Core Activities Research Articles

Thinking beyond core activities: evidence from telecom service providers competing in the digital platform economy

ABSTRACT This study investigates strategic options for telecom service providers (TSPs) to compete in the digital platform economy. It addresses the research question: How can TSPs compete in the digital platform economy? Using a single case study methodology, data was triangulated from archival documents, observations, and expert opinions. The findings contribute to the dynamic capability literature by offering empirical evidence and proposing strategic options for TSPs. These options include partnering with hyperscalers and fostering a product mindset within the organisation to develop higher-value digital products and services. The study highlights the importance of these strategies in enabling TSPs to navigate the competitive landscape of digital platforms effectively.

Sex-dependent effects of chronic jet lag on circadian rhythm and metabolism in mice

BackgroundThe circadian clock integrates external environmental changes into the internal physiology of organisms. Perturbed circadian clocks due to misaligned light cycles increase the risk of diseases, including metabolic disorders. However, the effects of sex differences in this context remain unclear.MethodsCircadian misalignment was induced by a chronic jet lag (CJL) shift schedule (light-on time advanced by 6 h every 2 days) in C57BL/6N male and female mice. Core body temperature and activity rhythms were recorded using a nano tag, and the gene expression rhythms of clock and clock-controlled genes in the liver and adrenal glands were analyzed using qPCR. Glucose metabolism and insulin response were evaluated using glucose tolerance, insulin sensitivity, and glucose response assays. Castration and testosterone replacement were performed to assess the fundamental role of testosterone in male phenotypes under CJL.ResultsUnder CJL treatment, male mice exhibited increased weight gain, whereas females exhibited decreased weight gain compared to that of the respective controls. CJL treatment induced a lower robustness of circadian rhythms in core body temperature and a weaker rhythm of clock gene expression in the liver and adrenal glands in females, but not in males. Only male mice exhibited glucose intolerance under CJL conditions, without the development of insulin resistance. Castrated mice without testosterone exhibited decreased weight gain and reduced robustness of body temperature rhythm, as observed in intact females. Testosterone replacement in castrated mice recovered the CJL-induced weight gain, robustness of temperature rhythm, and glucose intolerance observed in intact males.ConclusionsSignificant sex-based differences were observed in circadian clock organization and metabolism under CJL. Testosterone plays a crucial role in maintaining the circadian clock and regulating CJL metabolism in males.

Model for an International Case Sharing Program to Enhance Global Palliative Care Education.

In Thailand, the field of palliative medicine is growing but access and training remain limited. We sought to expand education of resident physicians at Chiang Mai University (CMU) in Thailand through development of an international case sharing program. The goals of this project were to increase knowledge of core palliative care topics, to cultivate a culture of reflective clinical practice, and to create a model for collaboration in international palliative care education that can be replicated by other institutions. We used a virtual case conference platform, in which two Family Medicine residents from CMU selected a challenging palliative care case. They prepared the case using an outline that included reflections on ethics, compassion and social responsibility. The residents presented the case in English to palliative care faculty from Thailand and Minnesota. Each case was followed by unstructured discussion. Over the course of 5.5 years (Nov 2018 - Mar 2024), 14 cases were presented. Each case discussion included at least 3 to 7 core palliative care topics. The program was adopted as one of the core activities of the Department of Family Medicine at CMU and led to clinical practice changes. We present a sustainable, convenient, low-cost, cross-cultural palliative care case conference model that has the potential to enrich palliative care education globally.

Intrinsic capacity and ageing well for Aboriginal people in remote Western Australia: a longitudinal cohort study

AbstractObjectiveTo assess intrinsic capacity, an important component of ageing well, in older Aboriginal people living in remote Western Australia.Study designLongitudinal cohort study; secondary analysis of survey and clinical assessment data.SettingKimberley region of Western Australia (six remote communities, and the town of Derby).ParticipantsAboriginal people aged 45 years or older, initially recruited 15 July 2004 – 17 November 2006.Main outcome measuresIntrinsic capacity (assessed in each participant by questionnaire and review by a consultant specialist), overall and by domain, and presence of core activity limitations, at baseline and follow‐up (8 February 2011 – 6 June 2013); risk of death by follow‐up; preservation of intrinsic capacity at follow‐up.ResultsThe mean age of the 345 participants at baseline was 60.2 years (standard deviation [SD], 11.6 years; range, 45–96 years); 152 were men (44.1%) and 193 were women (55.9%). Intrinsic capacity was unimpaired in all five domains for 55 participants (15.9%; 95% confidence interval [CI], 12.4–20.2%). Capacity in the vitality domain was unimpaired in 325 respondents (94.2%), in the psychological/mood domain in 318 (92.2%), and in the cognition domain in 289 people (83.8%); the locomotion domain was unimpaired in 174 people (50.4%), and the sensory domain in 117 people (33.9%). The proportion of men with full capacity in all five domains (32 of 152, 21.1%) was larger than for women (23 of 193, 11.9%). Of the 274 people included in follow‐up analyses, intrinsic capacity was lower than at baseline for 66 people (24.1%), it was unchanged or improved in 111 participants (40.5%; 95% CI, 34.8–46.5%), and 97 people had died (35.4%). Thirty‐seven of the 177 surviving participants for whom complete data were available had full capacity in all domains (20.9%; 95% CI, 15.5–27.6%). After adjustment for age, the number of unimpaired intrinsic capacity domains at baseline was inversely associated with having a core activity limitation at baseline (per domain: adjusted prevalence ratio, 0.43; 95% CI, 0.34–0.55) and follow‐up (adjusted risk ratio, 0.62; 95% CI, 0.44–0.88), and with risk of death by follow‐up (adjusted risk ratio, 0.83; 95% CI, 0.71–0.96).ConclusionsImpaired intrinsic capacity in older Aboriginal people living in the Kimberley was most frequent in the sensory and locomotion domains. Reduced capacity in these domains could be highly amenable to treatment that would ensure that Elders can continue to take part in activities important for quality of life.

Area sharing among tigers in re-introduced population of Sariska tiger reserve demonstrating space crunch in Human dominated landscape

We examined the home range dynamics, dispersal patterns, and space-sharing behaviour of reintroduced tigers and their progenies in different generations in Sariska Tiger Reserve (STR) from 2018 to 2022. During the study period, the tiger population increased from four males and eight females to seven males, 11 females, and three sub-adult females. Mean home ranges were 34 ± 2 km² (SE) for female tigers (n=11) and 95 ± 6 km² for male tigers (n=10), while core activity areas (50% KDE) averaged 6 ± 1 km² for females and 23 ± 3 km² for males. Female home ranges showed a decreasing trend due to natal dispersal by sub-adults, whereas male home ranges expanded due to territorial consolidation. Instances of territorial overlap, including fatal conflicts, highlighted the competitive pressures in this human dominated landscape. To accommodate the growing tiger population and mitigate human-tiger conflicts, we recommend enhanced monitoring, relocation of villages to create inviolate spaces, and strengthening the protection regime.

Advanced AI, Machine Learning and Deep Learning Techniques for Climate Change Studies: A Review

Climate models have become an important tool in understanding as well as projecting future climate conditions. They thus become very critical to decision-making processes, especially in mitigation and adaptation strategies. This paper provides a general overview of methodologies that are applied in climate modeling, its validation, and uncertainty mapping, notably their strengths, limitations, and challenges. The paper takes the reader through all the intricacies associated with the modeling of climate systems: global circulation models, regional climate models, and statistical downscaling. Much emphasis is given to the issue of model choice depending on the research objectives and spatial scales. Thorough model validation is considered, emphasizing that observational data forms the core and good quality and availability are issues. Climate modeling should incorporate uncertainty quantification as a core activity. This paper debates estimation and representation techniques of model uncertainties applied, such as probabilistic approaches, sensitivity analysis, and ensemble modeling. Introduce an idea called here uncertainty mapping, as a means of communicating the climate-related risks. This paper sets this tone by asserting that uncertainties in climate modeling have to be communicated as clearly as possible to decision-makers. No matter how intrinsically complex and limited they are, climate models represent, by themselves, very valuable means for the task of estimating the probable futures of climates. This quest ranges from enhancing model accuracy to ever-lowering estimates of uncertainties, all impelled by new advances made in computational powers and deeper insights into the climate systems.

Utilization and associated factors of TPMT testing among Australian adults receiving thiopurines: A national retrospective data-linkage study.

Thiopurine drugs are metabolized by thiopurine methyltransferase (TPMT) and low TPMT activity can result in severe adverse drug reactions. Therefore, TPMT testing is recommended for individuals receiving thiopurines to reduce the risk of toxicity. The objectives of this study were to assess the rate of TPMT testing among individuals receiving thiopurines and explore factors associated with undergoing TPMT testing in Australia. This retrospective cohort study utilized administrative data from the Pharmaceutical Benefits Scheme (PBS), Medicare Benefits Schedule (MBS), and the 2021 Census, accessed via the Person Level Integrated Data Asset (PLIDA) at the Australian Bureau of Statistics (ABS) DataLab. Individuals receiving thiopurines aged 18 years or above were identified using PBS data and exposure to TPMT testing was determined using MBS data. Multivariate logistic regression was performed to identify factors associated with TPMT testing. A total of 62,574 prevalent thiopurine users were identified between 2020 and 2022. Of these, 20,327 (32.5%) underwent TPMT testing (2011-2022). The most significant factor associated with TPMT testing was having at least one thiopurine medication prescribed by a medical specialist (adjusted odds ratio [aOR] 2.12, 95% confidence interval [CI] 2.02-2.22), compared to having medication solely prescribed by primary care physicians (PCPs). Other significant factors associated with TPMT testing included speaking a non-English language at home (aOR 1.29, 95% CI 1.22-1.36), having no chronic health conditions (aOR 1.18, 95% CI 1.13-1.24), not requiring assistance with core activities (aOR 1.16, 95% CI 1.08-1.23), and having a higher educational attainment (aOR 1.11, 95% CI 1.06-1.11). Compared to living in major cities, individuals living in remote areas were significantly less likely to undergo testing (aOR 0.49, 95% CI 0.39-0.60). Our study highlights the low utilization of TPMT testing in Australia and suggests the need for targeted interventions to address disparities and improve TPMT testing.

Exploring the enhanced bioactivity and reactivity of novel Fe(III) and Co(II) complexes incorporating sulfadiazine tetradentate ligand: Structural, DFT, molecular docking, and biological applications

This current work presented the synthesis, characterization and bio-evaluation of new Fe(III) (FePSD), and Co(II) (CoPSD) complexes based on N-[4-amino-5-cyano-6-(methylthio)pyridin-2-yl]-3-oxobutanamide in pyridine afford N-(4-amino-5-cyano-6-(methylthio) pyridin-2-yl)-3-oxo-2-([4-(pyrimidin-2-ylsulfamoyl) phenyl]hydrazono) butanamide (PSD). Interestingly, the FePSD and CoPSD complexes exhibit notable stability and solubility in organic solvents, with molar conductivity values of 79.35 Ω−1 cm2 mol−1 for FePSD and 8.89 Ω−1 cm2 mol−1 for CoPSD, indicating a 1:1 electrolytic nature for FePSD and non-electrolytic behavior for CoPSD. FTIR analysis confirmed metal–ligand interactions, as shifts in key bands were observed, while UV–Vis spectra and magnetic moment measurements supported octahedral geometries for both complexes. DFT calculations provided insights into the electronic structure, revealing that CoPSD has higher reactivity and electrophilicity, while FePSD showed moderate reactivity. Thermal and mass spectral analyses further characterized their stoichiometry and stability. The antibacterial and antifungal activities were evaluated against a range of Gram-positive and Gram-negative bacteria and fungal strains. The FePSD and CoPSD complexes demonstrated significantly enhanced antimicrobial efficacy compared to the parent ligand, as evidenced by larger inhibition zones, higher activity indices, and lower minimum inhibition concentrations (MIC). CoPSD exhibited superior antibacterial and antifungal activity compared to FePSD, nearing the effectiveness of standard antibiotics and antifungal drugs. Additionally, the anti-inflammatory potential of these compounds was assessed using the egg albumin denaturation method. Both FePSD and CoPSD showed remarkable inhibition of protein denaturation, surpassing the parent ligand and even outperforming the standard drug Ibuprofen at higher concentrations. The enhancement in biological activity is attributed to the metal chelation effect, which improves cell membrane permeability and reactive oxygen species (ROS) generation. Molecular docking studies further elucidated the binding interactions of PSD, FePSD, and CoPSD with target proteins, revealing stronger hydrophobic interactions and hydrogen bonding in the metal complexes, correlating with their superior biological activity. These findings highlight the potential of FePSD and CoPSD as promising antimicrobial and anti-inflammatory agents.

A Comprehensive Review of Interdepartmental Collaboration for Enhanced Patient Care

Integrated communication is a core activity that plays a significant role in today's healthcare organizations, as it offers a solution to how departments cooperate to improve patient services given the dynamic patient needs, available resources, and organizational system efficiency. All of these aspects of interdepartmental healthcare challenges and strategies of healthcare organizations are well presented in the literature review. These are communication as an element, leadership, the effective use of technology, and interdisciplinary working. Many practical instances, examples, and facts cited while sharing facts and figures in this review emphasize the significance of cross-function integration. It also explained future possible research topics such as the role of AI, hospital networks, and follow-up patient models. The findings raise awareness of the role of interdepartmental cooperation in providing good quality patient-oriented care and increasing healthcare.

Accounting Outsourcing in Tourism SMEs and Financial Risk Mitigation

Accounting Outsourcing in Tourism SMEs and Financial Risk Mitigation

Sulfur-Rich Norbornadiene-Derived Infrared Transparent Polymers by Inverse Vulcanization.

Infrared (IR) transparent polymer materials prepared by inverse vulcanization, as a promising candidate to replace inorganic materials, are new materials for constructing key devices in IR optics. However, it is difficult to achieve a balance between infrared optical and thermal properties in polymers due to the intrinsic infrared absorption of organic materials. Herein, our strategy is to construct a high boiling point symmetrical molecular norbornadiene derivative cross-linking agent (DMMD) which can be inverse vulcanized with molten sulfur, and obtain Poly (S-r-DMMD) with different sulfur content by controlling the feed ratio of sulfur. With the rigid core and low IR activity in DMMD, the prepared polymers exhibit tunable thermal properties (Tg: 98.3-119.8 °C) and high IR transmittance (medium-wave infrared region (MWIR): 42.9-52.6 %; long-wave infrared region (LWIR): 1.5-5.29 %). In addition, Poly (S-r-DMMD) can be used to prepare large-size free-standing Fresnel lenses for IR imaging by simple hot-pressing, which provides flexibility in the design and production of IR fine lenses. This study provides a novel strategy for balancing the thermal and optical properties of IR transparent polymer materials, while providing relevant references for balancing the IR optical and thermal properties of polymer materials.

Sulfur‐Rich Norbornadiene‐Derived Infrared Transparent Polymers by Inverse Vulcanization

AbstractInfrared (IR) transparent polymer materials prepared by inverse vulcanization, as a promising candidate to replace inorganic materials, are new materials for constructing key devices in IR optics. However, it is difficult to achieve a balance between infrared optical and thermal properties in polymers due to the intrinsic infrared absorption of organic materials. Herein, our strategy is to construct a high boiling point symmetrical molecular norbornadiene derivative cross‐linking agent (DMMD) which can be inverse vulcanized with molten sulfur, and obtain Poly (S‐r‐DMMD) with different sulfur content by controlling the feed ratio of sulfur. With the rigid core and low IR activity in DMMD, the prepared polymers exhibit tunable thermal properties (Tg: 98.3–119.8 °C) and high IR transmittance (medium‐wave infrared region (MWIR): 42.9–52.6 %; long‐wave infrared region (LWIR): 1.5–5.29 %). In addition, Poly (S‐r‐DMMD) can be used to prepare large‐size free‐standing Fresnel lenses for IR imaging by simple hot‐pressing, which provides flexibility in the design and production of IR fine lenses. This study provides a novel strategy for balancing the thermal and optical properties of IR transparent polymer materials, while providing relevant references for balancing the IR optical and thermal properties of polymer materials.

Use of Artificial Intelligence in the Banking Industry: A Case Study of Pakistan

This study investigates the adoption and impact of Artificial Intelligence (AI) in Pakistan’s banking sector, with a focus on Habib Bank Limited (HBL), Faysal Bank, and Bank Alfalah. The objective is to understand the extent to which AI technologies have transformed core activities within customer service, operations, fraud detection, and risk management in these banks. Data were collected from semi-structured interviews with ten respondents, selected based on their experience with AI implementation. This qualitative methodology allows for in-depth insights into the functionality and challenges associated with AI in banking. Results reveal that AI has notably improved operational efficiency by streamlining risk management and enabling real-time fraud detection. Additionally, AI-driven chatbots and virtual assistants have enhanced customer experiences by offering faster and more personalized services. Despite these benefits, the study identifies significant challenges, particularly regarding data privacy and regulatory compliance, as well as the need for human resources to adapt to AI-enabled tools. Key pressures in the industry include building capabilities to work alongside AI while addressing concerns over automation. To maximize the advantages of AI, the study emphasizes the need for comprehensive policies that balance technological adoption with ethical considerations, data security, and staff training. Strategic planning in Pakistan’s banking sector will be crucial to harnessing AI’s potential while managing its risks.

Internal control of the commercial bank resource use efficiency

Subject. This article considers the methodological approaches to the analysis of banking resources from the point of view of their possible use in controlling the efficiency of resource provision and funding of commercial banks. Objectives. The article aims to test standard analytical methods used in the analysis of economic indicators characterizing the efficiency of banking activities in order to draw conclusions about the possibility of their application to control the risks of resource availability. Methods. For the study, we used induction and deduction, analysis and synthesis, modeling, comparison, extrapolation, abstraction, as well as financial analysis and analytical calculations of indicators developed by the banking regulator to identify risk areas and determine key economic and financial indicators of a commercial bank. Results. The article finds that banks are experiencing difficulties in achieving the appropriate efficiency of resource provision within the parameters set by the regulator, which indicates the need to control performance indicators, especially those characterizing resource provision, and their use as one of the main generators of profit from core activities. Conclusions and Relevance. In the context of crisis phenomena in the banking sector, it is necessary to pay attention to the control of ensuring the profitability of resources attracted by the bank, as well as the factors affecting it, the main of which are the return on assets and liabilities and the completeness of the allocation of financial resources. The results of studying the methods of economic analysis for assessing the efficiency of resource provision can be useful for studying the problems of using bank resources and assessing their efficiency, as well as monitoring of efficiency parameters for internal control purposes.

Operant alcohol self-administration targets GluA2-containing AMPA receptor expression and synaptic activity in the nucleus accumbens in a manner that drives the positive reinforcing properties of the drug.

Rationale : The positive reinforcing effects of alcohol (ethanol) drive its repetitive use and contribute to alcohol use disorder (AUD). Ethanol alters the expression of glutamate AMPA receptor (AMPAR) subunits in reward-related brain regions, but the extent to which this effect regulates ethanol's reinforcing properties is unclear. Objective: This study investigates whether ethanol self-administration changes AMPAR subunit expression and synaptic activity in the nucleus accumbens core (AcbC) to regulate ethanol's reinforcing effects in male C57BL/6J mice. Results: Sucrose-sweetened ethanol self-administration (0.81 g/kg/day) increased AMPAR GluA2 protein expression in the AcbC, without effect on GluA1, compared to sucrose-only controls. Infusion of myristoylated Pep2m in the AcbC, which blocks GluA2 binding to N-ethylmaleimide-sensitive fusion protein (NSF) and reduces GluA2-containing AMPAR activity, reduced ethanol-reinforced responding without affecting sucrose-only self-administration or motor activity. Antagonizing GluA2-lacking AMPARs, through AcbC infusion of NASPM, had no effect on ethanol self-administration. AcbC neurons receiving projections from the basolateral amygdala (BLA) showed increased sEPSC area under the curve (a measurement of charge transfer) and slower decay kinetics in ethanol self-administering mice as compared to sucrose. Optogenetic activation of these neurons revealed an ethanol-enhanced AMPA/NMDA ratio and significantly reduced paired-pulse ratio, suggesting elevated GluA2 contributions specifically within the BLA→AcbC pathway. Conclusions: Ethanol use upregulates GluA2 protein expression in the AcbC and AMPAR synaptic activity in AcbC neurons receiving BLA projections and enhances synaptic plasticity directly within the BLA→AcbC circuit. GluA2-containing AMPAR activity in the AcbC regulates the positive reinforcing effects of ethanol through an NSF-dependent mechanism, highlighting a potential therapeutic target in AUD.

Mapping of c-Fos Expression in Rat Brain Sub/Regions Following Chronic Social Isolation: Effective Treatments of Olanzapine, Clozapine or Fluoxetine.

The c-Fos as a marker of cell activation is used to identify brain regions involved in stimuli processing. This review summarizes a pattern of c-Fos immunoreactivity and the overlapping brain sub/regions which may provide hints for the identification of neural circuits that underlie depressive- and anxiety-like behaviors of adult male rats following three and six weeks of chronic social isolation (CSIS), relative to controls, as well as the antipsychotic-like effects of olanzapine (Olz), and clozapine (Clz), and the antidepressant-like effect of fluoxetine (Flx) in CSIS relative to CSIS alone. Additionally, drug-treated controls relative to control rats were also characterized. The overlapping rat brain sub/regions with increased expression of c-Fos immunoreactivity following three or six weeks of CSIS were the retrosplenial granular cortex, c subregion, retrosplenial dysgranular cortex, dorsal dentate gyrus, paraventricular nucleus of the thalamus (posterior part, PVP), lateral/basolateral (LA/BL) complex of the amygdala, caudate putamen, and nucleus accumbens shell. Increased activity of the nucleus accumbens core following exposure of CSIS rats either to Olz, Clz, and Flx treatments was found, whereas these treatments in controls activated the LA/BL complex of the amygdala and PVP. We also outline sub/regions that might represent potential neuroanatomical targets for the aforementioned antipsychotics or antidepressant treatments.

Developing a Women's Heart Center With a Specialization in Coronary Microvascular and Vasomotor Dysfunction: If You Build It, They Will Come.

Women's Heart Centers (WHC) are comprehensive, multidisciplinary care centers designed to close the existing gap in women's cardiovascular care. The WHC at The Christ Hospital Heart and Vascular Institute (TCH-WHC) in Cincinnati, Ohio was established in October of 2020, and is a specialized coronary microvascular and vasomotor dysfunction (CMVD) program. The TCH-WHC focuses its efforts across five pillars: patient care, research, education, community outreach and advocacy, and grants and philanthropy. These areas, centered around providing specalized CMVD care and treatment have allowed for substantial growth. From October 2020-December 2023, TCH-WHC saw a total of 3219 patients, 42% of which were apart of the CMVD program. Since establishment, patient volume has consistently increased year over year. The CMVD program at TCH-WHC is one of the fastest growing in the U. S. and is nationally recognized for specialized clinical care, diagnostics, and research. The goal of this review is to provide an overview of the TCH-WHC structure that allows for the establishment and growth of a CMVD program and to outline core activities supporting the TCH-WHC approach.

From awareness to practice: Insights from the managers of Finnish circular economy pioneering companies

In recent years, research on circular economy has increased tremendously, as well as gained attention from governments and business practitioners. However, the knowledge of effective and efficient transition from a linear business model to circular economy remains limited. Therefore, the objective of this research is to explore the awareness and current practices of managers from companies implementing circular business models. The required data for this research were collected from 22 managers, whose companies belong to the list of “41 pioneering Finnish circular economy companies”. Methodologically, the study adopts a qualitative approach, following content analysis. The collected data is analyzed rigorously to uncover insights regarding managers’ awareness to circular economy, experienced barriers, drivers, and indicators of circular economy. Key research results show that 66.7% of responses represent circular economy as a core activity, with 68% having already integrated circular economy principles into the supply chain. Main barriers include lack of knowledge and technology (21.4%), while strategies to address the barriers focus on promoting technology innovation (33.3%) and improving education and communication (31.3%). Besides, circular economy performance is measured primarily through recycled materials used (21.7%). Additionally, the study investigates the approaches companies employ to develop circular economy implementation strategies, an area often overlooked in circular economy literature. The findings indicate that process-led and market-led management strategies are commonly practiced, accounting for 32% and 21%, respectively. Overall, this study sheds light on the current state of circular economy implementation at the micro level and provides valuable insights for policymakers, practitioners, and researchers aiming to promote the transition towards a circular economy.

Implementing Core Entrustable Professional Activities in Undergraduate Medical Education: A Psychometric Study.

This study examines the feasibility and psychometric results of an assessment of entrustable professional activities (EPAs) as a core component of the clinical program of assessment in undergraduate medical education, assesses the learning curves for each EPA, explores the time to entrustment, and investigates the dependability of the EPA data based on generalizability theory (G theory) analysis. Third-year medical students from the University of Minnesota Medical School in 7 required clerkships from May 2022 through April 2023 were assessed. Students were required to obtain at least 4 EPA assessments per week on average from clinical faculty, residents supervising the students, or assessment and coaching experts. Student ratings were depicted as curves describing their performance over time; regression models were used to fit the curves. The complete class of 240 (138 women [58.0%] and 102 men [42.0%]) third-year medical students at the University of Minnesota Medical School (mean [SD] age at matriculation, 24.2 [2.7] years) participated. There were 32,614 EPA-based assessments (mean [SD], 136 [29.6] assessments per student). Reliability analysis using G theory found that an overall score dependability of 0.75 (range, 0-1) was achieved with 4 assessors on 4 occasions. The desired level of entrustment by academic year end was met by all 240 students (100%) for EPAs 1, 6, and 7, 237 (98.8%), 236 (98.3%), and 218 (90.8%) students for EPAs 2, 5, and 9, respectively, 197 students (82.1%) for EPA 3, 178 students (74.2%) for EPA 4, and 145 students (60.4%) for EPA 12. The most rapid growth was for EPA 2 (β0 = .286), followed by EPA 1 (β0 = .240), EPA 4 (β0 = .236), and EPA 10 (β0 = .230). The study findings suggest that EPA ratings provide reliable and dependable data to make entrustment decisions about students' performance.

Focus Group Discussion and Workshop on Exploring the Tourism Potential of Jumpinang River Tubing Pasuruan

This community service program aims to improve the quality of management and promotion of Jumpinang River Tubing tourist destinations in Pasuruan through the use of digital technology. Implementation methods include problem identification, website creation, and guiding and safety training for local communities. This process was carried out for 3 months, with core activities in the form of Focus Group Discussion (FGD), website development, and technical training. The results of the program show that the community's capacity is increased in the management of tourist destinations, as well as the ease of promotion through digital platforms. The implication of this program is the increase in the number of tourist visits and the strengthening of the sustainability of tourism management by the community.