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Pharmacy-based PrEP service delivery models can help address many of the barriers that inhibit the uptake of PrEP. In an increasing number of states, legislation has been passed, or is under consideration, to allow pharmacists to initiate PrEP without a prescription from a physician or other prescriber. However, there is not yet legislation in Washington, DC to allow pharmacy-based PrEP despite its potential to curb new cases of HIV, which disproportionately affect the Black community in the area. The DC Ends HIV Plan has a goal of less than 130 new cases of HIV per year by 2030, which would require that over 13,000 high-risk residents use PrEP. However, in 2021 only 6,724 Washingtonians were taking PrEP. This study seeks to address the absence of critical formative research into the factors that would influence the implementation of pharmacy-based PrEP in Washington DC using the Implementation Mapping (IM) framework. A needs assessment will be conducted through in-depth interviews (IDIs) with pharmacists (n = 6), PrEP providers (n = 6), current PrEP users (n = 6), DC Department of Health officials (n = 2), DC Board of Pharmacy officials (n = 4) and pharmacy-based PrEP experts (n = 4) to provide input on the operational aspects of pharmacy-based PrEP model as a strategy to increase PrEP uptake. Information gathered through this needs assessment will be used to develop standard operating procedures for the introduction of pilot pharmacy-based PrEP into community-based retail pharmacies. [ABSTRACT FROM AUTHOR]

Abandoned, lost, or otherwise discarded fishing gears, also known as ghost gears (GG), are major contributors to global marine and freshwater plastic pollution. GG can lead to the accidental entanglement of several threatened freshwater and marine species, especially the air-breathing aquatic vertebrates, which is a matter of global concern. There is a lack of know-how and mechanisms for collecting and recycling GG, leading to their constant accumulation in aquatic ecosystems. In this study, we have examined the mortalities of threatened aquatic species in fishing nets and have proposed an incentive-based standard operating procedure (SOP) for effective collection and disposal of GG based on field observations and extant national and international policies and made recommendations for a net buyback scheme as a possible downstream solution to reduce GG in the Ganga River Basin. It is proposed that the collection of GG can be done by the local level institutions of fishing community through the fair-price shops. The nets are then to be deposited at the block-level processing centres to be transported to the district-level consolidating centres. Recycling partners identified by the Government of India will then collect the nets directly from district centres for further upcycling and recycling. A multi-level, multi-stakeholder approach with strong upstream and downstream linkages backed with appropriate policy interventions is needed to tackle the ghost gear issue in the Ganga River basin. [ABSTRACT FROM AUTHOR]

The article provides an overview of the International Society for Pediatric Neurosurgery (ISPN) and its history, highlighting key milestones and achievements over the past 50 years. It discusses the global and diverse nature of the ISPN, emphasizing the importance of collaboration and inclusivity within the organization. The article also delves into recent changes in ISPN's leadership structure and initiatives, such as the ISPN Library, aimed at enhancing educational resources and promoting global outreach. Additionally, it touches on efforts to train pediatric neurosurgeons and offers advice to the younger generation in the field. [Extracted from the article]

Objective: Learning Health Systems (LHSs) have not directly informed evidence‐based policymaking. The Translation‐to‐Policy (T2P) Learning Cycle aligns scientists, end‐users, and policymakers to support a repeatable roadmap of innovation and quality improvement to optimize effective policies toward a common public health goal. We describe T2P learning cycle components and provide examples of their application. Methods: The T2P Learning Cycle is based on the U.S. Department of Veterans Affairs (VA) Office of Research and Development and Quality Enhancement Research Initiative (QUERI), which supports research and quality improvement addressing national public health priorities to inform policy and ensure programs are evidence‐based and work for end‐users. Incorporating LHS infrastructure, the T2P Learning Cycle is responsive to the Foundations for Evidence‐based Policymaking Act, which requires U.S. government agencies to justify budgets using evidence. Results: The learning community (patients, providers, clinical/policy leaders, and investigators) drives the T2P Learning Cycle, working toward one or more specific, shared priority goals, and supports a repeatable cycle of evidence‐building and evaluation. Core T2P Learning Cycle functions observed in the examples from housing/economic security, precision oncology, and aging include governance and standard operating procedures to promote effective priority‐setting; complementary research and quality improvement initiatives, which inform ongoing data curation at the learning system level; and sustainment of continuous improvement and evidence‐based policymaking. Conclusions: The T2P Learning Cycle integrates research translation with evidence‐based policymaking, ensuring that scientific innovations address public health priorities and serve end‐users through a repeatable process of research and quality improvement that ensures policies are scientifically based, effective, and sustainable. [ABSTRACT FROM AUTHOR]

The Society for Vascular Medicine (SVM) has updated its Manual of Standard Operating Procedures (SOPs) for SVM Publications. The Research, Quality, and Publications Committee of SVM is responsible for developing position statements, practice guidelines, and other documents. The committee identifies potential topics through periodic assessments, considering input from stakeholders and addressing variations in clinical practice and inequalities in patient care. SVM may collaborate with other organizations in document development, following mutually agreed-upon policies and procedures. The committee also ensures conflict of interest disclosure and management, forms writing groups, and follows a structured methodology for document development. Peer review and public comment are conducted, and documents are evaluated and updated regularly to maintain quality and adherence to best practices. [Extracted from the article]

Background: Health of children plays an indispensable role in the development of the country. Nutrition and health of the tribal children continue to be a pressing concern in India. Biochemical and hematological examination of children is an essential tool for assessment of health status, early identification of preventable risk factors and for diagnosis of various diseases. Objective: To assess the health status of Hakki Pikki tribal school children by evaluating the biochemical and haematological parameters. Materials and Methods: This was a community based cross sectional study of 76(Boys-32 and Girls-44) Hakki Pikki tribal children studying at Government Higher Primary School, Hakki Pikki Colony, Gowripura, Bengaluru Karnataka, India. Biochemical and haematological parameters were determined in accordance with standard operating procedures followed by good laboratory practices Results: The study group consisted of children aged between 6 to 17 years, among them 32 students were males and 44 were females.21(11-boys and 10-girls) children were under weight and 02 girls were overweight. The common ailments found were, dental carries (2.63%), ear discharge (2.63%), anaemia (3.94%), Impetigo (7.89%). Comparing between Boys and Girls less than or equal to 10 years of age there was a significant difference in Creatinine as p-value< 0.05. There was a significant difference in Creatinine, Uric acid, AST, ALT, total protein, albumin, HbA1C and Haemoglobin when comparing between Boys and Girls of age greater than 10 years p-value < 0.05.In these tribal children the distribution of biochemical and haematological parameters values considerably follows the reported reference values Conclusions: This study highlights a puzzling situation of health status among these Hakki Pikki tribal children due to apparent change in socio cultural, lifestyle, nutrition, and urbanization. Under weight has emanated as a solemn problem unless addressed. [ABSTRACT FROM AUTHOR]

Beginning in 2025, water utilities in the United States are required to conduct a risk and resilience assessment (RRA) and update their emergency response plan (ERP) every five years to comply with the America's Water Infrastructure Act of 2018 (AWIA). The RRA process focuses on critical assets and identifies risks from specific events or scenarios, while the ERP outlines response actions for hazardous events. Utilities can benefit from coordinating their RRA and ERP efforts, as well as their local hazard mitigation plan (LHMP), to increase efficiency and save time and money. Combining these planning efforts allows utilities to avoid duplicating work and provides a more robust emergency planning program. [Extracted from the article]

Accurate discharge values form the foundation of effective water resource planning and management. Unfortunately, these data are often perceived as absolute and deterministic by users, modelers, and decision-makers, despite the inherent subjectivity and uncertainty in the data preparation processes. This study is undertaken to examine the discharge estimation methods used by the Water Survey of Canada (WSC) and their impacts on reported discharge values. First, we explain the hydrometric station network, essential terminologies, and fundamental concepts of rating curves. Subsequently, we examine WSC's standard operating procedures (SOPs), including shift, temporary shift, and override, in discharge estimation. Based on WSC's records of ∼ 1800 active hydrometric stations for discharge monitoring, we evaluated sample rating curves and their correlation with stage and discharge measurement. We investigate under-ice measurements, ice condition periods and frequency, and extreme values in contrast to rating curves. Employing an independent workflow, we demonstrate that 69 % of existing records align with the rating curve and temporary shift concept, while the remaining 31 % follow alternative discharge estimation methods (override). Selected example stations illustrate discharge estimation methods over time. We also demonstrate the impact of override and temporary shifts on commonly assumed uncertainty models. Given the practices of override and temporary shifts within WSC, there is a need to explore innovative methods for discharge uncertainty estimation. We hope our research helps in the critical challenge of estimating and communicating uncertainty in published discharge values. [ABSTRACT FROM AUTHOR]

Automatic assessment of the operation ability of operators based on computers is an essential approach for improving the effectiveness of equipment operation training and enhancing equipment safety. Present methods primarily focus on the operation results but pay less attention to the operation procedure. One reason is that there is a lack of a model that has the ability to describe all probable paths to accomplish the same task. Therefore, an operations chain model is put forward for the first time to describe the standard operation procedure and relationships among operations based on the decomposition of operational tasks and the relationships among the various operations required to fulfill the task. A specific operation task corresponds to an operations chain, which will form one or multiple standard operation sequences that will allow trainees to complete the same task through different paths. The Needleman–Wunsch sequence alignment algorithm is introduced to match the trainees' operation sequence with all standard sequences. The maximum alignment result is the score of the trainees' operations. An example shows that the operations chain model can accurately describe the complex structure of the standard operating procedures. The Needleman–Wunsch sequence alignment algorithm can objectively evaluate the trainee's operation capabilities. The combination of the operations chain model and sequence alignment algorithm can form a complete operation procedure assessment method that is friendlier to trainees and has more objective evaluation results. The method will help to improve the effectiveness of the competency assessment of equipment operators. [ABSTRACT FROM AUTHOR]

Background: Health of children plays an indispensable role in the development of the country. Nutrition and health of the tribal children continue to be a pressing concern in India. Biochemical and hematological examination of children is an essential tool for assessment of health status, early identification of preventable risk factors and for diagnosis of various diseases. Objective: To assess the health status of Hakki Pikki tribal school children by evaluating the biochemical and haematological parameters. Materials and Methods: This was a community based cross sectional study of 76(Boys-32 and Girls-44) Hakki Pikki tribal children studying at Government Higher Primary School, Hakki Pikki Colony, Gowripura, Bengaluru Karnataka, India. Biochemical and haematological parameters were determined in accordance with standard operating procedures followed by good laboratory practices. Results: The study group consisted of children aged between 6 to 17 years, among them 32 students were males and 44 were females.21(11-boys and 10-girls) children were under weight and 02 girls were overweight. The common ailments found were, dental carries (2.63%), ear discharge (2.63%), anaemia (3.94%), Impetigo (7.89%). Comparing between Boys and Girls less than or equal to 10 years of age there was a significant difference in Creatinine as p-value< 0.05. There was a significant difference in Creatinine, Uric acid, AST, ALT, total protein, albumin, HbA1C and Haemoglobin when comparing between Boys and Girls of age greater than 10 years p-value < 0.05.In these tribal children the distribution of biochemical and haematological parameters values considerably follows the reported reference values. Conclusions: This study highlights a puzzling situation of health status among these Hakki Pikki tribal children due to apparent change in socio cultural, lifestyle, nutrition, and urbanization. Under weight has emanated as a solemn problem unless addressed. [ABSTRACT FROM AUTHOR]

Background: Standardisation, a widely accepted concept for risk management, entails designing and implementing task-specific operating procedures. In community pharmacies, Standardised Operating Procedures (SOPs) are a mandatory requirement and are recognised as essential for upholding safety and quality. Aim: This study aimed to investigate community pharmacists' (CPs) compliance with SOPs when checking prescriptions, and the reasons for variations between standardised protocols and practice. Method: Eight sets of SOPs underwent hierarchical task analysis (HTA) to generate a normative description of clinical checking execution as per protocols. Subsequently, twelve CPs were engaged in a simulated clinical checking exercise, verbalising their thoughts while checking virtual prescriptions. Transcribed data underwent content analysis, aligned with a descriptive model to uncover engagement patterns, and disparities between SOPs and CPs' practices. Finally, a focus group discussion took place to contextualise the observed variations. Results: HTA aided in constructing a clinical checking model with six primary subtasks and 28 lower subtasks. CPs often omitted subtasks during checks, diverging from prescribed protocols. These deviations, observed in controlled environment, reveal an ingrained aspect within the professional culture of pharmacists, where there may be a tendency not to strictly adhere to protocols, despite variations in work conditions. Contributing factors to this culture include the exercise of professional judgment, reliance on others, and prioritisation of patient preferences. Conclusion: This study highlights ongoing deviations from SOPs during clinical prescription checks in community pharmacies, suggesting a cultural tendency. Future research should delve into risk management strategies for these deviations and address the delicate balance between flexibility and stringent compliance. [ABSTRACT FROM AUTHOR]

Background: Wastewater can contain a complex mixture of organic micropollutants, with both chemical analysis and effect-based methods needed to identify relevant micropollutants and detect mixture effects. Solid-phase extraction (SPE) is commonly used to enrich micropollutants prior to analysis. While the recovery and stability of individual micropollutants by SPE has been well studied, few studies have optimized SPE for effect-based methods. The aim of the current study was to develop and evaluate two standard operating procedures (SOPs) for the enrichment of micropollutants in preparation for chemical analysis and bioanalysis, one covering a broad range of chemicals and the other selective for estrogenic chemicals. Results: Pristine surface water spiked with > 600 micropollutants was used to develop a generic extraction method for micropollutants with a wide range of physiochemical properties, while water spiked with estrogenic chemicals was used to identify a selective extraction method. Three different SPE sorbents were tested, with recoveries of individual chemicals and effect in assays indicative of mutagenicity, estrogenic activity, and fish embryo toxicity assessed. The sorbent HRX at pH 7 was selected for the generic extraction method as it showed the best recovery of both individual chemicals and effect in the bioassays. The sorbent HLB at pH 3 showed optimal recovery of estrogenic chemicals and estrogenic activity. The two optimal SPE methods were applied to spiked and unspiked wastewater effluents, with the concentrations of detected chemicals and observed effects similar to those of previous studies. The long-term storage of both extracts and SPE cartridges for estrogens and estrogenic activity after extraction with the HRX and HLB methods were evaluated, with estrogenic effectiveness close to 100% after 112 days when HLB was used. Conclusions: HRX is recommended for generic extraction, while HLB is optimal for the selective extraction of estrogenic micropollutants. However, if a laboratory only wants to use a single SPE sorbent, HLB can be used for both generic and selective extraction as it yielded similar chemical and effect recovery as HRX for a wide range of micropollutants. This paper is supplemented by the final SOP that includes a variant for generic extraction and one for the extraction of estrogenic chemicals. [ABSTRACT FROM AUTHOR]

Inadequate energy management leads to more emission exposure, which causes climate change, severe environmental contamination, and human health risks. Therefore, the World Health Organisation (WHO) monitors universal efforts to prevent emissions and encourages governments to develop industries to transform the green economy. During the current study, the energy and cost variation was observed through three years (2020, 2021, and 2022) at a surface water plant in southern Egypt. Consistent with applying operation strategies that met convenient standard operating procedures (SOPs) during 2021 and 2022. Energy consumption was reduced by 13% to 17%, and the cost decreased by 5% to 12% for 2021 and 2022, respectively. These energy and financial savings should be considered as an influence of the water safety plans (WSPs). Detrended correspondence analysis (DCA) was utilised to identify the mechanism of energy consumption and its impact on the cost during the study period. The finding proves that the energy and cost rise is related to increased water demand during the summer months, periodic/emergency maintenance, and comprehensive cleaning activities. WSPs were applied to control biological oxygen demand (BOD), chemical oxygen demand (COD), and oil and grease (O & G) that show increasing values than Egyptian law. [ABSTRACT FROM AUTHOR]

INTRODUCTION Standard operating procedures (SOP), accessible to several laboratories, are essential for product verification. EU-JATC (European-Joint Action on Tobacco Control) SOP and the WHO TobLabNet (World Health Organization Tobacco Laboratories Network) SOP (SOP11) are available standard methodologies to measure nicotine, glycerol, and propylene glycol, and propose mass spectrometer (MS) as an alternative method to flame ionization detector (FID). This study conducted a comparison between FID and MS concentration results, following the MS method described in SOP11. METHODS In May 2020, five test e-liquids in replicates (A-E) were prepared at the Istituto di Ricerche Farmacologiche Mario Negri and sent, with SOP 11, validation document and results datasheet to 32 different laboratories all over the world from WHO TobLabNet and EU-JATC (18 from JATC, ten from WHO TobLabNet and four academic laboratories). Among thirty-two independent laboratories that participated in the study, results were received from 30 laboratories. RESULTS The e-liquids analyses, using the two approaches, were compared. Of the 30 laboratories surveyed, 21 utilized the FID approach exclusively, 7 opted for MS detection, and 2 employed both methods. The findings demonstrated that the gas chromatography-mass spectrometry (GC-MS) method offers comparable analytical capabilities regarding accuracy and precision for nicotine, glycerol, and propylene glycol to the FID approach. Through Pearson's correlation test with r=1 showing a positive correlation between GC-FID and GC-MS data, and the Student's t-test, no significant differences between the two approaches were revealed, showing p>0.005 for almost all three analytes in all samples. CONCLUSIONS This study indicates that it is possible to apply the available EU-JATC SOP and the WHO TobLabNet SOP11 even in laboratories that do not have access to an FID, for example, to analyze flavors, trace compounds or carcinogenic, mutagenic, or toxic for reproduction (CMR) in electronic cigarette liquids. [ABSTRACT FROM AUTHOR]

Infusion therapy involves the intravenous administration of drugs, fluids, and blood products to hospitalized clients. This study aimed to identify factors influencing nurse compliance in monitoring infusion fluids according to Standard Operating Procedures (SOPs). The research adopted a quantitative approach with a descriptive correlational design and a cross-sectional approach, focusing on a study population of 50 nurses. Data collection utilized observation techniques and questionnaires as research instruments, with the analysis employing Kendall's Tau B and Kendall's Tau C methods. The findings revealed significant correlations between age (p-value=0.000), education (p-value=0.006), career path level (p-value=0.013), and knowledge (p-value=0.011). However, there was no significant relationship between the length of work experience and nurse compliance in monitoring infusion fluids (p-value=0.257) according to SOPs in this private hospital. To enhance the quality of care, it is recommended that nurses receive additional training provided by the nursing education team at the hospital, focusing specifically on the monitoring of infusion fluids. This targeted training could contribute to reducing instances of complaints related to mismatched patient needs and ultimately improve compliance with established SOPs in infusion therapy. [ABSTRACT FROM AUTHOR]

Plenty of new approach methodologies (NAMs) for risk assessment have been developed but only some are included in OECD Test Guidelines (TGs) for regulatory implementation. Nevertheless, NAMs are increasingly applied, e.g. for nanomaterial (NM) risk assessments. The EFSA Guidance on NM risk assessment suggests that NAM‐derived data concerning degradation/dissolution (in relevant biofluids), intestinal uptake/crossing, genotoxicity, cytotoxicity, oxidative stress, (pro‐)inflammatory potential and barrier integrity, for many of which no OECD TGs exist, have to be evaluated first. Consequently, NM risk assessments involve data from non‐guideline studies, requiring time‐consuming and challenging case‐by‐case evaluations. Establishing an OECD TG is a formal process aiming for international use according to the Mutual Acceptance of Data (MAD). However, not every promising NAM can be prioritised for OECD TGs. A qualification, based on an expert opinion, may enable an efficient use of adequate NAMs for a specific context‐of‐use. Furthermore, it supports the optimisation of promising NAMs for regulatory applications. Existing qualification systems operate in the context of e.g., drug development tools (FDA) and research and development into pharmaceuticals (EMA). The NAMS4NANO consortium was tasked to propose a generic framework for a qualification system for chemical risk assessment in the food and feed sector to speed up the regulatory use of NAMs. Here we describe our proposal including the process and evaluation criteria. A detailed test method description, preferably as standard operating procedures (SOPs), describing the set‐up of the NAM including its application and evaluation phase is crucial. Furthermore, the scientific validity, i.e. its reliability and relevance for the context‐of‐use, needs to be demonstrated, for which we suggest a less rigorous process compared to OECD TGs. We propose to initially establish a qualification system for NM risk assessment, aligned with the EFSA framework. This document is an interim version to stipulate a broader discussion among experts and stakeholders. [ABSTRACT FROM AUTHOR]

Background: Prehospital anaesthesia is a complex intervention performed for critically ill patients. To minimise complications, a standard operating procedure (SOP) outlining the process is considered valuable. We investigated the implementation of an SOP for prehospital anaesthesia in helicopter emergency medical services (HEMS). Methods: We performed a retrospective observational study of patients receiving prehospital anaesthesia by Finnish HEMS from January 2012 to August 2019. The intervention studied was the implementation of an SOP at two of the five bases during 2015–2016. Patients were stratified according to whether they were anaesthetised before, during or after implementation and the primary outcomes were 1‐ and 30‐day mortality. Secondary outcomes included anaesthesia quality indicators. Confounding factors was assessed via logistic regression. Results: A total of 3902 tracheal intubations were performed without an SOP, 430 during implementation and 1525 after implementation. The SOP had a significant effect on 1‐day mortality during implementation with an odds ratio (OR) of 0.56, 95% confidence interval (95% CI) 0.37–0.81 and a further trend towards benefit after implementation (OR 0.84, 95% CI 0.68–1.04), but no difference in 30‐day mortality (OR after implementation 1.10, 95% CI 0.92–1.30). Implementation of an SOP improved first‐pass success rate from 87.3% to 96.5%, p < 0.001. Conclusion: Implementation of an SOP for prehospital anaesthesia was associated with a trend towards lower 1‐day mortality and an improved first‐pass success but did not affect 30‐day mortality. Despite this, we advocate prehospital systems to consider implementation of a prehospital anaesthesia SOP as immediate performance markers improved significantly. [ABSTRACT FROM AUTHOR]

Catecholamine-induced cardiomyopathy (CCM) is an entity associated with increased levels of catecholamines causing subendocardial and papillary muscle cardiomyocyte degeneration and necrosis. In 2020, 49 autopsies from early rabbit deaths in a colony used for medical device biocompatibility studies were submitted for microscopic examination. Of the 49 rabbits, 26 had histologic changes consistent with CCM. No common stressor for CCM was determined in affected rabbits. Animals were generally male, were 12–16-wk-old, and were found dead or had bloating, lethargy, and/or diarrhea. Those observed with clinical signs were euthanized and autopsied per the organization's standard operating procedures. Heart lesions consisted of various degrees of apical subendocardial myocardial degeneration and necrosis. Common non-cardiac lesions included pulmonary congestion and edema, hepatic congestion and centrilobular hepatocellular degeneration, and/or variable intestinal submucosal edema. [ABSTRACT FROM AUTHOR]

Background: Neurosurgical cranial titanium mesh and screws are commonly encountered in postoperative radiation therapy. However, only a limited number of reports are available in the context of proton therapy, resulting in a lack of consensus among the proton centers regarding the protocol for handling the hardware. Purpose: This study is to examine the impact of the hardware in proton plans. The results serve as evidence for proton centers to generate standard operating procedures to manage the hardware in proton treatment. Methods: Plans with different gantry angles and material overrides are generated on the CT images of a phantom made of the hardware. The dose distributions of the plans with and without material override, at different depths are compared. Films and ionization chambers are used to measure the plans and the measurements are compared to the treatment planning system (TPS) calculations by gamma analysis. Results: There are some overdose and underdose regions downstream of the hardware. The overdose and underdose values are within a few percent of the prescribed dose when multiple fields with large hinge angles are used. The gamma analysis results show that the measurements agree with the TPS calculations within limits that are clinically relevant. Conclusion: The study has demonstrated the influence of the hardware on proton plans. Based on the result of this study, a standard operating procedure of managing the hardware has been implemented in our clinic. [ABSTRACT FROM AUTHOR]

Complete medical record filling is an indicator of the quality of hospital services. Therefore, it is important to improve the quality of services, including medical record documentation. This study aims to examine the relationship between organizational climate, physician motivation, and transformational leadership style on medical record completion. This study used a cross-sectional design with a total sampling approach, involving 49 doctors involved in filling medical records. The relationship between organizational climate, physician motivation, and transformational leadership style was evaluated to understand their influence on medical record filling. The results showed that organizational climate, physician motivation, and transformational leadership style significantly and positively influenced medical record filling at North Serpong Regional General Hospital. This study has implications for hospitals should develop standard operating procedures (SOPs) related to medical record filling, conduct socialization and training for health workers, and provide sanctions or reprimands for those who do not comply with the established standards. [ABSTRACT FROM AUTHOR]

In the Korean cement industry, cement is not produced using fossil fuel such as bituminous coal alone but rather using combustible waste as an auxiliary fuel. The standards for using alternative fuel in cement processes are specified in the "Waste Management Laws." However, an analysis process has not been clearly defined, which hinders the development of appropriate standard operating procedures (SOPs) required to objectively evaluate the use of waste as an alternative fuel for cement production. This study proposed clear SOPs to expand the utilization of alternative fuels in cement production, and these procedures were derived by selecting appropriate analysis methods and standards. The thermal, environmental, and quality characteristics of non-recyclable wastes and cement samples treated based on the SOPs were critically examined. Non-recyclable wastes showed a higher calorific value (7010 kcal/kg) and lower chlorine content (0.08 wt.%) compared to bituminous coal, and the cement analysis indicated that the characteristics did not change based on the type of fuel used. Nonrecyclable waste is appropriate for application if processed with a fuel manufacturing system. These findings provide procedural guidelines to promote the use of combustible waste as auxiliary fuels in the cement industry. [ABSTRACT FROM AUTHOR]

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During the years of war, as a result of aviation and missile attacks, a significant number of health care facilities in various regions of Ukraine were destroyed, and the complexity and intensity of their work increased significantly. If the readiness of hospitals and their employees to treat gunshot and explosive injuries is established, in the case of mass destruction of chemically hazardous enterprises and the threat of the enemy using weapons of mass destruction, including chemical weapons, there is a need for special training of health care facilities to work in the in conditions of chemical threats. The aim of the work was justification of the development and set of measures for the implementation of standard operating procedures in the event of a chemical incident. The legal documents and recommendations of the Ministry of Health of Ukraine, management of the World Health Organization and the Red Cross on the topic of the study were used. The research methods: bibliosemantic, analytical, modeling were applied. It is established that the special management group, which includes representatives of various services, is of decisive impor­tance in the effective management of a health care facility during a chemical incident: administration; communication department; security department; management of nurses and the department of infection control; human resources department; pharmacy; intensive care unit; department of engineering maintenance and repair; laboratory; kitchen; laundry; cleaning service and waste management. The most important measures of response to a chemical incident that ensure the safety of medical personnel and patients are the organization of a triage zone and a decontamination area for chemically affected persons. Based on the above, to prepare a health care facility for work during a chemical incident, it is necessary to develop a response plan, which consists of special administrative and management decisions and provides for regular staff training.

Background: Microvascular decompression (MVD) is a well-established and effective treatment for primary trigeminal neuralgia (TN). Endoscopy has been implemented to provide a comprehensive view of neurovascular conflict and minimizes the damages of brain retraction during MVD. Objectives: To preliminarily evaluate the surgical safety and efficacy of fully endoscopic microvascular decompression (EMVD) for primary TN with surgeon performing two-hand manipulation and assistant holding endoscope. Methods: Retrospective clinical analysis of 189 patients with primary TN underwent EMVD between June 2019 and August 2022 was performed. By analyzing the intraoperative situation, the outcomes of postoperative symptoms and the main complications, we evaluated the reliability and effectivity of the operative technique in the treatment of primary TN. Results: We summarized the standard operating procedure of EMVD for primary TN with surgeon performing two-hand manipulation and assistant holding endoscope. In addition, acicular bipolar electrocoagulation technique was developed to handle venous compression. During the follow-up period, good pain relief was achieved in 178 patients (94.2%) and recurrence of pain was observed in 4 patients (2.1%). Postoperative temporary complications included trigeminal dysesthesias (7 patients, 4.8%), cerebrospinal fluid leak (2 patients, 1.1%), hearing difficulty (3 patient, 1.6%), facial paresis (2 patients, 1.1%) and vertigo (5 patients, 2.7%). There were no cases of intracranial hemorrhage, cerebellar swelling and death. Conclusion: This EMVD technique is reliable and effective, and can be used as a routine surgical procedure for primary TN. [ABSTRACT FROM AUTHOR]

Background: There is an increase in human subject research in developing countries and conducting them in an ethical manner depends on the research ethics oversight in these countries. The purpose of this study is to evaluate the operational, financial, and educational characteristics of research ethics committees (RECs) at institutions in Vietnam and Laos. Methods: A validated self-assessment tool designed to assess nine major characteristics of RECs was translated into Vietnamese and Laotian. The translated surveys were delivered to and completed by representatives from RECs at institutions in Vietnam and Laos. The surveys were collected, translated back into English, and scored. The data was analyzed to identify potential areas of strength and areas for improvement. Results: The mean survey score for the 19 RECs surveyed was 165.3 out of a maximum of 200 points with a standard deviation of 22.9. Committees scored the highest in the review of specific protocol items (95.6%), submission arrangements and materials (89.5%), and the policies referring to review procedures (85.6%) domains. RECs scored the lowest in the resources domain (65.5%), with only 26.3% of committees having an annual budget. Nearly all RECs have standard operating procedures (94.7%) and policies for disclosing conflicts of interest (89.5%). Most committees use prior ethics training as a criterion to select REC chairs (78.9%) and members (73.7%), with the majority of committees requiring a training course in ethics (76.5%). 68.4% of committees have continuing education in ethics for members and only 42.1% of committees have a budget for member training. Conclusion: This study demonstrated that RECs in Vietnam and Laos have strong foundational review processes for research protocols. Important areas of improvement include improved institutional oversight, financial and administrative resources, and the continued ethics education for current committee members. [ABSTRACT FROM AUTHOR]

Promoting equitable health care is to ensure that everyone has access to high-quality medical services and appropriate treatment options. The definition of health equity often can be misinterpreted, and there are challenges in fully understanding the disparities and costs of health care and when measuring the outcomes of treatment. However, these topics play an important role in promoting health equity. The COVID-19 pandemic has made us more aware of profound health-care disparities and systemic racism, which, in turn, has prompted many academic medical centers and health-care systems to increase their efforts surrounding diversity, equity, and inclusion. Therefore, it is important to understand the problems that some patients have in accessing care, promote health care that is culturally competent, create policies and standard operating procedures (at the federal, state, regional, or institutional level), and be innovative to provide cost-effective care for the underserved population. All of these efforts can assist in promoting equitable care and thus result in a more just and healthier society. [ABSTRACT FROM AUTHOR]

Upscaling Voluntary Sustainability Standards (VSS) can generate ecological and social benefits at a scale that is meaningful to address pressing environmental issues such as climate change and biodiversity losses. Lack of resources and risks of implementation gaps may, however, hinder the success of upscaling VSS. This paper aims to fill the gap in the literature regarding options to reduce certification costs to upscale VSS amid the limited financial resources available for certification. The paper presents the result of action research involving 3,507 independent oil palm farmers who are members of six farmer groups in two districts in Central Kalimantan to achieve Roundtable on Sustainable Palm Oil (RSPO) certification. The research found that achieving economies of scale by increasing the total number of certified farmers can reduce the certification costs per farmer. By establishing a district-level entity, the costs related to audits, RSPO membership fees, and the establishment of farmer groups, such as developing standard operating procedures (SOPs), can be lowered. Implementation gaps were not found with the increase of farmers joining the project based on the training frequency and the external audit findings reports on farmers' compliance with RSPO principles and criteria. The findings of this study provide a basis for promoting the upscaling of VSS, including through the RSPO jurisdictional approach. [ABSTRACT FROM AUTHOR]

Towards a better characterization of the increasing blast overpressure threat, person-borne sensors are being considered for large military population segments potentially subjected to explosive blast and firing of crew served weapons. Training and field data, tracked longitudinally across a soldier's entire career, can help with the diagnosis of blast injuries and the improvement of standard operating procedures for both explosive forced entry and large weapons firing. However, a current challenge with person-born blast dosimeters resides with the position of the overpressure sensors themselves. Often, the sensors are not fully exposed to the blast locally, resulting in pressure measurements not representative of the blast conditions surrounding an individual. While fielding multiple individual and uncoupled dosimeter units around the body increases the likeliness of catching the representative blast exposure, issues arise from differences in internal clock, potential partial triggering, and the complexity of merging data from different sources. Instead, integrating multiple overpressure sensors pointing in different directions, within a single device that captures and records all data simultaneously, proves highly beneficial for data analysis and interpretation. This paper presents algorithms that combine the overpressure data collected from such multiple coupled sensors for each blast event to minimize the effect of blast directionality. In particular, an algorithm estimating the equivalent side-on blast overpressure is presented, facilitating injury estimates from existing established blast injury models adapted for the outputs from the blast dosimeters. An algorithm is also presented that estimates the orientation or provenance of an explosive blast relative to the soldier. [ABSTRACT FROM AUTHOR]

Neuropsychological assessment in rare neurodevelopmental disorders has provided clinicians and researchers with a more comprehensive view of natural history as well as opportunities for additional endpoints in treatment trials. While challenges to protocol development have been addressed in the literature, cultural considerations have been overly broad resulting in limited utility when including mixed international samples. Using experiences over the past five years with the development of ten different protocols for neurogenetic rare diseases, this paper presents further considerations for protocol development that are culturally sensitive to international samples. Recommendations are offered across areas including participants from multiple countries; cognitive, sensory and motor impairments; psychometrics; and assessment logistics. A neuropsychological assessment selection checklist that guides researchers and clinicians through considerations and a standard operating procedure that provides guidance on thinking through the assessment process are offered. [ABSTRACT FROM AUTHOR]

Punctuated equilibrium theory (PET) posits that policy change is incremental for long periods of time with occasional shifts in problem definition and governing authority that produce large changes. Incrementalism results from shared norms and standard operating procedures within policy subsystems. The U.S. Congress experienced a series of institutional changes in the 1990s that both introduced more partisanship into subsystem interactions and made it easier for majority party leaders to enact their agenda. These changes have disrupted many of the processes that produce incrementalism. Using data from 1949 to 2022, I find that U.S. policy outputs, measured through public laws, have experienced fewer incremental changes from one term to the next and more moderate and very large changes since 1995. The shift in outputs has been driven primarily by increased partisan conflict within congressional committees. This study highlights the utility of using the stochastic process approach to compare distributions of outputs across time and not only across countries or institutions. [ABSTRACT FROM AUTHOR]

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Lembaga Perkreditan Desa (LPD) is a vital financial institution for traditional villages in Bali, whose role is to save funds, provide credit, and support village development. However, some LPDs, such as Tanggahan Peken LPD in Bangli Regency, have experienced legal problems related to alleged corruption crimes committed by their administrators. The purpose of this study is to determine and analyze the handling of criminal acts at the Tanggahan Peken Village Credit Institution, Susut District, Bangli Regency handled by the Bali Police. The natural method of this research uses empirical legal research. The results showed that the occurrence of criminal acts of corruption committed by the Tanggahan Peken LPD management was caused by internal factors from the individual aspect of the LPD management to gain profit, enrich themselves and perpetuate their positions and external factors from the organizational aspect, namely the lack of regular guidance, supervision and audits carried out by LPD internal supervisors and LPLPD as technical supervisors and audits. The handling of corruption crimes by the Bali Police at the Tanggahan Peken Village Credit Institution (LPD) uses Standard Operating Procedures (SOP) from the process of receiving public complaints, investigating and investigating. Creating effective investigation and investigation plans. Investigators also conduct independent audits and examinations by involving experts in the field of accounting and auditing, experts in the field of economics and experts in criminal law. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the impact of two different parameters (body position and distension medium) on the rectal sensory test in patients with functional constipation and provide data support for the development of standardized operating procedures in clinical practice. Methods: Based on a single-center process of the rectal sensory test, 39 patients with functional constipation were recruited for rectal sensory test under different body positions and distension mediums. Results: Among the items of the Constipation Scoring System, the score of frequency of bowel movements showed a negative correlation with the first constant sensation volume (r = -0.323, P = 0.045). Conversely, the score of painful evacuation effort showed a positive correlation with the desire to defecate volume (r = 0.343, P = 0.033). There was a statistically significant difference in the first constant sensation volume (when the distension medium was gas) measured in different body positions (left lateral position, sitting position, squatting position), and the data measured in the squatting position were significantly higher than those in left lateral position (P < 0.05). In terms of research on distension medium, it was found that the first constant sensation volume measured in the squatting position (when the distension medium was water) was significantly lower than that of gas (P < 0.05). Conclusion: For patients with functional constipation, there are differences in the results of rectal sensory tests between body positions and distension mediums. When conducting multicenter studies, it is necessary to unify the standard operating procedure (SOP) for operational details to ensure consistency and reliability of the test results. [ABSTRACT FROM AUTHOR]

One of the major attributes of boiled cassava roots is its ability to soften within a short period, otherwise known as mealiness. This study aimed to establish and validate standard operating procedures for assessing the mealiness of boiled cassava roots. Twenty cassava genotypes, including landrace and improved varieties, were selected for the protocol development, with an additional ten genotypes used for validation. Following cooking, the cassava roots were evaluated for hardness and work done in extrusion using a texturometer equipped with a five-blade Ottawa cell probe. The same samples were assessed for sensory texture analysis using trained panelists for parameters such as softness and chewiness. Pearson's correlation analysis revealed significant positive correlations (p < 0.01) between sensory softness and instrumental texture measurements, as well as between softness and cooking time (p < 0.01, r = 0.94), and between chewiness and cooking time (p < 0.05, r = 0.81). Validation results confirmed significant correlations (p < 0.01) between cooking time, sensory softness, and chewiness. These findings suggest that cooking time can serve as a reliable indicator, closely associated with sensory attributes, in determining the mealiness of boiled cassava roots. This approach offers a practical, mid-throughput method for assessing cassava root mealiness, with implications for breeding improved varieties, farmers adoption, and consumer acceptance. [ABSTRACT FROM AUTHOR]

• An ECFS-endorsed SOP was used to measure CFTR function using forskolin-induced swelling. • The Forskolin-induced swelling (FIS) assay demonstrates high repeatability and reproducibility. • Identical patient-derived organoids were shared with different laboratories. • Forskolin-induced swelling is a technically reliable biomarker of CFTR function. • Intestinal organoids may be used for cystic fibrosis precision medicine applications. The forskolin-induced swelling (FIS) assay measures CFTR function on patient-derived intestinal organoids (PDIOs) and may guide treatment selection for individuals with Cystic Fibrosis (CF). The aim of this study is to demonstrate the repeatability and reproducibility of the FIS assay following a detailed Standard Operating Procedure (SOP), thus advancing the validation of the assay for precision medicine (theranostic) applications. Over a 2-year period, FIS responses to CFTR modulators were measured in four European labs. PDIOs from six subjects with CF carrying different CFTR genotypes were used to assess the repeatability and reproducibility across the dynamic range of the assay. Technical, intra-assay repeatability was high (Lin's concordance correlation coefficient (CCC) 0.95–0.98). Experimental, within-subject repeatability was also high within each lab (CCCs all >0.9). Longer-term repeatability (>1 year) showed more variability (CCCs from 0.67 to 0.95). The reproducibility between labs was also high (CCC ranging from 0.92 to 0.97). Exploratory analysis also found that between-lab percentage of agreement of dichotomized CFTR modulator outcomes for predefined FIS thresholds ranged between 78 and 100 %. The observed repeatability and reproducibility of the FIS assay within and across different labs is high and support the use of FIS as biomarker of CFTR function in the presence or absence of CFTR modulators. [ABSTRACT FROM AUTHOR]

Background: Point-of-care (POC) analysers in community settings can provide opportunistic and regular HbA1c monitoring. Community pharmacies in NHS Scotland are utilised by populations at greatest risk of type two diabetes (T2D). This study describes initial development of an HbA1c pathway using a POC analyser in community pharmacies. Methods: The Abbott Afinion analyser was compared in (i) NHS Tayside's Blood Sciences Service and (ii) community pharmacies from four Scottish Health Boards. A side by side comparison with standard operating procedures for HbA1c quantification using 80 T2D patient venous samples. The machine was implemented into 11 community pharmacies and 144 samples obtained from patients for comparison to their recent laboratory HbA1c. Four focus groups examined themes around the intervention and an exit questionnaire was administered. Results: Laboratory assessment verified the efficacy of the POC test machine. The value for level 1 quality control was 44 mmol/mol and the mean during testing 42.7 mmol/mol. The greatest percent coefficient of variation (cv) was within-run for both levels of quality control material, at a value of 1.63% and 1.62%, respectively. The analyser performed robustly within the pharmacy assessment, with a mean difference of 1.68 and a standard deviation of 0.71 (CV 0.423). Patients with T2D reported positive experiences of using a pharmacy. The focus groups identified an appreciation of the convenience of pharmacies and of the longitudinal relationships with pharmacy staff. Conclusion: POC HbA1c analysers can be successfully established in community pharmacies. The target patient group responded positively to the opportunity to use a pharmacy service. [ABSTRACT FROM AUTHOR]

Plants are being researched as potential sources of novel drugs, which has led to a recent acceleration in the discovery of new bioactive compounds. Research on tissue culture technology for the synthesis and processing of plant compounds has skyrocketed, surpassing all expectations. These plants can be bought either raw or as extracts, where some of the chemicals are extracted by mashing the plant in water, alcohol, or another solvent. The use of herbal medicine may open new chances for reducing the onset of infections and treating different diseases including cancer. A perennial plant that blooms in the winter, Cyclamen, is one of the most widely used potted flowers in many nations. Alkaloids, flavonoids, phenols, tannins, saponins, sterols, and glycosides are the main active components of Cyclamen. Analgesic, cytotoxic, antioxidant, antimicrobial, and anti-inflammatory properties have all been demonstrated as potential effects of various extracts of Cyclamen tubers. However, the use of this medicinal plant in official medicine will require further research in the areas of pharmacology. Furthermore, it is necessary to create standard operating procedures for a crude herbal medication. In this regard, this review aims to highlight the key characteristics of the Cyclamen plant, such as its various parts, species, stages of development, and geographic range; pinpoint its intriguing bioactivities, its antioxidant, anti-inflammatory, and its anti-cancerous effects; and ascertain its potential medicinal uses and the main future perspectives. [ABSTRACT FROM AUTHOR]

This research aims to analyze the implementation of the open selection policy for high-level Primary (Pratama) leadership positions during the term of the Regent of Hulu Sungai Utara in 2023. This type of research is descriptive qualitative. Data collection was carried out using observation, interviews, and documentation. The data analysis technique is carried out through four stages, namely data collection, data condensation, data presentation, and conclusion. The results of the research show that the implementation of the open selection for Pratama high leadership positions during the term of Acting Regent of Hulu Sungai Utara has been carried out well in terms of the preparation stage, implementation stage, and monitoring and evaluation stage. Apart from that, looking at aspects of Edward III's implementation theory, namely: 1) Communication, the communication process from the source of information to the resulting impact, influences the efficiency and effectiveness of the implementation of open selection; 2) Resources, emphasizing that the quality and quantity of these resources greatly influences the smoothness and integrity of the implementation of the open selection; 3) Disposition, the process of appointing bureaucrats and the use of incentives as motivation factors; and 4) Bureaucratic Structure, Standard Operating Procedure which is not integrated between government agencies and fragmentation shows that separation in the implementation process can hamper the efficiency and effectiveness of the implementation of open selection and the inauguration of high-level pratama officials. [ABSTRACT FROM AUTHOR]

With the global impetus for the elimination of canine-mediated human rabies, the need for robust rabies surveillance systems has become ever more important. Many countries are working to improve their rabies surveillance programs and, as a result, the reported use of lateral flow devices (LFDs) is increasing. Despite their known diagnostic limitations, previous studies have hypothesised that the benefits associated with LFDs could make them potentially quite useful towards improving the overall robustness of surveillance programs. To test this, a best practice standard operating procedure was developed which was used to guide the implementation of the ADTEC LFD as a diagnostic screening tool in Zanzibar. Over the course of the first 22 months of this investigation, 83 samples were subjected to in-field diagnostic screening, coupled with subsequent laboratory confirmation, and only one false-negative result was detected. Furthermore, the findings of our investigation indicated that the routine use of LFDs as a diagnostic screening tool resulted in a four-fold increase in the number of samples subjected to rabies diagnosis per month and a three-fold increase in the number of wards where samples were collected per year. Our findings suggest that LFDs could play a noteworthy role in improving the robustness of surveillance systems by increasing the number of samples tested and promoting diagnostic screening in areas distant from laboratories. Their implementation would, however, need to be carefully controlled through standardised protocols that align with the international best practices to ensure their judicious use. [ABSTRACT FROM AUTHOR]

This article discusses the types of problematic results that can arise during microbiological testing of food and food processing environments, which potentially undermine the effectiveness of food safety programs. It outlines steps for their resolution and offers readers a structured approach for evaluating the multiple contributing biological, technological, and human factors. To assist in troubleshooting and identifying the root causes of these problems it gives examples of 15 common root causes. It also presents measures to prevent the recurrence of discrepant and ambiguous results. These measures are rooted in a robust laboratory quality system incorporating validated methods, standard operating procedures, calibrated equipment, maintenance of meticulous records, proficiency testing programs, and continuing education opportunities for laboratory personnel. In conclusion, the article advocates for comprehensive risk assessment of problematic results and offers actions to strengthen the application of microbiological methods within food safety programs, in line with the U.S. Food and Drug Administration’s objective of preventing adulterated food products from entering commerce. [ABSTRACT FROM AUTHOR]

Radiological disasters have been recognized as a prominent societal catastrophe worldwide since the Fukushima nuclear accident in 2011. In order to cope with such disasters, efforts have been made to improve disaster response plans and systems based on the lessons learned from the Fukushima accident. Particularly, as demonstrated by the Fukushima case, radiological disasters require the assumption of large-scale evacuation of residents. Thus, it is essential for prompt and accurate decision-making to take place at the local government's Emergency Management Center (EMC), enabling smooth execution of the missions assigned to personnel at the field. This is crucial for protecting the lives of residents and ensuring their safety. However, the existing systems for effective response to radiological disasters are relatively inadequate compared to other types of disasters. To overcome these limitations, this study aims to develop Standard Operating Procedures (SOPs) that are optimized for radiological disaster response by standardizing the Field Measure Motion Manual at nuclear safety for local governments. Based on these SOPs, The Resident Protection Measures Support System (RPMS) will be proposed, which enables the timely dissemination of specific missions and information to personnel, while providing real-time information on the situation at the field to the EMC, supporting decision-making and facilitating effective situation management. [ABSTRACT FROM AUTHOR]

Village-Owned Enterprises (BUMDes) are vital economic institutions in rural areas, serving both social and commercial functions. As social entities, BUMDes are expected to prioritize community interests by providing social services. Their primary function is to establish a professional and institutional platform for economic activities while leveraging the village's inherent potential. This approach enhances productivity and effectiveness in local businesses. A recent study aimed to develop a strategy for the institutional development of Village-Owned Enterprises in Karawang City using qualitative research and case study methods. The study found that the development of institutional capacity at both individual and organizational levels was not optimal due to constraints such as limited human resources, budgets, facilities, and infrastructure. Additional challenges included poor inter-sectoral coordination, ineffective implementation of standard operating procedures (SOPs), and deficiencies in understanding, skills, commitment, and leadership within BUMDes. The study recommended diversifying strategies at both individual and organizational levels and forming an Integrated Team Alliance to effectively promote the development of BUMDes in Karawang City. [ABSTRACT FROM AUTHOR]

In the permitting process for City Plan Information (KRK) and Suitability of Space Utilization Activities (KKPR), intensive communication is required between the two implementing agencies, namely, the Investment Service and One-Stop Integrated Services (DPMPTSP) and the Public Works Office for Spatial Planning. Housing and Settlement Areas (DPUPRPKP) and the Technical Service in processing permit applications recommending KRK and KKPR. Problems with long coordination and communication meetings in recommending requests for KRK and KKPR. The research aims to identify and analyze the coordination and communication in the KRK/KKPR licensing recommendation process. This study used a qualitative method by interviewing staff of the Implementing Service and applying for KRK/KKPR permits and secondary data through journals, textbooks, and Implementing Office data. The analytical approach utilized involves reducing data, presenting data, and making inferences or doing verification. Based on Standard Operating Procedures (SOP) and Government Regulation 21 of 2021 concerning Spatial Planning, this research produced recommendations for quick and consistent communication performance in licensing services issuing KRK and KKPR. [ABSTRACT FROM AUTHOR]

The internship at PT Intan Rahmadhani Santosa aims to address operational and product marketing challenges through digital strategies. This involved needs analysis, strategic planning, implementation of training programs, and evaluation of results. The results achieved included the development of detailed SOPs, establishment of company regulations, Canvas training for digital marketing, and Google Sheets training for inventory management. These programs improved operational efficiency, enhanced product marketing through digital media, and improved employee skills in inventory management and reporting. Overall, this internship program successfully provided solutions to improve the performance and long-term growth of PT Intan Rahmadhani Santosa amidst competitive market conditions. [ABSTRACT FROM AUTHOR]

The rapid changes in the global business environment demand quick adaptation to technological and regulatory shifts. Management consulting firms like PT Tetrahiel Profesional Manajemen in Yogyakarta assist businesses in navigating these challenges with services in financial, HR, marketing, and information systems consulting, plus training programs. This internship optimized PT Tetrahiel's online promotion and client database management. Activities included digital marketing training via Instagram and TikTok, developing SOPs for client acquisition and follow-up, and creating a computerized client database using Excel. These initiatives enhanced marketing efficiency, streamlined client acquisition, and organized client information, boosting PT Tetrahiel's operational effectiveness and market presence. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions While electrochemotherapy (ECT) is increasingly utilized as a highly effective method in the treatment of tumors in the head and neck region, there is significantly less data available for eyelid‐periocular skin tumors. Our group reported the first extensive case series of eyelid‐periocular basal cell carcinoma (BCC) patients with short‐term follow‐up treatment with ECT. The present study aims to report our long‐term results of eyelid‐periocular BCC cases treated with ECT.The treatments were performed according to the ESOPE (European Standard Operating Procedures on Electrochemotherapy) guidelines using the Cliniporator™ device. All patients received bleomycin‐based ECT, administered intratumorally or intravenously. Tumor response was evaluated using the RECIST 1.1 criteria.The results of 19 patients treated with ECT are presented. Four patients had locally advanced primary tumors, while 15 patients had recurrent tumors. Bleomycin was administered intratumorally in four patients and intravenously in 15 patients. The overall response was 100%, while the complete response rate proved to be 95%. In three cases (15.8%), recurrence was observed during the mean follow‐up period of 78.9 months.ECT can effectively treat locally advanced or recurrent BCC in the eyelid‐periocular skin region. Excellent tumor control can be achieved with good functional and cosmetic results without systemic adverse events with long interval follow‐up. [ABSTRACT FROM AUTHOR]