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Summary: Mortality and morbidity for high‐risk surgical patients are often high, especially in low‐resource settings. Enhanced peri‐operative care has the potential to reduce preventable deaths but must be designed to meet local needs. This before‐and‐after cohort study aimed to assess the effectiveness of a postoperative 48‐hour enhanced care pathway for high‐risk surgical patients ('high‐risk surgical bundle') who did not meet the criteria for elective admission to intensive care. The pathway comprised of six elements: risk identification and communication; adoption of a high‐risk post‐anaesthesia care unit discharge checklist; prompt nursing admission to ward; intensification of vital signs monitoring; troponin measurement; and prompt access to medical support if required. The primary outcome was in‐hospital mortality. Data describing 1189 patients from two groups, before and after implementation of the pathway, were compared. The usual care group comprised a retrospective cohort of high‐risk surgical patients between September 2015 and December 2016. The intervention group prospectively included high‐risk surgical patients from February 2019 to March 2020. Unadjusted mortality rate was 10.5% (78/746) for the usual care and 6.3% (28/443) for the intervention group. After adjustment, the intervention effect remained significant (RR 0.46 (95%CI 0.30–0.72). The high‐risk surgical bundle group received more rapid response team calls (24% vs. 12.6%; RR 0.63 [95%CI 0.49–0.80]) and surgical re‐interventions (18.9 vs. 7.5%; RR 0.41 [95%CI 0.30–0.59]). These data suggest that a clinical pathway based on enhanced surveillance for high‐risk surgical patients in a resource‐constrained setting could reduce in‐hospital mortality. [ABSTRACT FROM AUTHOR]

Joining collaborations and maintaining relationships has become a major concern for managers in industrial companies. This change, to a large extent, arises due to the globalization of markets and the ongoing specialization of companies, fostered by the possibilities of information technology and data-communication. However, such a structural change requires adaptations by companies to fit the characteristics of industrial collaborations. In particular, the increasing complexity of collaborations in highly dynamic environments oftentimes is underestimated. This paper demonstrates an approach to cope with this increasing complexity and to find an adequate - not necessarily minimum - level of complexity by the application of principles of complex systems from various sciences to industrial collaborations, considered as socio-technical systems. The industrial relevance of this research approach is illustrated through the example of the tool and die industry. [ABSTRACT FROM AUTHOR]

The implementation of lean thinking in innovation management has not been executed systematically yet. For instance, high uncertainties of processes or limited possibilities for automation in research and development (R&D) indicate special requirements for the implementation of lean thinking. A competitive R&D requires a holistic rethinking for the implementation of lean thinking. The lean innovation system represents the systematic interpretation of lean thinking principles with reference to product or process innovation and development. One core element of lean innovation is the value system, which is the basis for the value stream design in innovation and development projects. The value system defines, structures and prioritizes "values" adaptively for one specific innovation project. The values are defined by all relevant stakeholders in the innovation and development process, like external and internal customers, considering an organization's strategy and culture. It represents the basis for a consequent value-oriented alignment of project and processes in R&D. This paper introduces lean innovation and the core findings of the recent survey "Lean innovation" of the Laboratory for Machine Tools and Production Engineering WZL at RWTH Aachen University. Subsequently, the paper focuses on the value system, describes its elements, and shows how to use and benefit from the value system toward a powerful lean innovation. [ABSTRACT FROM AUTHOR]

Consecutive planning approaches, common in the theory of factory design today, fail to support planning projects in practice. They neglect the interactions and dynamics in the planning task and project as well as the subjectivity introduced by the different stakeholders. Unconsidered interactions, conflicting motives and inflexible project structure lead to time-consuming, expensive and late adaptations. Local optimisation and deviations from the overall objectives are consequences of insufficient synchronisation and coordination. The approach proposed in this paper strives for a paradigm shift from consecutive processes to a modular, parallel approach, which can be reconfigured according to the specific conditions of the planning project and enterprise. This new approach integrates the modularisation and configuration of the planning process as well as aspects of management of instability and second order observation. It has been successfully employed in industry cases, which will be introduced in this paper. [ABSTRACT FROM AUTHOR]

Today’s models in production engineering are mainly based on quasi-stationary design assumptions. With increasing dynamics, models reflecting the nonlinear characteristics of production are becoming increasingly relevant. Several approaches have been formulated to design self-organizing systems, leading to good results with regards to the efficiency in which dynamics are mastered by local interaction of a system’s entities. While in self-organization a system’s characteristics emerge bottom-up, effectiveness is designed into a system by an analytical, top-down design approach. The paper discusses how a target oriented analytical design approach can be combined with the concept of self-organization and shows its application and impact on practical examples. [ABSTRACT FROM AUTHOR]

Shorter delivery times and higher delivery reliability force engineering companies to integrate their order processing with all other business partners. Today's ERP systems do not have the ability to exchange data from one cooperation partner to another in a flexibly automated way. That is why today's inter-company order processing is still done manually by telephone and fax. With a totally integrated order management, there are possible cost savings of up to 50% in order processing. Furthermore, it helps companies to optimize their logistic and delivery processes. myOpenFactory provides an industry wide inter-company order processing technology. The developed IT-platform is founded on service oriented architecture, allowing all platform functions to be executed by the connected ERP systems via web services. The described technical compatibility has been realized in cooperation with a group of leading suppliers of ERP software. Furthermore a standardized data model secures an interface free flow of information. Commercializing the myOpenFactory platform, a new internet business model has been developed - the myOpenFactory cooperative society. [ABSTRACT FROM AUTHOR]

Focuses on the actions taken by the Humphrey Institute at the University of Minnesota in Minneapolis to resolve public policy issues. Perception that public administration centers needed revamping; Sources of income for financial needs of the institute; System used by the institute for attracting most of its outside funds; Overview of the design and operation of the institutions of governance.

This paper investigates the effects of economic integration among Taiwan, Hong Kong and China (CEA). A seven-region, seven-sector computable general equilibrium model for world production and trade is developed for this purpose. The simulation results demonstrate that the three Chinese economies would benefit greatly from further integration by means of liberalizing trade policies. The opportunity cost of isolating the United States from East Asia is high for both the US and the three Chinese economies, suggesting that an economically integrated CEA is in the long-term strategic interest of the United States. [ABSTRACT FROM AUTHOR]

The article presents a study on emission of volatile organic compounds (VOC) from ozone exposed plants. It mentions that the ozone-induced reactions of the ozone-sensitive Bel W3 plants look like the hypersensitive response found after pathogen attack. It highlights that feedback mechanisms in photooxidant formation may be caused by an increased VOC emission as a consequence of elevated ozone concentrations in the troposphere.

Focuses on a study which examined the macroeconomics of the United States agriculture. Changes in the economic environment; Implications of the changes; Details on the emerging institutional challenges.

Answers the comments made on an article about the exchange rate and the United States (U.S.) agriculture. Inaccuracies of the comments; Role of the overvaluation of the dollar in shaping the course of the U.S. agricultural development in the post World War II period; Independent variables included in the study.