84 research outputs found

    Customer integration and operational performance: The mediating role of information quality

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    Much supply chain integration literature tends to be biased towards its positive impact on operational performance. However, inconclusive results demand investigation of the mechanisms through which supply chain integration can lead to superior operational performance. The purpose of this study is to identify empirically the mediating role of information quality on the relationship between customer integration and operational performance, and the direct relationship between customer integration and operational performance. The study is based on a questionnaire sent to 228 manufacturing companies in the Republic of Ireland, and the relationships between the constructs are analyzed through regression analysis. The results indicate that information quality partially mediates the relationship between customer integration and quality, delivery and flexibility. Further, information quality was found to fully mediate the relationship between customer integration and cost

    An Integrative Design Framework for New Service Development

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    Service innovation is focused on customer value creation. At its core, customer-centric service innovation in an increasingly digital world is technology-enabled, human-centered, and process-oriented. This requires a cross-disciplinary, holistic approach to new service design and development (NSD). This paper proposes a new service strategy-aligned integrative design framework for NSD. It correlates the underlying theories and principles of disparate but interrelated aspects of service design thinking: service strategy, concept, design, experience and architecture into a coherent framework for NSD, consistent with the service brand value. Application of the framework to NSD is envisioned to be iterative and holistic, accentuated on continuous organizational and customer learning. The preliminary framework's efficacy is illustrated using a simplified telecom case example. Β© Springer International Publishing Switzerland 2014

    Can the outcome of pelvic-floor rehabilitation in patients with fecal incontinence be predicted?

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    Purpose: Pelvic-floor rehabilitation does not provide the same degree of relief in all fecal incontinent patients. We aimed at studying prospectively the ability of tests to predict the outcome of pelvic-floor rehabilitation in patients with fecal incontinence. Materials and methods: Two hundred fifty consecutive patients (228 women) underwent medical history and a standardized series of tests, including physical examination, anal manometry, pudendal nerve latency testing, anal sensitivity testing, rectal capacity measurement, defecography, endoanal sonography, and endoanal magnetic resonance imaging. Subsequently, patients were referred for pelvic-floor rehabilitation. Outcome of pelvic-floor rehabilitation was quantified by the Vaizey incontinence score. Linear regression analyses were used to identify candidate predictors and to construct a multivariable prediction model for the posttreatment Vaizey score. Results: After pelvic-floor rehabilitation, the mean baseline Vaizey score (18, SDΒ±3) was reduced with 3.2 points (p<0.001). In addition to the baseline Vaizey score, three elements from medical history were significantly associated with the posttreatment Vaizey score (presence of passive incontinence, thin stool consistency, primary repair of a rupture after vaginal delivery at childbed) (R2, 0.18). Th

    Management of obstetric anal sphincter injury: a systematic review & national practice survey

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    BACKGROUND: We aim to establish the evidence base for the recognition and management of obstetric anal sphincter injury (OASI) and to compare this with current practice amongst UK obstetricians and coloproctologists. METHODS: A systematic review of the literature and a postal questionnaire survey of consultant obstetricians, trainee obstetricians and consultant coloproctologists was carried out. RESULTS: We found a wide variation in experience of repairing acute anal sphincter injury. The group with largest experience were consultant obstetricians (46.5% undertaking β‰₯ 5 repairs/year), whilst only 10% of responding colorectal surgeons had similar levels of experience (p < 0.001). There was extensive misunderstanding in terms of the definition of obstetric anal sphincter injuries. Overall, trainees had a greater knowledge of the correct classification (p < 0.01). Observational studies suggest that a new 'overlap' repair using PDS sutures with antibiotic cover gives better functional results. However, our literature search found only one randomised controlled trial (RCT) on the technique of repair of OASI, which showed no difference in incidence of anal incontinence at three months. Despite this, there was a wide variation in practice, with 337(50%) consultants, 82 (55%) trainees and 80 (89%) coloproctologists already using the 'overlap' method for repair of a torn EAS (p < 0.001). Although over 50% of colorectal surgeons would undertake long-term follow-up of their patients, this was the practice of less than 10% of obstetricians (p < 0.001). Whilst over 70% of coloproctologists would recommend an elective caesarean section in a subsequent pregnancy, only 22% of obstetric consultants and 14% of trainees (p < 0.001). CONCLUSION: An agreed classification of OASI, development of national guidelines, formalised training, multidisciplinary management and further definitive research is strongly recommended

    Phase 1 clinical study of an embryonic stem cell-derived retinal pigment epithelium patch in age-related macular degeneration

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    Age-related macular degeneration (AMD) remains a major cause of blindness, with dysfunction and loss of retinal pigment epithelium (RPE) central to disease progression. We engineered an RPE patch comprising a fully differentiated, human embryonic stem cell (hESC)-derived RPE monolayer on a coated, synthetic basement membrane. We delivered the patch, using a purpose-designed microsurgical tool, into the subretinal space of one eye in each of two patients with severe exudative AMD. Primary endpoints were incidence and severity of adverse events and proportion of subjects with improved best-corrected visual acuity of 15 letters or more. We report successful delivery and survival of the RPE patch by biomicroscopy and optical coherence tomography, and a visual acuity gain of 29 and 21 letters in the two patients, respectively, over 12 months. Only local immunosuppression was used long-term. We also present the preclinical surgical, cell safety and tumorigenicity studies leading to trial approval. This work supports the feasibility and safety of hESC-RPE patch transplantation as a regenerative strategy for AMD

    Low rates of mutation in clinical grade human pluripotent stem cells under different culture conditions

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    Abstract: The occurrence of repetitive genomic changes that provide a selective growth advantage in pluripotent stem cells is of concern for their clinical application. However, the effect of different culture conditions on the underlying mutation rate is unknown. Here we show that the mutation rate in two human embryonic stem cell lines derived and banked for clinical application is low and not substantially affected by culture with Rho Kinase inhibitor, commonly used in their routine maintenance. However, the mutation rate is reduced by >50% in cells cultured under 5% oxygen, when we also found alterations in imprint methylation and reversible DNA hypomethylation. Mutations are evenly distributed across the chromosomes, except for a slight increase on the X-chromosome, and an elevation in intergenic regions suggesting that chromatin structure may affect mutation rate. Overall the results suggest that pluripotent stem cells are not subject to unusually high rates of genetic or epigenetic alterations

    Emphasising today over tomorrow: not a strategic option in operations.

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    The question to be addressed in this paper is: How is competing for tomorrow based on operations enabled or compromised by competing for today? Operations strategy has been defined as the total pattern of decisions which shape the long term capabilities of any type of operation and their contribution to overall strategy, through the reconciliation of market requirements with operations resources (Slack & Lewis, 2008). It is the \u201clong term\u201d element of this definition that is of interest in this paper and, in particular, the linkage between choices of emphasis on today and tomorrow. Managing for today while building the infrastructure for tomorrow involves a basic dilemma: building the systems and processes for the short run often undercuts the innovative process. Successful organizations innovate for today as well as for tomorrow. Yet, managing this duality is difficult and there are many examples of once-innovative firms trapped by their own success (Tushman & Nadler, 1986; Abell 1999). Boyer & McDermott (1999) examined the impact of strategic consensus or disagreement on the development of manufacturing capabilities and plant performance. They proposed that the critical factor in determining strategic success was not necessarily which priority was emphasized, but whether the priority was translated into a consistent pattern of decisions that helped to develop the capability into a competitive advantage. It is this \u201cpattern of decisions\u201d that is of interest in this paper

    A case study for merging supply chain and blockchain in Australian manufacturer

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    This paper examines implementation of Blockchain technology within an Australian manufacturer supply chain. We present a summary of the challenges in adopting this technology. The adoption of Blockchain technology has potential to bring greater transparency, validity across supply chain processes, and improvement of communication between all stakeholders and customers involved.N/

    Port-centric logistics

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