Expert Opinion Research Articles

Sustainability index development by integrating lean green and Six Sigma tools: a case study of the Indian manufacturing industry

PurposeIndia’s manufacturing sector employs about 12% of the labour force and contributes to about 17% of the nation’s GDP. The Indian government intends to implement several initiatives under the “Make in India” and Atma Nirbhar Bharat banners to increase the manufacturing sector’s share of the nation’s GDP to 25% by 2025. Applying lean manufacturing, green manufacturing and Six Sigma is crucial to ensure that India’s manufacturing sectors grow sustainably in international markets. This study aims to identify sustainability indicators and ascertain their respective weights to evaluate the sustainability performance of the Indian manufacturing industry.Design/methodology/approachThis research identifies 25 sustainability indicators and classifies them into the triple bottom line of sustainability based on an evaluative literature review and expert opinion. The Best Worst Method was utilised to determine the weights of the sustainability indicators. The sustainability index was developed to evaluate economic, social and environmental sustainability.FindingsThe sustainability performance of a foundry in a significant Western Indian State city was assessed by applying the developed sustainability index. After the adoption of integrated lean, green and Six Sigma (LG&SS) strategies and related practices in the foundry, there has been a notable improvement of 68.03% in the economic index, 61.62% in the social index and 13.24% in the environmental index.Research limitations/implicationsThe proposed sustainability index is applied and evaluated specifically for assessing the sustainability performance of Indian manufacturing SMEs. It can be used to substantiate firm’s sustainability performance and also to assess the improvement in firm’s performance in economic, environmental and social dimensions after implementing various operational excellence practices. However, it cannot serve as a benchmark tool across similar companies or organisations.Practical implicationsThe developed sustainable index can be used to analyse the company or organisation’s sustainability performance and see how various strategies have improved things. Practitioners can use this index to assess social, economic and environmental performance and focus on areas that need improvement.Social implicationsThe proposed sustainability index serves as a vital tool for monitoring a firm’s progress in triple bottom line (TBL) dimensions of sustainability, tracking a diverse range of indicators and encouraging sustainable organisational practices.Originality/valueThis study attempts to assess the economic, social and environmental performance of Indian Manufacturing SMEs by proposing a sustainability index.

Clinician-Prioritized Measures to Use in a Remote Concussion Assessment: Delphi Study.

There is little guidance available, and no uniform assessment battery is used in either in-person or remote evaluations of people who are experiencing persistent physical symptoms post concussion. Selecting the most appropriate measures for both in-person and remote physical assessments is challenging because of the lack of expert consensus and guidance. This study used expert consensus processes to identify clinical measures currently used to assess 5 physical domains affected by concussion (neurological examination, cervical spine, vestibular, oculomotor, or effort) and determine the feasibility of applying the identified measures virtually. The Delphi approach was used. In the first round, experienced clinicians were surveyed regarding using measures in concussion assessment. In the second round, clinicians reviewed information regarding the psychometric properties of all measures identified in the first round by at least 15% (9/58) of participants. In the second round, experts rank-ordered the measures from most relevant to least relevant based on their clinical experience and documented psychometric properties. A working group of 4 expert clinicians then determined the feasibility of virtually administering the final set of measures. In total, 59 clinicians completed survey round 1 listing all measures they used to assess the physical domains affected by a concussion. The frequency counts of the 146 different measures identified were determined. Further, 33 clinicians completed the second-round survey and rank-ordered 22 measures that met the 15% cutoff criterion retained from round 1. Measures ranked first were coordination, range of motion, vestibular ocular motor screening, and smooth pursuits. These measures were feasible to administer virtually by the working group members; however, modifications for remote administration were recommended, such as adjusting the measurement method. Clinicians ranked assessment of coordination (finger-to-nose test and rapid alternating movement test), cervical spine range of motion, vestibular ocular motor screening, and smooth pursuits as the most relevant measures under their respective domains. Based on expert opinion, these clinical measures are considered feasible to administer for concussion physical examinations in the remote context, with modifications; however, the psychometric properties have yet to be explored. RR2-10.2196/40446.

Kewenangan Notaris Melakukan Pekerjaan di Luar Wilayah Jabatan

The purpose of this research is to examine and analyze the authority of Notaries to carry out ork outside the region, including elements of unfair business competition for Notaries. and to review and analyze the authority of the Notary Supervisory Board regarding violations of unfair business competition for Notaries. Meanwhile, the research method used is Normative legal research, namely a method that uses primary legal material sources in the form of statutory regulations, legal theories and expert opinions, to analyze and draw conclusions about the problems used to test and study legal materials, hile the research results are obtained It is known that this unhealthy competition itself is related to Notaries ho carry out positions outside their area of office, such as ratifying deeds of establishment of business entities and legal entities, ratifying an agreement, stipulating an agreement. So the correlation is ith unhealthy business competition according to the provisions of Law Number 5 of 1999 concerning Prohibition of Monopolistic Practices and Unfair Business Competition, namely Article 17, and related to the authority of the Notary Supervisory Council hich carries out supervision, inspection and imposes sanctions on Notaries, and at every level The Notary Supervisory Council consists of the Regional Supervisory Council (MPD), Regional Supervisory Council (MPW); and the Central Supervisory Council (MPP), so that for violations of unfair business competition, efforts to enforce the Notary's code of ethics, namely based on Article 85 of Law Number 30 of 2004 concerning the Position of Notaries by placing a verbal arning in the first order of giving sanctions, is a arning to notary from the Supervisory Council hich if not fulfilled is followed up ith ritten sanctions. If this sanction is not complied ith by the notary concerned, subsequent sanctions can be imposed in stages.

Electrodiagnostic subtyping in Guillain-Barré syndrome patients in the International Guillain-Barré Outcome Study.

Various electrodiagnostic criteria have been developed in Guillain-Barré syndrome (GBS). Their performance in a broad representation of GBS patients has not been evaluated. Motor conduction data from the International GBS Outcome Study (IGOS) cohort were used to compare two widely used criterion sets and relate these to diagnostic amyotrophic lateral sclerosis criteria. From the first 1500 patients in IGOS, nerve conduction studies from 1137 (75.8%) were available for the current study. These patients were classified according to nerve conduction studies criteria proposed by Hadden and Rajabally. Of the 1137 studies, 68.3% (N = 777) were classified identically according to criteria by Hadden and Rajabally: 111 (9.8%) axonal, 366 (32.2%) demyelinating, 195 (17.2%) equivocal, 35 (3.1%) inexcitable and 70 (6.2%) normal. Thus, 360 studies (31.7%) were classified differently. The areas of differences were as follows: 155 studies (13.6%) classified as demyelinating by Hadden and axonal by Rajabally; 122 studies (10.7%) classified as demyelinating by Hadden and equivocal by Rajabally; and 75 studies (6.6%) classified as equivocal by Hadden and axonal by Rajabally. Due to more strictly defined cutoffs fewer patients fulfilled demyelinating criteria by Rajabally than by Hadden, making more patients eligible for axonal or equivocal classification by Rajabally. In 234 (68.6%) axonal studies by Rajabally the revised El Escorial (amyotrophic lateral sclerosis) criteria were fulfilled; in axonal cases by Hadden this was 1.8%. This study shows that electrodiagnosis in GBS is dependent on the criterion set utilized, both of which are based on expert opinion. Reappraisal of electrodiagnostic subtyping in GBS is warranted.

Bergamot extract and red yeast rice in reducing high cholesterol - what is known?

Obtaining optimal levels of lipoproteins and total cholesterol is one of the main goals for reducing cardiovascular risk. Many patients insist on changing their statin treatment to a nutraceutical such as Bergamot extract or red yeast rice extract, due to statin intolerance affecting some of them and increasing disinformation on statin side effects. This is why, interest in lipid-lowering ability of available nutraceuticals, is growing. In our work, we tried to summarise what is known about nutraceuticals such as red yeast rice and bergamot extract and how they can be used in clinical practise. We searched two databases such us Pubmed and Medline byusing the terms “bergamot”, ”red yeast rice”, “dyslipidaemia” and “hypercholesterolaemia” Products containing red yeast rice and bergamot extract are dietary supplements which are sold over the counter. There is possibility that they can be seen as natural substances which significantly reduce cholesterol levels, however, they have weaker effect than strong statins. They cannot be replacement for them. Red yeast rice is the leading substance. It can be used in patients with moderate hypercholesterolemia or can be combined with ezetimibe if statins are badly tolerated. There is no clear opinion of experts on bergamot due to lack of larger and longer studies. As our article show it is crucial to conduct more scientific research on nutraceuticals especially Bergamot extract.

Developing a cost-predictive model for hospital construction projects

ABSTRACT Hospital construction projects require the integration of innovative technologies, making them complex and challenging to estimate accurately. Without reliable guidelines, lists of considerations, or predictive models, decision-makers may choose an unsuitable contractor, leading to cost overruns and project delays. This research used quantitative and qualitative methods, including expert opinions and focus groups, to address this issue and identify critical factors affecting cost estimation in hospital construction. Using multi-regression analysis, historical data was analyzed to establish a cost-predictive model. The study identified 24 factors that determine the most critical criteria affecting the cost estimation of hospital construction. This model can evaluate the estimated direct cost provided to decision-makers in the early stages of the project with over 95% accuracy. The research results can assist professionals in the construction industry in better estimating and managing the costs of hospital construction projects, reducing risks, and improving project outcomes. Key findings indicate that specific components such as site and electrical works show average percentage errors of 8.02% and 5.11%, respectively, highlighting areas prone to cost estimation inaccuracies. This insight directs focus on improving accuracy in these critical sectors, thus further refining cost management strategies for hospital construction projects.

Patient regional index: a new way to rank clinical specialties based on outpatient clinics big data.

Many existing healthcare ranking systems are notably intricate. The standards for peer review and evaluation often differ across specialties, leading to contradictory results among various ranking systems. There is a significant need for a comprehensible and consistent mode of specialty assessment. This quantitative study aimed to assess the influence of clinical specialties on the regional distribution of patient origins based on 10,097,795 outpatient records of a large comprehensive hospital in South China. We proposed the patient regional index (PRI), a novel metric to quantify the regional influence of hospital specialties, using the principle of representative points of a statistical distribution. Additionally, a two-dimensional measure was constructed to gauge the significance of hospital specialties by integrating the PRI and outpatient volume. We calculated the PRI for each of the 16 specialties of interest over eight consecutive years. The longitudinal changes in the PRI accurately captured the impact of the 2017 Chinese healthcare reforms and the 2020 COVID-19 pandemic on hospital specialties. At last, the two-dimensional assessment model we devised effectively illustrates the distinct characteristics across hospital specialties. We propose a novel, straightforward, and interpretable index for quantifying the influence of hospital specialties. This index, built on outpatient data, requires only the patients' origin, thereby facilitating its widespread adoption and comparison across specialties of varying backgrounds. This data-driven method offers a patient-centric view of specialty influence, diverging from the traditional reliance on expert opinions. As such, it serves as a valuable augmentation to existing ranking systems.

Explorative sensory profile evaluation in central neuropathic pain following spinal cord injury.

Sensory profiling in neuropathic pain using quantitative sensory testing (QST) has not been extended to central neuropathic pain due to spinal cord injury (SCI). This study aims to fill this gap by evaluating sensory profiles in patients with neuropathic SCI pain. We retrospectively analysed consecutive QST data from 62 patients with neuropathic spinal cord injury pain (SCIP), following the German Research Network on Neuropathic Pain protocol. The study included at-level and below-level SCIP due to a spinal cord lesion, and at-level SCIP following a cauda equina lesion. QST parameters were compared between diagnostic groups. QST profiles of below-level SCIP (central neuropathic pain) were manually assigned to sensory phenotypes based on literature and expert opinion. No statistical difference in QST parameters between pain diagnoses was found. For central neuropathic pain (below-level SCIP), three phenotypes were descriptively observed: loss of function (59%), thermal and mechanical hyperalgesia combination (16%), and mechanical hyperalgesia (19%). The remaining 5% of patients did not fit a common pattern. There was no statistical difference in clinical and psychological variables between phenotypes. In a subgroup analysis, the loss of function phenotype weakly correlated with older age, longer time since injury, and longer pain duration. Here, we capture sensory phenotypes of central neuropathic pain following SCI. The limited sample size, high rate of missing values, and the retrospective nature of the study mean that results should be seen as strictly exploratory. Further research should replicate these findings and explore the significance of phenotypes. The evaluation of sensory phenotypes by quantitative sensory testing in central neuropathic pain due to SCI adds a new perspective on sensory phenotypes in comparison to peripheral neuropathic pain. The described thermal and mechanical hyperalgesia combination might represent involvement of the spinothalamic tract. In addition, there was a trend towards older age and longer time since injury in patients with loss of function.

Local ablation for hepatocellular carcinoma: 2024 expert consensus-based practical recommendation of the Korean Liver Cancer Association.

Local ablation for hepatocellular carcinoma (HCC), a non-surgical option that directly targets and destroys tumor cells, has advanced significantly since the 1990s. Therapies with different energy sources, such as radiofrequency ablation, microwave ablation, and cryoablation, employ different mechanisms to induce tumor necrosis. The precision, safety, and effectiveness of these therapies have increased with advances in guiding technologies and device improvements. Consequently, local ablation has become the firstline treatment for early-stage HCC. The lack of organized evidence and expert opinions regarding patient selection, pre-procedure preparation, procedural methods, swift post-treatment evaluation, and follow-up has resulted in clinicians following varied practices. Therefore, an expert consensus-based practical recommendation for local ablation was developed by a group of experts in radiology and hepatology from the Research Committee of the Korean Liver Cancer Association in collaboration with the Korean Society of Image-guided Tumor Ablation to provide useful information and guidance for performing local ablation and for the pre- and posttreatment management of patients.

Lateral Ankle Instability

Ankle sprains are frequent injuries among athletes and the general population, making them one of the most prevalent sports-relatedinjuries. While most lateral ankle ligament injuries typically respond well to conservative treatment, a significant portion evolves intochronic lateral ankle instability, which may require surgical intervention. Recently, new anatomical insights regarding the lateral ankleligaments have emerged, enhancing the advancement of innovative diagnostic and treatment approaches. The objective of this articlewas to discuss the latest trends in lateral ankle instability. Level of evidence V; Expert opinion.

Experiences of podiatrists in the delivery of routine foot care with self-management

Objective: Explore the experiences of podiatrists in the provision of foot care and identify gaps in promoting self-care to their patients. Methods: This study adopted a qualitative research paradigm comprising semi-structured interviews with 16 podiatrists from diverse clinical settings and varying experiences from February to May 2023. The data was analyzed inductively to develop themes. Results: Four themes emerged from the data: 1) Provision of nail care service, 2) Perceived reasons for referral for podiatric nail care, 3) Self-management with various patient sub-groups, and 4) Effectiveness of self-management, all from our participants’ perspective. Podiatrists agree that pathological nails and high-risk feet warrant continual podiatry care. However, the majority are ambivalent about providing care for non-pathological nails due to fear, indifference, lack of social support, and physical limitations. Interviewees reported the importance of managing patients’ expectations of the role of podiatry in nail care from the first visit to avert potential over-reliance on the service. Clear explanations and equipping patients with the appropriate tools helped promote self-management. Conclusion: This paper examined the complexity of the demand for podiatry nail care services, focusing on podiatrists’ perspectives. It emphasized the importance of effective communication with patients to clarify the purpose of podiatry and to ensure sustainable podiatry care for the future. Level of evidence V; Therapeutic studies - investigating the results of treatment; Expert Opinion.

Psychiatric symptoms of Huntington's disease

Huntington's disease (HD) is an autosomal dominant inherited disease, which leads to motor, cognitive and psychiatric symptoms. The diagnosis can be confirmed by genetic testing for extended CAG repeats in the Huntingtin gene. Mental and behavioral symptoms are common in HD and can appear several years before the onset of motor symptoms. The psychiatric symptoms include apathy, depression, anxiety, obsessive-compulsive symptoms and, in some cases, psychoses and aggression. These are currently restricted to symptomatic treatment as disease-modifying treatment approaches are still under investigation. The current clinical practice is based on expert opinions as well as experience with the treatment of similar symptoms in other neurological and mental health diseases. This article provides an overview of the complex psychiatric manifestations of HD, the diagnostic options and the established pharmacological and nonpharmacological treatment approaches.

Utilizing an acute hyperthermia-induced seizure test and pharmacokinetic studies to establish optimal dosing regimens in a mouse model of Dravet syndrome.

The current standard of care for Dravet syndrome (DS) includes polytherapy after inadequate seizure control with one or more monotherapy approaches. Treatment guidelines are often based on expert opinions, and finding an optimal balance between seizure control and adverse drug effects can be challenging. This study utilizes the efficacy and pharmacokinetic assessment of a second-line treatment regimen that combines clobazam and sodium valproate with an add-on drug as a proof-of-principle approach to establish an effective therapeutic regimen in a DS mouse model. We evaluated the efficacy of add-on therapies stiripentol, cannabidiol, lorcaserin, or fenfluramine added to clobazam and sodium valproate against hyperthermia-induced seizures in Scn1aA1783V/WT mice. Clobazam, N-desmethyl clobazam (an active metabolite of clobazam), sodium valproate, stiripentol, and cannabidiol concentrations were quantified in plasma and brain using liquid chromatography-tandem mass spectrometry for the combinations deemed effective against hyperthermia-induced seizures. The concentration data were used to calculate pharmacokinetic parameters via noncompartmental analysis in Phoenix WinNonLin. Higher doses of stiripentol or cannabidiol, in combination with clobazam and sodium valproate, were effective against hyperthermia-induced seizures in Scn1aA1783V/WT mice. In Scn1aWT/WT mice, brain clobazam and N-desmethyl clobazam concentrations were higher in the triple-drug combinations than in the clobazam monotherapy. Stiripentol and cannabidiol brain concentrations were greater in the triple-drug therapy than when given alone. A polypharmacy strategy may be a practical preclinical approach to identifying efficacious compounds for DS. The drug-drug interactions between compounds used in this study may explain the potentiated efficacy of some polytherapies.

Recommendations on the surveillance and supplementation of vitamins and minerals for upper gastrointestinal cancer survivors: a scoping review.

Early-stage upper gastrointestinal (UGI) cancer patients, after surgery, have altered gastrointestinal functions, compromising their nutritional status and health outcomes. Nutritional care provision to UGI survivors rarely focuses on long-term survivorship. Here, we explore recommendations for surveillance of micronutrient deficiency and supplementation for UGI cancer survivors after surgery. A scoping review, based on the Joanna Briggs Institute methodology for scoping reviews. Six databases (Medline, Embase, CINAHL, Cochrane, Scopus, and PsycINFO) and 21 cancer-related organisation websites were searched. Publications between 2010 and March 2024 with recommendations aimed at adult UGI cancer (oesophageal, gastric, pancreatic, small bowel, and biliary tract) survivors were included. Twenty-six publications met the selection criteria: 11 reviews (8 narrative reviews, 2 systematic, 1 meta-analysis), 7 expert opinions, 6 guidelines, and 2 consensus papers. Twenty-two publications recommended monitoring of micronutrient deficiencies, and 23 suggested supplementation, with 8 lacking details. Most were targeted at patients with gastric cancer (n = 19), followed by pancreatic cancer (n = 7) and oesophageal cancer (n = 3) with none for biliary tract and small bowel cancers. Vitamin B12 and iron were the most consistently recommended micronutrients across the three tumour groups. Limited publications recommend surveillance of micronutrient status in UGI cancer survivors during the survivorship phase, especially for oesophageal and pancreatic cancer survivors; most were narrative reviews. These recommendations lacked details, and information was inconsistent. Long-term UGI cancer survivors are at risk of micronutrient deficiency after surgery. A standardised approach to prevent, monitor, and treat micronutrient deficiencies is needed.

An improved understanding of paediatric chronic nonbacterial osteomyelitis (CNO) pathophysiology informs current and future treatment.

Chronic nonbacterial osteomyelitis (CNO) is an autoinflammatory bone disease that primarily affects children and young people. It can cause significant pain, reduced function, bone swelling and even (vertebral body) fractures. Because of a limited understanding of its pathophysiology, the treatment of CNO remains empiric and is based on relatively small case series, expert opinion and personal experience. Several studies linked pathological NLRP3 inflammasome activation and the resulting imbalance between pro- and anti-inflammatory cytokine expression with CNO. This agrees with elevated pro-inflammatory (mostly) monocyte-derived protein signatures in the blood of CNO patients that may be used as future diagnostic and/or prognostic biomarkers. Recently, rare variants in the P2RX7 gene, encoding for an ATP-dependent trans-membrane channel, were linked with increased NLRP3 inflammasome assembly and prolonged monocyte/macrophage survival in CNO. While the exact molecular mechanisms remain unclear, this will inform future target-directed and individualized treatment. This manuscript reviews most recent developments and their impact on diagnostic and therapeutic strategies in CNO.

Management of pulmonary hypertension in special conditions.

Care of pulmonary hypertension (PH) patients in special situations requires insightful knowledge of the pathophysiology of the cardiopulmonary system and close interaction with different specialists, depending on the situation. The role of this task force was to gather knowledge about five conditions that PH patients may be faced with. These conditions are 1) perioperative care; 2) management of pregnancy; 3) medication adherence; 4) palliative care; and 5) the influence of climate on PH. Many of these aspects have not been covered by previous World Symposia on Pulmonary Hypertension. All of the above conditions are highly affected by psychological, geographical and socioeconomic factors, and share the need for adequate healthcare provision. The task force identified significant gaps in information and research in these areas. The current recommendations are based on detailed literature search and expert opinion. The task force calls for further studies and research to better understand and address the special circumstances that PH patients may encounter.

Epilepsy knowledge scale for parents (EKS-P): Development and psychometric evaluation in Turkish sample

BackgroundEpilepsy is the most prevalent chronic neurological condition in childhood, affecting approximately 0.5%–1% of children worldwide. ObjectiveThis study aimed to (1) develop an “Epilepsy Knowledge Scale for Parents”, (2) evaluate the content validity of the scale, and (3) assess its psychometric properties. MethodsThis methodological study was conducted in a tertiary hospital's pediatric neurology outpatient clinic in Turkey. The study comprised two stages involving 500 parents of children with epilepsy. The first stage included validity and reliability analyses, while the second stage involved the calculation of the scale scoring. ResultsExploratory Factor Analysis for the preliminary scale development with 36 items based on expert opinions yielded 29 items and three dimensions. The factors explained 62.83% of the total variance, and the scale exhibited high reliability (Cronbach's alpha = 0.885). Confirmatory Factor Analysis, it was determined that the fit indices were at acceptable (CFI = 0.957, NFI = 0.932) or good level (χ2/df = 2.32, RMSEA = 0.048, GFI = 0.951). Consequently, a final structure comprising 29 items and three dimensions was obtained. The scale score's cutoff value was set at 15.50 points, with scores above this value indicating diagnostic value with 55.6% sensitivity and 80.2% specificity. ConclusionsThe study demonstrated that the “Epilepsy Knowledge Scale for Parents (EKS-P)”, designed to assess parents' knowledge of epilepsy, is a reliable and valid measurement tool for the Turkish population. Implications for practiceThis scale (EKS-P) developed for parents is recommended to be used in clinical settings and both experimental and non-experimental research.

Mechanism of action and selection of endoscopic bariatric therapies for treatment of obesity.

Endoscopic bariatric therapies (EBTs) are minimally invasive and safe procedures with favorable weight loss outcomes in obesity treatment. We aimed to present the weight loss mechanism of action of EBTs and an individualized selection method for patients with obesity. We searched PubMed, Medline, Scopus, Embase, and Google Scholar databases for studies on the topic from databases inception to July 1, 2023, written in English. We focused on EBTs potential mechanism of action to induce weight loss. We also present an expert opinion on a novel selection of EBTs based on their mechanism of action. EBTs can result in weight loss through variable mechanisms of action. They can induce earlier satiation, delay gastric emptying, restrict the accommodative response of the stomach, decrease caloric absorption, and alter the secretion of gastrointestinal hormones. Selecting EBTs may be guided through their mechanism of action by which patients with abnormal satiation may benefit more from tissue apposition devices and aspiration therapy while patients with fast gastric emptying may be better candidates for intragastric devices, endoscopic anastomosis devices, and duodenal mucosal resurfacing. Consequently, the selection of EBTs should be guided by the mechanism of action which is specific to each type of therapy.

Development of a site-screening method for hydrogen storage purposes and its application to an industrial dataset of Italian hydrocarbon reservoirs

A methodology is presented for the objective and transparent screening of hydrocarbon reservoirs for underground hydrogen storage (UHS), with subsequent testing on a large confidential dataset provided by the energy company Eni. The procedure uses the Analytic Hierarchy Process and the Delphi technique to gather expert opinions and weight 27 screening parameters in terms of: health, safety, and environment; geotechnical performance; and economic performance. A set of scores is produced that characterizes each site in terms of these three categories, as well as a comprehensive site ranking based on their overall suitability for UHS. The results highlight the importance of geotechnical parameters, while the characterization of faults and hydrocarbon type, the onshore or offshore location, the number of wells, and the reservoir architecture yielded the highest individual weights. Potential scores are also estimated for sites with incomplete datasets. Two blind tests evaluated the method's effectiveness against preexisting industrial assessments.

Clinical cases referring to the 2023 EACTS/STS guidelines for diagnosing and treating acute and chronic syndromes of the aortic organ.

Clinical cases referring to the EACTS/STS Guidelines for diagnosing and treating acute and chronic syndromes of the aortic organ aim to assist physicians in selecting the best management strategies for individual patients with a given condition. These expert opinions consider the impact on patient outcomes as well as the risk-benefit ratio of different diagnostic or therapeutic methods. These cases serve as a vital tool to aid physicians in making decisions in their daily practice. However, in essence, although these recommendations serve as a valuable resource to guide clinical practice, their application should be tailored to the needs of the individual patient. Each patient's case is unique, presenting its own set of variables and circumstances. This editorial is a tool designed to support, but not supersede, the decision-making process of physicians, based on their knowledge, expertise and understanding of their patients' individual situations. Furthermore, these clinical cases are based on the EACTS/STS Guidelines for diagnosing and treating acute and chronic syndromes of the aortic organ but should not be interpreted as legally binding documents. The legal responsibilities of healthcare professionals remain firmly grounded in applicable laws and regulations, and the guidelines and the clinical cases presented in this document do not alter these obligations.