Management Level Research Articles

Influence of supply chain digitalization on supply chain agility, resilience and performance: environmental dynamism as a moderator

PurposeThis study aims to examine the impact of supply chain digitalization (SCD) on supply chain performance (SCP) with the integration of supply chain agility (SCA) and supply chain resilience (SCR) in manufacturing firms. Additionally, it investigates the moderating role of environmental dynamism (ED) in these relationships in the context of manufacturing firms.Design/methodology/approachA quantitative research design was employed, utilizing a structured questionnaire to collect data. The sample consisted of 374 valid responses from various managerial levels within manufacturing firms in Jordan. A purposive sampling technique was used to ensure that participants had relevant expertise in supply chain management. The data were analyzed using structural equation modeling (SEM) through Smart PLS software to test the proposed hypotheses.FindingsThe study found that SCD positively impacts SCP by enhancing both SCA and SCR. Digital technologies were shown to improve supply chain visibility, speed of decision-making and resource efficiency, which are essential for maintaining performance under uncertain conditions. Furthermore, ED significantly moderates the relationship between digitalization and SCP, indicating that the benefits of digitalization on SCA and SCR are more pronounced in highly dynamic environments.Originality/valueThis study contributes to the literature by offering an investigation on the role of SCD in influencing SCA, SCR and ultimately SCP in manufacturing firms. It also sheds light on the moderating effect of ED, providing a deeper understanding of the conditions under which digital transformation in supply chains is most beneficial. The study was based on three theoretical foundations: the resource-based view (RBV), the dynamic capabilities theory (DCT) and the contingency theory (CT).

Corporate Governance Reporting, Disclosures, Monitoring, and Decision‐Making: The Role of Big Data Analytics and Technological Tools

ABSTRACTResearch QuestionUsing the lens of agency theory, this study seeks to reveal novel qualitative insights on how different governance actors use big data analytics (BDA) and technological tools for governance purposes. It also investigates whether there are any differences in the use of BDA and technological tools between management and the board of directors (BoDs) and whether there are any barriers to adopting new technological tools at the board and managerial levels.Research FindingsBased on insights from 40 interviews with senior executives at the board and managerial levels across multiple geographical contexts, we reveal three key findings. First, different perspectives exist on using BDA and technological tools to enhance governance between the BoDs and management. This can lead to conflicts if the BoDs receives information from these tools that management has not shared, which further exacerbates the information asymmetry and the agency problem. Second, our findings suggest a paradox where, on the one hand, excessive use of BDA may allow managers to manipulate data or present biased reports. On the other hand, BDA use can simultaneously enable more informed decisions at the board level, even with unclear data. Lastly, we also develop a typology of factors that underpin the use of BDA at the board and managerial levels.Theoretical ImplicationsThis study's insights deepen the conversation on the use of BDA and technological tools by providing a conceptual framework of a typology of the benefits and barriers to using BDA at both the board and managerial levels. Second, our findings reveal that some of the traditional agency assumptions of board effective monitoring may be more assumed than demonstrated when it comes to effective uses of BDA and new technology.Policy ImplicationsOur study suggests that some directors may not be aware of the potential of BDA and technological tools, and many may not understand how it can benefit them. Our findings also reveal the need to educate BoDs and management to keep up with the latest technological tools.

Educational Aspects Affecting Paramedic Preparedness and Sustainability of Crisis Management: Insights from V4 Countries and the Role of Innovative Technologies

Recent major disasters, including the COVID-19 pandemic and floods in Europe, highlight the unpredictability of crises and the necessity for systemic preparedness at all levels of crisis management, including pre-hospital emergency medical services. Paramedics observed, under these challenging conditions (but not exclusively during them), cases of insufficient knowledge and skills in providing pre-hospital medical care, which lead to inadequate or prolonged decision making in delivering assistance. For this reason, the authors aimed to determine the extent to which such situations occur and to examine their causes, focusing on potential gaps and shortcomings in the education of paramedics. This study examines the impact of educational systems on the professional preparedness of paramedics in V4 European countries (the Slovak Republic, the Czech Republic, Hungary, and Poland) during pre-hospital care through a questionnaire survey. A survey involving over 1600 respondents revealed significant disparities in perceived knowledge and skill gaps, with Poland demonstrating the highest deficiencies (78%) and the Slovak Republic the lowest (57%). Key factors influencing these gaps included the frequency of external educational and training activities, years of experience, and expertise in managing critical conditions. The findings underscore the importance of innovative technologies, such as simulations and virtual reality, in enhancing paramedic training, along with integrating digital solutions across all phases of disaster management. Recommendations focus on strengthening system resilience, fostering interdisciplinary approaches, and improving system sustainability and adaptability. By using the results obtained and leveraging technological advances, the study aims to contribute to more effective crisis preparedness, population protection, and sustainable development goals (SDGs), namely (3, 4, 9, and 11), especially in the field of crisis management. This reinforces the broader role of SDGs in building more robust, future-ready disaster management frameworks.

Community emergency management policy in China using a policy text tool.

Systematically analyzing the current status and problems of the Community Emergency Management Policy (CEMP) system in China and proposing practical suggestions that are conducive to subsequent policy formulation and improvement are important for improving community emergency management capabilities and levels and promoting sustainable community development. Based on the two-dimensional analysis framework of "policy tools-policy objectives", this paper draws from content analysis and social network analysis, quantitatively analyzing the CEMP texts at the national level from 2004 to 2024. The results show that the CEMP system in China has essentially taken shape, but there are still some problems, such as the uneven use of policy tools, the unbalanced internal structure of policy tools, the large distribution gap of policy objective elements, and the adaptability between policy tools and policy objectives, which needs to be improved. Given these results, we suggest 1) Appropriately increasing the frequency of using demand-type policy tools and effectively optimizing the internal structure of the three main types of policy tools; 2) Comprehensively deepening the reform of CEMP objectives; and 3) Reasonably improving the adaptability between policy tools and objectives.

Instructional quality in nursing vocational education and training

IntroductionInstructional quality refers to classroom management, personal learning support and cognitive activation.MethodsThis study was conducted in nurses’ vocational education and training (VET). We asked nursing students (N = 496) to estimate instructional quality of their classes (n = 52). Furthermore, we asked teachers (N = 52) to describe the learning objectives they aimed to achieve. We used online and paper- pencil questionnaires with validated scales to measure classroom management, personal learning support, and cognitive activation, and connectivity. For analyzing our data, we used descriptive statistics and Anova with Bonferroni and Turkey’ post hoc tests. We also used structuring qualitative content analysis to teachers’ descriptions of learning goals.ResultsOur results indicate that nursing students estimated the instructional quality of their classes quite high. When teacher aimed on achieving higher levels of learning objectives classroom management and personal learning support were estimated significantly different.DiscussionIn VET it is important to coordinate the content, the way of instruction, and the way learners are supported in the learning process to achieve high instructional quality.

Optimal Celebrity Endorsement Decision and Pricing Strategy with Strategic Consumers

Given the importance of determining the traffic level in celebrity endorsement management and prominent impacts from strategic consumers, this paper utilizes mathematical modelling to study the optimal traffic level and pricing strategy as well as relevant influencing factors in the context of celebrity endorsement. The results show that optimal traffic level is highest under uniform high pricing strategy and lowest under uniform low pricing strategy, with that of dynamic pricing strategy lying in between. Aside from the proportion of strategic consumers, optimal pricing strategy is also determined by the joint effects of celebrity endorsement characteristics, such as the premium effect of celebrity endorsement, the market demand expansion effect, and the traffic using cost. It depends on the tradeoff between the positive effects (premium effect and market demand expansion effect) and the negative effects (endorsement fee of unit traffic) of the celebrity endorsement.

Exploring the Macroeconomic Effects of Tax and Fee Reductions

This paper combines the IS-LM model to analyze the macroeconomic effects of China's positive fiscal policy of reducing taxes and fees, including tax burden, output, tax structure, consumption and investment, in the stage of combined tax cuts and fee reductions after the "Camp Reform" in 2016. Through the analysis of specific data, in this stage, China's overall tax burden continues to decline, the level of output rises slowly, the value-added tax accounted for the proportion of tax revenue declines while the proportion of income tax accounted for tax revenue rises, the tax structure changes, the level of consumption remains rising, in terms of investment, the growth rate of private-sector investment in the post-tax cut policy has a significant decline, there is the possibility of fiscal crowding out. For the tax cut and fee reduction policy at this stage, it is proposed that while adopting tax cuts as a fiscal policy tool to act against the economic winds, it can be combined with monetary policy; combining tax cuts with economic and social development trends, and promoting the combination of tax cuts with optimization of the tax system; and upgrading the level of tax collection and management and improving the efficiency of the use of fiscal expenditure funds, and other policy recommendations.

Multi-Temporal Remote Sensing for Forest Conservation and Management: A Case Study of the Gran Chaco in Central Argentina

Anthropogenic alteration of tropical and subtropical forests is a major driver of biodiversity loss; notably, the Chaco Forest, which is the largest dry forest in the Americas, is among the most impacted regions. Sustainable forest management, a key objective of the UN’s 15th Sustainable Development Goal (SDG), underscores the need for advanced monitoring tools. This study integrates Sentinel-2 remote sensing (RS) spectral indices with field data to analyze forests under varying management regimes and levels of alteration in a representative area of the Chaco region (Chancaní Provincial Reserve and surrounding areas of the West Arid Chaco). Forest structure types and conservation levels were linked to monthly spectral index behavior using linear mixed models. Spectral indices such as the BI (Brightness Index), NDWIGao (Normalized Difference Water Index), and MCARISent (Modified Chlorophyll Absorption in Reflectance Index) effectively differentiated forest stands by conservation status and structural alteration. This combined RS and field data approach proved highly effective for detecting and characterizing forests with diverse conservation and sustainability conditions. The methodology demonstrates significant potential as a reliable RS-based tool for monitoring forest health and supporting progress toward SDG targets, particularly in regions like the Chaco Forest, which face extensive anthropogenic pressures.

Development of Smart Water Management in China: Current Status, Opportunities, and Challenges

This paper analyzes the current status, opportunities, and challenges in the development of smart water management in China. Influenced by multiple factors, the traditional water management model is facing difficulties. Smart water management has emerged as a timely solution. China is in the phase of intelligent development. The development opportunities for smart water management include internal industry demand and benefits, as well as external policy support and technological drivers. However, challenges such as low internal management levels, lack of top-level planning, and difficulties in digital transformation pose significant barriers. To achieve high-quality and sustainable development, smart water management requires the improvement of standards, as well as region-specific planning. This will contribute to the rational use of water resources, effective prevention of water-related disasters, and the stable development of the socio-economic environment and ecological balance.

Adopting AI in education: optimizing human resource management considering teacher perceptions

There is an intense concern in various fields, in order to quantify in the most complete and explicit way the impact that the accelerated development of the technology that is the basis of AI has on education. A very special issue in this context is represented by the impact AI has on the teaching methods and techniques used by teachers. Still, in order to develop and refine new methods and techniques based on AI technology is necessary that perceptions and attitudes toward this technology in general and its application in education in special to become positive and people to be open to new experiences in using it. The present research explores how different variables like perception towards inclusion of Generative AI tools within teaching materials development, degree of familiarity, challenges of AI implementation in education, importance of AI within the teaching process, resilience to change can influence the perceived utility of AI in education fostering positive attitude towards it and usage intention among teachers. The results are showing that the influence exerted by the above variables can be assessed within an empirical model that can explain the intention of teachers to use effectively AI based tools at different levels of the didactic activity. Implications at the level of human resources management in education are also discussed.

Hydrodynamics of the Indus Valley Civilization: Ingenious Water Management through Physics

One of the earliest of such urban cultures (circa 3300 and 1300 BCE), the Indus Valley Civilization (IVC) displayed an advanced level of water management and incorporated simple principles of physics when designing its hydraulic systems. This paper examines how the IVC’s engineers applied concepts of fluid mechanics, gravity, and the pressure differential to create an efficient, sustainable irrigation network. At Mohenjo-Daro, Harappa, and Dholavira, excavations have uncovered sprawling motley of reservoirs, step-wells, underground drains, and public baths, built to maximize the flow and storage of water. “Da vinci code” to the new civilization's engineering choice depended on Bernoulli's equation and Pascal's law to control the water pressure in the closed drainage system of the new civilization where waste was disposed of on an hourly basis to avoid flood within a specific interval. Gentle slopes incorporated into drainage channels utilized gravitational potential energy to facilitate a continuous transport of wastewater, minimizing stagnancy and contamination. Additionally, well reservoirs were designed based on the principles of capillary action and hydraulic gradient to allow the extraction of water and control its seepage. The IVC also showcases an evolved concept of urban planning besides the incorporation of hydrodynamic principles in routing the combined monsoonal water through the harvesting systems to ensure water supply throughout the year. The precision of these structures points towards an experiential mastery of hydrostatics, enabling them to stockpile water without over seepage and overflow. The paper concludes that the water-management strategies of Indus Valley civilization were both technologically advanced and environmentally humane. Through intuitive application of fundamental physics principles, the IVC had struck a balance between urbanization and natural resource conservation—a feat that is still applicable to contemporary water management systems. Such ancient knowledge acts as a formidable source of knowledge to overcome modern-day hydrologic challenges and signifies the continued relevance of early scientific thinking in human society.

Influence of integrated nutrient management on agro-meteorological indices in cultivation of soybean (Glycine max L.) varieties of West Bengal

BackgroundUnder variable weather conditions, the concept of thermal time decides the duration of every phenological phase; consequently, crop maturity varies. Thus, knowledge of the occurrence of phenophases based on the thermal units helps farmers carry out various management practices at the right time for better crop growth. To explore it further, as well as to investigate the influence of five integrated nutrient management (INM) levels (N1: 100% recommended dose of fertilizers (RDF), N2: 75% RDF + 3t/ha Farm Yard Manure (FYM), N3: 75% RDF + 1.5 t/ha vermicompost, N4: N2 + 25 kg/ha ZnSO4, N5: N3 + 25 kg/ha ZnSO4) on different agro-meteorological indices [growing degree day (GDD), helio-thermal unit (HTU), photo-thermal unit (PTU), photo temperature (TPhoto), nycto temperature (TNycto), and inter-diurnal temperature range (TIDR)] of three soybean varieties (V1: PS 1225, V2: YEZIN 15, V3: PS 24), a field experiment was executed at Instructional Farm, Bidhan Chandra Krishi Viswavidyalaya, West Bengal, India, during monsoon seasons of 2019 and 2020. The experiment was placed in a factorial randomized block design with three replications.ResultsSoybean variety PS 1225 grown with applying 75% RDF + 1.5 t/ha vermicompost + 25 kg/ha ZnSO4 was least to attain phenophases and accumulated greater GDD (1933.1, 1952.7 Day °C), HTU (9695.0, 9132.3 Day °C hours), PTU (24,826.1, 24,821.5 Day °C hours), TPhoto (3343.0, 3421.2 °C), TNycto (2763.3, 2746.1 °C), and TIDR (1159.9, 1352.3 °C), while Myanmar variety YEZIN 15 was the lowest to accumulate these agro-meteorological indices. However, PS 24 under the same nutrient management level registered the highest thermal use efficiencies (heat use efficiency (HUE): 4.28, 4.05 kg/ha/day °C, helio-thermal use efficiency (HTUE): 0.87, 0.89 kg/ha/day °C hours, photo-thermal use efficiency (PTUE): 0.33 and 0.32 kg/ha/day °C hours, photo temperature use efficiency (TPhotoUE): 2.48, 2.31 kg/ha/°C, nycto temperature use efficiency (TNyctoUE): 2.99, 2.88 kg/ha/°C) in two consecutive years of experiment. This treatment combination was best in terms of seed yield and total biomass production.ConclusionThe finding suggests cultivation of the Indian variety PS 24 using the integrated application of 75% RDF + 1.5 t/ha vermicompost + 25 kg/ha ZnSO4 for achieving high thermal use efficiencies and productivity in the east Indian conditions.

Evaluation of Scrum-based Software Development Project Management Maturity Level at Bank Z

In the era of growing connectivity and the digital world, the growth of information technology requires organizations to adapt more efficient and effective software development methods. This research aims to measure the maturity level of Scrum-based software development project management at Bank Z, which has been implementing Agile approaches since 2023. With the challenges faced in timely project completion, this research explores the obstacles faced by Scrum teams and provides improvement recommendations to increase the efficiency and effectiveness of software development. The research methodology used includes quantitative and qualitative approaches, with data collection through questionnaires and interviews. The results show that the maturity level of the Scrum process at Bank Z is at level 2 (Managed), with some areas such as backlog management and Scrum meetings being well implemented. However, there is a need to improve transparency and collaboration between teams. Recommendations include increased training and consistent implementation of Scrum practices to achieve a higher level of maturity.

The impact of knowledge management on competitive advantage (A field study at Al- Qutaibi Islamic Microfinance Bank)

This study aims to examine the impact of knowledge management on competitive advantage at Al-Kuraibi Islamic Microfinance Bank. The research problem is about the impact of knowledge management dimensions on competitive advantage dimensions. In this context، the researchers have adopted a descriptive-analytical methodology، and the questionnaire is considered an important tool for collecting primary data. The population of this study encompasses all employees of Al-Kuraibi Bank، which totals 320 employees. A non-random purposive sample included 43 respondents، comprising the chief executive officer، the heads of the sections، department and deputy department managers، branch managers and their deputies، as well as all section heads. The data analysis was accomplished by using SPSS software. Some of the key findings from the study are that knowledge management has a significant effect on competitive advantage، the level of knowledge management and competitive advantage in Al-Kuraibi Islamic Microfinance Bank is very high، the retention of experienced employees with deep knowledge and greater attention to the cost aspect while offering services by the bank are recommended.

Construction of a performance evaluation index system for the management of chronic diseases based on medical and preventive integration

BackgroundThe medical and preventive integration(MPI) brings significant and substantial benefits to chronic disease management (CDM). Evaluating the effectiveness of MPI is curial to promote the high quality development of CDM. However, such a tool is not available in this field. We aimed to develop an evaluation index system for assessing the regional performance management level of MPI in the CDM and provide suggestions for improving quality construction of CDM at the county level.MethodsThe initial version of the performance evaluation index system was constructed based on literature analysis, panel discussions, and in-depth on-site interviews. The Delphi questionnaire was designed and 24 experts in the field of CDM were consulted in two rounds. The analytic hierarchy process method was employed to calculate the weight of indexes at the three levels.ResultsThe MPI performance evaluation index system at the county level includes five first-level indexes, 20 s-level indexes, and 69 third-level indexes. Among the five first-level indicators, “integration quality” (0.2060) ranked first, followed by “integration inputs” (0.2010), “integration effectiveness” (0.1982), “integration outputs” (0.1975), and “integration mode” (0.1973).ConclusionThe MPI performance evaluation indexes for CDM at the county level are scientific and reliable. This system can act as a useful tool for diversified subjects to find the loopholes and weak points in CDM. It also provides valuable experience for other national authorities to further improve their own CDM system by MPI evaluation.Strengths and limitations of this studyThis study complements the gaps in the field of MPI questionnaires in China, but the sample size is small, and it is recommended that reliability and validity tests be carried out in multiple regions of the country in later stages to increase the practicality of the questionnaire.

83 COST MANAGEMENT AND CONTROL OF MENTAL HOSPITAL BASED ON ACTIVITY BASED COSTING

Abstract Background Cost control is a key link in improving the quality and efficiency of operation services in psychiatric hospitals. Traditional cost calculation methods often fail to accurately reflect the true costs of various service projects and patients, resulting in unreasonable resource allocation and affecting treatment efficiency and patient satisfaction. As a cost management tool, activity-based costing divides indirect and direct expenses into activities, products or production processes based on specific criteria, providing more accurate cost information and strong support for management decision-making. The management environment of psychiatric hospitals is relatively complex, and there are many types of daily cost items. Strengthening cost control plays an important role in improving medical and health services and patient treatment efficiency. Therefore, the study proposes using activity-based costing to achieve cost management and control in psychiatric hospitals. Methods The study selected a psychiatric hospital as the research object. Firstly, through questionnaire surveys and interviews, data on the operational processes, resource consumption, and costs of various departments in the hospital were collected. Subsequently, the activity-based costing method was applied to break down hospital costs into direct and indirect costs. These costs were traced back to specific service projects and patients based on operational drivers, identifying key points and optimization spaces for cost control, and proposing targeted cost control measures. Results In Table 1, after implementing the activity-based costing method, the cost structure of psychiatric hospitals has been significantly optimized, and the average treatment cost for psychiatric patients has decreased by about 10%. The treatment cycle of patients is shortened, and the treatment effectiveness and satisfaction are improved to varying degrees. Specifically, the activity-based costing method has made the allocation of medical resources more rational, shortened the treatment cycle for patients, and achieved a treatment effectiveness rate of 90.22% after application. Before the application of activity-based costing, the average treatment cost only reached 46.23%, and patient satisfaction was below 70%. Discussion Psychiatric hospitals have weak awareness of cost accounting and control, and often use traditional cost calculation methods, which can easily lead to inaccurate budget support and affect the improvement of hospital management level. The study proposes the use of activity-based costing to achieve cost management and control. This method emphasizes the optimization and improvement of the workflow, which can help psychiatric hospitals analyze and evaluate the workflow and take relevant measures to optimize it, thereby reducing costs and improving hospital operational efficiency. And this method can promote transparency in hospital internal management, integrate cost resources, and improve the efficiency of cost monitoring and decision support. In the future, it is necessary to further explore the optimal dosage, treatment cycle, and combined application with other intervention measures of clozapine in order to achieve better therapeutic effects.

Predicting weekday and weekend sleep: Interactions between peers and mothers.

Adolescents often experience insufficient, inconsistent and poor-quality sleep. Deviant peer affiliation may promote insufficient or inconsistent sleep schedules, and could be an important factor in understanding adolescents' sleep. Furthermore, parenting behaviours have been shown to impact sleep in youth. We examined relations between deviant peer affiliation and sleep in adolescents, and assessed the role of maternal management of peer relationships as a moderator of these associations. A sample of 131 adolescents (Mage = 15.75 years, SD = 9.5 months; 70% white, 30% black; 54% female) reported their deviant peer affiliation, and mothers reported their directive and non-directive management of peer relationships. Adolescents wore actigraphs for 1 week to assess sleep hours, efficiency, onset and latency, which were used to calculate weekend (Friday-Saturday) and weekday (Sunday-Thursday) sleep parameters. Using latent difference score models, results indicated that deviant peer affiliation was associated with shorter and less efficient sleep during the weekend. Moderation effects suggested that deviant peer affiliation related to fewer sleep hours, later sleep onset and longer sleep latency during the weekend for adolescents with higher levels of non-directive maternal management. Furthermore, the greatest difference between weekend and weekday sleep onset was found for youth with both higher levels of deviant peer affiliation and higher levels of non-directive maternal management of peer relationships. Results of this study provide evidence that deviant peer relationships may be particularly influential for weekend sleep, and that more active maternal management of peer relationships can protect against poor sleep.

The Impact of Smart Management on Achieving the Strategic Goals of Saudi Educational Institutions: Case Study of the University of Bisha

The study aimed to identify the impact of smart management on achieving the strategic goals of Saudi educational institutions. The study relied on the descriptive analytical approach. The study also used a questionnaire as a data collection tool that was distributed to a random sample of the study population consisting of (410) educational staff at the University of Bisha. The data was analyzed using the statistical package program (SPSS) to reach the results. The results showed a high degree of appreciation for smart management at the University of Bisha. The results also indicated a high level of strategic objectives at the University of Bisha. The results of testing the study hypotheses showed a statistically significant effect at the significance level (0.05) of smart management in its dimensions (smart planning, smart organization, smart control) on achieving the strategic goals of Saudi educational institutions. The study concluded with several recommendations.

Different Strategy Choices Analysis Based on Stochastic Evolutionary Game Model for Construction Safety Supervision With/Without Smart Site Technology

The complexity and uncertainty of engineering construction present significant challenges to construction safety. Smart sites are an important measure of the transformation and upgrading of China’s construction industry. In the context of smart site technology, the impact and the influence path of the smart site technology on the project safety supervision system was introduced in this study, which was mainly based on stochastic evolutionary game theory. Meanwhile, a stochastic evolutionary game model between construction workers and project safety management departments was conducted to improve the safety management strategy of smart sites. Matlab simulation experiments were applied to analyze the changes in safety strategy selection among different groups in the context of the presence and absence of smart site technology. The results show that the introduction of smart site technology could promote the strategy selection of construction workers to be more stable; however, reasonable smart site operation strategies should be formulated to control the management costs in case of negative effects. In addition, an appropriate increase in penalties could reduce the probability of workers adopting unsafe construction strategies. The results are beneficial in assisting the formulation of project safety management strategies in the context of smart sites, improving the level of construction safety management, as well as reducing the occurrence of safety accidents.

A long term bone and renal safety of TAF treatment on renal transplant recipients.

The data on tenofovir alafenamide (TAF) in kidney transplant recipients (KTRs) with chronic hepatitis B virus (HBV) infection is limited. Retrospective cohort study SETTING & STUDY POPULATIONS: HBsAg-positive KTRs who received TAF between 2019 and 2022 were included in the analysis, categorized into treatment-naïve and treatment-experienced groups. Additionally, a subgroup of patients receiving ETV was analyzed for comparison. Four treatment-naïve (Group I) and 35 treatment-experienced (Group II) patients received TAF for 26.4±11.3 and 43.7±19.0 months, respectively. Both groups showed significant HBV DNA reduction, but Group I achieved higher rates of undetectable HBV DNA (50%, 75%, 75%, 100% at 6, 12, 24, 30 months, compared with 16.7%, 25.3%, 31.4%, 34.7% in Group II, p=0.018). Renal allograft function remained stable during follow-up, and bone toxicity was minimal. For ETV, 10 patients demonstrated excellent viral suppression (HBV DNA undetectable in 70% at 48 weeks and 100% at 96 weeks) with stable renal function over a median of 5.2 years. Retrospective study with a lack of prospective comparison of TAF and ETV. Our results suggest that TAF provides favorable efficacy, renal safety, and tolerability in KTRs. ETV also provided effective and sustainable viral suppression. TAF may offer additional advantages such as no concern of viral resistance and dose adjustment by eGFR levels for long-term management of HBsAg-positive KTRs.