Valuing Limited Information in Decision Making Under Uncertainty

Fresh Juice Inc. (FJI) is in the process of determining whether they should launch a new fruit juice in a market that has been relatively stagnant for the last 15 years. Management of FJI is faced with uncertainty surrounding market share, market size, price, and competitor entry. In addition, FJI has the ability to chose between alternative production processes; this choice directly affects the likelihood the investment will return a positive Net Present Value. This case teaches students how to develop a stochastic simulation models given limited information to analyze risk investment decisions.: simulation, uncertainty, strategic management, flexibility, limited information, investment analysis

Scorecarding and Heat Mapping: Tools and Concepts for Assessing Strategic Uncertainty

The dramatic changes occurring throughout the agriculture industry are creating new and different uncertainties that result from a turbulent business climate. The objective of this paper is to present a methodology to understand, assess and evaluate, and manage strategic uncertainty. The approach is to present a mental model that frames assessment of strategic uncertainty from a potential and exposure perspective. Scorecarding and heat mapping assessment tools operationalize the mental model. Participants in an executive agribusiness educational workshop applied this mental model and the assessment tools to one of three hypothetical seed companies. The participants then provided an evaluation of the usefulness and effectiveness of uncertainty scorecarding and heat mapping.Uncertainty, scorecarding, strategic uncertainty, heat mapping, potential, exposure, likelihood, Risk and Uncertainty,

Virilization and abdominal mass in a newborn female: A case report

We describe virilization in a newborn female secondary to bilateral congenital juvenile granulosa cell tumor (JGCT). The patient presented with abdominal mass and ambiguous genitalia at birth, and bilateral ovarian masses were discovered on further imaging. The patient underwent bilateral salpingo-oophorectomy in staged procedures, as it became apparent that we could not spare the ovaries. Diagnosis of JGCT was confirmed by surgical pathology. She required no adjuvant therapy and has no signs of recurrence at two-year follow-up

The 1994-1995 National Health Interview Survey on Disability (NHIS-D): A Bibliography of 20 Years of Research

The 1994-1995 National Health Interview Survey on Disability (NHIS-D) has been one of the most unique and important data sources for studying disability, impairment, and health in the United States. In celebration of the NHIS-D’s twenty-year anniversary, we created an extensive bibliography (n=212) of research that has used these data

Role of Mechanical Bowel Preparation and Perioperative Antibiotics in Pediatric Pull-Through Procedures

Background There are no clear guidelines for the use of mechanical bowel preparation and postoperative antibiotics in children undergoing elective colorectal pull-through surgery. The objective of this study was to determine whether preoperative bowel preparation administration or duration of postoperative antibiotics impacted the rate of complications after elective pediatric pull-through surgery. Materials and methods Patients aged <18 y who underwent a pull-through procedure between 2011 and 2017 were retrospectively identified. Patient data included diagnosis, procedure, administration of mechanical bowel preparation, and duration of perioperative intravenous (IV) antibiotics. Outcomes of interest included surgical site infections and anastomotic complications. Results A total of 180 patients met inclusion criteria, of which 47.2% received mechanical bowel preparation. The combined rate of infectious and anastomotic complications was 12.2%. There was no significant difference in combined complication rate among those receiving bowel preparation compared with those who did not (14.1% versus 10.5%, P = 0.46). Administration of bowel preparation in the perineal anoplasty subgroup was associated with higher rates of wound infection (33.3% versus 3.3%, P = 0.05). One hundred five patients (58.3%) received perioperative IV antibiotics for ≤24 h. This group had similar rates of complications (13.3%) compared with those receiving IV antibiotics for longer than 24 h (11.6%, P = 0.74). Conclusions Although mechanical bowel preparation did not affect the overall complication rate for pull-through procedures, it was associated with more wound infections in those undergoing perineal anoplasty. Duration of postoperative IV antibiotics was not significantly associated with the rate of wound and anastomotic complications

Synthesis and Purification of Cyclic Peptide Autophagy Inhibitor 4B1W and Its Target LC3a

https://openworks.mdanderson.org/sumexp21/1167/thumbnail.jp

Inter- and Intra-rater Reliability of A Grading System for Congenital Diaphragmatic Hernia Defect Size

Background The Congenital Diaphragmatic Hernia Study Group (CDHSG) registry is a multi-institutional tool to track outcomes of patients with CDH. The CDHSG asks surgeons to categorize diaphragmatic defect sizes as type A-D based on published guidelines. The reported size of the defect has been correlated with patient outcomes, but the reliability of this system has never been studied. Our goal was to evaluate the inter- and intra-rater reliability of the CDHSG grading system. Materials and methods Forty-six operative notes from CDH patients that underwent surgical repair at a single institution were collected and cropped to include only the information necessary to grade the hernia defect based on the CDHSG guidelines. The defects were graded by nine pediatric surgeons on two separate occasions (18 wk apart). Inter-rater reliability was calculated using a Cohen's kappa (κ). Intra-rater reliability was calculated using an intraclass correlation coefficient. Results Inter-rater reliability was minimal to weak (κ round1 = 0.395, κ round2 = 0.424). Agreement ranged from 19.57% (κ = −0.0745) to 82.61% (κ = 0.7543). Inter-rater agreement was similar despite operative findings and outcomes: survival yes/no (κ = 0.3690, κ = 0.3518), need for ECMO yes/no (κ = 0.3323, κ = 0.3362), patch repair yes/no (κ = 0.2050, κ = 0.1916), and liver up/down (κ = 0.2941, κ = 0.4404). Intra-rater reliability was good to excellent (intraclass correlation coefficient = 0.88, 95% CI [0.83-0.92]). Agreement with oneself ranged from 71.74% to 93.48%. Conclusions The demonstrated weak inter-rater reliability of the current CDHSG grading system shows the need for improvement in how the grading system is applied by surgeons when reporting CDH defect size