Expert Opinions on the Debate of Pericardial Reconstruction in Cardiovascular Surgery: To Close or Not to Close?

Background: As of 2019, pericardial closure was performed in only a small portion of the over 320,000 cardiac surgeries performed annually. However, evidence regarding the benefits of pericardial closure or reconstruction has been accruing, particularly with the publication of the RECON study in 2019. Methods: This group of authors convened to try to arrive at consensus expert opinion regarding pericardial reconstruction. Structured topic questions initially were used to stimulate discussion. Subsequently, a survey of proposed expert opinion statements was conducted among the authors. Based on that survey, consensus expert opinion statements and recommendations were compiled. Results: The expert opinions encompass various topics relating to pericardial reconstruction, including definitions, benefits/risks, and technique. Observed benefits include reductions in: (1) adhesions; (2) postoperative pericardial effusion, atrial fibrillation, and bleeding; and (3) readmissions and length of hospital stay. Expert opinion recommendations regarding surgical technique are compiled into a single chart. Complete pericardial reconstruction should be performed, using native pericardial tissue if available and viable; if not feasible, a patch may be used. Patches that stimulate the formation of site-specific tissue in situ (such as natural extracellular matrix) may have additional benefits (including bioregenerative properties and lack of inflammatory response). Closure should be taut, but tension-free. Adequate drainage of the closed pericardium must be ensured. Conclusions: Based on available data and collective surgical experience, we endorse pericardial reconstruction as standard approach in appropriately selected patients. We also endorse adoption of standardized pericardial reconstruction techniques to optimize patient outcomes and improve evidence quality in future studies.

Past and future of HIV infection. A document based on expert opinion

HIV infection is now almost 40 years old. In this time, along with the catastrophe and tragedy that it has entailed, it has also represented the capacity of modern society to take on a challenge of this magnitude and to transform an almost uniformly lethal disease into a chronic illness, compatible with a practically normal personal and relationship life. This anniversary seemed an ideal moment to pause and reflect on the future of HIV infection, the challenges that remain to be addressed and the prospects for the immediate future. This reflection has to go beyond merely technical approaches, by specialized professionals, to also address social and ethical aspects. For this reason, the Health Sciences Foundation convened a group of experts in different aspects of this disease to discuss a series of questions that seemed pertinent to all those present. Each question was presented by one of the participants and discussed by the group. The document we offer is the result of this reflection.

COVID-19 vaccine effectiveness among immunocompromised populations: a targeted literature review of real-world studies

IntroductionFrom July through October of 2021, several countries issued recommendations for increased COVID-19 vaccine protection for individuals with one or more immunocompromised (IC) conditions. It is critically important to understand the vaccine effectiveness (VE) of COVID-19 vaccines among IC populations as recommendations are updated over time in response to the evolving COVID-19 pandemic.Areas coveredA targeted literature review was conducted to identify real-world studies that assessed COVID-19 VE in IC populations between December 2020 and September 2021. A total of 10 studies from four countries were identified and summarized in this review.Expert opinion/commentaryVE of the widely available COVID-19 vaccines, including BNT162b2 (Pfizer/BioNTech), mRNA-1273 (Moderna), Ad26.COV2.S (Janssen), and ChAdOx1 nCoV-19 (Oxford/AstraZeneca), ranged from 64%-90% against SARS-CoV-2 infection, 73%-84% against symptomatic illness, 70%-100% against severe illness, and 63%-100% against COVID-19-related hospitalization among the fully vaccinated IC populations included in the studies. COVID-19 VE for most outcomes in the IC populations included in these studies was lower than in the general populations. These findings provide preliminary evidence that the IC population requires greater protective measures to prevent COVID-19 infection and associated illness, hence should be prioritized while implementing recommendations of additional COVID-19 vaccine doses.

Analysing the impact of artificial intelligence on the competitiveness of tourism firms: a modified total interpretive structural modeling (m-TISM) approach

PurposeThis study explores the variables that drive the impact of artificial intelligence (AI) on the competitiveness of a tourism firm. The relationship between the variables is established using the modified total interpretive structural modelling (m-TISM) methodology. The factors are identified through literature review and expert opinion. This study investigates the hierarchical relationship between these variables.Design/methodology/approachThe modified total interpretive structural modelling (m-TISM) method is used to develop a hierarchical interrelationship among variables that display direct and indirect impact. The competitiveness of a tourism firm is measured by investigating the effect of variables on the firm's financial performance.FindingsThe study identifies ten key factors essential for analysing the impact of AI on a firm's competitiveness. The m-TISM methodology gave us the hierarchical relationship between the factors and their interpretation. A theoretical TISM model has been constructed based on the hierarchy and relationship of the elements. The elements that fall in Level V are “AI Skilled Workforce”, “Infrastructure” and “Policies and Regulations”. Level IV includes the elements “AI Readiness”, “AI-Enabled Technologies” and “Digital Platforms”. Elements that fall under Level III are “Productivity” and “AI Innovation”. Level II and Level I comprise “Tourist Satisfaction” and “Financial Performance”, respectively. The levels indicate the elements' hierarchical level, with Level I the highest and Level V the lowest.Research limitations/implicationsTourism and AI scholars can analyse the given variables by including the transitive links and incorporate new variables depending upon future research. The m-TISM model constructed from literature review and expert opinion can act as a theoretical base for future studies to be conducted by researchers.Practical implicationsManagement/Practitioners can focus on the available characteristics and capitalise on them while working on the factors lacking in their organisation to enhance their competitiveness. Entrepreneurs starting their own business can utilise the elements in understanding the ecosystem of strengthening a firm's competitiveness. They can work to improve on the aspects which are crucial and trigger the impact on competitiveness. The government and management can devise policies and strategies that encompass the essential factors that positively impact the competitiveness of the firms. The approach can then be looked at with a holistic approach to cater to the other related components of the tourism industry.Originality/valueThis study is the first of its kind to use the modified TISM methodology to understand the impact of AI on the competitiveness of tourism firms.

NECESSARY (COMPULSORY) EVIDENCES IN CIVIL PROCEDURE

In this article, the author examines the concept and procedural and legal significance of necessary (mandatory) forensic evidence. It analyzes the formulated by M.K. Treushnikov, who was the first in the procedural doctrine who paid attention to the legal obligation to use certain means of proof when establishing certain legal facts, the positive rule of admissibility of evidence, the positions of other authors on the issue of necessary evidence in civil proceedings. The rule of necessary (obligatory) evidence is considered as a special rule of judicial proof. At the end of the study it is concluded that the allocation of necessary evidence is carried out from the same content of factual data, reflecting the same fact, based on the peculiarities of their procedural form. Necessary evidence in its form is a specific type of a written document or expert opinion. Thus, the rule of proving the circumstances of the case with the use of necessary evidence concerns the form of evidence, beyond its content. The thesis is also put forward that necessary evidence, due to the specifics of the procedure for its formation, the presence of requirements established by law to its form and content, has a significant evidentiary value.

ANALISYS OF MANAGEMENT INFORMATION SYSTEMS FOR TRADE ENTERPRISES

The analysis of management information systems for trade enterprises in Ukraine is considered. The process of a trade enterprise management determines the need to use information systems and technologies. However, the level of information support for Ukrainian trade enterprises remains very low because only 6 % of them actively used systems for customer relationship management. Therefore, the analysis and reasonable selecting of management information systems for trade enterprises is relevant and has practical importance. Analysis of the problem showed that researchers used two ways. The first one is to develop the own information systems. The second one is to use existing systems. The purpose of the article is a comparative analysis of management information systems for trade enterprises and their selection based on rating evaluation. Based on the method of analogy, a methodology for rating evaluation of information systems has been proposed. To check the consistency of expert opinion on the rating of information systems, an expert method was used. Kendall coefficient of concordance has been calculated. A comparative analysis of four information systems such as Bitrix24, Bpm'online, AmoCRM, Megaplan was carried out. Based on the survey, they were selected by fifteen signs. It is determined that the information systems such as bpm online and Bitrix24 have the highest ratings. There have been considered their functionality. Similar results were obtained for six information systems including Megaplan, bpm'online sales, Bitrix24, Amo CRM, 1C and Mango. The consistency degree of expert opinions on the rating of four information systems such as bpm'online sales, Bitrix24, AmoCRM and Megaplan is determined by the expert method. The value of Kendall concordance coefficient of 0.86 indicates a strong consistency of expert opinion, which confirms the preliminary calculations. So, information systems are arranged in the following order: bpm online ranks first, Bitrix24 ranks second, AmoCRM ranks third and Megaplan comes fourth. Thus, according to the results of the rating, the solution of the company Terrasoft «Bpm'online» is the most suitable for satisfying our needs.

Fenomena Praktik Ijtihad dan Taqlid dalam Pandangan Hukum Islam

This paper aims to analyze the extent of ijtihad and taqlid perspectives according to classical andcontemporary scholars. Understanding the scope of mujtahid and muqallid requirements and urgencyin Islamic Fiqh. The writing method used is a literature review method which is included in the categoryof textual historical research regarding the content of ijtihad. Sources of research through primary,secondary, and tertiary data obtained from literature, documentation, and expert opinion. The resultscan be concluded that the prospect of ijtihad in the current era is actually still wide open for thosewho have full competence, unfortunately it is still quite difficult to realize due to several obstaclesincluding one, many scholars think that after the third period the door of ijtihad has been closed, andalthough it is possible, it is possible Ijtihad is only at the level of muqayyad and not mustaqil. Two, thedifference in perspective on the boundaries of the legal object of ijtihad often creates conflicts andmakes intellectuals afraid and empty. Three, the actualization of Islamic law is still only a discoursewithout any continuity

Expert opinion on current and emerging treatment options in androgenetic alopecia and telogen effluvium: an Indian perspective

<p class="abstract">The diagnosis and management of hair loss needs an organized and systematic approach for recognizing pattern of hair loss and identification of hair loss etiology. Early and specific diagnosis is essential to initiate appropriate treatment in the early phases of hair loss. Topical minoxidil and oral finasteride are the only approved drugs for androgenetic alopecia (AGA). Various other treatment options are widely used but have limited clinical evidence. Similarly, there are no specific treatments recommended for telogen effluvium (TE). However, the treatment may become challenging with increasing availability of new formulations and drugs with no substantial evidence to support them. Multiple focused group discussions were conducted among Indian dermatologists to gain expert opinion on appropriate management of AGA and TE in the current scenario. This article summarizes the consensus clinical viewpoints for topical and oral medications, role of nutritional supplements, and other adjunctive therapies in managing AGA and TE. The panel highlighted that the choice of treatment for AGA and TE depends on the individual hair loss pattern and response to medications. A brief discussion on the use of shampoos and procedures has also been highlighted. </p>