Transformative capabilities of MedTech organizations in driving circularity in the healthcare industry: Insights from multiple cases

This is the author accepted manuscript. The final version is available on open access from Elsevier via the DOI in this recordData availability: Data will be made available on request.The healthcare industry's significant environmental impact has prompted the urgent need for sustainable practices. MedTech companies play a crucial role in advancing circularity within the sector by adopting sustainable approaches to product design, resource management, and waste reduction. This research aims to explore how MedTech companies initiate and drive transformation towards circular practices and the key factors influencing their successful transition. Using a qualitative approach, four multinational MedTech companies' case studies are conducted, employing semi-structured interviews with 33 managers and healthcare professionals. The results reveal a model grounded in dynamic capabilities, comprising three stages: sensing, seizing, and transforming, guided by adaptability and flexibility. The study extends the understanding of how MedTech companies can proactively respond to environmental challenges and embrace circular economy practices. Furthermore, the model offers practical implications for MedTech companies to foster sustainable practices, optimize resources, and enhance circularity in the healthcare industry

The critical role of procurement in the emergence of circular business models: Insights from multiple cases of Vietnamese manufacturers

This is the final version. Available on open access from Wiley via the DOI in this record. While recent literature acknowledges the role of procurement in circular business models (CBM), a comprehensive exploration of its potential contribution remains scarce. This study delves into the under-explored role of procurement in advancing CBMs within organizations. Employing a multiple case research design focused on four Vietnamese manufacturers, the research unveils procurement's distinctive contributions to CBM implementation. Emphasis is placed on supporting recyclability, reusability, waste reduction, and ethical standards aligned with competitive strategies. The study introduces a circular procurement framework, demonstrating its potential to drive CBM adoption. Theoretical contributions involve applying CE and CBM theories to procurement, identifying its role in CBM organization, uncovering barriers, and linking them to organizational context and financial considerations. In terms of practical implications, the research provides managerial guidance, emphasizing the pivotal link between procurement and CBM success, offering actionable insights for effectively navigating challenges, and fostering a culture of sustainable circularity within manufacturing businesses

Measurement of the top quark mass using the matrix element technique in dilepton final states

We present a measurement of the top quark mass in pp¯ collisions at a center-of-mass energy of 1.96 TeV at the Fermilab Tevatron collider. The data were collected by the D0 experiment corresponding to an integrated luminosity of 9.7  fb−1. The matrix element technique is applied to tt¯ events in the final state containing leptons (electrons or muons) with high transverse momenta and at least two jets. The calibration of the jet energy scale determined in the lepton+jets final state of tt¯ decays is applied to jet energies. This correction provides a substantial reduction in systematic uncertainties. We obtain a top quark mass of mt=173.93±1.84  GeV

CARS: Dynamic Cyber-attack Reaction in SDN-based Networks with Q-learning

In this paper, we propose a dynamic cyber-attack reaction system based on Q-learning, namely CARS, to effectively defeat cyber-attacks in Software-Defined Networks (SDN). In particular, we first examine a cyber-attack reaction system that operates at the SDN control plane. Then, we propose a dynamic cyber-attack reaction solution to maximize the attack defense performance while minimizing the negative influence on benign traffic forwarding in the data plane. Next, we model the cyber-attack reaction system based on a Markov decision process (MDP) and formulate its optimization problem. Afterward, we develop a Q-learning based cyber-attack reaction control algorithm to solve the optimization problem, obtaining the optimal cyber-attack reaction policy. As our case study on denial-of-service (DoS) attacks, the obtained results verify that CARS can effectively prevent malicious packets from reaching the victim server in all DoS attacks, i.e., approximately 80% of abnormal packets are dropped. In addition, by implementing the optimal cyber-attack reaction policy, CARS can significantly reduce the ratio of QoS (Quality-of-Service) violated traffic flows compared to two existing solutions, i.e., GATE (by approx. 66%) and GTAC-IRS (by approx. 75%)

Multi-Level Process Integration of Heat Pumps in Meat Processing

Many countries across the globe are facing the challenge of replacing coal and natural gas-derived process heat with low-emission alternatives. In countries such as New Zealand, which have access to renewably generated electricity, industrial heat pumps offer great potential to reduce sitewide industrial carbon emissions. In this paper, a new Pinch-based Total Site Heat Integration (TSHI) method is proposed and used to explore and identify multi-level heat pump integration options at a meat processing site in New Zealand. This novel method improves upon standard methods that are currently used in industry and successfully identifies heat pump opportunities that might otherwise be missed by said standard methods. The results of the novel method application suggest that a Mechanical Vapour Recompression (MVR) system in the Rendering plant and a centralized air-source heat pump around the hot water ring main could reduce site emissions by over 50%. Future research will develop these preliminary results into a dynamic emissions reduction plan for the site, the novel methods for which will be transferrable to similar industrial sites.fals

Factors associated with nosocomial SARS-CoV transmission among healthcare workers in Hanoi, Vietnam, 2003

Background: In March of 2003, an outbreak of Severe Acute Respiratory Syndrome (SARS) occurred in Northern Vietnam. This outbreak began when a traveler arriving from Hong Kong sought medical care at a small hospital (Hospital A) in Hanoi, initiating a serious and substantial transmission event within the hospital, and subsequent limited spread within the community. Methods: We surveyed Hospital A personnel for exposure to the index patient and for symptoms of disease during the outbreak. Additionally, serum specimens were collected and assayed for antibody to SARS-associated coronavirus (SARS-CoV) antibody and job-specific attack rates were calculated. A nested case-control analysis was performed to assess risk factors for acquiring SARS-CoV infection. Results: One hundred and fifty-three of 193 (79.3%) clinical and non-clinical staff consented to participate. Excluding job categories with <3 workers, the highest SARS attack rates occurred among nurses who worked in the outpatient and inpatient general wards (57.1, 47.4%, respectively). Nurses assigned to the operating room/intensive care unit, experienced the lowest attack rates (7.1%) among all clinical staff. Serologic evidence of SARS-CoV infection was detected in 4 individuals, including 2 non-clinical workers, who had not previously been identified as SARS cases; none reported having had fever or cough. Entering the index patient's room and having seen (viewed) the patient were the behaviors associated with highest risk for infection by univariate analysis (odds ratios 20.0, 14.0; 95% confidence intervals 4.1–97.1, 3.6–55.3, respectively). Conclusion: This study highlights job categories and activities associated with increased risk for SARS-CoV infection and demonstrates that a broad diversity of hospital workers may be vulnerable during an outbreak. These findings may help guide recommendations for the protection of vulnerable occupational groups and may have implications for other respiratory infections such as influenza

Defects in death-inducing signalling complex formation prevent JNK activation and Fas-mediated apoptosis in DU 145 prostate carcinoma cells

Androgen-independent prostate carcinomas are resistant to chemotherapy and cell lines derived from androgen-independent prostate carcinomas such as DU 145 cells are highly resistant to Fas-mediated apoptosis. The incubation of DU 145 cells with anti-Fas IgM agonistic antibody of Fas receptor fails to activate JNK, a stress kinase involved in regulating apoptosis. We have previously shown that JNK activation is sufficient and necessary to promote Fas-mediated apoptosis in DU 145 cells. We investigate the mechanisms by which JNK activation and apoptosis are abrogated. HSP27 is overexpressed in DU 145 cells and has previously been reported to sequester DAXX and prevent JNK activation in cells treated with anti-Fas IgM. However, we find no evidence that HSP27 interacts with DAXX in DU 145 cells. Instead, we find that FADD does not interact with caspase-8 and this results in defective death-inducing signalling complex formation following Fas receptor activation

Improved precision on the experimental E0 decay branching ratio of the Hoyle state

Stellar carbon synthesis occurs exclusively via the $3\alpha$ process, in which three $\alpha$ particles fuse to form $^{12}$C in the excited Hoyle state, followed by electromagnetic decay to the ground state. The Hoyle state is above the $\alpha$ threshold, and the rate of stellar carbon production depends on the radiative width of this state. The radiative width cannot be measured directly, and must instead be deduced by combining three separately measured quantities. One of these quantities is the $E0$ decay branching ratio of the Hoyle state, and the current $10$\% uncertainty on the radiative width stems mainly from the uncertainty on this ratio. The $E0$ branching ratio was deduced from a series of pair conversion measurements of the $E0$ and $E2$ transitions depopulating the $0^+_2$ Hoyle state and $2^+_1$ state in $^{12}$C, respectively. The excited states were populated by the $^{12}$C$(p,p^\prime)$ reaction at 10.5 MeV beam energy, and the pairs were detected with the electron-positron pair spectrometer, Super-e, at the Australian National University. The deduced branching ratio required knowledge of the proton population of the two states, as well as the alignment of the $2^+_1$ state in the reaction. For this purpose, proton scattering and $\gamma$-ray angular distribution experiments were also performed. An $E0$ branching ratio of $\Gamma^{E0}_{\pi}/\Gamma=8.2(5)\times10^{-6}$ was deduced in the current work, and an adopted value of $\Gamma^{E0}_{\pi}/\Gamma=7.6(4)\times10^{-6}$ is recommended based on a weighted average of previous literature values and the new result. The new recommended value for the $E0$ branching ratio is about 14% larger than the previous adopted value of $\Gamma^{E0}_{\pi}/\Gamma=6.7(6)\times10^{-6}$, while the uncertainty has been reduced from 9% to 5%.Comment: Accepted for publication as a Regular Article in Phys. Rev. C on July 29 202

Temporal Dynamics of Interferon Gamma Responses in Children Evaluated for Tuberculosis

BACKGROUND: Development of T-cells based-Interferon gamma (IFNgamma) assays has offered new possibilities for the diagnosis of latent tuberculosis infection (LTBI) and active disease in adults. Few studies have been performed in children, none in France. With reference to the published data on childhood TB epidemiology in the Paris and Ile de France Region, we considered it important to evaluate the performance of IGRA (QuantiFERON TB Gold In Tube(R), QF-TB-IT) in the diagnosis and the follow-up through treatment of LTBI and active TB in a cohort of French children. METHODOLOGY/PRINCIPAL FINDINGS: 131 children were recruited during a prospective and multicentre study (October 2005 and May 2007; Ethical Committee St Louis Hospital, Paris, study number 2005/32). Children were sampled at day 0, 10, 30, 60 (except Healthy Contacts, HC) and 90 for LTBI and HC, and a further day 120, and day 180 for active TB children. Median age was 7.4 years, with 91% of the children BCG vaccinated. LTBI and active TB children undergoing therapy produced significant higher IFNgamma values after 10 days of treatment (p = 0.035). In addition, IFNgamma values were significantly lower at the end of treatment compared to IFNgamma values at day 0, although the number of positive patients was not significantly different between day 0 and end of treatment. CONCLUSIONS/ SIGNIFICANCE: By following quantitative IFNgamma values in each enrolled child with LTBI or active TB and receiving treatment, we were able to detect an increase in the IFNgamma response at day 10 of treatment which might allow the confirmation of a diagnosis. In addition, a decline in IFNgamma values during treatment makes it possible for clinicians to monitor the effect of preventive or curative therapy