599 research outputs found
Success factors between suppliers and customers in service outsourcing activities
This study examines the relationship between outsourcing motives, supplier-customer relationship and perceived value in non-core service outsourcing. That is, key factors responsible for supplier-customer relationship which provide customer value in service outsourcing is still unclear. A total of 1,757 companies were randomly selected for the survey. 234 valid questionnaires were returned (13.4% response rate). The structural equation method was used to obtain the best fit model. The most significant contribution of this study is that, ‘relationship interaction’ has a greater impact on customer perceived value than ‘relationship quality’ in service outsourcing. That is, customer-supplier ‘relationship interaction’ that enhances communication, cooperation, coordination, conflict resolution, and integration activities rather than ‘relationship quality’ such as loyalty and trust, would exert the greatest effect on perceived customer value
Threshold voltage model for hetero-gate-dielectric tunneling field effect transistors
In this paper, a two dimensional analytical model of the threshold voltage for HGD TFET structure has been proposed. We have also presented the analytical models for the tunneling width and the channel potential. The potential model is used to develop the physics based model of threshold voltage by exploring the transition between linear to exponential dependence of drain current on the gate bias. The proposed model depends on the drain voltage, gate dielectric near the source and drain, silicon film thickness, work function of gate metal and oxide thickness. The accuracy of the proposed model is verified by simulation results of 2-D ATLAS simulator. Due to the reduction of the equivalent oxide thickness, the coupling between the gate and the channel junction enhances which results in lower threshold voltage. Tunneling width becomes narrower at a given gate voltage for the optimum channel concentration of 1016 /cm3. The higher concentration in the source (Ns) causes a steep bending in the conduction and valence bands compared to the lower concentration which results in smaller tunneling width at the source-channel interface
Assembling New Avengers: The Successful Comic-Book Superhero Film in PostMillennial Hollywood
Master'sMASTER OF ART
Properties of reaction fronts in a non-adiabatic two stage exothermic-endothermic competitive reaction scheme
We numerically derive the properties of reaction fronts arising in a pre-mixed one dimensional two staged non-adiabatic competitive exothermic-endothermic reaction scheme where both reaction pathways compete for the same fuel. We utilise FlexPDE and the method of lines to obtain numerical solutions for properties such as the front speed and stability over a range of parameter values such as the Lewis number and the ratios of enthalpies and activation energies. Steady and pulsating speeds are demonstrated for specific regions of the parameter space. We also show that in some circumstances there exists a chaotic regime of combustion wave propagation.
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Vortex Keratopathy in a Patient Receiving Vandetanib for Non-Small Cell Lung Cancer
We report a case of vortex keratopathy in a patient treated with vandetanib for non-small cell lung cancer (NSCLC). A 44-year-old female who underwent two cycles of chemotherapy for NSCLC complained of visual blurring in both eyes after the initiation of vandetanib, an anti-epidermal growth factor receptor (EGFR) and anti-vascular endothelial growth factor receptor 2 protein tyrosine kinase inhibitor. On ophthalmic examination, visual acuities were 20 / 20 OU and, with the exception of diffuse vortex keratopathy in both eyes, other findings were unremarkable. Vandetanib is believed to have caused vortex keratopathy in this patient. Anti-EGFR properties affecting normal corneal epithelial cell migration and wound healing or drug associated metabolite deposition, which is the case in numerous drug-associated vortex keratopathies, may be possible underlying mechanisms in the formation of this corneal complication
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The effect of atomoxetine on directed and random exploration in humans
The adaptive regulation of the trade-off between pursuing a known reward (exploitation) and sampling lesser-known options in search of something better (exploration) is critical for optimal performance. Theory and recent empirical work suggest that humans use at least two strategies for solving this dilemma: a directed strategy in which choices are explicitly biased toward information seeking, and a random strategy in which decision noise leads to exploration by chance. Here we examined the hypothesis that random exploration is governed by the neuromodulatory locus coeruleus-norepinephrine system. We administered atomoxetine, a norepinephrine transporter blocker that increases extracellular levels of norepinephrine throughout the cortex, to 22 healthy human participants in a double-blind crossover design. We examined the effect of treatment on performance in a gambling task designed to produce distinct measures of directed exploration and random exploration. In line with our hypothesis we found an effect of atomoxetine on random, but not directed exploration. However, contrary to expectation, atomoxetine reduced rather than increased random exploration. We offer three potential explanations of our findings, involving the non-linear relationship between tonic NE and cognitive performance, the interaction of atomoxetine with other neuromodulators, and the possibility that atomoxetine affected phasic norepinephrine activity more so than tonic norepinephrine activity
Effect of Base Curve Radius of Therapeutic Lenses on Epithelial Healing after Laser-Assisted Subepithelial Keratectomy
PURPOSE: To determine the effect of the base curve radius (BCR) of therapeutic soft contact lens (T-lens) on epithelial healing after laser-assisted subepithelial keratectomy (LASEK). METHODS: Ninety-two eyes in 47 patients with myopia were prospectively evaluated after LASEK. All the patients wore T-lenses with the BCR (R1) randomly chosen after LASEK. The T-lenses were removed after complete healing of the epithelial wounds. We calculated an estimated BCR (R2) from postoperative topography using a diopter conversion table. The patients were divided into two groups according to the differences between the BCR (R1) and the estimated BCR (R2). The flat fitting group was R1 > R2 (Group A), and the steep fitting group was R1R2) had 53 eyes, and Group B (R1<R2) had 39 eyes. Group A showed a shorter epithelial healing time than Group B (5.8+/-1.7 days vs. 6.7+/-2.1 days, p=0.04). CONCLUSIONS: The flat fitting group showed a shorter epithelial healing time than the steep fitting group after LASEK
Family carer experiences of hospice care at home: qualitative findings from a mixed methods realist evaluation
This document is the Accepted Manuscript version of a published work that appeared in final form in [Palliative Medicine]. To access the final edited and published work see https://doi.org/10.1177/02692163231206027Background: Hospice-at-home aims to enable patients approaching end-of-life to die at home and support their carers. A wide range of different service models exists but synthesised evidence on how best to support family carers to provide sustainable end-of -life care at home is limited.
Aim: To explore what works best to promote family carers’ experiences of hospice-at-home.
Design: Realist evaluation with mixed methods. This paper focuses on qualitative interviews with carers (to gain their perspective and as proxy for patients) and service providers from twelve case study sites in England. Interviews were coded and programme theories were refined by the research team including two public members.
Setting/participants: Interviews with carers (involved daily) of patients admitted to hospice-at-home services (n=58) and hospice-at-home staff (n=78).
Results: Post bereavement, 76.4% of carers thought that they had received as much help and support as they needed and most carers (75.8%) rated the help and support as excellent or outstanding. Of six final programme theories capturing key factors relevant to providing optimum services, those directly relevant to carer experiences were: integration and co-ordination of services; knowledge, skills and ethos of hospice staff; volunteer roles; support directed at the patient–carer dyad.
Conclusions: Carers in hospice-at-home services identified care to be of a higher quality than generic community services. Hospice staff were perceived as having ‘time to care’, communicated well and were comfortable with dying and death. Hands-on care was particularly valued in the period close to death
Patient-Related Diet and Exercise Counseling: Do Providers’ Own Lifestyle Habits Matter?
The goal of this research was to evaluate the personal health behaviors of physicians in training and attending physicians in association with patient-related lifestyle counseling. Physicians at a major teaching hospital were surveyed regarding their personal lifestyle behavior, perceived confidence, and frequency of counseling patients regarding lifestyle behaviors. One hundred eighty-three total responses were received. Trainees were more likely to consume fast food and less likely to consume fruits and vegetables than attendings. Attending physicians were more likely to exercise 4 or more days per week and more than 150 minutes per week. Attending physicians were more likely to counsel their patients regarding a healthy diet (70.7% vs 36.3%, P150 minutes per week, being overweight, and reported adequate training in counseling. Only adequate training in counseling was a predictor of strong self-efficacy for counseling in diet. Many physicians lack confidence in their ability to counsel patients regarding lifestyle. Personal behaviors including regular exercise and better training in counseling techniques may improve patient counseling. Prev Cardiol. 2010;13:180–185. © 2010 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79167/1/j.1751-7141.2010.00079.x.pd
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Catecholamine-mediated increases in neural gain improve the precision of cortical representations
Neurophysiological evidence suggests that neuromodulators, such as norepinephrine and dopamine, increase neural gain in target brain areas. Computational models and prominent theoretical frameworks indicate that this should enhance the precision of neural representations, but direct empirical evidence for this hypothesis is lacking. In two functional MRI studies, we examine the effect of baseline catecholamine levels (as indexed by pupil diameter and manipulated pharmacologically) on the precision of object representations in the human ventral temporal cortex using angular dispersion, a powerful, multivariate metric of representational similarity (precision). We first report the results of computational model simulations indicating that increasing catecholaminergic gain should reduce the angular dispersion, and thus increase the precision, of object representations from the same category, as well as reduce the angular dispersion of object representations from distinct categories when distinct-category representations overlap. In Study 1 (N = 24), we show that angular dispersion covaries with pupil diameter, an index of baseline catecholamine levels. In Study 2 (N = 24), we manipulate catecholamine levels and neural gain using the norepinephrine transporter blocker atomoxetine and demonstrate consistent, causal effects on angular dispersion and brain-wide functional connectivity. Despite the use of very different methods of examining the effect of baseline catecholamine levels, our results show a striking convergence and demonstrate that catecholamines increase the precision of neural representations
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