1) THE RESEARCH APPROACH

• To fill the gap: -leader (CEOs) role vs women representation; -Global (11 000 companies) vs local; -Quantitative (5 000 transcripts) vs qualitative; -Crisis: Feb. 8, 2020-Jan. 25, 2021;

• quota policy vs role model;

• Existing literature is ambivalent about differences in terms of performance and leadership style between women and men (Sandberg 2019;Eagly & Carli 2003;Foels et al. 2000;Saint-Michel 2011;2010;Fine 2007).

2) RESEARCH METHODOLOGY

• Focus on: women CEOs, largest worldwide companies (market capitalization>100M$, 61 countries) & link with workforce feminization;

• Mobilization of: earning calls transcripts (5k companies), artificial intelligence techniques & sentiment analysis;

• Multidisciplinary team: data scientists (S&P) & management sciences researchers (Paris Panthéon-Assas University).

3) 5 Key Take-Aways of the Research (1/3)

• 1-Women CEOs are still significantly underrepresented: 5% Jan. 25, 2021 (vs 4.9% -1y);

• 2-Countries with a higher share of women CEOs also tend to have more genderbalanced labor force participation;

3) 5 Key Take-Aways of the Research (2/3) 3-Sector and country of the company best explain stock market performance: Health care and real estate companies are about 4X more likely to have a woman CEO than energy companies;

3) 5 Key Take-Aways of the Research (3/3)

• 4-Women CEOs exhibited a more positive communication style: higher average scores for words expressing trust and anticipation (both genders expressed negative sentiment at comparable frequency);

• 5-Women CEOs exhibited a different leadership style than men during the COVID-19 crisis: empathy, adaptability, accountability and diversity. Women CEOs displayed a leadership style aligned with a wider range of stakeholders.

4) PROSPECTIVE: yesterday & today

• From "think manager, think male" (Chrobot- Mason et al., 2014;Schein, 1973Schein, , 1975));

• "Labyrinth" (Eagly & Carli, 2007);

• "Tunnel" (Chin, 2014): too masculine or too feminine;

• Glass ceiling: number of biases (gender-biased stereotypes);

• The example of feedback: 20% less actionable ones (McKinsey, 2016).

4) PROSPECTIVE: future

THANK YOU!

Q & A


Nejjari Zakaria

Concerns facing human resource managers after COVID-19

Keywords: Human resources management, Post-pandemic, Human resources professionals, COVID-19, Challenges for human resources

Concerns facing human resource managers after COVID-19

Zakaria Nejjari, Hanane Aamoum

Introduction

In January 2020, the World Health Organization (WHO) warned of the spread of a global pandemic, it is the Covid-19 virus that is driving the global health crisis.

An exceptional crisis which certainly hit Moroccan companies hard, discovering themselves in a dilemma situation for the reconciliation between the gravity of the crisis, their financial vulnerability and manage their human resources.

The health crisis has had serious repercussions on economies, national social activities and political decisions. These effects were seen at all levels: stock markets, national production, the economic fabric, health and public safety, employment and social policies. All economic players are thus invited to find solutions to ensure the continuity of their business while preserving the health of their employees. This large-scale health experience is a natural opportunity in terms of human resources management (HRM), companies are in a phase of reconsideration of their HRM practices, thus putting their relationships with employees in a new challenge in order to better manage this crisis, by developing strategies and action plans based on social integration, economic and environmental values into their daily HRM activities.

The Covid-19 crisis has put many people in a new situation: that of working from residence. Although many companies have already been doing it for several years, for other organizations, this situation is completely new. This is not just a few employees functioning from home from time to time, but most times, the entire personnel working from residence with no preparation or training. Especially since schools are closed, many parents have had to take care of their children at the same time. Quite a challenge for human resources!

The crisis of recent months has forced companies to reinvent themselves in order to continue their activities in the best possible conditions. Rules and certainties have been shaken up. Some companies, still reluctant to telecommute at the start of the year, are now seriously considering offering this opportunity to their employees.

Human resources play a central role in this crisis management. They are in direct contact with employees in order to respond to their fears and questions. They are also responsible for taking the steps to ensure their protection and the proper payment of wages.

The post-crisis period will be synonymous with new challenges for human resources (HR). Indeed, the HR function must today meet the expectations of general management to improve HR processes [START_REF] Hamouche | Human resource management and the COVID-19 crisis: implications, challenges, opportunities, and future organizational directions[END_REF], increasing the competence of the function and digitalization [START_REF] Akkermans | The Covid-19 crisis as a career shock: Implications for careers and vocational behavior[END_REF]. It must also integrate the expectations of employees who aspire to a more participative and collaborative management [START_REF] Hite | Careers after COVID-19: Challenges and changes[END_REF], to more flexible working methods [START_REF] Aitken-Fox | COVID-19 and the changing employee experience[END_REF], and wish to find meaning in their work. [START_REF] Hamouche | Human resource management and the COVID-19 crisis: implications, challenges, opportunities, and future organizational directions[END_REF].

Aspirations for a better quality of life at work that human resources will have to learn to foster while meeting very concrete human and organizational needs. Their priorities will therefore be to guarantee health security, strengthen social ties and integrate new ways of working [START_REF] Carnevale | Employee adjustment and well-being in the era of COVID-19: Implications for human resource management[END_REF].

To meet these expectations, company human resources (HR) departments plan to adjust their organizational model by developing areas of HR expertise and decentralizing certain HR activities. The emergence of these new priorities therefore pushes the HR function to rethink itself. Its representatives also identify several ways of adaptation to which human resources policies could be transformed. A considerable proportion of them therefore consider that their collective agreement would benefit from changes in terms of work organization, health and quality of life at work and the working time adaptation to changes in activity. This article will be presented in six parts: After the first introductory part, the second part will be dedicated to a contextualization around the human resources management in the pandemic's context, a third part will be devoted to the theoretical framework of the research, the fourth part will highlight the research methodology and fifth section will discuss the human resources concerns in the post-COVID-19 environment, the last part will be devoted to a general conclusion.

Research background

The job tendencies have changed as a result of COVID-19; therefore, HR directors must revamp workforce care, employee engagement, or alternative office regulations [START_REF] Morse | Addressing Post-COVID HR Issues[END_REF][START_REF] Bieńkowska | COVID-19 oriented HRM strategies influence on job and organizational performance through job-related attitudes[END_REF]. Companies must also get ready regarding impending shifts [START_REF] Sheppard | A guide to thriving in the post-COVID-19 workplace[END_REF].

The human resources managers play a critical part in helping the workers handle the challenges brought on by sudden events in both the company and community [START_REF] Bieńkowska | COVID-19 oriented HRM strategies influence on job and organizational performance through job-related attitudes[END_REF]. Although, if natural touch with the people is a requirement of the work, offices have previously begun redesigning its layouts to maintain social distance. As a result, protecting the security of its members is of the greatest preference. It is also crucial to look after employees' psychological health and raise staff feeling as they recover from a traumatic time. As a result, HRM should put in an attempt to maintain work commitment along with adaptability and understanding.

Additionally, businesses must train its staff members to develop capacity and properly handle uncertainty. More mobility, preserving job satisfaction, and attending to work requirements also are of utmost importance.

Businesses should react to the transformations brought on by the COVID-19 if they wish to maintain their strategic advantage in the presence of the tremendous modifications induced by the COVID-19 [START_REF] Carnevale | Employee adjustment and well-being in the era of COVID-19: Implications for human resource management[END_REF][START_REF] Branicki | Surviving Covid-19: The Role of Human Resource Managers in Shaping Organizational Responses to Societal Paradox[END_REF]. In order to deal with the developments, companies should make certain that all their human resources are knowledgeable about the very recent practices and technologies. So executives and workers need to be ready to face the challenges in the current surroundings if they want to produce the desired outcomes.

As a consequence, the human resource specialists should handle the open requirements of the modern environment. The main issues facing human capital in the post-pandemic era are now the subject of extensive debate [START_REF] Rice | The 6 Biggest Challenges HR Faces in a Post COVID World[END_REF][START_REF] Bieńkowska | COVID-19 oriented HRM strategies influence on job and organizational performance through job-related attitudes[END_REF]. In the post-COVID-19 "new reality," this article underscores the underlying HR challenges which must be resolved, especially for all those looking to rebuild and create workplaces fully equipped to handle crises in the upcoming years.

Theoretical background

Before the First World War, there were few companies that could justify the personnel function existence. It was often exercised by the boss himself. In addition, with the legal framework being less restrictive, the boss has no difficulty in coping with the social management of his company. Sometimes, he is assisted by an accountant mainly for payroll and sometimes by a general secretary to take charge of general administration. Personnel administration comprises securing the workforce by carrying out a set of activities of an administrative rather than a managerial nature, i.e., by ensuring rigorous payment of salaries and bonuses, by monitoring attendance management and absences, overtime, planning annual leave, organizing replacements.

There are two managerial theories representing a frame of reference for the structuring of the personnel function: the scientific organization of work and management by objectives will serve as the basis for the activities of the human resources function.

The management of human resources as a formal activity of the organization is closely linked to the design and implementation of the system of the Scientific Organization of Work (OST) as it was designed by Taylor at the end of the past century. Thus, this model inspired, at the 20th century beginning, changes in the organization of work in companies, for example, in the Renault factories. He found in Ford's doctrine the founding principles of the production chain, which made up for him a fertile ground for experimentation. According to Henry Ford "The two most important things do not appear on the balance sheet of the company: its reputation and its people" [START_REF] Leblanc | The Handbook of Board Governance: A Comprehensive Guide for Public, Private, and Not-for-Profit Board Members[END_REF] in the desire to prevent the reactions of braking and voluntary restriction of production by the workers the theorists of the OST were led to research what were the main determinants of human behavior faithful to their rational view of things, they stated a set of postulates on human nature according to which:

Man would be an essentially lazy being who must be encouraged to work by monetary incentives.

His irrational nature made him unable to control himself; if you want to get him to work in the organization's service, organize his work, plan it, control it within the framework of a strict hierarchy of authority.

The evolution of human resources management is strongly linked to the economic, technological and sociological evolution of society and to the strategies of companies put in place to respond correctly to various labor relations according to an approach suitable for its mode. Management.

As being an essential stakeholder and the one who suffered the most damage from the start of this health crisis. Company's human resources affected in their role as employees, but also as citizens, parents, consumers and stakeholders, have become a number one to manage for human resources executives. The complexity of the situation calls into question the practices of human resources management in their purely managerial sense. The responsible character remains essential to confront the crisis.

In this sense, the human resource management practices of companies should take into consideration that an employee is above all a collaborator and a stakeholder who contributes to the economic and social role of his recruiter, the salary offers him purchasing power and he gains a social status in society. Losing a job leads to a drop in consumption and a devaluation of social status. In this sense, human resource management practices challenge all other social roles and not just the employee as an individual [START_REF] Ferrary | La DRH et la responsabilité sociale de l'entreprise[END_REF].

With these practices evolution related to customer social responsibility, some authors even speak of the responsible management of human resources. A management style that is concerned with the expectations of employees [START_REF] Dubrion | Gestion des ressources humaines et responsabilité sociale des entreprises : éclairer des évolutions nouvelles à la lumière de questionnements anciens[END_REF]. The list of responsible human resources management practices is not limited to just one or two. These include information, consultation of employees, integration of disabled people, continuing vocational training and employment, compensation and benefits, accident prevention in the workplace, employees covered by health and safety measures, working conditions, work-life balance [START_REF] Chakor | La santé et sécurité au travail au sein des congrès de la communauté AGRH: retour sur 25 ans de travaux et perspectives futures de recherche[END_REF].

Responsible management of human resources stipulates human resources should be treated as a stakeholder and not in the same way as other factors of production. During this coronavirus crisis, socially responsible companies must show this commitment, and allow employees to have self-esteem and confidence in the decisions of their human resources directors. It therefore seems that the employees of a company grasp the responsible management of human resources in a way that affects their behavior. This helps to strengthen their self-esteem, their sense of pride in their company and their confidence in it [START_REF] Gond | Social Reporting as an Organisational Learning Tool? A Theoretical Framework[END_REF].

Methodology

This article is a comprehensive review of the broad literature that attempts to view the latest and pertinent papers on the pandemic effects on human resource management and the difficulties that followed the pandemic. Following settling on the investigation's features and goals, the poets used selected keywords related to the pandemic control, human resource management, post-COVID-19, and human resource management difficulties to scan for pertinent papers in Web of Science, Scopus, Emerald, Springer, Wiley Online Library, Google Scholar as well as alternative internet sources.

The investigators next focus on finding material that is particularly relevant to the subject. Just a few studies have examined this impact. In order to explore the postpandemic and human resource problems, the authors ultimately selected 15 released journal papers, 7 studies from reliable websites. The part marked "References" contains a list of all the papers acknowledged in the research.

Being challenged by virtual jobs as a habit

To combat COVID-19, an increasing volume of businesses have switched to the employment-from-residence model [START_REF] Anjum | Challenges for HR Professionals in the Post-COVID-19 Era[END_REF]. Even whereas businesses are nevertheless finding it difficult to operate in a distant setting, the pandemic shall make things even exceptionally difficult. Workers who move casually in the modern era have become accustomed to it, and many have turned to appreciate it.

Whenever they are asked to return to their workplaces, these employees might be disgruntled [START_REF] Lewis | HR Managers Rethink Their Role During the Coronavirus Pandemic[END_REF]. Organizations should be highly accommodating to employment-from-residence practices to fulfill the demands of a rising workforce.

The best way to change existing organizational functions is to distant areas; therefore, executives must explore this option [START_REF] Morse | Addressing Post-COVID HR Issues[END_REF]. Nevertheless, several companies that were ready to transition and to work in a virtual environment may indeed lack processes and programs for virtual workplaces.

Therefore, it is crucial for businesses to develop teleworking solutions, which might pose a significant burden to executives in the coming years (Roy, 2021). Additionally, a scattered worksite may present firms with a number of difficulties. With several workers conducting their business from residence, it would be challenging to run human resources, salary, absenteeism, or time tracking in the conventional manner [START_REF] Anjum | Challenges for HR Professionals in the Post-COVID-19 Era[END_REF]. The processes that currently involve documentation and inperson encounters would not anymore be used.

A further significant barrier to a virtual workplace situation is interaction [START_REF] Gaikwad | Future challenges for HR in COVID-19 world[END_REF]. In this context, the human resources management's goal is to gain all workers' confidence and loyalty by employing suitable communication techniques which are widely accepted [START_REF] Sulaiman | Covid-19 challenges and human resource management in organized retail operations[END_REF].

Furthermore, human resources must build alternative techniques for defining performance targets and worker assessment systems that are appropriate for virtual workplace conditions. Distant workers must also acquire crucial virtual collaboration skills [START_REF] Anjum | Challenges for HR Professionals in the Post-COVID-19 Era[END_REF]. Therefore, now is the moment for human resources managers to do what is appropriate for such a development.

Getting workers involved in their job as a struggle

Although virtual technology provides advantages, this cannot substitute the sentimental attachment and personal contact that occurs in the organization. Operators who work virtually just might lose out on little nuances which help people think as a unit at the job, including dinner with coworkers, birthday parties for coworkers, and other special celebrations [START_REF] Anjum | Challenges for HR Professionals in the Post-COVID-19 Era[END_REF].

The restrictions of performing a task from residence and the sense of isolation from reliable systems would strangle the personnel. For this reason, employers need to keep an eye on and recognize the danger of separation among staff. In a remote environment, human resources managers also can face difficulties in maintaining their employees' motivation and alignment with the corporation's objective [START_REF] Imam | New normal: An HRM perspective of post COVID-19 in the airline industry[END_REF]. Additionally, it might be difficult to stick to a strict timetable and keep an organized workflow whenever working remotely, especially if groups are multi-practical (Roy, 2021).

As employees lack the very identical drive to achieve targets that they could achieve in a traditional workplace environment, employees risk losing sight of the firm's objectives. Therefore, in the post-COVID-19 era, maintaining the current organization behavior will become a significant issue for human resources experts.

Companies are continually attempting to cut expenses by eliminating coaching and, perhaps, alternative activities.

Since individuals cannot progress without coaching, this shall have an impact on staff preservation, which could then influence the efficacy and business productivity [START_REF] Gigauri | Influence of Covid-19 Crisis on Human Resource Management and Companies' Response: The Expert Study[END_REF]. Companies have to be adaptable and aware of workplace diversity throughout this environment to secure worker commitment [START_REF] Sanders | The 10 biggest HR challenges and how to overcome them post COVID-19 lockdown[END_REF].

To maintain worker capacity after the COVID-19, constant notifications, conferences, and coaching periods should be held, in addition to an improved worker commitment action. The squad's coach must keep the group representatives engaged in interaction and persuade them to uphold entrepreneurial orientation. To re-establish the established order in the coming years, human resources must allow users to interact through creativity [START_REF] Gaikwad | Future challenges for HR in COVID-19 world[END_REF].

Increasing staff morale and accepting compassion as a problem

Most of us have had it hard throughout the pandemic, both emotionally and cognitively. During the COVID-19, several businesses saw high staff turnover, cutbacks, compensation reductions, overdue vacations, etc., that affected how people felt about their employers [START_REF] Adikaram | Battling COVID-19 with human resource management bundling[END_REF]. The anxiety, fear, and work instability have reduced the employees' commitment [START_REF] Gigauri | Influence of Covid-19 Crisis on Human Resource Management and Companies' Response: The Expert Study[END_REF]. Therefore, human resources must be mindful of its employees and provide them compensation while they adapt to a different workplace environment.

Another of the biggest issues facing human resources in the post-COVID-19 age is raising staff mood, and as such, it's one of the utmost importance [START_REF] Rice | The 6 Biggest Challenges HR Faces in a Post COVID World[END_REF].

Employees returning to the job should be handed over the chance to revive the prepandemic job environment and organization environment. The COVID-19 such, significantly altered people's perspectives as well as their demands, goals, and aspirations, so personnel should view the job otherwise [START_REF] Gigauri | Influence of Covid-19 Crisis on Human Resource Management and Companies' Response: The Expert Study[END_REF][START_REF] Rice | The 6 Biggest Challenges HR Faces in a Post COVID World[END_REF].

Throughout this situation, the human resources units must keep in touch with the employees in such a productive manner [START_REF] Adikaram | Battling COVID-19 with human resource management bundling[END_REF]. Recognizing whether workers have responded to the COVID-19 and also what workers require for a safe resumption is of the utmost significance. Addressing every worker equally in this situation is crucial and, although many workers could regard the COVID-19 as being a minimal influence on regular workdays, much may see it as having a major effect on the future goals and mode of living [START_REF] Gigauri | Influence of Covid-19 Crisis on Human Resource Management and Companies' Response: The Expert Study[END_REF]Adikaram et al., 2021a).

Whereas the COVID-19 could give certain workers a chance to invest more moments with loved ones, it could also have a massive effect on their wellness or the welfare of those who are close to them [START_REF] Hite | Careers after COVID-19: Challenges and changes[END_REF]. In addition, younger individuals can develop prevalent psychiatric illness as a result of being separated from social media whilst performing remotely after the COVID-19 [START_REF] Anjum | Challenges for HR Professionals in the Post-COVID-19 Era[END_REF].

To reduce the threat among the people, human resource managers have to create relationship-focused processes [START_REF] Carnevale | Employee adjustment and well-being in the era of COVID-19: Implications for human resource management[END_REF]. After the COVID-19, compassion will be among the very important abilities, and respect for people in all situations can indeed be critical to preserving a strong link with colleagues. As a result, following the pandemic, certain organizational behavioral "standards" require updating [START_REF] Sanders | The 10 biggest HR challenges and how to overcome them post COVID-19 lockdown[END_REF]Adikaram et al., 2021a).

Greater freedom and challenges in achieving job satisfaction

Increased adaptability is required in the company as a result of the pandemic effects.

For instance, businesses that have cut back on staffing must change the timetables of their employees, that may have an impact on their compensation, absence, as well as diverse regulations.

Many businesses that altered their whole range of products to accommodate shifting consumer expectations must alter existing roles and responsibilities and hiring procedures. Companies must organize timings and compensation among several sites to handle challenges with teleworking [START_REF] Chow | Teleworking from home experiences during the COVID-19 pandemic among public health workers (TelEx COVID-19 study)[END_REF]. Therefore, creating a malleable and transparent organization culture may present a significant problem for human resources experts after the COVID-19 [START_REF] Branicki | Surviving Covid-19: The Role of Human Resource Managers in Shaping Organizational Responses to Societal Paradox[END_REF].

To maintain workers' interested, businesses should involve them in the revision of these kinds of rules. Each employee now needs and expects mobility in the job [START_REF] Anjum | Challenges for HR Professionals in the Post-COVID-19 Era[END_REF]. Making job outburst into their activities is a crucial goal for workers.

Just after the pandemic, such worksite benefits would be beneficial to the workers [START_REF] Rice | The 6 Biggest Challenges HR Faces in a Post COVID World[END_REF]. To create a customized environment, firms must, nevertheless, inspire innovation and adaptability while take into consideration member demands [START_REF] Branicki | Surviving Covid-19: The Role of Human Resource Managers in Shaping Organizational Responses to Societal Paradox[END_REF]. The blending of particular and work activity when operating remotely may be the main difficulty human resources must handle inside the contemporary reality [START_REF] Branicki | Surviving Covid-19: The Role of Human Resource Managers in Shaping Organizational Responses to Societal Paradox[END_REF].

Workers are now managing both job and household obligations differently than they did before the pandemic lockout. The current expectations have complicated job and family responsibilities, making it difficult for people to keep a healthy job satisfaction [START_REF] Giurge | 3 Tips to Avoid WFH Burnout[END_REF]. As a result, businesses must provide greater assistance to employees so that they may find a middle ground across their obligations at home and at office. This assistance should take the form of vacation amenities, career breaks, flextime, etc.

The issue in shifting worker training from efficiency to resiliency

Companies often prioritize worker productivity; however, adaptability is more important after the COVID-19 era. Cutbacks, downsizing, and furloughs over the previous period have dropped firms short on competent staff.

Human resources managers should efficiently control its current personnel. HR specialists must participate in helping workers rehabilitate and maintain their careers after the COVID-19. The primary human resource job is to foster resistance in order to help people recuperate first from the trauma of the pandemic [START_REF] Hite | Careers after COVID-19: Challenges and changes[END_REF]. The human resources manager may demand to step up coaching to close potential awareness and knowledge deficiencies so that workers can feel empowered and thrive in the strange reality [START_REF] Anjum | Challenges for HR Professionals in the Post-COVID-19 Era[END_REF].

Following this circumstance, human resources managers must change the attention from conventional training recruitment to talent employment. Since educating a novice employee can have a negative impact on the company's productivity and result in significant expenditures [START_REF] Collings | Strategic Human Resource Management and COVID-19: Emerging Challenges and Research Opportunities[END_REF].

Although a few employment responsibilities may soon be less important, there would further be a rise in a need for fresh ones. Within this instance, human resource managers must determine how to employ current skills in a multi-practical means of fulfilling those advanced positions [START_REF] Gaikwad | Future challenges for HR in COVID-19 world[END_REF].

It is crucial to create specific transition action plans that assist a business in meeting prospective requirements through worker training and skill acquisition in order to address the post-COVID-19 issue. Since every worker is unique, companies must use several techniques that inspire and keep them [START_REF] Bieńkowska | COVID-19 oriented HRM strategies influence on job and organizational performance through job-related attitudes[END_REF]. Maybe the biggest human resource problem after the pandemic is getting the labor pool used to significantly different operating conditions [START_REF] Carnevale | Employee adjustment and well-being in the era of COVID-19: Implications for human resource management[END_REF].

Conclusion, practical implications and future research

Each company must continue to be on guard and ready to respond to any unplanned developments brought on by the COVID-19 crisis. Although human resource management played a crucial role through the COVID-19, human resource managers now need to go above and above to satisfy the expectations of the post-pandemic corporate environment. The research made an effort to define the main human resources difficulties in the post-COVID-19 era.

Plenty of the concerns found in this research will be of utmost importance to human resource professionals in the next years. Making transition from a regular office setting to a virtual one may not be simple at the start. Companies must generate new job rules founded on internet resources for workdays, break options, compensation, production assessment, etc. Furthermore, distant employees are poorly engaged.

Building a cohesive job environment, encouraging and keeping employees are difficult tasks with that kind of dispersed personnel. As a result, maintaining visibility, attending to staff issues, and coordinating work should be handed over top attention. Second, the time pressure brought on by COVID-19 has altered how workers understand the jobs or personal lives. Therefore, businesses must offer particular consideration to staff spirit.

To help workers feel comfortable, the human resource specialist should pay careful attention to their needs and react to their issues. Arrangements with a suitable working stability are still additional important worry for human resource rulers to keep and inspiring cherished personnel after the pandemic. Since the lines between job and personal time have been blurred over such periods, there would likely be more worklife conflicts once firm's return.

The workforce may call for further freedom in terms of job hours, employment place, or perhaps alternatives over how they choose to complete their jobs. Businesses should design an environment which strikes a harmony between workers' and employers' demands in order to address the drawbacks of additional agility.

Last but not least, businesses need to prioritize retraining and retraining the staff. Whenever workers return to work past such severe suffering, HR executives have to determine the abilities they will have to do their jobs better. Additionally, it's indeed crucial to provide staff with the training so they can adapt to the pandemic's alterations and get ready for professional advancement.

The pandemic has provided the impetus for accepting transformation in order to surmount the new difficulties. Human resource management must inspire the employees, involve them and consider individual thoughts. Employees are much possible to generate good performance and keep their attention on the company's purpose if they feel encouraged and protected in current position. The modern human resources practices must, therefore, inspire the staff to embrace unpredictability and devote time to the career enhancement.

In the coming years, human resource directors will face a few notable obstacles, according to this paper. The findings thus have important ramifications for human resource professionals and legislators. After the COVID-19, this should aid companies in designing their human resource policies.

The article's conclusions will indeed assist human resource professionals in developing several techniques for rethinking the workplace, increasing employee inspiration, assuring worker satisfaction, reinventing skills, and maintaining laborers in distant communities. Additionally, this will assist executives in adapting current regulations towards the needs of both the evolving corporate environment and surviving in a cutthroat economy.

By identifying the additional human resource issues in the post-COVID-19 current baseline, the research significantly adds to the body of current information. Even though these data highlight some of the human resource obstacles, more research could also uncover additional significant problems.

Remote jobs aren't just a millennial phenomenon but considerably a mode of living, wherever people are contented and highly useful, and businesses function more effectively as well as financially.

The corporate system is prone to catastrophes. Nobody, nevertheless, could have foreseen a disaster of the pandemic amplitude, that had speeded up the conventional human resource management practices interruption and posed major difficulties for supervisors and human resource management professionals who lacked the knowledge, assets, and skills necessary to address the intricacy and unexpectedness of the COVID-19.

To such difficulties, COVID-19 also created chances which businesses must really know in order to plan the upcoming human resource management activities. In order to support executives and human resource management professionals recognize the primary problems and possibilities linked to the pandemic, our study conducts a general literature search. They must be able to build an action agenda that is tailored to the requirements of their businesses and individuals with the aid of ideas presented in this article in the prospective scope of human resource management.

Nonetheless, it is important to keep in mind certain restrictions while evaluating the article's contribution. The fact that this study is a comprehensive review of the literature with an educational goal raises the probability that the literature was chosen subjectively.

Future study must concentrate on understanding workers' opinions about the use of telework either during or after the pandemic, as well as the appraisal of the state of teleworking inside enterprises. Longitudinal study will be the focus of forthcoming investigation to pinpoint such difficulties as well as chances.

  The investigators manipulated the successive steps in organizing the study: • Establish the analysis problem • Analyze the data origins • Gather the relevant information • Incorporate and match accessible data • Deliberations on the compiled information • Review the human resource challenges linked to COVID-195.Human resources concerns in the post-COVID-19 environment discussions


Sami Barrit

Alexandre Niset

LogDoctor: an open and decentralized worker-centered solution for occupational management in healthcare

Occupational stress among health workers is a pervasive issue that affects individual well-being, patient care quality, and healthcare systems' sustainability. Current time-tracking solutions are mostly employer-driven, neglecting the unique requirements of health workers. In turn, we propose an open and decentralized worker-centered solution that leverages machine intelligence for occupational health and safety monitoring. Its robust technological stack, including blockchain technology and machine learning, ensures compliance with legal frameworks for data protection and working time regulations, while a decentralized autonomous organization bolsters distributed governance. To tackle implementation challenges, we employ a scalable, interoperable, and modular architecture while engaging diverse stakeholders through open beta testing and pilot programs. By bridging an unaddressed technological gap in healthcare, this approach offers a unique opportunity to incentivize user adoption and align stakeholders' interests. We aim to empower health workers to take control of their time, valorize their work, and safeguard their health while enhancing the care of their patients.

Background

Work-related stress is a long-standing and widespread public health issue [START_REF] Leka | Work organisation and stress: systematic problem approaches for employers, managers and trade union representatives[END_REF], associated with inadequate working conditions [START_REF] Lawrence R Murphy | Occupational stress management: Current status and future directions[END_REF] due to structural failures [START_REF] Pross | The culture of organizations dealing with trauma: Sources of workrelated stress and conflict[END_REF]. Health workers are particularly exposed due to common resource-constrained [4] and crisis settings [START_REF] Prasad | Prevalence and correlates of stress and burnout among US healthcare workers during the COVID-19 pandemic: A national cross-sectional survey study[END_REF], as well as the inherent physical and emotional burdens of caregiving [START_REF] Mariné | Preventing occupational stress in healthcare workers[END_REF]. Primary missions such as caring, education, and research are often impeded by cost-cutting measures reducing supportive resources and the increasing administrative burden from medical liability documentation. These mismatches between resources and capacities result in work overload [START_REF] Nirel | Stress, work overload, burnout, and satisfaction among paramedics in Israel[END_REF] [8] [START_REF] Michie | Causes and management of stress at work[END_REF], job dissatisfaction [START_REF] Aiken | Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction[END_REF], and work-life imbalance [START_REF] Humphries | Hospital doctors in Ireland and the struggle for work-life balance[END_REF].

On a personal level, this leads to loss of health and life due to burnout, depression, suicide, stroke, and cardiovascular diseases [START_REF] Greiner | Occupational stressors and hypertension: a multi-method study using observer-based job analysis and self-reports in urban transit operators[END_REF] [13] [START_REF] Ferguson | A study of occupational stress and health[END_REF] [START_REF] Steptoe | Stress and cardiovascular disease: an update on current knowledge[END_REF]. On a collective level, it compromises the population's safety by undermining the quality of care [START_REF] Moustaka | Sources and effects of work-related stress in nursing[END_REF] and contributes to the brain drain of healthcare professionals and staff shortages, creating a self-reinforcing cycle [START_REF] Humphries | Hospital doctors in Ireland and the struggle for work-life balance[END_REF]. This growing issue threatens both the human and the economic sustainability of healthcare systems [17] [18].

Various institutional, national, and supranational initiatives have been undertaken to tackle this challenge [START_REF] Kim | The 2017 ACGME common work hour standards: Promoting physician learning and professional development in a safe, humane environment[END_REF] [START_REF] Sundberg | The Swedish duty hour enigma[END_REF]. However, even legal regulations have shown their limits in changing poor working conditions in healthcare [START_REF] Rachel | UK doctors' views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis[END_REF] [START_REF] Cresswell | Optimising working hours to provide quality in training and patient safety: a position statement by the Association of Surgeons in Training. Royal College of Surgeons[END_REF] [23] [START_REF] Machtey | Regulations of night shifts of pediatric residents: review of responses to a European survey[END_REF], partly due to the shortcomings of most working time recording systems. These employer-driven solutions focus on shift planning, rostering, and billing but are not designed to ease time tracking for health workers or ensure accurate activity tracking and safety monitoring [25] [26] [START_REF] Planner | [END_REF]. Additionally, the recordings may be subject to opaque management and manipulation, further exacerbating the issue, as they are particularly exposed to peer, hierarchical, and socio-cultural pressures [START_REF]49th Hawaii International Conference on System Sciences, HICSS 2016[END_REF].

Here, we propose an open and decentralized worker-centered solution utilizing machine intelligence. Our objective is to provide an empowering solution for health workers to take control of their time, valorize their work, enhance their capacity, and safeguard their health and that of their patients despite socio-cultural or economic pressures.

Conceptual framework

The input consists of multimodal data provided by the health worker, employer, or an approved third party. Data processing occurs within a multilayered approach, with the health worker retaining control and validating the processed data for a specific period. Following validation, a transaction is recorded on an open ledger, ensuring the immutability of the validated data. The output consists of multi-level reports and real-time monitoring tools. Feedback loops continuously enhance data processing through machine intelligence. The multimodal data input encompasses a combination of fixed attributes set for predetermined periods (e.g., gross hourly wage) and dynamic information. This dynamic information consists of individual tracking data with collective intelligence insights captured continuously. Timing inputs can be entered synchronously or asynchronously relative to the tracked event, either as a schedule or record. Timing inputs fall into one of several predefined mutually exclusive states (e.g., "at work," "available," or "on leave"). Indicators can be used to label or tag these inputs. Labels are predefined standardized sub-options tailored for collective needs (e.g., "care," "education," "research," and "administrative" for the "at work" state; "on-call" and "second-line" for the "available" state; "annual leave," "scientific leave," or "sickness leave" for the "on leave" state). Tags are freeform keywords defined by individual users for their specific needs. Additionally, indicators include sporadic event tracking, which can be either user-driven (e.g., incident reporting) or solution-driven (e.g., mood monitoring).

Process: a multi-layered approach

Input integration employs a tiered approach that combines various layers of timing data, such as schedules, time tracking, and records, along with complementary indicators. These layers serve as safety nets for missing information and can be tailored or deemed obligatory in accordance with specific needs or legal requirements. The multilayered approach for multimodal data integration enhanced by machine intelligence.

To address conflicting information between these layers, the solution offers four automated resolution options: union, intersection, superseding layer, or a machine learning (ML) forecast. Health workers have the ability to review and validate their time recordings on a punctual basis. Optionally, they can place the validated recording on hold for an approval period, allowing employers or authorized third parties to review it. In case of an unresolved dispute, the pending litigations are described in the final report. This report is then securely and immutably recorded on the blockchain.

Output: multi-level reporting

At the individual level, a dashboard displays time tracking, wage estimates, occupational safety, health monitoring, and legal compliance metrics. Users can generate on-demand static reports to summarize validated data for a specified period with automated email reports. At the collective level, the solution provides overview reports based on geographic or organizational criteria, such as institutional, local, or global levels. These collective reports are made openly accessible on a dedicated platform for all stakeholders and the general public.

Governance

A decentralized autonomous organization (DAO) [START_REF]Ethereum Whitepaper -ethereum[END_REF] [30] [START_REF] Jentzsch | Decentralized autonomous organization to automate governance[END_REF] facilitates distributed governance, enabling all stakeholders to participate equitably in decision-making and oversight of operations. Governance tokens act as a voting mechanism, featuring dynamic supply adjustments to prevent single-entity dominance [START_REF]Plutus. 408 BCE[END_REF]. Token distribution considers the varying sizes and influences of participants and allows individuals to delegate their voting power to trusted organizations. Sybil attacks -i.e., fraudulent creation of multiple accounts for increased voting power -are prevented by identification and authentication processes for user verification with rewarding protocols relying on proof of attendance, effort, and contribution [START_REF] Sizon | Decentralized Proof of Attendance Protocol[END_REF]. SubDAOs, functioning as independent DAOs within the larger organization, cater to specific endeavors. Developers can collaborate to address challenges such as feature development, technological enhancement, solution maintenance, and security monitoring. Besides, local stakeholders from specific regions or institutions can organize daily operations, dispute resolution, and policymaking, as well as request customizations to meet their unique requirements. This structure complements the delegation system.

Legal frameworks

The solution ensures compliance with governmental working time regulations and specific recommendations by generating derived metrics for informing health workers and stakeholders. In terms of data protection, it upholds privacy and security best practices. Key principles, such as purpose and storage limitations, are observed by processing data solely for its intended use and retaining it only for the necessary duration. Additionally, data minimization, pseudonymization, and encryption techniques are employed. Sharing aggregated personal data is contingent upon obtaining explicit user consent. Secure machine intelligence protocols, including federated learning, are incorporated to guarantee user privacy and data security, addressing related legal concerns.

Technological stack

The stack utilizes accessible open-source tools in a decentralized framework, promoting transparency and collaborative development. Crowdsourcing approaches engage various perspectives and innovations, bolstering the system's flexibility, adaptability, and versatility. Machine learning further empowers the solution to improve its capabilities continually in response to evolving user needs.

Versatile architecture

This robust, distributed, and privacy-preserving technological stack integrates multi-factor authentication, end-to-end encryption, blockchain technology, and machine intelligence. Users authenticate their identities using mobile phonebased two-factor authentication via a decentralized authentication protocol [START_REF] Yasuda | OpenID for Verifiable Credentials A Shift in the Trust Model Brought by Verifiable Credentials[END_REF] with electronic identification and signature. Data transmission security is ensured through end-to-end encryption, safeguarding sensitive information by allowing access exclusively to intended recipients. Blockchain technology offers a decentralized, transparent platform for data storage and sharing, guaranteeing data immutability, trusted timestamping, and tamper resistance. Furthermore, state-of-the-art blockchains feature Turing-complete smart contract capabilities, extensive decentralized applications ecosystems, and native interoperability. These blockchains provide virtual machines, enabling the execution of complex, logic-based smart contracts and applications designed to address the wide range of our use cases and requirements [29] [35].

Machine intelligence

Recurrent neural networks with long short-term memory units effectively analyze sequential data patterns, such as timing input resolution, work schedule optimization but also burnout prevention, and mood monitoring through sentiment analysis [START_REF] Hochreiter | Long Short-Term Memory[END_REF]. Anomaly detection identifies potential issues like overwork, resource misuse, and legal compliance violations [START_REF] Chandola | Anomaly Detection : A Survey[END_REF]. Additionally, convolutional neural networks complement these applications by managing image recognition and processing tasks involving multidimensional data, such as user interaction patterns, behavioral signals, and image-based input processing [START_REF] Yamashita | Convolutional neural networks: an overview and application in radiology[END_REF]. Adhering to the decentralized approach and privacy concerns, federated learning provides a secure and privacy-preserving method for analyzing aggregated user data. This technique enables the processing of individual data locally on the user's device or through anonymization and encryption before transmission, allowing global models to be trained without sharing identifiable raw data. Customized deep-learning models can be developed using available open-source frameworks suited to the solution's requirements [START_REF] Abadi | TensorFlow: Large-Scale Machine Learning on Heterogeneous Systems[END_REF] [40] [41] [START_REF] Paszke | PyTorch: An Imperative Style, High-Performance Deep Learning Library[END_REF].

Implementation

The solution's rollout requires addressing technical deployment challenges while promoting early adoption among users and stakeholders. To this end, we aim to capitalize on its agile infrastructure and innovative approach, tackling an unaddressed but widespread and longstanding issue in healthcare.

Technical deployment

Scalability is essential for accommodating an increasing user base and extending features. A modular architecture, employing microservices that integrate cloud and on-premises open-source software, can facilitate efficient scaling and performance while meeting user-specific needs and requirements. Interoperability, through standardized data exchange protocols, enables seamless integration with existing health information systems and time-tracking platforms. We propose a simplified time-tracking file in CSV format as a standard. Security must be maintained by thorough testing, periodic audits, and ongoing monitoring to protect sensitive data and ensure privacy regulation compliance. A dedicated subDAO will oversee these endeavors supported by the opensource community.

Early adoption

This solution bridges a technological gap in healthcare, addressing a critical unmet need for health workers by offering a versatile platform for individual and collective insights into occupational management. To promote early adoption, we will target individual users, particularly showcasing the platform's features and benefits for individuals. Creating momentum, we aim to incentivize diverse stakeholders to onboard subsequently, fully leveraging the potential of the platform. Moreover, open beta testing with pilot programs will provide real-world validation and insights for refining the solution, demonstrating its viability, and encouraging further adoption and retention. Engaging stakeholders, such as health workers' associations, governmental organizations, and healthcare employers, is essential for broad acceptance and impact. Along these lines, distributed and transparent governance aims to align often conflicting interests by maintaining the priority on improving health workers' lives and working conditions. Stakeholder engagement through workshops and seminars will foster shared ownership and address diverse perspectives. Coupled with incentivization via gamification and reward systems, this approach will motivate active engagement, contributing to long-term success. Additionally, providing training and support will empower users to effectively navigate the solution, ensuring maximum utility and benefits for all parties involved.

Conclusion

We have introduced a comprehensive worker-centered solution to support health workers facing pressing issues of safety, well-being, and productivity. By harnessing machine intelligence, this solution integrates multimodal data through a multilayered approach, enhancing user experience. Blockchain technology enables distributed governance and transparency, fostering effective cooperation among stakeholders. We have demonstrated the technology's readiness for deployment in compliance with the most stringent openness, decentralization, and privacy-preserving standards. Overcoming implementation hurdles is critical to realizing the solution's full potential and delivering a lasting, transformative impact on public health. This solution can bridge an unaddressed technological gap in healthcare, offering a unique opportunity to incentivize health workers' engagement and stakeholders' alignment in developing occupational management for better care.

Figure 1 :

 1 Figure 1: The conceptual framework

  Figure 2: The multilayered approach for multimodal data integration enhanced by machine intelligence.

Figure 3 :

 3 Figure 3: Examples of timing conflicts resolution approaches

Figure 4 :

 4 Figure 4: Example of a DAO-subDAO structure for synergistic yet independent working groups.

Table 1 :

 1 Examples of timing input modalities with their features.

		provider	timing	user friction	resilience *	infrastructure requirement
	manual completion	worker or employer	async	high	low	low
	physical badging	worker	sync	mid	mid to high	mid to high
	digital log	worker	sync	low to mid	mid	low to mid
	geofencing
	smart contact	process	sync	low	high	low to mid
	tracing

* resilience as the potential ability to withstand internal and external influences.

Table 2 :

 2 Examples of insights, metrics, indices, and alerts of interest.

	Work	Safety	Wellbeing	Wage
	working time	shift durations	mood tracker	salary calculator
	overtime	resting time	burnout index	extra pay
	unsociable hours legal compliance job satisfaction	salary comparisons
	activity tracking commute risk	incident reporting professional expenses

Table 3 :

 3 Examples of standardized fields and values for activity tracking

	Fields	Description
	location	latitude and longitude as decimal numbers
	employer	unique ID of employer
	start/end date	the date when the tracked activity begin-
		s/ends, in the format YYYY-MM-DD
	start/end time	the time when the tracked activity begin-
		s/ends, in the format HH:MM:SS
	state/label/tag	according to customized lists
	Cloud-based processes and cross-platform compatibility further enhance the solution's versatility. Customization,
	enabled by adaptable application programming interfaces (APIs), permits tailoring the solution to particular needs.

Acknowledgements

We express our gratitude to Maaz and Syed Ali Shahbaz from Timecrypt for our collaboration on this project. Additionally, we extend our thanks to the Belgian junior doctors from la Délégation des Médecins Francophones en Formation for their diligent alpha testing of the prototype app and their critical insights.


Maria Fleseriu

Frederic Castinetti

Monica Gadelha

Andrea Giustina

Andre Lacroix

Shlomo Melmed

John Newell-Price

Rosario Pivonello

Martin Reincke

Beverly M K Biller

Osilodrostat for the treatment of Cushing's disease: efficacy, stability, and persistence -Authors' reply

We thank Olivier Chabre and colleagues for their thoughtful comments on our Review. [START_REF] Fleseriu | Consensus on diagnosis and management of Cushing's disease: a guideline update[END_REF] We agree with the authors, as emphasised in our Review, that pituitary surgery is the first line of treatment for Cushing's disease. As most studies on medical therapy include patients not cured by surgery or who had disease recurrence after surgery, a direct head-to-head comparison of medical therapies versus surgery is not feasible. Further-more, as the authors highlight, and as we discussed in the Review, [START_REF] Fleseriu | Consensus on diagnosis and management of Cushing's disease: a guideline update[END_REF] direct comparison of drug efficacy between medical therapies is not possible due to differences in study design and an absence of head-tohead trials. In our Review, [START_REF] Fleseriu | Consensus on diagnosis and management of Cushing's disease: a guideline update[END_REF] we noted: "As designs, medication uptitration schemes, comparator arms, inclusion and exclusion criteria, and primary endpoints differ even among prospective studies, it is difficult to directly compare treatment outcomes, either for eficacy or for adverse effects. Furthermore, some drugs have not been prospectively studied for Cushing's syndrome". Rather, we extensively and individually discussed benefits, as well as safety, of each available medication.

Notably was an investigational medication with a published phase 3 study. [START_REF] Fleseriu | Eficacy and safety of levoketoconazole in the treatment of endogenous Cushing's syndrome (SONICS): a phase 3, multicentre, open-label, single-arm trial[END_REF] For this reason, we felt it important to list it in table 2 and note its investigational status, but we did not discuss levoketoconazole in the text, as we did with all the other approved medications.

We agree with Chabre and colleaguesregarding the caveats of a randomised withdrawal study design and, in discussing the osilodrostat phase 3 trial, [START_REF] Pivonello | Eficacy and safety of osilodrostat in patients with Cushing's disease (LINC 3): a multicentre phase III study with a doubleblind, randomised withdrawal phase[END_REF] Furthermore, patient selection (eg, baseline UFC), dosing titration, definition of disease control, and study duration are also paramount when discussing results, as we reviewed. [START_REF] Fleseriu | Consensus on diagnosis and management of Cushing's disease: a guideline update[END_REF] Because follow-up intervals differed between drugs, with some lasting only 12 weeks and others up to 48 weeks with intermediate results reported at varying intervals, we elected to show in table 2 of our Review 1 the prespecified primary endpoint of each study to ensure consistency across the prospective trials. We explained study design caveats in the text. For osilodrostat, the primary endpoint in the largest study published at that time, LINC 3, 3 was therefore included in table 2. We agree that whole-population analyses represent an important clinical measure for long-term treatment. However, even when analysing the whole patient population for each osilodrostat study, long-term efficacy rates vary widely, ranging from 78•9% at week 22 in LINC 2 [START_REF] Fleseriu | Osilodrostat, a potent oral 11β-hydroxylase inhibitor: 22-week, prospective, phase II study in Cushing's disease[END_REF] to 71•5% at week 12, 68% at week 24, and 66% at week 48 in LINC 3, [START_REF] Pivonello | Eficacy and safety of osilodrostat in patients with Cushing's disease (LINC 3): a multicentre phase III study with a doubleblind, randomised withdrawal phase[END_REF] and 81% (95% CI 69•9-89•1) at week 36 in LINC 4. 5 With regard to the primary endpoint in LINC 4, which had a placebo up-front design, UFC normalisation at week 12 was reached in 77% of patients receiving osilodrostat compared with 8% of those receiving placebo. 5 These data further afirm what we noted in our Review 1 about the need for close follow-up in all patients on medical therapy for Cushing's disease, to ensure they are controlled longterm, as doses might need to be adjusted (up or down).

We agree with Chabre and colleagues that differences in placebo response rates across various studies of patients with Cushing's syndrome are indeed intriguing and warrant further research. As of now, description of the levoketoconazole randomised withdrawal study is available only as a poster, but study design, including placebo duration, drug titration, and primary endpoints (including definition of loss of disease control) seem to have all differed slightly from that in the osilodrostat trials. Additionally, inclusion criteria and Cushing's syndrome type differed: the osilodrostat trial enrolled only patients with Cushing's disease, whereas patients with non-pituitary Cushing's syndrome were included in the levoketoconazole trial.

As raised by Chabre and colleagues, adrenal insufficiency is indeed an adverse event encountered with all Cushing's disease treatments, including surgery, but with higher rates occurring from potent medications that target adrenal steroidogenesis. A direct effect of osilodrostat on the adrenal glands has, to our knowledge, not been shown. However, recent experience 6 has highlighted the potential for delayed adrenal insuficiency in some patients treated with osilodrostat. Additional studies on this delayed effect are needed. Furthermore, levoketoconazole has been shown to directly inhibit cortisol production in adrenocortical cells, as well as to potentially affect human corticotroph pituitary adenoma cultures. [START_REF] Creemers | Levoketoconazole, the 2S,4R enantiomer of ketoconazole, a new steroidogenesis inhibitor for Cushing's syndrome treatment[END_REF] In agreement with the authors' concerns over adrenal insufficiency when treating patients with this class of agents, we did emphasise this risk and the need to monitor patients during treatment in our Review. [START_REF] Fleseriu | Consensus on diagnosis and management of Cushing's disease: a guideline update[END_REF] We thank Chabre and colleagues for concurring with our Review regarding the need for further, rigorous study of treatments for Cushing's disease and the importance of personalising therapy to each individual patient's situation.

MF has received grants to the institution from Novartis, Strongbridge, Novo Nordisk, Crinetics, Millendo, Ascendis, and Pfizer; personal honoraria for consulting and advisory boards from Crinetics, HRA Pharma, Novartis, Recordati, Strongbridge, Sparrow, Ascendis, Novo Nordisk, and Pfizer; is Deputy Editor for European Journal of Endocrinology; and has served on the Board for the Pituitary Society. FC has received personal honoraria for consulting, lectures, and support for meeting attendance from Recordati Rare Diseases, Ipsen, and HRA Pharma. MG has received grants to the institution from Novartis and Ipsen; personal honoraria for consulting, lectures, and advisory boards from Crinetics, Recordati Rare Diseases, Novo Nordisk, and Ipsen; has served on the Board of the Brazilian Society of Endocrinology and Metabolism; and is President of the Pituitary Society. AG has received grants to the institution from Pfizer; personal honoraria for consulting and advisory boards from Abiogen, Novo Nordisk, and Recordati; and has served on the Board or as an advisor to the European Hormone and Metabolism Foundation and Glucocorticoid Induced Osteoporosis Skeletal Endocrinology Group. AL has received grants from Recordati and Corcept for clinical trials; personal honoraria and education grants for lectures, support for meeting attendance, and participation in advisory boards from Pfizer, Ipsen, Corcept, Recordati, and the European Journal of Endocrinology; royalties from UpToDate Endocrinology; and has served as a Board member for the International Society of Endocrinology. SM has received grants to the institution from the US Food and Drug Administration; non-financial support from Cyclacel; and has served on the Board of the Pituitary Society. JN-P has received grants and honoraria to the institution for consulting and advisory boards from Diurnal, HRA Pharma, Crinetics, Recordati, and Novartis; and has served as a Board member or advisor for the Pituitary Foundation and Endocrine Society. RP has received grants to the institution from Novartis, Pfizer, Ipsen, Shire, IBSA Farmaceutici, HRA Pharma, Cortendo, Corcept Therapeutics, and Merck Serono; personal honoraria for consulting, lectures, support for meeting attendance, and advisory boards from Novartis, Shire, HRA Pharma, Cortendo, Pfizer, Recordati, IBSA Farmaceutici, and Crinetics Pharmaceuticals; and has served on the board of the Pituitary Society. MR has received personal honoraria for consulting, lectures, and advisory boards from Novartis, Recordati, HRA Pharma, and Ipsen; and is President of the European Society of Endocrinology. BMKB has received grants to the institution from Ascendis, Novartis, Strongbridge, and Millendo; personal honoraria for consulting from Aeterna Zentaris, Ascendis, Merck Serono, Novartis, Novo Nordisk, Recordati, Strongbridge, and Sparrow; and has served as an advisor for the Endocrine Society. *Maria Fleseriu, Frederic Castinetti, Mônica Gadelha, Andrea Giustina, André Lacroix, Shlomo Melmed, John Newell-Price, Rosario Pivonello, Martin Reincke, Beverly M K Biller, on behalf of all authors of "Consensus on diagnosis and management of Cushing's disease: a guideline update"