Issue resolution at a large aerospace manufacturer

Thesis (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division; and, (M.B.A.)--Massachusetts Institute of Technology, Sloan School of Management; in conjunction with the Leaders for Global Operations Program at MIT, 2013.Cataloged from PDF version of thesis.Includes bibliographical references (p. 39-40).UTC Aerospace Systems has a wide variety of problem solving tools driven by their Achieving Competitive Excellence (ACE) program. One tool that is frequently used to resolve and capture customer escapes is the 8D methodology. It is an eight-step process designed to identify, correct, and eliminate recurring problems and is useful in providing a feedback mechanism between the customers and suppliers. Its goal is to establish a permanent corrective action and focuses on the origin of the problem by determining its root causes. The objective of the project is to fully understand the cost benefit of implementing the 8D methodology. The initial investigation of the 8D process uncovered that some defects recorded using the 8D tool are omitted in metrics reporting, leading to poor issue resolution and limited feedback between customers and suppliers. Because the tool requires additional steps that were not required in previous problem solving techniques at UTC Aerospace Systems, it is both more cost and time intensive. To avoid wasteful spending, it is therefore important that the tool be applied only when necessary. A study was performed to identify situations when the 8D tool is used improperly. Two situations were identified: (1) when an 8D investigation is performed unnecessarily and (2) when the 8D investigation is not performed in a situation when it should be. In the first situation, the unnecessary implementation of the 8D tool results in wasted effort within the organization. In the second situation, the missed opportunity to implement the tool has the potential to allow future occurrences of the same defect that may have otherwise been avoided. Preventing a defect from occurring in the future is often achieved by redesigning a part to eliminate a systemic issue. It is therefore important to use the 8D tool in order to identify systemic issues more quickly and thereby reduce future repair costs. The costs associated with these two situations are further quantified in the project.by Sarah Clarke.M.B.A.S.M

Taking after a parent: phenotypic resemblance and the professional familialisation of genomics

This article draws on 2 years’ worth of ethnographic observation of team meetings to explore decision-making in an NHS clinical genomics service. The focus of discussions was on ambiguous genomic results known as VUS or Variants of Uncertain Significance, which may be pathogenic but which also may turn out to be benign. In examining decision-making around such results, we note how, in contrast to much policy and promotional material in this area, clinicians in these meetings (clinical geneticists and genetic counsellors) place great emphasis on parental phenotypes and whether the parents of a patient share the symptoms and signs of the suspected condition. This information is then combined with the result of genomic tests to decide whether the variant a patient has is responsible for their condition. This article explores the way in which clinicians attempt to flexibly enrol parents into genomic explanations through informal diagnosis of their possible phenotypes and the way in which actually meeting parents allows some clinicians to trump explanations based on documentary or photographic data. The paper sheds light on the way that earlier scholarly understandings of such decisions (around, say dysmorphology) remain relevant and explores claims that laboratory tests overrule clinical decision-making

Reflexive standardization and the resolution of uncertainty in the genomics clinic

In genomics, the clinical application of Next Generation Sequencing technologies (such as Whole Genome or Exome Sequencing) has attracted considerable attention from UK policymakers, interested in the benefits such technologies could bring the National Health Service. However, this boosterism plays little attention to the challenges raised by a kind of result known as a Variant of Uncertain Significance, or VUS, which require clinical geneticists and related colleagues to classify ambiguous genomic variants as ‘benign’ or ‘pathogenic’. With a rigorous analysis based on data gathered at 290 clinical meetings over a two-year period, this paper presents the first ethnographic account of decision-making around NGS technology in a NHS clinical genomics service, broadening our understanding of the role formal criteria play in the classification of VUS. Drawing on Stefan Timmermans’ concept of ‘reflexive standardisation’ to explore the way in which clinical genetics staff classify such variants this paper explores the application of a set of criteria drafted by the American College of Medical Genetics and Genomics, highlighting the flexible way in which various resources – variant databases, computer programmes, the research literature – are drawn on to reach a decision. A crucial insight is how professionals’ perception of, and trust in, the clinical practice at other genomics centres in the NHS, shapes their own application of criteria and the classification of a VUS as either benign or pathogenic

Electronic Structure Description of a Doubly Oxidized Bimetallic Cobalt Complex with Pro-Radical Ligands

The geometric and electronic structure of a doubly oxidized bimetallic Co complex containing two redox-active salen moieties connected via a 1,2-phenylene linker has been investigated and compared to an oxidized monomeric analogue. Both complexes, CoL1 and Co2L2 are oxidized to the mono- and di-cations respectively with AgSbF6 and characterized by X-ray crystallography for the monomer, and Vis-NIR spectroscopy, electron paramagnetic (EPR) spectroscopy, SQUID magnetometry and density functional theory (DFT) calculations for both the monomer and dimer. Both complexes exhibit a water molecule coordinated in the apical position upon oxidation. [CoL1-H2O]+ displays a broad NIR band at 8500 cm-1 (8400 M-1cm-1) which is consistent with recent reports on oxidized Co salen complexes (Kochem, A. et. al., Inorg Chem., 2012, 51, 10557-10571, Kurahashi, T. et. al., Inorg. Chem., 2013, 52, 3908-3919). DFT calculations predict a triplet ground state with significant ligand and metal contributions to the singularly occupied molecular orbital (SOMO). The majority (~75%) of the total spin density is localized on the metal, highlighting both high spin Co(III) and Co(II)L• character in the electronic ground state. Further oxidation of CoL1 to the dication affords a low spin Co(III) phenoxyl radical species. The NIR features for [Co2L2-2H2O]2+ at 8600 cm-1 (17800 M-1cm-1) are doubly intense in comparison to [CoL1-H2O]+ owing to the description of [Co2L2-2H2O]2+ as two non-interacting oxidized Co salen complexes bound via the central phenylene linker. Interestingly, TD-DFT calculations predict two electronic transitions that are 353 cm-1 apart. The NIR spectrum of the analogous Ni complex, [Ni2L2]2+, exhibits two intense transitions (4890 cm-1/26500 M-1cm-1 and 4200 cm-1/21200 M-1cm-1) due to exciton coupling in the excited state. Only one broad band is observed in the NIR spectrum for [Co2L2-2H2O]2+ as a result of the contracted donor and acceptor orbitals and overall CT character

Medical Students’ Experience: Community Engagement and Advocacy through Photovoice

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Characteristics and incidence of transfusion-associated necrotizing enterocolitis in the UK

BACKGROUND AND AIMS: The etiology of necrotizing enterocolitis (NEC) is unclear and postulated as being multifactorial. It has been suggested that one causative factor is the transfusion of packed red blood cells (PRBCs) leading to the disease entity commonly referred to as transfusion-associated NEC (TANEC). TANEC has been reported in North America but its incidence has not been formally investigated in the UK. Our aims were to identify the incidence of NEC and TANEC in tertiary-level UK neonatal units and to describe characteristics of TANEC cases. MATERIALS AND METHODS: Using strict case definitions for NEC and TANEC, we undertook a retrospective review to estimate the incidence of TANEC cases occurring in four UK tertiary-level centers during a 38-month period. RESULTS: Of 8007 consecutive neonatal admissions of all gestations to the four centers, 68 babies went on to develop NEC and all affected infants were of very low birth weight (VLBW); 34 of these had previously received a transfusion of PRBCs but did not fit the diagnostic criteria for TANEC, whereas 15 (22%) of the 68 babies with NEC qualified as TANEC cases. UK cases occurred at an earlier postnatal age than cases reported in multiple large North American series and were of a lower birth weight. CONCLUSIONS: We have confirmed the presence of TANEC in the UK VLBW neonatal population. Its incidence lies within the wide range described in previous reports of this phenomenon globally, though with some local variation in characteristics. Further work is needed to clarify causation, pathophysiology, and possible mechanisms of prevention of TANEC

Beluga whales in the western Beaufort Sea : current state of knowledge on timing, distribution, habitat use and environmental drivers

ECG was supported by a National Research Council-National Academy of Sciences Postdoctoral Fellowship.The seasonal and geographic patterns in the distribution, residency, and density of two populations (Chukchi and Beaufort) of beluga whales (Delphinapterus leucas) were examined using data from aerial surveys, passive acoustic recordings, and satellite telemetry to better understand this arctic species in the oceanographically complex and changing western Beaufort Sea. An aerial survey data-based model of beluga density highlights the Beaufort Sea slope as important habitat for belugas, with westerly regions becoming more important as summer progresses into fall. The Barrow Canyon region always had the highest relative densities of belugas from July-October. Passive acoustic data showed that beluga whales occupied the Beaufort slope and Beaufort Sea from early April until early November and passed each hydrophone location in three broad pulses during this time. These pulses likely represent the migrations of the two beluga populations: the first pulse in spring being from Beaufort animals, the second spring pulse Chukchi belugas, with the third, fall pulse a combination of both populations. Core-use and home range analyses of satellite-tagged belugas showed similar use of habitats as the aerial survey data, but also showed that it is predominantly the Chukchi population of belugas that uses the western Beaufort, with the exception of September when both populations overlap. Finally, an examination of these beluga datasets in the context of wind-driven changes in the local currents and water masses suggests that belugas are highly capable of adapting to oceanographic changes that may drive the distribution of their prey.PostprintPeer reviewe

Angiotensin-converting enzyme activity and inhibition in dogs with cardiac disease and an angiotensin-converting enzyme polymorphism

OBJECTIVE The objective of this study was to evaluate angiotensin-converting enzyme (ACE) activity in dogs and with and without an ACE polymorphism in the canine ACE gene, before and after treatment with an ACE inhibitor. METHODS Thirty-one dogs (20 wild-type, 11 ACE polymorphism) with heart disease were evaluated with ACE activity measurement and systolic blood pressure before and after administration of an ACE inhibitor (enalapril). RESULTS Median pre-treatment ACE activity was significantly lower for ACE polymorphism dogs than for dogs with the wild-type sequence ( P=0.007). After two weeks of an ACE inhibitor, ACE activity was significantly reduced for both genotypes (wild-type, P<0.0001; ACE polymorphism P=0.03); mean post-therapy ACE activity was no different between the groups. CONCLUSION An ACE polymorphism is associated with lower levels of ACE activity. Dogs with the polymorphism still experience suppression of ACE activity in response to an ACE inhibitor. It is possible that the genetic status and ACE activity of dogs may impact the response of dogs with this variant to an ACE inhibitor