PT. M is one of the largest flat glass manufacturers in Indonesia, serving both domestic and export markets. In meeting demand, the company faces various challenges in managing its supply chain to become more efficient and responsive. In January 2025, a delay occurred in the production of export glass, extending from the initial target of 6 days to 9 days. To address this, the implementation of the SCOR 12.0 model was proposed as a solution for continuous improvement analysis. The focus of the analysis is on the responsiveness attribute, specifically RS.1.1 Order Fulfillment Cycle Time, with a Level 2 matrix of RS.2.2 Make Cycle Time. At Level 3, the largest time gaps were identified in RS.3.101 Produce and Test Cycle Time with a gap of 259 minutes, and RS.3.128 Stage Finished Product Cycle Time with a gap of 1040 minutes. The problem was found to stem from several internal factors causing the production PT. M is one of the largest flat glass manufacturers in Indonesia, serving both domestic and export markets. In meeting demand, the company faces various challenges in managing its supply chain to become more efficient and responsive. In January 2025, a delay occurred in the production of export glass, extending from the initial target of 6 days to 9 days. To address this, the implementation of the SCOR 12.0 model was proposed as a solution for continuous improvement analysis. The focus of the analysis is on the responsiveness attribute, specifically RS.1.1 Order Fulfillment Cycle Time, with a Level 2 matrix of RS.2.2 Make Cycle Time. At Level 3, the largest time gaps were identified in RS.3.101 Produce and Test Cycle Time with a gap of 259 minutes, and RS.3.128 Stage Finished Product Cycle Time with a gap of 1040 minutes. The problem was found to stem from several internal factors causing the production process to fail in meeting the desired quality standards, leading to a higher risk of glass loss and a need for stringent quality control measures. Based on these issues, two best practice proposals were recommended as key priorities to improve supply chain efficiency: BP.024 Supply Chain Optimization (SCO) and BP.165 Convergence of SCOR with Lean and Six Sigma. Process to fail in meeting the desired quality standards, leading to a higher risk of glass loss and a need for stringent quality control measures. Based on these issues, two best practice proposals were recommended as key priorities to improve supply chain efficiency: BP.024 Supply Chain Optimization (SCO) and BP.165 Convergence of SCOR with Lean and Six Sigma.

Diethylene glycol (DEG) and ethylene glycol (EG) are organic compounds often found in various consumer products, including antifreeze and industrial solvents used in pharmaceutical preparations, as well as serving as raw materials for polymer manufacturing. Since September 2022, seven consecutive episodes of DEG and EG contamination have been reported across at least nine countries. A notable commonality among the affected products is that at least 14 of them are fixed-dose combinations (FDCs). However, the evidence supporting the efficacy of most of these combinations is insufficient, which renders their prescription, dispensing, and use irrational. Moreover, these products are not without risk, as they can cause adverse reactions. Several factors contribute to the prevalence of these irrational FDCs, including low production costs, consumer popularity, and a tendency to authorise locally manufactured products. As a result, many countries' pharmaceutical markets keep marketing authorisation for irrational FDCs. The persistent reports of DEG or EG contamination - especially those involving irrational fixed-dose combinations - present a crucial opportunity to enhance quality control measures. In addition, it is imperative to reevaluate the marketing authorisations of these products that lack evidence of safety and efficacy, adapting the national medicines lists and clinical guidelines to WHO recommendations. Strengthening regulatory frameworks and implementing stringent manufacturing and quality assurance standards are essential to prevent contamination incidents and ensure the safety of pharmaceutical products.

Abstract Background: Next-generation sequencing (NGS) has emerged as a vital diagnostic tool for various diseases; however, errors associated with NGS present significant challenges to its clinical implementation. Specifically, in cancer diagnostics, the analysis of low-level mutations is complicated by contamination from normal cells and tumor heterogeneity. Results: In targeted NGS (T-NGS) analyses involving reference-standard samples consisting of mixtures of homozygous Hydatidiform mole DNA and blood genomic DNA at varying ratios from four certified NGS service providers, we observed considerable variability in both the lower detection limits of variants (16.3-fold difference, ranging from 1.51% to 24.66%) and false positive (FP) error rates (4280-fold difference, ranging from 5.814 × 10^-4 to 1.359 × 10^-7). The commercially available Dragen system for bioinformatics analysis reduced FP errors in results from companies BB and CC; however, inherent errors from the raw NGS data remained. Adjustments to bioinformatics parameters aimed at increasing sensitivity (by less than two times) substantially elevated FP error rates (by 610 to 8200 times). Additionally, we identified issues such as biased base calling during bioinformatics analysis and a high frequency of false negative (FN) errors in HLA regions. Conclusion: T-NGS results from certified NGS service providers reveal considerable variability in sensitivity and FP error rates, underscoring the necessity for enhanced quality control measures in the clinical application of T-NGS. Furthermore, our study suggests that mixtures of homozygous and heterozygous DNA can serve as effective reference-standard materials for T-NGS quality control. Citation Format: Chunghwan Hong, Youngbeen Moon, Hye Won Choi, Eun-Kyung Kang, Jong-Kwang Kim, Young-Ho Kim, Dong-eun Lee, Tae-Min Kim, Seong Gu Heo, Namshik Han, Kyeong-Man Hong. Evaluation of false positive and false negative errors in targeted next generation sequencing [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 5058.

Abstract Breast cancer (BCa) is the most common cancer among Jamaican women, with 60-70% presenting at advanced stages (III or IV). Incidence rates are slightly lower (43.1 per 100, 000) than global rates (47.8 per 100, 000) and mortality rates are notably higher (18.1 per 100, 000 versus 13.6 per 100, 000). This study investigated germline testing in Jamaican women with BCa to examine clinicopathologic associations and to compare the utility of two genetic testing panels within this population. A retrospective, cross-sectional study was conducted on 178 Jamaican women with pathologically confirmed BCa at 8 hospital sites during 2018 - 2024. Cancer data extracted from patients' medical records included BCa type, cancer surgeries performed, metastatic sites, tumor stage, molecular markers (ER, PR, HER2, Ki67) and documentation of family history of cancer. Germline genetic testing was performed using comprehensive multigene panel tests from either Invitae (n=126) or Blueprint Genetics (n=52). The Invitae panel assessed 84 genes associated with hereditary cancer syndromes, while the Blueprint panel examined 160 genes. Both panels included core BCa susceptibility genes (BRCA1, BRCA2, PALB2, CHEK2, ATM). Data underwent quality control measures including removal of duplicates, standardization of formats, appropriate handling of missing values, and validation of outliers prior to statistical analysis using STATA 18 Software. The mean age was 44.5±10.5 years with most patients having at least one variant classification (36.5%). Just over 40% and 34% had Luminal A/B and triple negative molecular subtypes respectively, and 36% had advanced stage. Variants classified as pathogenic or likely pathogenic (P/LP) were identified in 15.7% of cases. P/LP status was significantly associated with multiple variant status (p<0.001) with 57.1% of cases with P/LP status having two or more gene variants overall when compared to 42.4% with VUS status. Of the 75 genes examined amongst the cases, 10.7% had mutations in BRCA2. Thirty-two of the 255 variants classified were unique P/LP variants. Of these variants, BRCA2 had the most positive (30.6%); c.3109C>T p.(Gln1037*) being the most common P/LP variant overall (8.3%). Other high frequency variants were c.303T>G p.(Tyr101*) in BRCA1 and c.258+2T>C in SBDS. A greater proportion of patients carried P/LP variants when tested by Blueprint Genetics (19%) in contrast to 14% when tested by Invitae. No genetic variants were identified for 32.6% of participants. Our findings reveal a high frequency of germline mutations in Jamaican BCa patients. This supports the need for implementing germline testing as part of treatment planning and to ensure the utilization of targeted therapies. Further investigations of broader gene panels beyond the traditional BCa susceptibility genes may be warranted for better understanding of the germline mutation landscape in this population. Citation Format: Patrick Roberts, Rory Thompson, Richard Shaw, Alison Ayoub, Imani Hewitt, Derria Cornwall, Natalie Guthrie-Dixon, Camille Ragin, Simone Ann Marie Badal. High frequency of germline mutations among breast cancer patients in Jamaica [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7402.

The exploration of lateritic nickel in Indonesia plays a crucial role in meeting the demands of the electric vehicle battery and stainless-steel industries. One of the critical aspects of exploration is proper handling of drilling samples to ensure the accuracy of geochemical and mineralogical data. PT. Cakrawala Resources Indonesia has implemented standard procedures for sample management at the Sambalagi Site. However, challenges remain regarding storage, transportation, and quality control, which may affect the integrity of exploration data. The purpose of this research study was conducted using a field study approach and technical analysis of sample handling procedures, covering site preparation, drilling, and storage in the sample house. The evaluation was carried out by observing the effectiveness of each stage and identifying factors that could potentially cause sample degradation. Additionally, a review of quality control system implementation was conducted, including sample duplication methods and blind sampling. The research results indicate that the applied sample handling methods comply with exploration standards. However, challenges remain, such as high humidity conditions that can affect sample quality and difficult-to-access terrain that may hinder transportation processes. While quality control measures have been implemented, optimization is still needed in record-keeping and storage to enhance data traceability. Improvements in sample house storage conditions, sample transportation optimization, and the implementation of a digital recording system are recommended to enhance exploration efficiency and accuracy.

This article describes the integration of Quality Management Systems and Good Manufacturing Practic-es in the production of traditional medicines at the Menjong Sorig Pharmaceuticals Corporation Limited, a state-owned traditional medicine manufacturer in Bhutan. Rooted in Sowa Rigpa principles, the orga-nization has adopted modern pharmaceutical standards to ensure the safety, efficacy, and quality of its products. Key components of Menjong Sorig’s Quality Management Systems include leadership commit-ment, risk-based preventive action, robust documentation, supplier qualification, personnel competency development, and stringent quality control. The alignment with ISO 9001:2015 standards and the prin-ciples of Good Manufacturing Practices underscores Menjong Sorig’s commitment to sustainable prac-tices, from sourcing medicinal plants to ensuring compliance with regulatory requirements. Sustainable sourcing of medicinal plants is supported by good agricultural and collection practices and communi-ty-based initiatives. Stringent quality control measures, such as the use of High-Performance Thin Layer Chromatography, ensure that raw materials, intermediates, and finished products meet predefined qual-ity standards. Menjong Sorig’s investment in personnel training and competency development reflects a commitment to continual improvement, with regular internal audits reinforcing compliance with global standards. Balancing traditional values with modern corporate expectations, Menjong Sorig has main-tained stakeholder trust through transparent operations and adherence to regulatory requirements. This article highlights Menjong Sorig’s systematic approach to integrating traditional practices with modern pharmaceutical standards, setting a benchmark for quality in traditional medicine manufacturing. Men-jong Sorig’s efforts exemplify a sustainable and innovative approach to preserving cultural heritage while ensuring the global relevance of traditional medicines.

BACKGROUND:Mouse models of myocardial ischemia with subsequent heart failure are common approaches to examine heart failure pathology and possible treatment strategies. We sought to establish a high-throughput approach for echocardiography-guided induction of myocardial ischemia/reperfusion (IR) in mice.METHODS:After visualization of the left coronary artery with high-resolution ultrasound imaging and echocardiographic definition of the level of coronary occlusion, the left anterior descending artery was temporarily occluded with 2 micromanipulator-controlled needles. Functional and molecular changes were assessed and compared with commonly performed surgical techniques.RESULTS:Echocardiography-guided induction of myocardial IR enabled standardized induction of myocardial IR injury with subsequent left ventricular remodeling. Incorporation of various quality control measures throughout the procedure ensured a high success rate and the absence of relevant postinterventional mortality in experienced hands. Compared with surgical approaches, echocardiography-guided induction of myocardial IR showed a quicker recovery time and induced a less pronounced inflammatory response characterized by decreased local and systemic neutrophil counts. Notably, infarct size and subsequent post–myocardial infarction cardiac dysfunction were comparable between methods. The novel procedure was successfully implemented at different academic institutions with imaging expertise and demonstrated high interinstitutional reproducibility.CONCLUSIONS:Echocardiography-guided induction of myocardial IR enables high-throughput induction of myocardial IR injury with precise echocardiographic definition of the occlusion level and immediate evaluation of cardiac function during ischemia. The method provides a more clinically relevant assessment of IR sequelae and offers notable animal welfare advantages by eliminating the need for ventilation and thoracotomy, thereby mitigating potential surgery-related confounders.

Relevance: Integrating molecular biomarkers with rigorous quality control (QC) measures in laboratory settings is essential for enhancing early detection strategies and prognostic evaluation in cancer patients. Precision and QC in laboratory diagnostics of oncological diseases have become particularly significant in the widespread implementation of targeted and personalized therapy. The study aimed to review publications evaluating quality control in biomarker identification within molecular genetics laboratories, using ovarian cancer diagnostics as a case study.Methods: This systematic literature review conducted in the framework of this study revealed 220 records, leading to 165 unique publications, of which 24 full-text articles were included in this review. The study followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020) guidelines. Results: All analyzed sources showed that Implementing QC, including calibration, internal controls, and proficiency testing provided by the College of American Pathologists (CAP), significantly reduces errors despite ongoing funding constraints. The European Molecular Quality Network (EMQN) and CAP jointly offer proficiency testing programs to evaluate laboratory performance globally, ensuring consistency and reliability in testing outcomes. Conclusion: Ensuring the accuracy and reliability of molecular diagnostic tests is critical in clinical settings, particularly for conditions such as ovarian cancer, where precise genetic analysis informs both diagnosis and treatment. Further advancements in early detection and personalized treatment can be achieved by integrating emerging technological innovations within robust QC framework, ultimately improving patient outcomes. Consequently, the establishment of standardized guidelines and standard operating procedures for molecular genetic testing, with a specific focus on the molecular genetic diagnosis of ovarian cancer, is imperative.

Shilajit, a natural substance with ancient medicinal roots, is increasingly used in modern supplements for its purported health benefits. However, there is a lack of comprehensive chemical characterization, particularly regarding inorganic anions. This study addresses this gap by quantifying common inorganic anions in 14 raw Shilajit samples sourced from Iran, India, Nepal, Kyrgyzstan, and Russia, as well as in 6 commercially available supplements from Poland, Russia, and Kyrgyzstan. Using ion chromatography, key anions including chloride, sulphate, nitrate, hydrogen phosphate, and fluoride were analyzed. Results revealed that chloride was the most prevalent anion, with concentrations ranging from 0.102 to 9.496 mg.g− 1 in raw Shilajit samples and up to 0.931 mg.g− 1 in supplements. Sulphate levels were significant, with concentrations up to 12.412 mg.g− 1 in raw Shilajit and 0.854 mg.g− 1 in supplements. Nitrate was detected in lower concentrations, peaking at 9.504 mg.g− 1 in raw Shilajit. Fluoride was quantifiable in only one sample at 0.064 mg.g− 1. The study concludes that Shilajit’s geographical origin significantly influences its anion composition, leading to variability in its potential health effects. These findings highlight the necessity for standardized formulations and stringent quality control measures in Shilajit supplement production to ensure consumer safety and product efficacy.

Background: Swasakasa Nei (SKN) is a traditional Siddha herbal formulation documented in ancient texts, recommended for various health conditions including asthma and eosinophilia. Understanding its phytochemical composition, antioxidant activity, and quality control parameters is crucial for ensuring its efficacy and safety. Methods: This study was conducted for phytochemical evaluation, HPTLC fingerprinting analysis, and antioxidant activity assessment of SKN. Phytochemical analysis was performed using standard methodologies, and HPTLC analysis was conducted to identify the phytochemical constituents. Antioxidant activity was assessed using DPPH and nitric oxide scavenging assays. Results: Phytochemical evaluation revealed the presence of alkaloids, flavonoids, glycosides, coumarin, and phenols in SKN. HPTLC fingerprinting identified distinct peaks corresponding to various phytocomponents, providing insights into its composition. Antioxidant activity assays revealed significant scavenging activity against DPPH and nitric oxide radicals, indicating its potential therapeutic benefits. Conclusion: The study highlights the importance of quality control measures for SKN, including phytochemical analysis, HPTLC fingerprinting, and antioxidant activity assessment. These findings contribute to understanding SKN's therapeutic potential and can guide future research on its efficacy and safety.

The role of quality control in product standardization is crucial for ensuring consistency, efficiency, and customer satisfaction in manufacturing processes. At Topworth Urja & Metals Limited, a leader in the steel production industry, implementing rigorous quality control measures has proven to be an effective strategy for enhancing product standardization. This research aims to investigate the impact of quality control practices on the standardization of products within the company. Through a combination of qualitative and quantitative methods, the study explores how quality control techniques, such as inspection, testing, and process monitoring, contribute to minimizing production variability and ensuring uniformity in product quality. By analysing operational data and gathering insights from key stakeholders, the study provides a comprehensive understanding of the relationship between quality control and product standardization. Findings indicate that robust quality control mechanisms lead to improved consistency in product specifications, reduce defects, and enhance the company's ability to meet regulatory and customer requirements. Moreover, the research highlights the importance of continuous training, technological advancements, and employee involvement in maintaining effective quality control systems. The outcome of this study emphasizes the significance of quality control as an integral tool for ensuring high standards and competitive advantage in the industry. This research also offers valuable recommendations for other manufacturing organizations seeking to improve product standardization and maintain high-quality output

This study investigated the effect of 7% Sodium Chloride treatment on the shelf life of garden eggs under distinct storage conditions (ambient and refrigerated) by examining the microbial dynamics, proximate composition, and mineral content. Standard microbiological and proximate methods were employed. Results indicated significant variations in microbial counts across different storage periods and conditions. The total heterotrophic bacterial count of unsalted garden eggs ranged from 1.29x106 CFU/g to 1.3x108 CFU/g, showcasing a notable increase over the storage duration. Staphylococcus counts fluctuated, with ambient temperature storage showing no growth at the final stage but refrigerated samples exhibiting counts of 1.5x102 CFU/g. Similarly, Total Coliform counts varied from 1.37x104 CFU/g to 3.6x105 CFU/g for unsalted garden eggs stored at different temperatures. Counts were less for Garden egg samples treated with 7% Sodium Chloride compared to those not treated across all storage conditions. Frequencies of occurrence differed among these organisms, with Staphylococcus spp. and Bacillus spp. being the most prevalent at 28.2% and 16.5%, respectively. Others were Escherichia coli 20%; Klebsiella spp. 2.3%; Proteus spp. 9.4%; Pseudomonas spp. 7.1% Lactobacillus 11.8 %; Corynebacterium 1.2%; and Salmonella spp. 3.5%. Fungal counts exhibited variations as well, ranging from 7.15x103 CFU/g to 5.95x104 CFU/g for unsalted garden eggs stored at room temperature. Predominant fungal isolates included: Yeast 24.1%; Aspergillus niger 24.1%; Mucor 22.2%; Fusarium 9.3%; Aspergillus flavus 7.4 %; Penicillium 11.1% and Trichoderma 1.9%. Moreover, proximate composition analyses displayed fluctuations in ash, moisture content, lipid, crude protein, crude fiber, and carbohydrates between day 0 and day 15 of storage, indicating changes in nutritional constituents during the shelf life. Additionally, the mineral content, Phosphorus, Calcium, and Potassium showed alterations in concentrations from day 0 to day 15 for both salted and unsalted samples across different storage conditions. These findings underscore the importance of refrigeration storage in controlling microbial proliferation, emphasizing the need for stringent quality control measures, awareness campaigns, and the potential incorporation of antimicrobial agents to extend the shelf life of garden eggs. This study provides valuable insights into optimizing storage conditions and enhancing food safety, quality, and nutritional retention of garden eggs.

Alterations in the mesenchymal-epithelial transition factor (MET) gene are critical drivers of non-small cell lung cancer (NSCLC). In recent years advances in precision therapies targeting MET alterations have significantly expanded treatment options for NSCLC patients. These alterations include MET exon 14 skipping mutations (MET exon 14 skipping), MET gene amplifications, MET point mutations (primarily kinase domain mutations), and MET protein overexpression. Accurate identification of these alterations and appropriate selection of patient populations and targeted therapies are essential for improving clinical outcomes. The East China Lung Cancer Group, Youth Committee (ECLUNG YOUNG, Yangtze River Delta Lung Cancer Cooperation Group) has synthesized insights from China's innovative drug development landscape and clinical practice to formulate an expert consensus on the diagnosis and treatment of NSCLC patients with MET alterations. This consensus addresses key areas, such as optimal testing timing, testing methods, testing strategies, quality control measures, and treatment approaches. By offering standardized recommendations, this guidance aims to streamline diagnostic and therapeutic processes and enhance clinical decision-making for NSCLC with MET alterations.

Additive manufacturing (AM) has gained significant traction in the production of high-performance metallic components, yet concerns persist regarding the consistency of powder materials and the mechanical properties of 3D-printed parts. This study addresses these challenges through a detailed analysis of a maraging steel part manufactured using laser powder bed fusion. The demonstration part was evaluated for geometric accuracy, surface roughness, chemical composition, microstructure, and mechanical properties, including hardness and density. The findings revealed that 3D-printed maraging steel components can achieve high levels of dimensional precision and mechanical integrity, making them suitable for demanding applications. Despite these promising results, the study highlighted the need for improved powder quality control and accurate composition measurement to ensure the consistent production of reliable parts. The non-destructive hardness testing method applied in this study proved effective for predicting tensile strength, offering a streamlined approach to quality assurance. These results contribute to a growing body of research and knowledge supporting the adoption of AM for producing critical mechanical components, while underscoring the need for further investigation into quality assurance and standardized non-destructive testing procedures for high-performance metal AM parts.

BackgroundAutism spectrum disorder (ASD) imposes a significant burden on both patients and society. Amino acid metabolism abnormalities are particularly relevant to ASD pathology due to their crucial role in neurotransmitter synthesis, synaptic function, and overall neurodevelopment. This study aims to explore the association between amino acid metabolic abnormalities and the severity of ASD by analyzing the amino acid concentrations in the blood of children with ASD.MethodsFasting peripheral blood samples were collected from 344 children with ASD, and amino acid concentrations were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS) while strictly following quality control measures. The association between amino acid concentrations and ASD severity was evaluated using logistic regression and restricted cubic spline (RCS) analysis. The ROC (receiver operating characteristic) curve, decision curve analysis (DCA), and calibration curve were used to construct and validate predictive models and nomograms, thereby assessing their predictive performance.ResultsMultivariate logistic regression analysis showed that aspartic acid (OR = 1.037, 95% CI: 1.009–1.068, P = 0.01), glutamic acid (OR = 1.009, 95% CI: 1.001–1.017, P = 0.03), phenylalanine (OR = 1.036, 95% CI: 1.003–1.072, P = 0.04), and leucine/isoleucine (OR = 1.021, 95% CI: 1.006–1.039, P = 0.01) were significantly positively correlated with the severity of ASD. On the other hand, tryptophan (OR = 0.935, 95% CI: 0.903–0.965, P < 0.01) and valine (OR = 0.987, 95% CI: 0.977–0.997, P = 0.01) were significantly negatively correlated with the severity of ASD. RCS analysis further revealed a nonlinear relationship between the concentrations of aspartic acid, proline, and glutamic acid and the risk of ASD. ROC curve analysis showed that the combined model achieved an AUC (area under the curve) of 0.806, indicating high diagnostic accuracy. Calibration and decision curve analysis further validated the predictive effectiveness and clinical utility of the model.ConclusionsThis study identifies potential amino acid biomarkers that may contribute to ASD severity assessment. Further research is needed to validate these findings and explore their clinical utility.

There is increasing awareness of the role of the maternal cardiovascular system in complicated pregnancies. Despite the high disease burden, noninvasive cardiac output monitors have not been used extensively in low- and middle-income countries. The aim of this study was to evaluate the quality control of the use of the ultrasonic cardiac output monitor (USCOM) 1A® in a LMIC (low an middle income country). This was a quality assessment study of the introduction of the USCOM 1A® to measure maternal hemodynamic indices. Inter-observer agreement was assessed across all four study sites by intraclass correlation coefficient. Quality control was assessed using pre-defined acceptability criteria, rated by 2 independent scorers. On average, nurses or midwives needed to obtain 30.4 (range 24-36) Doppler waveform recordings to be deemed competent to undertake USCOM 1A® measurements. There was very good inter-observer agreement across all 4 sites (intraclass correlation coefficient 0.86-0.93, all p < 0.001). A total of 138 images were randomly selected for quality review. Overall, 79 (89.8%) images were considered acceptable by both scorers; 4 (6.9%) were considered unacceptable by both scorers; and there was disagreement in 5 (5.7%) cases. Overall agreement was 94.3%. Agreement as assessed by Fleiss' kappa, was moderate (0.585 [95% CI 0.376-0.794], p < 0.001). Using a robust learning package and clearly defined image criteria, a novel cardiac-output monitor can be successfully introduced into low- and middle-income countries, in the context of research. Ongoing quality control measures are imperative to maintain the integrity of planned future studies using USCOM 1A®.

Halal food security ensures that food products and production processes comply with Islamic dietary laws, providing benefits beyond religious obligations. These include strict quality control measures that enhance safety, cleanliness, and product consistency, reducing the risk of foodborne illnesses for all consumers. For Muslim customers, halal certification offers assurance and trust that products meet Islamic requirements, encouraging confidence in their purchases. The global halal food market presents significant business opportunities, valued at billions of dollars. Countries and companies that prioritise halal food security can tap into this expanding market, particularly in regions with large Muslim populations. To export food to Muslim-majority countries or markets with substantial Muslim consumer bases, halal certification is essential. In the other aspects, political stability plays a critical role in facilitating the export of halal products. It strengthens regulatory integrity, enhances the reputation of certifying authorities, fosters trade agreements, attracts investment, and supports stable supply chains. These factors contribute to increased consumer confidence and allow countries to better meet the growing global demand for halal goods. Malaysia, in particular, is well-positioned to leverage this opportunity. This paper focusing on impact of political stability on Malaysia’s halal food exports to 55 Organization of Islamic Cooperation (OIC) member states from 2010 to 2021, using the Random Effects Model (REM), reveals that political stability in OIC countries has a significantly positive impact on Malaysia’s halal food exports. This stability allows Malaysia to capitalise on its unique position in the halal market, enabling stronger export potential to OIC nations.

Background/Aims Private healthcare facilities are often believed to provider better quality services than public healthcare facilities. This study compared perceived quality of care received at public and private hospitals among nurses and patients in Ranchi, India. Methods A cross-sectional design was deployed, including 37 hospitals (25 private, 12 public). Structured questionnaires were distributed to patients and nurses to assess perceptions of care quality across four dimensions: safety, patient-centredness, effectiveness and efficiency. Items were scored on a 5-point Likert scale. Scores above and below the 75th percentile were characterised as indicating ‘good’ and ‘bad’ quality respectively. Results were analysed using multiple linear regression and Z tests of proportions to compare public and private hospitals. Results Regression analysis showed no significant differences in care quality scores given by patient participants between public and private hospitals after adjusting for patient characteristics and competitive landscape. However, Z tests showed statistically significant differences, with patients and staff in private hospitals more likely to rate their service as ‘good’ compared to those in public hospitals. Conclusions This study suggests that private hospitals do not necessarily provide better quality care than public hospitals in this region, although both patients and staff were more likely to rate private facilities as ‘good’, reflecting the complex nature of quality perception. Increasing healthcare quality and access is crucial to achieving universal health coverage. Implications for practice Healthcare leaders and policymakers should focus on enhancing care quality in both the public and private sector, prioritising broad strategies that can enhance care quality in both types of facility. This should include implementing robust measures for quality control across the healthcare system.

Introduction: Abdominal aortic aneurysms (AAA) are strongly correlated with lower extremity aneurysms (LEA), with AAA present in 50-90% of patients with femoral aneurysms and up to 50% in those with popliteal aneurysms. Conversely, around 14% of patients with AAA have concurrent popliteal aneurysms. While the genetic architecture of AAA has been well characterized, the genetic basis of lower extremity aneurysms (LEA) comprising those in the femoral and popliteal arteries remains unknown. Methods: We conducted a genome-wide association study for LEA in the Million Veterans Program. Veterans were divided into European, African and Hispanic cohorts based on genetically similarity to 1000 Genomes reference populations. Association testing was conducted for each respective population and results were combined with inverse variance weighted fixed effects meta-analysis. Genetic correlation between LEA, AAA, TAAD, and peripheral artery disease (PAD) were estimated using linkage disequilibrium score regression (LDSC). The top 5 lead variants were then examined for colocalization with AAA. Results: After quality control measures, approximately 25 million variants tested for association with LEA in 3,094 Veterans with LEA and 594,497 Veterans without LEA (Figure 1). We identified 63 genome-wide significant variants across three loci (p &lt; 5 × 10 -8 ) (Table 1). Additionally, 1,473 variants spanning 406 loci reached suggestive significance (p &lt; 5 × 10 -5 ). Genetic correlation analysis using LDSC demonstrated a strong shared genetic architecture between LEA and AAA (rg = 0.882, p = 1 × 10 -7 ), a moderate correlation with PAD (rg = 0.687, p = 4 × 10 -6 ), and weaker correlation with TAAD (rg = 0.391, p = 1 × 10 -2 ) (Figure 2). Pairwise colocalization analysis revealed significant overlap between LEA and AAA at three of the top five lead variants, with a greater than 80% likelihood of the same causal genetic signal observed at the LPA , CDKN2B-AS1 , and AGPAT4 loci. Conclusion: This study identifies 3 novel genome wide significant loci associated with LEA. Furthermore, we provide evidence for genetic contribution to the relationship between LEA and AAA – particularly at the LPA , CDKN2B-AS1 and AGAPT4 loci. These findings provide a foundation for further investigation into the genetic etiology of LEA.

This dataset explores factors influencing tourist revisit intentions to Jeju Island during the COVID-19 pandemic. Collected through an online survey of 930 participants in February 2022, the data examines seven key variables: pandemic risk perception, social media impact, destination management image, travel anxiety, travel desires, attitudes toward Jeju travel, and revisit intentions. A multi-stage probability-proportional-to-size sampling method was used, covering 16 metropolitan cities and provinces in Korea, with stratification by region, gender, and age to ensure representativeness. The dataset includes raw survey responses, a detailed codebook, and variable descriptions, with all items measured on a 7-point Likert scale and mandatory responses to ensure completeness. Quality control measures, such as response pattern analysis and time monitoring, were implemented to maintain reliability. Publicly accessible via Mendeley Data, this dataset provides valuable insights for researchers and tourism professionals seeking to analyze tourist behavior during crises and develop effective strategies for tourism recovery and crisis management.