Evaluation of epidemiological and clinical factors in survival of patients with de novo myelodysplastic syndrome at the University of Texas MD Anderson cancer center

Little is known about epidemiological markers that are associated with survival of patients with myelodysplastic syndromes (MDS). We conducted a secondary case-based analysis of 465 de novo MDS patients from the University of Texas MD Anderson Cancer Center (UTMDACC). We investigated the association between demographic as well as occupational exposure markers and survival while incorporating known clinical markers of prognosis. In our patient population, 60.6% were men and the majority were white (93.1%). The distribution of MDS subtypes by the French–American–British (FAB) classification was 81 (19%) refractory anemia (RA), 46 (9.9%) refractory anemia with ringed sideroblasts (RARS), 57 (12.3%) chronic myelomonocytic leukemia (CMML), 173 (37.2%) RA with excess blasts (RAEB), and 86 (18.5%) RAEB in transformation (RAEBT). We found that those older at diagnosis (> 60 years of age) (HR = 1.68, CI = 1.26-2.25) were at a higher risk of dying compared to younger patients. Similarly, high pack years of smoking (>= 30 pack years of smoking) (HR = 1.34, CI = 1.02-1.74), and agricultural chemical exposure (HR = 1.61, CI = 1.05-2.46) were significantly associated with overall lower survival when compared to patients with none or medium exposures. Among clinical markers, greater than 5% bone marrow blasts (HR = 1.81 CI = 1.27-2.56), poor cytogenetics (HR = 3.20, CI = 2.37-4.33)), and platelet cytopenias (<100000/ul) (HR = 1.46, CI = 1.11-1.92) were also significantly associated with overall MDS survival.^ The identification of epidemiological markers could help physicians stratify patients and customize treatment strategies to improve the outcome of MDS based on patient lifestyle information such as smoking exposure and agrochemical exposure. We hope that this study highlights the impact of these exposures in MDS prognosis.^

CONSCIÊNCIA SANITÁRIA: UMA QUESTÃO DE COMUNICAÇÃO E SAÚDE: Um estudo sobre a Vigilância Sanitária de Vitória

O trabalho é um estudo de caso baseado na aná lise crítica do processo de comunicação utilizado pela Vigilância Sanitária de Vitória, ES no desenvolvimento de suas funções e no cumprimento de sua missão de prevenção, proteção e recuperação da saúde da população. Através da aplicação de questionários estruturados com perguntas abertas, semi-abertas e fechadas com funcionários do setor e com uma amostra extraída da lista de contribuintes que receberam o alvará sanitário em 2003 confeccionamos um diagnóstico dos problemas comunicacionais existentes e sugerimos mudanças possíveis. Optamos ter como referencial teórico além da teoria crítica, pesquisas realizadas pelo grupo de pensadores Comunicacionais Latino Americanos porque seus trabalhos se aproximam mais da realidade brasileira. Os resultados obtidos elucidam que a comunicação para a saúde ainda não recebe o reconhecimento necessário nas atividades diárias que visam a saúde coletiva, no caso de Vitória. Confirmamos com a pesquisa a hipótese de que as ações da Vigilância Sanitária não se concretizam sem comunicação eficiente e que muito pode ser feito para melhorar o serviço oferecido se os problemas comunicacionais forem sanados.

CONSCIÊNCIA SANITÁRIA: UMA QUESTÃO DE COMUNICAÇÃO E SAÚDE: Um estudo sobre a Vigilância Sanitária de Vitória

O trabalho é um estudo de caso baseado na aná lise crítica do processo de comunicação utilizado pela Vigilância Sanitária de Vitória, ES no desenvolvimento de suas funções e no cumprimento de sua missão de prevenção, proteção e recuperação da saúde da população. Através da aplicação de questionários estruturados com perguntas abertas, semi-abertas e fechadas com funcionários do setor e com uma amostra extraída da lista de contribuintes que receberam o alvará sanitário em 2003 confeccionamos um diagnóstico dos problemas comunicacionais existentes e sugerimos mudanças possíveis. Optamos ter como referencial teórico além da teoria crítica, pesquisas realizadas pelo grupo de pensadores Comunicacionais Latino Americanos porque seus trabalhos se aproximam mais da realidade brasileira. Os resultados obtidos elucidam que a comunicação para a saúde ainda não recebe o reconhecimento necessário nas atividades diárias que visam a saúde coletiva, no caso de Vitória. Confirmamos com a pesquisa a hipótese de que as ações da Vigilância Sanitária não se concretizam sem comunicação eficiente e que muito pode ser feito para melhorar o serviço oferecido se os problemas comunicacionais forem sanados.

Social Network Analysis and Qualitative Comparative Analysis: Their mutual benefit for the explanation of policy network structures

By switching the level of analysis and aggregating data from the micro-level of individual cases to the macro-level, quantitative data can be analysed within a more case-based approach. This paper presents such an approach in two steps: In a first step, it discusses the combination of Social Network Analysis (SNA) and Qualitative Comparative Analysis (QCA) in a sequential mixed-methods research design. In such a design, quantitative social network data on individual cases and their relations at the micro-level are used to describe the structure of the network that these cases constitute at the macro-level. Different network structures can then be compared by QCA. This strategy allows adding an element of potential causal explanation to SNA, while SNA-indicators allow for a systematic description of the cases to be compared by QCA. Because mixing methods can be a promising, but also a risky endeavour, the methodological part also discusses the possibility that underlying assumptions of both methods could clash. In a second step, the research design presented beforehand is applied to an empirical study of policy network structures in Swiss politics. Through a comparison of 11 policy networks, causal paths that lead to a conflictual or consensual policy network structure are identified and discussed. The analysis reveals that different theoretical factors matter and that multiple conjunctural causation is at work. Based on both the methodological discussion and the empirical application, it appears that a combination of SNA and QCA can represent a helpful methodological design for social science research and a possibility of using quantitative data with a more case-based approach.

Mechanics of raceway hysteresis in a packed bed

When a gas is introduced at high velocity through a nozzle into a packed bed, it creates a raceway in the packed bed. It has been found that the raceway size is larger when it is formed by decreasing the gas velocity from its highest value than when it is formed by increasing the gas velocity. This phenomenon is known as raceway hysteresis. A hypothesis has been oroposed to explain the hysteresis phenomenon based on a force-balance approach which includes frictional, bed-weight, and pressure forces. According to this hypothesis, the frictional force acts in different directions when the raceway is expanding and contracting. In this article, the entire packed bed has been divided into radial and Cartesian co-ordinate systems, and the forces acting on the raceway have been solved analytically for a simplified one-dimensional case. Based on the force-balance approach, a general equation has been obtained to predict the diameter of the raceway for increasing And decreasing velocities. A reasonable agreement has been found between the theoretical predictions and experimental observations. The model has also been compared with published experimental and plant data. The hysteresis mechanism in the packed beds can be described reasonably by taking into consideration the direction of frictional forces for the increasing- and decreasin-velocity cases. The effects of the particleshape factor and void fraction on the raceway hysteresis are examined.

CONSCIÊNCIA SANITÁRIA: UMA QUESTÃO DE COMUNICAÇÃO E SAÚDE Um estudo sobre a Vigilância Sanitária de Vitória

O trabalho é um estudo de caso baseado na aná lise crítica do processo de comunicação utilizado pela Vigilância Sanitária de Vitória, ES no desenvolvimento de suas funções e no cumprimento de sua missão de prevenção, proteção e recuperação da saúde da população. Através da aplicação de questionários estruturados com perguntas abertas, semi-abertas e fechadas com funcionários do setor e com uma amostra extraída da lista de contribuintes que receberam o alvará sanitário em 2003 confeccionamos um diagnóstico dos problemas comunicacionais existentes e sugerimos mudanças possíveis. Optamos ter como referencial teórico além da teoria crítica, pesquisas realizadas pelo grupo de pensadores Comunicacionais Latino Americanos porque seus trabalhos se aproximam mais da realidade brasileira. Os resultados obtidos elucidam que a comunicação para a saúde ainda não recebe o reconhecimento necessário nas atividades diárias que visam a saúde coletiva, no caso de Vitória. Confirmamos com a pesquisa a hipótese de que as ações da Vigilância Sanitária não se concretizam sem comunicação eficiente e que muito pode ser feito para melhorar o serviço oferecido se os problemas comunicacionais forem sanados.

CONSCIÊNCIA SANITÁRIA: UMA QUESTÃO DE COMUNICAÇÃO E SAÚDE: Um estudo sobre a Vigilância Sanitária de Vitória

O trabalho é um estudo de caso baseado na aná lise crítica do processo de comunicação utilizado pela Vigilância Sanitária de Vitória, ES no desenvolvimento de suas funções e no cumprimento de sua missão de prevenção, proteção e recuperação da saúde da população. Através da aplicação de questionários estruturados com perguntas abertas, semi-abertas e fechadas com funcionários do setor e com uma amostra extraída da lista de contribuintes que receberam o alvará sanitário em 2003 confeccionamos um diagnóstico dos problemas comunicacionais existentes e sugerimos mudanças possíveis. Optamos ter como referencial teórico além da teoria crítica, pesquisas realizadas pelo grupo de pensadores Comunicacionais Latino Americanos porque seus trabalhos se aproximam mais da realidade brasileira. Os resultados obtidos elucidam que a comunicação para a saúde ainda não recebe o reconhecimento necessário nas atividades diárias que visam a saúde coletiva, no caso de Vitória. Confirmamos com a pesquisa a hipótese de que as ações da Vigilância Sanitária não se concretizam sem comunicação eficiente e que muito pode ser feito para melhorar o serviço oferecido se os problemas comunicacionais forem sanados.

Using simulation to assess the introduction of technology in a continuous operations process

Purpose – To investigate the role of simulation in the introduction of technology in a continuous operations process. Design/methodology/approach – A case-based research method was chosen with the aim to provide an exemplar of practice and test the proposition that the use of simulation can improve the implementation and running of conveyor systems in continuous process facilities. Findings – The research determines the optimum rate of re-introduction of inventory to a conveyor system generated during a breakdown event. Research limitations/implications – More case studies are required demonstrating the operational and strategic benefits that can be gained by using simulation to assess technology in organisations. Practical implications – A practical outcome of the study was the implementation of a policy for the manual re-introduction of inventory on a conveyor line after a breakdown event had occurred. Originality/value – The paper presents a novel example of the use of simulation to estimate the re-introduction rate of inventory after a breakdown event on a conveyor line. The paper highlights how by addressing this operational issue, ahead of implementation, the likelihood of the success of the strategic decision to acquire the technology can be improved.

Modelling the relationship between local logistics management decisions and overall supply chain performance:A research agenda

Supply chains are advocated widely as being the new units for commercial competition and developments have made the sharing of supply chain wide information increasingly common. Most organisations however still make operational decisions intended to maximise local organisational performance. With improved information sharing a holistic focus for operational decisions should now be possible. The development of a pan supply chain performance framework requires an examination of the conditions under which holistic-decisions provide benefits to either the individual enterprise or the complete supply chain. This paper presents the background and supporting methodology for a study of the impact of an overall supply chain performance metric framework upon local logistics decisions and the conditions under which such a framework would improve overall supply chain performance. The methodology concludes a simulation approach using a functionally extended Gensym's e-SCOR model, together with case based triangulation, to be optimum. Copyright © 2007 Inderscience Enterprises Ltd.

Development of an e-business selection framework for manufacturing SMEs : a study of the printing industry

The aim of the research is to develop an e-business selection framework for small and medium enterprises (SMEs) by integrating established techniques in planning. The research is case based, comprising four case studies carried out in the printing industry for the purpose of evaluating the framework. Two of the companies are from Singapore, while the other two are from Guangzhou, China and Jinan, China respectively. To determine the need of an e-business selection framework for SMEs, extensive literature reviews were carried out in the area of e-business, business planning frameworks, SMEs and the printing industry. An e-business selection framework is then proposed by integrating the three established techniques of the Balanced Scorecard (BSC), Value Chain Analysis (VCA) and Quality Function Deployment (QFD). The newly developed selection framework is pilot tested using a published case study before actual evaluation is carried out in four case study companies. The case study methodology was chosen because of its ability to integrate diverse data collection techniques required to generate the BSC, VCA and QFD for the selection framework. The findings of the case studies revealed that the three techniques of BSC, VCA and QFD can be integrated seamlessly to complement on each other’s strengths in e-business planning. The eight-step methodology of the selection framework can provide SMEs with a step-by-step approach to e-business through structured planning. Also, the project has also provided better understanding and deeper insights into SMEs in the printing industry.

Internal service quality and its impact on external service quality:a study of the role of internal customer types and the dimensions which are used to assess internal suppliers within an organisation and how this affects external service quality

This research explores the role of internal customers in the delivery of external service quality. It will consider any potentially different internal customer types that may exist within the organisation. Additionally, it will explore any potential differences in the dimensions that are used to measure service quality internally and externally. If there are different internal customer types then there may be different dimensions which are used to measure service quality between these types and this will be considered also. The approach adopted given the depth and breadth of understanding required, was an action research case based approach. The research objectives were:(i) To determine the dimensions of internal service quality between internal customer supplier cells. (ii) To determine what variation, if any, there is in the dimension sets between internal customer supplier cells. (iii) To determine any ranking in the dimensions that could exist by internal customer supplier cell type. (iv) To investigate the impact of internal service quality on external service quality over time. The research findings were: (i) The majority of the dimensions used in measuring external service quality were also used internally. There were additions of new dimensions however and some dimensions which were used externally, for internal use, had to be redefined. (ii) Variation in dimension sets were revealed during the research. Four different dimension sets were identified and these were matched with four different types of internal service interaction. (iii) Differences in the ranking of dimensions within each dimension set for each internal customer supplier cell type were confirmed. (iv) Internal service quality was seen to influence external service quality but at a cellular level rather than company level. At the company level, the average internal service quality at the start and finish of the research showed no improvement but external service quality had improved. Further investigation at the cellular level showed that improvements in internal service quality had occurred. Those improvements were found to be with the cells that were closest to the customer.The research implications were found to be: (i) some cells may not be necessary in the delivery of external service quality. (ii) The immediacy of the cell to the external customer and number of interactions into and out of that cell has the greatest effect on external customer satisfaction. (iii) Internal service quality may be driven by the customer affecting those cells at the front end of the business first. This then cascades back to those cells which are less immediate until ultimately the whole organisation shows improvements in internal service quality.

Improving “last mile” delivery performance to retailers in hub and spoke distribution systems

Purpose – The purpose of this paper is to investigate the “last mile” delivery link between a hub and spoke distribution system and its customers. The proportion of retail, as opposed to non-retail (trade) customers using this type of distribution system has been growing in the UK. The paper shows the applicability of simulation to demonstrate changes in overall delivery policy to these customers. Design/methodology/approach – A case-based research method was chosen with the aim to provide an exemplar of practice and test the proposition that simulation can be used as a tool to investigate changes in delivery policy. Findings – The results indicate the potential improvement in delivery performance, specifically in meeting timed delivery performance, that could be made by having separate retail and non-retail delivery runs from the spoke terminal to the customer. Research limitations/implications – The simulation study does not attempt to generate a vehicle routing schedule but demonstrates the effects of a change on delivery performance when comparing delivery policies. Practical implications – Scheduling and spreadsheet software are widely used and provide useful assistance in the design of delivery runs and the allocation of staff to those delivery runs. This paper demonstrates to managers the usefulness of investigating the efficacy of current design rules and presents simulation as a suitable tool for this analysis. Originality/value – A simulation model is used in a novel application to test a change in delivery policy in response to a changing delivery profile of increased retail deliveries.

Servitization of manufacture:exploring the deployment and skills of people critical to the delivery of advanced services

Purpose - This "research note" sets out to fuel the debate around the practices and technologies within operations that are critical to success with servitization. It presents a study of four companies which are delivering advanced services and reports on the organisation and skill-sets of people within these. Design/methodology/approach - This has been case-based research at four manufacturers leading in their delivery of services. Findings - It describes the desirable behaviour of people in the front-line of service delivery, identifies the supporting skill-sets, how these people are organised, and explains why all these factors are so important. Originality/value - This paper contributes to the understanding of the servitization process and, in particular, the implications to broader operations of the firm. © 2013 Emerald Group Publishing Limited. All rights reserved.

Handling varying amounts of missing data when classifying mental-health risk levels

One of the main challenges of classifying clinical data is determining how to handle missing features. Most research favours imputing of missing values or neglecting records that include missing data, both of which can degrade accuracy when missing values exceed a certain level. In this research we propose a methodology to handle data sets with a large percentage of missing values and with high variability in which particular data are missing. Feature selection is effected by picking variables sequentially in order of maximum correlation with the dependent variable and minimum correlation with variables already selected. Classification models are generated individually for each test case based on its particular feature set and the matching data values available in the training population. The method was applied to real patients' anonymous mental-health data where the task was to predict the suicide risk judgement clinicians would give for each patient's data, with eleven possible outcome classes: zero to ten, representing no risk to maximum risk. The results compare favourably with alternative methods and have the advantage of ensuring explanations of risk are based only on the data given, not imputed data. This is important for clinical decision support systems using human expertise for modelling and explaining predictions.

An Intelligent System for Investigations and Provision of Safety for Complex Constructions

Methodology of computer-aided investigation and provision of safety for complex constructions and a prototype of the intelligent applied system, which implements it, are considered. The methodology is determined by the model of the object under scrutiny, by the structure and functions of investigation of safety as well as by a set of research methods. The methods are based on the technologies of object-oriented databases, expert systems and on the mathematical modeling. The intelligent system’s prototype represents component software, which provides for support of decision making in the process of safety investigations and investigation of the cause of failure. Support of decision making is executed by analogy, by determined search for the precedents (cases) with respect to predicted (on the stage of design) and observed (on the stage of exploitation) parameters of the damage, destruction and malfunction of a complex hazardous construction.