Management Goals Research Articles

What You Need to Know About: The Management of Malignant Pleural Effusion

Malignant pleural effusion (MPE) is a common complication of malignancy and is regularly seen on the general medicine take. Diagnosis of MPE is indicative of advanced or metastatic disease and carries a poor prognosis, with median survival ranging from 3 to 12 months. Despite recent advancements in systemic anti-cancer treatment, the goal of management in MPE remains the palliation of symptoms. This article reviews the current guidelines and evidence on the assessment and management of MPE. Assessment involves imaging techniques such chest X-ray and computed tomography (CT) scans, whilst thoracic ultrasound has a crucial role in guiding diagnostic procedures. Diagnostic pleural aspiration remains a cornerstone for establishing a tissue diagnosis, although its yield is variable depending on tumour type. Emergence of targeted immunotherapy has necessitated the need for large tissue samples for molecular testing, driving the need for pleural biopsies in relevant cases. Management encompasses therapeutic aspiration, chemical pleurodesis and indwelling pleural catheter insertion, each offering distinct benefits and considerations. Recent developments in equipment and combined approaches have enhanced patient outcomes and quality of life. The complexity of MPE requires a patient-centred approach to assessment and management and where possible patients should be managed with specialists in pleural disease on an outpatient basis.

Evaluating levee setback distance for the co-benefits of groundwater recharge and riparian ecosystem function

Constructed levees are designed to protect anthropogenic developments from destructive flooding events, but their construction has reduced groundwater recharge, increased flood risk severity under levee failure, increased the incision of river channels, and deteriorated riparian habitat. To reverse these impacts, levee setbacks are often designed to reduce flood risk and provide the opportunity to restore ecohydrological function, while groundwater recharge is rarely considered because it may require relatively detailed groundwater system analysis. In this study, we evaluated 100 heterogeneous hydrogeology realizations to estimate recharge with high-conductivity pathways (HCPs) under varying flood flows for a range of levee setback distances to identify the trade-offs in groundwater recharge and floodplain habitat. We find that on a regional scale, total recharge potential increases with setback distance, with the largest gains up to 1,400 m where there are outcropping HCPs and sufficient flow to inundate more of the setback area. In contrast, the recharge per unit area (i.e., the average daily recharge divided by setback area) generally decreases as levee setback increases, but there are local increases in the recharge per unit area at 1,400 m where HCP recharge may sufficiently offset the larger area. There is a median 10%–40% reduction in peak streamflow with increasing setback distance, which would aid flood risk reduction, but the increased area leads to decreasing depth due to flow losses and increased spreading of flood water. Ultimately, the decision for levee setback distance will depend on local conditions and management goals, as we find that increasing recharge will reduce the floodplain depth necessary for ecosystem function. Our results highlight the opportunity to consider groundwater recharge benefits in levee setback feasibility studies in semi-arid regions impacted by floods and groundwater overdrafts so that setback distance designs can achieve integration of flood risk reduction, riparian habitat, and groundwater recharge.

Addressing Non-Revenue Water Challenges: a Pathway Towards Sustainable Development Goal (SDG)

Objective: This study aims to investigate the level of non-revenue water (NRW) in Malaysia, explore the factors and outline the strategies for mitigating water losses to achieve sustainable water management goals. Theoretical Framework: In this topic, the main concepts and theories that underpin the research are presented. The theory of common-pool resources provides a solid basis for understanding the context of the investigation. Method: The methodology adopted for this research comprises employing secondary data from SPAN (National Water Services Commission) to investigate the level of NRW in Malaysia. Data collection was carried out by interviewing personnel from SPAN. Results and Discussion: The results obtained revealed that the level of NRW in Malaysia is high. The amount increased from 4,912 MLD in 2018 to 5,389 MLD in 2022, translating to a 10% increase over five years. Based on the interview, the factors contributing to the high level of NRW are leaks, theft, inaccurate metering, and old infrastructure. Research Implications: The practical and theoretical implications of this research are discussed, providing insights into how the results can be applied or influence practices in the field of NRW. These implications could encompass water scarcity and Sustainable Development Goal 6 (SDG 6). Originality/Value: This study contributes to the literature by highlighting the causes and factors that lead to the NRW. The relevance and value of this research significantly influence water scarcity, people's lifestyles, and SDGs.

Assessing the sustainability of Pacific walrus harvest in a changing environment

AbstractHarvest sustainability is a primary goal of wildlife management and conservation, and in a changing world, it is increasingly important to consider environmental drivers of population dynamics alongside harvest in cohesive management plans. This is particularly pertinent for harvested species that acutely experience effects of climate change. The Pacific walrus (Odobenus rosmarus divergens), a crucial subsistence resource for Indigenous communities, is simultaneously subject to rapid habitat loss associated with diminishing sea ice and an increasing anthropogenic footprint in the Arctic. We developed a theta‐logistic population modeling‐management framework to evaluate various harvest scenarios combined with 4 potential climate and disturbance scenarios (ranging from optimistic to pessimistic, based largely on sea ice projections from general circulation models) to simulate Pacific walrus population dynamics to the end of the twenty‐first century, focusing on the independent‐aged female subset of the population. We considered 2 types of harvest strategies: 1) state‐dependent harvest scenarios wherein we calculated harvest as a percentage of the population and updated annual harvests at set intervals as the population was reassessed, and 2) annually consistent harvest scenarios wherein annual harvest levels remain consistent into the future. All climate and disturbance scenarios indicated declines of varying severity in Pacific walrus abundance to the end of the twenty‐first century, even in the absence of harvest. However, we found that a state‐dependent annual harvest of 1.23% of the independent‐aged female subset of the population (e.g., 1,280 independent‐aged females harvested in 2020, similar to contemporary harvest levels) met our criterion for sustainability under all climate and disturbance scenarios, considering a medium risk tolerance level of 25%. This indicates that the present rate of Pacific walrus harvest is sustainable and will continue to be—provided the population is assessed at regular intervals and harvest is adapted to match changes in population dynamics. Our simulations indicate that a sustainable annually‐consistent harvest is also possible but only at low levels if the population declines as expected. Applying a constant annual harvest of 1,280 independent‐aged females failed to meet our criterion for sustainability under 3 of the 4 climate and disturbance scenarios we evaluated and had a higher probability of quasi‐extinction than an equivalent state‐dependent harvest scenario (1.23%). We highlight the importance of state‐dependent management strategies and suggest our modeling framework is useful for managing harvest sustainability in a changing climate.

Life cycle assessment and thermodynamic performance of biomass-based combined cogeneration

Abstract This study presents a thermodynamic and life cycle analysis of a biomass-based integrated energy system, comprising a biomass gasification cycle, a steam Rankine cycle, and an ammonia fluid Organic Rankine cycle. The primary objective of the system is to efficiently convert olive husk, a sustainable biomass source, into electricity and heating. The gasification process generates syngas, which fuels a gas turbine, producing high-temperature exhaust that drives a Rankine cycle. The thermodynamic analysis indicates that the overall system achieves an energy efficiency of 20.85% and an exergy efficiency of 11.70%. The Rankine cycle exhibits an energy efficiency of 23.91%, while the Organic Rankine cycle demonstrates a higher exergy efficiency of 68.87%. Parametric studies reveal that increasing the combustion chamber temperature significantly enhances system efficiency and output, with energy efficiency rising linearly as the temperature increases from 800 °C to 1000 °C. Additionally, the analysis emphasizes the importance of the compressor's compression ratio on system performance. A life cycle assessment conducted using the ReCiPe methodology evaluates the environmental impact of the system throughout its lifecycle, revealing critical insights into its sustainability. This comprehensive evaluation highlights the potential of utilizing agricultural waste, such as olive husk, to produce renewable energy, thereby supporting environmental sustainability and waste management goals. The findings underscore the viability of the proposed system for enhancing energy production while minimizing environmental impacts, making it a promising solution for renewable energy generation in regions with abundant biomass resources.

Comparative Analysis of Multi‐Criteria Decision‐Making Approaches for Identifying Groundwater Recharge Potential Zones in the River Basin of Northern Kerala, India

ABSTRACTGroundwater resources are increasingly strained by misuse and climate change, necessitating the identification of potential recharge zones for sustainable management. The study aimed to simulate potential recharge zones of a tropical river basin using two multi‐criteria decision‐making techniques: the Analytical Hierarchy Process (AHP) and Multi‐Influencing Factor (MIF) methods. Thematic layers of key variables were integrated using a weighted overlay analysis in GIS environment to model recharge areas within a tropical river basin in Northern Kerala, India. Normalized weights and ranks were calculated to evaluate their influence on groundwater development. Five classes of groundwater recharge potential zones (GWRPZ) with their derived areas were identified for AHP and MIF, respectively: high (30.39% and 28.24%), low (21.55% and 21.60%), very high (19.20% and 18.45%), moderate (16.96% and 20.25%), and very low (11.90% and 11.45%). Validation with overall accuracy and Kappa coefficient confirmed the methods' comparability. The results guide water well site selection and improve managed aquifer recharge (MAR) strategies. Local bodies within the river basin were ranked utilizing the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method to prioritize and implement recharge schemes, aiding sustainability goals in groundwater management.

Optimizing Conservation Planning: An Integrated Approach to Cost-Effective Biodiversity and Carbon Sequestration Management in Yunnan Province, China

This study introduces an innovative, integrated approach to optimizing conservation planning in Yunnan Province, China. By maximizing the synergistic benefits of threatened species protection and carbon sequestration while minimizing economic costs, the research identifies regions with the highest conservation cost-effectiveness. This is achieved by combining species distribution models (SDMs) for threatened species, carbon sequestration capacity estimates, and local economic data through an input-output (I-O) model at 1 kilometer resolution. The study highlights key regions within Yunnan—particularly in the northwestern areas of Shangri-la and Nujiang prefectures—as offering significant ecological benefits at relatively low opportunity costs. These findings provide a scalable framework for policymakers to prioritize regions for protected area (PA) expansion, thus enhancing conservation outcomes while minimizing financial expenditures. The proposed methodology improves conservation investments' cost-effectiveness and supports broader conservation and sustainable land management goals. This research underscores the necessity of integrating multiple ecological and economic factors to address the urgent challenges of biodiversity loss.

Effects of slurry concentration and co-digestion on biogas yields from unseeded Phaseolus vulgaris (bean) peels chaff and unseeded Musa paradisiaca (plantain) peels chaff

This study explored converting agricultural wastes of Bean peel chaff (Bu) and Plantain peel chaff (Pu) into biogas, an eco-friendly biofuel, without cow rumen liquor. By digesting these wastes anaerobically in various combinations and slurry concentrations, the study assessed their individual and combined biogas yields. Bean and plantain peels were digested alone and in two mixtures: BP1u (bean-to-plantain ratio 0.691:1) and BP2u (1:1 ratio). Three waste-to-water slurry concentrations (1:6, 1:11, and 1:16) were used, with anaerobic digestion lasting 37 days in triplicate 1000ml mini digesters. Biogas production was measured via water displacement. The study found total solids percentages of 96.03% for Bu, 90.12% for Pu, 84.15% for BP1u, and 84.94% for BP2u. The carbon/nitrogen (C/N) ratios ranged from 9.04 to 15.3. Average biogas yields showed BP1u produced the highest (11.12 ml/day), followed by Bu (9.8 ml/day), BP2u (7.5 ml/day), and Pu (0.55 ml/day). Among slurry concentrations, 1:6 (C1) yielded the most biogas (17.45 ml/day), followed by 1:11 (C2) and 1:16 (C3). ANOVA indicated significant effects from both slurry concentration and co-digestion on biogas yield, along with a notable interaction between both factors. In conclusion, both bean and plantain peels can generate biogas effectively, especially when combined and digested in higher slurry concentrations for improved yield. This approach supports waste management and renewable energy goals by transforming agricultural residues into valuable biofuel.

Assessing South Africa’s marine protected area quality and progress towards conservation goals: An application of The MPA Guide framework

Marine protected areas (MPAs) are a widely used area-based conservation tool for preventing or reversing the loss of marine biodiversity and sustaining the social-ecological systems that it underpins. Global targets for ocean protection typically track the extent of ocean area within MPAs. However, understanding the effectiveness of protection is crucial, as the level of protection and associated benefits for biodiversity and human wellbeing can vary among different types of MPAs. In South Africa, 41 MPAs currently protect 5.4 % of the country’s mainland exclusive economic zone (EEZ), each with varied conservation goals and unique zonation. We evaluated all 41 MPAs using the MPA Guide assessment framework to clarify levels of protection, expected conservation outcomes, and meaningful progress towards meeting national protection targets. We also compared types of site-specific management goals to the assessed level of protection for each MPA to understand whether MPAs are likely to achieve their stated goals. We found that all MPAs are at least Implemented, with most coverage Fully or Highly Protected (70.1 % of total MPA area; 3.8 % of EEZ). We also found that 40 MPAs have levels of protection that are likely to support all types of site-specific management goals. Our results indicate that South Africa’s MPA network has strong potential to deliver positive conservation benefits if MPA funding and capacity constraints, as well as other socio-economic factors, are addressed. Future protection initiatives should consider these factors prior to anticipated MPA expansion.

Consensus Report on the Use of Continuous Glucose Monitoring in Chronic Kidney Disease and Diabetes.

This report represents the conclusions of 15 experts in nephrology and endocrinology, based on their knowledge of key studies and evidence in the field, on the role of continuous glucose monitors (CGMs) in patients with diabetes and chronic kidney disease (CKD), including those receiving dialysis. The experts discussed issues related to CGM accuracy, indications, education, clinical outcomes, quality of life, research gaps, and barriers to dissemination. Three main goals of management for patients with CKD and diabetes were identified: (1) greater use of CGMs for better glycemic monitoring and management, (2) further research evaluating the accuracy, feasibility, outcomes, and potential value of CGMs in patients with end-stage kidney disease (ESKD) on hemodialysis, and (3) equitable access to CGM technology for patients with CKD. The experts also developed 15 conclusions regarding the use of CGMs in this population related to CGMs' unique delivery of both real-time information that can guide monitoring and management of glycemia and continuous and predictive data in this population, which is at higher risk for hypoglycemia and hyperglycemia. The group noted three major clinical gaps: (1) CGMs are not routinely prescribed for patients with diabetes and CKD; (2) CGMs are not approved by the United States Food and Drug Administration (FDA) for patients with diabetes who are on dialysis; and (3) CGMs are not routinely available to all of those who need them because of structural barriers in the health care system. These gaps can be improved with greater stakeholder collaboration, education, and awareness brought to the use of CGM technology in CKD.

Technical approaches to addressing ecological red-line management challenges in ecological security

As rapid industrialization, urbanization, and globalization heighten the urgency for ecological security worldwide, China faces a critical challenge in balancing economic development with environmental preservation. In response, China has implemented various ecological initiatives, with the establishment of ecological red lines as a cornerstone of its environmental governance and a fundamental strategy to safeguard ecological security. This study provides a comprehensive examination of the evolution of ecological protection red lines and the recent release of the Technical Guidelines for the Delineation of Ecological Protection Red Lines to develop a technical plan for regional ecological protection red-line management and control. It focuses on ecological security concerns, and the key considerations encompass defining essential concepts, highlighting the adverse impacts of human activities to justify the adoption of restrictive systems, recognizing regional disparities in resources, environment, and socioeconomic context, and employing multi-scale research methodologies for comprehensive data acquisition. The study addresses diagnosing ecological security issues, establishing prevention objectives and management goals, categorizing types of regional ecological protection red-line management and control, delineating spatial boundaries, and incorporating historical insights to propose scientifically grounded response strategies. These strategies aim to address ecological security challenges threatening ecological protection red lines while integrating extensive social feedback to ensure practicality and effectiveness.

Antifungal efficacy and biofumigation potential of hydrophobic deep eutectic solvents: Postharvest treatment against Monilinia fructicola and Botrytis Cinerea.

Hydrophobic Deep Eutectic Solvents (HDES), as a subclass of Natural Deep Eutectic Solvents (NADES), present a green-chemistry alternative to toxic chemicals. As HDES are based on terpenoids, these solvents could potentially be effective antifungal agents against phytopathogens Monilinia fructicola and Botrytis cinerea that frequently cause diseases in sweet cherry fruit. To contribute to the disease prevention and management goals, as a part of this study, 30 different HDES were tested in the vapor phase, at identical concentrations of 25%, 50%, and 100%. In vitro experiments were conducted on Potato Dextrose Agar medium (PDA), while in planta experiments were carried out in hermetically sealed containers with inoculated sweet cherry fruits. All tested HDES demonstrated efficacy in suppressing the growth of M. fructicola colonies (66 - 100%) and B. cinerea colonies (37 - 100%). According to the Area Under the Disease Progress Curve (AUDPC), all HDES exhibited high efficacy in preventing disease occurrence in cherry fruits by the tested phytopathogens. This research provides the first insights into the antifungal potential of HDES in the vapor phase, with promising applications as biofumigants that minimize harmful impacts on the food - human - environment complex.

Volunteer Peer Support for Chronic Pain Self-Management: A Qualitative Study of Benefits and Barriers.

Pain self-management is a key ingredient in chronic pain management. Peer support has been shown to be effective in helping patients self-manage other chronic conditions and may be a promising approach to implementing pain self-management programs more broadly without placing additional demands on clinicians. The Evaluation of a Peer Coach-Led Intervention to Improve Pain Symptoms (ECLIPSE) trial tested peer-supported chronic pain self-management. Although peers may be paid staff or volunteers, the ECLIPSE intervention was delivered by volunteer peer coaches, to test a low-resource model that could be easily implemented if effective. Trial results showed no statistically significant differences between intervention and control participants on key outcomes, and intervention adherence was low. To understand participants' experiences with peer coaching to help explain trial results. Semi-structured qualitative interviews with participants and peer coaches. Veterans with chronic musculoskeletal pain. Benefits to intervention participation included connecting with fellow veterans, receiving encouragement and hope, and improving pain self-management. Peer coaches described benefits unique to their role: facilitating their own pain self-management, having a "positive distraction," and a sense of "giving back." Barriers included difficulties reaching participants; resistance to focusing on the curriculum, including prioritizing socializing and being unwilling to set pain management goals; and phone delivery, which impeded communication and rapport-building. Participants described benefitting from the ECLIPSE intervention. Challenges, mostly related to engagement, were also described and may help explain trial results. The low-resource nature of the intervention may have exacerbated these difficulties. Volunteer coaches typically receive less training than paid peers and may have been less prepared to handle challenges; moreover, as volunteers, peer coaches likely had competing demands that left less time for coaching. Future research should seek to identify whom to target for peer-led versus other types of interventions to maximize benefit and use of resources.

Geospatial Analysis of LULC in the Srinagar Region of Jammu and Kashmir using Sentinel-2 Data

Geospatial analysis based LULC mapping finds great utility in Himalyan region in order to carry proper assessment, evaluation and sustainable management of the existing resources. With the aid of remote sensing (RS) and geographic information system (GIS), the current study on LULC mapping was conducted in district Srinagar of Jammu and Kashmir for the year 2022. European Space Agency (ESA) based Sentinel-2 satellite was used as a data source. By using the technique of visual image interpretation, the study area was demarcated into 11 LULC classes viz, agriculture, forest, forest scrub, built-up, TOF, grassland, wasteland, waterbody, wetland, snow and horticulture. The findings of the study revealed that from the delineated LULC classes highest percentage (19.61%) of area was covered by forest and least (2.17%) was covered by wetland. Moreover, the values obtained for overall classification accuracy and kappa statistics were 89.09% and 0.88 respectively. Due to increasing population and urbanisation some of the important LULC classes like wetland, agriculture etc have been encroached thereby disturbing the overall ecological balance. Therefore, findings of the current study might be useful in planning and demarcating the area where we can develop green infrastructure which might be fruitful in achieving the sustainable management goals.

Fire versus herbivory for oak woodland restoration: burning achieves short-term structural and compositional objectives whereas browsing alone fails to reduce stem densities and promote ground flora

BackgroundDeclines in ecologically beneficial fire, coincident with alterations to native herbivory and intensive land use, have led to dynamic changes in woodland structure and composition, leading to midstory densification and reductions in ground flora abundance and diversity. Frequent, low intensity fire is key to achieving woodland restoration objectives and prescribed burns are often used to meet management goals. For a variety of reasons, the use of prescribed fire is often limited. Further, growing season prescribed burning is often suggested to have a greater impact on woody stems than dormant season applications, but its implementation is difficult. Targeted herbivory may emulate many aspects of prescribed fire holding the potential to diversify management strategies for restoration. We designed a replicated, experimental study to evaluate targeted browsing and prescribed burning for achieving restoration objectives, specifically, a two layered oak woodland with a diverse and abundant native ground flora. The six treatments included: (1) spring browsing, (2) fall browsing, (3) dormant-season and fall browsing, (4) dormant-season prescribed fire, (5) spring browsing plus dormant-season prescribed fire, and (6) an untreated control.ResultsResults suggest that fire had an overriding effect on the reduction of midstory stems that was not comparable to the browsing treatments. Burning reduced leaf litter, increased bare soil exposure and forb coverage. Browsing may reduce the accumulation of woody stems when compared to the control, but this effect was not statistically meaningful. Differences in browsing seasonality and frequent browsing were also not statistically important but trends suggest a greater influence of spring browsing for meeting woodland objectives. Browsing may also exert compositional changes to woodlands because of forage preferences by goats.ConclusionsTo achieve woodland objectives in the short-term, fire is necessary to quickly reduce midstory densities, increase light availability, consume leaf litter, and thereby promote native ground flora abundance and diversity which may not be achieved with targeted browsing alone. Further, the interaction of fire and herbivory suggest that browsing preferences may influence structural and compositional outcomes associated with pyric herbivory regimes in woodlands that require further investigation.

Genetic, Metabolic, and Proteomic Polymorphisms and Clinical Phenotypes of Sepsis

The heterogeneity of sepsis patient populations remains an unresolved issue, hindering the development of effective therapeutic strategies and disease prognostic tools. Classification of diverse sepsis patients by molecular endotypes, together with multi-omics profiling, enables a more personalized treatment approach. Studying the immune response, genomic, metabolomic and proteomic profiles of sepsis patients will enable clinical phenotyping of this diverse population and the development of a precision approach to the diagnosis, prognosis and treatment of sepsis and septic shock.The aim of the review was to discuss sepsis subtypes as identified by profiling of patient genomic, metabolic, and proteomic data and present the latest approaches addressing the heterogeneity of sepsis patient populations, such as multi-omics endotyping and clinical phenotyping, which may aid in targeted therapy and optimization of diagnosis and therapy. The keywords "sepsis omics," "sepsis endotypes," and "sepsis heterogeneity" were used to search PubMed databases without language restrictions. From over 300 sources, 120 were selected for analysis as being most relevant to the aim of the review. More than half of these were published within the last five years. Criteria for excluding sources were their inconsistency with the aims of the review and their low informativeness.This review discusses the different types of immune responses, the impact of patient population heterogeneity on therapeutic interventions, and current perspectives on phenotyping sepsis patients. Despite the limitations of centralized collection of clinical information, cluster analysis of large data sets and the role of immune response genomics, metabolomics, and proteomics are beginning to dominate the prognosis and treatment of sepsis. Establishing links between all these elements and attempting clinical phenotyping of sepsis, including subtype analysis, appear to be critical in the search for personalized treatment approaches in the near future.Conclusion. Currently, the widely accepted goal in sepsis management is early detection and initiation of therapy to prevent the development of irreversible septic shock and multiorgan failure syndrome. Personalized genetic, metabolomic and proteomic profiling of the patient seems to be an intriguing and promising avenue in the search for new treatment strategies in sepsis.

Sexual Self-Disclosure Styles: Understanding Differences in Discussing Sensitive Sexual Topics with Relationship Partners

ABSTRACT This study explored sexual self-disclosure styles. Using an online self-report survey, participants (n = 428) reported levels of conversational goals, disclosure-related variables, and likelihood to disclose a sexual topic to their romantic partner. Cluster analysis resulted in three distinct styles of sexual self-disclosure. A seasoned self-discloser is experienced and efficacious in their sexual self-disclosures. Relationally constrained disclosers report concern for secondary goals paired with avoidance-related contextual variables. Functional self-disclosers seem to use verbal disclosure as a preferred tool for managing sexual issues in relationships, with less regard for the secondary influences of impression management, identity, and relational goals.

The role of global waste management and circular economy towards carbon neutrality

Solid waste management is a cross-cutting issue that significantly influences multiple aspects of sustainable development globally. The waste sector is a major anthropogenic source of global greenhouse gas (GHG) emissions. Most global GHG assessments of waste management rely on generic data due to limitations in available data. This research used reflective inventory data for municipal solid waste (MSW) treatment systems related to the income levels of countries, resulting in more context-specific and comprehensive assessments of GHG emissions. This study aims to assess life cycle GHG emissions from the global MSW management sector for the years 2023, 2030, and 2050 and then analyses the global and regional waste management goals set by the United Nations Environment Programme (UNEP) and the European Union (EU) to identify hotspots in the MSW management systems and critical factors that influence GHG emissions from the waste sector. The study was conducted in accordance with the standards outlined in ISO 14067:2018. The results show that the average global GHG emissions from 1 tonne of MSW in 2023 based on the existing MSW management practices was approximately 89.7 kg CO2e. The major contributor was the open dumping of MSW, contributing almost 70 % of GHG emissions. The global MSW management sector emitted a total of 173.2 Mt CO2e GHG emissions in 2023. If no improvements are made to existing systems, GHG emissions from the waste sector are projected to increase to 203.4 Mt CO2e by 2030, and to 289.5 Mt CO2e by 2050. Achieving waste management goals can reduce GHG emissions by approximately 1 % to more than 160 %. The implementation of the circular economy in the waste sector has the potential to achieve net zero emissions from the global MSW management sector by 2030 and 2050. This study provides achievable MSW management targets for the world and highlights key factors to achieve carbon neutrality from the waste sector. Prioritising policies such as upgrading open dumps, standardising household-level waste separation procedures, minimising food waste, establishing national recycling targets, and promoting circular economy through a zero-waste approach could substantially reduce GHG emissions from the waste sector. These findings are important for the adoption of circular economy principles in MSW management systems to effectively support the pursuit of carbon neutrality goals.

Detailed Lipid Profiles and Lipid-related Residual Risk after 12-week 10 mg Rosuvastatin Treatment for Acute Myocardial Infarction.

Objective We aimed to reveal detailed on-treatment lipid profiles, lipid-related surrogate markers, and factors predicting failure to achieve the guideline-recommended lipid management goal following guideline-recommended statin treatment in Japanese patients with acute myocardial infarction (AMI). Methods and Results Sixty AMI patients who underwent coronary intervention and had received rosuvastatin 10 mg/day since the start of their hospitalization were assessed for on-treatment lipid-related profiles, including high-sensitivity C-reactive protein, small dense low-density lipoprotein cholesterol (sd LDL-C), and lipoprotein (a), at the 12-week follow-up. Patients who failed to achieve the guideline-recommended lipid management at 12 weeks were defined as the "unachieved group." Univariate and multivariate logistic regression analyses were performed to evaluate the predictors of inclusion in the unachieved group after high-dose statin treatment. Despite the use of high-dose rosuvastatin, 61.7% of the enrolled AMI patients were included in the unachieved group. In addition, the unachieved group had higher sd LDL-C and lipoprotein (a) levels than the achieved group. Logistic regression analyses demonstrated that low baseline high-density lipoprotein cholesterol (HDL-C) levels and the absence of diabetes were predictors of inclusion in the unachieved group. Conclusion More than half of the Japanese AMI patients treated with rosuvastatin 10 mg/day did not achieve the guideline-recommended goal of lipid management and still had lipid-related residual risk at 12 weeks. Particular attention should be paid to patients with low baseline HDL-C levels and those without diabetes with regard to their on-treatment lipid profiles.

The Impact of Digital Transformation on Supply Chain Management: A Study of How Firms Adapt

Businesses need to embrace digital if they want to succeed in the cutthroat business climate of today. The goal of supply chain management is to maximise value for stakeholders and customers while also achieving operational efficiency. The planning, carrying out, managing, and verifying of store network exercises do this. The benefits and drawbacks of integrating digital technology into supply chain management practices are examined in this study. This analysis also aims to shed light on the potential advantages of advanced change for developing market organisations that aspire to become global. By using a qualitative methodology and carrying out a thorough analysis of six successful real cases in three different emerging markets—Iran, Bangladesh, and Pakistan—the study also seeks to offer recommendations for businesses in emerging markets on how to use digital technologies to optimise supply chain management processes and facilitate international business. The ultimate goal of this research is to improve knowledge of the role and importance of digital transformation in supply chain management for companies that operate in developing countries and to offer these companies useful advice so they can successfully compete on a global scale.