Recommendations For Management Research Articles

Enhancing landslide hazard prevention: Mapping vulnerability via considering the effects of human factors

Vulnerability mapping is necessary to reduce the effects of a landslide disaster. This study presents an approach to map vulnerability induced by a landslide hazard. The vulnerability was assessed by improved multi-criteria decision making (MCDM), in which the effects of human factors were incorporated. In the proposed approach, the weights of the indicators and factors were calculated using an integration method, including a grey decision-making trial and evaluation laboratory and the analytical hierarchy process (AHP) to calculate each index and factor’s weight. The effect of human factors is expressed as the ability of residents to cope with hazards in a community, which is evaluated by the adaptability index layer. The adaptability index layer includes four factors: gender ratio, age, education and medical resources. VIKOR is used to score and rank the adaptability index layer. The vulnerability is then mapped using geographic information system (GIS). A case study of historical landslides in Heyuan, China, was used for validation. The results demonstrate that 17.91% of Heyuan has the highest vulnerability, which is higher than that from the traditional method (13.76%). The model, considering adaptability, can predict areas with high vulnerability more accurately. Management recommendations are proposed via the following four specific aspects: i) urban vulnerability management and planning; ii) inter-regional differences in socio-economic vulnerability; iii) individual perceptions of landslides and iv) enhancing urban planning and strategies in similar cities.

Recommendations for Management of Chronic Pain Associated With TMJ Pain

Recommendations for Management of Chronic Pain Associated With TMJ Pain

How consistent are the key recommendations, and what is the quality of guidelines and expert consensus regarding paediatric cow's milk protein allergy?

The objective of this study was to assess the quality and consistency of recommendations in clinical practice guidelines (CPGs) and expert consensus on paediatric cow's milk protein allergy (CMPA) to serve as a foundation for future revisions and enhancements of clinical guidelines and consensus documents. We conducted a comprehensive literature search across several databases, including the Chinese Biomedical Literature Database (CBM), PubMed, Embase, Web of Science, UpToDate, ClinicalKey, DynaMed Plus and BMJ Best Practice. We spanned the search period from the inception of each database through October 1, 2023. We integrated subject headings (MeSH/Emtree) and keywords into the search strategy, used the search methodologies of existing literature and developed it in collaboration with a librarian. Two trained researchers independently conducted the literature screening and data extraction. We evaluated methodological quality and recommendations by using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) and AGREE-Recommendations for Excellence (AGREE-REX) tools. Moreover, we compared and summarized key recommendations from high-quality CPGs. Our study included 27 CPGs and expert consensus documents on CMPA. Only four CPGs (14.8%) achieved a high-quality AGREE II rating. The four high-quality CPGs consistently provided recommendations for CMPA. The highest scoring domains for AGREE II were 'scope and purpose' (77 ± 12%) and 'clarity of presentation' (75 ± 22%). The lowest scoring domains were 'stakeholder involvement' (49 ± 21%), 'rigor of development' (34 ± 20%) and 'applicability' (12 ± 20%). Evaluation with AGREE-REX generally demonstrated low scores across its domains. Conclusion: Recommendations within high-quality CPGs for the paediatric CMPA showed fundamental consistency. Nevertheless, the methodology and recommendation content of CPGs and the expert consensus exhibited low quality, thus indicating a substantial scope for enhancement. Guideline developers should rigorously follow the AGREE II and AGREE-REX standards in creating CPGs or expert consensuses to guarantee their clinical efficacy in managing paediatric CMPA. What is Known: • The quality of clinical practice guidelines and expert consensus on paediatric cow's milk protein allergy (CMPA) remains uncertain. • There is a lack of clarity regarding the consistency of crucial recommendations for CMPA management. What is New: • Improving the methodological quality of guidelines and consensus on CMPA requires greater emphasis on stakeholder engagement, rigorous development processes, and practical applicability. • The recommendations from four high-quality guidelines align. However, addressing clinical applicability, integrating values and preferences, and ensuring actionable implementation are critical to improving the quality of all guidelines.

Integrated impact of urban mixed land use on TOD ridership: A multi-radius comparative analysis

The global trend toward urbanization has spurred the widespread adoption of transit-oriented development (TOD). While previous research has extensively explored the relationship between land use and TOD ridership, much of it has focused on linear associations at a singular scale. Leveraging recent advancements in nonlinear modeling and the accessibility of open-source data, this study employs a comprehensive two-step methodology. Firstly, K-means clustering algorithm categorizes TOD sites in Shenzhen into three distinct clusters, providing a site-based understanding of their characteristics. Subsequently, a Light Gradient Boosting Machine (LightGBM) classification model, complemented by SHapley Additive exPlanations (SHAP) values for interpretation, quantitatively evaluates the influence of mixed land use on TOD ridership across various catchment areas. As for the findings, we discover that land-use factors have different effects on TOD site patronage at different buffer radii and delve into the intricacies of these effects. Further results reveal non-linear relationships with varying degrees of positivity and negativity. For instance, residents and health sites positively impact patronage across all buffer radii, while certain commercial land uses exhibit a negative influence. The study demonstrates how the importance of different land-use structures varies across these clusters, shedding light on the nuanced impacts of land use on TOD catchment areas. Our research optimizes land-use mixes based on predominant cluster characteristics by offering actionable recommendations for urban managers.

Quantified Metrics of Gastric Emptying Delay by Glucagon-Like Peptide-1 Agonists: A Systematic Review and Meta-Analysis With Insights for Periprocedural Management.

Divergent recommendations for periprocedural management of glucagon-like peptide-1 (GLP-1) receptor agonist (GLP-1 RA) medications rely on limited evidence. We performed a systematic review and meta-analysis to provide quantitative measures of gastric emptying relevant to mechanisms of weight loss and to periprocedural management of GLP-1 RA. We hypothesized that the magnitude of gastric emptying delay would be low and of limited clinical significance to procedural sedation risks. A protocolized search identified studies on GLP-1 RA that quantified gastric emptying measures. Pooled estimates using random effects were presented as a weighted mean difference with 95% confidence intervals (CIs). Univariate meta-regression was performed to assess the influence of GLP-1 RA type, short-acting vs long-acting mechanism of action, and duration of treatment on gastric emptying. Fifteen studies met the inclusion criteria. Five studies (n = 247) utilized gastric emptying scintigraphy. Mean T 1/2 was 138.4 minutes (95% CI 74.5-202.3) for GLP-1 RA vs 95.0 minutes (95% CI 54.9-135.0) for placebo, with a pooled mean difference of 36.0 minutes (95% CI 17.0-55.0, P < 0.01, I2 = 79.4%). Ten studies (n = 411) utilized the acetaminophen absorption test, with no significant delay in gastric emptying measured by T max , area under the curve (AUC) 4hr , and AUC 5hr with GLP-1 RA ( P > 0.05). On meta-regression, the type of GLP-1 RA, mechanism of action, and treatment duration did not impact gastric emptying ( P > 0.05). While a gastric emptying delay of ∼36 minutes is quantifiable on GLP-1 RA medications, it is of limited magnitude relative to standard periprocedural fasting periods. There were no substantial differences in gastric emptying on modalities reflective of liquid emptying (acetaminophen absorption test), particularly at time points relevant to periprocedural care.

Frailty evidence-practice gaps in acute care hospitals.

Frailty is common in hospitalised older people. Clinical practice guidelines for the management of frailty provide recommendations for identification and management; however, adoption into practice in hospitals is limited. This study identified and quantified the evidence-practice gap between frailty guidelines and clinical practice in two hospitals using an audit tool. A cross-sectional audit of medical records of frail older patients admitted to two hospitals was conducted. Data were collected using an audit tool based on the Asia Pacific Clinical Practice Guidelines for frailty management. Data were analysed using descriptive statistics and inter-rater reliability of the tool was assessed. Auditing of n = 70 electronic medical records showed that assessment of frailty in the acute setting did not regularly occur (17%). Few participants received guideline-recommended interventions. Physiotherapy treatment was limited, with 23% of participants receiving progressive resistance strength training. Gaps exist in provision of nutritional supplementation (26%) with limited recordings of weight during the admission for 10% of participants. Pharmacy review of medications was consistently documented on admission (84%) and discharge (93%). Vitamin D was prescribed for 57% of participants. Inter-rater reliability showed a high level of agreement using the audit tool. An audit tool was feasible to assess frailty evidence-practice gaps in the hospital setting. Further understanding of the contextual barriers is needed to inform implementation strategies (dedicated staffing, education and training and ongoing audit of practice cycles) for the uptake of frailty guidelines in hospital settings.

Fungal Diseases in Yerba Mate: Status and Management Strategies.

Yerba mate (Ilex paraguariensis St. Hil.), with its health benefits and socioeconomic significance, plays a crucial role in Argentina and other South American countries like Brazil and Paraguay. Its cultivation in the Province of Misiones (Argentina) supports various sectors, contributes to regional development, and provides employment opportunities. However, the transition from extractive practices to monoculture, accompanied with increased demand, has led to phytosanitary challenges. Imbalanced native microbiota, disease development, and pathogen dispersion have become prevalent issues. Understanding the known pathogens associated with yerba mate plants is crucial for developing effective agricultural strategies. The primary objective of this study is to synthesise current knowledge on prevalent fungal diseases in yerba mate cultivation, as well as to provide agricultural management recommendations for effective disease control. Fungal diseases can cause significant damage to different parts of the plant, resulting in economic losses. The proximity of neighbouring plantations to yerba mate crops may contribute to the cross-contamination of pathogens, emphasizing the need for comprehensive epidemiology and accurate diagnosis. Multiple fungal genera have been reported to cause pathologies in yerba mate. Among the fungi causing foliar diseases are Ceratobasidium niltonsouzanum, Cylindrocladium spathulatum, Pseudocercospora mate, Asterina sphaerelloides, Colletotrichum gloeosporioides aff var. yerbae, and Phyllosticta sp. Caulinary diseases are caused by Alternaria sp., Phoma sp., Colletotrichum sp., and Ceratocystis fimbriata. Regarding root rot, the genera Rhizoctonia sp., Pythium sp., Fusarium sp., and Rosellinia sp. have been reported. Proper crop management practices and monitoring are essential for effective disease control. To reduce reliance on chemical compounds, the use of biocontrol agents like Trichoderma sp. has shown promise in regulating phytopathogenic fungi populations. Continued research is vital to preserve the yerba mate industry and ensure its long-term viability while minimizing environmental impact.

Definition and management of arrhythmia-induced cardiomyopathy: findings from the EHRA SIC survey

Abstract Background Arrhythmia-induced Cardiomyopathy (AiCM) represents a subtype of heart failure (HF) in the context of a sustained arrhythmia. However, clear definitions and management recommendations for AiCM are lacking. Purpose The European Heart Rhythm Association Scientific Initiatives Committee (EHRA SIC) conducted a survey to determine the current definitions and management of patients with AiCM among European and non-European electrophysiologists. Methods A 25-item online questionnaire was developed and distributed among EP research network centres between September 4th and October 5th 2022. Results Out of the 206 respondents, 16% were females and the most (33%) were between 40-49 years old. Most of the respondents were EP-Specialists (81%) working at a University Hospital (47%). While most participants (67%) agreed that AiCM should be defined as a left ventricular ejection fraction (LVEF) impairment after new onset of an arrhythmia and/or LVEF recovery after treatment of the culprit arrhythmia, only 35% identified a specific LVEF drop/improvement to diagnose AiCM, the majority (50%) agreeing with a 10% change in LVEF (Figure) but with the rest of the experts choosing a wide range of values (from 5 to 20% LVEF drop). Most respondents used all available therapies in AiCM patients: catheter ablation was chosen by 93%, electrical cardioversion by 83%, antiarrhythmic drugs by 76% and adjuvant HF treatment were used by 76%. 83% of respondents indicated that adjuvant HF treatment should be started at first diagnosis of HF prior to antiarrhythmic treatment and 84% agreed that the therapy should be stopped within six months after LVEF normalization. Responses for the optimal time point for the first reassessment of LVEF during FU varied markedly (1 day to over 6 months after antiarrhythmic treatment). Conclusion This EHRA Survey reveals varying practices in defining and managing AiCM among European and non-European physicians. There is an unmet need for a consensus in the definition and management of AiCM patients to improve patient care.Figure

Factors of Social Networking Influencing Tourists' Destination Selection in Ho Chi Minh City

Objective: The overarching objective of this study is to identify the salient factors within social networks, specifically Facebook, TikTok, Instagram, and YouTube, and their impact on tourists' decision-making processes in selecting Ho Chi Minh City as a destination. Subsequently, we offer managerial recommendations aimed at aiding tourism enterprises in Vietnam to enhance their understanding of the social network components that positively influence tourists' choices to visit. Furthermore, we suggest potential avenues for performance enhancement to optimize advertising effectiveness across social media platforms, including Facebook, TikTok, Instagram, and YouTube. Theoretical Framework: To date, numerous international research endeavors have scrutinized the determinants within social networks that shape tourists' intentions and decision-making processes regarding travel destination selection. However, within the Vietnamese context, scholarly investigations have predominantly centered on factors such as pricing, destination imagery, quality, and allure, while neglecting to explore the influence of social network factors on tourists' decisions regarding destination selection in Ho Chi Minh City. Consequently, the thematic focus on "Factors of Social Networks Influencing Tourists' Destination Selection Decisions in Ho Chi Minh City" represents an evolutionary progression from antecedent research studies, albeit purposefully tailored and refined by the researcher to align with their specific research aims. Method: The quantitative data gathered aimed to systematically examine and comprehend tourists' behaviors in their decision-making processes regarding destination selections facilitated by social media platforms. Employing an online survey hosted on Google Forms facilitated the data collection endeavor. The survey instrument featured a Likert scale spanning from 1 to 5, encompassing response categories delineated as follows: (1) Strongly Disagree, (2) Disagree, (3) Neutral, (4) Agree, and (5) Strongly Agree. Results and Discussion: Following the regression model analysis conducted on a dataset comprising 307 survey samples, the researcher observed the rejection of one initial research hypothesis, denoted as H1, while five subsequent hypotheses, namely H2, H3, H4, H5, and H6, were accepted. This determination was made based on the statistical significance values (Sig.) obtained from the t-test results presented in Table 4.19. Notably, factors with Sig. &gt; 0.05 were deemed lacking in statistical significance, indicating a negligible influence on the dependent variable. Specifically, hypothesis H1, which pertained to the subjective norm factor, was rejected due to its Sig. value exceeding 0.05 (Sig. = 0.651). Conversely, the five accepted hypotheses (H2, H3, H4, H5) all demonstrated Sig. values below 0.05 (Sig. = 0.000). In summary, the study effectively achieves its predetermined objectives by identifying and analyzing five social media factors influencing tourists' destination selection decisions in Ho Chi Minh City. Additionally, the research assesses the magnitude of their impact and examines disparities in research outcomes across different customer segments in Ho Chi Minh City concerning travel destination decisions. Based on these findings, the researcher proposes managerial implications to support tourism businesses in Vietnam intending to utilize social media platforms for advertising. These implications aim to furnish essential insights for selecting and prioritizing key factors when designing advertising campaigns on social media, thereby enhancing brand effectiveness.

Cumulative Effects of Watershed Disturbances and Run-of-river Dams on Mercury Cycling: Case Study and Recommendations for Environmental Managers.

Run-of-river power plants (ROR) represent the majority of hydroelectric plants worldwide. Their environmental impacts are not well documented and are believed to be limited, particularly regarding the contamination of food webs by methylmercury (MeHg), a neurotoxin. RORs are typically installed in small rivers where combined effects of watershed disturbances with dam construction can complicate environmental management. We report a multi-year case study on the Saint-Maurice River (Canada) where an unpredicted temporary increase in MeHg accumulation in predator fish was observed after the construction of two ROR plants. The associated pondages acted as sedimentation basins for mercury (Hg) and organic matter from a watershed disturbed by a forest fire and by logging. This fresh organic carbon likely fueled microbial MeHg production. Hg methylation was more associated with environmental conditions than to the presence of Hg, and main methylating microbial groups were identified. A constructed wetland was a site of significant Hg methylation but was not the main source of the fish Hg increase. Organic carbon degradation was the main driver of MeHg accumulation at the base of the food chain whereas trophic levels explained the variations at the top of the food chain. Overall, carbon cycling was a key driver of Hg dynamics in this system, and ROR plants can cause temporary (ca. 12 years) Hg increase in food webs when developed in disturbed watersheds, although this increase is smaller than for large reservoirs. Recommendations for future ROR construction are to establish a good environmental monitoring plan with initial high temporal resolution and to consider recent and potential watershed disturbances in the plan.

AAPM&R consensus guidance on spasticity assessment and management.

The American Academy of Physical Medicine and Rehabilitation (AAPM&R) conducted a comprehensive review in 2021 to identify opportunities for enhancing the care of adult and pediatric patients with spasticity. A technical expert panel (TEP) was convened to develop consensus-based practice recommendations aimed at addressing gaps in spasticity care. To develop consensus-based practice recommendations to identify and address gaps in spasticity care. The Spasticity TEP engaged in a 16-month virtual meeting process, focusing on formulating search terms, refining research questions, and conducting a structured evidence review. Evidence quality was assessed by the AAPM&R Evidence, Quality and Performance Committee (EQPC), and a modified Delphi process was employed to achieve consensus on recommendation statements and evidence grading. The Strength of Recommendation Taxonomy (SORT) guided the rating of individual studies and the strength of recommendations. The TEP approved five recommendations for spasticity management and five best practices for assessment and management, with one recommendation unable to be graded due to evidence limitations. Best practices were defined as widely accepted components of care, while recommendations required structured evidence reviews and grading. The consensus guidance statement represents current best practices and evidence-based treatment options, intended for use by PM&R physicians caring for patients with spasticity. This consensus guidance provides clinicians with practical recommendations for spasticity assessment and management based on the best available evidence and expert opinion. Clinical judgment should be exercised, and recommendations tailored to individual patient needs, preferences, and risk profiles. The accompanying table summarizes the best practice recommendations for spasticity assessment and management, reflecting principles with little controversy in care delivery.

Clinical and Imaging Characteristics, Care Pathways, and Outcomes of Traumatic Epidural Hematomas: A Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury Study.

Guideline recommendations for surgical management of traumatic epidural hematomas (EDHs) do not directly address EDHs that co-occur with other intracranial hematomas; the relative rates of isolated vs nonisolated EDHs and guideline adherence are unknown. We describe characteristics of a contemporary cohort of patients with EDHs and identify factors influencing acute surgery. This research was conducted within the longitudinal, observational Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury cohort study which prospectively enrolled patients with traumatic brain injury from 65 hospitals in 18 European countries from 2014 to 2017. All patients with EDH on the first scan were included. We describe clinical, imaging, management, and outcome characteristics and assess associations between site and baseline characteristics and acute EDH surgery, using regression modeling. In 461 patients with EDH, median age was 41 years (IQR 24-56), 76% were male, and median EDH volume was 5 cm3 (IQR 2-20). Concomitant acute subdural hematomas (ASDHs) and/or intraparenchymal hemorrhages were present in 328/461 patients (71%). Acute surgery was performed in 99/461 patients (21%), including 70/86 with EDH volume ≥30 cm3 (81%). Larger EDH volumes (odds ratio [OR] 1.19 [95% CI 1.14-1.24] per cm3 below 30 cm3), smaller ASDH volumes (OR 0.93 [95% CI 0.88-0.97] per cm3), and midline shift (OR 6.63 [95% CI 1.99-22.15]) were associated with acute surgery; between-site variation was observed (median OR 2.08 [95% CI 1.01-3.48]). Six-month Glasgow Outcome Scale-Extended scores ≥5 occurred in 289/389 patients (74%); 41/389 (11%) died. Isolated EDHs are relatively infrequent, and two-thirds of patients harbor concomitant ASDHs and/or intraparenchymal hemorrhages. EDHs ≥30 cm3 are generally evacuated early, adhering to Brain Trauma Foundation guidelines. For heterogeneous intracranial pathology, surgical decision-making is related to clinical status and overall lesion burden. Further research should examine the optimal surgical management of EDH with concomitant lesions in traumatic brain injury, to inform updated guidelines.

A Novel NUTM1-NSMCE2 Fusion Gene in a Pediatric Chest NUT Carcinoma.

Nuclear protein of the testis carcinoma is an exceedingly rare and poorly differentiated carcinoma characterized by BDR4::NUTM1 gene translocation. Typically, the tumor affects young adults, and no standardized recommendations for therapeutic management have been available since 2022; the clinical course remains mostly dismal. We report the successful multimodal treatment of a 13-year-old boy affected by a primary chest NUT-carcinoma with a novel NUTM1 rearrangement that remains in complete continuous remission at 30 months from diagnosis.

Two sides of management recommendations for psoriatic arthritis.

Two sides of management recommendations for psoriatic arthritis.

Skin fragility and wound management in Ehlers- Danlos Syndrome: a report by the Ehlers Danlos Syndrome society skin working group.

The Ehlers-Danlos Syndromes (EDS) are a heterogenous group of heritable connective tissue disorders, characterised by joint hypermobility, skin hyperextensibility and generalised tissue fragility. In all types of EDS skin wound healing is impaired to a variable degree. Additional support through wound management plans may help to improve these outcomes, however, there is paucity of evidence regarding clinical management of skin fragility and wounds in EDS. This paper aims to review current evidence and provide recommendations for management of skin wounds in EDS types. Preventative measures to avoid skin injury are strongly recommended, including avoidance of high impact sport and use of appropriate protection such as shin guards. Bruising is common and some types of EDS are associated with haematoma formation with management including compression bandages and consideration of pharmacological therapy. Skin fragility and tears should be managed with a focus on protection of remaining tissue, avoidance of wound tension and low adherence dressings to avoid further injury. This paper provides clear recommendations to address skin management for this group of patients. It highlights the lack of good quality published data to support treatment decisions.

Enhanced recovery after fetal spina bifida surgery: what is our global practice?

Prenatal spina bifida closure results in improved outcomes for the child compared to postnatal surgery but is associated with significant maternal morbidity. Optimization of the perioperative care for women who underwent fetal spina bifida surgery could improve maternal and pregnancy outcomes. Enhanced Recovery After Surgery (ERAS) protocols are multimodal, evidence-based care plans that have been adopted for multiple surgical procedures to promote faster and better patient recovery and shorter hospitalization. This study aims to explore if fetal centers have implemented ERAS principles in this setting. Furthermore, we provide recommendations for the perioperative management of patients undergoing fetal spina bifida surgery. Fifty-three fetal therapy centers offering prenatal surgery for open spina bifida were identified and invited to complete a digital questionnaire covering their pre-, intra- and postoperative management. An overall score was calculated per center based on the center's compliance with 20 key ERAS principles, extrapolated from ERAS guidelines for cesarean section, gynecologic oncology and colorectal surgery. Each item was scored 1 or 0 when the center did or did not comply with each principle, with a maximum score of 20. The questionnaire was completed by 46 centers in 17 countries (response rate 87%). Twenty-two centers (48%) exclusively perform open fetal surgery (laparotomy and hysterotomy), whereas 14 (30%) offer both open and fetoscopic procedures and 10 (22%) use fetoscopy only. The perioperative management of patients undergoing fetoscopic and open surgery was highly similar. The median ERAS score was 12 (mean 12.5, SD 2.4, range 8-17). Center compliance was the highest for the use of regional anesthesia (98%), avoidance of bowel preparation (96%), and thromboprophylaxis (96%), while the lowest compliance was achieved for preoperative carbohydrate loading (15%), postoperative nausea and vomiting prevention (33%), avoidance of overnight fasting (33%) and a 2-hour fasting period for clear fluids (20%). ERAS scores were similar in centers with a short (2-5 days), medium (6-10 days) and long (≥11 days) hospital stay (12.8 ± 2.4, 12.1 ± 2.0, and 10.3 ± 3.2, respectively, p=0.15). Furthermore, there was no significant association between ERAS score and surgical technique or center volume. The perioperative management of fetal spina bifida surgery is highly variable across fetal therapy centers worldwide. Standardizing protocols according to ERAS principles may improve patient recovery, reduce maternal morbidity, and shorten hospital stay after fetal spina bifida surgery. This article is protected by copyright. All rights reserved.

Use of the OSCAR-Fusion v1.4.a code for a preliminary assessment of the ACP contamination within the main ITER water cooling circuit

Abstract One of the main objectives of ITER is to produce 500 MW of power from a D-T plasma for several seconds. This goal presents two inherent challenges: firstly, in-vessel components will require active cooling to remove the heat coming from the fusion reaction (i.e., mainly fast neutrons and alpha particles). Secondly, the materials exposed to the neutron flux will yield activated corrosion products (ACPs) in all primary cooling circuits of ITER. From a safety point of view, ACPs are one of the contributors to the Occupational Radiological Exposure (ORE), they represent a source of radiological waste and also contribute to the source term for accidental scenarios involving the loss of primary confinement. &amp;#xD;Therefore, ACPs assessment is key to estimate radiological impact for nuclear workers and the public. ITER nuclear safety engineers adopted OSCAR-Fusion v1.4.a code to assess the ACPs inventory in the Integrated Blanket ELMs and Divertor (IBED) cooling loop. This paper describes the selection of input data, the modelling of the circuits and the operational scenarios used in OSCAR-Fusion calculations. This study also examines the outcomes of such calculations, notably in terms of ACPs inventory, emphasizing the impact on the ORE and highlighting its driving parameters. Furthermore, this paper provides recommendations for better ACPs management in the context of the ITER project and in accordance with the ALARA principle&amp;#xD;

Case report: Chronic disseminated intravascular coagulopathy with concurrent paraneoplastic secondary hyperfibrinolysis in a dog with metastatic nasal adenocarcinoma

In human medicine, hemostatic disorders such as thrombocytopenia, hyperfibrinolysis, and disseminated intravascular coagulopathy (DIC) have been associated with many cancers. Acute hemorrhage secondary to hyperfibrinolysis has been predominantly reported with prostatic adenocarcinoma in human patients. To the author’s knowledge, severe bleeding due to paraneoplastic hyperfibrinolysis has not yet been reported in veterinary medicine. The case involves an 8-year-old neutered male Border Collie who was evaluated for progressive and recurrent epistaxis, having a history of 1 year of treatment for metastatic nasal adenocarcinoma. A progressive and severe coagulopathy thought to be related to the known cancer was diagnosed. Advanced coagulation testing was consistent with a chronic DIC and secondary hyperfibrinolysis. Throughout 1 week of hospitalization, the dog was treated with multiple blood products, vitamin K1, and anti-fibrinolytic medications. While the dog was initially discharged home, the dog re-presented the following day and was humanely euthanized due to a perceived poor quality of life. Post-mortem analysis revealed a histopathologic diagnosis of disseminated adenocarcinoma. In dogs with disseminated nasal adenocarcinoma that are experiencing severe bleeding, paraneoplastic secondary hyperfibrinolysis should be considered as a differential. Knowing this association could help guide treatment recommendations for optimal patient management.

Effect of Liquidity and Company Size on Company Value of Food and Beverage Companies Listed in The Indonesia Effects Secretary for The Period 2018-2022

The phenomenon occurring in Food and Beverage (F&amp;B) companies listed on the Indonesian Stock Exchange (IDX) reflects the broader development of the F&amp;B industry in Indonesia. This research aims to provide an overview of the condition of the F&amp;B industry in Indonesia by examining the impact of liquidity and company size on firm value. This quantitative and associative study utilizes non-participant observation to collect data from the official IDX website (www.idx.co.id) and relevant company websites, focusing on financial reports for analysis. The population consists of F&amp;B companies listed on the IDX from 2018 to 2022. Using purposive sampling, 29 companies were selected, resulting in a total of 145 observations over five years. Data analysis was conducted using the E-Views application. The results indicate that both liquidity and company size have a positive and significant effect on firm value. Recommendations for company management include optimizing inventory to ensure smooth operations and minimizing storage costs. Investors are advised to consider liquidity ratios, such as the current ratio and quick ratio, to assess a company's ability to meet short-term obligations. Future research should incorporate additional variables such as leverage, capital structure, and governance, employing both qualitative and quantitative approaches to gain a deeper understanding of these relationships. Comparing results across different contexts can also enhance understanding.

Green HRM fostering followers' green creativity: Unfolding the role of environmental concern and employee engagement with eco‐initiatives as a serial mediation

Recent literature in environmental management implies that employee behaviour is imperative for improving environmental sustainability. Despite this, little effort has been made into how human resource management (HRM) relates to green creativity. This research aims to examine if an organization's green HRM (GHRM) practices can foster green creativity among manufacturing sector employees through the serial mediation path of environmental concerns and employee engagement with environmental initiatives, using self‐determination theory (SDT). To conduct this research, we collected and analysed data from 309 employees of manufacturing firms in Pakistan using partial least square structural equation modelling (PLS‐SEM). The results supported a positive relationship between GHRM and green creativity and the role of environmental concern and employee engagement with environmental initiatives in mediating that relationship. Likewise, the findings indicated that the relationship between GHRM and green creativity would strengthen as employees become more environmentally concerned. Overall, this study contributes to the literature on HRM and environmental management by providing new insights into the critical role of GHRM in fostering green creativity. Using SDT as a foundation, this research provides theoretical and practical contributions and implications and valuable recommendations for scholars and managers in the manufacturing sector.