Essential chain compromise

Depletion of ATP is caused by many toxic compounds, and this will result in a variety of biochemical changes. Although there are many ways for toxic compounds to cause a depletion of ATP in the cell, interference with mitochondrial oxidative phosphorylation is perhaps the most common. Thus, compounds, such as 2,4-dinitrophenol, which uncouple the production of ATP from the electron transport chain, will cause such an effect, but will also cause inhibition of electron transport or depletion of NADH. Excessive use of ATP or sequestration are other mechanisms, the latter being more fully described in relation to ethionine toxicity in chapter 7. Also, DNA damage, which causes the activation of poly(ADP-ribose) polymerase (PARP), may lead to ATP depletion (see below). A lack of ATP in the cell means that active transport into, out of, and within the cell is compromised or halted, with the result that the concentration of ions such as Na+, K+, and Ca2+ in particular compartments will change. Also, various synthetic biochemical processes such as protein synthesis, gluconeogenesis, and lipid synthesis will tend to be decreased. At the tissue level, this may mean that hepatocytes do not produce bile efficiently and proximal tubules do not actively reabsorb essential amino acids and glucose. 

The last essential link in the equipment management program chain is an involvement and input into the equipment acquisition process. The lack of such involvement can and often does introduce error into the equipment inventory if the clinical engineering department does not know when a new equipment is purchased. Further, if the staff is not adequately trained or has the needed access to repair parts, diagnostic software, and so on, the preventive maintenance and repair ability of the department will also be severely compromised. 

Integrity risks Supply chain integrity has become an important necessity for brand owners across the industries. It is essential to keep supply chain from being compromised or interrupted and to ensure its integrity. Supply chain integrity protects the brand, minimizes costs due to loss or damage and enables to provide a quality product to the end consumer. These issues go beyond fraud alone to include risks associated with regulatory compliance, conflicts of interest, brand and reputation. 

In section 1.3 of Chapter 1 we reviewed the way in which different products may have different logistics strategies. While the range of classic shirts compete on price and brand, and demand is relatively stable over the year, fashion blouses compete on style and brand. For a fashion product, the logistics challenge is to be able to support highly uncertain demand in the marketplace. The logistics task for the two supply chains is essentially different, and some companies refer to a supply chain for every product to emphasise this difference. In Chapter 2, we stated the need for compromise here - between one size hts all on the one hand, and endless customisation on the other. 

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