Working Group Research Articles

Optimizing group work strategies in virtual dissection.

Due to its haptic and interactive nature, virtual anatomy provides an opportunity for small-group learning, enabling students to develop their group work skills before they graduate. However, there is currently little practical guidance supported by pedagogic principles detailing how to incorporate it into curricula. Anatomy educators at the University of Plymouth conducted action research aiming to capture students' overall perceptions of the virtual anatomy platform Anatomage. Questioning the benefits and challenges students face while interacting with Anatomage prompted the creation of evidence-based interventions to be later evaluated. Although a plethora of themes were identified, this report specifically examines those relating to group work. Thematic analysis of initial focus group data found group size and group dynamics impacted students' experience with the platform. Following the implementation of interventions to resolve these issues, a questionnaire and second series of focus groups were conducted to determine whether they were successful. Additional subthemes found from these data included facilitation, social pressure, peer learning and working with friends. This study contributed to the improvement of small group learning and integration of virtual anatomy into curricula based on student and staff feedback. As such, these data support the development of effective group working skills which are fundamental for healthcare professionals and widely recognized by regulators such as the General Medical Council and Health and Care Professions Council. In this report, the authors provide practical advice informed by pedagogy and principles from management and psychology to provide a multidisciplinary perspective.

Reproductive Behavior of Adolescent Girls: Analysis of Risk Factors, Prospects of Prevention and Education

INTRODUCTION: Caring of reproductive health of children and adolescents in the society, especially of adolescent girls as a group most vulnerable to risks in the reproductive sphere, continues to be of high importance. The studies confirm that education and awareness about reproductive health can reduce the probability of problems occurring. The existing legal regulations emphasize the importance of providing accurate and timely information of reproductive health. AIM: Scientific justification of the strategy of forming safe reproductive behavior of adolescent girls on the basis of the peculiarities of their current reproductive behavior taking into account the opinion of specialists in the fields of education and healthcare. MATERIALS AND METHODS: To assess the peculiarities of reproductive behavior of adolescent girls, an anonymous questionnaire survey of 400 adolescent girls was conducted. To determine the expectations of the participants of the sex education process, as well as the main directions of preventive work and education, a survey of 400 parents of adolescent girls, 86 pediatricians, 34 obstetricians-gynecologists and 420 teachers was conducted. For all groups of participants, author’s questionnaires were developed. RESULTS: The reproductive behavior of adolescent girls living in the territory of the Novosibirsk region, is characterized by early start of sex life (15.90 ± 0.14 years), promiscuity (1.70 ± 1.10 partners), refusal to use effective means of contraception. Parents of adolescent girls emphasize the leading role of the family in sex education, suggesting participation of doctors and teachers in the process, but remain dissatisfied with the intensity of preventive measures. A similar problem is emphasized by specialists in the healthcare and education systems who indicate the possibility of conducting preventive work with adolescent girls remotely. In the opinion of pediatricians and obstetricians-gynecologists, providing preventive information on the reproductive health and behavior, will not only create safe reproductive behavior for modern adolescents, but is also an effective strategy of improving the system of reproductive health protection. CONCLUSION: The study identified features of the reproductive behavior of adolescent girls that characterize it as risky. The results emphasize the need for an integrated approach to assessing and maintaining the health of adolescent girls, and also focus attention on the importance of educational work in this age group. The study serves as a basis for further preventive strategies in the field of reproductive health and education.

The ESC Working Group on e-Cardiology.

The ESC Working Group on e-Cardiology.

The ESC working group on pulmonary circulation and right ventricular function.

The ESC working group on pulmonary circulation and right ventricular function.

Confronting social dominance ideology: how professional women manage career stereotypes in male-dominated occupations

PurposeUsing social dominance theory as a conceptual lens, this study explores how female managers and professionals strive to defy the perceived career stereotypes in traditionally male-dominated occupations.Design/methodology/approachThe dataset comprises 30 interviews with female bank managers and senior engineers in Nigeria – a non-Western location and work group – a sample that is considered under-researched.FindingsThe qualitative analysis identifies how the interviewed women adopted three strategies in managing gender and career stereotypes, with some expressing concerns of experiencing emotional dissonance as they contend with occupational segregation based on gender.Research limitations/implicationsThe extent to which the findings can be generalised may be constrained by the study’s limited sample size. Nevertheless, the findings shed light on the underlying importance of disclosing how working women exert themselves in navigating the social dominance ideology in Nigeria that is notable for extreme gender role differentiation. This often results in an intensification of the efforts made by female professionals in confronting the endemic nature of male chauvinism in Nigerian organisations.Originality/valueResearch on gender and career constraints has, in the main, restricted our understanding of the barriers that Nigerian women face in their careers as a result of the masculine hegemony perpetuated by social dominance. The present study aims to challenge, however, proponents of social dominance by unveiling the mitigating strategies that women living in an inegalitarian society adopt to confront occupational male-group ascendency.

Protocol biopsy of kidney allograft enables early detection of BK virus nephropathy to preserve kidney allograft function.

The Banff Working Group has updated the histological classification of BK virus nephropathy (BKVN), highlighting the importance of early detection. However, an early detection strategy for BKVN using biopsy has not yet been established. Our investigation aimed to assess the efficacy of protocol biopsy for the diagnosis of BKVN. We performed a retrospective cohort study of 314 patients who had undergone kidney transplantation between 2006 and 2021. Kidney allograft biopsies were performed as part of a protocol biopsy at 3 months and 1 year post-transplantation. Following the diagnosis of BKVN, the immunosuppressant dose was reduced. Twelve patients (3.8%) were diagnosed with BKVN by biopsy. Most diagnoses are established during the early stages of BKVN (polyomavirus nephropathy class 1 in six, class 2 in five, and class 3 in one). Following the reduction in immunosuppressant dose, kidney allograft function did not deteriorate in any patients. Additionally, test for BK virus DNA in the blood was negative. All but one patient demonstrated histological resolution of BKVN, and the other had a very slight positivity for the simian virus 40 large T antigen. The median follow-up time after BKVN diagnosis was 6 years. One patient developed de novo donor-specific antibody and subclinical acute antibody-mediated rejection that was successfully cured. Our analysis indicates that protocol biopsy may enable the early detection of BKVN, resulting in the preservation of kidney function.

Responding to the workforce crisis: consensus recommendations from the Second Workforce Summit of the American Society of Pediatric Nephrology.

Pediatric patients with complex medical problems benefit from pediatric sub-specialty care; however, a significant proportion of children live greater than 80 mi. away from pediatric sub-specialty care. To identify current knowledge gaps and outline concrete next steps to make progress on issues that have persistently challenged the pediatric nephrology workforce. Workforce Summit 2.0 employed the round table format and methodology for consensus building using adapted Delphi principles. Content domains were identified via input from the ASPN Workforce Committee, the ASPN's 2023 Strategic Plan survey, the ASPN's Pediatric Nephrology Division Directors survey, and ongoing feedback from ASPN members. Working groups met prior to the Summit to conduct an organized literature review and establish key questions to be addressed. The Summit was held in-person in November 2023. During the Summit, work groups presented their preliminary findings, and the at-large group developed the key action statements and future directions. A holistic appraisal of the effort required to cover inpatient and outpatient sub-specialty care will help define faculty effort and time distribution. Most pediatric nephrologists practice in academic settings, so work beyond clinical care including education, research, advocacy, and administrative/service tasks may form a substantial amount of a faculty member's time and effort. An academic relative value unit (RVU) may assist in creating a more inclusive assessment of their contributions to their academic practice. Pediatric sub-specialties, such as nephrology, contribute to the clinical mission and care of their institutions beyond their direct billable RVUs. Advocacy throughout the field of pediatrics is necessary in order for reimbursement of pediatric sub-specialist care to accurately reflect the time and effort required to address complex care needs. Flexible, individualized training pathways may improve recruitment into sub-specialty fields such as nephrology. The workforce crisis facing the pediatric nephrology field is echoed throughout many pediatric sub-specialties. Efforts to improve recruitment, retention, and reimbursement are necessary to improve the care delivered to pediatric patients.

Regional Workshop on Optimization of Protection in Pediatric Interventional Radiology in Latin American and Caribbean Countries.

The purpose of this article is to describe the activities developed within the framework "Regional Workshop on Optimization of Protection in Pediatric Interventional Radiology in Latin American and Caribbean countries," developed between October 16th and 19th of the year 2023 in the city of San José, Costa Rica. The workshop was carried out as part of a joint work between the Pan American Health Organization (PAHO) and the World Health Organization (WHO), in cooperation with the International Atomic Energy Agency (IAEA). The main objective of the regional workshop was to gather the experiences and future work planning among participants in the Optimization of Protection in Pediatric Interventional Radiology in Latin America and the Caribbean (OPRIPALC) program. It involved professionals from 14 centers across 11 countries in the region, along with 4 experts from PAHO/WHO/IAEA. The work modalities during the workshop consisted of keynote presentations, individual presentations, group work, and general discussions. An online survey was carried out after the workshop, with the objective of knowing the opinion of the event participants and determining the impact and projection of the OPRIPALC program. During the workshop the centers had to present their experiences: the use of the DOLQA dose management system was presented and work was done on the consensus document on good practices. The activities, topics and organization of the workshop were valued positively by the participants. There is unanimity among the centers that the OPRIPALC program has had a positive impact and they wish to continue actively participating in the next biennium.

Customer Healthcare Complaints in Brazil Are Seldom about Medical Errors

This study reviewed different country studies and noted that complaints in Brazil are more concentrated in complaints about being attended to and receiving access to services, rather than about clinical quality and safety issues. This paper explores the possible explanations for these differences based on the institutional logics theory and which logics actors privilege, and how they may play out in the healthcare field. To accomplish this undertaking, this study makes use of the healthcare complaint categorization developed by Reader and colleagues, which has been used by various studies. Next, a set of studies about healthcare complaints in different countries was examined to analyze the issues most common in the complaints and compare this information with the Brazilian data. This study identified three explanations why complaints about medical errors seldom occur. One group of studies highlights the hardships of local health systems. Another focuses on patient behavior. Finally, the third kind focuses on the issue of power to determine health orientation. The studies about a lack of resources do not directly explain why fewer complaints about clinical quality occur, thus helping to stress the management issues. Patient behavior studies indicate that patients may be afraid to point out medical errors or may be unaware of the procedures of how to do so, suggesting that family logic is left out of the decisions in the field. The third group of work highlights the prominence of the medical professional logic, both in terms of regulation and medical exercise.

Role of Clinical Pharmacology in Diversity and Inclusion in Global Drug Development: Current Practices and Industry Perspectives: WhitePaper.

The 2022 United States Food and Drug Administration (US FDA) draft guidance on diversity plan (DP), which will be implemented through the Diversity Action Plans by December 2025, under the 21st Century Cures Act, marks a pivotal effort by the FDA to ensure that registrational studies adequately reflect the target patient populations based on diversity in demographics and baseline characteristics. This white paper represents the culminated efforts of the International Consortium of Quality and Innovation (IQ) Diversity and Inclusion (D&I) Working Group (WG) to assess the implementation of the draft FDA guidance by members of the IQ consortium in the discipline of clinical pharmacology (CP). This article describes current practices in the industry and emphasizes the tools and techniques of quantitative pharmacology that can be applied to support the inclusion of a diverse population during global drug development, to support diversity and inclusion of underrepresented patient populations, in multiregional clinical trials (MRCTs). It outlines strategic and technical recommendations to integrate demographics, including age, sex/gender, race/ethnicity, and comorbidities, in multiregional phase III registrational studies, through the application of quantitative pharmacology. Finally, this article discusses the challenges faced during global drug development, which may otherwise limit the enrollment of a broader, potentially diverse population in registrational trials. Based on the outcomes of the IQ survey that provided the current awareness of diversity planning, it is envisioned that in the future, industry efforts in the inclusion of previously underrepresented populations during global drug development will culminate in drug labels that apply to the intended patient populations at the time of new drug application or biologics license application rather than through post-marketing requirements.

Commentary-A Military Health Care Ethics Framework.

Ethical practice within military health care is a significant topic of professional and academic debate. The term "military health care ethics" enfranchises the entire health care team. Military health care professionals are subject to tension between their duties as military personnel, and their ethical duties as health care professionals, so-called "Dual Loyalty." Some military health care practitioners have suffered moral injury because of the psychological stress associated with ethical challenges on military operations. It is important to define military health care ethics and also to consider how it should be taught. The essence of ethical practice is ethical decision-making. It has become self-evident from our experience of teaching military health care ethics that a simple and agreed framework for analyzing an ethical problem is required. This paper describes the development of the King's Military Healthcare Ethics Framework in support of a military health care ethics policy on behalf of the NATO Military Healthcare Working Group. There is logic to using a stepped approach to analyze an ethical problem in military health care. These steps are: "Identify" the problem, "Analyze" the problem including consideration of perspectives, "Fuse" the analysis, and "Decide". Step 1-Identify-is intended to orientate the decision-making group, and to articulate the problem specifically and clearly in order to determine the exact ethical issue and the secondary issues that arise. Step 2-Analyse-considers the problem from 4 perspectives: patient, clinical, legal, and societal/military. These reflect the breadth of perspectives that impact on health care practice within a military context. Step 3-Fuse-is the culminating step. The conclusions from the analysis of perspectives should be summarized and key references cited. This will determine the exact decision(s) to be made. Step 4-Decide-clearly articulates the decision made and provides the record of the key reasons for making that decision. This may include areas of enduring uncertainly and any planned review of the decision. The King's Military Healthcare Ethics Analytical Framework has been evaluated for content validity through iterative discussion at 4 meetings of the NATO MHCWG and a specific workshop on military health care ethics over 2022/2023. It is included within the draft NATO Standardization Agreement on Military Healthcare Ethics.

Symptomatic remission and its associated factors among patients with schizophrenia on risperidone or olanzapine at Amanuel mental specialized hospital, Addis Ababa, Ethiopia

BackgroundSchizophrenia is a debilitating condition that affects 1% of the global population. Understanding the prevalence and the factors predicting schizophrenia remission is crucial for healthcare providers. This study aimed to determine the prevalence of remission and factors affecting the remission. Cross-sectional study was conducted at the Amanuel Mental Specialized Hospital from 3 October, 2022, to 31 August, 2023, and included 271 participants. Remission was measured using Remission in Schizophrenia Working Group (RSWG) symptom severity-based criteria. Data analysis was done using SPSS V.25.ResultsThe mean age of participants was 34.2 with standard deviation (SD) of 10.5 years. Most were male (90%), unmarried (63.8%), lived with their relatives (91.9%), and were unemployed (56.5%). Fifty-two percent achieved symptomatic remission. Remission in patients with medication switched to SGAs increased by 1.9 times compared to patients without medication switch (AOR 1.9, 95% CI: 1.1, 1.2). Adherent patients had 2.7 times higher odds of symptomatic remission as compared to non-adherent patients (AOR 2.7, 95% CI: 1.5,4.9), and for each unit increase in body mass index (BMI), the odds of achieving symptomatic remission were increased by 13% (AOR 1.13, 95% CI: 1.04, 1.23). The odds of symptomatic remission decreased by 71% in patients experiencing moderate-to-severe side effects compared to their counterparts (AOR 0.29, 95% CI: 0.1, 0.6).ConclusionsOur study revealed a symptomatic remission was achieved in 141 (52%) of the subjects. There is a possibility to improve symptomatic remission with counseling on the importance of adherence, monitoring and managing side effects, and switching medication to either risperidone or olanzapine. Measuring remission using RSWG time-based criteria is recommended.

Development and Validation of PRE-SARC (PREdiction of SARCopenia Risk in Community Older Adults) Sarcopenia Prediction Model

ObjectiveReliable identification of high-risk older adults who are likely to develop sarcopenia is essential to implement targeted preventive measures and follow-up. However, no sarcopenia prediction model is currently available for community use. Our objective was to develop and validate a risk prediction model for calculating the 1-year absolute risk of developing sarcopenia in an aging population. MethodsOne prospective population-based cohort of non-sarcopenic individuals aged 60 years or older were used for the development of a sarcopenia risk prediction model and model validation. Sarcopenia was defined according to the 2019 Asian Working Group for Sarcopenia consensus. Stepwise logistic regression was used to identify risk factors for sarcopenia incidence within a 1-year follow-up. Model performance was evaluated using the area under the receiver operating characteristics curve (AUROC) and calibration plot, respectively. ResultsThe development cohort included 1042 older adults, among whom 87 participants developed sarcopenia during a 1-year follow-up. The PRE-SARC (PREdiction of SARCopenia Risk in community older adults) model can accurately predict the 1-year risk of sarcopenia by using 7 easily accessible community-based predictors. The PRE-SARC model performed well in predicting sarcopenia, with an AUROC of 87% (95% CI, 0.83-0.90) and good calibration. Internal validation showed minimal optimism, with an adjusted AUROC of 0.85. The prediction score was categorized into 4 risk groups: low (0%-10%), moderate (>10%-20%), high (>20%-40%), and very high (>40%). The PRE-SARC model has been incorporated into an online risk calculator, which is freely accessible for daily clinical applications (https://sarcopeniariskprediction.shinyapps.io/dynnomapp/). ConclusionsIn community-dwelling individuals, the PRE-SARC model can accurately predict 1-year sarcopenia incidence. This model serves as a readily available and free accessible tool to identify older adults at high risk of sarcopenia, thereby facilitating personalized early preventive approaches and optimizing the utilization of health care resources.

Group formation methods used across a semester and students' experiences

‘Group work’ is a vague description of an instructional activity, because many factors shape its character and effect on students. One important factor is group formation, that is, how groups are formed by the instructor. In this paper, we sought to better understand the variation of group work with respect to group formation by addressing: How do university mathematics instructors form groups over the course of a semester? To this end, we examined eight instructors' methods of forming groups in one multi-section introduction to proof course. Our findings include a classification of group formation methods and descriptions of how instructors varied their formation methods across the semester. Further, we sought to understand: How do students experience different group formation methods? We analysed interviews with 29 students from the eight instructors' classes and identified central themes among students' experiences of different group formation methods. Finally, we discuss the sometimes conflicting research on (when) which group formation method is most appropriate and offer our thoughts on how the differences between typical undergraduate and K-12 mathematics classrooms may contribute to different recommendations.

The impact of biomarkers of malignancy (IMWG SLiM criteria) in myeloma in a real-world population: Clinical characteristics, therapy and outcomes from the Australian and New Zealand Myeloma and Related Diseases Registry (ANZ MRDR).

A decade after International Myeloma Working Group (IMWG) biomarkers (SLiM criteria) were introduced, this real-world study examined their impact on diagnosis, therapy and outcomes in myeloma. Using the ANZ MRDR, 3489 newly diagnosed patients from 2013 to 2023, comprising 3232 diagnosed by CRAB ('CRAB patients', including 1758 who also satisfied ≥1 SLiM criteria) and 257 by SLiM ('SLiM patients') criteria were analysed. CRAB patients had higher R-ISS and lower performance status, with no difference in cytogenetic risk. SLiM patients had improved progression-free survival (PFS, 37.5 vs. 32.2 months, hazard ratio [HR] 1.31 [1.08-1.59], p = 0.003), overall survival (80.9 vs. 73.2 months, HR 1.64 [1.26-2.13], p < 0.001) and PFS2 (54.6 vs. 40.3 months, HR 1.51 [1.22-1.86], p < 0.001) compared with CRAB patients, partially explained by earlier diagnosis, with no differential impact between the plasma cell and light-chain criteria on PFS. However, 34% of CRAB patients did not manifest SLiM characteristics, raising the possibility that SLiM features are associated with different biological behaviours contributing to a better prognosis, for example, improved PFS2 in SLiM patients suggested less disease resistance at first relapse. These data support earlier initiation of therapy by SLiM. The superior survival outcomes of SLiM versus CRAB patients highlight the importance of defining these subgroups when interpreting therapeutic outcomes at induction and first relapse.

Herbal Medicine in Children and Adults With Atopic Dermatitis: A Systematic Review and Meta-Analysis.

Herbal medicine is widely used for dermatological diseases, particularly atopic dermatitis. This study aims to systematically review existing literature on the efficacy of both topical and systemic herbal interventions for atopic dermatitis across various age groups. Conducting a comprehensive search on MEDLINE/PubMed, Scopus, and the Cochrane Central Register of Controlled Trials (Central) until April 12, 2023, only randomized controlled trials (RCTs) were included. The review is reported following the PRISMA guidelines and was conducted in accordance to Cochrane recommendations. Two authors independently extracted details, including demographics, medication, control/placebo groups, outcomes, adverse events, and results, with quality assessment using the Cochrane risk of bias tool 2.0. A meta-analysis, utilizing the random-effects model, was conducted, and publication bias was assessed through funnel plot inspection. The quality of evidence adhered to GRADE working group recommendations. The primary focus was evaluating atopic dermatitis or pruritus severity. The review encompassed 51 RCTs (3763 participants). Of these, 31 RCTs explored 19 distinct herbs and five complex remedies, whereas 20 RCTs (1088 participants) specifically investigated evening primrose oil (EPO). Herbs such as sunflower, licorice, figs, coconut, EPO, indigo naturalis, licorice, mauve, St. John's wort, and a combination of aloe vera and olive oil were found to have evidence of efficacy in the local treatment of atopic dermatitis. A meta-analysis on systemic used EPO, involving 13 RCTs, found no significant difference in atopic dermatitis severity compared with placebo (SMD: 0.14; 95% CI [-0.45; 0.73], 13 RCTs). In conclusion, this review provides a nuanced perspective on herbal substance efficacy for atopic dermatitis. While the EPO meta-analysis failed to show a discernible benefit beyond placebo, individual herbal preparations showed promising results in RCTs included in this review. Nevertheless, larger, methodologically rigorous studies are essential to establish evidence for herbal remedies in atopic dermatitis treatment.

O-240 Embryo assessment: the Istanbul consensus revised

Abstract Study question What are the current recommended criteria for morphological assessment of oocytes, zygotes and embryos? Summary answer The present ESHRE/Alpha Scientists in Reproductive Medicine consensus document provides several novel recommendations to assess oocyte and embryo morphology and rank embryos for transfer. What is known already A previous Alpha Scientists in Reproductive Medicine / ESHRE consensus on oocyte and embryo morphological assessment was published in 2011. After more than a decade, a thorough review and update was needed. Study design, size, duration A working group consisting of Alpha Scientists in Reproductive Medicine executive board members and ESHRE Special interest group of Embryology members formulated recommendations on oocyte and embryo morphological assessment. Participants/materials, setting, methods The working group included 17 internationally recognized experts with extensive experience in clinical embryology. Seven members represented Alpha Scientists in Reproductive Medicine and 8 members represented ESHRE, in addition to two methodological experts from the ESHRE central office. Based on a systematic literature search and discussion of existing evidence, the recommendations of the Istanbul Consensus (2011) were reassessed and, where appropriate, updated based on consensus within the working group. After stakeholder review, the final version will be approved by the working group, the Alpha executive board and the ESHRE Executive Committee. Main results and the role of chance This updated consensus paper provides 20 recommendations focused on the timeline of preimplantation developmental events and morphological criteria for oocyte, zygote, and embryo assessment. Based on duration of embryo culture, recommendations are given on the frequency and timing of assessments to ensure safety and effectiveness. Limitations, reasons for caution Several criteria relevant to oocyte and embryo morphology have not been well studied, leading to either a recommendation against their use for grading or for use in ranking rather than grading. Future updates may require further revision of these recommendations. Wider implications of the findings This document provides embryologists with clear advice on best practices when assessing oocyte and embryo quality based on the most recent evidence.

Twenty-one Years of Undergraduate Medical Student Research Training at the University of the Free State (UFS), South Africa

Abstract Introduction Since 2001, undergraduate medical students at the University of the Free State (UFS), South Africa, plan, perform, and report on their research projects during semesters 2–5 of their ten-semester training. We describe the research modules and review the projects of the first 21 years. Methods This cohort study included all undergraduate medical student projects that formed part of the first 21 presentations of the research modules. Information was obtained from material archived by the module leaders. Students’ 2020 feedback on the modules was summarised. Results In total, 607 projects were planned (range 22–35 per year) and involved 229 supervisors. Only four projects were not completed. Thirty-nine Faculty departments/divisions/units provided supervision with Family Medicine, Internal Medicine, and Paediatrics and Child Health each supervising 60 or more groups. Projects were predominantly quantitative (99.7%); only 4.9% of projects involved an intervention or experiment. Main topics were infectious diseases (10.5%), mental health (8.9%), and cancer (8.7%). Data subjects were mainly patients (61.9%) and undergraduate students (12.0%), and data collection was mostly performed at the faculty’s training hospitals or laboratories (71.4%). The most positive aspect indicated by students was the exposure to and learning about research; the most negative aspects were group work and supervisors. Conclusion The projects received support from a broad spectrum of supervisors and covered a wide variety of topics. Given the timing of the projects in the training programme, the mainly quantitative and observational nature of the projects was appropriate. Attention to supervision and group work is required.

O-110 Adenomyosis : the challenge of classification and diagnosis

Abstract Study question What does the collaborative document on adenomyosis terminology, classification, and diagnosis by ESGE, ESHRE, and WES provides? Summary answer This good practice recommendations paper offers guidance on the technical aspects, terminology, classification, and diagnosis of adenomyosis in women of reproductive age. What is known already The existing literature on adenomyosis terminology is heterogeneous and confusing. Various classification systems based on ultrasound and MRI have been proposed, yet none have gained international acceptance or clinical validation. The contradictory data on the diagnostic accuracy of these modalities further complicate adenomyosis diagnosis in reproductive-age women. Study design, size, duration A working group from ESGE, ESHRE, and WES has collaborated to write recommendations concerning the terminology, classification, and diagnosis of adenomyosis. Participants/materials, setting, methods Focusing on terminology, classification, and diagnosis, this good practice paper paves the way for further recommendations on the management and surgical treatment of adenomyosis in reproductive-age women. Main results and the role of chance The document overviews adenomyosis terminology and reviews proposed classification systems based on histology, ultrasound, and MRI, concluding with diagnostic recommendations. Limitations, reason for caution Owing the scarcity of evidence, these recommendations predominantly rely on clinical expertise. Wider implications of the findings The recommendations aim to enhance existing adenomyosis guidelines. Study funding/Competing interests All costs were covered by ESHRE funds, with no external funding for the development process or manuscript production.

Artificial Bee Colony Algorithm to Optimize the Safety Distance of Workers in Construction Projects

This paper presents the results of a simulation model regarding the productivity and safety working space for construction workers through the floors of a building using swarm intelligence (SI), a field of artificial intelligence (AI), and specifically using artificial bee colony (ABC) optimization. After designing the algorithm used to build the simulation model, the simulation was used in an actual building project by comparing the travel times of workers conventionally transporting material with another group working on routes optimized by the algorithm. Thus, the proposed algorithm provides routes combining shorter travel times and correct distances between workers when transporting materials in a construction site, handling the interference between crews. After validating the algorithm on-site, no statistically significant differences were found between the travel times of workers and the times delivered by the algorithm. Additionally, the travel times using the routes obtained through the algorithm were significantly lower than those made by workers who moved freely without a predefined route. In summary, the algorithm proposed may help construction practitioners maintain safe movements that respond to hazard contexts imposed by any restriction that demands a safety distance.