Outsourcing in humanitarian logistics – status quo and future directions

Purpose – Outsourcing of logistics has great importance in disaster relief. Aid agencies spend several billion US dollars every year on logistics services. However, the concept of outsourcing has not been established adequately in literature on humanitarian logistics, leading to a fragmented view of the practice. This paper provides a holistic perspective of the concept by constructing a conceptual framework to analyze both practice and research of outsourcing in humanitarian operations. Based on this analysis, we explore future trends and identify research gaps. Design/methodology/approach – The paper is based on a structured review of academic literature, a tworound Delphi study with 31 experts from aid agencies and a complementary full-day focus group with twelve experts from aid agencies and logistics service providers. Findings – The paper systemizes the current practice of outsourcing in humanitarian logistics according to a conceptual framework of five dimensions: subject, object, partner, design and context. In addition, it reveals ten probable developments of the practice over the next years. Finally, it describes eight important research gaps and presents a research agenda for the field. Research limitations/implications – The literature review considered peer-reviewed academic papers. Practitioner papers could provide additional insights into the practice. Moreover, the Delphi study focused on the perspective of aid agencies. Capturing the views of logistics service providers in more detail would be a valuable addition. Originality/value – The paper establishes the academic basis for the important practice of outsourcing in humanitarian logistics. It highlights essential research gaps and, thereby, opens up the field for future research

Long-Term Follow-Up of Peritoneal Interposition Flap in Symptomatic Lymphocele Reduction following Robot-Assisted Radical Prostatectomy: Insights from the PIANOFORTE Trial

The available randomised controlled trials (RCTs) assessing the influence of peritoneal interposition flaps (PIF) on the reduction of symptomatic lymphoceles (sLCs) post robot-assisted radical prostatectomy (RARP) do not constitute a sufficient follow-up (FU) to assess the long-term effects. The PIANOFORTE trial was the first of these RCTs, showing no sLC reduction at the 3-month FU. Therefore, all 232 patients from the PIANOFORTE trial were invited for long-term FU. One hundred seventy-six patients (76%) presented themselves for FU and constituted the study group (SG). The median FU duration was 43 months. No significant differences in group allocation or LC endpoints at 90 days were observed between SG patients and patients not presenting themselves for the FU. During the FU period, four patients (2.3%) in the SG developed sLCs, and six patients (3.4%) developed asymptomatic lymphoceles (aLCs), which persisted in five patients (2.9%). There were no significant differences between PIF and non-PIF regarding sLC/aLC formation or persistence, newly developed complications, stress urinary incontinence or biochemical/clinical tumour recurrence. Therefore, this long-term FU confirms the primary outcomes of the PIANOFORTE trial that, while PIF does not impact complications or functionality, it does not reduce sLC/aLC rates. Furthermore, it shows the potential occurrence of LC after the third postoperative month

Verfahren und Vorrichtung zur Herstellung eines Halbleiterbauelements

The method comprises depositing a semiconductor layer structure on a substrate, where the structure comprises a gallium nitride (GaN)-based semiconductor layer, and partially removing the semiconductor layer in local areas by laser machining. The laser treatment is carried out by: exposing the semiconductor layer to a projection mask (4), which is illuminated with laser radiation of an ablation laser (1) such that exposure areas of the semiconductor layer is exposed through recesses in the projection mask; and occulting the GaN-based semiconductor layer shaded by the projection mask. The method comprises depositing a semiconductor layer structure on a substrate, where the semiconductor layer structure comprises a gallium nitride (GaN)-based semiconductor layer, and partially removing the GaN-based semiconductor layer in local areas by laser machining. The laser treatment is carried out by: exposing the GaN-based semiconductor layer to a projection mask (4), which is illuminated with laser radiation of an ablation laser (1) such that exposure areas of the GaN-based semiconductor layer is exposed through recesses in the projection mask; and occulting the GaN-based semiconductor layer shaded by the projection mask. A laser fluence of the ablation laser is above an ablation threshold of the GaN-based semiconductor layer. An excimer laser is used as the ablation laser, and has a wavelength of = 351 nm and a pulse length of = 40 nanoseconds. The semiconductor layer structure comprises an active region in the exposure areas. A luminous area of a semiconductor device is effected by removing the active region in the exposure areas by mechanical separation and electrical isolation. The exposure areas of the semiconductor layer structure are completely removed. A set of semiconductor devices is formed on a wafer that is perpendicular to the laser radiation. The removing step is repeated for five times. The method further comprises displacing the wafer such that the displacement of the wafer is perpendicular to the laser radiation, and etching step. The displacing step is carried out simultaneously with the removing step. An independent claim is included for an apparatus for processing a semiconductor device. USE: The method is useful for manufacturing a semiconductor device such as GaN-based LED (all claimed). ADVANTAGE: The method is capable of accurately controlling the laser ablation depth thus economically and time-effectively manufacturing the semiconductor device with good quality and without damaging the semiconductor material during the laser processing. The diagram shows a schematic view of an apparatus for processing a semiconductor device. 1 : Ablation laser 3 : Beam homogenizer 4 : Projection mask 5 : Focusing lens 7 : Holde

High BMI, Aggressive Tumours and Long Console Time Are Independent Predictive Factors for Symptomatic Lymphocele Formation after Robot-Assisted Radical Prostatectomy and Pelvic Lymph Node Dissection

Introduction: Lymphocele (LC) formation is a common complication which may cause severe symptoms after robot-assisted radical prostatovesiculectomy (RARP) with concomitant pelvic lymph node dissection (PLND). Compared to open radical prostatectomy, the amount of data on potential risk factors for LC formation is still limited. The aim of the present study was to identify risk factors for symptomatic LC formation (sLC) after RARP with PLND. Methods: We used the data of a prospective multicentre series of 232 RARP patients which were treated between March 2017 and December 2017. The primary endpoint was the presence of sLC within 90 days. Asymptomatic LC (aLC) formation was also recorded. We evaluated clinical, perioperative, and histopathological criteria and compared their distribution in patients with and without post-operative sLC. Uni- and multivariable logistic regression analyses (MVAs) were performed to identify potential predictors for LC formation. Regarding the influence of patients’ BMI, 2 models were calculated: BMI continuously (model 1) and BMI dichotomized with cut-off 30 kg/m2 (WHO definition, model 2). Results: Post-operative sLC was present in 21 patients (9.1%), while aLC was detected in 49 patients (21.1%) 90 days after RARP with PLND. Patients with sLC showed higher median baseline PSA levels (9.8 vs. 8.1 ng/mL), higher prevalence of obesity (BMI >30; 42.9 vs. 19.9%), and longer median console time (180 vs. 165 min) compared to patients without sLC. On MVA higher BMI {model 1: OR 1.145 (confidence interval [CI] 1.025–1.278); model 2: OR 2.761 (1.045–7.296)}, longer console time (model 1: OR 1.013 [1.005–1.021]; model 2: OR 1.013 [1.005–1.020]) and an ISUP grade ≥3 (model 1: OR 3.247 [1.182–8.917]; model 2: OR 2.791 [1.050–7.423]) were identified as independent predictors for sLC development. Conclusion: Patients with aggressive tumours and higher BMI should be informed about a potentially increased risk for sLC formation. In case of a long console time, a close and regular follow-up should be considered to check for LC development

On the Fabrication and Characterization of Polymer-Based Waveguide Probes for Use in Future Optical Cochlear Implants

Improved hearing restoration by cochlear implants (CI) is expected by optical cochlear implants (oCI) exciting optogenetically modified spiral ganglion neurons (SGNs) via an optical pulse generated outside the cochlea. The pulse is guided to the SGNs inside the cochlea via flexible polymer-based waveguide probes. The fabrication of these waveguide probes is realized by using 6” wafer-level micromachining processes, including lithography processes such as spin-coating cladding layers and a waveguide layer in between and etch processes for structuring the waveguide layer. Further adhesion layers and metal layers for laser diode (LD) bonding and light-outcoupling structures are also integrated in this waveguide process flow. Optical microscope and SEM images revealed that the majority of the waveguides are sufficiently smooth to guide light with low intensity loss. By coupling light into the waveguides and detecting the outcoupled light from the waveguide, we distinguished intensity losses caused by bending the waveguide and outcoupling. The probes were used in first modules called single-beam guides (SBGs) based on a waveguide probe, a ball lens and an LD. Finally, these SBGs were tested in animal models for proof-of-concept implantation experiments

Genetic influences on muscle strength, lean body mass, and bone mineral density: a twin study.

Lean body mass and muscle strength are both associated with bone mineral density (BMD), which is known to be under strong genetic control. In this classical twin study, we examine the size of the genetic component of both muscle strength and lean body mass and to what degree they account for the genetic component of BMD. In all, 706 postmenopausal women were examined; 227 pairs of monozygous (MZ) twins and 126 pairs of dizygous (DZ) twins. Grip strength was measured using a hand-help grip bulb and leg strength using a dynamic leg extensor power rig. Lean body mass and BMD at multiple sites were measured by dual-energy X-ray absorptiometry. BMD correlated with both leg extensor strength (r = 0.16-0.26) and grip strength (r = 0.12-0.21). Lean mass was significantly correlated with BMD at all sites (r = 0.20-0.39). All three muscle variables have a moderate genetic component with heritability estimates of 0.52 for lean body mass, 0.46 for leg extensor strength, and 0.30 for grip strength (all p < 0.05). The genetic component of BMD was not significantly reduced after adjusting for lean mass and muscle strength, with less than 20% of the genetic variance of BMD explained by the muscle variables. In conclusion, these data suggest that the three muscle variables have a modest genetic component, suggesting the potential for clinical intervention and lifestyle modifications. The genetic component to muscle bulk and strength accounts for little of the genetic component to BMD, confirming the rationale for research into bone-specific genes