Purpose The purpose of this study was to advance the knowledge of pharmaceutical supply chain (PSC) resilience using complex adaptive system theory (CAS). Design/methodology/approach An exploratory research design, which adopted a qualitative approach was used to achieve the study’s research objective. Qualitative data were gathered through 23 semi-structured interviews with key supply chain actors across the PSC in the UK. Findings The findings demonstrate that CAS, as a theory, provides a systemic approach to understanding PSC resilience by taking into consideration the various elements (environment, PSC characteristics, vulnerabilities and resilience strategies) that make up the entire system. It also provides explanations for key findings, such as the impact of power, conflict and complexity in the PSC, which are influenced by the interactions between supply chain actors and as such increase its susceptibility to the negative impact of disruption. Furthermore, the antecedents for building resilience strategies were the outcome of the decision-making process referred to as co-evolution from a CAS perspective. Originality/value Based on the data collected, the study was able to reflect on the relationships, interactions and interfaces between actors in the PSC using the CAS theory, which supports the proposition that resilience strategies can be adopted by supply chain actors to enhance this service supply chain. This is a novel empirical study of resilience across multiple levels of the PSC and as such adds valuable new knowledge about the phenomenon and the use of CAS theory as a vehicle for exploration and knowledge construction in other supply chains.

Abstract:Purpose-This research is to develop a distributed system with an innovative supplier selection approach within a mass customization environment. It helps manufacturers to identify appropriate suppliers for the components, materials and services required within the procedure of product design and manufacture.Design/methodology/approach-To identify the barriers for the supplier selection issues, current researches regarding the issues of supplier selection and mass customization have been reviewed. Based on the findings, the new supplier selection approach has been developed. Findings:Within the global manufacturing environment, conventional way of appraising suppliers cannot enhance manufacturers' competitiveness advantage over their rivals. It is inevitable for manufacturers to identify appropriate competitive priorities for each of their potential market segments when designing products. Selecting appropriate suppliers is a fundamental issue to fulfill manufacturers' development strategy. The approach will enhance supplier selection efficiency and flexibility under the mass customization environment, enabling manufactures to avoid or minimize risks when external conditions change. Research limitation/implications-The case study is limited to selecting suppliers of two components for an ink cartridge, however, the general approach is applicable to other type of products. Practical implications:The whole concept of this selection system is to provide a supplier selection approach for mass customisation environment by utilising the Web-based technologies to deliver a means which enables geographically dispersed functions making supplier selection more efficiently. Manufacturers can utilise this approach to evaluate and to find most appropriate suppliers based on various situations. Originality/value:The supplier selection approach focuses on the general supplier selection issues incorporating with product market position and development directions issues for mass customisation, which provides a more dynamic and robust method to select and evaluate potential suppliers according to a range of conditions.

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The first X-ray crystal structures of two different bicyclo[1.1.0]butanones show a very long transannular bond of 1.69 A and a large carbonyl pyramidal distortion of 0.26 A out of the plane of the three carbons. These features are those expected of molecules with a hybrid cyclopropanone-oxyallyl structure, and these structures differ markedly from those of the parent bicyclo[1.1.0]butane skeleton.

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The use of Information and Communications Technology (ICTs) in healthcare has the potential of minimizing medical errors, reducing healthcare cost and improving collaboration between healthcare systems which can dramatically improve the healthcare service quality. However interoperability within different healthcare systems (clinics/hospitals/pharmacies) remains an issue of further research due to a lack of collaboration and exchange of healthcare information. To solve this problem, cross healthcare system collaboration is required. This paper proposes a conceptual semantic based healthcare collaboration framework based on Internet of Things (IoT) infrastructure that is able to offer a secure cross system information and knowledge exchange between different healthcare systems seamlessly that is readable by both machines and humans. In the proposed framework, an intelligent semantic gateway is introduced where a web application with restful Application Programming Interface (API) is used to expose the healthcare information of each system for collaboration. A case study that exposed the patient's data between two different healthcare systems was practically demonstrated where a pharmacist can access the patient's electronic prescription from the clinic.

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Background: To systematically assess the consistency of recommendations regarding diagnosis and treatment of non-small cell lung cancer (NSCLC) in clinical practice guidelines (CPGs).Methods: We systematically searched relevant literature databases and websites to identify CPGs related to NSCLC. We extracted the general characteristics of the included guidelines and their recommendations and descriptively compared and analyzed the consistency of recommendations across the guidelines.Results: A total of 28 NSCLC guidelines were retrieved. The recommendations covered mainly diagnosis and treatment. The recommendations in the guidelines differed substantially in various topics, such as the application of positron emission tomography (PET) and the classification of stage III. Fourteen guidelines divided stage III into two types: operable and inoperable; and the remaining 14 guidelines into three sub-stages IIIA, IIIB and IIIC. Recommendations regarding the treatment in stage III were relatively inconsistent. In driver gene (EGFR, ALK, ROS1) positive patients, targeted therapy was the most common recommendation for first-line treatment, but recommendations regarding second-line treatment varied according to the site of the mutation. In driver gene negative patients, immunotherapy was the most frequently recommended option as both first-and second-line treatment, followed by chemotherapy.Discussion: A number of countries are devoting themselves to develop NSCLC guidelines and the process of updating guidelines is accelerating, yet recommendations between guidelines are not consistent. We adopted a systematic review method to systematically search and analyze the NSCLC guidelines worldwide.We objectively reviewed the differences in recommendations for NSCLC diagnosis and treatment between the guidelines. Inconsistency of recommendations across guidelines can result from multiple potential reasons. Such as, the guidelines developed time, different countries and regions and many more. Poor consistency across CPGs can confuse the guideline users, and we therefore advocate paying more attention to examining the controversies and updating guidelines timely to improve the consistency among CPGs.Our study had also several limitations, we limited the search to CPGs published in Chinese or English, the interpretation of recommendations is inherently subjective, we did not evaluate the details of the clinical content of the CPG recommendations. Our research presents the current status of NSCLC guidelines worldwide and give the opportunity to pay more attention to the existing gaps. Further investigations should 2 Zhang et al. Consistency of NSCLC guidelines recommendations