An analysis of long-term agreements with suppliers in Lockheed Martin's commercial satellite systems division

Thesis (M. Eng. in Logistics)--Massachusetts Institute of Technology, Engineering Systems Division, 2009.Includes bibliographical references (leaves 68-69).Lockheed Martin designs and builds commercial satellites to customers' specifications. The customers, such as telecommunications companies and weather forecasters, are very price sensitive and, usually, award contracts to the lowest priced bids. Lockheed manufactures satellites using a combination of in-house manufacturing, purchasing, and subcontracting (for subcontract parts). The subcontract parts constitute a majority of a satellite's costs. Lockheed uses contracts and other supply management techniques to stay competitive and to keep satellite, specifically subcontract part, costs under control. Some of the subcontract part contracts are managed under subcontract agreements called long-term agreements (LTA). A small supplier pool, long turnover (for bringing these suppliers onboard), regulatory requirements, and capital-intensive nature of the industry are important considerations in evaluating these LTAs. The LTAs embody the risks inherent in project supply chains, specifically, price, currency, and supply risks. In such events, LTAs can become a liability and can lead to monetary losses or discord with suppliers. This thesis provides an overview of the satellite supply chain, analyzes supplier relations to better understand the business dynamics, and analyzes LTAs to better control the satellite input costs. Key words: commercial satellite, contractor, long-term agreement, subcontract, Lockheed, subcontractor, LTA, satellite supply chain, contracts.by Hem Singh.M.Eng.in Logistic

The study of maternal and perinatal outcome in prolonged pregnancy

Background: Prolonged pregnancy or post-dated pregnancy is that pregnancy which has exceeded duration considered to be upper limit of normal pregnancy that is above 40 completed weeks or 280 days from the first day of last menstrual period. The objective was to evaluate the maternal and perinatal outcome of post-dated pregnancy.Methods: A prospective case control study was conducted on antenatal women for 18 months period from May 2014- October 2015 admitted to the Obstetrics and Gynecology Department, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India. The study group was comprised of antenatal women having pregnancy beyond 40 weeks, and the control group was represented with antenatal women between 37-40 weeks admitted for delivery during this period.Results: The prevalence of post-dated pregnancy was found to be 17.6% and of post-term was 5.69%. Among post-dated subjects LSCS rate was 56.50% and in term (37-40 weeks) patient it was 34.18%. The NICU admission for birth asphyxia was 6.09% among term (37-40 weeks) patients and 17.6% in post-dated pregnancies.Conclusions: Any pregnancy that crosses expected date of delivery, Foetal well-being must be assessed and induction of labour should be considered to decrease the risk of perinatal morbidity and mortality

Role of amnioinfusion in meconium stained liquor in relation to fetal outcome

Background: Meconium aspiration syndrome complicates 1.7 to 35.8% of deliveries. The meconium aspiration syndrome is believed to result from aspiration of meconium during intrauterine gasping or at the time of first breath. Transcervical infusion of saline into amniotic cavity or amnioinfusion has been proposed as a method to reduce the risk of the meconium aspiration syndrome.Methods: The study was conducted in Department of Obstetrics and gynecology in collaboration with the department of paediatrics, Era’s Lucknow Medical College, Lucknow, India in the study period of 18 months. It was a prospective case control study. A total number of 80 patients were enrolled for the purpose of study. The patients were randomly divided into two groups. Control group (n=40) those who received standard treatment (i.e. labor analgesia, maternal nutrition and record of progress of labor) and Study group (n=40) patients who were managed by giving amnioinfusion in addition to the standard treatment. Both groups were compared in terms of fetal outcome. Data so obtained was subjected to statistical analysis using statistical package for Social Science Version 15.0.Results: Majority of babies of control group (n=22, 55%) have Apgar score at 1 minute was <7 whereas majority of babies born to mothers of study group (n=27, 67.5%) have apgar scores at 1 minute was ≥7.    Resuscitative measures were required in majority of control group babies (n=22, 55%) as compared to only 13 (32.5%) babies of study group. Meconium aspiraton syndrome was present in 12 babies (30%) of control group as compared to only 4 babies (10%) of study group. Rate of neonatal death was higher in control group (5%) as compared to study group (2.5%). A total of 25 (62.5%) babies required NICU admission in control group and 15 (37.5) babies in study group.Conclusions: The findings in present study indicates that aminoinfusion in a well-equipped tertiary care unit reduces the rate of caesarean section significantly while at the same time influences the neonatal outcome in terms of better Apgar score, reduced need of resuscitative measures and reduced neonatal morbidity

Association of Plasma Circulatory Markers, Chlamydia pneumoniae, and High Sensitive C-Reactive Protein in Coronary Artery Disease Patients of India

Plasma inflammatory markers have been shown to be predictors for cardiovascular risk, however, there is no study where the levels of plasma circulatory markers have been evaluated in coronary artery disease patients (CAD pts) positive for C. pneumoniae IgA and high sensitive C-reactive protein (hsCRP) which may help in better understanding of disease pathogenesis. A total of 192 patients and 192 controls attending the Cardiology Outpatient Department of Safdarjung Hospital were enrolled. The levels of plasma circulatory inflammatory markers were evaluated by ELISA. The levels of circulatory plasma markers (IL-4, IL-8, IL-13, ICAM-1, and VCAM-1) were significantly higher, whereas, levels of IL-10 and IFN-γ were significantly lower in CAD pts compared to healthy controls. The levels of IL-4, IL-8, and ICAM-1 (P = .007, .015, and .048) were significantly higher, however, IL-10 and IFN-γ were significantly lower (P < .001, < .001) in C. pneumoniae IgA positive CAD pts. The levels of IL-4, IL-8, IL-13, ICAM-1, and VCAM-1 were higher but not significant and levels of IL-10 and IFN-γ were significantly (P < .001, < .001) lower in hsCRP positive CAD pts. Our study suggested that circulatory cytokines, namely, IL-4, IL-8, and adhesive molecules like ICAM-1 were enhanced after infection with C. pneumoniae whereas in contrast to this IL-10 and IFN-λ were lowered. Suggesting the important role of these cytokines in progression of CAD

Strategizing quality implementation in intensive care unit: a statistically-sound, novel approach using Delphi technique

Background: Ascendancy of Intensive Care Medicine in the realm of healthcare has made Continuous Quality Improvement (CQI) in Intensive Care Units (ICUs) most imperative for hospital administrators worldwide. Perspicuous identification of all clinical and non-clinical drivers warranting contemplation is the most arduous step in achieving the same. This study avers the effectiveness of a statistically-sound, novel approach using Delphi technique in identifying various drivers to be prioritized for strategizing CQI in the postoperative ICU of a premier tertiary care hospital in Asia. Methods: Three rounds of Delphi survey were initially planned. Mean Rank Scores (MRS) was used to rank the opinions in this study. Results: Statistically validated consensus was reached among expert participants on five drivers that should galvanize hospital administration vis-à-vis strategizing quality implementation in the post-operative ICU. Foremost among these was adequate staff that is tantamount to desirable staff-patient ratio (MRS: 9.4), and regular medical audit for sustainable quality in healthcare delivery (MRS: 9.1). Experts further concurred that communication skills of ICU staff (MRS: 8.9), continuous medical education and training of these staff (MRS: 7.6) along with perspicuous ‘Standard Operating Procedures’ (MRS: 7.1) were other points to be considered. Conclusions: With regard to the process of planning, identification of correct drivers holds the crux in strategizing quality implementation in any setup. Implementing change management is equally imperative. This approach can be used to realize both of these.

Sotatercept safety and effects on hemoglobin, bone, and vascular calcification

Introduction: Patients with end-stage kidney disease (ESKD) exhibit anemia, chronic kidney disease‒mineral bone disorder (CKD-MBD), and cardiovascular disease. The REN-001 and REN-002 phase II, multicenter, randomized studies examined safety, tolerability, and effects of sotatercept, an ActRIIA-IgG1 fusion protein trap, on hemoglobin concentration; REN-001 also explored effects on bone mineral density (BMD) and abdominal aortic vascular calcification. Methods: Forty-three patients were treated in REN-001 (dose range: sotatercept 0.3‒0.7 mg/kg or placebo subcutaneously [s.c.] for 200 days) and 50 in REN-002 (dose range: 0.1‒0.4 mg/kg i.v. and 0.13‒0.5 mg/kg s.c. for 99 days). Results: In REN-001, frequency of achieving target hemoglobin response (\u3e10 g/dl [6.21 mmol/l]) with sotatercept was dose-related and greater than placebo (0.3 mg/kg: 33.3%; 0.5 mg/kg: 62.5%; 0.7 mg/kg: 77.8%; 0.7 mg/kg [doses 1 and 2]/0.4 mg/kg [doses 3‒15]: 33.3%; placebo: 27.3%). REN-002 hemoglobin findings were similar (i.v.: 16.7%-57.1%; s.c.: 11.1%‒42.9%). Dose-related achievement of ≥2% increase in femoral neck cortical BMD was seen among only REN-001 patients receiving sotatercept (0.3‒0.7 mg/kg: 20.0%‒57.1%; placebo: 0.0%). Abdominal aortic vascular calcification was slowed in a dose-related manner, with a ≤15% increase in Agatston score achieved by more REN-001 sotatercept versus placebo patients (60%‒100% vs. 16.7%). The most common adverse events during treatment were hypertension, muscle spasm, headache, arteriovenous fistula site complication, and influenza observed in both treatment and placebo groups. Conclusion: In patients with ESKD, sotatercept exhibited a favorable safety profile and was associated with trends in dose-related slowing of vascular calcification. Less-consistent trends in improved hemoglobin concentration and BMD were observed