Short-term Strategies Research Articles

Human resource management in homecare in England: managing people for safe care during crisis

BackgroundHuman resource management (HRM) of healthcare organisations plays an important role in improving the continuity of care, managing staff, and ensuring patient safety. During COVID-19, there were several HR-related issues, creating a significant challenging situation for health and social care institutions. This study explored the HRM issues that are associated with the patient safety in homecare, and how homecare providers have responded to these HR-related challenges during the COVID-19 pandemic. The aim of this is to explore the role of HRM practices in helping care organisations operate efficiently and supporting their workforce to adapt to future disruptive changes and crises.MethodsQualitative strategies include narrative inquiry involving gathering information in the form of storytelling by the research participants. Between February 2021 and December 2021, data were collected through semi-structured interviews of 31 participants, including homecare staff (homecare transition practitioners, homecare social workers, and carers), family members, and service users in England.ResultsThe research identified key HRM challenges during the pandemic, including staff shortages, high turnover, ineffective communication, occupational stress for front-line carers, and lack of training, all adversely affecting the safety of homecare patients. In response, homecare providers employed strategies like opportunistic recruitment, digital technology for training and communication, and flexible work arrangements to mitigate these issues.ConclusionsSeveral implications are proposed, with the over-riding aim of ensuring effective management of HRM practices in responding to address key areas: staffing, performance management, and training. Homecare providers should utilise short-term adaptive recruitment strategies, while also focusing on long-term workforce development and resilience to effectively respond to current and future care needs. Prioritising staff well-being for retention and care quality are crucial. Homecare providers are encouraged to offer flexible work arrangements and digital communication methods, all while being mindful of preventing technostress and digital exhaustion among their staff. They also need to bridge training gaps and employ effective delivery methods to equip healthcare workers with essential skills, thereby enhancing resilience and adaptability in homecare.

Adaptation to Flooding in St. Augustine, USA

While sea level rise is usually considered as a problem that will be faced in the future, the cumulative effect of decades of slowly rising water levels have meant that many low-lying communities around the planet are already experiencing an increased frequency in tidal flooding. This includes many communities in the United States, such as the city of St. Augustine, in Florida, which has also been devastated by several hurricanes in the early 21st century. The process of how communities will adapt or relocate is notably complicated, and in the present work the authors outline an improved framework that can help to explain the process which individuals undergo as a consequence of individual stressors caused by climate change. Particularly, the feelings of individuals has so far not been studied in detail, and the authors thus conducted a qualitative analysis of the adaptation response by interviewing 20 individuals in two different neighborhoods of St. Augustine, focusing on how “eco-anxiety” might influence them. The results suggest that adaptation countermeasures have been implemented at the city, and sometimes individual level, though community-level strategies have so far been lagging. While short-term adaptation strategies to flooding might be adequate even if individuals are not aware -or deny- long-term climate change, it is unclear whether long-term adaptation by such retroactive approaches might lead to maladaptation practices.

Global strategies to reduce elective surgery waiting times for sustainable health outcomes: a systematic review

ABSTRACT Objective Long waiting times for elective surgery reflect not just backlog issues but systemic inefficiencies that disrupt the smooth flow of patients through the surgical care pathway. This systematic review adopts a holistic approach to summarize global policies, strategies, and interventions aimed at reducing elective surgery wait times. Method A comprehensive electronic search was performed in PubMed, EMBASE, SCOPUS, Web of Science, and Cochrane Library from December 2019 to January 2020 and updated in April 2022. Eligible studies, published after 2013, focused on waiting lists for major elective surgeries in adults, excluding cancer-related surgeries. Both randomized and non-randomized studies and systematic reviews were included. Study quality was assessed using ROBINS-I, AMSTAR 2, and CASP tools, as appropriate. The review was registered in PROSPERO (CRD42019158455) and reported using a PRISMA flow diagram. Results From 7543 records, 92 articles met the inclusion criteria. Evidence was categorized into seven strategic areas: referral management, patient prioritization, preventing scheduled surgery cancellations, perioperative time management, quality improvement methods for surgical care pathways, and waiting time targets for hospitals. Strategies such as referral management, patient prioritization, and preventing cancellations had the most significant impact on reducing waiting times, while perioperative time management and waiting time targets proved less effective. Conclusion The review highlights that targeted interventions at different stages of the surgical care pathway yield variable impacts on overall waiting times. While individual measures had limited effects, combining multiple short-term strategies may be more beneficial, particularly for health systems recovering from the COVID-19 pandemic.

Analisis Strategi Pengembangan Bisnis Menggunakan Bisnis Model Kanvas pada Industri Logistik: Studi PT XYZ

This research analyzes and formulates the business strategy of PT XYZ using the Business Model Canvas to enhance and innovate in the logistics industry. The focus of the study is to identify logistics challenges, analyze the business model, develop business strategies, and provide policy recommendations to improve PT XYZ's competitiveness and operational efficiency. This research incorporates SWOT, PESTLE, and Porter’s Five Forces analyses in evaluating the nine building blocks of the Business Model Canvas. As a result, 26 strategies were developed, consisting of 9 SO strategies, 4 ST strategies, 6 WO strategies, and 6 WT strategies. Through focus group discussions and member checks, 9 priority strategies were identified and categorized into three approaches: short-term, medium-term, and long-term. The short-term strategies include offering competitive pricing packages, adopting innovative technology, and strengthening relationships with business partners. The medium-term strategies emphasize communication integration through social media and improving service quality. The long-term strategies focus on expanding the partner network and building innovative and sustainable partnerships. The implementation of the nine building blocks in the Business Model Canvas demonstrates PT XYZ's comprehensive adaptation to market dynamics and operational challenges, with the ultimate goal of strengthening its market position and supporting the company's sustainable growth.

Assessing the impacts of low-carbon intensity hydrogen integration in oil refineries

This paper evaluates the potential impacts of introducing low-carbon intensity hydrogen technologies in two oil refineries with different complexity levels, emphasizing the role of hydrogen production in reducing CO2 emissions. The novelty of this work lies in three key aspects: Comprehensive system analysis of refinery complexity using real site data, integration of low-carbon Hydrogen technologies, long-term and short-term strategies. Two Colombian refineries serve as case studies, with technological solutions adapted to their complexity levels. The methodology involves evaluating different options for hydrogen production, accounting for improvement in technological efficiency over time.The refinery systems were evaluated in a cost-optimization model built in Linny-r. Three different scenarios were considered, Business-As-Usual (BAU), high, and low-ambitions decarbonization scenarios, focusing on the time horizons of 2030 and 2050.When comparing the two case studies, the preferred decarbonization strategy for both facilities involves the substitution of SMR technology with water electrolyzers powered by renewable electricity. Post-2030, biomass-based hydrogen technology is still a costly alternative; however, to achieve CO2 neutrality, negative emissions storage of biogenic CO2 emerges as an achievable alternative.Our results indicate the achievability of CO2 reduction objectives in both refineries. Our results show that achieving long-term CO2 neutrality requires both refineries to increase renewable electricity production by 5 to 6 times for powering water electrolyzers, steam production by 2 to 2.5 times for CO2 capture, and supply of dry biomass by 2.6 to 4.5 kt/d.The two most significant factors influencing the refining net margin in the decarbonization scenarios are primarily the CO2 and the renewable electricity prices. The short-term horizon emerges as the pivotal period, particularly within the high-ambition decarbonization scenarios. In this context, the medium complexity refinery demonstrates economic viability until a CO2 price of 140 €/t CO2, while the high complexity refinery endures up to 205 €/t CO2.The high complexity refinery is better prepared to face the challenges of decarbonization and the impacts generated on the refining margin. Compared to the BAU scenario, the high complexity refinery shows a negative impact on the net margin that corresponds to a 40 % and 5 % reduction in the short and long term, respectively. Meanwhile, for the medium complexity refinery, the impact on net margin amounts to a 52 % reduction in the short term and a 27 % improvement in the long term.Furthermore, our research highlights the significant potential for reducing CO2 emissions by fully eliminating the use of refinery gas as fuel, providing alternative applications for it beyond combustion.

From Christian Reconstruction to Christian Nationalism: What the Media Need to Know about the 75-Year Effort to Establish Theocracy in the U.S.

ABSTRACT The essay explores Christian Nationalism and makes two intertwined arguments about why it’s difficult to grasp its complexity and far-reaching implications. One argument is that we misunderstand religion, mistakenly accepting simple heuristic categories as being “in the nature of things” rather the products of culture and history. The second, related, argument is that because we don’t see the fluid, constructed, ad hoc character of religion (and other social movements) we fail to account for the long-term strategies of Christian Nationalists. As a result, we are left trying to address the theocratic authoritarian threat Christian Nationalists pose with only short-term crisis-driven strategies. These two arguments are supported with examples and an examination of conservative American protestant strategies that have given rise to Christian Nationalism.

Unifying Effectiveness and Efficiency in Sustainable Supply Chain Management in Automotive: the 21st EWA Edu Model Enhanced by Wholeness Systems Thinking for Lifelong Learning

The contemporary business environment is characterized by VUCA (volatility, uncertainty, complexity, ambiguity), influencing many industries, notably automotive. As humanity encounters the finite constraints of Earth's ecosystems, it becomes imperative for strategic management to transcend mere economic metrics and incorporate environmental and social dimensions. This paper explores the critical role of Wholeness Systems Thinking (WST) in transitioning from traditional Knowledge-based educational frameworks that emphasize a Maximization Mindset to those fostering an Understanding-based, Purposeful mindset in lifelong learning. Employing the sustainable educational model, 21st EWA Edu, this approach cultivates a human capital intellectual capability. Furthermore, the study investigates how this paradigm aids in harmonizing the concepts of effectiveness and efficiency within Sustainable Supply Chain Management (SSCM). The findings indicate that when applied to lifelong learning, this novel intellectual capacity not only refines decision-making processes but also ensures alignment between long-term sustainability objectives and short-term operational strategies in the automotive sector.

Urban travel carbon emission mitigation approach using deep reinforcement learning

The urbanization process has led to a significant increase in energy consumption and carbon emissions, which can be mitigated through scientific urban planning and management. This research proposes a bottom-up urban carbon emission mitigation strategy based on deep reinforcement learning (DRL). Using Ningbo City as a case study, multi-source urban data, including points of interest (POI) data and urban transportation system data, are utilized, along with varying carbon emission coefficients for different travel modes, to construct a comprehensive carbon emission environment for urban areas. The proposed DRL model adopts an Actor-Critic framework, which iteratively optimizes the land use configuration and building type proportions within the urban matrix to achieve the goal of mitigating travel carbon emissions. Experimental results demonstrate that this approach exhibits significant carbon reduction effects in urban scenario. By adjusting the discount rate of the reward function, various optimization strategies can be obtained, such as short-term and long-term strategies, achieving reductions of 0.47% and 0.61%, respectively, which are notably higher than the 0.39% reduction expected if travel emissions were uniformly distributed across the matrix. The findings highlight the potential of DRL-based approaches in urban planning to achieve adaptive and data-driven strategies for carbon emission mitigation.

Evolutionary origins of temporal discounting: Modeling how time and uncertainty constrain optimal decision-making strategies across taxa.

The propensity of humans and non-human animals to discount future returns for short-term benefits is well established. This contrasts with the ability of organisms to unfold complex developmental sequences over months or years efficiently. Research has focused on various descriptive and predictive parameters of 'temporal discounting' in behavior, and researchers have proposed models to explain temporal preference in terms of fitness-maximizing outcomes. Still, the underlying ultimate cause of this phenomenon has not been deeply explored across taxa. Here, we propose an ultimate (i.e., evolutionary) causal explanation for the selection of temporal discounting largely conserved across taxa. We propose that preference for a short-term reward (e.g., heightened impulsivity) often is less than optimal and likely is the product of constraints imposed on natural selection with respect to predicting events in a temporal framework in the context of future uncertainty. Using a simple Newtonian model for time across a fitness landscape in which movement by organisms is only possible in one direction, we examine several factors that influence the ability of an organism to choose a distant reward over a more temporally proximate reward: including the temporal distance of the far reward, the relative value of the distant reward, and the effect of uncertainty about the value and presence of the distant reward. Our results indicate that an organism may choose a more distant reward, but only if it is not too far into the future and has a substantially higher-value fitness payoff relative to the short-term reward. Notably, any uncertainty about the distant reward made it extremely unlikely for an organism to choose the delayed reward strategy compared to choosing a closer reward, even if the distant reward had a much higher payoff because events that are uncertain are only partially visible to natural selection pressures. The results help explain why natural selection is constrained to promote more optimal behavioral strategies and why it has difficulty selecting a distant reward over a lower-value short-term reward. The degree of uncertainty is an especially salient ecological variable in promoting and preferencing short-term behavioral strategies across taxa. These results further help illustrate why, from an ultimate causal perspective, human and non-human taxa have difficulty making more optimal long-term decisions.

Evaluating Patient Rights and Agency: An In-depth Examination of Autonomous Decision-Making in AI-Powered Telemedicine

This study examines the adequacy of regulations concerning consent and patient autonomy in AI telemedicine in Ghana. Using the IRAC (Issue, Rule, Analysis, and Conclusion) method, the research analyzes existing Ghanaian healthcare laws and regulations in the context of AI-driven telemedicine. The study finds significant gaps in the current regulatory framework, including a lack of specific provisions for informed consent in AI telemedicine, unclear guidelines on maintaining patient autonomy, and inadequate addressing of liability issues in AI-assisted healthcare. Recommendations include developing specific AI healthcare legislation, updating existing laws to incorporate AI and telemedicine considerations, establishing AI ethics committees, and implementing short-term mitigation strategies such as interpretive guidelines and enhanced disclosure protocols. The study emphasizes the need for a two-pronged approach: long-term regulatory development and immediate implementation of interim measures to protect patient rights and ensure ethical use of AI in telemedicine.

Short-term interval prediction strategy of photovoltaic power based on meteorological reconstruction with spatiotemporal correlation and multi-factor interval constraints

Short-term photovoltaic (PV) power interval prediction provides a basis for day-ahead power dispatching and generation planning. However, the current gridded numerical weather prediction (NWP) has poor matching in specific PV stations, and the lack of consideration of PV power mutation characteristics and historical correlation in interval prediction, which further limit the improvement of PV power prediction accuracy. In this regard, this paper proposes a novel short-term interval prediction strategy for PV power. Based on the second-order extended hidden Markov model (HMM), the key meteorological elements of the PV station with poor matching are reconstructed. In the interval prediction, the trend mutation and historical correlation characteristics of the PV sequence are fully considered, and a PV power interval prediction method that combines three factors such as trend change, time correlation and numerical mutation is proposed. The proposed method is applied to a PV station in Jilin, China. The results show that compared with other methods, the RMSE of the proposed method is reduced by 5.3 % on average, and the CWC is reduced by at least 2.1 %, which verifies the effectiveness of the proposed method.

Relationship Status Rather than Sociosexuality or Sexual Orientation Predicts Male Sexual Functioning.

Male sexual functioning is a prerequisite for conception and consequently for reproduction and is thus a crucial mechanism from an evolutionary and social perspective. Previous studies reported better sexual functioning in coupled compared to single individuals. However, it is not clear whether sexual functioning increases or decreases with a short-term casual sexual strategy, which is another possibility, along with a long-term strategy. Furthermore, sexual orientation may represent yet another mating strategy that may influence sexual functioning. Here, we aimed to test the possible associations between male sexual functioning and sexual strategies, as measured through sociosexuality, relationship status, and sexual orientation. We hypothesize that due to its relationship with the evolved motivation of mate acquisition and mate retention, both stable relationships and sociosexuality would be positively associated with male sexual functioning. We did not expect significant differences in sexual functioning among men with different sexual orientations. We sampled 427 healthy men of different sexual orientations (203 heterosexuals, 77 bisexuals, and 147 gay men) who completed the Male Sexual Function Index (MSFI) and its subscales of desire, arousal, erection, orgasm, and satisfaction; the Sociosexual Orientation Inventory-Revised; and sociodemographic questions. A multivariate general linear model showed that, compared to single individuals, partnered individuals reported greater MSFI-arousal, MSFI-erection, MSFI-orgasm, and MSFI-satisfaction. Sociosexuality and sexual orientation only weakly predicted MSFI domains. Male sexual functioning thus seems to be moderately associated with a long-term mating strategy and can thus serve for relationship maintenance rather than for acquiring new partners.

Outcomes of Catheter Directed Thrombolysis for Early and Late Re-occlusions in Acute Lower Limb Ischemia.

Acute lower limb ischemia (ALI) is a sudden decrease in arterial limb perfusion due to an arterial blockage, threatening limb and life. Catheter-directed thrombolysis (CDT) is a minimally invasive procedure to remove such obstructions. However, approximately one-third of patients endure a re-occlusion after successful CDT. This study aimed to investigate the short- and long-term outcomes of CDT for early (<1 year) and late (>1 year) re-occlusions. This retrospective multicenter study reviewed patients from 2 medical centers with an acute arterial re-occlusion of the lower limb after successful CDT between December 1996 and April 2021. The primary endpoints were angiographic success, defined as thrombus dissolution over 95% with outflow to at least 1 crural artery, and clinical success, defined as a score of ≥1 on the Rutherford scale for assessing changes in clinical status. Secondary endpoints included bleeding complications, patency, amputation, and mortality. Kaplan-Meier analyses were used to estimate patency, survival, and freedom from amputation. Seventy-seven cases were included, with 52 early re-occlusions (<1 year) and 25 late re-occlusions (>1 year). The median time to re-occlusion since the last CDT treatment was 4 months in the early re-occlusion group and 24 months in the late re-occlusion group. Angiographic success was achieved in 73% of early and 64% of late re-occlusions. Clinical success rates were 80.8% for the early and 80.0% of the late re-occlusion cases. Major bleeding occurred in 2% of the early and 8% of the late re-occlusion group. Patients were followed up until symptoms or signs of limb ischemia were resolved, with a median follow-up time of 15 months for the early and 22 months for the late re-occlusion group. During follow-up, secondary re-occlusions were observed in 59.6% of the early and 44% in the late group. Cumulative amputation rates at 1, 5, and 8 years were 36%, 36%, and 52% for early and 18%, 30%, and 30% for the late re-occlusions, respectively. In our experience, CDT is an effective short-term revascularization strategy for the majority of patients with both early and late re-occlusions. Long-term results are limited by secondary re-occlusions and limb loss. Catheter-directed thrombolysis (CDT) is a well-established treatment for acute lower limb ischemia (ALI). Re-occlusions after successful treatment are, however, observed in almost a third of the patients. Yet, the outcomes of CDT for re-occlusions for patients who were previously treated with CDT are not well known. This study showed that CDT is effective in achieving revascularization in cases of early and late re-occlusion after treatment for ALI, but the risk for further re-occlusions is high. Future studies should focus on maintaining patency after successful CDT for ALI.

An eco-efficient European metal industry transition towards Circular Economy

The European metal industry can minimize carbon and energy intensity through Circular Economy (CE) solutions in order to achieve the Agendas’ 2030; 2050 targets. This paper evaluates the eco-efficiency in 21 European countries using hybrid window data envelopment analysis (WDEA) across two scenarios. The study compares short- and a meso-term policies by choosing different window widths. Inputs include gross fixed capital formation (GFCF), labor force, and energy intensity value added, with value added as desirable output and carbon intensity value added as undesirable output. Results show that the meso-term policy yields an average eco-efficiency of 47%, while the short-term policy achieves 55%, suggesting that short-term strategies are more effective for the metal industry in reaching the Net-Zero goals. Geographically, Western and Northern Europe exhibit better eco-efficiency than Eastern and Southern Europe. In essence, the European metal industry can reach a Net-Zero status through deep CE transformations in energy and carbon intensity via cleaner production.

Optimisation problem of China’s supply chain transportation issues in European logistics

The paper highlights the importance and validity of the research problem: the major consequence for logistics arising from China’s logistics market due to its effective short-term and long-term strategies and developing transportation wholesale. The presented viewpoint helps to clearly understand the international perspective of the vastly enlarging China’s supply chain market due to its strong links with logistics centres. In recent years, much scientific research and studies have been conducted in China and Europe regarding China’s transport evolution era, from the production stage to the physical distribution stage, involving multiple steps until loads are in customers’ hands. The article considers the optimisation problem of a supply chain with multiple periods and diverse means of transportation. The considered problem can be formulated as a dynamic multi-criteria decision-making problem, in which the criteria are minimising the total cost, minimising the carbon footprint, and minimising the average transporting time.

Staying with the Trouble: Commentary on the Knottiness of Knowledge Production in Migration Studies

ABSTRACT In this commentary, I pull out the threads that weave through the eight papers included in this special issue. Key themes untangled include: 1) how researchers maneuver through times of turbulence, 2) the ways in which research is peopled and practiced, 3) the emotional discomforts and ethical dilemmas that come with doing engaged scholarship, 4) the epistemological implications of these messy struggles, and 5) the short-term and long-term strategies offered by the contributors moving forward. I then offer a potentially transformative intervention designed to address systematic barriers related to knowledge production that can create more engaged, impactful scholarship. I conclude with a call to stay with the trouble to ensure more promising futures. The knottiness of knowledge production is present throughout the discussion.

Laboratory Science Workforce Pipeline Strategies

Abstract Introduction/Objective The U.S. Bureau of Labor Statistics projects 24,000 openings for clinical laboratory jobs each year until 2031 (BLS, 2022). The American Society for Clinical Pathology (ASCP, 2023) reported a 14.8% vacancy rate for medical laboratory scientists in the South-Central Atlantic region; this region includes South Carolina. There are not enough MLT or MLS certified laboratorians to keep up with current or future demands. On average, 3779 new certifications were awarded annually between 2019-2023. Pathology and Laboratory Medicine at the Medical University of South Carolina is taking short- and long-term approaches to address workforce challenges. Methods/Case Report Since 2018, Pathology and Lab Medicine has increased the number of clinical affiliates from 2 to 9 and have trained a total of 39 MLS students and 37 MLT students. In 2023, through collaboration with the MLT program at the local technical college, we began providing didactic education for 15 current lab team members with bachelor’s degrees but no clinical laboratory background. Employing youth apprentices is a long-term strategy being initiated in the 24-25 academic year. Juniors and seniors in high school are eligible for a two-year paid apprenticeship. Training includes medical lab assistant and phlebotomy certification. Through recruitment activities, we can increase awareness of the role of laboratory professionals in medicine. Long-term, the apprenticeship training provides an academic pathway to MLT and MLS certification. Results (if a Case Study enter NA) N/A Conclusion The short-term strategies have met with varying success and course corrections have been made. Successes and barriers will be discussed. Strategies for recruiting and selecting youth apprentices will be outlined. Training plans for youth apprentices will be presented.

Short-Term Dual Antiplatelet Therapy After Drug-Eluting Stenting in Patients With Acute Coronary Syndromes

The optimal duration of dual antiplatelet therapy (DAPT) in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI) remains under debate. To analyze the efficacy and safety of DAPT strategies in patients with ACS using a bayesian network meta-analysis. MEDLINE, Embase, Cochrane, and LILACS databases were searched from inception to April 8, 2024. Randomized clinical trials (RCTs) comparing DAPT duration strategies in patients with ACS undergoing PCI were selected. Short-term strategies (1 month of DAPT followed by P2Y12 inhibitors, 3 months of DAPT followed by P2Y12 inhibitors, 3 months of DAPT followed by aspirin, and 6 months of DAPT followed by aspirin) were compared with conventional 12 months of DAPT. This systematic review and network meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The risk ratio (RR) with a 95% credible interval (CrI) was calculated within a bayesian random-effects network meta-analysis. Treatments were ranked using surface under the cumulative ranking (SUCRA). The primary efficacy end point was major adverse cardiac and cerebrovascular events (MACCE); the primary safety end point was major bleeding. A total of 15 RCTs randomizing 35 326 patients (mean [SD] age, 63.1 [11.1] years; 26 954 male [76.3%]; 11 339 STEMI [32.1%]) with ACS were included. A total of 24 797 patients (70.2%) received potent P2Y12 inhibitors (ticagrelor or prasugrel). Compared with 12 months of DAPT, 1 month of DAPT followed by P2Y12 inhibitors reduced major bleeding (RR, 0.47; 95% CrI, 0.26-0.74) with no difference in MACCE (RR, 1.00; 95% CrI, 0.70-1.41). No significant differences were observed in MACCE incidence between strategies, although CrIs were wide. SUCRA ranked 1 month of DAPT followed by P2Y12 inhibitors as the best for reducing major bleeding and 3 months of DAPT followed by P2Y12 inhibitors as optimal for reducing MACCE (RR, 0.85; 95% CrI, 0.56-1.21). Results of this systematic review and network meta-analysis reveal that, in patients with ACS undergoing PCI with DES, 1 month of DAPT followed by potent P2Y12 inhibitor monotherapy was associated with a reduction in major bleeding without increasing MACCE when compared with 12 months of DAPT. However, an increased risk of MACCE cannot be excluded, and 3 months of DAPT followed by potent P2Y12 inhibitor monotherapy was ranked as the best option to reduce MACCE. Because most patients receiving P2Y12 inhibitor monotherapy were taking ticagrelor, the safety of stopping aspirin in those taking clopidogrel remains unclear.

Enhancing Olive Cultivation Resilience: Sustainable Long-Term and Short-Term Adaptation Strategies to Alleviate Climate Change Impacts

Olive cultivation, an icon of Mediterranean agriculture, economy, and cultural heritage, faces significant challenges due to climate change and soil degradation. Climate projections indicate that altered precipitation patterns, rising temperatures, and increased frequency of extreme weather events will adversely affect olive tree growth, fruit quality, and yield. This review provides a novel perspective on addressing these challenges through both long-term and short-term adaptation strategies, emphasizing innovative products, advanced technologies, and practical solutions that must work synergistically and be tailored to regional conditions. Long-term practices refer to proactive strategies for enduring climate resilience, including cover cropping, mulching, soil amendments, and breeding programs which enhance soil health, improve water retention, and increase the trees’ resilience. Short-term strategies focus on immediate impacts, offering immediate stress relief and enhanced plant physiological responses, including optimized irrigation systems, pruning management, particle coating films, biostimulants, and plant growth regulators. The review underscores the importance of aligning agricultural practices with sustainability goals and evolving environmental policies and the education of farmers and policymakers. By integrating adaptive practices and technological advancements, the olive sector can better address climate challenges, contribute to global food security, and advance environmental sustainability.

Étude capacité théranostique 2023–2024 – Modélisation sur la base de la RIV-PSMA. Radiothérapie interne vectorisée (RIV), une approche théranostique à laquelle le patient doit avoir accès. Partie II : analyse approfondie

This in-depth analysis highlights the issues and perspectives regarding the deployment and optimization of vectorized internal radiotherapy (VIR), based on the VIR-PSMA model, which is the first theranostic modality that changes the scale of clinical management in nuclear medicine. It made it possible to confirm a characterization of health establishments based on their experience and their ability to integrate this new treatment modality into their care offering. Here are 8 key points and recommendations highlighted in the following pages: 1. Current and future reception capacity: “experienced” and “initiated” establishments have the greatest short-term reception capacity, while “medium-term future” and “long-term future” establishments will come, in the medium and long term respectively, strengthen the provision of care. They will be able to strengthen the healthcare offer and the territorial network if the award of a B rating allows them to do so. 2. Discrepancy between capacity and need: a gap is already observed between the number of patients who can be treated and the real needs of patients eligible for VIR-PSMA, even though capacity projections are voluntarily restricted to “experienced” and “initiated” services only (the “future” services in the medium and long term are not to date uniform in obtaining the necessary authorizations). This gap between capacity and need can be considered initially by optimizing the use of existing resources (in particular thanks to available land capacity), which remains mainly limited by the shortage of professionals. Secondly, the granting of authorizations to “future” services will make it possible to complete the system, and in particular to promote the regional distribution of care provision which shows disparities that could be sources of inequitable access to care in France. 3. Clinical pathway and harmonization of practices: the clinical pathway for patients benefiting from a VIR requires harmonization of practices and the making of recommendations by the SFMN (from the assessment of eligibility to post-dose monitoring, including the organization of treatments and the reception of patients). 4. Training and recruitment needs: the anticipated growth in demand for VIR requires strengthening teams through the recruitment of all staff involved in the patient's journey, as well as the creation of cooperation protocols between all health professionals by strengthening the initial and continuing training of all professionals involved. 5. Investments and adaptation of infrastructure: significant investments in specialized infrastructure and in the upgrading of “up-and-coming” establishments are necessary to support the increase in VIR-related activity. 6. Define a valuation model allowing these care activities to be sustained while meeting specific constraints in terms of operation, infrastructure, and regulations. 7. Role of regional health agencies (ARS): the ARS play a crucial role in coordinating the deployment of the VIR, requiring adaptation of the offer to local needs and a coherent national policy to face the challenges, particularly in the awarding of B grades, but also by ensuring that the teams of professionals are sufficient and trained and that the service meets logistical and security requirements. 8. Short, medium and long term strategies: to respond to the anticipated saturation of reception capacities, strategic actions are necessary in the short-term (less than 2 years), in the medium-term (less than 5 years), and long-term (more than 5 years), including the structuring of the organization, the expansion of recruitment, the harmonization of practices, and the strengthening of reception capacities.