Effects Of Management Research Articles

A RELEVÂNCIA DOS FARMACÊUTICOS NO AVANÇO E NOS DESAFIOS DO DESENVOLVIMENTO DE ANTIDEPRESSIVOS: EFICÁCIA, SEGURANÇA E ADESÃO AO TRATAMENTO.

Introduction: This article explores the crucial role of pharmacists in advancing and managing the challenges related to antidepressant development, focusing specifically on efficacy, safety, and treatment adherence. The collected data highlight how pharmacists contribute to the efficacy of antidepressants through appropriate medication selection, dose adjustment, and continuous patient monitoring. Additionally, it discusses the merit of pharmacists in ensuring patient safety, inferring the identification and management of side effects, as well as strategies to achieve better treatment adherence, which is often compromised by adverse effects and the complexity of therapeutic regimens. Methodology: Studies from 2020 to 2024 were included, employing a combination of quantitative and qualitative approaches, with data gathered from bibliographic references within the platforms: PubMed, Scielo, Lilacs, and DeCS from BVS, which provided a cohesive basis for the creation of this work. Results: The research revealed that pharmacists play a fundamental role in optimizing antidepressant efficacy and reducing associated safety risks, as well as in implementing strategies to improve treatment adherence, such as patient education and personalized support. Conclusion: Despite advancements in antidepressant development, challenges related to efficacy, safety, and adherence remain significant. Pharmacists are essential in overcoming these challenges and ensuring more effective and safe treatment for patients. Continued research is necessary to explore new management strategies and support the ongoing advancement of antidepressant pharmacotherapy.

Evaluasi dan Perancangan Model Bisnis UMKM Miss Bluder dengan Business Model Canvas

Miss Bluder is an MSME that sells bluder bread in the city of Bandung. In recent times, Miss Bluder has experienced a significant decline in sales. This is due to limitations in human resource management, suboptimal partnerships, and lack of effectiveness in the sales media used. This research aims to evaluate and design a new business model for Miss Bluder using the Business Model Canvas method. The data used included current business models, customer profiles from interviews, as well as business environment data from literature studies and online research. A SWOT analysis was carried out to formulate an improvement strategy, followed by the design of a Value Proposition Canvas, Channels, and Customer Relationships. After the business model design is completed, verification, financial simulation, and validation processes are carried out through evaluations and interviews with business owners. With the implementation of the new business model, it is hoped that Miss Bluder can overcome the decline in sales, improve business performance, and strengthen its position in the market.

Board Characteristics and Internal Control Risk Management in Urban Investment Companies: A Case Study of Guangxi Urban Investment Group

This study explores the relationship between board characteristics and internal control effectiveness and risk management practices in Chinese urban investment companies. Using a mixed research method combining questionnaire surveys and case studies, an empirical study was conducted on 104 urban investment companies, with the Guangxi Urban Investment Group as a case study. The study found that board characteristics are significantly and positively correlated with internal control effectiveness and risk management practices. Among these, the impact of board expertise is the most significant, followed by board independence and diversity. Board size is positively correlated with internal control effectiveness, but has no significant relationship with risk management practices. The study also found that company size has a moderating effect on the relationship between board characteristics and governance practices. This study provides theoretical and practical guidance for the corporate governance of urban investment companies, emphasizing the importance of improving the professionalism, independence and diversity of the board of directors. The study suggests that urban investment companies should adjust the composition of the board of directors according to their size and complexity, and adopt a comprehensive governance framework to integrate internal control and risk management practices. Future research can further explore the relationship between board characteristics, governance practices and company performance, as well as the impact of emerging technologies on the governance requirements of urban investment companies.

The importance of healthcare monitoring systems

Abstract Issue Healthcare evaluation is an important tool of governance in the health sector that reinforces its key components: evidence-based care, effectiveness, programme standards, performance monitoring, quality improvement, risk and incident management and patient-centered care. One of the evaluation systems used by the Veneto Region (north italian region of about 4.8 million inhabitants) consists of the National Outcomes Programme (PNE) developed by the Italian National Agency for Regional Healthcare Services (AGENAS) on behalf of the Health Ministry. Description The PNE is an instrument used to measure, analyze, evaluate and monitor clinical and welfare assistance performances of Italian healthcare facilities. The Veneto Region, in particular, utilizes a regional epidemiologic service to periodically monitor 21 performance indicators based on “treemap” methodology. These indicators are used to assess processes, outcomes and volumes. The data used to monitor these practices derive from the hospital discharge documentation (SDO) and tax registry information system. The aim of this monitoring system is to track any critical situation that is not in alignment with national guidelines and to improve the efficacy, efficiency, appropriateness and safety within the healthcare system. Results In the Veneto region, over the course of nearly 10 years, this method of management has led to the development of various training courses that guide clinicians to correctly document and code different diagnosis and treatments. The treemap process of analysis has also made possible various clinical audits that have provided significant policy changes regarding risk and overall health management. Lessons Having a constant view of healthcare performance has proven to be helpful not only to identify some common gaps in care given from different facilities on a national level, but also guides different regions to develop specific strategies that lead to quality improvement. Key messages • Data on healthcare quality can be used as comparative information and for quality improvement. • Continuous monitoring of specific performance indicators can help identify difficulties in healthcare facilities and create strategies for long term solutions.

Angiotensin receptor-neprilysin inhibitor (Sacubitril/Valsartan) in cancer therapy-related cardiac dysfunction: real-world experience from a nurse-led cardio-oncology clinic

Abstract Introduction Cancer therapy-related cardiac dysfunction (CTRCD) is a common toxicity amongst patients receiving anti-cancer treatment1. Angiotensin receptor-neprilysin inhibitor (ARNI) Sacubitril/Valsartan is recommended to reduce Heart Failure (HF) admissions and cardiovascular mortality2. However, patients with active cancer were excluded from the key trials of ARNI. This study aims to provide a real-world experience of ARNI prescription and management from the perspective of a nurse-led Cardio-Oncology clinic. Methods This is a single centre, retrospective, observational cohort study performed at a Cardio-Oncology specialist centre between the period of 2021 to 2024. Adult cancer patients receiving anti-cancer therapy were included if they had symptomatic HF or asymptomatic CTRCD, were initiated on ARNI and followed up in the nurse-led Cardio-Oncology clinic. Results Twenty-nine patients were started on ARNI (see Figure 1). The mean age of the patients was 66+11 years and 17 (59%) were male. Cardiovascular risk factors were common: hypertension (45%), hyperlipidaemia (35%), diabetes mellitus (21%), and smoking (17%). Haematological and breast malignancies were most common (31% and 21% respectively), followed by gynaecological malignancies (14%). Twenty-one (72%) were treated with cytotoxic chemotherapy including 10 (35%) received anthracyclines. Five (17%) patients received human epidermal growth factor receptor 2 (HER2) targeted therapies, 3 (10%) were on tyrosine kinase inhibitors, and 2 (7%) received immunotherapy. Twenty-five (86%) patients presented with symptomatic HF while 4 (14%) had asymptomatic CTRCD. The median N-terminal-pro B-type natriuretic peptide (NTproBNP) level was elevated at 1325(806-4330)ng/L. Thirteen (45%) patients tolerated the maximum dose of 200mg twice daily, while 16 (56%) could only tolerate middle and lowest dosages. ARNI dose up titration to the maximum tolerated dose took 26 (15-79) days. Twenty-eight (97%) patients were on beta blockers, 26 (90%) received SGLT2 inhibitors, 25 (86%) on mineralocorticoid receptor antagonists, and 10 (35%) patients required diuretics. The most common side effect was symptomatic hypotension in 11 (38%) patients. Two (7%) had hyperkalemia, 1 (3%) acute kidney injury following initiation, and 1 (3%) had dizziness without significant hypotension. Nine (31%) required dose reduction allowing ARNI to be continued, while 3 (10%) patients had to permanently discontinue ARNI. There were no cardiovascular deaths, cancer deaths or HF admissions. Conclusion The Cardio-Oncology nurse-led clinic permits rapid up-titration of ARNI to target dosages in patients with CTRCD, resulting in significant improvements in cardiac function. The nurse lead clinic education, support and side effect management allowed uninterrupted continuation of cancer treatment. Whether this approach translates into be better cardiac and cancer outcomes requires further study.

Assessing the Effects of Organizational Culture on the Connection Between Innovation in Organizations and Human Resource Management

This article examines the significance of human resource management (HRM) in innovation, organizational culture, and organizational effectiveness. The conceptual framework creation was supported by extracting information from literature research on related study topics, such as resource-based views and organizational effectiveness. This paper seeks to address the existing gap in the literature on organizational effectiveness by emphasizing the role of HRM in influencing business performance. Specifically, it focuses on the intermediate impact of HRM on innovation and culture. This research can help higher education institutions better understand how human resource policies can improve long-term performance by encouraging innovation and fostering an effective culture.

Nanomaterial-Enhanced Microneedles: Emerging Therapies for Diabetes and Obesity.

Drug delivery systems (DDS) have improved therapeutic agent administration by enhancing efficacy and patient compliance while minimizing side effects. They enable targeted delivery, controlled release, and improved bioavailability. Transdermal drug delivery systems (TDDS) offer non-invasive medication administration and have evolved to include methods such as chemical enhancers, iontophoresis, microneedles (MN), and nanocarriers. MN technology provides innovative solutions for chronic metabolic diseases like diabetes and obesity using various MN types. For diabetes management, MNs enable continuous glucose monitoring, diabetic wound healing, and painless insulin delivery. For obesity treatment, MNs provide sustained transdermal delivery of anti-obesity drugs or nanoparticles (NPs). Hybrid systems integrating wearable sensors and smart materials enhance treatment effectiveness and patient management. Nanotechnology has advanced drug delivery by integrating nano-scaled materials like liposomes and polymeric NPs with MNs. In diabetes management, glucose-responsive NPs facilitate smart insulin delivery. At the same time, lipid nanocarriers in dissolving MNs enable extended release for obesity treatment, enhancing drug stability and absorption for improved metabolic disorder therapies. DDS for obesity and diabetes are advancing toward personalized treatments using smart MN enhanced with nanomaterials. These innovative approaches can enhance patient outcomes through precise drug administration and real-time monitoring. However, widespread implementation faces challenges in ensuring biocompatibility, improving technologies, scaling production, and obtaining regulatory approval. This review will present recent advances in developing and applying nanomaterial-enhanced MNs for diabetes and obesity management while also discussing the challenges, limitations, and future perspectives of these innovative DDS.

Feasibility and pilot study of Indonesia’s first telehealth support program for gynecological cancer survivors undergoing chemotherapy

Most Indonesian gynecological cancer survivors experience chemotherapy side effects on their physical and mental health as they face unmet needs of supportive care, which increases the likelihood of discontinuing treatment. Interventions in telehealth assist survivors in resolving these issues. The aim of this pilot study was to determine the feasibility of fighting distress, self-efficacy, health effects, and sexual (FoRSHE-X) interventions and evaluate their potential impact on distress level, side effects knowledge and management, self-efficacy, and sexual quality of life. The study involved gynecological cancer survivors who underwent chemotherapy and participated in ten weeks of individual social media-based education, tele-coaching, and teleconsultations, from September 2023 to June 2024. The study feasibility and pilot outcomes were evaluated using descriptive statistics and qualitative thematic analysis. Of the twelve women recruited, six (50%) completed the study, filled out pre- and post-intervention questionnaires, and participated in interviews. Fifty-four virtual education, coaching, and consultation sessions were performed individually. The statistical results indicated that participants were highly satisfied with the telehealth program, which significantly increased their knowledge (p=0.02), health practices (p=0.04), and self-efficacy (p=0.01). The qualitative analysis highlighted participants' and coaches' perspectives on the study’s acceptance, barriers, and recommendations. In conclusion, this pilot study suggests that a definitive trial to assess the FoRSHE-X interventions is feasible, acceptable, and can be applied not only to gynecological cancer survivors but also to other types of cancer, thereby broadening the potential impact of the study.

The impact of economic, social and health crises on victims of domestic violence

Aim: The situation of victims of domestic violence and partner abuse becomes even more serious in crisis situations. There have been and are ongoing conflicts in the world, which have been scrutinised by economists, sociologists, criminologists, health professionals and lawyers alike in recent years. The latest related research worldwide provides a lot of important new information that can help prepare for the problem and provide professionally competent answers. Methodology: A selection of research conducted in different parts of the world. Summary reports were prepared to shed light on similarities and differences. Findings: It is clear from the processed literature that the individual forms of violence are connected in crisis situations and pose an even greater danger. Violence at the macro level, such as war, also increases violent conflict at the micro level. The crises caused by the fear of COVID, the lockdown, war conflicts, hunger, and the climate disaster spill over into family homes and make the victims of domestic violence and partner abuse even more vulnerable. Most of the processed materials analyse research born after COVID. The COVID–19 epidemic also provided many lessons regarding the management and prevention of the economic effects of future natural disasters and the associated increased domestic violence. Value: Analyses point to relationships that need further research and evaluation. In the future, macro- and micro-level violence research must be continued, common global results must be aggregated, and complex, global solutions must be developed. International organisations must continue to collect data and provide clear guidelines to public bodies and social organisations for the joint management of macro- and micro-level problems.

A gazdasági, társadalmi és egészségügyi válságok hatása a családon belüli erőszak áldozataira

Aim: The situation of victims of domestic violence and partner abuse becomes even more serious in crisis situations. There have been and are ongoing conflicts in the world, which have been scrutinized by economists, sociologists, criminologists, health professionals and lawyers alike in recent years. The latest related research worldwide provides a lot of important new information that can help prepare for the problem and provide professionally competent answers. Methodology: A selection of research conducted in different parts of the world. Summary reports were prepared to shed light on similarities and differences. Findings: It is clear from the processed literature that the individual forms of violence are connected in crisis situations and pose an even greater danger. Violence at the macro level, such as war, also increases violent conflict at the micro level. The crises caused by the fear of COVID, the lockdown, war conflicts, hunger, and the climate disaster spill over into family homes and make the victims of domestic violence and partner abuse even more vulnerable. Most of the processed materials analyse research born after COVID. The COVID-19 epidemic also provided many lessons regarding the management and prevention of the economic effects of future natural disasters and the associated increased domestic violence. Value: Analyses point to relationships that need further research and evaluation. In the future, macro- and micro-level violence research must be continued, common global results must be aggregated, and complex, global solutions must be developed. International organizations must continue to collect data and provide clear guidelines to public bodies and social organizations for the joint management of macro- and micro-level problems.

The Ambivalence of Post COVID-19 Vaccination Responses in Humans.

The Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has prompted a massive global vaccination campaign, leading to the rapid development and deployment of several vaccines. Various COVID-19 vaccines are under different phases of clinical trials and include the whole virus or its parts like DNA, mRNA, or protein subunits administered directly or through vectors. Beginning in 2020, a few mRNA (Pfizer-BioNTech BNT162b2 and Moderna mRNA-1273) and adenovirus-based (AstraZeneca ChAdOx1-S and the Janssen Ad26.COV2.S) vaccines were recommended by WHO for emergency use before the completion of the phase 3 and 4 trials. These vaccines were mostly administered in two or three doses at a defined frequency between the two doses. While these vaccines, mainly based on viral nucleic acids or protein conferred protection against the progression of SARS-CoV-2 infection into severe COVID-19, and prevented death due to the disease, their use has also been accompanied by a plethora of side effects. Common side effects include localized reactions such as pain at the injection site, as well as systemic reactions like fever, fatigue, and headache. These symptoms are generally mild to moderate and resolve within a few days. However, rare but more serious side effects have been reported, including allergic reactions such as anaphylaxis and, in some cases, myocarditis or pericarditis, particularly in younger males. Ongoing surveillance and research efforts continue to refine the understanding of these adverse effects, providing critical insights into the risk-benefit profile of COVID-19 vaccines. Nonetheless, the overall safety profile supports the continued use of these vaccines in combating the pandemic, with regulatory agencies and health organizations emphasizing the importance of vaccination in preventing COVID-19's severe outcomes. In this review, we describe different types of COVID-19 vaccines and summarize various adverse effects due to autoimmune and inflammatory response(s) manifesting predominantly as cardiac, hematological, neurological, and psychological dysfunctions. The incidence, clinical presentation, risk factors, diagnosis, and management of different adverse effects and possible mechanisms contributing to these effects are discussed. The review highlights the potential ambivalence of human response post-COVID-19 vaccination and necessitates the need to mitigate the adverse side effects.

Evaluating Circulating Biomarkers for Diagnosis, Prognosis, and Tumor Monitoring in Pediatric Sarcomas: Recent Advances and Future Directions.

Pediatric sarcomas present a significant challenge in oncology. There is an urgent need for improved therapeutic strategies for high-risk patients and better management of long-term side effects for those who survive the disease. Liquid biopsy is emerging as a promising tool to optimize treatment in these patients by offering non-invasive, repeatable assessments of disease status. Circulating biomarkers can provide valuable insights into tumor genetics and treatment response, potentially facilitating early diagnosis and dynamic disease monitoring. This review examines the potential of liquid biopsies, focusing on circulating biomarkers in the most common pediatric sarcomas, i.e., osteosarcoma, Ewing sarcoma, and rhabdomyosarcoma. We also highlight the current research efforts and the necessary advancements required before these technologies can be widely adopted in clinical practice.

Targeted Drug Delivery in Periorbital Non-Melanocytic Skin Malignancies.

Targeted drug delivery has emerged as a transformative approach in the treatment of periorbital skin malignancies, offering the potential for enhanced efficacy and reduced side effects compared to traditional therapies. This review provides a comprehensive overview of targeted therapies in the context of periorbital malignancies, including basal cell carcinoma, squamous cell carcinoma, sebaceous gland carcinoma, and Merkel cell carcinoma. It explores the mechanisms of action for various targeted therapies, such as monoclonal antibodies, small molecule inhibitors, and immunotherapies, and their applications in treating these malignancies. Additionally, this review addresses the management of ocular and periocular side effects associated with these therapies, emphasizing the importance of a multidisciplinary approach to minimize impact and ensure patient adherence. By integrating current findings and discussing emerging trends, this review aims to highlight the advancements in targeted drug delivery and its potential to improve treatment outcomes and quality of life for patients with periorbital skin malignancies.

Continuing Safety Education and Workplace Efficacy of Student Workers

This study aims to evaluate students' awareness of safety education and its impact on work effectiveness. By analyzing background variables such as students' gender, age, grade, work experience, student status, and college affiliation, this study explored the relationship between safety education and work effectiveness. The results showed that students' awareness of safety education directly affects their task execution and situational performance on campus and in the workplace. In addition, the study showed that strengthening the popularization and effective cooperation of safety education on campus can help improve students' work effectiveness and campus safety management. This study recommends further improving the quality of safety education by strengthening training, promoting safety knowledge, and improving safety facilities, and strengthening the cultivation of safety awareness during students' internships and employment.

IT PROJECT MANAGEMENT FRAMEWORKS: EVALUATING BEST PRACTICES AND METHODOLOGIES FOR SUCCESSFUL IT PROJECT MANAGEMENT

This study provides a systematic review of IT project management frameworks, examining the effectiveness, adaptability, and risk management strategies of methodologies such as Agile, Waterfall, PRINCE2, Scrum, and hybrid approaches. A total of 133 peer-reviewed articles were analyzed to gain insights into how these frameworks are being applied across various industries and project environments. The findings reveal that hybrid models, which combine the structured governance of traditional methodologies like Waterfall with the iterative flexibility of Agile, are becoming increasingly popular, especially in industries requiring both regulatory compliance and adaptability to changing requirements. Agile frameworks were shown to significantly improve project delivery speed, stakeholder satisfaction, and risk mitigation through continuous iterations and feedback loops, while traditional methodologies like Waterfall remain essential in sectors with strict documentation and control requirements. The review also highlights the critical role of risk management across all frameworks, with hybrid models offering the most comprehensive approach by integrating early-stage planning with ongoing risk assessment. Despite the success of these frameworks in IT-related industries, a notable gap was identified in their application to non-IT sectors, suggesting a need for further research to explore their broader applicability. This review underscores the continued relevance of traditional, Agile, and hybrid project management frameworks, while also pointing to future opportunities for expanding their use beyond IT.

Management of adverse effects of construction digitalization on the quantity surveying key roles: a qualitative Delphi study

Purpose Digitalization has significantly impacted the job roles of construction professionals globally. This study aims to investigate how to manage the adverse effects of digitalization on roles of quantity surveyor (QS) by assessing the level of digitalization of quantity surveying key roles identifying the adverse effects of digitalization on key roles and proposing mitigation strategies to manage adverse effects. It addresses a critical gap by providing a nuanced understanding of adverse effects faced by QSs due to digital advancement. Design/methodology/approach Adopting an interpretive stance, the research involved three rounds of 16 semistructured interviews with experts selected through heterogeneous purposive sampling. The data were analyzed using code-based content analysis with NVivo12. Findings The study identified ten quantity surveying key roles adopting digital technologies. While digitalization has enhanced efficiency and accuracy, it has also introduced adverse effects such as increased workload, potential burnout due to skills shortages, resistance to digital tools and data security concerns. Effective mitigation strategies include task prioritization, balancing traditional and digital skills and investing in continuous training. The study underscores the need for ongoing professional development for QSs and organizational restructuring to support digital integration, enhance workflow efficiency and reduce resistance to technological changes. Research limitations/implications This study’s novel contribution lies in its exploration of the adverse effects of digitalization on the QSs, usage and the level of adaptation of digital tools by QSs and strategies to manage them. Therefore, the findings of this study serve as precious steerage for QSs to have an in-depth understanding of digitalization’s usage and level of adaptation, its adverse effects and mitigation of the adverse effects. Originality/value This study’s novel contribution lies in its exploration of the adverse effects of digitalization on the QSs, usage and the level of adaptation of digital tools by QSs and strategies to manage them. Therefore, the findings of this study serve as precious steerage for QSs to have an in-depth understanding of digitalization’s usage and level of adaptation, its adverse effects and mitigation of the adverse effects.

The Androgen Deprivation Therapy Landscape in 2024 – Co-navigating the Available Options with Prostate Cancer Patients

This symposium convened during the 2024 European Association of Urology (EAU) Congress in Paris, France, focusing on the multifaceted aspects of prostate cancer (PCa) treatment from the patient’s perspective. The session delved into the nuanced needs, expectations, and treatment experiences encountered by individuals diagnosed with this condition. A pivotal aspect of the discussion centred on the imperative of ensuring patient awareness and informed consent, particularly concerning androgen deprivation therapy (ADT), given its array of potential side effects. ADT, a cornerstone in advanced PCa management, encompasses a spectrum of side effects including both physical and psychological dimensions. These include, but are not limited to, body hair loss, weight fluctuations, mood alterations, decreased libido, cognitive impairments, muscle atrophy, and bone density loss. Effective management of these side effects requires comprehensive support to be provided to patients to mitigate complications and optimise quality of life. The options for ADT were discussed, with their comparative strengths and challenges. ADT strategies take effect over different time periods (from 12 hours up to 4 weeks), exert varying effects on testosterone levels, and carry different side effect profiles. Selecting the optimal course of treatment for localised or locally advanced PCa requires consideration of whether the patient is at intermediate-, high-, or very high-risk of biochemical recurrence, and whether the intermediate-risk disease is classified as favourable intermediate-risk (FIR) or unfavourable intermediate-risk (UIR). While continuous ADT is the standard of care, intermittent ADT has been associated with significantly better quality of life scores for hot flushes, desire for sexual activity, and urinary symptoms, with a trend toward improvement in the level of fatigue. Furthermore, the interplay between PCa, ADT, and cardiovascular disease (CVD) was discussed to underscore the imperative for clinicians to assess the cardiovascular risks associated with ADT, particularly in patients with heightened cardiovascular vulnerability. Mitigating the adverse skeletal effects of ADT mandates a multifaceted approach encompassing nutritional supplementation, exercise regimens, and lifestyle modifications including alcohol cessation and smoking cessation. Integrating a prehabilitation checklist into clinical practice emerges as a pragmatic strategy to facilitate informed discussions regarding the potential adverse effects of ADT, enabling proactive support provision to optimise patient outcomes.

12539 Estrogen Type In Contraceptives Matters: Effects On Spatial Memory And Anxiety-Like Behaviors In A Female Rat Model

Abstract Disclosure: A.P. Hegwood: None. S. Kujawa: None. A.V. Prakapenka: None. According to U.S. Centers for Disease Control & Prevention, ∼12% of the U.S. population uses combined oral contraceptives (COCs). Behavioral side effects are common factors in COC discontinuation. Management of COC-related side effects primarily centers around altering the synthetic ethinyl estradiol (EE) dose, the predominant estrogen in COCs. Estradiol valerate (EV) is a recently introduced natural estrogen alternative to EE. EE-containing COCs, such as EE/dienogest (DNG), were found to decrease free steroid hormone serum levels compared to EV-containing COCs, such as EV/DNG. In women and in female rodent models, steroid hormones (e.g., 17-ß estradiol (E2), testosterone) dose-dependently modulate spatial memory and anxiety-related behaviors. We hypothesized that in a rat model of hormonal contraceptive use, EE/DNG differentially modulates spatial memory and anxiety-like behaviors compared to EV/DNG, corresponding to circulating steroid hormone levels. Thirty-six young-adult (3-4-months-old) female rats were randomly assigned to EE/DNG (0.13µg EE and 8.6µg DNG per day), EV/DNG (8.6µg EV and 8.6µg DNG per day), or vehicle treatment (propylene glycol) continuously administered by subcutaneous osmotic pump. At four weeks of treatment, rats were tested on the delayed spontaneous alternation (dSA) task to evaluate spatial memory and the elevated plus maze (EPM) to evaluate anxiety-like behavior. Following EPM, serum was collected and analyzed for E2, progesterone, androstenedione, and testosterone levels using liquid chromatography-mass spectrometry and corticosterone levels using radioimmunoassay. Spontaneous alternation behaviors were similar across all three groups on the dSA. However, EE/DNG increased use of an egocentric navigational strategy, the use of consecutive turns, on the dSA compared to vehicle and EV/DNG. Egocentric strategy is likely mediated by the striatal memory system, engagement of which is elevated with stress and anxiety. Of note, EE/DNG decreased time spent in the open arms of the EPM compared to vehicle and EV/DNG, indicating increased anxiety-like behaviors with EE/DNG. Both EE/DNG and EV/DNG decreased androstenedione, testosterone, and E2 circulating levels compared to vehicle. Steroid hormone serum levels did not differ between EE/DNG and EV/DNG; 58% of EE/DNG serum samples were undetermined/below threshold for E2 levels, limiting statistical analysis. Altogether, we found that, compared to vehicle and the natural EV, the synthetic EE component in hormonal contraceptives elevates anxiety-like behaviors in female rats, an effect that corresponds to increased use of an egocentric navigational strategy on a spatial memory task. Our findings support the notion that estrogen type matters for behavioral outcomes associated with contraceptive use, identifying estrogen type as a possible tool for management of COC-related side effects. Presentation: 6/1/2024

The role of sustainable human resources management in the organizational effectiveness of the company

Sustainability has become an important part of strategy building both at the global and individual companies level. The principle of long-term development, conservation and reproduction of resources becomes relevant not only in terms of global problems, but also in the development of individual companies. The human resource management department plays a major role in achieving sustainable development of companies. This interaction takes on new meaning with the emergence of the concept of sustainable human resource management. This paper discusses the concept of sustainable human resource management and organizational effectiveness of the company. Organizational effectiveness, defined as the ability to achieve goals on time, is a strategically important indicator that companies strive to achieve. The purpose of this work is to study the concept of sustainable human resource management as a tool for achieving organizational effectiveness of the company. The paper presents the main indicators and advantages of the concept. The main barriers to implementing the concept in practice were also analyzed. By combining the results of content analysis, a model for achieving organizational effectiveness of the company by implementing sustainable human resource management practices was compiled. The method of systematic review of the literature based on the model of the author J. Garza-Reyes was applied in the work; Scopus and Science Direct databases articles for the entire period were considered. The article can be useful both for further theoretical study of the concept and for practical application by companies to build a strategy to achieve organizational effectiveness.

7426 Tamoxifen-Induced Ovarian Hyperstimulation in a Pre-Menopausal Patient with Breast Cancer History: Spontaneous Resolution with Conservative Management

Abstract Disclosure: S. Gondi: None. M. Contento: None. A. Leiter: None. Background: Tamoxifen is a selective estrogen receptor modulator (SERM) that competitively binds to estrogen receptors (ER) on tumors and inhibits the effect of estrogen, which is used in the treatment and prevention of ER-positive breast cancer. Tamoxifen therapy has been reported to increase serum estrogens and cause ovarian hyperstimulation in premenopausal women, but knowledge on how to manage these conditions is limited. Clinical Case: A 36-year-old pre-menopausal female with history of malignant neoplasm of the right breast (ER positive) who completed neoadjuvant chemotherapy, lumpectomy, and radiation, on tamoxifen for seven years presented with new-onset oligomenorrhea. Laboratory testing done by the patient’s gynecologist revealed total estrogen 2,723 pg/mL (reference range [RR] 34-501), testosterone 132 ng/dL (RR 8-60), anti-Mullerian hormone 12.7 ng/mL (RR for age 0.66-8.75), ovulation-phase follicle stimulating hormone 11.5 mIU/mL (RR 4.7-21.5) and luteinizing hormone (LH) 63.3 mIU/mL (RR 14-95.6). Further workup revealed that ovarian tumor markers alpha-fetoprotein and serum human chorionic gonadotropin and other labs including dehydroepiandrosterone sulfate, progesterone 17-OH, lactate dehydrogenase, prolactin, and thyroid stimulating hormone were normal. Transvaginal ultrasound (TVUS) showed a new 2.8 x 1.9 x 2.3 cm complex left ovarian cyst, which, along with the elevated estrogen level, was concerning for ovarian hyperstimulation. Treatment with LH-releasing hormone (LHRH) agonists, surgical consultation, and discontinuation of tamoxifen were offered as potential management strategies, but the patient opted for observation and continued tamoxifen. Two months later, estradiol was 989 pg/mL (RR 85-498), and then three months later decreased to 152 pg/mL with repeat TVUS showing resolution of the left ovarian cyst. The patient’s oligomenorrhea resolved with resumption of regular menstrual cycles. Conclusion: While it is well-known that tamoxifen causes elevated serum estrogen levels and can lead to ovarian hyperstimulation, there is limited research on the management of these side effects. Treatment strategies in past cases have included oophorectomy or medical management with LHRH agonists or gonadotropin-RH agonists. However, this case demonstrates that a tamoxifen-induced ovarian cyst and high estrogen levels can resolve on its own with continued tamoxifen treatment. Conservative management with monitoring via imaging and repeat estrogen levels may be sufficient in management of pre-menopausal women with tamoxifen-induced ovarian hyperstimulation. Presentation: 6/1/2024