Outsourcing and acquisition models comparison related to IT supplier selection decision analysis

This paper presents a comparison of acquisition models related to decision analysis of IT supplier selection. The main standards are: Capability Maturity Model Integration for Acquisition (CMMI-ACQ), ISO / IEC 12207 Information Technology / Software Life Cycle Processes, IEEE 1062 Recommended Practice for Software Acquisition, the IT Infrastructure Library (ITIL) and the Project Management Body of Knowledge (PMBOK) guide. The objective of this paper is to compare the previous models to find the advantages and disadvantages of them for the future development of a decision model for IT supplier selection

Análisis de decisiones en la selección de proveedores de tecnologías de la información: una revisión sistemática

En este artículo se aplica un protocolo de revisión sistemática de Ingeniería de Software para la decisión en la selección de proveedores de Tecnologías de la Información (TI). El objetivo es la búsqueda de documentos relacionados con la toma de decisión en la selección de proveedores de TI. Además, la revisión sistemática se centra en identificar las iniciativas y los informes de la toma de decisión en la selección de proveedores de TI. Los resultados obtenidos demuestran que existe una necesidad de más estudios y definen 16 criterios de evaluación para utilizarse en la selección de proveedores de TI

Evidências sobre a redução do colesterol de lipoproteínas de baixa densidade com outras drogas além de estatinas e inibidores de PCSK6 / Evidence on low-density lipoprotein cholesterol reducing with drugs other than statins and PCSK6 inhibitors

Os agentes de alteração de lipídios abrangem várias classes de medicamentos, incluindo estatinas, inibidores de absorção de colesterol, derivados de ácido fíbrico, sequestrantes de ácidos biliares, inibidores de proproteína convertase subtilisina/kexina tipo 9, ácido nicotínico e outros. Embora as estatinas sejam a terapia preferida para a maioria dos pacientes que necessitam de tratamento de dislipidemia, outros agentes estão disponíveis com vários níveis de evidência para benefícios clínicos. Em pacientes que não atingem a meta desejada de colesterol de lipoproteína de baixa densidade com terapia com estatina, adicionamos ezetimiba com mais frequência do que qualquer outra droga que altera os lipídios. O principal uso da terapia com fibratos é no manejo de pacientes com hipertrigliceridemia, o ácido nicotínico é pouco utilizado no tratamento do LDL-C e pode ser usado para diminuir a lipoproteína. A maioria dos pacientes para os quais uma terapia com medicamentos prescritos é considerada aconselhável terá uma elevação no nível de colesterol de lipoproteína de baixa densidade e uma estatina é a terapia de primeira linha estabelecida. Outros medicamentos hipolipemiantes são usados para aumentar os efeitos das estatinas no LDL-C, substituir as estatinas quando essa classe não pode ser usada, pode ser uma opção, ou para tratar distúrbios não-LDL-C, principalmente hipertrigliceridemia

A decision model for it supplier selection

En los últimos años la externalización de TI ha ganado mucha importancia en el mercado y, por ejemplo, el mercado externalización de servicios de TI sigue creciendo cada año. Ahora más que nunca, las organizaciones son cada vez más los compradores de las capacidades necesarias mediante la obtención de productos y servicios de los proveedores, desarrollando cada vez menos estas capacidades dentro de la empresa. La selección de proveedores de TI es un problema de decisión complejo. Los gerentes que enfrentan una decisión sobre la selección de proveedores de TI tienen dificultades en la elaboración de lo que hay que pensar, además en sus discursos. También de acuerdo con un estudio del SEI (Software Engineering Institute) [40], del 20 al 25 por ciento de los grandes proyectos de adquisición de TI fracasan en dos años y el 50 por ciento fracasan dentro de cinco años. La mala gestión, la mala definición de requisitos, la falta de evaluaciones exhaustivas, que pueden ser utilizadas para llegar a los mejores candidatos para la contratación externa, la selección de proveedores y los procesos de contratación inadecuados, la insuficiencia de procedimientos de selección tecnológicos, y los cambios de requisitos no controlados son factores que contribuyen al fracaso del proyecto. La mayoría de los fracasos podrían evitarse si el cliente aprendiese a comprender los problemas de decisión, hacer un mejor análisis de decisiones, y el buen juicio. El objetivo principal de este trabajo es el desarrollo de un modelo de decisión para la selección de proveedores de TI que tratará de reducir la cantidad de fracasos observados en las relaciones entre el cliente y el proveedor. La mayor parte de estos fracasos son causados por una mala selección, por parte del cliente, del proveedor. Además de estos problemas mostrados anteriormente, la motivación para crear este trabajo es la inexistencia de cualquier modelo de decisión basado en un multi modelo (mezcla de modelos adquisición y métodos de decisión) para el problema de la selección de proveedores de TI. En el caso de estudio, nueve empresas españolas fueron analizadas de acuerdo con el modelo de decisión para la selección de proveedores de TI desarrollado en este trabajo. Dos softwares se utilizaron en este estudio de caso: Expert Choice, y D-Sight. ABSTRACT In the past few years IT outsourcing has gained a lot of importance in the market and, for example, the IT services outsourcing market is still growing every year. Now more than ever, organizations are increasingly becoming acquirers of needed capabilities by obtaining products and services from suppliers and developing less and less of these capabilities in-house. IT supplier selection is a complex and opaque decision problem. Managers facing a decision about IT supplier selection have difficulty in framing what needs to be thought about further in their discourses. Also according to a study from SEI (Software Engineering Institute) [40], 20 to 25 percent of large information technology (IT) acquisition projects fail within two years and 50 percent fail within five years. Mismanagement, poor requirements definition, lack of comprehensive evaluations, which can be used to come up with the best candidates for outsourcing, inadequate supplier selection and contracting processes, insufficient technology selection procedures, and uncontrolled requirements changes are factors that contribute to project failure. The majority of project failures could be avoided if the acquirer learns how to understand the decision problems, make better decision analysis, and good judgment. The main objective of this work is the development of a decision model for IT supplier selection that will try to decrease the amount of failures seen in the relationships between the client-supplier. Most of these failures are caused by a not well selection of the supplier. Besides these problems showed above, the motivation to create this work is the inexistence of any decision model based on multi model (mixture of acquisition models and decision methods) for the problem of IT supplier selection. In the case study, nine different Spanish companies were analyzed based on the IT supplier selection decision model developed in this work. Two software products were used in this case study, Expert Choice and D-Sight

Neurofibromatosis: part 2 – clinical management

Part 1 of this guideline addressed the differential diagnosis of the neurofibromatoses (NF): neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis (SCH). NF shares some features such as the genetic origin of the neural tumors and cutaneous manifestations, and affects nearly 80 thousand Brazilians. Increasing scientific knowledge on NF has allowed better clinical management and reduced rate of complications and morbidity, resulting in higher quality of life for NF patients. Most medical doctors are able to perform NF diagnosis, but the wide range of clinical manifestations and the inability to predict the onset or severity of new features, consequences, or complications make NF management a real clinical challenge, requiring the support of different specialists for proper treatment and genetic counseling, especially in NF2 and SCH. The present text suggests guidelines for the clinical management of NF, with emphasis on NF1

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)