A FUZZY EVALUATION MODEL OF CHOOSING A MIDDLE MANAGER FOR AN INTERNATIONAL SHIPPING SERVICE PROVIDER

Choosing a middle manager with management competency and capabilities will have a decisive influence on the organization\u27s development for international shipping service providers. There is ambiguity and uncertainty in the decision-making environment during the selection of a middle manager and many evaluation criteria must be considered. The main purpose of this article is to construct a fuzzy multiple criteria decision-making (MCDM) model for international shipping service providers to use when selecting a middle manager. First, some methods and concepts of the fuzzy theory are introduced in this article. Five steps of evaluation model of fuzzy MCDM algorithms are then proposed to choose a best middle manager. Finally, an international shipping case is presented and the proposed fuzzy MCDM model is illustrated step by step. It can be seen from the demonstration that this evaluation model can be used to effectively select the best middle manager

Using Fuzzy AHP Method to Evaluate Key Competency and Capabilities of Selecting Middle Managers for Global Shipping Logistics Service Providers

The main purpose of this article is to use the fuzzy analytic hierarchy process (AHP) method to empirically study the key competency and capabilities affecting the selection of middle managers for global shipping logistics service providers (GSLSPs). To facilitate this theme for obtaining key competency and capabilities, a list of five management competency with twenty-five capabilities are preliminary summarized. Subsequently, the proposed fuzzy AHP method is applied to measure relative weights for evaluating these competency and capabilities. The appraisal approach is then to perform empirical survey via AHP expert questionnaires. Finally, the empirical results show that: (1) ‘professional competency’ is the most important management competency affecting the selection of middle managers for GSLSPs. (2) In order of relative importance, the top six key management capabilities affecting the selection of middle managers for GSLSPs are the ‘capability to manage work pressure,’ ‘capability to manage crisis,’ ‘capability to lead team awareness,’ ‘capability to manage interpersonal networks perfectly,’ ‘capability to use logistics expertise to enhance work efficiency,’ and ‘capability to effectively build team spirit and work atmosphere,’ respectively. Furthermore, concluding remarks are provided in this article

Comparison of single-incision mini-slings (Ajust) and standard transobturator midurethral slings (Align) in the management of female stress urinary incontinence: A 1-year follow-up

AbstractObjectiveTo investigate the effectiveness and safety of a new single-incision mini-sling (SIMS)—Ajust—compared with the standard transobturator midurethral sling (SMUS)—Align—for the treatment of female stress urinary incontinence (SUI).Materials and MethodsA retrospective cohort study was conducted between January 1, 2010 and August 31, 2012. Women with SUI who underwent either SMUS-Align or SIMS-Ajust were recruited. The primary outcomes included operation time, estimated operative blood loss, postoperative pain, and complications. The secondary outcomes included subjective and objective success, defined as an International Consultation on Incontinence Questionnaire (ICIQ) score of 0 or improvement as felt by the patient and a long-term complication, such as dyspareunia and mesh erosion after 6 months and 12 months of follow-up.ResultsA total of 136 patients were enrolled, including 76 receiving SMUS-Align and 60 receiving SIMS-Ajust. Baseline characteristics of the patients in both groups were similar, without a statistically significant difference. Primary outcomes between both groups were similar, except that women treated with SIMS-Ajust had statistically significantly shorter operation time (p = 0.003), less intent to treat (p < 0.05), and earlier postoperative discharge (p = 0.001) than women treated with SMUS-Align. Secondary outcomes were similar without a significant difference between the two groups (93% vs. 88% success rate in each group).ConclusionOur results showed that SIMS-Ajust was not inferior to SMUS-Align with respect to success rate, and might have a slight advantage in early discharge. A long-term follow-up or prospective study is needed to confirm the above findings

Women with endometriosis have higher comorbidities: Analysis of domestic data in Taiwan

AbstractEndometriosis, defined by the presence of viable extrauterine endometrial glands and stroma, can grow or bleed cyclically, and possesses characteristics including a destructive, invasive, and metastatic nature. Since endometriosis may result in pelvic inflammation, adhesion, chronic pain, and infertility, and can progress to biologically malignant tumors, it is a long-term major health issue in women of reproductive age. In this review, we analyze the Taiwan domestic research addressing associations between endometriosis and other diseases. Concerning malignant tumors, we identified four studies on the links between endometriosis and ovarian cancer, one on breast cancer, two on endometrial cancer, one on colorectal cancer, and one on other malignancies, as well as one on associations between endometriosis and irritable bowel syndrome, one on links with migraine headache, three on links with pelvic inflammatory diseases, four on links with infertility, four on links with obesity, four on links with chronic liver disease, four on links with rheumatoid arthritis, four on links with chronic renal disease, five on links with diabetes mellitus, and five on links with cardiovascular diseases (hypertension, hyperlipidemia, etc.). The data available to date support that women with endometriosis might be at risk of some chronic illnesses and certain malignancies, although we consider the evidence for some comorbidities to be of low quality, for example, the association between colon cancer and adenomyosis/endometriosis. We still believe that the risk of comorbidity might be higher in women with endometriosis than that we supposed before. More research is needed to determine whether women with endometriosis are really at risk of these comorbidities

Molecular characterization of bacteriocin loci in Lactobacillus plantarum I-UL4

Bacteriocin is a group of proteinaceous antimicrobial peptides produced inhibiting the growth of closely related bacterial strains. Bacteriocin and bacteriocinogenic Lactic Acid Bacteria (LAB) have received special attention due to their potential applications as biopreservative, therapeutic agent and antibiotic-replacer in livestock animals. Lactobacillus plantarum, a member of LAB is found in various ecological niches with more than 10 types of bacteriocins have been reported for this species. L. plantarum IUL4 isolated from the fermented tapioca exhibits a wide spectrum of bacteriocin activity against Gram-positive and Gram-negative bacteria as well as food-borne pathogens. It was reported to carry two bacteriocin structural genes, plW and plnEF encode for plantaricin W and plantaricin EF, respectively. However, the information regarding the bacteriocin biosynthetic genes for plantaricin W and plantaricin EF such as immunity, secretion and regulatory genes as well as the organisation of the respective bacteriocin loci are not available. Hence, the bacteriocin loci of L. plantarum I-UL4 containing plW and plnEF structural genes were analysed in this study. The presence of 24 selected plantaricin (pln) biosynthetic genes (structural, immunity, secretion and regulatory genes) described for plnS, pln423, plW and plnEF loci were amplified and sequenced. The result revealed the presence of eight pln genes and two pln genes from plnEF and plW locus,respectively. On the contrary, the pln genes of plnS locus, pln423 locus and nine pln genes of plnEF locus were absent from the studied strain as confirmed by gradient PCR. The DNA sequence of the flanking region of these pln genes were amplified and sequenced. The results revealed two contigs of 2.7 kilobase (kb) (UL4-plW locus) and 17.5 kb (UL4-plnEF locus), respectively. The UL4-plW locus contains three open reading frames (ORFs) arranged in the same orientation which showed remarkable DNA (≥99.7%) and amino acid (≥99.3%) sequence identities to the plW locus of L. plantarum LMG2379. On the contrary, 21 ORFs were predicted on the UL4-plnEF locus. Each ORF has remarkable DNA and amino acid sequence identities to the reported ORFs of plnEF loci in L. plantarum C11, WCFS1, V90, J51, NC8, J23 and JDM1 (reported plnEF loci). Five operons were deduced in the UL4-plnEF locus: orf345, plnLR, plnUL4IF-UL4HK-plnD, plnEFI and plnGHSUVW. The UL4-plnEF locus was demonstrated to contain different number of bacteriocin gene exhibiting different organisations from the reported plnEF loci. Specifically, plnF (bacteriocin structural gene encoding plantaricin EF) of the UL4-plnEF locus showed mutation which contributed to a longer plnF peptide with isoelectric point was 0.28 lower than the plnF of the reported plnEF loci. Interestingly, the UL4-plnEF locus was shown to be a hybrid of the plnEF locus of L. plantarum JDM1 and J51, where the left-half and right-half of UL4-plnEF locus resembled the plnEF locus of L. plantarum JDM1 and J51, respectively. Southern hybridisation with specific DNA probe showed that both UL4-plW and UL4-plnEF loci were chromosomally encoded. The UL4-plW locus encoded lantibiotic plantaricin W, while the UL4-plnEF locus encoded class IIb plantaricin EF and a putative two-peptide plantaricin orf34. In conclusion, the concurrent presence of the UL4-plW and the mosaic UL4-plnEF loci suggested that the L. plantarum I-UL4 was a novel multi-bacteriocinogenic LAB

Characterization of lactic acid bacteria isolated from Malaysian foods

Lactic Acid Bacteria (LAB)are a group of Gram positive bacteria,which are industrially important microorganisms due to their vast applications in various industries. In this study, 10 LAB isolates namely CB1, I-1, OMR1, TB-1, UP2, TP5, GP8, RW18, B12-M9 and Big-2-Y isolated from Malaysian foods were characterized phenol typically and genotypically. The genotypic characterization technique employed in this study was 16SrDNA-Polymerase Chain Reaction amplification, where a pair of universal primers: 8FPL16S and 149216S was used to amplify the 16S rDNA. The amplicon with approximate size of 1.5kb was then purified and analysed for DNA sequence. Based on the results of 16Sr DNA sequence, the isolates of CB1,TB-1 and UP2 were identified as Pediococcus acidilactici, whereas isolates of I-1, OMR1 and B12-M-9 were identified as Pediococcus pentosaceus and the other 4 isolates namely TP5, GP8, RW18 and Big-2-Y were identified as Lactobacillus plantarum with 100% homology. Carbohydrate fermentation profiles were determined for phenotypic characteristics, where the results of API50CHL kits showed more than 90% homology for all tested isolates, which were in agreement with the results of 16Sr DNA analyses. Antibiotic resistance profile was also determined according to the Kirby-Baueragar diffusion test using antibiotic impregnated disks. All tested LAB isolates showed resistance to nalidixic acid, streptomycin, vancomycin, gentamycin, kanamycin and bacitracin. However, they were sensitive to tetracycline, chloramphenicol, erythromycin and penicillin G. It is important to determine the antibiotic resistance profile of LAB isolates prior to their application in respective industry since the results in his study showed that some LAB isolates are resistant to several antibiotics being used commonly in livestock industry as growth promoter and disease treatment

Maintenance therapy for duodenal ulcer: A randomized controlled comparison of seven forms of treatment

PURPOSE: We performed a randomized controlled trial to compare the efficacy of seven forms of maintenance treatment of duodenal ulcer, including a mealtime regimen of antacids. PATIENTS AND METHODS: We randomized 785 patients with healed duodenal ulcer to receive: (1) no treatment; (2) mealtime antacids with an acid-neutralizing capacity of 80 mmol/day; (3) an antidepressant, trimipramine 25 mg; (4) an anticholinergic, pirenzepine 50 mg; (5) cimetidine 200 mg; (6) cimetidine 400 mg; (7) ranitidine 150 mg; or (8) sucralfate 1 g twice a day. Symptomatology and side effects were assessed every 2 months and endoscopy was performed every 4 months up to 1 year. RESULTS: The patients were comparable in the majority of clinical characteristics before entry. The cumulative percentages of patients with relapse of ulcers at 12 months by life-table analysis were 61% with no treatment, 38% with mealtime antacids, 60% with trimipramine, 52% with pirenzepine, 46% with cimetidine 200 mg, 44% with cimetidine 400 mg, 30% with ranitidine 150 mg, and 40% with sucralfate. Cimetidine 400 mg, antacids, ranitidine 150 mg, and sucralfate were significantly better than no treatment and the other forms of treatment. Ranitidine was significantly better than antacids, cimetidine, and sucralfate in preventing endoscopically documented duodenal ulcer relapse by multiple comparison at 12 months, but not by life- table analysis nor when symptomatic relapses were compared. No significant difference was detected among antacids, cimetidine, and sucralfate. No major side effects occurred with the seven forms of treatment, but those receiving antacids had the highest incidence of minor adverse events (26%). CONCLUSION: This study suggests that mealtime antacids are as effective as H 2-receptor antagonists and sucralfate in the maintenance treatment of duodenal ulcer disease, but have to be taken three times a day and had the highest incidence of reported minor adverse events. The relapse rate was lower with ranitidine than with cimetidine, sucralfate, and antacids, but the difference was small and may not be clinically important.link_to_subscribed_fulltex

Computer Aided Quantification of Pathological Features for Flexor Tendon Pulleys on Microscopic Images

Quantifying the pathological features of flexor tendon pulleys is essential for grading the trigger finger since it provides clinicians with objective evidence derived from microscopic images. Although manual grading is time consuming and dependent on the observer experience, there is a lack of image processing methods for automatically extracting pulley pathological features. In this paper, we design and develop a color-based image segmentation system to extract the color and shape features from pulley microscopic images. Two parameters which are the size ratio of abnormal tissue regions and the number ratio of abnormal nuclei are estimated as the pathological progression indices. The automatic quantification results show clear discrimination among different levels of diseased pulley specimens which are prone to misjudgments for human visual inspection. The proposed system provides a reliable and automatic way to obtain pathological parameters instead of manual evaluation which is with intra- and interoperator variability. Experiments with 290 microscopic images from 29 pulley specimens show good correspondence with pathologist expectations. Hence, the proposed system has great potential for assisting clinical experts in routine histopathological examinations

Clinical Impact of Speed Variability to Identify Ultramarathon Runners at Risk for Acute Kidney Injury

Background: Ultramarathon is a high endurance exercise associated with a wide range of exercise-related problems, such as acute kidney injury (AKI). Early recognition of individuals at risk of AKI during ultramarathon event is critical for implementing preventative strategies. Objectives: To investigate the impact of speed variability to identify the exercise-related acute kidney injury anticipatively in ultramarathon event. Methods: This is a prospective, observational study using data from a 100 km ultramarathon in Taipei, Taiwan. The distance of entire ultramarathon race was divided into 10 splits. The mean and variability of speed, which was determined by the coefficient of variation (CV) in each 10 km-split (25 laps of 400 m oval track) were calculated for enrolled runners. Baseline characteristics and biochemical data were collected completely 1 week before, immediately post-race, and one day after race. The main outcome was the development of AKI, defined as Stage II or III according to the Acute Kidney Injury Network (AKIN) criteria. Multivariate analysis was performed to determine the independent association between variables and AKI development. Results: 26 ultramarathon runners were analyzed in the study. The overall incidence of AKI (in all Stages) was 84.6% (22 in 26 runners). Among these 22 runners, 18 runners were determined as Stage I, 4 runners (15.4%) were determined as Stage II, and none was in Stage III. The covariates of BMI (25.22 ± 2.02 vs. 22.55 ± 1.96, p = 0.02), uric acid (6.88 ± 1.47 vs. 5.62 ± 0.86, p = 0.024), and CV of speed in specific 10-km splits (from secondary 10 km-split (10th – 20th km-split) to 60th – 70th km-split) were significantly different between runners with or without AKI (Stage II) in univariate analysis and showed discrimination ability in ROC curve. In the following multivariate analysis, only CV of speed in 40th – 50th km-split continued to show a significant association to the development of AKI (Stage II) (p = 0.032). Conclusions: The development of exercise-related AKI was not infrequent in the ultramarathon runners. Because not all runners can routinely receive laboratory studies after race, variability of running speed (CV of speed) may offer a timely and efficient tool to identify AKI early during the competition, and used as a surrogate screening tool, at-risk runners can be identified and enrolled into prevention trials, such as adequate fluid management and avoidance of further NSAID use

Ubiquitin-Specific Protease 6 n-Terminal-like Protein (USP6NL) and the Epidermal Growth Factor Receptor (EGFR) Signaling Axis Regulates Ubiquitin-Mediated DNA Repair and Temozolomide-Resistance in Glioblastoma

Glioblastoma multiforme (GBM) is the most malignant glioma, with a 30&ndash;60% epidermal growth factor receptor (EGFR) mutation. This mutation is associated with unrestricted cell growth and increases the possibility of cancer invasion. Patients with EGFR-mutated GBM often develop resistance to the available treatment modalities and higher recurrence rates. The drug resistance observed is associated with multiple genetic or epigenetic factors. The ubiquitin-specific protease 6 N-terminal-like protein (USP6NL) is a GTPase-activating protein that functions as a deubiquitinating enzyme and regulates endocytosis and signal transduction. It is highly expressed in many cancer types and may promote the growth and proliferation of cancer cells. We hypothesized that USP6NL affects GBM chemoresistance and tumorigenesis, and that its inhibition may be a novel therapeutic strategy for GBM treatment. The USP6NL level, together with EGFR expression in human GBM tissue samples and cell lines associated with therapy resistance, tumor growth, and cancer invasion, were investigated. Its pivotal roles and potential mechanism in modulating tumor growth, and the key mechanism associated with therapy resistance of GBM cells, were studied, both in vitro and in vivo. Herein, we found that deubiquitinase USP6NL and growth factor receptor EGFR were strongly associated with the oncogenicity and resistance of GBM, both in vitro and in vivo, toward temozolomide, as evidenced by enhanced migration, invasion, and acquisition of a highly invasive and drug-resistant phenotype by the GBM cells. Furthermore, abrogation of USP6NL reversed the properties of GBM cells and resensitized them toward temozolomide by enhancing autophagy and reducing the DNA damage repair response. Our results provide novel insights into the probable mechanism through which USP6NL/EGFR signaling might suppress the anticancer therapeutic response, induce cancer invasiveness, and facilitate reduced sensitivity to temozolomide treatment in GBM in an autolysosome-dependent manner. Therefore, controlling the USP6NL may offer an alternative, but efficient, therapeutic strategy for targeting and eradicating otherwise resistant and recurrent phenotypes of aggressive GBM cells