A strategic case for e-adoption in healthcare supply chains

A growing body of literature suggests that greater benefits of e-business will be obtained when e-business is integrated throughout a supply chain. However, organizations are still cautious in adopting e-business technologies. This paper examines whether a strategic case for e-commerce can be recognised and the factors that influence e-adoption, using e-business development models, a contingency approach and a stakeholder approach. The paper explores the link of e-commerce with strategy and the potential strategic benefits, risks and problems. This paper analysed e-adoption in four diverse healthcare supply chains in the context of the English National Health Service (NHS). The fieldwork showed there is of limited use of e- in supply chains; there are key problems associated with perceived benefits and costs by different actors both within organisations and within the chain. The paper proposes a framework to link the case for e-commerce with the achievement of strategic objectives across three inter-related domains—health, supply and business.

36 monocyte subpopulations counts and associations with global longitudinal strain in st-elevation myocardial infarction patients with normal ejection fraction

Introduction - Monocytes, with 3 different subsets, are implicated in the initiation and progression of the atherosclerotic plaque contributing to plaque instability and rupture. Mon1 are the “classical” monocytes with inflammatory action, whilst Mon3 are considered reparative with fibroblast deposition ability. The function of the newly described Mon2 subset is yet to be fully described. In PCI era, fewer patients have globally reduced left ventricular ejection fraction post infarction, hence the importance of studying regional wall motion abnormalities and deformation at segmental levels using longitudinal strain. Little is known of the role for the 3 monocyte subpopulations in determining global strain in ST elevation myocardial infarction patients (STEMI). Conclusion In patients with normal or mildly impaired EF post infarction, higher counts of Mon1 and Mon2 are correlated with GLS within 7 days and at 6 months of remodelling post infarction. Adverse clinical outcomes in patients with reduced convalescent GLS were predicted with Mon1 and Mon2 suggestive of an inflammatory role for the newly identified Mon2 subpopulation. These results imply an important role for monocytes in myocardial healing when assessed by subclinical ventricular function indices. Methodology - STEMI patients (n = 101, mean age 64 ± 13 years; 69% male) treated with percutaneous revascularisation were recruited within 24 h post-infarction. Peripheral blood monocyte subpopulations were enumerated and characterised using flow cytometry after staining for CD14, CD16 and CCR2. Phenotypically, monocyte subpopulations are defined as: CD14++CD16-CCR2+ (Mon1), CD14++CD16+CCR2+ (Mon2) and CD14+CD16++CCR2- (Mon3). Phagocytic activity of monocytes was measured using flow cytometry and Ecoli commercial kit. Transthoracic 2D echocardiography was performed within 7 days and at 6 months post infarct to assess global longitudinal strain (GLS) via speckle tracking. MACE was defined as recurrent acute coronary syndrome and death. Results - STEMI patients with EF ≥50% by Simpson’s biplane (n = 52) had GLS assessed. Using multivariate regression analysis higher counts of Mon1 and Mon 2 and phagocytic activity of Mon2 were significantly associated with GLS (after adjusting for age, time to hospital presentation, and peak troponin levels) (Table 1). At 6 months, the convalescent GLS remained associated with higher counts of Mon1, Mon 2. At one year follow up, using multivariate Cox regression analysis, Mon1 and Mon2 counts were an independent predictor of MACE in patients with a reduced GLS (n = 21)

Elevated serum free light chains predict cardiovascular events in type 2 diabetes

OBJECTIVE: Elevated polyclonal serum immunoglobulin free light chains (FLCs; combined FLCκ+FLCλ [cFLC]) are associated with adverse clinical outcomes and increased mortality; we investigated cFLC and cardiovascular disease (CVD) events in type 2 diabetes. RESEARCH DESIGN AND METHODS: In a cohort study of 352 south Asian patients with type 2 diabetes, serum cFLC, high-sensitivity C-reactive protein (hsCRP), and standard biochemistry were measured. CVD events over 2 years were recorded and assessed usingmultiple logistic regression. RESULTS: cFLC levels were elevated significantly in 29 of 352 (8%) patients with CVD events during 2 years of follow-up (50.7 vs. 42.8mg/L; P = 0.004). Inmultivariate analysis, elevated cFLC (>57.2 mg/L) was associated with CVD outcomes (odds ratio 3.3 [95% CI 1.3-8.2]; P = 0.012) and remained significant after adjusting for age, albumin-to-creatinine ratio, diabetes duration, or treatment. CONCLUSIONS: cFLC elevation is a novel marker for CVD outcomes in type 2 diabetes that warrants further investigation. © 2014 by the American Diabetes Association.

Local resources and procurement practices in humanitarian supply chains:an empirical examination of large-scale house reconstruction projects

Different procurement decisions taken by relief organizations can result in considerably different implications in regards to transport, storage, and distribution of humanitarian aid and ultimately can influence the performance of the humanitarian supply chain and the delivery of the humanitarian aid. In this article, we look into what resources are needed and how these resources evolve in the delivery of humanitarian aid. Drawing on the resource-based view of the firm, we develop a framework to categorize the impact of local resources on the configuration of humanitarian supply chains. In contrast to other papers, the importance of localizing the configuration of the humanitarian supply chain is not only conceptually recognized, but empirical investigations are also provided. In terms of methodology, this article is based on the analysis of secondary data from two housing reconstruction projects. Findings indicate that the use of local resources in humanitarian aid has positive effects on programs' overall supply chain performance and these effects are not only related to the macroeconomic perspective, but benefits expand to improvements related to the use of knowledge. At the same time, it was found that local sourcing often comes with a number of problems. For example, in one of the cases, significant problems existed, which were related to the scarcity of local supplies. Both housing reconstruction projects have indicated the continuous need for changes throughout the programs as a dynamic supply chain configuration is important for the long-term sustainability of reconstruction aid. © 2014 Decision Sciences Institute.

Developing a conceptual framework for investigating the resilience of construction SMEs and their supply chains against extreme weather events

Projections into future increasingly suggest that the intensity and frequency of Extreme Weather Events (EWEs) will increase in the future. This has demanded the business organisations as well to be prepared to face the increasing risk of EWEs, in order to ensure their business continuity. However, current evidence base suggests that businesses, especially SMEs, are not adequately prepared to face the threat of such events. Ability to adequately prepare them has been hindered by the lack of in depth studies addressing this issue. The paper presents a doctoral study designed to investigate the resilience of SMEs operating in the construction sector; which is said to be a highly vulnerable sector for the impacts of EWEs, and their supply chains to EWEs. A conceptual framework developed to investigate this issue is presented and explained. It is argued that the resilience of construction SMEs and their supply chains against EWEs can be improved by a combination of reducing their vulnerability, enhancing coping capacity and implementing coping mechanisms. Importance of undertaking a broader view to include the whole supply chain in making business decisions with regard to EWEs by SMEs is also highlighted.

Adoption of e-business solutions in food supply chains

The aim of this chapter is to increase understanding of e-business adoption in the food supply chain. In the first part of the paper an analysis of the concept and the context of e-business are presented along with a classification of the various e-business applications based on the dimensions of involvement and complexity. Next emphasis is given to the issue of e-business adoption. In particular an analysis of the factors that influence the adoption process is provided by exploring the specific characteristics of the food industry as well as the potential impact of the use of e-business solutions. These factors are not only related to the company but also to the supply chain of each company and the actual value of e-business applications. The chapter concludes that in many cases e-business is wrongly considered as a sole application and its adoption as mainly an intra-firm issue. Finally future trends are considered and discussed. © 2010 Woodhead Publishing Limited All rights reserved.

Resource-efficient supply chains:a research framework, literature review and research agenda

Purpose: To define a research agenda for creating Resource-Efficient Supply Chains (RESC) by identifying and analysing their key characteristics as well as future research opportunities. Design/methodology/approach: We follow a systematic review method to analyse the literature and to understand RESC taking a substantive theory approach. Our approach is grounded in a specific domain, the agri-food sector, because it is an intensive user of an extensive range of resources. Findings: The review shows that literature has looked at the use of resources primarily from the environmental impact perspective. It shows a lack of understanding of the specific RESC characteristics, and concludes more research is needed on multi-disciplinary methods for resource use and impact analyses as well as assessment methods for resource sensitivity and responsiveness. There is a need to explore whether or not, and how, logistics/supply chain decisions will affect the overall configuration of future food supply chains in an era of resource scarcity and depletion and what the trade-offs will be. Research limitations/implications: The paper proposes an agenda for future research in the area of resource–efficient supply chain. The framework proposed along with the key characteristics identified for RESC can be applied to other sectors. Practical implications: Our research should facilitate further understanding of the implications and trade-offs of supply chain decisions taken on the use of resources by supply chain managers. Originality/value: The paper explores the interaction between supply chains and natural resources and also defines the key characteristics of RESC.

Consuming linked data in supply chains:enabling data visibility via linked pedigrees

The performance of a supply chain depends critically on the coordinating actions and decisions undertaken by the trading partners. The sharing of product and process information plays a central role in the coordination and is a key driver for the success of the supply chain. In this paper we propose the concept of "Linked pedigrees" - linked datasets, that enable the sharing of traceability information of products as they move along the supply chain. We present a distributed and decentralised, linked data driven architecture that consumes real time supply chain linked data to generate linked pedigrees. We then present a communication protocol to enable the exchange of linked pedigrees among trading partners. We exemplify the utility of linked pedigrees by illustrating examples from the perishable goods logistics supply chain.

A solution for information management in logistics operations of modern manufacturing chains

One dominant feature of the modern manufacturing chains is the movement of goods. Manufacturing companies would remain an unprofitable investment if the supplies/logistics of raw materials, semi-finished products or final goods are not handled in an effective way. Both levels of a modern manufacturing chain-actual production and logistics-are characterized by continuous data creation at a much faster rate than they can be meaningfully analyzed and acted upon manually. Often, instant and reliable decisions need to be taken based on huge, previously inconceivable amounts of heterogeneous, contradictory or incomplete data. The paper will highlight aspects of information flows related to business process data visibility and observability in modern manufacturing networks. An information management platform developed in the framework of the EU FP7 project ADVANCE will be presented.

Enhancing visibility in EPCIS governing agri-food supply chains via linked pedigrees

Data integration for the purposes of tracking, tracing and transparency are important challenges in the agri-food supply chain. The Electronic Product Code Information Services (EPCIS) is an event-oriented GS1 standard that aims to enable tracking and tracing of products through the sharing of event-based datasets that encapsulate the Electronic Product Code (EPC). In this paper, the authors propose a framework that utilises events and EPCs in the generation of "linked pedigrees" - linked datasets that enable the sharing of traceability information about products as they move along the supply chain. The authors exploit two ontology based information models, EEM and CBVVocab within a distributed and decentralised framework that consumes real time EPCIS events as linked data to generate the linked pedigrees. The authors exemplify the usage of linked pedigrees within the fresh fruit and vegetables supply chain in the agri-food sector.

EPCIS Event-Based traceability in pharmaceutical supply chains via automated generation of linked pedigrees

In this paper we show how event processing over semantically annotated streams of events can be exploited, for implementing tracing and tracking of products in supply chains through the automated generation of linked pedigrees. In our abstraction, events are encoded as spatially and temporally oriented named graphs, while linked pedigrees as RDF datasets are their specific compositions. We propose an algorithm that operates over streams of RDF annotated EPCIS events to generate linked pedigrees. We exemplify our approach using the pharmaceuticals supply chain and show how counterfeit detection is an implicit part of our pedigree generation. Our evaluation results show that for fast moving supply chains, smaller window sizes on event streams provide significantly higher efficiency in the generation of pedigrees as well as enable early counterfeit detection.

Monocyte subpopulation counts and associations with left ventricular ejection fraction post ST elevation myocardial infarction

Background: Monocytes are implicated in the initiation and progression of the atherosclerotic plaque contributing to plaque instability and rupture. Little is known about the role of the three phenotypically and functionally different monocyte subpopulations in determining ventricular remodelling following ST elevation myocardial infarction (STEMI). Mon1 are the ‘classical’ monocytes with inflammatory action, whilst Mon3 are considered reparative with fibroblast deposition ability. The function of the newly described Mon2 subset is yet to be fully described. Method: STEMI patients (n=196, mean age 62±13 years; 72% male) treated with percutaneous revascularization were recruited within the first 24 h post-infarction. Peripheral blood monocyte subpopulations were enumerated and characterised using flow cytometry after staining for CD14, CD16 and CCR2. Phenotypically, monocyte subpopulations are defined as: CD14++CD16-CCR2+ (Mon1), CD14++CD16+CCR2+ (Mon2) and CD14+CD16++CCR2- (Mon3) cells. Transthoracic 2D echocardiography was performed within 7 days and at 6 months post infarct to assess ventricular volumes, mass, systolic, and diastolic functions as well as strain and strain rate. Results: Using linear regression analysis higher counts for Mon1, and lower counts for Mon2 and Mon3 were significantly associated with the baseline left ventricular ejection fraction (LVEF) within 7 days post infarct (table 1). At 6 months post STEMI lower counts of Mon2 remained positively associated with a decrease in LVEF at completion of remodelling (p=0.002). Conclusion: Peripheral monocytes of all three subsets correlate with LVEF after a myocardial infarction. High counts of the inflammatory Mon1 are associated with the reduced baseline ejection fraction post infarction. After remodelling, the convalescent ejection fraction was independently predicted by monocyte subpopulation 2. As lower counts depicted negative ventricular remodelling, this suggests a possible myofibroblast deposition and angiogenesis role for the newly described intermediate monocyte subpopulation Mon2 as opposed to the previously anticipated inflammatory role.

OntoPedigree:modelling pedigrees for traceability in supply chains

The sharing of product and process information plays a central role in coordinating supply chains operations and is a key driver for their success. "Linked pedigrees" - linked datasets, that encapsulate event based traceability information of artifacts as they move along the supply chain, provide a scalable mechanism to record and facilitate the sharing of track and trace knowledge among supply chain partners. In this paper we present "OntoPedigree" a content ontology design pattern for the representation of linked pedigrees, that can be specialised and extended to define domain specific traceability ontologies. Events captured within the pedigrees are specified using EPCIS - a GS1 standard for the specification of traceability information within and across enterprises, while certification information is described using PROV - a vocabulary for modelling provenance of resources. We exemplify the utility of OntoPedigree in linked pedigrees generated for supply chains within the perishable goods and pharmaceuticals sectors.