ORCID Profile
0000-0002-8197-5736
Current Organisations
Northumbria University
,
University of Pittsburgh
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Publisher: Informa UK Limited
Date: 09-01-2023
Publisher: Springer Science and Business Media LLC
Date: 04-09-2019
DOI: 10.1007/S12028-019-00835-Z
Abstract: Neurocritical care is devoted to the care of critically ill patients with acute neurological or neurosurgical emergencies. There is limited information regarding epidemiological data, disease characteristics, variability of clinical care, and in-hospital mortality of neurocritically ill patients worldwide. We addressed these issues in the Point PRevalence In Neurocritical CarE (PRINCE) study, a prospective, cross-sectional, observational study. We recruited patients from various intensive care units (ICUs) admitted on a pre-specified date, and the investigators recorded specific clinical care activities they performed on the subjects during their first 7 days of admission or discharge (whichever came first) from their ICUs and at hospital discharge. In this manuscript, we analyzed the final data set of the study that included patient admission characteristics, disease type and severity, ICU resources, ICU and hospital length of stay, and in-hospital mortality. We present descriptive statistics to summarize data from the case report form. We tested differences between geographically grouped data using parametric and nonparametric testing as appropriate. We used a multivariable logistic regression model to evaluate factors associated with in-hospital mortality. We analyzed data from 1545 patients admitted to 147 participating sites from 31 countries of which most were from North America (69%, N = 1063). Globally, there was variability in patient characteristics, admission diagnosis, ICU treatment team and resource allocation, and in-hospital mortality. Seventy-three percent of the participating centers were academic, and the most common admitting diagnosis was subarachnoid hemorrhage (13%). The majority of patients were male (59%), a half of whom had at least two comorbidities, and median Glasgow Coma Scale (GCS) of 13. Factors associated with in-hospital mortality included age (OR 1.03 95% CI, 1.02 to 1.04) lower GCS (OR 1.20 95% CI, 1.14 to 1.16 for every point reduction in GCS) pupillary reactivity (OR 1.8 95% CI, 1.09 to 3.23 for bilateral unreactive pupils) admission source (emergency room versus direct admission [OR 2.2 95% CI, 1.3 to 3.75] admission from a general ward versus direct admission [OR 5.85 95% CI, 2.75 to 12.45 and admission from another ICU versus direct admission [OR 3.34 95% CI, 1.27 to 8.8]) and the absence of a dedicated neurocritical care unit (NCCU) (OR 1.7 95% CI, 1.04 to 2.47). PRINCE is the first study to evaluate care patterns of neurocritical patients worldwide. The data suggest that there is a wide variability in clinical care resources and patient characteristics. Neurological severity of illness and the absence of a dedicated NCCU are independent predictors of in-patient mortality.
Publisher: Springer Science and Business Media LLC
Date: 07-06-2019
Publisher: Informa UK Limited
Date: 21-03-2022
Publisher: Informa UK Limited
Date: 02-01-2023
Publisher: Informa UK Limited
Date: 22-11-2022
Publisher: Informa UK Limited
Date: 20-03-2023
Publisher: Informa UK Limited
Date: 02-01-2023
Publisher: Springer Science and Business Media LLC
Date: 20-05-2022
DOI: 10.1007/S00134-022-06702-4
Abstract: Traumatic brain injury (TBI) remains one of the most fatal and debilitating conditions in the world. Current clinical management in severe TBI patients is mainly concerned with reducing secondary insults and optimizing the balance between substrate delivery and consumption. Over the past decades, multimodality monitoring has become more widely available, and clinical management protocols have been published that recommend potential interventions to correct pathophysiological derangements. Even while evidence from randomized clinical trials is still lacking for many of the recommended interventions, these protocols and algorithms can be useful to define a clear standard of therapy where novel interventions can be added or be compared to. Over the past decade, more attention has been paid to holistic management, in which hemodynamic, respiratory, inflammatory or coagulation disturbances are detected and treated accordingly. Considerable variability with regards to the trajectories of recovery exists. Even while most of the recovery occurs in the first months after TBI, substantial changes may still occur in a later phase. Neuroprognostication is challenging in these patients, where a risk of self-fulfilling prophecies is a matter of concern. The present article provides a comprehensive and practical review of the current best practice in clinical management and long-term outcomes of moderate to severe TBI in adult patients admitted to the intensive care unit.
Publisher: Informa UK Limited
Date: 07-11-2022
Publisher: Emerald
Date: 19-05-2022
Abstract: Today, proficient practices are required to stimulate along various boundaries of the supply chain (SC) to exploit manufacturing resources economically, effectually and gracefully for retaining operational excellence. Accordingly, varieties of paramount practices, i.e. Lean, Agile, Resilient and Green practices, are integrated in present study with the objective to develop a Decision Support Framework (DSF) to select robust supplier under the extent of Lean-Agile-Resilient-Green (LARG) practices for a manufacturing firm. The framework is developed and validated in the Indian automotive sector, where the primary data is collected based on perceptions of the respondents working in an automotive company. LARG metrics can ponder ecological balance, customer satisfaction, associations, effectiveness and sustainability and thus, the study consolidated LARG practices in one umbrella to develop a DSF. The analytical approach under DSF is developed by the integration AHP, DEMATEL, ANP, Extended MOORA and SAW techniques in present study to evaluate a robust supplier under the aegis of LARG practices in SC. DSF is developed by scrutinizing and categorizing LARG characteristics, where the selected LARG characteristics are handled by fuzzy sets theory to deal with the impreciseness and uncertainty in decision making. The study has identified 63 measures (15 for Lean, 15 for Agile, 14 for resilient and 19 for Green) to support the robust supplier selection process for manufacturing firms. The findings of study explicate “Internal communication agility”, “Interchangeability to personnel resources”, “Manufacturing flexibility”, “degree of online solution”, “Quickness to resource up-gradation”, “Manageability to demand and supply change”, “Overstocking inventory practices” as significant metrics in ranking order. Additionally, “Transparency to share information”, “Internal communication agility”, “Manufacturing Flexibility”, “Green product (outgoing)” are found as influential metrics under LARG practices respectively. A technical DSF to utilize by the managers is developed, which is connected with knowledge-based theory and a case of an automobile manufacturing firm is presented to illustrate its implementation. The companies can utilize presented DSF to impose service excellence, societal performance, agility and green surroundings in SC for achieving sustainable outcomes to be welcomed by the legislations, society and rivals. The framework represents an important decision support tool to enable managers to overcome imprecise SC information sources. The study presented a proficient platform to review the most significant LARG alternative in the SC. The study suggested a cluster of LARG metrics to support operational improvement in manufacturing firms for shifting gear toward sustainable SC practices. The present study embraces its existence in enrolling a high extent of collaboration amongst clients, project teams and LARG practices to virtually eradicate the likelihood of absolute project failure.
Publisher: Emerald
Date: 12-10-2023
DOI: 10.1108/IJQRM-05-2021-0134
Abstract: Industry 4.0 is a new trend among organizations. Some organizations have been early adopters or later adopters of Industry 4.0. The purpose of this paper is to investigate how performance effects vary between early and late adopters of Industry 4.0. This study applies a qualitative research methodology using grounded theory. 14 senior management professionals who have implemented Industry 4.0 participated in this study through a theoretical and snowball s ling approach. These professionals were from manufacturing and service sectors, from North America, Europe and Asia. The study used semi structured open-ended interviews to capture the organizational performance on operational, financial, environmental and social dimensions. The findings were analyzed in terms of four broad themes which emerged from the interviews. In operational performance the operational and implementation cost will be higher for early adopters. The late adopters may enjoy the advantage in terms of improved business models. In terms of financial performance, the early adopters may see a marginal increase in profit and increased stock price compared to late adopters. The performance on the environmental dimension will see early adopters enjoying material efficiency, energy savings and an improved image of the company compared to late adopters. In social performance, the early adopters will provide a better quality of work life, safer manufacturing environment. However, the resistance from labor unions will be higher for early adopters compared to late adopters. Organizations must decide the timing of implementation of Industry 4.0. This study will act as a guide wherein they can decide to be an early adopter or late adopter based on knowledge of the resulting performance consequences. This is the first paper that studies the performance effects of early versus late adopters of Industry 4.0.
Publisher: Informa UK Limited
Date: 02-01-2023
Publisher: Springer Science and Business Media LLC
Date: 20-06-2022
Publisher: Informa UK Limited
Date: 08-12-2022
Publisher: Informa UK Limited
Date: 07-05-2022
Publisher: Emerald
Date: 07-04-2023
Abstract: The purpose of this empirical research is to understand the application of Lean practices (technical and social) and tools in the service sector, whose implementation is less studied, despite its economic relevance. The study aims to extend previous studies that focused on the relationship between Lean and operational and financial performance, and analyzing the impact on sustainability, encompassing economic, social and environmental perspectives. A pilot survey was conducted with Lean experts in European service companies. The authors have utilized various professional contacts on LinkedIn and a satisfactory response rate was obtained for analysis. The results of the study showed that there are several motivating factors for the implementation of Lean, the highlights being improving customer satisfaction, efficiency, delivery and cost reduction. The most frequently used Lean tools are related to the identification of improvement opportunities and causes of problems. The pilot survey also made it possible to identify the greater use of technical practices than social practices. The sustainability performance analysis showed that the better performance of service companies is in the economic dimension. The authors have identified no empirical studies linking Lean and sustainable performance in the service sector. This study bridges this cognitive gap through a pilot study and therefore makes an original contribution to the current literature.
Publisher: Informa UK Limited
Date: 07-05-2022
Publisher: Informa UK Limited
Date: 20-12-2022
Publisher: Informa UK Limited
Date: 18-12-2022
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Jiju Antony.