Sustainability and Kaizen: Business Model Trends in Healthcare

[EN] Kaizen, or continuous improvement, is a management tool that allows the identification of activities that have no value in the processes examined. This identification leads to the improvement of these processes within any organization and promotes economic and social sustainability, and to a lesser extent environmental sustainability. Kaizen, already widely and successfully employed in the industrial sector, is now being applied in the health sector. However, the health sector tends to publish only the results of how processes have been improved in finely focused areas and the resulting benefits. The majority of the benefits focus on time and cost reduction. In this study, the authors carried out a bibliometric analysis using the Scimat program, which maps the thematic evolution of Kaizen in the health sector and its relationship with sustainability, in order to promote the interest of the health sector for this type of process improvement. 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(2019). El profesional de la información (EPI): Bibliometric and thematic analysis (2006-2017). El Profesional de la Información, 28(4). doi:10.3145/epi.2019.jul.17WOS Database Available from the Spanish Foundation for Science and Technology https://www.recursoscientificos.fecyt.es/Fundación Española para la Ciencia y la Tecnología (FECYT) www.fecyt.esJiménez-García, M., Ruiz-Chico, J., Peña-Sánchez, A. R., & López-Sánchez, J. A. (2020). A Bibliometric Analysis of Sports Tourism and Sustainability (2002–2019). Sustainability, 12(7), 2840. doi:10.3390/su12072840Chiarini, A., Baccarani, C., & Mascherpa, V. (2018). Lean production, Toyota Production System and Kaizen philosophy. The TQM Journal, 30(4), 425-438. doi:10.1108/tqm-12-2017-0178Garcia, J. A. M., Sabater, J. J. G., & Bonavia, T. (2009). The impact of Kaizen Events on improving the performance of automotive components’ first-tier suppliers. 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Visiting Dark Murals: An Ethnographic Approach to the Sustainability of Heritage

[EN] Political, war-themed and controversial murals aim to show the history of a community, making the intangible tangible, and, because these events are still recent, they stir people's emotions. Visitors to this type of heritage have a mixture of artistic and dark interests that lead to what we call 'dark mural attractions'. These political murals need a public strategy to be preserved, become better known and attract local economic development funds to make them sustainable. Therefore, the purpose of this paper is to analyse how communities could build a co-narrative around murals to generate a sustainable local development. To achieve this goal, an in depth study needs to be performed to establish what kind of narrative will enable political murals to attract dark visitors and examine how communities can build a sustainable co-narrative around a dark mural. As a case study, we analyse the Battle of Cable Street mural in London, located in the non-touristic borough of Tower Hamlets, by means of an ethnographic qualitative approach based on stakeholders' opinions, among other sources. In this case, results show that dark murals have the potential to attract visitors, but they require a public strategy for the sustainability of heritage, based on a narrative of community solidarity for educational and discovery purposes.This research was funded by the Valencian Regional Government, Spain, during the visiting research period of De Miguel at the University of Roehampton, under the enlightened supervision of Jonathan Skinner. Grant number: BEST/2019/175.De-Miguel-Molina, M. (2020). Visiting Dark Murals: An Ethnographic Approach to the Sustainability of Heritage. Sustainability. 12(2):1-16. https://doi.org/10.3390/su12020677S116122Hooper, G., & Lennon, J. J. (Eds.). (2016). Dark Tourism. doi:10.4324/9781315575865Yan, L., Xu, J. (Bill), Sun, Z., & Xu, Y. (2019). Street art as alternative attractions: A case of the East Side Gallery. Tourism Management Perspectives, 29, 76-85. doi:10.1016/j.tmp.2018.11.001Culture for Sustainable Development. UNESCOhttps://en.unesco.org/themes/culture-sustainable-developmentSantamarina-Campos, V., Carabal-Montagud, M. Á., Miguel-Molina, M. D., & Miguel-Molina, B. D. (Eds.). (2017). Conservation, Tourism, and Identity of Contemporary Community Art. doi:10.1201/9781315209586Neill, W. J. V. (2001). Marketing the Urban Experience: Reflections on the Place of Fear in the Promotional Strategies of Belfast, Detroit and Berlin. Urban Studies, 38(5-6), 815-828. doi:10.1080/00420980125183Walls and Places: Political Murals in Belfasthttp://web2.uwindsor.ca/courses/ps/dartnell/wallandplaces.htmlCampos, R., & Sequeira, Á. (2019). Urban Art touristification: The case of Lisbon. Tourist Studies, 20(2), 182-202. doi:10.1177/1468797619873108De Miguel Molina, M., de Miguel Molina, B., & Santamarina Campos, V. (2019). Visiting African American murals: a content analysis of Los Angeles, California. Journal of Tourism and Cultural Change, 18(2), 201-217. doi:10.1080/14766825.2019.1597877Merrill, S. (2014). Keeping it real? Subcultural graffiti, street art, heritage and authenticity. International Journal of Heritage Studies, 21(4), 369-389. doi:10.1080/13527258.2014.934902McAuliffe, C., & Iveson, K. (2011). Art and Crime (and Other Things Besides … ): Conceptualising Graffiti in the City. Geography Compass, 5(3), 128-143. doi:10.1111/j.1749-8198.2011.00414.xBarnes, T. J., & Hayter, R. (1992). ‘The Little Town That Did’: Flexible Accumulation and Community Response in Chemainus, British Columbia. Regional Studies, 26(7), 647-663. doi:10.1080/00343409212331347281Grondeau, A., & Pondaven, F. (2018). Le street art, outil de valorisation territoriale et touristique : l’exemple de la Galeria de Arte Urbana de Lisbonne. EchoGéo, (44). doi:10.4000/echogeo.15324Improving Places: Culture & Business Improvement District Partnershipshttps://www.artscouncil.org.uk/publication/improving-places-culture-business-improvement-district-partnershipsSaunders, A. (2013). Recovering the street: relocalising urban geography. Journal of Geography in Higher Education, 37(4), 536-546. doi:10.1080/03098265.2013.801069Figini, P., & Vici, L. (2012). Off-season tourists and the cultural offer of a mass-tourism destination: The case of Rimini. Tourism Management, 33(4), 825-839. doi:10.1016/j.tourman.2011.09.005Arts audiences: Insighthttps://www.artscouncil.org.uk/sites/default/files/download-file/arts_audience_insight_2011.pdfLight, D. (2017). Progress in dark tourism and thanatourism research: An uneasy relationship with heritage tourism. Tourism Management, 61, 275-301. doi:10.1016/j.tourman.2017.01.011Cohen, E. H. (2011). Educational dark tourism at an in populo site. Annals of Tourism Research, 38(1), 193-209. doi:10.1016/j.annals.2010.08.003Seaton, A. V. (1996). Guided by the dark: From thanatopsistothanatourism. International Journal of Heritage Studies, 2(4), 234-244. doi:10.1080/13527259608722178Foley, M., & Lennon, J. J. (1996). JFK and dark tourism: A fascination with assassination. International Journal of Heritage Studies, 2(4), 198-211. doi:10.1080/13527259608722175Raine, R. (2013). A dark tourist spectrum. International Journal of Culture, Tourism and Hospitality Research, 7(3), 242-256. doi:10.1108/ijcthr-05-2012-0037Blom, T. (2000). Morbid tourism - a postmodern market niche with an example from Althorp. Norsk Geografisk Tidsskrift - Norwegian Journal of Geography, 54(1), 29-36. doi:10.1080/002919500423564de-Miguel-Molina, M., & Barrera-Gabaldón, J. L. (2019). 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Reflections of battlefield tourist experiences associated with Vietnam War sites: an analysis of travel blogs. Journal of Heritage Tourism, 13(3), 197-210. doi:10.1080/1743873x.2017.1282491Podoshen, J. S. (2016). Trajectories in Holocaust tourism. Journal of Heritage Tourism, 12(4), 347-364. doi:10.1080/1743873x.2016.1197228Yankholmes, A., & McKercher, B. (2015). Rethinking slavery heritage tourism. Journal of Heritage Tourism, 10(3), 233-247. doi:10.1080/1743873x.2014.988159Eriksson, P., & Kovalainen, A. (2008). Qualitative Methods in Business Research. doi:10.4135/9780857028044An antidote to the far right’s poison’—The battle for Cable Street’s muralhttps://www.theguardian.com/artanddesign/2016/sep/21/battle-cable-street-mural-fascists-east-endStanding Up to Hatred on Cable Streethttps://www.facinghistory.org/resource-library/standing-democracy/standing-hatred-cable-streetMccarthy, J. (2006). Regeneration of Cultural Quarters: Public Art for Place Image or Place Identity? Journal of Urban Design, 11(2), 243-262. doi:10.1080/13574800600644118Yirik, S., Seyitoğlu, F., & Çakar, K. (2016). From the white darkness to dark tourism: the case of Sarikamish. International Journal of Culture, Tourism and Hospitality Research, 10(3), 245-260. doi:10.1108/ijcthr-06-2015-0064The Battle of Cable Street. APT Filmshttps://vimeo.com/5817684Duffy, A. (2016). Trusting me, trusting you: Evaluating three forms of trust on an information-rich consumer review website. Journal of Consumer Behaviour, 16(3), 212-220. doi:10.1002/cb.1628Museum in Cable St about women and suffragettes turns out to be ‘Jack the Ripper’. The Docklands & East London Advertiserhttps://www.eastlondonadvertiser.co.uk/news/heritage/museum-in-cable-st-about-women-and-suffragettes-turns-out-to-be-jack-the-ripper-1-4172863Miguel Molina, M., & Skinner, J. (2019). Walls of Expression and Dark Murals Tourism. Anthropology News, 60(6). doi:10.1111/an.1310Strange, C., & Kempa, M. (2003). Shades of dark tourism. 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Donning/Doffing and Arm Positioning Influence in Upper Limb Adaptive Prostheses Control

[EN] New upper limb prostheses controllers are continuously being proposed in the literature. However, most of the prostheses commonly used in the real world are based on very old basic controllers. One reason to explain this reluctance to change is the lack of robustness. Traditional controllers have been validated by many users and years, so the introduction of a new controller paradigm requires a lot of strong evidence of a robust behavior. In this work, we approach the robustness against donning/doffing and arm position for recently proposed linear filter adaptive controllers based on myoelectric signals. The adaptive approach allows to introduce some feedback in a natural way in real time in the human-machine collaboration, so it is not so sensitive to input signals changes due to donning/doffing and arm movements. The average completion rate and path efficiency obtained for eight able-bodied subjects donning/doffing five times in four days is 95.83% and 84.19%, respectively, and for four participants using different arm positions is 93.84% and 88.77%, with no statistically significant difference in the results obtained for the different conditions. All these characteristics make the adaptive linear regression a potential candidate for future real world prostheses controllers.This work is partially supported by Ministerio de Educacion, Cultura y Deporte (Spain) under grant FPU15/02870. The authors would like to thank Lucas Parra for the Myo device and Janne M. Hahne for discussions about the subject of the paper.Igual, C.; Camacho-García, A.; Bernabeu Soler, EJ.; Igual García, J. (2020). Donning/Doffing and Arm Positioning Influence in Upper Limb Adaptive Prostheses Control. Applied Sciences. 10(8):1-19. https://doi.org/10.3390/app10082892S119108Esquenazi, A. (2004). Amputation rehabilitation and prosthetic restoration. From surgery to community reintegration. Disability and Rehabilitation, 26(14-15), 831-836. doi:10.1080/09638280410001708850Ziegler-Graham, K., MacKenzie, E. J., Ephraim, P. L., Travison, T. G., & Brookmeyer, R. (2008). Estimating the Prevalence of Limb Loss in the United States: 2005 to 2050. Archives of Physical Medicine and Rehabilitation, 89(3), 422-429. doi:10.1016/j.apmr.2007.11.005Igual, C., Pardo, L. A., Hahne, J., & Igual, J. M. (2019). Myoelectric Control for Upper Limb Prostheses. Electronics, 8(11), 1244. doi:10.3390/electronics8111244Biddiss, E., & Chau, T. (2007). Upper-Limb Prosthetics. American Journal of Physical Medicine & Rehabilitation, 86(12), 977-987. doi:10.1097/phm.0b013e3181587f6cBiddiss, E. A., & Chau, T. T. (2007). Upper limb prosthesis use and abandonment. Prosthetics & Orthotics International, 31(3), 236-257. doi:10.1080/03093640600994581Davidson, J. (2002). 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Relation of common ABL kinase domain mutations with resistance to Tyrosine Kinase Inhibiters in patients with Chronic Myeloid Leukemia in Middle Euphrates of Iraq

Background: Chronic myeloid leukemia (CML) is a hematopoietic stem cell disease, associated with a reciprocal translocation between chromosomes 9 and chromosome 22, lead to the formation of the BCRABL fusion gene (Philadelphia chromosome). This fusion gene is believed to play golden role in the initial development of CML with constitutive tyrosine kinase activation. Successful use of tyrosine kinase inhibiters (TKIs) play a role in improve survival and increase prevalence of CML, but un fortunately mutations in the BCR-ABL kinase domain may cause, or contribute to increase, resistance to TKIs in CML patients. . Objective: This study was designed to assess the association of five most common BCR-ABL kinase domain mutations (T315I, M351T, E255K, M244V and E255V) with resistance state of CML patients on TKIs in Iraqi Middle Euphrates region. Patients and methods: A retrospective case-control study in which 85 patients with chronic myeloid leukemia in chronic phase (45 patients as cases group and 40 patient as control group) were selected from three hemato-oncology centers in middle Euphrates in Iraq during the period from January 2016 till October 2016 out of a total of 240 CML patients (108 male and 132 female) who were registered during this period in these three centers and all patients on TKI (Imatinib and Nilotinib). Venous blood sampling done for BCRABL kinase domain mutations screening. Results: four patients from cases group (4/45) were carriers of one of five selected ABL kinase domain mutations and no one of control group. T315I mutation was detected in 3/45 (6.6 %) of resistant patients, with a significant risk association to develop resistance to TKI therapy (odd ratio and C. I.) (6.67, 0.3340 - 133.2255). E255V was detected in 1/45 (2.2 %) and also had significant risk association to develop resistance to TKIs (odd ratio, C.I.) (2.73, 0.1081 -68.9424). No one of these mutations had significance correlation with demographic or hematological features. M351T, E255K and M244V were not detected in any one of our study groups CML patients. Conclusions: T315I and E255V among five ABL kinas domain mutations were detected in our CML patients with resistance to TKIs. All of them may play a role in development variable degree of resistance to first and second generation TKIs weather primary or secondary.T315I mutation is most common mutation within BCR-ABL domain kinase gene

Maternal haemodynamic function differs in pre‐eclampsia when it is associated with a small‐for‐gestational‐age newborn: a prospective cohort study

Objective To describe maternal haemodynamic differences in gestational hypertension with small‐for‐gestational‐age babies (HDP + SGA), gestational hypertension with appropriate‐for‐gestational‐age babies (HDP‐only) and control pregnancies. Design Prospective cohort study. Setting Tertiary Hospital, UK. Population Women with gestational hypertension and healthy pregnant women. Methods Maternal haemodynamic indices were measured using a non‐invasive Ultrasound Cardiac Output Monitor (USCOM‐1A®) and corrected for gestational age and maternal characteristics using device‐specific reference ranges. Main outcome measures Maternal cardiac output, stroke volume, systemic vascular resistance. Results We included 114 HDP + SGA, 202 HDP‐only and 401 control pregnancies at 26–41 weeks of gestation. There was no significant difference in the mean arterial blood pressure (110 versus 107 mmHg, P = 0.445) between the two HDP groups at presentation. Pregnancies complicated by HDP + SGA had significantly lower median heart rate (76 versus 85 bpm versus 83 bpm), lower cardiac output (0.85 versus 0.98 versus 0.97 MoM) and higher systemic vascular resistance (1.4 versus 1.0 versus 1.2 MoM) compared with control and HDP‐only pregnancies, respectively (all P < 0.05). Conclusion Women with HDP + SGA present with more severe haemodynamic dysfunction than HDP‐only. Even HDP‐only pregnancies exhibit impaired haemodynamic indices compared with normal pregnancies, supporting a role of the maternal cardiovascular system in gestational hypertension irrespective of fetal size. Central haemodynamic changes may play a role in the pathogenesis of pre‐eclampsia and should be considered alongside placental aetiology

Process intensification for post combustion CO₂ capture with chemical absorption: a critical review

The concentration of CO₂ in the atmosphere is increasing rapidly. CO₂ emissions may have an impact on global climate change. Effective CO₂ emission abatement strategies such as carbon capture and storage (CCS) are required to combat this trend. Compared with pre-combustion carbon capture and oxy-fuel carbon capture approaches, post-combustion CO₂ capture (PCC) using solvent process is one of the most mature carbon capture technologies. There are two main barriers for the PCC process using solvent to be commercially deployed: (a) high capital cost; (b) high thermal efficiency penalty due to solvent regeneration. Applying process intensification (PI) technology into PCC with solvent process has the potential to significantly reduce capital costs compared with conventional technology using packed columns. This paper intends to evaluate different PI technologies for their suitability in PCC process. The study shows that rotating packed bed (RPB) absorber/stripper has attracted much interest due to its high mass transfer capability. Currently experimental studies on CO₂ capture using RPB are based on standalone absorber or stripper. Therefore a schematic process flow diagram of intensified PCC process is proposed so as to motivate other researches for possible optimal design, operation and control. To intensify heat transfer in reboiler, spinning disc technology is recommended. To replace cross heat exchanger in conventional PCC (with packed column) process, printed circuit heat exchanger will be preferred. Solvent selection for conventional PCC process has been studied extensively. However, it needs more studies for solvent selection in intensified PCC process. The authors also predicted research challenges in intensified PCC process and potential new breakthrough from different aspects

Denture-related stomatitis is associated with endothelial dysfunction

Oral inflammation, such as periodontitis, can lead to endothelial dysfunction, accelerated atherosclerosis, and vascular dysfunction. The relationship between vascular dysfunction and other common forms of oral infections such as denture-related stomatitis (DRS) is unknown. Similar risk factors predispose to both conditions including smoking, diabetes, age, and obesity. Accordingly, we aimed to investigate endothelial function and major vascular disease risk factors in 44 consecutive patients with dentures with clinical and microbiological features of DRS (n = 20) and without DRS (n = 24). While there was a tendency for higher occurrence of diabetes and smoking, groups did not differ significantly in respect to major vascular disease risk factors. Groups did not differ in main ambulatory blood pressure, total cholesterol, or even CRP. Importantly, flow mediated dilatation (FMD) was significantly lower in DRS than in non-DRS subjects, while nitroglycerin induced vasorelaxation (NMD) or intima-media thickness (IMT) was similar. Interestingly, while triglyceride levels were normal in both groups, they were higher in DRS subjects, although they did not correlate with either FMD or NMD. Conclusions. Denture related stomatitis is associated with endothelial dysfunction in elderly patients with dentures. This is in part related to the fact that diabetes and smoking increase risk of both DRS and cardiovascular disease

Arbitrary-Lagrangian-Eulerian discontinuous Galerkin schemes with a posteriori subcell finite volume limiting on moving unstructured meshes

We present a new family of high order accurate fully discrete one-step Discontinuous Galerkin (DG) finite element schemes on moving unstructured meshes for the solution of nonlinear hyperbolic PDE in multiple space dimensions, which may also include parabolic terms in order to model dissipative transport processes. High order piecewise polynomials are adopted to represent the discrete solution at each time level and within each spatial control volume of the computational grid, while high order of accuracy in time is achieved by the ADER approach. In our algorithm the spatial mesh configuration can be defined in two different ways: either by an isoparametric approach that generates curved control volumes, or by a piecewise linear decomposition of each spatial control volume into simplex sub-elements. Our numerical method belongs to the category of direct Arbitrary-Lagrangian-Eulerian (ALE) schemes, where a space-time conservation formulation of the governing PDE system is considered and which already takes into account the new grid geometry directly during the computation of the numerical fluxes. Our new Lagrangian-type DG scheme adopts the novel a posteriori sub-cell finite volume limiter method, in which the validity of the candidate solution produced in each cell by an unlimited ADER-DG scheme is verified against a set of physical and numerical detection criteria. Those cells which do not satisfy all of the above criteria are flagged as troubled cells and are recomputed with a second order TVD finite volume scheme. The numerical convergence rates of the new ALE ADER-DG schemes are studied up to fourth order in space and time and several test problems are simulated. Finally, an application inspired by Inertial Confinement Fusion (ICF) type flows is considered by solving the Euler equations and the PDE of viscous and resistive magnetohydrodynamics (VRMHD).Comment: 39 pages, 21 figure

Evaluation and analysis of noise levels in Ilorin metropolis, Nigeria

Evaluation and analysis of noise pollution levels have been carried out to determine the level of noise and its sources in Ilorin metropolis. Noise measurements have been done in the morning, at noon, in the evening, and at night to determine noise pollution all over the city. The selected areas of study are commercial centers, road junctions/busy roads, passenger loading parks, and high-density and low-density residential areas. The road junctions had the highest noise pollution levels, followed by commercial centers. The results of this study show that the noise levels in Ilorin metropolis exceeded allowed values at 30 of 42 measurements points. There is a significant difference (P < 0.05) in the noise pollution levels and traffic noise index in all the locations. From the measured noise values, a map of noise pollution was developed for Ilorin. Many solutions proposed for noise abatement in the city are set out