Strategi Bersaing pada Perusahaan Kopi

-Peranan industri kopi yang terus meningkat disertai dengan kenaikan pesat akan permintaan kopi. Diamati memiliki kelemahan dalam jumlah kapasitas kopi yang masih belum merata serta kurang mampu memenuhi permintaan yang ada di Indonesia. Muncul tantangan bagi Perusahaan agar dapat bertahan dan melakukan pembaharuan dalam strategi bersaingnya.Penelitian ini bertujuan untuk dapat mengetahui strategi bersaing yang diterapkan oleh Perusahaan saat ini dan mencoba merumuskan strategi bersaing samudera biru Perusahaan. Dalammengumpulkan data menggunakan metode wawancara dan observasi. Penentuan narasumber wawancara menggunakan teknik purposive sampling. Data yang didapat kemudian diuji keabsahan datanya menggunakan triangulasi sumber. Dari hasil penelitian, saat ini Perusahaan menggunakan focus differentiation strategy. Strategi Perusahaan jika disusun berdasarkan strategi samudera biru akan memunculkan konsep outlet treatment and coffee shop serta produksi produk baru lulur dan aroma terapi untuk memberikan utilitas / manfaat lebih dan mengambil pangsa pasar yang belum terjangkau

Dedicated area within the emergency department versus an outside dedicated area for evaluation and management of suspected coronavirus disease 2019.

Background The circumstances of the coronavirus disease 2019 pandemic necessitated an alternate operations strategy for efficient patient management. Alternate care sites were a viable option for managing emergency department (ED) surge in previous epidemics and disasters. Objective This study describes the development of an alternate care site and evaluates efficiency by comparing key performance indicators between an ad hoc nested respiratory evaluation unit (NRU) within the ED and an alternate care site outside the ED. Methods This was a cohort study of 2 care models in the same ED during 2 different time periods. As coronavirus disease 2019 surged in March 2020, potential treat-and-release patients with fever or respiratory symptoms were triaged to a dedicated ED area (NRU). As ED volume grew, these low-acuity patients were triaged to an ACS. We compared ED length of stay, elopement, and left without being evaluated rates and ED recidivism between the 2 care models: NRU patients presented to the ED from March 16, 2020, to March 31, 2020, and ACS patients presented from April 1, 2020, to April 15, 2020. Continuous variables were compared using independent t test or Mann-Whitney test. Categorical variables were compared using χ2test. Results There were 414 NRU patients and 146 alternate care site patients with no significant differences in sex or age. The mean ED length of stay was shorter for alternate care site patients: 155 versus 45 minutes (P \u3c 0.01). Elopement and left without being evaluated rates were higher in the NRU. There was no significant difference in ED recidivism between groups: 10% versus 6% (P= 0.15). Conclusions An alternate care site provided an efficient resource for the evaluation of patients with fever or respiratory symptoms during the coronavirus disease 2019 pandemic

A generalized Stefan model accounting for system memory and non-locality

The Stefan problem, involving the tracking of an evolving phase-change front, is the prototypical example of a moving boundary problem. In basic one- dimensional problems it is well known that the front advances as the square root of time. When memory or non-locality are introduced into the system however, this classic signal may be anomalous; replaced by a power-law advance with a time exponent that differs from n = 1/2. Up to now memory treatments in Stefan problem models have only been able to reproduce sub-diffusive front movements with exponents n 1/2. In the present paper, using a generalized Caputo fractional derivative operator, we introduce new memory and non-local treatment for Stefan problems. On considering a limit case Stefan problem, related to the melting problem, we are able to show that, this gen- eral treatment can not only produce arbitrary power-law in time predictions for the front movement but, in the case of memory treatments, can also produce non-power-law anomalous behaviors. Further, also in the context of the limit problem, we are able to establish an equivalence between non-locality and a space varying conductivity and memory and a time varying conductivity

Aortic Arch Thrombus and Pulmonary Embolism in a COVID-19 Patient

© 2020 Elsevier Inc. Background: Coronavirus disease 2019 (COVID-19) is associated with endothelial inflammation and a hypercoagulable state resulting in both venous and arterial thromboembolic complications. We present a case of COVID-19-associated aortic thrombus in an otherwise healthy patient. Case Report: A 53-year-old woman with no past medical history presented with a 10-day history of dyspnea, fever, and cough. Her pulse oximetry on room air was 84%. She tested positive for severe acute respiratory syndrome coronavirus 2 infection, and chest radiography revealed moderate patchy bilateral airspace opacities. Serology markers for cytokine storm were significantly elevated, with a serum D-dimer level of 8180 ng/mL (normal \u3c 230 ng/mL). Computed tomography of the chest with i.v. contrast was positive for bilateral ground-glass opacities, scattered filling defects within the bilateral segmental and subsegmental pulmonary arteries, and a large thrombus was present at the aortic arch. The patient was admitted to the intensive care unit and successfully treated with unfractionated heparin, alteplase 50 mg, and argatroban 2 μg/kg/min. Why Should an Emergency Physician Be Aware of This?: Mural aortic thrombus is a rare but serious cause of distal embolism and is typically discovered during an evaluation of cryptogenic arterial embolization to the viscera or extremities. Patients with suspected hypercoagulable states, such as that encountered with COVID-19, should be screened for thromboembolism, and when identified, aggressively anticoagulated

ESPACIOS, TRADICIONES Y CAMBIOS EN CONCHUCOS. Ecos desde la Escuela de etnografía del Proyecto “Antonio Raimondi”, Ancash Perú

Este volumen nace con dos finalidades precisas. La primera, dar a conocer los trabajos de investigación etnográfica que un grupo de nueve estudiantes de la Universidad de Bologna (Italia) y otro de la Pontificia Universidad Católica del Perú han desarrollado en la provincia de Huari, Ancash, Perú, durante seis años, entre 2003 y 2008 en el marco del Proyecto Arqueológico y Antropológico “Antonio Raimondi”. La segunda finalidad es realizar la difusión de las únicas miradas etnográficas que hasta hoy se han producido sobre la región Conchucos. Otro objetivo, más teórico y más implícito, es desplegar a lo largo del camino de la lectura de los casos etnográficos, una visión processual y dinamista de la escritura etnográfica y de la especulación antropológica, procedente de una manera precisa de hacer trabajo de campo. Los artículos aquí propuestos presentan, mediante varios estilos y diferentes acercamientos, una realidad sociocultural en movimiento, en constante cambio. Construyendo cuadros de varios aspectos sociales, políticos y culturales de la provincia de Huari, los autores delinean un escenario en proceso en el cual diferentes actores, ámbitos y dinámicas socioculturales se interrelacionan, participando de maneras diferents en la transformación

Differential post-transcriptional regulation of IL-10 by TLR2 and TLR4-activated macrophages

The activation of TLRs by microbial molecules triggers intracellular-signaling cascades and the expression of cytokines such as IL-10. Il10 expression is tightly controlled to ensure effective immune responses, while preventing pathology. Maximal TLR-induction of Il10 transcription in macrophages requires signaling through the MAPKs, ERK, and p38. Signals via p38 downstream of TLR4 activation also regulate IL-10 at the post-transcriptional level, but whether this mechanism operates downstream of other TLRs is not clear. We compared the regulation of IL-10 production in TLR2 and TLR4-stimulated BM-derived macrophages and found different stability profiles for the Il10 mRNA. TLR2 signals promoted a rapid induction and degradation of Il10 mRNA, whereas TLR4 signals protected Il10 mRNA from rapid degradation, due to the activation of Toll/IL-1 receptor domain-containing adaptor inducing IFN-ß (TRIF) and enhanced p38 signaling. This differential post-transcriptional mechanism contributes to a stronger induction of IL-10 secretion via TLR4. Our study provides a molecular mechanism for the differential IL-10 production by TLR2- or TLR4-stimulated BMMs, showing that p38-induced stability is not common to all TLR-signaling pathways. This mechanism is also observed upon bacterial activation of TLR2 or TLR4 in BMMs, contributing to IL-10 modulation in these cells in an infection setting.Fundação para a Ciência e a Tecnologia (FCT

Chemotherapy-Response Monitoring of Breast Cancer Patients Using Quantitative Ultrasound-Based Intra-Tumour Heterogeneities

© 2017 The Author(s). Anti-cancer therapies including chemotherapy aim to induce tumour cell death. Cell death introduces alterations in cell morphology and tissue micro-structures that cause measurable changes in tissue echogenicity. This study investigated the effectiveness of quantitative ultrasound (QUS) parametric imaging to characterize intra-tumour heterogeneity and monitor the pathological response of breast cancer to chemotherapy in a large cohort of patients (n = 100). Results demonstrated that QUS imaging can non-invasively monitor pathological response and outcome of breast cancer patients to chemotherapy early following treatment initiation. Specifically, QUS biomarkers quantifying spatial heterogeneities in size, concentration and spacing of acoustic scatterers could predict treatment responses of patients with cross-validated accuracies of 82 ± 0.7%, 86 ± 0.7% and 85 ± 0.9% and areas under the receiver operating characteristic (ROC) curve of 0.75 ± 0.1, 0.80 ± 0.1 and 0.89 ± 0.1 at 1, 4 and 8 weeks after the start of treatment, respectively. The patients classified as responders and non-responders using QUS biomarkers demonstrated significantly different survivals, in good agreement with clinical and pathological endpoints. The results form a basis for using early predictive information on survival-linked patient response to facilitate adapting standard anti-cancer treatments on an individual patient basis

Measurement of B(B-->X_s {\gamma}), the B-->X_s {\gamma} photon energy spectrum, and the direct CP asymmetry in B-->X_{s+d} {\gamma} decays

The photon spectrum in B --> X_s {\gamma} decay, where X_s is any strange hadronic state, is studied using a data sample of (382.8\pm 4.2) \times 10^6 e^+ e^- --> \Upsilon(4S) --> BBbar events collected by the BABAR experiment at the PEP-II collider. The spectrum is used to measure the branching fraction B(B --> X_s \gamma) = (3.21 \pm 0.15 \pm 0.29 \pm 0.08)\times 10^{-4} and the first, second, and third moments = 2.267 \pm 0.019 \pm 0.032 \pm 0.003 GeV,, )^2> = 0.0484 \pm 0.0053 \pm 0.0077 \pm 0.0005 GeV^2, and )^3> = -0.0048 \pm 0.0011 \pm 0.0011 \pm 0.0004 GeV^3, for the range E_\gamma > 1.8 GeV, where E_{\gamma} is the photon energy in the B-meson rest frame. Results are also presented for narrower E_{\gamma} ranges. In addition, the direct CP asymmetry A_{CP}(B --> X_{s+d} \gamma) is measured to be 0.057 \pm 0.063. The spectrum itself is also unfolded to the B-meson rest frame; that is the frame in which theoretical predictions for its shape are made.Comment: 37 pages, 19 postscript figures, submitted to Phys. Rev. D. No analysis or results have changed from previous version. Some changes to improve clarity based on interactions with Phys. Rev. D referees, including one new Figure (Fig. 13), and some minor wording/punctuation/spelling mistakes fixe