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Background: Early diagnosis is crucial to the optimal management of patients with cognitive impairment due to Alzheimer's disease (AD) or AD-related dementias. For some patients, early detection of cognitive impairment enables access to disease-modifying therapies. For all patients, it allows access to psychosocial supports. Patients typically first present their concerns about their cognition to a primary care provider, but in this setting, cognitive impairment is commonly underdiagnosed. There is also high variability in how cognitive evaluations are performed. We sought to understand barriers to and facilitators of cognitive evaluations in primary care, map barriers to implementation strategies, and gain consensus from stakeholders on possible strategies to improve dementia diagnosis in primary care. Methods: Semi-structured interviews conducted with primary care providers (PCPs). We used the Consolidated Framework for Implementation Research to inform our question guide and analysis, and incorporated chart-stimulated recall – using actual patients who had cognitive complaints who had presented to these providers – to understand clinicians' medical decision-making processes. These data were used to map identified barriers and facilitators to targeted implementation strategies. Then, this candidate list of strategies was presented to an expert stakeholder panel including clinicians and clinical operations specialists. Through a modified Delphi process, the list was narrowed to select the most promising strategies to incorporate in an intervention to improve cognitive evaluations in primary care. Results: Twenty PCPs were interviewed and mentioned barriers included lack of expertise to perform or interpret an assessment, time pressures, lack of incentives, competing priorities, lack of decision-making supports, and limited access to dementia specialists. Facilitators included the presence of an informant or caregiver and having additional staff to conduct cognitive testing. Implementation mapping resulted in a list of 15 candidate strategies. Using the modified Delphi process, these were narrowed to six. Conclusions: We used a rigorous process to identify barriers to and facilitators of cognitive assessments in primary care, identify promising implementation strategies to address these barriers, and obtain the feedback of front-line users on these strategies. This holds substantial promise for improving cognitive assessments in primary care in future implementation trials. [ABSTRACT FROM AUTHOR]

Most countries face declining birth rates and an aging population, which makes the persistent healthcare labor shortage a pressing challenge. Introducing artificial intelligence (AI) robots into home healthcare could help address these issues. Exploring the primary considerations for integrating AI robots in home healthcare has become an urgent topic. However, previous studies have not systematically examined the factors influencing elderly individuals' adoption of home healthcare AI robots, hindering an understanding of their acceptance and adoption. Furthermore, traditional methods overlook the relative importance of each consideration and cannot manage the ambiguity inherent in subjective human cognition, potentially leading to biased decision-making. To address these limitations, this study employs the unified theory of acceptance and use of technology (UTAUT) as a theoretical framework, integrating the modified Delphi method (MDM) and the fuzzy analytical hierarchy process (FAHP) to identify the key considerations. The research determined the order of importance of four evaluation criteria and fourteen evaluation sub-criteria, revealing that customization, accompany, and subjective norms are key factors that influence elderly individuals' adoption of home healthcare AI robots. [ABSTRACT FROM AUTHOR]

Abstract Background Early diagnosis is crucial to the optimal management of patients with cognitive impairment due to Alzheimer’s disease (AD) or AD-related dementias. For some patients, early detection of cognitive impairment enables access to disease-modifying therapies. For all patients, it allows access to psychosocial supports. Patients typically first present their concerns about their cognition to a primary care provider, but in this setting, cognitive impairment is commonly underdiagnosed. There is also high variability in how cognitive evaluations are performed. We sought to understand barriers to and facilitators of cognitive evaluations in primary care, map barriers to implementation strategies, and gain consensus from stakeholders on possible strategies to improve dementia diagnosis in primary care. Methods Semi-structured interviews conducted with primary care providers (PCPs). We used the Consolidated Framework for Implementation Research to inform our question guide and analysis, and incorporated chart-stimulated recall – using actual patients who had cognitive complaints who had presented to these providers – to understand clinicians’ medical decision-making processes. These data were used to map identified barriers and facilitators to targeted implementation strategies. Then, this candidate list of strategies was presented to an expert stakeholder panel including clinicians and clinical operations specialists. Through a modified Delphi process, the list was narrowed to select the most promising strategies to incorporate in an intervention to improve cognitive evaluations in primary care. Results Twenty PCPs were interviewed and mentioned barriers included lack of expertise to perform or interpret an assessment, time pressures, lack of incentives, competing priorities, lack of decision-making supports, and limited access to dementia specialists. Facilitators included the presence of an informant or caregiver and having additional staff to conduct cognitive testing. Implementation mapping resulted in a list of 15 candidate strategies. Using the modified Delphi process, these were narrowed to six. Conclusions We used a rigorous process to identify barriers to and facilitators of cognitive assessments in primary care, identify promising implementation strategies to address these barriers, and obtain the feedback of front-line users on these strategies. This holds substantial promise for improving cognitive assessments in primary care in future implementation trials.

Purpose: The 2022 revision of the Model Core Curriculum (MCC) for Japanese undergraduate medical education aimed to develop a stratified, national-level competency framework. This paper aims to explore what innovations emerge during the process of competency-based medical education (CBME) glocalisation, driven by the interplay between global and local language and the dynamics among multiple stakeholders. Methods: This is an explanatory, retrospective, single-case study with a mixed-methods approach, combining document review and participant reflections. Meeting minutes, documents, email exchanges and data from the Delphi rounds (ratings, free-text comments and panellist demographics) were analysed to identify the influence of stakeholder interactions and external contexts when deliberating competency frameworks and their hierarchical structure. Results: The development of a shared language of imported educational concepts required the critical reframing of terminology rather than direct translation. This process involved the interweaving of expressions rooted in the local educational context and highlighted the importance of developing a unique structure that embodies the CBME philosophy through the educational language generated. Conclusions: The localisation of global educational trends into a country's own context may reveal the universality of imported educational concepts, provided that the process is underpinned by discussions with a robust, grounded rationale. [ABSTRACT FROM AUTHOR]

In recent years, as the infectious diseases caused by pathogens such as novel coronavirus and mpox (formerly called monkeypox) spread globally, the significance of identification, preservation, and sharing of pathogenic resources become prominent. Along with the rapid development of biorepositories, it is imperative to evaluate their operation in a scientific manner. By using the literature review and modified Delphi method, this study develops a benchmarking tool for the comprehensive evaluation of the operation of biorepositories for pathogenic resources. The effective response rates of both rounds of expert surveys were 100 %. The authority coefficients (Cr) were 0.82 and 0.85, respectively, manifesting the reliability of consultation results. In the second-round survey, the Kendall’s coefficient of concordance (Kendall’s W) of all indicators ranged from 0.09 to 0.31 (P

Specialized addiction services (SAS) are typically designed for people with a transient substance use disorder (SUD). However, some people who use these services have a persistent SUD. Apart from the need to offer continuity in services over time, there is little scientific data on the resources to deploy to better meet the needs of this population. Using a modified Delphi method, a consensus-building process was conducted with managers and clinicians from seven SAS centres in Quebec. The three phases of the process led to the identification of 93 service development proposals that were agreed upon by participants. These proposals were organized along three axes (duration, acuity, complexity) and four clinical principles. The resulting model can be used as a basis for further reflection on the development of services for people with a persistent SUD. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to develop a core outcome set for the frequency and modality of prenatal care visits. Material and Methods: A consensus development study was conducted in the United States with participants, including 31 health care professionals, 12 public policy members or public health payers, and 18 public members, representing 24 states. A modified Delphi method and modified nominal group technique were utilized. Results: Twenty-one potential core outcomes were developed by combining the outcomes reported in three systematic reviews that evaluated the frequency of prenatal care visits or modality of prenatal visit type (e.g., in person, telemedicine, or hybrids of both). Eighteen consensus outcomes were identified from the Delphi process, following which 10 maternal and 4 neonatal outcomes were agreed at the consensus development meeting. Maternal core outcomes include maternal quality of life; maternal mental health outcomes; the experience of maternity care; lost time; attendance of recommended visits; unplanned care utilization; completion of the American College of Obstetricians and Gynecologists-recommended services; diagnosis of obstetric complications—proportion and timing; disparities in care outcomes; and severe maternal morbidity or mortality. Neonatal core outcomes include gestational age at birth, birth weight, stillbirth or perinatal death, and neonatal intensive care unit admissions. Conclusions: The core outcome set for the frequency and modality of prenatal visits should be utilized in forthcoming randomized controlled trials and systematic reviews. Such application will warrant that in future research, consistent reporting will enrich care and improve outcomes. Clinical Trial Registration number: 2021. [ABSTRACT FROM AUTHOR]

With the advancement of society, voluntary service has become a prevalent phenomenon in the participation of citizens in many modern nations. In Taiwan, there exists a distinctive enterprise service volunteer groups known as the Small and Medium Enterprise Honorary Instructors Association (SMEHIA). This association is comprised of entrepreneurs, experts, and scholars who have been vetted and trained by the Small and Medium Enterprise Administration of the Ministry of Economic Affairs. These individuals possess extensive professional knowledge or technical expertise and are willing to voluntarily serve Small and Medium Enterprises (SMEs) without compensation. The primary function of SMEHIA is to provide services to domestic SMEs and to serve as a crucial communication bridge between the government and SMEs. The purpose of this study is to focus on this volunteer organization and employs modified Delphi method expert questionnaires to explore and identify the key success factors of this enterprise service volunteer groups encompass government policy, organizational culture, professional training, budgeting, volunteer self-identity dimensions, totaling 42 key factors. The implications of this study can serve as references for the future development of enterprise service volunteer organizations and for the formulation of policies by supervisory authorities. [ABSTRACT FROM AUTHOR]

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Most countries face declining birth rates and an aging population, which makes the persistent healthcare labor shortage a pressing challenge. Introducing artificial intelligence (AI) robots into home healthcare could help address these issues. Exploring the primary considerations for integrating AI robots in home healthcare has become an urgent topic. However, previous studies have not systematically examined the factors influencing elderly individuals’ adoption of home healthcare AI robots, hindering an understanding of their acceptance and adoption. Furthermore, traditional methods overlook the relative importance of each consideration and cannot manage the ambiguity inherent in subjective human cognition, potentially leading to biased decision-making. To address these limitations, this study employs the unified theory of acceptance and use of technology (UTAUT) as a theoretical framework, integrating the modified Delphi method (MDM) and the fuzzy analytical hierarchy process (FAHP) to identify the key considerations. The research determined the order of importance of four evaluation criteria and fourteen evaluation sub-criteria, revealing that customization, accompany, and subjective norms are key factors that influence elderly individuals’ adoption of home healthcare AI robots.

Introduction: Employee assistance programs require resources and manpower of various natures across different types of public sector organization. Methods: This study began by outlining elements for comparing employee assistance programs’ evaluation criteria in four types of public sector organization on the basis of 22 service measures for such programs implemented by the Ministry of Labor in relation to three major aspects: work, life, and health. Elements of the evaluation criteria for public sector employee assistance programs were determined by surveying a panel of experts using the modified Delphi method. Last, the weight associated with the elements of evaluation criteria were calculated using the fuzzy analytic hierarchy process, and the criteria of four types of public sector organization were explored. Results: Data analysis indicated that the weight and priorities associated with elements of evaluation criteria for EAPs implemented by four types of public sector organization were not fully identical. Discussion: The results of this study suggest that, in terms of EAPs, the Directorate-General of Personnel Administration of the Executive Yuan should be pursuant to appropriate employee assistance programs provided by various public sector organizations according to the needs of their employees as well as the diverse objective conditions in which these organizations operate. [ABSTRACT FROM AUTHOR]

To develop an investigation form for postoperative infection outbreak (PIO), and to identify sources of the outbreak in the early stage. After an exhaustive literature review, we used the Delphi method to determine the indicators and relative risk scores of the assessment tools through 2 rounds of specialist consultation and overall consideration of the opinions and suggestions of 20 specialists. A total of 203 studies of PIO were eligible for inclusion. The mean authority coefficient (Cr) was 0.87. Kendall's W coefficient of the specialist consultation was 0.704 after 2 rounds of consultation (P <.005), suggesting that the specialists had similar opinions. Based on 4 primary items and 19 secondary items of the source of PIO, and tripartite distribution characteristics of infected patients, we constructed the PIO investigation form. The PIO investigation form can be used in the investigation of the early-stage cluster of cases, it's a prerequisite for taking effective control measures, avoiding PIO occurrence. However, the effect of the investigation form needs to be further evaluated. • Postoperative infection outbreak investigation differs from individual infection. • Identifying the source of the outbreak is the most crucial aspect of investigation. • The investigation form provides a reference for infection preventionists. • The Delphi method combined with literature research is better than traditional. [ABSTRACT FROM AUTHOR]

Through strategically implementing sustainable practices, businesses can enhance their public image and incentivize consumers to purchase environmentally friendly products. In recent years, many enterprises have actively pursued corporate social responsibility, striving to achieve profitability, fairness, and societal benefits simultaneously, thus creating a beneficial cycle for both businesses and the environment. The COVID-19 pandemic has altered brand perceptions and consumer habits, impacting not only packaging materials, product life cycles, and corporate social responsibility but also significantly impacted sustainability. Personal care products are utilized by individuals on a daily basis, emphasizing the need to consider various indicators in designing brand image strategies to ensure sustainable development. This study focuses on indicators for sustainable brand image design strategies within the personal care product indicators, employing a modified Delphi method to establish these indicators. The relative weights of these indicators were determined using the Analytic Hierarchy Process. The research findings underscore that conveying brand ideals to consumers, committing to brand values, enhancing brand visibility, and creating value are considered the most crucial indicators in the design of sustainable branding strategies for personal care products. These results provide essential insights for researchers and brand developers to formulate corresponding strategies, thereby achieving sustainable brand development and enhancing competitiveness. [ABSTRACT FROM AUTHOR]

Africa faces a significant energy crisis, with over 600 million people lacking access to affordable and reliable power to meet their energy demands, despite the continent's vast solar energy potential. Several studies have indicated the high potential of solar water heaters (SWH) in various African countries in Africa due to the enormous solar energy resource. However, the diffusion and use of the same in Africa, especially in the West African sub-region, have been very slow compared to other sub-regions. This study thus assesses the barriers that affect the adoption and use of SWH systems using the Delphi method and the Fuzzy Analytical Hierarchy Process to prioritize and rank them for decision-making. The study identified five main barriers and prioritized them in the order of financing, gender, and market-related barriers (51 %), political, policy, and regulatory barriers (19 %), technical barriers (14 %), socio-cultural and public awareness barriers (11 %), as well as lack of standardization and quality assurance (6 %). The high cost of finance as well as difficulties in accessing finance prevent private sector investment, which ultimately affects the large-scale use of the SWH system in the sub-region. Also, the uneducated and a section of the educated do not fully appreciate the merits of the SWH system. This paper is expected to inform academics, practitioners, and regulators on future efforts to adopt for the SWH technologies in Africa, and to improve policies and strategies for their adoption across the continent.

In the process of developing clinical practice guidelines, consensus method is essential to determine clinical problems and recommendations, among which Delphi method and modified Delphi method are the most common. Therefore, scientific and standardized application of Delphi method to reach a consensus (such as expert selection, process design) has become an important topic in urgent need of study. In the process of using Delphi method, it is necessary to refer to mature methodological suggestions to make theconsensus process structured and transparent. This article focuses on the key elements of Delphi method in the development of clinical practice guidelines, and elaborates its basic methods and processes, including the number, composition, standards and selection methods of the 'expert group', as well as the key points of patients' participation. In terms of technical points, anonymity, consensus threshold and time control are described. Furthermore, the limitations of Delphi method and the highlights of the report are presented, in order to promote the standardized application of Delphi method in the development of the guidelines.

Adopting electric vehicles (EVs) is a potential solution to reduce emissions and protect the environment. Although countries encourage people to use EVs to replace gasoline and diesel vehicles, the application of EVs still needs to overcome many barriers, especially in developing countries such as Thailand. This study aims to identify critical barriers that hinder the adoption of EVs not only among EV owners but also among non-EV owners. First, two rounds of the modified Delphi method were used to identify significant barriers through expert opinions. The decision-making trial and evaluation laboratory (DEMATEL) method was then applied to determine their relationship. Among financial, technical, infrastructure, and policy dimensions, industrial experts agree about 14 significant barriers to the adoption of EVs. The results show that the long charging duration, limited driving range, and lack of charging stations are the most critical barriers affecting Thai customers adopting EVs. This study's findings will help manufacturers and policymakers understand customer requirements and develop appropriate strategies to improve the adoption of EVs. [ABSTRACT FROM AUTHOR]

This study aims to establish precise quality indicators for evaluating and enhancing ultrasound performance, employing a methodology based on a comprehensive review of the literature, expert insights, and practical application experiences. We conducted a thorough review of both the domestic and international literature on ultrasound quality control to identify potential indicators. A dedicated team was formed to oversee the complete indicator development process. Utilizing a three-round modified Delphi method, we sought expert opinions through personalized email correspondence. Subsequently, data from diverse hospital indicators were collected to validate and assess feasibility. A novel set of seven indicators was compiled initially, followed by the convening of a 36-member nationally representative expert panel. After three rounds of meticulous revisions, consensus was reached on 13 indicators across three domains. These finalized indicators underwent application in various hospital settings, demonstrating their initial validity and feasibility. The development of thirteen ultrasound quality indicators represents a significant milestone in evaluating ultrasound performance. These indicators empower hospitals to monitor changes in quality effectively, fostering efficient quality management practices. [ABSTRACT FROM AUTHOR]

Nonspecific low back pain, a common clinical disease, is with high morbidity and prone to recurrent attacks. Clinical practice has proven that acupuncture and moxibustion therapies have positive effects on nonspecific low back pain, and the therapies are various, yet there is a lack of scientific and normative clinical practice guidelines. Identifying clinical questions is the most important step in developing clinical practice guidelines. This paper summarized the process and experience of the successful identification of clinical questions in the development of Clinical Practice Guideline on Acupuncture and Moxibustion for Nonspecific Low Back Pain by the guideline expert panel using the modified Delphi method, hoping to provide a reference for developing acupuncture and moxibustion-related clinical practice guidelines.

Background China owns a huge number of asthma patients and an increasing incidence of asthma, but low rate of overall control and high rate of acute asthma exacerbation. Moreover, there is a lack of methods for systematically screening the risks of acute exacerbation of asthma. Objective To develop a risk prediction questionnaire for acute exacerbation of asthma after screening the associated risk factors using the modified Delphi technique, providing a reference for building a multidimensional risk prediction model of asthma acute exacerbation. Methods Based on literature reports and our clinical pre-investigation results, an expert consultation questionnaire on risk predictors of acute exacerbation of asthma was developed, and was distributed through E-mail to 30 experts for review through two rounds of online consultation survey using the modified Delphi technique conducted from April to October 2021. SPSS 25.0 was used to assign weight and analyze the risk predictors. Then according to the screening criteria developed by the experts, the risk predictors were finally determined. Results Both two rounds of consultation achieved a 100% response rate. The familiarity, judgment, and authority coefficients as well as Kendall's W were 0.894, 0.963, 0.929, and 0.331, respectively, for the first round of expert consultation (P

This study introduces an evaluative framework aimed at delineating the pivotal criteria for overfunding risks in the realm of crowdfunding, employing a hierarchical model. The proposed framework amalgamates the modified Delphi method with the Analytic Hierarchy Process (AHP). Initially, the evaluative structure constructs a hierarchical arrangement comprising two overarching criteria and eight corresponding sub-criteria. Subsequently, the AHP methodology is employed to derive the relative weightings assigned to both the criteria and sub-criteria. Ultimately, the application of the multi-criteria decision-making process culminates in the identification of critical criteria for overfunding risks within crowdfunding, affording investors a vantage point encompassing financial and operational dimensions. Within the academic context, the findings propose a multi-criteria decision-making theory, serving to ascertain the decisive criteria governing overfunding risks. In the commercial context, this study equips investors with a concise tool to discern the pivotal elements contributing to overfunding risk within the crowdfunding sphere. [ABSTRACT FROM AUTHOR]

With the rapid aging of the population structure, the change of living patterns has caused the demand has gradually taken shape. Factors involved include a declining interest in caring for people at an old age, increasing income, the pursuit of high-quality services, and desires for a dignified and safe environment. The goal of this study was to construct the optimal configuration of resources to enhance the competitive mode of a long-term care center for operations research, to provide a reference for business owners. This study conducted an evaluation based on resource-based theory and Porter's AIERP diamond model, to identify developmental trends and factors that may give enterprises a competitive advantage in the rehabilitation medical device industry. Expert opinions were collected using a modified Delphi method, and the criteria for the allocation optimization model were then determined. Next, the effectiveness of the proposed model was assessed using the analytical hierarchy process (AHP) for operations research. The proposed method can help administrators of senior citizen housing communities to select the most feasible options, by considering finance and market analysis-related concerns to ensure success in daily operations. This research proposes a competitive pattern for allocating resources for long-term care centers. The approach also allows operators to change increasingly rapidly in a competitive environment. The industry needs to learn and take in information about an incomplete situation in a short time. While this can create challenges, providing a conceptual strategic thinking framework. [ABSTRACT FROM AUTHOR]

As Taiwan heads steadily toward becoming a super-aged society, the impact of aging on society at large will become increasingly extensive and intense. Therefore, establishing an age-friendly environment in Taiwan is an important issue for the government. Feasible guidelines for age-friendly communities are necessary to ensure that appropriate social welfare measures are enacted to achieve the national goal of aging in place. The first draft of the guideline questionnaire was developed based on the World Health Organization Guidelines for Age-Friendly Cities, a literature review, and input from seven experts on aging. Three rounds of questionnaire surveys were then conducted to assess the correctness, appropriateness, and importance of the guidelines, with amendments, additions, and deletions made based on the experts' responses until they all expressed a high degree of satisfaction with all of the guidelines. The Taiwan Age-friendly Community Guidelines document discussed in this article includes 38 guidelines that address the eight facets of "outdoor spaces and buildings", "transportation", "housing", "social participation", "respect and social inclusion", "civil participation and employment", "communication and information", and "community support and health services". The guidelines document describes in detail the goals of age-friendly communities in specific and easy-to-understand terms. Moreover, it provides a reference for frontline personnel in the community to promote age-friendly environs. [ABSTRACT FROM AUTHOR]

Background/purpose: The implementation of competency-based medical education is a social construction process within a local and cultural context. However, little is known about the process of adaptation to different systems, known as “glocalization”. We analyzed the documents in the development of a milestone project from adapting global standards into a local context and identified a framework underlying this process. Methods: Taiwan Society of Emergency Medicine (TSEM) had developed learning milestones based on the ACGME's version through series of consensus methods including committee work, nominal group technique (NGT), and a modified Delphi method. We applied qualitative content analysis to characterize the evolution of the three versions of TSEM and the original ACGME milestones documents and to explore the meaning behind the differences revealed by the glocalization process. Results: We found 48 differences between ACGME and TSEM milestones. Among these differences, one was made by committee work, 44 came from NGT, and 3 were from the modified Delphi process. Two themes and seven sub-themes emerged from the coding process to explain the contextualization process of the milestones. Conclusion: We identified a framework that incorporates local expression and local needs into the process called glocalization through which global models of competency-based standards could be optimally implemented in a local context with different systems and cultures.

\n To understand changes in the underlying progression of early Parkinson's disease, it is important to derive estimates of the threshold for meaningful motor progression on the MDS-UPDRS Part III in OFF medication state.To estimate this threshold using two approaches: anchor-based analyses, and clinical consensus via a modified Delphi panel.For the anchor-based analyses, data from a Phase II clinical trial were used. Mean and median MDS-UPDRS Part III change scores were calculated for those participants rated as ‘Minimally worse’ on the Clinical Global Impression of Improvement (using the first visit rated as ‘Minimally worse’ or worse, and at Weeks 24 and 52). Cumulative data up to Week 104 were used to assess the difference between motor progressors’ and non-progressors’ change scores on motor-related outcomes. For the modified Delphi panel, a panel of 13 expert clinicians received an online survey in two rounds and provided responses anonymously.For the anchor-based analyses, estimates of meaningful change ranged from 4−6 points. Numerically worse change scores were identified on motor-related outcomes for participants who had experienced motor progression compared with those who had not. For the modified Delphi panel, consensus was reached in Round 2, with 92% agreeing that 5 points is suitable to define a clinically meaningful motor progression threshold.Results of the anchor-based analyses and modified Delphi panel were consistent, supporting a meaningful motor progression threshold of a worsening of 5 points on the MDS-UPDRS Part III (OFF medication state) in an early Parkinson's disease population. When the symptoms experienced by people with Parkison's disease are observed by others, such as doctors, they are called signs. The MDS-UPDRS Part III is a tool used by doctors to measure how severe motor signs are in people with Parkinson's disease. These signs include slowness, tremor, and rigidity. Doctors can use this tool whilst someone with Parkinson's disease is taking medication to manage their motor symptoms (known as ON medication state), or when the effect of the medication has worn off (known as OFF medication state). People with Parkinson's disease not receiving medication are in OFF medication state. It is important to assess symptoms/signs when the medication is not working to understand how the disease is progressing, and how new potential treatments may slow it down. In this study, the researchers wanted to understand what level of change in the MDS-UPDRS Part III score assessed in OFF medication state shows that the motor signs of someone with early disease have worsened. They looked at data from a clinical trial called PASADENA and found a change of 5 points on the scale to be meaningful for showing that motor signs were getting noticeably worse. They also asked a group of 13 expert doctors what they thought would be a meaningful change of points on this scale. The experts reached an agreement that a change of 5 points on the scale would be meaningful. This information can help doctors and researchers better understand and track Parkinson's disease in its early stages. [ABSTRACT FROM AUTHOR]

BackgroundUnderstanding the occurrence and severity of child injuries is the cornerstone of preventing child injuries. Currently, there is no standardized child injury surveillance dataset in China.MethodsMultistage consultation by a panel of Chinese experts in child injury to determine items to include in the core dataset (CDS) was performed. The experts participated in two rounds of the modified Delphi method comprising a consultation questionnaire investigation (Round 1) and a face-to-face panel discussion (Round 2). Final consensus was established based on the opinions of the experts regarding the modified CDS information collection items. Enthusiasm and authority exhibited by the experts were evaluated by the response rate and using the expert authority coefficient, respectively.ResultsThe expert panel included 16 experts in Round 1 and 15 experts in Round 2. The experts during both rounds had a high degree of authority, with an average authority coefficient of 0.86. The enthusiasm of the experts was 94.12%, and the proportion of suggestions reached 81.25% in Round 1 of the modified Delphi method. The draft CDS evaluated in Round 1 included 24 items, and expert panelists could submit recommendations to add items. Based on findings in Round 1, four additional items, including nationality, residence, type of family residence, and primary caregiver were added to the draft of the CDS for Round 2. After Round 2, consensus was reached on 32 items arranged into four domains—general demographic information, injury characteristics, clinical diagnosis and treatment, and injury outcome—to include in the final CDS.ConclusionThe development of a child injury surveillance CDS could contribute to standardized data collection, collation, and analysis. The CDS developed here could be used to identify actionable characteristics of child injury to assist health policymakers in designing evidence-based injury prevention interventions.

The crypto and digital assets ecosystems have attracted investment, regulators, and speculators to their environment. As the blockchain-based framework can reduce transaction costs, generate distributed trust, and enable decentralized platforms, it has become a potential new base for decentralized business models. Previous studies have highlighted the advantages and drawbacks of each platform, such as interest rates, cost concerns, transparency issues, hacking issues, and hazards. Consequently, it is challenging for investors to evaluate the cryptocurrency trading system which determines the optimum exchanges and crucial aspects. Therefore, in order to rank the optimal digital token trading system, this paper develops an evaluation architecture to determine the various token trading systems. The developed architecture integrates fuzzy theory and the best-worst method (BWM) into the decision-making process to assess decision behaviors regarding preference for digital token trading systems in investors in Taiwan. First, this work establishes the views and parameters by modifying the Delphi method based on a literature review and survey. Second, the fuzzy-BWM is applied to obtain the fuzzy weights of the views and parameters. Then, defuzzification and BWM are used to rank the optimal alternatives of the digital token trading systems for investors. The results indicate that the optimal digital token trading system is the decentralized platform, and the critical parameters are gas fees, interest rates, and the mechanism of savings under fuzzy uncertain scenarios. This means that when considering the uncertain and ambiguous characteristics of the expert decision process in digital token trading systems, the evaluation is decentralized and the gas fees are the most important parameter in the digital token investment platform. Academically, the fuzzy BWM-based decision-making architecture can provide corporations and investors with valuable guidance to rank the optimal digital token trading systems based on fuzzy uncertain scenarios. Commercially, the proposed architecture could provide corporations and investors with a useful model to measure the optimal digital token trading system. [ABSTRACT FROM AUTHOR]

Robust water management systems are crucial for sustainable water use, particularly considering rapidly changing, ever-improving water supply system technologies. However, the establishment of specific management standards in upland fields is challenging, as several types of crops are cultivated in upland fields. Hence, the timing and required amount of water vary greatly, further rendering drought response challenging. In this study, we evaluated the agricultural drought vulnerability of South Korean upland fields, considering the lack of water resources, to establish preliminary drought damage prevention measures. The Technique for Order of Preference method was used for the drought vulnerability assessment, and the assessment indicators used were annual rainfall, number of dry days, upland field area, available soil water capacity, and groundwater usage. The 20 areas of highest vulnerability comprised large cultivation areas with minimal subsurface-water usage, except for areas where the number of dry days appeared to be the major factor for drought vulnerability. Damage caused by recurring droughts accumulated over time; thus, upland-field-oriented management may be required and can even be used in cases where insufficient drought information is available. Future studies can use the proposed method while considering assessment factors that describe upland field conditions. [ABSTRACT FROM AUTHOR]

In order to improve the quality of youth in entrepreneurship. Schools managements need to know the entrepreneurial intention (EI) of their students. A past study systematic review findings showed that EI measurement has to be improved. To the best ability, this is the contribution of this study and a novel strategy that may pave the way for further research in this area in the future. Thereupon, this study aims for scale development specially for youth in vocational school context and determine the dimensionality of items measuring the EI construct. This study also conducted bibliometric analysis. Research tools used were SPSS version 24 and VOS viewer. The validation used Modified Delphi Method for content and face validity with seven panelists, meanwhile Exploratory Factor Analysis (EFA) for construct validity was administered to 100 students in 23 vocational high schools (VHS), using questionnaires. The initial items were analyzed using Fleiss Kappa Index (FKI) and Content Validity Index (CVI) that consist of I-CVI and S-CVI. However, the I-CVI achieved the criteria, S-CVI is 0.898, and FKI is 0.432, then processed to the EFA procedure. The EFA identified four sub-constructs of EI with 73.729% of the total variance explained (TVE) in this study. The study found that the instrument is valid and reliable in measuring the values aspect of EI. The study's findings could be of interest to the governments, schools managements, and other researchers. It will enable those parties to analyze which factorsare needed to enhance the quality and successful youth in entrepreneurship post-covid-19. [ABSTRACT FROM AUTHOR]

To overcome the continuous decline in its gross domestic product growth rate, China has advocated new and old kinetic energy conversion (NOKEC) as a policy for sustainable economic development in the post-COVID-19 era. The innovation drivers of NOKEC are the key to promoting sustainable economic development. However, the innovation drivers have various orientations, and their selection requires multiple-criteria decision-making (MCDM). This study proposes a modified Delphi method combined with the best–worst method (BWM) as a research framework for selecting and ranking innovation drivers. Our results show the validity of this integrated research framework on a case based in China in the post-COVID-19 era. The results reveal 21 innovation-driven factors of NOKEC with varying levels of relative importance. These results may provide a basis for policymakers and researchers with a useful further understanding of the importance and prioritizing of innovation drivers. In this study, BWM uses 4% fewer pairwise comparisons than AHP, and the consistency ratio is in the range of 0.00 to 0.24. [ABSTRACT FROM AUTHOR]

Abstract Background Randomised controlled trials (RCTs) evaluating ectopic pregnancy have reported many different outcomes, which are themselves often defined and measured in distinct ways. This level of variation results in an inability to compare results of individual RCTs. The development of a core outcome set to ensure outcomes important to key stakeholders are collected consistently will guide future research in ectopic pregnancy. Study aim To develop and implement a core outcome set to guide future research in ectopic pregnancy. Methods and analysis We have established an international steering group of key stakeholders, including healthcare professionals, researchers, and individuals with lived experience of ectopic pregnancy. We will identify potential outcomes from ectopic pregnancy from a comprehensive literature review of published randomised controlled trials. We will then utilise a modified Delphi method to prioritise outcomes. Subsequently, key stakeholders will be invited to score potential core outcomes on a nine-point Likert scale, ranging from 1 (not important) to 9 (critical). Repeated reflection and rescoring should promote whole and individual stakeholder group convergence towards consensus ‘core’ outcomes. We will also establish standardised definitions and recommend high-quality measurements for individual core outcomes. Trial registration COMET 1492 . Registered in November 2019.

Electric vehicles (EVs) are positioned as an alternate green energy technology, which potentially can enable the efficient transition to sustainable low-carbon emission transportation systems. However, different barriers hamper the public adoption of EVs. The degree to which these barriers prevent the adoption of EVs and the potential alternatives to these barriers are mostly unknown. To fill this research gap, the current study contributes by systematically identifying those barriers based on their importance. Initially, several barriers were identified using existing literature, and then by employing the modified Delphi method, a total of twenty-five barriers were classified into five significant dimensions. The Analytical Hierarchical Process (AHP) determined the rankings of these barriers based on weight allocation. As a next step, the Grey Technique for Order Preference by Similarity to Ideal Solution (G-TOPSIS) ranked alternative solutions to these barriers. The findings indicate that 'technological barrier' is the top-ranked barrier among all major dimensions. The overall ranking indicated that 'battery technology' is most influential among sub-dimensions. It is recommended that "investment in research and development" is the best alternative to overcome these barriers. In order to improve the renewable and sustainable urban transportation system, all stakeholders should cooperate in a consistent and coherent manner. [ABSTRACT FROM AUTHOR]

Background/purpose: The implementation of competency-based medical education is a social construction process within a local and cultural context. However, little is known about the process of adaptation to different systems, known as "glocalization". We analyzed the documents in the development of a milestone project from adapting global standards into a local context and identified a framework underlying this process.Methods: Taiwan Society of Emergency Medicine (TSEM) had developed learning milestones based on the ACGME's version through series of consensus methods including committee work, nominal group technique (NGT), and a modified Delphi method. We applied qualitative content analysis to characterize the evolution of the three versions of TSEM and the original ACGME milestones documents and to explore the meaning behind the differences revealed by the glocalization process.Results: We found 48 differences between ACGME and TSEM milestones. Among these differences, one was made by committee work, 44 came from NGT, and 3 were from the modified Delphi process. Two themes and seven sub-themes emerged from the coding process to explain the contextualization process of the milestones.Conclusion: We identified a framework that incorporates local expression and local needs into the process called glocalization through which global models of competency-based standards could be optimally implemented in a local context with different systems and cultures. [ABSTRACT FROM AUTHOR]

The tourism industry contributes more than 10% of global GDP, and creates than 330 million jobs. Since the outbreak of COVID-19, tourism has been one of the hardest hit areas, and one of the most explosive growth sectors, in the post-COVID-19 era. This study analyses the operational efficiency of tourism factories, before and after the COVID-19 outbreak. This study develops a PADME (Product, Aesthetic, Digitalization, Management and Experience) efficiency evaluation model for the non-financial components of tourism factories. This study has also successfully developed the evaluation scale of the PADME model. In addition, with reference to studies on the operational efficiency of financial components, two output variables (turnover and net profit after tax), and three input variables (assets, R&D expenses, and employees) were set, and the efficiency of the PADME model was calculated. The data envelopment analysis (DEA) approach was used to measure the operational efficiency of tourism factories. The empirical research goals of this study are focused on 12 listed companies in Taiwan, with operational efficiency before and after COVID-19 analyzed in relation to their general and individual analyses. The conclusions of this study lead to both enlightening and practical management implications. Academically, this study fills a gap in the research on operational efficiency of tourism factories in the tourism industry. [ABSTRACT FROM AUTHOR]

STUDY QUESTION We aim to develop, disseminate and implement a minimum data set, known as a core outcome set, for future male infertility research. WHAT IS KNOWN ALREADY Research into male infertility can be challenging to design, conduct and report. Evidence from randomized trials can be difficult to interpret and of limited ability to inform clinical practice for numerous reasons. These may include complex issues, such as variation in outcome measures and outcome reporting bias, as well as failure to consider the perspectives of men and their partners with lived experience of fertility problems. Previously, the Core Outcome Measure for Infertility Trials (COMMIT) initiative, an international consortium of researchers, healthcare professionals and people with fertility problems, has developed a core outcome set for general infertility research. Now, a bespoke core outcome set for male infertility is required to address the unique challenges pertinent to male infertility research. STUDY DESIGN, SIZE, DURATION Stakeholders, including healthcare professionals, allied healthcare professionals, scientists, researchers and people with fertility problems, will be invited to participate. Formal consensus science methods will be used, including the modified Delphi method, modified Nominal Group Technique and the National Institutes of Health's consensus development conference. PARTICIPANTS/MATERIALS, SETTING, METHODS An international steering group, including the relevant stakeholders outlined above, has been established to guide the development of this core outcome set. Possible core outcomes will be identified by undertaking a systematic review of randomized controlled trials evaluating potential treatments for male factor infertility. These outcomes will be entered into a modified Delphi method. Repeated reflection and re-scoring should promote convergence towards consensus outcomes, which will be prioritized during a consensus development meeting to identify a final core outcome set. We will establish standardized definitions and recommend high-quality measurement instruments for individual core outcomes. STUDY FUNDING/COMPETING INTEREST(S) This work has been supported by the Urology Foundation small project award, 2021. C.L.R.B. is the recipient of a BMGF grant and received consultancy fees from Exscentia and Exceed sperm testing, paid to the University of Dundee and speaking fees or honoraria paid personally by Ferring, Copper Surgical and RBMO. S.B. received royalties from Cambridge University Press, Speaker honoraria for Obstetrical and Gynaecological Society of Singapore, Merk SMART Masterclass and Merk FERRING Forum, paid to the University of Aberdeen. Payment for leadership roles within NHS Grampian, previously paid to self, now paid to University of Aberdeen. An Honorarium is received as Editor in Chief of Human Reproduction Open. M.L.E. is an advisor to the companies Hannah and Ro. B.W.M. received an investigator grant from the NHMRC, No: GNT1176437 is a paid consultant for ObsEva and has received research funding from Ferring and Merck. R.R.H. received royalties from Elsevier for a book, consultancy fees from Glyciome, and presentation fees from GryNumber Health and Aytu Bioscience. Aytu Bioscience also funded MiOXYS systems and sensors. Attendance at Fertility 2020 and Roadshow South Africa by Ralf Henkel was funded by LogixX Pharma Ltd. R.R.H. is also Editor in Chief of Andrologia and has been an employee of LogixX Pharma Ltd. since 2020. M.S.K. is an associate editor with Human Reproduction Open. K.Mc.E. received an honoraria for lectures from Bayer and Pharmasure in 2019 and payment for an ESHRE grant review in 2019. His attendance at ESHRE 2019 and AUA 2019 was sponsored by Pharmasure and Bayer, respectively. The remaining authors declare no competing interests. TRIAL REGISTRATION NUMBER Core Outcome Measures in Effectiveness Trials (COMET) initiative registration No: 1586. Available at www.comet-initiative.org/Studies/Details/1586. TRIAL REGISTRATION DATE N/A. DATE OF FIRST PATIENT'S ENROLMENT N/A. [ABSTRACT FROM AUTHOR]

Purpose: Child injuries are a public health concern globally. Injury surveillance systems (ISSs) have beneficial impact on child injury prevention. There is a need for evidence-based consensus on frameworks to establish child ISSs. This research aims to investigate the key components of a child ISS for Iran and to propose a framework for implementation. Methods: Data were gathered through interview with experts using unstructured questions from January 2017 to December 2018 to identify child ISS functional components. Qualitative data were analyzed using content analysis method. Then, modified Delphi method was used to validate the functional components. Based on the outcomes of the content analysis, a questionnaire with closed questions was developed and presented to a group of experts. Consensus was achieved in two rounds. Results: In round I, 117 items reached consensus. In round II, 5 items reached consensus and were incorporated into final framework. Consensus was reached for 122 items comprising the final framework and representing 7 key components: goals of the system, data sources, data set, coalition of stakeholders, data collection, data analysis and data distribution. Each component consisted of several sub-components and respective elements. Conclusion: This agreed framework will assist in standardizing data collection, analysis and distribution, which help to detect child injury problems and provide evidence for preventive measures.

Abstract Background The purpose of this study was to use the modified Delphi method to identify the influencing factors of health-related quality of life (HRQoL) in patients with unruptured intracranial aneurysms (UIAs) after endovascular treatment. Methods A modified Delphi method to obtain expert consensus on the content of potential influencing factors of HRQoL in patients with UIAs treated by endovascular intervention was employed. The research team consists of three neuroradiologists and one epidemiologist from Xuanwu Hospital of Capital Medical University. They randomly selected 21 well-known experts in cerebrovascular disease diagnosis and treatment as participating experts. The importance of the indicator is based on the 5-Likert scale. The standard deviation (SD), coefficient of variation (CV), mean ( x ¯ $$ \overline{x} $$ ), and minimum and maximum scores of each indicator were calculated. The consistency was described by Kendall coefficient of concordance with a p value

Purpose: The purpose of this study was to obtain a validated consensus among expert periodontists in Saudi Arabia regarding end-of-periodontics-residency-training entrustable professional activities (EPAs) using a modified Delphi method., Methods: The study consisted of two phases. A preliminary phase in which experts met and proposed an initial list of EPAs following an extensive literature review. The second phase consisted of two rounds of the modified Delphi method in which expert periodontists in Saudi Arabia determined the content validity of each EPA. This was determined with a 5-point scale ranging from 1 (not important/relevant) to 5 (very important/relevant), and the mean score for each EPA was calculated. EPAs with a mean value of ≤ 4 or agreement rate among experts of less than 80% were excluded., Results: An initial list of 40 EPAs was proposed. A total of 30 expert periodontists participated in the first round, and 24 participated in the second round of the modified Delphi method ratings. Most of the participants were program directors and represented different programs and cities in Saudi Arabia. Five EPAs were removed, and a final list of EPAs was produced based on the defined criteria. The Cronbach's alpha was 0.920, indicating high reliability., Conclusions: A final list of 35 end-of-periodontics-training EPAs was produced. The findings of this study can serve as a valuable resource for curriculum development, assessments, and evaluation of periodontics training programs in Saudi Arabia., (© 2024 The Author(s). Journal of Dental Education published by Wiley Periodicals LLC on behalf of American Dental Education Association.)

Background Effective gender-based violence (GBV) interventions depend on precise tools to assess healthcare providers' knowledge, attitudes, and practices (KAP). This study aimed to develop and validate a culturally appropriate GBV questionnaire on the KAP of healthcare workers in India using a modified e-Delphi method. Methodology The study used a modified e-Delphi approach, conducted online, to validate a GBV questionnaire. The process included the following three rounds: content validation, quantitative validation, and finalization. It began with a literature review and questionnaire drafting in May 2022, followed by validation from September 2022 to December 2023. The expert panel included healthcare professionals, public health experts, and researchers. The questionnaire included the following four sections: demographic information, knowledge of GBV, attitudes toward GBV, and GBV-related practices. Results In Round 1, significant revisions were made to enhance relevance and clarity, including the addition of a "Don't Know" option and revisions to questions on gender roles and societal expectations. The quantitative validation of Round 2 revealed high scores for Importance (4.980), Usefulness (4.965), Relevance (4.965), Clarity (4.955), Simplicity (4.980), and Ambiguity (4.815), with all items retained and no significant modifications. In Round 3, consensus was achieved, finalizing the questionnaire with expert validation certificates, demonstrating strong reliability and contextual appropriateness. Conclusions The validated KAP questionnaire is a reliable tool for assessing healthcare providers' capacity to manage GBV. It can be used to inform and enhance interventions aimed at improving GBV management in healthcare settings., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee, KLE Jagadguru Gangadhar Mahaswamigalu Moorsavirmath Medical College issued approval JGMMMCIEC/058/2023. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: The study “Catalyzing Change: Enhancing the Capacity of Healthcare Workers to Address Violence Against Women - An Interventional Study in the Field Practice Area of KLE’s JGMM Medical College, Hubballi, Karnataka” was funded by the Research and Development Cell, KAHER, Belagavi, Karnataka, India. Financial relationships: Dr. Namratha Kulkarni Dr. Rizwana B Shaikh declare(s) a grant from Research Cell, KLE Academy of Higher Education and Research. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Kulkarni et al.)

Since a variety of barriers pose challenges to the Indian wind energy sector, the extent to which these barriers hamper this sector and the alternative solutions are largely unknown. We identify several barriers using existing literature, and then using the modified Delphi approach, refine 25 barriers and classify them into five significant dimensions. Later, the Analytical Hierarchical Process determined the ranking of barriers using pairwise comparison matrices. The Grey Technique for Order Preference by Similarity to Ideal Solution method ranked alternative solutions to these barriers. Results indicate that "financial barrier" is the most important barrier among all dimensions, while "limited government subsidy" is most influential among all sub-barriers. "Availability of adequate funds" is the best alternative to overcome these barriers. Finally, a sensitivity analysis is performed to validate the study findings. The study findings may assist practitioners and policymakers in boosting the current sluggish growth of the Indian wind sector. [ABSTRACT FROM AUTHOR]

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ObjectiveHealth care providers are increasingly being evaluated by the quality of care they provide. Our aim was to assess the feasibility of recently developed quality indicators (QIs) for pelvic organ prolapse (POP) and identify possible deficits in care.Study designA panel ranked 14 QIs based on the RAND appropriateness method assessing screening and diagnosis, pessary management, and surgery for POP. Retrospective chart abstraction was performed after identifying patients with a diagnosis of POP evaluated within a hospital-based multispecialty group using International Classification of Diseases, ninth edition, diagnosis codes.ResultsOf 283 patients identified, 98% of those with a new complaint of vaginal bulge had a pelvic examination. The POP was described but not staged in 6% and not documented at all in 25.1%. Among those managed with pessaries, 98% had vaginal examinations at least every 6 months. Forty-nine percent of the patients who had surgery had complete preoperative POP staging. Only 20% of women undergoing apical surgery had documentation of counseling regarding different surgical options, and of the women who underwent a hysterectomy for POP, only 48% had a concomitant vault suspension. Although 71% had documentation about the risk of postoperative stress incontinence, only 14.5% had documented counseling regarding risks of mesh. Only 37% of patients implanted with mesh for POP had documented follow-up at 1 year. An intraoperative cystoscopy was performed in 86% undergoing cystocele repair or apical surgery.ConclusionThe quality of care for women with POP can be feasibly measured with QIs. Processes of care were deficient in many areas, and our findings can serve as a basis for quality improvement interventions.

Background: Randomised controlled trials (RCTs) evaluating ectopic pregnancy have reported many different outcomes, which are themselves often defined and measured in distinct ways. This level of variation results in an inability to compare results of individual RCTs. The development of a core outcome set to ensure outcomes important to key stakeholders are collected consistently will guide future research in ectopic pregnancy.Study Aim: To develop and implement a core outcome set to guide future research in ectopic pregnancy.Methods and Analysis: We have established an international steering group of key stakeholders, including healthcare professionals, researchers, and individuals with lived experience of ectopic pregnancy. We will identify potential outcomes from ectopic pregnancy from a comprehensive literature review of published randomised controlled trials. We will then utilise a modified Delphi method to prioritise outcomes. Subsequently, key stakeholders will be invited to score potential core outcomes on a nine-point Likert scale, ranging from 1 (not important) to 9 (critical). Repeated reflection and rescoring should promote whole and individual stakeholder group convergence towards consensus 'core' outcomes. We will also establish standardised definitions and recommend high-quality measurements for individual core outcomes.Trial Registration: COMET 1492 . Registered in November 2019. [ABSTRACT FROM AUTHOR]

In Industry 4.0, the concept of a Smart Factory heralds a new phase in manufacturing; the Smart Factory System (SFS) will have a huge demand in Taiwan. However, the cost of constructing a factory system will be high, and the complexity processes and introduction time must be considered. Thus, it is important to figure out how to grasp the key success factors for Smart Factories to reduce difficulties in the process, deal with the occurrence of problems, and improve the success rate of constructing Smart Factories. This research constructs an SFS recommendation model to make up for past research deficiencies in terms of recommendation. It combines the methodology of the Engel–Kollat–Blackwell Model (EKB Model) and the Modified Delphi Method to derive SFS recommendation indicators. Through analyzing weights, the ELECTRE II was used to obtain the importance of each dimension by calculating the Modified Compound Advantage Matrix. For prototype indicators, it reviewed the past literature to find out deficiencies and examined the world's four largest manufactories or computer technology corporations to analyze their Smart Factory solutions regarding the SFS function characteristics. The survey ran for several rounds with a group of five experts to amend indicators until a consensus was obtained. It proposed 64 indicators of 8 primary dimensions in total, based on the Updated Information System Success Model, and then added the concepts of SFS Function characteristics, Information Security, Perceived Value, Perceived Risk, and UI Design. According to the indicators, the framework and prototype of this system will provide solutions and references for purchasing SFS, the functions of which include SFS purchase ability analysis, demand analysis of manufacture problems, and raking and scoring of recommendation indicators. It will provide real-time ranking and the best alternative recommendations to suppliers, and will not only be referred to for design and modification but also enable the requirements to be closer to the users' demands. [ABSTRACT FROM AUTHOR]

Over the last few decades, the training methods for rowers have been converging toward similar models owing to the progress in science and technology, in particular, the increased flow of information. As a result, rowing performance in competitions at the international level is the best it has ever been. However, it is possible to further enhance rowers' performance. An important first step to obtain an advantage on the race course is the selection of rowing athletes. The selection method presented here began by inviting experts and scholars in the field to complete a questionnaire, which was established through the analysis and compilation of relevant literature on rowing and athlete selection. Subsequently, the modified Delphi method is applied to achieve an expert consensus on the selection criteria to be evaluated. Five primary criteria, including athlete monitoring via internet-of-things (IoT) technology, and twenty sub-criteria were identified for the selection of elite rowers. An evaluation model for the athletes was constructed from the data using the analytic hierarchy process. The results showed that when selecting rowers the primary criterion of body factor has the highest priority, followed by IoT measurement factor, professional factor, reaction factor, and psychological factor. Furthermore, it reveals that the important sub-criteria affecting athlete selection are body composition, muscle composition, and competition scores. The framework provided by this study for the selection of elite rowers can be refined and adapted for the selection of elite athletes in related sports.

2014 年《十二年國民基本教育課程綱要總綱》中，「生活課程」是專為國小低年級設置的銜接課程，為一門超越學科的統整課程，教師需具備足夠的專業素養，方能落實十二年國民基本教育核心素養之課程理念。本研究旨在建構一套「生活課程教師專業素養指標」，先瞭解國民小學生活課程教師之專業素養，再結合教師教學能力成熟度模型，分為「初始級」、「基本課程管理」、「進階課程管理實施」、「量化管理」與「永續最適化」五個層級，其下包含 15個指標向度及 45 個指標檢核項目，並以修正式德爾菲法取得專家學者之共識，進而透過模糊層級分析法分析各層級指標之權重分配及重要性排序，藉此建構出一套系統化及科學化之指標體系，期能提供生活課程教師自我檢核與專業成長，並作為教育行政機關推動教師專業發展與師資培育之參考依據。 Guidelines for a 12-year basic education curriculum were announced and implemented in Taiwan in 2014. In these guidelines, “life curriculum” is defined as a course that is designed to bridge the gap in elementary and kindergarten course knowledge for first and second graders. Teachers should demonstrate adequate professionalism to fully implement the core literacies embodying the curriculum ideas of the 12-year basic education curriculum. This study aimed to develop a set of indicators for the professionalism of life curriculum teachers. Literature on Taiwanese and international studies was first reviewed to establish criteria for the professionalism of life curriculum teachers. The teaching capability maturity model was adopted, which divides professionalism into five levels, namely the beginner level, basic curriculum management, advanced curriculum management and implementation, quantitative management, and sustainable optimization, and incorporates 15 dimensions and 45 indicator checkup items. A modified Delphi method was adopted to obtain consensus among experts and scholars. A fuzzy hierarchical analysis was performed to assign weights and ranks to the indicators at all five levels. This empirical indicator system was therefore developed to serve as a self-assessment tool for life curriculum teachers to develop their professionalism; moreover, the indicators may serve as a reference for educational administrative agencies to promote the development of teacher professionalism and support future teachers.

Background: Endoscopic sleeve gastroplasty (ESG) is an innovative, minimally invasive bariatric procedure with an excellent safety and efficacy profile in adults with obesity. The purpose of the procedure is to shorten and tubularize the stomach along its greater curvature. Nevertheless, there are some heterogeneities in the approach to ESG, which will be important to address as the procedure sees increasingly widespread clinical adoption. Here, an expert consensus on standardized ESG techniques is presented., Methods: The modified Delphi method was used to establish the key procedural steps of an ESG. A panel of 8 experts was selected, of which 6 participated. The panel was selected based on their experience with performing the procedure and consisted of 1 bariatric surgeon and 5 interventional gastroenterologists. A neutral facilitator was designated and produced a skeletonized initial version of the key steps that was sent to each expert. Each survey began with the experts rating the given steps on a Likert scale of 1 to 5, with 1 being the most inaccurate and 5 being the most accurate. Furthermore, the final product was rated. The survey continued with open-ended questions designed to revise and polish the key steps. Areas of discrepancy were addressed using binary questions and a majority vote. The respondents were given 10 days to complete each survey. At the end of each round, the survey was redistributed with updated key steps and questions. This process was continued for a predesignated 3 rounds., Results: Of the 8 experts who were queried, 6/8, 5/8, and 5/8 replied to each round. The given ratings for the accuracy of the steps in each round were 4.2, 4.6, and 4.4. The final rating was 4.8. Although expert opinion varied around smaller portions of the procedure, such as the placement of an overtube and the shape of each suture line, there was consensus on the need for full-thickness bites and appropriate swirling of the tissue with the helix device. Whether or not to include the fundus in the gastroplasty was an additional area of discrepancy. Of note, 4 of 5 experts agreed that the fundus should remain intact. The final protocol consisted of 21 steps curated from the summarized responses of the experts., Conclusion: Using the modified Delphi method, 21 key steps have been described for a safe and effective ESG. This rubric will be standardized across institutions and practitioners. Furthermore, these findings allow for the generation of educational assessment tools to facilitate training and increase the adoption of ESG by endoscopists., (Copyright © 2024. Published by Elsevier Inc.)