bluuebunny/crossref_metadata_2025 huggingface dataset:
Green Accounting, Intellectual Capital, and Corporate Sustainability Performance
Authors:   Politeknik Negeri Bali, Mahayana I Dewa Made , Sudiadnyani I G A Oka ,   Politeknik Negeri Bali, Ardina Cening ,   Politeknik Negeri Bali, Sudana I Made ,   Politeknik Negeri Bali, Sukayasa I Ketut ,   Politeknik Negeri Bali
Published: September 2024

This study aims to determine the effect of green accounting and intellectual capital on Corporate Sustainability Performance (CSP). The population in the study consisted of companies listed in the SRI-KEHATI Index for the 2019-2023 period. The sample determination was carried out using purposive sampling technique, with the number of samples obtained as many as 12 companies. Multiple linear regression analysis was used to test the effect of green accounting and intellectual capital on CSP. The results of this study indicate that green accounting and intellectual capital have a positive effect on CSP. This research can support stakeholder theory and be able to provide additional information as a consideration for stakeholders regarding decision making.
Uma leitura interseccional da subjetividade em Garota, mulher, outras, de Bernardine Evaristo
Authors:   , Tôrres Laura Cabral
Published: September 2024

Garota, mulher, outras foi o primeiro romance de Bernardine Evaristo traduzido e publicado no Brasil. O objetivo deste trabalho é discutir a respeito das personagens e suas subjetividades interseccionando gênero, raça, classe e sexualidade. Para tanto, retomamos o histórico do desenvolvimento do conceito de interseccionalidade antes mesmo de ser cunhado (COLLINS & BILGE, 2020), e situamos os debates sobre identidade em contato com as questões diaspóricas (HALL, 2003; 2005). Nos baseamos principalmente em Judith Butler (2010) que, ao propor o gênero como uma performance, abriu uma série de discussões a respeito da subjetividade gendrada. Assim, foi possível debater as identidades de Amma enquanto mulher negra, lésbica e ativista; a de Nzinga, enquanto dominadora em um relacionamento lésbico; e a de Bummi, atravessada por diversas vivências relacionadas à colonialidade. Outras filósofas e pensadoras como Adrienne Rich, Monique Wittig e Françoise Vergès também foram essenciais para o desenvolvimento dessa pesquisa. Pudemos concluir que no romance de Evaristo as subjetividades das personagens oferecem uma representação quase inédita na ficção literária, por tratar de personagens que ultrapassam os estereótipos a respeito da feminilidade e da negritude. Palavras-chave: Garota, mulher, outras; Bernardine Evaristo; estudos feministas; identidade; lesbianidade
Enhancing Data Security in Higher Education Administration: Strategies for Protecting Student Information and Institutional Integrity in Cloud-Based Systems
Authors:   USA, Chananagari Prabhakar Rohit Reddy
Published: September 2024

The widespread adoption of cloud-based systems in higher education has brought significant benefits and heightened concerns over data security. This research paper explores practical strategies for enhancing data security in cloud-based systems used by higher education institutions. The study employed a literature review, case studies, and surveys to gather data on current practices, challenges, and technological solutions in data security. The findings reveal that while cloud computing offers convenience and cost savings, it also introduces new vulnerabilities that must be addressed through a comprehensive security program. The paper discusses the importance of risk assessment, transparent governance, encryption, access controls, and the integration of emerging technologies like blockchain and AI. The implications of this research suggest the need for policymakers, administrators, and IT professionals to prioritize data security as a critical component of cloud-based system adoption in higher education.
Automating Troubleshooting Network Issues with AIOps and Machine Learning
Authors:   USA, Bajpai Mohit
Published: September 2024

Network issues can significantly impact an organization's productivity and profitability. Traditional troubleshooting methods are often time-consuming and reactive, relying on human expertise to identify and resolve problems. The emerging field of AIOps offers a promising solution by leveraging machine learning and advanced analytics to automate the troubleshooting process. This paper explores the use of AIOps and machine learning in automating network troubleshooting, presenting real-life scenarios, a high-level architecture, and a comprehensive diagram to illustrate the approach.
The Development of Clioquinol Labeled-Gold Nanoparticles for the Treatment of Alzheimer’s Disease
Authors: Jung Selice , Lee Jooyeong
Published: September 2024

Clioquinol has emerged as a prominent metal-chelating agent for Alzheimer’s Disease. While clioquinol was once a popular antibiotic for skin infections, it has recently been investigated as a potential therapeutic for Alzheimer’s Disease. Its metal chelating property can restore metal homeostasis and prevent copper (Cu2+) and zinc (Zn2+) from interacting with amyloid-β (Aβ) peptides. Here, we propose labeling gold nanoparticles with clioquinol as a novel therapeutic approach for Alzheimer’s Disease to enable effective delivery of the agent across the blood-brain barrier. Based on previous studies on the individual efficacies of clioquinol and gold nanoparticles, we anticipate that this approach will prevent the formation of Aβ oligomers by disrupting metal-protein interactions. Our proposed clioquinol-labeled gold nanoparticles provide a novel curative approach for Alzheimer’s Disease and insights into subsequent therapeutic developments.
Assessing the Impact of Human Resource Competency and Employee Commitment on Performance at Urban Republic, a Member of the Erajaya Group, Palembang
Authors: Sari Indah Permata , Heriyanto Heriyanto
Published: September 2024

Companies must innovate and improve employee performance in today’s competitive business climate to maintain their market share. Urban Republic, a company headquartered in Palembang and part of the Erajaya Group, is the subject of this study, which examines the relationship between employee participation and HR competency and performance. Improving employee performance requires HR competency, including technical and non-technical skills, and employee commitment, characterized by loyalty and dedication. For Urban Republic to remain competitive, they must understand how these elements affect performance. This study aimed to assess the impact of employee commitment and HR competency on performance. Three sections of labor area heads, store leaders, and staff were given surveys as part of the quantitative approach. Multiple regression analysis was used to analyze the data, supported by validity, reliability, and classical assumption tests. The results showed that employee dedication showed almost significant significance, indicating a possible influence, while employee competence had a statistically significant impact on employee performance. Dedication and HR competency significantly impact performance when the two work together. This analysis emphasizes the importance of continuous HR development investment and the potential benefits of employee commitment. To reduce the risk of employee turnover, it is recommended that HR training programs be improved, employee recognition programs be strengthened, commitment issues be addressed, and staff well-being be monitored to avoid burnout. It is recommended that more research be conducted to examine the intricacies of employee dedication and how it impacts work outcomes. The study concluded that a balanced focus on HR competency and employee commitment is essential to optimize employee performance at Urban Republic
Collaboration Between Technical Colleges and Industries for Skills Acquisition in Motor Vehicle Mechanic Works in Edo State, Nigeria
Authors: J. Ogbebor, , S.O. Osuyi,
Published: September 2024

The study investigated strategies for improving collaboration between technical colleges and industries for skill acquisition in Motor Vehicle Mechanic Works (MVMW) in Edo State, Nigeria. Four (4) research questions were raised to guide the study and one hypothesis was formulated and tested at 0.05 level of significance. The study adopted a descriptive survey research design. The population of the study consisted 80 respondents, which comprised 53 technical teachers from five public technical colleges and 27 managers of automobile industries in Edo State. The entire population was used as the sample because it was of manageable size. The research instrument used for data collection in the study was a structured questionnaire with 18 item statements arranged in clusters. The instrument was validated by three experts in the Department of Vocational and Technical Education, Faculty of Education, University of Benin, Benin City, Edo State, Nigeria. In order to establish the stability of the instrument, Cronbach alpha coefficient formula was used. The test yielded an overall coefficient of 0.85. The findings of the study revealed that there was no adequate collaboration between technical colleges and industries for skill acquisition in motor vehicle mechanic works in Edo State. Based on the findings, it was recommended that industries should collaborate with technical colleges by training and re-training technical teachers, providing modern teaching and learning facilities and granting permission for students to use its facilities during students’ industrial work experience scheme.
Facilitating Access to Art and Pre-exposure Prophylaxis for LGBTQ Individuals in Combating HIV in Malaysia: An Analysis from a Shariah Perspective
Authors: Rosidi Mohd Harifadilah
Published: September 2024

The increasing rate of new HIV infections poses a significant public health challenge, particularly among young individuals engaging in high-risk sexual behaviours, including male-to-male interactions. Effectively addressing HIV prevention and management within the LGBT community in Malaysia necessitates a comprehensive approach that considers both medical and socio-cultural aspects. This academic inquiry seeks to comprehensively evaluate the progress in HIV preventive measures and therapeutic interventions in the Malaysian context, examining their effectiveness within the affected communities and their adherence to Sharia principles despite religious barriers to modern medical approaches. The findings of this study indicate that the implementation of Antiretroviral Therapy (ART) and Pre-Exposure Prophylaxis (PrEP) measures, supported by the Ministry of Health, align with Sharia principles, underscoring the importance of disease prevention, treatment, and harm reduction. Nonetheless, the research emphasises the vital role of integrating Islamic practices as a preventive measure against HIV transmission. Consequently, this study advocates for improving HIV prevention and treatment strategies pursued by the Ministry of Health by integrating Islamic ethical considerations into Malaysia’s public health policies.
Brand Supportive Behavior among Insurance Agents in Malaysia
Authors: Othman Adilah , Shaari Hasnizam , Mohd Sidik Siti Noor Aishah
Published: September 2024

Brand supportive behavior is important to companies because it shows the willingness of agents to go beyond their prescribed roles for the good of the corporate brand. Hence, this study aimed to examine the relationship of internal brand orientation and customer orientation on brand supportive behavior. A research framework was established based on existing literature to test the relationship among these variables. The Social Exchange Theory were employed to explain the relationship between the variables being studied. In order to empirically test the research framework of the study, data were collected by employing a questionnaire survey. 350 respondents from the insurance industry were selected using the systematic sampling. The data collected was analyzed using the Partial Least Square Structural Equation Modelling (PLS-SEM). The empirical result revealed that internal brand orientation, customer orientation, influenced brand supportive behavior. The results of this study provide insights to managers whereby they must use appropriate applications of internal brand management practices such as internal brand orientation and customer orientation. These findings also suggest that internal brand orientation, customer orientation are crucial factors that affect the willingness of agents to commit to brand supportive behavior.
Islamic Finance and its Effect on Financial Performance of Commercial Banks in Kenya: A Case Study of First Community Bank Limited
Authors: Ibrahim Issack Najma , Nyaloti Laura
Published: September 2024

In this study, First Community Bank Limited was used as a case study to examine the goals of islamic finance as they relate to the financial performance of commercial banks. Determine the effect of riba, gharar, and maysir bans on the monetary execution of commercial banks was the explicit aim. The management of First Community Bank Limited and other academics will find the study important. The target population consisted of 106 staff of First Community Bank. The study utilized stratified random sampling, allowing generalizations to be made across a broader population that are statistically valid. Slovin’s Formula was used to arrive at a sample of 84 staff out of a target of 106 staff of First Community Bank. Questionnaires were used as the data gathering tools. The study concluded that the restriction of riba (interest) has an impact on the financial health of commercial banks based on its findings. The majority of respondents concurred that gharar restriction had an impact on the financial performance of commercial banks. According to the research’s conclusions, commercial banks’ financial performance is impacted by the prohibition of gharar. Majority of respondents stated that the ban on maysir (gambling) affects how well commercial banks function financially. The study concluded that the restriction of maysir (gambling), based on its findings, had an impact on the financial health of commercial banks. Majority of the respondents agreed that sharing of business risks influence financial performance of commercial banks. Based on the findings, the study came to a conclusion that sharing of business risks affects financial performance of commercial banks. The response of prohibition of riba (interests) and financial performance of commercial banks. On property rights affect financial performance of commercial banks in Kenya, 3% strongly disagreed, 15% disagreed, 20% were neutral, 23% agreed and 40% strongly agreed. On creating wealth affect financial performance of commercial banks in Kenya, 28% agreed and 37% strongly agreed. On reduction of state resources affect financial performance of commercial banks in Kenya, 25% agreed and 36% strongly agreed. banks.
Evaluating Company Efficiency in Malaysian Stock Markets: Insights from DEA and
Risk Analysis and Management and Significance of Halalan Tayyiban Sustainability in Halal Warehousing Operations
Authors: Said Norsabrina Mohd , Rahman Fadilah Abd , Saidin Nurulaina Binti , Samori Zakiah , Putera Mohd Shith Mohd Sirajuddin Siswadi
Published: September 2024

The global warehousing and storage market was valued at 451.9 billion in 2021 and is predicted to be approximately USD 605.6 billion by 2026. The current existing landscape of the global warehousing and storage market is skyrocketing dramatically, owing to the rapid enhancement of digitalization, globalization, and technological development. This situation can create both potential and obstacles which directly shows an alarming need for comprehensive risk analysis and management in the industry. In Halal warehousing operation, the Halal product is potentially exposed to a variety of cross-contamination risks that would affect the Halalan Tayyiban integrity, which embraces both the safety risks as well as Halal risks. This study critically focuses on the integration of comprehensive risk analysis and management processes in Halal warehouses by examining any potential risk in depth, ranging from contamination and productivity issues to misconduct. It also explains how the implementation of risk analysis and management could assist in the long-term sustainability of the Halal warehousing industry by ensuring that operations completely adhere to the principle of Halalan Tayyiban while fulfilling the growing market for Halal products. In doing so, the relevant literature was reviewed and analyzed qualitatively using content analysis. Applicable secondary sources, including previous studies, operating handbooks, certification guidelines, and legislation will be reviewed. Therefore, through the implementation of a content analysis approach, the study’s findings demonstrate that Halal products are exposed to various risks and contaminants, during various activities in Halal warehouse business operations. Because risk can result in a significant loss, a critical part of the Halal warehouse business operation is the identification, assessment, elimination, and/or control of hazards. These could be done by conducting a risk analysis and developing a risk management plan with the integration of the Halalan Tayyiban concept.
Symbolism in the Queen of Lepa as the Regatta Lepa Festival of Bajau Semporna Co
Study of the Effectiveness of Drama Therapy in Enhancing Communication Skills of Institutionalized Children
Authors: Vidanagamage S.D. , Bhaumik A.O. , Irugalbandara A.I.
Published: September 2024

This study investigates the effectiveness of drama therapy in enhancing communication skills among institutionalized children in the Southern Province of Sri Lanka. In the global context, drama therapy is recognized as a therapeutic tool for mental well-being. However, the application of drama therapy as a therapeutic tool in Sri Lanka is still underexplored. Institutionalized children who are exposed to trauma often show poor communication abilities. This study provides valuable insight to address this critical gap in both research and application within this context. The study utilized Qualitative methods and data was gathered through observations, in-depth interviews, and focus group discussions. The study sample consisted of 80 female children aged 12-16, in state-run children’s homes under the Department of Probation and Childcare Service in Southern Provinces. Thematic analysis was used to identify key themes: Verbal Communication Challenges, Non-Verbal Communication Challenges, Active Listening, and Engagement. Under these key themes, sub-themes were identified as Articulating, Clarity in Expressing Ideas, Body Language, and Confidence in Presentation. The results revealed a significant improvement in communication skills, including expressiveness, engagement, and social interaction. It aligns with previous research on the effectiveness of drama therapy. The study suggested integrating tailored drama therapy interventions into the child welfare framework in Sri Lanka. Incorporating drama therapy into regular therapeutic programs, and training staff to implement therapeutic intervention effectively would support the reintegration of institutionalized children into society by improving their communication skills and overall emotional well-being.
Beyond the Written Word: Emerging Innovative Writing Practices in a Malaysia University Classroom
Authors: Mat Nur Huslinda Che , Tazijan Farina , Ramli Nor Fazlin Mohd , Zakaria Siti Fauziana , Mahmud Malissa Maria , Manap Mohammad Radzi
Published: September 2024

According to recent studies, there is a widening gap between traditional writing pedagogies and the demands of the digital age. It is evident that both teachers and students have expressed challenges in negotiating the complex standards of meeting the requirements of academic writing conventions. In the Malaysian educational context, there is a noticeable struggle to balance traditional writing approaches with the demands of the digital era. Given the unique practices observed in the university setting, this study aims to provide an in-depth qualitative exploration of changes in academic writing practices and innovative solutions to the identified challenges. Drawing on the theoretical foundations of Vygotsky’s Sociocultural Theory and Brian Street’s Academic Literacies, this study utilises semi-structured group interviews with four students and one teacher from a university writing classroom. Exploring the academic landscape in Malaysia, the findings shed lights on several key issues: the pressing need for adaptable teaching approaches, the importance of students acquiring and using digital skills, and the value of collaborative learning in achieving effective writing outcomes. This study highlights the need for a blended teaching approach to prepare the teachers, policymakers, and students for global writing standards. The findings are expected to have important implications for curriculum development, teaching approaches, and broader educational policies.
Factors Affecting the Adoption of BIM-FM Integration at the Early Phase of the BIM Project
Authors: Ariffin Erni Yusnida , Misnan Mohd Saidin , Sapri Maimunah
Published: September 2024

Building Information Modelling (BIM) aims to support the whole-of-life project life cycle. BIM has been practiced broadly at the design and construction stages in the Malaysian construction industry. However, it has not yet been extensively implemented in the Facility Management (FM) industry. The adoption of BIM-FM integration is complex, and the information on the adoption of BIM in the FM process is still scarce. Hence, to improve early integration of FM in BIM project, it is necessary to understand the adoption factors from various level of FM management. Thus, this research aimed to address this gap by examining the factors influencing the Facility Management Organization (FMO) in adopting the BIM-FM integration into the early phase of the BIM project. A qualitative method was adopted, and a semi-structured interview was utilised as the primary method to execute the research objective. The data were thematically analysed. The results revealed various issues influencing the BIM-FM adoption at the early phase of the BIM project. It has been concluded that there are twenty-three (23) relevant factors that contribute to the adoption BIM-FM integration. The findings of this study expected to offer better understanding to the significant factors and provide a strategy in activation the integration of BIM-FM the early BIM project in Malaysia. However, this study not considered the essential factors that contribute to the adoption process.
Эффективные практики трансформации магистерских программ в онлайн-формат: исследование на примере «Программной инженерии и кибернетики»
Authors: Ковалев И. В. , Ворошилова А. А.
Published: September 2024

В статье рассматриваются эффективные практики трансформации магистерских программ в онлайн-формат на примере программы "Программная инженерия и кибернетика" в Сибирском федеральном университете. Актуальность исследования обусловлена стремительной цифровизацией образования и растущим интересом к онлайн-форматам, что делает магистерские программы более доступными для студентов, совмещающих учебу с работой. В работе представлен анализ успешных практик реализации онлайн-курсов, включая элементы структуры и дизайна, контента и мультимедиа, методов преподавания и взаимодействия с учащимися, а также оценки и обратной связи. Особое внимание уделяется выбору платформы для онлайн-обучения, где обоснован выбор Moodle как наиболее подходящей системы для реализации магистерской программы. Также в статье представлен портрет студента онлайн-магистратуры, который помогает выявить потребности и ожидания учащихся, что способствует оптимизации образовательного процесса. Результаты исследования подчеркивают важность применения передовых практик для создания качественного образовательного опыта и достижения целей программы.
Política Nacional de Educación Inicial (PNEI) en México
Authors: Delgado Fuentes Marco Antonio , Fritz Macías Heidi Diana
Published: September 2024

Este artículo analiza las limitaciones y desafíos de la implementación de la Política Nacional de Educación Inicial (PNEI) en el Sistema Nacional para el Desarrollo Integral de la Familia (DIF) de México, bajo el modelo del derecho a la educación de De Beco. El estudio explora cómo la PNEI afecta la calidad y accesibilidad de la educación inicial en contextos no integrados plenamente en la Secretaría de Educación Pública. Se utilizó un enfoque de estudio de caso, basado en observaciones y entrevistas durante cuatro meses en un Centro de Atención, Cuidado y Desarrollo Infantil del DIF. Se empleó análisis temático para documentar las condiciones del personal y las prácticas educativas dirigidas a infancias menores de tres años. Los resultados destacan las dificultades para transformar una fuerza laboral precaria y con alta rotación en una estable y capacitada, crucial para implementar un currículum congruente al enfoque de derechos. Se subraya la necesidad de integrar el DIF más efectivamente dentro de la PNEI para mejorar la calidad educativa y cumplir con los estándares de derechos en la educación infantil. Este estudio aporta al debate académico sobre políticas educativas inclusivas y su impacto en la equidad educativa y el desarrollo infantil en México.
A propriedade intelectual na contratação pública: entre a proteção da titularidade do poder público contratante e a promoção da inovação
Authors: Baptista Patrícia
Published: September 2024

A legislação nacional brasileira sobre contratação pública em vigor (Lei federal 14.133/2021) cuida da propriedade intelectual nos contratos administrativos nos seus artigos 30, parágrafo único, e 93. Neles, o legislador almeja tutelar não apenas a propriedade intelectual do contratante sobre o produto da execução do contrato feito às suas expensas, mas também procura não inibir a iniciativa privada de inovação. O presente artigo apresenta uma análise comparada das normas vigentes com o disposto no anterior art. 111 da Lei federal 8.666/1993, bem como examina seu alcance, adequação técnica e hipóteses de incidência.
La convencionalización de los derechos en entredicho: reflexiones en torno a las dificultades para su consolidación en América Latina, y el papel de los jueces constitucionales al respecto
Authors: Barrera Eloy Espinosa-Saldaña
Published: September 2024

El presente trabajo pretende abordar el desafío de la convencionalización de los derechos fundamentales en el contexto constitucional de los países latinoamericanos, al mismo tiempo que pretende exponer el importante papel de los jueces en la búsqueda de una interpretación acorde con un consenso social. Para ello, rastrea las distintas tutelas por parte de los sistemas de América Latina y Europa, expone el papel de las Cortes de ese continente y analiza las especificidades de casos concretos en Argentina y Perú.
La prueba en el proceso administrativo
Authors: Polanco Francisco A. Ortega
Published: September 2024

El presente trabajo pretende analizar el valor de la prueba y su comportamiento en el ámbito de los procedimientos administrativos. Para ello, se inspira en la Teoría General de la Prueba y el Régimen Administrativo de la Prueba en la Constitución. Analizar el estado de derecho en la legislación administrativa. Finalmente, presenta la Teoría de la carga dinámica de la prueba en el proceso administrativo y La cuestión probatoria en la doctrina administrativa.
Comitê de resolução de disputas: referências de utilização no Brasil
Authors: Rossi Alina de Toledo , Mendes Karen Cristina Moron Betti
Published: September 2024

Para cada conflito existe uma solução mais adequada. Além das formas autocompositivas já consagradas no ordenamento jurídico brasileiro, como a mediação e a conciliação, e a arbitragem como forma de solução adjudicada, outras formas podem ser utilizadas na prevenção e resolução de conflitos. O presente trabalho objetiva apresentar o Comitê de Resolução de Disputas, Comitê de Especialista ou Dispute Resolution Board como forma eficaz na prevenção e resolução de conflito, além de demonstrar que o instituto já vem sendo utilizado no Brasil com resultados positivos.
Judaism in South India, 849–1489
Authors: Gamliel Ophira
Published: September 2024

Jewish presence in the Malabar Coast of southwestern India is attested since the ninth century in various sources and diverse languages. Malabar Jewry emerged out of the Indian Ocean maritime trade networks that connected people and communities in West and South Asia forging kinship alliances and cross-cultural exchange. This book traces the evolution of Malabar Jewry in the history of contact and exchange that gave rise to Indo-Arab coastal communities in the period between 849 and 1489.
Emerging Trends in Perioperative Buprenorphine Management
Authors: Engle Amanda , Cleary Jacqueline , Winans Amanda
Published: September 2024

Background: Historically, there has been limited evidence and no clear consensus suggesting best practices for perioperative buprenorphine management (PBM). Previously published PBM strategies included a wide variation in dosing, complexity, and clinical decision making points. Importantly, there are limited published algorithms reporting corresponding patient outcomes data.
Purpose/hypothesis: To review the literature for newly published perioperative PBM strategies, with the aims of identifying emerging trends and assessing patient outcomes data.
Procedures/data/observations: Literature review of manuscripts published from 2020 to current containing PBM strategies.
Conclusions/applications: Pending completion of analysis, the authors will present findings of emerging trends and patient outcomes data in PBM.
Clinical Pharmacist with DEA License: Efforts to Increase Access to Buprenorphine in a Veteran Population
Authors: Stevens Shelley
Published: September 2024

Background: Opioid overdoses continue to rise in the United States. In 2021, a record 80,411 reported overdoses occurred in the US alone, nearly double that in 2017. Buprenorphine’s pharmacology is ideal for management of patients with opioid use disorder (OUD) with or without chronic pain.
Within the VA, clinical pharmacist practitioners (CPP) are uniquely equipped to operate with significant scope of practice to prescribe medications including controlled substances, an opportunity to vastly increase access to care for veterans suffering from OUD, complex opioid dependency or pain.
Purpose/hypothesis: The purpose of this case series is to describe how DEA licensed pain CPP safely and effectively manages 1) Suboxone home inductions to increase access for OUD 2) rotations from traditional full mu opioids to chronic pain buprenorphine products and 3) off label use of Suboxone for pain.
Procedures/data/observations: Cases were collected in usual workload for clinical pharmacist. High rate of tolerability and efficacy noted with buprenorphine across all products.
Conclusions/applications: DEA licensed Pain CPPs can make an immediate positive impact for veterans with OUD and/or complex pain and may be more comfortable with buprenorphine than many other providers.
Buprenorphine for the Treatment of Pain in Cancer Patients
Authors: Chwistek Marcin , Sherry Dylan , Kinczewski Leigh
Published: September 2024

Background: Opioids remain the cornerstone for the treatment of moderate to severe cancer pain. Due to benefits over full agonist opioids (FAO), buprenorphine has emerged as an alternative treatment.
Purpose/hypothesis: Buprenorphine is only approved for the treatment of pain that is chronic non-cancer. Cancer-related pain is often progressive with breakthrough pain. There is limited evidence for using short-acting FAO in combination with buprenorphine. There are concerns about withdrawal and the efficacy of pain control using buprenorphine. We hypothesize buprenorphine, in combination with short-acting FAOs, can adequately control cancer-related pain without causing withdrawal symptoms.
Procedures/data/observations: Our prospective, single-arm, open-label study enrolls patients with cancer-related pain who are on buprenorphine in combination with an FAO at > 30 mg OME/day, either requiring long-acting pain relief or their pain is not controlled with an FAO alone. Our study is ongoing, with 15 patients enrolled and a target of 50. The patient’s pain is self-assessed daily using a mobile application. Withdrawal is assessed regularly using a modified Clinical Opioid Withdrawal Scale (COWS) score.
Conclusions/applications: Buprenorphine appears to be effective for the treatment of cancer pain without causing withdrawal in combination with short-acting FAO >30 mg/day.
Buprenorphine: The Opioid that Cried 'Partial Agonist'
Authors: Bettinger Jeffrey J. , Cleary Jacqueline
Published: September 2024

Background: Although buprenorphine use has increased dramatically over the past decade, its unique pharmacologic and pharmacokinetic profile often leads to misconceptions about its overall utility and has created a drastic underrepresentation in patients with chronic non-cancer pain. A common misnomer associated with buprenorphine is because of ‘partial agonist’ activity, it exhibits a plateauing of typical opioid-related side effects (including respiratory depression, constipation, euphoria, and hypogonadal axis suppression), but additionally it must exhibit a plateauing effect of overall analgesic potential. However, novel downstream molecular and cellular mechanisms offer new insights that help support the clinical potential that buprenorphine’s analgesic actions may not have a ceiling, like its side effect profile. This interactive symposium will provide an enhanced review of the evolving research that helps unravel the complexity around buprenorphine’s varying pharmacologic effects including actions on various opioid receptors, promiscuity to elicit varying actions on mu-opioid receptors coupled with different isoforms of G~ subunits, role in the intracellular recruitment of beta-arrestin, binding to different splice variants of mu-opioid receptors, and greater spinal versus supraspinal activity. The final half of this symposium will be designed to substantiate evidence with various human clinical trial data to further support buprenorphine’s place on the analgesic ladder.
Conversion of CII Opioid Medications to Buprenorphine in the Chronic Pain Population - Insights and Clinical Pearls
Authors: Zimmerman Amanda
Published: September 2024

Background: There is a great deal of confusion associated with conversion from CII opioid to buprenorphine products. The data presented supports that patients can be converted from high dose opioid medication to buprenorphine products safely and effectively.  This presentation will provide a road map to help guide practitioners who are interested in applying this to their clinical practice.
Purpose/hypothesis: The purpose of the research was not only to discover if conversion to a partial agonist CIII medication from full agonist CII medications would be achieveable without sacrificing analgesia, but also to provide guidance to providers who are interested in pursuing this option in clinical practice.   
Procedures/data/observations: Patients who met inclusion criteria were stratified into subgroups on the basis of preconversion morphine milligram equivalents, whether they remained on opioids for breakthrough pain post-conversion, and pre- and post-conversion numerical rating scale pain scores. Outcomes of interest included the differences between pre- and post-conversion numerical rating scale pain scores and daily morphine milligram equivalents for each subgroup. Of 157 patients reviewed, 87.9% were successfully converted to buprenorphine buccal film. Overall, numerical rating scale pain scores were stable after conversion. Statistically significant reductions were demonstrated in the <90 daily morphine milligram equivalent subgroup. Post-conversion daily morphine milligram equivalents decreased by 85.4% from baseline. Change in daily morphine milligram equivalents is representative of patients who remained on breakthrough pain medication. 
Conclusions/applications: Results demonstrate continued analgesia after conversion to buprenorphine buccal film despite reductions in daily morphine milligram equivalents. Most patients were able to convert directly from their long-acting opioid to buprenorphine buccal film and sta- bilized without the use of concomitant opioids for breakthrough pain. Aggressive titration strategies were associated with greater success. This data proves that conversion from full agonist CII medications is possible without sacrificing analgesia while reducing the risk of adverse events associated with full agonist CII medications.
Overcoming challenges of prescribing long-term opioid therapy in residency clinics
Authors: Brown Kathryn , Farley Joel , Golberstein Ezra , Satin David , Harper Peter , Pereira Chrystian , Slattengren Andrew H. , Van Riper Kristi , Montag Schafer Katherine
Published: September 2024

Objectives: To describe the impact of a standardized opioid prescribing intervention when implemented in three family medicine (FM) residency training clinics—environments that face operational challenges including regular resident turnover.
Design: We performed a retrospective cohort study to compare patterns of long-term opioid prescribing between residency and nonresidency clinics.
Setting: This study took place within a large, academic, health system.
Patients and participants: Three FM residency clinics were compared with three nonresidency FM clinics.
Interventions: A standardized opioid prescribing process was developed and implemented within the FM residency clinics. Nonresidency clinics used an independent process and were not exposed to the intervention.
Main outcome measures: Descriptive comparisons were performed for treatment and control clinics' opioid prescribing from 2015 to 2018. The primary outcome was a patient's annual opioid exposure supplied from these select clinics. We also examine coprescribing with high-risk medications that potentiate the overdose risk of opioid prescriptions. Difference-in-difference modeling was used to control for clinic-level variation in practice.
Results: Statistically significant decreases were observed in both residency and nonresidency clinics for the mean number of opioid prescriptions and the mean daily morphine milligram equivalent. These decreases were comparable between the residency and nonresidency clinics.
Conclusions: Residency clinics face unique challenges and require innovative solutions to keep up with best practices in opioid prescribing. Our residency clinics' implementation of a standardized intervention, including electronic health record integration, standardized processes, and metric management, suggests steps that may be valuable in achieving outcomes comparable to nonresidency clinics in large health systems.
Why pharmacogenetic testing should be reimbursed by Medicare and commercial health insurance
Authors: Pesce Amadeo
Published: September 2024

It is well documented in the field of psychiatry that pharmacogenomic testing improves patient care by providing physicians a tool to accurately monitor patient compliance and tolerance to certain drugs and their dosages. For example, in guidelines promulgated by several organizations including the Food and Drug Administration (FDA) list the pharmacogenomics testing that should be performed when prescribing psychiatric drugs such as amitriptyline. Among the CYP450 metabolizing enzymes with variants is CYP2D6, responsible for the metabolism of drugs such as oxycodone. The field of pain medicine could also benefit from the use of pharmacogenomics testing for opioid management but has been stymied by lack of support by government and commercial entities that label these tests as, at best “experimental” and at worst, outright fraudulent.
Opioid-related clinical outcomes and associated healthcare costs following abuse/misuse of oxycodone formulations: A HEOR analysis from real-world data
Authors: Green Jody L. , Dailey-Govoni Taryn , Vosburg Suzanne K.
Published: September 2024

Objective: The United States (US) opioid epidemic is a continued burden on the healthcare system and on the lives of individuals affected by the consequences of opioid abuse/misuse. The objective of this study was to use real-world data from intentional abuse/misuse exposures managed by US poison centers to compare clinical outcomes and quantify healthcare costs among three study cohorts: exposures that involved Xtampza ER®, other oxycodone extended-release (ER), and oxycodone immediate-release (IR).
Study design: A real-world, observational study.
Main outcome measures: Descriptive statistics were used to describe patient and exposure characteristics. Drug utilization-adjusted rates of intentional abuse/misuse and clinical outcomes were used to determine relative risk. Healthcare cost estimates were calculated by extrapolating average charge per opioid-related disorder emergency department (ED) visit and per inpatient stay based upon case disposition rates, adjusted for population and drug utilization.
Results: Compared to Xtampza ER, exposures that involved other oxycodone ER were 7.4 times more likely to be intentional abuse/misuse, 25.9 times more likely to result in major effect or death, 9.7 times more likely to require a visit to the ED, and 14.3 times more likely to result in hospital admission. Similar results were found for oxycodone IR when compared to Xtampza ER.
Conclusions: This study is the first of its kind to synthesize clinical outcomes with opioid-related healthcare costs, suggesting that even when Xtampza ER is abused/misused, the rates of major effect/death, ED visits, and hospital admissions were significantly lower than those for other oxycodone-containing medications, resulting in relatively low downstream opioid-related healthcare costs.
BUPRENORPHINE: NOT JUST ANOTHER OPIOID – MYTHBUSTING THE WORLDS MOST INTERESTING OPIOID
Authors: Rubinstein Andrea
Published: September 2024

This is a talk that highlights the specific ways in which buprenorphine is different from other opioids used to treat pain. It will specifically discuss analgesia, tolerance, respiratory depression and the unique role buprenorphine can play in patients who suffer from both pain and depression.
Qualitätsseile seit 1949
Authors: Buschmeier Nicole
Published: September 2024

Lanex a.s. ist tschechischer Hersteller von Qualitätsseilen und ein zuverlässiger Geschäftspartner mit langer Tradition – die ersten Seile wurden in Bolatice bereits im Jahre 1949 hergestellt. Heute stellt Lanex nicht nur Seile und Fasern her, sondern entwickeln sie auch selbst. Autorin: Nicole Buschmeier, KPNB
Wirtschaftliche Lösung für High-Speed-Anwendung
Authors: Henning Ralf
Published: September 2024

Schnelllaufende Prozesse wie sie in der Papierindustrie häufiger vorkommen, sind für leistungsstarke Sensorik zumeist kein Problem. Wenn sie jedoch nicht permanent im Einsatz ist und sich daher trotz hoher Anforderungen größere Investitionen in technisch aufwendigere Lösungen nicht lohnen, wird die Kosten-Nutzen-Rechnung schon schwieriger. Autor: Ralf Henning, Applikationsspezialist ipf electronic gmbh
KẾT QUẢ PHẪU THUẬT NỘI SOI CẮT ĐẠI TRÀNG PHẢI ĐIỀU TRỊ UNG THƯ BIỂU MÔ TẠI BỆNH VIỆN E GIAI ĐOẠN 2019-2023
Authors: Ngô Văn Công , Đặng Quốc Ái
Published: September 2024

Mục tiêu: Đánh giá kết quả phẫu thuật nội soi cắt đại tràng phải điều trị ung thư biểu mô tại bệnh viện E giai đoạn 2019- 2023. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả hồi cứu trên 45 bệnh nhân được chẩn đoán là ung thư biểu mô đại tràng được phẫu thuật nội soi cắt đại tràng phải nạo vét hạch từ 1/2019 đến 12/2023. Kết quả: Trong khoảng thời gian từ tháng 1 năm 2019 đến tháng 12 năm 2023 chúng tôi thu thập được 45 bệnh nhân đủ tiêu chuẩn nghiên cứu. Tuổi trung bình nhóm nghiên cứu là 65,42 ± 13,73 tuổi. Trong đó có 64,4% là nam giới và 35,6%, là nữ giới. Vị trí khối u gồm có 27 (60%) đại tràng lên, 11 (24,4%) đại tràng góc gan, 5 (11,1%) đại tràng ngang và 2 (4,4%) manh tràng. Thời gian phẫu thuật trung bình là 157,89 ± 27,64 phút. Lượng máu mất trung bình là 25,73 ± 6,03 ml, tỷ lệ tai biến trong mổ là 0%. Số hạch vét được trung bình là 16,62 ± 7,54 hạch và 16 bệnh nhân có di căn hạch. Tỷ lệ biến chứng sau mổ là 15,6% bao gồm tắc ruột, viêm phổi và nhiễm trùng vết mổ. Có 88,9 % bệnh nhân ra viện kết quả tốt. Tỷ lệ sống thêm toàn bộ sau mổ ước tính tại thời điểm 48 tháng là 90%. Kết luận: Phẫu thuật nội soi cắt đại tràng phía bên trái điều trị ung thư đại tràng cho thấy ngoài những ưu điểm của kết quả sớm thì đã đáp ứng được yêu cầu về mặt ung thư học.
KẾT QUẢ SỚM PHẪU THUẬT NỘI SOI CẮT ĐOẠN TRỰC TRÀNG SAU HÓA XẠ TRỊ TIỀN PHẪU TẠI BỆNH VIỆN K
Authors: Vương Xuân Hồng Quang , Trịnh Lê Huy , Đoàn Trọng Tú
Published: September 2024

Mục tiêu: Đánh giá kết quả sớm phẫu thuật nội soi (PTNS) cắt đoạn trực tràng sau hóa xạ trị (HXT) tiền phẫu. Đối tượng và phương pháp nghiên cứu: Nghiên cứu hồi cứu kết hợp tiến cứu trên 54 bệnh nhân ung thư trực tràng (UTTT) được HXT tiền phẫu và PTNS cắt đoạn trực tràng nối máy tại khoa Ngoại bụng 2, bệnh viện K từ tháng 4/2023 đến tháng 6/2024. Kết quả: Tuổi trung bình 59,4 ± 12,8 (31-80), tỉ lệ nam/nữ = 1,7/1. Thời gian phẫu thuật trung bình 140,8 ± 28,5 phút (95 – 200), 12 bệnh nhân làm hậu môn nhân tạo bảo vệ (22,2%), số hạch vét trung bình 7,63 ± 3,51 (4-15), khoảng cách từ cực dưới u đến diện cắt dưới trung bình 2,61 ± 1,28 (1-6 cm), tất cả bệnh nhân đều đạt diện cắt âm tính. 3 bệnh nhân biến chứng rò miệng nối (5,56%), tỉ lệ tai biến/biến chứng chung là 9,3%, không có bệnh nhân nào tử vong. Kết luận: PTNS cắt đoạn trực tràng sau HXT tiền phẫu an toàn, khả thi, đảm bảo tốt tiêu chí về ung thư học.
ĐẶC ĐIỂM CỦA POLYP ĐẠI TRỰC TRÀNG KÍCH THƯỚC 10 – 19 MM
Authors: Đào Đức Tiến , Doãn Trung Kiên , Nguyễn Ngọc Cường
Published: September 2024

Mục tiêu: Mô tả đặc điểm hình ảnh nội soi và mô bệnh học của polyp đại trực tràng kích thước 10 – 19 mm và mối liên quan giữa mô bệnh học với một số yếu tố. Đối tượng và phương pháp nghiên cứu: Nghiên cứu cắt ngang trên 98 bệnh nhân có polyp đại trực tràng kích thước 10 – 19 mm, điều trị tại bệnh viện Quân y 175, thời gian từ tháng 01 năm 2022 đến tháng 12 năm 2023. Chẩn đoán mô bệnh học polyp đại trực tràng theo tiêu chuẩn của Tổ chức Y tế thế giới năm 2019. Kết quả: Tuổi trung bình của bệnh nhân là 58,2 ± 10,3. Tỷ lệ nam/ nữ là 7,2. Polyp đại tràng đoạn xa chiếm tỷ lệ cao hơn so với polyp đại tràng đoạn gần (74,4% so với 25,6%), trong đó polyp đại tràng sigma (46,9%), polyp trực tràng (14,3%), polyp đại tràng xuống (12,2%). Tỷ lệ polyp có cuống là 52%, polyp không cuống là 48%. Tỷ lệ carcinoma tuyến là 6,1% và tỷ lệ polyp tuyến ống nhánh là 11,2%. Loạn sản mức độ cao chiếm 6,6% trong tổng số polyp tân sinh. Tỷ lệ ung thư tuyến đại trực tràng ở nhóm bệnh nhân ≥ 60 tuổi cao hơn so nhóm bệnh nhân dưới 60 tuổi, ở nữ giới cao hơn so với nam giới, sự khác biệt có ý nghĩa thống kê (với p < 0,05). Không có mối liên quan giữa mô bệnh học với vị trí, hình dạng và đặc điểm bề mặt của polyp kích thước 10 – 19 mm.  Kết luận: Polyp kích thước 10 – 19mm có tỷ lệ ác tính là 6,1%. Tỷ lệ polyp ác tính tăng theo tuổi, cao hơn ở nữ giới và không có mối liên quan với đặc điểm vị trí, hình dạng và bề mặt polyp trên nội soi.