Methodology for integrated management system improvement: combining costs deployment and value stream mapping

Integrated Management System – Quality, Environment, Safety (IMS-QES) combines all related components of a business into one system for easier management and operations Quality (QMS/ISO 9001), Environmental (EMS/ISO 14001), and Health & Safety (OHSAS 18001). IMS-QES has been generally used to increase operational performance in manufacturing systems. However, the economic impact of standard approach of IMS-QES remains difficult due to the lack of alignment between IMS-QES objectives and strategic management of the company (policy of IMS-QES) and also the inadequacy between the improvement processes and the cost of losses.

Therefore, the main objective of this work is to overcome this limitation. The Framework proposed approach called IM-VCF integrates concepts from IMS-QES, Value Stream Mapping and Cost Deployment tool. It is structured in ten steps. It allows a company to assure proper alignment between IMS-QES policy and business operations and identify the categories of losses. IM-VCF allows analysing critical issues and estimating the potential savings, in terms of cost. A case study taken from the application of the IM-VSF within certified QSE chemical fertiliser port is presented.     

An epidemiological study of diagnostic and therapeutic strategies in office practice patients with subacute or chronic pain in the thoracic or low back. Comparison of practices in primary care and rheumatology settings

Mucin was purified by the gel filtration method on columns with high porous molecular sives in buffers with SDS and proteinase inhibitors. The addition of proteinase inhibitors distinctly inhibited proteolytic activity. It was found that the obtained mucin, after disulphide-bound reduction, is dissociated to mucin subunits and N-glycosylated glycoprotein of molecular weight about 75 kDa. This protein has carbohydrate and amino acid composition different from high molecular fraction. The 75 kDa protein is strongly associated with high molecular mass mucin subunits and can be separated either during electrophoresis or fractionation in buffers with 2-mercaptoethanol.     

Strategies for graft immunomodulation in islet transplantation

BACKGROUND: The cortex of patients with schizophrenia exhibits a deficit in neuropil, but the nature and extent of cellular abnormalities remain unclear. To gain further insight into this abnormality, neuronal and glial somal size were analyzed in postmortem brains from 9 patients with schizophrenia, 10 normal (control) patients, and 7 patients with Huntington disease, the latter representing a known neurodegenerative disorder. METHODS: A 3-dimensional image analyzer was used to measure the perimeters of 10722 neuronal and 19913 glial profiles in Brodmann areas 9 and 17. Neurons and glia were classified by size and layer to assess specific vulnerabilities with respect to cortical architecture and circuitry. RESULTS: The schizophrenic prefrontal cortex was characterized by a downward shift in neuronal sizes accompanied by 70% to 140% per layer increases in the density of small neurons. In layer III only, a significant reduction in mean neuronal size was associated with a significant decrease in the density of very large neurons in sublayer Illc. Neither neuronal size in occipital area 17 nor glial size in prefrontal or occipital cortexes were reduced. In cortex with Huntington disease, neuronal degeneration was evidenced by concurrence of reduced neuronal size, decreased density of large neurons, and dramatic elevation in density of large glia. CONCLUSIONS: Distinct cytometric abnormalities support the hypothesis that neuronal degeneration in the prefrontal cortex is not a prominent feature of the neuropathological changes in schizophrenia, although an ongoing process in Huntington disease. Rather, schizophrenia appears to involve more subtle abnormalities, with the largest corticocortical projection neurons of layer IIIc expressing the greatest somal reduction.     

Red long-lasting phosphorescence (LLP) in β-TCP type Ca9.5Mn(PO4)7 compounds

Mn-ion doped calcium phosphates namely Ca₅(PO₄)₃(OH) hydroxyapatite (HAP), β-Ca₃(PO₄)₂ (β-TCP) as well as Ca_9.5Mn(PO₄)₇ whitlockite were synthesized and the optical properties of the Mn²⁺ cations were investigated. Annealing under reducing atmosphere enhances the emission of the divalent manganese species. Electron paramagnetic resonance (EPR) and optical spectroscopies confirm that Mn²⁺ ions are the active species. Orange and red emissions occur respectively for the Mn:HAP and Mn:TCP. For this latter, long-lasting phosphorescence (LLP) coming from the Mn²⁺ emission (⁴T₁ → ⁶A₁ transition) is observed at 640 nm but it appears that the traps depths are either two shallow or too deep to lead to an efficient long-lasting emission.     

Pretreatment with prednisolone enhances the effect of human lymphoblastoid interferon in chronic hepatitis B

Patients (n = 213) with chronic hepatitis B were randomised to prednisolone (two weeks of 0.6 mg/kg/day, one week of 0.45 mg/kg/day and one week of 0.25 mg/kg/day) or placebo followed by two weeks rest, and were then given human lymphoblastoid interferon 10 MU daily for five days followed by 10 MU thrice weekly for 11 weeks. There were statistically significant effects of prednisolone pre-treatment on both HBeAg disappearance and HBeAg to anti-HBe seroconversion (log rank test statistics 5.43; p = 0.02 and 4.75; p = 0.03). HBeAg disappearance and HBeAg to anti-HBe seroconversion rates were 28 vs. 44% and 23 vs. 38% (placebo vs. prednisolone). Fifteen patients (7.5%) lost HBsAg. Three out of 22 cirrhotic patients (14%), one of whom received prednisolone pre-treatment, developed hepatic decompensation with a fatal outcome. Prednisolone pre-treatment, enhances the effect of lymphoblastoid interferon in chronic hepatitis B. Interferon treatment (with and without prednisolone) should be used with caution in patients with cirrhosis and avoided in patients with evidence of hepatic decompensation.     

Predicting and Detecting Symmetries in FOL Finite Model Search

Symmetries abound in logically formulated problems where many axioms are universally quantified, as this is the case in equational theories. Two complementary approaches have been used so far to dynamically tackle those symmetries: prediction and detection. The best-known predictive symmetry elimination method is the least number heuristic (lnh). A more recent predictive method, the extended least number heuristic (xlnh), focuses first on the enumeration of a bijection in the problem and easily exploits in the sequel the remaining isomorphisms. On the other hand, dynamic symmetry detection is costly in the general case (the problem is Graph Iso complete) but allows one to exploit more symmetries, and efficient (polytime) yet incomplete detection algorithms can be used on each node. This paper presents a generalization of xlnh that focuses on the enumeration of a unary function that does not require the function to be bijective, a general notion of symmetry for finite-model search in first-order logic together with an efficient symmetry detection algorithm, and a function-ordering heuristic that exploits the inherent structure of first-order logic theories to improve the search when using function-centric methods. A comprehensive study of the compared efficiency of all methods, in isolation and in combination, demonstrates the acceleration that can be expected in all cases. These ideas are implemented by using the known system SEM as an experimentation framework, to allow for accurate comparisons.     

Medical treatment for alcoholic liver disease

The most effective treatment for alcoholic liver disease is abstinence from alcohol and it is the only treatment for patients with alcoholic fatty liver. Although many empirical therapeutic agents have been studied in the short-term and long-term treatment of alcoholic hepatitis, results have been mainly inconclusive. To date, only corticosteroids have proved to decrease the short-term mortality rate of patients with severe forms of acute alcoholic hepatitis. Corticosteroids are not beneficial to the majority of patients with mild or moderate forms of acute alcoholic hepatitis; such patients improve with abstinence from alcohol and general supportive measures and do not need a specific short-term treatment. Most long-term trials have only showed that most patients with alcoholic liver disease were neither abstinent nor compliant, and that long-term survival was strongly correlated to abstinence from alcohol. In one study, propylthiouracil decreased the long-term mortality rate of compliant patients with severe alcoholic liver disease who reduced their alcohol intake; however, further clinical trials are needed before propylthiouracil can be recommended. In another study, colchicine decreased the long-term mortality rate of cirrhotic patients, 45% of whom had alcoholic cirrhosis. Results were highly significant, and the need for further clinical trials of colchicine in the long-term treatment of alcoholic and non-alcoholic cirrhosis is imperative. Enteral nutrition should also be studied in severely malnourished cirrhotic patients, since it was shown to decrease the short-term mortality rate of such patients in a recent study.     

The phospholipids in Enterocytozoon bieneusi: an electron spectroscopic imaging study

A case of a 38 year old male with WPW syndrome and frequently recurrent antidromic atrio-ventricular sustained tachycardias is presented. In his ecg recordings delta wave depolarizations indicated right free wall accessory pathway. This was proved during electrophysiologic study. The effective refractory period of this pathway was short in both directions-below 200 ms. There was a wide zone of sustained antidromic tachycardia 236-247/min induction. Intravenous injection of flecainide terminated antidromic tachycardia but a wide zone of sustained orthodromic tachycardia 150/min induction appeared. Dissection of the right free wall accessory pathway was performed using Sealy technique (Cox modification). During the intraoperation electrophysiologic study an orthodromic tachycardia with retrograde conduction through an antero-septal accessory pathway was induced. After dissection of that second pathway abnormal atrioventricular conduction was abolished. The patients has been free from episodes of tachycardia during one year follow-up period.     

Decreased alloreactivity to human islets secreting recombinant viral interleukin 10

The objective of this study was to analyze allogeneic lymphocyte proliferative responses to cultured human pancreatic islets after gene transfer of viral interleukin (IL)-10 to the islets using replication-defective adenoviral vector. Human islets, either whole or dispersed into single cells, were cocultured with adenovector containing an expression cassette encoding the viral IL-10 gene under control of an SV40 promoter, this sequence replacing viral E1A and part of E1B early viral protein sequences. Subsequent production of recombinant protein by islets was determined by ELISA, and was found dependent on the multiplicity of infection (or ratio of vector to target cells). Protein was secreted by transfected islets at high levels 3-7 days after gene transfer. At high multiplicity of infection (100:1), islet viability was normal, but insulin secretion in response to glucose stimulation was blunted by 50%. Low-level recombinant viral IL-10 secretion by the islets was associated with increased allogeneic lymphocyte proliferation in mixed islet lymphocyte reactions. At protein levels in islet supernatant above 5 ng/ml, lymphocyte proliferation was significantly reduced. This pattern of viral IL-10 effect on lymphocyte proliferation correlated well with mixed lymphocyte reaction assays using purified protein. We conclude that transferred cytokine sequences are secreted by transfected islets as a function of the initial vector inoculum. The functional effect of the secreted cytokine viral IL-10 on allogeneic lymphocyte proliferation is dose dependent. Low-level recombinant protein secretion tended to augment lymphocyte proliferation, whereas high-level secretion significantly down-regulates this response.