Expert Opinion Research Articles

Validity assessment of oral health promotion activities targeting the older population for community care in South Korea: A Delphi study.

The purpose of this study was to establish an oral health activity assessment tool for older people and evaluate its validity. To provide reasonable and efficient oral health promotion services with limited medical resources, a tool including categories and items of oral health promotion activities for older people should be prepared. The tool initially consisted of 76 items on oral health promotion activities for older people classified into assessment-performance-evaluation stages. Topics for each stage included general and oral health, daily health, oral health status, behaviour, and awareness. In addition, two Delphi surveys were conducted on 10 experts who met the selection criteria, and the final items were derived based on the review opinions. As a result of the first and second Delphi surveys, the content validity for all items was ≥0.60 and the content validity index was ≥0.80. In the first survey, the degree of convergence in some items was 0-0.88. After modifying the contents according to expert opinions, the degree of convergence was improved from 0 to 0.50 in the second survey. The degree of agreement ranged from 0.75 to 1.00, indicating that experts agreed. Finally, a total of 65 items were derived. A 65-item tool was derived through two Delphi surveys for the assessment of oral health activities for older people. The use of the tool developed in this study would likely contribute to better prevention of oral diseases and the promotion of oral health among older people.

Contemporary Treatment of Pulmonary Arterial Hypertension: A US Perspective.

Pulmonary arterial hypertension (PAH) is a complex fatal condition which requires aggressive treatment with close monitoring. Significant progress has been made over the last three decades in the treatment of PAH but despite this progress, survival has remained unacceptably low. In the quest to improve survival, therapeutic interventions play a central role. In the last few years, there have been remarkable attempts to identify novel treatments. Finally, we have had a breakthrough with the discovery of the fourth treatment pathway in PAH. Activin signaling inhibition distinguishes itself as a potential antiproliferative intervention as opposed to the traditional therapies which mediate their effect primarily by vasodilatation. With this novel treatment pathway, we stand at an important milestone with an exciting future ahead and the natural question of when to utilize Activin signaling inhibitor (ASI) for the treatment of PAH. In this state-of-the-art review, we focus on the placement of this novel agent in the PAH treatment paradigm based on the available evidence, with special focus on the US patient population. This review also provides an expert opinion of the current treatment algorithm on important subgroups of patients with comorbidities from the US perspective.

Tailoring neo/adjuvant systemic therapy in breast cancer: "The advent of a personalized approach"-The Breast-Gynecological and Immuno-Oncology International Cancer Conference (BGICC) consensus and recommendations.

The management of early breast cancer (BC) has witnessed an uprise in the use of neoadjuvant therapy and a remarkable reshaping of the systemic therapy postneoadjuvant treatment in the last few years, with the evolution of many controversial clinical situations that require consensus. During the 14th Breast-Gynecological and Immuno-Oncology International Cancer Conference held in Egypt in 2022, a panel of 44 BC experts from 13 countries voted on statements concerning debatable challenges in the neo/adjuvant treatment setting. The recommendations were subsequently updated based on the most recent data emerging. A modified Delphi approach was used to develop this consensus. A consensus was achieved when ≥75% of voters selected an answer. The consensus recommendations addressed different escalation and de-escalation strategies in the setting of neoadjuvant therapy for early BC. The recommendations recapitulate the available clinical evidence and expert opinion to individualize patient management and optimize therapy outcomes. Consensus was reached in 63% of the statements (52/83), and the rationale behind each statement was clarified.

A Digital Framework for the Implementation of the Circular Economy in the Construction Sector: Expert Opinions

The construction sector plays a significant role in resource consumption and waste generation, making the transition to a circular economy (CE) imperative for sustainability in this sector. This paper focuses on developing a framework for implementing CE principles in the construction sector, guided by expert opinions and insights. The main objective of this study was to enhance existing theoretical frameworks by incorporating feedback from construction experts to improve practical utility and applicability in real-world construction practices. By addressing key areas for enhancement, the revised framework facilitates the adoption of CE practices throughout the asset lifecycle, considering buildings from cradle to cradle. This research’s methodology involved a comprehensive literature review to identify gaps in current frameworks related to CE implementation in the construction sector. Unstructured interviews with twenty construction experts were conducted to gather insights and recommendations for framework improvement. Data analysis highlighted the importance of integrating CE principles at various stages of the asset lifecycle, such as design, construction, and end-of-life phases. The key recommendations from experts include incorporating sustainable approaches, aligning with BIM models, and considering whole-life design aspects to promote circularity in the construction sector. By incorporating expert feedback and industry insights, the framework aims to guide practitioners toward more sustainable and resource-efficient construction practices, contributing to the broader field of CE implementation in the built environment.

A decision-making framework for determinants of an organisation’s readiness for smart warehouse

Demanding, competitive business dynamics drive organisations to continually evaluate and adopt automation in their structural setups, particularly warehouses, for growth and profitability. Industry 4.0 technologies are revolutionising warehouse operations, resulting in cost savings, increased efficiency, and a more environmentally friendly approach for businesses. The readiness of organisations to adopt these technologies is evaluated with the help of hard and soft determinants selected through a theoretical framework of Technology–Organisation-Environment (TOE). In this study, a unique method is used that combines the Modified Delphi method, content validity for scale validation, expert opinion consensus tests for agreement, ranking determinants using the Best Worst Method (BWM), and rank validation through sensitivity analysis for warehousing industry experts and organisations. Warehouse service providers who convert their warehouses into smart modes to serve fast-moving consumer goods companies in Tier-2 cities are chosen for the structural framework. Results present the role of the ‘operational efficiency of technology’, ‘top management’, ‘employee’s education’, and ‘technical background’ as the most effective driving determinants. This research provides valuable information to researchers and managers trying to upgrade their warehouse into a smart warehouse.

SCIENTIFIC PROJECT TEAMS MANAGEMENT IN WARTIME REALITIES: PERSONNEL SECURITY ENSURING ASPECTS

The study is devoted to the scientific project teams management in the realities of wartime and personnel security ensuring aspects. The purpose of the work was to identify features that should be taken into account by personnel management and scientific and pedagogical personnel who are heads of scientific projects during the management of project teams engaged in research work under the influence of wartime risks. The research methodology means the use of content analysis and specialized literature processing, as well as taking expert opinion on modern features of scientific project management into account. As a result of the study, features were identified that should be taken into account by managers and scientific and pedagogical staff , including heads of scientific projects, when managing project teams mission is to provide research work under the influence of wartime risks; the characteristic features of the scientific projects management in comparison with applied research were investigated; the peculiarities of the scientific project team formation are determined, personnel risks accompanying the process of implementing a scientific project both in peacetime and in wartime are determined, and proposals are made for optimizing the management of scientific projects in the realities of wartime. The peculiarities of the scientific project team formation have been established, which include: the need for a team member to belong to the work team of a scientific institution or institution of higher education, the team members' compliance with the characteristics of active researchers, their availability of professional publications on the topic of the project; search for people with scientific degrees and scientific titles and united by common scientific interests. The field of application of research results is science management, project management, flexible management and team management in scientific and educational institutions, critical infrastructure enterprises and business structures.

A standard to report biological variation data studies- based on an expert opinion.

There is a need for standards for generation and reporting of Biological Variation (BV) reference data. The absence of standards affects the quality and transportability of BV data, compromising important clinical applications. To address this issue, international expert groups under the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) have developed an online resource (https://tinyurl.com/bvmindmap) in the form of an interactive mind map that serves as a guideline for researchers planning, performing and reporting BV studies. The mind map addresses study design, data analysis, and reporting criteria, providing embedded links to relevant references and resources. It also incorporates a checklist approach, identifying a Minimum Data Set (MDS) to enable the transportability of BV data and incorporates the Biological Variation Data Critical Appraisal Checklist (BIVAC) to assess study quality. The mind map is open to access and is disseminated through the EFLM BV Database website, promoting accessibility and compliance to areporting standard, thereby providing a tool to be used toensure data quality, consistency, and comparability of BV data. Thus, comparable to the STARD initiative for diagnostic accuracy studies, the mind map introduces a Standard for Reporting Biological Variation Data Studies (STARBIV), which can enhance the reporting quality of BV studies, foster user confidence, provide better decision support, and be used as a tool for critical appraisal. Ongoing refinement is expected toadapt to emerging methodologies, ensuring a positive trajectory toward improving the validity and applicability of BV data in clinical practice.

Machine learning system for commercial banana harvesting

The conventional process of visual detection and manual harvesting of the banana bunch has been a known problem faced by the agricultural industry. It is a laborious activity associated with inconsistency in the inspection and grading process, leading to post-harvest losses. Automated fruit harvesting using computer vision empowered by deep learning could significantly impact the visual inspection process domains, allowing consistent harvesting and grading. To achieve the goal of the industry-level harvesting process, this work collects data from professional harvesters from the industry. It investigates six state-of-the-art architectures to find the best solution. 2,685 samples were collected from four different sites with expert opinions from industry harvesters to cut (or harvest) and keep (or not harvest) the banana brunch. Comparative results showed that the DenseNet121 architecture outperformed the other examined architectures, reaching a precision, recall, F1 score, accuracy, and specificity of 85%, 82%, 82%, 83%, and 83%, respectively. In addition, an understanding of the underlying black box nature of the solution was visualized and found adequate. This visual interpretation of the model supports human expert’s criteria for harvesting. This system can assist or replace human experts in the field.

Development of a marital self-disclosure programme for alleviating the fear of cancer recurrence in patients with gastric cancer and undergoing chemotherapy: a modified Delphi method.

This study aimed to develop a marital self-disclosure programme to alleviate the fear of cancer recurrence in patients with gastric cancer who are undergoing chemotherapy. Delphi method. Data from available literature and stakeholder interviews were utilised to formulate the initial draft of a marital self-disclosure programme aimed to alleviate the fear of cancer recurring in patients with gastric cancer and undergoing chemotherapy. A panel of experts subsequently conducted a two-round modified Delphi method to finalise the programme. A total of 13 experts participated in the first round of consultation, while 11 experts were involved in the second round, as two experts withdrew due to unavailability. The response rates of both rounds of expert consultation were 100 and 84.62%, respectively, and the expert authority coefficients (Cr) of the programme were 0.83 and 0.84, respectively. The coordination coefficients of the expert opinions were 0.124 (χ2 = 61.214, p = 0.010) and 0.167 (χ2 = 69.668, p = 0.001) for each Delphi round. The average score of the second round was (4.545 ± 0.688) to (5.000 ± 0), with a full score ratio of 0.55-1.00. The coefficient of variation (CV) ranged from 0 to 0.031. Outcomes from both rounds of consultations were considered acceptable and credible. The finalised marital self-disclosure programme for alleviating the fear of cancer recurrence in patients with gastric cancer undergoing chemotherapy consists of two parts; disclosure guidance for patients and their spouse with nine items, and the structure and themes of marital self-disclosure with 31 items. After two rounds of expert consultations, the marital self-disclosure programme for patients with gastric cancer undergoing chemotherapy is suggested to be scientifically valid and reliable. This programme is anticipated to potentially support patients and their spouses effectively by providing a reliable intervention plan focused on alleviating the fear of cancer recurrence.

The Unique Formality in the Fabric Designs of the Iraqi Fashion House

This research addresses the topic of unique formality in the designs of the fashion house by employing symbols and colors in the elements executed on fashion fabrics for the Iraqi fashion house's runway shows, and the methods and techniques of their implementation, which distinguish the house from its counterparts.The research problem was identified through the following question: How can unique formality be achieved in the fabric designs of the Iraqi fashion house? The aim of the research was to study and analyze the concept of unique formality in the fabric designs of the Iraqi fashion house. The research discussed relevant literature, including the concept and importance of unique formality in fabrics, history and cultural heritage as sources for fashion design, and techniques for showcasing decorative designs in fashion fabrics. The research followed a descriptive analytical method, relying on theoretical framework indicators and expert opinions in analyzing sample models. The research concluded with several findings, the most significant of which are: the elements used greatly influence highlighting the unique formality of fashion fabric designs, and unique formality enhances the beauty and authenticity of fabric designs, reflecting cultural and heritage identity. The research also made several recommendations, the most important of which is to emphasize uniqueness in designs by matching the elements used with historical symbols, referencing original images in museums. Lastly, the research proposed further study on decorative display techniques for the Iraqi fashion house's designs.

Emerging Evidence in Out-of-Hospital Cardiac Arrest-A Critical Appraisal of the Cardiac Arrest Center.

The morbidity and mortality of out-of-hospital cardiac arrest (OHCA) due to presumed cardiac causes have remained unwaveringly high over the last few decades. Less than 10% of patients survive until hospital discharge. Treatment of OHCA patients has traditionally relied on expert opinions. However, there is growing evidence on managing OHCA patients favorably during the prehospital phase, coronary and intensive care, and even beyond hospital discharge. To improve outcomes in OHCA, experts have proposed the establishment of cardiac arrest centers (CACs) as pivotal elements. CACs are expert facilities that pool resources and staff, provide infrastructure, treatment pathways, and networks to deliver comprehensive and guideline-recommended post-cardiac arrest care, as well as promote research. This review aims to address knowledge gaps in the 2020 consensus on CACs of major European medical associations, considering novel evidence on critical issues in both pre- and in-hospital OHCA management, such as the timing of coronary angiography and the use of extracorporeal cardiopulmonary resuscitation (eCPR). The goal is to harmonize new evidence with the concept of CACs.

Core items to be included in a definition of moderate psoriatic arthritis: literature review and expert opinion.

Evidence-based treatment recommendations for psoriatic arthritis (PsA) suggest that treatment should be individualised but acknowledge the difficulty of correctly defining levels of activity (mild, moderate and severe). The aim of this study was to define the parameters or disease characteristics that should be included in a future definition of moderate PsA. Mixed. methods: (1) literature review to identify previous assessment tools used to classify patients into mild, moderate and severe forms, and (2) survey of rheumatologists, and experts in PsA, to obtain their opinion on the degree of validation and applicability of published definitions and tools, and on the parameters that should be included in a future definition of moderate PsA. We propose eight domains/items to be included in a definition of moderate PsA: number of active joints and inflamed entheses, physician global assessment (by visual analogue scale), dactylitis, body surface area (BSA) affected by psoriasis, psoriasis in special locations, and absence of hip involvement. The Disease Activity Index for Psoriatic Arthritis (DAPSA) score would be supported as part of this definition, as would the Psoriatic Arthritis Impact of Disease (PsAID) index. This study proposes a set of items/domains to be included in a definition of moderate PsA based on literature and expert opinion, which can be the starting point for further development and validation studies of the proposed items.

Geospatial insights into Alphonso mango cultivation: a comprehensive land suitability study in the coastal belt of Maharashtra, India.

Land suitability assessment is integral to the advancement of precision agriculture. This inquiry is focused on identifying optimal regions for cultivating Alphonso mango in the coastal belt of Maharashtra, spanning across Palghar, Raigad, Thane, Ratnagiri, and Sindhudurg districts. Employing a GIS-based Analytic Hierarchy Process (AHP) methodology, 10 crucial parameters have been considered, encompassing climatic, physical, and chemical soil characteristics: cation exchange capacity, organic carbon, slope, rainfall, soil pH, soil texture, mean annual soil temperature, base saturation, soil drainage, and soil depth. Weights are assigned to these parameters based on expert opinions and existing literature to determine their significance in developing a soil suitability map. The study reveals distinct land suitability zones for Alphonso mango cultivation. The land suitability map designates 25.78% of the study area as highly suitable, while 9.18% is considered unsuitable for Alphonso mango cultivation. To validate the study, the Receiver Operating Characteristic (ROC) curve has been employed, indicating an 83% approval rate for the reliability and performance of the soil suitability. The results categorise soil suitability classes, providing valuable insights for farmers and agricultural planners to make informed decisions regarding Alphonso mango cultivation in similar geoenvironmental regions.

Guideline "Parkinson's disease" of the German Society of Neurology (Deutsche Gesellschaft für Neurologie): concepts of care.

In 2023, the German Society of Neurology published a new guideline on Parkinson's disease. An important section dealt with PD care concepts, which represent a particularly dynamic field of PD research, including their implementation in clinical practice. Parkinson's disease is the second most common age-associated neurodegenerative disease. Current estimates of the number of cases in the population describe a significant increase in prevalence in Germany by 2030 with higher proportions in rural areas, which also have a lack of sufficient PD care resources. In comparison with other international guidelines, which have so far mentioned palliative care and Parkinson's nurses in particular, the German S2k guideline expands the recommended concepts of PD care to include PD day clinics, inpatient complex treatment, and PD networks. Concepts of PD care guidelines are necessary because of the complex and rapidly evolving field of PD care provision. If applied appropriately, the potential for optimized care can be exploited and both the patient burden and the economic burden can be reduced. Given that modern care concepts have so far only been applied in a few regions, it is often impossible to generate broad evidence-based data, so that the evaluation of PD care concepts is partly dependent on expert opinion.

«Savage Division» in the battle for Tsu-Babino: military valor included in the military chronicle of the Russian Imperial Army (February 1915)

The article examines the course of the battle between the regiments of the Caucasian Native Cavalry Division and the Austrian units for the Ukrainian villages of Tsu-Babino and Brin. Great importance is attached to the study of specific events that took place on the battlefield and the interaction of regiments of divisions of the Russian Imperial Army. It is important that the history of the formation of the traditions of the military commonwealth of peoples cannot be revealed without considering the process of increasing the combat skills of officers and riders of the regiments of the Caucasian Native Cavalry Division.The author used archival materials from the funds of the Russian State Military Historical Archive and the Central State Archive of the Archive Service of the Kabardino-Balkarian Republic, as well as studies by foreign authors and domestic scientists, which allow us to examine thoroughly the actual development of the stages of the battle near the villages of Tsu-Babino and Brin. The application of the principle of historicism allows the author to show the course of the battle in increasing dynamics from the issuance of the order of the commander of the 8th Army of the Southwestern Front to break through the Austrian positions and the execution of it by the commanders of divisions, regiments and hundreds to the specific skillful and selfless actions of the officers and horsemen of the «Savage Division».The author has concluded that the increase in combat skills of the officers and riders of the «Savage Division» regiments, their skillful interaction with units of the Russian Imperial Army, best contributed to the formation of the traditions of the military commonwealth of peoples. At the same time, Grand Duke Mikhail Alexandrovich always remained a special favorite at the front; and the «Savage Division» led by him, contrary to the skeptical opinion of many military experts, became a combat-ready part of the regular Russian Imperial Army.

Reliability And Validity Study For Quick Assessment Scale Of Lymphoedem Management Information

Objective: A scale to evaluate knowledge about lymphedema has not been found in the Turkish literature before. With this study, it was aimed to develop a scale that enables the evaluation of the level of knowledge of healthcare personnel on lymphedema management. Materials and Methods: The permission for this methodological study was obtained from the Ethics Committee of University Faculty of Medicine with protocol 31 number 1453. Application permission was obtained from University Rectorate Practice and Research Hospital Chief Physician. With literature review, the item pool of the Lymphedema Management Knowledge Scale, consisting of 35 45 items including the headings of ”etiology, diagnosis, treatment, and lifestyle”, was organized. For 36 the evaluation of the scale, opinions of 16 faculty members who are experts in the field of Physical Therapy and Rehabilitation were consulted. Results:In our study, lymphedema management was gathered under four main headings and a conceptual framework was created, and it was seen that it was appropriate to evaluate all the questions in one dimension after the construct and reliability validity analyses. The scale is suitable for real life and easy to apply in terms of the questions it contains. Conclusion: With this Lymphedema Management Information Rapid Assessment Scale, which was developed by reviewing the literature and taking expert opinions, the quality of counselling services provided to lymphedema patients will be raised, and the rise in protective measures will increase the quality of life of the patients

Citizen satisfaction with arm's length bodies in local government: expert insights on policy and practice

PurposeThe purpose of this study is to investigate the application of citizen satisfaction (CS) as a tool for measuring performance by arm's length bodies (ALBs) in local governments across eleven countries, addressing central questions about its functionality and influencing factors.Design/methodology/approachWe employ a hybrid inductive-deductive explorative study design, characterized by an iterative interpretative approach guided by sensitizing concepts. Expert interviews are analyzed through template analysis and cover eleven countries where ALBs are present due to decentralization and outsourcing.FindingsOur study uncovers limited real-world applications of CS in evaluating public service delivery by ALBs. Expert interviews reveal insights into factors potentially influencing CS use, such as the level of autonomy of local governments, state traditions and austerity measures. A research agenda is formulated for further investigation.Originality/valueContributing to the CS debate, our study focuses on its application in evaluating public service delivery by ALBs. The explorative design, expert opinions and theoretical foundations enhance understanding, offering insights into factors potentially shaping CS use in this context. The study proposes a research agenda, propelling further investigations into this underexplored, yet emerging, area.

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

PurposeThis research aims to investigate the feasibility of imperfect produce use in the on-site foodservice management industry.Design/methodology/approachStudy 1 explored experts’ perspectives via expert interviews on the use of imperfect produce in on-site foodservice operations, acceptability, and willingness to choose imperfect produce. Study 2, a sensory discrimination test, was performed with 100 consumers.FindingsStudy 1 yielded seven themes with managerial recommendations: appearance perception, customer value perception, operational difficulties, concerns for the world, food safety concerns, corporate advantages, and implementation. Study 2 found that participants were willing to choose menu items prepared with imperfect produce over those prepared with perfect produce. The ability to taste differences depended on the type of produce; participants could not taste differences between tangerines but could taste differences between apples and pears.Research limitations/implicationsThe findings of this study suggested that the psychological barriers of imperfect produce impact managers’ perceptions and decision-making processes. It is recommended that operators communicate with consumers about imperfect produce, its waste reduction benefits, and its quality.Originality/valueThis study shows that taste perception could be influenced by how imperfectness is described. Thus, appropriate marketing strategies could improve consumer acceptance of imperfect produce.

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.