International Peer Review Research Articles

International PCOS guideline clinical research priorities roadmap: a co-designed approach aligned with end-user priorities in a neglected women’s health condition

Polycystic ovary syndrome (PCOS) is a common endocrinopathy with significant reproductive, metabolic, and psychological complications. Consensus on PCOS clinical research priorities across end-users is fundamental and necessitates a robust co-development of a clinical research roadmap to guide international research efforts. A multistage process included: i) international surveys of women and healthcare providers to identify research priorities and unmet needs; ii) interrogation of systematic reviews conducted for the International PCOS Guideline to identify research gaps; iii) International PCOS Guideline Network consensus generated clinical research roadmap; and iv) international peer review for external validation. A codesigned survey engaging 1278 women with PCOS and 1474 healthcare providers found general concordance on research priorities. International PCOS Guideline development processes identified gaps in the literature and coproduced over 150 research priorities throughout the women's life course, affirmed in international peer review. Key themes included: 1) Optimizing PCOS diagnosis; understanding natural history across diverse populations and life stages; detecting and preventing complications, and integrating and interrogating large data assets; 2) developing evidence-based resources, exploring optimal modes for information provision and models of care; 3) exploring effective lifestyle and weight management strategies; minimising weight stigma; 4) exploring intervention effects (including treatment efficacy, safety, cost-effectiveness, and long-term follow-up) on diverse features of PCOS across subgroups; and 5) optimising preconception care and fertility treatments in PCOS. This rigorously coproduced International PCOS Guideline clinical research roadmap addresses stakeholder priorities to guide future clinical research in this common yet neglected condition. The roadmap complements the established PCOS Core Outcome Set to enhance research quality, and tackles evidence-practice gaps to improve health outcomes for women with PCOS throughout their life course. The survey, International PCOS Guideline Network and 2018 and 2023 International PCOS Guidelines were funded by the Australian National Health and Medical Research Council (NHMRC) Centres of Research excellence in PCOS (APP1078444) and in Women's Health in Reproductive life (APP1171592). Guideline partners, American Society for Reproductive Medicine (ASRM), Endocrine Society, European Society of Human Reproduction and Embryology (ESHRE), and European Society of Endocrinology (ESE), provided additional funding and assisted in guideline development. HT and AM are NHMRC Research Fellows. LM was funded by a Heart Foundation Future Leader and Veski Fellowship and CTT by the NHMRC Centres of Research excellence in Women's Health in Reproductive life. All disclosures of interest were declared before commencing GDG involvement and updated before all major milestones and are available alongside the PCOS Guideline (https://www.monash.edu/__data/assets/pdf_file/0009/3371292/Register-of-disclosures-of-interest.pdf).

Slovenia’s Food-Based Dietary Guidelines 2024: Eating for Health and the Planet

The dietary guidelines of Slovenia, ‘12 Steps to Healthy Eating’, were first published in 2000 and revised in 2011. The ‘Food Guide Pyramid’ was initially published in 2000 and subsequently revised in 2015. ‘The Healthy Plate’ was first introduced in 2007. In February 2023, the Slovenian Strategic Council for Nutrition proposed new Food-Based Dietary Guidelines (FBDGs) that integrate both health and environmental considerations. In September 2023, the creation of new FBDGs was included in the Action Plan for implementing the Resolution on the National Program on Nutrition and Physical Activity for Health 2015–2025. In October 2023, the Ministry of Health of Slovenia appointed the core working group of 10 multidisciplinary experts from fields such as nutrition, food science medicine, public health, environment, pharmacy, and agriculture led by Prof. Dr. Nataša Fidler Mis, who drafted the guidelines. In February 2024, the World Health Organization Regional Office for Europe organized a virtual international workshop to assist Slovenia in developing food-based dietary guidelines. In May 2024, an international expert meeting was organized by the Ministry of Health of Slovenia, the Ministry of the Environment, Climate, and Energy, and the National Institute of Public Health of Slovenia to present the first scientific draft of the SLO FBDG for external international peer review. The meeting included lectures from world-leading experts to present healthy diets from sustainable food systems, integrate climate and sustainability aspects into the new SLO FBDG, discuss the findings with the Slovenian core working group, extended working group of the SLO FBDG, and invited experts. The final version of SLO FBDG is expected to be released by the end of 2024.

International Guidelines and Significant Advances in Diagnosis

Objective: To develop and translate rigorous, comprehensive evidence-based guidelines for diagnosis, assessment, and treatment, to improve the lives of those with polycystic ovary syndrome (PCOS) worldwide. Here we will focus on diagnosis. Participants: Extensive health professional and consumer or patient engagement informed the guideline priority areas. International society-nominated panels included consumers, and experts in paediatrics, endocrinology, gynaecology, primary care, reproductive endocrinology, psychology, dietetics, exercise physiology, sleep, bariatric/metabolic surgery, public health, other co-opted experts, project management, evidence synthesis and translation. Evidence: Best practice, evidence-based guideline development involved extensive evidence synthesis and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework covered evidence quality, feasibility, acceptability, cost, implementation and ultimately recommendation strength. Process: Governance included an international advisory board, project board and five guideline development groups with 52 members, consumer, and translation committees. The Centre for Research Excellence in Women’s Health in Reproductive Life, funded by the Australian National Health and Medical Research Council (NHMRC), and led by Monash University, partnered with the American Society for Reproductive Medicine, the Endocrine Society, the European Society of Endocrinology and the European Society of Human Reproduction and Embryology. Thirty-six organisations collaborated with international meetings over nine months. Fifty-five prioritised clinical questions involved 52 systematic and three narrative reviews, generating evidence-based and consensus recommendations with accompanying practice points. Committee members nominated by collaborating organisations provided international peer review, and evidence expert-reviewed methods and outputs were submitted to NHMRC for independent review. Recommendations: PCOS should be diagnosed using the revised consensus Rotterdam criteria, which are now updated to evidence-based criteria in the International Guideline. In adults this requires the presence of two of i) clinical/biochemical hyperandrogenism ii) ovulatory dysfunction and iii) polycystic ovaries on ultrasound or elevated anti-mullerian hormone (AMH) levels, after other causes of these features are excluded. Where irregular menstrual cycles and hyperandrogenism are present, ultrasound or AMH are not required for diagnosis. In adolescents, both hyperandrogenism and ovulatory dysfunction are required, with ultrasound and AMH not recommended, due to poor specificity. Conclusion: Overall, evidence in PCOS is low to moderate quality. Based on high prevalence and significant health impact, greater priority, funding, and research is recommended. Guideline translation will be extensive including multilingual education outputs and evidence-based resources for consumers (the ASKPCOS app), healthcare professionals and policy makers.

An open educational resource to teach language and culture

Many studies on teaching language have shown that language and culture are closely related and are best acquired together (Brook, 1968; Brown, 2000; Kramsch, 2020; Kourdis & Zafiri, 2022). In an English language program (ELP), we use a variety of textbooks. These textbooks feature culture as part of the content (e.g., customs and traditions). However, the resources are typically information-focused which directs students to simply compare and contrast the similarities and differences between their own and the target cultures in a traditional way that is insufficient for the complexity of language and culture learning. Educators found that this type of traditional approach runs the risk of oversimplifying the richness and variety of a culture by reducing it to a few salient principles (Stockwell, 2018). Although language teachers have incorporated more culture in their lessons, the major concern is finding effective ways to integrate culture and language to prepare learners to engage and collaborate effectively in a global society by discovering appropriate ways to interact with people from other cultures. In addition, it may be very demanding for them to teach culture or be individually knowledgeable about other cultures to the extent required for a truly holistic English program. The project introduces a reusable technology-enhanced learning resource in the form of an open textbook for use in an English for Academic Purpose programme. This resource aims to facilitate a general reduction in issues such as ethnocentrism, stereotypes, prejudice and similar issues that have a negative effect on intercultural communication?in multicultural language classrooms, and to students’ understanding of their own culture and other cultures through activities which require critical reflections and self-assessment. It consists of three modules and self-assessment tools for using critical reflections and assessing students’ intercultural competence. Each module has main content, practice and performance tasks. Using multimodal resources and materials are provided that make student think, reflect and discuss the main concept of the module. Through these tasks, students are able to learn the main concept of each module regarding cultural knowledge and understand what they learned through the real situation and finally demonstrate awareness of the cultural knowledge in the module. The content will be shaped with technology-integrated materials to utilise the affordance and efficacy of the innovative technology. The challenges posed by the disconnect between traditional teaching materials and a fulsome understanding of culture are met by the affordances of open pedagogy and the inclusion of open educational resources. The student-centred open pedagogy approach positions learners as co-creators of knowledge in the classroom, leveraging a constructivist learning design by providing students with opportunities to share and deeply reflect on lived experience of culture. The open textbook developed for the course provides opportunities for student revision, international peer-review of learning materials, and iterative development across multiple institutions. Furthermore, students enhance the text through web annotation, supporting peer learning. This presentation outlines the transformation of an English language program aimed toward mature understanding of language and culture, enabled by open education, and will be of interest to educators in similar fields, and those planning to implement OER more generally. The project also represents a partnership between the College and the Library, bringing together expertise in open educational practices, and student-centred learning and teaching approaches that result in more opportunities for learner engagement, and accessible, shareable content for the sector.

Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome.

Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome.

Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome†.

Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome†.

EGC 2023 Conference Announcement

The abstracts of the papers will be published in the Book of Abstracts of the 1st European GREEN Conference. Papers will be published in the Proceedings or in the supporting journal.All submitted abstracts and papers will undergo an international peer review process.

Dry mineral processing: the new topic of XXXII international mineral processing congress

Minerals and Mineral Materials, an open access and online journal with international peer review, dedicated to providing an international forum and an authoritative source of information related to mineral processing and mineral materials in scientific and engineering aspects.

HSD31 Analysis of the Balanced Scorecard's Managerial Subdimensions in Health Care Organizations During the COVID-19 Pandemic

We intended to review all the managerial subdimensions used in balanced scorecard (BSC) implementations and then to assess the impact of the pandemic on the managerial subdimensions of health care organizations (HCOs). We performed a systematic review in accordance with PRISMA guidelines to find all internal key performance indicators (KPIs) used in BSC implementations from the time of inception until October 2020 in PubMed, Embase, Cochrane, Google Scholar databases, and Google's search engine. Second, we searched for independent studies using the resulting managerial subdimensions with the COVID-19 keyword in Google engine and Google Scholar until June 2021. Out of 4031 studies, 36 implementations remained. From these, 72 managerial KPIs were extracted. Categorizing KPIs resulted in 4 subdimensions: planning and targets, standards and regulations, internal assessment, and external assessment. Hospitals utilized some of these subdimensions’ KPIs to perform planning and internal assessment of their performance. The CDC developed a checklist to help hospitals assess and improve their preparedness for responding to COVID-19. However, insufficient standardization of quality measurement approaches in the COVID-19 era was perceived, which disrupted the comparison and understanding of health systems’ optimal performance. The lack of standardization and conflicting or irrational managerial decisions were deemed dissatisfactory factors for health care workers in the pandemic. Moreover, few studies have examined centralized governance's impact on HCOs during the pandemic, which positively affected reactive strategies. Learning from past pandemics was suggested to may positively influences proactive and reactive strategies. However, the role of internal assessment, such as BSC and total quality management tools, or external assessments, such as Joint Commission International accreditations, certification, auditing, or peer review on HCOs during the pandemic, still requires more investigation. Future research to improve the performance of the managerial subdimensions during the pandemic, as well as a comprehensive assessment for HCOs is still needed.

Education Theory Made Practical: Creating open educational resources via an apprenticeship model.

Clinical faculty may have limited knowledge of education theories and best practices in health professions education. Many faculty development programs focus on passive learning with limited application to practice. There is a need for more active engagement for early career educators. We created an apprenticeship-based electronic book series focused on translating education theories into practical applications for clinician educators. Chapters were authored by teams of two to four geographically separated early career educators, who were tasked with explaining an education theory and relating it to their educational practice. The chapters underwent internal peer review, followed by open peer review as a blog post and eventual publication. Usage data were collected, and surveys were sent to authors and end-users. Six volumes (60 total chapters) have been created to date by 180 unique authors and 17 editors over a 6-year period. There have been 65,571 total blog page views and 17,180 total book downloads across the five published volumes. Authors reported an increase in their perceived knowledge (pre 2.6 ± 1.7 vs. post 7.2 ± 1.1, mean difference 4.5/9.0, 95% confidence interval [CI] 4.0-5.0, p < 0.001) after writing their chapter. Authors also reported career benefits including authorship for academic advancement/promotion and developing an area of education theory expertise. End-users also reported a mean increase in their perceived knowledge (pre 4.4 ± 2.5 vs. post 7.3 ± 1.4, mean difference 2.9/9.0, 95% CI 2.1-3.8, p < 0.001) after reading a chapter. The Education Theory Made Practical electronic book series represents a proof of concept for an apprenticeship-based model to teach education theory, while also creating scholarship and open access resources for the broader community.

A Road Toward Greater Visibility of Research Output in International Peer-Review Journals: Lessons from Poland

A Road Toward Greater Visibility of Research Output in International Peer-Review Journals: Lessons from Poland

Transfer Patient Imaging: A Novel Peer Feedback Program Beyond Institutional Boundaries

At our level 1 trauma center, we overread cross-sectional scans on all transferred patients, initially reported by community radiologists (CR). We designed a unique peer feedback learning model to address discrepancies encountered with outside overreads with the goal of practice improvement on the part of the CRs. Although there is ample literature on internal peer review and peer learning programs, no publications address errors committed by peers outside institutional boundaries. In this paper we describe our model and report a survey analyzing the perception of the program by the CRs. Outside CT and MR exams and reports of patients transferred to our level 1 trauma center were imported into PACS and prospectively overread by specialist trauma radiologists. Our report contained a summary of the outside findings as well as our findings. In the case of a significant discrepancy, a paper copy of our final report was sent by US mail to the originating CR. When the program had been active for 18 months, an invitation to participate in a survey was sent to all radiologists who had been sent reports. Eight thousand three hundred forty patients were transferred, of which 4331 (52%) had 9175 exams with outside reports (8666 CT scans and 509 MRI). One hundred seventy six final report letters containing significant discrepancies were sent to 139 individual radiologists. These 139 radiologists also later received our survey letter. Thirty-eight (27%) responses were received. Thirty-two respondents (84%) recalled receiving the report and reviewed the exam in question. Twenty-eight of them (85%) agreed with the overread and 30 (88%) believed that our feedback program should be continued. We have designed a novel peer feedback learning model to address discrepancies in outside overreads which is administratively simple and well received by the CRs getting feedback. Those CR who responded to the survey rated the experience favorably and wanted the practice continued, although the overall response rate did not allow statistical analysis. Also, institutions trying to design similar or new peer learning models can benefit from our experience.

Research subjects suggested to young scientists in mineral processing to tackle future challenges of mining and minerals processing

Minerals and Mineral Materials, an open access and online journal with international peer review, dedicated to providing an international forum and an authoritative source of information related to mineral processing and mineral materials in scientific and engineering aspects.

Exome and genome sequencing for pediatric patients with congenital anomalies or intellectual disability: an evidence-based clinical guideline of the American College of Medical Genetics and Genomics (ACMG)

PurposeTo develop an evidence-based clinical practice guideline for the use of exome and genome sequencing (ES/GS) in the care of pediatric patients with one or more congenital anomalies (CA) with onset prior to age 1 year or developmental delay (DD) or intellectual disability (ID) with onset prior to age 18 years. MethodsThe Pediatric Exome/Genome Sequencing Evidence-Based Guideline Work Group (n = 10) used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence to decision (EtD) framework based on the recent American College of Medical Genetics and Genomics (ACMG) systematic review, and an Ontario Health Technology Assessment to develop and present evidence summaries and health-care recommendations. The document underwent extensive internal and external peer review, and public comment, before approval by the ACMG Board of Directors. ResultsThe literature supports the clinical utility and desirable effects of ES/GS on active and long-term clinical management of patients with CA/DD/ID, and on family-focused and reproductive outcomes with relatively few harms. Compared with standard genetic testing, ES/GS has a higher diagnostic yield and may be more cost-effective when ordered early in the diagnostic evaluation. ConclusionWe strongly recommend that ES/GS be considered as a first- or second-tier test for patients with CA/DD/ID.

AGA Clinical Practice Update on Surveillance After Pathologically Curative Endoscopic Submucosal Dissection of Early Gastrointestinal Neoplasia in the United States: Commentary

The purpose of this American Gastroenterological Association (AGA) Institute Clinical Practice Update was to review the available evidence and provide expert advice regarding surveillance using endoscopy and other relevant modalities after removal of dysplastic lesions and early gastrointestinal cancers with endoscopic submucosal dissection deemed to be pathologically curative. This Clinical Practice Update was commissioned and approved by the AGA Institute Clinical Practice Updates Committee and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership, and underwent internal peer review by the Clinical Practice Updates Committee and external peer review through standard procedures of Gastroenterology. This expert commentary incorporates important as well as recently published studies in this field, and it reflects the experiences of the authors, who are advanced endoscopists with high-level expertise in performing endoscopic submucosal dissection to treat dysplasia and early cancers in the luminal gastrointestinal tract.

Demonstrating Your Work: A Guide to Educators' Portfolios for Graduate Medical Educators.

Demonstrating Your Work: A Guide to Educators' Portfolios for Graduate Medical Educators.

When Surgeons Are “Too Old” to Practice Surgery: Recommendations to Balance the Imperatives of Public Safety and Practical Necessity

Few countries have legally set a maximum age for practicing surgery. This is difficult to sustain as surgeon shortages in many localities require hospitals to grant surgical privileges based on internal peer review systems. This approach is not without problems. Some hospitals and medical societies have developed competency assessment programs. Based on the literature and the experience of various jurisdictions, the authors recommend a policy approach that does not mandate a retirement age for surgeons, but rather a mandatory age of 65 at which surgeons shall be legally subject to periodic assessment of physical dexterity, eye/hand coordination, and cognitive skills.

Evaluation of an online course for prevention of unwanted sexual behaviour in residential aged care services-A pilot study.

Residential aged care services (RACS) staff have substantial gaps in knowledge to prevent and manage unwanted sexual behaviour (USB) in RACS. This study aimed to explore the feasibility of a pilot online course (intervention) addressing USB in RACS. Development of a self-guided e-learning educational course was based on existing research, national and international approaches to human rights approaches to sexual assault and underwent internal and external peer review. An anonymous, online, cross-sectional survey was conducted post-intervention completion. RAC-Communiqué subscribers were recruited via an e-invitation. English speaking enrolled or registered nurses, employed in an Australian RACS, were eligible. From the 167 participants who expressed interest to enrol, 129 were eligible and 45 returned completed consent forms. Fifteen survey items regarding perceived competence and intervention satisfaction were analysed. The intervention addressed content pertaining to staffs' legal and regulatory requirements, managing incidents and awareness of key services. Thirty-eight of 45 eligible participants responded (84.4%). Participants reported they would recommend the intervention to a colleague (n=36, 97.3%). Participants self-reported (i) advanced learning post-completion; (ii) raised awareness (n=29, 78.4%) (iii) prompted current practice reflection (n=35, 94.6%) and (iv) prompted improving USB workplace management (n=34, 91.9%). Results are subjected to social desirability bias. The intervention was relevant, engaging and practical. The findings contribute to a more comprehensive understanding of the specific training topics relevant and useful to RACS staff. E-learning tools could be an effective teaching method for USB in RACS. The intervention may be a useful tool to encourage staff to reflect and change current practice.

Quality Management System at NPLI: Transition of ISO/IEC 17025 From 2005 to 2017 and Implementation of ISO 17034: 2016

ISO/IEC 17025 is the single most popular and well adopted international standard which is applicable for any testing and calibration laboratories irrespective of size of the laboratories. Similarly, ISO 17034 is also very important international standard for development/production of reference materials (RMs) by competent producers. CSIR-National Physical Laboratory of India (NPLI) was one of the 38 National Metrology Institutes (NMIs) those who signed International Committee for Weights and Measures Mutual Recognition Arrangement (CIPM MRA) during 21st General Conference on Weights and Measures (CGPM) meeting in Paris, France on 14th October, 1999. NPLI has been maintaining quality system based on ISO/IEC 17025 for more than two decades to fulfil the requirements of CIPM MRA. NPLI has participated in 130 international inter-comparisons so far; some of them were also piloted by NPLI. NPLI has also undergone International Peer Reviews through Asia Pacific Metrology Programme (APMP) to register 236 Calibration and Measurement Capabilities (CMCs) on various parameters in International Bureau of Weights and Measures Key Comparison Database (BIPM KCDB). However, NPLI for the first time implemented uniform quality system based on ISO 17034 in 2020. In this direction, NPLI for the first time prepared integrated Quality Manual to make policies, objectives and procedures addressing all the requirements of both the standards. Presently, 28 Sub-Divisions of NPLI follow quality system. Some of the Sub-Divisions are involved only in calibration/testing activities maintain only ISO/IEC 17025: 2017. Similarly, some of the Sub-Divisions are involved only in development/production of RMs/certified reference materials (CRMs) (Bharatiya Nirdeshak Dravya, BND®–Indian Reference Material) maintain only ISO 17034. On the other hand, few Sub-Divisions are involved both in calibration/testing as well as BND activities and accordingly follow both the standards. It is an extraordinary challenge for implementation and monitoring of quality system in such a big organization like NPLI. In this article, authors have highlighted preparation process of integrated quality manual based on ISO/IEC 17025: 2017 and ISO 17034: 2016 including policies, objectives & procedures adopted and its implementation process at NPLI. In November, 2020, NPLI has undergone on-site peer review of quality system of 23 Sub-Divisions through APMP.

P0689 / #1947: ENHANCING POSTGRADUATE SKILLS IN PAEDIATRIC CRITICAL CARE PHYSIOTHERAPY VIA SIMULATION-BASED EDUCATION: A COLLABORATIVE APPROACH

AIMS & OBJECTIVES: Cardiorespiratory physiotherapy within the paediatric critical care unit requires specialist knowledge and postgraduate training to ensure safety and clinical competency. Within the United Kingdom, simulationbased education (SBE) is primarily used for treatment skills and updates for cardiorespiratory on-call physiotherapists (Gough et al, 2013). The availability and accessibility of high-fidelity resources and specialist education is variable. A collaboration between Great Ormond Street Hospital and the Royal Brompton Hospital, London, was established with the aim of providing a comprehensive SBE course to paediatric physiotherapists nationally. There are currently no other paediatric SBE programmes within the region. METHODS: During May 2018, 2 courses were run with a combination of pre-simulation lectures, simulation scenarios and peer group discussion. Following an international peer review from Queensland Children's Hospital and anonymised candidate feedback (N=23), the course content was divided into 2 separate study days (October 2018 and May 2019). This allowed targeted, specific SBE to both a critical care group and a high dependency care group of paediatric physiotherapists. RESULTS: 15 candidates attended the SBE paediatric critical care (N=8) and high dependency care (N=7) courses. Of the 14 anonymised electronic feedback responses, 96.5% rated the 4 simulation scenarios as extremely useful or very useful. Feedback themes were collated to guide future course content. CONCLUSIONS: The targeted SBE programme for paediatric critical care physiotherapists demonstrated improved confidence in managing highly complex scenarios alongside an opportunity for shared peer learning and reflective practice. In the current COVID-19 pandemic, the course is being modified for teaching via a virtual platform.