Efficient Outcomes Research Articles

Relationship Between Organisational Innovation and Organisation Performance: A Study of Nigeria Bottling Company

In an increasingly competitive business environment, the role of organisational innovation as a driver of performance is more crucial than ever. This study investigates the relationship between organisational innovation and organisational performance with a specific focus on Nigeria Bottling Company. Using a mixed-methods approach, the study explores how innovations in product development, processes, and management systems contribute to enhanced operational efficiency, market share, and financial outcomes. The study adopts a descriptive cross-sectional survey. The target population for this study consisted of two hundred and forty-five (245) staff members from Nigeria Bottling Company. Data was collected through structured questionnaires with key personnel across various departments within the organisation and analysed using descriptive statistics and regression analysis for the hypotheses. The study revealed that film size innovation is vital for a company's success in today's highly competitive business environment and leads to higher productivity, meaning that the same input generates a greater output. Innovatiocontributeste to firms’ success in terms of better performance in the form of higher profits, lower production costs, more efficient working procedures, and better relationships with customers. Furthermore, finding shows that creativity and innovation helps and improves the work of employees together with improving organisational performance. The study concludes that fostering a culture of continuous innovation is essential for sustaining competitive advantage in the beverage industry. It is therefore recommended that technological innovation be incorporated at all levels. The management of the organisation has to design an effective and timely market innovation strategy and communicate it to all staff members to enhance organisational performance and productivity. Organisations should consider innovation that is either market, product or organisation-based to improve and increase the organisational performance as innovation is significant to new product development, product modification and creation of a new market as experienced in new product lines like increase in online marketing, online purchase of different products and global connection of markets into one.

CAD Sensitization, an Easy Way to Integrate Artificial Intelligence in Shipbuilding

There are two main areas in which the Internet of Ships (IoS) can help: firstly, the production stage, in all its phases, from material bids to manufacture, and secondly, the operation of the ship. Intelligent ship management requires a lot of information, as does the shipbuilding process. In these two phases of the ship’s life cycle, IoS acts as a key to the keyhole. IoS tools include sensors, process information and real-time decision-making, fog computing, or delegated processes in the cloud. The key point to address this challenge is the design phase. Getting the design process right will help in both areas, reducing costs and making agile use of technology to achieve a highly efficient and optimal outcome. But this raises a lot of new questions that need to be addressed: At what stage should we start adding control sensors? Which sensors are best suited to our solution? Is there anything that offers more than simple identification? As we begin the process of answering all these questions, we realize that a Computer Aided Design (CAD) tool, as well as Artificial Intelligence (AI), mixed in a single tool, could significantly help in all these processes. AI combined with specialized CAD tools can enhance the sensitization phases in the shipbuilding process to improve results throughout the ship’s life cycle. This is the base of the framework developed in this paper.

Red Blood Cell (RBC) Antigen Confirmation Workflow – A Positive Impact at an Academic Medical Center

Abstract Introduction/Objective Introduction: Blood group antigens, present on the surface of red blood cells (RBCs), play a crucial role in transfusion medicine. These antigens are recognized serologically and form the basis of RBC phenotyping. Understanding the significance of antigen-negative RBCs is essential for mitigating the risk of hemolytic transfusion reactions and hemolytic disease of the fetus and newborn (HDFN). This study aims to assess the impact of implementing a new RBC antigen confirmation workflow on transfusion service efficiency and patient outcomes. Methods/Case Report Method: The study involved collaboration between our Transfusion Services Department (TS), the Blood Center supplier, and the Apheresis department. A comprehensive review of historical practices and FDA recommendations regarding RBC antigen labeling was conducted. Changes were implemented to streamline antigen confirmation testing and labeling processes. The impact on TS workload, turnaround time, and patient care metrics was evaluated. Results (if a Case Study enter NA) Results: Implementation of the new RBC antigen confirmation workflow led to a significant reduction in antigen confirmation tests performed by TS, with a 607% decrease observed from 2020 to 2023. Concurrently, the workload for reference lab workups increased by 337% over the same period. This shift in workload distribution allowed TS staff to focus more on patient reference workup cases and case review. The improved workflow efficiency resulted in enhanced turnaround times for providing patients with antigen-negative RBCs, ultimately improving the patient experience. Conclusion Conclusion: The adoption of the new RBC antigen confirmation workflow has resulted in compliance with FDA labeling requirements, efficient utilization of TS staff resources, and decreased turnaround times for blood delivery. These improvements have positively impacted patient care by ensuring timely access to compatible blood products. Future steps include developing reports to track turnaround time for patients with special blood product needs and continuing collaboration with the blood supplier and the Apheresis department to optimize inventory management and transfusion processes.

Ultrasound and Helium Plasma-Assisted Liposuction for Body Contouring: A Single-Retrospective Cohort Study of 639 Patients.

Over the past two decades, liposuction techniques have significantly evolved, moving from basic fat removal to sophisticated methods aimed at improving safety, efficiency, and cosmetic outcomes. This study evaluates the efficacy and safety of a combined approach using ultrasound-assisted liposuction (UAL) and helium plasma radiofrequency (HPRF) technology to enhance skin tightening without the need for extensive surgical interventions. We conducted a retrospective analysis of 639 patients who underwent the combined UAL and HPRF liposuction technique. The patient cohort had an average age of 31.5 years and a mean BMI of 27.9 kg/m2. The procedure predominantly targeted the abdomen, with an average of 2.4 body areas treated per patient. Surgical duration averaged 118 minutes, with a mean aspirate volume of 1698 mL. Minimal residual skin laxity was observed in 87% of patients, and 91% achieved excellent improvement in body contouring. The complication rates were low, with minor occurrences of seroma (5.6%) and a very low incidence of infection (0.3%). This combined technique demonstrated safety and efficacy, providing significant skin tightening and reducing recovery time compared to more invasive procedures. The combined use of UAL and HPRF technology offers a safe and effective method for enhancing skin tightening and improving body contouring outcomes. Despite the promising results, this study acknowledges the limitations of its retrospective design. Future prospective, multicenter studies are recommended to further validate these findings. This technique represents a significant advancement in the field of cosmetic surgery, emphasizing minimally invasive solutions with substantial esthetic benefits. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Deep Learning for Robust Facial Expression Recognition: A Resilient Defense Against Adversarial Attacks

Adversarial attacks can be extremely dangerous, particularly in scenarios where the precision of facial expression identification is of utmost importance. Hiring adversarial training methods proves effective in mitigating these threats. Although effective, this technique requires large computing resources. This study aims to strengthen deep learning model resilience against adversarial attacks while optimizing performance and resource efficiency. Our proposed method uses adversarial training techniques to create adversarial examples, which are permanently stored as a separate dataset. This strategy helps the model learn and enhances its resilience to adversarial attacks. This study also evaluates models by subjecting them to adversarial attacks, such as the One Pixel Attack and the Fast Gradient Sign Method, to identify any potential vulnerabilities. Moreover, we use two different model architectures to see how well they are protected against adversarial attacks. It compared their performances to determine the best model for making systems more resistant while still maintaining good performance. The findings show that the combination of the proposed adversarial training technique and an efficient model architecture outcome in increased resistance to adversarial attacks. This also improves the reliability of the model and saves more resources for computation. This is evidenced by the high accuracy results achieved at 98.81% accuracy on the CK+ datasets. The adversarial training technique proposed in this study offers an efficient alternative to overcome the limitations of computational resources. This fortifies the model against adversarial attacks, resulting in significant increases in model resilience without loss of performance.

Costs, efficiency, and patient-reported outcomes associated with suture-mediated percutaneous closure for atrial fibrillation ablation: Secondary analysis of a randomized clinical trial.

To evaluate the cost and efficiency of suture-mediated percutaneous closure (SMC) compared to manual compression (MC) after atrial fibrillation (AF) ablation. SMC has been demonstrated to be efficacious in reducing hemostasis and bedrest times after AF ablation. To date, randomized data comparing the direct and indirect cost between the two techniques have not been described. We conducted a 1:1 randomized trial comparing SMC to MC following AF ablation. The primary endpoints have been previously published. However, secondary endpoints pertinent to indirect cost including complication rates, hospital utilization (i.e., delays in discharge, additional patient encounters, nursing utilization), pain, patient reported outcomes, as well as the direct costs of care associated with AF ablation were collected. We also performed secondary analysis of the primary endpoint to evaluate for a learning curve, and subgroups analysis comparing efficacy across different numbers of access sites and compared to those in the MC group with a figure-of-eight suture (Fo8), that could potentially have impacted the relative efficiency of the procedure. A total of 107 patients were randomized and included: 53 in the SMC group and 54 in MC. A learning curve was observed in the SMC group between the first and second half of the study group (p = 0.037), with no such difference in the MC group. After accounting for the number of access sites, time to hemostasis remained shorter in the SMC Group (p = 0.002). Compared to those in the Fo8 arm (n = 37), the time to hemostasis remained shorter in the SMC group (p = 0.001). Among those planned for same-day discharge, there were more delays in the MC group (31.5% vs. 11.3%, p = 0.0144). Rates of major and minor complications were similar between SMC and MC groups at discharge (p = 0.243) and 30 days (p = 1.00), as were nursing utilization, self-reported pain, and overall patient reported outcomes. The overall cost of care related to the procedure was similar between the MC and SMC groups ($56 533.65 [$45 699.47, $66 987.64] vs. $57 050.44 [$47 251.40, $66 426.34], p = 0.601). SMC has been shown to decrease time to hemostasis and ambulation and facilitate earlier same-day discharge after AF ablation without an increase in direct or indirect costs.

The Potential Role of Non-coding RNAs in Regulating Ferroptosis in Cancer: Mechanisms and Application Prospects.

Cancer is the second leading cause of death globally. Despite some successes, conventional cancer treatments are insufficient to address the growing problem of drug resistance in tumors and to achieve efficient treatment outcomes. Therefore, there is an urgent need to explore new therapeutic options. Ferroptosis, a type of iron- and reactive oxygen species-dependent regulated cell death, has been closely associated with cancer development and progression. Non-coding RNAs (ncRNAs) are a class of RNAs that do not code for proteins, and studies have demonstrated their involvement in the regulation of ferroptosis in cancer. This review aims to explore the molecular regulatory mechanisms of ncRNAs involved in ferroptosis in cancer and to emphasize the feasibility of ferroptosis and ncRNAs as novel therapeutic strategies for cancer. We conducted a systematic and extensive literature review using PubMed, Google Scholar, Web of Science, and various other sources to identify relevant studies on ferroptosis, ncRNAs, and cancer. A deeper understanding of ferroptosis and ncRNAs could facilitate the development of new cancer treatment strategies.

Retail company voluntary arrangements: A dubious remedy?

AbstractDespite much debate on Company Voluntary Arrangements (CVA) among UK retailers, understanding of retail CVAs remains limited. There is continuing uncertainty about the uptake of CVAs, what aspects lead to successful outcomes and whether CVAs can be viewed as a remedy for struggling UK retailers. To address these questions, we developed and analysed a novel and detailed dataset of Companies House records for the population of retailers' CVAs between mid‐2012 and early 2021. We find that CVAs, despite detrimental impacts on other actors (landlords and suppliers), can be a useful tool for some retailers in adjusting to the new market conditions. The uptake of CVAs among retailers is stable, though not among large retailers. Retail CVAs help to avoid immediate business failure, but we found limited evidence of the success and efficient longer term outcome of the procedure, suggesting that alternative methods could be considered. The success and efficiency of CVA do not seem to depend on the size of the business, but there are variations in both the uptake and efficiency of CVAs across retail sub‐sectors. This suggests that a range of mechanisms are required to cater to the different needs across retail categories. Despite the market challenges, CVAs are not prolonged on average. However, longer duration CVAs seem to have a lower chance of succeeding and of being efficient implying that CVA cannot remedy fundamental business issues. Finally, we observed differences related to who oversees the procedure, suggesting that greater emphasis should be put on upskilling and selection of insolvency practitioners.

Lesion characteristics using high-frequency low-tidal volume ventilation versus standard ventilation during ablation of paroxysmal atrial fibrillation.

High-frequency low-tidal-volume (HFLTV) ventilation during radiofrequency catheter ablation (RFCA) for paroxysmal atrial fibrillation (PAF) has been shown to be superior to standard ventilation (SV) in terms of procedural efficiency, acute and long-term clinical outcomes. Our study aimed to compare ablation lesions characteristics utilizing HFLTV ventilation versus SV during RFCA of PAF. A retrospective analysis was conducted on patients who underwent pulmonary vein isolation (PVI) for PAF between August 2022 and March 2023, using high-power short-duration ablation. Thirty-five patients underwent RFCA with HFLTV ventilation and were matched with another cohort of 35 patients who underwent RFCA with SV. Parameters including ablation duration, contact force (CF), impedance drop, and ablation index were extracted from the CARTONET database for each ablation lesion. A total of 70 patients were included (HFLTV = 35/2484 lesions, SV = 35/2830 lesions) in the analysis. There were no differences in baseline characteristics between the groups. While targeting the same ablation index, the HFLTV ventilation group demonstrated shorter average ablation duration per lesion (12.3 ± 5.0 vs. 15.4 ± 8.4 s, p < .001), higher average CF (17.0 ± 8.5 vs. 10.5 ± 4.6 g, p < .001), and greater impedance reduction (9.5 ± 4.6 vs. 7.7 ± 4.1 ohms, p < .001). HFLTV ventilation group also demonstrated shorter total procedural time (61.3 ± 25.5 vs. 90.8 ± 22.8 min, p < .001), ablation time (40.5 ± 18.6 vs. 65.8 ± 22.5 min, p < .001), and RF time (15.3 ± 4.8 vs. 22.9 ± 9.7 min, p < .001). HFLTV ventilation during PVI for PAF was associated with improved ablation lesion parameters and procedural efficiency compared to SV.

An Experimental Study on Algae Biodiesel with Nano-additives for Engine Performance and Emission Reduction

Introducing nano-additives like aluminum oxide and cerium oxide into the B20 blend biodiesel exhibited encouraging outcomes of combustion efficiency and emission reduction. These additives likely catalyzed combustion, leading to more complete fuel burn and lower emissions. Additionally, the presence of nano-additives might have facilitated better fuel atomization and distribution within the combustion chamber, resulting in enhanced engine performance. The results indicate that adding nano-additives to biodiesel blends has significant potential for reducing environmental impact and enhancing engine longevity and efficiency. Moreover, the utilization of nano-additives represents a promising avenue for addressing the dual challenges of energy sustainability and environmental preservation. By harnessing the synergistic effects of nano-scale materials, such as aluminum oxide and cerium oxide, in biodiesel formulations, engineers and researchers can strive towards developing cleaner and more efficient propulsion systems. This holistic approach underscores the importance of cooperation across disciplines between materials science, engineering, and environmental studies to advance the frontiers of sustainable energy technologies. The study attempted to improve combustion efficiency and reduce emissions by introducing nano-additives like aluminum oxide and cerium oxide into B20 biodiesel. The outcome showed enhanced engine performance, more complete fuel burn, and significant potential for reducing environmental impact.

Sustainable Management Strategies to Enhance Business Competitiveness in the Technology Sector

The increasing global demand for sustainable business practices has placed significant pressure on organizations, particularly within the technology sector, to adopt strategies that balance environmental, social, and economic goals. This study investigates the role of sustainable management strategies in enhancing business competitiveness in the technology industry. The research employs a mixed-method approach, integrating quantitative data from key performance indicators (KPIs) such as market share, operational efficiency, and innovation outcomes, with qualitative insights gathered from in-depth interviews with senior executives. The results demonstrate that companies adopting sustainability practices experience a measurable improvement in operational efficiency (10%) and market share (15%), confirming that sustainability serves as a critical enabler of competitive advantage. Qualitative findings further reveal that sustainability initiatives bolster brand differentiation, customer loyalty, and regulatory compliance, contributing to long-term success. These strategies not only help firms navigate evolving regulatory landscapes but also enhance their positioning as leaders in innovation and social responsibility. This study concludes that sustainable management strategies are essential not just for compliance, but for fostering long-term business resilience and market leadership in the fast-paced technology sector.

Adopting integrated project delivery (IPD) in oil and gas construction projects

This review explores the adoption of Integrated Project Delivery (IPD) in oil and gas construction projects, focusing on the potential benefits, challenges, and strategies for successful implementation. IPD is a collaborative project delivery method that brings together the owner, designer, contractor, and other key stakeholders early in the project lifecycle to optimize efficiency, reduce waste, and enhance communication. In the oil and gas sector, where projects are often complex, capital-intensive, and high-risk, adopting IPD can lead to significant improvements in project outcomes. The review highlights the core principles of IPD, including shared risk and reward, early involvement of key stakeholders, and the use of collaborative tools and technologies, such as Building Information Modeling (BIM). These elements of IPD can help to streamline decision-making processes, improve cost management, and reduce the likelihood of disputes. Furthermore, the integration of IPD with advanced technologies, such as digital twins and AI-driven analytics, can enhance real-time monitoring and predictive maintenance, leading to better project performance. However, the review also discusses the challenges of adopting IPD in the oil and gas industry, including resistance to change, the need for cultural shifts within organizations, and the complexity of aligning multiple parties with differing interests. It suggests strategies for overcoming these challenges, such as providing training on IPD principles, fostering a culture of collaboration, and developing clear contractual frameworks that support IPD objectives. The review concludes by emphasizing the potential of IPD to transform oil and gas construction projects, leading to more efficient, cost-effective, and sustainable project outcomes. It calls for industry-wide efforts to embrace IPD as a standard practice, supported by appropriate policies and guidelines that facilitate its adoption and implementation.

Identifying biomarkers for treatment of uveal melanoma by T cell engager using a QSP model.

Uveal melanoma (UM), the primary intraocular tumor in adults, arises from eye melanocytes and poses a significant threat to vision and health. Despite its rarity, UM is concerning due to its high potential for liver metastasis, resulting in a median survival of about a year after detection. Unlike cutaneous melanoma, UM responds poorly to immune checkpoint inhibition (ICI) due to its low tumor mutational burden and PD-1/PD-L1 expression. Tebentafusp, a bispecific T cell engager (TCE) approved for metastatic UM, showed potential in clinical trials, but the objective response rate remains modest. To enhance TCE efficacy, we explored quantitative systems pharmacology (QSP) modeling in this study. By integrating a TCE module into an existing QSP model and using clinical data on UM and tebentafusp, we aimed to identify and rank potential predictive biomarkers for patient selection. We selected 30 important predictive biomarkers, including model parameters and cell concentrations in tumor and blood compartments. We investigated biomarkers using different methods, including comparison of median levels in responders and non-responders, and a cutoff-based biomarker testing algorithm. CD8+ T cell density in the tumor and blood, CD8+ T cell to regulatory T cell ratio in the tumor, and naïve CD4+ density in the blood are examples of key biomarkers identified. Quantification of predictive power suggested a limited predictive power for single pre-treatment biomarkers, which was improved by early on-treatment biomarkers and combination of predictive biomarkers. Ultimately, this QSP model could facilitate biomarker-guided patient selection, improving clinical trial efficiency and UM treatment outcomes.

Pelatihan Software Akuntansi untuk Musyawarah Guru Mata Pelajaran Ekonomi Daerah Istimewa Yogyakarta

Economic disruption and changes in corporate operations in the Fourth Industrial Revolution will necessitate the understanding and control of artificial intelligence, or robots. This is a major issue, but it is also important for economic teachers to introduce companies that are already successful and sophisticated. Accounting software may help make bookkeeping, analyzing, reporting, and investigating easier and more precise; this concludes an opportunity in this era. Therefore, educational institutions must develop graduates who are adaptable and have soft skills. The Accounting Program and Financial Accounting Pillar team respond to economic teachers at MGMP in the Special Region of Yogyakarta by organizing a discussion forum and simulation to provide them with knowledge and best practices for using accounting software to manage business activities and achieve effective and efficient business outcomes. These exercises involve a class lecture using an andragogic approach. The discussion results suggest that economic teachers have best practices to offer accounting software to their pupils. On the other hand, it can increase teaching motivation for improving both financial and technology for themselves and the topic itself.

‘I Just Felt A Bit Faint’: The Role Of Physiotherapists In Older Adults Presenting With Transient Loss Of Consciousness (T-LOC)

Abstract Background Clinical presentation of transient loss of consciousness (T-LOC) in older adults presents significant diagnostic challenges, especially in those with frailty or multi-morbidity. This study analysed T-LOC presentations in individuals over the age of 75 and assess the impact of physiotherapy in this cohort. Methods A retrospective review was conducted on 56 older adults (&amp;gt;75 years), who presented with T-LOC to a large academic teaching hospital, over a six-month period in 2023. Data on demographics, presenting complaints, diagnostic tests, physiotherapy input and discharge diagnoses was collected and analysed. Results The analysis included 56 older adults, 57% (N=32) were male, with an average age of 81.6 years (75 – 94 years). The average length of stay was 9.1 days (1-64 days). Physiotherapy was provided to 59% (n=33) of the patients, with those in the physiotherapy group more likely to have a history of falls (55% compared to 4%) and a diagnosis of dementia (27% compared to 9%). Patients with T-LOC presentations were five-times more likely to be referred to physiotherapy if they had at least two diagnoses of recurrent falls, dementia or stroke (24% vs 4%). Of those who received physiotherapy, the number of sessions ranged from 1-25 (averaging 4.5 sessions per patient). Outcome measures were completed for 73% (n=24) of these patients, and 70% were discharged at their mobility baseline. Education on syncope, orthostatic hypotension or falls was documented for only 12% (N=4). 79% (N=26) were discharged directly home and 50% (N=13) were referred for community follow up. Conclusion Physiotherapy is often required for older adults with T-LOC, particularly those with a history of falls and dementia. Physiotherapy should be considered a fundamental component in the multi-disciplinary management strategy to improve healthcare efficiency and clinical outcome for this cohort.

Assessment of the Effectiveness of the E-Government System in Camarines Norte Provincial Hospital

The research focuses on evaluating the effectiveness of the e-government system at Camarines Norte Provincial Hospital. It assesses the system's performance using the System Evaluation Questionnaire aligned with the ISO 25010-2011 system/software quality model indicators, which include functionality, reliability, usability, performance efficiency, compatibility, portability, and security. The study's findings indicate that iHOMIS performs exceptionally well at Camarines Norte Provincial Hospital, particularly excelling in functionality, reliability, usability, and security. This suggests that the system is robust, user-friendly, and meets users' needs effectively, with users expressing confidence in the system's data protection and privacy measures.However, the results for performance efficiency, compatibility, maintainability, and portability are satisfactory but suggest areas for improvement. Overall, the findings point to a positive user experience at Camarines Norte Provincial Hospital, although there is potential for further enhancements to achieve consistent excellence across all evaluated criteria. The study concludes that iHOMIS is well-suited to meet the e-governance needs of government facilities like Camarines Norte Provincial Hospital. The successful implementation of iHOMIS at CNPH demonstrates the significant impact of the Department of Health's initiative in improving hospital operational efficiency and patient outcomes. CNPH's digital transformation journey serves as a model for other government healthcare facilities aiming to enhance patient outcomes through digital means. The insights from this study are expected to be pivotal in advancing e-government initiatives nationwide.

The roles of governments for polycentricity’s vulnerabilities: an analysis of South Korea’s PV panel recycling policies

ABSTRACT Polycentricity can be beneficial for analyzing the structures and interactions of multiple decision-makers and for achieving efficient outcomes. In contrast, polycentric governance may not function properly under specific conditions such as external shocks and inadequate institutions. Here, governments can play a significant role in overcoming the vulnerability of polycentric systems. This study uses a case of photovoltaic panel recycling and comprehensively understands the roles of governments in polycentric settings. Polycentricity explains that photovoltaic panels can be efficiently installed and operated through the voluntary transactions of multiple decision-makers. However, the polycentric vulnerabilities can emerge during the recycling stage of solar panel wastes due to shifts in socio-economic factors and limited regulatory capacities. This study suggests that redesigning policy package can empower governments to address the weaknesses of polycentric governance. It highlights the potential application of polycentric governance to energy and environmental management, and emphasizes the significance of governmental intervention for efficient governance.

The Evolution of Paperless Education in Medical Universities: Enhancing Efficiency and Health Outcomes

The adoption of paperless education in medical universities has revolutionized various aspects of academic life, offering enhanced efficiency, cost savings, and improved health outcomes. Traditional paper-based systems in medical education have long been associated with inefficiencies and environmental concerns. The advent of digital technologies has provided opportunities to streamline educational processes, reduce waste, and improve accessibility. This mini review examines the transformative impact of paperless education on medical universities, focusing on its benefits in registration, teaching, education, and exams. The shift to online registration systems has simplified the enrollment process for both students and administrators, allowing for seamless registration, payment, and course selection. Online registration also enables real-time tracking of student progress and facilitates communication between students and faculty. In teaching, digital tools such as e-learning platforms and virtual classrooms offer students flexible learning opportunities, promoting active engagement and knowledge retention. Similarly, the adoption of electronic textbooks and digital libraries has significantly reduced the reliance on printed materials in medical education, fostering self-directed learning and research. Furthermore, digital assessment methods such as online quizzes and remote proctoring have streamlined the examination process, offering greater flexibility in scheduling exams and ensuring the integrity of the assessment process. Economically, the transition to paperless education has resulted in cost savings by eliminating the need for printed materials, storage, and distribution. Additionally, digital technologies enable universities to reach a broader audience, potentially increasing enrollment and revenue. Moreover, paperless education offers health benefits by reducing exposure to allergens and pathogens associated with paper-based materials, and promoting social distancing to reduce the risk of transmission of infectious diseases. In conclusion, the adoption of paperless education in medical universities represents a transformative shift, offering numerous benefits including enhanced efficiency, cost savings, and improved health outcomes. As technology continues to evolve, medical universities need to embrace digital innovations to ensure a sustainable and effective learning environment.

Does culture matter in corporate cash holdings?

AbstractThis paper identifies culture as an important factor affecting corporate cash holdings by using China and its national culture, Confucianism, as the setting. We find that firms located in regions with stronger Confucian culture hold persistently higher levels of cash. We employ an instrumental variable to draw causal inference. Confucian culture strengthens the effect of cash flow risk on cash holdings of financially‐constrained firms, suggesting precautionary motives as the underlying mechanism. We find that the culture effect remains intact after controlling for corporate governance heterogeneity, which rules out the agency motives. Lastly, firms' operating performance indicates that high cash holdings is an efficient outcome.

Enhanced Extracellular Vesicle Cargo Loading via microRNA Biogenesis Pathway Modulation.

Extracellular vesicles (EVs) are physiological vectors for the intercellular transport of a variety of molecules. Among these, small RNAs, and especially microRNAs (miRNAs), have been identified as prevalent components, and there has thus been a robust investigation of EVs for therapeutic miRNAs delivery. However, intrinsic levels of EV-associated miRNAs are generally too low to enable efficient and effective therapeutic outcomes. We hypothesized that miRNA localization to EVs could be improved by limiting competing interactions that occur throughout the miRNA biogenesis process. Using miR-146a-5p as a model, modulation of transcription, nuclear export, and enzymatic cleavage steps of miRNA biogenesis were tested for impact on EV miRNA loading. Working in HEK293T cells, various alterations in the EV biogenesis pathway were shown to impact miRNA localization to EVs. The system was then applied in induced pluripotent stem cells (iPSCs), a more promising substrate for therapeutic EV production, and EVs were separated and assessed for anti-inflammatory efficacy in vitro and in a murine colitis model, where the preservation of function was validated. Overall, the results highlight necessary considerations when designing a cell culture system for the devoted production of miRNA-loaded EVs.