TQM implementation in hospitals

This paper discusses the essential elements for successful Total Quality Management (TQM) implementation in hospital, and the challenges that occur with such implementation. Guidelines for this implementation are provided to show how TQM tools can be used effectively in hospitals.     

Sequence capture-PCR improves detection of mycobacterial DNA in clinical specimens

The rapid identification of mycobacterial DNA in clinical samples by PCR can be useful in the diagnosis of tuberculous infections, but several large studies have found that the sensitivity of this approach is not better than that of culture. In order to improve the sensitivity of detection of mycobacterial DNA in clinical specimens from patients with paucibacillary forms of tuberculosis, we have developed a procedure permitting the specific capture of mycobacterial DNA in crude samples prior to amplification, thereby concentrating the target sequences and removing irrelevant DNA and other potential inhibitors of the amplification reaction (sequence capture-PCR). By using this approach to capture and amplify two different sequences specific for organisms of the Mycobacterium tuberculosis complex (IS6110 and the direct repeat region), it was possible to detect as little as one genome of mycobacterial DNA in samples containing up to 750 micrograms of total DNA, representing a 10- to 100-fold increase in sensitivity compared with that obtained by purifying total DNA prior to amplification. Detection of the IS6110 sequence in pleural fluid samples from patients with tuberculous pleurisy by sequence capture-PCR gave positive results in 13 of 17 cases, including 3 of 3 culture-positive samples and 10 of 14 culture-negative samples. In contrast, when total DNA was purified from these samples by adsorption to a silica matrix prior to amplification, only the three culture-positive samples were positive by PCR. The sensitivity of detection of the direct repeat sequence in these samples by sequence capture-PCR was similar to that of IS6110 and, in addition, permitted immediate typing of the strains from some patients. We conclude that sequence capture-PCR improves the sensitivity of detection of mycobacterial DNA in paucibacillary samples. This approach should be useful in detecting rare target sequences from organisms implicated in other pathologic processes.     

Minimum-phase filter design from linear-phase startpoint viabalanced model truncation

A new practical design approach for minimum-phase FIR or IIR filters, setting out from a high dimensionality FIR linear-phase prototype is described. The novelty of this technique lies in overcoming the inherent problem of finding the roots of a high order polynomial with repeated and/or very closely clustered roots     

Influence of interfacial microcracks on the elastic properties of composites

A model is established to quantify the influence of interfacial microcracks on the elastic properties of a particulate composite using a combination of theoretical and finite element analysis. A unique way to construct physical models which could accommodate both crack size and crack density is proposed. Based on energy principles, the influence of a dilute concentration of interfacial microcracks is first studied. The case of a finite concentration of microcracks is solved subsequently by combining the dilute concentration solutions and the differential scheme. Both cases agreed well with existing composite theories for the limiting condition of complete decohesion. The final model predicts the effective elastic properties as functions of both crack size and microcrack density.     

Diffusion bonding of ferritic oxide dispersion strengthened alloys to austenitic superalloys

The superior high temperature mechanical strength and oxidation resistance of ferritic oxide dispersion strengthened (ODS) tubular alloys are compromised by the difficulties encountered in joining. Conventional fusion welding techniques generate a weld fusion zone which is devoid of the mechanical strength exhibited by the base material. Therefore, more sophisticated solid state joining techniques, such as diffusion bonding, must be employed when joining ODS materials. This paper describes a series of solid state diffusion bonding experiments carried out between two tubular ferritic ODS alloys and two high temperature austenitic alloys. Careful control of bonding conditions produced pressure retaining joints between one of the tubular ODS alloys and both austenitic alloys. The successful joint design was incorporated into the manufacture of a tubular creep component, which enabled a series of internally pressurized creep tests to be carried out. The microstructure developed at the bond interface of each of the four separate material couples is described and the high temperature performance of the pressure retaining joints is discussed.     

Materials modelling: A bridge from atoms to bulk properties

The use of molecular-level materials modelling techniques in the development of advanced performance polymers is discussed, with particular emphasis upon bridging the large difference in the scales of dimensions between atomic structure and fabricated parts. The advantages and disadvantages of bulk quantitative structure-property relations and atomistic modelling are assessed, and the method of group interaction modelling is suggested as a means of bridging the dimensional scales.After a brief introduction to the concept of group interaction modelling, examples of modelling the engineering properties of polymers are presented which are difficult to model quantitatively by any other means. The important phase transitions from the crystal and glassy states of matter to those of rubber- and liquidlike states are shown quantitatively to be due to the same isoenergetic condition. The viscoelastic properties of a polymer are critical for many applications and expressions are derived for the loss and storage components of the complex modulus, with reference to failure initiation conditions. The effect of crosslinking in thermosets upon the glass transition temperature and viscoelastic properties is outlined. Finally, the scaling of time from atomic vibrations to the years involved in creep and ageing effects are discussed.     

Trends in low-cost, high-performance substrate technology

The trends in high density interconnection (HDI) multichip module (MCM) techniques that have the potential to reduce interconnection cost and production time are described. The implementation in laminated dielectric (MCM-L) technology of a workstation processor core illustrates current substrate technology capabilities. The design, routing, layout and thermal management of the processor core are described. Thin-film deposited dielectric (MCM-D) technology is discussed as a cost-effective method for future interconnection applications     

A mechanism for transgranular stress-corrosion cracking

A model is proposed to explain transgranular-stress corrosion cracking (T-SCC) in face-centered cubic (fcc) materials. Crack propagation is shown to be anisotropic, in that growth near {110} < 001> is discontinuous due to crack arrest by dislocation blunting whereas growth away from this growth orientation is continuous. For the former case, renucleation of arrested cracks involves active dissolution of shear bands at the crack tip, which changes the stress state at Lomer-Cottrell locks, causing them to fail by cleavage. Once the crack is nucleated, its instantaneous macroscopic crack-growth velocity is considered to be comprised of multiple nucleation of microcracks with intervening arrests. This microcracking results from the interaction of the stress fields from neighboring cracks which are forming simultaneously, the crack-opening constraint due to ligaments which act as “bridges” behind the crack front, and the localized dissolution at the microcrack tip which affectsK _IC and leads to the “cobblestone” appearance. Experimental evidence and theoretical considerations are presented to support the model. The system studied was Cu-25 at. pct Au in 0.6 M NaCl solution at potentials between 300 and 400 mV (sce), which precludes hydrogen embrittlement. This article is based on a presentation made in the symposium “Quasi-Brittle Fracture” presented during the TMS fall meeting, Cincinnati, OH, October 21–24, 1991, under the auspices of the TMS Mechanical Metallurgy Committee and the ASM/MSD Flow and Fracture Committee.     

Afterburner [network-independent card for protocols]

Many current implementations of protocols such as the Transmission Control Protocol/Internet Protocol (TCP/IP) are inefficient because data are often accessed more frequently than necessary. Three techniques that reduce the need for memory bandwidth are proposed. The techniques are copy-on-write, page remapping, and single-copy. Afterburner, a network-independent card that provides the services that are necessary for a single-copy protocol stack, is described. The card has 1 MByte of local buffers and provides a simple interface to a variety of network link adapters, including HIPPI and asynchronous transfer mode (ATM). Afterburner can support transfers to and from the link adapter card at rates up to 1 Gbit/s. An implementation of TCP/IP that uses the features provided by Afterburner to reduce the movement of data to a single copy is discussed. Measurements of the end-to-end performance of Afterburner and the single-copy implementation of TCP/IP are presented     

Dietary α-Tocopheryl Acetate Enhances Beef Quality in Holstein and Beef Breed Steers

The effect of long-term feeding (252 days) of three supplemental levels of α-tocopheryl acetate (actual 0, 360 and 1290 IU/head/day) on meat quality was evaluated in Holstein and beef breed steers. Tissue vitamin E concentrations were increased by each increment of supplementation. The color display life of fresh beef under simulated retail conditions was extended 2 to 5 days by vitamin E and lipid oxidation was markedly reduced. Microbial population was not affected by level of supplementation. No deterioration in sensory quality occurred for steaks from supplemented steers that were displayed until the time steaks from unsupplemented steers discolored.