Successful Penetration of Emerging Markets - Finding Business Opportunities for High Profile Industrial Products

Equipment Fluids & Utility (EFU) is one of nine segments within Alfa Laval. The segment has experienced initial problems with sales volumes on the emerging markets so far entered, even though there is a seemingly large potential. No clear reason for this has been identified, and the management of EFU wants an efficient solution to the problem. The problem was to investigate what areas are affecting an efficient penetration of emerging markets for an industrial company, and how those should be addressed to ensure a continuous favourable development. Purpose: Our purpose is divided in two parts: Understand and investigate the business of Alfa Laval and EFU to be able to identify areas of improvement regarding the sales process in Vietnam. It also includes developing recommendations and actions for every defined area with the aim to generate a more efficient procedure to find business opportunities in an emerging market. Develop a conceptual framework that will contribute with a structured approach for problem solving in emerging markets when selling industrial products. The aim of the framework is to create awareness of what areas of improvement are most important, and to give guidelines of how to work with those improvements. Method: An abductive research is made based on qualitative in-depth interviews and literature studies. A case study is made on Vietnam and the findings from this certain case results in a generic solution valid for all emerging markets. Conclusion: Nine areas of improvement are defined and discussed, and actions for success are suggested. Furthermore, a methodological framework is developed to facilitate a structured approach when working with the improvements

Foxe3 is required for morphogenesis and differentiation of the anterior segment of the eye and is sensitive to Pax6 gene dosage

AbstractThe dysgenetic lens (dyl) mouse mutant has mutations in Foxe3, which inactivate DNA binding by the encoded forkhead transcription factor. Here we confirm, by targeted inactivation, that Foxe3 mutations are responsible for the dyl phenotype, which include loss of lens epithelium; a small, cataractic lens; and failure of the lens to detach from the surface ectoderm. In contrast to a recent report of targeted Foxe3, we found no phenotypic difference between dyl and Foxe3−/− mutants when congenic strains were compared, and thus nothing that argues against Foxe3dyl being a null allele. In addition to the lens, most tissues of the anterior segment–iris, cornea, ciliary body and trabecular meshwork–are malformed or show differentiation defects. Many of these abnormalities, such as irido-corneal and irido-lenticular adherences, are present in a less severe form in mice heterozygous for the Foxe3 mutation, in spite of these having an intact lens epithelium. Early Foxe3 expression is highly sensitive to a halved Pax6 gene dosage and there is a striking phenotypic similarity between Pax6 and Foxe3 mutants. We therefore propose that many of the ocular malformations associated with Pax6 haploinsufficiency are consequences of a reduced expression of Foxe3

Multiple myeloma and infections: a population-based study on 9253 multiple myeloma patients.

Infections are a major cause of morbidity and mortality in patients with multiple myeloma. To estimate the risk of bacterial and viral infections in multiple myeloma patients, we used population-based data from Sweden to identify all multiple myeloma patients (n=9 253) diagnosed from 1988 to 2004 with follow-up to 2007 and 34 931 matched controls. Cox proportional hazard models were used to estimate the risk of infections. Overall, multiple myeloma patients had a 7-fold (hazard ratio =7.1; 95% confidence interval = 6.8-7.4) risk of developing any infection compared to matched controls. The increased risk of developing a bacterial infection was 7-fold (7.1; 6.8-7.4), and for viral infections 10-fold (10.0; 8.9-11.4). Multiple myeloma patients diagnosed in the more recent calendar periods had significantly higher risk of infections compared to controls (p<0.001). At one year of follow-up, infection was the underlying cause in 22% of deaths in multiple myeloma patients. Mortality due to infections remained constant during the study period. Our findings confirm that infections represent a major threat to multiple myeloma patients. The effect on infectious complications due to novel drugs introduced in the treatment of multiple myeloma needs to be established and trials on prophylactic measures are needed

Monoclonal gammopathy of undetermined significance and risk of infections: a population-based study.

To access publisher full text version of this article. Please click on the hyperlink in Additional Links field.No comprehensive evaluation has been made to assess the risk of viral and bacterial infections among patients with monoclonal gammopathy of undetermined significance. Using population-based data from Sweden, we estimated risk of infections among 5,326 monoclonal gammopathy of undetermined significance patients compared to 20,161 matched controls. Patients with monoclonal gammopathy of undetermined significance had a 2-fold increased risk (P<0.05) of developing any infection at 5- and 10-year follow up. More specifically, patients with monoclonal gammopathy of undetermined significance had an increased risk (P<0.05) of bacterial (pneumonia, osteomyelitis, septicemia, pyelonephritis, cellulitis, endocarditis, and meningitis), and viral (influenza and herpes zoster) infections. Patients with monoclonal gammopathy of undetermined significance with M-protein concentrations over 2.5 g/dL at diagnosis had highest risks of infections. However, the risk was also increased (P<0.05) among those with concentrations below 0.5 g/dL. Patients with monoclonal gammopathy of undetermined significance who developed infections had no excess risk of developing multiple myeloma, Waldenström macroglobulinemia or related malignancy. Our findings provide novel insights into the mechanisms behind infections in patients with plasma cell dyscrasias, and may have clinical implications.Stockholm County Council Karolinska Institutet Cancer Society in Stockholm NIH, NC

Ubiquitin carboxy-terminal hydrolase L1 (UCHL1) S18Y polymorphism in Alzheimer's disease

Alzheimer's disease (AD) is characterized by protein aggregates, i.e. senile plaques and neurofibrillary tangles. The ubiquitin-proteasome system has been proposed a role in proteolytic removal of these protein aggregates. Ubiquitin carboxy-terminal hydrolase L1 (UCHL1) is a de-ubiquitinating enzyme with important functions in recycling of ubiquitin. The S18Y polymorphism of the UCHL1 gene confers protection against Parkinson's disease. In this study, the genotype and allele frequencies of the UCHL1 S18Y polymorphism were investigated in 452 AD patients and 234 control subjects, recruited from four memory clinics in Sweden. Using a binary logistic regression model including UCHL1 allele A and APOE ε4 allele positivity, age and sex as covariates with AD diagnosis as dependent variable, an adjusted OR of 0.82 ([95% CI 0.55-1.24], P = 0.35) was obtained for a positive UCHL1 allele A carrier status. The present study thus do not support a protective effect of the UCHL1 S18Y polymorphism against AD

Increased serum miR-193a-5p during non-alcoholic fatty liver disease progression: diagnostic and mechanistic relevance

Background & Aims: Serum microRNAs (miRNAs) levels are known to change in non-alcoholic fatty liver disease (NAFLD) and may serve as useful biomarkers. This study aimed to profile miRNAs comprehensively at all NAFLD stages.Methods: We profiled 2,083 serum miRNAs in a discovery cohort (183 NAFLD cases representing the complete NAFLD spectrum and 10 population controls). MiRNA libraries generated by HTG EdgeSeq were sequenced by Illumina NextSeq. Selected serum miRNAs were profiled in 372 additional NAFLD cases and 15 population controls by quantitative reverse transcriptase-polymerase chain reaction.Results: Levels of 275 miRNAs differed between cases and population controls. Fewer differences were seen within individual NAFLD stages but miR-193a-5p consistently the showed increased levels in all comparisons. Relative to NAFL/NASH with mild fibrosis (stage 0/1), three miRNAs (miR-193a-5p, miR-378d and miR378d) were increased in cases with NASH and clinically significant fibrosis (stage 2-4), seven (miR193a-5p, miR-378d, miR-378e, miR-320b, c, d & e) increased in cases with NAFLD Activity Score (NAS) 5-8 compared with lower NAS, and three (miR-193a-5p, miR-378d, miR-378e) increased but one (miR-19b-3p) decreased in steatosis, activity, and fibrosis "activity" (SAF-A) score 2-4 compared with lower SAF-A. The significant findings for miR-193a-5p were replicated in the additional NAFLD cohort. Studies in Hep G2 cells showed that following palmitic acid treatment, miR-193a-5p expression decreased significantly. Gene targets for miR-193a-5p were investigated in liver RNAseq data for a case subgroup (n=80); liver GPX8 levels correlated positively with serum miR-193a-5p. Conclusions: Serum miR-193a-5p levels correlate strongly with NAFLD activity grade and fibrosis stage. MiR-193a-5p may have a role in the hepatic response to oxidative stress and is a potential clinically tractable circulating biomarker for progressive NAFLD

Performance of non-invasive tests and histology for the prediction of clinical outcomes in patients with non-alcoholic fatty liver disease: an individual participant data meta-analysis

BackgroundHistologically assessed liver fibrosis stage has prognostic significance in patients with non-alcoholic fatty liver disease (NAFLD) and is accepted as a surrogate endpoint in clinical trials for non-cirrhotic NAFLD. Our aim was to compare the prognostic performance of non-invasive tests with liver histology in patients with NAFLD.MethodsThis was an individual participant data meta-analysis of the prognostic performance of histologically assessed fibrosis stage (F0–4), liver stiffness measured by vibration-controlled transient elastography (LSM-VCTE), fibrosis-4 index (FIB-4), and NAFLD fibrosis score (NFS) in patients with NAFLD. The literature was searched for a previously published systematic review on the diagnostic accuracy of imaging and simple non-invasive tests and updated to Jan 12, 2022 for this study. Studies were identified through PubMed/MEDLINE, EMBASE, and CENTRAL, and authors were contacted for individual participant data, including outcome data, with a minimum of 12 months of follow-up. The primary outcome was a composite endpoint of all-cause mortality, hepatocellular carcinoma, liver transplantation, or cirrhosis complications (ie, ascites, variceal bleeding, hepatic encephalopathy, or progression to a MELD score ≥15). We calculated aggregated survival curves for trichotomised groups and compared them using stratified log-rank tests (histology: F0–2 vs F3 vs F4; LSM: 2·67; NFS: 0·676), calculated areas under the time-dependent receiver operating characteristic curves (tAUC), and performed Cox proportional-hazards regression to adjust for confounding. This study was registered with PROSPERO, CRD42022312226.FindingsOf 65 eligible studies, we included data on 2518 patients with biopsy-proven NAFLD from 25 studies (1126 [44·7%] were female, median age was 54 years [IQR 44–63), and 1161 [46·1%] had type 2 diabetes). After a median follow-up of 57 months [IQR 33–91], the composite endpoint was observed in 145 (5·8%) patients. Stratified log-rank tests showed significant differences between the trichotomised patient groups (p<0·0001 for all comparisons). The tAUC at 5 years were 0·72 (95% CI 0·62–0·81) for histology, 0·76 (0·70–0·83) for LSM-VCTE, 0·74 (0·64–0·82) for FIB-4, and 0·70 (0·63–0·80) for NFS. All index tests were significant predictors of the primary outcome after adjustment for confounders in the Cox regression.InterpretationSimple non-invasive tests performed as well as histologically assessed fibrosis in predicting clinical outcomes in patients with NAFLD and could be considered as alternatives to liver biopsy in some cases

Förbättrat informationsflöde för ökad synkronisering och kostnadseffektivitet i försörjningskedjan – en fallstudie

Slut i hyllan-problematiken är en fråga som aktualiserats i dagligvaruhandeln i allt högre grad det senaste året. I takt med att konkurrensen ökar och marginalerna minskar måste lagernivåer pressas. Det här sker så småningom på bekostnad av servicegraden. Problemet har visat sig särskilt stort i samband med kampanjer. Syftet med detta examensarbete är att kartlägga informationsflödet i försörjnings-planeringen mellan en leverantör och en grossist i dagligvarubranschen samt att se hur detta flöde kan förbättras för att hög servicegrad ska kunna uppnås utan alltför höga lager. Arbetet är utfört som en fallstudie på Findus och Ica med Findus laxfilé naturell som modellprodukt. Kartläggningen av informationsflödet i planeringsprocessen har visat på ett komplext flöde där många personer och funktionella enheter från båda företag är inblandade. Undersökningen har också identifierat ett antal svagheter som gör att servicegrad och kostnadseffektivitet försämras. De problem vi ser grundar sig främst i de ingående aktörernas bristande medvetenhet om försörjningskedjans förutsättningar och begränsningar. Detta leder till att förståelse för vilken information som är viktig att förmedla saknas. Vidare saknar processen en tydlig struktur där flera prognoser görs oberoende av varandra med olika underlag och med olika syften. Resultatet blir en hög osäkerhet vilken måste hanteras med säkerhetslager. Undersökningen har visat att kostnadsfokus är svagt i förhållande till servicegrad vilket riskerar försörjningskedjans kostnad-seffektivitet Vi tror att en ökad integration i en enkel och tydligt strukturerad planeringsprocess skulle kunna förbättra servicegraden och kostnadseffektiviteten. En ökad medvetenhet om försörjningskedjans förutsättningar och kostsamma flexibilitet skulle göra fördelarna med informationsdelning tydligare. Att använda balanserade styrmått som belyser försörjningskedjans synkronisering såväl som kostnads-effektivitet minskar risken för att problem döljs med höga lager. Våra slutsatser visar att det finns en klar förbättringspotential i informationsflödet; förändringar skulle bidra till en högre servicegrad till en lägre kostnad