Preferred Management Research Articles

Clinical profile and management of patients with acute myocardial infarction admitted to cardiac care units: The EYESHOT-2 registry

BackgroundThe clinical governance of patients with acute myocardial infarction (AMI) has markedly changed in the last few years. We sought to assess the contemporary in-hospital management patterns of patients with AMI at a country level. MethodsEYESHOT (EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units)-2 was a nationwide, prospective registry aimed to evaluate the current management of patients admitted to intensive cardiac care units (CCUs) for an AMI in Italy. ResultsOver a 4-week period (February 1st-29th, 2024), 183 CCUs enrolled 2806 consecutive patients: 52.6 % with non-ST elevation myocardial infarction (NSTEMI) and 47.4 % with ST-elevation myocardial infarction (STEMI). The median time from hospital admission to angiography in NSTEMI was 22.3 h (IQR 10.9–46.1), while for STEMI was 1.1 h (IQR 0.5–2.2) with significant difference between hospitals with and without catheterization laboratories. In both NSTEMI and STEMI patients, percutaneous coronary intervention (PCI) was the preferred management strategy (73.3 % and 94.2 %, respectively). An optimal secondary prevention therapy, including dual antiplatelet therapy, inhibition of the renin-angiotensin system, a beta-blocker and a high-intensity statin was prescribed at discharge in more than 75 % of patients with AMI. In-hospital major bleedings occurred in 2.0 % and 2.3 % (p = 0.58), while death in 1.8 % and 2.8 % (p = 0.09) of NSTEMI and STEMI patients, respectively. ConclusionsThe EYESHOT-2 registry shows the current management strategies and outcome of AMI patients admitted to Italian CCUs and provides insights to improve the clinical care of such patients.Clinical Trial Registration. URL: http://www.clinicaltrials.gov. Unique identifier: NCT06316128.

Manager political preferences and company investor bases

AbstractWe investigate how the personal political preferences of top managers shape the investor base of firms. Based on the risk‐aversion attitude of firm decisions that rely on conservative political ideologies, we find that Republican managers tend to maintain a lower leverage level; invest less in tangible assets and R&D to pursue near‐term profitability; and maintain a high quality of information disclosure to increase stock liquidity. We demonstrate that firms led by Republican managers can attract more transient institutions. This relationship becomes stronger during financially stressful periods and is robust after considering the moderating role of managerial discretion and potential endogeneity.

Management of Acute Hand Burns: A Survey of American Burn Association-Verified Burn Centers.

Hand burns have a significant impact on the long-term function of burn patients. Recently, new protocols and technologies, such as dermal substitutes, have been introduced for the treatment of hand burns. This cross-sectional study investigates the preferred current management of acute hand burns and the role of dermal substitutes in treatment. A 10-question survey related to acute hand burns management was sent to 64 directors of American Burn Association (ABA)-verified burn centers. A total of 51.6% (n=33) directors of ABA-verified burn centers responded to the survey. For the treatment of superficial partial-thickness hand burns, 90.9% preferred a non-operative approach. Conversely, most respondents chose a single-stage excision and skin graft for deep partial-thickness hand burns (75.8%) and full-thickness hand burns (51.5%). However, for full-thickness hand burns, some surgeons prefer a two-stage reconstruction involving excision and placement of a skin substitute (27.3%) or allograft (9.1%), followed by a skin graft. Only 6.1% would utilize a three-stage reconstruction involving excision and allograft, excision and skin substitute, followed by skin grafting. Among surgeons who used skin substitutes (n=26), Integra (42.3%) and Novosorb Biodegradable Temporising Matrix (BTM) (23.1%) were preferred. The top reasons for choosing one specific dermal substitute were surgeon's preference (n=20; 76.9%) and cost (n=9; 34.6%). While a conservative non-operative approach is preferred for superficial partial-thickness hand burns, excision and skin grafting as a one-stage procedure remains the most common strategy for deep partial-thickness and full-thickness hand burns.

Role of Percutaneous Trans-Tracheal Endoscopic Approach in Managing Thoracic Tracheal Pathologies: A Step Back for Better Outcomes.

Thoracic tracheal tumors are relatively rare in routine clinical practice. Though surgery is the preferred management choice, acute presentation is challenging for the surgeon and the anesthetist. In this study, we discuss the role of the percutaneous trans-tracheal endoscopic approach (PTTEA) in the modern era of minimally invasive surgery. Its indications, advantages, complications, and anesthetic options are enumerated. A retrospective review was performed of patients with thoracic tracheal lesions treated in our department between 2015 and 2022. A total of 16 patients underwent PTTEA in an emergency after a failed fiberoptic or transoral approach and were included in the review. Twelve patients were ventilated by intermittent apnea, and four had a Cardiopulmonary bypass. Amongst the 16 patients, nine had benign, and seven had malignant pathologies. All the benign lesions were excised completely, and patients were de-cannulated, except for one case with disseminated respiratory papillomatosis. Malignant lesions underwent debulking of the lesions for acute respiratory distress, followed by initiation of adjuvant therapy. PTTEA is an effective alternative to traditional fiberoptic or rigid bronchoscopy techniques for selected patients for whom minimally invasive techniques fail. The advantages of the approach include better surgical access, hemostasis, and airway control, resulting in reduced operative time and minimal complications.

Risk-return adaptive receding Horizon Index Tracking Strategy

Index tracking is a well-established financial strategy for passive investing. Typical index tracking models are single period in nature, deriving an optimal tracking portfolio based on future price/return estimates, using most if not all index constituent assets. In this article, we propose a framework for index tracking that can accommodate multi-periods and asset selection. First, we propose a risk-return-based index tracking strategy within a multi-period adaptive receding horizon framework. The framework demonstrates strong tracking fidelity with the benchmark whilst accounting for future tracking states. We then adapt a Penalized Alternating Direction Method (PADM) to the multi-period framework to efficiently enforce a limit on tracking portfolio size (cardinality). The PADM produces high-quality solutions to the cardinality-constrained models and can be used effectively in both low and higher re-balancing frequency environments. Finally, we generalize our base multi-period formulation to an enhanced index tracking strategy, which can easily accommodate possible portfolio manager (PM) preferences. We present computational results that indicate that our cardinality-constrained and non-cardinality-constrained adaptive receding horizon framework for index tracking yields high tracking accuracy when compared to equivalent single-period or return-based models used in a rolling horizon framework.

Frozen shoulder: subjects’ needs and perspectives and clinicians’ beliefs and management strategies: do they align? A cross-sectional study

ObjectivePhysiotherapists (PTs) play a crucial role in managing individuals with Frozen Shoulder (FS), frequently being the first healthcare professionals involved in the treatment of this condition.AimThis study aimed to compare the beliefs, expectations, and perspectives of individuals with FS with the knowledge, skills, and strategies of PTs, highlighting similarities and differences.MethodThis study adhered to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). From May 1st to August 1st, 2023, a two-part survey was conducted involving PTs and individuals diagnosed with FS. The survey focused on comparing key areas such as clinical assessment, patient education, treatment expectations, and the psychological aspects of the patient-clinician relationship.ResultsA total of 501 PTs and 110 subjects with FS participated in the survey. Most PTs showed proficiency in FS pathoanatomical conditions and were also attentive to psychological aspects (88.4%), describing the pathology evolution in three or two stages (68.2%). They also highlighted the importance of patient education (89.6%) and recognized the potential benefits of a multiprofessional collaboration in managing FS (82.2%). Reassurance was reported as a priority by 32.3% of PTs. Subjects with FS expressed a preference for PTs who are both expert and empathetic (73.6%). Regarding their understanding of FS, 29.09% of subjects reported receiving a three-phase explanation, while 26.36% felt inadequately informed. Nearly half of the subjects (49.09%) anticipated being managed independently by a PT, with 93.64% prioritizing the improvement of their range of motion.ConclusionThis study revealed a general agreement between subjects with FS and PTs regarding aspects of the therapeutic relationship, patient education, pathology management, compliance and motivation strategies, and pain management preferences. However, significant differences emerged concerning the perception of physiotherapy effectiveness, primary treatment goals, subjects’ priorities, and the importance of psychological assessment.

Temporal trends and practice variation in early repair of the ruptured aneurysm among patients with aneurysmal subarachnoid hemorrhage in the United States, 2012-2019.

Early repair of the ruptured cerebral aneurysm (RRCA), preferably within 24 h of onset, is endorsed by clinical guideline as the preferred management strategy for patients with aneurysmal subarachnoid hemorrhage (aSAH). However, a comprehensive picture of this guideline-recommended usage in contemporary clinical practice is not available. This study aimed to characterize trends over time and practice variation in the implementation of an early RRCA strategy among patients with aSAH in a large, national representative data. Using data from the 2012-2019 National Inpatient Sample, we measured trends in the proportion of early RRCA, defined as within day 1 of admission, overall, and by demographic and geographical subgroups. In addition, we created multilevel regression models to quantify hospital-level variation in the early RRCA rates. We identified 82,615 aSAH hospitalizations (mean age = 56.1 years; 68.9% women) undergoing RRCA and, among these, 84.0% (95% confidence interval (CI) = 83.4-84.7%) receiving early RRCA. The proportion of early RRCA increased steadily from 82.5% in 2012 to 85.8% in 2019 (p for trend <0.001). The proportion of patients receiving early RRCA across geographic regions ranged from 78.7% to 87.9%, with a median (interquartile range (IQR)) of 84.2% (83.0-86.1%). In contrast, the delivery of early RRCA varied widely among hospitals, with a median (IQR) rate of 86.1% (75.0-100.0%) and a range from 0% to 100.0%. The median odds ratio for the early use of RRCA treatment was 1.24 (95% CI = 1.21-1.27) in 2019, indicating 24% increased odds of implementing early RRCA if moving from a lower-use to a higher-use hospital. Most patients in the United States with aSAH received early RRCA treatment and exhibited an upward trend over the recent 8-year period. However, substantial variation in access to early RRCA was observed across population subgroups, particularly at the hospital level. Future efforts are necessary to identify further sources of this variation and to develop initiatives that could represent an opportunity to optimize guideline-based quality of care in aSAH management. The data are available from the corresponding author upon reasonable request following completion of onboarding and verification procedures as specified by the HCUP.

WP4.16 - Gallstone ileus as an infrequent cause of bowel obstruction- a review of small cohort

Abstract Introduction It is uncommon cause of small bowel obstruction, presents 1 – 5% of adult population. It is a rare complication of chronic cholecystitis which lead to cholecysto-enteric fistula and impaction of gall stone in GI tract leading to mechanical bowel obstruction. Our aim is to report the natural history and management of this condition in District Hospital. Method Retrospective 10 years of data was collected with CT findings of intestinal obstruction with gall stone ileus. It included 10 patients over 10 years whose medical records were evaluated retrospectively. Results Majority of patients were female (90%, n:9) with mean age of 81.6 years (range 61-96) although 90% of population were above 70 years. Presenting complaints were mostly pain and vomiting. Onset of symptoms between 2- 7 days. The site of obstruction was mostly ileum (n=9) with exception of one case in sigmoid proximal to stricture and size of stone was ranging ffrom2.5 to 4 cm, moreover most of the patients had previous history of gall stone (n=7) with one post cholecystectomy status. During routine investigations 50 % of patients had deranged LFT &amp;AKI and 50-60% had raised inflammatory markers (WBC,CRP).Intervention as Enterolithotomy was the preferred approach (n=8,2 lap ,7 open) and non operative management was performed in two cases.The mean post op length of stay were 10 days in open and 5 days in Lap respectively. Conclusions Elderly female patients are more prone to have gallstone ileus particularly with a past medical history of gall stone and the preferred management option is Enterolithotomy which could be open or laparoscopic depending on expertise of the Surgeon.

Into the Jungle of Biological Agents of Foodborne Diseases: Time to Put Some Order for the French Risk Manager.

Consumers can be exposed to many foodborne biological hazards that cause diseases with varying outcomes and incidence and, therefore, represent different levels of public health burden. To help the French risk managers to rank these hazards and to prioritize food safety actions, we have developed a three-step approach. The first step was to develop a list of foodborne hazards of health concern in mainland France. From an initial list of 335 human pathogenic biological agents, the final list of "retained hazards" consists of 24 hazards, including 12 bacteria (including bacterial toxins and metabolites), 3 viruses and 9 parasites. The second step was to collect data to estimate the disease burden (incidence, Disability Adjusted Life Years) associated with these hazards through food during two time periods: 2008-2013 and 2014-2019. The ranks of the different hazards changed slightly according to the considered period. The third step was the ranking of hazards according to a multicriteria decision support model using the ELECTRE III method. Three ranking criteria were used, where two reflect the severity of the effects (Years of life lost and Years lost due to disability) and one reflects the likelihood (incidence) of the disease. The multicriteria decision analysis approach takes into account the preferences of the risk managers through different sets of weights and the uncertainties associated with the data. The method and the data collected allowed to estimate the health burden of foodborne biological hazards in mainland France and to define a prioritization list for the health authorities.

Laparoscopic cornual resection for interstitial pregnancy: Staying in the Marginal Zone.

Fortunately, interstitial pregnancies are a rare early pregnancy presentation, yet they can be challenging to managed and are associated with a high risk of intra-abdominal haemorrhage. Once detected, surgical laparoscopic resection can be the preferred management method for both patient safety and for definitive treatment. The video presents a new technique for laparoscopic resection of an interstitial pregnancy which enables the procedure to be effectively bloodless. We report on a new technique for laparoscopic cornual resection. As shown in the video, staying in the marginal zone may result in the enblock resection of the gestational sac. Using meticulous applications of bipolar energy and cutting with scissors in the marginal zone, the operation may be completed with almost no blood loss and minimal damage to the adjacent healthy myometrium. The operation lasted 30 min with almost no blood loss. The patient had an uneventful recovery and was discharged on the first postoperative day. Staying in the marginal zone during dissection permits even less experienced laparoscopists to complete laparoscopic cornual resection with minimal blood loss concomitantly with minimal trauma to the adjacent myometrium.

Does Sperm DNA Fragmentation Index Continuously Decrease Over Time After Varicocelectomy in Varicocele-Induced Infertility? A Systematic Review and Meta-Analysis.

Varicocele (VC) is the most frequent and reversible cause of male infertility. One of the preferred management strategies to alleviate this problem is varicocelectomy. However, there are no researchers who have explored the relationship between better timing and postoperative sperm DNA fragmentation index (DFI) improvement in patients. We conducted this meta-analysis by enrolling published studies to find out the best waiting time after varicocelectomy to wait for better improvement of sperm DFI. A literature search was conducted using PubMed, Embase, Scopus, Web of Science, and Cochrane Library databases. The data from the pooled analysis were presented as mean difference (MD) along with a 95% confidence interval (CI). Heterogeneity was evaluated using I2. Four studies were included after screening relevant literature. Statistical analysis revealed that after varicocelectomy, follow-up results within 3 months showed a significant improvement in sperm DFI compared with the preoperative period (MD: -3.66, 95% CI = [-5.17, -2.14], p < .00001), and follow-up results with 6 months showed a significant improvement in sperm DFI compared with the postoperative 3 months as well (MD: -1.51, 95% CI = [-2.73, -0.29], p = .02). Notably, no further improvement in sperm DFI was observed when the follow-up period reached 12 months (MD: -1.59, 95% CI = [-3.22, 0.05], p = .06). Six months after varicocelectomy may be the optimal time for sperm DFI compared with 12 months or even longer, which means it is also the preferable time for conception. However, more well-designed prospective studies are needed in the future to validate our conclusion.

Review of biodiversity assessment and resource management orientation for sustainable rural development in Lang Son province, Vietnam

This study examines the conservation and biodiversity management efforts in Lang Son province, Vietnam, in the context of global environmental concerns. Under Decision No 2447/QD-UBND, the province’s Special-use Forest Planning focuses on conserving areas such as the Huu Lien Nature Reserve and the Mau Son special-use forests. This initiative covers a substantial planned land area to sustain biodiversity and foster rural development up to 2030. Recent surveys indicate a notable increase in plant species within these areas, from 842 species in 2017 to 961 in 2019, and significant efforts towards conserving endangered species like the Asiatic black bear and the Annam flying frog. The province encompasses diverse ecosystems spread across 832,075.82 ha, characterized by varied terrains and climates contributing to its rich biodiversity. These regions are crucial for various species, including those listed in conservation documents, such as the 77 plant species recorded. RAP-Plant analysis and Monte Carlo simulation indicate that Lang Son’s biodiversity, with a Shannon index of 2.85 and Simpson index of 0.75, is threatened by a projected forest area decline to 514,578.61 ha by 2040, risking extinction for rare species like Hoang dan and Lan kim tuyen. Furthermore, Lang Son’s strategic initiatives towards sustainable agricultural practices, forest management, and restoration efforts highlight the integration of biodiversity conservation into broader socio-economic development plans. The province’s approach aligns with global strategies emphasizing the protection of endangered and endemic species as essential to maintaining ecological balances and supporting sustainable development. This study underscores the importance of comprehensive regional planning and community engagement in biodiversity conservation efforts to mitigate economic development, illegal activities, and climate change challenges. Threats such as illegal logging and habitat fragmentation persist, necessitating more vital community-based conservation efforts and robust legal frameworks.

Assessment of socio-economic correlates for analyzing the management orientation of muga silk entrepreneurs in Assam

Assessment of socio-economic correlates for analyzing the management orientation of muga silk entrepreneurs in Assam

Current trends in the management of hypospadias: the Ibero-American experience

Introduction: Hypospadias management has seen various trends over the years, likely due to the diverse clinical presentations and evolving surgical techniques. However, there is a lack of consensus among pediatric urologists on many aspects of hypospadias management. To address this, our research aims to survey specialists and establish a consensus on hypospadias management. Methodology: In July 2021, a cross-sectional study was conducted using a Survey Monkey questionnaire consisting of 23 questions. The survey aimed to gather information about the generalities and management preferences of distal and proximal hypospadias from specialists belonging to the Ibero-American Society of Pediatric Urology (SIUP). The data collected was categorized into subgroups based on surgical techniques, perioperative preferences, and complications. Results: Most hypospadias surgeries are performed between 13-18 months. Penile curvature is evaluated with artificial erection and visual inspection. The Nesbit technique (36.1%) and ventral corportomies (26.9%) corrections are more common, while grafts corporoplasties are used less frequently (10.2%) for correction. For urethroplasty, the surveyed group prefers using a running suture or a combination of continuous and interrupted stitches (49.1% and 24.3%, respectively). The use of Polydioxanone 6-0 in a double-layer suture group yielded a higher response rate. The use of prophylactic antibiotics and their maintenance when the catheter is in place was also favored by most surgeons. Discussion: When repairing hypospadias, the surgeon must consider factors such as the quality of the urethral plate, the presence of penile curvature, and the location of the urethral opening. This study highlights the different strategies and technical preferences used for hypospadias repair by a group of specialists from different countries. Conclusion: The survey describes current trends in hypospadias management. Two-stage repair is commonly used for proximal hypospadias, while TIP repair is the most used technique for distal hypospadias. The most common complication is the development of an urethrocutaneous fistula.

Tourists’ preferences for managing invasive species in national parks: a choice experiment study in Taiwan

ABSTRACT This research study utilises the choice experiment methodology to examine tourists’ preferences regarding the adverse effects of managing invasive species in national parks. The study estimates the willingness of tourists to pay for mitigating various negative externalities associated with invasive species management. By understanding these willingness to pay estimates, national park management authorities can develop invasive species management strategies that have minimal impact on tourists. The study focuses on tourists visiting Yushan National Park and Taroko National Park in Taiwan. The findings indicate that tourists recognise the significant impact of negative externalities resulting from invasive species management, yet they still exhibit a preference for management over non-management. Among the negative externalities, tourists prioritise avoiding ecological disturbances and health risks over reducing recreational areas. National parks that are more easily accessible tend to have lower travel costs, making them more attractive to tourists visiting other destinations, particularly those on group tours. However, these characteristics result in stronger reactions from tourists towards management measures or lesser impacts from not managing invasive species, leading to reduced support for management initiatives. Furthermore, the study’s questionnaire format and sampling method are deemed consistent and reliable, effectively addressing potential biases associated with on-site visitor sampling.

Livelihood Enhancement of Scheduled Caste Farmers through Integrated Farming System in Kolar District, India

The study was conducted in purposively selected Kolar district, a total sample of 353 respondents were purposively selected for the study. Data was collected by using pretested structured interview schedule and analyzed by using appropriate statistical tools. The results revealed that a majority of the respondents belonged to low category of mass media exposure, medium category of education, livestock possession, cosmopoliteness, extension participation, social participation, scientific orientation, risk orientation, training undergone followed by high category of cropping pattern, innovativeness, management orientation, level of aspiration, participation in the developmental programmes, willingness towards IFS, access to extension personnel and access to resources. Livelihood Security of respondents in ‘highly satisfied category’ increased to 37.96 per cent from 28.33 per cent out of seven dimensions, maximum increase was noticed in economic efficiency (52.71%). The personal, socio-economic and psychological characteristics such as cropping pattern, livestock possession, risk orientation, training undergone, access to extension personnel and access to resources had positive and significant relationship with livelihood security. The multiple regression value indicated that all the 18 independent variables had contributed to the tune of 23.20 per cent of variation in livelihood security of the respondents. The results pertaining to economic analysis indicated that BC ratio has been increased to 2.98 from 1.93 in crop component and with respect livestock component BC ratio was found to be enhanced to 3.18 from 1.93 after the implementation of the project. Hence, the concerned development departments should organize the demonstrations, trainings, field days, exposure visits etc., to educate the farmers about IFS. The positive and significantly related characteristics need to be considered while selecting the farmers for the extension educational programmes to enhance their livelihood security.

Impact of the diagnostic label for a low-risk prostate lesion: protocol for two online factorial randomised experiments

IntroductionMany types of prostate cancer present minimal risk to a man’s lifespan or well-being, but existing terminology makes it difficult for men to distinguish these from high-risk prostate cancers. This...

Differences between resident and nonresident hunters’ perceptions about CWD and associated implications: a case study from Colorado

ABSTRACT State wildlife agencies (SWAs) rely on hunter harvest submissions to help monitor and manage chronic wasting disease (CWD). Thus, effective CWD management is contingent upon SWAs’ understanding of hunters’ attitudes about, concerns with, and management preferences used to address CWD. We examined these and other human dimensions constructs, including trust and behavioral intentions, by surveying a random sample of resident and nonresident deer hunters who had purchased licenses in areas of Colorado where CWD had been detected. Our results suggest that regardless of residency, hunters are concerned about CWD. However, we detected substantive differences across the groups’ hunting motivations, management acceptability, and behavioral intentions. These data can help agencies develop communication strategies based on specific stakeholder motivations, concerns, and management preferences. Additionally, findings can help SWAs understand how hunting behavior may change if CWD prevalence increases, allowing them to adjust course as needed.

A systematic review of symptoms experienced by children and young people with kidney failure.

Kidney failure at any age has a significant impact on quality of life (QoL) but the overall symptom burden for children and young people (CYP) is poorly described. Kidney failure has no cure and whilst transplantation is the preferred management option, it is not always possible, with patients requiring supportive care at the end oftheir lives. To use the literature to understand the symptom burden for CYP with kidney failure who are approaching end-of-life. Using three databases, a systematic literature review was performed to identify eligible studies to extract data on symptoms experienced in CYP aged < 21years with kidney failure. Data extraction was completed by two authors using a pre-designed proforma. Study quality assessment was undertaken using the BMJ AXIS tool. A total of 20,003 titles were screened to yielding 35 eligible studies including 2,862 CYP withchronic kidney disease (CKD), of whom 1,624 (57%) had CKD stage 5. The studies included a median of 30 (range 7-241) patients. Symptoms were subcategorised into eight groups: sleep, mental health, gastrointestinal, dermatology, ear, nose and throat (ENT), neurology, multiple symptoms, and ophthalmology. The prevalences of the most commonly reported symptoms were: restless leg syndrome 16.7-45%, sleep disordered breathing 20-46%, hypersomnia 14.3-60%, depression 12.5-67%, anxiety 5.3-34%, overall gastrointestinal symptoms 43-82.6%, nausea and vomiting 15.8-68.4%, abdominal pain 10.5-67.4%, altered appetite or anorexia 19-90%, xerosis 53.5-100%, pruritis 18.6-69%, headache 24-76.2% and ophthalmological symptoms 26%. Within each subgroup, the symptomdefinitions used were heterogeneous, the methods of assessmentwere varied and some symptoms, such as pain and constipation, were poorly represented. There is a marked lack of evidence relating to the symptom burden for CYP with CKD. This study highlights the high symptom prevalence, particularly in relation to sleep, mental health, headache, dermatological and gastrointestinal symptoms. There is a need for consensus recommendations on the evaluation and management of symptoms for CYP with CKD approaching end-of-life. CRD42022346120.

Maintaining Sustainable Growth of Micro and Small Enterprises: Antecedents of Management Orientation and Digital Business

Maintaining Sustainable Growth of Micro and Small Enterprises: Antecedents of Management Orientation and Digital Business