An integrated model of supply chain resilience and its impact on supply chain performance under disruption

PurposeThis study aims to explore the relationships among the five components of supply chain (SC) resilience (SCRES): visibility, velocity, flexibility, robustness and collaboration and their impacts on the SC performance under disruption (SCPUD).Design/methodology/approachFive SCRES components are identified from the literature review and data are collected using an web survey from 113 manufacturing companies in Taiwan. The data are analyzed by structured equation modeling with the partial least square solution. Two-stage least-squares (2SLS) regression was used to test the potential endogeneity of SC collaboration (SCC).FindingsThe results reveal that SCC is an exogenous driver of SCRES; it directly affects visibility, velocity, flexibility, robustness and SCPUD. Furthermore, SC flexibility is the only component of SC agility that directly affects SCPUD; it is influenced directly by SC velocity and indirectly by SC visibility through SC velocity. SC visibility is a vital agility component that positively influences SC velocity and SC robustness.Research limitations/implicationsThe data in this study are cross-sectional and the sample size of 113 is relatively small. The relationship between SC robustness and SCPUD needs a longer observation period to reveal. The logistic issue in the shortage of carriers caused by the pandemic has been overlooked.Practical implicationsA firm should enhance its collaboration and flexibility in the SC as they both are the critical antecedents of SC performance (SCP) during the disruption period.Originality/valueThis study integrates visibility, velocity, flexibility, robustness and collaboration into a complete framework of SCRES. The dependent variable, SCPUD, measures SC performance (SCP) under the disruption caused by the COVID-19 pandemic. It is the first study to investigate the associations of the six constructs in a research model.

Silver Jubilee of Stroke Thrombolysis With Alteplase: Evolution of the Therapeutic Window

In 1995, the results of a landmark clinical trial by National Institute of Neurological Disorders and Stroke (NINDS) made a paradigm shift in managing acute cerebral ischemic stroke (AIS) patients at critical care centers. The study demonstrated the efficacy of tissue-type plasminogen activator (tPA), alteplase in improving neurological and functional outcome in AIS patients when administered within 3 h of stroke onset. After about 12 years of efforts and the results of the ECASS-III trial, it was possible to expand the therapeutic window to 4.5 h, which still represents a major logistic issue, depriving many AIS patients from the benefits of tPA therapy. Constant efforts in this regards are directed toward either speeding up the patient recruitment for tPA therapy or expanding the current tPA window. Efficient protocols to reduce the door-to-needle time and advanced technologies like telestroke services and mobile stroke units are being deployed for early management of AIS patients. Studies have demonstrated benefit of thrombolysis guided by perfusion imaging in AIS patients at up to 9 h of stroke onset, signifying “tissue window.” Several promising pharmacological and non-pharmacological approaches are being explored to mitigate the adverse effects of delayed tPA therapy, thus hoping to further expand the current tPA therapeutic window without compromising safety. With accumulation of scientific data, stroke organizations across the world are amending/updating the clinical recommendations of tPA, the only US-FDA approved drug for managing AIS patients. Alteplase has been a part of our neurocritical care and we intend to celebrate its silver jubilee by dedicating this review article discussing its journey so far and possible future evolution.

Resource Allocation Mechanism of Cloud Services in Logistic

Cloud computing has become the essential computer system in internet, but in how to use cloud computing to serve the information transfer in logistics and supply chain in order to enhance the efficiency of management is still an emerging research topic. This study explore the concept of cloud services and cloud computing operations in logistic issue of China, the status quo, and to analyze resources demand, operating environment, means of support and management services in the logistics process. Finally, according to these requirements, we discus the resource distribute mechanism which can enhance the use of cloud services capabilities and better improve the efficiency of logistics operations.

Determination of Thyroid Volume by Ultrasonography among Schoolchildren in Philippines

Objective. Iodine deficiency is defined by the goiter and the urinary iodine concentration. However, a lack of local thyroid volume reference data resulted in the vague definition of goiter, especially in school-aged children. The aim of this paper was to determine the thyroid volumes by ultrasonography in schoolchildren aged 6 to 12 years living in Cagayan areas in Philippine.Methods. Cross-sectional thyroid ultrasonographic data of 158 schoolchildren aged 6–12 years from Tuguegarao and Lagum in Cagayan valley, Philippine were used. Thyroid volumes were compared based on logistic issue and urban and rural area and compared with other previously reported data.Results. The mean values of thyroid volume in Tuguerago and Lagum were2.99±1.34 mL and2.42±0.92 mL. The thyroid size was significantly in association with age (P<0.00), weight (P<0.00), height (P<0.00), and BSA (P<0.00) by Pearson’s correlation. The median thyroid volumes of schoolchildren investigated in this study were generally low compared to international reference data by age group but not by BSA.Conclusions. We propose for the first time local reference ultrasound values for thyroid volumes in 6–12 aged schoolchildren that should be used for monitoring iodine deficiency disorders.

Whole Slide Images and Digital Media in Pathology Education, Testing, and Practice: The Oklahoma Experience

Examination of glass slides is of paramount importance in pathology training. Until the introduction of digitized whole slide images that could be accessed through computer networks, the sharing of pathology slides was a major logistic issue in pathology education and practice. With the help of whole slide images, our department has developed several online pathology education websites. Based on a modular architecture, this program provides online access to whole slide images, still images, case studies, quizzes and didactic text at different levels. Together with traditional lectures and hands-on experiences, it forms the back bone of our histology and pathology education system for residents and medical students. The use of digitized whole slide images has a.lso greatly improved the communication between clinicians and pathologist in our institute.

The CATCH Kids Club: a pilot after-school study for improving elementary students’ nutrition and physical activity

BackgroundAlthough many school-based diet and physical activity interventions have been designed and evaluated, relatively few have been tested for the after-school setting. After-school day-care programmes at either elementary schools or private locations provide a ready-made opportunity for health programmes that may be difficult to incorporate into an already-full school day. The purpose of this paper is to report on a pilot study of an after-school adaptation of the CATCH (Coordinated Approach To Child Health) elementary school programme called the CATCH Kids Club (CKC).MethodsThe CKC was pilot-tested and formatively evaluated in 16 Texas after-school programmes: eight in El Paso and eight in Austin (four intervention and four reference sites each). Evaluation consisted of direct observation of moderate to vigorous physical activity during play time, self-reported food intake and physical activity, and focus group interviews with after-school programme staff.ResultsStudents responded well to the physical activity and snack components and were less interested in the five-module education component. Routine staff training was a key variable in achieving proper implementation; the ideal would be a full day with repeated follow-up model teaching visits. Staff turnover was a logistic issue, as was programme leader readiness and interest in conducting the programme. Strong and significant effects were observed for the physical activity but not for the education component. The results of the physical education component suggest it is feasible, effective and ready for larger-scale evaluation or dissemination.