Managing Waiting Times to Predict No-shows and Cancelations at a Children’s Hospital

Purpose: Since long waits in hospitals have been found to be related to high rates of no-shows and cancelations, managing waiting times should be considered as an important tool that hospitals can use to reduce missed appointments. The aim of this study is to analyze patients’ behavior in order to predict no-show and cancelation rates correlated to waiting times. Design/methodology/approach: This study is based on the data from a US children’s hospital, which includes all the appointments registered during one year of observation. We used the call-appointment interval to establish the wait time to get an appointment. Four different types of appointment-keeping behavior and two types of patients were distinguished: arrival, no-show, cancelation with no reschedule, and cancelation with reschedule; and new and established patients. Findings: Results confirmed a strong impact of long waiting times on patients’ appointment-keeping behavior, and the logarithmic regression was found as the best-fit function for the correlation between variables in all cases. The correlation analysis showed that new patients tend to miss appointments more often than established patients when the waiting time increases. It was also found that, depending on the patients’ appointment distribution, it might get more complicated for hospitals to reduce missed appointments as the waiting time is reduced. Originality/value: The methodology applied in our study, which combines the use of regression analysis and patients’ appointment distribution analysis, would help health care managers to understand the initial implications of long waiting times and to address improvement related to patient satisfaction and hospital performance.Peer Reviewe

Competencia e incentivos a la cooperación en la interacción de grupos de interés que pretenden aumentar su influencia política directa: ¿cuál es la importancia de la presión política?

This study is about the interactions between GDI and government under political pressure, in a context with an agency relationship and the existence of relevant information. In particular, interactions are studied when the agency relationship is with symmetric information and it is build a research model of the GDI-government interactions in a context with an agency relationship and asymmetric information, where groups can operate in a competitive or cooperative manner. The model highlights that government expectations of utility are higher when the GDI works together, and the benefit when the GDI makes pressure in an independent way is limited to the reserve. Cooperation establishes a type of relations based on credibility that benefit to the government and the GIDI, and this will help to strengthen those linksGroups with Direct Influence (GDI), Political Pressure, Lobby (-ing), Agency Relationship, Symmetric and Asymmetric information

Packaging design for competitiveness. Contextualizing the search and adoption of changes from a sustainable supply chain perspective

[EN] The Sustainable Packaging Logistics (SPL) approach seeks sustainable integration of the combined packaging-product-supply chain system orientated to increase competitiveness. However, characterizing which changes make it possible to guide such design in each company and supply chain is an aspect that has not been covered in the literature from different supply chain perspectives. The main goal of this paper is to identify and justify the main actions for improvement in SPL, combined with a proposal of methodology for contextualizing, selecting and implementing each of these potential actions, applying the Action Research approach. Likewise, this paper illustrates the interest of this methodology with its adoption in four different companies and supply chains. This paper opens up new avenues of applied research in packaging design, generating knowledge that contributes to sustainable and competitive improvement.García-Arca, J.; González-Portela Garrido, AT.; Prado-Prado, JC.; González-Boubeta, I. (2022). Packaging design for competitiveness. Contextualizing the search and adoption of changes from a sustainable supply chain perspective. International Journal of Production Management and Engineering. 10(2):115-130. https://doi.org/10.4995/ijpme.2022.16659OJS11513010

Combined therapies of antithrombotics and antioxidants delay in silico brain tumor progression

Glioblastoma multiforme, the most frequent type of primary brain tumor, is a rapidly evolving and spatially heterogeneous high-grade astrocytoma that presents areas of necrosis, hypercellularity and microvascular hyperplasia. The aberrant vasculature leads to hypoxic areas and results in an increase of the oxidative stress selecting for more invasive tumor cell phenotypes. In our study we assay in silico different therapeutic approaches which combine antithrombotics, antioxidants and standard radiotherapy. To do so, we have developed a biocomputational model of glioblastoma multiforme that incorporates the spatio-temporal interplay among two glioma cell phenotypes corresponding to oxygenated and hypoxic cells, a necrotic core and the local vasculature whose response evolves with tumor progression. Our numerical simulations predict that suitable combinations of antithrombotics and antioxidants may diminish, in a synergetic way, oxidative stress and the subsequent hypoxic response. This novel therapeutical strategy, with potentially low or no toxicity, might reduce tumor invasion and further sensitize glioblastoma multiforme to conventional radiotherapy or other cytotoxic agents, hopefully increasing median patient overall survival time.Comment: 8 figure

Ruling out the impact of defects on the below band gap photoconductivity of Ti supersaturated Si

In this study, we present a structural and optoelectronic characterization of high dose Ti implanted Si subsequently pulsed-laser melted (Ti supersaturated Si). Time-of-flight secondary ion mass spectrometry analysis reveals that the theoretical Mott limit has been surpassed after the laser process and transmission electron microscopy images show a good lattice reconstruction. Optical characterization shows strong sub-band gap absorption related to the high Ti concentration. Photoconductivity measurements show that Ti supersaturated Si presents spectral response orders of magnitude higher than unimplanted Si at energies below the band gap. We conclude that the observed below band gap photoconductivity cannot be attributed to structural defects produced by the fabrication processes and suggest that both absorption coefficient of the new material and lifetime of photoexcited carriers have been enhanced due to the presence of a high Ti concentration. This remarkable result proves that Ti supersaturated Si is a promising material for both infrared detectors and high efficiency photovoltaic devices

Room temperature photo-response of titanium supersaturated silicon at energies over the bandgap

Silicon samples were implanted with high Ti doses and subsequently processed with the pulsed-laser melting technique. The electronic transport properties in the 15–300 K range and the room temperature spectral photoresponse at energies over the bandgap were measured. Samples with Ti concentration below the insulator-metal (I-M) transition limit showed a progressive reduction of the carrier lifetime in the implanted layer as Ti dose is increased. However, when the Ti concentration exceeded this limit, an extraordinary recovery of the photoresponse was measured. This result supports the theory of intermediate band materials and is of utmost relevance for photovoltaic cells and Si-based detectors

Ischemic postconditioning reduces reperfusion arrhythmias by adenosine receptors and protein kinase C activation but is independent of KATP channels or connexin 43

Funding: This study was supported by Secretaría de Investigación, Internacionales y Posgrado, Universidad Nacional de Cuyo (06/J505) and by the Spanish, Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III (CIBERCV), cofinanced by the European Regional Development Fund (ERDF-FEDER, a way to build Europe), and by Fundació La Marató de TV3 (n◦. 201536-10). Antonio Rodríguez-Sinovas has a consolidated Miguel Servet contract. Jose A. Sánchez was supported by the International Research Training Group 1566 on Protecting the Heart from Ischemia (PROMISE).Ischemic postconditioning (IPoC) reduces reperfusion arrhythmias but the antiarrhythmic mechanisms remain unknown. The aim of this study was to analyze IPoC electrophysiological effects and the role played by adenosine A, A and A receptors, protein kinase C, ATP-dependent potassium (K) channels, and connexin 43. IPoC reduced reperfusion arrhythmias (mainly sustained ventricular fibrillation) in isolated rat hearts, an effect associated with a transient delay in epicardial electrical activation, and with action potential shortening. Electrical impedance measurements and Lucifer-Yellow diffusion assays agreed with such activation delay. However, this delay persisted during IPoC in isolated mouse hearts in which connexin 43 was replaced by connexin 32 and in mice with conditional deletion of connexin 43. Adenosine A, A and A receptor blockade antagonized the antiarrhythmic effect of IPoC and the associated action potential shortening, whereas exogenous adenosine reduced reperfusion arrhythmias and shortened action potential duration. Protein kinase C inhibition by chelerythrine abolished the protective effect of IPoC but did not modify the effects on action potential duration. On the other hand, glibenclamide, a K inhibitor, antagonized the action potential shortening but did not interfere with the antiarrhythmic effect. The antiarrhythmic mechanisms of IPoC involve adenosine receptor activation and are associated with action potential shortening. However, this action potential shortening is not essential for protection, as it persisted during protein kinase C inhibition, a maneuver that abolished IPoC protection. Furthermore, glibenclamide induced the opposite effects. In addition, IPoC delays electrical activation and electrical impedance recovery during reperfusion, but these effects are independent of connexin 43

Sub-bandgap spectral photo-response analysis of Ti supersaturated Si

We have analyzed the increase of the sheet conductance (ΔG□) under spectral illumination in high dose Ti implanted Si samples subsequently processed by pulsed-laser melting. Samples with Ti concentration clearly above the insulator-metal transition limit show a remarkably high ΔG□, even higher than that measured in a silicon reference sample. This increase in the ΔG□ magnitude is contrary to the classic understanding of recombination centers action and supports the lifetime recovery predicted for concentrations of deep levels above the insulator-metal transition

First Case of Multiple Resistance to EPSPS and PSI in Eleusine indica (L.) Gaertn. Collected in Rice and Herbicide-Resistant Crops in Colombia

Eleusine indica is a highly competitive and difficult-to-control plant in annual and perennial crops. In Colombia, broad-spectrum herbicides, such as paraquat and glyphosate, have begun to present poor levels of control for this weed. The multiple resistance to glyphosate and paraquat, the increase in herbicide performance with adjuvants (Retenol® and Trend® 90), and alternative herbicides were evaluated in a resistant (R) population of E. indica collected in rice fields, which is rotated with herbicide-resistant (HR) crops. Based on plant mortality, the R population was 9.8 and 7.2 times more resistant than susceptible (S) plants to glyphosate and paraquat, respectively. R plants accumulated 4.2 less shikimic acid and had at least 70% less electrolyte leakage than S plants when they were exposed to glyphosate and paraquat, respectively. Both adjuvants increased the foliar retention of herbicides. In addition, adjuvants also increased the performance of glyphosate effectiveness between 22% and 58% and that of paraquat from 61% to 100%. Alternative herbicides (atrazine, clethodim, imazamox, diuron, flazasulfuron, glufosinate, oxyfluorfen, quizalofop, and tembotrione) provided high levels of control in both populations of E. indica. This is the first case of multiple resistant E. indica confirmed in Colombia. Adjuvants improved the leaf retention and efficacy of glyphosate and paraquat. In summary, the alternative herbicides evaluated in this study should be adopted by Colombian farmers and provide additional herbicide modes-of-action to combat future resistance

Sostenibilidad y mejora logística. Un caso práctico

[ESP] Las empresas, en el contexto competitivo actual, deben enfrentarse a los desafíos de la innovación constante de nuevos productos, disminución de los ciclos de vida de los productos, la proliferación de productos, la demanda de precios cada vez más bajos y estándares de calidad y servicio cada vez más elevados. Esto ha ocurrido en mercados que pueden caracterizarse como cada vez más globales, turbulentos y volátiles y ha obligado a muchas organizaciones a buscar como fuente de ventajas competitivas, una mejor gestión de la cadena de suministro (“supply chain management”, en adelante SCM), incluyendo la posible deslocalización de procesos y actividades a países emergentes o de bajo coste. En esta misma línea, está bastante extendida la visión de que la competencia en los mercados actuales ya no sigue un modelo de compañía contra compañía, sino que la competencia es entre cadenas de suministro. Ahora bien, la búsqueda sistemática de alternativas más eficientes para diseñar y gestionar la cadena suministros pueden basarse, tanto en el ámbito de la reducción de costes (enfoque “lean”) como en el ámbito de la mejora de la flexibilidad (enfoque “ágil”). Tradicionalmente, ambos enfoques se han contrapuesto, si bien, más que conceptos excluyentes, ambos deben complementarse en un entorno cada vez más competitivo, en el que no es suficiente ofrecer productos que, o bien sólo sean baratos, que sólo tengan calidad o que sólo ofrezcan un buen plazo de entrega