Redesigning a planning process in a multinational company

Thesis (M.B.A.)--Massachusetts Institute of Technology, Sloan School of Management; and, (S.M.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science; in conjunction with the Leaders for Global Operations Program at MIT, 2011.Cataloged from PDF version of thesis.Includes bibliographical references (p. 66).As a consumer-packaged-goods company dealing with multiple suppliers, "Company X" (the company's real name has been disguised) has a clear need for an accurate raw material forecast. The current planning process has not managed to supply a forecast that will answer Company X's raw material procurement needs, and so a need for a new process has arisen. Process change initiatives are a task that every company frequently encounters, and creating the right setting for a successful change initiative is critical to determining whether the company will be able to drive the cost savings and remain competitive. This thesis outlines the process of redesigning the raw material planning process within the company's regional operations in several developing countries. The new process was designed in an attempt to balance creating a more accurate and more robust forecast with designing an implementable, wellaccepted new process that will establish the settings for a successful change initiative. In the process evaluation section, we examine the new procedure's potential accuracy improvement, as well as two unique management tools to evaluate the process' implementation potential and the trade-offs made in designing the process. We evaluate the impact of the finished goods forecast and production error on the overall material plan accuracy. One common course of action companies typically take in order to decrease material plan variability is to reduce the number of finished goods SKU by aggregating similar SKUs. SKU reduction increases the forecast mean of the individual SKUs and thereby decreases the percent error of the forecast. One interesting conclusion this thesis outlines is that when the production error is not negligible, SKU reduction will only help if the decreased finished goods forecast percent error is above a certain ratio (the square root of the forecast mean). This conclusion suggest that local optimizations of the sub-processes that generate the full material plan will not necessarily optimize the resulting material plan, and that material plan optimization should be done using a comprehensive approach, not as a set of sub-processes optimizations. While these results, and the methodology for the design and assessment of new process was revealed during my work within company X, the material plan accuracy results are relevant for any material plan process improvement, and the change management methodology discussed is relevant for any company with a need for a smooth and successful implementation of a new process.by Liron Azrielant.S.M.M.B.A

Diffuse Facial Hyperpigmentation as a Presenting Sign of Lupus Erythematosus: Three Cases and Review of the Literature

Lupus erythematosus (LE) is an autoimmune disorder commonly affecting the skin; cutaneous lesions may indicate systemic involvement, warranting further evaluation. Photosensitivity, which may result in hyperpigmentation, is a well-known feature of the disease. In contrast, the prevalence of primary hyperpigmentation as a presenting sign of LE is not well established. Here, we compare 3 unique cases of diffuse facial hyperpigmentation as the primary manifestation of LE (cutaneous or systemic) and review previously reported cases. Our data highlight the need for considering LE in the differential diagnosis of facial hyperpigmentation and substantiate the importance of this unique lupus variant in early diagnosis and patient evaluation

Mesenchymal stromal cells as rescue therapy in biologic-refractory psoriasis: insights from a case series

Cytokine-targeted biologics have revolutionized the management of moderate-to-severe psoriasis; however, all available therapies have failed a growing number of patients. Mesenchymal stromal cells (MSCs), with their immunomodulatory properties, offer a novel therapeutic option. Here, we report the cases of three adult female patients with long-standing, severe plaque psoriasis who were refractory to multiple biologic therapies, and were consequently treated with two intravenous infusions of allogeneic umbilical cord-derived MSCs (UC-MSCs; 1.96 – 3.00 × 106 cells/kg) 1 week (W) apart. Two patients received UC-MSCs as monotherapy; one received them alongside etanercept. Upon relapse, two patients resumed their last failed biologic at W9, while one switched to a new biologic at W24. UC-MSCs were well-tolerated and yielded variable clinical benefits. The best responder to MSCs experienced an 87% reduction in the Psoriasis Area and Severity Index (PASI 87) by W4. Two patients showed improved responses to previously failed biologics (absolute PASI of 0–2), sustained for over 2 years following reinitiation. Multi-parameter flow cytometry revealed increased frequencies of CD4+ and CD8+ skin-homing (CLA+CD103−) and skin-recirculating (CLA+CD103+) memory T cells, CD25HiCD127LoFoxP3+ regulatory T cells, and non-classical (CD14LoCD16+) monocytes, associated with clinical improvements. These findings suggest that UC-MSCs may potentially provide direct benefits for biologic-refractory psoriasis and restore responsiveness to previously ineffective biologics, possibly by resetting the immune response. Further investigation in larger cohorts is warranted

Diffuse Facial Hyperpigmentation as a Presenting Sign of Lupus Erythematosus: Three Cases and Review of the Literature

Lupus erythematosus (LE) is an autoimmune disorder commonly affecting the skin; cutaneous lesions may indicate systemic involvement, warranting further evaluation. Photosensitivity, which may result in hyperpigmentation, is a well-known feature of the disease. In contrast, the prevalence of primary hyperpigmentation as a presenting sign of LE is not well established. Here, we compare 3 unique cases of diffuse facial hyperpigmentation as the primary manifestation of LE (cutaneous or systemic) and review previously reported cases. Our data highlight the need for considering LE in the differential diagnosis of facial hyperpigmentation and substantiate the importance of this unique lupus variant in early diagnosis and patient evaluation. </jats:p

Mpox proctitis as a likely predisposing factor for chlamydial perihepatitis in a male patient

Perihepatitis (Fitz-Hugh-Curtis syndrome) is a rare complication of sexually transmitted infections, mostly seen in women. Only 12 male cases have been reported to date, of whichChlamydia trachomatiswas confirmed in 2. We report a case of chlamydial perihepatitis in a male patient, occurring 1 month after Mpox and associated with the unusual LGV ST23 strain. Our case suggests that rectal Mpox lesions may facilitate chlamydial dissemination.</jats:p

Vitamin D and systemic lupus erythematosus - The hype and the hope

Over the past 20. years, much has been written about the potential role of vitamin D in on adverse health outcomes. In recent years, evidence has accumulated regarding the effect of vitamin D on the immune system, and its different cells. Some studies have noted lower vitamin D concentrations in patients with SLE. These epidemiological data still not answer the question: is vitamin D deficiency the cause or the effect? To answer this, we will discuss the association between vitamin D deficiency and SLE and review the evidence from interventional studies