Individual Criteria Research Articles

Diagnostic Criteria for Oral Epithelial Dysplasia: Predicting Malignant Transformation.

In 2022, the World Health Organization (WHO) proposed new criteria for the diagnosis of oral epithelial dysplasia (OED), however their association with patient's outcome is still unknown. This study compared the different classification systems of OED and evaluate their efficacy in predicting malignant transformation. A total of 195 slides of leukoplakia and erythroplakia were graded according to the WHO 2017, 2022, and the Binary System classification, and were correlated with the lesion's evolution. A progressive increase in malignant transformation according to the severity of OED, with both the WHO and the Binary classification systems was detected. Among individual criteria, changes in cell morphology were independently associated with an increased risk of malignant transformation (HR = 2.8, 95%CI 1.1-7.5, p = 0.032). Considering the new set of OED criteria published in 2022, it was detected that a new cutoff of 4 architectural alterations and 6 cytological alterations predicts better malignant transformation. Malignant transformation was equally predicted by the OED classification systems. Due to the increased number of architectural and cytological features in WHO 2022, a new cutoff for classifying OED from low to high-grade considering 4 architectural and 6 cytological alterations is proposed. The findings allow a more accurate assessment of malignant transformation risk in OED.

In-vitro simulation methods for mechanical plaque removal: a systematic scoping review of current techniques and future directions.

Different methods to simulate plaque in order to test the efficacy of oral cleaning methods have been published. This scoping review aims to provide an overview of the existing models and to highlight their respective benefits and limitations. Following the recommended scoping review methodology the scientific literature was systematically searched electronically (PubMedand Scopus) and by hand search up to July 2024, using combinations of search items related to oral plaque simulation, periodontitis or peri-implantitis. Retrieved study titles and abstracts were screened for possible inclusion. Finally, data from included fulltexts was extracted by two independent reviewers. Nine different characteristics for proper plaque simulation method were defined and each existing method evaluated and rated accordingly, and an overall rating was calculated for each method. Initially, 1787 records were identified. After abstract and title screening and fulltext revision, 25 fulltexts describing 7 different simulation methods, were included. The assessed methods of simulation were ink (12), varnish (5), calcium phosphate (1), calcium carbonate (1), occlusal spray (3), aluminum (1), commercially distributed and prepared artificial plaque (2). Even though some materials achieved good results in the assessment for individual criteria like water solubility, big differences could be found concerning practicability and production time, no simulation method was rated "very good" or even "good" in the overall evaluation. While ink and varnish were considered simulation materials of moderate quality for oral plaque simulation, all other techniques were assessed as weak simulation materials. Among the different published methods for the simulation of mechanical plaque removal, none seems to sufficiently simulate the essential characteristics of oral plaque, while some simulation methods may be useful to feature single properties of plaque in in-vitro studies sufficiently. Nevertheless, advanced models reflecting the diverse features of dental plaque more comprehensively are needed.

Prevalence and impact of Internet Gaming Disorder: A population-based study

Internet Gaming Disorder (IGD) has emerged as a significant public health concern, yet not enough is known about its prevalence among the general population as well as its relationship to well-being, mental health, specifically depression and anxiety, and gaming genres. This study aimed to address these questions. The research was conducted on a representative sample of the Croatian general population including 4,994 participants, aged between 15 and 64 years (M = 40.75, SD = 15.49). The Ten-Item Internet Gaming Disorder Test, Mental Health Inventory-5, Personal Well-being Index, Gaming time and Game Genres Preferences were used. The prevalence of the IGD in the general population of Croatia, aged 15-64 years, was estimated at 0.48%, 95% CI [0.30%, 1%], and among video game players (N = 1,239) at 1.63%, 95% CI [1.11%, 3%]. The highest prevalence was observed among young males. IGD showed the strongest relationship with depression, and weaker relationships with anxiety and well-being. Among the individual criteria, negative consequences for significant relationships, deception and escape had the strongest, while tolerance, loss of control and withdrawal had the weakest relationship to depression, anxiety and well-being, in a relative sense. Sports games and casual games players had lower risk for IGD, while other genres did not differ in their risk for IGD. Online and offline games did not differ in their risk for IGD. This study has shown that IGD has a relatively low prevalence among the general population and video game players, and that not all IGD criteria are equally relevant. Future longitudinal studies and studies on clinical samples are needed.

Analysis and improvement of human stability in floodwaters through numerical simulation with SPH-DEM model

This study improves the formulae for determining the incipient velocity of sliding and toppling instability through force analysis. It introduces a self-adjusting posture parameter to make the approach applicable to actual human subjects. In addition, a novel concept of critical water depth is proposed to classify the type of instability. The smoothed particle hydrodynamics model, coupled with the discrete element method, is employed to simulate the instability scenarios of human bodies. Through the validated fluid–structure interaction model, the influence of critical factors on human stability is investigated, including the friction coefficient, height, mass, and body postures. The developed formulae are corroborated with experimental data about actual human subjects. The incipient velocity formula for toppling instability in a bending posture is introduced, previously overlooked in the literature. The results contribute new insights into the instability criterion for individuals in floodwaters and offer additional strategies to enhance human stability.

Indications for surgical treatment of traumatic fractures of the thoracic spine and lumbar spine

Fractures of the thoracic (Th) and lumbar (L) vertebrae are among the most frequent fracture entities in Germany and particularly affect the thoracolumbar junction (TLJ; Th11-L2). Based on expert recommendations and consensus meetings, the thoracolumbar AOSpine injury score was established for patients with healthy bone and the osteoporotic fracture (OF) score for geriatric patients with the respective classifications for treatment decisions. In both cohorts, the treatment decision is based on the fracture morphology, neurological status and patient-specific contextual factors. In terms of fracture morphology, surgical treatment is generally indicated for distraction and rotation/translation injuries. The treatment decision for compression fractures is more complex as additional factors must be taken into consideration. The decision in patients with healthy bone is primarily influenced by imaging morphological criteria (deformity and destruction) whereas in osteoporotic patients the decision is influenced by individual criteria, such as the general condition, the possibility of low pain mobilization and concomitant diseases. Overall, the treatment decision for fractures of the TLJ is not dogmatic as individual factors must be considered and high-quality studies are lacking.

Certifying ‘not yet sustainable’ fisheries—the uncertain journey to global best practice

The Marine Stewardship Council (MSC) aims to drive the adoption of sustainable practices in fisheries through the marketing of certified sustainable products. For certification, a fishery needs to achieve ‘global best practice’ ratings in each of the three core principles. However, for individual assessment criteria, a score of 60, representing ‘minimum acceptable levels’ is possible. In such a case, fisheries get certified with conditions linked to actions that, according to the MSC’s theory of change, will help them achieve best practice levels across all criteria within the terms of certification. We reviewed the publicly available MSC certification reports of all fisheries and units of certification (UoC) to evaluate the extent of the spread of certification with conditions under the MSC certification scheme and whether improvements have been achieved within the stipulated time frame. Our results show that most fisheries do not meet global best practices across all criteria at first certification. Additionally, in contradiction to the MSC Standard’s requirements, only a minority of all UoC improve to achieve this requirement within the first certification cycle. A third of all UoC carry conditions into the second certification cycle, while a fifth withdraw from certification or are suspended. We argue that conditional certification may contradict the theory of change of the MSC. Rather than driving the adoption of fishing practices in line with global best practices, conditional certification may become a hindrance. Enjoying the same market access privileges as fisheries with no conditions, affected fisheries appear to not improve to best practice levels within a timely manner. While our study did not investigate the underlying reasons or what the implications are for the environment, we recommend further investigation. Insights into these aspects could help strengthen the MSC certification program and might contribute to regaining its credibility.

P0871 Textbook Outcomes in Acute Severe Ulcerative Colitis: A Novel Approach to Assessing Patient Quality of Care in Inflammatory Bowel Disease

Abstract Background Textbook outcome (TBO) is a concept of quality performance measurement that has garnered traction in the medical and surgical field. While traditional methods evaluate individual outcome parameters, TBO is a composite measurement of key performance indicators and is only achieved when all individual criteria are met. Studies suggest that a composite TBO provides a superior holistic assessment of patient outcomes, better captures the multidimensional aspects of patient care and sets a comparable benchmark for quality improvement across treatment centres.1,2 To date, a TBO has not been defined or utilised in the setting of acute severe ulcerative colitis (ASUC). We aimed to define a TBO using guideline-based standards of care for ASUC presentations and assessed whether TBO was associated with improved treatment outcomes.3 Methods All ASUC presentations to a Quaternary Sydney hospital over a 10-year period were included. A modified True-love Witts’ Criteria was used to identify ASUC as ≥6 bloody bowel motions daily and presence of at least one systemic feature, including heart rate >90 bpm, temperature >37.8°C, haemoglobin <105 g/L, and C-reactive protein (CRP) ≥30 mg/L.4 We defined achievement of TBO as IV steroids and venous thromboembolism prophylaxis (VTEp) commenced on admission, stool samples to exclude infective pathogens, including C. difficile, abdominal imaging completed within 24 hours from presentation, and flexible sigmoidoscopy completed within 48 hours from presentation. Treatment outcomes measured were rates of rescue therapy, colectomy, length of stay, 30-day and 90-day readmission. Results During the study period, 172 presentations met criteria for ASUC and of these, 14.0% (n=24) admissions achieved a TBO. The number of presentations meeting each TBO criteria is shown Figure 1. Stool sample screening (91.3%), IV steroids (79.1%) and VTEp (73.3%) on admission were the most frequently achieved parameters. The least frequently achieved parameter was timely flexible sigmoidoscopy within 48 hours of presentation (36.0%). A comparison of outcomes for patients achieving TBO compared to those without a TBO is shown in Table 1. Achieving a TBO was associated with significantly shorter length of stay. Conclusion Composite outcome measures, such as TBO, have become a popular metric of comparing and benchmarking standards of care. ASUC patients who achieved a TBO, defined by meeting five guideline-based criteria as part of their initial investigations and management, were found to have a significantly shorter length of stay. There were no differences in need for rescue therapy, colectomy and readmission rate. More research is required to refine the consensus parameters that encompass a TBO in ASUC presentations.

P0260 Scoring indices grading radiologic disease activity severity on magnetic resonance imaging strongly reflect clinical healing of Crohn’s perianal fistulas

Abstract Background Magnetic resonance imaging (MRI) is the gold-standard for evaluating Crohn’s perianal fistulas. Multiple scoring indices to grade radiologic disease activity severity have been established, with limited comparative data and a lack of consensus regarding which index correlates most accurately with clinical findings. In a prospective MRI series, we explored the relationship between established radiologic indices and clinical healing. Methods Serial MRI scans from 60 adults with Crohn’s perianal fistulas enrolled in a prospective study were acquired. The prospective study evaluated the efficacy of a protocolised treatment strategy optimising care delivery at a single tertiary centre. Patients had ≥12 months follow-up with serial MRI performed annually. Each MRI scan had a paired physical examination, with clinical healing defined as the absence of externally draining perianal fistulas and no seton. MRI scans were reviewed by a specialist radiologist blinded to clinical findings. Radiologic disease activity severity was graded using the Van Assche Index (VAI), Magnetic Resonance Index for Assessing Fistulas in Patients with Crohn’s Disease (MAGNIFI-CD) and Fibrosis Score (FS). The primary endpoint was the relationship between radiologic indices and clinical healing. Secondary endpoints included the optimal index scores for clinical healing and the relationship between individual scoring criteria and clinical healing. Results A total of 135 MRI scans were acquired. All patients had baseline imaging, with 88% and 37% having serial imaging at 1 and 2 years, respectively. The median interval between baseline and final MRI was 16 months. Clinical healing significantly correlated with less severe radiologic disease activity, reflected by lower VAI (OR 0.70, P<0.001), lower MAGNIFI-CD (OR 0.76, P<0.001) and higher FS (OR 3.14, P<0.001). On ROC curve analysis, all radiologic indices exhibited a similarly high degree of correlation with clinical healing; AUROC of 0.91, 0.84 and 0.92, respectively (Figure 1). The optimal index scores for clinical healing were VAI ≤6 (sensitivity 83%, specificity 94%, AUROC 0.88), MAGNIFI-CD ≤8 (sensitivity 78%, specificity 73%, AUROC 0.75) and FS ≥5 (sensitivity 83%, specificity 94%, AUROC 0.88). On multivariable logistic regression analysis, increasing degree of fibrosis on FS (OR 2.68, P<0.001) and increasing fistula tract extension on VAI (OR 0.09, P<0.001) were independent positive and negative indicators of clinical healing, respectively. Conclusion Radiologic disease activity severity using established scoring indices have equally strong correlations with clinical healing of Crohn’s perianal fistulas. Further studies are needed to explore the predictive utility of individual radiologic parameters.

Complex Analysis of Micronutrient Levels and Bone Mineral Density in Patients with Different Types of Osteogenesis Imperfecta

Background: Osteogenesis imperfecta (OI) is a rare monogenic connective tissue disorder characterized by fragility of bones and recurrent fractures. In addition to the hereditary component, there are a number of factors that influence the course of the disease, the contribution of which is poorly understood, in particular the levels of micronutrients. Methods: A cross-sectional study was conducted involving 45 with OI and 45 healthy individuals. The concentrations of micronutrients (calcium, copper, inorganic phosphorus, zinc, and magnesium) and bone mineral density (BMD) were evaluated in all the participants. Results: The concentrations of micronutrients in all the groups were within the reference values. In the OI overall, magnesium and copper were elevated, and phosphorus and zinc were lower. Type I exhibited higher concentrations of magnesium and copper and the lowest phosphorus; type III was associated with lower zinc, type IV with lower calcium and higher copper, and type V with the lowest phosphorus. OI overall was associated with lower BMD values. A correlational analysis in the OI group showed that the number of fractures correlated with BMD in absolute values but not with the Z-score. Conclusions: The obtained data emphasize the importance of the levels of micronutrients in the pathogenesis of connective tissue diseases, in particular OI. As in the results of previous studies, the levels of micronutrients were within the population norm, which probably requires the development of individual criteria for the content of substances in this category of patients.

The application of the SPOC teaching model in college elective basketball courses: integrating biomechanical principles for enhanced performance

The SPOC (Small Private Online Course) model is a new teaching model derived from Massive Open Online Courses (MOOC) and is an important direction for the reform and innovation of future higher education. In the practical application of SPOC teaching, subjectivity issues may arise, namely the influence of individual opinions and judgment criteria. The evaluation may focus on certain aspects and neglect others, resulting in incomplete overall assessment results. This paper applies the SPOC teaching model in three time periods: before class, during class, and after class, with a focus on integrating biomechanical principles into the evaluation of student performance in basketball. The study employs various research methods such as literature review, Analytic Hierarchy Process (AHP) analysis, and fuzzy comprehensive evaluation to construct a comprehensive evaluation index system for student ability improvement in SPOC teaching in higher education. This system incorporates biomechanical factors such as movement efficiency, force production, and body mechanics, which are essential for enhancing basketball skills. Based on this, an evaluation method for student ability improvement in college SPOC elective basketball courses is proposed using the AHP-fuzzy evaluation model. This model not only assesses traditional skill metrics but also integrates biomechanical assessments, such as shooting mechanics, dribbling efficiency, and defensive posture. The application of the AHP-fuzzy evaluation model, enhanced with biomechanical insights, demonstrates that his method can effectively improve students basketball abilities. The incorporation of biomechanical principles allows for a more holistic evaluation of student performance, emphasizing the importance of physical mechanics in skill development. The integration of the SPOC teaching model with biomechanical principles in elective basketball courses provides a comprehensive framework for evaluating and improving student performance. By focusing on both skill acquisition and biomechanical efficiency, this approach not only enhances basketball abilities but also fosters a deeper understanding of the physical demands of the sport.

Frontier-Model Chatbots Can Help Instructors Create, Improve, and Use Learning Objectives.

Learning Objectives (LOs) are a pillar of course design and execution, and thus a focus of curricular reforms. This study explored the extent to which the creation and usage of LOs might be facilitated by three leading chatbots: ChatGPT-4o, Claude 3.5 Sonnet, and Google Gemini Advanced. We posed three main questions, as follows. Question A: When given course content, can chatbots create LOs that are consistent with five best practices in writing LOs? Question B: When given LOs for a low level of the Revised Bloom's Taxonomy, can chatbots convert them to a higher level? Question C: When given LOs, can chatbots create assessment questions that meet six criteria of quality? We explored these questions in the context of four undergraduate courses: Applied Exercise Physiology, Human Anatomy, Human Physiology, and Motor Learning. According to instructor ratings, chatbots had a >70% success rate on most individual criteria for Questions A-C. However, chatbots' "difficulties" with a few criteria (e.g., provision of appropriate context for an LO's action, assignment of an appropriate Revised Bloom's taxonomy level) meant that, overall, only 38.3% of chatbot outputs fully met all criteria and thus were possibly ready for use with students. Our findings thus underscore the continuing need for instructor oversight of chatbot outputs, but also illustrate chatbots' potential to expedite the design and improvement of LOs and LO-related curricular materials such as Test Question Templates (TQTs), which directly align LOs with assessment questions.

Performance of individual criteria of the Pediatric Emergency Care Applied Research Network (PECARN) intraabdominal injury prediction rule.

The Pediatric Emergency Care Applied Research Network (PECARN) derived and externally validated a clinical prediction rule to identify children with blunt torso trauma at low risk for intraabdominal injuries undergoing acute intervention (IAIAI). Little is known about the risk for IAIAI when only one or two prediction rule variables are positive. We sought to determine the risk for IAIAI when either one or two PECARN intraabdominal injury rule variables are positive. We performed a planned secondary analysis of a prospective, multicenter study that included 7542 children (<18 years old) with blunt torso trauma evaluated in six emergency departments from December 2016 to August 2021. Patients with only one or two PECARN rule variables positive were included. The outcome was IAIAI (IAI undergoing therapeutic laparotomy, angiographic embolization, blood transfusion, or two or more nights of intravenous fluids). Among the 7542 children enrolled, 2986 (39.6%, 95% confidence interval [CI] 38.5%-40.7%) had one or two PECARN variables positive and were included. Of this subpopulation, 227 (7.6%, 95% CI 6.7%-8.6%) had intraabdominal injuries. In the 1639 patients with only one rule variable positive, 21 (1.3%, 95% CI 0.8%-2.0%) had IAIAI. In the 1347 patients with two rule variables positive, 27 (2.0%, 95% CI 1.3%-2.9%) had IAIAI. Risk for IAIAI for each variable was highest for Glasgow Coma Scale (GCS) score <14 (16/291, 5.5%, 95% CI 3.2%-8.8%) and abdominal wall trauma (three of 321, 0.9%, 95% CI 0.2%-2.7%). Risk for IAIAI when two variables were present was highest when decreased breath sounds (three of 44, 6.8%, 95% CI 1.4%-18.7%) and GCS <14 (10/207, 4.8%, 95% CI 2.3%-8.7%) were present with one other variable. Few children with blunt torso trauma and one or two PECARN predictor variables present have IAIAI. Those with GCS score <14, however, are at highest risk for IAIAI.

Application of the 2023 World Heart Federation guidelines for the echocardiographic diagnosis of rheumatic heart disease.

Rheumatic heart disease remains prevalent in some regions of Australia and New Zealand. Echocardiography is the gold standard for detection and diagnosis using the 2023 World Heart Federation guidelines. The guidelines describe specific features of mitral and aortic valve morphology and define pathological regurgitation associated with RHD. The aim of this education piece was to assist cardiac sonographers and reporting specialists in the accurate detection, diagnosis, and classification of RHD findings. We present the echocardiographic features of RHD as defined by the 2023 WHF guidelines, including a poster summarising the individual criteria for diagnosis.

Divergence in Cannabis and Alcohol Use Disorder Prevalence Trends from 2002-2019

IntroductionDespite increases in availability, potency, and consumption of cannabis, epidemiological data suggest decreases in prevalence of cannabis use disorder (CUD) in some groups. Understanding mechanisms for these changes may help improve diagnostic tools for identifying disordered use. This analysis evaluates changes in CUD compared to a substance with comparably stable social and environmental context (alcohol use disorder [AUD]) as well as treatment engagement and need from 2002 to 2019. MethodsData were from the National Survey on Drug Use and Health. Outcomes included CUD and AUD symptoms, treatment engagement, and perceived need. Temporal trends and average annual rate of change [AARC] were computed. ResultsBetween 2002 and 2019, daily cannabis use prevalence increased by 94% (AARC=11.68%), whereas CUD prevalence among those using cannabis daily reduced by 47.9% (AARC=-10.30%). Daily alcohol use prevalence decreased by 10.86% (AARC=-1.90%), and AUD prevalence among those using alcohol daily reduced by 3.9% (AARC=-0.67%). Prevalence of individual 12-month CUD criteria among those using cannabis daily decreased (-13.4 to -59.6% change; AARC = -2.4% to -14%). Among those using cannabis daily, trends in prevalence of individual AUD criteria varied, with some criteria increasing in prevalence and others decreasing (-30.2% to 24.6% change; AARC = -5.82% to 3.7%). Treatment engagement and perceived need reduced for cannabis, whereas treatment engagement increased and perceived need decreased for alcohol. ConclusionThese results suggest that CUD and AUD criteria may be determined within the cultural context dictating the definition of harm which has changed for cannabis, but not alcohol, from 2002-2019.

The lens of business model element activation

A business model is the foundation for understanding the functioning of a business entity and is a source of innovation and change. Therefore, developing a business model is necessary, and proactive activation can be a source of competitive advantage to meet the appropriate requirements in the composition of business model elements. The study aims to identify the key elements of activation in business models and to discover their significance. This study uses an expert-based approach based on the use of multi-criteria decision-making (MCDM) with the definition of the main elements. It also compares data from fuzzy analytical hierarchy process (AHP) and conduct primary research among small and medium-sized enterprises (SMEs) to determine the importance of various elements in their business models. It provides insight into determining the degree of significance of business model elements, with its expansion to the Delphi method and a panel of experts on 97 sub-criteria. Predominant factors such as value proposition, customer segments, and key partnerships have been identified as primarily critical for SMEs. The results obtained can then be used by businesses for subsequent concentration on a specific business element to achieve higher company performance and strengthen the competitive position. This study presents a fresh perspective on reimagining the classification of business models, their elements, and, above all, the determination of the meaning of individual business model criteria.

Area Deprivation Index and Frailty Among Older People With HIV.

We evaluated the relationship between neighborhood disadvantage (measured by the Area Deprivation Index [ADI]) and frailty. We performed a secondary analysis, pooling cross-sectional data collected from 209 people with HIV (PWH) aged ≥50years enrolled in studies in Colorado (CO) and Missouri (MO). MO participants (N = 137) had a higher ADI (µ= 70, ơ2 = 25) compared to CO (µ= 32, ơ2 = 15; p < .001). No significant differences in ADI were observed between frailty categories when cohorts were examined either separately or combined; however, when comparing individual frailty criteria, the most apparent differences by neighborhood disadvantage were seen among those with limited physical activity (μ = 67, ơ2 = 28) compared to those without (μ = 55, ơ2 = 29, p = .03). Neighborhood disadvantage was associated with low physical activity but not with overall frailty status. Future research should examine how access to physical activity spaces varies based on ADI, as this could be crucial in preventing frailty.

Multi-Criteria Optimization of Special-Purpose Geodetic Network Using the Vikor Method

This paper discusses and applies an approach for the design of a geodetic network intended to serve as an adequate basis for analyzing the verticality of buildings in Podgorica, Montenegro. The method analyzed in this paper is the Multi-Criteria Compromise Ranking/Solution (VIKOR), a technique used in multi-criteria optimization for different systems. During the research preparation, six competitive alternatives were established. The ranking of these alternatives was carried out based on four different preference approaches. The primary difference between these approaches lies in the varying weights assigned to certain criteria. Specifically, the weight ratios for individual criteria were adjusted. For the analysis of the building's verticality, a geodetic network design, selected as the optimal compromise solution, was utilized. The network measurements were conducted using appropriate geodetic instrument and supporting equipment. After completing the measurements in the optimized network, the network was adjusted, and the accuracy of the positional coordinates was assessed.

Application of the Analytic Hierarchy Process Method to Select the Final Solution for Multi-Criteria Optimization of the Structure of a Hybrid Generation System with Energy Storage

This paper concerns the application of the AHP (analytic hierarchy process) multi-criteria decision support method for the final selection of the structure of a hybrid power system with RESs (renewable energy sources) and EES (electrical energy storage) from a set of solutions obtained through multi-criteria optimization. These solutions, depending on their position within the Pareto front, may differ significantly in terms of the values of the criteria functions, or may be located very close to each other in the solution space. The role of the expert is to select the final solution, taking into account many additional criteria, often of a subjective nature. The article optimizes the structure of the proposed system using the multi-criteria NSGA-II (Non-dominated Sorting Genetic Algorithm) method, taking into account three technical criteria. The AHP method was used to select the final solution, which allows determination of the ranking of solution variants, taking into account selected additional criteria. In the analyzed case, these are primarily economic indicators, technical conditions, and preferences of the system recipients. In addition to determining the ranking of solutions, a sensitivity analysis was performed, which gives the expert extensive knowledge on the impact of individual criteria on the order of variants in the ranking. It was shown that in the case of selecting hybrid structures of generating systems with EES for a specific type of receiver, the use of the AHP method significantly facilitates making the final decision.

Building a research agenda on preventing and addressing sexual assault and intimate partner violence against trans people: a two-stage priority-setting exercise

BackgroundTransgender (trans) people experience high rates of sexual assault (SA) and intimate partner violence (IPV) and seldom receive the care and supports they need post-victimization. However, there is little to no research that aids in the development or improvement of related interventions. We undertook a study to build a novel Canadian research agenda on SA/IPV against trans people to guide future work and address these profound gaps in knowledge.MethodsGuided by the Child Health and Nutrition Research Initiative (CHNRI) method for research priority-setting, we developed and circulated two consecutive surveys to a multi-stakeholder group of government decision makers; mental health, health and social service providers, researchers and trans communities, among others, who proposed research questions related to preventing and addressing SA/IPV against trans persons. The initial survey launched March 2021 garnered responses from 213 stakeholders. These items were cleaned and collated into 20 final questions that fell within seven thematic areas. The refined research questions were evaluated in August 2021 on predefined criteria for answerability, feasibility, impact and equity by 79 of 95 survey 1 respondents who agreed to participate in the second survey (response rate = 83.2%). The questions were ranked using a research priority score calculated by dividing the sum of all the answers for each question across the four criteria by the number of answers received.ResultsAll questions were highly rated on each individual criterion and each had an overall research priority score of above 80%, with the most highly ranked question falling within the theme, “improving quality and implementation of education and training: How can training (e.g., for university/college students, educators, nurses, physicians, social workers, police, lawyers, security guards) be improved to better support trans survivors of sexual assault and intimate partner violence?”.ConclusionsThese questions form Canada’s first research agenda on SA/IPV against trans people. Together, they reflect the insights of stakeholder groups who have been historically excluded from research priority-setting processes and will guide future and much-needed work on the topic. Actionable information on preventing and addressing SA/IPV against trans persons will help reduce negative outcomes associated with being victimized.

Adherence to national trauma triage criteria in Norway: a cross-sectional study

BackgroundNorwegian hospitals employed individual trauma triage criteria until 2015 when nationwide criteria were implemented. There is a lack of empirical evidence regarding adherence to Norwegian national criteria for activation of the trauma team (NTrC) and the decision-making processes regarding trauma team activation (TTA) within Norwegian trauma hospitals. The objectives of this study were to investigate institutional adherence to the NTrC and to investigate similarities and differences in the decision-making process leading to TTA in Norwegian trauma hospitals.MethodsA digital semi-structured questionnaire regarding adherence to criteria, TTA decision-making and criteria documentation was distributed to all Norwegian trauma hospitals (n = 38) in the spring of 2022. Contact details of trauma coordinators and registrars were provided by the Norwegian Trauma Registry secretariat. Follow-up telephone interviews were conducted at the investigator’s discretion in cases of non-respondents or need to clarify answers.ResultsThirty-eight trauma hospitals were invited to answer the survey, where 35 hospitals responded (92%), making 35 the denominator of the results. Thirty-four (97.1%) hospitals stated that they followed NTrC. Thirty-three (94.3%) of the responding hospitals provided documentation of their criteria in use, of which twenty-eight (80%) of responding hospitals adhered to the NTrC. Three (8.6%) hospitals employed a tiered TTA approach with different sized teams. In addition four hospitals (11.4%) used specialized teams to meet the needs of defined patient groups (e.g. geriatric patients, traumatic brain injury). Twenty-one (60%) of the responding hospitals had written guidelines on who could perform TTA and in 18 hospitals (51.4%) TTA could be performed by pre-hospital personnel. Twenty-three (65.7%) of the hospitals documented which criteria that were used for TTA.ConclusionThere is good adherence to the national criteria for activation of the trauma team among Norwegian trauma hospitals after implementation of national guidelines. Individual hospitals argue the use of certain local criteria and trauma team activation decision-making processes to increase their precision in specific patient populations and demographics. Further steps should be done to reduce the variation in TTA decision-making processes among hospitals and improve documentation quality.