Search results for: Pulmonary delivery

Authors: Mohammad Nasri, Hossein Mirshekarpour

Abstract:

We aimed to investigate how can target and optimize pulmonary delivery distribution by changing physicochemical characteristics of instilled liquid.Therefore, we created a new liquids group: a. eligible for desired distribution within lung because of assorted physicochemical characteristics b. capable of being augmented with a broad range of chemicals inertly c. no interference on respiratory function d. compatible with airway surface liquid We developed forty types of new liquid,were composed of Carboxymethylcellulose sodium,Glycerin and different types of Polysorbates.Viscosity was measured using a Programmable Rheometer and surface tension by KRUSS Tensiometer.We subsequently examined the liquids and delivery protocols by simple and branched glass capillary tube models of airways.Eventually,we explored pulmonary distribution of liquids being augmented with technetium-99m in mechanically ventilated rabbits.We used a single head large field of view gamma camera.Kinematic viscosity between 0.265Stokes and 0.289Stokes,density between 1g/cm3 and 1.5g/cm3 and surface tension between 25dyn/cm and 35dyn/cm were the most acceptable.

Keywords: Pulmonary delivery, Liquid instillation into airway, Physicochemical characteristics, Optimal distribution.

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Authors: Alfred L. Guiffrida

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A review of the literature on supply chain delivery models which use delivery windows to measure delivery performance is presented. The review herein serves to meet the following objectives: (i) provide a synthesis of previously published literature on supply chain delivery performance models, (ii) provide in one paper a consolidation of research that can serve as a single source to keep researchers up to date with the research developments in supply chain delivery models, and (iii) identify gaps in the modeling of supply chain delivery performance which could stimulate new research agendas.

Keywords: Delivery performance, Delivery window, Supply chain delivery models, Supply chain performance.

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Authors: Colette Malyack, Pius Egbelu

Abstract:

Business-to-Customer (B2C) delivery options have improved to meet increased demand in recent years. The change in end users has forced logistics networks to focus on customer service and sentiment that would have previously been the priority of the company or organization of origin. This has led to increased pressure on logistics companies to extend traditional B2B networks into a B2C solution while accommodating additional costs, roadblocks, and customer sentiment; the result has been the creation of the omnichannel delivery network encompassing a number of traditional and modern methods of package delivery. In this paper the many solutions within the omnichannel delivery network are defined and discussed. It can be seen through this analysis that the omnichannel delivery network can be applied to reduce the complexity of package delivery and provide customers with more options. Applied correctly the result is a reduction in cost to the logistics company over time, even with an initial increase in cost to obtain the technology.

Keywords: Network planning, Last Mile Delivery, LMD, omnichannel delivery network, omnichannel logistics.

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Authors: A. Maruf Aytekin

Abstract:

We present our approach on using continuous delivery pattern for release management. One of the key practices of agile and lean teams is the continuous delivery of new features to stakeholders. The main benefits of this approach lie in the ability to release new applications rapidly which has real strategic impact on the competitive advantage of an organization. Organizations that successfully implement Continuous Delivery have the ability to evolve rapidly to support innovation, provide stable and reliable software in more efficient ways, decrease the amount of resources need for maintenance, and lower the software delivery time and costs. One of the objectives of this paper is to elaborate a case study where IT division of Central Securities Depository Institution (MKK) of Turkey apply Continuous Delivery pattern to improve release management process.

Keywords: Automation, continuous delivery, deployment, release management.

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Authors: Inas S. Khayal, Weiping Zhou, Jonathan Skinner

Abstract:

Healthcare delivery systems around the world are in crisis. The need to improve health outcomes while decreasing healthcare costs have led to an imminent call to action to transform the healthcare delivery system. While Bioinformatics and Biomedical Engineering have primarily focused on biological level data and biomedical technology, there is clear evidence of the importance of the delivery of care on patient outcomes. Classic singular decomposition approaches from reductionist science are not capable of explaining complex systems. Approaches and methods from systems science and systems engineering are utilized to structure healthcare delivery system data. Specifically, systems architecture is used to develop a multi-scale and multi-dimensional characterization of the healthcare delivery system, defined here as the Healthcare Delivery System Knowledge Base. This paper is the first to contribute a new method of structuring and visualizing a multi-dimensional and multi-scale healthcare delivery system using systems architecture in order to better understand healthcare delivery.

Keywords: Health informatics, systems thinking, systems architecture, healthcare delivery system, data analytics.

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Authors: Wei Lo, Ming-En Kuo

Abstract:

While to minimize the overall project cost is always one of the objectives of construction managers, to obtain the maximum economic return is definitely one the ultimate goals of the project investors. As there is a trade-off relationship between the project time and cost, and the project delivery time directly affects the timing of economic recovery of an investment project, to provide a method that can quantify the relationship between the project delivery time and cost, and identify the optimal delivery time to maximize economic return has always been the focus of researchers and industrial practitioners. Using genetic algorithms, this study introduces an optimization model that can quantify the relationship between the project delivery time and cost and furthermore, determine the optimal delivery time to maximize the economic return of the project. The results provide objective quantification for accurately evaluating the project delivery time and cost, and facilitate the analysis of the economic return of a project.

Keywords: Time-Cost Trade-Off, Genetic Algorithms, Resource Integration, Economic return.

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Authors: Paul David Henry

Abstract:

This paper describes the results and implications of a correlational study of learning styles and learner satisfaction. The relationship of these empirical concepts was examined in the context of traditional versus e-blended modes of course delivery in an introductory graduate research course. Significant results indicated that the visual side of the visual-verbal dimension of students- learning style(s) was positively correlated to satisfaction with themselves as learners in an e-blended course delivery mode and negatively correlated to satisfaction with the classroom environment in the context of a traditional classroom course delivery mode.

Keywords: Course delivery mode, e-blended, hybrid, learner satisfaction, learning style.

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Authors: M. Safaei, M. Seifert, K. D. Thoben

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Supply network management adopts a systematic and integrative approach to managing the operations and relationships of various parties in a supply network. The objective of the manufactures in their supply network is to reduce inventory costs and increase customer satisfaction levels. One way of doing that is to synchronize delivery performance. A supply network can be described by nodes representing the companies and the links (relationships) between these nodes. Uncertainty in delivery time depends on type of network relationship between suppliers. The problem is to understand how the individual uncertainties influence the total uncertainty of the network and identify those parts of the network, which has the highest potential for improving the total delivery time uncertainty.

Keywords: Delivery time uncertainty, Distribution function, Statistical method, Supply Network.

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Authors: G. Schuh, A. Kampker, A. Hoeschen, T. Jasinski

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Today-s manufacturing companies are facing multiple and dynamic customer-supplier-relationships embedded in nonhierarchical production networks. This complex environment leads to problems with delivery reliability and wasteful turbulences throughout the entire network. This paper describes an operational model based on a theoretical framework which improves delivery reliability of each individual customer-supplier-relationship within non-hierarchical production networks of the European machinery and equipment industry. By developing a non-centralized coordination mechanism based on determining the value of delivery reliability and derivation of an incentive system for suppliers the number of in time deliveries can be increased and thus the turbulences in the production network smoothened. Comparable to an electronic stock exchange the coordination mechanism will transform the manual and nontransparent process of determining penalties for delivery delays into an automated and transparent market mechanism creating delivery reliability.

Keywords: delivery reliability, machinery and equipmentindustry, non-hierarchical production networks, supply chainmanagement

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Authors: Matthew O. Ikuabe, Ayodeji E. Oke, Clinton O. Aigbavboa, Douglas O. Aghimien, Tshepo P. Mokori

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The use of technological innovations has been touted to be beneficial in the delivery of construction projects. Particularly, Radio Frequency Identification (RFID) technology is widely regarded to be of immense advantage for the management of construction projects. This study focused on evaluating the barriers to the use of RFID technology for the delivery of construction projects. Using Gauteng Province in South Africa as the study area, questionnaire was used in eliciting responses from construction professionals which made up the population of the study. Retrieved data were analyzed using Mean Item Score and One-Sample t-test. Findings from the study showed that the most significant barriers to the deployment of RFID for construction project delivery are high cost and lack of awareness. Conclusively, the study made recommendations that would aid in the abatement of the barriers to the use of RFID technology for construction project delivery.

Keywords: Barriers, construction, project delivery, RFID.

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Authors: Ahmed Mohsen, Yoshinobu Kitamura, Katsuyuki Shimizu

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The improvement of irrigation systems in the Nile Delta is one of the most important attempts in Egypt to implement more effective irrigation technology by improving the existing irrigation networks. Demand delivery system in the existing irrigation network is using of mechanical gates structures to automatically divert water from one portion of an agricultural field to another in the desired amount and sequence. This paper discusses evaluating main irrigation networks system under the government managed before and after improvement systems in the Nile Delta. The overall results indicate that policy of using the demand delivery concept through irrigation networks is successful by improving water delivery performance among them than the rotation delivery concept that used before. It is provided fair share of water delivery among irrigation districts and available water in the end of irrigation network, although this system located in an end of irrigation networks in the Nile Delta.

Keywords: Automation system, Irrigation district, Rotation system, Water delivery performance

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Authors: M. Duran Toksarı, B. Uçarkuş

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In this paper, we propose two algorithms to optimally solve makespan and total completion time scheduling problems with learning effect and job dependent delivery times in a single machine environment. The delivery time is the extra time to eliminate adverse effect between the main processing and delivery to the customer. In this paper, we introduce the job dependent delivery times for some single machine scheduling problems with position dependent learning effect, which are makespan are total completion. The results with respect to two algorithms proposed for solving of the each problem are compared with LINGO solutions for 50-jobs, 100-jobs and 150- jobs problems. The proposed algorithms can find the same results in shorter time.

Keywords: Delivery times, learning effect, makespan, scheduling, total completion time.

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Authors: Haluk Eren, Ümit Çelik

Abstract:

Recent developments in unmanned aerial vehicles (UAVs) have begun to attract intense interest. UAVs started to use for many different applications from military to civilian use. Some online retailer and logistics companies are testing the UAV delivery. UAVs have great potentials to reduce cost and time of deliveries and responding to emergencies in a short time. Despite these great positive sides, just a few works have been done for routing of UAVs for package deliveries. As known, transportation of goods from one place to another may have many hazards on delivery route due to falling hazards that can be exemplified as ground objects or air obstacles. This situation refers to wide-range insurance concept. For this reason, deliveries that are made with drones get into the scope of shipping insurance. On the other hand, air traffic was taken into account in the absence of unmanned aerial vehicle. But now, it has been a reality for aerial fields. In this study, the main goal is to conduct risk analysis of package delivery services using drone, based on delivery routes.

Keywords: Drone risk assessment, drone package delivery.

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Authors: Nareeluk Suwannobol, Lakkhana Suwachan

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The purpose of this study was to study the practical delivery room experience of nursing students. The respondents were 6 junior nursing students of Suranaree University of Technology who had a direct experience from practicing in a delivery room between January 9 and March 30, 2012 as part of Nursing Care of the Family and Midwifery 3. The data was collected by using in-depth interview, observation, and reflective report. The results of the study found that the practical delivery room experience of nursing students consisted of three issues: 1) stress and coping with stress during practical exercise, 2) changes in daily routine, and 3) source during practical exercise. The results of this study would lead to the understanding of the meaning of the practical exercise of nursing students.

Keywords: Delivery Room, Practical Experience, Nursing Students.

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Authors: G. Venkata Hari Prasad, P. Rajesh Kumar

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Phonocardiography is important in appraisal of congenital heart disease and pulmonary hypertension as it reflects the duration of right ventricular systoles. The systolic murmur in patients with intra-cardiac shunt decreases as pulmonary hypertension develops and may eventually disappear completely as the pulmonary pressure reaches systemic level. Phonocardiography and auscultation are non-invasive, low-cost, and accurate methods to assess heart disease. In this work an objective signal processing tool to extract information from phonocardiography signal using Wavelet is proposed to classify the murmur as normal or abnormal. Since the feature vector is large, a Binary Particle Swarm Optimization (PSO) with mutation for feature selection is proposed. The extracted features improve the classification accuracy and were tested across various classifiers including Naïve Bayes, kNN, C4.5, and SVM.

Keywords: Phonocardiography, Coiflet, Feature selection, Particle Swarm Optimization.

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Authors: Guo Xiuhua, Sun Tao, Wu Haifeng, He Wen, Liang Zhigang, Zhang Mengxia, Guo Aimin, Wang Wei

Abstract:

Purpose: To explore the use of Curvelet transform to extract texture features of pulmonary nodules in CT image and support vector machine to establish prediction model of small solitary pulmonary nodules in order to promote the ratio of detection and diagnosis of early-stage lung cancer. Methods: 2461 benign or malignant small solitary pulmonary nodules in CT image from 129 patients were collected. Fourteen Curvelet transform textural features were as parameters to establish support vector machine prediction model. Results: Compared with other methods, using 252 texture features as parameters to establish prediction model is more proper. And the classification consistency, sensitivity and specificity for the model are 81.5%, 93.8% and 38.0% respectively. Conclusion: Based on texture features extracted from Curvelet transform, support vector machine prediction model is sensitive to lung cancer, which can promote the rate of diagnosis for early-stage lung cancer to some extent.

Keywords: CT image, Curvelet transform, Small pulmonary nodules, Support vector machines, Texture extraction.

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Authors: Sajjad Shojaeidoust, Mohsen Ghanbarzadeh, Abdolhamid Habibi

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Exercise-induced bronchospasm (EIB) is a transitory condition of airflow obstruction that is associated with physical activities. It is noted that high ventilation can lead to an increase in the heat and reduce in the moisture in airways resistance of trachea. Also causes of pathophysiological mechanism are EIB. Accordingly, studying some parameters of pulmonary function (FVC, FEV1) among active people seems quintessential. The aim of this study was to analyze bronchospasm following the implementation of a program of maximum aerobic exercise in active men at Chamran University of Ahwaz. Method: In this quasi-experimental study, the population consisted of all students at Chamran University. Among from 55 participants, of which, 15 were randomly selected as the experimental group. In this study, the size of the maximum oxygen consumption was initially measured, and then, based on the maximum oxygen consumed, the active individuals were identified. After five minutes’ warm-up, Strand treadmill exercise test was taken (one session) and pulmonary parameters were measured at both pre- and post-tests (spirometer). After data normalization using KS and non-normality of the data, the Wilcoxon test was used to analyze the data. The significance level for all statistical surveys was considered p≤0/05. Results: The results showed that the ventilation factors and bronchospasm (FVC, FEV1) in the pre-test and post-test resulted in no significant difference among the active people (p≥0/05). Discussion and conclusion: Based on the results observed in this study, it appears that pulmonary indices in active individuals increased after aerobic test. The increase in this indicator in active people is due to increased volume and elasticity of the lungs as well. In other words, pulmonary index is affected by rib muscles. It is considered that progress over respiratory muscle strength and endurance has raised FEV1 in the active cases.

Keywords: Bronchospasm, aerobic active maximum, pulmonary function, spirometer.

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Authors: Abdurrahim Bolukbasi, Hassan Athari, Dogan Ciloglu

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The modeling lung respiratory system that has complex anatomy and biophysics presents several challenges including tissue-driven flow patterns and wall motion. Also, the pulmonary lung system because of that they stretch and recoil with each breath, has not static walls and structures. The direct relationship between air flow and tissue motion in the lung structures naturally prefers an FSI simulation technique. Therefore, in order to toward the realistic simulation of pulmonary breathing mechanics the development of a coupled FSI computational model is an important step. A simple but physiologically relevant three-dimensional deep long geometry is designed and fluid-structure interaction (FSI) coupling technique is utilized for simulating the deformation of the lung parenchyma tissue that produces airflow fields. The real understanding of respiratory tissue system as a complex phenomenon have been investigated with respect to respiratory patterns, fluid dynamics and tissue viscoelasticity and tidal breathing period. 

Keywords: Lung deformation and mechanics, tissue mechanics, viscoelasticity, fluid-structure interactions, ANSYS.

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Authors: L. Korpinen, T. Kava, I. Salmi

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This study aimed to describe the operating model of obstructive sleep apnea. Due to the large number of patients, the role of nurses in the diagnosis and treatment of sleep apnea was important. Pulmonary physicians met only a minority of the patients. The sleep apnea study in 2018 included about 800 patients, of which about 28% were normal and 180 patients were classified as severe (apnea-hypopnea index [AHI] over 30). The operating model has proven to be workable and appropriate. The patients understand well that they may not be referred to a pulmonary doctor. However, specialized medical follow-up on professional drivers continues every year.

Keywords: Sleep, apnea patient, operating model, hospital.

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Authors: M. Antonelli, G. Frosini, B. Lazzerini, F. Marcelloni

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In this paper we describe a computer-aided diagnosis (CAD) system for automated detection of pulmonary nodules in computed-tomography (CT) images. After extracting the pulmonary parenchyma using a combination of image processing techniques, a region growing method is applied to detect nodules based on 3D geometric features. We applied the CAD system to CT scans collected in a screening program for lung cancer detection. Each scan consists of a sequence of about 300 slices stored in DICOM (Digital Imaging and Communications in Medicine) format. All malignant nodules were detected and a low false-positive detection rate was achieved.

Keywords: computer assisted diagnosis, medical imagesegmentation, shape recognition.

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Authors: Marketa Kotova, Jana Kolarova, Ludek Zalud, Petr Dobsak

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A game for training of breath (TRABR) for continuous monitoring of pulmonary ventilation during the patients’ therapy focuses especially on monitoring of their ventilation processes. It is necessary to detect, monitor and differentiate abdominal and thoracic breathing during the therapy. It is a fun form of rehabilitation where the patient plays and also practicing isolated breathing. Finally the game to practice breath was designed to evaluate whether the patient uses two types of breathing or not.

Keywords: Pulmonary ventilation, thoracic breathing, abdominal breathing, breath monitoring using pressure sensors, game TRABR (TRAining of BReath).

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Authors: Elaheh Jooybar, Mohammad J. Abdekhodaie, Marcel Karperien, Pieter J. Dijkstra

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In this study, hyaluronic acid (HA) microgels were developed for the goal of protein delivery. First, a hyaluronic acid-tyramine conjugate (HA-TA) was synthesized with a degree of substitution of 13 TA moieties per 100 disaccharide units. Then, HA-TA microdroplets were produced using a water in oil emulsion method and crosslinked in the presence of horseradish peroxidase (HRP) and hydrogen peroxide (H₂O₂). Loading capacity and the release kinetics of lysozyme and BSA, as model proteins, were investigated. It was shown that lysozyme, a cationic protein, can be incorporated efficiently in the HA microgels, while the loading efficiency for BSA, as a negatively charged protein, is low. The release profile of lysozyme showed a sustained release over a period of one month. The results demonstrated that the HA-TA microgels are a good carrier for spatial delivery of cationic proteins for biomedical applications.

Keywords: Microgel, inverse emulsion, protein delivery, hyaluronic acid, crosslinking.

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Authors: Nikola Vlahovic, Blazenka Knezevic, Petra Batalic

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In this paper, we will present a research about feasibility of implementing unmanned aerial vehicles, also known as 'drones', in logistics. Research is based on available information about current incentives and experiments in application of delivery drones in commercial use. Overview of current pilot projects and literature, as well as an overview of detected challenges, will be compiled and presented. Based on these findings, we will present a conceptual model of business process that implements delivery drones in business to business logistic operations. Business scenario is based on a pharmaceutical supply chain. Simulation modeling will be used to create models for running experiments and collecting performance data. Comparative study of the presented conceptual model will be given. The work will outline the main advantages and disadvantages of implementing unmanned aerial vehicles in delivery services as a supplementary distribution channel along the supply chain.

Keywords: Business process, delivery drones, logistics, simulation modelling, unmanned aerial vehicles.

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Authors: Kevser Simsek, Rahime Gunay

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In this paper, we focused primarily on Istanbul data that is gathered by using intelligent transportation systems (ITS), and considered the developments in traffic information delivery and future applications that are being planned for implementation. Since traffic congestion is increasing and travel times are becoming less consistent and less predictable, traffic information delivery has become a critical issue. Considering the fuel consumption and wasted time in traffic, advanced traffic information systems are becoming increasingly valuable which enables travelers to plan their trips more accurately and easily.

Keywords: Data Fusion, Istanbul, ITS, Real Time Information, Traffic Information, Travel Time, Urban Mobility

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Authors: G. Spada, E. Gavini, P. Giunchedi

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Aim of this work was to compare the efficacy of two loading methods of proteins onto polymeric nanocarriers: adsorption and encapsulation methods. Preliminary studies of protein loading were done using Bovine Serum Albumin (BSA) as model protein. Nanocarriers were prepared starting from polylactic co-glycolic acid (PLGA) polymer; production methods used are two different variants of emulsion evaporation method. Nanoparticles obtained were analyzed in terms of dimensions by Dynamic Light Scattering and Loading Efficiency of BSA by Bradford Assay. Loaded nanoparticles were then submitted to in-vitro protein dissolution test in order to study the effect of the delivery system on the release rate of the protein.

Keywords: Drug delivery, nanoparticles, PLGA, proteinadsorption, protein encapsulation.

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Authors: Aurelija Burinskienė, Dalė Dzemydienė, Arūnas Miliauskas

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This research aims at developing the approach for more effective freight delivery and transportation process management. The road congestions and the identification of causes are important, as well as the context information recognition and management. The measure of many parameters during the transportation period and proper control of driver work became the problem. The number of vehicles per time unit passing at a given time and point for drivers can be evaluated in some situations. The collection of data is mainly used to establish new trips. The flow of the data is more complex in urban areas. Herein, the movement of freight is reported in detail, including the information on street level. When traffic density is extremely high in congestion cases, and the traffic speed is incredibly low, data transmission reaches the peak. Different data sets are generated, which depend on the type of freight delivery network. There are three types of networks: long-distance delivery networks, last-mile delivery networks and mode-based delivery networks; the last one includes different modes, in particular, railways and other networks. When freight delivery is switched from one type of the above-stated network to another, more data could be included for reporting purposes and vice versa. In this case, a significant amount of these data is used for control operations, and the problem requires an integrated methodological approach. The paper presents an approach for providing e-services for drivers by including the assessment of the multi-component infrastructure needed for delivery of freights following the network type. The construction of such a methodology is required to evaluate data flow conditions and overloads, and to minimize the time gaps in data reporting. The results obtained show the possibilities of the proposing methodological approach to support the management and decision-making processes with functionality of incorporating networking specifics, by helping to minimize the overloads in data reporting.

Keywords: Transportation networks, freight delivery, data flow, monitoring, e-services.

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Authors: Jing Zhou, Steven Su, Aihuang Guo

Abstract:

COSMED K4b2 is a portable electrical device designed to test pulmonary functions. It is ideal for many applications that need the measurement of the cardio-respiratory response either in the field or in the lab is capable with the capability to delivery real time data to a sink node or a PC base station with storing data in the memory at the same time. But the actual sensor outputs and data received may contain some errors, such as impulsive noise which can be related to sensors, low batteries, environment or disturbance in data acquisition process. These abnormal outputs might cause misinterpretations of exercise or living activities to persons being monitored. In our paper we propose an effective and feasible method to detect and identify errors in applications by principal component analysis (PCA) and a back propagation (BP) neural network.

Keywords: BP Neural Network, Exercising Testing, Fault Detection and Identification, Principal Component Analysis.

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Authors: Steven R. Hawks

Abstract:

The Master-s of Public Health (MPH) degree is growing in popularity among a number of higher education institutions throughout the world as a distance education graduate program. This paper offers an overview of program design and development strategies that promote successful distance delivery of MPH programs. Design and development challenges are discussed in terms of type of distance delivery, accreditation, student demand, faculty development, user needs, course content, and marketing strategies. The ongoing development of a distance education MPH program at Utah State University will be used to highlight and consider various aspects of this important but challenging process.

Keywords: Public health, course content, distance education, higher education, graduate students.

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Authors: Zuhrotun Ulya, Muchammad Syamsulhadi, Debree Septiawan

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Patients with bipolar disorder are three times more likely to suffer cardiovascular disorders than the general population, which will influence their level of morbidity and rate of mortality. Bipolar disorder also affects the pulmonary system. The choice of long term-monotherapy and other combinative therapies have clinical impacts on patients. This study investigates the case of a woman who has been suffering from bipolar disorder for 16 years, and who has a history of Steven Johnson Syndrome. At present she is suffering also from cardiovascular and pulmonary disorder. An analysis of the results of this study suggests that there is a relationship between cardiovascular disorder, drug therapies, Steven Johnson Syndrome and mood stabilizer obtained from the PubMed, Cochrane, Medline, and ProQuest (publications between 2005 and 2015). Combination therapy with mood stabilizer is recommended for patients who do not have side effect histories from these drugs. The replacement drugs and combinations may be applied, especially for those with bipolar disorders, and the combination between atypical antipsychotic groups and mood stabilizers is often made. Clinicians, however, should be careful with the patients’ physical and metabolic changes, especially those who have experienced long-term therapy and who showed a history of Steven Johnson Syndrome (for which clinicians probably prescribed one type of medicine).

Keywords: Cardio-pulmonary disease, bipolar disorder, Steven Johnson Syndrome, therapy.

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Authors: Wan Hasrulnizzam Wan Mahmood, Mohd Razali Muhamad, Nurulain Mat Tahar

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This paper is prepared to provide a review of how an automotive manufacturer, ISUZU HICOM Malaysia Co. Ltd. sustained the supply chain management after business process reengineering in 2007. One of the authors is currently undergoing industrial attachment and has spent almost 6 months researching in the production and operation management system of the company. This study was carried out as part of the tasks in the attachment program. The result shows that delivery lateness and outsourcing are the main barriers that affected productivity. From the gap analysis, the authors found that new business process operation had improved suppliers delivery performance.

Keywords: Supply Chain Management, Business Process Re- Engineering, Delivery, Outsourcing, Automotive Manufacturer.

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