Management Tool Research Articles

Effect of a Bacillus subtilis plus Yeast Cell Wall Synbiotic on Salmonella Enteritidis Colonization in Ceca of Layer Pullets

Salmonella Enteritidis (SE) is a major contamination concern in eggs and risk for Salmonellosis in humans. Strains of Bacillus subtilis and yeast cell wall can be used as substitutes for antibiotic substances in feed against Salmonella in poultry. The objective of this study was to assess the effect of BacPack® (Quality Technology International, Inc., Elgin, IL, USA) Q1+1 (BPQ11), a feed additive combination of a Bacillus subtilis strain and Saccharomyces cerevisiae cell wall, on SE cecal colonization in Lohmann LSL pullets. A control group (CON) and a test group (BPQ) were each randomly assigned 100-day-old chicks. CON was fed a corn–soybean meal-based vegetarian mash diet, and BPQ was fed the control diet supplemented with BPQ11 for the duration of the study. At 8 days of age, chicks were orally challenged with a nalidixic acid-resistant SE strain at a dose of 6.3 × 107 colony forming units (CFUs) per bird. At 7, 11, 15, and 19 days post-challenge (DPC), 25 birds per group were euthanized, and their cecal contents were collected and analyzed for SE. SE counts were 6.88, 7.98, 7.79, and 7.50 in CON and 7.18, 7.31, 6.35, and 6.30 log10 CFU/g in BPQ at 7, 11, 15, and 19 DPC, respectively. SE did not differ between CON and BPQ at 7 DPC; however, BPQ had lower (p < 0.0001) SE at 11 (−0.67), 15 (−1.45), and 19 (−1.20 log10 CFU/g) DPC. Results indicate that synbiotic BPQ11 may be a useful dietary pre-harvest tool for SE management in layer birds.

The Advent of the 2023 “BBNJ” Agreement: A Preliminary Legal Analysis

On 4 March 2023, the Member States of the United Nations agreed in New York on the text of a new treaty on biodiversity in areas beyond national jurisdiction (BBNJ or ABNJ) –in international maritime areas. It took marathon process spread over more than ten years of informal discussions, four years of formal negotiations and the final session of almost 36 hours. Rena Lee, the President of the intergovernmental conference, announced to the applause of the delegates that the ship had finally “reached the shore”. This new BBNJ Agreement, now signed by more than 80 countries, is a historic step for the conservation and sustainable use of marine biodiversity of areas beyond national jurisdiction. It is also in consonance with the objectives of the global Kunming-Montreal Biodiversity Framework adopted at CBD COP15 in December 2022. This article aims to provide a preliminary analysis of the environmental (preamble, principles and approaches, area-based management tools and environmental impact assessments) and economic (marine genetic resources, capacity building and transfer of marine technologies) content of the 2023 BBNJ Agreement, which are both the result of important compromises. It also seeks to underline the numerous remaining uncertainties and potential difficulties it raises, especially in terms of implementation and articulation with existing instruments and frameworks.

Be Happy, Be Loyal? Exploring Drivers for Renewal of Mobile-Delivered Index Insurance

Agricultural microinsurance is a promising risk management tool for smallholder farmers. However, adoption rates remain low and only a small share of farmers renew their policy after the first period. With the increasing availability of cell phones, mobile-delivered insurance is gaining importance on the market. As for any agricultural microinsurance, it is essential for the longevity of a mobile-delivered insurance scheme to retain a solid customer base. To date, it is unknown what drives the decision to renew a mobile-delivered agricultural microinsurance policy. We address this question by performing mean comparisons and logistic regressions based on primary data collected from 479 smallholder farmers in Mali who purchased a mobile-delivered weather index-based insurance in 2020. Results show that the level of satisfaction with the insurance product was considerably higher among farmers who renewed. We found low levels of understanding of the product among all clients, but especially among those who did not renew. Both factors were confirmed as drivers for renewal. Consistent with previous findings, receiving a payout had the strongest effect on the decision to renew. We conclude that additional measures to foster client satisfaction as well as to promote understanding of agricultural insurance among smallholder farmers are highly recommended.

Choice of tools of anti-crisis management at industrial enterprises of Ukraine

The relevance of the research of the tools of anti-crisis management at domestic enterprises and the prerequisites for its optimization in conditions of systemic financial and economic crisis and military conflict are substantiated. The structure of the anti-crisis management system and peculiarities of choosing the anti-crisis management toolkit are defined, which includes tools for identifying the crisis at the enterprise, tools for developing anti-crisis management decisions and tools for assessing the effectiveness of adopted anti-crisis management decisions. It is substantiated that the concept of anti-crisis management determines the relationship between the components of the "reactive" and "preventive" character in the anti-crisis management system, the role and place of the anti-crisis component in the general strategy of enterprise management. The concept of crisis management should take into account such features of the enterprise as: size, industry, methods of capital formation, stage of the life cycle of the enterprise, types of production and financial strategy, market position, types of risks inherent in this enterprise. The tools of crisis management at the enterprise are investigated within two large groups: diagnostic methods and methods aimed at overcoming the crisis. The tools of crisis management are considered in terms of the stages of crisis at the enterprise. The priority of preventive measures in the anti-crisis management system has been determined. The model of anti-crisis management tools is proposed taking into account the factors of crisis, stages of crisis, tasks of anti-crisis management at the enterprise. Therefore, during the study, stages, crisis factors, the structure of the crisis management toolkit, which includes both tools for diagnosing the crisis state at the enterprise and directly tools for overcoming the crisis, which can be the basis for optimizing the crisis management system at the enterprise, are determined.

Stress and primary headaches – Mindfulness-Based Stress Reduction (MBSR) as a novel avenue for treatment

Introduction: In today's fast-paced life, an increasing number of people are experiencing chronic stress, which negatively impacts our mental and physical health, leading to troublesome conditions such as primary headaches. Faced with this challenge, more individuals are turning their attention to mindfulness techniques as an effective tool for stress management. In light of this, mindfulness, focusing on the awareness of the present moment, emerges as a promising method for preventing and alleviating stress-induced headaches and the resulting aftermath. 
 Purpose: Offer a comprehensive overview of the current understanding of the efficacy of mindfulness training, particularly Mindfulness-Based Stress Reduction (MBSR), in the prevention and relief of primary headaches and their associated consequences. 
 Description of the state of knowledge: MBSR demonstrates the potential for effectively coping with stress-induced headaches and their subsequent effects, including disability related to headaches. This category of pain includes conditions like migraine and tension-type headaches. In the clinical trials conducted thus far participants in the MBSR program show noticeable improvement in headache-related disability, self-efficacy, quality of life, catastrophic pain, and depression scores. 
 Summary: Studies suggest that integrating mindfulness training could present a promising strategy for preventing and reducing the severity of primary headaches and their consequences, by mitigating stress, a crucial factor influencing the onset of these headaches. To validate these promising findings, further randomized, large-scale, placebo-controlled studies are required.

Effects of European eel egg and larval stocking density on rearing water, offspring bacteriome and derived immune response

If human exploitation of the “critically endangered” European eel (Anguilla anguilla) is to continue, the eel's life cycle in captivity must be closed and techniques established to produce viable offspring in hatcheries. Despite stable offspring production, high mortality rates during early developmental stages have hindered progress in closing the lifecycle in captivity. We hypothesised that mortalities affecting embryos and newly hatched larvae, when the immune system is expected to play a vital role in protecting the offspring, could be linked to adverse microbial conditions arising in high-density rearing. We therefore set out to explore the bacteriome changes in rearing water and offspring as well as the molecular immunologic development of offspring at different initial stocking densities (500, 1000, 2000, and 4000 eggs/L) from fertilisation to 3 days post-hatch (dph). The lowest density resulted in ∼5% higher survival. Independent of density, most mortality (∼75%) occurred during embryonic rather than larval development. The bacteriomes of both offspring and rearing water differed according to stocking density, with a potentially healthier bacteriome at the lowest density, marked by greater ASV richness and abundance from various phyla (Proteobacteria, Actinobacteria, Fusobacteria, and Firmicutes). In contrast, the bacteriome of the highest density was dominated by Proteobacteria ASVs, including the potentially harmful Vibrionales order. We observed stage-specific bacteriome changes in offspring, transitioning from an inherent and balanced bacteriome in unadulterated eggs to a dominance of rapid-growing opportunistic bacteria in embryos (48 hpf), and finally to a more diverse bacterial community in larvae (3 dph). Thus, host-microbe interactions appear to significantly impact the overall high mortality observed during embryonic development. As the expression of stress and immune related genes was not affected by density, it seems that the molecular immune system was incapable of handling microbial interference during these early stages, aggravating the challenges faced during hatchery production. We conclude that low-density (500 eggs/L) incubation is a valid strategy to improve survival. However, high stocking densities (up to 4000 eggs/L) might be an acceptable compromise allowing more efficient utilisation of infrastructure and labour. At 4000 eggs/L, survival was reduced by only ∼5%, while there was no effect on hatching success and no cellular stress response. Nevertheless, bacterial community management tools should be in place during high-density incubation to avoid r-selection and thus counter bacteria-associated mortality.

On the issue of state property management in the agro-industrial complex of the Republic of Belarus

In the Republic of Belarus, a decentralized system of ownership supervision has been formed, when shares are managed by ministries, concerns, and committees that were in charge of state-owned en-terprises before their transformation into joint-stock companies. In addition to the sectoral system, there are centralized and dual systems, which are actively used by our key foreign trade partners — the Russian Federation and the People’s Republic of China. Currently, in the agro-industrial com-plex of the Republic of Belarus there is a high share of state-owned enterprises and organizations with a state share in the authorized capital. An analysis of the state share of ownership in the author-ized capital of OJSC shows that in agricultural organizations in recent years it has consistently been in the range of 70–80 %, and in industrial and service organizations — 40–50 %. At the same time, the operating effi ciency of many JSCs is not at a high enough level, which predetermines the need and importance of improving management tools for enterprises and organizations, including owner su-pervision. The article substantiates promising directions for improving owner’s supervision, including: organizational — the transition from an industry-based to a centralized model of organizing owner’s supervision in the agro-industrial complex; economic — development of the corporate governance system in business companies; administrative and economic — development of a methodology for assessing the effectiveness of state property management in the agro-industrial complex. The use of the results of the proposed study is aimed at improving owner supervision and will improve the efficiency of functioning of business entities of the agro-industrial complex of the Republic of Belarus.

Pragmatic phase II clinical trial to improve depression care in a real-world diverse MS cohort from an academic MS centre in Northern California: MS CATCH study protocol

IntroductionDepression occurs in over 50% of individuals living with multiple sclerosis (MS) and can be treated using many modalities. Yet, it remains: under-reported by patients, under-ascertained by clinicians and under-treated....

Salvia officinalis L. exerts oncostatic effects in rodent and in vitro models of breast carcinoma.

Introduction: Based on extensive data from oncology research, the use of phytochemicals or plant-based nutraceuticals is considered an innovative tool for cancer management. This research aimed to analyze the oncostatic properties of Salvia officinalis L. [Lamiaceae; Salviae officinalis herba] using animal and in vitro models of breast carcinoma (BC). Methods: The effects of dietary administered S. officinalis in two concentrations (0.1%/SAL 0.1/and 1%/SAL 1/) were assessed in both syngeneic 4T1 mouse and chemically induced rat models of BC. The histopathological and molecular evaluations of rodent carcinoma specimens were performed after the autopsy. Besides, numerous in vitro analyses using two human cancer cell lines were performed. Results and Conclusion: The dominant metabolites found in S. officinalis propylene glycol extract (SPGE) were representatives of phenolics, specifically rosmarinic, protocatechuic, and salicylic acids. Furthermore, the occurrence of triterpenoids ursolic and oleanolic acid was proved in SPGE. In a mouse model, a non-significant tumor volume decrease after S. officinalis treatment was associated with a significant reduction in the mitotic activity index of 4T1 tumors by 37.5% (SAL 0.1) and 31.5% (SAL 1) vs. controls (set as a blank group with not applied salvia in the diet). In addition, salvia at higher doses significantly decreased necrosis/whole tumor area ratio by 46% when compared to control tumor samples. In a rat chemoprevention study, S. officinalis at a higher dose significantly lengthened the latency of tumors by 8.5 days and significantly improved the high/low-grade carcinomas ratio vs. controls in both doses. Analyses of the mechanisms of anticancer activities of S. officinalis included well-validated prognostic, predictive, and diagnostic biomarkers that are applied in both oncology practice and preclinical investigation. Our assessment in vivo revealed numerous significant changes after a comparison of treated vs. untreated cancer cells. In this regard, we found an overexpression in caspase-3, an increased Bax/Bcl-2 ratio, and a decrease in MDA, ALDH1, and EpCam expression. In addition, salvia reduced TGF-β serum levels in rats (decrease in IL-6 and TNF-α levels were with borderline significance). Evaluation of epigenetic modifications in rat cancer specimens in vivo revealed a decline in the lysine methylations of H3K4m3 and an increase in lysine acetylation in H4K16ac levels in treated groups. Salvia decreased the relative levels of oncogenic miR21 and tumor-suppressive miR145 (miR210, miR22, miR34a, and miR155 were not significantly altered). The methylation of ATM and PTEN promoters was decreased after S. officinalis treatment (PITX2, RASSF1, and TIMP3 promoters were not altered). Analyzing plasma metabolomics profile in tumor-bearing rats, we found reduced levels of ketoacids derived from BCAAs after salvia treatment. In vitro analyses revealed significant anti-cancer effects of SPGE extract in MCF-7 and MDA-MB-231 cell lines (cytotoxicity, caspase-3/-7, Bcl-2, Annexin V/PI, cell cycle, BrdU, and mitochondrial membrane potential). Our study demonstrates the significant chemopreventive and treatment effects of salvia haulm using animal or in vitro BC models.

Transport, dispersion, and degradation of nonpoint source contaminants during flood‐managed aquifer recharge

AbstractIn water‐stressed regions of the world, the inundation of working landscapes to replenish aquifers—known as flood‐managed aquifer recharge (flood‐MAR)—has become a valuable tool for sustainable groundwater management. Due to their diverse land use histories, however, many potential recharge sites host nonpoint source contaminants (such as salts, pesticides, and fertilizers) within the vadose zone that may flush to groundwater during recharge operations. To identify the controls on contaminant migration, we perform stochastic simulations of flood‐MAR through a heterogeneous alluvial aquifer and apply transient particle tracking to evaluate conservative and reactive contaminant transport over 80 years of recharge operations. With semi‐annual recharge events, the water table begins to rise 0.13–1.84 years after the first inundation event while solutes take much longer (11 to 80 years) to transit the 45‐m thick unsaturated zone. We derive a parametric expression for the ratio of celerity (or rate of pressure transmission) to velocity of the flood‐MAR wetting front and show that this simplified expression agrees with values calculated from heterogeneous model simulations. Slow solute velocities (0.25–1.75 m year−1) allow for significant contaminant removal through denitrification, but the contaminant plume experiences minimal dispersion or dilution over this time, reaching the water table as a sharp front. Our results suggest that minimizing groundwater velocity and maximizing groundwater celerity during flood‐MAR should optimize increases in water supply while limiting water quality degradation.

Designing a Sustainability Assessment Framework for Peruvian Manufacturing Small and Medium Enterprises Applying the Stakeholder Theory Approach

Among the main obstacles affecting the competitiveness of Peruvian Small and Medium Enterprises (SMEs) are poor strategic planning and incipient use of management control systems that support the integration of sustainable practices for the growth of the organization. Not considering sustainability in the strategy and management control systems of Peruvian SMEs can jeopardize their stability and growth, as they are part of the supply chain of large companies that look for suppliers that comply with sustainability standards. Since manufacturing SMEs play a vital role in the economies and social welfare of countries, providing them with appropriate management tools to evaluate the sustainable performance of their activities is urgent to assure their survival. Thus, the aim of this study is to design a holistic sustainability assessment framework that enables Peruvian manufacturing SMEs to evaluate the full integration of sustainability into their business strategy and the creation of value for each stakeholder. Based on the gaps found in the literature review, a conceptual assessment framework was designed, then a multiple-case study was conducted in three Peruvian manufacturing SMEs in the plastic sector, and the data obtained were used to deploy the proposed conceptual assessment framework.

The prediction and analysis of heart disease using XGBoost algorithm

Heart diseases remain a global health concern, with their intricate aetiology and multifactorial risk factors making early diagnosis challenging. Recognizing the pressing need for accurate prediction tools, this research ventured into harnessing the power of machine learning, notably the Xtreme Gradient Boosting (XGBoost) algorithm, to fill this gap. The main object is to devise a robust predictive framework capable of early and accurate identification of heart disease. Specifically, our methodology unfolded systematically, beginning with data preprocessing, then delving into incisive feature selection, rigorous model training, and finally, thorough evaluation. This study is meticulously conducted on the heart.csv dataset, a comprehensive repository of cardiovascular data points. The experimental outcomes were nothing short of revelatory. Not only did the XGBoost model manifest superior performance metrics, but its precision also outpaced several contemporary models referenced in existing literature. Ultimately, our findings underscore the profound potential of the XGBoost algorithm in heart disease predictions. Beyond academic intrigue, this research holds tangible implications for healthcare practitioners, potentially offering a novel tool for early interventions and patient management.

Digital resilience framework for managing crisis: A qualitative study in the higher education and research sector

AbstractAustralia's Higher Education and Research Sector (HERS) must adopt digital resilience strategies to tackle cybersecurity challenges and manage major crises effectively. In this study, we have developed a digital resilience framework to mitigate these cybersecurity issues. Our findings suggest a range of keystone factors for crisis management, such as implementing cybersecurity awareness programmes, providing cyber support, redefining roles and responsibilities, implying risk management tools, partnerships with external security organizations, introducing policies, reconfiguring technologies, adopting new technologies, and evaluating current changes to combat these issues. These keystone factors will help achieve digital resilience and significantly minimize cybersecurity issues in HERS, not only during the current major crisis but also in the future. This research offers valuable theoretical and practical contributions that can be applied beyond the context of the recent crisis.

HyFish: hydrological factor fusion for prediction of fishing effort distribution with VMS dataset

Predicting fishing effort distribution is crucial for guiding fisheries management in developing effective strategies and protecting marine ecosystems. This task requires a deep understanding of how various hydrological factors, such as water temperature, surface height, salinity, and currents influence fishing activities. However, there are significant challenges in designing the prediction model. Firstly, how hydrological factors affect fishing effort distributions remains unquantified. Secondly, the prediction model must effectively integrate the spatial and temporal dynamics of fishing behaviors, a task that shows analytical difficulties. In this study, we first quantify the correlation between hydrological factor fields and fishing effort distributions through spatiotemporal analysis. Building on the insights from this analysis, we develop a deep-learning model designed to forecast the daily distribution of fishing effort for the upcoming week. The proposed model incorporates residual networks to extract features from both the fishing effort distribution and the hydrological factor fields, thus addressing the spatial limits of fishing activity. It also employs Long Short-Term Memory (LSTM) networks to manage the temporal dynamics of fishing activity. Furthermore, an attention mechanism is included to capture the importance of various hydrological factors. We apply the approach to the VMS dataset from 1,899 trawling fishing vessels in the East China Sea from September 2015 to May 2017. The dataset from September 2015 to May 2016 is used for correlation analysis and training the prediction model, while the dataset from September 2016 to May 2017 is employed to evaluate the prediction accuracy. The prediction error ratio for each day of the upcoming week range is only 5.6% across all weeks from September 2016 to May 2017. HyFish, notable for its low prediction error ratio, will serve as a versatile tool in fisheries management for developing sustainable practices and in fisheries research for providing quantitative insights into fishing resource dynamics and assessing ecological risks related to fishing activities.

Managerial aspects in macro social work education: comparative analysis between MSW macro programs and nonprofit management education

ABSTRACT The aim of this study is to evaluate the scope of management education within macro social work programs in the U.S. and to contrast this with similar nonprofit management education programs across various disciplines. This comparison aims to shed light on the strengths and weaknesses of management education in social work programs. For this purpose, a thorough list of macro-focused MSW degree programs in the U.S. was compiled using the CSWE database. We examined 521 courses from 86 MSW programs with a macro focus. These courses were analyzed and their content compared with that of nonprofit management education programs in other fields. Our findings reveal that while MSW programs in macro practice emphasize personal and interpersonal management skills, they often overlook crucial management tools like fundraising, marketing, philanthropy, and economics. Consequently, it is recommended that social work educators acknowledge the critical managerial competencies needed in social work agencies and incorporate a broader range of subjects to better equip future leaders in the field.

"Are all referrals necessary?" Experiences and perceptions of maternity healthcare providers on emergency intrapartum referrals in Dar es Salaam, Tanzania.

Intrapartum continuity of care to reduce maternal morbidity and mortality relies heavily on a functional and effective referral system between tiers of care. Capacity building of providers in managing intrapartum referrals is expected to improve the efficiency of the referral system, but this does not always work in practice. This study explored the experiences and perceptions of maternity healthcare providers on emergency intrapartum referrals in Dar es Salaam, Tanzania. An exploratory qualitative study was conducted at Amana Regional Referral Hospital and Muhimbili National Hospital in Dar es Salaam. Maternity healthcare providers were purposively recruited based on cadre, working experience of more than three years in the maternity wards. An in-depth interview guide which involved questions and probes was used to conduct eleven interviews. Data was thematically analyzed. Three major themes emerged, namely: 1) causes of referrals are beyond medical indications; 2) limited maternity healthcare provider capability at referring facilities; and 3) limited communication between referring and receiving facilities. According to maternity healthcare professionals, referrals were seen as a way to minimize blame and a clinical management tool to prevent difficulties. They advocated for more understanding of the skill set among maternity healthcare providers, but some had negative perceptions towards performing their responsibilities. Skills gaps among maternity healthcare providers at referring hospitals influenced referral decision-making and service provision. There was hostility between referring and receiving hospitals. Capacity-strengthening strategies such as ongoing skills training and changes in attitudes toward referrals require improvements. The referring hospital should only consider referrals as a last resort after other case management has been completed.

Regional Anesthesia in the Austere Environment: Lessons Learned from Current Out-of-Hospital Practice.

Pain management for trauma in the extreme environment is vital for both casualty comfort and aiding safe extrication. However, adequate pain management in a resource-limited environment can be challenging and is often limited. We conducted a scoping review of the use of regional anesthesia in the prehospital environment, evaluating which regional anesthetic procedure was performed for various indications, their efficacy, and the type of healthcare provider delivering the anesthetic. A PRISMA-guided systematic literature review was conducted of Medline, Embase, and Cochrane databases for studies reporting the use of regional anesthesia in the prehospital environment published before June 30, 2022. Thirty studies met the criteria and were included in the review. The most common types of regional anesthesia were fascia-iliaca compartment block (n = 317, from 12 studies) and femoral nerve block (n = 210, from 8 studies), along with various other blocks for a range of indications. These blocks had good efficacy and a low-risk profile and could be delivered by a wide range of healthcare providers. Regional anesthesia is an effective and non-resource-heavy pain management tool in prehospital environments, which may be applicable to austere settings. It can cover a wide range of injuries and can avoid systemic complications for casualties that may already be challenging to manage in out-of-hospital settings. Additionally, regional anesthesia can be effectively delivered by a wide range of providers. This review provides a holistic summary of pain management using regional anesthesia in the prehospital environment, with a discussion on its potential use in more extreme settings.

Insecticidal activity against rice pest of oxazosulfyl, a novel sulfyl insecticide.

The development and commercialization of new chemical classes of insecticides are important for efficient crop protection, particularly for combatting insecticide resistance and providing sustainable agricultural production. This study reports on oxazosulfyl, a novel "sulfyl" class of insecticide, against a wide range of insect pests of rice. In the laboratory assay, oxazosulfyl showed insecticidal activity against all developmental stages of the brown planthopper Nilaparvata lugens (Stål). Phosphor imaging assays and soil drench bioassays demonstrated good systemic distribution in rice plants. Oxazosulfyl showed insecticidal activity against imidacloprid- and fipronil-resistant field populations of N. lugens, the white-backed planthopper Sogatella furcifera (Horváth), and the small brown planthopper Laodelphax striatellus (Fallén), as well as the respective susceptible strains. No cross-resistance was observed among oxazosulfyl, imidacloprid, and fipronil. Oxazosulfyl with a wide insecticidal spectrum is a potentially useful pest management tool for sustainable rice production.

Prevalence and predictors of hypercoagulability detected by rotational thromboelastometry in peritoneal malignancy patients undergoing cytoreductive surgery

Background: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is an established treatment for peritoneal malignancy. A hypercoagulable state in these patients and the associated risk of venous thromboembolism (VTE), remains the most common cause of 30-day mortality. This study aimed to evaluate the prevalence and perioperative factors associated with baseline hypercoagulability detected by rotational thromboelastometry (ROTEM), a point-of-care haemostatic assay, in peritoneal malignancy patients. Methods: A retrospective cohort study was performed in a peritoneal malignancy unit on patients undergoing CRS between 2019 and 2023, who underwent preoperative ROTEM testing. Patients were divided into group A (hypercoagulable) and Group B (normal coagulation). Baseline characteristics, pathology results, operative details and post operative outcomes were reviewed. Univariate and multivariate analysis were used to identify factors associated with baseline hypercoagulability. Results: The 70 patients were included, 23 patients in group A (32.9%) and 47 patients in group B (67.1%). Group A had a lower preoperative haemoglobin (p<0.001), higher platelet count (p<0.001) and median peritoneal carcinomatosis index (33 vs 10, p=0.003). Appendiceal primary was associated with hypercoagulability (47.8% vs 23.4%, p=0.039). Group A required more intraoperative transfusion with red blood cells (p=0.014) but not platelets (p=0.6) or cryoprecipitate (p=0.8). Although group A had a higher incidence of VTE events (30.4% vs 23.4%) this was not statistically significant. Conclusions: Baseline hypercoagulability exists in one-third of patients with peritoneal malignancy and was associated with increased tumour burden and appendiceal primary. The increasing use of ROTEM is a valuable tool for perioperative management of complex peritoneal malignancy patients.

Eliminating Non-Value-Added Activities and Optimizing Manufacturing Processes Using Process Mining: A Stock of Challenges for Family SMEs

Family small and medium enterprises (FSMEs) differ from non-family SMEs regarding leadership type, human resource management practices, innovation orientation, change management, information and communication technology deployment, process maturity, and resource availability. These differences present challenges when leading any change. Process mining (PM) tools can optimize process value and eliminate non-added-value activities in FSMEs based on “Event Logs”. The present study investigates how a PM project is implemented in an FSME operating in the agri-food sector, focusing on challenges faced in every project phase to extract the most appropriate process that eliminates all sources of waste and bottleneck cases. Drawing upon the L*Lifecycle methodology combined with quality and lean management tools such as the fishbone diagram, Pareto diagram, and overall equipment efficiency (OEE), this study applied a PM project to a manufacturing process for an FSME operating in the agri-food sector. To achieve theoretical production capacity (TPC) and customer satisfaction, the method was analyzed and optimized using Disco and ProM toolkits. The results analysis using Disco and ProM toolkits gave clues about the organizational and technical causes behind the manufacturing process’s inefficiency. First, OEE showed that the studied FSME is struggling with equipment availability. Then, the implementation of the L*Lifecycle methodology allowed for the identification of five critical causes. An action plan to eliminate causes was proposed to the FSME managers.