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With growing pressure on service providers to reduce cost and improve quality of deliverables in shorter timelines, CDM organizations and professionals need to think out of the box to retain existing clients and win new clients. Traditionally LEAN techniques have been the stronghold of manufacturing, but in the last few decades they have been effectively used in the service industry, including healthcare. In CDM, LEAN has emerged as an impactful tool in improving process efficiency and reducing operational costs. It also allows professionals to engage with senior leadership in discussions around successful deployment of LEAN. The presentation will focus on the main LEAN principles, practices, tools and methodologies and a strategic approach for its successful deployment in CDM. It will focus on the key benefits that CDM can derive from LEAN techniques such as reducing waste, rework, redundancy in process, and providing deliverables with greater accuracy and shorter timeframes while also addressing challenges such as determining process/input/output metrics, end to end process streamline, longer wait/cycle times, resource utilization and measuring deliverables with less effort. This in turn will drive client delight.

In order to improve the efficiency of the work in daily life, we adopt the office automation (OA) system to assist the management and service. By the online function and automatic management with the system software, the daily works ran well, the working efficiency got improved. The practice implies that it is feasible to apply the OA system to the daily work and management.

Trichomonas vaginalis causes the Trichomoniasis, in women and urethritis and prostate cancer in men. Presently Metronidazole, nitroimidazoles and tinidazole are used as the drugs of choice. But the emergence of drug resistant and cross resistance varieties of T. vaginalis has led to a search for novel drug targets. We have performed an insilico comparative analysis of metabolic pathways of the host Homo sapiens and the pathogen T. vaginalis. Enzymes from the biochemical pathways of T. vaginalis from the KEGG metabolic pathway database were compared with proteins from the host H. sapiens, by performing a BLASTp search against the non-redundant database restricted to the H. sapiens subset. The e-value threshold cutoff was set to 0.005. Enzymes, which do not show similarity to any of the host proteins, below this threshold, were filtered out as potential drug targets. Out of total 55 metabolic pathway in humans 26 metabolic pathways were identified when compared to the host H. sapiens. These 26 identified metabolic pathways contain 30 unique enzymes which are only present in T. vaginalis and absent in humans. The T. vaginalis genes for the identified enzymes were also retrieved for BLASTP search to identify any homologous protein in humans. Cysteine synthase and methionine gamma-lyase are two novel drug targets which were also reported well in literature and thus can be used to designing of inhibitors for the remedy of trichomoniasis.

Neurological complications of infectious endocarditis (IE) occur in 20% to 40% of patients with IE and increase their risk (1). Most often, it is about embolisms, at the origin of ischemic vascular accidents, sometimes secondarily hemorrhagic. Central nervous system infections during IE are relatively rare (2,3,4): 6-7% for meningitis (2,4) and 1-4% for brain abscess (2,4). We report the case of a 34-year-old patient whose diagnosis of endocarditis complicated by massive mitral insufficiency by ruptured cordage was retained after a dramatic episode of meningoencephalitis, the origin of which was described as tuberculosis surgical treatment. The interest of this case lies in the importance to be accorded to the cardiovascular examination in the context of neurological emergencies, the scarcity of the tubercular origin of this affection and the medical and surgical challenge to raise in front of a patient carrying a massive mitral insufficiency, a candidate for cardiac surgery and subjected to an anti-bacillary treatment of difficult management

The purpose of this study is to evaluate the influence of PIF in relation to the types of plantain trees in Gbadolite in the Democratic Republic. The experimental set-up used was that of complete randomized blocks with 3 treatments (T1: French; T2: True Horn; T3: False Horn) and 3 replications. Weaned per cormus, 44 rejects; 32 rejects and 30 rejects respectively for the French, True Horn and False Horn types. The French type gave more weaned offspring than the true and false horn types under Gbadolite conditions. In short, the second hypothesis is confirmed. Therefore, the french type responds to this technique than the other types.

One of the most important purposes in reading English written texts is to understand writer's messages. However, it seems that the Iranian EFL learners have fundamental problems in understanding and interpreting English written texts. Making EFL/ESL students aware of efficient reading strategies that help in the reading of English texts has been the concern of educators and researchers, and necessarily reading instructors for years. Educators usually use different text structures such as; compare/contrast, cause/effect, problem/solution and a collection of descriptions to convey the message to their readers. Studies have identified that learners performed differently after they have read different text structures. In this research I investigated 2 groups of Iranian students’ performance after reading two kinds of text structures which are compare/contrast and cause/effect. These groups of subjects were 10 intermediate and 10 advanced levels who participated in study. The results of the study through t-test analysis identified that both groups performed differently after reading the different text structures. Findings of this research could provide significant awareness for both teachers and students to recognize how different reading texts can be organized in terms of difficulty.

There are currently one billion overweight and obese people in the globe. The frequency of obesity has sharply increased worldwide. For the healthcare system, this results in extremely high expenses. Due to the poor compliance characteristic of adolescents, dietary restrictions and meticulous programmed to change their lifestyle are frequently ineffectual in managing the specific group of patients. In order to address obesity, a number of strategies, including medical treatments and surgical procedures, have been developed. Some people say they would like to lose weight surgically or are able to do so. Many people view bariatric surgery as risky and think that maintaining their current weight is safer than having the procedure. There are several novel laparoscopic and endoscopic procedures available to help with weight loss, with intragastrical balloons among the most recent developments. The weight loss achieved with the balloon is an opportunity to lower the surgical and anesthesiologic consequences resulting from bariatric surgery in super-obese individuals with various comorbidities. A novel swallow able intragastrical balloon has been tested for safety and efficacy in reducing excess weight. Utilizing intragastrical balloons, the review's major focus is on helping patients lose weight while improving their co-morbidities.

Reinvention of the mortgage market through the creation of a secondary market has been identified as one of the solution to the lack of funds that plague the Nigerian housing sector. There is however a set of institutional barriers that have created risk factors that are responsible for the high interest rates on mortgage loans in economy. This paper identifies some of these barriers as the requirement of Governor’s consent, revocation of right of occupancy, mortgage registration period and foreclosure period and the cost of foreclosure. It further reveals their nature in the present mortgage lending practice and makes recommendation to improve the practice in preparation for any secondary mortgage market operations.

Reliable NGOs are an extended arm to any Governments. The purpose of this paper is to give an overview of the quantum of foreign aid contributed to Indian development and the role played by International non-Governmental development aid agencies and Bi-lateral and Multi-lateral agencies in this area. The paper also explains the role played by Indian non-Governmental organizations in the poverty alleviation programmed among marginal sections of the Indian society. The paper then examines some of the drawbacks in their aid programmed with special reference to Dalit cause and makes some recommendations to address these drawbacks. However some of the conclusions we have drawn in the paper is based on interaction with many groups and years of experience. Therefore please treat this as a first attempt of a beginning of a wider debate in the months to come.

The level of pollution has increased with times by lot of factors like the increase in population, increased vehicle use, industrialisation and urbanisation which results in harmful effects on human being by directly affecting health of population exposed to it. IOT Based system for monitoring and controlling Air Pollution in which monitor the Air Quality at any Industry over a web server using sensors when the air quality goes down across a certain level, means when there are sufficient amount of harmful gases are present in the air like CO2, smoke, alcohol, benzene and NH3. It will show the air quality in PPM on the display screen and as well as on website so that we can handle and monitor it easily. After gathered the information about air quality, this information is send to the Air Pollution Control Officer and the owner of Industry through mail and message in order to take strict action.