Key Factors to Increasing Free Cash Flow for Manufacturers Utilizing Lean Production: An AHP-DEMATEL Approach

This paper aims to apply AHP and DEMATEL to analyze the key factors and interrelationships of lean production to increase free cash flow for manufacturers. The AHP hierarchy was determined through literature and interviews with leading management experts. The assessment criteria were categorized into five major criteria and 15 sub-criteria, including production, sales, human resources, R&D, and finance. According to the AHP results, the first eight key factors were identified as the key factors to increasing cash flow for manufacturers who utilized lean production. DEMATEL was used to identify the interactions among the eight key factors and further identify the four more important ones. The four key factors are strategic planning, strategic deployment, leadership, and goal orientation. This paper proposes management implications and improvement suggestions for the four key factors and their interactions

Refinement treatment of nasal bone fracture: A 6-year study of 329 patients

SummaryBackgroundThe reliability of X-ray radiography for diagnosing nasal bone fractures (NBFs) remains controversial. Recent studies show that, for determining the orientation and location of the displaced/depressed fracture, nasal sonography is as accurate as facial computed tomography. This retrospective study compared conductor-assisted nasal sonography (CANS) to conventional diagnostic tools and reported subjective patient satisfaction and discomfort after closed reduction combined with tube technique.MethodsThis retrospective study reports the results of 329 refinement treatments for nasal bone fracture (including 199 men and 130 women) performed from 2005 to 2011. All patients were assessed with CANS and completed a survey immediately prior to removing the packing. Questionnaires were adapted from the nasal obstruction symptom evaluation (NOSE) scale.ResultsThe study found that CANS has a 97.2% rate of accuracy in diagnosing NBF. The visual analog scale scores of nasal obstruction, nasal congestion, sleep disturbance, trouble breathing, and inability to move air through the nose were analyzed. The experimental group scores were significantly different from the control group for all scores (p < 0.001).ConclusionCompared to conventional methods, CANS is more accurate for detecting NBF. We recommend its use as an alternative tool for diagnosing a nasal fracture. Because the tube technique balances pressure between the nasopharynx and middle ear during swallowing, patient comfort is enhanced. Application of these modifications can improve accuracy in diagnosing NBF and can improve the quality of NBF treatment

Optimal Color Stability for White Organic Light-Emitting Diode (WOLED) by Using Multiple-Ultra-Thin Layers (MUTL)

The work demonstrates the improvement of color stability for white organic light-emitting diode (WOLED). The devices were prepared by vacuum deposition on ITO-glass substrates. These guest materials of 5,6,11,12-tetraphenylnaphthacene (Rubrene) were deposited in 4,4′-bis(2,2-diphenyl vinyl)-1,1′-biphenyl (DPVBi), resulting in an emitting layer. Experimental results reveal that the properties in the multiple-ultra-thin layer (MUTL) are better than those of the emitting layer with a single guest material, reaching the commercial white-light wavelength requirement of 400–700 nm. The function of the MUTL is as the light-emitting and trapping layer. The results show that the MUTL has excellent carrier capture effect, leading to high color stability of the device at various applied voltages. The Commissions Internationale De L’Eclairage (CIE) coordinate of this device at 3~7 V is few displacement and shows a very slight variation of (0.016, 0.009). The CIE coordinates at a maximal luminance of 9980 cd/m2 are (0.34, 0.33)

Computational analysis of a novel mutation in ETFDH gene highlights its long-range effects on the FAD-binding motif

<p>Abstract</p> <p>Background</p> <p>Multiple acyl-coenzyme A dehydrogenase deficiency (MADD) is an autosomal recessive disease caused by the defects in the mitochondrial electron transfer system and the metabolism of fatty acids. Recently, mutations in electron transfer flavoprotein dehydrogenase (<it>ETFDH</it>) gene, encoding electron transfer flavoprotein:ubiquinone oxidoreductase (ETF:QO) have been reported to be the major causes of riboflavin-responsive MADD. To date, no studies have been performed to explore the functional impact of these mutations or their mechanism of disrupting enzyme activity.</p> <p>Results</p> <p>High resolution melting (HRM) analysis and sequencing of the entire <it>ETFDH </it>gene revealed a novel mutation (p.Phe128Ser) and the hotspot mutation (p.Ala84Thr) from a patient with MADD. According to the predicted 3D structure of ETF:QO, the two mutations are located within the flavin adenine dinucleotide (FAD) binding domain; however, the two residues do not have direct interactions with the FAD ligand. Using molecular dynamics (MD) simulations and normal mode analysis (NMA), we found that the p.Ala84Thr and p.Phe128Ser mutations are most likely to alter the protein structure near the FAD binding site as well as disrupt the stability of the FAD binding required for the activation of ETF:QO. Intriguingly, NMA revealed that several reported disease-causing mutations in the ETF:QO protein show highly correlated motions with the FAD-binding site.</p> <p>Conclusions</p> <p>Based on the present findings, we conclude that the changes made to the amino acids in ETF:QO are likely to influence the FAD-binding stability.</p

DeepOpht: Medical Report Generation for Retinal Images via Deep Models and Visual Explanation

In this work, we propose an AI-based method that intends to improve the conventional retinal disease treatment procedure and help ophthalmologists increase diagnosis efficiency and accuracy. The proposed method is composed of a deep neural networks-based (DNN-based) module, including a retinal disease identifier and clinical description generator, and a DNN visual explanation module. To train and validate the effectiveness of our DNN-based module, we propose a large-scale retinal disease image dataset. Also, as ground truth, we provide a retinal image dataset manually labeled by ophthalmologists to qualitatively show, the proposed AI-based method is effective. With our experimental results, we show that the proposed method is quantitatively and qualitatively effective. Our method is capable of creating meaningful retinal image descriptions and visual explanations that are clinically relevant.Comment: Accepted to IEEE WACV 202

Query-controllable Video Summarization

When video collections become huge, how to explore both within and across videos efficiently is challenging. Video summarization is one of the ways to tackle this issue. Traditional summarization approaches limit the effectiveness of video exploration because they only generate one fixed video summary for a given input video independent of the information need of the user. In this work, we introduce a method which takes a text-based query as input and generates a video summary corresponding to it. We do so by modeling video summarization as a supervised learning problem and propose an end-to-end deep learning based method for query-controllable video summarization to generate a query-dependent video summary. Our proposed method consists of a video summary controller, video summary generator, and video summary output module. To foster the research of query-controllable video summarization and conduct our experiments, we introduce a dataset that contains frame-based relevance score labels. Based on our experimental result, it shows that the text-based query helps control the video summary. It also shows the text-based query improves our model performance. Our code and dataset: https://github.com/Jhhuangkay/Query-controllable-Video-Summarization.Comment: This paper is accepted by ACM International Conference on Multimedia Retrieval (ICMR), 202

Down-regulation of PKCζ in renal cell carcinoma and its clinicopathological implications

<p>Abstract</p> <p>Background</p> <p>Metastatic renal cell carcinoma (RCC) is highly resistant to systemic chemotherapy. Unfortunately, nearly all patients die of the metastatic and chemoresistant RCC. Recent studies have shown the atypical PKCζ is an important regulator of tumorigenesis. However, the correlation between PKC<b>ζ </b>expression and the clinical outcome in RCC patients is unclear. We examined the level of PKCζ expression in human RCC.</p> <p>Methods</p> <p>PKCζ mRNA and protein expressions were examined by real-time polymerase chain reaction (PCR) and immunohistochemistry (IHC) respectively in RCC tissues of 144 patients. Cellular cytotoxicity and proliferation were assessed by MTT.</p> <p>Results</p> <p>PKCζ expression was significantly higher in normal than in cancerous tissues (<it>P </it>< 0.0001) by real-time PCR and IHC. Similarly, PKCζ expression was down-regulated in four renal cancer cell lines compared to immortalized benign renal tubular cells. Interestingly, an increase of PKCζ expression was associated with the elevated tumor grade (<it>P </it>= 0.04), but no such association was found in TNM stage (<it>P </it>= 0.13). Tumors with higher PKCζ expression were associated with tumor size (<it>P </it>= 0.048). Expression of higher PKCζ found a poor survival in patients with high tumor grade. Down-regulation of PKCζ showed the significant chemoresistance in RCC cell lines. Inactivation of PKCζ expression enhanced cellular resistance to cisplatin and paclitaxel, and proliferation in HK-2 cells by specific PKC<b>ζ </b>siRNA and inhibitor.</p> <p>Conclusions</p> <p>PKCζ expression was associated with tumorigenesis and chemoresistance in RCC.</p

Risk of Diabetic Retinopathy between Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists

BACKGROUND: To compare risk of diabetic retinopathy (DR) between patients taking sodium-glucose cotransporter-2 inhibitors (SGLT2is) and those taking glucagon-like peptide-1 receptor agonists (GLP1-RAs) in routine care. METHODS: This retrospective cohort study emulating a target trial included patient data from the multi-institutional Chang Gung Research Database in Taiwan. Totally, 33,021 patients with type 2 diabetes mellitus using SGLT2is and GLP1-RAs between 2016 and 2019 were identified. 3,249 patients were excluded due to missing demographics, age \u3c40 \u3eyears, prior use of any study drug, a diagnosis of retinal disorders, a history of receiving vitreoretinal procedure, no baseline glycosylated hemoglobin, or no follow-up data. Baseline characteristics were balanced using inverse probability of treatment weighting with propensity scores. DR diagnoses and vitreoretinal interventions served as the primary outcomes. Occurrence of proliferative DR and DR receiving vitreoretinal interventions were regarded as vision-threatening DR. RESULTS: There were 21,491 SGLT2i and 1,887 GLP1-RA users included for the analysis. Patients receiving SGLT2is and GLP-1 RAs exhibited comparable rate of any DR (subdistribution hazard ratio [SHR], 0.90; 95% confidence interval [CI], 0.79 to 1.03), whereas the rate of proliferative DR (SHR, 0.53; 95% CI, 0.42 to 0.68) was significantly lower in the SGLT2i group. Also, SGLT2i users showed significantly reduced risk of composite surgical outcome (SHR, 0.58; 95% CI, 0.48 to 0.70). CONCLUSION: Compared to those taking GLP1-RAs, patients receiving SGLT2is had a lower risk of proliferative DR and vitreoretinal interventions, although the rate of any DR was comparable between the SGLT2i and GLP1-RA groups. Thus, SGLT2is may be associated with a lower risk of vision-threatening DR but not DR development

Otalgia and eschar in the external auditory canal in scrub typhus complicated by acute respiratory distress syndrome and multiple organ failure

<p>Abstract</p> <p>Background</p> <p>Scrub typhus, a mite-transmitted zoonosis caused by <it>Orientia tsutsugamushi</it>, is an endemic disease in Taiwan and may be potentially fatal if diagnosis is delayed.</p> <p>Case presentations</p> <p>We encountered a 23-year-old previously healthy Taiwanese male soldier presenting with the right ear pain after training in the jungle and an eleven-day history of intermittent high fever up to 39°C. Amoxicillin/clavulanate was prescribed for otitis media at a local clinic. Skin rash over whole body and abdominal cramping pain with watery diarrhea appeared on the sixth day of fever. He was referred due to progressive dyspnea and cough for 4 days prior to admission in our institution. On physical examination, there were cardiopulmonary distress, icteric sclera, an eschar in the right external auditory canal and bilateral basal rales. Laboratory evaluation revealed thrombocytopenia, elevation of liver function and acute renal failure. Chest x-ray revealed bilateral diffuse infiltration. Doxycycline was prescribed for scrub typhus with acute respiratory distress syndrome and multiple organ failure. Fever subsided dramatically the next day and he was discharged on day 7 with oral tetracycline for 7 days.</p> <p>Conclusion</p> <p>Scrub typhus should be considered in acutely febrile patients with multiple organ involvement, particularly if there is an eschar or a history of environmental exposure in endemic areas. Rapid and accurate diagnosis, timely administration of antibiotics and intensive supportive care are necessary to decrease mortality of serious complications of scrub typhus.</p