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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]

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]

Copyright of Wiener Medizinische Wochenschrift is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

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]

Copyright of Notfall & Rettungsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

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 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]

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]

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]

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]

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]

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]

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 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]

Roots, tubers and bananas (RTBs) contribute immensely to food security and livelihoods in sub‐Saharan Africa, Asia and Latin America. The adoption of RTB genotypes in these regions relies on the interplay among agronomic traits, ease of processing and consumer preference. In breeding RTBs, until recently little attention was accorded key textural traits preferred by consumers. Moreover, a lack of standard, discriminant, repeatable protocols that can be used to measure the textural traits deter linkages between breeding better RTB genotypes and end user/consumer preferences. RTB products texture – that is, behaviour of RTB food products under unique deformations, such as disintegration and the flow of a food under force – is a critical component of these preferences. The preferences consumers have for certain product texture can be evaluated from expert sensory panel and consumer surveys, which are useful tools in setting thresholds for textural traits, and inform breeders on what to improve in the quality of RTBs. Textural characterization of RTBs under standard operating procedures (SOPs) is important in ensuring the standardization of texture measurement conditions, predictability of textural quality of RTBs, and ultimately definition of RTB food product profiles. This paper reviews current SOPs for the textural characterization of RTBs, including their various associated methods, parameters, challenges and merits. Case studies of texture characterized during development of SOPs and evaluation of texture of RTB populations are discussed, together with insights into key textural attributes and correlations between instrumental, sensory and consumer assessment of texture unique to various RTB food products. Hardness was considered a universal key textural attribute to discriminate RTBs. The review should provide adequate insight into texture of RTB food products and critical factors in their measurement. It aims to promote inclusion of texture in breeding pipelines by investigating which textural traits are prioritized by consumers, particularly since the inclusion of textural traits has recently gained prominence by breeders in improving RTBs. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

As technology advances and cybercrime rates increase, cyberattacks, cyber fraud, and theft of property are becoming serious. Accordingly, digital evidence is inevitable for investigating related crimes. To obtain digital evidence, digital forensics with advanced sensor technology is required following international standards. For digital evidence preservation and processing, the control measures and norms for effective management are critical. Therefore, we analyzed and compared the international standards of digital evidence identification including the International Organization for Standardization/International Organization for Standardization (ISO/IEC 27050) and Digital Evidence Forensics Standard Operating Procedure (DEFSOP). We also studied how to use sensor technology for the standard and operating procedures of digital evidence forensics in real cybercrime. The results provide a basis for constructing effective evidence preservation by identifying principles of digital evidence identification. [ABSTRACT FROM AUTHOR]

Background: To support clinical decision-making at the point of care, the "best next step" based on Standard Operating Procedures (SOPs) and actual accurate patient data must be provided. To do this, textual SOPs have to be transformed into operable clinical algorithms and linked to the data of the patient being treated. For this linkage, we need to know exactly which data are needed by clinicians at a certain decision point and whether these data are available. These data might be identical to the data used within the SOP or might integrate a broader view. To address these concerns, we examined if the data used by the SOP is also complete from the point of view of physicians for contextual decision-making. Methods: We selected a cohort of 67 patients with stage III melanoma who had undergone adjuvant treatment and mainly had an indication for a sentinel biopsy. First, we performed a step-by-step simulation of the patient treatment along our clinical algorithm, which is based on a hospital-specific SOP, to validate the algorithm with the given Fast Healthcare Interoperability Resources (FHIR)-based data of our cohort. Second, we presented three different decision situations within our algorithm to 10 dermatooncologists, focusing on the concrete patient data used at this decision point. The results were conducted, analyzed, and compared with those of the pure algorithmic simulation. Results: The treatment paths of patients with melanoma could be retrospectively simulated along the clinical algorithm using data from the patients' electronic health records. The subsequent evaluation by dermatooncologists showed that the data used at the three decision points had a completeness between 84.6% and 100.0% compared with the data used by the SOP. At one decision point, data on "patient age (at primary diagnosis)" and "date of first diagnosis" were missing. Conclusions: The data needed for our decision points are available in the FHIR-based dataset. Furthermore, the data used at decision points by the SOP and hence the clinical algorithm are nearly complete compared with the data required by physicians in clinical practice. This is an important precondition for further research focusing on presenting decision points within a treatment process integrated with the patient data needed. [ABSTRACT FROM AUTHOR]

Based on the background that has been presented, the researcher wants to evaluate the effectiveness of the birth certificate making process at the Population and Civil Registration Office of Kuningan Regency, especially in terms of service speed and community satisfaction. This research uses a qualitative approach by involving key informants such as the Head of Civil Registration Division, Reni Sriherliyani, SE, M.M., and the Head of Civil Registration Section, Teti Tresnawati, SE. The results of the interview show that the process of making a birth certificate at the Population and Civil Registration Office of Kuningan Regency has been carried out in accordance with applicable legal provisions, including Law Number 24 of 2013 concerning Amendments to Law Number 23 of 2006 concerning Population Administration, as well as Regional Regulation Number 1 of 2015 concerning Amendments to Kuningan Regency Regional Regulation Number 3 of 2010 concerning Population Administration Services. The author concludes that the service of making birth certificates at the Population and Civil Registration Office has been effective, with an emphasis on achieving concrete time and in accordance with applicable legal provisions. Nevertheless, there are still some obstacles in the process of making birth certificates at the Office. [ABSTRACT FROM AUTHOR]

The article focuses on the challenges faced by organizations in today's corporate environment, such as ensuring product quality, establishing partnerships & maximizing resource allocation. Topics include TPL Manufacturing's digitalization journey to address inefficiencies; streamline operations; and foster collaboration through integrating ISO standards, aiming to achieve Industry 4.0 success with improved operational efficiency and customer-centric approaches.

Public transport is essential for urban mobility, reducing traffic congestion, and minimizing environmental impact. However, inadequate public transport conditions in Karachi have shifted interest towards private vehicles. The Green Line Bus Rapid Transit (BRT) System aims to offer a modern alternative and improve the current situation. This study aims to explore the role of technological developments, best practices, and standard operating procedures (SOPs) in improving service quality and attracting people to public transportation in Karachi. A cross-sectional study and survey were conducted in Karachi to gauge residents' perceptions and expectations of the Green Line BRT System. Data were collected from 450 participants using a non-probability sampling technique. The findings reveal that technological advancements contribute to improved service quality and are considered significant by consumers when evaluating and selecting public transport services. Improved road quality further reinforces this connection. These insights are essential for policymakers and transport authorities to develop strategies that increase the attractiveness of public transportation and ensure sustainable urban mobility. Addressing core issues with modern technological methods can improve public transport systems and inspire further research. [ABSTRACT FROM AUTHOR]

Whole-body vibration (WBV) is a training modality, and it seems to be a safe and efficient exercise especially to improve different aspects of physical fitness in different populations. The protocols for WBV are still not standardized. The difficulty in comparing the data confuses the real efficacy of this instrument. Consequently, the objective of this umbrella review is to analyze the protocols previously adopted and eventually to propose a standard operating procedure for WBV training. Systematic review and meta-analysis of randomized controlled trials on WBV were searched on the electronic databases PubMed, Web of Science, and Scopus until 18 March 2024. A quality assessment of the studies included has been performed. A total of 20 studies were included in this umbrella review and frequency, magnitude, and amplitude intensity data were recorded. Detailed information about the protocols (static or dynamic exercises, barefoot or with shoes, intensity duration, weekly frequency, and vibration characteristics) was also collected. WBV presents widely different protocols. Consequently, a standard operating procedure has not been proposed for WBV training. A hypothesis of intervention was instead written in which parameters for frequency, amplitude, acceleration, and training mode were proposed. [ABSTRACT FROM AUTHOR]

Background: Clinical leaders in health systems play critical roles in making decisions that impact patient care and health system performance. Current literature has focused on the importance of clinical leaders' roles in healthcare settings and has not addressed the leadership aspect that clinical leaders engage in day-to-day decision-making in HIV facilities while providing HIV patient care. Therefore, identifying the leadership roles that wclinical leaders perform at HIV primary facilities is of critical importance. Purpose: The study explored the views of healthcare providers working in AMPATH-MTRH HIV facility on what they perceived as the roles of clinical leaders at the HIV primary care facility. Methods: We conducted a qualitative exploratory study between December 2019 to May 2020, involving in-depth interviews with (n = 22) healthcare providers working in AMPATH-MTRH HIV facility, who were purposively and conveniently sampled to participate in in-depth interviews to explore perceptions regarding the leadership roles of clinical leaders. The collected data were analyzed thematically and Nvivo vs.12 software was used for data management. Results: The following themes were identified from the analysis regarding perceived clinical leaders' roles in an HIV primary care facility: 1) Strategic roles: providing direction and guidance, ensuring goals and objectives of the department are achieved within the set timelines, planning, and budgeting for adequate resources to support patient HIV care 2) Interconnecting health systems levels and supervisory oversight roles: a link between management, staff, and patients, solving problems, organizing and attending departmental meetings, facilitate staff training, accountable, collaborating with other departments and leaders, defines and assigns responsibilities, ensure quality patient service, coordination, and management of daily activities 3) Research roles: data collation, analysis, generation, review and reporting to the management. Conclusion: Clinical leaders in the HIV care system perform leadership roles that are characterized by strategic, middle-level, supervisorial and research which reflects the model of the leadership and management style of the HIV care system. The understanding of these roles contributes valuable insights to HIV leaders and managers to recognize the important contribution of clinical leaders and consider reviewing Standard Operating Procedures to include these leadership roles and strengthen their capacity to maximize clinicians' contribution to improve HIV care and enhance responsive health systems. [ABSTRACT FROM AUTHOR]

Localized projections of 21st‐century hydroclimate variables obtained from downscaling Global Climate Model (GCM) output are central to informing regional impact assessments and infrastructure planning. Regional GCM biases can be significant and, for dynamical downscaling, can be addressed either before (a priori) or after (a posteriori) downscaling. However, a priori bias correction (APBC) has generally unexplored effects on climate change signals. Here we analyze dynamically downscaled solutions of CMIP6 GCMs over the Western U.S., with and without APBC, and quantify APBC's impact on climate change signals relative to other irreducible uncertainty sources. For temperature and precipitation, the uncertainty introduced by APBC is negligible compared to that arising from GCM choice or internal variability. Furthermore, APBC greatly reduces regional models' unrealistically high snow‐water‐equivalent (SWE) biases that result directly from GCM errors. We leverage this finding to encourage the dynamical downscaling community to adopt APBC as a standard operating procedure. Plain Language Summary: Global Climate Models are coarse in resolution and often biased at the regional scale. Thus they are ill‐suited to provide local information needed for climate change adaptation planning. Dynamical downscaling is the most physically realistic solution to this problem, and involves running a weather model with climate model boundary conditions. But global model biases in the region of interest can prevent dynamical downscaling from producing data realistic enough for decision‐making. To address this challenge, we present the first comprehensive calculations showing that biases in global model boundary conditions can safely be corrected before being used for dynamical downscaling. This finding suggests it is possible to make regional climate projections that are both realistic and dynamically consistent with global model output. Key Points: A priori bias correction (APBC) of Global Climate Models (GCMs) introduces trivial uncertainty in dynamically downscaled temperature and precipitation projectionsCorresponding uncertainties in snow are significant, but non‐APBC projections of snow are physically unrealistic and should be discardedMinimally invasive APBC preserves GCM trends at regional scales while producing useable and realistic downscaled hydroclimate projections [ABSTRACT FROM AUTHOR]

A pharmaceutical warehouse is part of the pharmaceutical supply chain and is essential to maintaining the quality and efficacy of veterinary pharmaceuticals for successful animal health service delivery. However, poor storage conditions, improper handling, and inappropriate use and disposal constitute challenges for veterinary supplies in animal health services. Therefore, this study aimed to assess the existing practices and challenges in warehouse management in government veterinary clinics and private veterinary drug wholesalers in Ethiopia. A cross-sectional study was conducted on 37 veterinary health facilities in four selected zones (south Gondar, west Gondar, central Gondar, and west Gojam zones) and Bahir Dar administrative city. Zones were selected using a simple random sampling technique. Data was collected using a structured questionnaire, pre-defined and tested observational checklists, and semi-structured interview guides. Descriptive statistics were used to analyze the quantitative data, while qualitative data was analyzed using a thematic approach. The study revealed the presence of poor stock management practices, such as the absence of standard operating procedures for warehouse activities in ~59.5% of facilities surveyed. In none of the surveyed facilities, bin cards and system software utilization were satisfactory. The absence of disposal guidelines was detected in 83.8% of the facilities, and the practice of timely disposal of expired drugs was not satisfactory. Compared to the government veterinary clinics, private veterinary drug wholesalers had better storage practices (86.25%) following theoretical recommendations. The storage conditions in government clinics were rated poor at 48.3% (>80%, which is the limit to the acceptable rate for good storage conditions). The challenges of inadequate infrastructure, a lack of qualified staff, problems with the availability and affordability of pharmaceutical products, insufficient regulatory practice, and budget constraints were identified. A holistic approach involving related stakeholders should be followed to improve the existing challenges and the sector's efficiency. [ABSTRACT FROM AUTHOR]

Macrophages are well known for their involvement in the biocompatibility, as well as biodistribution, of nano(bio)materials. Although there are a number of rodent cell lines, they may not fully recapitulate primary cell responses, particularly those of human cells. Isolation of tissue-resident macrophages from humans is difficult and may result in insufficient cells with which to determine the possible interaction with nano(bio)materials. Isolation of primary human monocytes and differentiation to monocyte-derived macrophages may provide a useful tool with which to further study these interactions. To that end, we developed a standard operating procedure for this differentiation, as part of the Regulatory Science Framework for Nano(bio)material-based Medical Products and Devices (REFINE) project, and used it to measure the secretion of bioactive molecules from M1 and M2 differentiated monocytes in response to model nano(bio)materials, following an initial assessment of pyrogenic contamination, which may confound potential observations. The SOP was deployed in two partner institutions with broadly similar results. The work presented here shows the utility of this assay but highlights the relevance of donor variability in responses to nano(bio)materials. Whilst donor variability can provide some logistical challenges to the application of such assays, this variability is much closer to the heterogeneous cells that are present in vivo, compared to homogeneous non-human cell lines. [ABSTRACT FROM AUTHOR]

Background/aim: LUNGBANK was established as part of Project LUNGMARK, pioneering a biorepository dedicated exclusively to lung cancer research. It employs cutting-edge technologies to streamline the handling of biospecimens, ensuring the acquisition of high-quality samples. This infrastructure is fortified with robust data management capabilities, enabling seamless integration of diverse datasets. LUNGBANK functions not merely as a repository but as a sophisticated platform crucial for advancing lung cancer research, poised to facilitate significant discoveries. Materials and methods: LUNGBANK was meticulously designed to optimize every stage of biospecimen handling, from collection and storage to processing. Rigorous standard operating procedures and stringent quality control measures guarantee the integrity of collected biospecimens. Advanced data management protocols facilitate the efficient integration and analysis of various datasets, enhancing the depth and breadth of research possibilities in lung cancer. Results: LUNGBANK has amassed a comprehensive collection of biospecimens essential for unraveling the intricate molecular mechanisms of lung cancer. The integration of state-of-the-art technologies ensures the acquisition of top-tier data, fostering breakthroughs in translational and histological research. Moreover, the establishment of patient-derived systems by LUNGBANK underscores its pivotal role in personalized medicine approaches. Conclusion: The establishment of LUNGBANK marks a significant milestone in addressing the critical challenges of lung cancer research. By providing researchers with high-quality biospecimens and advanced research tools, LUNGBANK not only supports Project LUNGMARK's objectives but also contributes extensively to the broader landscape of personalized medicine. It promises to enhance our understanding of lung cancer initiation, progression, and therapeutic interventions tailored to individual patient needs, thereby advancing the field towards more effective diagnostic and therapeutic strategies. [ABSTRACT FROM AUTHOR]

Vascularized Composite Tissue Allotransplantation (VCA) allows replacement of lost body parts from brain-dead donors. These surgeries are laborious, time-intensive, and require vast planning. With the advent of better immunosuppressants, VCA will increasingly play an important role in the reconstructive field. In this paper, the authors share their standard operating protocol created after much deliberation. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to determine the level of compliance of venous blood sampling (VBS) in Lithuania with the joint recommendations of the European Federation of Clinical Chemistry and Laboratory Medicine and the Latin American Confederation of Clinical Biochemistry (EFLM-COLABIOCLI) and to analyse possible causes of errors. A survey was conducted between April and September 2022. Materials and methods: A self-designed questionnaire was distributed to the Lithuanian National Societies. Error frequencies and compliance score were computed. Differences between groups were analysed using Pearson's chi-square, Fisher's exact criterion, Mann-Whitney U (for two groups), or Kruskal-Wallis (for more than two groups) for categorical and discrete indicators. The association between ordinal and discrete variables was assessed using Spearman's rank correlation coefficient. Statistical significance was determined at P < 0.05. Results: A total of 272 respondents completed the questionnaire. Median error rate and compliance score were 31.5% and 13/19, respectively. Significant differences were found among professional titles, standard operating procedures availability, training recency, and tourniquet purpose opinions. A negative correlation was noted between compliance and time since training (rs = - 0.28, P < 0.001). Conclusions: The findings of this study indicate that there is a significant need for improvement in compliance with the EFLM-COLABIOCLI recommendations on VBS among specialists in Lithuania. Essential measures include prioritizing ongoing phlebotomy training and establishing national guidelines. Harmonisation of blood collection practices across healthcare institutions is crucial. [ABSTRACT FROM AUTHOR]

Background: When the Public Health Agency of Canada’s Human Pathogens and Toxins Act and Human Pathogens and Toxins Regulations came into force, the reporting of laboratory incidents to the Laboratory Incident Notification Canada (LINC) surveillance system became mandatory. This report summarizes the laboratory exposure and non-exposure data reported from 2016 to 2022, with a particular focus on factors that are not typically presented in LINC’s annual report. Methods: Reported laboratory incidents from 2016 to 2022 were analyzed. Exposures were analyzed by severity, occurrence and root cause, and affected individuals were analyzed by disease outcome, role and applied interventions. Non-exposures were analyzed by incident type. Exposure and non-exposure incident rates were calculated. Results: Events reported to LINC totalled 928. Of those, 355 were confirmed non-exposures, 361 were confirmed exposures, and 111 were other events. Both exposure and non-exposure incident rates per 100 active licences peaked in 2018 (9.44 and 7.11, respectively). Most exposures were rated as minor or negligible severity. The most cited exposure occurrence types were sharps-related and procedure-related (23% each), and standard operating procedurerelated root causes were most cited (24%). While 781 individuals were affected in the exposure incidents, most did not develop a laboratory-acquired infection (n=753; 96%) and received at least one form of treatment post-exposure (n=717; 92%). Inadvertent possession/production cases were the most common non-exposure incidents reported. Conclusion: Exposure and non-exposure incident rates have decreased since 2018. Among exposure incidents, sharps-related and procedure-related occurrences were the most common, and the root cause was usually a standard operating procedure. Non-exposure incidents were mostly inadvertent possession/production cases. Exposure and illness outcome severity was mostly minor. [ABSTRACT FROM AUTHOR]