Objective The objective of the Prospective Observational Trial to Optimize Pediatric Health in Intrauterine Growth Restriction (IUGR) (PORTO Study), a national prospective observational multicenter ...study, was to evaluate which sonographic findings were associated with perinatal morbidity and mortality in pregnancies affected by growth restriction, originally defined as estimated fetal weight (EFW) <10th centile. Study Design Over 1100 consecutive ultrasound-dated singleton pregnancies with EFW <10th centile were recruited from January 2010 through June 2012. A range of IUGR definitions were used, including EFW or abdominal circumference <10th, <5th, or <3rd centiles, with or without oligohydramnios and with or without abnormal umbilical arterial Doppler (pulsatility index >95th centile, absent or reversed end-diastolic flow). Adverse perinatal outcome, defined as a composite outcome of intraventricular hemorrhage, periventricular leukomalacia, hypoxic ischemic encephalopathy, necrotizing enterocolitis, bronchopulmonary dysplasia, sepsis, and death was documented for all cases. Results Of 1116 fetuses, 312 (28%) were admitted to neonatal intensive care unit and 58 (5.2%) were affected by adverse perinatal outcome including 8 mortalities (0.7%). The presence of abnormal umbilical Doppler was significantly associated with adverse outcome, irrespective of EFW or abdominal circumference measurement. The only sonographic weight-related definition consistently associated with adverse outcome was EFW <3rd centile ( P = .0131); all mortalities had EFW <3rd centile. Presence of oligohydramnios was clinically important when combined with EFW <3rd centile ( P = .0066). Conclusion Abnormal umbilical artery Doppler and EFW <3rd centile were strongly and most consistently associated with adverse perinatal outcome. Our data call into question the current definitions of IUGR used. Future studies may address whether using stricter IUGR cutoffs comparing various definitions and management strategies has implications on resource allocation and pregnancy outcome.
Purpose
This paper aims to examines the moderating effect of small vs large supply base size on the relationship between strategic sustainable purchasing (SSP) and organizational sustainability ...performance (OSP). SSP is conceptualized as a dynamic capability consisting of strategic purchasing and environmental purchasing. Environmental collaboration is conceptualized as a mediator between SSP and OSP. Extant research has not examined the effect of the size of the supply base on the relationship between SSP and OSP.
Design/methodology/approach
The hypothesized relationships are tested using a two-step multi-group analysis in partial least squares-structural equation modeling (PLS-SEM).
Findings
A small supply base size positively moderates the relationship between SSP and environmental collaboration, thus achieving OSP. In contrast, when the supply base is large, strategic purchasing is positively associated with environmental collaboration, while environmental purchasing is negatively related to environmental collaboration. A large supply base has a positive relationship to environmental collaboration and economic sustainability, while the relationship between environmental collaboration and environmental and social performance is not significant.
Practical implications
This research argues that despite the nuances in the moderating effects of small versus large supply base size, managers need to invest in both dynamic and relational capabilities to achieve organizational sustainability.
Originality/value
Scant research is available in supply chain management research that has examined the important effect of the supply base size on the relationship between SSP and OSP. This research aims to fill this gap. The study helps practitioners understand the effects of supply base sizes for their organizations, increase interrelationships among suppliers, reduce the level of differentiation among them, and, thereby, reduce costs and increase revenues.
ABSTRACT
Extant research consistently illustrates the positive benefits customers get from having more innovative suppliers. However, do suppliers benefit financially from positioning themselves as ...leading innovators? Utilizing a secondary dataset of 1039 supplier to customer base observations, and grounding our study in the structure‐conduct‐performance framework, we examine the extent to which suppliers are able to benefit from pursuing a more leading or lagging innovation strategy within their industry. While in general we find that suppliers employing a leading innovator strategy have higher levels of financial performance, such an effect is not universal. Rather, the ability of the supplying firm to leverage their innovation strategy into increased performance is highly contingent upon not only the innovation levels of their own industry, but also the innovation levels of the industries which they supply. Our results, therefore, suggest that it would be advantageous for suppliers to take a supply chain perspective and strategically incorporate the innovation characteristics of their customers when determining whether to pursue a leading or lagging innovation strategy.
Successful supply chain management necessitates an effective sourcing strategy to combat uncertainties in both supply and demand. In particular, supply disruption results in excessive downtime of ...production resources, upstream and downstream supply chain repercussions, and eventually a loss in the market value of the firm. In this paper we analyze single period, single product sourcing decisions under demand uncertainty. Our approach integrates product prices, supplier costs, supplier capacities, historical supplier reliabilities and firm specific inventory costs. A unique feature of our approach is the integration of a firm specific supplier diversification function. We also extend our analysis to examine the impact of minimum supplier order quantities. Our results indicate that single sourcing is a dominant strategy only when supplier capacities are large relative to the product demand and when the firm does not obtain diversification benefits. In other cases, we find that multiple sourcing is an optimal sourcing strategy. We also characterize a non-intuitive trade-off between supplier minimum order quantities, costs, and supplier reliabilities. Finally, we examine the robustness of our results through an extensive numerical analysis of the key parameters of our model.
This research investigates compound causes of the bullwhip effect (BWE) by considering an inventory system with multiple price-sensitive demand streams. Joint price and demand dynamics are captured ...by a vector time-series process that incorporates the stochastic co-movements in price and demand. We study two BWE measures, one for each demand stream individually and one for the aggregated demand. We show that demand parameters including demand autocorrelation, cross-correlation, and price sensitivity serve as root causes of the BWE. We prove that the impact of these parameters on the BWE can be additively decomposed. Conditions are established under which a pair of simultaneous compound causes may attenuate or dampen the BWE. When demand streams are aggregated, we derive a pooling factor that quantifies the impact of demand aggregation on order stability. When positive, the pooling factor corresponds to a synergy effect that captures the gain in the stability of the pooled orders. Conditions for the existence of the synergy effect are obtained for several special cases involving a zero leadtime. We also discuss how our analytical findings can be managerially applied to bullwhip mitigation strategies.
Objective The aim of the Prospective Observational Trial to Optimize Pediatric Health in IUGR Study was to evaluate the optimal management of fetuses with an estimated fetal weight less than the 10th ...centile. The objective of this secondary analysis was to describe the role of the cerebroplacental ratio (CPR) in the prediction of adverse perinatal outcome. Study Design More than 1100 consecutive singleton pregnancies with intrauterine growth restriction (IUGR) were recruited over 2 years at 7 centers, undergoing serial sonographic evaluation including multivessel Doppler measurement. CPR was calculated using the pulsatility and resistance indices of the middle cerebral and umbilical artery. Adverse perinatal outcome was defined as a composite of intraventricular hemorrhage, periventricular leukomalacia, hypoxic ischemic encephalopathy, necrotizing enterocolitis, bronchopulmonary dysplasia, sepsis, and death. Results Data for CPR calculation was available in 881 cases, which was performed at a mean gestational age of 33 weeks (interquarile range, 28.7–35.9). Of the 146 cases with CPR less than 1, 18% (n = 27) had an adverse perinatal outcome. This conferred an 11-fold increased risk (odds ratio, 11.7; P < .0001) when compared with cases with normal CPR (2%; 14 of 735). An abnormal CPR was present in all 3 cases of mortality. Prediction of adverse outcomes was comparable when using all definitions of abnormal CPR. Conclusion Irrespective of the CPR calculation used, brain sparing is significantly associated with an adverse perinatal outcome in IUGR. This adds further weight to integrating CPR evaluation into the clinical assessment of IUGR pregnancies. The impact of this finding on long-term neurodevelopmental outcomes in this patient cohort is underway.
Innovation types and performance in growing UK SMEs Oke, Adegoke; Burke, Gerard; Myers, Andrew
International journal of operations & production management,
06/2007, Letnik:
27, Številka:
7
Journal Article
Recenzirano
Purpose - The objective of this study is to explore the types of innovation that are predominant in UK SMEs, whether they are predominantly radical or incremental, and to investigate the impact of ...these innovations on performance.Design methodology approach - A web-based survey instrument was used to administer survey questionnaires to a sample of UK SMEs in manufacturing, engineering, electronics, information technology and telecommunications industries. The response rate was 13.8 percent. Relevant statistical analytical techniques including regression for analysis was then used.Findings - It is found that the SMEs tend to focus more on incremental than radical innovations and that this focus is related to growth in sales turnover.Practical implications - It is not such a bad idea for SMEs, particularly those operating in high technological industries, to focus on incremental innovations as these are actually related positively to sales turnover growth.Originality value - An investigation of the types of innovation that SMEs pursue is pioneering in the field as previous studies of this type have been based on large firms. The contention that the raison d'etre of SMEs is to develop radical innovations is not supported empirically, at least for the sample of SMEs. In addition, it is found that the age of an SME is not related to its focus on either incremental or radical innovation. These are the contributions of this paper.
In this paper, we analyze the impact of supplier pricing schemes and supplier capacity limitations on the optimal sourcing policy for a single firm. We consider the situation where the total quantity ...to be procured for a single period is known by the firm and communicated to the supplier set. In response to this communication, each supplier quotes a price and a capacity limit in terms of a maximum quantity that can be supplied to the buyer. Based on this information, the buyer makes a quantity allocation decision among the suppliers and corresponding to this decision is the choice of a subset of suppliers who will receive an order. Based on industry observations, a variety of supplier pricing schemes from the constituent group of suppliers are analyzed, including linear discounts, incremental units discounts, and all units discounts. Given the complexity of the optimization problem for certain types of pricing schemes, heuristic solution methodologies are developed to identify a quantity allocation decision for the firm. Through an extensive computational comparison, we find that these heuristics generate near-optimal solutions very quickly. Data from a major office products retailer is used to illustrate the resulting sourcing strategies given different pricing schemes and capacity limitations of suppliers in this industry. We find for the case of capacity constrained suppliers, the optimal quantity allocations for two complex pricing schemes (linear discount, and incremental units discount) are such that at most one selected supplier will receive an order quantity that is less than its capacity.
Objective An objective of the Prospective Observational Trial to Optimize Pediatric Health in IUGR (PORTO) study was to evaluate multivessel Doppler changes in a large cohort of intrauterine growth ...restriction (IUGR) fetuses to establish whether a predictable progressive sequence of Doppler deterioration exists and to correlate these Doppler findings with respective perinatal outcomes. Study Design More than 1100 unselected consecutive ultrasound-dated singleton pregnancies with estimated fetal weight (EFW) less than the 10th centile were recruited between January 2010 and June 2012. Eligible pregnancies were assessed by serial Doppler interrogation of umbilical (UA) and middle cerebral (MCA) arteries, ductus venosus (DV), aortic isthmus, and myocardial performance index (MPI). Intervals between Doppler changes and patterns of deterioration were recorded and correlated with respective perinatal outcomes. Results Our study of 1116 nonanomalous fetuses comprised 7769 individual Doppler data points. Five hundred eleven patients (46%) had an abnormal UA, 300 (27%) had an abnormal MCA, and 129 (11%) had an abnormal DV Doppler. The classic pattern from abnormal UA to MCA to DV existed but no more frequently than any of the other potential pattern. Doppler interrogation of the UA and MCA remains the most useful and practical tool in identifying fetuses at risk of adverse perinatal outcome, capturing 88% of all adverse outcomes. Conclusion In contrast to previous reports, we have demonstrated multiple potential patterns of Doppler deterioration in this large prospective cohort of IUGR pregnancies, which calls into question the usefulness of multivessel Doppler assessment to inform frequency of surveillance and timing of delivery of IUGR fetuses. These data will be critically important for planning any future intervention trials.
