Comprehensive Benefits Research Articles

Prognosis evaluation and efficacy analysis of different treatment options for patients with visceral pleural invasion in stage IIA–IIB lung cancer

ObjectiveControversy surrounds the treatment of visceral pleural invasion in lung cancer, and no studies have compared the efficacy of its four main treatment options (i.e., surgery, chemotherapy, targeted therapy, and immunotherapy). This study aims to compare and analyze surgery, chemotherapy, targeted therapy, and immunotherapy outcomes and explore the optimal treatment of visceral pleural invasion in lung cancer.MethodsWe searched electronic databases (i.e., Pubmed, Embase, Cochrane Library, CNKI, and Chinese Biomedical Literature Database Search) for relevant studies of treatment options for patients with visceral pleural invasion in stage IIA–IIB lung cancer. Searches times were limited to studies published between January 1, 2000 and February 20, 2021. Meta analysis was performed using RevMan 5.3 software We also downloaded original RNA transcription data about lung cancer invasion in the GEO and TCGA tumor databases, and used R 4.0.3 software to perform differential expression and co-expression gene network analyses.ResultsWe included a total of 25 high-quality (i.e., Jadad score 4–7) studies. Meta-analysis found that surgical treatment was associated with a 3-year survival rate OR = 3.80 (95% CI 3.53, 4.09; P < 0.0001), 5-year survival rate OR = 4.10 (95% CI 3.72, 4.53; P < 0.0001), and median survival time OR = 2.71 (95% CI 2.53, 2.89; P < 0.0001). Chemotherapy was associated with a 3-year survival rate OR = 2.08 (95% CI 1.93, 2.25; P < 0.0001), 5-year survival rate OR = 1.68 (95% CI 1.49, 1.89; P < 0.0001), and median survival time OR = 1.84 (95% CI 1.66, 2.04; P < 0.0001). Targeted therapy was associated with a 3-year survival rate OR = 2.91 (95% CI 2.65, 3.19; P < 0.0001), 5-year survival rate OR = 1.83 (95% CI 1.39, 2.33; P < 0.0001), and median survival time OR = 1.76 (95% CI 1.59, 1.94; P < 0.0001). Finally, immunotherapy was associated with a 3-year survival rate OR = 1.89 (95% CI 1.73, 2.07; P < 0.0001), 5-year survival rate OR = 1.66 (95% CI 1.46, 1.88; P < 0.0001), and median survival time OR = 2.53 (95% CI 2.27, 2.82; P < 0.0001). After screening differential genes and co-expressed genes in tumor gene databases, we found that AC245595.1, ITGB1-DT and AL606489.1 may be involved in the process of lung cancer invasion, and macrophages M1 and M2, CD4+-Th1, CD8+-Th1 may participate in immune infiltration.ConclusionsIn patients with visceral pleural invasion of stage IIA-IIB lung cancer, chemotherapy has shown a significant effect on improving prognosis and enhancing efficacy. However, surgical treatment did not significantly improve the overall prognosis. Therefore, the individual situation of the patient and the comprehensive benefits of the treatment program should be fully considered when developing the treatment program.

Exploring market potential and consumer preferences for fungus-resistant grape varieties: A discrete choice analysis in Germany

While fungus-resistant grape varieties (FRGVs) offer comprehensive sustainable benefits, their slow adoption and consumer preferences warrant investigation. Therefore, a discrete choice model for key parameters influencing consumer perceptions, including product attributes, pricing, grape variety preferences, labelling and information dissemination, was constructed based on a representative sample of 1276 wine consumers in Germany. The data were analysed using a conditional logit utility model to gain insights into the preferences and willingness to pay (WTP) of each product attribute. Due to the low level of awareness of these grape varieties, the sample was divided into two groups: a control group and an experimental group, which was conditioned prior to the study to investigate the market potential of FRGVs. The results show that the conditioned group exhibited a stronger inclination towards FRGVs, indicating an increased awareness of environmentally friendly practices. Price sensitivity was influenced by conditioning, with consumers being more sensitive to higher prices after being informed. The study highlights the importance of informed consumer education in promoting environmentally sustainable products like wine from FRGVs.

Effects of chemical regulation on the growth, yield and fiber quality of cotton varieties with different plant architectures

Chemical regulation has beneficial effects on the growth, yield, and fiber quality of cotton with different plant architectures. This study aimed to investigate the combined effects of chemical regulators such as mepiquat chloride (1,1-dimethyl-piperidiniuchloride, DPC), chlormequat chloride (CCC), thidiazuron (TDZ), and ethephon (ETH) during the growth period of cotton. Different combinations of chemical regulators were applied to examine the growth, development, yield, and quality of cotton. The results showed that the application of different chemical regulators had varying effects on the yields of the two cotton varieties with distinct plant architecture. Specifically, K1C1 (before and after topping with 1:1 25% DPC, 50% TDZ, and 40% ETH) and K2C2 (before topping with 25% DPC and after topping with 50% CCC, 50% TDZ, and 40% ETH) were sprayed on ‘Wankemian-1’ and ‘Wanmian-191’, thereby increasing the cotton yield. The K2C2 treatment increased the upper half mean length and fiber strength of the two varieties but decreased the fiber length uniformity index. The fiber strength, fiber length uniformity index, and spinning consistency index of ‘Wankemian-1’ were higher than those of ‘Wanmian-191’. Based on comprehensive yield, quality, and economic benefits, K1C1 and K2C2 were determined to be the most effective chemical regulators of ‘Wankemian-1’ and ‘Wanmian-191’, respectively.

Uncovering the scientific landscape: A bibliometric and visualized analysis of artificial intelligence in traditional Chinese medicine

The emergence of artificial intelligence (AI) technology has presented new challenges and opportunities for Traditional Chinese Medicine (TCM), aiming to provide objective assessments and improve clinical effectiveness. However, there is a lack of comprehensive analyses on the research trajectory, key directions, current trends, and future perspectives in this field. This research aims to comprehensively update the progress of AI in TCM over the past 24 years, based on data from the Web of Science database covering January 1, 2000, to March 1, 2024. Using advanced analytical tools, we conducted detailed bibliometric and visual analyses. The results highlight China's predominant influence, contributing 54.35 % of the total publications and playing a key role in shaping research in this field. Significant productivity was observed at institutions such as the China Academy of Chinese Medical Sciences, Beijing University of Chinese Medicine, and Shanghai University of Traditional Chinese Medicine, with Wang Yu being the most prolific contributor. The journal Molecules contributed the most publications in this field. This study identified hepatocellular carcinoma, chemical and drug-induced liver injury, Papillon-Lefèvre disease, Parkinson's disease, and anorexia as the most significant disorders researched. This comprehensive bibliometric assessment benefits both seasoned researchers and newcomers, offering quick access to essential information and fostering the generation of innovative ideas in this field.

Championing student participation in co-designing digital education resources: A student experience

The aim of this contemporary piece is to discuss the student experience of co-design and the process involved in the co-creation of developing digital educational resources. A discussion of the need for digital educational resources in the era of pre-registration nursing students being digital natives is explored and the potential benefits or barriers for nursing education and practice are outlined. The need for co-design as a methodology in nurse education which is inclusive of the student-led role is discussed and a personal account of student experience will be detailed. By focusing on the student voice this article aims to provide a first-hand experience of working alongside academic and educational research teams, whilst also promoting student participation within co-design projects further than simply tokenistic involvement, highlighting the comprehensive benefits associated for all. The importance of support, knowledge sharing, and effective communication will be detailed to allow other students to gain insight and empower them to participate in a co-designed project should it arise in their university education.

Optimal Urban EV Charging Station Site Selection and Capacity Determination Considering Comprehensive Benefits of Vehicle-Station-Grid

Optimal Urban EV Charging Station Site Selection and Capacity Determination Considering Comprehensive Benefits of Vehicle-Station-Grid

Current developments in prehabilitation in urologic oncology.

Prehabilitation describes interventions that are undertaken prior to a major surgical or medical intervention with the objective of improving functional capability with the goal of improving candidacy for therapy, bolstering one's ability to withstand treatment-associated toxicity, functional decline, and facilitating accelerated recovery. The objective of this review is to detail the key tenets of prehabilitation, synthesize contemporary advances in prehabilitation science within Urologic Oncology, and discuss key methodologic trial design considerations salient to future prehabilitation investigations. Contemporary prehabilitation clinical trials have primarily evaluated unimodal interventions aiming to improve functional capacity across the domains of physical exercise, nutrition, and cognition with heightened interest in evaluating multimodal interventions addressing two or more domains. Recent investigations have have demonstrated variable improvements in strength, balance, physical function, and quality of life with preoperative exercise. Although presurgical immunonutrition showed promise in other fields, initial results in uro-oncology have not demonstrated reductions in complications nor improvements in early survival. Emerging data supports the potential of multimodal prehabilitation programs to offer more comprehensive benefits, improving functional outcomes, reducing length of stay, and supporting improved recovery. To date, early prehabilitation studies in patients undergoing surgery for genitourinary malignancies have demonstrated variable ability to facilitate gains in functional capacity and perioperative outcomes. Key issues have arisen including the need to ensure that interventions are pragmatic, scalable, feasible, and acceptable in these populations that often also have a high prevalence of coincident multimorbidity, frailty, and mental health concerns that can increase risk of adverse outcomes after surgery. The integration of personalized prehabilitation strategies as extensions of perioperative enhanced recovery after surgery protocols, supportive care and survivorship paradigms offers of promise to further engage patients in their care, enhance patient resilience and outcomes, while reducing treatment burden in urologic oncology.

Benefit evaluation of HVAC and HVDC for offshore wind power transmission system under the multidimensional index

With the development of offshore wind power transmission technology and the emergence of new dimensions in deep-sea wind power scenarios, some indexes in the existing evaluation system cannot meet the comprehensive benefit evaluation of multiple offshore wind power transmission schemes in new operating scenarios, making the identification of the optimal economic distance of different schemes vague. Therefore, this paper integrates multiple parameters into the total life cycle cost and levelized cost of energy indexes for traditional and new transmission schemes in deep-sea scenarios, considers power generation income, environmental and carbon index, and proposes a multidimensional evaluation method for offshore wind power transmission systems, and analyzes the sensitivity of the constructed indicators. Then, using actual geographic information data, the established parameter fusion multidimensional evaluation method is used to analyze the technical and economic ranges of four offshore transmission schemes. The results show that the optimal economic critical interval of active commutation type high voltage direct current transmission system (CSC) is 98 km, which is about 23 % higher than that of voltage source converter based high voltage direct current transmission system (VSC). Therefore, CSC is more suitable for deep offshore wind power transmission than VSC and has better comprehensive technical and economic performance.

Research on Benefit Evaluation and Optimization Strategy of Rural Ecological Products Value Realization

As the cornerstone of human existence and progress, ecological products indispensably support the sustainable development of society. In order to deeply discuss the benefits and achievements of eco-product value realization in various regions, this paper sorts out the research status of the evaluation system and method of rural eco-product value realization in Pukou District, and constructs an evaluation system of eco-product value realization benefit including 11 indicators of three subsystems: ecological benefit, economic benefit and social benefit. Using entropy weight method to measure the value realization benefit of rural ecological products. The results show that: (1) the overall development level of Pukou District is relatively high, and the work of promoting the realization of the value of rural ecological products is in good condition, and the overall development is in the growth stage; (2) From 2017 to 2022, the comprehensive benefits of ecological products in Pukou District have been steadily improved, and the comprehensive benefits have increased from 0.385 to 0.642; (3) Ecological benefits increased significantly, followed by economic benefits, and social benefits increased in a downward trend.

Capacity configuration of cascaded hydro-wind-photovoltaic complementary systems considering comprehensive benefits based on a synergetic-orderly framework

The rational configuration of hydro-wind-photovoltaic complementary system is fundamental to fully leveraging the regulation capacity of hydropower and the complementarity between different natural resources. However, complementary systems involving cascaded reservoirs often have comprehensive utilization requirements, which current techno-economic frameworks struggle to address. To solve the above issues, this study proposes a novel framework based on the theory of synergetics to determine the optimal capacities for wind and photovoltaic power considering the comprehensive benefits. Firstly, an inner operation model aimed at maximizing overall order degree is established to optimize the system’s operational performance. Secondly, Kolmogorov entropy is utilized in the outer layer to characterize the synergy of different wind and photovoltaic capacity schemes, thereby selecting the one with the best synergistic effect. Additionally, current techno-economic evaluation indicators are introduced to validate the framework’s effectiveness. A case study of the clean energy base on the upper Yellow River was conducted, and the results indicate that: (1) The proposed framework effectively addresses the comprehensive benefits of multiple subsystems and the optimal capacity scheme performs well in economic and technical aspects. (2) Compared to variations in wind and solar resources, inflow conditions and agricultural water demand have a greater impact on the capacity configuration and operational performance. (3) The optimal capacity ratio of hydro to renewable energy in the upper Yellow River is around 1:0.59. Therefore, this study provides important theoretical support for expanding capacity configuration methods in multi-energy complementary systems.

A Case Study on the Innovative Development of Digital Supply Chain Finance Based on MYbank in China

Small and medium-sized enterprises (SMEs) play a critical role in promoting the development of China’s real economy and improving national productivity, but their financing still faces challenges. In recent years, supply chain finance (SCF) has become one of the most important solutions to SMEs’ financing difficulties. Promoting the digital and innovative development of SCF can better meet the financing needs of SMEs. This study is based on a case study of Zhejiang MYbank Co., Ltd. (MYbank) in Hangzhou, China, which is a representative institution of digital supply chain finance development in China and committed to realizing the digital innovation development of SCF. Based on MYbank’s financial index data from 2018 to 2022, the implementation effect of MYbank’s digital supply chain finance is quantitatively analyzed from the perspectives of SMEs and MYbank. The main findings are as follows.(1) In the practice of digital supply chain finance, MYbank implements the new concepts of SCF decentralization and full coverage of supply chain links while enhancing the sustainability of SCF. (2) For SMEs, MYbank’s digital supply chain finance development has led to an increase in the financing scale and financing availability of SMEs. (3) The analysis of MYbank’s comprehensive benefits shows that the digital innovation development of SCF effectively increased the overall economic value of the enterprise during the period of 2018–2022. Based on these findings, this study provides implications for commercial banks and other financial institutions to develop digital supply chain finance.

3D hybrid path planning for optimized coverage of agricultural fields: A novel approach for wheeled robots

AbstractOver the last few decades, the agricultural industry has made significant advances in autonomous systems, such as wheeled robots, with the primary objective of improving efficiency while reducing the impact on the environment. In this context, determining a path for the robot that optimizes coverage while taking into account topography, robot characteristics, and operational requirements, is critical. In this paper, we present H‐CCPP, a novel hybrid method that combines the comprehensive coverage benefits of our previous approach O‐CCPP with the computational efficiency of the Fields2Cover algorithm. Besides optimizing coverage area, overlaps, and overall travel time, it significantly improves the computation process, and enhances the flexibility of trajectory generation. H‐CCPP also considers terrain inclination to address soil erosion and energy consumption. In an effort to support this innovative approach, we have also created and made available a public data set that includes both 2D and 3D representations of 30 agricultural fields. This resource not only allows us to illustrate the effectiveness of our approach but also provides invaluable data for future research in complete coverage path planning (CCPP) for modern agriculture.

Is return on investment the appropriate tool for healthcare quality improvement governance?

PurposeIn this article, we outline our views on the appropriateness and utility of Return on Investment (ROI) for the evaluation of the value of healthcare quality improvement (QI) programmes.Design/methodology/approachOur recent research explored the ROI concept and became the genesis of our viewpoint. We reflect on our findings from an extensive research project on the concept of ROI, involving a multidisciplinary global systematic literature review, a qualitative and Delphi study with mental healthcare leaders from the United Kingdom National Health Service. Research participants included board members, clinical directors and QI leaders. Our findings led to our conclusions and interpretation of ROI against the broad QI governance. We discuss our views against the predominant governance frameworks and wider literature.FindingsROI is in-line with top-down control governance frameworks based in politics and economics. However, there is evidence that to be of better utility, a tool for the assessment of the value of QI benefits must include comprehensive benefits that reflect broad monetary and non-monetary benefits. This is in-line with bottom-up and collaborative governance approaches. ROI has several challenges that may limit it as a QI governance tool. This is supported by wider literature on ROI, QI as well as modern governance theories and models. As such, we question whether ROI is the appropriate tool for QI governance. A more pragmatic governance framework that accommodates various healthcare objectives is advised.Practical implicationsThis article highlights some of the challenges in adopting ROI as a QI governance tool. We signal a need for the exploration of a suitable QI governance approach. Particularly, are healthcare leaders to be perceived as “agents”, “stewards” or both. The evidence from our research and wider literature indicates that both are crucial. Better QI governance through an appropriate value assessment tool could improve clarity on QI value, and thus investment allocation decision-making. Constructive discussion about the utility and appropriateness of ROI in the evaluation of healthcare QI programmes may help safeguard investment in effective and efficient health systems.Originality/valueThe article raises awareness of QI governance and encourages discussions about the challenges of using ROI as a tool for healthcare QI governance.

Study on the optimal water−biochar management mode based on pan evaporation for solar greenhouse tomato (Solanum lycopersicum L.) in Northeast China

Biochar is commonly employed to enhance soil structure. However, the soil structure degradation due to multi-year continuous cropping poses a significant obstacle to the advancement of solar greenhouse agriculture. This study aimed to optimize the water−biochar management mode for seasonal solar greenhouse tomatoes (Solanum lycopersicum L.), which have been continuously cultivated over three years, with irrigation guided by the evaporation of a 20 cm evaporation pan (Ep-20). The experimental design employed a split–plot arrangement with two factors. The primary factor, irrigation amount, was tested at three levels: 0.6 Ep-20 (W1), 0.8 Ep-20 (W2), and 1.0 Ep-20 (W3). The secondary factor, biochar amount, was tested at three levels: 0 (B0), 20 t ha−1 (B1), and 40 t ha−1 (B2). The results revealed that biochar reduced soil bulk density and enhanced field capacity, tomato plant height, and photosynthesis. Increased irrigation improved tomato appearance quality but reduced nutritional quality, whereas higher biochar application improved both aspects. Principal component analysis (PCA) and grey relational analysis (GRA) results identified W2B2 as the optimal mode for the quality of spring tomato and autumn tomato. Compared to the control (W3B0), W2B2 exhibited an average increase of 18.0 % in yield and 47.5 % in irrigation water productivity (WPI) with a 20 % reduction in irrigation amount across two seasons. The technique for order preference by similarity to ideal solution (TOPSIS) comprehensive evaluation determined that the W2B2 mode maximized comprehensive benefits, enhancing both the overall quality of tomato and achieving higher yield and WPI. This study utilized the Ep-20 to characterize the reference crop evapotranspiration (ETo) and the crop evapotranspiration (ETc). The investigation demonstrated the feasibility of utilizing Ep-20 to guide irrigation under biochar application conditions and develop ETc estimation models for water−biochar management modes to optimize solar greenhouse tomato production.

Constructive retrieval: Benefits for learning, motivation, and metacognitive monitoring

AimsWe tested whether combining constructive learning prompts with retrieval practice (constructive retrieval) positively affects delayed learning outcomes (factual knowledge, comprehension), metacognitive accuracy, and motivation. Sample & methodsUndergraduate students (N = 152) learned from a video-recorded lecture, and then engaged in follow-up learning activities involving retrieval practice, restudy, elaboration, or a combination of retrieval practice with elaboration. We ensured that initial retrieval success was high and that all groups had the same expectations about the nature of content to be tested. We assessed both factual knowledge and comprehension, as well as the respective indicators of metacognitive-monitoring accuracy (metamemory, metacomprehension). We assessed self-efficacy and situational interest as motivational variables. ResultsIn a one-week-delayed posttest, elaboration improved factual knowledge and comprehension. This pattern held whether learners just elaborated or additionally engaged in retrieval practice. Having students self-generate their own examples during retrieval practice improved comprehension, but merely letting students retrieve experimenter-provided examples did not. Students' self-reported mental effort mediated the factual knowledge benefits of retrieval practice. The number of students’ self-generated elaborations mediated comprehension benefits. Students engaging in constructive retrieval while learning revealed the highest metacognitive-monitoring accuracy in factual knowledge and comprehension. We found no differences between conditions regarding situational interest and self-efficacy. Motivation to reuse the respective learning strategies was higher in all conditions compared to restudy. ConclusionConstructive retrieval seems advantageous when considering its benefits on learning outcomes and metacognition. When working on retrieval tasks, students only profited from self-generated, but not from provided, examples with respect to comprehension.

Interplay of yoga, physical activity, and probiotics in irritable bowel syndrome management: A double-blind randomized study

ObjectivesThis study aimed to explore the synergistic impact of online yoga, mindfulness practices, and probiotics on irritable bowel syndrome (IBS) by evaluating changes in physical fitness, mental health, and gut microbiota composition. Design, setting and interventionsThe six-week randomized, double-blinded, placebo-controlled trial included 31 IBS patients categorized into three groups: online yoga with probiotics (EP), online yoga with a placebo (EC), and probiotics only (P). Assessments involved physical fitness tests, subjective questionnaires (IBS-QOL, BSRS-5), and gut microbiome analysis. Main outcome measuresParticipants self-collected stool samples and were given a set of questionnaires at baseline and after six weeks of intervention. Their symptoms were measured by changes in the gut microbiota, physical fitness and quality of life, and psychological well-being. ResultsThe EP group demonstrated improved cardiovascular endurance (P < 0.001) and a significant reduction in Klebsiella bacterial strains (P < 0.05). Both the EP and EC groups exhibited significantly decreased IBS-QOL scores (P < 0.001 and P < 0.05, respectively), indicating enhanced quality of life. While BSRS-5 scores decreased in both groups, the reduction was statistically insignificant. ConclusionIntegrating online yoga, mindfulness practices, and probiotics demonstrated comprehensive benefits for IBS patients. This intervention improved physical fitness and mental well-being and positively influenced gut microbiota composition. The study highlights the potential of this multifaceted approach in managing IBS symptoms and enhancing overall health, emphasizing the relevance of the gut-muscle-brain axis in understanding and addressing IBS complexities. Trial registrationTaiwanese Registry of Institutional Review Board IRBHP210009/CH11000259.

Comprehensive benefit evaluation of Carbon reduction in power transmission and transformation projects by TOPSIS method based on combination weighting

Abstract With the continuous promotion of carbon peak carbon neutrality, the investment and construction of new power systems have accelerated, and the construction of a low-carbon economy has become an inevitable trend of the transformation and development of power transmission and transformation projects. In this paper, the FAHP and entropy methods are used to evaluate the economic, social, and social benefits of carbon reduction in power transmission and transformation projects and finally establish a set of comprehensive benefit evaluation systems for carbon reduction in power transmission and transformation projects. Under this evaluation system, the comprehensive benefit of 220 kV power transmission and transformation project in A province is sorted by entropy weight-TOPSIS method. The comprehensive benefit of power transmission and transformation project B &gt;C &gt;A project is finally obtained. At the same time, in the sub-criteria of economic benefits, the index of “enterprise asset-liability ratio” has the largest comprehensive weight. The “using distributed energy generation” index has the largest comprehensive weight in the sub-criteria layer of carbon reduction benefit. In the subsequent construction of power transmission and transformation projects, enterprises can prioritize improving the above indicators to improve carbon reduction efficiency and economy.

Impact of the carbon market on investment benefits of power-grid enterprises in China: A system dynamics analysis

The power grid, as the hub connecting the power supply and consumption sides, plays an important role in achieving carbon neutrality in China. In emerging carbon markets, assessing the investment benefits of power-grid enterprises is essential. Thus, studying the impact of the carbon market on the investment and operation of power- grid enterprises is key to ensuring their efficient operation. Notably, few studies have examined the interaction between the carbon and electricity markets using system dynamics models, highlighting a research gap in this area. This study investigates the impact of the carbon market on the investment of power-grid enterprises using a novel evaluation system based on a system dynamics model that considers carbon-emissions from an established carbon-emission accounting model. First, an index system for benefit evaluation was constructed from six aspects: financing ability, economic benefit, reliability, social responsibility, user satisfaction, and carbon-emissions. A system dynamics model was then developed to reflect the causal feedback relationship between the impact of the carbon market on the investment and operation of power-grid enterprises. The simulation results of a provincial power-grid enterprise analyze comprehensive investment evaluation benefits over a 10-year period and the impact of carbon emissions on the investment and operation of power-grid enterprises. This study provides guidelines for the benign development of power-grid enterprises within the context of the carbon market.

DEXMEDETOMIDINE: A VERSATILE, MULTITASKING ANESTHETIC AGENT FOR PERIOPERATIVE MANAGEMENT, A NARRATIVE REVIEW

Dexmedetomidine stands out as a versatile anesthetic agent with a unique combination of sedative, analgesic, and sympatholytic properties, making it highly suitable for various perioperative applications. Its ability to provide arousable sedation, reduce opioid requirements, and maintain hemodynamic stability offers significant advantages in the perioperative management of surgical patients, particularly those with cardiovascular risks or a history of opioid use. The neuroprotective potential of dexmedetomidine further broadens its clinical applicability, especially in neurosurgical and trauma settings. While generally well-tolerated, its use necessitates careful monitoring to mitigate side effects such as bradycardia and hypotension, particularly in patients with hepatic impairment. The availability of atipamezole as an antidote enhances the safety profile of dexmedetomidine, allowing for rapid and effective reversal of its sedative and cardiovascular effects. Given the comprehensive benefits and the evolving evidence supporting its use, dexmedetomidine represents a valuable addition to the anesthesiologists toolkit, warranting its continued exploration and integration into perioperative care protocols.

The Relationship between Key Factors and Gen Z Employee Retention in Indonesian FMCG Start-Ups

This study investigates the factors relationship between turnover intention and employee retention of Generation Z employees in the workplace, using a combination of qualitative and quantitative research methods. Data were collected through interviews and surveys, followed by a comprehensive analysis employing descriptive statistics, and multiple linear regression. The qualitative findings highlight significant financial needs, high expectations of career advancement, and the adverse impact of long working hours on job satisfaction and retention. Quantitative analysis identifies financial opportunities, comprehensive employee benefits, and a sense of being financially rewarded as major factors contributing to economic security and retention. Work-life balance and an open, collaborative company culture, characterized by effective communication and teamwork, also play critical roles in enhancing job satisfaction and loyalty among Gen Z employees. The study reveals that financial factors, work-life balance, and organizational culture significantly impact retention rates. Furthermore, it emphasizes the interconnectedness of these variables, noting how unmet financial needs and unrealistic career expectations can lead to job dissatisfaction and increased turnover. The research concludes with recommendations for longitudinal studies, comparative research, and intersectional studies to further understand the evolving and diverse needs of Gen Z employees. Implementing robust career development programs and addressing financial needs are crucial strategies for start-ups aiming to retain young talent in the long term.