Identifying and Prioritizing the Effective Criteria in Selecting Lean Six Sigma Improvement Projects in the Healthcare Sector

[EN] The main objective of this study was to identify and prioritize effective criteria in selecting Lean Six Sigma improvement projects in the healthcare and treatment sector in Iran. The present study was an applied research in terms of objective and a descriptive and analytical one according to the research methodology and data collection approach. The research statistical population included experts and managers with experience in the field of implementing the lean six sigma methodology in the field of healthcare and treatment in Iran. We used interviews and questionnaire tools to collect the data. The effective criteria were identified through reviewing previous research, which were then prioritized based on the experts’ opinions using the BWM method. According to the results, out of the six main dimensions and 20 criteria identified, the customer development dimension with a weight of 0.387 and the customer satisfaction criterion with a weight of 0.066 were determined as the most effective dimension and the most effective criterion, respectively. Accordingly, the directors of medical centers and organizations affiliated with the healthcare sector are recommended to pay special attention to these defined criteria of the customer development dimension to effectively implement the lean six sigma methodology and managing an effective customer relationship.Bazrkar, A.; Aramoon, V.; Aramoon, E. (2021). Identifying and Prioritizing the Effective Criteria in Selecting Lean Six Sigma Improvement Projects in the Healthcare Sector. WPOM-Working Papers on Operations Management. 12(2):41-55. https://doi.org/10.4995/wpom.15766OJS4155122Ahmed, S., Abd Manaf, N. H., & Islam, R. (2018). 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The state-of-the-art survey on integrations and applications of the best worst method in decision making: Why, what, what for and what's next?. Omega, 87, 205-225. https://doi.org/10.1016/j.omega.2019.01.009Morell-Santandreu, O., Santandreu-Mascarell, C., & Garcia-Sabater, J. J. (2021). A Model for the Implementation of Lean Improvements in Healthcare Environments as Applied in a Primary Care Center. International Journal of Environmental Research and Public Health, 18(6), 2876. https://doi.org/10.3390/ijerph18062876Morell-Santandreu,O., Santandreu-Mascarell, C., & García-Sabater, J. (2020). Sustainability and Kaizen: Business Model Trends in Healthcare. Sustainability, 12(24), 10622. https://doi.org/10.3390/su122410622Mrugalska, B., & Wyrwicka, M. K. (2017). Towards lean production in industry 4.0. Procedia Engineering, 182, 466-473. https://doi.org/10.1016/j.proeng.2017.03.135Naumovich, A. (2020). 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THE TOOLS OF INCREASING EFFICIENCY OF HUMAN RESOURCE IN THE LEAN PRODUCTION ENVIRONMENT: CONCEPTUAL STUDY. International Journal of Core Engineering & Managenet,6(7),1-18.Singh,M.,Rathi,R.,Antony,J.,Garza-Reyes,J.A.(2021).L Lean Six Sigma Project Selection in a Manufacturing Environment Using Hybrid Methodology Based on Intuitionistic Fuzzy MADM Approach, IEEE Transactions on Engineering Management, doi: 10.1109/TEM.2021.3049877. https://doi.org/10.1109/TEM.2021.3049877Sunder, M. V. (2013). Synergies of lean six sigma. IUP Journal of Operations Management, 12(1), 21.Sunder., M, V., & Kunnath, N. R. (2020). Six Sigma to reduce claims processing errors in a healthcare payer firm. Production Planning & Control, 31(6), 496-511. https://doi.org/10.1080/09537287.2019.1652857Swarnakar, V., & Vinodh, S. (2014). Lean Six Sigma Project Selection using Analytical Network Process. 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Utjecaj marketinške strategije društvenih medija na korisnikovu namjeru sudjelovanja u odnosu na medijatorsku ulogu korisnikove percipirane vrijednosti

Purpose – The main purpose of this study is to assess the effect of social media marketing strategy components on customer participation with organizations active in the Iranian insurance industry, taking into account the mediating role of value perceived by insurance service customers. Design/Methodology/Approach – This is an applied research study based on the objective and a descriptive survey. A questionnaire was used in the research to collect the research data among the customers of Iranian insurance companies. Fifteen insurance companies were randomly selected for the sample using the simple random sampling method. The respondents to the questionnaires were identified using a judgmental method. Findings and implications – The results of this study show that social media marketing strategy has a positive and significant effect on customer participation intention. The results also indicated that the perceived value of customers in the insurance industry plays a mediating role in the relationship between the social media marketing strategy and customer participation intention. Companies working in the insurance industry as well as other service-providing organizations can apply the findings of this research to enhance the level of participation of their customers and improve the performance of social media marketing in attracting customers. Limitations – Since this is an exploratory study, the research findings are limited to the specific sample, and thus, the results may change in the case of changes in the sample size. Also, different opinions about the research topic among members of the sample population can affect the research results to a certain extent. Originality – Proper analysis of the impact of social media marketing strategies on customer participation intention, and attention to the perceived value of customers when receiving insurance services, is crucial in improving the performance of insurance companies. This is the first time that research on the Iranian insurance industry was conducted for this purpose and the results can be very effective.Svrha – Glavna svrha studije jest procijeniti učinak komponenata marketinške strategije društvenih medija na sudjelovanje korisnika u uslugama u iranskoj industriji osiguranja, a s obzirom na medijatorsku ulogu percipirane vrijednosti korisnika usluge osiguranja. Metodološki pristup – Radi se o primijenjenom, opisnom anketnom istraživanju. Za prikupljanje podataka korišten je anketni upitnik. Statistički skup istraživanja činila su aktivna poduzeća u iranskoj industriji osiguranja. Metodom slučajnog uzorkovanja odabran je uzorak od 15 osiguravajućih poduzeća. Ispitanici koji su sudjelovali u anketnom istraživanju odabrani su na temelju prosudbe. Rezultati i implikacije – Rezultati studije otkrili su da marketinška strategija društvenih medija ima pozitivan i značajan učinak na namjeru sudjelovanja korisnika. Rezultati su također pokazali da percipirana vrijednost korisnika u industriji osiguranja igra posredničku ulogu u odnosu između marketinške strategije društvenih medija i namjere sudjelovanja korisnika. Poduzeća u industriji osiguranja, kao i druge uslužne organizacije, mogu koristiti zaključke ovog istraživanja kako bi unaprijedili razinu sudjelovanja korisnika usluga i poboljšali učinkovitost marketinga na društvenim medijima radi privlačenja korisnika usluga. Ograničenja – S obzirom da se radi o izviđajnom istraživanju, rezultati su ograničeni veličinom uzorka pa se mogu i promijeniti ako se promijeni veličina uzorka. Osim toga, različita mišljenja o temi istraživanja među ispitanicima mogu donekle utjecati na rezultate. Doprinos – Pravilna analiza utjecaja marketinških strategija društvenih medija na korisnikovu namjeru sudjelovanja, kao i njegovu pozornost na percipiranu vrijednost pri korištenju usluga osiguranja, presudni su za poboljšanje poslovanja osiguravajućih poduzeća. Ovo je prvi put da se u iranskoj osiguravajućoj industriji provodi istraživanje u tu svrhu, a dobiveni rezultati mogu biti korisni

A Multiscale Computational Framework to Predict Deformation and Failure in Polymer Matrix Composites

Composite materials are made by combining different materials with distinct properties to create a more unique and superior material. Nowadays, composites such as polymer matrix composites (PMCs) are extensively used in aerospace applications due to their excellent thermal stability, high strength, and light weight. Perhaps, the greatest advantage of using composite materials over metals is the ability to tailor the properties of the material by properly choosing the resin, and reinforcement materials. Epoxy polymers are often used as the matrix of advanced PMCs. The failure in PMCs occur mainly in the matrix. Therefore, manipulating the properties of PMCs requires a deep understanding of properties of the matrix. However, despite the excellent service record of PMCs, especially in aerospace applications, in many cases there remains a considerable lack of basic understanding of the microstructure and mechanisms that control their properties. Thus, there is a strong need to develop a better understanding of the role of the microstructure and the dominant deformation mechanisms to improve upon the properties of PMCs for more advanced applications. In this thesis, a coarse-grained molecular dynamics model for modeling a highly cross-linked bisphenol a diglycidyl ether (DGEBA) system are developed to study the effects of microstructural variations on the behavior of PMCs. First, a coarse-grained molecular dynamics model is developed to simulate the thermomechanical properties of large scale epoxy systems. The interactions between particles in the coarse-grained structure are formulated by the inversion of the Boltzmann distribution of the coordinates associated with each interaction. The Boltzmann distributions are calculated from a large set of random walk simulations of the conformation of the atomic structure of the polymers using quantum mechanics simulations. In addition, a new algorithm is developed for simulating the curing process of highly cross-linked polymers. This algorithm is used to create a uniformly cross-linked epoxy system with a very high degree of cross-linkings not attainable by other algorithms in the literature. These new algorithms are available for public use as an open-source code for LAMMPS. Furthermore, a new algorithm is developed to characterize the free-volume hole distributions inside the network of epoxies. A free-volume hole is defined here as the volume between polymer chains in the network of the system. The distributions calculated from coarse-grained simulations are compared with the free-volume distribution measured from positron annihilation lifetime spectroscopy (PALS) at different temperatures, pressures, and during deformation. The predicted free-volume holes are in excellent agreement with those measured experimentally. The algorithms developed here are publicly available as an open-source software. To investigate the effect of structural features on predicted properties of epoxy systems, several cross-linked epoxy systems are created by varying the length of cross-linking, and the degree of cross-linking of the system. It is shown that there are strong correlations between the free-volume hole average radius size and the strength and glass transition temperature of these epoxies. Based on these simulations, a new model is developed to predict the glass transition temperature of a polymeric system based on the experimentally or computational measured initial distribution of free-volume holes. Finally, to investigate the effect of structural variation of the matrix on strength and damage evolution of PMCs, a highly cross-linked epoxy is created in the presence of two fibers. The free-volume hole distribution along the direction normal to the fibers shows a variation of matrix structure as a function of distance from the fibers. A multi-scale finite element model has been developed to better investigate the effects of localized matrix properties on the PMCs

Flexural Fatigue Behavior of Fiber-reinforced Concrete Based on Dissipated Energy Modeling

After a century of study of fatigue phenomena in concrete, most of the proposed models for predicting the fatigue life of concrete are not sufficiently precise. The traditional models for predicting fatigue life of concrete are only based on the strength-related parameters such as stress level. The high variation of concrete's strength has led to highly scattered fatigue test result and, consequently, reduced the predictive quality of fatigue models. Recently, several studies have focused on incorporation of new damping-related parameters in fatigue life models to improve the predictability of these models. Damping properties have a crucial effect on dynamic motion and energy dissipation capacity in fatigue life, and therefore they seem to be an important factor in characterizing fatigue as a dynamic motion. The general objective of this research was to acquire a comprehensive understanding of the fatigue behavior of concrete in terms of energy dissipation and, consequently, develop a more statistically reliable approach to characterize the fatigue properties of concrete such as fatigue life. To achieve this purpose, damping properties of several concrete mixtures, with or without fiber reinforcement, were studied. A fatigue model based on dissipated energy concept was developed. The new model is then compared to traditional model. The results show that the new fatigue model has better predictive quality than the traditional approach

Human gingival fibroblasts culture in an autologous scaffold and assessing its effect on augmentation of attached gingiva in a pilot clinical trial

BACKGROUND AND AIM: An important goal of periodontal plastic surgery is the creation of attached gingiva around the teeth. In this study, the aims were to culture gingival fibroblasts in a biodegradable scaffold and measure the width of attached gingiva after the clinical procedure. METHODS: This study was carried out on 4 patients (8 sites), with inadequate attached gingiva next to at least two teeth in contralateral quadrants of the same jaw. A biopsy of attached gingiva (epithelial + connective tissue) was taken using a surgical blade. Following culture of gingival fibroblasts, 250 × 103 cells in 250 μl nutritional medium were mixed with platelet-rich in growth factor (PRGF). Periosteal fenestration technique was done on one side (control) and tissue-engineered mucosal graft (test) was carried out on the contralateral side in each patient. The width of keratinized tissue, probing depth (PD) and width of attached gingiva were recorded at baseline and 3 months after the operation. RESULTS: An increased width of keratinized and attached tissue on all operated sites after 3 months was observed. These results showed the increased mean of the width of keratinized and attached gingiva to be 4.17 mm and 4.14 mm in test and 1.10 mm and 1.10 mm in control sites, respectively. The difference of keratinized and attached gingiva width between test and control sites was significant (P = 0.030, and P = 0.010 respectively). CONCLUSION: According to the results of this study, PRGF can be used as a scaffold to transfer gingival fibroblasts to recipient sites with significant clinical results. KEYWORDS: Tissue Engineering; Gingiva; Blood Platelet; Scaffol

The Relationship between Lifeguards' Needs and Their Job Satisfaction Based on Maslow's Hierarchy of Needs

Introduction: Many studies have been conducted regarding employees' motivation, their job satisfaction and organizational success. The purpose of this study was to investigate the relationship between lifeguards' needs and their job satisfaction based on Maslow's hierarchy of needs. Methods: This field study was a correlational research in which the study sample included all lifeguards who worked in Tehran swimming pools. Based on Krejcie and Morgan table, 306 participants entered the study. Of all distributed questionnaires, 238 questionnaires were returned. In order to collect data, Needs Evaluation Questionnaire (NEQ) and Job Descriptive Index (JDI) were used. For data analysis, Pearson correlation coefficient used (p≤0.05). Results: Findings revealed significant relationship between elementary level needs accommodation and job satisfaction of Lifeguard. It also showed that female lifesaving job satisfaction was in a higher level than male lifesaving job satisfaction. (p≤0.05). Conclusion: It can be concluded that, increasing staff satisfaction in all private organizations in order to achieve efficiency and sport promotion is necessary. Managers of organizations have to try to find the ways to increase lifeguards job satisfaction in order to gain more efficiency

Investigating the Effect of Implementing the Lean Six Sigma on Organizational Performance Based on the Mediating Role of Strategic Knowledge Management with Structural Equation Modeling Approach

The main purpose of this study was to investigate the effect of implementing the lean six sigma on organizational performance with the strategic knowledge management as mediating variable in private hospitals in Tehran- Iran. The research method was based on purpose of applied research and in terms of data collection and the analysis method was survey-correlation. The statistical population of this study were 51 private hospitals in Tehran. Questionnaires were used for data collection. Structural equation modeling was used to analyze the data. The results showed that the implementation of the lean six sigma does not have a positive and significant effect on organizational performance; however, it is effective on the strategic knowledge management. On the other hand, strategic knowledge management has a positive and significant effect on organizational performance. Moreover, the implementation of the lean six sigma has a positive effect on the organizational performance through the mediating variable of strategic knowledge management.  The research findings can be used to improve the Organizational Performance of Medical centers and private hospitals through the implementation of Lean Six Sigma.

Intellectual Property Protection: From Integrated Circuits to Machine Learning Models

The increasing popularity of intellectual property (IP) based design in the semiconductor and artificial intelligence (AI) industry has created a growing market for silicon and machine learning (ML) IPs. The emerging IP market in both sectors has facilitated the exchange of designs and ideas among entities, which in turn has helped speed up innovations, lower R&D costs, and shorten the time-to-market for new products. Nonetheless, two major concerns have been raised in the IP market that may overshadow these benefits and, consequently, discourage suppliers (IP vendors) and consumers (IP buyers) from entering the IP market. First, there is the issue of IP infringements, which negatively impact IP vendors. Given that IPs can easily be copied and distributed, sharing them with other entities in a market environment increases the risk of IP theft and copyright violations. Such infringements would erode the profit margins of IP vendors and discourage them from investing in further IP development. The second issue pertains to IP buyers, who are primarily concerned about how using third-party IPs might impact the safety and security (S&S) of their systems. Many real-world applications require designers to provide S&S assurance for their products. However, this becomes challenging for systems that make use of third-party IPs since IP buyers often lack the necessary knowledge about the core design features of commercial IPs to devise effective S&S measures. In this thesis, our goal is to develop technical solutions to address these two concerns in order to promote participation in the semiconductor and AI IP markets and thereby stimulate faster growth in both sectors. The first part of this thesis is dedicated to addressing vendors' concerns regarding IP infringements by proposing IP watermarking and IP fingerprinting solutions. Protecting IPs through legal means is passive and ineffective unless forensic means such as IP watermarking and IP fingerprinting are available to assist vendors in establishing ownership over pirated IPs and identifying the source of infringement. In this direction, we make four contributions: (1) Our first contribution is a dynamic watermarking scheme for silicon IPs that relies on the multi-functionality of polymorphic gates to hide ownership information in circuits. With the proposed watermarking method, the circuit functions as expected at normal operating temperature; however, when the circuit is heated, the hidden behavior of polymorphic gates is activated and the circuit's functionality changes to reveal the watermark. Experiment results demonstrate that our scheme can embed large multi-bit signatures while incurring low overhead in terms of performance, area, and power consumption. (2) The second contribution is a black-box watermarking method for ML IPs, particularly deep neural network (DNN) classifiers, which we call GradSigns. The proposed scheme embeds the ownership information as a set of stego-constraints on the gradients of model components. Our experiments suggest that GradSigns is extremely robust to counter-watermark attacks and is capable of embedding large multi-bit signatures without sacrificing the performance of the model, two properties that were lacking in the prior art. (3) The third contribution is a fingerprinting scheme for silicon IPs that replaces standard cells holding “Satisfiability Don’t Care” (SDC) conditions with signal-controlled polymorphic gates. With the proposed approach, each copy of the IP and its corresponding buyer can be identified based on the configuration of the polymorphic gates, i.e. the IP fingerprint. This attribute can help vendors trace the source of IP piracy if needed. Experiments demonstrate that our method can provide sufficiently strong fingerprints with about half the overhead of similar methods. (4) The fourth and final contribution in this direction is a fingerprinting technique where the standard testing infrastructure in system-on-chips (SoCs) design is repurposed to create unique fingerprints. To this end, we adopt the reconfigurable scan network (RSN) in SoCs and develop a fingerprinting protocol that configures a unique RSN for each sold copy by utilizing different connection styles between scan cells. Experiments show that the proposed method is capable of creating a large number of distinct fingerprints while incurring little overhead. The second part of this thesis is dedicated to addressing IP buyers’ concerns regarding the security and safety risks of using third-party IPs, with an emphasis on ML IPs. Commercial models are primarily marketed as black box oracles to reduce the risk of IP infringements. However, having little knowledge about the design details of commercial models can complicate IP buyers’ efforts in addressing various S&S threats that may arise in real-world applications of ML. In this thesis, we specifically discuss two of such concerns, namely (a) inaccuracy and overconfidence of DNN classifiers in the presence of anomalous inputs, and (b) the threat from model tampering (or model integrity) attacks, and explain why existing countermeasures aren't applicable to black-box commercial DNNs. The following two contributions are made to address this shortcoming: (1) Our first contribution is a tamper detection technique, called AID (Attesting the Integrity of DNNs). The proposed method generates a set of input-output test cases that can reveal whether a model has been tampered with. AID does not require access to parameters of models and thus is compatible with black-box commercial DNNs. Experimental results show that AID is highly effective and reliable, in that, with at most four test cases, AID is able to detect eight representative integrity attacks with zero false-positive. (2) The second contribution in this direction is PAD-Lock, a Power side-channel-based Anomaly Detection framework for black-box DNN classifiers. The proposed method uses the power side-channel information during DNN inference operation as a proxy for the model's inner computation and discovers patterns that can be used to detect anomalous inputs such as adversarial and out-of-distribution samples based on this information. Upon preliminary examination, PAD-Lock appears to be a practical and effective framework for detecting anomalies in black-box commercial DNNs. In summary, the methods presented in this dissertation fortify the protection of semiconductor and ML IPs against IP infringement activities and assist IP buyers in ensuring the safety and security of systems containing commercial IPs. We believe these technical solutions constitute a major step toward addressing concerns raised in the semiconductor and AI IP markets, and will ultimately encourage more entities to participate in both markets

Comparing Perceived Stress, Self-efficacy and Mental Health in Patients With HIV and Hepatitis C

Abstract Background: The purpose of the present research was to compare the perceived stress, self-efficacy and mental health in patients with HIV and Hepatitis C. Materials and Methods: The method of present research was causal-comparative research. Population included of all patients with acquired immune deficiency syndrome or AIDS referred to a behavioral disease counseling centers of Arak city and all patients of chronic hepatitis caused by the hepatitis C virus referred to Gastroenterology Research Center and private practice of digestive specialists in Arak city. The sample consisted of 200 people, including 100 HIV and 100 people with hepatitis C who participated in the study and were selected for screening. All participants responded to the three instruments including Cohen Perceived Stress, Kamark and Mrimlstyn, Sherer's Self-efficacy and Goldberg general health questionnaires. Data analysis was done in two descriptive and inferential levels using SPSS version 20. Results: The results of MONOVA showed that two groups were different in the perceived stress, self-efficacy and mental health, physical symptoms, depression, anxiety, social dysfunction, at the level of 0.01. Conclusion: It is suggested that workshops to be held to careful inform how much stress and self-efficacy had affected on physical and mental health of patients with acquired immune deficiency syndrome or AIDS