Greening of supply chain to drive performance through logical integration of supply chain resources

Sustainability has always been a concern of humankind in one form or the other. Still, it has come into sharper focus after the promulgation of the sustainable development goals in 2015 and the disruptive forces unleashed by the COVID‐19 pandemic. Supply chain management is an aspect of business operations wherein the need for sustainability has been felt more keenly. The academic and business understanding of various nuances of incorporating sustainability, particularly environmental concerns in the supply chain, is still evolving. Our study seeks to enrich the growing literature in the area by proposing to uncover a novel, logical sequence of intangible supply chain resources that can amplify the impact of green supply chain management practices (GSCMPs) on business performance. We use the dual‐theoretical lens of a resource‐based view and stakeholder theories to conceptualize the sequential mediational role of supply chain visibility, resilience, and robustness between GSCMP and performance. Analyzing data collected from 318 individuals working in the manufacturing sector in the United Kingdom, we found a positive direct association of GSCMP with performance and the serial mediational role of visibility and robustness between the two. The findings of our study are pertinent for theorists as well as managers

Study of fetomaternal outcome in pre-eclampsia at tertiary care centres, South Gujarat

Background: Hypertensive disorders are among the most common medical disorder during pregnancy and continue to be a serious challenge in obstetric practice. It affects about 7-15% of all gestations. In India it accounts for the third most important cause of maternal mortality. Aim if this study was to study the prevalence of pre-eclampsia and feto-maternal outcome in cases of pre-eclampsia. Methods: This was a descriptive observational study conducted over a period from February 2019 to July 2021. This study enrolled 106 cases of pre-eclampsia, cases were selected by inclusion and exclusion criteria, data were entered and analysed by using SPSS version 20. Results: A total of 106 patients were analysed. It was observed that it was more common in age group of 26 to 30 years 51%, 56% were unbooked patients. Maximum number of patients were primigravida 60%, 96% patients were from lower socioeconomic class, 37% patients had normal vaginal delivery, 63% had caesarean delivery. The most common maternal complication was eclampsia (12%), HELLP Syndrome 12%, abruptio occurred in 8% of patients. Maternal mortality occurred in 4 cases. Out of 106 babies 37 (34.93%) babies had normal outcome while 29% (27.35%) had low birth weight, 16 (15.09%) babies were IUGR, 15 (14.5%) babies were IUFD, 7 (6.6%) babies had RDS and 2 (1.8%) babies were stillbirth 40 (44.94%) babies were admitted in NICU. Conclusions: This study concludes that foetal and maternal outcome were markedly affected by pre-eclampsia and also the grave complications were more common in pre-eclampsia. So proper antenatal care, early diagnosis of pre-eclampsia and timely intervention will decrease maternal perinatal morbidity and mortality

Primary tumor–derived systemic nANGPTL4 inhibits metastasis

Primary tumors and distant site metastases form a bidirectionally communicating system. Yet, the molecular mechanisms of this crosstalk are poorly understood. Here, we identified the proteolytically cleaved fragments of angiopoietin-like 4 (ANGPTL4) as contextually active protumorigenic and antitumorigenic contributors in this communication ecosystem. Preclinical studies in multiple tumor models revealed that the C-terminal fragment (cANGPTL4) promoted tumor growth and metastasis. In contrast, the N-terminal fragment of ANGPTL4 (nANGPTL4) inhibited metastasis and enhanced overall survival in a postsurgical metastasis model by inhibiting WNT signaling and reducing vascularity at the metastatic site. Tracing ANGPTL4 and its fragments in tumor patients detected full-length ANGPTL4 primarily in tumor tissues, whereas nANGPTL4 predominated in systemic circulation and correlated inversely with disease progression. The study highlights the spatial context of the proteolytic cleavage-dependent pro- and antitumorigenic functions of ANGPTL4 and identifies and validates nANGPTL4 as a novel biomarker of tumor progression and antimetastatic therapeutic agent

High-Grade B-cell Lymphoma, Not Otherwise Specified: A Multi-Institutional Retrospective Study

In this multi-institutional retrospective study, we examined the characteristics and outcomes of 160 patients with high-grade B-cell lymphoma, not otherwise specified (HGBL-NOS)-a rare category defined by high-grade morphologic features and lack of MYC rearrangements with BCL2 and/or BCL6 rearrangements ( double hit ). Our results show that HGBL-NOS tumors are heterogeneous: 83% of patients had a germinal center B-cell immunophenotype, 37% a dual-expressor immunophenotype (MYC and BCL2 expression), 28% MYC rearrangement, 13% BCL2 rearrangement, and 11% BCL6 rearrangement. Most patients presented with stage IV disease, a high serum lactate dehydrogenase, and other high-risk clinical factors. Most frequent first-line regimens included dose-adjusted cyclophosphamide, doxorubicin, vincristine, and etoposide, with rituximab and prednisone (DA-EPOCH-R; 43%); rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP; 33%); or other intensive chemotherapy programs. We found no significant differences in the rates of complete response (CR), progression-free survival (PFS), or overall survival (OS) between these chemotherapy regimens. CR was attained by 69% of patients. PFS at 2 years was 55.2% and OS was 68.1%. In a multivariable model, the main prognostic factors for PFS and OS were poor performance status, lactate dehydrogenase \u3e3 × upper limit of normal, and a dual-expressor immunophenotype. Age \u3e60 years or presence of MYC rearrangement were not prognostic, but patients with TP53 alterations had a dismal PFS. Presence of MYC rearrangement was not predictive of better PFS in patients treated with DA-EPOCH-R vs R-CHOP. Improvements in the diagnostic criteria and therapeutic approaches beyond dose-intense chemotherapy are needed to overcome the unfavorable prognosis of patients with HGBL-NOS

LRG1 destabilizes tumor vessels and restricts immunotherapeutic potency

Background: A poorly functioning tumor vasculature is pro-oncogenic and may impede the delivery of therapeutics. Normalizing the vasculature, therefore, may be beneficial. We previously reported that the secreted glycoprotein leucine-rich α-2-glycoprotein 1 (LRG1) contributes to pathogenic neovascularization. Here, we investigate whether LRG1 in tumors is vasculopathic and whether its inhibition has therapeutic utility. Methods: Tumor growth and vascular structure were analyzed in subcutaneous and genetically engineered mouse models in wild-type and Lrg1 knockout mice. The effects of LRG1 antibody blockade as monotherapy, or in combination with co-therapies, on vascular function, tumor growth, and infiltrated lymphocytes were investigated. Findings: In mouse models of cancer, Lrg1 expression was induced in tumor endothelial cells, consistent with an increase in protein expression in human cancers. The expression of LRG1 affected tumor progression as Lrg1 gene deletion, or treatment with a LRG1 function-blocking antibody, inhibited tumor growth and improved survival. Inhibition of LRG1 increased endothelial cell pericyte coverage and improved vascular function, resulting in enhanced efficacy of cisplatin chemotherapy, adoptive T cell therapy, and immune checkpoint inhibition (anti-PD1) therapy. With immunotherapy, LRG1 inhibition led to a significant shift in the tumor microenvironment from being predominantly immune silent to immune active. Conclusions: LRG1 drives vascular abnormalization, and its inhibition represents a novel and effective means of improving the efficacy of cancer therapeutics. Funding: Wellcome Trust (206413/B/17/Z), UKRI/MRC (G1000466, MR/N006410/1, MC/PC/14118, and MR/L008742/1), BHF (PG/16/50/32182), Health and Care Research Wales (CA05), CRUK (C42412/A24416 and A17196), ERC (ColonCan 311301 and AngioMature 787181), and DFG (CRC1366)

Large-scale multifidelity, multiphysics, hybrid reynolds-averaged navier-stokes/large-eddy simulation of an installed aeroengine

The aerodynamics and noise produced by aeroengines are critical topics in engine design. Hybrid Reynoldsaveraged Navier-Stokes/large-eddy simulation are used to investigate the influence of upstream internal geometry on jet flow and noise. The methods are validated using an isolated nozzle. The internal geometry is added by using approximated immersed boundary methods and body force methods, reducing grid complexity and cost. Installed coaxial nozzles, including an intake, wing, and flap, as well as (internally) the fan, outlet guide vanes, and other large features, are modeled. These large-scale multifidelity, multiphysics calculations are shown to reveal substantial new aeroacoustic insights into an installed aeroengine. The turbulence generated internally introduces a complex unsteady nozzle exit flow. This accelerates inner shear layer development, moving it one jet diameter upstream; and it reduces the potential core length by 5%. For the more intense outer shear layer, the effect appears secondary

Cost-effective hybrid RANS-LES type method for jet turbulence and noise prediction

Jets at higher Reynolds numbers have a high concentration of energy in small scales in the nozzle vicinity. This is challenging for large-eddy simulation, potentially placing severe demands on grid density. To circumvent this, we propose a novel procedure based on well-known Reynolds number (Re) independent of jets. We reduce the jet Re while rescaling the boundary layer properties to maintain incoming boundary layer thickness consistent with high Re jet. The simulations are carried out using hybrid large-eddy simulation type of approach which is incorporated by using near-wall turbulence model with modified properties. No subgrid scale model is used in these simulations. Hence, they effectively become numerical large-eddy simulation with Reynolds-averaged Navier–Stokes covering the full boundary layer region. The noise post-processing is carried out using the Ffowcs-Williams-Hawking approach. The simulations are made for Mach numbers (M) of 0.75 and 0.875 (cold and hot). The results for the overall sound pressure level are observed to be within 2–3% of the measurements, and directivity of sound is also captured accurately for both the cases. Hence, the low Re simulations can be more beneficial in saving time and cost while providing reasonably accurate results