4 resultados para BWE
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Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para obtenção do Grau Mestre em Engenharia Civil – Perfil de Construção
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21th Annual Conference of the International Group for Lean Construction (IGLC 21), July 2013, Fortaleza, Brazil
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Our objective was a prospective comparison of MR enteroclysis (MRE) with multidetector spiral-CT enteroclysis (MSCTE). Fifty patients with various suspected small bowel diseases were investigated by MSCTE and MRE. The MSCTE was performed using slices of 2.5 mm, immediately followed by MRE, obtaining T1- and T2-weighted sequences, including gadolinium-enhanced acquisition with fat saturation. Three radiologists independently evaluated MSCTE and MRE searching for 12 pathological signs. Interobserver agreement was calculated. Sensitivities and specificities resulted from comparison with pathological results ( n=29) and patient's clinical evolution ( n=21). Most pathological signs, such as bowel wall thickening (BWT), bowel wall enhancement (BWE) and lymphadenopathy (ADP), showed better interobserver agreement on MSCTE than on MRE (BWT: 0.65 vs 0.48; BWE: 0.51 vs 0.37; ADP: 0.52 vs 0.15). Sensitivity of MSCTE was higher than that of MRE in detecting BWT (88.9 vs 60%), BWE (78.6 vs 55.5%) and ADP (63.8 vs 14.3%). Wilcoxon signed-rank test revealed significantly better sensitivity of MSCTE than that of MRE for each observer ( p=0.028, p=0.046, p=0.028, respectively). Taking the given study design into account, MSCTE provides better sensitivity in detecting lesions of the small bowel than MRE, with higher interobserver agreement.
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This dissertation delivers a framework to diagnose the Bull-Whip Effect (BWE) in supply chains and then identify methods to minimize it. Such a framework is needed because in spite of the significant amount of literature discussing the bull-whip effect, many companies continue to experience the wide variations in demand that are indicative of the bull-whip effect. While the theory and knowledge of the bull-whip effect is well established, there still is the lack of an engineering framework and method to systematically identify the problem, diagnose its causes, and identify remedies. ^ The present work seeks to fill this gap by providing a holistic, systems perspective to bull-whip identification and diagnosis. The framework employs the SCOR reference model to examine the supply chain processes with a baseline measure of demand amplification. Then, research of the supply chain structural and behavioral features is conducted by means of the system dynamics modeling method. ^ The contribution of the diagnostic framework, is called Demand Amplification Protocol (DAMP), relies not only on the improvement of existent methods but also contributes with original developments introduced to accomplish successful diagnosis. DAMP contributes a comprehensive methodology that captures the dynamic complexities of supply chain processes. The method also contributes a BWE measurement method that is suitable for actual supply chains because of its low data requirements, and introduces a BWE scorecard for relating established causes to a central BWE metric. In addition, the dissertation makes a methodological contribution to the analysis of system dynamic models with a technique for statistical screening called SS-Opt, which determines the inputs with the greatest impact on the bull-whip effect by means of perturbation analysis and subsequent multivariate optimization. The dissertation describes the implementation of the DAMP framework in an actual case study that exposes the approach, analysis, results and conclusions. The case study suggests a balanced solution between costs and demand amplification can better serve both firms and supply chain interests. Insights pinpoint to supplier network redesign, postponement in manufacturing operations and collaborative forecasting agreements with main distributors.^