaires were analyzed. Paracetamol was the most prescribed drug to treat fever. Most participants were influenced by related symptoms when choosing the most appropriate drug. Almost all participants selected the oral route as their preferred one. This survey provides a current state of fever management among physicians in different settings throughout Italy. It highlights a trend in treating fever with antipyretics at appropriate doses and evaluating pain through validated scales.

Transcultural adaptation and validation of the Eating Self-Efficacy Brief Scale (ESEBS): the Brazilian version

PurposeThis study aimed to develop and validate the Brief Eating Self-Efficacy Scale (ESEBS-BR) in Brazilian Portuguese, addressing the lack of tools to assess eating self-efficacy beliefs in Portuguese-speaking populations.MethodThe study sought to cross-culturally adapt the scale, evaluate its internal structure, validate its reliability and validity, and explore potential associations between eating self-efficacy and eating behaviors. The cross-cultural adaptation process involved translation and back-translation, expert committees, and pre-testing. Scale validation was conducted with 228 participants, including reliability analyses, confirmatory factor analysis, and correlations with established measures of eating behavior.ResultsThe ESEBS-BR, maintaining all 8 original items, demonstrated high reliability, with a two-factor structure model confirmed by confirmatory factor analysis. Significant correlations were found between ESEBS-BR scores and measures of binge eating and eating behaviors, validating its criterion validity.ConclusionsThe development and validation of the ESEBS-BR represent a significant contribution to the assessment of eating self-efficacy in the Brazilian population. The scale proved to be sensitive, reliable, and valid, offering an important tool for research and clinical interventions related to eating behavior.Level of evidence: V, descriptive cross-sectional study.

Expert consensus on the perioperative management of co-ablation system therapy of lung tumors

In order to improve the quality of clinical therapy and nursing care for patients with lung tumors undergoing Co-Ablation System and standardize perioperative management, the Committee of Ablation Therapy in oncology, Chinese Anti-Cancer Association, and the Expert committee on Ablation Therapy and the Committee of Interventional Perioperative, Interventional Physician Branch of Chinese Medical Doctor Association organized medical and nursing experts in China. Based on the clinical practice of Co-Ablation System therapy in China and relevant domestic literature, a perioperative management expert consensus was developed. The expert consensus included the key points of perioperative nursing care, prevention and intervention of complications, and discharge guidance for Co-Ablation System therapy of lung tumors, to provide reference for the standardization and development of clinical management for lung tumors.

Investigating the Relationship Between β-Carotene Intake from Diet and Supplements, Smoking, and Lung Cancer Risk

β-carotene is a naturally occurring and safe dietary source of vitamin A that is associated with cancer risk reductions when consumed in typical dietary amounts. However, two clinical trials reported increased incidence of lung cancer and total mortality among heavy smokers taking β-carotene supplements (20 or 30 mg/day). Based on these findings, the Joint FAO/WHO Expert Committee on Food Additives withdrew Acceptable Daily Intake values for β-carotene (0-5 mg/kg bw). We evaluated relevant epidemiological and toxicological literature to assess the biological plausibility of this relationship and identified three mechanisms involving cellular proliferation signaling, a mode of action for cancer promotion. The overall weight of evidence consistently demonstrated typical dietary doses of β-carotene decreased cellular proliferation signaling via these mechanisms, even in the presence of smoke, while co-exposure to smoke and higher, supplemental doses increased cellular proliferation signaling through these same pathways. The production of excessive oxidative β-carotene metabolites via reactions with smoke constituents may be a key event underlying this relationship. Consistent with previous findings, our evaluation indicated consumption of up to 50 mg/day β-carotene does not present safety concerns for the non-smoking general population. Heavy smokers consuming less than 15 mg β-carotene/day are not expected to be at an increased risk of lung cancer.

Practice guideline of influenza vaccination and antiviral drugs use in children(2024 editon)

Influenza is the most common acute respiratory infectious diseases among children in China. The annual seasonal influenza outbreak has a significant impact on children's health, poses a significant disease and socioeconomic burden, and arouses a wide public concern. In recent years, a number of new influenza vaccines and influenza antivirals have been approved for use in children, expanding the choices for prevention and treatment of influenza. Pediatric Infection Group, Chinese Society of Infectious Diseases of Chinese Medical Association and Infection Group, Pediatric Expert Committee of National Health Commission Capacity Building and Continuing Education, and China Clinical Practice Guidelines Alliance Methodology Committee organized a multidisciplinary guideline development group (GDG) consisting of experts in pediatrics, infectious diseases,epidemiologists,health policy,and guideline methodology proposed eight key issues concerning influenza vaccination and antiviral use from a practice perspective. Through research question construction, evidence retrieval and synthesis, evidence appraisal and evidence-to-decision discussion, recommendations and implementation suggestions were formulated. This guideline is intended to provide guidance for pediatricians at different facility levels and healthcare providers engaged in vaccination services,and institutional professionals dealing with prevention and control of infectious diseases.

Strategic Expert Committees and the Markets That Assess Them: A Laboratory Experiment

Committees of experts are widely used to make decisions. We experimentally investigate the relationship between decision making in committees and the assessment of the ability of committee members by evaluators, comparing observed behavior with theoretical predictions. Treatments vary in whether members care only about a state-dependent project payoff or also about assessments and whether evaluators can base their assessments only on the decision the committee makes or also on cheap-talk statements made by committee members on their confidence in the committee decision. Evidence for the equilibrium predictions is mixed; for example, contrary to theory, committees with a concern for their assessment do not distort their decisions more than committees without, whereas in line with theory, evaluators give higher assessments to committees that take the risky decision rather than the riskless. We analyze whether evaluators rationally base their assessments on observed behavior of committees using an orthogonality test. In treatments with cheap-talk statements, assessments are quite rational; in treatments without, they are too low on average. We investigate whether committees best reply to expected project payoffs and, in treatments in which members’ payoffs also depend on assessments, to predicted assessments conditional on observed committee behavior. In all treatments, committees respond to the possibilities to raise expected payoffs but do not use them as much as predicted by theory. We conclude by showing that the amount of information about committee members’ abilities that ends up in assessments is considerably larger when evaluators observe committees’ decisions and statements rather than only decisions. This paper was accepted by Yan Chen, behavioral economics and decision analysis. Funding: We gratefully acknowledge financial support from the Dutch Research Council (NWO) under the grant 400-09-338; and Erasmus University Rotterdam [Grant CSTO 2014–54]. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2021.03007 .

Vaccination health literacy: cultural validation and pilot testing of the HLS19-VAC instrument

Abstract Introduction Vaccinаtion health literacy (VHL) is considered an extremely important aspect of health literacy. HLS19-VAC questionnaire is a 14-item ‘subjective’ perception-based instrument used for measuring VHL in the M-POHL Health Literacy Survey 2019-2021, which Serbia was not part of. Aim Translation and cultural validation of the HLS19-VAC questionnaire and using the validated Serbian version (HLS19-VAC_RS) for pilot study research. Materials and methods The English version of HLS19-VAC was translated using a systematic approach; three forward and one back-translations were synthesized and compared by an expert committee. Thereafter, cognitive interviews with 11 participants produced a version that was culturally validated by an expert panel. We conducted a cross-sectional pilot study using a HLS19-VAC_RS, on a convenient sample of the general population in Serbia. VHL was assessed by calculating the score for 4 out of 14 questions. Additional data were collected through a general questionnaire with 30 questions. Descriptive and inferential statistics were used. Results Cognitive interviews showed some problems in wording, and cultural adaptation resulted in minor refinements to eight out of 14 items. The instrument was pretested by 11 experts who adjusted it accordingly to produce culturally validated HLS19 -VAC_RS. Of 439 respondents in a pilot study, 15% had problematic VHL, while the levels of sufficient and excellent VHL were nearly the same (38.5% and 35.1%, respectively). There was difficulty in deciding whether to receive the flu vaccine (15.0%) and to find information about recommended vaccines (12.3%). There was a significant statistical difference in responses to VHL and monthly income and alcohol consumption. Most of the respondents contacted pharmacists as primary sources of information about medication (42.7%). Conclusions HLS19 -VAC_RS could be implemented in a local context as culturally appropriate. Further testing on a population level is needed. Key messages • HLS19-VAC_RS Questionnaire is culturally appropriate for assessing vaccination health literacy in Serbia. • Majority of respodents had sufficient or excellent vaccination health literacy.

Real-life data on the tolerability of SGLT2 inhibitors in elderly patients with heart failure

Abstract Introduction Sodium-glucose co-transporter 2 inhibitors (SGLT2i) have demonstrated their effectiveness in improving the prognosis of heart failure. However, there is some hesitation in clinical practice to prescribe them to elderly patients due to a lack of long-term safety data. The SafeGLT2 study aims to evaluate the tolerance of SGLT2i in elderly patients with heart failure in real-life settings. Methods This is a prospective study conducted in acute geriatric units in the Île-de-France region between February 2020 and May 2023. All patients admitted for acute heart failure (AHF), aged 75 years and older, were included. The diagnosis was confirmed by an expert committee, and patients were followed for one year. Treatments were recorded upon admission and discharge, along with demographic characteristics and medical history. SGLT2i tolerance data were collected and analyzed, including renal insufficiency, hypovolemia, genital infections, urinary infections, hypoglycemia, diabetic ketoacidosis, fractures, amputations, etc. A comparison of tolerance data between heart failure patients treated with SGLT2i and those not receiving SGLT2i was performed. Results 288 patients were included in the study with a mean age of 88 years, 53% (n=153) were female, and a median Charlson Comorbidity Index (CCI) of 8.77 [2.71]. 44.1% (n=127) of patients had neurocognitive disorders, 39.6% (n=114) were malnourished, 32.6% (n=94) were fallers, 53.8% (n=155) had renal insufficiency (eGFR < 60 ml/min), and 11.5% (n=33) lived in institutions. A total of 33% (n=95) were treated with SGLT2i upon discharge. No serious adverse effects were found in this very frail population receiving SGLT2i compared to the group not receiving SGLT2i (severe hypotension, hypovolemia, ketoacidosis, hypoglycemia, fracture, amputation). Beneficial effects on renal function (improvement of renal function at 6 months) were observed in the SGLT2i group despite a temporary decrease in glomerular filtration rate of less than 30% after SGLT2i initiation. However, a statistically significant increase in urinary tract infections (16.8% vs 4.15%), genital infections (12.6% vs 1.5%), and constipation (10% vs 1%) was found in the SGLT2i group compared to the group without SGLT2i. Conclusion These data indicate that SGLT2i are well tolerated in very elderly frail heart failure patients. However, the occurrence of urogenital infections appears to be more frequent in this population and requires particular surveillance.

Advancing Dementia Care in Austria: developing a Dementia Registry using a multimethod approach

Abstract Background Austria faces an increasing demand for dementia care in an ageing population. However, a lack of representative data hampers evidence-based policy development and evaluation of care. To address this gap, the Austrian National Institute of Public Health is undertaking the task of developing the Austrian Dementia Quality Registry (ÖDQR). Methods Based on the AIHTA Good Practice Framework for Dementia Registries, the development and testing of the ÖDQR has unfolded in 4 distinct phases: 1) planning; 2) registry design (including definition of quality indicators and minimum data set, recruitment, and governance); 3) definition of data collection, sources, and management; 4) pilot testing. A steering committee of government representatives and dementia care experts was convened to oversee the project. A scientific committee provided oversight and ensured methodological rigor. Working groups of national and international dementia care experts focused on standards for diagnosis and therapy, activities of daily living and quality of life, legal aspects, and technical implementation, thus contributing to the content development of the ÖDQR. Results An initial systematic literature review informed the selection of quality indicators in the working groups. A conceptual framework of 15 descriptive and 30 quality indicators was developed. Preliminary results of pilot testing indicate feasibility and content validity. As a result, the ÖDQR will be established as a longitudinal survey-based registry, based on an instrument comprising 163 variables and emphasizing data collection across care settings. Legal and technical frameworks are being developed. Conclusions The öDQR holds the promise of informing evidence-based policy and improving the quality of dementia care in Austria. Careful planning and collaboration have laid the foundation for a data repository that will inform policy and improve care for people with dementia and their caregivers. Key messages • Dementia registries require a complex development to assure validity and adherence. • The Austrian Dementia Registry aims to establish best practice by focusing on the life situation of those affected by this condition.

Institutionalising guideline development in a new universal healthcare system: a study in Cyprus

Abstract Issue Guideline development is a lengthy and diligent process that involves the assessment and interpretation of evidence by a committee. Whilst the implementation of high quality healthcare guidelines ensures consistency and quality in healthcare delivery, many countries worldwide, including Cyprus, lack the capacity and resources to develop de novo guidelines. Description of the problem Guidelines developed by internationally recognised organisations, such as NICE, are a valuable resource for countries like Cyprus. The collaboration between NICE and the newly established healthcare system in Cyprus introduced a process for guideline institutionalisation, taking advantage of existing human resources and building guideline development capability in Cyprus. Results This process involved recruiting local professionals to form a guideline secretariat. The secretariat, supported by NICE, is responsible for overseeing the guideline development process including technical expert committee (TEC) recruitment and stakeholder consultation. The TEC contextualise an existing NICE guidelines to reflect local considerations. NICE provides quality assurance to ensure changes are contextual in nature and consistent with the underpinning evidence. Despite initial challenges, getting stakeholder buy-in and engaging healthcare professionals in the TEC, one contextualised guideline has been produced and two others are at the final stage. Lessons Guideline contextualisation is an efficient and sustainable way of building guideline development capability to institutionalize guidelines in settings with limited capacity. Key messages • De-novo guideline development is time consuming and demanding and many countries require an alternative process for producing locally relevant guidelines, capitalising on existing resources. • Support by an established organisation ensures quality, is less resource intensive, and builds capability for the sustainability of the process.

Suicide in young and middle-aged individuals: lessons from a psychosocial autopsy study

Abstract Background Sociodemographic characteristics of suicides are available from Statistics Netherlands. To improve suicide prevention, it is not only necessary to know who dies but also why people die. A psychosocial autopsy was conducted in the Netherlands to investigate differences in psychosocial characteristics and precipitating factors of suicides of young (<30) and middle-aged (40-70) suicide decedents. Methods Data were collected from bereaved individuals. A questionnaire detailed sociodemographic and psychosocial characteristics of the decedents. We reconstructed the suicidal process in the months preceding the suicide in an interview. Findings from the questionnaire and interview were integrated. An independent expert committee formulated recommendations for suicide prevention. Results 162 suicides were investigated. Young decedents showed high levels of substance use and academic pressure. Young adults with developmental disorders were vulnerable in the transition to adulthood. Young males reached out less to support and care. By contrast, suicides of young females were distinguished by comorbidity of psychiatric disorders, frequent suicidal behaviours, high levels of care use, wait lists and a loss of (treatment) perspective, harmful social media use and bullying. Work and financial problems were common in middle-aged decedents. Physical disability and pain were frequently mentioned for middle-aged females. Suicide in middle-aged males was characterized by financial distress, interpersonal conflicts such as divorce, high levels of binge drinking and addiction. Conclusions Our data provide a topology of the needs of individuals at risk for suicide. Suicide prevention strategies can be improved by better transition support and explicit suicide monitoring in young adults with a developmental disorder, active waitlist policies in mental healthcare, and improved collaboration between debt counsellors and mental care professionals based on shared accountability. Key messages • Bereaved individuals elucidated a wide range of psychosocial problems in suicide decedents. • Suicide prevention should adhere to a needs-based approach.

Travel to malaria-endemic areas: using digital geo-location to assess potential exposure risks and health behaviours.

Travellers frequently visit popular destinations like Brazil, India, Peru, Thailand, and Tanzania, each presenting varying malaria risks. The extent to which travellers enter high-risk malaria-endemic areas in destinations with heterogeneous malaria risk remains unclear. We used geo-location via smartphone application to (i) describe where travellers go within countries with heterogeneous malaria risk (Brazil, India, Peru, Thailand), and (ii) compare mosquito bite prevention behaviours between these destinations and Tanzania, considered entirely high-risk for malaria. This analysis is a sub-study of the TOURIST2 cohort, which prospectively recruited 1000 travellers (≥ 18years, travelling ≤ 4weeks) from Swiss travel clinics (Zurich and Basel) between 09/2017-04/2019. We included 734 travellers to Brazil, India, Peru, Thailand, and Tanzania who provided geo-location data. Daily health and geo-location data were collected using a smartphone application. Malaria risk was categorised using 2022 malaria maps from the Swiss Expert Committee for Travel Medicine. Of the 734 travellers, 525 travelled to Brazil, India, Peru, and Thailand, and 225 to Tanzania. In Brazil, India, Peru, and Thailand, only 2% (n = 13) visited high-risk malaria areas. In Peru, 4% (n = 4) visited a high-risk area; in Brazil, 3% (n = 6); in Thailand, 2% when crossing the border into Myanmar (n = 3); and in India, 0%. Travellers to high-risk areas were more often male (62%), slightly older (median age 42.0), and planned longer trips (median 23.0days) than other travellers. No participants were diagnosed with malaria. Travellers to Brazil, India, Peru and Thailand used mosquito bite prevention measures less frequently than travellers to Tanzania. Those in Tanzania had higher, but still suboptimal, use of insect spray (65% of travel-days). Travellers to Brazil, India, Peru, and Thailand rarely visited high-risk malaria areas, and their adherence to mosquito bite prevention measures was generally low. In Tanzania, adherence was higher but still suboptimal.

French translation and transcultural adaptation of the shoulder pain and disability index (SPADI)

BackgroundA French version of the Shoulder Pain and Disability Index (SPADI) is currently unavailable for clinical and research use in French-speaking countries. ObjectivesTo translate and transculturally adapt the Shoulder Pain And Disability Index (SPADI) from English to French language. DesignTranslation and transcultural adaptation of a Patient-Reported Outcome Measure. MethodsFollowing international guidelines for translating and adapting PROMs, we carried out a seven-step process involving 15 contributors. The forward translation was performed by five independent native French speakers, while five independent native English speakers conducted the blinded back-translation. A bilingual expert committee synthesized the translations, and three healthcare professionals participated in the pre-test phase. Ten patients were involved in pre-testing to evaluate the pre-final version. ResultsA final French version of the SPADI was achieved after making seven adjustments across the 18 items, instructions, and examples on the Likert scale. Changes were implemented only if at least 20% of the pre-test participants suggested modifications to enhance readability or coherence. Face validity was assessed by the expert committee. ConclusionThe French version of the SPADI is now available, enabling condition-specific self-assessment and quantitative follow-up of shoulder pain and function in both clinical practice and research. Although psychometric properties of this version are yet to be assessed, future studies are expected to confirm the preservation of the original tool's validity and reliability.

An expert system based decision-making framework for benchmarking industry in sustainable manufacturing

PurposeThe purpose of this study is to evaluate and enhance sustainable manufacturing practices across various industries, focusing on environmental, economic and social dimensions, to promote a comprehensive understanding and implementation of sustainability, thereby improving overall industry performance and fostering long-term ecological and economic health.Design/methodology/approachThe study uses multi-criteria decision-making-multivariate analysis technique to examine sustainable manufacturing practices (SMPs) in the Indian manufacturing sector. It identifies 11 SMP criteria through literature review and expert recommendations. Data are collected through questionnaires, expert committees and interviews. The study focuses on four key industries: automobile, steel, textile and plastic. Techniques like principal component analysis (PCA), technique for order preference by similarity to ideal solution (TOPSIS) and complex proportional assessment (COPRAS) are used to rank and assess performance.FindingsThe Indian automobile industry has shown the most effective SMPs compared to steel, textile and plastic sectors. The automobile sector is the benchmark for sustainable measures, emphasizing the importance of green practices for environmental, social and economic performance. Recommendations extend beyond the automobile sector to cement, electronics and construction.Practical implicationsThe research emphasizes the importance of SMPs across various industries, focusing on economic, environmental and social considerations. It advocates for a holistic approach that enhances resource efficiency and minimizes ecological footprint.Originality/valueThe study uses ranking methods like PCA-integrated TOPSIS and COPRAS to evaluate performance in different industries, focusing on the benchmarked automobile sector. The research offers valuable insights and advocates for the widespread adoption of sustainable policies beyond the studied sectors.

A novel gene editing lexicon strategy for the haemophilia community: Research plan for development and preliminary results.

Despite the progress in gene editing platforms like CRISPR/Cas9 with thepotential to transform the standard of care for haemophilia, the language used to explain and discuss gene editing is not aligned across the haemophilia community. Here, we present the objective and rationale for developing a clear, consistent, and globally aligned gene editing lexicon to address these communication gaps. Effectively communicating complex gene editing concepts requires a clear and consistent vocabulary. Through collaboration with a diversity of haemophilia stakeholders, our main goal is to develop an accurate, informative lexicon which avoids overpromising or highly technical terminology. Using an innovative process, representatives from several patient and scientific haemophilia organizations and select biotechnology companies will develop and refine language concepts to be tested with approximately seventy participants across the United States of America, United Kingdom, and Germany. Participants will include lived experience experts (LEEs) and haematologists. The process will be overseen by the Lexicon Steering Committee of global experts from leading scientific and patient organizations in the haemophilia and gene editing fields. Initial feedback provided a robust foundation and rationale for building clear, consistent language around gene editing. This lexicon development framework will allow for increased understanding across the haemophilia community, including thedevelopment of valid informed consent and shared decision-making materials. Results provide important building blocks for stimuli development and highlight the need for a novel gene editing lexicon. In the next phase, language stimuli will be tested with LEEs and haematologists to better understand audience preferences and help shape the final lexicon.

The decriminalization of illicit drugs in British Columbia: a national evaluation protocol

BackgroundOn January 31st, 2023, the province of British Columbia (BC), Canada, was granted a federal exemption allowing adults (aged 18 +) to possess up to 2.5 g of select illicit drugs. The exemption will be in place for three years (2023–2026), marking the first formal decriminalization of illicit drug policy reform in Canada. BC’s decriminalization initiative is premised on several goals. This project seeks to evaluate each of these goals and their individual and combined contributions to determine the overall success of this policy.MethodsThe following protocol paper provides a detailed outline of a five-year (2022-2027) national evaluation of BC’s decriminalization initiative, as well as the specific objectives, methodologies, and planned analyses for eight interrelated sub-studies that comprise the evaluation. These sub-studies fall under the following five topical areas of research: 1) people who use drugs (PWUD), 2) the police and the criminal justice system, 3) the general public, 4) the health services system, and 5) an economic analysis. Additional research activities may also be explored.ResultsThe overall evaluation and specific sub-study designs were informed by intensive stakeholder engagement. The evaluation was developed in collaboration with an international expert committee who came together to undertake a nominal group technique to decide on the final evaluation design and corresponding logic model. The evaluation will also employ an advisory board and individual sub-study working groups comprised of experts and PWUD who will oversee the development and implementation of the overall evaluation as well as each sub-study.DiscussionThis evaluation will draw on implementation science research practices to evaluate and understand the full impacts of this novel drug policy experiment. Results will be widely disseminated through manuscripts, reports, presentations, and infographics, which will be adapted and tailored for specific audiences. The protocol identifies several anticipated challenges and limitations. This evaluation’s evidence-based findings will be poised to offer pivotal insights that can shape and refine the discourse on drug policy and will serve as a critical resource for understanding the multifaceted impacts of decriminalization.

Practical Consensus Guidelines on the Use of Cetuximab in Head and Neck Squamous Cell Carcinoma (HNSCC)

Head and neck squamous cell carcinoma (HNSCC) is the most common malignancy group in India and several other low- and middle-income countries. Currently, majority of the patients present in advanced stage where systemic therapy is standard of care. Multiple relapses are also not uncommon. Almost all HNSCC tumors have epidermal growth factor receptor (EGFR) overexpression, making an attractive target. Cetuximab is the most successful method to target EGFR in HNSCC. After decades of its use, it still is a prominent part of the current management guidelines. Since other agents have also been proven to be useful, we felt it was necessary to develop a real-world consensus guideline to help the decision-making process among the community oncologists. Our expert committee therefore put together currently available data, insights from their real-world clinical practice, and voted to arrive at a consensus. These consensus guidelines represent how cetuximab should be used today in the management of HNSCC.