Key Issues Research Articles

Can a consensus occur on a research case definition for ME/CFS?

ABSTRACT Introduction: Many controversies have emerged around developing a consensus on a research case definition for ME and ME/CFS. To determine if there might be a consensus among patients, healthcare workers, and researchers, a brief questionnaire was distributed to an international group of patients to assess key issues involving ME and ME/CFS case definitions. Method: Respondents were asked questions about core symptoms and other critical case definition issues. Results: Overall, post-exertional malaise, cognitive impairment, fatigue, and unrefreshing sleep were the most endorsed core symptoms with at least 80% consensus among participants. Considerable support occurred for the ME-ICC (Myalgic Encephalomyelitis-International Consensus Criteria) and the Canadian Consensus Criteria (CCC), whereas the Fukuda Criteria received the least support. Items rated as important for a research case definition included the severity of the illness, onset type, duration of illness, illness course, exclusions, and comorbidities. Conclusions: The implications of these findings for developing a consensus on research case definition criteria are discussed.

A Deformable Constraint Transport Network for Optimal Aortic Segmentation From CT Images.

Aortic segmentation from computed tomography (CT) is crucial for facilitating aortic intervention, as it enables clinicians to visualize aortic anatomy for diagnosis and measurement. However, aortic segmentation faces the challenge of variable geometry in space, as the geometric diversity of different diseases and the geometric transformations that occur between raw and measured images. Existing constraint-based methods can potentially solve the challenge, but they are hindered by two key issues: inaccurate definition of properties and inappropriate topology of transformation in space. In this paper, we propose a deformable constraint transport network (DCTN). The DCTN adaptively extracts aortic features to define intra-image constrained properties and guides topological implementation in space to constrain inter-image geometric transformation between raw and curved planar reformation (CPR) images. The DCTN contains a deformable attention extractor, a geometry-aware decoder and an optimal transport guider. The extractor generates variable patches that preserve semantic integrity and long-range dependency in long-sequence images. The decoder enhances the perception of geometric texture and semantic features, particularly for low-intensity aortic coarctation and false lumen, which removes background interference. The guider explores the geometric discrepancies between raw and CPR images, constructs probability distributions of discrepancies, and matches them with inter-image transformation to guide geometric topology in space. Experimental studies on 267 aortic subjects and four public datasets show the superiority of our DCTN over 23 methods. The results demonstrate DCTN's advantages in aortic segmentation for different types of aortic disease, for different aortic segments, and in the measurement of clinical indexes.

Study of Proton-Exchange Membrane Fuel Cell Degradation and its Counter Strategies: Flooding/drying, Cold Start and Carbon Monoxide Poisoning

In the context of advancing automotive fleet electrification dynamics, the development of hybrid electric vehicles (HEV) and electric vehicles (EV) serves as a pivotal strategy to mitigate CO2 emissions and promote decarbonization in the transportation sector. While Battery Electric Vehicles (BEV) are prevalent, Fuel Cell Electric Vehicles (FCEV) are gaining traction as a compelling alternative for heavy mobility, particularly Light Commercial Vehicles (LCV) and trucks were relying solely on batteries may not be feasible. Ensuring the efficiency of FCEVs necessitates a profound understanding and control of fuel cell operational conditions. However, concerns persist regarding fuel cell durability due to specific aging phenomena leading to performance decay after operational cycles. The objective of this study is to build a model to accurately characterize and control the fuel cell within a FCEV, by simulating its behavior during cycling and by dealing with common ageing issues like flooding, cold start, and carbon monoxide poisoning. The model described in this study allows not only to simulate the cathode, the anode, and the fuel cell membrane, but it also proposes strategies to handle the wa-ter management at the membrane, deal with cold starts, counter poisoning and, in the end, en-hance the fuel cell performance and lifespan.

Moratorium As a Crucial Component of Corporate Restructuring Under Saudi Bankruptcy Law

Abstract The moratorium or automatic stay is a fundamental component of corporate restructuring procedures. It provides the distressed company with a brief respite from its creditors by temporarily barring all collection efforts and all proceedings against the company and its assets. By temporarily barring such actions, the moratorium provides the company with time during which it can negotiate with its creditors and formulate a proper restructuring plan. The purpose of this article is to examine the efficacy of moratorium under the Saudi restructuring law in light of the UK and the US experiences. The article is principally concerned with two key issues: the scope of the moratorium and the circumstances under which relief from a moratorium may be granted.

Ten dos and don’ts of Character Strengths Research

AbstractWhile both practitioners and the public regard character strengths positively, some psychologists and philosophers harbor skepticism. In this analytical commentary on current research and literature, we trace such skepticism to a premature focus on positive outcomes, which eclipsed the theoretical groundwork outlined in the 2004 handbook. We propose solutions to ten key issues which, in our estimation, not only sustain this skepticism but also hinder meaningful advancement in the field of character strengths research: (1) Criteria evaluation, (2) Virtue functions, (3) Situational affordances, (4) Content validity, (5) Criterion validity, (6) Fulfillment conceptualization, (7) Adverse outcome modeling (8) Moral excellency, (9) Strengths conservatism, and (10) Methodological mainstream thinking. We contend that resolving these issues is necessary to uphold the standing of character strengths and positive psychology among its counterparts, and to establish a potent foundation for effective character development.

Standards for fecal microbiota transplant: Tools and therapeutic advances

Fecal microbiota transplantation (FMT) has been demonstrated to be efficacious in preventing recurrent Clostridioides difficile (C. difficile) infections, and is being investigated for treatment of several other diseases including inflammatory bowel disease, cancer, obesity, liver disease, and diabetes. To speed up the translation of FMT into clinical practice as a safe and standardized therapeutic intervention, additional evidence-based technical and regulatory guidance is needed. To this end in May of 2022, the International Alliance for Biological Standardization (IABS) and the BIOASTER Microbiology Technology Institute hosted a second webinar to discuss key issues still impeding the advancement and standardization of FMT. The goal of this two-day webinar was to provide a forum for scientific experts to share and discuss data and key challenges with one another. Discussion included a focus on the evaluation of safety, efficacy, clinical trial design, reproducibility and accuracy in obtained microbiome measurements and data reporting, and the potential for standardization across these areas. It also focused on increasing the application potential and visibility of FMT beyond treating C. difficile infections.

Long-term Kidney Transplant Survival Across the Globe.

The outcomes after kidney transplantation (KT), including access, wait time, and other issues around the globe, have been studied. However, issues do vary from one country to another. We obtained data from several countries from North America, South America, Europe, Asia, and Australia, including the number of patients awaiting KT from 2015, transplant rate per million population (pmp), proportion of living donor and deceased donor (LD/DD) KT, and posttransplant survival. We also sought opinions on key difficulties faced by each of these countries with respect to KT and long-term survival. Variation in access to KT across the globe was noted. Countries with the highest rates of KT pmp included the United States (79%) and Spain (71%). A higher proportion of LD transplants was noted in Japan (93%), India (85%), Singapore (63%), and South Korea (63%). A higher proportion of DD KTs was noted in Spain (90%), Brazil (90%), France (85%), Italy (85%), Finland (85%), Australia-New Zealand (80%), and the United States (77%). The 5-y graft survival for LD was highest in South Korea (95%), Singapore (94%), Italy (93%), Finland (93%), and Japan (93%), whereas for DD, it was South Korea (93%), Italy (88%), Japan (86%), and Singapore (86%). The common issues surrounding KTs are access and a limited number of LDs and DDs. Key issues identified for long-term survival were increasing age of donors and recipients, higher recipient comorbidity, and posttransplant events, such as alloimmune injury to the kidney, infection, cancer, and suboptimal adherence to therapy. A unified approach is necessary to improve issues surrounding KT as the demand continues to increase.

Analysis of Digital Teacher Education: Key Aspects for Bridging the Digital Divide and Improving the Teaching–Learning Process

The quality of teacher education plays a key role in equipping students with the skills they need and it is important in avoiding learning inequalities. To bridge the digital divide and ensure that all students have equal access to technology and digital resources as well as advanced teaching–learning processes using digital tools, it is crucial to analyse the current state of teacher education in order to identify the key issues. The sample in this research consisted of 325 master of education students and in-service teachers studying at various universities (in Spain, Cyprus, and México) in the 2022–2023 academic year who filled out a questionnaire partly based on DigComEdu and this was expanded with questions relating to other digital and educational aspects. The findings reveal that there is potential for enhancement in many areas. Despite teachers having technical training associated with their profession, they lack the necessary training to overcome inequalities or digital gaps. Moreover, it is striking that those who are already working as teachers are the most pessimistic about aspects such as the use of digital resources, perhaps because of the difficulties they face in their daily work.

Tell me a story: a framework for critically investigating AI language models

ABSTRACT Large language models are rapidly being rolled out into high-stakes fields like healthcare, law, and education. However, understanding of their design considerations, operational logics, and implicit biases remains limited. How might these black boxes be understood and unpacked? In this article, we lay out an accessible but critical framework for inquiry, a pedagogical tool with four dimensions. Tell me your story investigates the design and values of the AI model. Tell me my story explores the model’s affective warmth and its psychological impacts. Tell me our story probes the model’s particular understanding of the world based on past statistics and pattern-matching. Tell me ‘their’ story compares the model’s knowledge on dominant (e.g. Western) versus ‘peripheral’ (e.g. Indigenous) cultures, events, and issues. Each mode includes sample prompts and key issues to raise. The framework aims to enhance the public’s critical thinking and technical literacy around generative AI models.

Profiling teacher educators: ready to prepare the next generation for educational technology use?

ABSTRACT This study explores ICT profiles of teacher educators to understand personal, pedagogical and organisational factors affecting technology use in teacher education. After delineating latent profiles based on survey data, 12 teacher educators were interviewed on technology integration in educational settings for a deeper insight. Based on the Synthesis of Qualitative Research model developed to outline strategies for preparing preservice teachers to integrate technology, findings revealed key issues including teacher educators’ classroom stance as role models for effective technology use, importance of technological-pedagogical content knowledge in designing technology-enriched learning environments, peer collaboration and avoidance of using technology regardless of pedagogical concerns. Issues related to assessment, professional development, attitudes and ICT competency were raised. Findings are discussed considering potential consequences for current practices and areas of future research.

Texts, Politics and Identities: New Challenges on Iron Age Ethnicity. A Case from Northwest Iberia

This paper presents an approach to the study of European Iron Age ethnicity, a core topic for several decades which has begun to lose interest in the last years. A review of some of the uncertainties involved in the archaeology of ethnicity, focused on several key issues, is proposed. Moreover, some relevant topics that are usually undermined are suggested in order to address new challenges in the discipline: the introduction of political identity as a major focus of study, the reassessment of the etic perspective as an inner part of processes of collective differentiation, or the need for a holistic approach to join and combine different forms of expression. Finally, these approaches will be explored in a case study based on the northwest of the Iberian peninsula. This region has been chosen because of the feasibility of combining the results of different studies about social and political organizsation with relevant textual evidence to extract information about their ethnic dynamics.

Research Progress on Forest Eco-Product Value Realization and Eco-Industry: The Inspiration for Planted Forests in Karst Desertification Control

Karst desertification (KD) is a phenomenon in which the surface of the karst region presents a landscape similar to desertification, which restricts the social development of the karst region. How to develop values based on karst desertification control is the focus of current research, with the continuous promotion of karst desertification control (KDC). Planted forests for KDC are an important part of the value realization of ecological products (EPs) and ecological industry (EI) in karst areas. The statistical analysis of 265 relevant papers in this paper shows the following: (1) the literature focuses on EP and EI research; (2) the overall research shows a year-on-year growth trend. It includes three stages: budding (2001–2006), fluctuating growth (2007–2015) and rapid development (2016–2023), with 6, 58 and 211 articles published in each stage, respectively; (3) China is the country with the largest number of articles published, followed by the United States and then Canada, accounting for 47.74%, 11.93% and 6.17%. This paper summarizes the landmark results and key scientific issues to be solved in the study directions of EP supply capacity, EP value accounting, eco-products value realization (EPVR) and EI, taking into account the above results.

Visual Clue Guidance and Consistency Matching Framework for Multimodal Named Entity Recognition

The goal of multimodal named entity recognition (MNER) is to detect entity spans in given image–text pairs and classify them into corresponding entity types. Despite the success of existing works that leverage cross-modal attention mechanisms to integrate textual and visual representations, we observe three key issues. Firstly, models are prone to misguidance when fusing unrelated text and images. Secondly, most existing visual features are not enhanced or filtered. Finally, due to the independent encoding strategies employed for text and images, a noticeable semantic gap exists between them. To address these challenges, we propose a framework called visual clue guidance and consistency matching (GMF). To tackle the first issue, we introduce a visual clue guidance (VCG) module designed to hierarchically extract visual information from multiple scales. This information is utilized as an injectable visual clue guidance sequence to steer text representations for error-insensitive prediction decisions. Furthermore, by incorporating a cross-scale attention (CSA) module, we successfully mitigate interference across scales, enhancing the image’s capability to capture details. To address the third issue of semantic disparity between text and images, we employ a consistency matching (CM) module based on the idea of multimodal contrastive learning, facilitating the collaborative learning of multimodal data. To validate the effectiveness of our proposed framework, we conducted comprehensive experimental studies, including extensive comparative experiments, ablation studies, and case studies, on two widely used benchmark datasets, demonstrating the efficacy of the framework.

Transition to a weaker Sun: Changes in the solar atmosphere during the decay of the Modern Maximum

The Sun experienced a period of unprecedented activity during the 20th century, now called the Modern Maximum (MM). The decay of the MM after its maximum in cycle 19 has changed the Sun, the heliosphere, and the planetary environments in many ways. However, studies disagree on whether this decay has proceeded synchronously in different solar parameters or not. One of the related key issues is if the relation between two long parameters of solar activity, the sunspot number and the solar 10.7\,cm radio flux, has remained the same during this decay. A recent study argues that there is an inhomogeneity in the 10.7\,cm radio flux in 1980, which leads to a step-like jump ("1980 jump") in this relation. If true, this result would reduce the versatility of possible long-term studies of the Sun during the MM. Here we aim to show that the relation between sunspot number and 10.7\,cm radio flux does indeed vary in time, not due to an inhomogeneous radio flux but due to physical changes in the solar atmosphere. We used radio flux measurements made in Japan at four different wavelengths, and studied their long-term relation with the sunspot number and the 10.7\,cm radio flux during the decay of MM. We also used two other solar parameters, the MgII index and the number of solar active regions, in order to study the nature of the observed long-term changes in more detail. We find that the 1980 jump is only the first of a series of 1-2-year "humps" that mainly occur during solar maxima. All five radio fluxes depict an increasing trend with respect to the sunspot number from the 1970s to 2010s. These results exclude the interpretation of the 1980 jump as an inhomogeneity in the 10.7\,cm flux, and reestablish the 10.7\,cm flux as a homogeneous measure of solar activity. The fluxes of the longer radio waves are found to increase with respect to the shorter waves, which suggests a long-term change in the solar radio spectrum. We also find that the MgII index of solar UV irradiance and the number of active regions also increased with respect to the sunspot number, further verifying the difference in the long-term evolution in chromospheric and photospheric parameters. Our results provide evidence for important structural changes in solar magnetic fields and the solar atmosphere during the decay of the MM, which have not been reliably documented so far. We also emphasize that the changing relation between the different (e.g., photospheric and chromospheric) solar parameters should be taken into account when using the sunspot number or any single parameter in long-term studies of solar activity.

Navigating Cyber Diplomacy in the Governance of Emerging AI Technologies: Lessons from Transatlantic Cooperation

The rise of Artificial Intelligence (AI) technology presents vast transformative possibilities across various sectors, encompassing economic, industrial, social, political, intelligence, and military realms. Consequently, governing the development and deployment of AI has garnered significant attention not only from policymakers and decision-makers but also from the general public. Given AI's potential to shape state power and its dual strategic applications, the governance of AI has become an integral part of global discussions, falling under the purview of cyber diplomacy. This article delineates key issues surrounding AI governance, discusses the evolving role of the EU as a normative force in this arena, and underscores the importance of transatlantic collaboration amid broader global technological competitions.

Factors Affecting Private Sector Partnerships with Non-Governmental Organizations in Zambia: A Case Study of Musokotwane Compassion Mission Zambia

The objective of the study was to determine how NGO-private sector partnerships can be forged to raise resources and funding for their activities that supplement government efforts. Data was collected from a purposive sample of 83 staff. The study utilized a questionnaire with both closed-ended and open-ended questions for data collection from the respondents. The study adopted a mixed-methods approach. Correlation and regression analyses were used to establish the relationship among the variables of the study, and qualitative textual data was analyzed. The results of the study show that governance, transparency, political intervention, and decision-making processes are key determinants of partnership performance between the private sector and non-governmental organizations in Zambia. The study further established that lack of transparency in donor fund administration and management, corruption, poor governance, and decision-making hugely contribute to the poor performance and sustenance of these partnerships. The study recommends that NGOs should possess the highest professional and ethical standards and exercise responsible resource management to obtain funding from donors. It is also recommended that NGOs be as accountable and transparent as possible to establish confidence-driven partnerships with the private sector, as these are key issues affecting these partnerships.

Enhancing the Rights of Protection-Seeking Migrants through the Global Compact for Migration: The Case of EU Asylum Policy

Abstract This article argues that the Global Compact for Safe, Orderly and Regular Migration (GCM) is not only a breakthrough for a rights-based approach in international migration governance but also an asset to the international protection system. By way of example, three key issues of the European Union’s (EU) Common European Asylum System are discussed: access to protection, reception conditions, and detention. These examples illustrate that faithfully implementing the Migration Compact would require the EU and its Member States to make significant changes in their asylum policy. The parallel emergence of the Global Compact on Refugees (GCR) may suggest otherwise – namely, that the GCM is not relevant for refugees and other protection-seeking migrants. However, the legal construction that best serves the object and purpose of both documents is the assumption that the two Compacts have an overlapping scope of application. The GCM addresses specific protection needs of protection-seeking migrants who are not covered by the 1951 Refugee Convention, and it serves as an umbrella, strengthening the core human rights of migrants regardless of their status, including protection-seeking migrants. Hence, the GCM improves the international protection system as a whole and should be acknowledged as such.

URBAN PLANNING APPROACHES TO PLANNING THE BEAUTIFICATION SYSTEM OF RESIDENTIAL AREAS DURING THEIR RECONSTRUCTION

The analysis of planning experience of inhabited localities urban beautification in view of reconstruction was undertaken in the article. The question of Ukrainian experience of urban beautification system in accordance with approved standards and State Constructional Standards was envisaged. Analysis of validation state of local documents in urban beautification field was carried out and it has shown deficient percentage of regulatory documents approval on local level, which is one of key issues of urban beautification development. Furthermore, detailed analysis of foreign experience of urban beautification planning and development trend of this system I such countries, as USA, Canada, France, Singapore, Hong Kong, Japan was carried out. It is shown that first and critical stage of planning of effective urban beautification is preparing and approving corresponding certificates and standards. Emphasis added to functioning normative legal documents on issues relating to urban beautification, in accordance to which the territory reconstruction in mentioned countries is realized. It was established that reference direction of urban beautification development in mentioned countries lies in parking lots removing out of the borders of curtilage or underground parking arrangement, landscape gardening development and classification of such territories by levels of urban gardening, territory reconstruction in accordance with typical schemes of street infrastructure development, urban gardening, cycle paths, etc. It is shown that problem solution of habitable open grounds organization on city level resides in usage intensification of such territories, and on the level of residential compounds – in increasing exploitation properties of open grounds. As a result of undertaken analysis it was established that raised problem of increasing the effectiveness of residential area usage within residential areas imposes complex approach, including question of land development intensiveness, architectural and planning organization and open grounds beautification.

Feasibility and Design Factors for Home-Based Pulmonary Rehabilitation of Patients With Chronic Obstructive Pulmonary Disease and Chronic Lung Diseases Based on a People-Object-Environment Framework: Qualitative Interview Study.

The feasibility of implementing home-based pulmonary rehabilitation (PR) can be assessed from the perspectives of patients with chronic lung disease and health care professionals involved in PR. Through a qualitative inquiry using interviews and the adoption of the people-object-environment framework, this study aims to understand the influences of interpersonal, environmental, and situational factors on the perceptions and considerations of individuals involved in home-based PR for patients with chronic lung disease. One-on-one interviews were conducted with 20 patients with chronic lung disease and 20 health care professionals for investigating their attitudes and opinions based on their experiences regarding home-based PR as well as for identifying the key factors affecting the benefits and drawbacks of such therapies. This study further evaluates the feasibility of using digital tools for medical diagnosis and treatment by examining the technology usage of both parties. The 4 key issues that all participants were the most concerned about were as follows: distance to outpatient medical care, medical efficiency, internet connectivity and equipment, and physical space for diagnosis and treatment. Interviews with patients and health care professionals revealed that the use of technology and internet was perceived differently depending on age and area of residence. Most participants reported that digital tools and internet connectivity had many benefits but still could not solve all the problems; moreover, these same digital tools and network transmission could lead to problems such as information security and digital divide concerns. This study also emphasizes the significant impact of human behavior and thinking on shaping the design of health care interventions and technologies. Understanding user perspectives and experiences is crucial for developing effective solutions for unmet needs. The results of this study indicate that despite the different perspectives of patients and health care professionals, their considerations of the key issues are very similar. Therefore, the implementation of plans related to telemedicine diagnosis, treatment, or rehabilitation should take the suggestions and considerations of both parties into account as crucial factors for telehealth care design.

Delivering Patient Education in Healthcare Organizations: An Integrative Review of the Nursing Administrative Actions

Aim. To analyze the literature on nursing administrative actions related to patient education to inform healthcare organizations for the development of patient education and identify the knowledge gaps for future research. Background. Patient education is a patient’s right, yet numerous organizational factors can hinder the effective delivery of patient education. Nursing administrative actions can mediate these factors, but little is known about nursing administration in patient education. Evaluation. A systematic integrative review was conducted in October 2022 on five databases (CINAHL (Ebsco), PubMed, Web of Science, ABI/Inform, and Business Source Complete). No time limitations were set. Empirical research articles reporting nursing administrative actions related to educational actions as a main topic were screened and evaluated. The data analysis was based on a constant comparison method. Key Issues. There were 3,110 studies identified, of which five quantitative and four qualitative studies were included. Three main themes were generated from the data describing nursing administrative actions related to patient education: (1) strengthen the commitment to patient education, (2) ensure the necessary resources for patient education, and (3) enhance patient education policies. Conclusion. This review provides insights into nursing administration in patient education, focusing on commitment, resources, and policies. It not only highlights the critical role of nurse administrators but also calls for further research to assess the impact of these actions. Implications for Nursing Management. The findings of this review will be useful for nurse administrators by providing knowledge about nursing administrative actions in patient education and underlining the need for them to pay more attention to it. The implications for nursing management also include supporting further research in the field.