Determinants of sourcing flexibility and its impact on performance

© 2018 Elsevier B.V. Sourcing flexibility is an increasingly important building block of supply chain flexibility. Our study which is grounded in information processing theory argues that two mechanisms can support firms in building up sourcing flexibility. Based on a survey of 336 manufacturing firms from Europe and the U.S. and using partial least squares (PLS) modeling as well as hierarchical regression analysis, we show that supplier evaluation and selection, and the integration of information systems at the buyer-supplier interface are positively related to sourcing flexibility. Sourcing flexibility, in turn, is curvilinearly related to delivery performance. Finally, delivery performance positively influences the product's financial performance. The strong associations between sourcing flexibility, delivery performance, and product financial performance underscore that sourcing flexibility merits the attention of supply chain managers during supplier selection and purchasing decisions

Clinician-driven artificial intelligence in ophthalmology: resources enabling democratization

PURPOSE OF REVIEW: This article aims to discuss the current state of resources enabling the democratization of artificial intelligence (AI) in ophthalmology. RECENT FINDINGS: Open datasets, efficient labeling techniques, code-free automated machine learning (AutoML) and cloud-based platforms for deployment are resources that enable clinicians with scarce resources to drive their own AI projects. SUMMARY: Clinicians are the use-case experts who are best suited to drive AI projects tackling patient-relevant outcome measures. Taken together, open datasets, efficient labeling techniques, code-free AutoML and cloud platforms break the barriers for clinician-driven AI. As AI becomes increasingly democratized through such tools, clinicians and patients stand to benefit greatly

Transcorneal electrical stimulation for the treatment of retinitis pigmentosa: results from the TESOLAUK trial

OBJECTIVE: To explore the impact of weekly transcorneal electrical stimulation (TES) over a 6-month period as a treatment for retinitis pigmentosa (RP). METHODS AND ANALYSIS: A prospective open-label observational trial was carried out assessing weekly TES in participants with RP for a period of 6 months followed by observation for a further 6 months. Clinical examination and investigations were carried out at 3 monthly intervals for a total of 12 months. The primary outcome measure explored safety through a descriptive analysis of adverse effects with secondary outcome measures evaluating structural and functional efficacy. RESULTS: Seven male and seven female participants with RP aged 18-80 years were recruited. TES was well tolerated with no serious adverse events reported. Two participants reported transient foreign body sensation and one participant had discomfort underneath the skin electrode. Following 6 months of TES, best-corrected visual acuity increased by 1.1±1.4 letters in the control arm and 0.93±1.4 letters in the treated arm. Central microperimetry threshold sensitivity rose by 0.02±0.5 decibels (dB) and 0.37±0.4 dB and Goldmann visual field volume by 0.16±0.09 steradians (sr) vs 0.22±0.12 sr for the control and treated eye, respectively. There was no statistical significance seen between eyes following the treatment or observation period. CONCLUSION:: This small open-label clinical trial showed that TES was safe and well tolerated in patients with RP. Visual function measurements at 6 months demonstrated no significant difference between the control and treated eyes. The results justify a larger clinical trial over a longer period of time in order to identify any treatment effect

"A contradiction between our state and the tobacco company":Conflicts of interest and institutional constraints as barriers to implementation of Article 5.3 in Bangladesh.

INTRODUCTION: Bangladesh has not yet adopted measures to implement Article 5.3 of the WHO Framework Convention on Tobacco Control. The National Tobacco Control Cell (NTCC) has drafted a guideline for implementation, but progress has stalled amid high levels of tobacco industry interference in public policy. This paper examines the barriers to minimising industry interference in a context of close relationships between government officials and tobacco companies. METHODS: In-depth interviews were conducted with government officials, representatives from civil society, think tank and media organisations, and academic researchers. The data were analysed using a ‘3 Is’ framework developed within the political sciences, emphasising the interactive role of ideas, interests and institutions in policy change. RESULTS: The findings indicate that policy ideas about protecting public health policy making from tobacco industry interests are largely restricted to the Ministry of Health and Family Welfare, and the NTCC specifically. Both individual and institutional conflicts of interest emerge as key barriers to progress to minimising industry interference and for tobacco control governance more broadly. The data also suggest that development of an Article 5.3 guideline has been shaped by the perceived interests of political actors and institutions, and the institutional position of the NTCC, constrained by limits on its resources, authority and isolation from other ministries. CONCLUSION: NTCC’s initiatives towards implementing Article 5.3 constitute an important opportunity to address conflicts of interest that restrict tobacco control in Bangladesh. Progress in minimising industry interference is essential to realising the commitment to being smoke free by 2040

Association of Over-The-Counter Pharmaceutical Sales with Influenza-Like-Illnesses to Patient Volume in an Urgent Care Setting

We studied the association between OTC pharmaceutical sales and volume of patients with influenza-like-illnesses (ILI) at an urgent care center over one year. OTC pharmaceutical sales explain 36% of the variance in the patient volume, and each standard deviation increase is associated with 4.7 more patient visits to the urgent care center (p<0.0001). Cross-correlation function analysis demonstrated that OTC pharmaceutical sales are significantly associated with patient volume during non-flu season (p<0.0001), but only the sales of cough and cold (p<0.0001) and thermometer (p<0.0001) categories were significant during flu season with a lag of two and one days, respectively. Our study is the first study to demonstrate and measure the relationship between OTC pharmaceutical sales and urgent care center patient volume, and presents strong evidence that OTC sales predict urgent care center patient volume year round. © 2013 Liu et al

EuroSL – a European taxonomic backbone for vegetation databases and other taxon- related databases: version 1.0

Background: A taxonomic reference list is an indispensable tool to sample, manage and match biodiversity data from different sources. Merging vegetation databases or combining them with taxon-related attributes needs reliable and consistent information about the taxon concepts used and an appropriate naming. Aim: Creating a “taxonomic backbone” of European vascular plants and bryophytes with links to widespread taxonomic references. Methods: We used the Euro+Med plant list (Euro+Med 2006ff), version 2015/04. For all families not yet covered there we used taxa from Flora Europaea (Tutin et al. 1980ff). Additionally we included the aggregates from the Ehrendorfer (1973) list. For bryophytes we rely on Grolle & Long (2000) and Hill et al. (2006). Results: EuroSL 1.0 covers > 45T accepted taxa and >77T synonyms from approx. 370 families. At the species level this means approx. 32T accepted names and >44T synonyms. EuroSL list will be published open access to allow referencing and connecting taxon-related databases beyond country borders. Future releases of EuroSL might contain additional taxonomic groups (algae and lichens), aggregates or new names as needed. However, a thorough documentation and transparency regarding taxon concepts, i.e. name usage = taxon circumscription, given by citing the source lists, will remain the highest priority. The first application of EuroSL will be the compilation of Ecological Indicator Values for Europe (EIVE version 1.0)

Serum sclerostin is associated with recurrent kidney stone formation independent of hypercalciuria

Kidney stones are frequent in industrialized countries with a lifetime risk of 10 to 15%. A high percentage of individuals experience recurrence. Calcium-containing stones account for more than 80% of kidney stones. Diet, environmental factors, behavior, and genetic variants contribute to the development of kidney stones. Osteocytes excrete the 21 kDa glycoprotein sclerostin, which inhibits bone formation by osteoblasts. Animal data suggests that sclerostin might directly or indirectly regulate calcium excretion via the kidney. As hypercalciuria is one of the most relevant risk factors for kidney stones, sclerostin might possess pathogenic relevance in nephrolithiasis. We performed a prospective cross-sectional observational controlled study in 150 recurrent kidney stone formers (rKSF) to analyse the association of sclerostin with known stone risk factors and important modulators of calcium-phosphate metabolism. Serum sclerostin levels were determined at the first visit. As controls, we used 388 non-stone formers from a large Swiss epidemiological cohort. Sclerostin was mildly increased in rKSF in comparison to controls. This finding was more pronounced in women compared to men. Logistic regression indicated an association of serum sclerostin with rKSF status. In hypercalciuric individuals, sclerostin levels were not different from normocalciuric patients. In Spearman correlation analysis we found a positive correlation between sclerostin, age, and BMI and a negative correlation with eGFR. There was a weak correlation with iPTH and intact FGF 23. In contrast, serum sclerostin levels were not associated with 25-OH Vitamin D3, 1,25-dihydroxy-Vitamin D3, urinary calcium and phosphate or other urinary lithogenic risk factors. This is the first prospective controlled study investigating serum sclerostin in rKSF. Sclerostin levels were increased in rKSF independent of hypercalciuria and significantly associated with the status as rKSF. It appears that mechanisms other than hypercalciuria may be involved and thus further studies are required to elucidate underlying pathways

Histopathological and parasitological study of the gastrointestinal tract of dogs naturally infected with Leishmania infantum

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to provide a systematic pathological and parasitological overview of the gastrointestinal tract (GIT), including the stomach, duodenum, jejunum, ileum, caecum and colon, of dogs naturally infected with <it>Leishmania</it>.</p> <p>Methods</p> <p>Twenty mongrel dogs naturally infected with <it>Leishmania (Leishmania) infantum </it>and obtained from the Control Zoonosis Center of the Municipality of Ribeirão das Neves, Belo Horizonte Metropolitan area, Minas Gerais (MG) state, Brazil, were analyzed. The dogs were divided into two groups: Group 1 comprised nine clinically normal dogs and group 2 comprised 11 clinically affected dogs. After necropsy, one sample was collected from each GIT segment, namely the stomach, duodenum, jejunum, ileum, caecum and colon. Furthermore, paraffin-embedded samples were used for histological and parasitological (immunohistochemistry) evaluation and a morphometrical study were carried out to determine the parasite load (immunolabeled amastigote forms of <it>Leishmania</it>). The Friedman and the Mann Whitney tests were used for statistical analysis. The Friedman test was used to analyze each segment of the GIT within each group of dogs and the Mann Whitney test was used to compare the GIT segments between clinically unaffected and affected dogs.</p> <p>Results</p> <p>The infected dogs had an increased number of macrophages, plasma cells and lymphocytes, but lesions were generally mild. Parasite distribution in the GIT was evident in all intestinal segments and layers of the intestinal wall (mucosal, muscular and submucosal) irrespective of the clinical status of the dogs. However, the parasite load was statistically higher in the caecum and colon than in other segments of the GIT.</p> <p>Conclusion</p> <p>The high parasite burden evident throughout the GIT mucosa with only mild pathological alterations led us to consider whether <it>Leishmania </it>gains an advantage from the intestinal immunoregulatory response (immunological tolerance).</p

In vitro binding and survival assays of Leishmania parasites to peripherical blood monocytes and monocyte-derived macrophages isolated from dogs naturally and experimentally infected with Leishmania (Leishmania) chagasi

<p>Abstract</p> <p>Background</p> <p>There are a few works considering the characterization of canine monocyte-derived macrophages as well as a standardized procedure for isolation, culture, and infection of these cells with <it>Leishmania</it>. We have performed several modifications in order to improve the canine monocyte-derived macrophage cultures. In addition, we have done a comparative study between monocytes and monocyte-derived macrophages from dogs naturally and experimentally infected with <it>L. chagasi</it>.</p> <p>Results</p> <p>In the presence of exogenous serum, opsonized <it>Leishmania </it>promastigotes binds better to monocytes/macrophages than without serum. Otherwise, this binding occurs due to the strict correlation between the opsonized biologic particles with the third receptor of the complement (CR3-CD11b/CD18). In fact, our assays with CD11b confirmed the importance of this receptor for canine cells and the <it>L. chagasi </it>experimental system. Moreover, monocytes obtained from naturally infected dogs have shown a higher number of monocytes bounded to promastigotes. The experimental results regarding survival have shown that promastigote forms of opsonized <it>L. chagasi </it>were more infective, because we found higher numbers of promastigotes bound to the different cells. As a consequence, after forty-eight hours of binding, higher numbers of amastigotes appeared inside monocyte-macrophages.</p> <p>Conclusion</p> <p>These studies have given support to continue comparative studies involving canine monocytes, monocyte-derived macrophages and peritoneal macrophages. Since we have standardized the canine cell culture, we are looking forward to determining the phenotypic properties of these cells before and after <it>L. chagasi </it>infection using flow cytometry.</p