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Using data on firm entries into the U.S. market for four product categories, we examine: (1) the complementary impact of marketing and R&D capabilities on firms’ market entry strategies, (i.e., entry timing, product innovativeness, and product line breadth); (2) the extent that entry timing mediates the relationship between marketing-R&D capability complementarity, product line breadth and product innovativeness; and, (3) the effects of the three market entry strategies on firms’ survival in the product categories. We provide three important contributions. First, we clarify the role of entry timing in influencing other market entry imperatives. Second, by providing evidence that both entry timing and product line breadth determine survival duration, we propose that the ‘optimal’ entry time varies along an entry-timing continuum. Third, we provide a more holistic examination of market entry considerations, which reveals the indirect relationship between marketing and R&D capability complementarity and survival through mediated paths.

To determine the benefits and safety of direct trocar insertion versus Veress needle technique in obese women undertaking diagnostic laparoscopy procedures. Randomized-controlled trial on 135 obese women undergoing diagnostic laparoscopy and dye test for infertility was conducted. Women were randomly assigned to either direct trocar access (n = 68) or Veress needle access (n = 67) before achieving pneumoperitoneum. The same surgeon executed the laparoscopic techniques with a single-puncture technique. The primary outcome measures included total length of the procedure and incidence of any complications, while the mean laparoscopic entry time, volume of CO2 required, and total of tries needed to attain successful entry were secondary outcomes. Intention-to-treat principle was applied to analysis. Women in both groups had similar socio-demographic and clinical characteristics and none were lost to follow-up. The overall length of the procedure was significantly lesser in the direct trocar group compared to the Veress needle group (9.9 ± 6.0 vs 16.7 ± 4.7 min; p 0.05). Direct trocar technique may be an effective alternative to Veress needle for pneumoperitoneum in obese women for diagnostic laparoscopy. It has a comparable rapid laparoscopic entry time but a significantly lower duration of the procedure and shorter exposure to anesthesia. Both methods are equally effective as there was no significant difference in the complications recorded. A greater sample trial may be essential for more corroborative substantiation. Clinical trial registration: PACTR201510000999192.

Yellow fever (YF) is an acute infectious disease caused by yellow fever virus (YFV), which is one of the three infectious diseases of international health regulations. We tested people from epidemic areas of Tianjin port in 2014 to investigate the prevalence and distribution characteristics of yellow fever virus antibody. 192 samples were collected and the positive rate of yellow fever virus antibody was 22.92%. The positive rates among different countries, genders, ages, occupations and entry time were calculated and analyzed. There were significant difference in the detection rate of YFV antibody among people with different age groups and occupations. The positive rate of people 40 age and workers engaged in labor were relatively high and had statistical significance compared to other groups.

To determine how frequently the published operating room (OR) schedule of case start times correlated with the actual OR entry time for elective cases in the Fraser Health Authority (FHA) in British Columbia, Canada. Society guidelines recommend periods of fasting of two hours prior to the induction of general anesthesia, but patients frequently end up fasting much longer. This review aimed to determine when patients arrive in the OR—either earlier than their scheduled time or later. The premise of some is that patients often arrive earlier, and advising short fasting times on the basis of the OR slate time is unreliable. I wished to determine whether this fear is justified. The computerized OR management database was queried for slated time of entry and actual time of entry for elective surgical cases in 11 hospitals in the FHA. The difference in slated vs actual entry time of patients (in 30 min blocks) was reviewed to examine the proportion of patients entering the OR earlier than 90 min from their slated time. Additionally, anesthesiologists from the Royal Columbian/Eagle Ridge Hospitals were surveyed for their recall of case delays that were related to inappropriate consumption of fluids. One hundred and twenty-three thousand eight hundred and sixty-five cases from 11 hospitals over a 32-month period were analyzed. A very small proportion of cases (753 of 123,865 cases, 0.6%) entered the OR earlier than 90 min from their slated time. Relatively few cases were actually cancelled because of inappropriate fluid consumption in the recall of anesthesiologists in two institutions. In the FHA, the OR schedule is a reliable guide to providing instructions on timing of preoperative fluid consumption in appropriately selected elective surgical patients. Quality of care and patient satisfaction will safely be enhanced by limiting the period of fasting for elective surgical patients.

Objective: To explore the effect and value of transvaginal ultrasound in screening early ectopic pregnancy. Methods: A total of 146 patients with ectopic pregnancy in our hospital were selected. The patients' entry time was from May 2018 to December 2020. 146 patients were divided into two groups. The control group was screened by abdominal ultrasound with 73 cases, and the experimental group was screened by vaginal ultrasound with 73 cases. The uterine adnexal mass, pelvic effusion, peritoneal effusion and diagnostic accuracy were detected. Results: The positive number of abdominal ultrasound was significantly higher than that of vaginal ultrasound; In the detection process of abdominal ultrasound, 54 cases of ectopic pregnancy, 19 cases of non-ectopic pregnancy, the detection rate was 73.97%, 26 cases of ectopic pregnancy, 47 cases of non-ectopic pregnancy, the detection rate was 32.62%. Conclusion: The accuracy of transvaginal ultrasound is relatively high, and the accuracy of ectopic pregnancy examined by transvaginal ultrasound is higher, which is more friendly to patients, less traumatic and high operability. It can provide more accurate reports for patients and relieve the psychological pressure of patients, which is worthy of application in actual screening.

Keyboard-based emoji entry can be challenging for people with visual impairments: users have to sequentially navigate emoji lists using screen readers to find their desired emojis, which is a slow and tedious process. In this work, we explore the design and benefits of emoji entry with speech input, a popular text entry method among people with visual impairments. After conducting interviews to understand blind or low vision (BLV) users’ current emoji input experiences, we developed Voicemoji, which (1) outputs relevant emojis in response to voice commands, and (2) provides context-sensitive emoji suggestions through speech output. We also conducted a multi-stage evaluation study with six BLV participants from the United States and six BLV participants from China, finding that Voicemoji significantly reduced entry time by 91.2% and was preferred by all participants over the Apple iOS keyboard. Based on our findings, we present Voicemoji as a feasible solution for voice-based emoji entry.

In 2016, the construction of the New Suez Canal was completed, enabling most large-size vessels to pass through and causing more ships to queue into the canal. As the queueing problem at the entrance of the canal was anticipated to be serious, an optimal non-queueing toll scheme was previously established to eliminate the queueing phenomenon at the anchorage of the canal. However, no information about each ship&rsquo, s arrival time adjustment under the optimal non-queueing toll scheme is available from the previous literature. To solve this problem, we derive a series of mathematical formulae for each ship&rsquo, s arrival time, length of queuing time and entry time before, and after, implementing the optimal non-queueing toll scheme. The arrival time adjustments, which enable ships to enter the canal without queueing, could then be obtained. These results enable the Suez Canal authorities to draw up the ship&rsquo, s arrival timetable under the optimal non-queueing toll scheme, so that the captain could follow to enter the canal. The above information that we provide would be conducive to the management decision for the canal authorities to implement such a toll scheme. Once a tolled ship could enter the canal at the scheduled time without queueing, the ship owner could accurately control the sailing schedule, and the use of the ship could be more efficient.

Change of direction (COD) testing has commonly reported a single total time to quantify performance despite that tests are made up of a number of different phases. No investigation into these phases has been completed, therefore the aim of this study was to examine the reliability between sessions and directions of the different phases of a 505 test. Twenty-one male youth athletes performed the 505 test in both directions on three occasions. Differences between directions and sessions were determined via a T-test and Two-way ANOVA respectively and a significance threshold was set at P ≤ 0.05. All strategy variables show acceptable relative and absolute reliability in both directions between sessions (ICC = 0.73–0.94; CV = 2.3–6.3%) apart from ground contact time (GCT) (ICC = 0.57–0.68; CV = 14.8–22.4%). Significant differences were identified between session one and three for entry time. Significant differences between directions for exit time on day two and for full approach, entry and GCT on day three. The non-dominant turning direction showed lower relative and absolute reliability between session for entry time (ICC = 0.73 vs 0.89; CV = 6.3 vs 3.7%) and GCT (ICC = 0.57 vs 0.68; CV = 14.8 vs 22.4%). Results indicate the phases of a 505 COD test have high relative and absolute reliability between sessions, although turning directions should be considered independently.

The use of the entry time, chute score, and exit velocity as tools for the assessment water buffaloes (WB) temperament were used. Seventy-five non-castrated WB (390±32 days of age; 310±61.27 kg of initial body weight) of 3 genetic groups (GG:Jafarabadi, Mediterranean, and Murrah; n = 25 for each GG) were used. The WB arrived at research center (-28d) and were submitted to 28 days of adaptation period to the feedlot facilities, diet, and handling. On day 0, the temperament variables were collected, namely: entry time into squeeze chute (by chronometer); chute score (5-point scale:1=calm animals; 5=very reactive animals); and, exit velocity (by infrared sensors). Subsequently, blood samples were collected from the jugular vein and analyzed for serum levels of cortisol using radioimmunoassay technique; and, rectal temperature was recorded. The individual temperament score (TSc) was calculated averaging entry time score (5-point scale:1=greater time spent, and 5=less time spent), chute score, and exit velocity score (5-point scale:1=lower speed; 5=higher speed). Data were subjected to a stepwise discriminant analysis (SDA) using the STEPDISC procedure in SAS. The value of P < 0.01 was stipulated to consider and include the variable in the model. The respective data of the selected variables were submitted to multivariate analysis of variance using the GLM procedure in SAS. The GG were added to the model to test the possible effect. Correlation analysis was performed using CORR procedure in SAS. The SDA used three steps and selected only the entry time and exit velocity scores (Table 1). Positive correlations were verified between the TSc and cortisol (r=0.37; P = 0.02), and TSc and rectal temperature (r=0.36; P < 0.01). In conclusion, the entry time and exit velocity may be tools for the assessment of water buffalo temperament and their use should be tested in animals of different categories. Supported by FAPESP (#2018/25939-1; #2014/05473-7).

Background and objectives Attentional biases play an important role in the development and maintenance of obsessive-compulsive disorder (OCD). Previous studies using reaction time tasks in OCD have produced inconsistent results. This is the first study to measure attentional biases in patients with several subtypes of OCD using eye tracking. Methods Twenty-eight patients with OCD and 21 healthy controls were assessed using a free-viewing paradigm, incorporating contamination-related, checking-related, and neutral stimuli. Attentional patterns were measured using an eye tracker. A possible vigilance bias was assessed using entry time, and a possible maintenance bias was assessed using dwell time. Results Patients with checking-related symptoms of OCD showed a maintenance bias but no vigilance bias in regard to checking-related compared to neutral stimuli. No differences in attention were found in patients with contamination-related symptoms. Limitations Internal validity is restricted due to a high overlap between subgroups, the lack of negative (not OCD-related) control stimuli, and the absence of a clinical control group. Conclusions Patients with checking-related symptoms of OCD showed a maintenance bias to checking-related stimuli. Due to methodological limitations, the results should be considered preliminary and need to be replicated before firm conclusions can be drawn.

Background and Importance.—Globally, almost one million new cases of stomach cancer were estimated to have occurred in 2012 (952,000 cases, 6.8% of the total), making it the fifth most common malignancy in the world, after lung, breast, colorectal, and prostate. Gastric cancer was the world's third leading cause of cancer mortality in 2012, responsible for 723,000 deaths, 8.8% of total cancer deaths.1 In 2017, 28,000 new cases and 10,960 deaths are estimated for gastric cancer in the United States.2 Estimated United States prevalence counts on January 1, 2014, for patients diagnosed within the previous 5-years was 48,271 (SEER Cancer Statistics Review-2014). Prognostic indices of survival & mortality in patients with gastric cancer are related to tumor stage including nodal involvement, direct tumor extension beyond the gastric wall, and wide-spread dissemination. Tumor histologic grade (degree of loss of cellular differentiation), and oncotype-specific ICD-O-3 phenotypes also provides important prognostic information. By more than 90%, the most common histologic type of stomach cancer is adenocarcinoma. The National Cancer Institute (NCI) ICD-O-3 SEER Site/Histology Validation List catalog (September 18, 2015) enumerates almost 200 subtypes for gastric cancer sites C160-C166, C168-C169. Based on the results of molecular evaluation of 295 primary gastric adenocarcinomas reported to The Cancer Genome Atlas (TCGA) project in 2014, a novel classification separating gastric cancers into four subtypes according to Epstein-Barr virus positive status, microsatellite instability, chromosomal instability, or genomic stability was proposed.3 Of interest, Helicobacter Pylori infection and its role in the development of gastric cancer is not mentioned. All cancer has a genetic basis. However, given the histologic and etiologic heterogeneity of gastric cancer, eventual comprehensive molecular characterization and genomic sequencing with identification of chromosomal aberrations, nucleotide substitutions mortality follow-up study is focused on short- and long-term comparative patient outcomes of stomach adenocarcinoma, ICD-O-3 8140-8147, and other selected gastric cancer oncotypes. Objective.—To update trends in incidence, prevalence, short- and long-term survival, and mortality of gastric cancer using the statistical database of SEER*Stat 8.3.4 for diagnosis years 1973-2014 employing multiple case selection variables. Methods.—A retrospective, population-based study using nationally representative data from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) program to evaluate 157,258 cases for diagnosis years 1973-2014 comparing multiple variables of age, sex, race, stage, grade, cohort entry time-period, disease duration and histologic oncotype: Relative survival statistics were analyzed in two cohorts: 1973-1994 and 1995-2014. Survival statistics were derived from: SEER*Stat Database: Incidence – SEER 9 Regs Research Data, November 2016 Submission (1973-2014) Released April 2017. Results.—By more than 90%, the most common type of stomach cancer is adenocarcinoma. From 1975 to 2014, gastric cancer incidence has been steadily decreasing in the United States at the rate of −1.5% per year. In a total of 157,258 cases of invasive staged cancer of the stomach, mean age in males was 67.5 years, females 69.6 years, both male & female 67.4 years. Greater than 90% of cases occurred between ages 45-85+ years with the zenith in males at 70-74 years (15.1%) and 85+ years in females (17.9%). The overall annual US death rate per 100,000 per year for stomach cancer from 1975 to 2014 has decreased from 5.1 to 3.1, but excess mortality at 0-5 years remains exceedingly high. Mortality is a function of incidence and survival, and unfortunately, almost all of this decrease is due to the decrease in incidence of stomach cancer. Of the 157,258 invasive cases, 86.6% were clinically staged and 76.8% were histologically graded. Conclusions.—Given the histologic and etiologic heterogeneity of gastric cancer, major improvements in mortality and survival outcomes await the development of diagnostic markers for earlier diagnosis, and genomic sequencing and identification of chromosomal aberrations, nucleotide substitutions and epigenetic modifications that drive malignant transformation, for the development of targeted therapies for almost 200 gastric cancer subtypes.

Social hierarchy affects the access of animals to feed resources. On daily rotational pasture systems, supplementation time may influence feeding behavior. This trial was designed to test the effect of grain delivery time on the feeding behavior of heifers. Heifers divided into two groups according to breed (n = 15 Braford and n = 19 Jersey) were tested in a crossover design with two treatments: INITIAL—supplement at 8 am (entry time to a fresh paddock), and MIDDLE—supplement at 4 pm (middle time of paddock use). Animals entered a new paddock every morning, and grain supplement at 2 kg/animal/day was offered at the fence line (1 m/animal). Then, ingestive and other behaviors were registered by direct visual observation through scan sampling at 2-min intervals for 1 h after grain supply. Agonistic interactions were recorded continuously (instigator–victim) to build a social matrix whereby each heifer was defined as dominant, intermediate, or subordinate. Weekly pasture samples were collected according to the order that animals left the feeding area, using the hand-plucking technique, to determine crude protein and fiber content. Heifers spent more time grazing on the INITIAL treatment (p < 0.0001) but exhibited more behaviors on the MIDDLE treatment (p < 0.0001). Dominant heifers spent more time eating grain (p = 0.0008), whereas subordinate heifers spent more time grazing along the paddock (p = 0.0067), but not along the fence (p = 0.0008). The crude protein content of pasture samples was higher for the INITIAL treatment (p < 0.0001). Behavioral interaction occurred with respect to the order of leaving the feeding area, social rank, and crude protein consumed (p = 0.04). Subordinate heifers consistently grazed more and ate less grain supplement than dominant and intermediate heifers. However, when grain supplement was offered at the time animals entered the paddock, more grazing activity took place during supplement feeding, and subordinate heifers could select a high-protein diet. In the INITIAL treatment, this means that subordinate animals could benefit from the better pasture available, keeping a distance from dominant heifers, reducing agonistic interactions and likely improving their welfare.

We study the determinants of firms’ exit from product segments in a technologically dynamic industry to understand whether exit depends on entry timing, the pre-entry experience of entrants, and the presence of a dominant firm in the segment. Relying upon a detailed database of products from the digital audio player industry since its inception, we find that late entry in a product segment is beneficial for a firm's survival. Firms without prior experience in related markets have a higher hazard of exit from a product segment than those having previous experience. However, late entry into a product segment can mitigate this negative effect. We find also that the presence of a dominant firm in a product segment is generally associated with an increase in the hazard of exit for all the firms, but this effect is less evident for the firms that entered before the dominant firm. These results show that in industries with heterogeneous demand and several market segments, delaying entry into a specific segment may represent a successful strategy, especially for those firms that are relatively inexperienced. This strategy, however, can backfire if entry occurs ‘too late’, specifically after the dominant firm has entered the segment.

Background We explored whether a previously successful initiative to improve first-case on-time starts succeeded because (i) preoperative steps started earlier (but the process did not necessarily improve) or (ii) the process was brought into better control. Methods We analysed 35 months of data comprising 28 882 first cases to calculate the difference of the time a patient entered the operating room (OR) vs the scheduled entry time. Median and inter-quartile range were used to evaluate changes in distribution parameters. A statistical process-control methodology was used to compare the differences in performance between the pre- and post-intervention phases. Results Post-intervention first cases entered the OR on average within 4 min [95% confidence interval (CI): 4–5 min] of the scheduled start time, as opposed to within 8 min (95% CI: 8–8 min) in the pre-intervention period. The median delay decreased from 5 min (95% CI: 5–5 min) to 2 min (95% CI: 2–2 min). The inter-quartile range of the difference between the scheduled start time and the first case in room time decreased from 13 min (95% CI: 13–13 min) to 10 min (95% CI: 9–10 min). Conclusions The reduction in inter-quartile range demonstrates that improvement in on-time starts resulted from the process being in better control. The start time of preoperative preparatory activities did not move earlier, which means that OR and preoperative staff do not need to arrive at work earlier. Improvements resulting from the process being in control were sustained.

Background.—The values of SEER site recode variables are based on the primary site and histology data fields submitted to SEER by the registries. The site recode variables define the major cancer site/histology groups that are commonly used in the reporting of cancer incidence data and are added to the SEER databases as a convenience for researchers. These codes and definitions are periodically updated and changed by the National Cancer Institute as newer and more applicable information becomes available. Because this myeloma analysis includes cases diagnosed 2010+, the ICD-O-3 recode-updates with adjustment for WHO 2008 hematopoietic histologies that account for changes in the obsolete classification of hematopoietic histology codes, and the assignment of new names (ie, multiple myeloma-MM – to – plasma cell myeloma-PCM) is adhered to and used here. Plasma cell myeloma (PCM) is a bone-marrow based multifocal plasma cell malignancy (primary site C421). PCM is characterized by a single clone of plasma cells, believed to be derived from lymphoid B cells, and spans a clinical spectrum from asymptomatic to aggressive forms, plus disorders caused by the deposition of abnormal immunoglobulin chains in tissue. The current myeloma group ICD-O-3 histologic morphology types consists of:ICD-O-3 9731: Plasmacytoma, NOS, occurring in bone (osseous plasmacytoma malignancy data reportable to SEER only beginning since 1986);ICD-O-3 9732: Plasma cell myeloma – composed of three clinical variants: a) asymptomatic, b) Non-secretory myeloma, and c) Plasma cell leukemia (all coded to 9732);ICD-O-3 9734: Extramedullary plasmacytoma; anatomic sites other than bone. Objective.—Using the statistical database of SEER*Stat 8.3.4 (produced 4/14/2017 for diagnosis years 1973-2014), to assess, determine, compare, and summarize the occurrence, long-term survival and mortality indices of the three morphologic types of myeloma by age, sex, race and stage in two-cohort entry time-periods (1973-1994 and 1995-2014). All analyses are accomplished within the context of current SEER Site Recode ICD-O-3 (1/27/2003) definitions, terminologies and descriptions, and also in accordance with the rules of the consolidated Hematopoietic and Lymphoid Neoplasm Coding Manual data base (effective 1/1/2010 – release date January 2015). Methods.—Population data including 111,041 cases collected by the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Frequency Database (18 SEER Registries Research Data + Hurricane Katrina Impacted Louisiana Cases, November 2016 Submission, 1973-2014 varying) for diagnosis years 1973-2014: Relative Survival Statistics were analyzed in two cohorts: 1973-1994 and 1995-2014. Survival statistics were derived from: SEER*Stat Database: Incidence – SEER 9 Regs Research Data, November 2016 Submission (1973-2014) Released April 2017. Results.—Tables 1-3 provide basic SEER comparative survival and mortality data of the three myeloma oncotypes by age, sex, stage and disease duration of patients in the 1973-2014 time-period. Epidemiologic, demographic, and case statistics data extracted from the most current NCI Cancer Statistics Review (CSR 2010-2014) are included. Conclusions.—Recent SEER age-adjusted incidence trends, 2011-2014, for all races has been downward, with an annual percentage change (APC) of -2.5% per year. Mean age in plasma cell myeloma (PCM) patients was about 1-year less in males (67.8 yrs) than in females (69.2 yrs). PCM is accompanied by a very high excess mortality and much reduced 5-year relative survival ratio especially in older age groups. Generally, first year excess death rates (EDRs) decreased with duration but increased with advancing entry age, and there was no sex difference. First year EDRs in blacks, all ages combined, was quite high but lower than EDRs in whites. Median survival, actual survival and 5-year relative survival ratios diminished precipitously to extremely low levels with increasing entry age attesting to the lethal character of this disease especially in older patients.

The importance of severe accident management is being re-examined because severe accident management failed during the Fukushima nuclear accident. Having an accurate estimation of a severe accident is important for coping properly with unfavorable conditions. In this study, the extended group method of data handling (GMDH) with a fuzzy concept is proposed as a means of predicting the major severe accident events that represent the severe accident management guideline (SAMG) entry time, including the time at which the reactor vessel (RV) water level decreases, the time when the core exit temperature (CET) reaches 450 degrees-centigrade, the time when the hydrogen concentration in the containment is over 4%, and the time when the reactor coolant system (RCS) pressure is over 2.86 MPa under loss of coolant accidents (LOCAs) in pressurized water reactors (PWRs). To train the extended GMDH model, it was necessary to acquire the data needed from a number of numerical simulations due to the lack of actual LOCA data. The data was obtained by carrying out simulations using the MAAP5 code. To optimize the developed model, the optimal input selection processes were performed using the clustering analysis including self-organizing feature map (SOFM), hierarchical and non-hierarchical clustering methods. The prediction accuracy of the three types of initiating accident, small break (SB), medium break (MB), and large break (LB) LOCAs, was high enough to predict the SAMG entry time. When compared with other artificial intelligence (AI) methods, the extended GMDH was found to be superior to the original GMDH and support vector regression (SVR). Therefore, it is expected that the extended GMDH model will help operators to properly mitigate severe accidents in PWRs.

In this paper a porous flow approach on a cul de sac is proposed to understand the dynamics of crowd at ghat regions (banks of the sacred river) in mass religious gatherings. Kumbh Mela, one of the mankind's largest religious gathering encompassing almost all possible crowd scenarios, provides a unique opportunity to explore the crowd dynamics along all facets. Here, Cul-de-sac refers to the ghat region where people gather with the intention to take holy dip. The data used for this study was collected during Kumbh Mela held during 22nd April to 21st May 2016. Visual observations from the video data shows a high degree of complexity probably due to the nature of activities at the study location, e.g., lane formation, creeping behavior etc. The proposed porous flow approach divides the entire study area into pores, and it is assumed that pilgrims traverse this network through interconnected vacant pores. The pedestrian data from video sequences (entry time, exit time, and flow) is extracted manually and time series analysis of pore occupancy is done to get an approximate measure of local density. Further, using Poisson regression analysis it was found that both the inflow and the duration of holy dip are significant factors in influencing the number of arrivals into the pore. Since behavioral aspects of a pedestrian is a significant governing factor of crowd dynamics, these microscopic parameters can be used to get a measure of criticality of the system in terms of crowd risk.

This paper explores the optimal initial inventory at launch, sales plan, and introduction time for a new generation of a product. We propose a multi-generation demand model that accounts for supply constraints. A mathematical model of the supply-restricted multi-generation diffusion problem is then developed and the optimal sales policy is derived. Closed-form analytical expressions as well as numerical experiments are used to investigate the effect of consumers' backlogging, cost of production capacity, unit profit margin for the products, market expansion by the new generation, and cannibalization of older generations. Through consideration of supply restrictions and lost sales, we are able to generalize previous findings on market entry policy by showing that there is a continuous range of optimal introduction times. We show that the inter-dependence between production capacity and initial inventory varies based on the introduction time of the new generation. We also provide an application of the proposed model in the case of Sony's PlayStation®3 game console. The results suggest that the company introduced the product too late and overproduced inventory which, as supported by empirical evidence, had a negative impact on the product's performance. Limitations and considerations for the application of the model are also discussed.

The performance of Malaysian international contractors has been deteriorated due to different factors including fluctuations of the global economy. Previous studies highlighted strategies f...

It is unknown how variations in surgical entry time in primary cesarean delivery (CD) may affect operative outcomes and maternal morbidity.Determine whether performing a primary CD in labor emergently ("stat") is associated with adverse maternal outcomes.Retrospective cohort study of patients who underwent primary CD at The Mount Sinai Hospital during the years of 2011-2016. Women with a singleton pregnancy and without a prior uterine scar attempting a trial of labor were included. An emergent CD was defined as a skin-to-uterine incision (I-U) time of ≤3 minutes. Subjects were dichotomized into those with an I-U time of ≤3 minutes or ≥5 minutes.1722 patients underwent primary CD and met eligibility criteria. 72 patients with an I-U time of 4 minutes were removed from the analysis. 196 patients (11.9%) had an I-U time ≤3 minutes and 1454 patients (88.1%) had an I-U time ≥5 minutes. There were no differences in any outcomes between groups. The likelihood of transfusion, hysterectomy, or admission to the intensive care unit (ICU) was 1.5% in the emergent group and 1.0% in the control group (p = .334). Postpartum length of stay was also similar between the groups (3.3 versus 3.2 days, p = .259). When 384 patients with I-U times10 minutes were excluded, surgical outcomes remained similar between groups. Among the subgroup of patients who reached the second stage of labor, surgical outcomes were also similar between groups.Emergent primary CD is not associated with increased maternal morbidity.

Background.—Incidence and prognosis of cancers of the endocrine glands vary greatly by stage and histologic type, and, thyroid cancer accounts for most (92%) of the cancers of the endocrine glands. It is the 8th most common of cancers and has been rising in incidence since 1975. It remains a formidable health threat in the United States in 2016 with estimated cases of 64,300 and 1980 deaths. Objective.—Provide 20-year comparative mortality analysis of thyroid cancer in a recent group of 145,457 staged cases (97.5%) of a total of 149,202 patients during the 1993-2013 entry time-period in six histologic subtypes by age, sex, race, stage and disease duration. Methods.—Population-based data from SEER registries,1 1973-2013, (SEER*Stat 8.3.2.) were analyzed. Results.—Tables 1-8 provide basic SEER epidemiologic, demographic, case-statistics, and comparative mortality follow-up data of 4 principal and 2 supplementary thyroid cancer oncotypes by age, sex, race, stage and disease duration of patients in the 1993-2013 time-period.Table 1.Thyroid Cancer Overview: Epidemiologic & Demographic Characteristics: SEER 1993-2013Table 2.Thyroid Cancer: Six Histologic Subtypes; Epidemiologic & Demographic Case Statistics, SEER 1993-2013Table 3.Papillary Adenocarcinoma, NOS, (ICD-O-3, 8260), 1993-2013, Age, StageTable 4.Follicular Adenocarcinoma, NOS, (ICD-O-3, 8330), 1993-2013, Age, StageTable 5.Papillary Carcinoma, Follicular Variant (ICD-O-3, 8340) Compared With Pap. & FollTable 6.Medullary, Papillary & Follicular Carcinoma 1993-13 Compared; All Stages CombinedTable 7.Thyroid Carcinoma, 1973-2013, Histology, All Ages, Race, Sex, Stage, Durations 0-5 & 5-10 YrsTable 8.Thyroid Carcinoma, 1973-2013, Histology, All Ages, Race, Sex, Stage, Durations 0-5 & 5-10 Yrs Conclusions.—Thyroid cancer when localized has a very good prognosis, with no significant excess mortality after diagnosis in papillary and papillary follicular variant cancers (PFV). Because nearly two thirds of thyroid cancers are localized, and excess death rate (EDR) is small in patients with regional cancer under age 50, overall excess mortality for all ages also virtually disappeared after 10 years in papillary and follicular cancer. Overall, the 5-year survival rate is greater than 90% for papillary and follicular carcinomas. Nevertheless, because of the marked predominance of papillary carcinoma, the continued increase in its relative frequency and annual projected deaths, thyroid carcinoma remains a significant health concern in the current era.

International audience; In phase II oncology trials, the use of new cytostatic drugs raises some questions regarding the endpoint. Time-to-event endpoints such as Progression-Free Survival have been recommended and led to new designs. In 2003, Case and Morgan proposed a design based on the comparison of the cumulative hazards at a clinically relevant timepoint. In 2013, Kwak proposed a design based on the one-sample log-rank test. If all the patients are followed from their entry time to the analysis date, the Kwak and Jung's design leads to a smaller sample size as compared to the Case-Morgan's design. However, the Case and Morgan's design requires less information since it only needs to follow every patient during a fixed interval of time. We propose a trade-off between these two approaches that corresponds to an adaptation of Kwak and Jung's design when the follow-up is expected to be restricted. Our proposal is based on the one-sample log-rank test as the Kwak and Jung's design but it uses the same follow-up information as the Case-Morgan's design. Simulation study shows that our proposal allows reducing the sample size as compared to the Case-Morgan's design (median difference of 23% [15%-33%]). Type I and type II error rates are close to their nominal rates planned in the protocol. A real phase II clinical trial in cervical cancer illustrated the interest of this new design. Thus, our proposal can be recommended as an alternative to the Kwak's design when patients' follow-up is restricted.

Now a daysUsers typically reuse the same personalized identification number (PIN) for multiple times. Direct PIN entries are highly dangerous for shoulder surfing attackers can effectively observe PIN entry with hidden cameras. Indirect PIN entry methods proposed as countermeasures are rarely deployed because they demand a heavier brain stuff workload for users. To achieve security and usability, we present a practical indirect PIN entry method called SteganoPIN. The human–machine interface of SteganoPIN is two numeric keypads, one which is covered and the other open, designed mainly to block shoulder-surfing attacks. After locating a long-term PIN in the more typical layout ,through the covered permuted keypad, a user generates a one-time PIN that can safely be entered in plain view of attackers. Forty-eight participants were involved in investigating the PIN entry time and error rate of SteganoPIN. Our experimental manipulation used a within-subject factorial design with two independent variables: PIN entry system (standardPIN, SteganoPIN) and PIN type (system-chosen PIN, user-chosen PIN).The PIN entry time in SteganoPIN (5.4–5.7 s) was slower but acceptable, and the error rate (0–2.1%) was not significantly different from that of the standard PIN.

In this paper, we have addressed an approach for accurate smart attendance monitoring system designed on the basis of deep learning algorithm. This approach will spectate the entry and exit of people into an institute or university. When a person approaches a surveillance camera near the entrance, automatically his/her face will be recognized and the entry time will be stored. Similarly while exiting, their faces will be recognized in another deep learning model embedded surveillance camera and the exit time will be stored. Our approach will help the institute to provide attendance even for attending a lecture for a percentage of time. The smart attendance monitoring system provides an advantage over the traditional approach of signing or giving bio-metric and is more reliable. This is based on real-time approach and consumes no additional time of the institute, university, or its students and faculties.

The article deals with voltage sags and interruptions, which are the most dangerous power failures for oilfield power consumers. The purpose of the research was to assess the sustainability of the oilfield power consumers by developing a safety factor taking into account the dependence coefficient of power sources. In this paper the safety factor has been proposed on the basis of the area method. We have analyzed the influence of the power supply dependence coefficient and the setpoint for automatic reserve entry time on the safety factor.

Parking pool or parking area is a place provided for parking of motorized vehicles outside of the road whih is provided by individual or institution, including motorized vehicle storage and motorized vehicle garage. In managing the parking pool, the parking owner must have a system to facilitate the processing of the parking area. The existing parking system at Palma tower building Jakarta is still manual, that is by entering the vehicle number into the computer by operator, then printing. The parking ticket provided is only a form of paper containing the vehicle number and vehicle entry time. Payment transactions method made by parking operators are currently not efficient, because the level of officer error when calculate parking fees and change money is high. Deal with these various problems, an idea arises to create a subscription parking system by using an automated parking system. This automated parking system is named with an RFID system (Radio Frequency Identification). The design of this automatic parking system is the best solution to solve the problems that are already running. This computerized system is better than a manual system because this system can run more effectively and efficiently and it is more conducive than the previous system.

Background: The assessment of chronic wounds such as digital ulcers (DUs) in systemic sclerosis relies heavily on visual aspects. However, inter-rater variability in the assessment and definition of digital ulcers is low and there are no evidence-based data concerning the visual assessment of digital ulcersa. Objectives: We analysed gaze pattern data in order to evaluate differences in the visual assessment of digital ulcers in systemic sclerosis patients. Methods: We analysed gaze pattern data from 36 subjects: 9 expert medical professionals (EMP), 8 non-expert medical professionals (NEMP), 9 medical graduates (MG) and 10 lay persons (novices). Assessment was done using a mobile eye-tracking device that tracks eye movements of subjects. Twenty pictures from digital ulcers of SSc patients were presented to each subject, 30 seconds each and characteristics of gaze pattern data were analysed. The analysis comprised the scan path, the dwell times (for areas of interest, AOI), fixation counts and the entry time for each picture and subject. Areas of interest were defined as the wound ground, wound margin, wound surroundings and distracting and non-relevant parts of the pictures. The visual assessment of the digital ulcers was accompanied by questions for each subject about their assessment of the DUs, the expected healing of the ulcer, the medical treatment of the patient. Results: Most significant differences were found between novices and medically educated groups (expert medical professionals, non-expert medical professionals, medical graduates - EMP, NEMP, MG). Dwell times in the wound area for novices differed statistically significant from all medically educated groups (1.76s-3.1s less). Above all, novices had lower dwell times in wound margin and wound surrounding and spent more time in areas with other distracting features of the picture and white space (up to 1.92s longer). Correspondingly, they had less fixation points and longer overall scan paths in wound areas. Similar gaze pattern data were observed for medically educated groups, however NEMP had a statistically significantly lower dwell time in the wound area than EMP. Questionnaire responses were compared to an expert opinion (gold standard) and EMP had significantly more correct answers on prognosis and treatment than MG for wound assessment, but not better than NEMP. However, treatment and prognosis were best in the EMP group with statistical difference to the NEMP and MG group. Conclusion: For the first time, we provide evidence-based data on the visual assessment of digital ulcers in SSc. These data will be useful for the development of a structured educational programme for young physicians, rheumatology trainees and medical graduates. A key finding is that the visual assessment of digital ulcers should increasingly emphasize the importance of pathologic changes in the wound margin and surrounding area of the wound. Hence a structured approach should focus on all areas of the wound while discarding distracting visual information. An adequate terminology should be used alongside. Reference [1] Hughes M et al., J Scleroderma Relat Disord. 2018 Jun 1;3(2):170-174. Disclosure of Interests: Thomas Moser: None declared, Quentin Lohmeyer: None declared, Mirko Meboldt: None declared, Oliver Distler Grant/research support from: Prof. Distler received research funding from Actelion, Bayer, Boehringer Ingelheim and Mitsubishi Tanabe to investigate potential treatments of scleroderma and its complications, Consultant for: Prof. Distler has/had consultancy relationship within the last 3 years with Actelion, AnaMar, Bayer, Boehringer Ingelheim, ChemomAb, espeRare foundation, Genentech/Roche, GSK, Inventiva, Italfarmaco, iQvia, Lilly, medac, MedImmune, Mitsubishi Tanabe Pharma, Pharmacyclics, Novartis, Pfizer, Sanofi, Serodapharm and UCB in the area of potential treatments of scleroderma and its complications. In addition, he had/has consultancy relationship within the last 3 years with A. Menarini, Amgen, Abbvie, GSK, Mepha, MSD, Pfizer and UCB in the field of arthritides and related disorders, Mike O. Becker: None declared

Purpose: We present our data for every single fraction for every patient treated at our center for the past 4 years, analyzing the waiting and treatment times. Materials and Methods: Between January 2014 and February 2018, all patients and their corresponding recorded measurements of waiting time and machine treatment time were analyzed. Times recorded included actual arrival time, designated arrival time, linac entry time, and last beam treatment time. The complete waiting time information was divided into two categories (1) first day treatments and (2) subsequent day treatments. SPSS version 18 was used for statistical calculations, correlations, and assessing significance. Results:First day treatments - of 1982 patients following treatments were carried out; 1557 volumetric-modulated arc therapy (78.6%), 88 three-dimensional conformal radiotherapy (RT) (4.4%), 14 electron (0.7%), 10 intensity-modulated RT (0.5%), 264 stereotactic irradiation (13.3%), 17 stereotactic body RT (0.7%), and 32 total body irradiation (1.6%). The mean (± standard deviation) times for early/late time, total spent time (TST), wait time gross (WTG), and wait time net (WTN) were 11.0 ± 49.6 min, 74.7 ± 44.8 min, 47.46 ± 43.9 min, and 24.1 ± 44.4 min, respectively. Subsequent day treatments - a total of 34,438 sessions of treatment delivery were recorded. Overall average WTG was 37.4 ± 32.7 min. Overall WTN was 12.1 ± 62.7 min. Overall mean total spent time (TST) was 52.4 ± 33.0 min, overall mean setup and treatment time was 15.1 ± 10.9 min. Conclusion: We have presented our results of patient-related times during RT. Our study covers the daily waiting times before RT as well as the actual treatment times during modern-day RT. This consecutive patient data from a large series shall be an important resource tool for future planners and policymakers.

Background:It has been reported that female rheumatoid arthritis (RA) patients have a longer time to pregnancy than healthy women (1), and that high Disease Activity Score with 28 joint count (DAS28) -CRP in preconception increases the frequency of infertility (2). Before the era of biologics, RA treatment tended to be inadequate from pregnancy planning to the end of lactation. And it was not uncommon for female RA patients to be unable to get pregnant or develop physical dysfunction as a result of insufficient control of the disease. There are some reports of disease activity during pregnancy and postpartum in RA patients, and the effects of RA disease activity on pregnancy and childbirth outcomes (3-5), but there are few reports focusing on the physical function during pregnancy planning of RA patients.Objectives:To investigate disease activity and physical function in female patients with RA who planned and didn’t plan pregnancy.Methods:The IORRA cohort is a large, single institute-based, observational cohort of RA patients established at the Institute of Rheumatology, Tokyo Women’s Medical University, in 2000. We identified female RA patients aged 20-49 years who answered ‘pregnant’ or ‘delivered’ in the IORRA survey in 2010-2015 and whose pregnancy and the pregnancy planning time was confirmed in the medical records, and defined them as the pregnancy planning (PP) group. Matched control was extracted at 1:3 ratio from patients without pregnancy plan based on entry time, age, RA disease duration, DAS28-CRP, Japanese version of Health Assessment Questionnaire (J-HAQ) score, and comorbidities. The primary endpoint was J-HAQ at 3years from the baseline, which was defined as the most recent IORRA survey before planning pregnancy. The mixed-effect model for repeated measures was used to analyze group difference.Results:There were 40 patients in the PP group (average 32.2 years, disease duration 5.7 years, DAS28-CRP 1.7, J-HAQ 0.26), and 120 patients in the control group (average 32.4 years, disease duration 5.9 years, DAS28-CRP 1.7, J-HAQ 0.21). The proportion of user and dosage of MTX and glucocorticoid (GC) and bDMARDs user at baseline were comparable between the groups (MTX: PP 87.5% [9.8 mg/week], control 85.0% [8.8 mg/week]; GC: PP 32.5% [3.6 mg/day], control 27.5% [4.4 mg/day]; bDMARDs: PP 40.0%, control 27.5%). DAS28-CRP at year 3 of the PP group elevated and was higher than the control group (PP 2.3, control 1.7, pConclusion:Physical function in pregnancy planning patients with RA did not deteriorate as well as the control patients in clinical settings.References:[1]Arthritis Rheum. 2011;63:1517-1521.[2]Ann Rheum Dis. 2015;10:1836-1841.[3]J Rheumatol. 2015;42:1376-1382.[4]J Rheumatol. 2019;46:245-250.[5]Arthritis Care Res. 2017;69:1297-1303.Disclosure of Interests:Moeko Ochiai: None declared, Eiichi Tanaka Consultant of: ET has received lecture fees or consulting fees from Abbvie, Asahi Kasei pharma co., Bristol Myers Squibb, Chugai Pharmaceutical, Daiichi Sankyo Co., Eisai Pharmaceutical, Janssen Pharmaceutical K.K., Nippon Kayaku, Pfizer, Takeda Pharmaceutical, Taisho Toyama Pharmaceutical Co., and UCB Pharma., Speakers bureau: ET has received lecture fees or consulting fees from Abbvie, Asahi Kasei pharma co., Bristol Myers Squibb, Chugai Pharmaceutical, Daiichi Sankyo Co., Eisai Pharmaceutical, Janssen Pharmaceutical K.K., Nippon Kayaku, Pfizer, Takeda Pharmaceutical, Taisho Toyama Pharmaceutical Co., and UCB Pharma., Eisuke Inoue Speakers bureau: EI has received speaker fee from Bristol-Meyers, Pfizer, Merck serono., Mai Abe: None declared, Eri Sugano: None declared, Naohiro Sugitani: None declared, Kumiko Saka: None declared, higuchi yoko: None declared, Rei Yamaguchi: None declared, Naoki Sugimoto: None declared, Ikari Katsunori Speakers bureau: KI has received speaker’s fee from Asahi Kasei Pharma Corp., Astellas Pharma Inc., AbbVie Japan GK, Ayumi Pharmaceutical Co., Bristol Myers Squibb Co., Ltd., Chugai Pharmaceutical Co., Ltd., Eis, ai Co., Ltd., Eli Lilly Japan K.K., Janssen Pharmaceutical K.K., Kaken Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Corp.Pfizer Japan Inc., Takeda Pharmaceutical Co. Ltd., Teijin Pharma Ltd and UCB Japan Co. Ltd., Ayako Nakajima Grant/research support from: AN has received research grants from Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Co., Pfizer Japan Inc., Consultant of: AN has consultant fee from Nippon Kayaku Co. Ltd., Speakers bureau: AN has received speaker’s fee from AbbVie Japan GK, Actelion Pharmaceuticals Japan LTD., Asahi Kasei Pharma Co., Astellas Pharma Inc., Ayumi Pharmaceutical Co., Bristol Myers Squibb Co., Ltd., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., GlaxoSmithKline K.K., Hisamitsu Pharmaceutical Co. Inc., Kyorin Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Co., Otsuka Pharmaceutical Co. Ltd., Pfizer Japan Inc., and Teijin Pharma Ltd., Atsuo Taniguchi: None declared, Hisashi Yamanaka Grant/research support from: HY has received research grant or speaker fee from AbbVie, Astellas, Ayumi, Behringer, Bristol-Meyers, Chugai, Daiichi-Sankyo, Eisai, Kaken, Nippon-Shinyaku, Novartis, Ono, Pfizer, Taisyo-Toyama, Takeda, Tanabe-Mitsubishi, Teijin Pharma, Torii, UCB, YLbio., Speakers bureau: HY has received research grant or speaker fee from AbbVie, Astellas, Ayumi, Behringer, Bristol-Meyers, Chugai, Daiichi-Sankyo, Eisai, Kaken, Nippon-Shinyaku, Novartis, Ono, Pfizer, Taisyo-Toyama, Takeda, Tanabe-Mitsubishi, Teijin Pharma, Torii, UCB, YLbio., masayoshi harigai Grant/research support from: AbbVie Japan GK, Ayumi Pharmaceutical Co., Bristol Myers Squibb Co., Ltd., Eisai Co., Ltd., Mitsubishi Tanabe Pharma Co., Nippon Kayaku Co., Ltd., and Teijin Pharma Ltd. MH has received speaker’s fee from AbbVie Japan GK, Ayumi Pharmaceutical Co., Boehringer Ingelheim Japan, Inc., Bristol Myers Squibb Co., Ltd., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., GlaxoSmithKline K.K., Kissei Pharmaceutical Co., Ltd., Oxford Immuotec, Pfizer Japan Inc., and Teijin Pharma Ltd. MH is a consultant for AbbVie, Boehringer-ingelheim, Kissei Pharmaceutical Co., Ltd. and Teijin Pharma.