Quantifying the desired degree of supply chain flexibility

The dynamic nature of today\u27s market drives the need for flexibility in supply chains. The ever-growing need for and importance of flexibility in supply chains has motivated researchers to develop frameworks to achieve supply chain flexibility. Much of the research on supply chain flexibility focuses on drivers of the need for flexibility and classification of supply chain flexibility. Existing frameworks for determining the desired degree of flexibility in supply chains give an overview methodology; however, a comprehensive framework is absent. This research proposes a comprehensive framework to quantify the desired degree of flexibility in supply chains and accordingly determine its associated configuration --Abstract, page iii

Successful single stage management of trifocal femoral fracture associated with distal medial condyle and Hoffa’s component by a novel technique

Isolated fractures of the shaft of the femur are relatively common injuries. Ipsilateral multifocal fractures of the femur are less common with an additional proximal femoral fracture estimated to occur in up to 5% of diaphyseal fractures and additional distal femoral fracture occurring in 3-4%. Trifocal femoral fractures consisting of ipsilateral fractures of the proximal, diaphyseal, and distal femur are extremely rare. These fracture patterns are seen in the young adult population following high velocity trauma such as fall from height and road traffic accidents. The sequence of fracture type to be fixed first and the type of implant to be used are questions yet to be answered as one implant used for fixation of one fracture may not be amenable for fixation of the other fracture. These fractures are associated with significant complications and delayed rehabilitation. We describe a novel method in one such trifocal fracture pattern where the distal femoral intra-articular medial condyle with a hoffas element was stabilised by open reduction with a 4.5 proximal tibial ipsi-lateral anterolateral LCP and 2 inter-fragmentary compression screws which has not been reported in literature before. The advantages of such an implant is easy contour ability to the medial femoral condyle and adequate strength and achieving satisfactory absolute stability with options of using uni-cortical locking screws, all of which facilitates early knee ROM and rehabilitation.

CFD Simulations of Crude Oil Fouling on Heat Transfer Surfaces

Advancements in the computational techniques have led to the development of various numerical models and methods to predict the occurrence of crude oil fouling in heat exchangers. Computational fluid dynamics has been employed in the field of crude oil fouling research in the recent past, which led to the concept of investigating the effects of various operating conditions on deposit formations on heat transfer surfaces. Various processes associated with crude oil fouling, such as asphaltenes precipitation and chemical reactions, have been studied through CFD simulations. This chapter provides state-of-the-art review on various CFD approaches and describes the discrete-phase CFD modeling of crude oil fouling through asphaltenes deposition on heat transfer surfaces

Intraarticular use of tranexamic acid during primary total knee arthroplasty

Background: Tranexamic acid (TXA) is effective in reduction of blood loss after major surgical procedures. In TKA surgeries, it is commonly administered intravenously. Since there are contraindications of systemic use of TXA, local/intraarticular TXA can also be used. The efficacy of both systemic and local TXA administration is demonstrated in the literature. The aim was to assess the effect of intraarticular TXA during total knee arthroplasty in terms of total blood loss and transfusion rate. Methods: A total of 50 TKA in 34 patients were included in this prospective study.  Patients received one dose of intraarticular TXA of 3 g after skin closure and before deflation of the tourniquet. Results: The mean total blood loss in intra-articular TXA was 456.9 ml. None of the patients required transfusion postoperatively including those who underwent bilateral staged TKR. Mean postoperative hemoglobin loss was 1.07. Conclusions: TXA reduced blood loss and transfusion requirement. Intra-articular administration of TXA seems to be more effective in terms of reducing total blood loss and transfusion rates. We recommend administration of topical TXA in primary TKA in healthy patients to decrease perioperative blood loss

A prospective study on functional outcome of uncemented total hip arthroplasty in patients with inflammatory arthropathies

Background: Although medical management has improved the outcome and may have reduced the need for surgery, total hip arthroplasty (THA) is often required to manage pain and restore function and mobility. The successful functional outcome of THA in patients with inflammatory arthropathies is essential in understanding the need for THA, and its benefits in those undergoing it. Objective of the study is to evaluate the functional outcome of total hip arthroplasty in patients suffering from inflammatory arthritis using Harris hip score (HHS) and to assess the post operative complication in these patients.Methods: In a prospective study conducted on patients with inflammatory arthritis treated with THA between a study period of January 2018 to January 2020. All the patients after assessing them clinically and radiologically were operated with uncemented THA through posterolateral approach. Functional outcomes of hip were evaluated using HHS at various intervals.Results: In this study, patients were followed up to 24 months. About 46.7% of patients were diagnosed with rheumatoid arthritis, 33.3% of patients were diagnosed with ankylosing spondylitis, 20% of patients were diagnosed with sero negative arthritis. 90% of patients had no limb length discrepancy, no other post-operative complications were noted. The final functional outcome of hip according to HHS were 13.3% of excellent, 56.7% good results and 30% of fair results.Conclusions: This study concludes that THA in patients with inflammatory arthritis with restricted activities of life had improved in short term follow up and ease of rehabilitation and return to function

No2−^−_2 and Scn−^−-Intercalated Layered Double Hydroxides: Structure and Orientation of Anions in the Interlayer Gallery

NO− 2 and SCN− are two common small inorganic anions. The former is a common industrial pollutant. The latter is linear and is a good mimic for the toxic CN− ion. The structures of these two anions are refined within the gallery of the [Zn–Al]-layered double hydroxide (LDH). Both LDHs crystallize as mixed anion phases. The nitrite is found to co-exist with the nitrate ion. The nitrite ion is intercalated with its molecular plane inclined to the metal hydroxide layer. In the case of the SCN− intercalated LDH, no other anion was detected by ion chromatography, suggesting that the SCN− deficiency is compensated by intercalated hydroxyl ions. In this case, the SCN− ion is found to be intercalated with its molecular axis inclined to the metal hydroxide laye

DNA marker-assisted evaluation of cultivated and local mulberry genotypes of southern India

Germplasm evaluation is essential in any crop improvement program and genetic characterization atmorphological and molecular level is very vital for breeding programs to be successful. Twenty six cultivated and localgenotypes of mulberry were subjected to diversity analysis with RAPD markers. Among the total 31 RAPD primers studied, 24were polymorphic and 7 were monomorphic. Of the total 197 loci obtained from 24 polymorphic primers, 110 loci (55.83%)were polymorphic and 87 (44.16%) were monomorphic. A clear grouping was seen among the cultivated genotypes based onyield with varieties like S36, V1, S54 and M5 showing proximity to each other and sharing a close similarity. Local genotypesare rich reservoirs of resistant gene sources and are well acclimatized to the prevailing environmental conditions.Utilizationof these along with other high yielding varieties will produce various combinations of resistance sources which can beincorporated into high yielding varieties

How Accurate is the Use of Contralateral Implant Size as a Template in Bilateral Hemiarthroplasty?

Purpose Accurately predicting implant size for hemiarthroplasties offers an important contribution to theatre efficiency and patients’ intraoperative care. However, pre-operative sizing using templating of implants in hip fracture patients requiring a hemiarthroplasty is often difficult due to non-standard radiographs, absence of a calibration marker, poor marker placement, variable patient position, and in many institutions a lack of templating facilities. In patients who have previously undergone a hemiarthroplasty on the contralateral side, surgeons can use the contralateral implant size for pre-operative planning purposes. However, the accuracy of doing this has not previously been reported. The aim of this study was to investigate the reliability of using an in situ contralateral implant as a predictor of implant size on the contralateral side. Methods A retrospective review of our local neck of femur fracture (NOF) database was undertaken to identify patients who had bilateral hip hemiarthroplasty. Operative records were reviewed to establish the size of prostheses used at operation. Correlation, agreement, and reliability analysis were performed using the least squares, Bland–Altman plot, and intra-class correlation coefficient (ICC) methods, respectively. Results Operative records were identified for 45 patients who had bilateral hemiarthroplasties. There was a difference in implant size used in 58% of cases. Of these 77% required a larger implant on the right. Implant sizes were within 1 mm of the contralateral side in 78% and within 2 mm in 91% of patients. However, in 9% of patients, there was a discrepancy greater than 2 mm with some cases having up to 6 mm discrepancy. Correlation coefficient was 0.83 and the ICC 0.90. Conclusions The findings in this study indicated that using the size of a contralateral implant can be used as a reliable indicator of head size in cases of bilateral hemiarthroplasty. However, the surgeon should remain cautious as there is a one in ten chance of there being a 3 mm or more difference in implant size

Genetic divergence of new germplasm and advanced breeding lines of groundnut (Arachis Hypogaea L.) studied under late kharif situation

Analysis of genetic divergence of sixty four genotypes (39 new germplasm accessions and 25 advanced breeding lines) of groundnut revealed wide range of D2 values ranging between 4.52 and 27.75 suggesting the presence of considerable amount of genetic diversity in the genotypes studied, which were grouped in to seven clusters where, cluster VII (28) was the largest followed by cluster I (24) and cluster VI (4). Maximum inter cluster distance was recorded between IV and VI representing wide divergence among these clusters. On the basis of intercluster distance and cluster means the genotypes viz., ICGV-05033, ICGV-05052, PAFRGVT58, GG-20×ICGV-91114, ICGX-020063-F-B-SSD-P20-B, ICGX-020055-F-SSD-P37-B were 21121 widely diverse therefore may be considered for future breeding programme