Gastric duplication-colonic fistula with colonic ulceration and bleeding

An 11-month-old girl had massive rectal bleeding. A midabdominal mass was palpated. Ultrasound scan showed a large cystic mass with diffusely echogenic contents; Tc-99M radionuclide scan confirmed a duplication. Exploratory surgery and pathology examination showed a gastric duplication with formation of a fistula into the transverse colon with a colonic ulcer and hemorrhage. This combination of findings is presented as a rare cause of lower gastrointestinal hemorrhage in infancy.     

The effect of Six Sigma projects on innovation and firm performance

The paper develops a theoretical base for the effect of Six Sigma projects on innovation and firm performance. It has been proposed that Six Sigma projects enhance technological innovation of the firms; however, they are beneficial for firms in stable environments. Since Six Sigma programs are focused on variance reduction and efficiency, these initiatives are not very effective in dynamic environments, where the rate of technological change is dramatic. With their emphasis on variance-reduction and efficiency Six Sigma programs can be effective in enhancing incremental innovation. In addition, due to the focus of Six Sigma projects on existing customers, they may impede innovation for new customers. Accordingly, implementing Six Sigma projects in fast pace environments with high level of innovation and change may be a challenge, and may not result in the expected outcome. Building upon theories form process management and quality management the paper proposes several propositions to address the effect of Six Sigma projects on innovation and firm performance.     

A multi-objective model for risk mitigating in supply chain design

The goal of this study is to recognise various factors for responsive SCs that affect supply risk and model their impact on SC design and operation. We propose a conceptual model for SC responsiveness that encompasses practices such as flexibility, agility, internal integration, and visibility. This conceptual model is utilised to build up a multi-objective, multi-period SC design and operation model. A heuristic algorithm is developed to find the supplier, product, period, and production rate for the numerical problem. The improved genetic algorithm (GA) produces solutions with more accuracy in considerably less time than a traditional GA. Finally, an approach to prioritise the objective functions is developed that allows managers to focus on specific objective functions more than optimum values. This approach provides risk-averse, responsiveness-oriented, cost-effective managers the capability to set priorities based on their policies.     

Linking quality citizenship to process design: a quality management perspective

As organisations emphasise their role in society, there is a need to determine the effect of socially responsible practices on organisational processes and firm performance. Although the effect of corporate social responsibility on firm performance has been addressed from different perspectives, little is known about the influence of corporate social responsibility on organisational processes and internal operations of firms. The paper aims to make a link between corporate social responsibility, quality management practices and quality outcomes through emphasising quality citizenship as one of the practices associated with quality management. This paper provides a new perspective on the link between quality citizenship and product/process design within the quality management framework. The stakeholder theory of the firm is used to explain the formation and development of new management practices within a firm. Data were collected from managers in the petroleum industry to examine the role of quality citizenship on design and development of organisational processes. The results show that quality citizenship has a significant effect on employee involvement and an indirect effect on process design. Quality citizenship enables firms to obtain a much broader perspective on product/process design and facilitates design and development of products, services and processes that meet the needs of a broader set of customers – the stakeholders.     

Cell-Free Multi-Enzyme Synthesis and Purification of Uridine Diphosphate Galactose

High costs and low availability of UDP-galactose hampers the enzymatic synthesis of valuable oligosaccharides such as human milk oligosaccharides. Here, we report the development of a platform for the scalable, biocatalytic synthesis and purification of UDP-galactose. UDP-galactose was produced with a titer of 48 mM (27.2 g/L) in a small-scale batch process (200 μL) within 24 h using 0.02 g_enzyme/g_product. Through in-situ ATP regeneration, the amount of ATP (0.6 mM) supplemented was around 240-fold lower than the stoichiometric equivalent required to achieve the final product yield. Chromatographic purification using porous graphic carbon adsorbent yielded UDP-galactose with a purity of 92 %. The synthesis was transferred to 1 L preparative scale production in a stirred tank bioreactor. To further reduce the synthesis costs here, the supernatant of cell lysates was used bypassing expensive purification of enzymes. Here, 23.4 g/L UDP-galactose were produced within 23 h with a synthesis yield of 71 % and a biocatalyst load of 0.05 g_{total_protein}/g_product. The costs for substrates per gram of UDP-galactose synthesized were around 0.26 €/g.