Consensus-Based Recommendations for the Implementation of Health Technology Assessment in the United Arab Emirates.

OBJECTIVES: Healthcare research and development have accelerated at an unprecedented rate creating a challenge even for high-income countries to finance all new technologies. Health technology assessment (HTA) aims to maximize health gains out of available resources. Our study aimed to provide tailor-made recommendations for HTA implementation in the United Arab Emirates (UAE). METHODS: We conducted a policy survey to explore the gap between the current and preferred future environment of HTA implementation in the UAE. The survey was distributed in 2 workshops discussing the importance of HTA implementation, and results were further aggregated to yield a list of draft recommendations. Recommendations were then assessed for their feasibility in a round table discussion with experts in the field to generate actions for HTA implementation. RESULTS: Survey results and round table discussion indicated the need to leverage HTA for value-based decision making. Experts confirmed the unmet need for broader coverage of graduate and postgraduate HTA training with the aim of specific PhD programs in the UAE. Public funding for HTA appraisals and expanding the scope of HTA to nonpharmaceuticals was recommended. Furthermore, experts recommended that several HTA bodies should be coordinated centrally and highlighted the importance of having an explicit soft cost-effectiveness threshold for common technologies and a higher threshold for orphan drugs. CONCLUSIONS: Although HTA in the UAE is still in its early stages, strong initiatives are being taken for its implementation. Our survey results served as a step in developing a detailed action plan for HTA implementation that will enhance the sustainability of the healthcare system.

The 2024 magnonics roadmap.

Magnonicsis a research field that has gained an increasing interest in both the fundamental and applied sciences in recent years. This field aims to explore and functionalize collective spin excitations in magnetically ordered materials for modern information technologies, sensing applications and advanced computational schemes. Spin waves, also known as magnons, carry spin angular momenta that allow for the transmission, storage and processing of information without moving charges. In integrated circuits, magnons enable on-chip data processing at ultrahigh frequencies without the Joule heating, which currently limits clock frequencies in conventional data processors to a few GHz. Recent developments in the field indicate that functional magnonic building blocks for in-memory computation, neural networks and Ising machines are within reach. At the same time, the miniaturization of magnonic circuits advances continuously as the synergy of materials science, electrical engineering and nanotechnology allows for novel on-chip excitation and detection schemes. Such circuits can already enable magnon wavelengths of 50 nm at microwave frequencies in a 5G frequency band. Research into non-charge-based technologies is urgently needed in view of the rapid growth of machine learning and artificial intelligence applications, which consume substantial energy when implemented on conventional data processing units. In its first part, the 2024 Magnonics Roadmap provides an update on the recent developments and achievements in the field of nano-magnonics while defining its future avenues and challenges. In its second part, the Roadmap addresses the rapidly growing research endeavors on hybrid structures and magnonics-enabled quantum engineering. We anticipate that these directions will continue to attract researchers to the field and, in addition to showcasing intriguing science, will enable unprecedented functionalities that enhance the efficiency of alternative information technologies and computational schemes.

Left ventricular lead placement in cardiac resynchronization therapy: Current data and potential explanations for the lack of benefit.

The present article reviews the literature on image-guided cardiac resynchronization therapy (CRT) studies. Improved outcome to CRT has been associated with the placement of a left ventricular (LV) lead in the latest activated segment free from scar. The majority of randomized controlled trials investigating guided LV lead implantation did not show superiority over conventional implantation approaches. Several factors may contribute to this paradoxical observation, including inclusion criteria favoring patients with left bundle branch block who already respond well to conventional anatomical LV lead implantation, differences in activation wavefronts during simultaneous right ventricular and LV pacing, incorrect definition of target regions, and limitations in coronary venous anatomy that prevent access to target regions that are detected by imaging. It is imperative that exclusion of patients lacking access to target regions from these studies would lead to larger benefit of image-guided CRT.

Examining the status of rural post-graduate family medicine education.

Introduction: Rural populations in Canada are generally in worse health when compared to their urban counterparts. In 2014, the College of Family Physicians of Canada and the Society of Rural Physicians of Canada formed a joint Task force to advocate for improved health in rural communities. As a task force, they developed the Rural Road Map for Action. This paper uses the Rural Road Map for Action as a framework to examine the current state of family medicine's Post-Graduate Medical Education (PGME) in Canada. Methods: Surveys were sent to the programme directors of all English- and French-speaking post-graduate family medicine programmes. Both quantitative and qualitative methods were used to analyse survey responses. Results: Thirteen of 17 respondents completed the questionnaire. Despite on-going efforts, our results suggest that few programmes have equity and diversity admission's policies for rural and Indigenous students; a gap exists between the number of residents who are educated in rural areas and those who end up practising in rural areas; residents lack skills in Indigenous health; and more funded professional development opportunities are needed for rural physicians. Conclusion: Rural healthcare concerns are typically under-represented in PGME. The Rural Road Map for Action brings focus to the specific healthcare needs of rural areas, highlighting a recruitment and retention strategy that aligns education, practice, policy and research activities. Medical schools and national physician organisations need to continue to advocate for the health of rural communities through increasing the rural physician workforce and providing appropriate training for rural practice.

Résumé Introduction: Les populations rurales du Canada sont généralement en moins bonne santé que leurs homologues urbaines. En 2014, le Collège des médecins de famille du Canada et la Société de la médecine rurale du Canada ont formé un groupe de travail conjoint pour défendre l'amélioration de la santé dans les collectivités rurales. En tant que groupe de travail, ils ont élaboré le Plan d'action pour la médecine rurale. Le présent document utilise ce Plan comme cadre pour examiner l'état actuel de la formation médicale postuniversitaire (FMP) de la médecine familiale au Canada. Méthodes: Les enquêtes ont été envoyées aux directeurs de programme de tous les programmes de médecine familiale postuniversitaire anglophones et francophones. Des méthodes quantitatives et qualitatives ont été utilisées pour analyser les réponses. Résultats: Treize des 17 répondants ont rempli le questionnaire. Malgré les efforts en cours, nos résultats suggèrent que peu de programmes ont des politiques d'admission en matière d'équité et de diversité pour les étudiants ruraux et autochtones; un écart existe entre le nombre de résidents qui sont formés dans les zones rurales et ceux qui finissent par exercer dans ces zones; les résidents manquent de compétences en matière de santé autochtone et; que davantage d'opportunités de développement professionnel financées sont nécessaires pour les médecins ruraux. Conclusion: Les préoccupations relatives aux soins de santé en milieu rural sont généralement sous-représentées dans la FMP. Le Plan d'action pour la médecine rurale met l'accent sur les besoins spécifiques des zones rurales en matière de soins de santé, en soulignant une stratégie de recrutement et de rétention qui aligne les activités d'éducation, de pratique, de politique et de recherche. Les facultés de médecine et les organisations nationales de médecins doivent continuer à défendre la santé des collectivités rurales en augmentant le nombre de médecins ruraux et en offrant une formation appropriée à la pratique rurale. Mots-clés: éducation médicale rurale, plan d'action pour la médecine rurale, santé rurale.

An Optimized Probabilistic Roadmap Algorithm for Path Planning of Mobile Robots in Complex Environments with Narrow Channels.

In this paper, we propose a new path planning algorithm based on the probabilistic roadmaps method (PRM), in order to effectively solve the autonomous path planning of mobile robots in complex environments with multiple narrow channels. The improved PRM algorithm mainly improves the density and distribution of sampling points in the narrow channel, through a combination of the learning process of the PRM algorithm and the APF algorithm. We also shortened the required time and path length by optimizing the query process. The first key technology to improve the PRM algorithm involves optimizing the number and distribution of free points and collision-free lines in the free workspace. To ensure full visibility of the narrow channel, we extend the obstacles through the diagonal distance of the mobile robot while ignoring the safety distance. Considering the safety distance during movement, we re-classify the all sampling points obtained by the quasi-random sampling principle into three categories: free points, obstacle points, and adjacent points. Next, we transform obstacle points into the free points of the narrow channel by combining the APF algorithm and the characteristics of the narrow channel, increasing the density of sampling points in the narrow space. Then, we include potential energy judgment into the construction process of collision-free lines shortening the required time and reduce collisions with obstacles. Optimizing the query process of the PRM algorithm is the second key technology. To reduce the required time in the query process, we adapt the bidirectional A* algorithm to query these local paths and obtain an effective path to the target point. We also combine the path pruning technology with the potential energy function to obtain a short path without collisions. Finally, the experimental results demonstrate that the new PRM path planning technology can improve the density of free points in narrow spaces and achieve an optimized, collision-free path in complex environments with multiple narrow channels.

Cluster Analysis and Discriminant Analysis for Determining Post-Earthquake Road Recovery Patterns.

The transport network in eastern Japan was severely damaged by the 2011 Tohoku earthquake. To understand the road recovery conditions after a large earthquake, a large amount of time is needed to collect information on the extent of the damage and road usage. In our previous study, we applied cluster analysis to analyze the data on driving vehicles in Fukushima prefecture to classify the road recovery conditions among municipalities within the first six months after the earthquake. However, the results of the cluster analysis and relevant factors affecting road recovery from that study were not validated. In this study, we proposed a framework for determining post-earthquake road recovery patterns and validated the cluster analysis results by using discriminant analysis and observing them on a map to identify their common characteristics. In addition, our analysis of objective data reflecting regional characteristics showed that the road recovery conditions were similar according to the topography and the importance of roads.

Therapeutic acute intermittent hypoxia: A translational roadmap for spinal cord injury and neuromuscular disease.

We review progress towards greater mechanistic understanding and clinical translation of a strategy to improve respiratory and non-respiratory motor function in people with neuromuscular disorders, therapeutic acute intermittent hypoxia (tAIH). In 2016 and 2020, workshops to create and update a "road map to clinical translation" were held to help guide future research and development of tAIH to restore movement in people living with chronic, incomplete spinal cord injuries. After briefly discussing the pioneering, non-targeted basic research inspiring this novel therapeutic approach, we then summarize workshop recommendations, emphasizing critical knowledge gaps, priorities for future research effort, and steps needed to accelerate progress as we evaluate the potential of tAIH for routine clinical use. Highlighted areas include: 1) greater mechanistic understanding, particularly in non-respiratory motor systems; 2) optimization of tAIH protocols to maximize benefits; 3) identification of combinatorial treatments that amplify plasticity or remove plasticity constraints, including task-specific training; 4) identification of biomarkers for individuals most/least likely to benefit from tAIH; 5) assessment of long-term tAIH safety; and 6) development of a simple, safe and effective device to administer tAIH in clinical and home settings. Finally, we update ongoing clinical trials and recent investigations of tAIH in SCI and other clinical disorders that compromise motor function, including ALS, multiple sclerosis, and stroke.

[The dynamics of indices of professional self-evaluation and social status of physicians: the first results of reforms in health care system].

In Russia, an active transformation of national health care system takes place and one of the most important of its activities became approval of the "road map". In 2017, survey of physicians was carried out that revealed a number of patterns and problems in the field of physicians perception of their own lives, social self-implementation. In 2019, survey was re-carried out covered 311 specialists from the Republic of Bashkortostan. The purpose of this study was to analyze the dynamics of indices of professional self-assessment and social status of physicians in 2017-2019. The results testify a number of significant changes that took place by 2019: 1) number of specialists evaluating their own competence as "Excellent" statistically significantly increased (p=0.015); 2) percentage of specialists of second qualification category significantly decreased (p=0.0068) and previously observed relationship between professional self-assessment and qualification category lost its significance; 3) physicians began to statistically significantly more often identify themselves with highest stratum of society (p=0.012); 4) situation associated with lack of free time (p=0.021) and fears of losing job (p=0.044) worsened significantly. The research data mainly testify positive changes in social well-being of physicians in 2017-2019 and can be considered as first results of reform of national health care system. Nevertheless, increase of deficiency of free time and fears of losing job requires development and implementation of appropriate preventive measures.

An Inspection of the Life Cycle of Sustainable Construction Projects: Towards a Biomimicry-Based Road Map Integrating Circular Economy.

According to the National Energy Plan in Panama, the construction sector is one of the most prosperous and impactful sectors in the economy and it is expected to expand due to population growth by almost 300% by 2050. However, this sector must work on the transition towards sustainability and resilience in the face of climate change, since its growth implies a high consumption of resources and the contribution of greenhouse gases. The need to establish practices and strategies that embrace the dimension of sustainability and a circular economy is imminent. Currently, there is little guidance in the reference framework beyond certifications in planning, management and evaluation tools for its implementation. Different studies vary in the number of phases and considerations for projects. Therefore, the present work proposes the development of a unified road map, with defined phases, practices and indicators based on principles inspired by nature, such as biomimicry (Greek words: "bio" means life and "mimesis", imitation), and focuses on a circular economy, validated by construction professionals, where strengths, opportunities, skills and threats are identified with a high level of acceptance. This contributes to strengthening the field of sustainable construction project management and a precedent for Panama.

The Role of Coronary Artery Calcium Testing for Value-Based Clinical Trials in Primary Prevention.

PURPOSE OF REVIEW: Review the role of coronary artery calcium (CAC) testing in designing future clinical trials in primary prevention. RECENT FINDINGS: While there are numerous new agents that have been found to lower cardiovascular event rates in clinical trials, these studies have required a large sample size, in part due to low event rates as well as improved baseline treatments. More precise risk assessment could allow for better identification of individuals who stand to derive the most benefit from various therapies. Coronary CAC testing offers a simple method for identifying high-risk primary prevention cohorts, and thus may allow for improved efficiency of clinical trials, enhanced efficacy of various therapies, and ultimately more favorable cost-effectiveness estimates. The use of CAC testing as part of the inclusion criteria used in clinical trials may result in identifying high-risk individuals who were previously not included in such studies while achieving favorable absolute risk reductions. The advantages afforded by using CAC to enrich clinical trials offer a potential road map for future clinical trials in primary prevention.

DEVELOPMENT OF PUBLIC HEALTH IN THE PROFESSIONAL TRAINING OF FUTURE TEACHERS.

OBJECTIVE: The aim: Investigate the health-saving direction of the content of academic disciplines and pedagogical practice in the educational programs of the 1st (bachelor's) educational level of specialties 012 Preschool education and 013 Primary education. PATIENTS AND METHODS: Materials and methods: A set of methods were used in the paper: general scientific (analysis, synthesis, comparison, systematization, generalization), empirical (observation, interviews, questionnaires) to form and understand the values of public health in the student community. RESULTS: Results and conclusions: The development of public health in the student community is seen as an understanding of the value of their own health and mastery of healthsaving technologies for their use in the future teaching profession. Theoretical understanding and the results of practical work with students of the 1st (bachelor's) educational level of specialties 012 Preschool education and 013 Primary education made it possible to determine the nature and content of the development of public health elements during student life of higher education students and the near future professional activity of preschool and primary school teachers.

The World Health Organization road map for neglected tropical diseases 2021-2030: implications for onchocerciasis elimination programs.

In its new roadmap for neglected tropical diseases, the World Health Organization proposes three important strategic shifts: (i) Stronger accountability which shifting from process to impact indicators; (ii) Intensified cross-cutting approaches; and (iii) Stronger country ownership. In this paper we discuss the implementation of these three strategies in the setting of a high onchocerciasis disease burden in South Sudan.

Publication Trend in Islamic Medical Ethics in Iran and the World: Designing a Road.

This study aimed at determining the publication trend in Islamic medical ethics; finally, a road map was designed. All published English and Persian papers in Islamic medical ethics were searched until June 2017. Finally, 971 English papers and 204 Persian papers were analyzed. Our results show that publication in Islamic medical ethics started in 1973. The beginning of life was considered the most favorable subject followed by public health and biotechnology by both Iranian and non-Iranian scholars. Taken together, the publication trend in Islamic medical ethics has experienced ups and downs and is not as satisfactory as it should be.

A roadmap for implementing general policies of resistance economy in the Isfahan Universities of Medical Sciences.

CONTEXT AND AIMS: The country development can be promoted through applying policies of the resistance economy in the health system and universities. Therefore, this paper aimed to provide a scientific analysis of resistance economy policies and providing a roadmap for their implementation in the field of health care of Isfahan University of Medical Sciences. MATERIALS AND METHODS: This is a qualitative study. The basis, general purposes, and strategies of the resistance economy were extracted from the review of the policy of the resistance economy with a political research approach. Then, effective programs and indicators to achieve the goals of the resistance economy were proposed by holding 10 sessions of a centralized group discussion. Finally, the implementation of the resistance economy in the deputies of the University of Medical Sciences was approved by these programs and indicators along with other components and Delphi questionnaire to 30 experts. Framework analysis and descriptive statistics were used to analyze the data from the group discussion and the Delphi stage, respectively. RESULTS: Implementation of general policies of resistance economy in the field of health and treatment of Isfahan University of Medical Sciences with eight thematic bases, 39 goals, 54 strategies, and 98 programs and indicators were approved by experts. The eight areas of people-centered, economic growth, economic justice, support for internal services, economic flexibility, economic stability, economic influence, and economic health were identified as the thematic bases of communicative policies of the resistance economy in the field of health. CONCLUSION: The implementation of resistance economy policies entails planning in the long run, culture-building, appreciating the resistance economy in health issues, cooperation, and synergy among different institutions, restructuring the education system at different levels of the health system, and entrepreneurship training.

World Chagas Disease Day and the New Road Map for Neglected Tropical Diseases.

The first-ever World Chagas Disease Day, celebrated in April 14, 2020, is a key initiative to raise awareness of the impact of this neglected tropical disease (NTD). This landmark comes along with the first World NTD Day and the new WHO Road Map on NTDs for 2021-2030.

[Unmet research and developmental needs in ophthalmology : A consensus-based road map of the European Vision Institute for 2019-2025]. / Forschungs- und Entwicklungsbedarf in der Augenheilkunde ("Unmet needs") : Ein konsensbasierter Fahrplan des European Vision Institute (EVI) für die Jahre 2019 bis 2025.

PURPOSE: To define unmet needs in ophthalmology which can realistically be addressed in the next years (2019-2025) and to describe potential avenues for research to address these challenges. METHODS: Outcomes of a consensus process within the European Vision Institute (EVI, Brussels) are outlined. Disease areas which are discussed comprise glaucoma, retinal dystrophies, diabetic retinopathy, dry eye disease, corneal diseases, cataract and refractive surgery. RESULTS: Unmet needs in the mentioned disease areas are discussed and realistically achievable research projects outlined. CONCLUSION: Considerable progress can be made in the field of ophthalmology and patient-relevant outcomes in the near future.

Road map for progress and attractiveness of Iranian hospitals by integrating self-organizing map and context-dependent DEA.

Hospitals play an important role in healthcare systems and usually stay on the end node of the healthcare chain. Thus, determining their road map to get close to the desired efficiency frontier and developing short-term and long-term plans could help to manage costs and resources, efficiently. As the efficiency frontier depends on the size of the hospital and the complexity of its structure, the homogeneity in benchmarking must be considered. For tackling this problem, the self-organizing map (SOM) is used to create homogeneous groups. On the other hand, data envelopment analysis (DEA) is a well-known methodology for evaluating decision-making units. Each unit obtains the efficiency score based on the ratio of weighted outputs to weighted inputs, where each unit can take the desirable weights for inputs and outputs to provide the maximum value. One of the problems of DEA is the selection of the reference set and distinguishing between the efficient hospitals. To overcome these problems, the context-depended DEA has been applied and the progress and attractiveness of hospitals are obtained. To evaluate the capability of the proposed approach, data of 288 Iranian hospitals are utilized. By applying SOM the hospitals are clustered into appropriate homogeneous groups and by applying context-dependent DEA, the road map for progress and attractiveness of each hospital is determined. In other words, using the proposed approach the hospitals are able to determine the short and long-term goals according to their strategic plans.

Enacting Space in Virtual Reality: A Comparison Between Money's Road Map Test and Its Virtual Version.

In the field of spatial cognition research the mutual relationship between perception and action that brings out spatial orientation was lately investigated. Besides, the sameness between creating a cognitive map from the exploration of a not simulated environment, from the use of an allocentric (survey-like) sketched map, and from the interaction with egocentric (route-like) 3D virtual environments, is generally contrived. To understand if different embodied affordances could provide different knowledge organization during wayfinding through the use of distinct spatial simulations, the same group of 61 healthy subjects experienced both the classical version of the Money's Road Map test (M-RMT) and a virtual reality version of the Road Map test (VR-RMT). The M-RMT requires a allocentric to egocentric right/left reasoning to explore a stylized city provided in a survey perspective. The VR-RMT is a 3D version of the same environment through which participants can actively navigate by choosing egocentric-based right/left directions in a route perspective. The results showed that the different embodiments afforded by the two environments and the increasing complexity in turn types provides different spatial outcomes. Results were discussed according to the sensorimotor coupling theory provided from the enactive cognition approach and significances for spatial cognition research were provided.

Management and research strategies of karst aquifers in Greece: Literature overview and exemplification based on hydrodynamic modelling and vulnerability assessment of a strategic karst aquifer.

Karst aquifers are valuable water resources in terms of quantity and quality, hence, their protection and rational management is of utmost importance to sustain water supply. An overview of research articles regarding Karst aquifers in Greece was obtained revealing that progressively the initial simple statistical analysis was replaced from advanced tools but rarely coupled. Additionally, a combined approach including the concept of groundwater vulnerability and pollution risk in conjunction with statistical and hydrodynamic analysis was performed in the complex karst aquifer of Damasi-Titanos in Thessaly Central Greece. The karst aquifer discharges via three springs and it is in dynamic interaction with one of the two rivers that cross the system. The water demands of the area are mainly met with groundwater from the karst aquifer rendering its protection fundamental priority for the sustainability of the area. The hydrodynamic analysis of the karst system was performed by pairing statistical techniques and KarstMod. The analysis revealed a high correlation between the springs that highlights the karstification maturity of the aquifer. Additionally, spring discharge is mainly controlled by the percolation of River Titarisios rather than precipitation. Following the hydrodynamic analysis, the PaPRIKa method was applied and validated using sensitivity analysis in order to assess the intrinsic vulnerability. The vulnerability and hazard maps were combined to produce the pollution risk map of the karst aquifer. The majority of the karst aquifer is characterized by high to very high vulnerability as well as pollution risk. The case study and the obtained overview revealed that a holistic approach can provide mutually supported results increasing their reliability. In this base, a four-step road map including hydrogeological observation, statistical analysis, modelling and vulnerability assessment is suggested in order to obtain the sustainable exploration and integrated management of karst aquifers in Greece.