Search

The global population's rapid growth, economic expansion, and ongoing urbanization have led to a significant surge in energy demand. Green hydrogen has found new interest in most scientific discussions because it is more environmentally friendly, scalable, and has wide application. However, it has general disadvantages, such as storage, pollutants, and generation costs. This review critically examined the current challenges of hydrogen production and how it can be further scaled down to attract biogas players and admirers. Several hydrogen production technologies were critiqued in line with user-friendliness and low energy requirements during production. The concept of 'biogas to hydrogen' and 'biomass to hydrogen' could potentially reduce the cost of green hydrogen production to about 40%. However, the main challenge of this concept is the wastage of feedstock and cost-effective hydrogen separation technologies. It was also observed that, unlike the thermochemical conversion, the biological conversion has a low energy requirement, further reducing the cost of production by 15%. The review observed that the 'biomass to biohydrogen,' which is becoming cheaper, is plagued with feedstock wastage and inefficient mechanisms to expunge impurities. It was concluded that the biological water gas shift reaction is expected to attract biogas users as its technique is similar procedurally. Hence, developing countries can now participate in cheap green hydrogen. [Display omitted] • Examined the major challenges of hydrogen production. • Evaluated the hydrogen production technique that is less cumbersome. • Highlighted ways hydrogen production can be accepted as biogas especially in developing countries. [ABSTRACT FROM AUTHOR]

In recent years, Malaysia has seen a surge in stem cell therapy for various medical conditions. However, the regulation of stem cell research and therapy in Malaysia faces several challenges such as the emergence of unregulated clinics and a lack of specific legislation. Some urgent measures, including enactment of specific laws, strengthened monitoring, as well as increased public awareness and education, are crucial. Therefore, stem cell therapy regulation requires concerted efforts by the policymakers, regulator bodies and healthcare professionals. This commentary discusses the current guidelines and challenges in Malaysian stem cell therapy regulation and proposes some future recommendations that could pave the way for responsible progress of stem cell research and therapy globally. [ABSTRACT FROM AUTHOR]

Carbon dioxide (CO 2) and methane (CH 4) are highly hazardous air pollutants that pose significant threats to the environment and human health and contribute indirectly to global warming. The dry reforming of methane (DRM) reaction has been investigated in numerous applications, including hydrogen production and catalytic converters. Catalytic DRM is one of the most effective approaches for utilizing CO 2 and CH 4 in syngas, which has garnered a lot of scholarly attention as a model reaction throughout the past couple of decades. Previous studies have extensively investigated the development of catalysts for DRM, with a particular emphasis on noble metal catalysts, catalyst configuration, and the influence of process parameters. However, despite the current understanding, there still needs to be a research gap in comprehending the synergistic interactions between catalytic activity and physicochemical features. Addressing this gap is of utmost importance. Therefore, a state-of-the-art review that clarifies new advancements for specific recently developed catalytic DRM systems with a complete evaluation and the synergistic link to physicochemical properties and their correlation with catalyst deactivation is critically urgent. Furthermore, in this study, we emphasized Ni-based catalysts as a promising option for DRM, given their potential, wide availability, and cost-effectiveness, owing to their high activity. Also, we discussed the limitations associated with this particular active metal. Additionally, this review integrates informetric analysis, employing robust search resources such as Web of Science. This analysis provides valuable insights into the DRM reaction, facilitating a deeper understanding of research trends and developments. This review can serve as a critical reference for scientists and experts engaged in mitigating CO 2 and CH 4 using DRM reactions and supports the academic and industrial sectors in their research and development efforts by contributing to developing well-designed catalysts suitable for future applications. [Display omitted] • A comprehensive review of the role of catalytic properties for Dry Reforming of Methane (DRM). • Rational and suitable design of catalysts for DRM were addressed. • Metal-support interaction, particle size, basicity, oxygen vacancies, reducibility, and porosity were elucidated. • Current challenges and future perspectives for DRM developments have been proposed. [ABSTRACT FROM AUTHOR]

The evolution of paediatric care in the UK is a compelling journey that reflects medical progress and a profound commitment to improving the health and wellbeing of children. Paediatric medicine has undergone significant transformations, from a nascent field with limited understanding to a dynamic and multidisciplinary domain focused on specialized care and groundbreaking research. This review aims to summarize the major advancements in the various paediatric specialties in the UK. As paediatric care evolved, the emergence of paediatric subspecialties became increasingly prevalent. Paediatric cardiology, haematology, and various other disciplines gained prominence, allowing for more targeted and effective treatments. The integration of research into paediatric medical practice became a driving force, leading to innovative discoveries and therapies. Contemporary paediatric care in the UK is characterized by a holistic approach that extends beyond treating illnesses to promoting overall wellbeing. The ongoing journey reflects a dynamic field that continues to adapt and innovate, promising a brighter and healthier future where every child receives the most effective and compassionate healthcare possible. [ABSTRACT FROM AUTHOR]

• Wastewater treatment technologies under microgravity were reviewed. • Wastewater treatment challenges under microgravity were discussed. • Potential solution strategies are suggested. Exploring the vast extraterrestrial space is an inevitable trend with continuous human development. Water treatment and reuse are crucial in the limited and closed space that is available in spaceships or long-term use space bases that will be established in the foreseeable future. Dedicated water treatment technologies have experienced iterative development for more than 60 years since the first manned spaceflight was successfully launched. Herein, we briefly review the related wastewater characteristics and the history of water treatment in space stations, and we focus on future challenges and perspectives, aiming at providing insights for optimizing wastewater treatment technologies and closing the water cycle in future. [ABSTRACT FROM AUTHOR]

The global COVID-19 crisis has underscored the critical role of effective decision-making in healthcare systems. Saudi Arabia has shown resilience by implementing comprehensive testing, tracing, and vaccination measures. Given the unique cultural and religious characteristics of Makkah, specific challenges have prompted efforts to uncover local pandemic responses. This qualitative assessment aims to delineate the challenges faced by decision-makers during COVID-19 in Makkah and identify key interventions implemented by the Makkah healthcare cluster to manage and coordinate care. Utilizing a purposive sampling approach, executive leaders within the Makkah Healthcare Cluster were invited for semi-structured interviews during the COVID-19 period. Thematic analysis was carried out in five steps, ensuring rigor and trustworthiness through multiple checks, and employing a critical and collaborative approach. Throughout the COVID-19 outbreak in Makkah, participants revealed Several factors that have hindered healthcare organizations' ability to effectively manage the pandemic, including testing difficulties, resource shortages, vaccination misconceptions, continuity of care issues, infections among healthcare workers, and the need for consistent protocols. The participant leaders in Makkah's healthcare cluster specified implemented strategies that helped in overcoming the encountered challenges, such as adopting new technologies, enhancing communication, managing supply and demand, and improving workforce adaptability and development. Their experience in managing Hajj and Umrah provided valuable insights for handling the pandemic effectively. The study emphasizes the significance of technology adoption, effective communication, supply management, workforce development, and lessons from managing religious events. Its findings have implications for healthcare systems globally, emphasizing the importance of preparedness, response, and resilience in diverse cultural contexts. [ABSTRACT FROM AUTHOR]

The rapid advancement of Artificial Intelligence (AI) technologies has the potential to revolutionize legal practice and judicial systems globally. In Colombia, the adoption of AI in the legal sector is still in its early stages, presenting both opportunities and challenges. This article investigates the emergence of AI in legal contexts, its diverse applications, and the specific hurdles Colombia must overcome to successfully integrate AI into its judicial system. By examining case studies from other jurisdictions and analyzing Colombia's ongoing legislative efforts, we underscore the potential benefits of AI, such as optimizing case management and enhancing the decision-making process, which could significantly improve the efficiency and effectiveness of the Colombian legal system. However, significant obstacles remain, including underdeveloped technological infrastructure, the digital divide, the risk of algorithmic bias, and concerns regarding data privacy. Despite these challenges, Colombia's proactive approach to addressing them through comprehensive legislation and targeted training initiatives for legal professionals demonstrates the country's commitment to the responsible and ethical implementation of AI. These efforts lay the groundwork for the successful integration of AI within the Colombian legal framework, fostering public trust and confidence in the system. [ABSTRACT FROM AUTHOR]

Despite the well-known neurosurgical workforce deficit in Sub-Saharan Africa, there remains a low number of neurosurgical training programs in Nigeria. This study sought to reassess the current status of specialist neurosurgical training in the country. An electronic survey was distributed to all consultant neurosurgeons and neurosurgery residents in Nigeria. Demographic information and questions relating to the content, process, strengths, and challenges of neurosurgical training were explored as part of a broader survey assessing neurosurgical capacity. Descriptive statistics were used for analysis. Respondents identified 15 neurosurgical training centers in Nigeria. All 15 are accredited by the West African College of Surgeons, and 6 by the National Postgraduate Medical College of Nigeria. The average duration of core neurosurgical training was 5 years. Some identified strengths of Nigerian neurosurgical training included learning opportunities provided to residents, recent growth in the neurosurgical training capacity, and satisfaction with training. Challenges included a continued low number of training programs compared to the population density, lack of subspecialty training programs, and inadequate training infrastructure. Despite the high number of neurosurgery training centers in Nigeria, compared to other West African countries, the programs are still limited in number and capacity. Although this study shows apparent trainee satisfaction with the training process and contents, multiple challenges exist. Efforts at improving training capacity should focus on continuing the development and expansion of current programs, commencing subspecialty training, driving health insurance to improve funding, and increasing available infrastructure for training. [ABSTRACT FROM AUTHOR]

This study investigates the scope, trends, and challenges of neurosurgical research in Nigeria since inception of the specialty in 1962. A bibliometric review of the neurosurgical literature from Nigeria was performed. Variables extracted included year and journal of publication, article topic, article type, research type, study design, article focus area, and limitations. Descriptive and quantitative analyses were performed for all variables. Trends of research publications were described in three periods: pioneering (1962–1981), recession (1982–2001), and resurgent (2002–2021). Of the 1023 included articles, 10.0% were published in the pioneering period, 9.2% in the recession period, and 80.8% in the resurgent period. Papers were predominantly published in World Neurosurgery (4.5%) and Nigerian Journal of Clinical Practice (4.0%). A total of 79.9% of the 4618 authors were from Nigerian institutions; 86.3% of the articles covered clinical research and were mainly focused on service delivery and epidemiology (89.9%). The most prominent topics were traumatic brain injury (25.8%) and central nervous system malignancy (21.4%). Only 4.4% of the publications received funding, mostly from agencies in the United States (31.7%). Barriers to neurosurgical research included lack of clinical databases (18.0%), increasing burden of disease (12.5%), and diagnostic challenges (12.4%). Neurosurgical research in Nigeria continues to grow due to increased training, workforce, and infrastructural improvements. Addressing the major challenges through establishment of research databases, development of evidence-based management guidelines, and increasing research training, funding and opportunities can increase research capacity in Nigeria. [ABSTRACT FROM AUTHOR]

Cancer and cardiovascular disease (CVD) commonly coexist, with increasing evidence that long-term cancer survivors are more likely to die from CVD than the general population. Effective management of CVD and its risk factors requires identification of patients at increased risk who may benefit from early intervention and their appropriate monitoring across the disease trajectory. Improving outcomes requires new models of multidisciplinary cancer care supported by care pathways. Such pathways require a clear delineation of the roles and responsibilities of all team members and provision of appropriate enablers for their delivery. These include accessible point-of-care tools/risk calculators, patient resources, and the provision of tailored training opportunities for health care providers. [ABSTRACT FROM AUTHOR]

Autism Spectrum Disorder (ASD) is a condition commonly characterized by challenges with social interaction, repetitive atypical behaviour, and restricted interest. It is estimated that about 1 in 160 children has ASD. Caring for children with ASD is challenging for many parents or caregivers. The study aims at exploring the challenges experienced by caregivers of children with ASD. A qualitative phenomenological study was employed using an exploratory descriptive research design. A total of 10 participants were recruited in this study using a purposive sampling technique. Data were analysed using content analysis procedures. Caregivers of children with ASD face social, financial, and emotional challenges, challenges in accessing health care, education and training of their children in mainstream school settings. The numerous challenges have implications for the quality of life of the caregivers and their children. The financial challenges and inaccessibility of specialist health services have serious implications for the continuous medical care and monitoring of children with ASD. The challenges in education and training of children with ASD has negative consequences for enrolment and retention of children with ASD in mainstream school settings. [ABSTRACT FROM AUTHOR]

Information technology infrastructure (ITI) has gone through an exponential change due to the rapid evolution of digital technologies during the past few years. It is therefore relevant to identify the factors that push organizations towards the adoption of new technologies. This paper considers a specific case study of the higher education institutions (HEI) to present (i) the motivational factors that push HEIs toward the adoption of new technologies, and (ii) the key challenges HEIs face in the adoption of these technologies. The data was gathered after conducting 17 open-ended interviews with practitioners working at HEIs in Finland and Pakistan. Data analysis identified 10 motivational factors and 41 challenges faced by HEI in the adoption of the latest technologies. Furthermore, the data was further classified to identify broad themes and categories representing the challenges and motivation factors. [ABSTRACT FROM AUTHOR]

This research paper explores the risks associated with Robotic Process Automation (RPA) projects, with a focus on the impact of disregarding key factors that affect project success. While previous studies have identified challenges and success factors for RPA projects, there is a lack of research that systematically and quantitatively evaluates these factors. To address this gap, the study uses a two-dimensional matrix to rate the impact and controllability of such risks associated with key factors in RPA projects, with data collected from 20 subject matter experts. The findings suggest that project managers should pay close attention to RPA development and process management. The high controllability ratings imply that proper planning and execution can effectively manage the identified risks. The study offers valuable insights into risk assessment for RPA projects and can assist project managers in increasing project success rates. [ABSTRACT FROM AUTHOR]

This study aimed to explore the psychosocial challenges and support needs of young people after suicide attempt. In the research, the phenomenological approach was used. Semi-structured interviews were held with 16 young people shortly after suicide attempt. Data were analysed via content analysis. The data were categorized into five themes: effort to return to the old normal, living with remains, need for support, barriers to seeking help, and awareness. Understanding the psychological challenges and support needs of young people who have attempted suicide will facilitate future research and practice. To support young people in the acute period following the intervention, supportive interventions at the individual, social and political levels need to be established. These findings shed light into the structuring of supportive interventions to be applied to young people following a suicide attempt. [ABSTRACT FROM AUTHOR]

• This study investigated perceptions of challenges for patients and health care workers (HCW) in dealing with preeclampsia in Blantyre, Malawi using a validated indepth interview guide. • From a patient's perspective, psychological stress, inadequate information, physical symptoms, and delay in receiving care were the challenges associated with managing their preeclampsia. Late diagnosis, inadequate skills, staff burn out, inadequate resources both at QECH and referring sites were the identified by HCW. • Engaging women in their care, providing sufficient information and timely intervention could reduce the psychological burden of preeclampsia on mothers, and improve clinical outcomes Supplying sufficient resources in primary health centres as well as secondary level of care for t women screened to be at risk of preeclampsia would improve maternal outcomes. • Lastly, addressing patients and health worker challenges provides a golden opportunity to improve comprehensive ANC for pregnant women. This study investigated perceptions of the challenges for patients and health care workers (HCW) in dealing with preeclampsia in Blantyre, Malawi. A descriptive cross-sectional formative study using semi-structured In-Depth Interviews (IDI) was conducted at Queen Elizabeth Central Hospital (QECH), Malawi. Data was analyzed using NVIVO™ software. Thematic content analysis was used to analyze and interpret the findings. Emerging themes were then developed inductively and deductively. Patients were interviewed who recently had preeclampsia. Stress, lack of information, physical symptoms, delay in receiving care were identified challenges to better care among patients as well as the impact of poor pregnancy outcomes. Late diagnosis, staff burn out, inadequate skills and lack of resources were expressed as challenge to provide better management by the interviewed HCWs. Our study showed that a diagnosis of preeclampsia is challenging to both patients and HCWs. These challenges need to be addressed carefully at all levels for optimal management of preeclampsia in Malawi, Africa and in order to improve outcomes. [ABSTRACT FROM AUTHOR]

Information dashboards consolidate large amounts of data into a single visual display, providing instant insights to decision-makers. However, their development is challenging due to limited study on a unified methodology for designing effective dashboards. This preliminary study, using the narrative review method, explores the existence of commonalities in principles, best practices, and challenges in designing information dashboards across diverse domains. The result confirms the existence of commonalities and paves the way for future research to develop a standardized methodology for designing effective information dashboards universally across different domains. [ABSTRACT FROM AUTHOR]

Higher education institutions in Indonesia are required to report their academic data to the national higher institution database (namely PDDikti) through a synchronization mechanism. Because the PDDikti database has been used as the reference for nationwide programs such as university ranking, diploma verification, faculty promotion, and tenure, academic data in their reports have to be valid, accurate, and up to date. Yet, data quality is an issue among higher institutions, while data governance is the heart of data quality. This paper investigates challenges encountered by a public university in Indonesia in implementing data governance and how to resolve them. The findings outline six main challenges in data governance implementation. [ABSTRACT FROM AUTHOR]

• Currently available conventional treatment modalities in β-thalassemia have posed many challenges and limitations. • There is a need for therapies that reduce patient reliance on RBC transfusions and iron chelation therapy. • Many novel therapies for β-thalassemia are now being tested in clinical trials. • These can be classified into three major categories based on their efforts to address different features of the underlying pathophysiology of β-thalassemia: correction of the α/β globin chain imbalance, addressing ineffective erythropoiesis, and improving iron overload. β-thalassemias are genetic disorders causing an imbalance in hemoglobin production, leading to varying degrees of anemia, with two clinical phenotypes: transfusion-dependent thalassemia (TDT) and non-transfusion-dependent thalassemia (NTDT). Red blood cell transfusions and iron chelation therapy are the conventional treatment options for the management of β-thalassemia. Currently available conventional therapies in thalassemia have many challenges and limitations. Accordingly, multiple novel therapeutic approaches are currently being developed for the treatment of β-thalassemias. These strategies can be classified into three categories based on their efforts to address different aspects of the underlying pathophysiology of β-thalassemia: correction of the α/β globin chain imbalance, addressing ineffective erythropoiesis, and targeting iron dysregulation. Managing β- thalassemia presents challenges due to the many complications that can manifest, limited access and availability of blood products, and lack of compliance/adherence to treatment. Novel therapies targeting ineffective erythropoiesis and thus improving anemia and reducing the need for chronic blood transfusions seem promising. However, the complex nature of the disease itself requires personalized treatment plans for each patient. Collaborations and partnerships between thalassemia centers can also help share knowledge and resources, particularly in regions with higher prevalence and limited resources. This review will explore the different conventional treatment modalities available today for the management of β-thalassemia, discuss the unmet needs and challenges associated with them in addition to exploring the role of some novel therapeutic agents in the field. [ABSTRACT FROM AUTHOR]

Human resources information systems have enhanced monitoring, documenting, and recording functions for organizations, and consequently have accelerated swift completion of routine processes. This change demonstrates the critical impact of adopting and using advanced technology such as artificial intelligence in the human resources function; in multiple functional gamut's, particularly in recruitment. This manuscript presents a scoping review of academic articles on the impact of adopting and using artificial intelligence in the human resource management function. The current review draft considered a total of 653 academic articles and aggregated review of 35 articles to present a classification framework with three distinct dimensions: artificial intelligence-enabled human resources benefits, challenges, and functionalities. Implications for future research and their directions are identified in the areas of value-added human services for decision-making, security, and privacy for customer and organization data, monitoring features, and creative IT service delivery models. [ABSTRACT FROM AUTHOR]

Additive manufacturing (AM) or 3D printing creates three-dimensional objects by adding materials using digital format files to achieve the desired shape. Researchers worldwide, including those in Malaysia, have shown interest in AM for over a decade. Although 3D printing has gained widespread adoption, 3D food printing is still in its early stages. This study aims to explore the challenges of implementing 3D printing technology in Malaysian food manufacturing firms. The research utilized a semi-structured interview method, conducting in-depth interviews with seven respondents. Snowball sampling was employed to identify potential experts, building upon the recommendations of the initial respondent. The literature review identified nine challenges: time-consuming processes, lack of standardization, scarcity of expertise, extrusion molds and materials, limitations in scalability, cost, food safety, halal compliance, and intellectual property. During the interviews, many respondents revealed that they had not yet integrated 3D food printing into their operations. Furthermore, respondents introduced a new challenge, which was related to spare parts and maintenance. In conclusion, the investigation revealed that the implementation of 3D food printing in Malaysian manufacturing firms is still at an early stage, as evidenced by the challenges reported by the respondents. [ABSTRACT FROM AUTHOR]

The rapid advancement of Industry 4.0 technologies has revolutionized industrial processes and production systems, creating unprecedented optimization opportunities. The Internet of Production (IoP) concept has emerged as a transformative approach that capitalizes on integrating cyber-physical systems, big data analytics, artificial intelligence, and the Industrial Internet of Things (IIoT) to drive efficient, flexible, and intelligent manufacturing. This study explores the current state of expert discourse on the symbiotic relationship between IoP and Industry 4.0, focusing on production technology, automation, and digitalization. For this purpose, we performed a content-centric qualitative review in a systematic manner. The findings show that connectivity, data-driven decision-making, flexibility, intelligent optimization, digital twins, and collaborative networks promotes IoP's potential within Industry 4.0. Overall, this study explains how harnessing the potential of IoP by enhancing efficiency, productivity, and innovation in industrial processes contributes to Industry 4.0, and how understanding the strengths, weaknesses, opportunities, and threats of IoP, leveraging advanced technologies, and data-driven approaches can pave the way for the future of efficient, flexible, and intelligent manufacturing systems. [ABSTRACT FROM AUTHOR]

This study explores the changes in perceptions of transitional challenges faced by learners studying Chemistry through English-medium instruction (EMI) at a university in Japan over one academic semester. The research investigates the relationship between students' English proficiency, academic performance, and their perception of transitional challenges. The study involves 27 students from an introductory Chemistry course and adopts a mixed-methods approach. The quantitative analysis utilises IELTS scores, as well as pre-and post-content tests, to examine the relationship between language proficiency and academic performance. Complementing these findings, the qualitative analysis provides insights from semi-structured interviews conducted at the start and end of a 12-week semester. These interviews offer an in-depth look into the individual transition processes of six purposefully selected students who represent a range of backgrounds and varying degrees of success in EMI, including both international and local students. The findings indicate that English proficiency alone does not guarantee a successful transition into EMI. Other factors play crucial roles in the rate and extent to which students overcome transitional challenges. The study recognises the need for ongoing support to help students navigate persistent transitional challenges in EMI. Implications are discussed regarding language support, EMI curriculum planning, and future research directions. • The study offers in-depth insights through the lens of six selected students. • English proficiency, while crucial, is not the sole determinant of success in EMI. • Familiarity with EMI and academic conventions impacts transitional difficulties. • Transitional challenges were largely mitigated by the end of the semester. • Language support must be tailored and ongoing to cater to students' evolving needs. [ABSTRACT FROM AUTHOR]

This paper discusses the current medical sonographer status in the United Arab Emirates (UAE). The paper explores the current education, skills, job description, and challenges towards developing sonography professions and a sonographer framework. The study employed a quantitative descriptive research approach using a cross-sectional study design to collect and analyse data from sonographers in the UAE. Data was collected through a structured survey that included sections addressing demographic information, education, skills, current practices, and challenges. The data showed a relatively even distribution across different age groups, with a higher proportion falling in the 31–40 age range. Females constitute a slightly higher percentage (55.9 %) than males (44.1 %). The study found that sonographers have the necessary skills and knowledge to interpret the scan results and provide a formal report. A significant percentage of participants taught ultrasound to others and participated in research activities. The survey responses indicate difficulty in reporting sonograms. The study found that sonographers possess the necessary expertise and skills to pass on their knowledge to trainees and colleagues. The participants expressing a desire to increase their knowledge and skills indicate that sonographers recognised that continuous professional development is crucial for staying updated with advancements in the field. The participant's "Advanced Practitioners" title recommendation suggests a desire for professional recognition, career progression, and specialisations in sonography. Effective interdisciplinary collaboration is important for providing quality patient care. The paper emphasises the importance of recognising sonography as a vital healthcare profession. It aims to raise awareness about the crucial role of sonographers in patient care. The study also stresses the need for a well-defined career progression framework to guide professional growth and acknowledgement. [ABSTRACT FROM AUTHOR]

• Using ChatGPT in education may reduce students' thinking abilities, and those who rely too much on technology may tend to abuse the technology. • As suggested by some educators, "Don't Ban ChatGPT in Schools. Teach With It," but this involves requiring students be educated against the malicious use of ChatGPT but ensure that they are taught to distinguish between fact and fiction and the consequences that could come with the use of ChatGPT. • Nurse educators may need to create more personalized and engaging learning experiences for students while streamlining administrative tasks and improving the quality of student feedback. • Nurse educators must be forward-thinkers and educate students to embrace AI and ChatGPT to optimize their potential and the cautions needed in using this technology. Chat Generative Pre-trained Transformer (ChatGPT), trained on big data, has the potential to be an excellent starting point resource for nursing students to expand their knowledge of basic information. This contemporary paper provides the responses given by ChatGPT for the authors' prompt on nursing education, teaching, and learning. The authors explored the challenges and opportunities of using ChatGPT in nursing education with four key prompts given to ChatGPT related to teaching and learning. The response from ChatGPT was supported by evidence of benefits and risks to nursing education and practice. Although ChatGPT is considered controversial, given the changing landscape, rather than banning ChatGPT, educators could adopt ChatGPT as a learning assistant. [ABSTRACT FROM AUTHOR]

Conducting a vaccine trial in a low- and middle-income country (LMIC) can present unique challenges and lessons learned. This Ebola vaccine trial, enrolling 699 healthcare providers and frontliners and jointly set up by the University of Antwerp (Sponsor) and the University of Kinshasa (Principal Investigator (PI)), was conducted in Boende, a remote city in the Democratic Republic of the Congo (DRC), between December 2019 and October 2022 (ClinicalTrials.gov : NCT04186000). While being bound by strict ICH-GCP and international funder regulations, this trial, exemplary for being a public–private partnership, required collaboration between several international stakeholders (e.g., two universities, a pharmaceutical company, and a clinical research organization), local communities and government agencies. Here we address several logistical and administrative challenges, cultural differences, language barriers and regulatory, political, and ethical considerations over the trial's 2.5-year duration, while tailoring and adapting the study to the specific local context. Lessons learned include the importance of clear communication with participants in all phases of the study, but also within the study team and among different stakeholders. Challenges, mitigations, and lessons learned are presented in nine categories (e.g., safety management; trial documentation, tools, and materials; communication, staff training and community engagement/sensitization; financial and administrative hurdles; and more). Ultimately, to reach the successful end of the vaccine trial in this remote Ebola endemic area in the DRC, careful planning, collaboration, and great flexibility and adaptability was often required from all involved partners. Despite the encountered challenges, the vaccine trial discussed in this paper was able to obtain high participant retention rates (i.e., 92% of participants completed the study). We hope that other international teams aspiring to conduct similar trials in remote areas of LMICs can learn from the way our challenges were addressed, mitigations developed, and lessons were learned. [ABSTRACT FROM AUTHOR]

Antibiotic resistance (ABR) is a global health threat with the potential to cause mortality and morbidity on an unprecedented scale. In the past, civil society organizations (CSOs) have been successful in complementing the efforts of government health systems, thereby shaping the course of various public health programs, especially in low- and middle-income countries (LMICs). This article reports the outcomes of a CSO sensitization workshop held by one of the regional nodes of ReAct and highlights the perspectives of CSOs on their role in supporting the implementation of national and sub-national action plans for AMR mitigation. CSOs can contribute to (i) redefining the AMR narrative, (ii) generating the data for action and policy change, (iii) advocating for policy change, (iv) promoting research and influencing decisions pertaining to research in AMR, and (v) undertaking behavioral change communication for different target groups, among others. Governments in LMICs could leverage the expertise of CSOs by playing the role of facilitator while ensuring that the interventions align with national priorities and are sustainable. Efforts to ensure diverse funding and capacity building among CSOs should happen in parallel to ensure maximum impact on communities. [ABSTRACT FROM AUTHOR]

As the largest demographic group utilizing primary healthcare facilities, older adults often face the challenge of managing multiple chronic illnesses, leading to numerous medications. The present study aims to assess medication use problems among older adults and explore the factors affecting them in primary healthcare settings. A mixed-method study was conducted to establish a baseline understanding of the perspectives and challenges faced by older adults, with regards to medication use. Translated Medication Use Questionnaire (MedUseQ), a patient-centered tool, was distributed to older adults above 60 in primary healthcare settings to assess their frequency of problems related to medication use. Fifteen semi-structured interviews were conducted to explore this topic in depth. Descriptive and inferential analyses were conducted with quantitative data. Interviews were transcribed verbatim, and thematic analysis was conducted. Quantitative and qualitative findings data were triangulated. The study involved 393 participants. The most common problems with regards to medication use were polypharmacy (55.4%), administration difficulties (48.4%), limited awareness about adverse drug events (47.3%), issues with adherence (46.5%), and accessibility to primary healthcare (42.7%). Approximately 55% were satisfied with the older adult-centered medication use services by pharmacist and doctors. The qualitative findings showed that major factors affecting medication use were forgetfulness, language barriers, lack of awareness, transportation problems, long waiting times, and multiple visits to healthcare facilities. The findings of this study reveal that a significant proportion, around 50%, of the older adult population face challenges with medication use in Penang. These difficulties mainly stem from medication administration, adherence, accessibility, polypharmacy, and inadequate medication knowledge. The qualitative analysis further highlighted several factors that contribute to such medication-related problems. Given the rapidly aging Association of Southeast Asian Nations (ASEAN) population, it is essential to devise effective solutions and strategies to tackle medication use-related issues among older adults. • Various challenges exist among older adults in obtaining medication use. • Findings contribute to the exploration of older adults' views. • Strategies can be channeled to improve medication use services. [ABSTRACT FROM AUTHOR]

Over the past century, neuroendoscopy developed into a mainstay of neurosurgical practice, allowing for minimally invasive approaches to the ventricles, skull base, and spine. Its development, however, is far from over. Current challenges are inherent in the very feature that renders neuroendoscopy appealing—the small channels of the modern endoscope allow surgery to be performed with minimal tissue retraction, but they also make hemostasis and resection of large masses difficult. New optics allow for significantly improved image quality; yet open craniotomy often allows for 3-dimensional visualization and bimanual dissection and is part of everyday neurosurgical training. Finally, the utilization of neuroendoscopy remains limited, presenting ongoing challenges for neurosurgical teaching and achievement of technical mastery. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: Artificial intelligence (AI) and its subfields such as machine learning (ML) and deep learning (DL) have been reported to show high performance, particularly in the diagnosis and prognosis of various cancers 1–3. Despite the promising results obtained from these studies, advancements in technology have increased the availability of medical images in different formats such as computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and ultrasound images 1,2. Interestingly, these image formats are more than pictures, they are in fact, data 4. As a result, several approaches such as radiomics have been recently used to extract information that is not visible to the human eye during routine examination from these images 5. Hence, radiomics is an emerging field in radiology that provides a non-invasive approach for extracting quantitative features from medical cancer images such as CT, PET, MRI, or a combination of these image formats 5. Traditionally, the extracted features are processed using statistical approaches. However, due to the large amount of extracted features, statistical approaches can no longer effectively handle these features 6,7. Therefore, in recent years, several studies exploring the potential of AI or its subfields such as ML and DL in handling the extracted features to produce a predictive model have shown promising results that are capable of revolutionizing HNC management 8. However, in actual everyday clinical practice, the use of AI-based radiomics models remains limited 5. This is due to several implementation challenges 5. Objectives: This study provides a systematic review of the challenges, concerns, and limitations of AI-based models in head and neck cancer (HNC) oncology. Furthermore, we suggest possible solutions to these challenges. We searched OvidMedline, PubMed, Scopus, and Web of Science databases for articles that examine the challenges of AI-based models in HNC oncology. The quality of included studies and their risk of biases were evaluated using the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) and Prediction Model Risk of Bias Assessment Tool (PROBAST). A total of 11 studies examined the challenges of these models in HNC oncology. These challenges have been summarized into 5 themes. These include data, science of machine learning, model generalizability, model maintenance and performance improvements, and ethical and regulatory concerns. The data concerns include data management, data imbalance and heterogeneity, privacy, and confidentiality. The concerns relating to the science of machine learning include model and result interpretability, explainability, and model performance. The model's generalizability encompasses internal and external independent geographic validation of the models. Some of the ethical and regulatory concerns were as follows: model-clinician disagreement (contradictory diagnostic or prognostic opinion between the model and clinician), workflow and user-design challenges, patient's liberty to decide the type of treatment to follow may be violated, patient–clinician relationship may change, standardized reporting guidelines of AI model development, and outdated regulatory and legal frameworks. Stakeholders such as the governments, medical institutions, hospital management, clinicians, physicians, regulatory agencies, technological companies, politicians, ethicists, philosophers, legal experts, patient representatives, data scientists, and machine learning experts need to be deeply involved in the development of internationally standardized and structured reporting guidelines for the AI-based model to be beneficial in daily clinical practice. The envisioned guidelines should define solutions to data issues by defining a robust data economy framework. Model interpretability and explainability can be handled using explainability techniques by providing both local and global interpretations of the predictions made by the model. Independent external geographic validation of the model should be a standard procedure. A federated learning paradigm can enhance continuous model improvement and generalizability. The guidelines should also include a defined ethical and regulatory framework for the development and reporting of AI-based radiomics models. [ABSTRACT FROM AUTHOR]

Burns are global public health devastating and life-threatening injuries. Telehealth can be an appropriate answer for the effective utilization of health care resources, prevention referrals and reduce socio-economic burden of burns injuries. Thus, this study aimed to systematically evaluate the applications, opportunities, and challenges of using telehealth in burn injuries management. A structured search was conducted according to PRISMA statement guidelines in the Web of Science, PubMed, Scopus, and Science Direct as well as the Google Scholar for studies published until June 28, 2022. Of the total 2301 yielded studies, 36 articles were included in the final review. Quality appraisal was done according to the Mixed Methods Appraisal Tool (MMAT) version 2018. Thematic analysis was applied for data analysis. Patient triage, transfer, and referral (38.9%) follow-up (22%), care (22%), consultation (9%), education (3%), and rehabilitation (3%) were the most prevalent application of telehealth, respectively. Our findings identified 72 unique concepts, eight initial themes, and two clinical and administrative final themes for opportunities of using telehealth in burn injury management. Furthermore, we identified 27 unique concepts, three initial themes, and two clinical and administrative final themes for remaining challenges. Despite providing pivotal opportunities such as improving burn injury diagnosis and quality of care, increasing patient and provider satisfaction, and cost containment using telehealth in burn injuries management, the concept faces challenges such as the impossibility of the physical examination of patients and technological difficulties. Our findings provide valuable information for policymakers and decision-makers infield of burn injuries and effective planning for using telehealth technology. • Burn injuries are global public health devastating and life-threatening injuries. • Telehealth can led to utilizing healthcare resources, preventing referrals, and reducing socio-economic burden of burns. • Patient triage, transfer, referral follow were the most common application of telehealth. • Improving burn injuries diagnosis and patients and provider satisfaction arecommon opportunities of telehealth in burns. • Impossibility of physical examination and technological difficulties are the main obstacles to using telehealth in burns. [ABSTRACT FROM AUTHOR]

Despite several initiatives taken by government of India since 2013 to improve the performance of major ports, growth was not as anticipated. Hence, there is a need to understand the performance of these major ports during 2013–2020 and to identify the critical challenges that affect their performance. Performance analysis was conducted using Malmquist productivity index (MPI) and critical challenges were identified using interpretive structural modelling (ISM) technique as well as the cross-impact matrix multiplication (MICMAC). Ten major ports in terms of operational, 12 ports in terms of service quality, and six ports in terms of financial performance have been categorised as high performers, based on the MPI values. 19 challenges affecting the performance were identified in an eight layered ISM model. This research is limited to major ports of India and does not cover the non-major ports of India due to unavailability of data This study will enable the port decision-makers to identify the ports which are high performers in terms of operational, service quality, and financial performance, and thereby the best practices followed across can be replicated. This study explored the multi dimensions of performance of Major ports of India and there was no such study in the past. Despite the existence of performance studies in the literature, none of them explored the challenges faced by the major ports. [ABSTRACT FROM AUTHOR]

Hepatitis B virus (HBV) infection is a major public health concern globally with higher prevalence in Middle Eastern countries. Both Saudi Arabia and the UAE face critical challenges in HBV treatment and management despite the implementation of a mass vaccination program. This review aimed to understand the gaps and unmet needs related to HBV infection, public health challenges associated with its diagnosis, and treatment barriers in Saudi Arabia and the UAE. Additionally, the review aimed to provide the best practices in the HBV care pathway for effective remedial measures and disease reduction. The literature search was done from Pubmed. The lack of disease awareness and knowledge about disease transmission among patients and their family members and healthcare professionals, lack of proper screening, underdiagnosis, social stigma, lack of established referral system, and treatment cost are the primary barriers to HBV diagnosis and management. Appropriate healthcare initiatives should be undertaken to lower the disease burden in Saudi Arabia and the UAE. [ABSTRACT FROM AUTHOR]

Thalassemia is a persistent hemolytic disease and has debilitating effects on patients and their parents. Parents of these children experience pain and suffer from additional emotional strain as they provide daily and lifetime care and are mostly concerned about the health and future of their children. The study aimed to understand the experiences of parents of children with thalassemia related to their family, financial, social, treatment, and psychological issues in Pakistan. This descriptive phenomenological study recruited 21 parents of children with thalassemia through purposive sampling until data saturation was achieved. Analysis of transcribed interviews was performed through Colaizzi's method and themes and subthemes revolving around diagnosis, challenges, and treatment issues were extracted. A total of 21 Pakistani parents participated in this study. Most of the participants were females (n = 16, 76.19%), housewives/stay-at-home moms (n = 13 (61.90%), and were uneducated (n = 6, 28.57%). Regarding genetic traits, only three (14.28%) parents declared that they had genetic traits of thalassemia. The findings of our study revealed that thalassemia is enormously influenced by psychosocial and economic problems because of this disease in their families. Our findings indicated that parents of these children face multi-faceted challenges, such as physical, socio-emotional, financial, and familial. These findings may lead to an adequate understanding of their individual needs and efficient utilization of supportive and care programs. An understanding of such experiences, involving those distinctive to Pakistani culture, is especially vital to inform the care of these children and enhance their quality of life. • Statement of significance • Thalassemia is a persistent hemolytic disease and has debilitating effects on patients and their parent's physical, socio-emotional, financial aspects. • What is already known • International studies examined the challenges of thalassemia to parents having a child with thalassemia. • What this paper adds • Very little research on this area urges a need to explore parents' experiences of living with a child with thalassemia in Pakistan. An understanding of such experiences, involving those distinctive to Pakistani culture, is especially vital to inform the care of these children and enhance their quality of life. [ABSTRACT FROM AUTHOR]

The aim of this study is to thoroughly examine the challenges experienced by pediatric nurses providing care for the children of immigrant families and to contribute to the solutions that can be provided. Phenomenological research design was used in this qualitative study. Semi-structured interviews were performed with face-to-face technique and individually. Four categories, ten main themes and twenty-four sub-themes were obtained in the analysis of data. The themes included communication barriers and cultural differences in the category of difficulties that the nurses experienced with immigrant patients or their relatives, nurses' practices, communication barriers and cultural differences in the category of problems that the nurses experienced in the care. It was determined that nurses experienced difficulty, especially in the areas of communication, culture and education. These difficulties were reported to cause disruptions in the care and treatment process of immigrant patients. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) seriously affects patient's life. A systematic summary of the latest epidemic trend and pathogenesis of IBD is lacking. In addition, some health benefits of lactic acid bacteria (LAB) were reported, whereas a comprehensive review of its mechanisms for alleviating IBD is limited. This review systematically revealed the epidemic trend and pathogenesis of IBD, and showed the potential regulatory mode of LAB on gut health, then critically exhibited the possible mechanisms of LAB in alleviating IBD based on animal and clinical studies. Moreover, it pointed out the challenges and opportunities of LAB for IBD. Higher incidences and death rates of IBD were found in developed countries. Environmental and genetic factors are important factors for the occurrence of IBD. LAB provided numerous advantages and had great potential for improving IBD as its ability to produce bioactive metabolites, regulate gut immunity, protect the intestinal mechanical barriers, inhibit oxidative damage, and restore unbalanced gut microbiota. Then, the manuscript advice to screen effective LAB by cell models and metabolites, to control the optimal intake of LAB through dose-effect studies, to encapsulate LAB through nanoencapsulation and microencapsulation to improve utilization, to promote the understanding of LAB by investigating the mechanism, and to improve the design of the clinical study to improve the lives of patients. This will contribute to understanding the epidemic trend, pathogenesis, and treatment of IBD, and promote the development of targeted therapeutic products such as LAB. • Higher incidences and death rates of IBD were found in developed countries. • The intestinal mucosal barrier is an important target for regulating IBD. • LAB have potential benefits to human health. • LAB alleviate IBD by improving the intestinal mucosal barrier. • LAB are helpful for adjuvant therapy of IBD patients. [ABSTRACT FROM AUTHOR]

Brachytherapy has a long history of delivering a highly conformal radiation dose to the target volume with sparing of adjacent normal tissue and has an irreplaceable role in certain cancers, such as cervical and prostate cancers. There have been futile attempts to replace brachytherapy with other radiation techniques. Despite that there are multifaceted challenges in preserving this dying art, from establishment, to a trained workforce, to maintenance of the equipment and source replacement costs. Here we focus on the challenges to access brachytherapy, the availability and distribution of care across the globe and appropriate training leading to proper implementation of the procedure. Brachytherapy holds a significant place in the treatment armamentarium of most common cancers, such as cervical, prostate, head and neck and skin cancers. However, there is an uneven distribution of brachytherapy facilities, not only across the globe, but also at a national level, with a larger proportion of facilities concentrated in certain regions, more so in low and low-middle income countries. The regions with the highest incidence of cervical cancer have the least access to brachytherapy facilities. Attempts to bridge the gap are essential and should be focused on uniform distribution and access to care, improving training of the workforce through specialised training programmes, reducing the cost of care, planning to reduce the recurring cost, generating evidence and research guidelines, renewing interest in brachytherapy through rebranding, use of social media and building an attainable long-term roadmap. • There is disparity in access to brachytherapy across the globe. • Several challenges in implementation have led to declined use of brachytherapy, but not replaced completely. • Structured education and training, generating evidence through multi-institutional collaborative studies are some of the ways to improve brachytherapy. • Changes in the reimbursement structure may improve utilization of brachytherapy. • Effective use of social media and rebranding could be considered for preserving this dying art. [ABSTRACT FROM AUTHOR]

• Most ADL nursing interventions target older adults, with or without dementia. • ADL nursing interventions vary in characteristics, components, outcomes and quality. • Evidence on ADL nursing interventions remains fragmented and inconclusive. • Guiding nursing professionals to provide effective ADL care remains challenging. Despite its frequent provision, evidence of nursing interventions in Activities of Daily Living (ADL) remains unclear. Hence, we addressed the research question: What are the effects of ADL nursing interventions on independence and comfort in adults across all care settings? We conducted a systematic review of randomized controlled trials and quasi-experimental studies described in systematic reviews. In three databases, we searched for systematic reviews that we used as a portal to select (quasi) experimental studies. After narratively summarizing the studies on characteristics, effects, and interventions, we assessed the risk of bias. Among the 31 included studies, 14 studies evaluated independence, 14 studies measured comfort, and three studies assessed both outcomes. Seven interventions significantly improved independence and seven interventions significantly improved comfort. The studies varied highly in intervention components, outcome measures, and quality. Evidence on ADL nursing interventions affecting independence and comfort remains fragmented and inconclusive, limiting guidance for nursing professionals. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Taibah University Medical Sciences is the property of Elsevier B.V. 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.)

The Abbott i-STAT and Siemens Healthineers epoc are commonly used in the provision of care during emergency medical services calls and other settings. Maintaining these systems within manufacturer's temperature claims in these settings poses challenges across the world. This review summarizes solutions that have been reported in the peer-reviewed literature and proposes additional strategies to further address these challenges. A literature search was performed with Clarivate's Web of Science from inception to August 3, 2022. Search terms included i-STAT, epoc, temperature, cold, hot, heat, freeze, frozen, prehospital, disaster, POCT, point of care, blood gas, helicopter, airplane, and ambulance. One author also reviewed manually every issue of the Journal of Paramedic Practice. The search identified 17 solutions for addressing temperature-related challenges with the i-STAT device, nine solutions for i-STAT cartridges, one solution for the epoc device, and one solution for the epoc test card. The majority of solutions were highly portable and consisted of widely available, inexpensive components. The solutions demonstrated only partial or entirely questionable effectiveness in achieving temperature control. The search also identified five reports on the impact of storage temperatures on cartridges and test cards. The reports suggested that these reagents may be able to withstand storage at temperatures outside of manufacturer's claims with only minimal deterioration in performance. The heterogeneity of solutions and the paucity of evidence on their effectiveness suggest that additional strategies are needed to better understand and further address temperature-related challenges with these systems. A collaborative approach and shared decision making are recommended. [ABSTRACT FROM AUTHOR]

Antibiotics help in preventing and treating infections and increasing life expectancy globally. Globally, many people's lives are being threatened by the emergence of antimicrobial resistance (AMR). The cost of treating and preventing infectious diseases has increased due to AMR. Bacteria can resist the effects of antibiotics by altering drug targets, inactivating drugs, and activating drug efflux pumps. According to estimates, five million individuals died in 2019 from AMR-related causes, wherein 1.3 million deaths were directly linked to bacterial AMR. Sub-Saharan Africa (SSA) experienced the greatest mortality rate from AMR in 2019. In this article, we discuss AMR's causes and challenges SSA faces in implementing AMR prevention measures and propose recommendations to address the challenges. Antibiotic misuse and overuse, widespread usage in agriculture, and the pharmaceutical industry's absence of new antibiotic development are the factors contributing to AMR. SSA's challenges in preventing AMR include poor AMR surveillance and lack of collaboration, irrational use of antibiotics, weak medicine regulatory systems, lack of infrastructural and institutional capacities, lack of human resources, and inefficient infection prevention and control (IPC) practices. The challenges faced by countries in SSA can be addressed by increasing the public's knowledge of antibiotics and AMR, promoting antibiotic stewardship, improving AMR surveillance, promoting collaboration within and beyond countries, antibiotics regulatory enforcement, and improving the practice of IPC measures at home, food handling establishments, and healthcare facilities. [ABSTRACT FROM AUTHOR]

Agile development has successfully established itself for coping with VUCA conditions on a team level. Furthermore, in developing cyber-physical systems or mechatronic products, the collaboration of multiple teams is often necessary. This necessity to scale contrasts with the paradigm of agile development from which additional challenges arise. The study examines the current challenges in scaling agile product development, characterized by scale-related challenges and physical constraints. This paper provides an empirical investigation to address these challenges. This publication shows that product development's top challenges are synchronization, coordination, resource allocation, and dependencies between different organizational units. It is determined that the challenges in the non-scaled environment also apply to scaling; however, substantial differences in their dependencies exist. Furthermore, an attempt to explain differences in scaled agile software development using comparative analysis is given. It becomes apparent that challenges such as production setup or physical limitations are non-existent. [ABSTRACT FROM AUTHOR]

Internet of things (IoT) implementations are gaining increased momentum worldwide. IoT infrastructures may aid in better and more efficient resource management and attain sustainability goals. Thus, with limited resources in developing countries (DCs), IoT solutions have the potential to optimize operations and efficiently manage those resources. One of the challenges facing countries worldwide is the need for more sustainable and smart waste management (WM) solutions. Hence, IoT technologies can significantly improve the overall WM process and its logistics. It is then crucial to identify the challenges of IoT adoptions for WM in DCs, to ensure more successful adoptions. While the IoT literature is booming, very little research has been conducted focusing on WM in DCs specifically. Hence, this research summarizes and provides an overview of the existing literature on the challenges of implementing IoT technologies for WM in DCs. The primary purpose of this review is to present the findings from the reviewed articles, shed light on current research gaps, and offer recommendations for future research. Our main findings suggest that DCs can develop optimization plans for WM processes that may aid them in joining the worldwide efforts to protect public health and reach the sustainable development goals put forward by the UN. Facing the social, environmental, economic, and technical challenges when implementing IoT in WM can further increase the efforts for sustainable development in DCs. [ABSTRACT FROM AUTHOR]

Business process automation has been gaining more and more space in the management of organizations, since it translates into a reduction in the execution time of routine tasks in an organization, freeing up employees for other more creative and interesting tasks. However, it is important to check what types of processes are eligible, benefits, and challenges in the adoption of RPA technology. Robotic Process Automation (RPA) is a growing trend in business process restructuring, combined with digital transformation. This technology can be applied in various areas of business processes, and by organizations from any sector of activity. This work, through a literature review, aims to clarify the RPA's concept, the benefits found in this adoption, the main characteristics that the processes must have to be eligible, and the main barriers encountered for successful RPA adoption. In short, this preliminary literature review aims to contribute to the organization's clarification of RPA adoption. [ABSTRACT FROM AUTHOR]

The concept of transforming maritime industry into a digital platform with real-time communication has rapidly emerged within industry discussions. A big part of the topic was tied around blockchain technology that due to its decentralization feature can simplify the complexity of the supply chain network and interconnect its actors. Nevertheless, only a few studies have investigated the feasibility in detail, yet not covered limitations other than those generally discussed. The purpose of the study is to identify and summarize the challenges of blockchain implementation in the maritime industry and within maritime ports. Based on the literature and previous research findings, 18 challenges to the blockchain implementation were identified and categorized into four dimensions: human factor, operational, organizational, and technological. The findings show that different priorities among ports, low level of digitalization, scalability of blockchain systems, and unwillingness to change business routine are important challenges. [ABSTRACT FROM AUTHOR]

We aimed to identify the challenges in the management of sexual development abnormalities in a low-resource country. The study was retrospective from January 2000 to December 2017 based on patient records from two pediatric surgery departments. Epidemiological, clinical, paraclinical, treatment, and outcome data were studied. We collected data on 13 patients (average age = 7.95 years). The sex of rearing was as follows: three females (23%), 10 males (77%). Atypical genitalia other than hypospadias represented the reason for consultation in 92% of the cases. We could not find complete hormonal analyses; testosterone levels were studied in 69.23% of cases. We found the following disorders of sexual development (DSD): four patients with 46,XX karyotype (30.77%), eight patients with 46,XY karyotype (61.53%), and one patient with 46,XX/XY karyotype. Four patients had medical treatment only, four had surgical treatment only, and one patient had medical and surgical treatment. The medical treatment comprised topical administration of androgen. The surgical treatment consisted of feminizing genitoplasty for one patient and masculinizing genital surgeries for two patients. Six of the 13 patients were lost to follow-up. The socioeconomic difficulties of the population and the lack of access to basic diagnostic and paraclinical methods, coupled with the negative cultural representations of the pathology, constitute the challenges in the management of DSD in our practice. [ABSTRACT FROM AUTHOR]

Background: Malnutrition among pregnant women and lactating mothers remains an issue of public health concern in developing countries. The Gikuriro program, an integrated nutrition-specific and nutrition-sensitive intervention, was implemented in 5 districts of Rwanda for 5 y to address this problem. Postprogram quasi-experiments showed significant effect of the intervention on maternal and child undernutrition. Notwithstanding, there was a need for a qualitative study to explore the views of the beneficiaries and implementers regarding its benefits, challenges, and limitations to inform future interventions. Objective: This study aimed to explore the effect and challenges of an integrated nutrition-intervention program among pregnant women and lactating mothers. Methods: This was a qualitative study involving 25 community health officers and 27 nutritionists as key informants and 80 beneficiaries in 10 focus group discussions. All interviews and group discussions were audio-recorded, transcribed verbatim, translated into English, and double coded. A deductive and inductive content analysis approach was used with the help of ATLAS.ti, version 9.15. Results: The study identified several positive effects, such as improved knowledge and skills on nutrition, a positive mindset toward a balanced diet, perceived improved nutrition, and economic independence among pregnant women and lactating mothers. However, some of the main obstacles of the integrated nutrition intervention were lack of awareness of the program, negative beliefs, poverty, lack of spousal support, and time constraints. Moreover, the study identified a main limitation: the lack of inclusiveness for all social categories. Conclusions: This study demonstrates that integrated nutrition interventions have perceived positive effect on nutrition; however, such interventions may face some challenges and limitations. These findings suggest that, apart from contributing to the body of evidence for scale up of such interventions in resource-limited settings, economic challenges and misconceptions have to be addressed to maximize the effect of such interventions. [ABSTRACT FROM AUTHOR]