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An optimization model with a lagrangian relaxation algorithm for artificial internet of things-enabled sustainable circular supply chain networks
No full textCircular supply chain (CSC) networks improve sustainability and create socially responsible enterprises through recycling, harvesting, and refurbishing. This study develops a Lagrangian relaxation (LR) algorithm for solving location-inventory-routing (LIR) problems with heterogeneous vehicles in multi-period and multi-product sustainable CSC networks. The proposed Artificial Internet of Things (AIoT) enabled sustainable CSC is designed to increase network performance and create a secure and traceable environment. For the first time, an LR algorithm is proposed to solve the LIR problems in an AIoT-enabled CSC network with storage, backorder shortage, split-delivery, and time window potentials. Sixteen small- and medium-size simulated problems were produced to assess the performance of the proposed algorithm relative to the GAMS software. The results show the proposed algorithm can solve the small- and medium-size problems as effectively as GAMS software but faster and more efficiently. In addition, eight large-size simulation problems were produced and solved by the algorithm. While the GAMS software failed to solve the large-size problems, the LR algorithm solved them efficiently and successfully
Evidence-Based Educational Modules on the Safe Delivery of Anesthesia in MRI Suites
Full text linkFew citations were located on the formal education on MRI patient safety for anesthesia providers administering anesthesia services in MRI suites. Consequently, patients and staff may be at risk for injury or death during MRI procedures and health care institutions can be threatened with financial loss secondary to legal exposure, equipment damage and resultant morbidity and mortality associated with MRI patient safety events. This doctoral project will create three evidence-based continuing education modules to educate anesthesia providers on the operation of the MRI unit, potential MRI associated risks and complications, and specific anesthesia considerations for providers assigned to the MRI suite for procedural care. Safety threats and injuries are confirmed in the literature and include the creation of projectiles within the MRI suite, patient burns, and death within the MRI unit itself. Integrating the three newly created evidence-based educational modules into health care quality improvement programs and required employee annual training events could improve provider preparedness and patient safety in the MRI suite
A new strategic approach for R&D project portfolio selection using efficiency-uncertainty maps
No full textPurpose: New business practices and the globalization of markets force firms to take innovation as the fundamental pillar of their competitive strategy. Research and Development (R&D) plays a vital role in innovation. As technology advances and product life cycles become shorter, firms rely on R&D as a strategy to invigorate innovation. R&D project portfolio selection is a complex and challenging task. Despite the management\u27s efforts to implement the best project portfolio selection practices, many projects continue to fail or miss their target. The problem is that selecting R&D projects requires a deep understanding of strategic vision and technical capabilities. However, many decision-makers lack technological insight or strategic vision. This article aims to provide a method to capitalize on the expertise of R&D professionals to assist managers in making informed and effective decisions. It also provides a framework for aligning the portfolio of R&D projects with the organizational vision and mission.
Design/methodology/approach: This article proposes a new strategic approach for R&D project portfolio selection using efficiency-uncertainty maps.
Findings: The proposed strategy plane helps decision-makers align R&D project portfolios with their strategies to combine a strategic view and numerical analysis in this research. The proposed strategy plane consists of four areas: Exploitation Zone, Challenge Zone, Desperation Zone and Discretion Zone. Mapping the project into this strategic plane would help decision-makers align their project portfolio according to the corporate perspectives.
Originality/value: The new approach combines the efficiency and uncertainty dimensions in portfolio selection into an integrated framework that: (i) provides a complete representation of the stochastic decision-making processes, (ii) models the endogenous uncertainty inherent in the project selection process and (iii) proposes a computationally practical and visually unique solution procedure for classifying desirable and undesirable R&D projects
A combinatorial data envelopment analysis with uncertain interval data with application to ICT evaluation
No full textInformation and Communication Technologies (ICTs) have been extensively adopted by firms worldwide due to the significant positive effect on their performance. This fact contrasts with the uncertainty faced by decision makers when entering a country and selecting local firms with which to interact. Consider selecting Decision Making Units (DMUs) according to their relative efficiency, this efficiency being determined via Data Envelopment Analysis (DEA) based on the potential inputs consumed and outputs produced. The values of these variables are uncertain and defined through interval evaluations. Assume now that the interactions may be interrupted several times and new DMUs selected in place of previous ones. The new DMUs may require higher or lower amounts of inputs to produce variable amounts of outputs. The consequences derived from the potential realizations resolving the uncertainty should be incorporated into the DEA problem when deciding which DMUs to interact with and in which order. We study the combinatorial decision framework arising from the potential interactions with new DMUs. A numerical example is provided to complement the problem statement and outline the drawbacks of the existing approaches. It is shown that the selected DMUs and their order may differ substantially when accounting for the complementarities existing among all the DMUs. Moreover, the selection process and any subsequent decision vary with the number of modifications considered relative to the DMU initially selected. A case study analyzing the productive and environmental efficiency of a group of European countries displaying uncertain interval levels of ICT development is presented
Mortality and Length of Stay in Patients with COVID-19 on ECMO: A Retrospective Before and After Quality Improvement Study
Full text linkThe use of extracorporeal membrane oxygenation as a supportive modality for patients with COVID-19 pneumonia emerged as the gold standard of care for those who do not respond to traditional therapies. The primary aim of this 10-month, quantitative, retrospective, quality improvement project was to identify if V-V ECMO treatment guidelines, implemented in the treatment of COVID-19 pneumonia, led to decreased mortality rates and lengths of stay. A total of 27 patients met inclusion criteria during queried time frames (n = 14 in Wave 1 and n = 13 in Wave 2). Data collected demonstrated no significant difference (p = .385) in mortality in Wave 1 and Wave 2. Length of stay was significantly longer for Wave 2 (p = .026). Statistically significant differences were identified in four clinical characteristics: inhaled vasodilator utilization (p \u3c .001), remdesivir utilization (p = .004), days to mechanical ventilation (p = .009), and CRRT hours (p = .026). Further research is required to determine if the results of this study are comparable to larger studies with similar treatment guidelines
An Evidence-Based Teaching Plan for Anesthesia Providers on the Patient Safety Aspects and Pharmacoeconomic Advantages Associated with Sugammadex Use
Full text linkAnesthesia providers are often required to administer neuromuscular blockade during surgical procedures to optimize both surgical conditions and allow for mechanical ventilation. Reversal of neuromuscular blockade at the conclusion of surgery assists anesthesia providers in preventing adverse events and optimizing patient safety. Current literature supports the use of sugammadex as the safest neuromuscular blockade reversal agent in many cases, but also shows a lack of provider education regarding its use. The hesitancy of anesthesia providers and medical institutions to utilize sugammadex as a standard of care despite evidence-based literature supporting its regular use implies that there is either a knowledge gap in the anesthesia community or an extrinsic barrier preventing access to sugammadex. The purpose of this DNP project was to assess barriers related to sugammadex use and to create and disseminate an evidence- and theoretically-based teaching plan on the patient safety aspects and pharmacoeconomic advantages of using sugammadex for reversal of neuromuscular blockade.
After a systematized review of the literature was completed, major themes were extracted to create a survey that was then sent to anesthesia experts from three separate healthcare institutions. 17 of 26 experts responded, which was a 65% survey response rate. Survey results indicated that while anesthesia experts acknowledge that sugammadex leads to decreased side effects and increased patient safety, there is a knowledge gap when it comes to the pharmacoeconomic advantages of its use. There are also both extrinsic and intrinsic barriers placed on sugammadex use by anesthesia providers and the institutions in which they work
An Evidence-Based Teaching Plan for Anesthesia Providers on Intraoperative Blood Glucose Monitoring in Diabetic Patients Undergoing Noncardiac Surgery
Full text linkAs the incidence of diabetes continues to rise both locally and nationally, anesthesia providers must be prepared to manage diabetic patients intraoperatively during the administration of anesthesia. Literature suggests that blood glucose levels are not adequately monitored in the operating room, potentially contributing to many postoperative complications. Therefore, this doctoral project aims to develop an evidence-based teaching plan for monitoring intraoperative glucose levels in the diabetic patient population to enhance anesthesia provider knowledge
Dialogue Fearlessly: The Catholic Church’s Theological Key to Fostering and Safeguarding Human Dignity in Our Time
No full textDuring his 2015 Apostolic Visit to the United States, Pope Francis told the bishops that he could never “tire of encouraging [them] to dialogue fearlessly.” The Holy Father’s words reveal the trajectory of development in doctrine from the exclusivist stance of “extra ecclesiam nulla salus” to dialogue and synodality. The study of dialogue is relatively new as a theological discipline. It is a field of study with roots in war and genocide, whose aim is to act as both a salve for past wounds and a prophylactic for future polarization and violence—a way to foster and safeguard human dignity. This project attempts to highlight the historical context and experiences of the (post)-Conciliar popes as spiritual leaders and practical theologians promoting a better understanding of the genesis and development of dialogue ad extra and bringing those lessons to bear fruit ad intra. Additionally, this project’s purpose is to provide insights into specific spiritual habits that are necessary for an authentic approach to dialogue. The research for this project focuses on primary documents from the various popes from Pope John XXIII through Pope Francis, the Second Vatican Council, as well as relevant documents from Vatican dicasteries that shape the Church’s teaching and practice of dialogue. Applying lessons learned in dialogue ad extra to attempts at dialogue ad intra addresses issues of human dignity, religious freedom, and ecclesial life—key areas of tension and polarization today. This project also discusses certain obstacles to the adoption of dialogue as a modus operandi of the Church. Such barriers include the unfamiliarity with the roots and development of dialogue as a theological discipline, a lack of spiritual formation for authentic dialogue, and a fear of the unfamiliar and vulnerability. This dissertation indicates the need for stronger spiritual formation, catechesis, and education regarding the theology and practice of dialogue in service of the synodal Church Pope Francis envisions for the future
From classical interpretive structural modeling to total interpretive structural modeling and beyond: A half-century of business research
No full textDespite the widespread use of interpretive structural modeling (ISM) in business research, little is known about its overall scientific productivity and impact on business research. This study presents a comprehensive review of the published ISM research and its latest editions in business using text mining. A two-tier review (narrative and systematic) is used to examine the methods and provide a comprehensive bibliometric analysis and an application roadmap. We demonstrate the number of ISM publications has been increasing in the past fifteen years, even though ISM was developed half a century ago. The study provides evidence for the increasing impact of ISM research in business. Content analysis shows an increase in the application of an updated edition of ISM, total interpretive structural modeling (TISM). In addition, the overall scientific productivity of ISM and TISM is assessed, and an ISM/TISM method selection roadmap is proposed. We further develop ISM+, a new integrated framework combining ISM and its latest editions to improve its performance and potential applications in business research