2,349 research outputs found
The Future of Manufacturing Global Value Chains, Smart Specialization and Flexibility!
Β© 2018, Global Institute of Flexible Systems Management. The future manufacturing and global value chain will be highly dominated by technological and business innovations to cope with the accelerating pace of changes in consumer behaviour and global business environment. This editorial for the special issue βThe future of manufacturing: global value chains, smart specialization and flexibilityβ enriches the topic of future of manufacturing operations and supply chain management literature. In the line with the theme, this special issue publishes five articles that clearly articulate the emerging thematic discussions
Computing a rectilinear shortest path amid splinegons in plane
We reduce the problem of computing a rectilinear shortest path between two
given points s and t in the splinegonal domain \calS to the problem of
computing a rectilinear shortest path between two points in the polygonal
domain. As part of this, we define a polygonal domain \calP from \calS and
transform a rectilinear shortest path computed in \calP to a path between s and
t amid splinegon obstacles in \calS. When \calS comprises of h pairwise
disjoint splinegons with a total of n vertices, excluding the time to compute a
rectilinear shortest path amid polygons in \calP, our reduction algorithm takes
O(n + h \lg{n}) time. For the special case of \calS comprising of concave-in
splinegons, we have devised another algorithm in which the reduction procedure
does not rely on the structures used in the algorithm to compute a rectilinear
shortest path in polygonal domain. As part of these, we have characterized few
of the properties of rectilinear shortest paths amid splinegons which could be
of independent interest
Framework Guidlines and Governance for Designing Local Adaptation Plan of Action to Mainstream Climate Smart Villages in India
Based on the extensive review of existing frameworks and practices on climate change adaptation and
authors experiences in Indian context, this study presented BRIFFS (bottom-up, responsive, inclusive,
flexible, forward-looking, and sustainable) as the major guidelines for developing LAPA. This study presented
the major steps of LAPA with clear actions, activities and also tools that can be used in each step. The nine
steps of LAPA are as follows: 1) Communicating climate change risks and adaptation measures at local level,
2) Assessment of climate risks and vulnerabilities and scoping of adaptation actions, 3) Prioritisation
of adaptation options, 4) Formulation of LAPA, 5) LAPA integration in planning process, 6) Institutional
arrangement to implement LAPA, 7) Implementation of LAPA, 8) Progress assessment of LAPA, and
9) Feedback and revision of LAPA
Pain during ice water test distinguishes clinical bladder hypersensitivity from overactivity disorders.
BACKGROUND: The Bladder cooling reflex (BCR) i.e. uninhibited detrusor contractions evoked by intravesical instillation of cold saline, is a segmental reflex believed to be triggered by menthol sensitive cold receptors in the bladder wall, with the afferent signals transmitted by C fibres. The BCR is a neonatal reflex that becomes suppressed by descending signals from higher centres at approximately the time when the child gains full voluntary control of voiding. It re-emerges in adults with neurogenic detrusor overactivity as a consequence of loss of central descending inhibition, resulting from conditions such as spinal cord injury or multiple sclerosis. We have recently shown an increase of nerve fibres expressing the cool and menthol receptor TRPM8 in both overactive (IDO) and painful bladder syndrome (PBS), but its functional significance is unknown. We have therefore studied the bladder cooling reflex and associated sensory symptoms in patients with PBS and overactivity disorders. METHODS: The BCR, elicited by ice water test (IWT) was performed in patients with painful bladder syndrome (PBS, n = 17), idiopathic detrusor overactivity (IDO, n = 22), neurogenic detrusor overactivity (NDO, n = 4) and stress urinary incontinence (as controls, n = 21). The IWT was performed by intravesical instillation of cold saline (0 - 4 degrees C). A positive IWT was defined as presence of uninhibited detrusor contraction evoked by cold saline, associated with urgency or with fluid expulsion. Patients were asked to report and rate any pain and cold sensation during the test. RESULTS: A positive IWT was observed in IDO (6/22, 27.3%) and NDO (4/4, 100%) patients, but was negative in all control and PBS patients. Thirteen (76.5%) PBS patients reported pain during the IWT, with significantly higher pain scores during ice water instillation compared to the baseline (P = 0.0002), or equivalent amount of bladder filling (100 mls) with saline at room temperature (P = 0.015). None of the control or overactive (NDO/IDO) patients reported any pain during the IWT. CONCLUSION: The BCR in DO may reflect loss of central inhibition, which appears necessary to elicit this reflex; the pain elicited in PBS suggests afferent sensitisation, hence sensory symptoms are evoked but not reflex detrusor contractions. The ice water test may be a useful and simple marker for clinical trials in PBS, particularly for novel selective TRPM8 antagonists
Intra-operative measurement of tumour size in breast cancer and its comparison with other methods: a prospective study
Accurate measurement of breast tumour size determines staging and prognosis. Discrepancies amongst clinical examination (CE), ultrasonography (USG), mammography, pathological examination (PE) and magnetic resonance imaging have been reported. However, few studies have evaluated changes in breast tumour size from the operating table to the laboratory
A theory-grounded framework of Open Source Software adoption in SMEs
This is a post-peer-review, pre-copyedit version of an article published in European Journal of Information Systems. The definitive publisher-authenticated version Macredie, RD and Mijinyawa, K (2011), "A theory-grounded framework of Open Source Software adoption in SMEs", European Journal of Informations Systems, 20(2), 237-250 is available online at: http://www.palgrave-journals.com/ejis/journal/v20/n2/abs/ejis201060a.html.The increasing popularity and use of Open Source Software (OSS) has led to significant interest from research communities and enterprise practitioners, notably in the small business sector where this type of software offers particular benefits given the financial and human capital constraints faced. However, there has been little focus on developing valid frameworks that enable critical evaluation and common understanding of factors influencing OSS adoption. This paper seeks to address this shortcoming by presenting a theory-grounded framework for exploring these factors and explaining their influence on OSS adoption, with the context of study being small- to medium-sized Information Technology (IT) businesses in the U.K. The framework has implications for this type of business β and, we will suggest, more widely β as a frame of reference for understanding, and as tool for evaluating benefits and challenges in, OSS adoption. It also offers researchers a structured way of investigating adoption issues and a base from which to develop models of OSS adoption. The study reported in this paper used the Decomposed Theory of Planned Behaviour (DTPB) as a basis for the research propositions, with the aim of: (i) developing a framework of empirical factors that influence OSS adoption; and (ii) appraising it through case study evaluation with 10 U.K. Small- to medium-sized enterprises in the IT sector. The demonstration of the capabilities of the framework suggests that it is able to provide a reliable explanation of the complex and subjective factors that influence attitudes, subjective norms and control over the use of OSS. The paper further argues that the DTPB proved useful in this research area and that it can provide a variety of situation-specific insights related to factors that influence the adoption of OSS
An Alternate Method of Classifying Allergic Bronchopulmonary Aspergillosis Based on High-Attenuation Mucus
Allergic bronchopulmonary aspergillosis (ABPA) is classified radiologically based on the findings of central bronchiectasis (CB) and other radiologic features (ORF). However, the long-term clinical significance of these classifications remains unknown. We hypothesized that the immunological activity and outcomes of ABPA could be predicted on HRCT chest finding of high-attenuation mucus (HAM), a marker of inflammatory activity. In this study, we evaluate the severity and clinical outcomes of ABPA with different radiological classifications. specific IgE levels, eosinophil count) severity of the disease and clinical outcomes in various classifications were analyzed.Of the 234 (123 males, 111 females; mean age, 34.1 years) patients, 55 (23.5%) had normal HRCT, 179 (76.5%) had CB, 49 (20.9%) had HAM, and 27 (11.5%) had ORF. All immunological markers were consistently higher in the HAM classification, while in other classifications these findings were inconsistent. On multivariate analysis, the factors predicting frequent relapses were presence of HAM (OR 7.38; 95% CI, 3.21β17.0) and CB (OR 3.93; 95% CI, 1.63β9.48) after adjusting for ORF.The classification scheme based on HAM most consistently predicts immunological severity in ABPA. Central bronchiectasis and HAM are independent predictors of recurrent relapses in ABPA. Hence, HAM should be employed in the radiological classification of ABPA
A study of empyema thoracis and role of intrapleural streptokinase in its management
BACKGROUND: Clinical spectrum, microbiology and outcome of empyema thoracis are changing. Intrapleural instillation of fibrinolytic agents is being increasingly used for management of empyema thoracis. The present study was carried out to describe the clinical profile and outcome of patients with empyema thoracis including those with chronic empyema and to study the efficacy and safety of intrapleural streptokinase in its management. METHODS: Clinical profile, etiological agents, hospital course and outcome of 31 patients (mean age 40 Β± 16 years, M: F 25: 6) with empyema thoracis treated from 1998 to 2003 was analyzed. All patients were diagnosed on the basis of aspiration of frank pus from pleural cavity. Clinical profile, response to therapy and outcome were compared between the patients who received intrapleural streptokinase (n = 12) and those who did not (n = 19). RESULTS: Etiology was tubercular in 42% of the patients (n = 13) whereas the rest were bacterial. Amongst the patients in which organisms could be isolated (n = 13, 42%) Staphylococcus aureus was the commonest (n = 5). Intrapleural streptokinase was instilled in 12 patients. This procedure resulted in increase of drainage of pleural fluid in all patients. Mean daily pleural fluid drainage after streptokinase instillation was significantly higher for patients who received intrapleural streptokinase than those who did not (213 ml vs 57 ml, p = 0.006). Only one patient who was instilled streptokinase eventually required decortication, which had to be done in five patients (16.1%). Mean hospital stay was 30.2 Β± 17.6 days whereas two patients died. CONCLUSIONS: Tubercular empyema is common in Indian patients. Intrapleural streptokinase appears to be a useful strategy to preserve lung function and reduce need for surgery in patients with late stage of empyema thoracis
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