Quality management in heavy duty manufacturing industry: TQM vs. Six Sigma

‘Is TQM a management fad?’ This question has been extensively documented in the quality management literature; and will be tackled in this research though a critical literature review on the area. ‘TQM versus Six-Sigma’ debate, which has also been a fundamental challenge in this research filed, is addressed by a thematic and chronological review on the peer papers. To evaluate this challenge in practice, a primary research in heavy duty machinery production industry have been conducted using a case-study on, J C Bamford Excavators Ltd (JCB), the largest European construction machinery producer. The result highlights that TQM is a natural foundation to build up Six-Sigma upon; and not surprisingly the quality yield in a TQM approach complemented by Six-sigma is far higher and more stable than when TQM with no Six-Sigma focus is being put in place; thus presenting the overall finding that TQM and Six Sigma are compliments, not substitutes. The study will be concluded with an overview on quality management approaches in the heavy duty manufacturing industry to highlight the way forward for the industry

Festchrift: A Collection of Essays on Architectural History

A collection of essays on architectural history prepared by the Northern Pacific Coast Chapter Society of Architectural Historians dedicated to Professor Marion Dean Ross, chapter founder, on the occasion of his 65th birthday

Habitat Complexity Affects the Structure but Not the Diversity of Sessile Communities on Tropical Coastal Infrastructure

Increasing human population, urbanisation, and climate change have resulted in the proliferation of hard coastal infrastructure such as seawalls and breakwaters. There is increasing impetus to create multifunctional coastal defence structures with the primary function of protecting people and property in addition to providing habitat for marine organisms through eco-engineering - a nature-based solutions approach. In this study, the independent and synergistic effects of physical complexity and seeding with native oysters in promoting diversity and abundances of sessile organisms were assessed at two locations on Penang Island, Malaysia. Concrete tiles with varying physical and biological complexity (flat, 2.5 cm ridges and crevices, and 5 cm ridges and crevices that were seeded or unseeded with oysters) were deployed and monitored over 12 months. The survival of the seeded oysters was not correlated with physical complexity. The addition of physical and biological complexity interacted to promote distinct community assemblages, but did not consistently increase the richness, diversity, or abundances of sessile organisms through time. These results indicate that complexity, whether physical or biological, is only one of many influences on biodiversity on coastal infrastructure. Eco-engineering interventions that have been reported to be effective in other regions may not work as effectively in others due to the highly dynamic conditions in coastal environment. Thus, it is important that other factors such as the local species pools, environmental setting (e.g., wave action), biological factors (e.g., predators), and anthropogenic stressors (e.g., pollution) should also be considered when designing habitat enhancements. Such factors acting individually or synergistically could potentially affect the outcomes of any planned eco-engineering interventions.</jats:p

Genetic determinants of glucose levels in pregnancy: genetic risk scores analysis and GWAS in the Norwegian STORK cohort

Objective: Hyperglycaemia during pregnancy increases the risk of adverse health outcomes in mother and child, but the genetic aetiology is scarcely studied. Our aims were to (1) assess the overlapping genetic aetiology between the pregnant and non-pregnant population and (2) assess the importance of genome-wide polygenic contributions to glucose traits during pregnancy, by exploring whether genetic risk scores (GRSs) for fasting glucose (FG), 2-h glucose (2hG), type 2 diabetes (T2D) and BMI in non-pregnant individuals were associated with glucose measures in pregnant women. Methods: We genotyped 529 Norwegian pregnant women and constructed GRS from known genome-wide significant variants and SNPs weakly associated (p>5×10−) with FG, 2hG, BMI and T2D from external genome-wide association studies (GWAS) and examined the association between these scores and glucose measures at gestational weeks 14-16 and 30-32. We also performed GWAS of FG, 2hG and shape information from the glucose curve during an oral glucose tolerance test (OGTT). Results: GRS explained similar variance during pregnancy as in the non-pregnant population (~5%). GRS and GRS explained up to 1.3% of the variation in the glucose traits in pregnancy. If we included variants more weakly associated with these traits, GRS and GRS explained up to 2.4% of the variation in the glucose traits in pregnancy, highlighting the importance of polygenic contributions. Conclusions: Our results suggest overlap in the genetic aetiology of FG in pregnant and non-pregnant individuals. This was less apparent with 2hG, suggesting potential differences in postprandial glucose metabolism inside and outside of pregnancy

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Male Microchimerism at High Levels in Peripheral Blood Mononuclear Cells from Women with End Stage Renal Disease before Kidney Transplantation

Patients with end stage renal diseases (ESRD) are generally tested for donor chimerism after kidney transplantation for tolerance mechanism purposes. But, to our knowledge, no data are available on natural and/or iatrogenic microchimerism (Mc), deriving from pregnancy and/or blood transfusion, acquired prior to transplantation. In this context, we tested the prevalence of male Mc using a real time PCR assay for DYS14, a Y-chromosome specific sequence, in peripheral blood mononuclear cells (PBMC) from 55 women with ESRD, prior to their first kidney transplantation, and compared them with results from 82 healthy women. Male Mc was also quantified in 5 native kidney biopsies obtained two to four years prior to blood testing and in PBMC from 8 women collected after female kidney transplantation, several years after the initial blood testing. Women with ESRD showed statistically higher frequencies (62%) and quantities (98 genome equivalent cells per million of host cells, gEq/M) of male Mc in their PBMC than healthy women (16% and 0.3 gEq/M, p<0.00001 and p = 0.0005 respectively). Male Mc was increased in women with ESRD whether they had or not a history of male pregnancy and/or of blood transfusion. Three out of five renal biopsies obtained a few years prior to the blood test also contained Mc, but no correlation could be established between earlier Mc in a kidney and later presence in PBMC. Finally, several years after female kidney transplantation, male Mc was totally cleared from PBMC in all women tested but one. This intriguing and striking initial result of natural and iatrogenic male Mc persistence in peripheral blood from women with ESRD raises several hypotheses for the possible role of these cells in renal diseases. Further studies are needed to elucidate mechanisms of recruitment and persistence of Mc in women with ESRD