Mitigating the Bullwhip Effect and Enhancing Supply Chain Performance through Demand Information Sharing: An ARENA Simulation Study

The supply chain is a network of organizations that collaborate and leverage their resources to deliver products or services to end-customers. In today's globalized and competitive market, organizations must specialize and form partnerships to gain a competitive edge. To thrive in their respective industries, organizations need to prioritize supply chain coordination, as it is integral to their business processes.   Supply chain management focuses on the collaboration of organizations within the supply chain. However, when each echelon member optimizes their goals without considering the network's impact, it leads to suboptimal performance and inefficiencies. This phenomenon is known as the Bullwhip effect, where order variability increases as it moves upstream in the supply chain. The lack of coordination, unincorporated material and information flows, and absence of ordering rules contribute to poor supply chain dynamics. To improve supply chain performance, it is crucial to align organizational activities. Previous research has proposed solutions to mitigate the Bullwhip effect, which has been a topic of intense study for many decades. This research aims to investigate the causes and mitigations of the Bullwhip effect based on existing research. Additionally, the paper utilizes ARENA simulation to examine the impact of sharing end-customer demand information. As far as we are aware, no study has been conducted to deeply simulate the bullwhip effect using the ARENA simulation. Previous studies have investigated this phenomenon, but without delving into its intricacies. The simulation results offer potential strategies to mitigate the Bullwhip effect through demand information sharing. Keywords: Supply Chain Management, Bullwhip effect, Inventory management, ARENA simulation, Information sharing, forecasting technique, Demand variability. DOI: 10.7176/JESD/14-14-07 Publication date:August 31st 202

Risk factors for cannula-associated arterial thrombosis following extracorporeal membrane oxygenation support: a retrospective study

Background Hemostatic dysfunction during extracorporeal membrane oxygenation (ECMO) due to blood-circuit interaction and the consequences of shear stress imposed by flow rates lead to rapid coagulation cascade and thrombus formation in the ECMO system and blood vessels. We aimed to identify the incidence and risk factors for cannula-associated arterial thrombosis (CaAT) post-decannulation. Methods A retrospective study of patients undergoing arterial cannula removal following ECMO was performed. We evaluated the incidence of CaAT and compared the characteristics, ECMO machine parameters, cannula sizes, number of blood products transfused during ECMO, and daily hemostasis parameters in patients with and without CaAT. Multivariate analysis identified the risk factors for CaAT. Results Forty-seven patients requiring venoarterial ECMO (VA-ECMO) or hybrid methods were recruited for thrombosis screening. The median Sequential Organ Failure Assessment score was 11 (interquartile range, 8–13). CaAT occurred in 29 patients (61.7%), with thrombosis in the superficial femoral artery accounting for 51.7% of cases. The rate of limb ischemia complications in the CaAT group was 17.2%. Multivariate analysis determined that the ECMO flow rate–body surface area (BSA) ratio (100 ml/min/m2) was an independent factor for CaAT, with an odds ratio of 0.79 (95% confidence interval, 0.66–0.95; P=0.014). Conclusions We found that the incidence of CaAT was 61.7% following successful decannulation from VA-ECMO or hybrid modes, and the ECMO flow rate–BSA ratio was an independent risk factor for CaAT. We suggest screening for arterial thrombosis following VA-ECMO, and further research is needed to determine the risks and benefits of such screening

TextANIMAR: Text-based 3D Animal Fine-Grained Retrieval

3D object retrieval is an important yet challenging task, which has drawn more and more attention in recent years. While existing approaches have made strides in addressing this issue, they are often limited to restricted settings such as image and sketch queries, which are often unfriendly interactions for common users. In order to overcome these limitations, this paper presents a novel SHREC challenge track focusing on text-based fine-grained retrieval of 3D animal models. Unlike previous SHREC challenge tracks, the proposed task is considerably more challenging, requiring participants to develop innovative approaches to tackle the problem of text-based retrieval. Despite the increased difficulty, we believe that this task has the potential to drive useful applications in practice and facilitate more intuitive interactions with 3D objects. Five groups participated in our competition, submitting a total of 114 runs. While the results obtained in our competition are satisfactory, we note that the challenges presented by this task are far from being fully solved. As such, we provide insights into potential areas for future research and improvements. We believe that we can help push the boundaries of 3D object retrieval and facilitate more user-friendly interactions via vision-language technologies.Comment: arXiv admin note: text overlap with arXiv:2304.0573

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

University Students’ Perceptions on the Use of Google Translate: Problems and Solutions

Machine learning has globally become a trend in most educational settings. This study aims to explore students’ perceptions when using Google Translate (GT) to support their learning as well as their problems and solutions from GT. With the participation of 250 university students at a private educational institution, a 5-point Likert-scale questionnaire and a semi-structured interview were employed to examine how students perceived the use of GT in their learning process. The findings revealed that practically students had positive perceptions on GT’s use in learning. Several major problems were recorded when they used GT, and some recommended solutions were also considered for improvement. Specifically, students utilized GT as a learning tool, particularly for language study, because of its useful features such as multi-language translation, time saving, ease of use, and improving pronunciation. Although Google Translate has a number of advantages for students, several problems such as erroneous grammar and semantics on a frequent basis have led to misunderstanding of original words. As a result, students discovered that they needed to deal with these problems by double checking the results in a dictionary or other translation programs, as well as the help from a peer or supervisor. It is suggested that GT is a helpful machine translator, but students are encouraged to know how to make some judgement on its results for a better translation version

Ligand-Assisted Sulfide Surface Treatment of CsPbI3 Perovskite Quantum Dots to Increase Photoluminescence and Recovery

CsPbI3 perovskite quantum dots (QDs) are more unstable over time as compared to other perovskite QDs, owing to ligand loss and phase transformation. The strong red emission from fresh CsPbI3 QDs gradually declines to a weak emission from aged QDs, which PLQY dropped by 93% after a 20 day storage; finally, there is no emission from delta-phase CsPbI3. The present study demonstrated a facile surface treatment method, where a sulfur-oleylamine (S-OLA) complex was utilized to passivate the defect-rich surface of the CsPbI3 QDs and then self-assembly to form a matrix outside the CsPbI3 QDs protected the QDs from environmental moisture and solar irradiation. The PLQY of the treated CsPbI3 QDs increased to 82.4% compared to initial value of 52.3% of the fresh QDs. Furthermore, there was a significant increase in the colloidal stability of the CsPbI3 QDs. Above 80% of the original PLQY of the treated QDs was reserved after a 20 day storage and the black phase could be maintained for three months before transforming to the yellow phase. The introduction of S-OLA induced the recovery of the lost photoluminescence of the nonluminous aged CsPbI3 QDs with time to 95% of that of the fresh QDs. Furthermore, the photoluminescence was maintained for one month. The increase in the stability and photoluminescence are critical for realizing high-performance perovskite-QD-based devices. Therefore, this work paves the way for increasing the performance of perovskite-based devices in the near future.

Guillain–Barré Syndrome due to COVID-19 Vero Cell Vaccination Associated with Concomitant COVID-19 Infection-induced ARDS and Treated Successfully by Therapeutic Plasma Exchange: A First Case Report from Vietnam

Abstract Post-vaccination adverse reactions have been reported with varying symptoms and severity owing to research and production time pressures during the coronavirus disease 2019 (COVID-19) pandemic. In this article, we report a rare case of Guillain–Barré syndrome (GBS) in a patient with COVID-19 with acute respiratory distress syndrome (ARDS) after receiving Sinopharm's Vero Cell vaccine (China). The patient who was initially negative for COVID-19 was diagnosed with GBS based on paralysis that developed from the lower extremities to the upper extremities, as confirmed by cytoalbuminologic dissociation in the cerebrospinal fluid. The patient's condition worsened with ARDS caused by COVID-19 infection during the hospital stay, and SpO2 decreased to 83% while receiving oxygen through a non-rebreather mask (15 l/min) on day 6. The patient was treated with standard therapy for severe COVID-19, invasive mechanical ventilation, and five cycles of therapeutic plasma exchange (TPE) with 5% albumin replacement on day 11 due to severe progression. The patient was weaned off the ventilator on day 28, discharged on day 42, and was completely healthy after 6 months without any neurological sequelae until now. Our report showed the potential of TPE for GBS treatment in critically ill patients with COVID-19 after COVID-19 vaccination

CD40LG mutations in Vietnamese patients with X-linked hyper-IgM syndrome; catastrophic anti-phospholipid syndrome as a new complication

Background: X-linked hyper-IgM syndrome (XHIGM) is a rare primary immunodeficiency caused by CD40 ligand defects. Methods: We identified three patients with XHIGM in Ho Chi Minh City, Vietnam. Whole-exome sequencing, immunological analyses and western blot were performed to investigate phenotypic and genotypic features. Results: Despite showing symptoms typical of XHIGM, including recurrent sinopulmonary infections, oral ulcers and otitis media, the diagnosis was significantly delayed. One patient developed anti-phospholipid syndrome, which has been documented for the first time in XHIGM syndrome. Two patients had elevated IgM levels and all of them had low IgG levels. Exome sequencing revealed mutations in the CD40LG gene: one novel splicing mutation c.156+2T&gt;A and two previously characterised mutations (non-frameshift deletion c.436_438delTAC, stop-gain c.654C&gt;A). Due to these mutations, the CD40 ligand was not expressed in any of the three patients, as demonstrated by western blot analysis. Conclusion: This is the first report of XHIGM syndrome in Vietnam indicates that an effective diagnostic strategy, such as sequencing analysis, contributes to reliable diagnosis and subsequent therapy.</p