Euglycemic diabetic ketoacidosis is a rare, acute, and life-threatening complication of diabetes mellitus associated with several risk factors such as infection, surgery, pregnancy, fasting, alcohol ...intake, acute vascular events (acute coronary syndrome or stroke), and the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors. It is characterized by euglycemia, high-anion-gap metabolic acidosis, and ketoacidosis. Herein, we report two patients who used SGLT2 inhibitors before surgery and presented with severe metabolic acidosis after surgery. Subsequently, one patient required intubation, and both patients received two cycles of hemodialysis despite normal renal parameters. This was done to correct the metabolic acidosis, which led to early recovery.
Supplier involvement is touted as enhancing a firm's competitive edge, but its linkage with specific dimensions of manufacturing flexibility (e.g., volume flexibility) has not been established. This ...study investigates the relationship between supplier involvement, manufacturing flexibility, and business performance in the motherboard industry. Using data collected from 105 manufacturing firms, we first verified the effect of manufacturing flexibility on business performance. A field study was then conducted to benchmark various supplier involvement practices in the motherboard industry and to decipher the impact of supplier involvement on different dimensions of manufacturing flexibility. Our findings indicate that supplier involvement plays a major role in the development and performance of a firm's manufacturing flexibility. More importantly, we found specific associations between various supplier involvement activities and different dimensions of manufacturing flexibility. Not all supplier activities contribute equally to the development of different types of manufacturing flexibility, and manufacturing flexibility should be integrated with supply chain management. Finally, research propositions are presented and several managerial implications are discussed.
Background: Patients with end-stage renal disease need renal replacement therapy, including hemodialysis, peritoneal dialysis, and kidney transplant (KT), to live a relatively normal life. Compared ...with other dialysis modalities, KT remains the choice for better survival. Objectives: This study aimed to report the KT outcomes at our center and investigate risk factors for graft and patient survival. Methods: This is a retrospective chart review of 72 KT recipients cared for at our center between July 1, 2004, and June 30, 2017. Delayed graft function (DGF) was defined as the need for dialysis within 1 week after KT. The primary outcome is death after KT. The secondary outcome is graft failure, which is defined as a return to dialysis while the patient is alive. Patient death with functional graft was censored during the survival analysis. Results: Among the patients, 17 KT recipients had primary diabetic nephropathy (23.6%) with a mean age of 47.4 ± 11.8 years. Furthermore, 13 patients returned to dialysis and 12 died during the study period, with malignancy being the leading cause of death (n = 4). The 1-, 3-, and 5-year graft survival rates were 94.3%, 90.4%, and 85.4%, respectively. The 1, 3-, and 5-year patient survival rates were 97.1%, 92.1%, and 85.7%, respectively. A total of 24 patients (33%) encountered DGF after KT. Patients with DGF had significantly poorer graft survival than those without DGF (P = 0.002 by log-rank test). Cox-proportional hazard analysis revealed that only DGF increased the risk of graft failure (hazard ratio (HR) = 6.52, 95% confidence interval (CI): 1.4629.2), and age predicted patient survival (HR = 1.09, 95% CI: 1.021.17). Conclusion: This study showed that patients with DGF had significantly poor graft survival. Patient's age was the only prognostic factor for patient survival in our cohort.
Environmental protection is an important topic in the 21st century. Environmental design has become an integral part of corporate perpetual growth. In pursuit of economic development and ...environmental protection, enterprises should focus more on effective environmental design activities, and thus achieve the goal of perpetual growth. This research attempts to study the impact of environmental strategies and environmental design activities on environmental design implementation and in turn the impact of environmental design implementation on business competitive advantages. In this research, the intermediate variable, ‘industry group and enterprise scale’, is considered. A theoretical correlation model is developed based on various discussions on relevant theories and literature. The empirical analysis results on ISO 14001 certified enterprises and firms qualified for environmental protection standards in Taiwan show that the internal motivation for environmental design has a significant effect on environmental design implementation. Communication with related interest groups, continuous education and persistent innovation could all substantially impact environmental design implementation. The better the communication with related interest groups, or the higher the education with environment-related knowledge, the more successful the environmental design implementation. Furthermore, environmental design implementation has a fundamentally significant effect on business competitive advantages. The ‘more successful environmental design implementation results in greater competitive advantages’ hypothesis is statistically tested and proven in this research. The two intermediate variables, industry group and enterprise scale do not show noticeable impacts on environmental design and business competitive advantages.
A risk-based inspection system and a piping inspection guideline model were developed in this study. The research procedure consists of two parts—the building of a risk-based inspection model for ...piping and the construction of a risk-based piping inspection guideline model. Field visits at the plant were conducted to develop the risk-based inspection and strategic analysis system. A knowledge-based model had been built in accordance with international standards and local government regulations, and the rational unified process was applied for reducing the discrepancy in the development of the models. The models had been designed to analyze damage factors, damage models, and potential damage positions of piping in the petrochemical plants. The purpose of this study was to provide inspection-related personnel with the optimal planning tools for piping inspections, hence, to enable effective predictions of potential piping risks and to enhance the better degree of safety in plant operations that the petrochemical industries can be expected to achieve. A risk analysis was conducted on the piping system of a petrochemical plant. The outcome indicated that most of the risks resulted from a small number of pipelines.
Many scholars have recently researched the relationship between quality management and performance, but there was no one who had discussed the relationship between quality management and performance ...from the view of business value. This study focuses on the business value of Total Quality Management (TQM) as we studied the fifteen enterprises of the National Quality Award (Taiwan) from seven industries and used eighteen indices of five perspectives to value them. There were eight conclusions, as follows: (1) the business value of all 15 enterprises was greater than the average industry level; (2) the business value of the electronic industry of the National Quality Award owners was over the average business value of the electronic industry; (3) there was a growth trend of business value in the automobile industry award-winning; (4) there was a downward trend of business value in the iron and steel industry award-winning after they obtained the award for seven years; (5) there was a superior business value of the electrical machinery industry before award-winning than after; (6) the business value of food industry award-winning showed an situation over average industry level after obtained the award seventh year; (7) the business value of plastic and rubber industry was significant over the average industry level; (8) there was a continuous growth trend in the electric and cable industry of the National Quality Award (Taiwan) owners after they obtained the award.
Innovation is an important topic in the 21st century. Innovation management has become a compulsory path to sustained enterprise growth. In this research, we studied the degree of innovation ...implementation among domestic high-tech manufacturers and the impact of innovation management implementation on competitiveness. We considered the mediating variables of "industry type" and "enterprise scale", developed a theoretical model of impact relationship, and conducted the empirical analysis of Taiwan's high-tech manufacturers. We found from the research results that the degree of innovation management implementation has a significant impact on competitiveness. The degree of innovation management implementation has an essential impact on the two competitiveness dimensions including technological innovation and differentiation. Moreover, the two mediating variables of "industry type" and "enterprise scale" were proven to have a significant impact on the degree of innovation management and competitiveness.
Since the execution of National Health Insurance system in Taiwan, the competition of medical industry is becoming more and more severe. The ways the hospital operate knowledge management (KM) ...concept, combine current human resources and professional knowledge by information techniques and upgrade the competitiveness through reinvention of organizational culture have become the important issues. This research is based on the relationship between KM and organizational operation, integrates the characteristic of medical institutions and framework of medical knowledge cycle and starts the research subject by questionnaires from three dimensions: current situation of KM construction in medical organizations, executive effect of KM activities and the challenges faced by KM; subsequently, from qualitative interview, this research attempts to understand how a medical organization executes and adjusts in the consideration of theory and reality as well as quality and costs when actually operates the organization. This research accesses to KM system application of medical institutions and the empirical executive benefits and difficulties through questionnaires. The research results are as follows: (1) having initial understanding toward current KM establishment of medical institutions; (2) confirming the most important items of KM establishment of medical organizations; (3) understanding the most difficulty which the medical organizations encounter when executing KM; (4) establishing medical knowledge cycle figure of the hospitals receiving interviews. Through case interview, this research profoundly accessed to the actual operation of KM application of medical organizations. The target hospitals intended to try many medical KM measures; however, during to complicated hospital organizations and cultural characteristics, the promotion was not successful and the results were not apparent. The most difficulty was to change the employees' behavior. The targets believed that only the continuous promotion of KM can allow it to be an important aspect of organizational culture and the competitiveness could constant be upgraded.
Customer Support Knowledge of Customer Support Organization is one of the important assets of enterprises and "Customer Support Knowledge Management" is also the critical aspect of Business Knowledge ...Management; however, the attributes of Customer Support Knowledge are complicated, diverse, renewed rapidly and difficult to be managed. Thus, in order to design a successful Customer Support Knowledge Management System, apart from the consideration of "human" and "information technology" aspects, the concerns of attributes and Customer Support Knowledge and industry characteristics should be involved for meeting the requirements of Customer Support Organization and allowing the organization to acquire the competitive advantage of "Differentiation Service". This research used the "Customer Support Knowledge Management System" in a high-tech industry as an example and treated the end users of medical instruments in different types of hospitals in Taiwan which have received the support service of our company in recent six months as the population. The end users were mostly the nursing executives or ultrasonic wave technical personnel in intensive care unit and they had similar educational background and incomes and adopted the medical instruments such as physical supervision system, ultrasonic wave system, heart start or ECG machine produced by our company; the research method was to randomly treat the investigation results of the telephone customers' satisfaction from respective 30 end users in the population three months before and after this system execution as the samples and use hypotheses to validate if the end users' customer satisfaction significantly improved in terms of "Remote Support," "On-site Support," "Service Turn Around time," "Technical Competence" and "Service Manner" in order to understand the influence and managerial significance of execution of "Customer Support Knowledge Management System" on Customer Support Organization.
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