bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does size matter for Six Sigma implementation?
Authors: Kumar Maneesh , Antony Jiju , Douglas Alex 
Published: January 2010

PurposeThe purpose of this paper is to identify the quality initiatives implemented in UK manufacturing small and medium‐sized enterprises (SMEs) and to perform a comparative analysis of quality management practices within Six Sigma firms against the non‐Six Sigma manufacturing SMEs.Design/methodology/approachTo achieve the research objective, a survey‐based approach is adopted by designing a short questionnaire addressing the issues of quality practices in SMEs. The paper encompasses the survey results from the first phase of Doctoral study to identify Six Sigma and non‐Six Sigma companies.FindingsThe response rate from the survey is 12.7 per cent out of 500 companies identified through the use of random sampling technique within the FAME and Dun & Bradstreet database of manufacturing SMEs. Data analysis was carried out using SPSS and Microsoft Excel. The findings from the study reveal that there is a significant difference in the performance of the Six Sigma/Lean firms against ISO certified companies. However, it is interesting to reflect on the findings of critical success factors (CSFs) of the sample firms. There is no significant difference in the perceived importance of the identified CSFs' variables in the Six Sigma and ISO certified SMEs.Research limitations/implicationsThe focus of the study is only on UK manufacturing SMEs encompassing 64 firms. The small sample size and focus on manufacturing sector limits its generalisability to the entire SME population. Future study should focus on performing a comparative study of manufacturing and service based SMEs in UK or Europe.Originality/valueThe novelty of the paper lies in conducting a comparative study on the performance of Six Sigma and non‐Six Sigma UK SMEs and drawing out valuable lessons for academics, consultants, researchers and practitioners of continuous improvement initiatives like Lean and Six Sigma.
Quality framework in education through application of interpretive structural modeling
Authors: Sahney Sangeeta , Banwet D.K. , Karunes S. 
Published: January 2010

PurposeThe Indian higher educational system is one of the largest in the world. Besides, the growth of students and universities, the range of disciplines and universities in professional and vocational education has greatly increased. With the sudden immense growth of the educational institutes all over the country, educational institutions must improve the quality of their services to compete and achieve a leading position. Orientation towards quality and competitiveness in higher education in India has thus started gaining the attention of the policy makers, educational planners, and administrators as also the various stakeholders of the educational system. With the internal and external stakeholders becoming more demanding in a gradually liberalizing Indian economy, the issues related to quality need to be addressed from varying perspectives on the very conceptualization, implementation, and assessment. Starting with a theoretical background, the purpose of this paper is to present the results of an empirical study conducted on the administrative staff, so as to obtain the internal customer's perspective on quality.Design/methodology/approachBased on the literature review followed by a pilot study and an earlier study based on the quality function deployment technique, certain elements critical to quality management in education are identified. Thereafter, the interpretive structural modeling (ISM) technique is applied.FindingsThe ISM technique helps prioritize the strategic issues in quality assessment qualitatively, so as to propose a hierarchical structure through prioritizing, sequencing, and categorizing of ideas. The elements are classified as drivers, enablers and dependents, and the hierarchically structured.Practical implicationsThe adoption of such a framework in educational institutions would lead to the creation of an environment where the administrative staff would be satisfied and in turn, be able to deliver quality service to the other customers and stakeholders.Originality/valueAn implementation of the integrated framework of such critical components can help policy makers, educational planners, and administrators as also the various stakeholders of the educational system contribute towards growth, success and survival in the rapidly changing environment.
Holistically integrated model and strategic objectives for service business
Authors: Yang Ching‐Chow , Jang Yang King , Cheng Lai‐Yu 
Published: January 2010

PurposeThe purpose of this paper is to establish an integrated model of a service‐delivery system, customer relationship management (CRM), and customer satisfaction evaluation. The strategic objectives, such as the pursuit of key performances, the retention of customers, the provision of new services, can be realized through this integrated model. The paper then uses the “strategy map” of the balanced scorecard (BSC) to develop and deploy these strategies and the related objective performance indices.Design/methodology/approachThe establishment of a conceptually integrated model based on the literature review, holistic thinking, and the researchers' consultant experience. The development of strategy map and the related performance indicators based on the integrated model.FindingsThe analysis presented by this paper shows that the perspectives of the BSC and the stages in CRM have good correspondence in the development of an integrated model.Originality/valueThe integrated model, strategy map, and related performance indicators' presented in this paper offer useful guidance for service organizations to having a holistic view of their operational systems.
Combination of vesicular stomatitis virus matrix protein gene therapy with low‐dose cisplatin improves therapeutic efficacy against murine melonoma
Authors: Luo Shan , Chen Ping , Luo Zi‐chao , Zhang Ping , Sun Ping , Shi Wei , Li Zhi‐yong , Zhang Xiao‐long , Wang Li‐qiang , Chen Xin , Wei Yu‐quan , Wen Yan‐jun 
Published: January 2010

Vesicular stomatitis virus (VSV) matrix protein (MP) can directly induce apoptosis via the mitochondrial pathway due to the inhibition of host gene expression. Our previous studies have demonstrated that MP gene therapy efficiently suppressed the growth of malignant tumor in vitro and in vivo. The present study was designed to determine the possibility that the combination of MP gene therapy with low‐dose cisplatin would improve therapeutic efficacy against murine melanoma. Immunocompetent C57BL/6 mice bearing B16‐F10 melanoma were established. Mice were treated once every 5 days with i.v. administration of 10 μg pVAX‐MP/30 μg liposome complex per mouse for 16 days and i.p. delivery of cisplatin at 4 mg/kg/mouse on days 6 and 12 after the initiation of MP treatment. We found that MP + cisplatin treatment resulted in significant inhibition of tumor growth and improved the survival time of melanoma‐bearing mice. MP successfully inhibited angiogenesis as assessed by CD31. Histological examination revealed that the combination therapy led to significant increased induction of apoptosis, tumor necrosis, and elevated CD8+ lymphocyte infiltration. Furthermore, the induction efficacy of the CTL response was dramatically enhanced by the combination therapy. Our findings may prove useful in further explorations of the application of these combinational approaches to the treatment of malignant melanoma.(Cancer Sci 2010; 101: 1219–1225)
Clinical study of asbestos‐related lung cancer in Japan with special reference to occupational history
Authors: Kishimoto Takumi , Gemba Kenichi , Fujimoto Nobukazu , Onishi Kazuo , Usami Ikuji , Mizuhashi Keiichi , Kimura Kiyonobu 
Published: January 2010

A total of 152 patients with asbestos‐related lung cancer recognized by the criteria of Japanese compensation law for asbestos‐related diseases were examined and compared with 431 patients with non‐asbestos‐related lung cancer. Male comprised 96% of patients. Ages ranged from 50 to 91 years with a median of 72 years. Eighty‐nine percent were smokers or ex‐smokers. Almost all patients had occupational histories of asbestos exposure. The median duration of asbestos exposure was 31 years and the median latency period was 47 years. Thirty‐four percent of patients exhibited asbestosis and 81% exhibited pleural plaques by radiography. Regarding asbestos particles in the lung for 73 operated or autopsied patients, 62% had more than 5,000 particles per gram. On the other hand, 100% of non‐asbestos‐related lung cancer patients had <5000 particles per gram with a median of 554 particles. The number of asbestos bodies in the lung, male gender, absence of symptoms, smoking index, and early stage of cancer were significantly much more than those of non‐asbestos‐related lung cancer. In this study, a diagnosis of asbestos‐related lung cancer was made in 34% of patients by asbestosis, in 62% by presence of both pleural plaques and more than 10 years’ occupational asbestos exposure, and in 4% by more than 5000 asbestos particles per gram of lung tissue. Occupational histories, duration of asbestos exposure, and pleural plaques are common categories for the recognition of asbestos‐related lung cancer in Japan.(Cancer Sci 2010; 101: 1194–1198)
Pleomorphic phenotypes of gastrointestinal stromal tumors at metastatic sites with or without imatinib treatment
Authors: Sakamoto Kazuha , Sakurai Shinji , Kanda Tatsuo , Sakuma Yuji , Hishima Tsunekazu , Hironaka Mitsugu , Bamba Takeo , Keira Yoshiko , Takano Yasuo , Niki Toshiro , Hasegawa Tadashi , Hirota Seiichi 
Published: January 2010

Secondary resistance of gastrointestinal stromal tumors (GISTs) to tyrosine kinase inhibitors occurs after several years’ administration. However, the mechanism of resistance has not been fully clarified. In this study, we analyzed the genotypes and the histologic and immunohistochemical phenotypes of metastatic GISTs with and without imatinib treatment, and clarified the pleomorphic nature of metastatic GISTs. We examined 31 autopsy cases in which the patients died of multiple metastases of GISTs, and two surgically resected specimens with and without imatinib treatment. A total of 152 primary and metastatic lesions in 33 cases of GISTs were examined for histologic and immunohistochemical expression of KIT and CD34. We analyzed the expression of other receptor tyrosine kinases (RTKs) in KIT‐negative lesions, including human EGFR‐related 2 (HER2), epidermal growth factor receptor (EGFR), hepatocyte growth factor receptor (MET), platelet‐derived growth factor receptor‐α (PDGFRA), and platelet‐derived growth factor receptor‐β (PDGFRB). Fifteen lesions in seven cases (9.9%) lacked KIT expression, and 74 (49%) in 22 cases lacked CD34 expression. Eight KIT‐negative lesions in five cases expressed PDGFRB, one of which also expressed EGFR, and three lesions in one case expressed MET. Results for the other RTKs were negative. Missense point mutations at PDGFRB gene exon 12 were detected in one PDGFRB‐positive case. Our results indicate that histomorphology, immunohistochemical phenotypes, and genotypes of metastatic GISTs vary among lesions, even in cases without imatinib treatment. A KIT‐independent mechanism, such as activation of other RTKs, might participate in the proliferation of late‐stage GISTs and might be a cause of secondary imatinib resistance.(Cancer Sci 2010; 101: 1270–1278)
Mechanisms of behavior change in alcoholics anonymous: does Alcoholics Anonymous lead to better alcohol use outcomes by reducing depression symptoms?
Authors: Kelly John F. , Stout Robert L. , Magill Molly , Tonigan J. Scott , Pagano Maria E. 
Published: January 2010

ABSTRACTRationale  Indices of negative affect, such as depression, have been implicated in stress‐induced pathways to alcohol relapse. Empirically supported continuing care resources, such as Alcoholics Anonymous (AA), emphasize reducing negative affect to reduce relapse risk, but little research has been conducted to examine putative affective mechanisms of AA's effects.Methods  Using lagged, controlled, hierarchical linear modeling and mediational analyses this study investigated whether AA participation mobilized changes in depression symptoms and whether such changes explained subsequent reductions in alcohol use. Alcohol‐dependent adults (n = 1706), receiving treatment as part of a clinical trial, were assessed at intake, 3, 6, 9, 12 and 15 months.Results  Findings revealed elevated levels of depression compared to the general population, which decreased during treatment and then remained stable over follow‐up. Greater AA attendance was associated with better subsequent alcohol use outcomes and decreased depression. Greater depression was associated with heavier and more frequent drinking. Lagged mediation analyses revealed that the effects of AA on alcohol use was mediated partially by reductions in depression symptoms. However, this salutary effect on depression itself appeared to be explained by AA's proximal effect on reducing concurrent drinking.Conclusions  AA attendance was associated both concurrently and predictively with improved alcohol outcomes. Although AA attendance was associated additionally with subsequent improvements in depression, it did not predict such improvements over and above concurrent alcohol use. AA appears to lead both to improvements in alcohol use and psychological and emotional wellbeing which, in turn, may reinforce further abstinence and recovery‐related change.
Clinical trial: short‐term effects of combination of satavaptan, a selective vasopressin V2 receptor antagonist, and diuretics on ascites in patients with cirrhosis without hyponatraemia – a randomized, double‐blind, placebo‐controlled study
Authors: GINÈS P. , WONG F. , WATSON H. , TERG R. , BRUHA R. , ZARSKI J.‐P. , DUDLEY F. ,   FOR THE NORMOCAT STUDY INVESTIGATORS
Published: January 2010

Aliment Pharmacol Ther 31, 834–845SummaryBackground  There is little information on the effects of vaptans in patients with cirrhosis.Aim  To investigate the short‐term effects of satavaptan, a selective vasopressin V2 receptor antagonist on ascites in cirrhosis without hyponatraemia.Methods  A total of 148 patients with cirrhosis, ascites and serum sodium >130 mmol/L were included in a multicentre, double‐blind, randomized, controlled study of 14 days comparing three fixed doses of satavaptan (5 mg, 12.5 mg or 25 mg once daily) vs. placebo. Average MELD scores were: 13.4, 12.3, 13.8 and 13.1 respectively. All patients received spironolactone 100 mg/day plus furosemide 20–25 mg/day.Results  Satavaptan treatment was associated with a decrease in ascites (mean change in body weight was −0.36 kg (±3.03) for placebo vs. −2.46 kg (±3.11), −2.08 kg (±4.17) and −2.28 kg (±3.24) for the 5 mg, 12.5 mg and 25 mg doses respectively; P = 0.036, P = 0.041 and P = 0.036 for satavaptan 5, 12.5 and 25 mg/day vs. placebo respectively). Thirst and slight increases in serum sodium were more common in patients treated with satavaptan compared with placebo, while other adverse events were similar.Conclusions  The administration satavaptan for a 14‐day period is associated with reduction in ascites in patients with moderately severe cirrhosis without hyponatraemia under diuretic treatment.
Dietary poorly absorbed, short‐chain carbohydrates increase delivery of water and fermentable substrates to the proximal colon
Authors: BARRETT J. S. , GEARRY R. B. , MUIR J. G. , IRVING P. M. , ROSE R. , ROSELLA O. , HAINES M. L. , SHEPHERD S. J. , GIBSON P. R. 
Published: January 2010

SummaryBackground  Functional gut symptoms are induced by inclusion and reduced by dietary restriction of poorly absorbed short‐chain carbohydrates (FODMAPs), but the mechanisms of action remain untested.Aims  To determine the effect of dietary FODMAPs on the content of water and fermentable substrates of ileal effluent.Methods  Twelve ileostomates without evidence of small intestinal disease undertook two 4‐day dietary periods, comprising diets differing only in FODMAP content in a randomized, cross‐over, single‐blinded intervention study. Daytime (14 h) ileal effluent was collected on day four of each diet. Patients rated effluent volume and consistency on a 10‐cm visual analogue scale. The FODMAP content of the diet and effluent was measured.Results  Ingested FODMAPs of 32% (range 6–73%) was recovered in the high FODMAP diet effluent. Effluent collection weight increased by a mean of 22% (95% CI, 5–39), water content by 20% (2–38%) and dry weight by 24% (4–43%) with the high compared to low FODMAP diet arm. Output increased by 95 (28–161) mL. Volunteers perceived effluent consistency was thicker (95% CI, 0.6–1.9) with the low FODMAP diet than with the high FODMAP diet (3.5–6.1; P = 0.006).Conclusions  These data support the hypothetical mechanism; FODMAPs increase delivery of water and fermentable substrates to the proximal colon.
Effects of head rotation on the right internal jugular vein in infants and young children
Authors: Gwak M. J. , Park J. Y. , Suk E. H. , Kim D. H. 
Published: January 2010

SummaryWe investigated the effects of head rotation on the cross‐sectional area of the right internal jugular vein and its relative position to the carotid artery. Eighty‐eight subjects were divided into infants and children groups. The cross‐sectional area of the right internal jugular vein and the degree of the carotid artery overlap were measured at 0° (neutral), 40° and 80° of head rotation. The cross‐sectional area of the right internal jugular vein was significantly larger at 40° and 80° head rotation compared with the neutral position in both infants and children (p < 0.001). As the head was rotated, the percentage overlap of the carotid artery increased significantly (p < 0.001). We suggest that 40° head rotation appears to be optimal for right internal jugular vein cannulation in paediatric patients.
Assessment of agreement for assignment of a normal grade to human conjunctival impression cytology samples
Authors: Doughty M. J. 
Published: January 2010

M. J. Doughty Assessment of agreement for assignment of a normal grade to human conjunctival impression cytology samples Objective:  To assess the level of agreement for assignment of a normal grade for human ocular surface bulbar conjunctival cells as collected by conjunctival impression cytology.Methods:  Suitable images from published articles that included a scale marker were subjected to the same planimetry method to assess cell area, nucleus area, long (L) and short (S) dimensions of the cells and the nucleus. These measures, along with the nucleus‐to‐cytoplasmic (N/C) ratio, were compared.Results:  Area measures on normal grade images indicated a broad unimodal distribution (250–275 μm2), and distribution of nucleus area values was heterogeneous, with neither being normally distributed. The inter‐sample variance for any particular area value ranged from 11 to 90% (group averages of 49%). The L:S dimension ratio averaged 1.288, consistently showing these cells are not round. N/C values showed a wide range (from 0.151 to 0.655), as did nucleus‐to‐cytoplasm dimensions (from 0.332 to 0.603).Conclusions:  Current criteria for subjective assignment of a normal grade to bulbar conjunctival cells do not appear to be robust enough to allow for inter‐sample comparison. Quantitative measures need to be developed further.
The utility of assessing the gross appearances of FNA specimens
Authors: Mayall F. , Cormack A. , Slater S. , McAnulty K. 
Published: January 2010

F. Mayall, A. Cormack, S. Slater and K. McAnulty The utility of assessing the gross appearances of FNA specimens Objective:  Ideally, fine needle aspiration (FNA) cytology should be performed with near‐patient assessment of the adequacy of the specimen by a cytopathologist. However, this is often not feasible. A cruder alternative is for the FNA practitioner to examine the gross appearances of the specimen and to try to predict the its quality. This study set out to determine the value of this approach.Methods:  The study was conducted in tertiary public hospitals in New Zealand and the UK. FNA gross material grading was performed by a variety of pathologists on FNA samples taken using manual guidance and image guidance. The FNA gross material grade was compared with the findings on microscopic examination.Results:  Nine out of 123 FNA samples were assessed as Grade 1 (unlikely to contain diagnostic material). All were subsequently reported as having insufficient diagnostic tissue on microscopic examination. Forty‐two of the FNA samples were assessed as Grade 2 (possibly contains diagnostic material) and 46 as Grade 3 (probably contains diagnostic material). None from either of these grades was reported as showing insufficient diagnostic material on microscopic examination. Twenty‐six cases were reported as Grade 4 (material suggesting a specific diagnosis). None of these was reported as showing insufficient diagnostic material on microscopic examination. The most common Grade 4 provisional diagnosis was that of a colloid cyst or colloid nodule of the thyroid (seven cases). Only two cases had misleading Grade 4 provisional diagnoses. Both were thought to be pus on gross examination but showed necrotic carcinoma on microscopic examination.Conclusions:  The gross appearances of FNA samples can usually predict the adequacy of the samples and sometimes predict the final microscopic diagnosis. However, near‐patient microscopic assessment of FNA specimens is preferable if available.
Five α globin chain variants identified during screening for haemoglobinopathies
Authors: Nair S. , Nadkarni A. , Warang P. , Bhave A. , Ghosh K. , Colah R. 
Published: January 2010

Eur J Clin Invest 2010; 40 (3): 226–232AbstractBackground  This study was undertaken to analyse cases of microcytosis, and/or haemolytic anaemia where an unusual peak on HPLC or an abnormal electrophoretic mobility in isolation or along with common β‐globin gene defects was found, and to identify the molecular abnormality in them.Patients and methods  Investigations included a complete blood count, HPLC analysis, cellulose acetate electrophoresis (pH 8.9), heat stability test and DNA sequencing.Results  Five α chain variants were identified. This is the first report of Hb Jackson and Hb O Indonesia in the Indian population. The presence of Hb J Meerut along with Hb E and Hb J Paris I with heterozygous β‐thalassaemia are uncommon associations. Hb Sun Prairie would have remained undetected in the heterozygous state. The presence of a homozygous child in the family helped to identify this variant.Conclusions  This study emphasizes the need to undertake systematic investigations while screening for the β haemoglobinopathies to identify rare α chain variants in a population.