Efficient Project Delivery Using Lean Principles - An Indian Case Study

Construction industry in India is growing at a rapid pace. Along with this growth, the industry is facing numerous challenges that are making delivery of projects inefficient. Experts believe that capacity constraints in the industry need to be addressed immediately. Government has recommended ‘introduction of efficient technologies and modern management techniques’ to increase the productivity of the industry. In this context, lean principles can act as a lever to make project delivery more efficient and provide the much needed impetus to the Indian construction sector. Around the globe lean principles are showing positive results on the projects. Project teams are reporting improvements in construction time, cost and quality along with softer benefits of enhanced collaboration, coordination and trust in project teams. Can adoption of lean principles provide similar benefits in the Indian construction sector? This research was conducted to answer this question. Using an action research approach a key lean construction tool called Last Planner System (LPS) was tested on a large Indian construction project. The work described in this work investigates the improvements achieved in project delivery by adopting LPS in Indian construction sector. Comparison in pre- and post-implementation data demonstrates increase in the certainty of work-flow and improves schedule compliance. This is measured through a simple LPS metric called percent plan complete. Explicit improvements in schedule performance are seen during 8 week LPS implementation along with implicit improvements in coordination, collaboration and trust in the project team. This work reports the findings of LPS implementation on the case study project outlining the barriers and drivers to adoption, strategies needed to ensure successful implementation and roadmap for implementation. Based on the findings the authors envision that lean construction can make project delivery more efficient in India

Knowledge-based Lean Six Sigma Maintenance System for Sustainable Buildings

YesPurpose– This paper develops a Knowledge-based (KB) System for Lean Six Sigma (LSS) Maintenance in environmentally Sustainable Buildings (Lean6-SBM). Design/methodology/approach– The Lean6-SBM conceptual framework has been developed using the rule base approach of KB system and joint integration with Gauge Absence Prerequisites (GAP) technique. A comprehensive literature review is given for the main pillars of the framework with a typical output of GAP analysis. Findings– Implementation of LSS in the sustainable building maintenance context requires a pre-assessment of the organisation’s capabilities. A conceptual framework with a design structure is proposed to tackle this issue with the provision of an enhancing strategic and operational decision making hierarchy. Research limitations/implications– Future research work might consider validating this framework in other type of industries. Practical implications– Maintenance activities in environmentally sustainable buildings must take prodigious standards into consideration and, therefore, a robust quality assurance measure has to be integrated. Originality/value– The significance of this research is to present a novel use of hybrid KB/GAP methodologies to develop a Lean6-SBM system. The originality and novelty of this approach will assist in identifying quality perspectives while implementing different maintenance strategies in the sustainable building context.Ministry of Defence Engineering Services (Sultanate of Oman

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials.

Funder: laura and john arnold foundationBACKGROUND: Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ). METHODS: In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. RESULTS: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. CONCLUSIONS: Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care

Characterization of greater middle eastern genetic variation for enhanced disease gene discovery

The Greater Middle East (GME) has been a central hub of human migration and population admixture. The tradition of consanguinity, variably practiced in the Persian Gulf region, North Africa, and Central Asia1-3, has resulted in an elevated burden of recessive disease4. Here we generated a whole-exome GME variome from 1,111 unrelated subjects. We detected substantial diversity and admixture in continental and subregional populations, corresponding to several ancient founder populations with little evidence of bottlenecks. Measured consanguinity rates were an order of magnitude above those in other sampled populations, and the GME population exhibited an increased burden of runs of homozygosity (ROHs) but showed no evidence for reduced burden of deleterious variation due to classically theorized ‘genetic purging’. Applying this database to unsolved recessive conditions in the GME population reduced the number of potential disease-causing variants by four- to sevenfold. These results show variegated genetic architecture in GME populations and support future human genetic discoveries in Mendelian and population genetics

Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes.

Abstract BACKGROUND: The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS: We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy. RESULTS: In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups. CONCLUSIONS: Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo. (Funded by Amylin Pharmaceuticals; EXSCEL ClinicalTrials.gov number, NCT01144338 .)

Aggregate Matching Efficiency: A Stochastic Production Frontier Approach, France 1990-1994

We evaluate the determinants of aggregate matching efficiency changes through a stochastic Cobb-Douglas production frontier model. The efficiency coefficient is represented by a stochastic function of variables meant to capture workers and firms characteristics. The model is estimated on French data covering twenty-two regions from March 1990 till February 1995. Our estimates suggest that aggregate matching efficiency has decreased steadily in the early nineties. There are also wide cross-regional differences. On average, about 30% of the variations of efficiency observed across time and regions can be related to changes in the explanatory variables used in the model. The most important explanatory variables are the proportion of youngsters, females and immigrants in the stock of job seekers. Long-term unemployment has a significant negative effect, population density a significant positive one. The huge decline in the proportion of permanent job offers has apparently little effect on matching efficiency

Issues associated to rare earth silicide integration in ultra thin FD SOI Schottky barrier nMOSFETs

The paper focuses on specific issues associated to rare earth silicide integration on UTB-SOI substrate with a particular attention to erbium and ytterbium silicides. Due to the limited Si source, defects generation on SOI is prevented compared to bulk substrate. Reaction of RE with dielectric materials limits the temperature of silicidation. It is shown that RE S/D MOSFETs are still limited in current-drive by the Schottky barrier height

UHV fabrication of the ytterbium silicide as potential low Schottky barrier S/D contact material for n-type MOSFET

Ytterbium silicide provides a low Schottky barrier height to electron on n-type silicon. This property makes this material very attractive for the realization of Source/Drain contacts for n-type MOSFETs. In this communication, the study of structural and electrical properties of YbSi2-x fabricated at different temperature in Ultra-High Vacuum condition without any protective layers is presented. N-type SB-MOSFETs with ytterbium silicide based S/D contacts were fabricated at optimal silicidation temperatures on SOI substrate with an ultra thin body