Evaluation Plan Research Articles

Вимоги до клінічного оцінювання медичних виробів у законодавстві Європейського Союзу та України

ABSTRACT. Within the framework of the association agreement between Ukraine, on the one hand, and the European Union, the European Atomic Energy Community and their member states, on the other hand, Ukraine has committed itself to gradually achieve compliance with EU technical regulations and systems of Standardization, Metrology, accreditation, conformity assessment work and market surveillance of the EU and has committed itself to adhere to the principles and practices set out in current EU decisions and regulations. Aim. To carry out a comparative analysis of approaches to the technical regulation of medical devices and their clinical evaluation. Materials and methods. An analysis of EU and Ukrainian regulatory acts in the field of technical regulation of medical devices and their clinical evaluation was carried out. Results. The provisions of the EU regulation governing the issue of clinical evaluation of medical devices are considered. Attention is focused on the approaches and requirements of the EU in the field of regulation of medical devices regarding their clinical evaluation, as well as on regulatory and legal aspects of the regulation of clinical evaluation of medical devices in Ukraine. The authors made proposals for improving the legal regulation of clinical evaluation of medical devices in Ukraine in accordance with EU requirements, in particular, the requirements for the clinical evaluation plan and the report on its results. Conclusions. The regulatory framework for conducting clinical evaluation of medical devices needs to be improved. When developing and implementing it, it is necessary to take into account the following aspects: new definitions of terms, improvement of the procedure for conducting clinical evaluation of medical devices, mandatory and requirements for post-monitoring clinical observation and postmonitoring supervision. Keywords: medical devices, clinical assessment, clinical data, post-monitoring clinical observation, post-monitoring supervision.

The Safe Sport Allies bystander training: developing a multi-layered program for youth sport participants and their coaches to prevent harassment and abuse in local sport clubs.

Harassment and abuse represent a pervasive and critical problem in sport with far-reaching consequences. Survivors' testimonials underscore the profound and enduring impact of these experiences at individual, interpersonal, organizational and community level. Many of their stories reveal painful inaction from responsible adults in the sport organization, aggravating the harm. Other contributing factors to the harm inflicted include a culture of silence, lack of knowledge and understanding of what constitutes abuse, unawareness of reporting and supporting mechanisms, and fear of potential consequences. While effective bystander interventions have been developed outside the sport context, particularly targeting students in higher education, such initiatives have yet to be extensively adapted and assessed within the sport context. To address this gap, the Safe Sport Allies Erasmus+ collaborative partnership relied on the intervention mapping approach as a guiding framework to systematically develop a bystander training program (i.e., Safe Sport Allies) to train youth sport participants and youth sport coaches to act as effective bystanders. The current paper describes the comprehensive development process and provides an overview of implementation and evaluation possibilities. Throughout the paper, it is explained how each step of the Intervention Mapping approach shaped the Safe Sport Allies bystander training program. The program development, and the developed plans for implementation and evaluation are presented, shedding light on challenges encountered. The bystander training program developed in this paper and the implementation and evaluation plans can serve as an outline to build future interventions within this critical domain of safeguarding in sport.

CP-04. UNVEILING THE MYSTERIES OF PEDIATRIC ADAMANTINOMATOUS CRANIOPHARYNGIOMA - INSIGHTS FROM DIAGNOSIS TO ADVANCED THERAPEUTICS

Abstract BACKGROUND Adamantinomatous Craniopharyngiomas (ACPs) are rare tumors arising from the remnants of the craniopharyngeal duct epithelium. Their diagnosis poses unique challenges, often resulting in delayed identification due to their slow growth and nonspecific symptoms. Additionally, the prolonged overall survival (OS) is overshadowed by a substantial recurrence rate and late consequences, posing significant challenges, and impairing the patient’s quality of life (QoL). Recent advancements in understanding ACP’s genomic, transcriptomic, and proteomic aspects underscore the need for innovative treatments to mitigate these long-term consequences. METHODS We conducted an in-depth literature review, focusing on large clinical trials and major publications in ACP to provide a comprehensive perspective on the challenges in the diagnosis, treatment, and molecular aspects of pediatric ACP. RESULTS ACP’s clinical presentation involves increased intracranial pressure, endocrine abnormalities, and visual impairments. Despite their low-grade classification, ACPs exhibit aggressive clinical behavior, often invading or adhering to adjacent tissues, particularly critical neurovascular structures. Imaging techniques, including CT and MRI with a focus on hypothalamic involvement, play a crucial role in diagnosis, pre-operative evaluation, and surgical planning. Multidisciplinary approaches are essential for developing tailored treatment strategies. Neurosurgical management and radiotherapy, particularly proton therapy, are the primary therapeutic modalities. The molecular landscape reveals intricate and complex mechanisms and include the upregulation of the Wingless (WNT) signaling pathway driven by CTNNB1 mutations, along with involvement of inflammatory, programmed cell death, and the MAPK/ERK pathways. Ongoing trials exploring targeted therapies may play a pivotal role in refining treatment strategies and improving outcomes. CONCLUSIONS Navigating the complexities of ACP requires a multidisciplinary approach. Advances in diagnostics, surgical strategies, and targeted therapies, informed by molecular insights, offer promising avenues for improving outcomes and QoL. Ongoing collaborative efforts and participation in clinical trials are vital for refining treatment strategies and advancing the understanding of this challenging condition.

Analisis Strategi Bisnis Menggunakan SWOT, BMC, dan Balance Scorecard pada UMKM AC

The food and beverage industry contributes significantly to Indonesia's Gross Domestic Product (GDP), with UMKM AC, located in Bogor City, being one of the contributors. This research formulates a business strategy for UMKM AC using the Business Model Canvas (BMC), SWOT analysis, and evaluation of Key Performance Indicators (KPIs) with the Balanced Scorecard (BSC). Data were collected through questionnaires and literature studies. The BMC analysis results indicate strengths in customer segmentation and community relations. The internal and external factor analysis shows that UMKM AC is in a position to grow and develop. The SWOT analysis identifies opportunities for UMKM AC, focusing on strategies that have a positive impact. The BSC evaluation shows overall good performance, but there are some strategic goals that need further improvement. This research highlights the importance of strategic planning and performance evaluation for SMEs in facing industry competition.

Periacetabular osteotomy using computed tomography-based navigation: preoperative planning and accuracy evaluation

PurposeSince 2011, we have used computed tomography (CT)-based navigation to perform safe and accurate rotational acetabular osteotomy (RAO) for treating developmental dysplasia of the hip. We developed a new method with four fiducial points to improve the accuracy of a published technique. In this study, we introduced a new method to achieve reorientation in accordance with planning and evaluated its accuracy.MethodsThis study included 40 joints, which underwent RAO used CT-based navigation. In 20 joints, reorientation was confirmed by touching the lateral aspect of the rotated fragment with navigation and checking whether it matched the preoperative plan. A new fiducial point method was adopted for the remaining 20 joints. To assess the accuracy of the position of the rotated fragment in each group, postoperative radial reformatted CT images were obtained around the acetabulum and three-dimensional evaluation was performed. The accuracy of acetabular fragment repositioning was evaluated using the acetabular sector angle (ASA).ResultsThe absolute value of ΔASA, which represents the error between preoperative planning and the actual postoperative position, was significantly smaller in the new fiducial method group than the previous method group in the area from 11:30 to 13:30 (p < 0.05). The Harris Hip Score at 1 year after surgery did not differ significantly between the previous and new fiducial point methods.ConclusionThe new fiducial point method significantly reduced reorientation error in the superior-lateral area of the acetabulum: significantly fewer errors and fewer cases of under-correction of lateral acetabular coverage were recorded. The four-reference fiducial method facilitates reorientation of the acetabulum as planned, with fewer errors. The effect of the improved accuracy of the fiducial point method on clinical outcomes will be investigated in the future work.

IMG-03. PRE-TREATMENT EVIDENCE OF ABNORMAL SUPRATENTORIAL WHITE MATTER IN CHILDREN WITH POSTERIOR FOSSA TUMOURS USING DIFFUSION MRI

Abstract BACKGROUND Over half of childhood brain tumours originate in the posterior fossa, which includes low-grade (e.g. pilocytic astrocytoma) and high-grade (e.g. medulloblastoma) tumours. Even though overall survival rates of paediatric brain tumours have substantially increased, survivors face neuropsychological impairments impacting behaviour, cognition, language and motor skills. Post-treatment outcomes are associated with structural changes within the brain, but it is unclear if observed microstructural damage is caused exclusively by radiotherapy or if there is earlier damage from the tumour and related effects. Diffusion MRI is a non-invasive technique that can be used to better understand white matter microstructure by quantifying water diffusion in the brain. Diffusion tensor imaging (DTI) can be used to assess white matter damage. METHODS In this work, we used DTI to understand white matter microstructure in 8 posterior fossa tumour patients prior to surgery. We compared individual patients to age- and sex-matched healthy controls in a one-against-many approach. RESULTS We demonstrate the presence of supratentorial white matter abnormalities prior to treatment in 3 patients. Before treatment, all patients are found to have significantly enlarged lateral ventricles relative to total brain volume (p&amp;lt;0.05). Patients with ventricle volumes &amp;gt;4% relative to brain volume correspond to significant changes in DTI parameters found in pre-treatment images, suggesting that hydrocephalus impacts white matter microstructure before surgery. Observed white matter changes are complex and patient-dependent, patients demonstrate compression (increased fractional anisotropy; FA) or diffuse oedema and damage (decreased FA). These white matter abnormalities persist over time, which could lead to cumulative damage, for example when adjuvant treatment involves radiotherapy. CONCLUSIONS To improve patient outcomes, pre-treatment imaging could be considered during individual treatment planning and risk evaluation to avoid further injury to white matter. Pre-treatment white matter abnormalities may have a bearing on neurocognitive patient outcomes, which will be the focus of future work.

Surgical Techniques for Lymphovenous Bypass: A Review

Background: Lymphedema is a progressive, debilitating disease that may affect up to 250 million individuals worldwide. Complex decongestive therapy (CDT) remains the first line of treatment for lymphedema, and surgical treatment currently has no formally established role. In recent years, lymphovenous bypass (LVB) has emerged as a potentially efficacious intervention to improve patients' objective and subjective measures of lymphedema. Despite this promise, there are few evidence-based recommendations to inform the adoption of the practice. Methods: A narrative review of the present literature on LVB was performed through a query of records using various combinations of Medical Subject Heading (MeSH) terms and keywords such as “lymphatic vessels,” “lymphedema,” “breast cancer lymphedema,” “surgical anastomosis,” “lymphovenous bypass,” “lymphovenous anastomosis.” The articles were assessed for 1) bibliometric characteristics, 2) preoperative evaluation, 2) operative techniques, 3) postoperative regimens, and 4) outcome measures. Results: The sixty-year evolution of LVB has transformed rapidly in response to technological advances in the last two decades. The geographically distributed investigation of these surgical innovations has prompted a fragmentation of LVB practice. As original research outpaces literature review, there needs to be more consistency in terminology, perioperative practices, and evaluation of outcomes of LVB, which challenge systematic analysis. The systematic reviews to date emphasize the ability of LVB to improve objective measures such as limb circumference. Still, the inconsistent use of subjective measures limits our appreciation of the collective improvement in patient-reported outcomes. Moreover, there are a limited number of accepted methods for patient selection, preoperative evaluation, and surgical planning, with many surgical techniques employed. Conclusion: The unifying principles and scientific evidence must be clarified to guide an overarching consensus before the widespread adoption of LVB. This article aims to synthesize recommendations and current institutional preferences concerning the research and clinical applications of LVB. The collaboration and continued refining of these practices will be necessary to establish the role of LVB in the treatment and prevention of lymphedema.

Randomized feasibility trial for evaluating the impact of primary nursing on delirium duration during intensive care unit stay

ObjectiveWe tested the feasibility of a randomized controlled trial for comparing primary nursing with standard care. Research MethodologyElective cardiac surgical patients were eligible for inclusion. Patients with an intensive care unit stay of ≥ 3 days were followed up until intensive care unit discharge. Recruitment period was one year. SettingTwo intensive care units at a university hospital specialized in cardiovascular and diabetic diseases. Main Outcome MeasuresPrimary outcomes were recruitment and delivery rate. Primary clinical outcome was duration of delirium, as assessed by the Confusion Assessment Method for Intensive Care Units. Secondary outcomes included the incidence of delirium, anxiety (10-point Numeric Rating Scale), and the satisfaction of patient relatives (validated questionnaire). ResultsOf 369 patients screened, 269 could be allocated to primary nursing (n = 134) or standard care (n = 135), of whom 46 patients and 48 patients, respectively, underwent an intensive care unit stay ≥ 3 days. Thus, recruitment and delivery rates were 73 and 26 %, respectively. During primary nursing and standard care, 18 and 24 patients developed a delirium, with a median duration of 32 (IQR: 14–96) and 24 (IQR: 8–44) hours (P = 0.10). The risk difference of delirium for primary nursing versus standard care was 11 % and the relative risk was 0.65 (95 % CI: 0.28–1.46; P = 0.29). The extent of anxiety was similar between groups (P = 0.13). Satisfaction could be assessed in 73.5 % of relatives, without substantial differences between groups. ConclusionData demonstrate that a trial for comparing primary nursing with standard care is generally feasible. However, the incidence of delirium may be a better primary outcome parameter than delirium duration, both in terms of long-term patient outcome and robustness of data quality. Implications for clinical practiceA randomized clinical trial regarding nursing organization during intensive care unit stay requires detailed planning of patient recruitment, data evaluation, and power calculation.

ადამიანური კაპიტალის მართვა ისტორიული თეორიის ჭრილში

The historical role of human resource management and its importance in effective organizational performance and continuous development is discussed. To understand the historical role of the human resource management, the article reviews the corresponding literature and analyzes management approach based on human capital theory in relation to effective performance of contemporary organizations. At an early stage of scientific research in economic development a human’s role was evaluated as a special resource (human resource) and as a subject of social development. At a later stage a human was considered as a subject of economic development. This gave origin to terms like an “individual” and a “person”. In this case a human is considered as a subject of social and labor relations. Currently, key elements of the social-economic reform, such as stabilization of social-economic and political environment, invention and establishment of new manufacturing and management technologies, rationalization of the finance and banking systems and improvement of social welfare and quality of lifestyle are still critical challenges facing our country. These challenges can only be addressed by implementation of consistent policy in social and labor relations. Establishment of social market economy in the country and its well-organized functioning is possible with integration into global production. This primarily refers to adaptation of domestic labor relations with the internationally recognized social and labor relation system. This goal can be achieved by continuous organizational development efforts. For this reason, it is essential for each organization to develop and periodically renew its human resource management strategy and action plan that will ensure alignment of its personnel conduct and behavior and entire progress with its organizational needs. For organizational development it is essential to develop and periodically renew employee performance evaluation, motivation, personnel development policy and procedures. Staff motivation policy shall define both monetary and non-monetary incentives and be targeted at maintaining best human capital crucial for the long-term success of any organization. Personnel development policy should reflect the correlation between the results of performance evaluation and personnel development plan. The policy should prescribe rules for developing an individual development plan and setting career development criteria. In addition, a personnel career development policy and procedures should prescribe organizational training needs identification methodology, priority trainings, training opportunities and respective actions. Knowledge gained at the trainings should be expanded throughout the organization. Concentrating on above processes will turn an organization into an attractive employer with desirable working environment and organizational culture.

Multi-centre real-world validation of automated treatment planning for breast radiotherapy

PurposeTo present the results of the first multi-centre real-world validation of autoplanning for whole breast irradiation after breast-sparing surgery, encompassing high complexity cases (e.g. with a boost or regional lymph nodes) and a wide range of clinical practices. MethodsThe 24 participating centers each included 10 IMRT/VMAT/Tomotherapy patients, previously treated with a manually generated plan (‘manplan’). There were no restrictions regarding case complexity, planning aims, plan evaluation parameters and criteria, fractionation, treatment planning system or treatment machine/technique. In addition to dosimetric comparisons of autoplans with manplans, blinded plan scoring/ranking was conducted by a clinician from the treating center. Autoplanning was performed using a single configuration for all patients in all centres. Deliverability was verified through measurements at delivery units. ResultsTarget dosimetry showed comparability, while reductions in OAR dose parameters were 21.4 % for heart Dmean, 16.7 % for ipsilateral lung Dmean, and 101.9 %, 45.5 %, and 35.7 % for contralateral breast D0.03cc, D5% and Dmean, respectively (all p < 0.001). Among the 240 patients included, the clinicians preferred the autoplan for 119 patients, with manplans preferred for 96 cases (p = 0.01). Per centre there were on average 5.0 ± 2.9 (1SD) patients with a preferred autoplan (range [0–10]), compared to 4.0 ± 2.7 with a preferred manplan ([0,9]). No differences were observed regarding deliverability. ConclusionThe automation significantly reduced the hands-on planning workload compared to manual planning, while also achieving an overall superiority. However, fine-tuning of the autoplanning configuration prior to clinical implementation may be necessary in some centres to enhance clinicians’ satisfaction with the generated autoplans.

Study protocol for a pilot quasi-experimental study on oral health education for nurses and community health workers in Nigeria.

The primary health care system provides an ideal setting for the integration of oral health into general health care as well as equitable access to oral health care. However, the limited oral health knowledge of primary health care workers necessitates appropriate training before they can participate in health promotion efforts. This pilot training was designed to examine the impact of the Oral Health Education module for Nurses and Community Health Care Workers on their oral health awareness and referral practices. This study will utilize a quasi-experimental design (pre-and post with a non-equivalent control group) to assess the impact of a five-day pilot oral health education program on the knowledge and referral practices of Nurses and Community Health Workers in primary health care centers in three states in Nigeria-(Lagos, Oyo, and Kano). The training modules were developed based on the six iterative steps described in the intervention mapping framework - needs assessment, highlighting program objectives and outcomes, selection of theory and mode of intervention, designing program based on theory, designing implementation plans, and developing an evaluation plan. Only the intervention group will participate in the full educational training sessions but both groups will complete the pre-and post-intervention questionnaires. This pilot training combined the standardized training modules from the recently launched "Oral Health Training Course for Community Health Workers in Africa" and a newly developed maternal and child oral health module by our group using an evidence-based approach. To the best of our knowledge, this is the first program to examine the impact of the standardized OpenWHO modules. The success of this training will lay the foundation for developing a sustained channel for providing oral health education at the primary health care level in Nigeria, West Africa, and Africa.

Survey of driver's functional state change, considering movement through mountain passes

According to traffic accident statistics, the main causes are violations of traffic rules. Based on scientific research, it is clear that the main reason for these events is the drivers' incorrect assessment of the road situation and their inadequate response. Assessing road conditions depends on drivers' qualifications, skills, work experience, reaction time, and other physiological factors. The functional state of drivers is important to consider. It reflects their ability to work reliably and affects both fatigue levels and how fatigue builds up. Factors that impact decision-making speed and quality are crucial when evaluating the risks of the transportation process, particularly those associated with human behavior. This study investigates the safety of freight transportation for drivers, road users, third parties, and the environment. The study focuses on road traffic characteristics in mountainous conditions at high altitudes. The study aims to analyze how drivers' performance is affected while navigating challenging sections of mountain roads in the Ukrainian Carpathians. Four different routes will be examined. The research will provide graphic analysis of the results. It will show the main patterns of changes in drivers' functional state based on the route's complexity. The research aims to analyze indicators of drivers' functional state and their impact on their performance reliability. It allows for a more detailed evaluation of transport routes and planning of truck drivers' work and rest schedules on suburban routes.

Curriculum Development Based on Workplace-Oriented Learning to Improve The Competence of Prospective Early Childhood Education Teachers

This study aims to develop a curriculum design based on Workplace-Oriented Learning (WOL) to improve the professional competence of prospective Early Childhood Education (ECE) teachers. The Educational Design Research (EDR) approach was used in the development of this design, through problem identification, curriculum planning, prototype development, and design evaluation. Through needs analysis and careful planning, this curriculum integrates theory with practice in the field. The results showed that the WOL curriculum was designed according to the current needs in the field. Based on the existing needs, the curriculum design is divided into several stages, including career awareness, career exploration, career preparation, and career training, which allow students to understand the tasks and skills needed in the world of work. With collaboration between educational institutions and industry, this curriculum bridges the gap between theory and practice, preparing students to become PAUD teachers who are ready to face the dynamic demands of early childhood education. Thus, the development of WOL-based curriculum design is expected to make a significant contribution to improving the quality of education and learning in early childhood.

A participatory approach to move towards a One Health surveillance system for anthrax in Burkina Faso.

The One Health approach calls for collaboration across various sectors and different scales to improve understanding of complex health issues. Regarding epidemiological surveillance, this implies the development of integrated systems that link several surveillance components operating in different domains (human, domestic animals, environment) and involving several actor networks. However, surveillance continues to operate in a very compartmentalized way, with little interaction between sectoral institutions and with the community for the governance and operation of surveillance activities. This is partly explained by the insufficient consideration of the local context and the late involvement of national stakeholders when developing programmes that aimed at strengthening the integration of surveillance. In low- and middle-income countries in particular, there is a strong influence of external partners on the development of intersectoral programmes, including surveillance systems. In this context, we developed and implemented a participatory planning process to support stakeholders of the surveillance system of anthrax in Burkina Faso, in the definition of the One Health surveillance system they wish for and of the pathway to reach it. The workshop produced an action plan that reflects the views and perspectives of representatives of the different categories of stakeholders and beneficiaries of surveillance. In addition, the participation of stakeholders in this participatory co-construction process has also improved their knowledge and mutual understanding, fostering a climate of trust conducive to further collaboration for surveillance activities. However, the quality of the participation raises some questions over the results, and contextual factors may have influenced the process. This underlines the need to include a monitoring and evaluation plan in the process to assess its implementation and ability to produce One Health surveillance modalities that are appropriate, accepted and applied over the long term.

Strategic project management for digital transformations in public sector education systems

This review paper presents a strategic framework for project management in digital transformations within public sector education systems. The framework emphasizes key components such as needs assessment, stakeholder engagement, project planning, change management, resource allocation, risk management, project execution, and outcome evaluation. Practical examples, including implementing a learning management system and digital inclusion initiatives, demonstrate the framework's application in real-world scenarios. The research contributes to the field by providing a comprehensive guide for decision-making and project planning, emphasizing the importance of maximizing impact and efficiency in digital transformation projects. The implications of the research findings for practitioners and policymakers are discussed, highlighting the framework's potential to drive successful digital transformation initiatives. Recommendations for future research include long-term impact assessment, change management strategies, scalability and sustainability, ethical and privacy considerations, hybrid learning environments, and teacher professional development. Keywords: Strategic Framework, Project Management, Digital Transformations.

Gender- and Age-Related Characterization of Lower Eyelid Morphology: Three-Dimensional Analysis in a Chinese Population.

The lower eyelid region is a critical component of the face. It is essential to establish anthropometric reference values for the evaluation of aging, surgical planning and assessment of outcomes in periocular esthetic and rejuvenation procedures. This study aims to provide comprehensive anthropometric data on the Chinese lower eyelid region, into account factors such as sex and age, through three-dimensional imaging analysis. Three-dimensional facial images were obtained from 84 healthy Chinese individuals aged between 20-35 and 50-65 years, as well as eight patients aged between 20 and 35 who presented with eyelid bags. A total of 27 landmarks were identified, leading to the generation of corresponding 21 lines, 5 curves, 4 angles, 2 areas and 5 ratios. The measurements were compared among different age groups, genders and young patients with or without eyelid bags. Compared to females, males exhibited a more elongated palpebral fissure, lower tear trough and lid-cheek junction, smaller inner and outer canthus angles, as well as a larger area and proportion of the lower palpebral region. As age progressed, the height and width of the palpebral fissure and inner canthus angle decreased gradually, which was accompanied by sagging of the tear trough and lid-cheek junction, an increase in lower eyelid area and swelling of the lower eyelid. Young patients undergoing eyelid bags demonstrated larger and more swelling lower eyelid which held clinical significance for rejuvenation surgery. Males exhibited a higher proportion of the brow-eye unit occupied by the lower eyelid region compared to females. Elderly individuals displayed noticeable drooping of the tear trough and lid-cheek junction, accompanied by swelling in the lower palpebral region. These findings can serve as standard references for esthetic procedures and reconstructive periocular operations. This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266.

Research on Autonomous Vehicle Obstacle Avoidance Path Planning with Consideration of Social Ethics

Self-driving car research can effectively reduce the occurrence of traffic accidents, but when encountering sudden people or obstacles cutting into the lane, how to reduce the damage hazard to traffic participants and make ethical decisions is the key point that the development of self-driving technology must break through. When faced with sudden traffic participants, self-driving vehicles need to make ethical decisions between ramming into the traffic participants or other obstacles. Therefore, in this paper, we propose a model decision planning method based on multi-objective evaluation function path evaluation of local path planning. This method addresses the ethical model disagreement problem of self-driving vehicles encountering traffic participants and other obstacles. The aim is to ensure the safety of the lives of the traffic participants and achieve the vehicle’s reasonable ethical decision planning. Firstly, when anticipating traffic participants and other obstacles, the vehicle’s planning intention decisions are obtained through fuzzy algorithms. Different sets of curves for various positions are generated based on dynamic programming algorithms. These curves are then fitted using B-spline curves, incorporating obstacle collision costs, and classifying obstacles into different types with varying cost weights. Secondly, factors such as path length and average path curvature are considered for path total cost calculations. Finally, a local path that avoids traffic participants is obtained. This path is then tracked using a pure pursuit algorithm. The proposed algorithm’s effectiveness is verified through simulation experiments and comparative analyses conducted on the MATLAB platform. In conclusion, this research promotes a safer and more sustainable transport system in line with the principles of sustainable development by addressing the challenges associated with safety and ethical decision making in self-driving cars.

Development of the Fit&Fab Exercise Intervention for Women With Obesity: A Community Advisory Board Informed Process.

Women with higher body mass index report low rates of and face unique barriers to exercise. Increasing exercise participation can improve mental and physical health independent of weight loss; however, most exercise programs targeting this population focus predominately on losing weight. This paper aims to describe the development of Fit&Fab, a community-based exercise intervention focused on increasing exercise participation and enjoyment for women with obesity. In partnership with the YMCA, we recruited women ages 35-64years (body mass index ≥ 30) to participate in 4 focus groups to understand exercise preferences. Formative work was used to identify theory constructs and associated intervention components. Women from the focus groups were recruited for a community advisory board that finalized the intervention design, recruitment, and evaluation plan. Focus groups participants (N = 29) preferred to exercise without men and wanted a cohort-style class that included women of similar exercise levels and body types, incorporated social support, fun activities, and broke exercise into smaller bouts. They wanted a supportive instructor who was fit but understood weight-related challenges. The community advisory board and research team used focus group findings to inform design of the final intervention including group exercise classes, psychosocial support sessions, personalized training, exercise tracking, outcome monitoring, and rewards. Our findings emphasize the need to focus on exercise enjoyment and benefits other than losing weight to improve exercise participation among women with higher body mass index. In addition to having outcomes other than weight loss, exercise interventions with this population should also consider group composition, instructor, and class format.

Evaluation of the Physical Education Literacy Plan in Elementary Schools: A Qualitative Research

Background: The issue of the physical health of students has been taken into consideration by educational systems more than ever nowadays. Among these, literacy in physical education is of special importance. In this regard, the study aimed to evaluate the approved plan in elementary schools and to provide suitable solutions. Methods: The research approach was "qualitative" and the method was "phenomenology". The "target group" included all the teachers of girls' primary schools in Maybod, who were selected through purposive sampling. Twelve teachers participated in the research. The research tool was an "in-depth semi-structured interview". Data collection ended after reaching theoretical saturation. The data were analyzed by "coding" and "categorization". The validity of the data was confirmed through the "triangulation” in the form of "data" and "researcher" types. Results: The findings showed 23 main themes and 61 sub-themes. The results were determined in the form of the strengths, weaknesses, consequences, and solutions. The results of the strengths indicated the good design of the plan, attention to the student's basic skills, national implementation, creating interest in sports, the possibility of online implementation, and lifestyle modification. In addition, the weak points were the lack of proper follow-up, poor time and method of implementation, poor knowledge of the teachers, insufficient cooperation of the parents, and the lack of facilities. Also, the consequences included increasing basic skills, promoting learning, improving physical and mental health, and discovering sports talents. Conclusion: In general, this research showed that to make the plan more effective in elementary schools, some actions should be taken, such as the scientific implementation of the plan, sports play therapy in schools, increasing the time, changing the way of evaluation, more organizational attention and reinforcing the follow-up procedures.

Management of Severe Bone Defects in Femoral Revision following Total Hip Arthroplasty.

Treatment of femoral bone defects continues to be a challenge in revision total hip arthroplasty (THA); therefore, meticulous preoperative evaluation of patients and surgical planning are required. This review provides a concise synopsis of the etiology, classification, treatment strategy, and prosthesis selection in relation to femoral bone loss in revision THA. A search of literature was conducted for identification of research articles related to classification of bone loss, management of femoral revision, and comparison of different types of stems. Findings of a thorough review of the included articles were as follows: (1) the Paprosky classification system is used most often when defining femoral bone loss, (2) a primary-length fully coated monoblock femoral component is recommended for treatment of types I or II bone defects, (3) use of an extensively porouscoated stem and a modular fluted tapered stem is recommended for management of types III or IV bone defects, and (4) use of an impaction grafting technique is another option for improvement of bone stock, and allograft prosthesis composite and proximal femoral replacement can be applied by experienced surgeons, in selected cases, as a final salvage solution. Stems with a tapered design are gradually replacing components with a cylindrical design as the first choice for femoral revision; however, further confirmation regarding the advantages and disadvantages of modular and nonmodular stems will be required through conduct of higher-level comparative studies.