Search Results (16)

Health Professions Education research is playing an increasing role in ensuring evidence-based practice in Health Professions Education (HPE). To this end, HPE research uses, among other approaches, comparisons as a method in the sense of Comparative Education Research (CER), which allows to compare programs at different levels of education. To obtain evidence-based results, it needs a methodologically sound approach with transparent and justifiable sampling strategies as well as defined sampling criteria. The aim of this research is to identify sampling criteria used in CER for program comparisons and to draw conclusions about what HPE research can probably learn from that. We conducted a scoping review following the Arksey and O’Malley framework, searching three databases and grey literature for international comparative education studies. Four reviewers selected and analyzed the studies using content analysis. A total of 68 studies were included, and six sampling criteria for international CER were identified: (1) culture, (2) education system, (3) curriculum of an education program, (4) ranking, achievement or performance, (5) state and relevance of research, and (6) opportunities and pragmatic reasons. All these criteria appear to be applicable to education research on HPE programs. The sampling criteria derived can serve as a guide for sample selection in international CER and HPE research, providing impetus to improve the quality of research methodology. This necessitates unrestricted access to data on educational programs and a more profound comprehension of the cultural, political and educational characteristics of the respective country. Full article

Background/Objectives: GLP-1 receptor agonists (GLP-1RAs) have revolutionized weight loss and shown anti-inflammatory actions in several experimental models of colitis. There has been a wealth of recent data suggesting that GLP-1RA treatment may modify disease outcomes in inflammatory bowel disease (IBD). The aim of this systematic review is to determine if GLP-1RAs can act as a sole or adjunctive agent to induce steroid-free clinical remission in IBD patients. Methods: The PubMed/Medline, Cochrane Clinical Trial, and EMBASE databases were interrogated with a pre-defined search strategy and eligibility criteria to examine the evidence regarding GLP-1RAs’ use in IBD and non-IBD immune-mediated inflammatory disease (IMID) patients. Results: While there is a wealth of pre-clinical animal data suggesting that GLP-1RAs can ameliorate experimental colitis, there is a lack of prospective clinical studies on treating active IBD with GLP-1RAs to specifically induce steroid-free clinical remission. Surrogate data on better IBD composite outcomes have been reported with the use of GLP-1RAs, including a lower risk of surgery, hospitalization, corticosteroid use, and/or the initiation of advance therapies. Data from non-IBD IMID patients are only available for the effect of these agonists on psoriatic plaques, with positive signals. Conclusions: The current evidence for the role of GLP-1RAs as a potential anti-inflammatory therapy in IBD is limited, but provides the impetus for much-needed prospective studies and RCTs that include patients with active IBD. Full article

Background/Objectives: Individuals with Pediatric Acute-onset Neuropsychiatric Syndrome (PANS), an immune-modulated disorder, experience exacerbation-related neuropsychiatric symptoms, functional impairments, and high rates of developmental diagnosis. The literature describes links between giftedness and mental illness, and giftedness and autoimmune disorders. We sought to explore rates of giftedness among children with PANS as perceived by their caregivers, and to examine whether giftedness was related to PANS symptom severity, persistence, or duration. Methods: Data were extracted from a larger, 146-item survey, with 680 respondents meeting inclusion criteria of being a parent/guardian of a child with PANS and answering questions regarding perceived giftedness in empathy, social skills, verbal ability, reading, memory, math, creativity, or “other.” Results: In all, 604 respondents indicated some type of giftedness; the categories of giftedness were each endorsed by 30–57% of respondents. We found no significant associations between giftedness and severity of worst symptoms, persistence of symptoms, or length of time since symptom onset, once Bonferonni corrections were applied. Significantly more females than males were identified as gifted in creativity, but no other sex-related differences were seen. Thematic analysis of optional comments revealed three themes: (1) Elaboration on Types of Giftedness; (2) Objective Basis for Perceptions of Giftedness; and (3) Impact of PANS on Giftedness. Conclusions: The rate of giftedness reported by parents of PANS subjects in this study is much higher than would be expected in the general population, even when adjusting generously for potential overestimation. This study of the “flip side” of PANS should serve as impetus for future studies regarding giftedness in this population; a robust finding of exceptionally high rates of giftedness would have implications for diagnosis, interpretation of symptoms (for example, perfectionism and social challenges) and disease management. Full article

In politics and society, organic farming is widely seen as the ideal way to address the many challenges facing agriculture and food security. In order to examine the extent to which this view is realistic, the impact of organic and conventional farming is compared on the basis of relevant criteria such as land requirements, greenhouse gas emissions, biodiversity, food quality, production and environmental costs, reduced meat consumption, the need for agricultural imports and the global expansion of arable land. Land is considered to be a central factor. Such a comprehensive analysis is necessary to assess the impact of different influencing factors and to provide important suggestions for targeted decision making. Although organic farming has a positive impact on land use in many ways, it quickly reaches its limits. The low yields and high production costs resulting from the limited choice of means of production make organic farming an unsuitable model for the future in a world with limited arable land, a high and growing demand for food, and low incomes for large sections of the population. It can, however, provide significant impetus and contribute important technological knowledge for the further development of agriculture as a whole to meet the complex objectives of sustainability, greenhouse gas mitigation, biodiversity and global food security by incorporating all available technologies. Based on this, a model for responsible, sustainable intensive agriculture is outlined and proposals for an eco-social framework to support this model are put forward. Full article

To ensure that limited domestic resources are invested in the most effective interventions, immunization programs in low- and middle-income countries (LMICs) must prioritize a growing number of new vaccines while considering opportunities to optimize the vaccine portfolio, as well as other components of the health system. There is a strong impetus for immunization decision-making to engage and coordinate various stakeholders across the health system in prioritization. To address this, national immunization program decision-makers in LMICs collaborated with WHO to structure deliberation among stakeholders and document an evidence-based, context-specific, and transparent process for prioritization or selection among multiple vaccination products, services, or strategies. The output of this effort is the Country-led Assessment for Prioritization on Immunization (CAPACITI) decision-support tool, which supports using multiple criteria and stakeholder perspectives to evaluate trade-offs affecting health interventions, taking into account variable data quality. Here, we describe the user feedback from Indonesia and Ethiopia, two initial countries that piloted the CAPACITI decision-support tool, highlighting enabling and constraining factors. Potential immunization program benefits and lessons learned are also summarized for consideration in other settings. Full article

Initial staging of patients diagnosed with multiple myeloma (MM) can lead to negative results using conventional diagnostic imaging workup, including [¹⁸F]Fluorodesoxiglucose ([¹⁸F]FDG) PET/CT. The aim of this prospective pilot study was to evaluate the diagnostic efficacy of [¹⁸F]Fluorocholine ([¹⁸F]FCH) PET/CT in the initial staging of MM patients who were candidates for autologous bone marrow transplant. Materials and Methods: The inclusion criteria of our study were: (a) patients diagnosed with MM; (b) candidates for autologous bone marrow transplant (AT); and (c) studied with [¹⁸F]FCH PET/CT and [¹⁸F]FDG PET/CT for initial staging less than 4 weeks apart. Imaging analysis included the presence of: bone marrow infiltration, focal bone lesions, and para-medullary or extra-medullary disease, according to the proposed IMPeTus criteria. The analysis was performed per lesion, per patient, and per location. Results: The study population included ten patients. Globally, [¹⁸F]FCH PET/CT showed bone marrow uptake in all the patients and visualised 16 more focal lesions than [¹⁸F]FDG PET/CT. One patient presented a plasmacytoma, detected by both tracers. Extra-medullary and para-medullary disease was identified with different degrees of uptake by both tracers. In summary, [¹⁸F]FCH PET seemed to be superior to [¹⁸F]FDG PET/CT in detecting focal bone lesions. SUVmax values were slightly higher in [¹⁸F]FCH PET/CT than in [¹⁸F]FDG PET/CT. Conclusions: Taking into account the small study population, according to our results, [¹⁸F]FCH PET/CT could be a useful tool for staging MM patients. Full article

With the high impetus in global digitization, online shopping (OS) is anticipated to increase further in the near future. Contrary to this anticipation, however, recent studies have emphasized a certain amount of drop in a considerable number of online purchasing transactions in 2022. One of the reasons might be customer dissatisfaction. To analyze online customer reviews, manual sentiment analysis was conducted to detect which quality criteria cause the dissatisfaction of online shoppers. The quality parameters are categorized into product, delivery service, and aftersales service quality (SQ). These main quality criteria are then divided into sub-factors. Eight health category products, including personal care products, wellness products, and household cleaners, were ranked to the importance of the sub-quality parameters using the multi-criteria decision-making (MCDM) method. In this study, a new hybrid MCDM method was also proposed, which combines the triangular fuzzy logarithm methodology of additive weights (F-LMAW) and the Fermatean fuzzy weighted aggregated sum product assessment method (FF-WASPAS). The study reveals that the most important criteria were products’ performance, as well as their side effects, pay-back, and change possibility, while the products’ reasonable price was the least important criterion. Aftersales service was more significant than delivery service. Furthermore, moisturizing creams and medical pillows were the most popular products bought in OS compared with hair conditioners and washing liquids. The study’s multifold contributions and managerial implications were elaborately discussed. Full article

This paper presents a comprehensive literature review that addresses procurement selection criteria associated with procurement system evaluation in the construction sector. The aim is to consolidate the knowledge of construction procurement selection criteria (PSC) and provide future research directions. A systematic literature review (SLR) of 37 peer-reviewed journal articles from 1998 to 2019 in the construction procurement system selection process is carried out to understand the extant theoretical and practical foundations of the field. Two hundred fifty-six PSC have been identified. Descriptive and material analysis reveals (1) PSC evolved to match the promotion of emerging procurement systems in the construction industry; (2) three emerging themes of PSC have been identified, namely procurement systems, decision aid tools, and PSC identification methods; (3) PSC could be classified into generic criteria and unique criteria; (4) geographic location may not have a significant impact on the choice of procurement systems. This work identifies and discusses potential research interests in improving PSC identification. The research path, current trends, and future research directions in construction procurement selection are revealed. The paper provides the foundation and impetus for further investigation into procurement system selection practices. Full article

The rapid development of sensing technology has created an urgent need for chemical sensor systems that can be rationally integrated into efficient, sustainable, and wearable electronic systems. In this case, the triboelectric nanogenerator (TENG) is expected to be a major impetus to such innovation because it can not only power the sensor by scavenging mechanical energies and transforming them into electricity but also act as the chemical sensor itself due to its intrinsic sensitivity towards the chemical reaction that occurs at the triboelectric interface. In this review, recent research achievements of chemical sensors that are based on TENGs are comprehensively reviewed according to the role of TENGs in the system, that is, pure power supplies or self-powered active chemical sensors. Focus is put on discussing the design criteria and practical applications of the TENG-based active sensors in different fields, which is unfolded with a classification that includes biosensors, gas sensors, and ion sensors. The materials selection, working mechanism, and design strategies of TENG-based active chemical sensor systems (CSSs) are also discussed, ending with a concise illustration of the key challenges and possible corresponding solutions. We hope this review will bring inspiration for the creation and development of TENG-based chemical sensors with higher sensitivity, simpler structure, and enhanced reliability. Full article

Methyl group metabolism belongs to a relatively understudied field of research. Its importance lies in the fact that methyl group metabolic pathways are crucial for the successful conversion of dietary nutrients into the basic building blocks to carry out any cellular methylation reaction. Methyl groups play essential roles in numerous cellular functions such as DNA methylation, nucleotide- and protein biosynthesis. Especially, DNA methylation is responsible for organizing the genome into transcriptionally silent and active regions. Ultimately, it is this proper annotation that determines the quality of expression patterns required to ensure and shape the phenotypic integrity and function of a highly specialized cell type. Life is characterized by constantly changing environmental conditions, which are addressed by changes in DNA methylation. This relationship is increasingly coming into focus as it is of fundamental importance for differentiation, aging, and cancer. The stability and permanence of these metabolic processes, fueling the supplementation of methyl groups, seem to be important criteria to prevent deficiencies and erosion of the methylome. Alterations in the metabolic processes can lead to epigenetic and genetic perturbations, causative for diverse disorders, accelerated aging, and various age-related diseases. In recent decades, the intake of methyl group compounds has changed significantly due to, e.g., environmental pollution and food additives. Based on the current knowledge, this review provides a brief overview of the highly interconnected relationship between nutrition, metabolism, changes in epigenetic modifications, cancer, and aging. One goal is to provide an impetus to additionally investigate changes in DNA methylation as a possible consequence of an impaired methyl group metabolism. Full article

There have been increasing reports of Guillain–Barré syndrome (GBS), a rare but debilitating neurological disease, occurring post-COVID-19 vaccination. However, the outcomes and relationships between patient demographics and clinical outcomes of post-COVID-19 vaccination GBS remain unclear. To bridge this gap, our study investigates the outcomes and clinical factors associated with poorer GBS outcomes following COVID-19 vaccination. We conducted a review and pooled analysis of detailed data extracted from 57 published cases with the relevant search strategies and criteria. The groups compared included male versus female patients, 1st dose versus 2nd dose and early onset versus late onset of GBS. Multivariate regression analysis was performed to compare the vaccine type, clinical severity and post-treatment outcomes between these groups of patients. Our results highlight for the first time that females were significantly more likely to have severe clinical presentation and poorer outcomes compared to males. Additionally, viral vector vaccines were the predominant vaccine type administered in early-onset post-COVID-19-vaccination GBS and GBS occurring after the 1st vaccination dose. It was also shown that reported cases of post-vaccination GBS generally displayed a positive response to conventional treatment and had favourable post-treatment outcomes. Through this study, we have established important links and provided assuring evidence for treatment response and post-treatment outcomes of GBS occurring post-COVID-19 vaccination. While the COVID-19 vaccination brings about much greater benefits than risks, our findings provide further impetus for greater vigilance in certain patient groups and more studies to explore the mechanisms behind these links. Full article

The world is facing the observable and direct impacts of climate change in the shape of extreme weather events, irregular precipitation, glacial melt, sea-level rise, an asymmetric average temperature trends, higher oceanic temperatures, damage to natural ecosystems, and biodiversity. In 2015, collective wisdom stirred the global community to agree upon two unprecedented milestones in recent human history—the Paris agreement and sustainable development goals (SDGs). The twin global agreements set a platform for collective efforts to secure socio-economic and climatic sustainability. Pakistan also joined the board to put forth policy interventions for the mitigation and adaption of climate change risks to maintain symmetry between the environmental quality and economic development. The government of Pakistan (GOP) formulated the National Climate Change Policy (NCCP (2012)) and passed the Pakistan Climate Change Act (PCCA (2017)) to provide an impetus for the implementation of the NCCP. Yet, an appropriate assessment and prioritization of the objectives of the NCCP are indispensable for productive and effective policies to achieve the targets. This study serves this purpose by prioritizing the climate change policy objectives (CCPOs) based on symmetric principles, i.e., energy, transport, urban and town planning, industry, and agriculture as criteria, with 17 sub-criteria in total. The fuzzy analytical hierarchy process (AHP) results show that the energy sector is the most pivotal while implementing the NCCP. Energy production is the most critical area that needs mitigation policy intervention for shifting the energy mix of the economy from high-carbon to low-carbon energy. The fuzzy AHP analysis further revealed the railway, population and urbanization, air pollution, crop growing practices and techniques as the most important related to transport, urban planning, industry, and agriculture sub-criteria, respectively. The fuzzy VIseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) analysis showed the ranking of the CCPOs from high to low through the integration of policies, institutional capacity building, water security, natural resource management, natural disaster management, environmental financial structure development, and social sector development. The findings of the present research would be helpful for experts and policymakers to re-examine the NCCP and put forth action plans to achieve sustainable climate and SDGs. Full article

The International Myeloma Working Group (IMWG)recommends FDG PET/CT (Fluoro-Deoxy-glucose Positron Emission Tomography/Computed Tomography) as the gold standard imaging modality for initial evaluation and response to therapy assessment in multiple myeloma. In fact, FDG PET/CT, provides multiple useful indexes to risk-stratify patients and has significant prognostic value. However, multiple myeloma remains a complex disease to interpret on imaging. The Italian myeloma criteria for PET use (IMPeTUs) were proposed to standardize FDG PET/CT reading in multiple myeloma. In this communication an overview on IMPeTUs is provided as well as some examples of application. Full article

Over the last decade, the term social innovation has received increased attention as a potential solution to address complex global social problems and to add collective values to society. The forest sector has great potential for fostering employment, community development and reducing increased emigration from rural to urban areas. This potential is not always realised, especially in economically weak and remote rural areas. Hence, this paper tackles the question of how social innovations in forestry are able to succeed under adverse circumstances and contribute to respond to some of the before mentioned challenges? To answer this question, we first identified four very different cases across Europe that are compatible with the criteria of social innovation. Proceeding from this starting point, comparative research was undertaken with the aim to identify the cases´ specific features and key criteria for success. In the cases considered, it is evident that the sheer determination and voluntary investment of time and effort by key individuals, who were convinced of the value of the idea for the community, provided indispensable impetus to all four social innovations. In drawing its conclusions, this paper highlights the principal areas that need consideration and that hence have implications when developing supportive policies. Furthermore, we provide some insight into future research topics that would allow us to better understand the positive impacts of social innovation in the forest-based sector. Full article

The effects of globalization have often been adverse for the agricultural sector, especially its most vulnerable element—the small farm. The importance of the agricultural sector as a whole and small farms in the sense of ensuring food security, employment and viability of rural areas, implies a necessity to support the sector and small farms in particular. For this purpose, the Common Agricultural Policy (CAP) of the European Union (EU) seeks to boost the sustainability of agriculture in multiple dimensions. The 2013 reform of the CAP has provided a particularly strong impetus towards this direction. This paper establishes an indicator system to quantify the effects of the CAP direct payments on the socioeconomic sustainability of small farms. Expert survey and multi-criteria assessment are used to this end. The Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method is applied for the multi-criteria analysis. Lithuania is taken as a case study. The results show that, in the case of Lithuania, the direct payment system did not contribute to the improvement in socioeconomic sustainability of small farms up until 2013 CAP reform when its impact became undeniable. Full article