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Rheumatoid Arthritis (RA) is a chronic disease that impacts patients’ quality of life. Sophisticated organization of care delivery drives quality improvement. Therefore, the study objective was establishing a validated process map of the care cycle for RA patients. Hence, increasing transparency and optimizing care delivery and identifying areas of improvement. To map the RA care cycle, the care delivery value chain (CDVC) approach was used as framework to document activities and resources systematically. A mixed method study was conducted where quantitative data on activities were collected from health records and unstructured interviews with medical staff were held. Consequently, the process map was separately validated in a consensus meeting with a delegation of the medical staff and patient advisory board. At the start of the care cycle, the focus is predominantly on defining the treat-to-target strategy and examining disease activity. Towards the monitoring phase, tapering medication and managing the disease through patient-reported outcome measures are becoming increasingly important. Although patient’s functioning, quality of care and patient’s evaluation of received care are monitored, reflection of CDVC and engaging patients in the evaluation process resulted in improvement actions on outcome and process level. Mapping the RA care cycle following a systematic approach, provides insight and transparency in delivered activities, involved resources and the engagement of patients and caregivers at multiple levels, contributing to a system facilitating value-based care delivery. The CDVC framework and applied methodology is recommended in other conditions. Future research will focus at assigning outcomes and costs to activities and evaluating interventions to explore patient value.

Purpose: The purpose is to analyze the hospitals and their processes for knowing their functions and commonalities for the benefit of the best hospital choice for patients. In this study, five hospitals of Mangalore have been considered for the analysis. There are a few common things among these hospitals and certain competitive advantages that a few of them have. Hence, analysis is done based on various approaches like marketing, finance, HR, Strategy as well as the service in general. It is also to know the growth, uniqueness, competitive advantage, patient satisfaction, social contribution, and sustainability measures as well as to know the survival ability of hospitals. Design: This study is designed to collect information from various stakeholders of the respective hospitals and to analyze the same using various statistical tools. The data is then interpreted to ensure there is a perfect cross-sectional analysis of each organization from top to bottom as well as bottom-to-top approach. Findings: The findings are based on the data collected about the commonalities and differentiation of services that these five hospitals offer. KMC stands out to be number one among the five. Originality: This is a first of its kind approach to analyze five hospitals in one city in a paper and the entire study is done by the researcher as part of a bigger study. Type of Paper: Industry analysis; an empirical study.

Purpose: We continue our investigation into the origins of business models and look at how the business models of new firms originate by integrating institutional and restriction theories. Design: Amazon's business models are studied following the deductive and inductive approaches. Inductive: by checking the assumptions and coming to a conclusion, Deductive: by checking the theories and proving the hypothesis. Objective: To find out the competitive digital strategies of Amazon, that could be learned and copied for other organizational applications. Findings/Result: The findings show that there are several consumer complaints and service issues about Amazon's influence, notably in regard to pricing, customer service, in-store staff, and post-purchase support. The paper claims that Amazon's development and profitability have been greatly aided by business strategies combining technology, distribution networks, and customer service. These tactics have also assisted Amazon in differentiating itself from its competitors in the brick-and-mortar and online retail industries. Originality/Value: The business model as well as the SWOT analysis presented may be used by organizations to assess and narrow down their options for a business modeling platform. This case study work is original and would help researchers to do further study accordingly. Paper Type: Case study.

Carbonylation of (hetero)aryl iodides/bromides with highly deactivated 2-aminopyridines using Pd-Co(CO)4 bimetallic catalysis is accomplished. The use of Co2(CO)8 as a solid CO(g) source enhanced reaction rates observed when compared to CO(g), and excellent yields highlight the versatility of the developed protocol. A wide range of electronically and sterically demanding heterocyclic amines and (hetero)aryl iodides/bromides employed for this study resulted in excellent yields of amino carbonylated products. The developed methodology was further extended to synthesize Trypanosome brucie and luciferase inhibitors.

A series of 2,5-disubstituted 1,3,4-thiadiazole was synthesized and evaluated for their antioxidant and molecular docking studies. These molecules were efficiently synthesized under mild and inexpensive starting material. Construction of these molecules developed using substituted aldehydes and substituted dithioesters in presence of NCS (N-Chorosuccinimide). The compounds 4a, 4b, 4c, 4f, and 4k showed good antibacterial and antioxidant activity among which, 4k possess excellent antibacterial and antioxidant activity. The results of antioxidant activity studies revealed that compound 4k manifested profound antioxidant potential. The molecular docking study was performed with respective newly synthesized compounds to ascertain the binding mode of 4k with respect to the critical proteins involved in biosynthesis and metabolic pathways.

Background: Microvascular flap reconstruction (MFR) of medium–large tongue defects following ablative surgery is the standard of care. The decision for MFR is often made prior to surgery or intraoperatively depending on the extent of the defect and the volume of remnant tongue. However, there exists no objective technique to predict this requirement preoperatively. This knowledge is crucial for counseling and planning. We aimed to identify an objective magnetic resonance imaging (MRI) measurement tool to predict the need for MFR of tongue tumors. Materials and Methods: This was a retrospective analysis of patients undergoing surgery (with or without reconstruction) for squamous cell carcinoma of the tongue. Patients had a preoperative MRI as part of their assessment. As per our institution protocol, the decision for the requirement of MFR was made by a consensus of two experienced reconstructive surgeons intraoperatively. This decision was correlated with the ratio of tumor volume to the total tongue volume (tv) as observed in the MRI. Results: A total of 47 patients were identified. Twenty-eight patients underwent reconstruction, while 19 did not. The ratio of tumor thickness to tongue thickness (Tt/tt) was calculated, and a cutoff of >0.395 (sensitivity 89.3% and specificity 89.5%) was found to significantly correlate with the decision for MFR (P < 0.001). The volume of a tumor to total tv ratio was calculated from the data of 22 cases, and a cutoff of >4.2 (sensitivity 83.3 and specificity 90) was found to be correlated significantly with the decision for MFR (P < 0.001). Conclusion: Tt/tt ratio is a useful tool to determine the need for MFR of tongue tumor excision defects in the preoperative setting and can help guide counseling.

A protocol has been devised for the synthesis of 3-substituted 5-amino-1,2,4-thiadiazoles utilizing isothiocyanates, amidoximes and water as an eco-friendly solvent. The strategy involves consecutive C���N and S���N bonds formation in a one-pot reaction under catalyst-free conditions. Operational simplicity, low cost, broad substrate scope and readily available starting materials are the main features of this protocol.

Current work describes the environmentally benign approach for the synthesis of o-ureidobenzonitriles, from o-aminobenzamides and isothiocyanates using T3P. Here, the conversion of thiourea to urea and amide to nitrile take place simultaneously via unprecedented intramolecular rearrangement. This protocol is operationally facile and offers wide variety of o-ureidobenzonitriles at room temperature in good to excellent yields.