International Experts Research Articles

Foresight study using scenarios and the Delphi method in the leather agroindustrial chain to 2035 - Alignment of results with open innovation

ObjectiveThe objective of this article is to prioritize technologies, innovations, and new businesses related to the leather agroindustrial chain in the department of Quindío (Colombia) for the year 2035. MethodThe prospective scenario and Delphi methods were used to prioritize key variables, technologies, actors, innovations, objectives, and scenarios in the leather agroindustry. As a previous phase, the Scopus database was used with the critical factors of leather, tanning, tanneries, tannery, leather transformation, cowhide, and suede, and the results were used as input for structured, anonymous and reiterative consultations with national and international experts on topics related to the chain and with a time horizon of 2035. The questionnaire was posed by groupings, including product and by-product innovation, sustainability, technology, and genetics, and, for the first round of the Delphi method, was sent to more than 70 national and industry experts/stakeholders, representatives of universities, the public and private sectors, and organizations related to the chain. FindingsAfter conducting a bibliometric analysis, key terms related to the leather sector were visualized and a validation was made for MICMAC methods, with 44 variables found; with topics ranging from raw materials to current regulations. For the MACTOR method, future objectives were determined for clean technologies, the creation of new product development, and an R&D&I Center for productive transformation. Meanwhile, for the Delphi method, 44 technologies and innovations were prioritized through rounds with complementary analysis using Python and natural language processing. ConclusionsTopics such as vegan leather made, from mushrooms; bio-leather or leather made, from mango peel; nanofibers, nanocomposites, biogas production, nanofiltration, 4D Printing, Artificial Intelligence to improve leather quality; augmented reality to improve customer experience; genetic improvement of animals to improve leather quality, among others, in which innovation challenges and open innovation strategies can be generated, as well as in R&D&I projects, were identified.

Diagnosis and management of pediatric acute liver failure: consensus recommendations of the Indian Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ISPGHAN).

Timely diagnosis and management of pediatric acute liver failure (PALF) is of paramount importance to improve survival. The Indian Society of Pediatric Gastroenterology, Hepatology, and Nutrition invited national and international experts to identify and review important management and research questions. These covered the definition, age appropriate stepwise workup for the etiology, non-invasive diagnosis and management of cerebral edema, prognostic scores, criteria for listing for liver transplantation (LT) and bridging therapies in PALF. Statements and recommendations based on evidences assessed using the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) system were developed, deliberated and critically reappraised by circulation. The final consensus recommendations along with relevant published background information are presented here. We expect that these recommendations would be followed by the pediatric and adult medical fraternity to improve the outcomes of PALF patients.

Metadata recommendations for light logging and dosimetry datasets

BackgroundLight exposure significantly impacts human health, regulating our circadian clock, sleep–wake cycle and other physiological processes. With the emergence of wearable light loggers and dosimeters, research on real-world light exposure effects is growing. There is a critical need to standardize data collection and documentation across studies.ResultsThis article proposes a new metadata descriptor designed to capture crucial information within personalized light exposure datasets collected with wearable light loggers and dosimeters. The descriptor, developed collaboratively by international experts, has a modular structure for future expansion and customization. It covers four key domains: study design, participant characteristics, dataset details, and device specifications. Each domain includes specific metadata fields for comprehensive documentation. The user-friendly descriptor is available in JSON format. A web interface simplifies generating compliant JSON files for broad accessibility. Version control allows for future improvements.ConclusionsOur metadata descriptor empowers researchers to enhance the quality and value of their light dosimetry datasets by making them FAIR (findable, accessible, interoperable and reusable). Ultimately, its adoption will advance our understanding of how light exposure affects human physiology and behaviour in real-world settings.

Reaching consensus amongst international experts on the use of high importance-rated antimicrobials in animals – a Delphi study

In Australia, antimicrobials are given an importance rating by the Australian Strategic and Technical Advisory Group on antimicrobial resistance. High importance antimicrobials are those essential for the treatment or prevention of infections in humans, where there are few or no treatment alternatives. In this study we consulted with experts from across human and animal health using the Delphi consensus-building process to establish the circumstances under which antimicrobials with high importance to human health could be used in animals in Australia. We used three rounds of online surveys. Group responses were provided to participants in each subsequent round to facilitate convergence of opinion. Consensus was defined as 80 % or more of respondents selecting the same option for a question. By the end of the third round, consensus was achieved on eight items. This included the use of high importance antimicrobials being appropriate if culture and sensitivity testing indicated the organism was resistant to low- and medium-rated antimicrobials that could be used to treat the case. If any high-importance antimicrobials are prescribed for animals there was also agreement that a clear indication for this use and justification for antimicrobial choice must be recorded in the medical history, along with the dose rate, route of administration, the duration and the time point for review of the condition and associated antimicrobial therapy.Appropriateness of use of high importance antimicrobials in critically ill animals where culture and sensitivity results are not available is still undefined. Further work is also required to establish which particular organisation should be notified of the use of high importance antimicrobials not registered for use in animals. The Delphi process was valuable in facilitating consensus amongst international experts from a broad range of health backgrounds and experience.

Advance care planning in the acute hospital: A qualitative analysis of terms and conditions

Advance care planning in the acute hospital: A qualitative analysis of terms and conditions Abstract: Background: Advance Care Planning (ACP) is an internationally established concept aimed to facilitate anticipatory care planning in the event of future inability to consent. In Germany, ACP is currently not regularly offered to patients in acute care hospitals. Aim: We aimed to identify preconditions for implementation of ACP in acute care hospitals in Germany through review of the international literature and expert interviews. Methods: A systematic literature search was carried out in the databases MEDLINE and CINAHL for internationally used strategies for implementing ACP in acute care hospitals. Consecutively, a guide for interviews with experts to evaluate the strategies was developed. Interviews were analyzed by qualitative content analysis according to Mayring. Results: Out of 13 included publications, 17 preconditions were identified and assigned to 16 categories after evaluation by experts. In international ACP programs, it was described how to proceed and organize the ACP conversation. German experts emphasized that appropriate preconditions, such as sufficient time resources and training, must be granted, whereas the literature search revealed the conversation process and organization as important determinants. Conclusions: The implementation of ACP programs is conceivable, but requires specific conditions as legal regulation and defining and structuring of the processes.

Digitalising Clinical Guidelines: The Challenge of Patient's Preferences.

Will digitalised clinical guidelines be compatible with individualised and personalised patient care if the disease definitions and classifications used within them contain embedded preferences? Taking bone health as a case study, we found the dominant definition of osteoporosis installs the consensus preference judgement of a 1992 International Expert Committee in the form of a threshold cut-off on the bone mineral density continuum. We found that subsequent UK clinical guidelines follow suit on this diagnostic threshold, but also endorse preference-sensitive thresholds for interventions to prevent fractures, including ones underpinned by cost-effectiveness analysis. The resulting pre-emption of patient's preferences needs to be removed if 'computable' guidelines are to be reconcilable with personalised care. The challenges to be met in digitalisation therefore include major conceptual ones as well as the technical ones that are currently the almost exclusive focus.

Development of the Patient-Reported Indicator Surveys (PaRIS) conceptual framework to monitor and improve the performance of primary care for people living with chronic conditions

BackgroundThe Organisation for Economic Co-operation and Development (OECD) Patient-Reported Indicator Surveys (PaRIS) initiative aims to support countries in improving care for people living with chronic conditions by collecting information on...

Can optical evaluation distinguish between t1a and t1b esophageal adenocarcinoma: an international expert inter-observer agreement study.

While piecemeal endoscopic mucosal resection (EMR) for T1a oesophageal adenocarcinoma is acceptable, enbloc-R0 excision is advocated for T1b disease as it may offer a potential cure and mitigate recurrence. Thus, distinguishing between T1a and T1b disease is imperative under current treatment paradigms. We sought to ascertain whether expert Barrett's endoscopists were able to make this distinction based on optical evaluation. Sixty sets of endoscopic images of histologically confirmed high grade dysplasia (HGD), T1a and T1b disease (n=20 for each) were compiled from consecutive patients at a single institution. Each set contained four images, and were standardized to include an overview, a close-up in high-definition white light, a near-focus magnification image, and a narrow-band image. Experts were invited to predict histology for each set. 19 experts from 8 countries (Australia, USA, Italy, Netherlands, Germany, Canada, Belgium, and Portugal) participated. The majority had been practicing for >20 years, with a median annual case volume for Barrett's EMR of 50 (IQR 18-75), and Barrett's ESD of 25 (IQR 10-45). Oesophageal adenocarcinoma (T1a/b) could be distinguished from HGD, with a pooled sensitivity of 89.1% (95% CI:84.7-93.4. When predicting T-stage for T1b adenocarcinoma cases, pooled sensitivity was 43.8% (95% CI:29.9-57.7). Fleiss' kappa was 0.421 (95% CI:0.399-0.442, P<0.001), indicating fair-to-moderate agreement. Expert Barrett's endoscopists can reliably differentiate T1a/T1b oesophageal adenocarcinoma from HGD. Although there is fair-to-moderate agreement for T-staging, T1b disease cannot be reliably distinguished from T1a disease. This may have implications on clinical decision making and selection of endoscopic treatment methods.

Projective Psychological Tests from the Point of View of Neural Network Theory of Society

It is shown that the issues raised by the international expert community in the discussion regarding the legality of using projective techniques (in particular, tests such as the Luscher test, the Szondi test and the Dellinger test) can be resolved on the basis of an adequate interpretation of the concept of “archetype” and an analogy with neural networks. At the same time, the interpretation of the concept “archetype” is based on the neural network theory of society, which allows us to remove the difficulties that arise with the traditional interpretation of this concept. It is shown that there is an equivalent scheme for the testing procedure, in which the testing itself can be reduced to the functioning of the external (output) layer of the general neural network, which also includes a neural network formed by the human brain. This approach makes it possible to remove many of the criticisms put forward against the use of projective techniques (even declaring them pseudoscientific), but it implies a significant change in existing approaches to the interpretation of results obtained when using tests of the type in question. Namely, within the framework of the proposed approach, not every possible combination of images on which the test is built makes sense. Such a meaning can be given only to some of them, specifically to those that are most often encountered in experiments. Such combinations, which can be interpreted as basic, are interpreted on the basis of an analogy with images recognized by a neural network. The remaining combinations are treated as images containing errors; they are reduced to the basic ones based on an analogy with the methods used in constructing error-resistant codes.

International consensus definitions for infection-triggered encephalopathy syndromes.

To develop standardized diagnostic criteria for 'infection-triggered encephalopathy syndrome (ITES)' and five specific clinical syndromes of ITES. The draft definitions were based on existing criteria, standardized, and discussed by a panel of international experts using nominal group technique over 18 months to achieve consensus. All criteria use the same format: (1) presence of infection/fever; (2) clinical features including encephalopathy; (3) neuroradiological features on magnetic resonance imaging; (4) exclusion of other causes. We first highlighted differences between ITES and infectious and autoimmune encephalitis, which is the most important differential diagnosis. Consensus was achieved to define five specific ITESs: acute encephalopathy with biphasic seizures and late reduced diffusion; acute necrotizing encephalopathy; mild encephalopathy with a reversible splenial lesion; acute fulminant cerebral oedema; and acute shock with encephalopathy and multiorgan failure. Two further conditions that are currently classified as epilepsy syndromes but have similar features to ITES, namely febrile infection-related epilepsy syndrome and hemiconvulsion-hemiplegia-epilepsy syndrome, are also discussed. The consensus definition is expected to improve awareness of this disease concept, provide diagnostic framework, and facilitate future international research and clinical trials.

Infection prevention and control in 2030: a first qualitative survey by the Crystal Ball Initiative

BackgroundHealthcare delivery is undergoing radical changes that influence effective infection prevention and control (IPC). Futures research (short: Futures), the science of deliberating on multiple potential future states, is increasingly employed in many core societal fields. Futures might also be helpful in IPC to facilitate current education and organisational decisions. Hence, we conducted an initial survey as part of the IPC Crystal Ball Initiative.MethodsIn 2019, international IPC experts were invited to answer a 10-item online questionnaire, including demographics, housekeeping, and open-ended core questions (Q) on the “status of IPC in 2030” (Q1), “people in charge of IPC” (Q2), “necessary skills in IPC” (Q3), and “burning research questions” (Q4). The four core questions were submitted to a three-step inductive and deductive qualitative content analysis. A subsequent cross-case matrix produced overarching leitmotifs. Q1 statements were additionally coded for sentiment analysis (positive, neutral, or negative).ResultsOverall, 18 of 44 (41%) invited experts responded (from 11 countries; 12 physicians, four nurses, one manager, one microbiologist; all of them in senior positions). The emerging leitmotifs were “System integration”, “Beyond the hospital”, “Behaviour change and implementation”, “Automation and digitalisation”, and “Anticipated scientific progress and innovation”. The statements reflected an optimistic outlook in 66% of all codes of Q1.ConclusionsThe first exercise of the IPC Crystal Ball Initiative reflected an optimistic outlook on IPC in 2030, and participants envisioned leveraging technological and medical progress to increase IPC effectiveness, freeing IPC personnel from administrative tasks to be more present at the point of care and increasing IPC integration and expansion through the application of a broad range of skills. Enhancing participant immersion in future Crystal Ball Initiative exercises through simulation would likely further increase the authenticity and comprehensiveness of the envisioned futures.

Proposals for revised International Working Group–European LeukemiaNet criteria for anemia response in myelofibrosis

AbstractWith emerging new drugs in myelofibrosis (MF), a robust and harmonized framework for defining the severity of anemia and response to treatment will enhance clinical investigation and facilitate interstudy comparisons. Accordingly, the lead authors on the 2013 edition of the International Working Group–European LeukemiaNet (IWG-ELN) response criteria in MF were summoned to revise their document with the intent to (1) account for gender-specific differences in determining hemoglobin levels for eligibility criteria; (2) revise the definition of transfusion-dependent anemia (TDA) based on current restrictive transfusion practices; and (3) provide a structurally simple and easy to apply response criteria that are sensitive enough to detect efficacy signals (minor response) and also account for major responses. The initial draft of the 2024 IWG-ELN proposed criteria was subsequently circulated around a wider group of international experts and their feedback incorporated. The proposed articles include new definitions for TDA (≥3 units in the 12 weeks before study enrollment) and hemoglobin thresholds for eligibility criteria (<10 g/dL for women and <11 g/dL for men). The revised document also provides separate (TDA vs non-TDA) and graded (major vs minor response) response criteria while preserving the requirement for a 12-week period of screening and observation on treatment.

Strategi Pengembangan Bisnis Ekspor Bumbu Makanan Olahan dengan Menggunakan Analisis Business Model Canvas (BMC) dan SWOT pada CV Restu Mande

This research was conducted to determine the appropriate CV Restu Mande business strategy design using strengths, weaknesses, opportunities and threats (SWOT) analysis and the Business Model Canvas (BMC) in achieving export targets. The method used in this research is a descriptive qualitative method. Data collection carried out in this research was interviews with the leadership of CV Restu Mande, observation both directly and indirectly, and documentation. The SWOT analysis carried out in this research produces a SWOT matrix as a recommendation for CV Restu Mande's business strategy. The results of the SWOT analysis, SWOT matrix, and proposed new Business Model Canvas at CV Restu Mande are that in the customer segments section, target consumers are added in the form of Indonesian communities abroad, in the channels section, websites, international e-commerce and overseas retail need to be added, in the customer relationship section, rewards need to be added for resellers, dropshippers and loyal customers, in the key resources section we need to add production facilities, in the key activities section we need to add more interesting and detailed marketing activities, in the key partnership section we need to add agent collaboration. or distributors, loyal customers, production partners, and international trade consultants or experts, and in the cost structure section it is necessary to focus on investment in production facilities.

Prevalence rates for ectodermal dysplasia syndromes.

Ectodermal dysplasias (EDs) are a heterogeneous group of genetic conditions affecting the development and/or homeostasis of two or more ectodermal derivatives, including hair, teeth, nails, and certain glands. There are currently 49 recognized EDs with molecularly confirmed etiology. The EDs are very rare disorders, individually and in aggregate. Very little is published regarding the prevalence of these rare disorders. As a result of the genomics revolution, rare diseases have emerged as a global health priority. The various disabilities arising from rare disorders, as well as diagnostic and treatment uncertainty, have been demonstrated to have detrimental effects on the health, psychosocial, and economic aspects of families affected by rare disorders. Contemporary research methodologies and databases can address what have been historic challenges encountered when conducting research on rare diseases. In this study, we aim to ascertain period prevalence rates for several of the more common ectodermal dysplasia syndromes, by querying a large multicenter database of electronic health records, Oracle Real-World Data. For each of the included ectodermal dysplasia syndromes a clinical definition was developed by a committee of international experts with interests in EDs. The clinical definitions were based upon a combination of clinical features and designated by ICD-9 and ICD-10 codes. The January 2023 version of the Oracle Real-World Data database was queried for medical records that coincided with the clinical definitions. For our study, there were 64,523,460 individual medical records queried. Period prevalence rates were calculated for the following ED disorders: hypohidrotic ectodermal dysplasia, found to be 2.99 per 100,000; ectodermal dysplasia and immunodeficiency 1, 0.23 per 100,000; Clouston syndrome, 0.15 per 100,000; ectrodactyly ectodermal dysplasia and cleft lip/palate syndrome, 0.61 per 100,000; ankyloblepharon-ectodermal defects-cleft lip/palate syndrome, 0.36 per 100,000; focal dermal hypoplasia, 0.10 per 100,000; and incontinentia pigmenti, 0.88 per 100,000. This study established estimated period prevalence rates for several of the ectodermal dysplasia syndromes, and it demonstrated the feasibility of utilizing large multicenter databases of electronic health records, such as Oracle Real World Data.

Update on Genetic Counselor Practice and Recommendations for Pediatric Cancer Predisposition Evaluation and Surveillance.

In July 2023, the American Association for Cancer Research held the second Childhood Cancer Predisposition Workshop, at which international experts in pediatric cancer predisposition met to update the previously published 2017 consensus statements on pediatric cancer predisposition syndromes. Since 2017, advances in tumor and germline genetic testing and increased understanding of cancer predisposition in patients with pediatric cancer have led to significant changes in clinical care. Here, we provide an updated genetic counseling framework for pediatric oncology professionals. The framework includes referral indications and timing, somatic and germline genetic testing options, testing for adult-onset cancer predisposition syndromes in children with and without cancer, evolving genetic counseling models to meet the increased demand for genetic testing, barriers to cancer genetic testing and surveillance in children, and psychosocial and equity considerations regarding cancer genetic testing and surveillance in children. Adaptable genetic counseling services are needed to provide support to pediatric oncology provider teams and diverse patients with pediatric cancer, cancer predisposition, and their families.

Exploring strategies promoting interprofessional collaborative practice in spinal cord injury rehabilitation at a private South African hospital group

Background. Implementing an interprofessional collaborative practice (IPCP) in hospitals improves health outcomes, enhances patient safety and reduces length of stay by optimising resource utilisation. Although this approach was desired at a private hospital group in South Africa (SA), the specific strategies for clinical guidelines and capacity management pertaining to spinal cord injury (SCI) patients and the implementation of IPCP were unknown. Objective. To explore strategies for implementing clinical guidelines and capacity management for SCI rehabilitation to promote IPCP in a private hospital group in SA. Method. This exploratory descriptive qualitative study included participants who were selected through purposive sampling. The participants comprised 11 staff from various disciplines and management of the private hospital group, one local and one international expert in IPCP. Three online focus groups (n=13) were conducted, involving three to five participants. The transcriptions were analysed thematically using Braun and Clarke’s framework. Results. Interprofessional communication and tools as well as capacity development were three emergent themes from the data. Strategies pertaining to communication methods, digitisation, visual displays, patient care information, educational information and education of healthcare workers were suggested to promote IPCP. Conclusion. These findings from the emergent themes could assist in implementing and integrating an IPCP approach into the rehabilitation service. Further research assessing the efficacy of implementing the IPCP strategies and digital platform would be beneficial.

Early major fracture care in polytrauma-priorities in the context of concomitant injuries: A Delphi consensus process and systematic review.

The timing of major fracture care in polytrauma patients has a relevant impact on outcomes. Yet, standardized treatment strategies with respect to concomitant injuries are rare. This study aims to provide expert recommendations regarding the timing of major fracture care in the presence of concomitant injuries to the brain, thorax, abdomen, spine/spinal cord, and vasculature, as well as multiple fractures. This study used the Delphi method supported by a systematic review. The review was conducted in the Medline and EMBASE databases to identify relevant literature on the timing of fracture care for patients with the aforementioned injury patterns. Then, consensus statements were developed by 17 international multidisciplinary experts based on the available evidence. The statements underwent repeated adjustments in online- and in-person meetings and were finally voted on. An agreement of ≥75% was set as the threshold for consensus. The level of evidence of the identified publications was rated using the GRADE approach. A total of 12,476 publications were identified, and 73 were included. The majority of publications recommended early surgery (47/73). The threshold for early surgery was set within 24 hours in 45 publications. The expert panel developed 20 consensus statements and consensus >90% was achieved for all, with 15 reaching 100%. These statements define conditions and exceptions for early definitive fracture care in the presence of traumatic brain injury (n = 5), abdominal trauma (n = 4), thoracic trauma (n = 3), multiple extremity fractures (n = 3), spinal (cord) injuries (n = 3), and vascular injuries (n = 2). A total of 20 statements were developed on the timing of fracture fixation in patients with associated injuries. All statements agree that major fracture care should be initiated within 24 hours of admission and completed within that timeframe unless the clinical status or severe associated issues prevent the patient from going to the operating room. Systematic Review/Meta-Analysis; Level IV.

Validating and Updating GRASP: An Evidence-Based Framework for Grading and Assessment of Clinical Predictive Tools

BackgroundWhen selecting clinical predictive tools, clinicians are challenged with an overwhelming and ever-growing number, most of which have never been implemented or evaluated for effectiveness. The authors developed an evidence-based framework for grading and assessment of predictive tools (GRASP). The objective of this study is to refine, validate GRASP, and assess its reliability for consistent application. MethodsA mixed-methods study was conducted, involving an initial web-based survey for feedback from a wide group of international experts in clinical prediction to refine the GRASP framework, followed by reliability testing with two independent researchers assessing eight predictive tools. The survey involved 81 experts who rated agreement with the framework's criteria on a five-point Likert scale and provided qualitative feedback. The reliability of the GRASP framework was evaluated through interrater reliability testing using Spearman's rank correlation coefficient. ResultsThe survey yielded strong agreement of the experts with the framework's evaluation criteria, overall average score: 4.35/5, highlighting the importance of predictive performance, usability, potential effect, and post-implementation impact in grading clinical predictive tools. Qualitative feedback led to significant refinements, including detailed categorisation of evidence levels and clearer representation of evaluation criteria. Interrater reliability testing showed high agreement between researchers and authors (0.994) and among researchers (0.988), indicating strong consistency in tool grading. ConclusionThe GRASP framework provides a high-level, evidence-based, and comprehensive, yet simple and feasible, approach to evaluate, compare, and select the best clinical predictive tools, with strong expert agreement and high interrater reliability. It assists clinicians in selecting effective tools by grading them on the level of validation of predictive performance before implementation, usability and potential effect during planning for implementation, and post-implementation impact on healthcare processes and clinical outcomes. Future studies should focus on the framework's application in clinical settings and its impact on decision-making and guideline development.

Functioning and translation of English and Russian architectural terms in academic discourse

The study provides the analysis of architectural terminology in English and Russian in academic discourse. The object of the study is the terminological system of architecture. The subject of the study is the specifics of the use, functioning and translation of English and Russian architectural terminology in academic discourse. The classification and systematization of architectural terms, their hierarchical structure and functional types in academic texts are considered. In addition, the interdisciplinary nature of the architectural sublanguage is emphasized, which intersects with terms from the fields such as engineering, architecture, construction, art and design. The paper also identifies existing difficulties and problems that arise when translating English and Russian-language architectural terms, including differences in the linguistic structure of languages, semantic ambiguity, the need for a high degree of specialization of the translator for the correct interpretation of the term, the use of idiomatic and figurative language to describe some architectural terms, etc. The study uses a comprehensive methodology, in particular, methods of comparative and component analysis, as well as methods of corpus linguistics used to study semantic fields, hierarchical relationships and functional types of terms. The research results emphasize the importance of standardization of architectural terminology, understanding of cultural and historical background, as well as technical knowledge to ensure effective communication in the global architectural community. Analyzing the corpus of texts, including dictionaries, architectural reviews and academic articles, the author explains how specific terms function in academic discourse. This study makes a special contribution to the development of linguistic research in the field of architecture, offering an in-depth analysis of semantic fields and their role in structuring architectural vocabulary. The novelty of the research lies in an integrated approach to the study of the functioning and translation of architectural terms, which allows to identify the difficulties associated with the interdisciplinary character of the terminology. The results of the study will be useful not only for teachers and translators, but also for international experts in the field of architecture.

Development of a core outcome set for maternal and perinatal health research and surveillance in light of emerging and ongoing epidemic threats.

Maternal and perinatal health is often directly and indirectly affected during infectious disease epidemics. Yet, a lack of evidence on epidemics' impact on women and their offspring delays informed decision-making for healthcare providers, pregnant women, women in the post-pregnancy period and policy-makers. To rapidly generate evidence in these circumstances, we aim to develop a Core Outcome Set (COS) for maternal and perinatal health research and surveillance in light of emerging and ongoing epidemic threats. We will conduct a Systematic Review and a four-stage modified Delphi expert consensus. The systematic literature will aim to inform experts on outcomes reported in maternal and perinatal research and surveillance during previous epidemics. The expert consensus will involve two individual, anonymous online surveys to rate outcomes' importance and suggest new ones, one virtual meeting to discuss disagreements, and one in-person meeting to agree on the final COS, outcomes definitions and measurement methods. Four panels will be established to participate in the modified Delphi with expertise in (a) maternal and perinatal health, (b) neonatal health, (c) public health and emergency response, and (d) representation of civil society. We will recruit at least 20 international experts for each stakeholder group, with diverse backgrounds and gender, professional, and geographic balance. Only highly-rated outcomes (with at least 80% of ratings being 7-9 on a 9-point Likert scale) and no more than 10% of low ratings (1-3) will be included in the final COS. Implementing this COS in future maternal and perinatal research and surveillance, especially in the context of emerging and ongoing epidemic threats, will facilitate the rapid and systematic generation of evidence. It will also enhance the ability of policy-makers, healthcare providers, pregnant women and women in the post-pregnancy period and their families to make well-informed choices in challenging circumstances.