TQM consultant selection in SMEs with TOPSIS under fuzzy environment

Although much has been written about TQM in SMEs, little attention has been paid to the role of external consultant in the successful implementation of a TQM program in this kind of firms. Sometimes there are some candidates and companies have to select the best one. In general, many factors affect this problem which adheres to uncertain and imprecise data, and usually several people from different functional areas of the company are involved in this process. This study aims to improve the quality of decision in this area. In this paper a systematic decision process for selecting external consultant is proposed. The proposed method is based on TOPSIS method in fuzzy environment. Decision criteria are obtained from the nominal group technique (NGT). Additionally, a real case study is presented to illustrate the application of the proposed method.     

LaMer diagram approach to study the nucleation and growth of Cu2O nanoparticles using supersaturation theory

Uptake to cuprous oxide (Cu₂O) nanoparticle synthesis with various particle sizes and shapes via supersaturation chemistry approach (LaMer model) has been conducted. Ascorbic acid and maltodextrine as reducing agents and polyvinylpyrrolidone (PVP) as a surfactant were utilized for synthesis of Cu₂O nanoparticles in aqueous solution. The narrow particle size range was achieved by controlling the kinetics of nucleation and growth of particles to satisfy LaMer theory. This mean was performed utilizing different reducing agents (ascorbic acid and maltodextrin) and also, changing the reducing agent addition condition. The results showed the reducing agent addition condition, varying the size of Cu₂O nanoparticles from 89 nm to 74 nm for drop-wisely and at-once routes, respectively. The samples were characterized by XRD, SEM, and UV-Vis spectroscopy. The results indicate the shape of as-prepared cuprous oxide nanoparticles have close relationship with thermodynamic and kinetic conditions, and also reducing addition condition.     

The sequence of precipitation in the Al-Mg-Si-Cu alloy AA6111

The preciptation behavior of the aluminum alloy AA6111 in the advanced stages of aging has been studied using differential scanning calorimetry (DSC), transmission electron microscopy (TEM), and high-resolution TEM (HRTEM). The results have demonstrated the formation of various precipitate types and morphologies of quaternaryQ phase andβ (Mg₂Si) families at the peak-aged condition and during overaging at different temperatures. The work has clarified the sequence ofQ phase formation and showed evidence for a new morphology of this phase. The sequence of precipitation in AA6111 is elaborated in light of the new findings.     

Global ESRD Costs Associated with a Short Daily Hemodialysis Program in the United States

In spite of the growing evidence that daily hemodialysis (DHD) improves clinical outcomes and quality of life, the additional dialysis costs are not currently reimbursed in the United States. Nor have there been reports of the effects of DHD on end-stage renal disease (ESRD) global costs, which would help predict the financial impact of DHD on the ESRD program. Since 1996, 22 patients (20 in-center, 2 home) have switched from conventional thrice-weekly dialysis to short, daily dialysis with six treatments per week. Eighteen patients started for medical indications, and four started for nonmedical reasons. Causes of ESRD were the following: diabetes mellitus (6), hypertension (4), glomerulonephritis (6), hereditary (2), and other (4). Mean age was 56 ± 16 years. Patients had an average of 3.3 major comorbidities. Weekly conventional HD dialysis times were divided into six DHD treatments, each 2.0 ± 0.3 hours. Weekly Kt/V remained unchanged. Twenty-two patients were followed on DHD for 220 patient-months: 7 patients died after 1.8 ± 1.3 months, 2 were transplanted at 4.3 ± 3.2 months, and 2 discontinued DHD at 3.6 ± 4.8 months. Eleven patients remain on DHD at 17.4 ± 8.3 months. Actual costs per extra dialysis session are as follows: $14.30 for supplies and $3.20 for labor for setup/cleanup time (15 minutes at $12.80/hour). Annualized DHD savings are based on comparison of doses of epoetin alpha (Epogen) and blood pressure medication at the start and after 12 months of DHD. Hospitalization rates include all enrolled patients, comparing rates for the 12 months prior to DHD with the first year on DHD, or annualized rates for those on DHD less than one year. Cost assumptions are $9/ 1000 U Epogen, $1/blood pressure pill, and $1200/per day of hospitalization. Extra transportation costs were covered by the patients. No increased access problems were observed. For patients on short DHD longer than 12 months, supply and labor costs increased to $2733/patient/year; however, Epogen use was reduced 55%, and blood pressure medications were reduced 40%. For all patients who switched to DHD, hospitalization rates were reduced 24%. This resulted in a net savings of about $4241/patient/ year after 12 months on DHD. Overall ESRD costs were substantially decreased on DHD. These cost savings must be passed on to providers before DHD becomes more widely available.     

Adaptive Immune Responses in a Multiple Sclerosis Patient with Acute Varicella-Zoster Virus Reactivation during Treatment with Fingolimod

Fingolimod, an oral sphingosine 1-phosphate (S1P) receptor modulator, is approved for the treatment of relapsing forms of multiple sclerosis (MS). The interference with S1P signaling leads to retention particularly of chemokine receptor-7 (CCR7) expressing T cells in lymph nodes. The immunological basis of varicella zoster virus (VZV) infections during fingolimod treatment is unclear. Here, we studied the dynamics of systemic and intrathecal immune responses associated with symptomatic VZV reactivation including cessation of fingolimod and initiation of antiviral therapy. Key features in peripheral blood were an about two-fold increase of VZV-specific IgG at diagnosis of VZV reactivation as compared to the previous months, a relative enrichment of effector CD4+ T cells (36% versus mean 12% in controls), and an accelerated reconstitution of absolute lymphocytes counts including a normalized CD4+/CD8+ ratio and reappearance of CCR7+ T cells. In cerebrospinal fluid (CSF) the lymphocytic pleocytosis and CD4+/CD8+ ratios at diagnosis of reactivation and after nine days of fingolimod discontinuation remained unchanged. During this time CCR7+ T cells were not observed in CSF. Further research into fingolimod-associated VZV reactivation and immune reconstitution is mandatory to prevent morbidity and mortality associated with this potentially life-threatening condition.     

Effects of Nb Alloying on Nano-Crystallization Kinetics of Fe55-x Cr18Mo7B16C4Nbx(x=0, 3) Bulk Amorphous Alloys

Crystallization kinetics of Fe55-xCr18Mo7B16C4Nbx(x= 0, 3) bulk amorphous alloys were analyzed using X-ray diffraction and differential scanning calorimetric (DSC) tests. In practice, crystallization and growth mechanism were evaluated using DSC tests at four different heating rates (10, 20, 30, and 40 K/min) and kinetic models. Two-step crystallization behavior was observed when Fe55Cr18Mo7B16C4 and Fe52Cr18Mo7B16C4Nb3 bulk amorphous alloys were annealed, where Fe36Cr12Mo10 phase was crystallized in the first step of crystallization. Results show that Fe36Cr12Mo10 and Fe3C phases were crystallized in the structures of the alloys after further annealing process. Activation energy for the crystallization of Fe36Cr12Mo10 phase was measured to be 543 kJ/mol in Fe52Cr18Mo7B16C4Nb3 alloy and 375 kJ/mol for Fe55Cr18Mo7B16C4 alloy according to Kissinger-Starink model. Moreover, a two-dimensional diffusion controlled growth mechanism with decreasing nucleation rate was found in Fe52Cr18Mo7B16C4Nb3 alloy whereas a three-dimensional diffusion controlled growth mechanism with decreasing nucleation rate was found in crystallization of Fe36Cr12Mo10 phase dur- ing annealing of Fe55Cr18Mo7B16C4 alloy. TEM (transmission electron microscopy) observations reveal that crystalline Fe36Cr12Mo10 phase nucleated in the structures of the alloys in an average size of 10 nm with completely mottled morphology.     

Preparation and Characterization of Nanocrystalline Misch-Metal-Substituted Yttrium Iron Garnet Powder by the Sol–Gel Combustion Process

Nanocrystalline Y_{3− x} MM _x Fe₅O₁₂ powders (MM denotes Misch-metal, x =0.0, 0.25, 0.5, 0.75, and 1.0) were synthesized by a sol–gel combustion method. Magnetic properties and crystalline structures were investigated using X-ray diffraction (XRD), a vibrating sample magnetometer (VSM), and a scanning electron microscope. The XRD patterns showed that the single-phase garnet of Y_{3− x} MM _x Fe₅O₁₂ was formed at x values ≤1.0. The saturation magnetization of powders increased with decreasing MM content and reached the maximum value at Y₃Fe₅O₁₂. The crystallite size of powders calcined at 800°C for 3 h was in the range of 38–53 nm.