Present Guidelines Research Articles

Emergency Primary Ureteroscopy for Acute Ureteric Colic-From Guidelines to Practice.

To review the factors that may influence the ability to achieve the present guidelines' recommendations in a well-resourced tertiary centre. According to current National Institute for Health and Care Excellence (NICE) guidelines, definitive treatment (primary ureteroscopy (URS) or shock wave lithotripsy (ESWL)) should be offered to patients with symptomatic renal colic that are unlikely to pass the stone within 48 h of diagnosis. Retrospective review of all patients presenting to the emergency department between January and December 2019 with a ureteric or renal stone diagnosis. The rate of emergency intervention, risk factors for intervention and outcomes were compared between patients who were treated by primary definitive surgery vs. primary symptom relief by urethral stenting alone. A total of 244 patients required surgical management for symptomatic ureteric colic without symptoms of urinary infection. Of those, 92 patients (37.7%) underwent definitive treatment by either primary URS (82 patients) or ESWL (9 patients). The mean time for the procedure was 25.5 h (range: 1-118). Patients who underwent primary definitive treatment were likelier to have smaller and distally located stones than the primary stenting group. Primary ureteroscopy was more likely to be performed in a supervised setting than emergency stenting. Although definitive treatment carries high success rates, in a high-volume tertiary referral centre, it may not be feasible to offer it to all patients, with emergency stenting providing a safe and quick interim measure. Factors determining the ability to provide definitive treatment are stone location, stone size and resident supervision in theatre.

Actions aimed at reducing, reusing and recycling waste in the construction of buildings

Being responsible for the generation of more than 50% of urban solid waste poses incessant challenges to the construction industry. Commonly called rubble, civil construction waste (RCC) causes major environmental impacts when an order of priority of actions in forwarding the management of discarded materials is not observed. It is a situation that requires the application of practices that aim to reduce, reuse and recycle (3R's) the waste generated by civil construction at construction sites. This work aims to present good practice guidelines, through an action plan, for the reduction, reuse and recycling of RCC in construction sites. The methodology included a systematic review of scientific articles considering the indications of the PRISMA method (Preferred Reporting Items for Systematic reviews and Meta-Analyses). It also included a field research, with seven case studies, with five works located in the city of Recife and two works located in the city of Caruaru, both in the State of Pernambuco, in which we sought to investigate waste management in the works and the actions reduction, reuse and recycling carried out at construction sites. The results showed the identification of reduction actions applied to the management of services, materials and equipment used in the execution of works and good practices of reuse and recycling for the main construction materials, such as: concrete, wood, plastic, plaster and metal. The main contribution of this work was to identify and describe good practice guidelines for better management of civil construction waste in terms of the 3R's.
 
 KEYWORDS: Reduction. reuse. Recycling.

Joint EANM/SNMMI guideline on radiomics in nuclear medicine

PurposeThe purpose of this guideline is to provide comprehensive information on best practices for robust radiomics analyses for both hand-crafted and deep learning-based approaches.MethodsIn a cooperative effort between the EANM and SNMMI, we agreed upon current best practices and recommendations for relevant aspects of radiomics analyses, including study design, quality assurance, data collection, impact of acquisition and reconstruction, detection and segmentation, feature standardization and implementation, as well as appropriate modelling schemes, model evaluation, and interpretation. We also offer an outlook for future perspectives. ConclusionRadiomics is a very quickly evolving field of research. The present guideline focused on established findings as well as recommendations based on the state of the art. Though this guideline recognizes both hand-crafted and deep learning-based radiomics approaches, it primarily focuses on the former as this field is more mature. This guideline will be updated once more studies and results have contributed to improved consensus regarding the application of deep learning methods for radiomics. Although methodological recommendations in the present document are valid for most medical image modalities, we focus here on nuclear medicine, and specific recommendations when necessary are made for PET/CT, PET/MR, and quantitative SPECT.

Perceptions of Engineers' Environmental Responsibility and Professional Codes of Ethics

In Canada, provincial and territorial level Professional Engineering Codes of Ethics (PECoEs) derived from national guidelines presented by Engineers Canada, provide principles for engineers to aid in decision making and to evaluate the ethical correctness of professional behaviour [1]. Engineers Canada states that engineers must, “Hold paramount the safety, health and welfare of the public and the protection of the environment and promote health and safety within the workplace” [1]. This is frequently the only guideline directly related to the environment included in Canadian provincial and territorial PECoEs)[2-13]; Notably, Ontario’s PECoE currently does not explicitly mention the environment in any capacity [14]. Present professional engineering ethics guidelines for environmental responsibility are either missing or largely open to interpretation in Canada, and complex environmental issues may require more robust ethical frameworks to be effectively approached long-term within engineering industry.
 Developing PECoEs requires a better understanding of how engineers view their ethical responsibility with respect to the environment. This paper outlines a study to investigate the ethical beliefs and PECoE interpretations of participants through an online survey with ethical case studies, and interviews. The ultimate goal of this research is to aid the development of PECoEs and engineering ethics education to support sustainable practice.

Sustainable Livelihood: Guidelines for Human Capital Access of Goat Farmers in the Upper Northern Region of Thailand: A case study

This article aimed to explain and present guidelines for the human capital development of goat farmers in the upper northern region of Thailand. To analyze the whole point of development towards sustainability, there was a field visit to explore the basic information of the basic goat farming context. In-depth interviews and non-participant observations were used as tools for conducting the research using the narrative method, and the story of goat farmers who have a high experience in raising goats was analyzed and conveyed. The information was obtained from farmers of 3 cases (Information–Rich Case) in Chiang Mai, Lamphun, and Lampang provinces and examined in a triangular way from visiting the area, and the results of the study were analyzed, summarized, and described. The results of the study revealed that “Human Capital” is the most valuable factor in production among other factors of production because, in addition to acting as a mechanism for carrying out various activities, it is also a factor that must be developed for the development of sustainable practices. Sustainable livelihoods will be available in the future for farmers as well, but before human capital can be a quality factor, it has to be learned to acquire skills, experience, and what human beings have accumulated, forged, and merged. That is to say, the development of the human capital of goat farmers for sustainable livelihoods is the development of knowledge of specific professional skills that are applied to ensure the stability of the farmer sector along with continuous support from the government and academic departments.

보건의료종사자의 산업재해특성에 관한 연구: 체계적 문헌 고찰

Objective: The aim of this study is to investigate the characteristics of industrial accidents and improvement measures through systematic literature review, and to present guidelines for health care workers to work in a safer and healthier workplace based on the contents derived from the systematic literature review.BRBRBackground: Previous studies on the characteristics of occupational accidents in health care workers have consisted of musculoskeletal diseases, infections, chemical-induced occupational cancers, and skin diseases, but systematically organized studies are insufficient.BRBRMethod: The research was conducted on articles searched on June 29, 2021 in databases such as Pubmed, Web of Science, and ScienceDirect using the following search formula (

Anosmia: Brighton Collaboration case definition and guidelines for data collection, analysis, and presentation of immunization safety data

Anosmia: Brighton Collaboration case definition and guidelines for data collection, analysis, and presentation of immunization safety data

Anosmia: Brighton Collaboration case definition and guidelines for data collection, analysis, and presentation of immunization safety data (Manuscript draft)

Anosmia: Brighton Collaboration case definition and guidelines for data collection, analysis, and presentation of immunization safety data (Manuscript draft)

The emergence of smart service ecosystems—The role of socio‐technical antecedents and affordances

AbstractAs physical products are increasingly augmented with digital technology, manufacturing firms have become part of the development of so‐called smart products and smart services. As such, manufacturing firms are challenged by new market participants and ecosystem partners, particularly from the software development industry, and by the dynamic nature of business relationships. While the academic literature on the distinctive characteristics of ecosystems, particularly digital ecosystems, is rich, the effect of smart service ecosystems' emergence on the foundation of smart products remains uncertain. This study reports on case study research based on 47 semi‐structured interviews with four companies that participate in an industrial smart service ecosystem. Taking an affordance‐theoretic perspective, we uncover the antecedents of and the process of emergent smart service ecosystems. We find that smart service ecosystems have three socio‐technical antecedents: a shared worldview, structural flexibility and integrity, and architecture of participation. We explain the emergence of smart service ecosystems as the result of specialisation in shared affordances and integration of idiosyncratic affordances into collective affordances. We derive seven propositions regarding the emergence of smart services, outline opportunities for further research, and present practical guidelines for manufacturing firms.

Guidelines for the reliable use of high throughput sequencing technologies to detect plant pathogens and pests

High-throughput sequencing (HTS) technologies have the potential to become one of the most significant advances in molecular diagnostics. Their use by researchers to detect and characterize plant pathogens and pests has been growing steadily for more than a decade and they are now envisioned as a routine diagnostic test to be deployed by plant pest diagnostics laboratories. Nevertheless, HTS technologies and downstream bioinformatics analysis of the generated datasets represent a complex process including many steps whose reliability must be ensured. The aim of the present guidelines is to provide recommendations for researchers and diagnosticians aiming to reliably use HTS technologies to detect plant pathogens and pests. These guidelines are generic and do not depend on the sequencing technology or platform. They cover all the adoption processes of HTS technologies from test selection to test validation as well as their routine implementation. A special emphasis is given to key elements to be considered: undertaking a risk analysis, designing sample panels for validation, using proper controls, evaluating performance criteria, confirming and interpreting results. These guidelines cover any HTS test used for the detection and identification of any plant pest (viroid, virus, bacteria, phytoplasma, fungi and fungus-like protists, nematodes, arthropods, plants) from any type of matrix. Overall, their adoption by diagnosticians and researchers should greatly improve the reliability of pathogens and pest diagnostics and foster the use of HTS technologies in plant health.

Research and Design Considerations for Presentation of Non-Safety Related Information via In-Vehicle Displays during Automated Driving

As automated vehicles become more prevalent on roadways, it is necessary to study driver behaviors in interacting with such systems. With higher levels of vehicle automation, drivers may become less engaged with the roadway environment. As a result, how to effectively bring non-safety related information (e.g., guide and service sign content) to a driver’s attention is an open research question. In this review, we summarize current literature on three domains of research, including: (1) the design and effectiveness of traditional road signage, (2) human factors considerations in vehicle automation design, and (3) current design guidelines for in-vehicle information presentation. Based on the review, including empirical studies, we identify knowledge relevant to communicating road signage information in automated vehicles. We propose a framework highlighting various factors that could determine the effectiveness of in-vehicle messaging. The framework is intended to motivate future research on development of in-vehicle interfaces for highly automated driving.

Timing of cesarean delivery in women with uncomplicated placenta previa

Objective The optimal timing of an elective cesarean delivery for uncomplicated placenta previa remains controversial. Although the present guidelines recommend an elective cesarean delivery between 360/7 and 376/7 weeks of gestation, data supporting this recommendation does not differentiate in outcomes between elective and emergent delivery, or between women with and without ante-partum hemorrhage. Recommendations regarding optimal timing of delivery are based on the risks and benefits associated with delivery at a certain gestational week, compared with a reference of 38 weeks. Therefore, the aim of this paper was to assess the maternal and neonatal adverse outcomes associated with elective delivery at different gestational weeks from 360/7 to 386/7 weeks compared with expectant management in women with uncomplicated placenta previa. Methods A retrospective cohort study in a single tertiary medical center of 251 women with a diagnosis of uncomplicated placenta previa, who delivered between 360/7 and 386/7 weeks of gestation, who delivered at our center between Jan 2011 and Dec 2019. Maternal and neonatal outcomes at each gestational week were compared with expectant management. Results At 360/7–366/7 weeks, the rate of composite maternal adverse outcome was similar for elective delivery and expectant management (10.5% vs 7.7%, p = .68). Similarly, at 370/7–376/7 the rate of composite maternal adverse outcome was comparable for elective cesarean delivery and expectant management (7.2% vs 6.4%, p = .54). Maternal bleeding was the main indication of an urgent cesarean delivery, and account for 86% of urgent cesarean delivery at 360/7–366/7, 76.4% of urgent cesarean delivery at 370/7–376/7, and for 70.6% of all urgent cesarean delivery at 380/7–386/7 weeks. This group of women who were delivered due to maternal bleeding had a history of maternal bleeding during 2nd and/or 3rd trimester in 75–92.3% of cases. Composite adverse neonatal outcome was similar for elective cesarean delivery at each gestational age compared with expectant management. The risk for lower 5-min APGAR score and hypoglycemia was higher for newborns that were delivered electively a 36th weeks of gestation compared with expectant management. Conclusion Our study suggests that the optimal time of delivery for women with an uncomplicated placenta previa is between 380/7 and 386/7 weeks of gestation, especially in women without ante-partum bleeding.

Planning and Deploying Transit Signal Priority in Small and Medium-Sized Cities: Burlington, Vermont, Case Study

Innovations in traffic signal systems have generated a great deal of interest in the provision of preferential traffic signal strategies and treatments for transit buses and other vehicles at signalized intersections in cities of all sizes. The primary objective of this paper is three fold: 1) to synthesize the literature of the lessons learned associated with planning and deploying transit signal priority (TSP) strategies in small and medium-sized cities; 2) to demonstrate the application of a micro-simulation model, VISSIM, to assess transit priority impacts in small and medium-sized communities where the required VISSIM input data are often limited; and 3) to present guidelines to aid traffic engineers and transit planners who are considering TSP strategies in small and medium-sized cities. An underlying aim of this paper is to recognize the differences in transit priority planning and deployment in small and medium-sized cities as compared to major metropolitan areas.

How the different explanation classes impact trust calibration: The case of clinical decision support systems

Machine learning has made rapid advances in safety-critical applications, such as traffic control, finance, and healthcare. With the criticality of decisions they support and the potential consequences of following their recommendations, it also became critical to provide users with explanations to interpret machine learning models in general, and black-box models in particular. However, despite the agreement on explainability as a necessity, there is little evidence on how recent advances in eXplainable Artificial Intelligence literature (XAI) can be applied in collaborative decision-making tasks, i.e., human decision-maker and an AI system working together, to contribute to the process of trust calibration effectively. This research conducts an empirical study to evaluate four XAI classes for their impact on trust calibration. We take clinical decision support systems as a case study and adopt a within-subject design followed by semi-structured interviews. We gave participants clinical scenarios and XAI interfaces as a basis for decision-making and rating tasks. Our study involved 41 medical practitioners who use clinical decision support systems frequently. We found that users perceive the contribution of explanations to trust calibration differently according to the XAI class and to whether XAI interface design fits their job constraints and scope. We revealed additional requirements on how explanations shall be instantiated and designed to help a better trust calibration. Finally, we build on our findings and present guidelines for designing XAI interfaces.

Rehabilitation Guidelines for Use Following a Periacetabular Osteotomy (PAO): A North American Based Delphi Consensus.

BackgroundTreatment of acetabular dysplasia with a periacetabular osteotomy (PAO) has been shown to improve long term outcomes and is considered the gold standard in the setting of symptomatic hip dysplasia in patients younger than 35 years of age. Post-operative rehabilitation following a PAO plays an important role in helping patients return to their prior level of function and reduce the impact of strength deficits that may persist. Currently, there is a paucity of research supporting post-operative rehabilitation guidelines. The purpose of this study is to present expert-driven rehabilitation guidelines to reduce practice variation following a PAO.MethodsA panel of 16 physiotherapists from across the United States and Canada who were identified as experts in PAO rehabilitation by high-volume hip preservation surgeons participated in this Delphi study. Panelists were presented with 11 questions pertaining to rehabilitation guidelines following a PAO. Three iterative survey rounds were presented to the panelists based on responses to these questions. This three-step Delphi method was utilized to establish consensus on post-operative rehabilitation guidelines following a PAO.ResultsTotal (100%) participation was achieved for all three survey rounds. Consensus (>75%) was reached for 11/11 questions pertaining to the following areas: 1) weight-bearing and range of motion (ROM) precautions, 2) therapeutic exercise prescription including neuromuscular control, cardiovascular exercise, and flexibility, and 3) objective measures for return to straight line running and return to full participation in sports.ConclusionThis Delphi study established expert-driven rehabilitation guidelines for use following a PAO. The standardization of rehabilitative care following PAO is essential for achieving optimal outcomes despite other factors such as geographical location and socioeconomic status. Further research on patient-reported outcomes is necessary to confirm successful rehabilitation following the guidelines outlined in this study.

Considerations on efficient procedural steps for seismic capacity assessment and diagnostics of historic structural glass systems

Structural designers are nowadays supported by standards and guidelines to optimize the mechanical performance and safety level of glass load-bearing elements and assemblies in buildings. Key role is given to deformation and stress check, and post-breakage verification, for newly designed glass systems. Performance limits are provided also for extreme events, such as earthquakes. Besides, major risk for people could derive from existing/historic glass components and systems that have not been conceived to offer minimum structural capacity against operational loads and accidents. No technical recommendations are available to quantify their actual vulnerability and capacity, thus retrofits and mitigations are also hard to plan. In this paper, possible procedural methodology steps towards are addressed. The attention is given to present technical guidelines for structural design, on one side, and on the optimized use of non-destructive methods (like Operational Modal Analysis (OMA)) and numerical methods to facilitate diagnostic steps and the mechanical characterization of components, as well as to realistic description of boundaries and even damage. Practical examples are discussed for a case-study glass-steel envelope built in 60s in Italy, which is analyzed with the support of Finite Element (FE) numerical models against in-plane and out-of-plane seismic actions.

Clinical Practice Guidelines of the Russian Scientific Liver Society, Russian Gastroenterological Association, Russian Association of Endocrinologists, Russian Association of Gerontologists and Geriatricians and National Society for Preventive Cardiology on Diagnosis and Treatment of Non-Alcoholic Liver Disease

Aim:present clinical guidelines, aimed at general practitioners, gastroenterologists, cardiologists, endocrinologists, comprise up-to-date methods of diagnosis and treatment of non-alcoholic fatty liver disease.Key points.Nonalcoholic fatty liver disease, the most wide-spread chronic liver disease, is characterized by accumulation of fat by more than 5 % of hepatocytes and presented by two histological forms: steatosis and nonalcoholic steatohepatitis. Clinical guidelines provide current views on pathogenesis of nonalcoholic fatty liver disease as a multisystem disease, methods of invasive and noninvasive diagnosis of steatosis and liver fibrosis, principles of nondrug treatment and pharmacotherapy of nonalcoholic fatty liver disease and associated conditions. Complications of nonalcoholic fatty liver disease include aggravation of cardiometabolic risks, development of hepatocellular cancer, progression of liver fibrosis to cirrhotic stage.Conclusion.Progression of liver disease can be avoided, cardiometabolic risks can be reduced and patients' prognosis — improved by the timely recognition of diagnosis of nonalcoholic fatty liver disease and associated comorbidities and competent multidisciplinary management of these patients.

Interaction Gardens and Butterfly Catalogues: a Joint Strategy to Promote Capacity Development in Protected Areas and Reduce the Extinction of Experience in Cities

More than half of the world’s population live in cities. Increasing numbers of generations are now born and raised in urban landscapes with decreasing opportunities towards interacting with natural environments. This extinction of experience leads to environmental apathy and lack of bioliteracy, which is a central aspect to be tackled in conservation strategies. At the same time, people who live near or at non-urban settings are closer to natural habitats but do not have similar access to concepts of environmentalism and may lack incentives to lean towards nature conservation, instead of its exploitation or even illegal activities. We here propose that interaction gardens, that is, gardens with multiple trophic levels (primary producers, herbivores, predators, and parasitoids), can tackle these issues, especially if planned with incentives, such as butterfly catalogues, aimed as a common goal of the garden community. It can also bring benefits to human health and well-being, increase the survival chances of local biodiversity, and strengthen the front line of conservation by promoting income strategies to people who live near protected areas. Our specific aims are to 1) share a case study of capacity development at the Intervales State Park in the Atlantic Forest, Southeast Brazil; 2) present the butterfly catalogue of this protected area; 3) present guidelines for interaction gardens at both urban and non-urban settings; and 4) discuss alternative perspectives about Neotropical conservation. We provide a translated version of the text in Portuguese to encourage students, educators, NGOs and local communities of other protected areas to venture in our proposed joint strategy of interaction gardens with butterfly catalogues.

Changes in renal function in patients with chronic hepatitis C treated with sofosbuvir‐velpatasvir

AbstractDirect‐acting antivirals (DAAs) have become an effective first‐line treatment for chronic hepatitis C (CHC), and the fixed‐dose combination of sofosbuvir (SOF) and velpatasvir (VEL) is one of the most important pangenotypic DAA regimen according to present treatment guideline. The association between SOF‐based regimens and renal toxicity remains controversial. A total of 953 patients including 130 with estimated glomerular filtration rate (eGFR) ≤ 60 mL/min/1.73m2 and 823 with eGFR > 60 mL/min/1.73m2 receiving SOF/VEL therapy for 12 weeks were enrolled in this study. The eGFR was assessed at baseline, end of treatment (EOT), and 12 weeks after completion of the therapy (end of follow‐up, EOF). The eGFR in patients with eGFR ≤ 60 mL/min/1.73m2 increased from baseline (47.89 ± 10.25 mL/min/1.73m2) to EOT (51.65 ± 15.92; P < .001) and EOF (51.51 ± 14.46 mL/min/1.73m2; P < .05). The eGFR in patients with eGFR > 60 mL/min/1.73m2 at baseline (91.52 ± 22.06 mL/min/1.73m2) was lower at EOT (90.37 ± 22.3; P < .05), with no difference between EOT and EOF (P = .06). Multivariable analysis showed that a higher serum albumin level was associated with a lower risk of eGFR decrease at EOT, and the patients with baseline eGFR > 60 mL/min/1.73m2 were associated with a higher risk of eGFR decrease at EOF. The rates of sustained virologic response 12 weeks after treatment cessation (SVR12) were 99.2% in per‐protocol analysis, and the most common adverse events were fatigue (4.7%), abdominal discomfort (4.5%), and skin itching (3.7%). In conclusion, renal function improved after the SOF/VEL treatment in patients with CHC and chronic kidney disease. Thus, SOF/VEL was safe, effective, and tolerable in these patients.

Thrombosis and thromboembolism: Brighton collaboration case definition and guidelines for data collection, analysis, and presentation of immunization safety data

This is a Brighton Collaboration case definition of thrombosis and thromboembolism to be used in the evaluation of adverse events following immunization, and for epidemiologic studies for the assessment of background incidence or hypothesis testing. The case definition was developed by a group of experts convened by the Coalition for Epidemic Preparedness Innovations (CEPI) in the context of active development of SARS-CoV-2 vaccines. The case definition format of the Brighton Collaboration was followed to develop a consensus definition and defined levels of certainty, after an exhaustive review of the literature and expert consultation. The document underwent peer review by the Brighton Collaboration Network and by selected expert reviewers prior to submission.