Management Research Articles

Clinical Application and Risk Assessment of CAR-T Cell Technology in Cancer Immunotherapy

As a cutting-edge personalized treatment method, CAR-T cell technology transforms patients' own T cells through genetic engineering, making them have the ability to specifically identify and kill tumor cells. The aim of this paper is to thoroughly organize the foundational principles and clinical utility of CAR-T cell technology, highlighting its recent advancements in treating both hematological and solid tumors. Through a comprehensive assessment of CAR-T cell technology's efficacy and risks, this study aims to inform clinical decision-making. Initially, the paper outlines the basic mechanisms of CAR-T cell technology, followed by an analysis of its notable therapeutic outcomes in hematological tumors. Additionally, it addresses the challenges posed by solid tumor treatment, including antigen expression complexity and tumor microenvironment impact. Emphasis is placed on the crucial role of regulatory bodies in enhancing oversight and developing risk management strategies to safeguard patient safety.

Impact of Respiratory Syncytial Virus (RSV) in Adults 60 Years and Older in Spain

Background/Objectives: Respiratory illnesses frequently lead to hospitalization in adults aged 60 and older, especially due to respiratory viral infectious (RVI). This study investigates hospitalization patterns and characteristics of RVI at HM Hospitals from October 2023 to March 2024; Methods: We retrospectively explored hospitalizations of patients aged 60 years and older with RVIs, gathering data on demographics, clinical profiles, comorbidities, and treatments. Outcomes included hospitalization, ICU admissions, and mortality, and independent factors associated with outcomes were identified using a multi-state model; Results: From October 2023 to March 2024, from a total of 3258 hospitalizations, 1933 (59.3%) were identified as positive for RVIs. Overall, SARS-CoV-2 was the most prevalent (52.6%), followed by influenza (32.7%), and RSV (11.8%). Most RVI involved single infections (88.2%). Hospitalization rates increased with age for SARS-CoV-2 (333.4 [95% CI: 295.0–375.2] to 651.6 [95% CI: 532.1–788.4]), influenza (169.8 [95% CI: 142.6–200.7] to 518.6 [95% CI: 412.1–643.1]), and RSV (69.2 [95% CI: 52.2–90.0] to 246.0 [95% CI: 173.8–337.5]), with SARS-CoV-2 showing the highest rate, followed by influenza and RSV. In the multi-state model, RSV infection significantly increased ICU admission risk (HR: 2.1, 95%, p = 0.037). Age on admission (HR: 1.1, 95%, p < 0.001) and Charlson score (HR: 1.4, 95%, p = 0.001) were associated with transitioning from admission to death. ICU to death risks included age at admission (HR: 1.7, 95%, p < 0.001); Conclusions: RVI in adults 60 years and older are associated with high hospitalization and mortality rates, primarily driven by influenza and SARS-CoV-2, followed by RSV. Age and comorbidities significantly impact disease severity, emphasizing the need for targeted prevention and management strategies for RSV in this vulnerable population.

A Review on the Mathematical Modelling of the Grain Storage Ecosystemin Storage Structures and Bags

The grain storage ecosystem comprises of biotic and abiotic factors that interact during grain storage, and their interaction affects the quality of the stored grains over time. The understanding and management of the complex interaction of the biotic and abiotic factors in the stored grain ecosystem is crucial to decision-making and in the development of management strategies for grain farmers and elevators. Mathematical modelling has emerged as an essential approach in tackling complex systems such as the stored grain ecosystem. This review explores the application of mathematical modelling in the grain storage ecosystem and synthesizes the existing literature, highlighting the various mathematical models and approaches to solving issues relating to the grain storage ecosystem. The review will be helpful to researchers and stored grain experts in the grain industry on the various mathematical modelling approaches and equations that can be employed to solve problems associated with grain storage in order to better manage the quality of stored grain.

Comparative analysis of climate-induced habitat shift of economically significant species with diverse ecological preferences in the Northwest Pacific

The Northwest Pacific Ocean is the most productive fishing ground in the Pacific Ocean, with a continuous rise in water temperature since 1990. We developed stacked species distribution models (SSDMs) to estimate the impacts of climate change on the distribution dynamics of economically significant species under three climate change scenarios for the periods 2040-2060 and 2080-2100. Overall, water temperature is the most important factor in shaping the distribution patterns of species, followed by water depth. The predictive results indicate that all the species show a northward migration in the future, and the migration distance varies greatly among species. Most pelagic species will expand their habitats under climate change, implying their stronger adaptability than benthic species. Tropical fishes are more adaptable to climate change than species in other climate zones. Though limitations existed, our study provided baseline information for designing a climate-adaptive, dynamic fishery management strategy for maintaining sustainable fisheries.

Effect of Changing Temperature and CO2 Concentration on Weed Dynamics and Behaviour: A Review

Agriculture and climate change are interwoven with each other in various measures, as climate change is the main culprit of biotic and abiotic stresses, which has adverse impact on crops and weed flora and the effectiveness of weed management strategies. Indeed weed physiology and crop productivity has been greatly influenced by several means of climate variability. Climate change causes a shift in weed population dynamics by altering the physiological pathways with the changing temperature and CO2 conditions. Climate change can affect crop-weed interactions by favouring C4 weeds in increased temperature scenarios requiring adaptation and mitigation strategies. Weeds can also shift their range by invading into new areas and higher latitudes or altitudes due to climatic variability affecting weed diversity, establishment, and management. These factors helps in understanding the crop interactions, weed infestation and herbicide efficacy. This review paper summarizes the challenges that occur due to climate change in weed behaviour requiring more attention on sustainable agricultural production.

Role of Nasopharyngeal Airway in Management of Craniofacial Syndrome-Associated Upper Airway Obstruction in Children.

Upper airway obstruction (UAO) management in children, particularly those with associated anatomical mid-face structural differences, poses a significant challenge. This study describes using a nasopharyngeal airway (NPA) in managing infants with severe upper airway obstruction. Infants discharged home from Queensland Children's Hospital with an NPA insitu for the management of upper airway obstruction were retrospectively evaluated for clinical and demographic parameters, underlying diagnoses and respiratory support, including NPA insertion details and comorbidities. Sixty-seven children (24 male) were included with a median age at NPA insertion of 24 (IQR 7-59) days and a median duration of NPA use of 229.1 (IQR 151.50-297.75) days. Fifty-two (77.6%) had Pierre Robin sequence. Other diagnoses included CHARGE syndrome, Treacher Collins syndrome, Stickler syndrome, Crouzon syndrome, Bohring-Opitz syndrome, isolated cleft palate, Beckwith-Wiedemann syndrome, Chromosome 3 deletion and VACTERL association. Four infants required tracheostomy, and no complications related to NPA use were reported. Those with oximetry and polysomnography data showed improving indices following NPA insertion [pre NPA median (IQR) SpO2: 95.9% (94.73-97.73), AHI: 51.40 (44.50-69.45), OAHI 65.9 (56.45-73.35) and TcCO2 (mmHg) 65.70 (61.95-67.30) vs. post-NPA median (IQR) SpO2: 97.1% (96.19-97.9), AHI: 12.20 (11.25-24.35), OAHI 10.20 (6.12-5.62) and TcCO2 (mmHg) 52.40 (47.90-58.40)]. Our findings highlight the effectiveness and safety of NPA as a noninvasive management option for severe upper airway obstruction in children, particularly in those with anatomical midface structural differences. Further research and larger studies are warranted to confirm these findings and optimise management strategies for these patients.

Chronic pain among primary fentanyl users: The concept of self-medication.

Chronic pain is among the leading causes of disability worldwide, of which only a small percentage of patients receive adequate treatment for. Non-prescribed opioid analgesics are commonly sought out in effort to alleviate unrelieved pain. This study assesses the prevalence and correlates of chronic pain among primary fentanyl users. A cross-sectional and structured survey was conducted with 200 adults who reported fentanyl as their drug of choice from a Vancouver acute care hospital. Presence and levels of chronic pain were determined through self-report. The majority of participants (n = 130, 72.6%) reported having chronic pain in the past 6 months, with the mean level of pain on a typical day to be 7.6 out of a scale of 10 (SD = 1.9). Majority (n = 85, 65.4%) reported using street opioids to self-medicate, while only 9 (6.9%) reported that their chronic pain was unrelated. Regression analysis indicated that increasing age and co-use of cannabis and opioids were independent associated factors of chronic pain. Higher levels of reported pain on a typical day were further associated with age and self-medication. The findings of this study demonstrate a significant association between self-medication and chronic pain among primary fentanyl users in British Columbia. For these individuals, inadequate pain relief may drive continued opioid use, which in turn may increase risks of treatment discontinuation and overdose. Appropriate pain management strategies are crucial to avoid opioid misuse and decrease the large societal burden caused by chronic pain. Our work points to the high prevalence of self-reported chronic pain among individuals who primarily use fentanyl. Among those with self-reported fentanyl use and chronic pain, self-medication with street opioids was found to be common and associated with higher reported pain levels on a typical day. This highlights the need for pain management strategies to be integrated into opioid dependence treatment and more research in the overlap of pain and fentanyl use.

Synergistic Epistasis and Systems Biology Approaches to Uncover a Pharmacogenomic Map Linked to Pain, Anti-Inflammatory and Immunomodulating Agents (PAIma) in a Healthy Cohort

The global public health addiction crisis has been stark, with over 932,400 deaths in the USA and Canada from opioid overdose since 1999–2020, surpassing the mortality rates at the top of the HIV/AIDS epidemic. Both nations exhibit opioid consumption rates significantly above the norm for developed countries. Analgesic type of opioids present both therapeutic benefits and substantial health risks, necessitating balanced drug regulation, careful prescribing, and dedicated opioid stewardship. The role of the cytochrome P450 2D6 (CYP2D6) system (Enzymatic functions) in metabolizing opioids highlights the potential of genotype-guided analgesia. By integrating Pharmacogenomics (PGx), this approach aims to optimize pain management, enhance safety, and reduce addiction risks. This understanding prompted the utilization of multifactor dimensionality reduction (MDR) to explore a range of phenotypes including PGx and gene–gene interactions (GGI) in a healthy cohort, thereby personalizing pain management strategies. The study sampled 100 unrelated healthy Western Iranians and 100 individuals from the 1000 Genome Project. Pre-testing involved searching for PGx annotations (variants associated with drug-gene-diseases) related to pain sensitivity and inflammation using the PharmGKB database, which identified 128 relevant genes. A questionnaire helped select 100 participants who had never used potent opioids but also other psychoactive agents (e.g., nicotine, amphetamines, etc.) and disease-related drugs. Whole-exome sequencing (WES) was then employed to analyze these genes in an Iranian cohort. Further analyses included MDR for identifying synergistic gene annotations and GGI for exploring complex gene interactions through the Visualization of Statistical Epistasis Networks (ViSEN). The study identified a Pain, Anti-Inflammatory, and Immunomodulating agents (PAIma) panel from the 128 genes, resulting in 55,590 annotations across 21 curated pathways. After filtering, 54 significant structural or regulatory variants were identified. This research also highlighted novel gene relationships involving the CYP3A5 gene, hsa-miR-355-5p, Paliperidone, and CYP2D6, which warrant further investigation. This study offers a novel pharmacogenetic framework that could potentially transform opioid prescribing practices to mitigate misuse and enhance personalized pain management. Further validation of these findings from multi countries and ethnic groups could guide clinicians in implementing DNA-based opioid prescribing, aligning treatment more closely with individual genetic profiles.Graphical abstract

Diagnosis and treatment of patients with gastroesophageal reflux disease - a systematic review of cost-effectiveness and economic burden.

This study aims to review the existing knowledge on the cost-effectiveness and item costs related to the diagnosis and treatment of gastroesophageal reflux disease (GERD) patients at different stages. The study adhered to the PRISMA guidelines. The systematic search involved several steps: finding and identifying relevant articles, filtering them according to the set criteria, and examining the final number of selected articles to obtain the primary information. The number of articles published between 2013 and September 2024 in the Web of Science and PubMed databases was considered. The CHEERS checklist was used for the risk of bias assessment. Ultimately, 36 studies were included. Regarding the cost-effectiveness of GERD treatment, Proton pump inhibitors (PPIs) appeared to be the dominant solution for non-refractory patients. However, this might change with the adoption of the novel drug vonoprazan, which is more effective and cheaper. With advancements in emerging technologies, new diagnostic and screening approaches such as Endosheath, Cytosponge, and combined multichannel intraluminal impedance and pH monitoring catheters should be considered, with potential implications for optimal GERD management strategies. The new diagnostic methods are reliable, safe, and more comfortable than standard procedures. PPIs are commonly used as the first line of treatment for GERD. Surgery, such as magnetic sphincter augmentation or laparoscopic fundoplication, is only recommended for patients with treatment-resistant GERD or severe symptoms. Advances in emerging technologies for diagnostics and screening may lead to a shift in the entire GERD treatment model, offering less invasive options and potentially improving patients' quality of life.

Comparative study of endophytic bacterial strains from non-host crops for enhancing plant growth and managing early blight in tomato

Bacillus pseudomycoides, Paenibacillus polymyxa, and B. velezensis are potent bacterial endophytes, which typically exhibit host-specific interactions. However, comparative studies of these endophytes in vitro and in planta in non-host crops are lacking. Therefore, in this study, we evaluated the potential of endophytes B. pseudomycoides strain HP3d, P. polymyxa strain PGSS1, B. velezensis strain A6, and P42, isolated from various crop ecosystems in promoting plant growth and inducing systemic resistance against early blight disease in tomato. In vitro, endophytes exhibited 44.44–55.56% and 37.50–87.50% inhibition of Alternaria solani in dual culture and volatilome bioassay, respectively. In the glasshouse, individual and combined applications via seed treatment (ST), seedling dip (SD), and foliar spray (FS) significantly enhanced shoot growth (23.63–57.61%), root growth (43.27–118.23%), number of leaves (77.52–93.58%), number of shoots (33.42–45.28%) and root dry matter (42.17–43.86%), reducing early blight (PDI) by 70.95–76.12% compared to uninoculated control. Enzymatic activities, including such as polyphenol oxidase (30–40 fold), peroxidase (65.00–75.00 fold), superoxide dismutase (34.20–37.20 fold) and phenylalanine ammonia-lyase (44.44–45.56 fold) were elevated post-inoculation in endophytes treated tomato plants challenged with A. solani compared to control treated only with A. solani and declined after the fifth day. The total chlorophyll content declined from the 0th to the 10th day, but endophyte treated plants exhibited lesser reductions (2.03–2.09) than uninoculated control. Field trials confirmed the glasshouse findings, showing reduced early blight and improved growth parameters in tomato where the ST + SD + FS combination emerged as the most effective treatment for all endophytes showing 1.06–1.88 fold increase in fruit yield per plant and 28.92–32.52% decrease in PDI compared to untreated control. Thus, the study highlights the broad-spectrum potential of these strains in promoting plant growth and controlling early blight in tomato, demonstrating non-host specificity. These endophytes offer eco-friendly alternatives to chemical pesticides, supporting sustainable agriculture. Their success in field trials suggests the potential for commercialization and large-scale use across diverse crops and pave the way for further interdisciplinary research to optimize their application in integrated pest management strategies.

Managing Edge States in Reduced-Dimensional Perovskites for Highly Efficient Deep-Blue LEDs.

Pure-halide reduced-dimensional perovskites, featuring large exciton binding energy and tunable bandgap, show great potential for high-efficiency deep-blue perovskite light-emitting diodes (PeLEDs). However, their efficiency, particularly in the low n-value phase domain ("n" represents the number of octahedral sheets), lags behind analogous perovskite emitters. Herein, it is demonstrated that the vibration of edge-dangling octahedra in the low n-value phase activates notorious exciton-phonon (EP) coupling, thereby deteriorating efficiency. To address this issue, an approach is reported to manage edge-state lattices by introducing tris(4-fluorophenyl) phosphine (TFP) ligands. Attributed to the large steric hindrance of TFP ligands and their strong binding affinity for edge-dangling octahedra, the edged-octahedral tilting reconstruction can effectively suppress lattice vibration and inhibit EP coupling. This strategy yields deep-blue emitting film with a spectral linewidth of 21nm and a photoluminescence quantum yield of 85% at low excitation densities. The resulting PeLEDs achieve deep-blue emission at 469nm, with a maximum luminance of 2,428cdm-2 and a maximum external quantum efficiency of 10.4%, marking them among the most efficient deep-blue PeLEDs reported. The strategy also showcases universality for higher n-value reduced-dimensional perovskites. It is believed that the observation, along with the edge-state management strategy, lays the groundwork for further advancements in reduced-dimensional perovskite optoelectronic devices.

Subsidence and Uplift in Active and Closed Lignite Mines: Impacts of Energy Transition and Climate Change

This study examines the combined effects of decommissioning lignite mining operations and long-term climate trends on groundwater systems and land surface movements in the Konin region of Poland, which is characterised by extensive open-pit lignite extraction. The findings reveal subsidence rates ranging from −26 to 14 mm per year within mining zones, while land uplift of a few millimetres per year occurred in closed mining areas between 2015 and 2022. Groundwater levels in shallow Quaternary and deeper Paleogene–Neogene aquifers have declined significantly, with drops of up to 26 m observed near active mining, particularly between 2009 and 2019. A smaller groundwater decline of around a few metres was observed outside areas influenced by mining. Meteorological data show an average annual temperature of 8.9 °C from 1991 to 2023, with a clear warming trend of 0.0050 °C per year since 2009. Although precipitation patterns show a slight increase from 512 mm to 520 mm, a shift towards drier conditions has emerged since 2009, characterised by more frequent dry spells. These climatic trends, combined with mining activities, highlight the need for adaptive groundwater management strategies. Future research should focus on enhanced monitoring of groundwater recovery and sustainable practices in post-mining landscapes.

Efficacy of L-arabinose in managing cucumber Fusarium wilt and the underlying mechanism of action.

Cucumber Fusarium wilt (CFW), triggered by Fusarium oxysporum f. sp. cucumerinum, leads to substantial yield reductions in global cucumber (Cucumis sativus L.) production. Common management strategies for CFW include soil fumigation, grafting, and crop rotation. However, these methods have limitations regarding safety and efficacy stability, necessitating the development of new, cost-effective, and eco-friendly control strategies. Our prior research demonstrated that L-arabinose, an inexpensive and safe sugar commonly used in food and beverages, effectively suppressed bacterial wilt in tomatoes. This study explores the potential of L-arabinose in managing CFW and investigates its mechanism of action. Soil applications of L-arabinose, ranging from 0.00001 to 0.01%, effectively suppressed CFW. The most significant suppressive effect was observed at 0.01%, reducing the disease severity index by 67.5% compared to the control treatment. Microscopic examination of transverse root sections showed that pathogen hyphae colonized the epidermis but seldom penetrated the cortical layer of roots in L-arabinose-treated seedlings. In contrast, the entire root tissue of control seedlings was colonized by the pathogen. Quantitative real-time PCR revealed a significant increase in the expression of defense-related genes dependent on salicylic acid, jasmonic acid, and ethylene in L-arabinose-treated plants compared to control plants, 6 and 10 days post pathogen inoculation. This study demonstrated that soil application of L-arabinose can effectively suppress CFW by priming root tissues for multiple defense signaling pathways. Therefore, L-arabinose holds potential as a new fungicide for managing CFW. © 2024 The Author(s). Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Mathematical Modeling of the Co‐Infection Dynamics of Dengue and Malaria Using Delay Differential Equations

AbstractThis study presents a comprehensive mathematical model to analyze the dynamics of co‐infection between dengue and malaria using delay differential equations. The model investigates the transmission dynamics of both diseases, focusing on the stability of equilibrium points and the basic reproductive ratio, which measures the number of secondary infections caused by a single infected individual. A time‐delay component is incorporated to account for the incubation periods, enhancing the model's realism. The study performs a detailed sensitivity analysis and global stability assessments, providing insights into the control and management of diseases. Numerical simulations are conducted to illustrate the effect of various transmission parameters on disease spread. This research highlights the importance of mathematical modeling in understanding co‐infection dynamics and provides critical insights for public health interventions, particularly in regions where both diseases are endemic. The results emphasize the role of controlling transmission rates and the use of vector management strategies in mitigating disease outbreaks.

Synchronous primary ovarian tumours in postmenopausal women: A rare case report and literature review

The reported incidence of synchronous primary cancers of genital tract is 1-2%, among this synchronous primary ovarian tumour is rarest. Herein, a postmenopausal woman, who had previously undergone abdominal hysterectomy, presented with vague lower abdominal pain persisting for six months. A computed tomography scan confirmed the presence of an 8.1 x 8.2 cm cyst on her right ovary. Despite her CA125 levels being normal, she was scheduled for laparoscopic cystectomy. During the surgery, the left ovary was found to be enlarged, prompting bilateral salpingo-oophorectomy. Histological analysis revealed a serous cystadenoma in the left ovary and a mucinous cystadenoma in the right ovary.Most reported synchronous ovarian tumors are malignant, with only a few cases of benign synchronous ovarian tumors documented in the literature. Early diagnosis and reporting of such cases are crucial for improving our understanding of synchronous ovarian neoplasms, which can impact management strategies and help prevent complications.

Edge Computing for Smart-City Human Habitat: A Pandemic-Resilient, AI-Powered Framework

The COVID-19 pandemic has highlighted the need for a robust medical infrastructure and crisis management strategy as part of smart-city applications, with technology playing a crucial role. The Internet of Things (IoT) has emerged as a promising solution, leveraging sensor arrays, wireless communication networks, and artificial intelligence (AI)-driven decision-making. Advancements in edge computing (EC), deep learning (DL), and deep transfer learning (DTL) have made IoT more effective in healthcare and pandemic-resilient infrastructures. DL architectures are particularly suitable for integration into a pandemic-compliant medical infrastructures when combined with medically oriented IoT setups. The development of an intelligent pandemic-compliant infrastructure requires combining IoT, edge and cloud computing, image processing, and AI tools to monitor adherence to social distancing norms, mask-wearing protocols, and contact tracing. The proliferation of 4G and beyond systems including 5G wireless communication has enabled ultra-wide broadband data-transfer and efficient information processing, with high reliability and low latency, thereby enabling seamless medical support as part of smart-city applications. Such setups are designed to be ever-ready to deal with virus-triggered pandemic-like medical emergencies. This study presents a pandemic-compliant mechanism leveraging IoT optimized for healthcare applications, edge and cloud computing frameworks, and a suite of DL tools. The framework uses a composite attention-driven framework incorporating various DL pre-trained models (DPTMs) for protocol adherence and contact tracing, and can detect certain cyber-attacks when interfaced with public networks. The results confirm the effectiveness of the proposed methodologies.

A Co-produced International Qualitative Systematic Review on Lived Experiences of Trauma During Homelessness in Adulthood and Impacts on Mental Health.

Trauma can be both a cause and a consequence of homelessness and has lasting impacts on mental health and wellbeing. Often research focusses on trauma and adversity in childhood leading to homelessness, but understanding traumatic experiences during adulthood homelessness can be just as important for informing intervention development and policies to mitigate and eradicate homelessness. Working with people with lived experience of homelessness, this review aimed to synthesis the qualitative evidence exploring the impact of trauma during homelessness on mental health (including substance use) from the perspective of adults (18 years of age and older) experiencing homelessness. Alongside gray literature, ASSIA, CINAHL, Cochrane, EMBASE, MEDLINE, Proquest theses and dissertations, PsychInfo, Scopus and Web of Science were searched from inception until February 2024. No language, date, or geographical limits were applied. A 'best-fit' framework synthesis of 26 papers, covering the experience of over 900 people, identified three overarching themes linked with the SAMHSA three E's of trauma: 1) making sense of homelessness as a trauma, 2) dealing with the impacts of trauma and 3) responses to repeated exposure to trauma. Trauma rarely takes place in isolation and often prior experiences shape how people experiencing homelessness make sense and cope with trauma. Policy and prevention should prioritise early intervention to reduce the mental health burden of trauma and homelessness. Additionally, creating support that empowers and builds resilience will encourage more positive management strategies.

Integration of flexible corporate demographic policy tools into the personnel management system

Amid staff shortages and rising labour costs, many Russian enterprises are looking for non-material methods to man age personnel. Organizational, labour and socio-psychological aspects of employee incentives are closely linked to the corporate demographic policy tools. The article aims to analyse the demand for flexible working arrangements for employees with family responsibilities, as well as to determine the opportunities for integrating flexible organizational and labour tools of corporate de mographic policy into the personnel management system. Flexibilization theory in the context of corporate demographic policy constitutes the methodological basis of the study. The standard methods of structured personal interviews, frequency analysis with equality of proportions hypothesis test using a chi-square statistic, and comparison of mean values based on the Kruskal Wallis test were applied. The empirical evidence includes collective agreements and local regulations of the largest employers in the Russian Federation, as well as results of a sociological survey conducted in June–September, 2023 (the analyzed sample cov ered 2,804 respondents). The study statistically proves that employees working flexible hours are more satisfied with their job and life compared to those with rigid schedules. It also shows that flexible working arrangements are in demand among employees with parental commitments. The paper presents a model and an algorithm for integrating flexible organizational and labour tools of corporate demographic policy into the personnel management system. We develop a list of HR metrics and identify potential positive implications of this integration through strengthening the HR brand, increasing employee loyalty and engagement, and reducing staff turnover.

Most Hampering Factors in the Implementation of Total Quality Management at Public Secondary Schools in South Africa

The study aims to investigate the most inhibiting factors to the implementation of Total Quality Management (TQM) at public secondary schools in the King Cetshwayo district of KwaZulu-Natal province in South Africa. The study adopted a posistivist paradigm and employed aa quantitative research approach in order to attend to the nature of the research problem and present numerical data. Three hundred (300) teachers and departmental heads were conveniently, but randomly sampled, and served with questionnaires to participate in the study. Empirical findings of this study revealed that the most factors hampering implementation of TQM at public secondary schools were the lack of resources/financial resources, failure by top management to create a suitable environment for quality improvement, lack of management skills, and poor commitment and philosophy to devise quality management strategies by top management. This paper indicates the suggested changes which the Department Basic Education needs to implement to improve the quality of education in public schools. The proposed changes are: to train and capacitate school principals regarding the best TQM to be implemented. There is a need to resource and fund schools to ensure all TQM-related infrastructure and human resources are available for effective or successful implementation. Received: 23 March 2024 / Accepted: 30 October 2024 / Published: 05 November 2024

Neglected perilunate injuries: Management strategies and long-term consequences: A narrative review

Neglected perilunate injuries are a challenging and often overlooked condition that can result in significant long-term consequences if not properly managed. These injuries, typically resulting from high-energy trauma, involve dislocations and fractures around the lunate bone, with delayed diagnosis leading to complex management scenarios. This narrative review examines the management strategies for neglected perilunate injuries and the associated long-term outcomes. The review explores the efficacy of different surgical approaches, including open reduction and internal fixation, proximal row carpectomy, wrist fusion, and bone retinacular bone graft scapholunate reconstruction. By evaluating the existing literature, this article highlights the critical need for early diagnosis and appropriate intervention to minimize the risk of post-traumatic arthritis and other degenerative changes.