Lean i serviceorganisationer - En fallstudie på Ängelholm Helsingborg Airport

Sammanfattning Titel: Lean i serviceorganisationer - En fallstudie på Ängelholm Helsingborg Airport. Universitet: Lunds Universitet, Campus Helsingborg, Institutionen för Service Management. Kurs: SMKK10 Service Management: Examensarbete för kandidatexamen, 15hp (Lp2, VT12) Löpnummer: 2426 Inlämningsdatum: 15 juni 2012. Författare: Viktor Kristiansson, Johannes Lenander, Martin Lundberg. Handledare: Richard Ek, Mats Johnsson. Nyckelord: Lean, turnaround-processer, kund, servicesektorn, värde. Syfte: Syftet med uppsatsen är att ge ett bidrag till den pågående diskussionen kring det nyanserade begreppet lean inom servicesektorn. Metod: En kvalitativ fallstudie har genomförts på Ängelholm Helsingborg Airport, innehållande semistrukturerade djupintervjuer och systematiska observationer. Slutsatser: Genom fallstudien på Ängelholm Helsingborg Airport har vi kommit fram till att det är svårt att avgöra vem ÄHA:s gemensamma kund är. ÄHA:s två kundgrupper/intressenter, flygbolagen och resenärerna, påverkar på olika sätt förutsättningarna för arbetet med lean. Även arbetsmoment och rutiner som finns på ÄHA är ytterligare en aspekt som kan skapa kundproblematik. Ytterligare en aspekt vi finner genom att sammanfoga Mays (2005) tankar tillsammans med resultatet från Radnors et al. (2012) studier är att fokus bör läggas på hur definitionen av kund kan variera genom värdekedjan. Detta kan vara av större vikt än att definiera en enskild kund. Vi poängterar även vikten av att se ÄHA:s arbete med turnaround-processer utifrån mer mjuka värden, som inriktas på inställningar, värdegrunder och möjliggörare. Dessa kulturella aspekter som inriktar sig på människor och beteenden kan vi se som en positiv förutsättning som ÄHA borde se som en fördel för en implementering av lean. På liknande sätt borde även ÄHA inte stänga ute idéer och tankesätt som kan hämtas i form av inspirationsarbete i samarbete med andra flygplatser. I ÄHA:s fall fastslår vi även att det är svårt att förbättra vissa värdeadderande aktiviteter med hjälp av lean filosofin och dess verktyg eftersom aktiviteterna styrs av externa aktörer

Sparks of Artificial General Intelligence: Early experiments with GPT-4

Artificial intelligence (AI) researchers have been developing and refining large language models (LLMs) that exhibit remarkable capabilities across a variety of domains and tasks, challenging our understanding of learning and cognition. The latest model developed by OpenAI, GPT-4, was trained using an unprecedented scale of compute and data. In this paper, we report on our investigation of an early version of GPT-4, when it was still in active development by OpenAI. We contend that (this early version of) GPT-4 is part of a new cohort of LLMs (along with ChatGPT and Google's PaLM for example) that exhibit more general intelligence than previous AI models. We discuss the rising capabilities and implications of these models. We demonstrate that, beyond its mastery of language, GPT-4 can solve novel and difficult tasks that span mathematics, coding, vision, medicine, law, psychology and more, without needing any special prompting. Moreover, in all of these tasks, GPT-4's performance is strikingly close to human-level performance, and often vastly surpasses prior models such as ChatGPT. Given the breadth and depth of GPT-4's capabilities, we believe that it could reasonably be viewed as an early (yet still incomplete) version of an artificial general intelligence (AGI) system. In our exploration of GPT-4, we put special emphasis on discovering its limitations, and we discuss the challenges ahead for advancing towards deeper and more comprehensive versions of AGI, including the possible need for pursuing a new paradigm that moves beyond next-word prediction. We conclude with reflections on societal influences of the recent technological leap and future research directions

Puerto Rican Karst - A Vital Resource

The limestone region of Puerto Rico covers about 27.5 percent of the island\u27s surface and is subdivided into the northern, southern, and dispersed limestone areas. All limestone areas have karst features. The karst belt is that part of the northern limestone with the most spectacular surficial karst landforms. It covers 142,544 ha or 65 percent of the northern limestone. The karst belt is the focus of this publication, although reference is made to all limestone regions. The northern limestone contains Puerto Rico\u27s most extensive freshwater aquifer, largest continuous expanse of mature forest, and largest coastal wetland, estuary, and underground cave systems. The karst belt is extremely diverse, and its multiple landforms, concentrated in such a small area, make it unique in the world. Puerto Rico\u27s karst forests whether dry, moist, or wet share common physiognomic and structural characteristics. Karst forests contain the largest reported number of tree species per unit area in Puerto Rico. Both fauna and flora are rich in taxa; and many rare, threatened, endangered, and migratory species find refuge in the karst belt. Almost all fossil records of Puerto Rico\u27s extinct flora and fauna come from the karst belt

Educational needs and preferences of young European clinicians and physician researchers working in the field of rheumatology

Funding Information: CB: Grant BE 5191/1-1 of the Deutsche Forschungsgemeinschaft.Objectives: To understand the educational needs and preferences of young clinicians and physician researchers in the field of rheumatology in Europe. Methods: An international online survey was performed as a joint venture of ESCET and EMEUNET. The survey assessed the acceptance of and the access to the current European League Against Rheumatism (EULAR) educational portfolio, as well as the unmet educational needs and learning preferences among individuals below the age of 40 years working in rheumatology in Europe. Results: Among 568 European clinicians and physician researchers, 65% indicated that the existing EULAR educational portfolio adequately covers their educational needs. Within the EULAR portfolio, the online course on rheumatic diseases and the postgraduate course were the most appreciated. Participants were very much in favour of new educational courses on imaging techniques, and 63% of participants indicated a particular interest in musculoskeletal ultrasound. A strong interest in refresher (60%) and general review (55%) courses was observed. Lack of funding was considered the major obstacle to participating in existing EULAR programmes. Finally, participants showed diverse preferences regarding learning modalities with common interests in live courses and conferences. Conclusions: EULAR's training opportunities are well appreciated among young clinicians and physician researchers in rheumatology. The results from this survey will help to develop EULAR's future educational portfolio.publishersversionPeer reviewe

Rheumatology training experience across Europe : Analysis of core competences

Publisher Copyright: © 2016 The Author(s). Copyright: Copyright 2019 Elsevier B.V., All rights reserved.Background: The aim of this project was to analyze and compare the educational experience in rheumatology specialty training programs across European countries, with a focus on self-reported ability. Method: An electronic survey was designed to assess the training experience in terms of self-reported ability, existence of formal education, number of patients managed and assessments performed during rheumatology training in 21 core competences including managing specific diseases, generic competences and procedures. The target population consisted of rheumatology trainees and recently certified rheumatologists across Europe. The relationship between the country of training and the self-reported ability or training methods for each competence was analyzed through linear or logistic regression, as appropriate. Results: In total 1079 questionnaires from 41 countries were gathered. Self-reported ability was high for most competences, range 7.5-9.4 (0-10 scale) for clinical competences, 5.8-9.0 for technical procedures and 7.8-8.9 for generic competences. Competences with lower self-reported ability included managing patients with vasculitis, identifying crystals and performing an ultrasound. Between 53 and 91 % of the trainees received formal education and between 7 and 61 % of the trainees reported limited practical experience (managing ≤10 patients) in each competence. Evaluation of each competence was reported by 29-60 % of the respondents. In adjusted multivariable analysis, the country of training was associated with significant differences in self-reported ability for all individual competences. Conclusion: Even though self-reported ability is generally high, there are significant differences amongst European countries, including differences in the learning structure and assessment of competences. This suggests that educational outcomes may also differ. Efforts to promote European harmonization in rheumatology training should be encouraged and supported.publishersversionPeer reviewe

Is Mn-Bound Substrate Water Protonated in the S2 State of Photosystem II?

In spite of great progress in resolving the geometric structure of the water-splitting Mn4OxCa cluster in photosystem II, the binding sites and modes of the two substrate water molecules are still insufficiently characterized. While time-resolved membrane-inlet mass spectrometry measurements indicate that both substrate water molecules are bound to the oxygen-evolving complex (OEC) in the S2 and S3 states (Hendry and Wydrzynski in Biochemistry 41:13328–13334, 2002), it is not known (1) if they are both Mn-bound, (2) if they are terminal or bridging ligands, and (3) in what protonation state they are bound in the different oxidation states Si (i = 0, 1, 2, 3, 4) of the OEC. By employing 17O hyperfine sublevel correlation (HYSCORE) spectroscopy we recently demonstrated that in the S2 state there is only one (type of) Mn-bound oxygen that is water exchangeable. We therefore tentatively identified this oxygen as one substrate ‘water’ molecule, and on the basis of the finding that it has a hyperfine interaction of about 10 MHz with the electron spin of the Mn4OxCa cluster, we suggest that it is bound as a Mn–O–Mn bridge within a bis-μ2 oxo-bridged unit (Su et al. in J Am Chem Soc 130:786–787, 2008). Employing pulse electron paramagnetic resonance, 1H/2H Mims electron-nuclear double resonance and 2H-HYSCORE spectroscopies together with 1H/2H-exchange here, we test this hypothesis by probing the protonation state of this exchangeable oxygen. We conclude that this oxygen is fully deprotonated. This result is discussed in the light of earlier reports in the literature

Periodontal Ehlers-Danlos Syndrome Is Caused by Mutations in C1R and C1S, which Encode Subcomponents C1r and C1s of Complement

Periodontal Ehlers-Danlos syndrome (pEDS) is an autosomal-dominant disorder characterized by early-onset periodontitis leading to premature loss of teeth, joint hypermobility, and mild skin findings. A locus was mapped to an approximately 5.8 Mb region at 12p13.1 but no candidate gene was identified. In an international consortium we recruited 19 independent families comprising 107 individuals with pEDS to identify the locus, characterize the clinical details in those with defined genetic causes, and try to understand the physiological basis of the condition. In 17 of these families, we identified heterozygous missense or in-frame insertion/deletion mutations in C1R (15 families) or C1S (2 families), contiguous genes in the mapped locus that encode subunits C1r and C1s of the first component of the classical complement pathway. These two proteins form a heterotetramer that then combines with six C1q subunits. Pathogenic variants involve the subunit interfaces or inter-domain hinges of C1r and C1s and are associated with intracellular retention and mild endoplasmic reticulum enlargement. Clinical features of affected individuals in these families include rapidly progressing periodontitis with onset in the teens or childhood, a previously unrecognized lack of attached gingiva, pretibial hyperpigmentation, skin and vascular fragility, easy bruising, and variable musculoskeletal symptoms. Our findings open a connection between the inflammatory classical complement pathway and connective tissue homeostasis

Rheumatoid arthritis - clinical aspects: 134. Predictors of Joint Damage in South Africans with Rheumatoid Arthritis

Background: Rheumatoid arthritis (RA) causes progressive joint damage and functional disability. Studies on factors affecting joint damage as clinical outcome are lacking in Africa. The aim of the present study was to identify predictors of joint damage in adult South Africans with established RA. Methods: A cross-sectional study of 100 black patients with RA of >5 years were assessed for joint damage using a validated clinical method, the RA articular damage (RAAD) score. Potential predictors of joint damage that were documented included socio-demographics, smoking, body mass index (BMI), disease duration, delay in disease modifying antirheumatic drug (DMARD) initiation, global disease activity as measured by the disease activity score (DAS28), erythrocyte sedimentation rate (ESR), C reactive protein (CRP), and autoantibody status. The predictive value of variables was assessed by univariate and stepwise multivariate regression analyses. A p value <0.05 was considered significant. Results: The mean (SD) age was 56 (9.8) years, disease duration 17.5 (8.5) years, educational level 7.5 (3.5) years and DMARD lag was 9 (8.8) years. Female to male ratio was 10:1. The mean (SD) DAS28 was 4.9 (1.5) and total RAAD score was 28.3 (12.8). The mean (SD) BMI was 27.2 kg/m2 (6.2) and 93% of patients were rheumatoid factor (RF) positive. More than 90% of patients received between 2 to 3 DMARDs. Significant univariate predictors of a poor RAAD score were increasing age (p = 0.001), lower education level (p = 0.019), longer disease duration (p < 0.001), longer DMARD lag (p = 0.014), lower BMI (p = 0.025), high RF titre (p < 0.001) and high ESR (p = 0.008). The multivariate regression analysis showed that the only independent significant predictors of a higher mean RAAD score were older age at disease onset (p = 0.04), disease duration (p < 0.001) and RF titre (p < 0.001). There was also a negative association between BMI and the mean total RAAD score (p = 0.049). Conclusions: Patients with longstanding established RA have more severe irreversible joint damage as measured by the clinical RAAD score, contrary to other studies in Africa. This is largely reflected by a delay in the initiation of early effective treatment. Independent of disease duration, older age at disease onset and a higher RF titre are strongly associated with more joint damage. The inverse association between BMI and articular damage in RA has been observed in several studies using radiographic damage scores. The mechanisms underlying this paradoxical association are still widely unknown but adipokines have recently been suggested to play a role. Disclosure statement: C.I. has received a research grant from the Connective Tissue Diseases Research Fund, University of the Witwatersrand. All other authors have declared no conflicts of interes

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements