Loyola Medicine

Purpose This research investigates how circular economy practices and sustainable digital closed-loop supply chains impact economic performance and intellectual capital development in the manufacturing sector of Gulf Cooperation Council countries. The geographical region faces unique sustainability and financial challenges when addressing critical gaps in understanding how circular practices integrate with sustainable digital and closed-loop supply chains and leverage structural, human and relational capital. Design/methodology/approach Modeling sustainable digital closed-loop supply chain as a multidimensional construct mediating the relationship between the circularity practices and economic outcomes through the lens of intellectual capital, using 200 respondents from manufacturing firms, is the core of this research. The study applies the structural equation modeling approach and analyzes the model pathways that significantly enhance sustainable digital performance. Findings The results indicate that circular economy practices significantly enhance sustainable digital closed-loop supply chain performance, which in turn has a strong positive impact on economic performance. The mediating role of closed-loop supply chain performance indicates how structural and relational capital help in generating economic value. This indirect effect exceeds the direct effect of circular practices on economic performance. Practical implications The findings of this research offer guidance to managers and policymakers to consider circular economic initiatives as necessary investments toward developing intangible intellectual assets. Strengthening digital infrastructure, employee competencies and supply chain partnerships are critical in leveraging the circular economy–driven intellectual capital. Originality/value While earlier studies consider circular economy and digital closed-loop supply chain as only operational strategies to minimize waste and improve efficient use of resources, this study conceptualizes them as primary mechanisms for intellectual capital formation. This research is among the first empirical studies to examine the integration of circular practices and digital closed-loop supply chain performance through the intellectual capital lenses. This integrative approach extends intellectual capital theory into the sustainability and digitalization domains underpinning the economic performance in Gulf Cooperation Council manufacturing.

Objetivo: Analisar as complicações pós-operatórias agudas (até 30 dias) em pacientes submetidos à cistectomia em um centro oncológico terciário da Região Norte do Brasil, entre janeiro de 2020 e dezembro de 2024. Métodos: Estudo observacional, retrospectivo, descritivo e analítico, baseado na revisão de prontuários de pacientes submetidos à cistectomia radical em um hospital terciário. Foram incluídos pacientes com neoplasias vesicais ou tumores com invasão da bexiga, hematúria grave com indicação cirúrgica e seguimento pós-operatório mínimo de 30 dias. Os dados abrangeram variáveis sociodemográficas, clínicas, cirúrgicas e complicações pós-operatórias, classificadas segundo Clavien-Dindo. Utilizaram-se estatísticas descritiva e analítica, com testes Qui-quadrado e G de aderência, adotando-se nível de significância de 5%. Resultados: A amostra incluiu 63 pacientes, baixa escolaridade e procedência do interior do estado. A maioria apresentava câncer de bexiga, risco cirúrgico ASA II e múltiplas comorbidades, especialmente hipertensão arterial sistêmica e doença pulmonar obstrutiva crônica. As cirurgias foram majoritariamente eletivas, com predomínio da cistoprostatectomia radical e derivação urinária tipo Bricker. Observou-se elevada taxa de complicações pós-operatórias, sobretudo gastrointestinais, de baixa gravidade. Conclusão: Os achados evidenciam elevada morbidade perioperatória, reforçando a necessidade de protocolos multimodais de analgesia, vigilância nutricional e estratégias de recuperação otimizada adaptadas à realidade regional.

A 69‐year‐old female with a history of reverse total shoulder arthroplasty presented with persistent anterior shoulder pain and restricted range of motion. Imaging subsequently demonstrated calcific changes of the conjoint tendon. Targeted corticosteroid injections provided temporary symptom relief; however, recurrence after discontinuation due to steroid‐induced hyperglycemia prompted surgical tendon release. Postoperatively, range of motion improvements were sustained, but anterior shoulder pain recurred and Quick‐DASH scores worsened by the 6‐month follow‐up. Although calcific changes were identified within the conjoint tendon, the clinical course suggests that calcification may represent a contributing or secondary phenomenon rather than a definitive primary pain generator. Conjoint tendon release may improve mobility, although pain relief may be unpredictable.

Pathology is essential to global health care, yet disparities remain in access to education and training. The College of American Pathologists (CAP) Foundation addresses these gaps through grants and awards that support trainees, early-career pathologists, and initiatives promoting equity worldwide. Since 2015, total funding has increased from $18,400 to $84,098, an astounding 357%. To evaluate the CAP Foundation Grants and Awards Program during a 10-year period, assessing financial investment, award distribution, recipient characteristics, and impact. A mixed-methods retrospective study integrated (1) quantitative analysis of program data, (2) qualitative feedback from awardees, and (3) a quantitative award impact survey of past CAP Foundation awardees. Variables included demographics, award type, funding amounts, geographic distribution, and career stage. Surveys assessed professional development, mentorship, and long-term engagement with CAP. From 2015 to 2024, a total of 744 applicants submitted 760 applications, resulting in 355 awards across 14 categories. Applications increased more than 8-fold, peaking in 2023, with surges during the COVID-19 pandemic. Medical student applications grew from 1 in 2020 to 17 in 2024 (76% annual growth); 9 of 12 Medical Student Travel Award recipients (75%) entered pathology residency. Geographic disparities were noted, with smaller residency programs showing higher per capita application rates. Among 174 survey respondents, 129 (74%) reported networking benefits, 127 (73%) learning benefits, and 99 (57%) mentorship benefits, though only 49 (28%) sustained long-term mentoring relationships. The CAP Foundation's awards program has expanded access, supported career development, and fostered future pathologists. Strengthening long-term mentorship and bridging education-to-practice gaps may further enhance its impact.

An environment that is characterised by a high rate of technological change, short product life cycle, and fluctuating market demand demands a high level of technology, and therefore, the conventional project management approaches may no longer be effective. This paper analyzes how agile project management strategies can be used to support cross-functional coordination and better market adaptation in high-tech supply chains. The study will determine the important agile practices that maximise the operational performance, decrease the lead time, and enhance the organisational responsiveness to the dynamic market environment. A mixed-method approach is followed, combining a survey of the project and supply chain professionals working in high-tech industries with a close case study of a few chosen companies. The quantitative data are compared by regression and structural equation modelling in order to measure the relationships between agile adoption, cross-functional integration, and supply chain performance, whereas the qualitative insights offer contextual knowledge about the challenges and enablers of the implementation. The results indicate that iterative planning, real-time collaboration, and a continuous feedback mechanism can be of great benefit in enhancing interdepartmental alignment, decision speed, and demand responsiveness. The practices of an agile firm have been shown to result in greater schedule compliance, less rework, and increased customer satisfaction than conventional ones. The paper draws the conclusion that agile project management is an important key competence for a robust and adaptive high-tech supply chain. In practice, managers are advised to support cross-functional agile teams, invest in digital collaboration tools, and integrate learning cycles into project workflows to maintain a competitive edge in turbulent markets.