Expert Opinion Research Articles

Anesthesia for traumatic brain injury.

Traumatic brain injury (TBI) presents complex clinical challenges, requiring a nuanced understanding of its pathophysiology and current management principles to improve patient outcomes. Anesthetists play a critical role in care and need to stay updated with recent evidence and trends to ensure high-quality treatment. The Brain Trauma Foundation Guidelines, last updated in 2016, have shown moderate adherence, and much of the current management relies on expert opinions. This literature review synthesizes the current evidence and provides insights into the role of anesthetists in TBI management. Recent literature has emphasized the importance of tailored anesthetic management principles in treating TBI, focusing on minimizing secondary brain injury during neurosurgical interventions or extracranial surgery. Emerging trends include individualized intracranial pressure approaches and multimodal neuromonitoring for comprehensive assessment of cerebral physiology. Anesthesia for TBI patients requires a comprehensive approach that balances anesthetic goals with the unique pathophysiological factors of brain injury. Despite recent research expanding our understanding, challenges remain in standardizing protocols and addressing individual patient response variability. Adherence to established management principles, personalized approaches, and ongoing research is crucial for improving the outcomes.

Feasibility of adopting imperfect produce in on-site foodservice: expert opinions and consumer sensory discrimination

Feasibility of adopting imperfect produce in on-site foodservice: expert opinions and consumer sensory discrimination

Advocating for the inclusion of kidney health outcomes in neonatal research: best practice recommendations by the Neonatal Kidney Collaborative.

Acute kidney injury (AKI) occurs in nearly 30% of sick neonates. Chronic kidney disease (CKD) can be detected in certain populations of sick neonates as early as 2 years. AKI is often part of a multisystem syndrome that negatively impacts developing organs resulting in short- and long-term pulmonary, neurodevelopmental, and cardiovascular morbidities. It is critical to incorporate kidney-related data into neonatal clinical trials in a uniform manner to better understand how neonatal AKI or CKD could affect an outcome of interest. Here, we provide expert opinion recommendations and rationales to support the inclusion of short- and long-term neonatal kidney outcomes using a tiered approach based on study design: (1) observational studies (prospective or retrospective) limited to data available within a center's standard practice, (2) observational studies involving prospective data collection where prespecified kidney outcomes are included in the design, (3) interventional studies with non-nephrotoxic agents, and (4) interventional studies with known nephrotoxic agents. We also provide recommendations for biospecimen collection to facilitate ancillary kidney specific research initiatives. This approach balances the costs of AKI and CKD ascertainment with knowledge gained. We advocate that kidney outcomes be included routinely in neonatal clinical study design. Consistent incorporation of kidney outcomes across studies will increase our knowledge of neonatal morbidity.

Therapeutic challenges and unmet needs in the management of myasthenia gravis: an Italian expert opinion.

Myasthenia gravis (MG) is a rare, autoimmune, neurological disorder. Most MG patients have autoantibodies against acetylcholine receptors (AChRs). Some have autoantibodies against muscle-specific tyrosine kinase (MuSK) or lipoprotein-receptor-related protein 4 (LRP4), and some are seronegative. Standard of care, which includes anti-cholinesterase drugs, thymectomy, corticosteroids (CS), and off-label use of non-steroidal immunosuppressive drugs (NSISTs), is bounded by potential side effects and limited efficacy in refractory generalized MG (gMG) patients. This highlights the need for new therapeutic approaches for MG. Eculizumab, a monoclonal antibody that inhibits the complement system, has been recently approved in Italy for refractory gMG. A panel of 11 experts met to discuss unmet therapeutic needs in the acute and chronic phases of the disease, as well as the standard of care for refractory patients. Survival was emphasized as an acute phase outcome. In the chronic phase, persistent remission and early recognition of exacerbations to prevent myasthenic crisis and respiratory failure were considered crucial. Refractory patients require treatments with fast onset of action, improved tolerability, and the ability to slow disease progression and increase life expectancy. The Panel agreed that eculizumab would presumably meet the therapeutic needs of many refractory gMG patients. The panel concluded that the unmet needs of current standard of care treatments for gMG are significant. Evaluating new therapeutic options accurately is essential to find the best balance between efficacy and tolerability for each patient. Collecting real-world data on novel molecules in routine clinical practice is necessary to address unmet needs.

Urgensi Psikologi Pendidikan dalam Pembelajaran Bahasa Arab

This research discusses educational psychology which has a significant contribution in increasing the effectiveness of Arabic language learning. By understanding the learning and teaching process as well as individual student needs. This research uses a literature review method (library research), where the discussion in this research is based on expert opinions and the results of previous research on psychology and the learning process. The results show that educational psychology is very important in learning Arabic, as in learning other languages. The following are several reasons why educational psychology is important in this context, including (1) Understanding the Learning Process, (2) Student Motivation and Engagement, (3) Effective Classroom Management, (4) Assessment and Feedback, and (5) Needs Special for Students. By utilizing these educational psychology concepts, Arabic teachers can create a supportive, motivating, and effective learning environment for all their students.

Use of Delphi methodology to select sustainability indicators on dairy farms: an exploration of environmental, economic, social and animal welfare dimensions

Sustainable livestock production is essential to ensure the availability of food and resources, and to address the social, economic, and environmental challenges that threaten conventional livestock production. While there is consensus among economic, social, and scientific groups on the need to assess sustainability to make decisions that protect resources for present and future generations, there are few sustainability assessment tools that address it holistically. The aim of this study was to develop an assessment tool applicable to farms by identifying the indicators currently applied in dairy farms, based on a systematic literature review and expert opinion. This study used the Delphi methodology to explore sustainability indicators at the farm level. A panel of seven expert researchers and academics in livestock sustainability and animal welfare participated in the study. A high level of consensus was found for 15 economic indicators, 14 social indicators, 20 environmental indicators, and 16 animal welfare indicators. Some indicators, such as financial autonomy, transmissibility, cow and labor productivity, husbandry system, labor intensity, community bonding, labor satisfaction, biodiversity, crop rotation, fertilization, manure management, and water management, showed a high level of consensus and were considered useful in assessing sustainability on dairy farms. In addition, livestock sustainability experts reached a high consensus on 16 animal welfare indicators that could be useful in assessing farm sustainability. These results provide a solid basis for sustainability indicators in the economic, social, environmental, and animal welfare dimensions, which could serve as a basis for developing a sustainability assessment tool for dairy farms.

Heat therapy for different knee diseases: expert opinion

Heat therapy for different knee diseases: expert opinion

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.

Developing a customised set of evidence-based quality indicators for measuring workplace violence towards healthcare workers: a modified Delphi method

BackgroundWorkplace violence (WPV) is a complex global challenge in healthcare that can only be addressed through a quality improvement initiative composed of a complex intervention. However, multiple WPV-specific quality indicators...

Use of Delphi methodology to select sustainability indicators on dairy farms: an exploration of environmental, economic, social and animal welfare dimensions

Sustainable livestock production is essential to ensure the availability of food and resources, and to address the social, economic, and environmental challenges that threaten conventional livestock production. While there is consensus among economic, social, and scientific groups on the need to assess sustainability to make decisions that protect resources for present and future generations, there are few sustainability assessment tools that address it holistically. The aim of this study was to develop an assessment tool applicable to farms by identifying the indicators currently applied in dairy farms, based on a systematic literature review and expert opinion. This study used the Delphi methodology to explore sustainability indicators at the farm level. A panel of seven expert researchers and academics in livestock sustainability and animal welfare participated in the study. A high level of consensus was found for 15 economic indicators, 14 social indicators, 20 environmental indicators, and 16 animal welfare indicators. Some indicators, such as financial autonomy, transmissibility, cow and labor productivity, husbandry system, labor intensity, community bonding, labor satisfaction, biodiversity, crop rotation, fertilization, manure management, and water management, showed a high level of consensus and were considered useful in assessing sustainability on dairy farms. In addition, livestock sustainability experts reached a high consensus on 16 animal welfare indicators that could be useful in assessing farm sustainability. These results provide a solid basis for sustainability indicators in the economic, social, environmental, and animal welfare dimensions, which could serve as a basis for developing a sustainability assessment tool for dairy farms.

Guideline for treating relapsed or refractory myeloid leukemia in children with Down syndrome.

Treatment of relapsed and refractory myeloid leukemia in Down syndrome (r/r ML-DS) poses significant challenges, as prognosis is dire and there is no established standard treatment. This guideline provides treatment recommendations based on a literature review and collection of expert opinions, aiming to improve overall and event-free survival of patients. Treatment options include fludarabine and cytarabine (FLA)±gemtuzumab ozogamicin (GO), azacytidine (AZA)±panobinostat, and hematopoietic stem cell transplantation (HSCT). Preferred approaches are AZA±panobinostat for cases with low blast count or FLA±GO for cases with high blast count, followed by HSCT after remission. Further research is crucial for the investigation of targeted therapies (e.g., BH3 mimetics, LSD1, JAK inhibitors).

An artificial intelligence grading system of apical periodontitis in cone-beam computed tomography data.

In order to assist junior doctors in better diagnosing apical periodontitis (AP), an artificial intelligence AP grading system was developed based on deep learning (DL) and its reliability and accuracy were evaluated. 120 cone-beam computed tomography (CBCT) images were selected to construct a classification dataset with four categories, which were divided by CBCT periapical index (CBCTPAI), including normal periapical tissue, CBCTPAI 1-2, CBCTPAI 3-5 and young permanent teeth. Three classic algorithms (ResNet50/101/152) as well as one self-invented algorithm (PAINet) were compared with each other. PAINet were also compared with two recent Transformer-based models and three attention models. Their performance was evaluated by accuracy, precision, recall, balanced F score (F1-score) and the area under the macro-average receiver operating curve (AUC). Reliability was evaluated by Cohen's kappa ​​to compare the consistency of model predicted labels with expert opinions. PAINet performed best among the four algorithms. The accuracy, precision, recall, F1-score and AUC on the test set were 0.9333, 0.9415, 0.9333, 0.9336 and 0.9972, respectively. Cohen's kappa was 0.911, which represented almost perfect consistency. PAINet can accurately distinguish between normal periapical tissues, CBCTPAI 1-2, CBCTPAI 3-5 and young permanent teeth. Its results were highly consistent with expert opinions. It can help junior doctors diagnose and score AP, reducing the burden. It can also be promoted in areas where experts are lacking to provide professional diagnostic opinions.

Adaptation of the Social Media Addiction Scale into Azerbaijani Turkish: Validity and Reliability Study

Excessive attachment to social media, a constant desire to be online, being driven by uncontrollable motivation, and the negative impact of this situation on other significant areas of life are considered as social media addiction. In this study, the Social Media Addiction Scale Student Form (SMAS-SF), previously developed in Türkiye to determine students' levels of social media addiction, was adapted into Azerbaijani Turkish. The SMAS-SF is a five-point likert-type scale consisting of 29 items that can be grouped under four factors. The study group consisted of a total of 1,074 students aged 18-26 studying at different universities in Baku. The sample of the study was determined using the convenient sampling method, one of the non-probabilistic sampling determination types. Within the scope of the validity and reliability studies of the scale, expert opinion, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), item total correlations, lower and upper group mean differences, and internal consistency coefficient and stability analyses were performed. As a result of the analyses, it was found that the original structure of the SMAS-SF, consisting of 29 items and 4 dimensions, was confirmed, and significant evidence was provided that it can be used as a valid and reliable measurement tool to determine the level of social media addiction among university students aged 18-26. The lowest possible score that can be obtained from the scale is 29, and the highest score is 145. A high score may indicate a high level of social media addiction in students.

Utility of Neonatal Pain, Agitation and Sedation Scale and Amplitude Integrated Electroencephalogram for Detection of Different Levels of Sedation in NICUs

Abstract Background Sedatives are essential drugs in every intensive care unit used to ensure the patient's optimal level of comfort. Avoiding conditions of over and under sedation is a challenge in a neonatal intensive care setting. To date, there are no definitions of optimal levels of sedation in neonates. Testing the hypothesis that if a combined use of Neonatal Pain, Agitation and Sedation Scale (N- PASS) and amplitude integrated electroencephalography (aEEG) score might be helpful to distinguish different levels of neonatal sedation and therefore useful in titration of the drugs used. Aim of the Work The primary aim of the present study is to assess Neonatal Pain, Agitation and Sedation Scale (N-PASS) and amplitude integrated electroencephalography (aEEG) in the detection of different levels of neonatal sedation. Patients and Methods This was prospective observational study conducted on 30 full term neonates on mechanical ventilation reciving sedation (midazolam,fentanyl). we divided our patients into two groups (lightly sedated and deeply sedated patients) according to dose of sedation which determined by the expert opinion according to the clinical condition of the patients. all patients were subjected to the following:(demographic data, clinical signs & symptoms, laboratory investigations, N-PASS and aEEG before and after sedation from march 2021 to August 2022 to evaluate N-PASS and aEEG in the detection of different levels of neonatal sedation. Results In our study which was conducted on 30 patients admitted to NICU at Ain shams university hospitals, our patients were of mean gestational age 38.34, all patients presented with respiratory distress, were mechanically ventilated and received sedation (midazolam, fentanyl). we divided our patients into two groups (lightly sedated patients who were 11 patients (36.7%), deeply sedated patients who were 19 patients ( 63.3% ) according to dose of sedation. There was a significant decrease of co2 level in deeply sedated patients, mean co2 after deep sedation 43.36 mmHg while mean co2 after light sedation 51.52 mmHg (p 0.034),and regarding N-PASS significant decrease in N-PASS total score after sedation (p < 0.001 ),and regarding aEEG significant decrease of total burdjalov score after sedation (p < 0.001 ) Conclusion We recommend combining a clinical scoring system such as the N-PASS, with a continuous brain activity monitor such as the aEEG for assessing the level of sedation in neonates.

Magnetic Resonance Imaging Signs of Idiopathic Intracranial Hypertension

The magnetic resonance imaging (MRI) criteria currently used to diagnose idiopathic intracranial hypertension (IIH) are based on expert opinion and have limited accuracy. Additional neuroimaging signs have been proposed and used with contradictory results; thus, prospective evidence is needed to improve diagnostic accuracy. To provide evidence-based, accurate MRI signs for IIH diagnosis. This prospective cohort study was conducted from January 2018 to May 2021 with 3 validation cohorts at 2 Danish headache centers and with 3 independent international cohorts. Consecutive patients with suspected IIH were enrolled. Eligibility required the clinical suspicion of IIH, age 18 years or older, and written informed consent. The validation cohorts comprised patients with confirmed IIH from Austria and the US, and patients without IIH from the US. Data analysis was performed from December 2021 to August 2023. Standardized diagnostic workup was performed to classify cases according to current criteria, and blinded evaluation of cerebral radiological diagnostics and papilledema was performed. The primary outcomes were MRI signs associated with IIH as assessed by univariate analyses. An MRI score estimating papilledema was calculated using machine learning. Internal validation of associations with lumbar puncture opening pressure and outcome and external validation of accuracy were performed in 3 cohorts. Of 192 eligible patients (185 women [96.4%]; median [IQR] age, 28.0 [23.0-35.0] years), 110 were classified as having IIH, 4 as having probable IIH, and 1 as having suspected IIH without papilledema; 77 did not have IIH and served as controls, with corresponding age, sex, and weight. Papilledema at diagnosis was associated with perioptic subarachnoid space distension (56 patients [68.3%] vs 21 patients [41.2%]), posterior globe flattening (53 patients [66.3%] vs 10 patients [21.3%]), optic nerve disc protrusion (35 patients [30.4%] vs 2 patients [2.3%]), and transverse sinus venous stenosis (75 patients [79.8%] vs 29 patients [46.8%]). The papilledema-estimating MRI score showed optimal balance between sensitivity (49%) and specificity (87%) when 2 of the 3 latter signs were present and was associated with the lumbar puncture opening pressure and ophthalmological outcome. The score showed strong diagnostic accuracy in the external validation cohorts (587 patients; area under the receiver operating characteristic curve, 0.86) and outperformed the current (2013) diagnostic MRI criteria. The findings of this cohort study of patients with IIH and controls suggest that an evidence-based MRI score including posterior globe flattening, optic nerve disc protrusion, and transverse sinus stenosis can estimate the presence of papilledema more accurately than the current diagnostic criteria.

P-458 Development and validation of the fertility lifestyle assessment scale

Abstract Study question Can the development of the “Fertility Lifestyle Assessment Scale” contribute to the evaluation of person lifestyle habits related to fertility? Summary answer The development of the Fertility Healthy Lifestyle Assessment Scale will contribute to the evaluation of person lifestyle habits related to fertility. What is known already Healthy lifestyle habits are important for preparing the body and reproductive hormones for the demands of conception. Malnutrition, overeating, smoking, sedentary life, stress, sleep deprivation etc., situations all represent unhealthy lifestyles. The individuals may also preserve and increase fertility potential by modifying their lifestyles. Despite wide evidence about the benefits of healthy lifestyle for individuals with fertility problems, lifestyle is not systematically evaluated in generally fertility clinics. Current in study aimed to develop a valid and reliable measurement tool in order to determine risky lifestyle behaviors that may contribute to the development of fertility problems of individuals. Study design, size, duration A methodological study was conducted between July 2020- December 2021. An item pool (123 items) was prepared by reviewing the literature and the opinions of researchers and fertility experts. A multidisciplinary team of doctor, nurses and patient collaborated to asses suitability of each item of Fertility Lifestyle Assesment Scale. The Item Content Validity Index varied between .80 and 1.00. As a result a final 46-item Fertility Lifestyle Assessment Scale was developed. Participants/materials, setting, methods Participants (a) who can speak, read and write Turkish; (b) 18 years of age or older; married/single women or men, (c) who have not yet had children, and (d) who are considering having children in the future were included. The sample of this study consisted of 526 participants who met the inclusion criteria and agreed to be a part of the present study. Main results and the role of chance In the exploratory factor analysis (EFA), the Kaiser-Meyer-Olkin (KMO) coefficient of 46 items was .865 and the result of Bartlett’s sphericity test was χ2 = 15265.707, p < .001. As a result of EFA, it was determined that the scale consisted of seven subscale. Also, seven subscales were exposed to explanatory analysis: “emotional well-being”, “physical activity”, “sleep quality”, “nutrition”, “clothing/hygiene”, “use of technology”, “spiritual dimension”. These seven subscales explained 71.25% of the total variance, which shows the power of the factor structure of the scale. The total Cronbach’s alpha was .87. The item-total score correlation coefficients ranged between .19 and .57. The Pearson correlation coefficients between subscale scores and scale total scores were between .21 and .98. The Cronbach’s alpha coefficients of the subscales ranged from .60 to .98. According to the Spearman–Brown analysis, the split-half correlation coefficient was .898. Item scores were different from each other (Hotelling’s T2 = 1189.347, p= .000). This scale is valid and reliable for measuring the healthy lifestyle for improving fertility of women and man who unmaried. Limitations, reasons for caution The limitation of the study was that only 3/1 of the sample to which the scale was applied was composed of men. Wider implications of the findings This scale can be used to evaluate fertility-related lifestyle factors in individuals who are considering getting pregnant starting from the preconceptional period or who have fertility problems and apply for treatment. The scale may be easily performed by healthcare professionals and may contribute to improve fertility. Trial registration number Not applicable

Menstrual poverty scale: reliability and validity study

ABSTRACT The tendency toward poverty in the globalizing world significantly affects women. Unlike men, women have mandatory expenses every month. Especially poor women have difficulty in accessing to the hygienic products they need during the menstrual period. That is why, this study aims to develop a measurement tool that can effectively and widely assess women’s menstrual poverty. This study is a methodological study that evaluates the psychometric properties of the scale. The study included 420 women living in a middle-income province in the north of Türkiye between April – July, 2023. The data were collected using the Menstrual Poverty Scale, and the items on the scale were developed based on a review of existing literature and expert opinions (CVI = 0.85–0.95). The sample was divided into two parts. It was made exploratory factor analysis and confirmatory factor analysis. Before conducting the study, an ethics committee decision and informed consent of the women were obtained. The collected data were analyzed using the SPSS 23 and AMOS 23 programs. The EFA revealed a structure consisting of 13 items and four factors. The four factors considered were as follows; access to hygiene products, quality of life, embarrassment, and receiving information, and education about menstruation. The item factor loadings varied from 0.46 to 0.91. The Cronbach’s alpha coefficient was determined to be 0.69. The corrected item-total correlations for the scale items ranged from 0.62 to 0.84. According to the confirmatory factor analysis, the structural equation modeling results of the Menstrual Poverty Scale were found to be meaningful (p = .000; RMSEA 0.64; CMIN/Df 1.70). It is suggested to conduct validity and reliability studies in different cultures by applying the scale to women from different cultural backgrounds.

Fracture sonography-review of literature and current recommendations.

Over a span of more than two years, a collaborative expert group consisting of 9 professional societies has meticulously crafted the S2e guideline on fracture sonography. This publication encapsulates the essential insights pertaining to specific indications. A thorough and systematic literature search, covering the period from 2000 to March 2021, was conducted across PubMed, Google Scholar, and the Cochrane Database of Systematic Reviews, complemented by an evaluation of bibliographies. Inclusion criteria encompassed randomized controlled clinical trials, observational clinical trials, meta-analyses, and systematic reviews, while guidelines, conferences, reviews, case reports, and expert opinions were excluded. The SIGN grading system (1999-2012) was applied to assess evidence, and resultant SIGN tables were presented to the expert group. Specific recommendations for the application of fracture sonography were then derived through unanimous consensus after detailed discussions. Out of the initial pool of 520 literature sources, a meticulous screening and content assessment process yielded 182 sources (146 clinical studies and 36 meta-analyses and systematic reviews) for evaluation. The comprehensive analysis identified twenty-one indications that substantiate the judicious use of fracture sonography. Ultrasound emerges as a pragmatic and user-friendly diagnostic method, showcasing feasibility across a diverse range of indications.

Developing a quality and safety assessment framework for Iran’s military hospitals

BackgroundThe first crucial step towards military hospitals performance improvement is to develop a local and scientific tool to assess quality and safety based on the context and aims of military hospitals. This study introduces a Quality and Safety Assessment Framework (Q&SAF) for Iran’s military hospitals.MethodsThis is a literature review which continued with a qualitative study. The Q&SAF for Iran’s military hospitals was developed initially, through a review of the WHO’s framework for hospital performance, literature review (other related framework), review of military hospital-related local documents, consultations with a national and sub-national expert. Finally, the Delphi technique used to finalize the framework.ResultsBased on the literature review results; 13 hospital Q&SAF were identified. After reviewing literature review results and expert opinions; Iran’s military hospitals Q&SAF was developed with 58 indictors in five dimensions including clinical effectiveness, safety, efficiency, patient-centeredness, and Responsive Management (Command and Control). The efficiency dimension had the highest number of indictors (19 indictors), whereas the patient-centered dimension had the lowest number of indices (4 indictors).ConclusionRegarding the comprehensiveness of the developed assessment framework due to its focus on the majority of quality dimensions and important components of the hospital’s performance, it can be used as a useful tool for assessing and continuously improving the quality of hospitals, particularly military hospitals.

Italian adaptation to Regulation (EU) 2017/625 on food official controls: a case study

Foodborne diseases can be prevented by implementing a food safety system that manages food chain risks from producer to end-user, from a One Health perspective. In 2017, the European Parliament and the European Council adopted Regulation No. 625 on official food controls and other official activities performed to ensure the application of food and feed laws and rules on animal health and welfare, plant health, and plant protection products. Italy issued a national law, Legislative Decree No. 27/2021, to adapt and adhere to European standards. We aim to describe the adoption and implementation of the new Legislative Decree by an Italian Food Hygiene and Nutrition Service, specifically focusing on the amendments introduced by Articles 7 and 8, namely the establishment of the second expert opinion and dispute procedures, and their integration with the promulgation of Article 70 of Legislative Decree No. 150/2022. These modifications aim to reduce the number of minor offenses that proceed to trial.