Search Results (68)

Background: The emergency department (ED) often represents the entry point to care for patients that require urgent medical attention or have no alternative for medical treatment. This has implications on scope of practice and how quality of care is measured. A diverse array of methodologies has been developed to evaluate the quality of clinical care and broadly includes quality improvement (QI), quality assurance (QA), observational research (OR) and clinical quality registries (CQRs). Considering the overlap between QI, QA, OR and CQRs, we conceptualized a modular framework for TECOR to effectively and efficiently streamline clinical quality evaluations. Streamlining is both appropriate and justified as it reduces redundancy, enhances clarity and optimizes resource utilization, thereby allowing clinicians to focus on delivering high-quality patient care without being overwhelmed by excessive data and procedural complexities. The objective of this study is to describe the process for designing a modular framework for ED CQRs using TECOR as a case study. Methods: We performed a scoping audit of all quality projects performed in our ED over a 1-year period (1 January 2021 to 31 December 2021) as well as data mapping and categorical formulation of key themes from the TECOR dataset with clinical data sources. Both these processes then informed the design of TECOR. Results: For the audit of quality projects, we identified 29 projects. The quality evaluation methodologies for these projects included 12 QI projects, 5 CQRs and 12 OR projects. Data mapping identified that clinical information was fragmented across 11 distinct data sources. Through thematic analysis during data mapping, we identified three extraction techniques: self-extractable, manual entry and on request. Conclusions: The modular framework for TECOR aims to enable an efficient streamlined approach that caters to all aspects of clinical quality evaluation to enable higher throughput of clinician-led quality evaluations and improvements. TECOR is also an essential component in the development of a learning health system to drive evidence-based practice and the subject of future research. Full article

Evaluating performance is a necessary and specific process across all sectors and organizational levels, shaped by context, indicators, and purpose. Considering global sustainability transitions, understanding financial performance entails a deeper perspective on technical accuracy, conceptual clarity, and systemic integration. This study investigates how financial performance is assessed and interpreted in sustainability-focused research, drawing on a bibliometric analysis of 490 articles indexed in the Web of Science from 2007 to 2023. Using SciMAT, we traced thematic evolutions and revealed a fragmented research landscape marked by competing theoretical, methodological, and practical orientations. To address this conceptual dispersion, we applied the Analytic Hierarchy Process (AHP) to evaluate five key alternatives to financial-performance assessment (quantitative measurement, definition-oriented reasoning, theoretical frameworks, experiential comparison, and integration with sustainability and ethics) against three conceptual criteria (philosophical depth, holistic scope, and multidisciplinary relevance). The results highlight a strong preference for holistic and integrative models of financial performance, with quantitative measurement ranking highest in practical terms, followed by experiential and sustainability-driven approaches. These results underscore the need to align financial evaluation more closely with sustainability values, bridging short-term metrics with long-term societal impact. By combining diachronic thematic mapping with structured decision analysis, this study advances a more reflective and forward-looking framework for performance research. It contributes to sustainability research by identifying underexplored epistemological pathways and supporting the development of financial evaluation models that are inclusive, ethically grounded, and aligned with sustainable development goals. Full article

The recent birth of genetically modified canids phenotypically resembling the extinct dire wolf (Aenocyon dirus) was hailed as a landmark in synthetic biology. Using genome editing and cloning, the biotech company Colossal Biosciences created three such animals from gray wolf cells, describing the project as an effort in “functional de-extinction”. This case raises significant questions regarding animal welfare, moral justification, and regulatory governance. We used the five domains model framework to assess the welfare risks for the engineered animals, the surrogate mothers used in reproduction, and other animals potentially affected by future reintroduction or escape scenarios. Ethical implications are examined through utilitarian, deontological, virtue, relational, and environmental ethics. Our analysis suggests that the project suffers from ontological ambiguity: it is unclear whether the animals created are resurrected species, hybrids, or novel organisms. While the current welfare of the engineered animals may be manageable, their long-term well-being, particularly under rewilding scenarios, is likely to be compromised. The moral arguments for reviving long-extinct species are weak, particularly in cases where extinction was not anthropogenic. Legally, the current EU frameworks lack the clarity and scope to classify, regulate, or protect genetically engineered extinct animals. We recommend that functional de-extinction involving sentient beings be approached with caution, supported by revised welfare tools and regulatory mechanisms. Full article

This scoping review examines the application of sensory research methodologies and methods in primary research, guided by Arksey and O’Malley’s five-stage framework. The scoping review addresses two primary questions: (1) what is the extent and nature of research activities that use multisensory methodologies and (2) what is the extent and nature of research activities that use multisensory methods? The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist was used to guide the reporting and mapping process. A total of 80 sources (45 peer-reviewed articles and 35 dissertations) met the inclusion criteria. Findings reveal ethnographic-based methodologies were the most common sensory approach, whereas combined visual and audio methods were the most commonly used techniques. There is the potential for more innovative and inclusive methodologies and methods to expand the use of taste and smell, which remain underrepresented in the literature. Additionally, greater attention is needed to address power dynamics and reflexivity in sensory research to avoid essentializing or misrepresenting participants’ experiences. Future research could improve methodological clarity and consistency while emphasizing accessibility and community engagement. This scoping review contributes to the field of sensory research by synthesizing current practices and identifying gaps that warrant future exploration, particularly in underrepresented sensory modalities. Full article

Brief family support interventions may be an effective and acceptable option when demands on services and pressures on families can often mean intensive, long-term family support interventions are an inefficient and unappealing course of action. The purpose of this scoping review was to better understand the nature of non-medical brief interventions targeted at parents and families experiencing adversity or challenging circumstances that may lead them to seek support from family services. We used a systematic search and selection process to identify publications (papers or webpages) about brief interventions for parents and families within three academic databases and 70 websites. Publications were in scope if the interventions were targeted to parents and families, were non-medical in nature, and were brief (no longer than 10 h duration, or up to four sessions). We identified 78 papers and webpages eligible for inclusion in this scoping review, covering 46 brief interventions. Data were extracted by two researchers and charted in a spreadsheet. Most interventions were delivered in the mental health sector, followed by the education, and then community or family services sector, and most often in a clinical setting. Intervention duration varied, ranging from 45 min to a two-day workshop, and were usually aimed at improving the mental health of children and young people. Interventions were delivered to groups of parents, followed by whole families or individual parents. This review highlights the pressing need for high-quality evaluations of brief interventions for family support, and given the diversity of delivery modes, durations and conceptualisation of ‘brief intervention’ in the field and literature, further synthesis of the evidence through systematic reviews is required. This paper advances understanding and clarity on how brief interventions may be beneficial for families experiencing adversity, yet further evaluation and systematic review for acceptability and efficacy is required. Full article

Background and Objectives: Individuals with chronic obstructive pulmonary disease (COPD) often exhibit some degree of intolerance to physical exercise and several limitations in daily activities. Therefore, the objective of this study was to conduct a scoping review on the characteristics—frequency, intensity, time, and type (FITT)—and the effects of exercise programs on quality of life and functional capacity in individuals with COPD. Materials and Methods: The present review included 21 studies that were scoping-reviewed to describe their main findings and training characteristics. Results: The participants across studies ranged in age from ~39 to 76 years with mild to very severe COPD stages. The results showed that, among all studies, eleven used cardiorespiratory training (e.g., walking or cycling), five used strength training (e.g., exercises with elastic bands or traditional resistance training), and five implemented combined training (i.e., cardiorespiratory and strength exercises). Conclusions: Overall, all training protocols improved aerobic capacity (cardiorespiratory training), strength (resistance training), and both capacities together (combined training). In conclusion, this review provided complementary insights to existing exercise prescription guidelines, particularly concerning cardiorespiratory, strength, and combined training in individuals with COPD. However, the methodologies of the training protocols varied widely, and detailed descriptions of FITT components were often incomplete or lacking clarity, especially regarding the specific exercises used. Future research should include more comprehensive spirometry variables such as forced expiratory volume 1 or forced vital capacity, as these are critical for determining COPD stages. Thus, there is a clear need for more high-quality research with robust methodological design in the context of exercise interventions for individuals with COPD. Full article

Seed dispersal studies have primarily relied on prediction model methods, which limit clarity regarding how variables affect movement direction. Suggestions for improvement are limited to specific domains due to the lack of quantitative evaluation of the comprehensive scope of the basic steps, from explaining seed dispersal to its application in related fields. This study aimed to reconsider the classification of seed movement mechanisms, identify research trends from an integrated perspective, and discuss the current implications and improvement measures. The data included 240 studies related to seed dispersal across the observation, generalization, and application phases. By classifying the mechanisms based on the direction of movement, the main variables affecting movement due to gravity or wind can be clearly distinguished. Although seed dispersal models assume gravity as the core principle, only 12.91% of the studies addressed terminal velocity, and a mere 1.25% measured the diaspore area, both of which are essential for accurate prediction. In addition, attempts to utilize seed dispersal for natural regeneration were relatively frequent (14.58%), but they remained at the empirical model stage, relying on data collected in the field, and thus lacked connection with models developed in previous studies. The requirements for enhancing the field usability of seed dispersal based on the current review include (1) improving the data collection system for securing primary data, (2) collecting sufficient field data, and (3) developing a unified model that can be applied to various conditions and species. Full article

Using the PRISMA-ScR methodology, this scoping review systematically analyzes how EU laws and regulations influence the development, adoption, and deployment of AI-driven digital solutions in energy generation, transmission, distribution, consumption, and markets. It identifies key regulatory barriers such as stringent risk assessments, cybersecurity obligations, and data access restrictions, along with enablers like regulatory sandboxes and harmonized compliance frameworks. Legal uncertainties, including AI liability and market manipulation risks, are also examined. To provide a comparative perspective, the EU regulatory approach is contrasted with AI governance models in the United States and China, highlighting global best practices and alignment challenges. The findings indicate that while the EU’s risk-based approach to AI governance provides a robust legal foundation, cross-regulatory complexity and sector-specific ambiguities necessitate further refinement. This paper proposes key recommendations, including the integration of AI-specific energy sector guidelines, acceleration of standardization efforts, promotion of privacy-preserving AI methods, and enhancement of international cooperation on AI safety and cybersecurity. These measures will help strike a balance between fostering trustworthy AI innovation and ensuring regulatory clarity, enabling AI to accelerate the clean energy transition while maintaining security, transparency, and fairness in digital energy systems. Full article

Quantifying GHG emissions from cashew cultivation, especially in Brazil, is essential to assess the environmental impact and promote the sustainable development of this activity. The objective of this study is to evaluate and compare methods for quantifying GHG emissions based on empirical equations for life cycle inventories, using the conventional cashew production system in Brazil as a case study. The scope of the study encompasses, from gate to gate in a dwarf cashew production system, considering the production of one ton of cashew as a functional unit. GHG emissions were assessed and compared using the following methodologies: Nemecek-Calc, WFLDB, IPCC-Calc, BR-Calc, and Agri-footprint. The environmental assessment followed ISO standards (14040, 14044, and 14067). The results showed that the carbon footprint varied among the evaluated methodologies, with a difference of 24.5% between the highest value (129.5 kg CO₂ eq-IPCC-Calc and BR-Calc) and the lowest (104 kg CO₂ eq-Nemecek-Calc) per ton of cashew. N₂O was the main contributor to emissions, accounting for up to 75.9%, while CO₂ represented up to 25.8%. Based on the analysis criteria, WFLDB, IPCC-Calc, and BR-Calc are the most recommended methodologies, balancing clarity, scientific robustness, and regional adaptation. The choice of methodology is fundamental, as it directly influences the results and interpretation of the carbon footprint in cashew farming, impacting the sustainability of this agricultural activity. Full article

Background/Objectives: Comprehensive cancer centers (CCCs) remain at the forefront of cancer control efforts. Limited clarity and variation exist around the models, scope, characteristics, and impacts of CCCs around the globe. This scoping review systematically searched and synthesized the international literature, describing core attributes and anticipated and realized impacts of CCCs, detailing changes over time. Methods: Searches for English language sources were conducted across PubMed, Cochrane CENTRAL, Epistemonikos, and the gray literature from January 2002 to April 2024. Data were extracted and appraised by two authors. Results were narratively synthesized. Results: Of 3895 database records and 843 gray literature sources screened, 81 sources were included. Papers were predominantly opinion-based, from the USA and Europe, and published between 2011 and 2020. Internationally, the interconnected attributes of CCCs included (1) clinical service provision; (2) research, data, and innovation; (3) education and clinical support; (4) networks and leadership; (5) health equity and inclusiveness; and (6) accountability and governance. Largely anticipated impacts were synergistic and included delivery of optimal, person-centered, complex care; development of a highly qualified cancer workforce; greater research activity and funding; effective, strategic alliances; and reduction in cancer-related inequalities. Limited evidence was found demonstrating measurable broad outcomes of CCCs. The early literature highlighted the establishment, development, and accreditation of CCCs. The ongoing literature has reflected the evolution of cancer care, key areas for growth, and limitations of CCCs. Recently, the CCC literature has increased exponentially and focused on the need for CCCs to drive networks and leadership to address health equity and inclusiveness. Conclusions: Results suggest that CCCs are yet to reach their full potential, with future efforts ideally focusing on accountability, effective networking, and health equity at a local, national, and international level. CCCs must generate evidence of impact, and continue to evolve in line with contemporary healthcare, to fulfil their role in cancer control efforts. Full article

Background/Objectives: Artificial intelligence (AI) has attracted great interest due to its applicability in many fields. The adoption of visual illustration techniques produced by AI in the field of graphic design has further expanded the field of use of this technology. This study focuses on foot anatomy illustrations generated by Adobe Firefly and Microsoft Designer Image Creator applications, evaluating them based on detail, clarity, anatomical realism, accuracy, and aesthetic appeal. Methods: The illustrations were created using text-based scripts, and five anatomists compared them to traditional illustrations from the Sobotta Atlas of Human Anatomy. Results: Fleiss’ Kappa statistic was used to analyze consistency among expert evaluations. For the four figures generated by both AI applications, Fleiss’ Kappa agreement was high. Adobe Firefly performed slightly better in illustrating phalanx and ankle bones, but its anatomical accuracy was lower for tarsal and metatarsal bones. Microsoft Designer Image Creator excelled in illustrating metatarsal bones, while its tarsal and phalanx illustrations were less anatomically accurate than Adobe Firefly and the atlas drawings. Both programs showed average realism in ankle structures, while the tarsal bones had low realism. Conclusions: Artificial intelligence applications within the scope of the study showed fast performance. Aesthetic appeal is dominant at first glance in the resulting drawings. In general, both applications have struggled to reflect anatomical reality. Full article

Winemaking generates significant amounts of byproducts, mainly grape pomace, which is composed of skins, seeds, and stems. Rich in phenolic compounds with antioxidant properties, grape pomace is often underutilized in low-value applications such as compost or animal feed. Recent research highlights its potential as a sustainable alternative to conventional fining agents, such as bentonite, commonly used to improve wine clarity, stability, and sensory attributes. However, previous studies have been limited in scope, focusing on selected wine parameters or narrow experimental conditions. This study explored the use of red and white grape pomace as fining agents for Mavrodaphne red wine, evaluating their effects on anthocyanin level, tannin content, total polyphenol index, chromatic properties, and aromatic profile across varied dosages and contact times. The results indicated that grape pomace, either from red or white grapes, achieved comparable or superior tannin and anthocyanin removal and chromatic enhancement relative to commercial fining agents, without significantly altering aromatic complexity. The findings underscore grape pomace’s suitability as a natural, vegan-friendly, and sustainable fining option, aligning with consumer preferences for cleaner-label wines. This study promotes the adoption of grape pomace in winemaking, supporting waste valorization and advancing sustainable practices within the industry. Full article

This scoping review provides clarity on the landscape of evidence-based and High-Leverage Practices that have been shown to be effective with students with disabilities and have the potential to meet the needs of marginalized students across lines of difference. Of 672 articles screened, 85 met eligibility criteria, including 46 studies, 11 systematic reviews, and 28 conceptual papers. Among included articles, instruction practices were the most frequently reported High-Leverage Practice category (89.4%), followed by social, emotional, and behavioral practices (37.6%), and assessment practices (25.8%). A wide variety of specific evidence-based practices were identified in the literature. Marginalized student identities represented included English language learners, students with disabilities, neurodivergent students, racially or ethnically marginalized students, students with health disabilities, and students with behavioral or emotional difficulties. Future research should consider further examining the effectiveness of different practices to inform data-driven decision-making to improve educational outcomes for marginalized students. Full article

Objectives: The intricate relationship between malocclusions and speech sound disorders (SSDs) is yet to be fully understood. This is particularly true for pediatric patients during the deciduous and mixed dentition stages. Employing a methodical scoping review approach, this study scrutinizes the recent literature to elucidate how these dental misalignments impact speech articulation and phonetic clarity. Methods: The present scoping review has been conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The selected articles have been found using PubMed, Scopus, Web of Science, and The Cochrane Library; the scope was limited to studies describing cases of patients in the deciduous or mixed dentition stage and the presence of both malocclusion and SSDs. Results: Out of the 1880 articles found, 44 passed the initial screening and 12 met the eligibility criteria and have been included in this review. Conclusions: The analysis reveals that while there is a consensus on the influence of malocclusions on speech production, the extent and specific nature of these effects vary across studies. anterior open bite is frequently associated with speech disorders, affecting phonemes by altering airflow and tongue placement. The review highlights the need for multidisciplinary approaches for effective treatment and calls for further investigation into the causative relationships between malocclusions and SSDs. Full article

This research presents a significant contribution to the methodologies and protocols for studying diatom communities in cryoconite holes on glaciers. Cryoconite holes are unique microenvironments found on glacial surfaces that support intricate microbial ecosystems, with diatoms playing a pivotal role in these communities. The refined methodologies developed in this study include optimizing sampling techniques to ensure that collections are both representative and diverse, which is crucial for accurate ecological assessments. Additionally, advanced digestion processes have been implemented to effectively isolate and purify diatom samples while minimizing contaminants, thereby improving sample integrity. Improved microscopic mounting techniques enhance visual clarity, facilitating more precise identifications of diatoms under the microscope. Furthermore, integrating DNA-based taxonomy broadens the taxonomic scope, providing valuable molecular insights into the diversity and evolutionary relationships of diatoms. Collectively, these protocols aim to enhance the reliability, depth, and multidimensional understanding of diatom ecology in cryoconite holes and broader glacial ecosystems, ultimately contributing to the field of glaciology and microbial ecology. Full article