Business Process Standardization of Multinational Enterprises: Two Distinctive Organizational Models

Business process standardization practice was studied in the context of integration and adaptation. 31 Japanese and non-Japanese MNE were interviewed to find a practice of standardizing business process globally. 4 distinctive types of standardization were identified. Two top down approaches were consistent with organizational characteristics such as clear job specification, in contrasting on those using Kaizen approaches, with general characteristic employment as membership. Although the top-down approach is consistent with integration strategy, its multi-layer implementation preserves the room for flexible replication to balance adaptation needed

Factors Affecting the Absorption of Midazolam to the Extracorporeal Membrane Oxygenation Circuit

Sedatives are administered during extracorporeal membrane oxygenation (ECMO) therapy to ensure patient safety, reduce the metabolic rate and correct the oxygen supply-demand balance. However, the concentrations of sedatives can be decreased due to absorption into the circuit. This study examined factors affecting the absorption of a commonly used sedative, midazolam (MDZ). Using multiple ex vivo simulation models, three factors that may influence MDZ levels in the ECMO circuit were examined: polyvinyl chloride (PVC) tubing in the circuit, use of a membrane oxygenator in the circuit, and heparin coating of the circuit. We also assessed changes in drug concentration when MDZ was re-injected in a circuit. The MDZ level decreased to approximately 60% of the initial concentration in simulated circuits within the first 30 minutes. The strongest factor in this phenomenon was contact with the PVC tubing. Membrane oxygenator use tended to increase MDZ loss, whereas heparin circuit coating had no influence on MDZ absorption. Similar results were obtained when a second dose of MDZ was injected to the second-use circuits

GLP-1 release and vagal afferent activation mediate the beneficial metabolic and chronotherapeutic effects of D-allulose

The sweetener D-allulose has beneficial metabolic effects in animal models, but its mechanism of action was unclear. Here the authors report that D-allulose triggers GLP-1 release in the gut and GLP-1R signaling on vagal afferents, counteracting arrhythmic overeating, obesity and diabetes