Top Research Priorities Research Articles

Research activity amongst DCM research priorities

IntroductionDegenerative cervical myelopathy (DCM) is a progressive neurodegenerative disorder. DCM is common (estimated prevalence, 2% of adults) and significantly impacts quality of life. The AO Spine RECODE-DCM (Research Objectives and Common Data Elements in DCM) project has recently established the top research priorities for DCM. This article examines the extent to which existing research activity aligns with the established research priorities.MethodsA systematic review of MEDLINE and Embase for “Cervical” AND “Myelopathy” was conducted following PRISMA guidelines. Full-text papers in English, exclusively studying DCM, published between January 1, 1995 and August 08, 2020 were considered eligible. Extracted data for each study included authors, journal, year of publication, location, sample size and study design. Each study was then analysed for alignment to the established research priorities.ResultsIn total, 2261 papers with a total of 1,323,979 patients were included. Japan published more papers (625) than any other country. Moreover, 2005 (89%) of 2261 papers were aligned to at least one research priority. The alignment of papers to the different research priorities was unequal, with 1060 papers on the most researched priority alone (#15, predictors of outcome after treatment), but only 64 total papers on the least-researched 10 priorities. The comparative growth of research in the different priorities was also unequal, with some priorities growing and others plateauing over the past 5 years.DiscussionResearch activity in DCM continues to grow, and the focus of this research remains on surgery. The established research priorities therefore represent a new direction for the field.

Research priorities in maternal and neonatal health in Africa: results using the Child Health and Nutrition Research Initiative method involving over 900 experts across the continent.

Background: Africa will miss the maternal and neonatal health (MNH) Sustainable Development Goals (SDGs) targets if the current trajectory is followed. The African Academy of Sciences has formed an expert maternal and newborn health group to discuss actions to improve MNH SDG targets. The team, among other recommendations, chose to implement an MNH research prioritization exercise for Africa covering four grand challenge areas. Methods:The team used the Child Health and Nutrition Research Initiative (CHNRI) research prioritization method to identify research priorities in maternal andnewbornhealth in Africa. From 609 research options, a ranking of the top 46 research questions was achieved. Research priority scores and agreement statistics were calculated, with sub-analysis possible for the regions of East Africa, West Africa and those living out of the continent. Results: The top research priorities generally fell into (i) improving identification of high-risk mothers and newborns, or diagnosis of high-risk conditions in mothers and newborns to improve health outcomes; (ii) improving access to treatment through improving incentives to attract and retain skilled health workers in remote, rural areas, improving emergency transport, and assessing health systems' readiness; and (iii) improving uptake of proven existing interventions such as Kangaroo Mother Care. Conclusions: The research priorities emphasized building interventions that improved access to quality healthcare in the lowest possible units of the provision of MNH interventions. The lists prioritized participation of communities in delivering MNH interventions. The current burden of disease from MNCH in Africa aligns well with the list of priorities listed from this exercise but provides extra insights into current needs by African practitioners. The MNCH Africa expert group believes that the recommendations from this work should be implemented by multisectoral teams as soon as possible to provide adequate lead time for results of the succeeding programmes to be seen before 2030.

Climate-Mediated Changes to Linked Terrestrial and Marine Ecosystems across the Northeast Pacific Coastal Temperate Rainforest Margin

ABSTRACTCoastal margins are important areas of materials flux that link terrestrial and marine ecosystems. Consequently, climate-mediated changes to coastal terrestrial ecosystems and hydrologic regimes have high potential to influence nearshore ocean chemistry and food web dynamics. Research from tightly coupled, high-flux coastal ecosystems can advance understanding of terrestrial–marine links and climate sensitivities more generally. In the present article, we use the northeast Pacific coastal temperate rainforest as a model system to evaluate such links. We focus on key above- and belowground production and hydrological transport processes that control the land-to-ocean flow of materials and their influence on nearshore marine ecosystems. We evaluate how these connections may be altered by global climate change and we identify knowledge gaps in our understanding of the source, transport, and fate of terrestrial materials along this coastal margin. Finally, we propose five priority research themes in this region that are relevant for understanding coastal ecosystem links more broadly.

Systematic Development of a Patient-centered Outcomes Measure to Assess the Psychosocial Impact of Food Allergy in Routine Clinical Practice

A recently conducted patient-centered outcomes study identified assessment and treatment of food allergy (FA)-related psychosocial issues a top research priority. Most currently available instruments are designed for use in research settings and focus primarily on FA-related quality of life. Our team sought to systematically develop a measure of FA psychosocial impact on caregivers that is sensitive to change with treatment.

Designing the GALAXY study: Partnering with the cystic fibrosis community to optimize assessment of gastrointestinal symptoms

BackgroundGastrointestinal (GI) involvement among persons with cystic fibrosis (CF) is highly prevalent, representing a significant source of morbidity. Persons with CF have identified GI concerns as a top research priority, yet universal clinical outcome measures capturing many of the GI symptoms experienced in CF are lacking. The GALAXY study was envisioned to address this unmet need. MethodsThe GALAXY study team partnered with Community Voice, a community of patients with CF and their caregivers, to identify the patient reported outcome measures that most accurately reflected their experience with GI symptoms in CF. We also surveyed CF care teams to identify the comfort level of various team members (providers, nurses and dieticians) in managing a variety of GI conditions. ResultsMembers of Community Voice identified the combination of PAC-SYM, PAGI-SYM, PAC-QOL and the Bristol Stool scale with three additional symptom-specific questions as patient-reported outcome measures that comprehensively captured the CF experience with GI disease. CF care team providers reported a high level of comfort in treating GI conditions including constipation (92%), GERD (93%), and gassiness (77%), however comfort level was limited to only first-line interventions. ConclusionBy partnering with persons with CF as well as their caregivers and medical providers, the GALAXY study is designed to uniquely capture the prevalence and severity of GI involvement among persons with CF in a manner that reflects the CF patient experience. The results of GALAXY will inform the development of future interventional trials and serve as a reproducible and objective study endpoint.

Establishing key research questions for the implementation of artificial intelligence in colonoscopy: a modified Delphi method.

Background Artificial intelligence (AI) research in colonoscopy is progressing rapidly but widespread clinical implementation is not yet a reality. We aimed to identify the top implementation research priorities. Methods An established modified Delphi approach for research priority setting was used. Fifteen international experts, including endoscopists and translational computer scientists/engineers, from nine countries participated in an online survey over 9 months. Questions related to AI implementation in colonoscopy were generated as a long-list in the first round, and then scored in two subsequent rounds to identify the top 10 research questions. Results The top 10 ranked questions were categorized into five themes. Theme 1: clinical trial design/end points (4 questions), related to optimum trial designs for polyp detection and characterization, determining the optimal end points for evaluation of AI, and demonstrating impact on interval cancer rates. Theme 2: technological developments (3 questions), including improving detection of more challenging and advanced lesions, reduction of false-positive rates, and minimizing latency. Theme 3: clinical adoption/integration (1 question), concerning the effective combination of detection and characterization into one workflow. Theme 4: data access/annotation (1 question), concerning more efficient or automated data annotation methods to reduce the burden on human experts. Theme 5: regulatory approval (1 question), related to making regulatory approval processes more efficient. Conclusions This is the first reported international research priority setting exercise for AI in colonoscopy. The study findings should be used as a framework to guide future research with key stakeholders to accelerate the clinical implementation of AI in endoscopy.

In the Eye of the Beholder: A Comprehensive Analysis of Stimulus Type, Perceiver, and Target in Physical Attractiveness Perceptions

Physical attractiveness plays a central role in psychosocial experiences. One of the top research priorities has been to identify factors affecting perceptions of physical attractiveness (PPA). Recent work suggests PPA derives from different sources (e.g., target, perceiver, stimulus type). Although smiles in particular are believed to enhance PPA, support has been surprisingly limited. This study comprehensively examines the effect of smiles on PPA and, more broadly, evaluates the roles of target, perceiver, and stimulus type in PPA variation. Perceivers (n = 181) rated both static images and 5-s videos of targets displaying smiling and neutral-expressions. Smiling images were rated as more attractive than neutral-expression images (regardless of stimulus motion format). Interestingly, perceptions of physical attractiveness were based more on the perceiver than on either the target or format in which the target was presented. Results clarify the effect of smiles, and highlight the significant role of the perceiver, in PPA.

Optical Spectrometer With a Pulse-to-Pulse Resolution for Terahertz and mm-Wave Signals

The development of ultracompact particle accelerators and accelerator-based high-power THz generators are some of the top priorities for research and development programs around the world. These tools require the development of accelerating structures, operating in the mm-Wave and THz range, where diagnostics are not available or are insufficient. This article presents the design of a pulse-to-pulse THz spectrometer, primarily developed for diagnostics of accelerating structures and THz radiation sources. In particular, this spectrometer can be used to detect RF pulse shortening caused by vacuum breakdown and beam misalignment in THz accelerators, as well as for bunch length monitoring and radiation source diagnostics. The spectrometer is based on a diffraction grating and is capable of covering a frequency range where RF-based breakdown measurements are not possible. We have built and tested the first prototype with different sources in a frequency range of 0.1–1.0 THz. In this article, we present the physical design, supported numerical simulations, electronics development, and test results.

P209 Key priorities in mental health research: results of a community and provider survey across the US

Objectives: Integrating mental health screening and treatment into cystic fibrosis (CF) centres has led to numerous successes: increased awareness, reduced stigma and greater access to mental health care (Quittner et al., 2020). Given that anxiety and depression screening are now part of routine care, the major aim was to identify the most important, future research priorities in mental health. Method: A 22-item online survey was sent out July 2020 to people with CF (pwCF), caregivers, and US providers in the CF community, who were given 3 weeks to respond. Questions focused on: ranking topics by importance and impact, identifying gaps in our understanding of mental health issues, and priorities and needs during COVID-19. Results: Response time was 7–11 minutes, with 693 community respondents (half pwCF, majority ages 26–45 years) and 352 CF clinicians (mainly social workers, center directors). Substantial agreement was found between community respondents and providers on the top 5 priorities:1) anxiety, 2) depression, 3) effects of psychological symptoms on physical health, 4) risk factors for anxiety/depression, and 5) effects on family functioning and parenting. Although ranked highly, differences emerged for substance misuse and disordered eating, with higher rankings endorsed by providers than community respondents. Priorities for improving outcomes were also similar: 1) greater access to mental health providers and 2) improving mental health interventions. Conclusion: A large-scale survey of CF community members and providers revealed clear consensus on the top research priorities. In addition to increased understanding of anxiety and depression (e.g., risk factors, long-term effects), new topics emerged, including substance misuse, disordered eating, and interactions between medications and mental health (e.g., modulators). Acknowledgement: Cystic Fibrosis Foundation

Mapping the evolution and current trends in climate change adaptation science

Research on climate change adaptation has increased in number and significance since the 1970s. Yet, the volume of information on adaptation is now difficult to manage given its vast scope and spread across journals, institutions, disciplines and themes. While an increasing number of researchers have used systematic literature reviews to analyse particular themes within this rapidly growing field of research, there is still missing an overall analysis of the current state of climate change adaptation science literature and its evolution. This paper fills this gap by providing a multifaceted bibliometric review of climate change adaptation science literature that is focused on the human dimensions and how it has been constructed across time, disciplines, social relationships and geographies. Our novel review, spanning from 1978 to mid-2020, identifies the underpinning foundations of climate change adaptation literature, leading authors, countries and organisations as well as dominant research themes and priorities and explores how these have changed over time. Our results show an annual average increase of 28.5% in climate change adaptation publications, with over 26,000 authors publishing on this topic, and increasing diversity in publishing sources. Priority research topics and themes have been dynamic over time, while some core concepts (vulnerability, resilience, adaptive capacity) and sectors (water, agriculture) have remained relatively stable. The key challenge going forward is how to consolidate this vast research endeavour into a more coherent adaptation theory that in turn can better guide science of adaptation and support adaptation policy and practice (science for adaptation).

Optimization model for perishable products with time-base demand,stand on Pareto boundary and uncertainty

Optimizing the perishable food, supply chain, taking into account all aspects, such as location, time, inventory control and routing, has become one of the top research priorities in today's competitive market. The primary objective is to reduce the overallcost, and the second one is to diminish the probability of warehouses failing to maintain the product (storage waste), which in turn, maximizes product quality.In this research, the issue of integrated supply chainplanning has been investigated in which it is assumed that there is a central warehouse for food distribution. The model developed in the present study considers two contradictory objectives for supply chainoptimization.In this research, foods are classified into three categories with the rate of deterioration common, high and very high. The concept of Pareto boundary and a set of optimal responses have been used. Demand is defined as uncertain and dependent on two factors, the demand for the prior period and the remaining time until the expiration of the products. The research problem is solved with both NSGA-II and NRGA algorithms whose parameters of these two algorithms are optimized by the Taguchi method. The two efficient boundaries are created by the four criteria MID, DM, SM and NOS. Finally, concluded that the efficiency of the NSGA-II method in solving the research problem and forming an effective boundary is higher than the NRGA method.

One hundred research questions in conservation physiology for generating actionable evidence to inform conservation policy and practice.

Environmental change and biodiversity loss are but two of the complex challenges facing conservation practitioners and policy makers. Relevant and robust scientific knowledge is critical for providing decision-makers with the actionable evidence needed to inform conservation decisions. In the Anthropocene, science that leads to meaningful improvements in biodiversity conservation, restoration and management is desperately needed. Conservation Physiology has emerged as a discipline that is well-positioned to identify the mechanisms underpinning population declines, predict responses to environmental change and test different in situ and ex situ conservation interventions for diverse taxa and ecosystems. Here we present a consensus list of 10 priority research themes. Within each theme we identify specific research questions (100 in total), answers to which will address conservation problems and should improve the management of biological resources. The themes frame a set of research questions related to the following: (i) adaptation and phenotypic plasticity; (ii) human–induced environmental change; (iii) human–wildlife interactions; (iv) invasive species; (v) methods, biomarkers and monitoring; (vi) policy, engagement and communication; (vii) pollution; (viii) restoration actions; (ix) threatened species; and (x) urban systems. The themes and questions will hopefully guide and inspire researchers while also helping to demonstrate to practitioners and policy makers the many ways in which physiology can help to support their decisions.

An International Delphi Survey on Exercise Priorities in CKD

IntroductionDefining the role of exercise in chronic kidney disease (CKD) is a top research priority for people with CKD. We aimed to achieve consensus on specific research priorities in exercise and CKD among an international panel of stakeholders.MethodsUsing the Delphi method, patients/caregivers, researchers, clinicians, and policymakers submitted their top research priorities in round 1 and ranked their importance in rounds 2 and 3 using a 9-point Likert scale. The mean, median, and proportion of scores ranked 7 to 9 were calculated. Consensus was defined as priorities that scored above the overall mean and median score within each stakeholder panel. Qualitative description was used to understand participants’ rankings.ResultsSeventy participants (78% response) completed round 1: 15 (21.4%) clinicians, 33 (47.1%) researchers, 13 (18.6%) policymakers, and 9 (12.9%) patients; (85.7%) completed round 3. The top research priorities were defining exercise-related outcomes meaningful to patients, identifying patients’ motivation and perspective towards exercise, understanding the effect of exercise on the risk of institutionalization, mortality, and mobility, and understanding the effect of pre- and post-transplant exercise on postoperative recovery. Themes from the qualitative analysis were individualization, personal experience, and holistic approach to exercise (patients), the need to address common clinical problems (clinicians), developing targeted interventions (researchers), and the importance of evidence-based development versus implementation (policymakers).ConclusionsPreventing physical disability was a common priority. Policymakers emphasized that more efficacy studies were needed. Other panels expressed the need for holistic and targeted exercise interventions and for outcomes that address common clinical problems.

Research Priorities for mHealth and Innovative Strategies in Sexual and Reproductive Health and Rights in the WHO Africa Region

Background: The use of mobile phones continues to rise rapidly in the provision of health related services. Many countries have adopted the use of mobiles to provide sexual and reproductive health and rights and especially among the adolescents where specific messages are tailored for various audiences with specific messages. The purpose of this paper is to present the results of a research priority setting exercise on mHealth and innovative strategies. Methods: We adapted Child Health and Nutrition Research Initiative methodology to identify and set research priorities on mHealth and innovative strategies that respond to sexual and reproductive health and rights services. General potential research questions were gathered online from multiple stakeholders in the region and sent for consolidation consolidated to technical experts in World Health Organization headquarters. The second phase involved a meeting with experts to review and thematically analyze the questions list of 33 questions producing a list of 22 research questions. The questions were scored against a six point criteria and ranked accordingly. Ten top priority research questions were identified. Results: Lists of 33 priority research questions for mHealth and innovative strategies were proposed for discussions by 67 stakeholders. The questions were reviewed, scored and ranked in a technical meeting by experts. The highest ranking questions at 87% include evaluation of mHealth for data management and sexual and reproductive health and rights decision making, assessment of innovative local financing techniques to support community based sexual reproductive health and rights and evaluation of the role of mobile technologies in referral and counter referral. Conclusions: Information and communication technology is developing drastically and has a great potential in improving health especially in sexual and reproductive health and rights service delivery. This potential must be demonstrated with more relevant and quality research on mHealth and innovative strategies priorities identified.

Identifying research priorities for improving patient care in the perioperative environment: A descriptive cross-sectional study

Aim The aim of this study was to categorise priority research topics in perioperative nursing. Methods A descriptive cross-sectional study design was used to identify research priorities in perioperative nursing. Sample and setting Members of the Australian College of Perioperative Nurses College were invited to participate in a survey, via email through the Australian College of Perioperative Nurses membership database. Results Three priority research topics were identified in this study, including patient safety, management of risk in the operating room and culture of the perioperative environment. With regards to staff well being, bullying and disruptive behaviour were rated as being important and relevant. Topics such as noise in the operating room, instrument tracking and obesity among perioperative nurses, while rated lower in the relevant and importance categories, have identified opportunities for perioperative nurses to undertake research in order to address these issues and improve patient safety and well being of healthcare professionals. Conclusion This study has identified issues that relate to patient and staff safety with many linked to the negative culture of the setting. While a number of barriers prevent the application of best practice standards in the operating suite it is clear that building research capacity is important, not only to demonstrate the positive impact of perioperative nursing on patient outcomes, but also to strengthen the evidence base of the standards and this professional group.

How do Planktonic Particle Collection Methods Affect Bacterial Diversity Estimates and Community Composition in Oligo-, Meso- and Eutrophic Lakes?

Particles are hotspots of bacterial growth and nutrient recycling in aquatic ecosystems. In the study of particle-attached (PA) and/or free-living (FL) microbial assemblages, the first step is to separate particles from their surrounding water columns. Widely used collection techniques are filtration using different pore size filters, and centrifugation; however, it is unclear how the bacterial diversity, bacterial community structure (BCS) and taxonomic composition of PA assemblages are affected by different particle collection methods. To address this knowledge gap, we collected planktonic particles from eutrophic Lake Taihu, mesotrophic Lake Tianmu, and oligotrophic Lake Fuxian in China, using filtration with five pore size of filters (20, 10, 8.0, 5.0, and 3.0 μm), and centrifugation. Bacterial communities were then analyzed using Illumina MiSeq sequencing of the 16S rRNA gene. We found that PA collection method affected BCS significantly in all lakes. Centrifugation yielded the highest species diversity and lowest mean percentage of photoautotrophic Cyanobacteria in Lake Taihu, but not in the other two lakes, thus highlighting the potential compatibility of this method in the study of PA assemblage in eutrophic lakes. The high bacterial diversity and low relative percentage of Cyanobacteria was in samples retained on 5.0 μm filters in all lakes. These results suggest that collecting PA samples in lakes using filters with 5.0 μm pore size is the preferred protocol, if species diversity and heterotrophic bacteria are the top research priorities, when comparing bacterial communities in different trophic lakes at the same time. The present study offers the possibility of collecting PA samples using unified methods in oligotrophic to eutrophic lakes.

Setting global research priorities for private sector child health service delivery: Results from a CHNRI exercise.

BackgroundThe private health sector is an important source of sick child care, yet evidence gaps persist in best practices for integrated management of private sector child health services. Further, there is no prioritized research agenda to address these gaps. We used a Child Health and Nutrition Research Initiative (CHNRI) process to identify priority research questions in response to these evidence gaps. CHNRI is a consultative approach that entails prioritizing research questions by evaluating them against standardized criteria.MethodsWe engaged geographically and occupationally diverse experts in the private health sector and child health. Eighty-nine experts agreed to participate and provided 150 priority research questions. We consolidated submitted questions to reduce duplication into a final list of 50. We asked participants to complete an online survey to rank each question against 11 pre-determined criteria in four categories: (i) answerability, (ii) research feasibility, (iii) sustainability/equity, and (iv) importance/potential impact. Statistical data analysis was conducted in SAS 9.4 (SAS Institute Inc, Cary NC, USA). We weighted all 11 evaluation criteria equally to calculate the research priority score and average expert agreement for each question. We disaggregated results by location in high-income vs low- and middle-income countries.ResultsForty-nine participants (55.1%) completed the online survey, including 33 high-income and 16 low- and middle-income country respondents. The top, prioritized research question asks whether accreditation or regulation of private clinical and non-clinical sources of care would improve integrated management of childhood illness services. Four of the top ten research priorities were related to adherence to case management protocols. Other top research priorities were related to training and supportive supervision, digital health, and infant and newborn care. Research priorities among high-income and low- and middle-income country respondents were highly correlated.ConclusionTo our knowledge, this is the first systematic exercise conducted to define research priorities for the management of childhood illness in the private sector. The research priorities put forth in this CHNRI exercise aim to stimulate interest from policy makers, program managers, researchers, and donors to respond to and help close evidence gaps hindering the acceleration of reductions in child mortality through private sector approaches.

What are the Top Research Priorities in Surgical Simulation and How Can They Be Best Addressed? Results From a Multidisciplinary Consensus Conference.

To define the top priorities in simulation-based surgical education where additional research would have the highest potential to advance the field and develop proposals that would address the identified research priorities. Simulation has become integral part of surgical training but there are a number of outstanding questions that have slowed advances in this field. The Delphi methodology was used to define the top priorities in simulation-based surgical education. A research summit was held with multiple stakeholders under the auspices of the American College of Surgeons Division of Education to develop proposals to address these priorities. Consensus was achieved after the first round of voting on the following 3 most important topics: (1) impact of simulation training on patient safety and outcomes, (2) the value proposition of simulation, and (3) the use of simulation for physician certification and credentialing. Knowledge gaps, challenges and opportunities, and research questions to address these topics were defined by summit participants. The top 3 priorities in surgical simulation research were defined and project outlines were developed for impactful projects on these topics. Successful completion of such projects is expected to advance the field of simulation-based surgical education.

Aerosol Retention Barriers.

Aerosol Retention Barriers.

Defining a humanitarian shelter and settlements research agenda

Despite the knowledge gained on post-disaster sheltering and housing over the last several decades, there remains a disconnect in the evidence needed by humanitarian practitioners and the learning that the research community is capturing. To determine the research needed by practitioners, we assembled a Delphi panel of experts in humanitarian shelter and settlements. They first identified and then ranked the relative importance of research topics. Ninety-six research needs were identified and ranked by importance in six key areas that included: (1) comparing and evaluating approaches to sheltering, (2) shelter and settlement programming, (3) design and construction of shelter, (4) understanding impacts and outcomes of shelter, (5) disaster risk reduction and the humanitarian-development nexus, and (6) challenging contexts and topics. Top research priorities identified include a need to better understand how to support shelter self-recovery, longitudinal and long-term impacts of shelter, and the transition from response to recovery. The resulting needs provide a research agenda for humanitarian organizations, academic institutions, and donors, aligning with the Global Shelter Cluster's strategy to invest in evidence-based response.