RESUMEN
Gedryf deur die totale koste van eienaarskap, handel en tegnologiemededinging tussen die Verenigde State van Amerika en China, en die COVID-19-pandemie, ondergaan wereldwye voorsieningskettings 'n groot herstrukturering wat binnekort die besigheid en ekonomie oor die hele wereld sal transformeer. Onlangs het voorsieningskettings met end-totend-integrasie vir premium landbouvoedselprodukte as 'n nuwe sakemodel na vore gekom. Hierdie artikel ondersoek hoe hulle moet funksioneer, en identifiseer die voorsieningskettingstruktuur / - produksie / - besigheids toestande wat nodig is vir hul ontwikkeling. Ons bestudeer 'n premium voorsieningsketting wat bestaan uit baie klein plase wat piesangs van topgehalte produseer, een integreerfirma en duisende kleinhandelwinkels. Ons gebruik industrie- en besigheidsdata om 'n meervoudige roete-vloei-gebaseerde model te kalibreer van plase tot integreerder tot kleinhandelaars/markte. Ons gebruik dan sensitiwiteitsanalise om die belanghebbendes se besluitgedrag te analiseer, en identifiseer en bespreek drie hoofbesluitkwessies: kontrakboerdery, kapasiteitstrategie en besigheidsrobuustheid. Vir kontrakspesifikasie is kontraktering op prys, eerder as hoeveelheid, bevorderlik om die belange van die belanghebbendes te koördineer. Vir die kapasiteitstrategie moet die integreerder rou produkte van baie klein plase verkry eerder as minder groot plase. Vir besigheid se robuustheid kan die integreerder steeds robuuste winste verseker deur sy produkaanbod te reguleer wanneer nuwe mededingers ontstaan of vraag verander. Hierdie resultate word onder verskeie scenario's getoets om die impak van insetparameters of voorsieningskettingstruktuur te bepaal, en word geverifieer met 'n bedryfspraktisyn wat ondervinding het met veelvuldige premium agri-voedselprodukte. Die resultate, tesame met die vloeimodel en sy berekeningsprosedure, kan deur voorsieningskettingbeplanners gebruik word om nuwe besighede te begin of om kleinhandelaars se premium produkaanbiedinge in mededingende besigheidsomgewings te onderskei.Alternate :Driven by the total cost of ownership, US-China trade and technology competition, and the COVID-19 pandemic, global supply chains are undergoing a major restructuring that will soon transform business and economics all over the world. Recently, supply chains with end-to-end integration for premium agri-food products have emerged as a new business model. This paper examines how they should function, and identifies the supply chain structure/production/business conditions necessary for their development. We study a premium supply chain consisting of many small farms that produce top-quality bananas, one integrator firm, and thousands of retail stores. We use industry and business data to calibrate a multiple-route flow-based model from farms to integrator to retailers/markets. We then use sensitivity analysis to illuminate the stakeholders' decision behaviour, and identify and discuss three main decision issues: contract farming, capacity strategy, and business robustness. For contract specification, contracting on price rather than quantity is conducive to coordinating the interests of the stakeholders. For the capacity strategy, the integrator should source raw products from many small farms rather than fewer large farms. For business robustness, the integrator could still ensure robust profits by regulating its product supply when new competitors arise or demand changes. These results are tested under various scenarios to determine the impact of input parameters or supply chain structure, and are verified with an industry practitioner who has experience with multiple premium agri-food products. The results, along with the flow model and its computation procedure, could be used by supply chain planners to start new businesses or to differentiate retailers' premium product offerings in competitive business environments.
RESUMEN
Organ transplant recipients have diminished humoral immune responses to COVID-19 vaccination than the general population. The current study have reported the risk factors about the antibody response after vaccination. Data from several studies show that to use of mycophenolate mofetil (MMF) as a major factor associated with poor antibody response after COVID-19 vaccination. But little is known at heart transplant recipients(HTXs) and in Asian race. We performed a single-center, prospective observational cohort study of 59 HTXs from National Taiwan University Hospital, Taiwan, was conducted between Jun 1, 2021 and July 31, 2022. We identified the response of antibody titers after vaccination and there were stratified into two categories: with MMF;without MMF. Anti‐spike IgG (S‐IgG) antibody was determined at a specified time point, which is 30 days after each dose of vaccine, and a S‐IgG value of 0.8 U/mL or higher was considered positive (Roche Diagnostics). We enrolled 59 patients (age: 53±13 years;86 % were men) with a negative SARS-CoV-2 anti-nucleocapsid antibody test. 21 patients received an immunosuppressive regimen with MMF, Among these patients, 21 received an immunosuppressive regimen with MMF (36%) throughout the study period. The time period of vaccine administration between the first and the second dose ranged from 28 to 135 days. The time period between the second and the third dose ranged from 34 to 182 days For those recipient, tacrolimus blood levels is 2.6 to 12.1 ng/mL, MMF is given in dose of 250 to 3000 mg QD, the everolimus(EVR) blood level is 1.6 to 5 ng/mL before the first vaccination. The antibody response positive of HTXs on a MMF-containing immunosuppressive regimen were 13% after first vaccination, whereas the response on the no-MMF regimen was significantly higher at 50% (P = 0.002). And the antibody response titer of an MMF-containing group is were significantly lower than no MMF-containing group (P = 0.019 and P = 0.002) after 1 and 2 vaccinations. An immunosuppressive regimen with MMF (no/with EVR) is hampered the antibody response after COVID-19 2 vaccinations and no significantly after COVID-19 3 vaccinations(p=0.101). The result will not affected by the type of vaccination. This finding should be investigated in larger cohorts, including transplant recipients of all races. [ABSTRACT FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)