Performance Improvement Through Benchmarking for Small and Medium Manufacturers (SMM)

Die wichtigsten Kostenfaktoren innerhalb einer Lieferkette lassen sich drei Kategorien zuordnen: Produktions-, Transport-und Lagerkosten. Die Strukturen dieser operativen Kosten im Hinblick auf die Gesamtkosten variieren stark je nach Industriesektor. Produktionskosten stellen dennoch die höchste Kostenart in fast allen Branchen dar, weniger bedeutend folgen danach jeweils die Transport- und Lagerkosten. Die Optimierung einer dieser Kategorien ohne Rücksicht auf die anderen kann zur Erhöhung der Gesamtkosten sowie der allgemeinen Leistungsfähigkeit führen. Diese Dissertation befasst sich mit dem „production distribution problem“ wobei synchronisierte Strategien entwickelt werden können, um die Leistung der Supply Chain zu verbessern und gleichzeitig die Gesamtkosten zu minimieren. Dazu wurde eine Fallstudie aus der Realität untersucht, nämlich das Praxisbeispiel eines Herstellers von Waschmitteln. Zwei Hauptszenarien werden bewertet. Das erste Szenario ist der konventionelle Plan, wobei die Hersteller dominieren. Dies bedeutet, dass der Hersteller findet seinen eigenen optimalen Job-Scheduling-Plan, während die Distribution versucht mit Hilfe dessen ihren optimalen Plan zu finden. Dadurch erhöhen sich die Distributionskosten. Das zweite Szenario betrifft die Synchronisation der Produktions-, Lagerhaltungs- und Transportzeitpläne. Ein zu diesem Zweck entwickeltes Java-Programm und die Job-Scheduling-Software Simal wurden für die Modellierung der konventionellen und integrierten Szenarien verwendet. Beide Szenarien wurden verglichen und validiert. Die Fallstudie betrachtet mehrere Produkte sowie ein schwer zu planendes flowshop- System. Die Ergebnisse zeigen, dass die Gesamtkosten, einschließlich der Einrichtungs-, Lager- und Transportkosten, minimiert werden können, wenn das synchronisierte System angewendet wird.The main cost factors within a supply chain can be put into the categories of production, transportation, and inventory costs. The composition of these operational costs relative to total costs varies largely by industry. However, production cost is the largest of all in almost all the industries, followed by transportation and inventory costs. Optimizing one of these categories without consideration of the others may increase the total cost and reduce the overall performance. This dissertation deals with the production distribution problem of developing synchronized strategies to improve the supply chain performance and to minimize the total cost. A real case study is investigated. This real-life case study is a powder detergent plant located in Libya. There are two main scenarios evaluated. The first scenario is the conventional plan, where the manufacturer dominates. This means the manufacturer finds his own optimum job-scheduling plan, and the distributor tries to find the optimum plan according to it. This will increase the distribution cost. The second scenario involves synchronizing the production, inventory and transportation schedules. A Java program and SimAl (job-schedulingsoftware) were constructed for modelling conventional and integrated scenarios. The two scenarios were compared and validated. The case study considered multiple products and a flowshop system which is difficult to schedule. The results show that the total costs, including setup, inventory and transportation, can be minimized when the synchronized system is applied

Efficacy and safety of cardioprotective drugs in chemotherapy-induced cardiotoxicity: an updated systematic review & network meta-analysis

BACKGROUND: Cancer patients receiving chemotherapy have an increased risk of cardiovascular complications. This limits the widespread use of lifesaving therapies, often necessitating alternate lower efficacy regimens, or precluding chemotherapy entirely. Prior studies have suggested that using common cardioprotective agents may attenuate chemotherapy-induced cardiotoxicity. However, small sample sizes and conflicting outcomes have limited the clinical significance of these results. HYPOTHESIS: A comprehensive network meta-analysis using updated and high-quality data can provide more conclusive information to assess which drug or drug class has the most significant effect in the management of chemotherapy-induced cardiotoxicity. METHODS: We performed a literature search for randomized controlled trials (RCTs) investigating the effects of cardioprotective agents in patients with chemotherapy-induced cardiotoxicity. We used established analytical tools (netmeta package in RStudio) and data extraction formats to analyze the outcome data. To obviate systematic bias in the selection and interpretation of RCTs, we employed the validated Cochrane risk-of-bias tools. Agents included were statins, aldosterone receptor antagonists (MRAs), ACEIs, ARBs, and beta-blockers. Outcomes examined were improvement in clinical and laboratory parameters of cardiac function including a decreased reduction in left ventricular ejection fraction (LVEF), clinical HF, troponin-I, and B-natriuretic peptide levels. RESULTS: Our study included 33 RCTs including a total of 3,285 patients. Compared to control groups, spironolactone therapy was associated with the greatest LVEF improvement (Mean difference (MD) = 12.80, [7.90; 17.70]), followed by enalapril (MD = 7.62, [5.31; 9.94]), nebivolol (MD = 7.30, [2.39; 12.21]), and statins (MD = 6.72, [3.58; 9.85]). Spironolactone was also associated with a significant reduction in troponin elevation (MD =  - 0.01, [- 0.02; - 0.01]). Enalapril demonstrated the greatest BNP reduction (MD =  - 49.00, [- 68.89; - 29.11]), which was followed by spironolactone (MD =  - 16.00, [- 23.9; - 8.10]). Additionally, patients on enalapril had the lowest risk of developing clinical HF compared to the control population (RR = 0.05, [0.00; 0.75]). CONCLUSION: Our analysis reaffirmed that statins, MRAs, ACEIs, and beta-blockers can significantly attenuate chemotherapy-induced cardiotoxicity, while ARBs showed no significant effects. Spironolactone showed the most robust improvement of LVEF, which best supports its use among this population. Our analysis warrants future clinical studies examining the cardioprotective effects of cardiac remodeling therapy in cancer patients treated with chemotherapeutic agents

Usus al-amn al-fikri fi al-sunnah al-nabawiyah (Basics of security thinking in prophets sunnah)

Security thinking has become one of the necessities of preserving the basics, principles and value of Islamic Civil culture confronting current challenges risks. The most important one is globalization. In this paper we try to introduce an Islamic vision establishing basics of thinking security in its comprehensive concept and wide significance coming up from the Sunnah of our Prophet Mohamed (peace be upon him) by employing what was mentioned in the Sunnah of origins and applications it can be a guiding light for generations of our ascending Ummah. They keep following its guiding principles. The Ummah recognize clearly the ways of being pioneers in civilization. This paper attempts answering the following questions : -What is meant by thinking security from Islamic perspective? -What is its importance? -What are the most important basics mentioned in the Sunnah of the Holy Prophet to achieve thinking Security? -What are the implementing examples in the biography of the Holy Prophet (peace be upon him) that support and activate those basics? -What are sayings of scholars that show these basics and clarify them? The researcher followed the inductive method in gathering basics of thinking security from books of the Sunnah and the biography of the Holy Prophet with the analytical method to change those basics into practical means aiming at realizing the thinking security in current times

Integrated deprivation area mapping system for displacement durable solutions and socio-economic reconstruction, Sudan (IdeaMapSudan).

African great metropolises are rapidly growing due to rural-urban migration. In Khartoum, Sudan, the urban population increased from around 245,000 in 1956, to over 8 million, due to wider changes in urbanization patterns driven by climate change, civil-unrest and protracted forced displacement. With the lack of sustainable planning strategies to secure land tenure and access to services, the level of deprivation in Khartoum informal settings witnessed a swift increase in urban poverty, that requires mapping the vulnerabilities of the urban poor and providing evidence-based data to support displacement ‘durable solutions’. In response, IDeaMapSudan was launched in 2020, as a joint collaboration between Sudan Urban Development Think-Tank, Ministries of Social Development, Physical Planning, Infrastructure and Transport, and the Faculty Geo-Information and Earth Observation Science (ITC) at Twente University, to achieve three key objectives: 1) Provide capacitybuilding on using Earth Observation (EO) and spatial data innovation to fill the gaps in existing administrative GIS maps, 2) Develop a community-led geo-spatial database for mapping deprived areas (e.g. informal settlements) using socio-economic indicators for deprived areas in Khartoum, 3) Establish an ‘Integrated Deprivation Area Mapping System’ for data sharing and communication, that can guide the city planning decision -making process. Using Expert discussions and local field data collection, IDeaMapSudan revealed that local data on deprivation do not exist or are scattered within different local authorities, and the need to overcome the challenges of urban governance and technical congruence between EO data and community-driven vulnerability assessments is essential, by having a spatial distinction between slums, informal settlements, precarious areas, and other deprived areas, beyond the limited understanding of physical deprivation and humanitarian led vulnerability assessments

Additional file 1: of Diabetes Intervention Accentuating Diet and Enhancing Metabolism (DIADEM-I): a randomised controlled trial to examine the impact of an intensive lifestyle intervention consisting of a low-energy diet and physical activity on body weight and metabolism in early type 2 diabetes mellitus: study protocol for a randomized controlled trial

SPIRIT 2013 Checklist: Recommended items to address in a clinical trial protocol and related documents*. (DOC 124 kb

Diabetes Intervention Accentuating Diet and Enhancing Metabolism (DIADEM-I):a randomised controlled trial to examine the impact of an intensive lifestyle intervention consisting of a low-energy diet and physical activity on body weight and metabolism in early type 2 diabetes mellitus: study protocol for a randomized controlled trial

Abstract Background Type 2 diabetes mellitus (T2DM) and obesity are syndemic and will have a significant impact on affected individuals and healthcare services worldwide. Evidence shows that T2DM remission can be achieved with significant weight loss in those who are younger with early diabetes and requiring fewer medications for glycaemic control. DIADEM-I aims to examine the impact of an intensive lifestyle intervention (ILI) using a low-energy diet (LED) meal replacement approach combined with physical activity in younger individuals with early T2DM. Methods The planned study is an ongoing, non-blinded, pragmatic, randomised controlled, parallel-group trial examining the impact of an LED-based ILI on body weight and diabetes remission in younger (18–50 years) T2DM individuals with early diabetes (≤ 3-year duration). The ILI will be compared to usual medical care (UMC). The primary outcome will be weight loss at 12 months. Other key outcomes of interest include diabetes remission, glycaemic control, diabetes complications, cardiovascular health, physical activity, mental health, and quality of life. It is planned for the study to include 138 subjects for assessment of the primary outcome. Safety will be assessed throughout. Discussion If DIADEM-I demonstrates a clinically significant effect for younger individuals with early T2DM, it will inform clinical guidelines and services of the future for management of T2DM. Trial registration ISRCTN: ISRCTN20754766 (date assigned: 7 June 2017); ClinicalTrials.gov, ID: NCT03225339 Registered on 26 June 2017