Internal Consensus Research Articles

Factors for Consideration by Pediatric Rheumatologists When Scoring the Physician Global Assessment of Disease Activity in Juvenile Idiopathic Arthritis: First Step Toward an Internal Consensus.

The physician global assessment of disease activity (PhGA) is a tool used nearly ubiquitously by pediatric rheumatologists for the assessment of patient disease activity status. However, this tool lacks standardization in its scoring. This survey aimed to identify score influencing factors, along with inclusion or exclusion of extra-articular manifestations and imaging, when scoring the PhGA in juvenile idiopathic arthritis (JIA). Electronic surveys were sent to Paediatric Rheumatology International Trials Organisation and Pediatric Rheumatology Care and Outcomes Improvement Network members who completed a previous survey on scoring of the PhGA. Respondents were asked to rank their top seven factors for inclusion in the PhGA for nonsystemic JIA (nsJIA) and systemic JIA (sJIA), along with ranking extra-articular manifestations and imaging for inclusion. Frequency and percentage of rank and Likert responses were analyzed, and geographic regions as well as level of experience were compared using the chi-square test and Fisher's test. A total of 276 respondents from 54 countries and six continents participated. For nsJIA, factors selected by >50% included number of swollen joints, active uveitis, duration of morning stiffness, and number of tender joints. For sJIA, factors selected by >50% were presence and duration of fever, laboratory tests, number of swollen joints, serositis, rash, hepatomegaly, lung disease, and lymphadenopathy. Agreement on the inclusion of extra-articular factors, such as uveitis, macrophage activation syndrome, and sJIA-associated lung disease, had >70% moderate or strong agreement for inclusion, whereas psoriasis had only 50.5% agreement for inclusion and imaging had 64.7% agreement for inclusion. Variations in rank between different geographic regions or level of experience were minor. This survey identifies factors that pediatric rheumatology providers find important for PhGA scoring of disease activity, documents varying agreement on inclusion of extra-articular manifestations of disease, and lays the framework for further consensus work.

Graph Model for Conflict Resolution With Internal Consensus Reaching and External Game

Graph Model for Conflict Resolution With Internal Consensus Reaching and External Game

Organizational Culture Relation With Innovation Comment on "Employee-Driven Innovation in Health Organizations: Insights From a Scoping Review".

This commentary article is important and relevant, as organizational culture and innovation are essential to health organization's performance and viability in a dynamic and competitive setting. Organizational culture is the unquenchable drive that propels an organization's growth and serves as its soul. However, effective internal innovation management is one way that managers and organizations may foster innovation. Health organizations that prioritize service and technological innovation while simultaneously cultivating an appropriate innovation culture to establish a sustainable internal consensus that stimulates innovation are the most inventive. Individuals as well as groups have a deeply ingrained culture that influences how they think and behave, causing health organizations to operate in a way that is rational and consistent.

International Memberships and Their Contribution to the Development of Additional State Capacities of Bosnia and Herzegovina: Membership in the Council of Europe

The membership of Bosnia and Herzegovina (BiH) in the Council of Europe, in a broader theoretical sense, is an example of a somewhat neglected aspect in the relations between states and international organizations — the effect that international memberships, with a company in rights and obligations, have on achieving internal political consensus and building additional state capacities. This is particularly important for small, vulnerable, and highly decentralized states like Bosnia and Herzegovina. Although the concept of membership is neither demanding nor exclusive like that of the European Union, BiH waged a fierce diplomatic and political battle for this membership – by fulfilling pre-accession conditions (adopting the Election Law of BiH) and through intensive diplomatic lobbying, along with the obligation to meet a whole series of post-admission conditions. More than two decades of membership have provided examples of building additional state capacities – the imperative for constitutional changes, the upgrading of judicial and diplomatic-bureaucratic infrastructure through the formation of inter-ministerial groups, innovative institutional solutions, introduction of new functions or institutions; projecting one's political values in the context of current problems and issues that the international organization and its membership address, and opening new opportunities for international careers for officials, diplomats, or citizens of BiH.

Pengembangan Kompetensi Sumber Daya Manusia Pada Dinas Pariwisata Kabupaten Maluku Tenggara

The development of human resources competencies in the Tourism Department of Maluku District of the South has been done for this time, as a whole has been realized quite well, but from the implementation process has not achieved optimal results, there is a need for improvement in order to maximum results. Overall the results of the research achievement imply for the development of the human resource competence in the tourism department in Maluku County the South according to the sociogram of priorities that have been empirically realized as a follow-up process through the internal consensus of the organization in forming a special format for development of competence human resources in tourism Department Maluku Districts of the south.

작곡 AI의 현재와 쟁점에 따른 국내 음악저작권 논의방향 연구

AI composer stands out as one of the most vigorously applied domains of AI technology within the music sector. This study discusses the current status of AI composer as perceived by various stakeholders in Korea through recent issues in the music industry and relevant literature, while also examining the copyright-related issues and directions of discourse. The aim is to encourage policymakers to adopt a balanced perspective on technological advancement and copyright protection, and to facilitate understanding among music industry stakeholders and composers regarding the direction of copyright discussions. To emphasize the contentious issues arising in the process of music content production, this study categorizes them into pre-creation stages, creation stages, and other areas. First, in the pre-creation stages involving data learning, copyright infringement issues arise from the replication and transmission of original data. Thus, we propose the necessity for transparent disclosure of information regarding training data, as well as discussions on the extent and method of compensation for the data copyright holders, and the need for policy support to facilitate such agreements. Second, in the post-creation stages, copyright issues revolve around the recognition of AI composer creators, ownership attribution, and protection methods. Concerning the recognition of creators, as instances of recognizing AI as creators increase globally, this study suggests preparations for potential impacts on international copyright laws. Furthermore, the distribution criteria based on AI’s role and contribution must be established, with an emphasis on the necessity for internal consensus within the music industry. Lastly, the sharing and commercial use of music composed by AI and the determination of similarity with existing works are also discussed. Specifically, ethical guidelines regarding plagiarism and the need for systems enabling objective judgment are proposed.

Handling time-varying treatments in observational studies: A scoping review and recommendations.

Time-varying treatments are common in observational studies. However, when assessing treatment effects, the methodological framework has not been systematically established for handling time-varying treatments. This study aimed to examine the current methods for dealing with time-varying treatments in observational studies and developed practical recommendations. We searched PubMed from 2000 to 2021 for methodological articles about time-varying treatments, and qualitatively summarized the current methods for handling time-varying treatments. Subsequently, we developed practical recommendations through interactive internal group discussions and consensus by a panel of external experts. Of the 36 eligible reports (22 methodological reviews, 10 original studies, 2 tutorials and 2 commentaries), most examined statistical methods for time-varying treatments, and only a few discussed the overarching methodological process. Generally, there were three methodological components to handle time-varying treatments. These included the specification of treatment which may be categorized as three scenarios (i.e., time-independent treatment, static treatment regime, or dynamic treatment regime); definition of treatment status which could involve three approaches (i.e., intention-to-treat, per-protocol, or as-treated approach); and selection of analytic methods. Based on the review results, a methodological workflow and a set of practical recommendations were proposed through two consensus meetings. There is no consensus process for assessing treatment effects in observational studies with time-varying treatments. Previous efforts were dedicated to developing statistical methods. Our study proposed a stepwise workflow with practical recommendations to assist the practice.

Sustainable entrepreneurial culture in promoting innovation: a higher education perspective

<span lang="EN-US">This research aimed to build a quadruple-helix partnership model between universities, government, industry, and community from the higher education (HE) perspective in creating various innovations to support sustainable regional socio-economic development. This study used exploratory quantitative research to develop, predict the model, and explain the empirical evidence. In addition to the model, this study found that institutional sustainable entrepreneurial culture (SEC) could be developed by transforming the university into an entrepreneurial university (EU) and applying sustainable development goals (SDGs) principles to teaching-researching-community service activities, management and governance, and institutional leadership. This study also confirmed that universities with an SEC cannot directly affect the emergence of various innovations sourced from knowledge and research results but must be mediated by internal consensus within academia and external consensus among partnership actors. The research contributions are aimed at: i) HE policymakers who will transform their institutions into EU as a first step in carrying out the university’s third mission; ii) HE will build quadruple helix partnerships; and iii) Micro, small, and medium enterprise (MSME) which will take advantage of the innovations offered in the quadruple-helix. In addition, this research deepens the Etzkowitz partnership path model in which HE, a source of knowledge for innovation, becomes more focused in the form of SDGs-based EU.</span>

Consented indicators for the evaluation of integrated strategies of community health promotion targeting children and adolescents: results of an eDelphi.

To date, there is no consensus on indicators for the evaluation of integrated community-based interventions for health promotion and prevention targeting children and adolescents. This study aims at consenting on a scoped set of indicators to evaluate integrated community-based interventions. Out of 738 indicators derived from a literature search, we preselected 94 indicators allotted to 20 domains based on an internal quality appraisal and consensus process and conducted an eDelphi procedure to assess their relevance in view of experts. Experts were recruited in the field of public health, health sciences and communal health promotion in practice and were invited as participants in this eDelphi. During the eDelphi, 47 experts rated the relevance of 94 indicators in two rounds. Consensus was defined as agreement of 75% (or above). After round 1, 27 indicators among 11 consented subdomains reached a consensus on relevance. After round 2, a total of 36 indicators reached consensus on relevance in 9 subdomains (such as socioeconomic factors, health education, nutrition and physical activity, oral health, overall health status, specific health conditions, drug related behavior, exposure to drugs and violence, family factors). These identified indicators may provide a basis for evaluation concepts of integrated community-based interventions for children and adolescents to inform stakeholders about intervention impacts.

OGC P39 The accuracy of Hospital Acquired Pneumonia (HAP) Diagnosis after Oesophagectomy

Abstract Background Oesophagectomy is a high-risk intervention associated with significant rates of morbidity. Pneumonia is a complex spectrum of infective and non-infective aetiology, varying in severity and is common after oesophagectomy. Inconsistent definitions of pulmonary complications pose significant challenges in both the clinical and research setting. The internal Esophageal Consensus Complications Group (ECCG) have adopted the Centre for Disease Control (CDC) criteria for HAP diagnosis to address this. However, other validated diagnostic criteria are also available. This study aimed to better understand the incidence of HAP after oesophagectomy, and the accuracy of four validated diagnostic tools. Methods This was a retrospective review of all consecutive oesophagectomies undertaken at a regional OG centre serving a population of 3.5 million patients between 2014-2022. Datapoints included patient demographics; comorbidities; post-operative course and re-admissions. The timing of pneumonia diagnosis was determined in the post-operative period, alongside observations and Computed Tomography (CT) and Chest X-Ray (CXR) reports. Four diagnostic criteria (Centres for Disease control- CDC, American Thoracic Society - ATS, Utrecht and Clinical Pulmonary Infection Score - CPIS) were applied to determine the incidence of HAP in comparison to patients treated for HAP. Statistical tests were performed in STATA. Results 460 patients were included, 356 (77.40%) were male. 223 (48.5%) were treated for HAP between 2014-2022. 56 (12.2%) met the CDC criteria. Mean days to diagnosis was 5 days (SD +/- 3.72). Diagnostic sensitivity and specificity for HAP was 88.89%, and 50.15% respectively. The ATS criteria were met by 79 patients (17.2%), showing a similar sensitivity (97.53%) and specificity (92.02%) to the CDC criteria. The Utrecht criteria had the lowest specificity (75.20%) for HAP diagnosis. 192 patients had sputum samples; 158 (82.29%) were culture positive. 52 patients were re-intubated, of which 29 (55.8%) were reintubated due to respiratory failure. Conclusions HAP is a complex and nuanced diagnosis with high inter-observer variation. Currently available and validated diagnostic tools result in different rates of HAP diagnosis. These findings highlight the importance of adopting robust approaches to diagnosing HAP to avoid unnecessary treatments and to more accurately determine the effectiveness of protocolised management (such as ERAS) that target HAP. The findings also highlight important implications on outcome reporting in research, particularly with interventions (e.g. minimally invasive and robotic surgery) which aim to reduce the burden of post-operative morbidity. Further widescale studies are required to validate these findings.

The hospital Israelita Albert Einstein standards for constitutional sequence variants classification: version 2023

BackgroundNext-generation sequencing has had a significant impact on genetic disease diagnosis, but the interpretation of the vast amount of genomic data it generates can be challenging. To address this, the American College of Medical Genetics and Genomics and the Association for Molecular Pathology have established guidelines for standardized variant interpretation. In this manuscript, we present the updated Hospital Israelita Albert Einstein Standards for Constitutional Sequence Variants Classification, incorporating modifications from leading genetics societies and the ClinGen initiative.ResultsFirst, we standardized the scientific publications, documents, and other reliable sources for this document to ensure an evidence-based approach. Next, we defined the databases that would provide variant information for the classification process, established the terminology for molecular findings, set standards for disease-gene associations, and determined the nomenclature for classification criteria. Subsequently, we defined the general rules for variant classification and the Bayesian statistical reasoning principles to enhance this process. We also defined bioinformatics standards for automated classification. Our workgroup adhered to gene-specific rules and workflows curated by the ClinGen Variant Curation Expert Panels whenever available. Additionally, a distinct set of specifications for criteria modulation was created for cancer genes, recognizing their unique characteristics.ConclusionsThe development of an internal consensus and standards for constitutional sequence variant classification, specifically adapted to the Brazilian population, further contributes to the continuous refinement of variant classification practices. The aim of these efforts from the workgroup is to enhance the reliability and uniformity of variant classification.

Impact of Time from Referral to Treatment on Outcomes and Cost of Therapy for Patients Undergoing Chimeric Antigen Receptor T-Cell Therapy for B-Cell Lymphoma: An Intention to Treat Analysis

BACKGROUND: Chimeric antigen receptor (CAR) T-cell therapy has changed the treatment landscape for B-cell non-Hodgkin lymphoma (B-NHL). Results from recent studies have expanded patient access to this treatment. However, little data is available evaluating the impact of time from referral to treatment on outcomes or cost for patients receiving CAR-T. METHODS: Patients (pts) aged ≥18 years with B-NHL who were referred either internally or externally between November 2017 and March 2023 for commercial CAR-T at Vanderbilt University Medical Center were included. Pts who died prior to leukapheresis or infusion were not excluded. Pts on a clinical trial were excluded. Date of referral was defined by presentation at an internal consensus meeting shortly after the initial provider visit. Other key time points were date of leukapheresis and date of CAR-T infusion. Cox regression analysis and the Kaplan Meier method were used for survival outcomes. Results were stratified by time to leukapheresis (within vs. greater than 45 days) as a proxy for a reasonable timeline, including evaluation, insurance approval, line placement, and scheduling. Pts who died prior to leukapheresis were included in the greater than 45 day group. Post referral therapy included treatment given between referral and leukapheresis, and bridging therapy included treatment given after leukapheresis. A crude cost estimate of therapies prior to CAR-T infusion was performed accounting for drug costs by type and number of cycles, administration (inpatient vs. outpatient), and estimated related costs of complications. Dollar amounts were obtained by review of CMS and previously published studies. Mann-Whitney U test was used to compare mean cost differences. RESULTS: Baseline characteristics are shown in Table 1. A total of 51 pts received axicabtagene ciloleucel (axi-cel, 78%), tisagenlecleucel (tisa-cel, 7%), or brexucabtagene autoleucel (brexu-cel, 15%) with a median follow up of 280 days. There were 9 pts (15%) who died while awaiting leukapheresis. The median age at referral was 62 (range 22-84). More pts had relapsed (43%) disease than relapsed/refractory (22%) or primary refractory disease (35%). Most patients had stage 3 or 4 disease (72%) and elevated LDH (75%). Private insurance (63%) was more common than Medicare (37%). The median time from referral to leukapheresis was 67 days (range 21-182) and median time from referral to CAR-T infusion was 99 days (range 49-212). There were 43 pts (73%) who underwent leukapheresis after 45 days. Most pts (85%) required post-referral therapy and many pts (21%) required two or more lines. Post referral therapy regimens were platinum-based (39%), polatuzumab-based (29%), other systemic chemotherapy (16%), and oral targeted agents (16%). Few pts (35%) required bridging therapy after leukapheresis with only two pts getting steroid monotherapy as bridging. The 12-month overall (OS) and progression free (PFS) survival for the cohort were 59.3% and 54.5% respectively. There was no difference in survival outcomes when stratified by early vs. late leukapheresis. Time from referral to leukapheresis or CAR-T infusion were not associated with survival outcomes in multivariate analysis. Excluding costs for leukapheresis and CAR-T infusion, the median cost of post-referral and bridging therapies was $43,700 USD (range $22,680 - $133,570). The median cost of therapies (Figure 1) for pts who underwent early leukapheresis was lower than for pts who underwent late leukapheresis (median $23,900 vs. $48,550, p=0.01). In a multivariate regression analysis, time from referral to leukapheresis (p=0.008) and the receipt of bridging therapy (p=0.010) were associated with increased costs. A sensitivity analysis performed based on year of referral did not change survival or cost outcomes. CONCLUSION: In this intention to treat analysis, we showed that time from referral to CAR-T infusion is longer than expected but did not impact survival in multivariate analysis. Prior to leukapheresis, most pts required one or more lines of systemic therapy. Given increased healthcare utilization, the cost of therapies prior to CAR-T was high, reflecting a pressing need to minimize logistic barriers prior to CAR-T to reduce costs and improve patient quality of life. Future multicenter studies should be conducted to better understand the impact of time from referral to treatment on costs, outcomes, and quality of life.

A qualitative study to elicit user requirements for lower limb wearable exoskeletons for gait rehabilitation in spinal cord injury

ObjectiveWe aim to determine a comprehensive set of requirements, perceptions, and expectations that people with spinal cord injury (SCI) and the clinicians in charge of their rehabilitation have regarding the use of wearable robots (WR) for gait rehabilitation.BackgroundThere are concerns due to the limited user acceptance of WR for gait rehabilitation. Developers need to emphasize understanding the needs and constraints of all stakeholders involved, including the real-life dynamics of rehabilitation centers.Methods15 people with SCI, 9 without experience with WR and 6 with experience with these technologies, and 10 clinicians from 3 rehabilitation centers in Spain were interviewed. A directed content analysis approach was used.Results78 codes grouped into 9 categories (physical results, usability, psychology-related codes, technical characteristics, activities, acquisition issues, context of use, development of the technologies and clinical rehabilitation context) were expressed by at least 20% of the users interviewed, of whom 16 were not found in the literature. The agreement percentage between each group and subgroup included in the study, calculated as the number of codes that more than 20% of both groups expressed, divided over the total amount of codes any of those two groups agreed on (≥ 20%), showed limited agreement between patients and clinicians (50.00%) and between both types of patients (55.77%). The limited accessibility and availability of lower limb exoskeletons for gait rehabilitation arose in most of the interviews.ConclusionsThe limited agreement percentage between patients and clinicians indicates that including both types of users in the design process of these technologies is important, given that their requirements are complementary. Engaging users with prior technology experience is recommended, as they often exhibit strong internal consensus and articulate well-defined requirements. This study adds up the knowledge available in the literature and the new codes found in our data, which enlighten important aspects that ought to be addressed in the field to develop technologies that respond to users’ needs, are usable and feasible to implement in their intended contexts.ApplicationThe set of criteria summarized in our study will be useful to guide the design, development, and evaluation of WR for gait rehabilitation to meet user’s needs and allow them to be implemented in their intended context of use.

KRITIK DAN PENOLAKAN ULAMA HANBALI ATAS PEMIKIRAN TEOLOGI IBNU TAIMIYYAH

Ibnu Taimiyyah (d. 728 H) has been the source of tension between his supporters and opponents for centuries. These supporters believed that Ibn Taimiyyah was ma'shum, more superior to Imam Ahmad bin Hanbal, and they even believed he was the ultimate mujtahid (khatim al-mujtahidin). However, such claims ignore the sharp rejection of Sunnis schools and generations (Hanafiyyah, Malikiyyah, Syafi'iyyah) and even the internal assessments of the Hanbali scholars such as Imam Ibn Rajab al-Hanbali (w. 795H), Imam Ibnu al-Mardawi al-Hanbali (w. 885H), Imam Ibnu Najjar al-Hanbali (w. 972H), Imam al-Buhuti al-Hanbali (w. 1051H), dan Imam al-Safarayni al-Hanbali (w. 1188H). This paper uses an interdisciplinary approach to analyze primary sources to demonstrate the referential hierarchy as the internal consensus of the Hanbali school (ijma' fi al-madhabihi), as the dispute over the results of tarjih formulation in ushul and furu' comes up. The first rank is the founding father of Hanbali school, Imam Ahmad bin Hanbal himself. The second place is Imam Ibnu Qudamah al-Maqdisi al-Hanbali, the writer of Kitab al-Kafi fi Fiqh al-Imam Ahmad bin Hanbal and Kitab al-Mughni. The third contributor is Imam Majduddin Abu al-Barakah al-Taimy, the writer of Kitab al-Muharrar fi al-Fiqh. The fourth rank belongs to Imam Ibn Muflih al-Hanbali, Kitab al-Furu's writer. The fifth place is Imam Ibnu Rajab al-Hanbali, the writer of Kitab al-Qawa'id al-Fiqhiyah. The sixth rank is Imam Ibnu Hamdan al-Hanbali, the writer of Kitab al-Ri'ayah al-Kubra. The seventh contributor is Imam Taqiyyuddin Ibn Taimiyyah, who wrote Kitab Majmu' al-Fatawa. The eighth rank is Imam Ibn 'Abdus al-Hanbali, the writer of Kitab al-Tadhkirah fi al-Fiqh. Furthermore, this article also proves that Ibn Taymiyyah is not the only scholar of the Hanbali school to hold the title of Syaikhul Islam among Hanbali scholars; there are still many others. Instead, Syaikhul Imam Abdul Qadir al-Jilani al-Hanbali received a more prestigious title as the Sultan-al-Masyayikh among the leading scholars of the Hanbali school.

Motor rehabilitation after stroke: European Stroke Organisation (ESO) consensus-based definition and guiding framework.

To propose a consensus-based definition and framework for motor rehabilitation after stroke. An expert European working group reviewed the literature, attaining internal consensus after external feedback. Motor rehabilitation is defined as a process that engages people with stroke to benefit their motor function, activity capacity and performance in daily life. It is necessary for people with residual motor disability whose goal is to enhance their functioning, independence and participation. Motor rehabilitation operates through learning- and use-dependent mechanisms. The trajectory of motor recovery varies across patients and stages of recovery. Early behavioral restitution of motor function depends on spontaneous biological mechanisms. Further improvements in activities of daily living are achieved by compensations. Motor rehabilitation is guided by regular assessment of motor function and activity using consensus-based measures, including patient-reported outcomes. Results are discussed with the patient and their carers to set personal goals. During motor rehabilitation patients learn to optimize and adapt their motor, sensory and cognitive functioning through appropriately dosed repetitive, goal-oriented, progressive, task- and context-specific training. Motor rehabilitation supports people with stroke to maximize health, well-being and quality of life. The framework describes the International Classification of Functioning, Disability and Health in the context of stroke, describes neurobiological mechanisms of behavioral restitution and compensation, and summarizes recommendations for clinical assessment, prediction tools, and motor interventions with strong recommendations from clinical practice guidelines (2016-2022). This definition and framework may guide clinical educators, inform clinicians on current recommendations and guidelines, and identify gaps in the evidence base.

Development of EPAT: An assessment tool for pediatric hematology/oncology training programs.

In the absence of a standardized tool to assess the quality of pediatric hematology/oncology training programs, the Education Program Assessment Tool (EPAT) was conceptualized as a user-friendly and adaptable tool to evaluate and identify areas of opportunity, pinpoint needed modifications, and monitor progress for training programs around the world. The development of EPAT consisted of three main phases: operationalization, consensus, and piloting. After each phase, the tool was iteratively modified based on feedback to improve its relevance, usability, and clarity. The operationalization process led to the development of 10 domains with associated assessment questions. The two-step consensus phase included an internal consensus phase to validate the domains and a subsequent external consensus phase to refine the domains and overall function of the tool. EPAT domains for programmatic evaluation are hospital infrastructure, patient care, education infrastructure, program basics, clinical exposure, theory, research, evaluation, educational culture, and graduate impact. EPAT was piloted in five training programs in five countries, representing diverse medical training and patient care contexts for proper validation of the tool. Face validity was confirmed by a correlation between the perceived and calculated scores for each domain (r=0.78, p<.0001). EPAT was developed following a systematic approach, ultimately leading to a relevant tool to evaluate the different core elements of pediatric hematology/oncology training programs across the world. With EPAT, programs will have a tool to quantitatively evaluate their training, allowing for benchmarking with centers at the local, regional, and international level.

Branded Identities. Remarks on the Holocaust chapter of the Macedonian-Bulgarian War on Identity

The paper approaches the issue of the Holocaust in South-Eastern Europe from the perspective of country branding and „competing identities” – term coined by Simon Anholt in the first decade of the 21st century. Though examination of the official North Macedonian and Bulgarian discourses about the WWII reflected in the contem-porary films, serials, political and historical statements, quasi-academic pamphlets, and partly architecture, the study aims to explore the mechanisms of construction of a new, “Holocaust-based” historical identity in these countries. The study argues that the current politics of memory of the two sides is propagandistic and mostly based on PR technologies which are rather indifferent or only partly sensitive to the historical facts and moral/humanist aspects of the question. The conclusion therefore is that the construction of a "competitive identity" by both sides was doomed to failure because countries that cannot achieve a minimum internal consensus on basic human, legal, aesthetic, political, etc. norms and values – as Anholt's concept would require -, have no chance of presenting an outwardly attractive, or at least acceptable, image.

Partnership consensus in triple helix pathways: A challenge for sustainable higher education

The study’s purposes are (i) to determine the gender role in the relationship between partnership consensus with the lecturer’s attributes and (ii) to test Etzkowitz’s partnership pathways in determining the role of consensus in mediating the influence of an institution’s sustainable entrepreneurial culture (ISEC) on innovation. This study confirmed that the partnership consensus has no relationship with the education level of male lecturers, while the functional position has one. In contrast, a partnership consensus for female lecturers has no significant relationship with the educational level and functional position. The partnership consensus was able to mediate ISEC’s influence in the Etzkowitz partnership path towards the emergence of innovation to 53% from 30% directly. The quadruple helix in Indonesia was decomposed into a triple helix with a university-government-community and university-industry-community partnership pattern. The conclusions are lecturers’ partnership consensus has no relationship with internal factors, such as education level or functional position, but rather because of the institutional culture that supports increasing innovation capability, namely ISEC. Internal and external partnership consensus triggers innovation significantly. These findings are helpful for higher education (HE) policymakers, where gender equality is crucial to formulate in partnership. Furthermore, HE must build an ISEC to trigger the innovations as a manifestation of HE’s contribution to sustainable regional socio-economic development.

Macroeconomics under pressure: the feedback effects of economic expertise

The influence of macroeconomists’ on policymakers through economic expertise is usually taken for granted. Yet, the reverse proposal appears far less elusive and as significant. From the analysis of Malinvaud’s writings, I set forth three significant feedback effects of economic expertise on macroeconomics, which has (i) become oversensitive to the results of economic policies, (ii) behaved as a tool for decision-making, and (iii) been impelled to search for internal consensus in order to guide policymaking. Taken together, these feedback effects of economic expertise draw how macroeconomics has been structurally intertwined with policymakers’ needs and issues since World War II, thus providing new insights on the “Keynesian consensus” in France and the broader history of macroeconomics.

Two-Stage Feedback Mechanism With Different Power Structures for Consensus in Large-Scale Group Decision Making

This article investigates a two-stage consensus feedback mechanism that considers different power structures in large-scale group decision-making (LSGDM) environments. A Louvain algorithm type is used to detect subgroups in LSGDM by trust relationship. The concepts of internal subgroups and external subgroup consensus levels are defined, and an approach to identify the inconsistent individual/subgroup is developed to avoid the issue of “pseudoconsensus.” Combined with the background of the company’s shareholder power management regulations, the following three power structures are constructed: “absolute power,” “relative power,” and “democratic power.” A two-stage feedback mechanism is investigated with minimum adjustments to achieve the optimal power allocation under each power structure. This mechanism supports individuals reach consensus both inside and outside their subgroup. An illustrative example and discussions to verify the validity of the proposed method are reported.