Miracle-dz/UniFAR-FTUs huggingface dataset:
Six Sigma arises from the ashes of TQM with a twist.

PURPOSE This paper sets out to analyse the use of the Six Sigma methodology to improve quality in healthcare. It looks at how Six Sigma grew out of the concept of Total Quality Management (TQM). DESIGN/METHODOLOGY/APPROACH Six Sigma is a quality improvement methodology that has been widely adopted by companies since the early 1990s and has grown exponentially in the healthcare industry during the past five years. Some of the main tenets of Six Sigma have emerged from the principles of TQM, including the notion that the entire organization must support the quality effort; that there should be a vigorous education effort; and that a quality improvement process should emphasize root cause analysis. FINDINGS In spite of its early success, TQM "crashed and burned" for several reasons including the fact that financial benefits were difficult to assign to TQM efforts, root cause was not always determined resulting in recurring errors, there was no common metric to measure the level of quality attained, and quality efforts were sometimes aimed at processes or operations that were not critical to the customer. Six Sigma filled the vacuums created by these TQM failures in several ways. Under the Six Sigma methodology, quality improvement projects are carefully defined so that they can be successfully completed within a relatively short time frame. Financials are applied to each completed project so that management knows how much the project saves the institution. ORIGINALITY/VALUE On each project, intense study is used to determine root cause analysis; and in the end, a metric known as "sigma level" can be assigned to signify the level of quality. Six Sigma has a "critical to quality" dimension that keeps the quality effort focused on improving only those things that really matter to the customer.
The Nitrate Transporter AtNRT1.1 (CHL1) Functions in Stomatal Opening and Contributes to Drought Susceptibility in Arabidopsis Article, publication date, and citation information can be found at www.plantcell.org/cgi/doi/10.1105/tpc.006312.

The movement of guard cells in stomatal complexes controls water loss and CO2 uptake in plants. Examination of the dual-affinity nitrate transporter gene AtNRT1.1 (CHL1) revealed that it is expressed and functions in Arabidopsis guard cells. CHL1 promoter–β-glucuronidase and CHL1 promoter–green fluorescent protein constructs showed strong expression in guard cells, and immunolocalization experiments with anti-CHL1 antibody confirmed these results. To assess CHL1 function, chl1 mutant plants grown in the presence of nitrate were examined. Compared with wild-type plants, chl1 mutants had reduced stomatal opening and reduced transpiration rates in the light or when deprived of CO2 in the dark. These effects result in enhanced drought tolerance in chl1 mutants. At the cellular level, chl1 mutants showed reduced nitrate accumulation in guard cells during stomatal opening and failed to show nitrate-induced depolarization of guard cells. In wild-type guard cells, nitrate induced depolarization, and nitrate concentrations increased threefold during stomatal opening. These results identify an anion transporter that functions in stomatal opening and demonstrate that CHL1 supports stomatal function in the presence of nitrate.
Understanding Green Advertising Attitude and Behavioral Intention: An Application of the Health Belief Model

ABSTRACT Despite the high interest in green advertising and its potential to foster sustainable consumerism, academic research in this area has been somewhat limited. The current study developed a predictor model of green advertising attitude and behavioral intention using environmental issue-focused factors that included the Health Belief Model, consumption-focused factors, and demographic factors to help understand the significant influences that shape global green advertising outcome. An online survey of 385 participants showed that a number of factors in both issue-focused (e.g., response-efficacy and ecocentric/anthropocentric attitudes) and consumption-focused (e.g., green product purchase frequency and past green product attitude) categories significantly predicted green advertising attitude and behavioral intention. Theoretical as well as practical implications of the findings will be discussed in detail.
Exploring Genomic Structure Differences and Similarities between the Greek and European HapMap Populations: Implications for Association Studies

Studies of the genomic structure of the Greek population and Southeastern Europe are limited, despite the central position of the area as a gateway for human migrations into Europe. HapMap has provided a unique tool for the analysis of human genetic variation. Europe is represented by the CEU (Northwestern Europe) and the TSI populations (Tuscan Italians from Southern Europe), which serve as reference for the design of genetic association studies. Furthermore, genetic association findings are often transferred to unstudied populations. Although initial studies support the fact that the CEU can, in general, be used as reference for the selection of tagging SNPs in European populations, this has not been extensively studied across Europe. We set out to explore the genomic structure of the Greek population (56 individuals) and compare it to the HapMap TSI and CEU populations. We studied 1112 SNPs (27 regions, 13 chromosomes). Although the HapMap European populations are, in general, a good reference for the Greek population, regions of population differentiation do exist and results should not be light‐heartedly generalized. We conclude that, perhaps due to the individual evolutionary history of each genomic region, geographic proximity is not always a perfect guide for selecting a reference population for an unstudied population.
A Study of Controlled Ovarian Stimulation with Clomiphene Citrate or Letrozole in Combination with Gonadotropins and IUI in Unexplained Infertility

Aim: To compare the effect of clomiphene citrate (CC) + human menopausal gonadotropin (hMG) with letrozole + hMG on size, number of follicles, endometrial thickness, serum levels of oestradiol and progesterone and pregnancy rate. Settings and Design: Non-randomised interventional study. Patients and Methods: A total number of 60 patients in the age group of 20–35 years with unexplained infertility were divided into two groups, 30 in each. Group A received CC + hMG and group B received letrozole + hMG. In both the groups, ovulation was triggered by hCG followed by intrauterine insemination. Results: The number of follicles on day 8 were significantly higher in the CC + hMG group than that in the letrozole + hMG group. Serum oestradiol level was significantly higher in the CC + hMG group on day 10 and on the day of hCG administration. Pregnancy rate in the CC + hMG group was 23.3% and 13.3% in the letrozole + hMG group. Conclusion: The sequential protocol was cost-effective. CC + hMG could be a preferred ovarian stimulation protocol in couples with unexplained infertility with the added advantage of having no significant complications in properly monitored cycles.
THE EFFECT OF USING AUDIO-VISUAL AIDS VERSUS PICTURES ON FOREIGN LANGUAGE VOCABULARY LEARNING OF INDIVIDUALS WITH MILD INTELLECTUAL DISABILITY

This study aimed to examine the effect of using audio-visual aids and pictures on foreign language vocabulary learning of individuals with mild intellectual disability. Method: To this end, a comparison group quasi-experimental study was conducted along with a pre-test and a post-test. The participants were 16 individuals with mild intellectual disability living in a center for mentally disabled individuals in Dezfoul, Iran. They were all male individuals with the age range of 20 to 30. Their mother tongue was Persian, and they did not have any English background. In order to ensure that all participants were within the same IQ level, a standard IQ test, i.e. Colored Progressive Matrices test, was run. Afterwards, the participants were randomly assigned to two experimental groups; one group received the instruction through audio-visual aids, while the other group was taught through pictures. The treatment lasted for four weeks, 20 sessions on aggregate. A total number of 60 English words selected from the English package named 'The Smart Child' were taught. After the treatment, the participants took the posttest in which the researchers randomly selected 40 words from among the 60 target words. Results: The results of Mann-Whitney U-test indicated that using audio-visual aids was more effective than pictures in foreign language vocabulary learning of individuals with mild intellectual disability. Conclusions: It can be concluded that the use of audio-visual aids can be more effective than pictures in foreign language vocabulary learning of individuals with mild intellectual disability.
The effect of continuous and interval exercise on PGC‐1α and PDK4 mRNA in type I and type II fibres of human skeletal muscle

Aim: Differences in fibre‐type recruitment during exercise may induce a heterogenic response in fibre‐type gene expression. We have investigated the effect of two different exercise protocols on the fibre‐type‐specific expression of master genes involved in oxidative metabolism [proliferator‐activated receptor‐γ coactivator‐1α (PGC‐1α) and Pyruvate dehydrogenase kinase 4 (PDK4)].
Religion and Completed Suicide: a Meta-Analysis

Introduction Suicide is a major public health concern and a leading cause of death around the world. How religion influences the risk of completed suicide in different settings across the world requires clarification in order to best inform suicide prevention strategies. Methods A meta-analysis using search results from Pubmed and Web of Science databases was conducted following PRISMA protocol and using the keywords “religion” or “religious” or “religiosity” or “spiritual” or “spirituality” plus “suicide” or “suicidality” or “suicide attempt”. Random and fixed effects models were used to generate pooled ORs and I2 values. Sub-analyses were conducted among the following categories: young age (<45yo), older age (≥45yo), western culture, eastern culture, and religious homogeneity. Results Nine studies that altogether evaluated 2339 suicide cases and 5252 comparison participants met all selection criteria and were included in the meta-analysis. The meta-analysis suggested an overall protective effect of religiosity from completed suicide with a pooled OR of 0.38 (95% CI: 0.21–0.71) and I2 of 91%. Sub-analyses similarly revealed significant protective effects for studies performed in western cultures (OR = 0.29, 95% CI: 0.18–0.46), areas with religious homogeneity (OR = 0.18, 95% CI: 0.13–0.26), and among older populations (OR = 0.42, 95% CI: 0.21–0.84). High heterogeneity of our meta-analysis was attributed to three studies in which the methods varied from the other six. Conclusion Religion plays a protective role against suicide in a majority of settings where suicide research is conducted. However, this effect varies based on the cultural and religious context. Therefore, public health professionals need to strongly consider the current social and religious atmosphere of a given population when designing suicide prevention strategies.
The mediating role of emotional control in the link between parenting and young children's physical aggression

ABSTRACT Aggression in early childhood has been found to predict future psychopathology, academic problems, and delinquency. In a sample of 136 mother–child pairs (Mage = 4 years, 11 months, SD = 11 months, 58% boys) associations among mothers’ responding with distress to children's negative emotions, children's emotional control, and children's physically aggressive behaviours were explored. Children's emotional control problems mediated the relation between mothers’ distress responses and children's physical aggression – higher levels of distress responses by mothers to children's negative emotions were associated with increases in emotional control problems in children, which in turn were associated with higher levels of children's physical aggression. Contrary to expectations, children's negative emotionality (i.e. temperament) did not significantly moderate the association between mothers’ responding with distress to children's negative emotions and children's emotional control problems. Results emphasize the importance of focusing on children's emotional control skills and adaptive maternal responses to children's negative emotions.
Modeling the Impact of the Trench Depth on the Gate–Drain Capacitance in Power MOSFETs

Trench depth is important in low-voltage trench MOSFETs because it affects the switching losses through the gate-drain capacitance (<i>C</i><sub>GD</sub>). The dependence of <i>C</i><sub>GD</sub> on the trench depth is investigated by analytical modeling and experimental characterization. An analytical model that relates the trench depth, trench bottom oxide thickness, n<sup>-</sup> layer doping, and drain voltage (<i>VD</i>) to <i>C</i><sub>GD</sub> is developed and validated by experimental measurements. Trench MOSFETs with thick bottom oxides have been fabricated with 1.3-, 1.5-, 1.7-, and 2-μm deep trenches. <i>CV</i> measurements show that <i>C</i><sub>GD</sub> is proportional to the trench depth at low <i>VD</i> and becomes increasingly independent of trench depth as <i>VD</i> is increased. The model is used to show that this is due to <i>C</i><sub>GD</sub> being dominated by the oxide capacitance at low <i>VD</i> and the depletion capacitance at high <i>VD</i>. The fact that the average thickness of the trench bottom oxide decreases as the trench depth increases (because of additional sidewall oxide overlapping the drain) means that the impact of the trench depth is the highest at low <i>VD</i> , where the depletion capacitance is ineffective.
Tetanus, Diphtheria, Pertussis Vaccination Coverage Before, During, and After Pregnancy — 16 States and New York City, 2011

In June 2011, the Advisory Committee on Immunizations Practices (ACIP) recommended 1 dose of a tetanus, diphtheria, and acellular pertussis (Tdap) vaccine during pregnancy for women who had not received Tdap previously. Before 2011, Tdap was recommended for unvaccinated women either before pregnancy or postpartum. In October 2012, ACIP expanded the 2011 recommendation, advising pregnant women to be vaccinated with Tdap during each pregnancy to provide maternal antibodies for each infant. The optimal time for vaccination is at 27-36 weeks' gestation as recommended by ACIP. In response to ACIP's Tdap recommendation for pregnant women in 2011, CDC added a supplemental question to the Pregnancy Risk Assessment Monitoring System (PRAMS) survey to determine women's Tdap vaccination status before, during, or after their most recent delivery. This report describes overall and state-specific Tdap vaccination coverage around the time of pregnancy using data from 6,852 sampled women who delivered a live-born infant during September-December 2011 in one of 16 states or New York City (NYC). Among the 17 jurisdictions, the median percentage of women with live births who reported any Tdap vaccination was 55.7%, ranging from 38.2% in NYC to 76.6% in Nebraska. The median percentage who received Tdap before pregnancy was 13.9% (range = 7.7%-20.1%), during pregnancy was 9.8% (range = 3.8%-14.2%), and after delivery was 30.9% (range = 13.6%-46.5%). The PRAMS data indicate a wide variation in Tdap vaccination coverage among demographic groups, with generally higher postpartum coverage for non-Hispanic white women, those who started prenatal care in the first trimester, and those who had private health insurance coverage. This information can be used for promoting evidence-based strategies to communicate the importance of ACIP guidelines related to Tdap vaccination coverage to women and their prenatal care providers.
Simultaneous Assessment of Acidogenesis-Mitigation and Specific Bacterial Growth-Inhibition by Dentifrices

Dentifrices can augment oral hygiene by inactivating bacteria and at sub-lethal concentrations may affect bacterial metabolism, potentially inhibiting acidogenesis, the main cause of caries. Reported herein is the development of a rapid method to simultaneously measure group-specific bactericidal and acidogenesis-mitigation effects of dentifrices on oral bacteria. Saliva was incubated aerobically and anaerobically in Tryptone Soya Broth, Wilkins-Chalgren Broth with mucin, or artificial saliva and was exposed to dentifrices containing triclosan/copolymer (TD); sodium fluoride (FD); stannous fluoride and zinc lactate (SFD1); or stannous fluoride, zinc lactate and stannous chloride (SFD2). Minimum inhibitory concentrations (MIC) were determined turbidometrically whilst group-specific minimum bactericidal concentrations (MBC) were assessed using growth media and conditions selective for total aerobes, total anaerobes, streptococci and Gram-negative anaerobes. Minimum acid neutralization concentration (MNC) was defined as the lowest concentration of dentifrice at which acidification was inhibited. Differences between MIC and MNC were calculated and normalized with respect to MIC to derive the combined inhibitory and neutralizing capacity (CINC), a cumulative measure of acidogenesis-mitigation and growth inhibition. The overall rank order for growth inhibition potency (MIC) under aerobic and anaerobic conditions was: TD> SFD2> SFD1> FD. Acidogenesis-mitigation (MNC) was ordered; TD> FD> SFD2> SFD1. CINC was ordered TD> FD> SFD2> SFD1 aerobically and TD> FD> SFD1> SFD2 anaerobically. With respect to group-specific bactericidal activity, TD generally exhibited the greatest potency, particularly against total aerobes, total anaerobes and streptococci. This approach enables the rapid simultaneous evaluation of acidity mitigation, growth inhibition and specific antimicrobial activity by dentifrices.
Assessing Novices’ Game Performance in Rugby Union: The Rugby Attack Assessment Instrument (RAAI)

The application of Teaching Games for Understanding (TGfU) and Game Centered Approaches (GCA) in team sports initiation generated the need for assessing game performance. In this paper we introduce the Rugby Attack Assessment Instrument (RAAI), a tool to assess the actions of players in attack and their incidence in the generated game situations in rugby. The RAAI focuses the attention on the ball carrier during a 5 vs. 5 situation. The actions of players in possession of the ball are described and codified. A weight is allocated to each simple and combined action in relation to its tactical value. Thus, the codified actions provide a weighted Index of Performance, the team score of the RAAI. Validity and reliability were tested in two different studies. Results suggest that the RAAI is valid and reliable to assess ball carrier’s actions and their influence in attacking game situations of novice rugby union players.
Neural Rhythms of Change: Long-Term Improvement after Successful Treatment in Children with Disruptive Behavior Problems

Neural changes were investigated for children with disruptive behavior problems one year after a treatment program ended. Thirty-nine children and their parents visited the research lab before, after, and a year after treatment ended. During those lab visits, electroencephalography (EEG) was recorded during a challenging Go/No-go task. Treatment consisted of intensive 14-week combined cognitive behavioral therapy and parent management training sessions. For the analysis, participants were divided into long-term improvers (IMPs) and long-term nonimprovers (NIMPs) based on changes in their externalizing problem scores. The results showed early no-go theta power (4–8 Hz, 100–250 ms) decreased for long-term IMPs compared to NIMPs. When participants were divided based on changes in their comorbid internalizing symptoms, effects were stronger and reductions in theta power were found for early as well as later phases (250–650 ms). We provided preliminary evidence that theta power is a useful neural measure to trace behavioral change linked to improved self-regulation even up to a year after treatment ended. Results may have implications for the characterization of children with disruptive behavior problems and may lead to the development of novel markers of treatment success.
Effect of proton pump inhibitors on clinical outcome in patients treated with clopidogrel: a systematic review and meta‐analysis

Summary. To investigate whether proton pump inhibitors (PPIs) negatively affect clinical outcome in patients treated with clopidogrel. Systematic review and meta‐analysis. Outcomes evaluated were combined major adverse cardiac events (MACE), myocardial infarction (MI), stent thrombosis, death and gastrointestinal bleeding. Studies included were randomized trials or post‐hoc analyzes of randomized trials and observational studies reporting adjusted effect estimates. Twenty five studies met the selection criteria and included 159 138 patients. Administration of PPIs together with clopidogrel corresponded to a 29% increased risk of combined major cardiovascular events [risk ratio (RR) = 1.29, 95% confidence intervals (CI) = 1.15–1.45] and a 31% increased risk of MI (RR = 1.31, 95%CI = 1.12–1.53). In contrast, PPI use did not negatively influence the mortality (RR = 1.04, 95%CI = 0.93–1.16), whereas the risk of developing a gastrointestinal bleed under PPI treatment decreased by 50% (RR = 0.50, 95% CI = 0.37–0.69). The presence of significant heterogeneity might indicate that the evidence is biased, confounded or inconsistent. The sensitivity analysis, however, yielded that the direction of the effect remained unchanged irrespective of the publication type, study quality, study size or risk of developing an event. Two studies indicate that PPIs have a negative effect irrespective of clopidogrel exposure. In conclusion, concomitant PPI use might be associated with an increased risk of cardiovascular events but does not influence the risk of death. Prospective randomized trials are required to investigate whether a cause‐and‐effect relationship truly exists and to explore whether different PPIs worsen clinical outcome in clopidogrel treated patients as the PPI‐clopidogrel drug–drug interaction does not seem to be a class effect.
The Deuteronomist Reforms and Lehi’s Family Dynamics: A Social Context for the Rebellions of Laman and Lemuel

Page 1/9 10/26/2019 https://journal.interpreterfoundation. org/the-deuteronomist-reforms-and-lehis-family-dynamics-a-social-context-for-the-rebellions-of-laman-and-lemuel/ Over the last few years, several Latter-day Saint scholars have commented on how the socio-religious setting of Judah in the late-seventh century BC informs and contextualizes our reading of the Book of Mormon, especially that of 1 and 2 Nephi. Particular emphasis has been placed on how Lehi and Nephi appear to have been in opposition to certain changes implemented by the Deuteronomists at this time, but Laman’s and Lemuel’s views have only been commented on in passing. In this paper, I seek to contextualize Laman and Lemuel within this same socioreligious setting and suggest that, in opposition to Lehi and Nephi, they were supporters of the Deuteronomic reforms.