This article compiles the main topics addressed by management systems (MSs) literature concerning MSs integration by performing a systematic literature review. In this paper, it is intended to ...present the main limitations of non-integrated management systems (IMSs), the main motivations driving an IMS implementation, the major resistances faced, the most common resultant benefits, the suitable guidelines and standards and the critical success factors. In addition, this paper addresses the issues concerning integration strategies and models, the integration levels or degrees achieved by an IMS and the audit function in an integrated context. The motivations that drive companies to integrate their management subsystems, the obstacles faced and the benefits collected may have internal or external origins. The publishing of standards guiding companies on how to integrate their management subsystems has been done mainly at a national level. There are several models that could be used in order to support companies in their management subsystems integration processes, and a sequential or an all-in strategy may be adopted. Four audit typologies can be distinguished, and the adoption of any of these typologies should consider resource availability and audit team know-how, among other features.
Companies aim to increase the quality of products and competitiveness to gain and retain more customers. This study proposes a novel approach to identifying and prioritizing customer requirements ...(CRs) to improve black uniformity as a characteristic that refers to luminance differences on the surface of a display by evaluating the CRs. The refined Kano model was applied to find the significant CRs to develop the product. Firstly, 112 CRs were identified in 5 main categories (1) technical, (2) quality, (3) delivery, (4) sustainability, and (5) cost. Then, the refined Kano questionnaire was designed to categorize the CRs. An example is performed to validate the method on the automotive display' CRs. The findings showed that mechanical and delivery needs are critical CRs. Today, climate change is a significant challenge and a severe customer concern. Although sustainability's CRs not classed as essential items in the production process, suppliers must be diligent in providing them. The results help to improve the automotive industry and other production systems.
Our goal was to evaluate the outcomes of the first patients treated by venous coronary artery bypass grafting (CABG) or percutaneous coronary interventions (PCIs) with balloon angioplasty at a single ...centre who have reached up to 40 years of life-long follow-up.
We analysed the outcomes of the first consecutive patients who underwent (venous) CABG (n = 1041) from 1971 to 1980 and PCI (n = 856) with balloon angioplasty between 1980 and 1985. Follow-up was successfully achieved in 98% of patients (median 39 years, range 36-46) who underwent CABG and in 97% (median 33 years, range 32-36) of patients who had PCI.
The median age was 53 years in the CABG cohort and 57 years in the PCI cohort. A total of 82% of patients in the CABG group and 37% of those in the PCI group had multivessel coronary artery disease. The cumulative survival rates at 10, 20, 30 and 40 years were 77%, 39%, 14% and 4% after CABG, respectively, and at 10, 20, 30 and 35 years after PCI were 78%, 47%, 21% and 12%, respectively. The estimated life expectancy after CABG was 18 and 17 years after the PCI procedures. Repeat revascularization was performed in 36% and 57% of the patients in the CABG and PCI cohorts, respectively.
This unique life-long follow-up analysis demonstrates that both CABG and PCI were excellent treatment options immediately after their introduction as the standard of care. These procedures were lifesaving, thereby indirectly enabling patients to be treated with newly developed methods and medical therapies during the follow-up years.
The systematic assurance of the occupational health, safety and wellbeing of the employees may be accomplished through the implementation (and certification) of standardized occupational health and ...safety management systems in accordance with the requirements listed in the BS OHSAS 18001 standard. In Portugal the certification of occupational health and safety management systems is usually carried out against the requirements of the BS OHSAS 18001 and the NP 4397 standard which is a national adaptation of the former. The purpose of this paper is to "snapshot" the diffusion of the certified occupational health and safety management systems in Portugal dissecting the following features: regional geographic location, integration phenomenon, evolution throughout the years, more involved activity sectors, more often found integrated management systems typologies and the most relevant and active certification bodies. To address this research goal a thorough, in-depth and comprehensive analysis of the data available in a Portuguese periodical publication (Barómetro da Certificação) was carried out. Results show that a great deal of the certified occupational health and safety management systems (96.3%) is integrated (in the sense that encompasses a multiple certification scheme). However the occupational health and safety management system is not typically the primordial subsystem of an integrated management system. In our view these results provide insights to the companies' top management. On one hand, it seems that a patterned and "logical" path is pursued by the companies that seek organizational excellence- management systems integration. On the other hand, it seems that previously implemented subsystems, such as the quality management system, facilitate a "smoother" integration process encompassing the occupational health and safety management system.
Currently, due to the globalization phenomenon and technological evolution, we are facing a new challenging set of paradigms encompassing social, industrial, financial and cultural issues. Hence, it ...is a difficult task to anticipate the new demands of the market concerning the most appreciated skills in the forthcoming workforce. This paper intends to report the sets of skills that comprise the desirable profile of the quality professional in the 21 st century. To meet this purpose, a worldwide online survey was held online throughout the first quarter of 2018, assessing (adopting a 5-point Likert scale) the importance of 27 skills identified in relevant literature. A total of 319 valid answers, originated from 61 different countries, were collected and summarized through descriptive statistics. The results suggest that seven sets of skills (appreciated skills to forthcoming quality professionals) comprise the profile of the quality professional in the 21 st century. Thus, professionals aiming the quality leader role may now tailor their skills based on the information provided in this paper. In addition, companies can use these results to specify the dimensions that their human resources should develop.
The process of integration of management systems is being unfolded by a great deal of companies nowadays. A crucial feature of it relates with the audit function and the integrated perceptions of the ...auditors. This issue is of utmost importance if one takes into account the remarkable effort developed by ISO in the last revisions (2015) of the ISO 9001 and ISO 14001 standards aiming at the standards integration by adopting a common high level structure, identical core context, and common terms and common definitions. The available drafts of the new ISO 45001 standard suggest the same effort. This paper aims, within a global research study on ISO 9001:2015, to report the integrated versus non-integrated perspectives of auditors concerning the new ISO 9001 revision based on the results from a survey conducted among IRCA auditors. It is intended specifically to assess if the perceptions from the auditors holding several certifications are different of those from the auditors that hold solely the QMS certification. Results suggest that the auditors holding several certifications foreseen more benefits from this new revision, i.e., auditors with a wider integrated perspective rate systematically higher the different dimensions assessed in this survey.
Biosorption is a sustainable biological treatment for remediating environmental hazardous matrices. The shells of the invasive bivalve
Corbicula
fluminea
were tested for their potential as a natural, ...abundant sorption material to cope with extremely toxic olive oil mill wastes (OOMW). Shells of
C.
fluminea
were exposed for 14 days to OOMW and variations in the chemical composition of the waste and the shells were monitored by FTIR analysis. In general, the results showed the inefficacy of the shells in adsorbing chemicals from OOMW, namely regarding predominant aromatic structures. A significant slight increase in the 1750–1180 cm
−1
region was found, relating to a mild reduction of the peak areas in the same FTIR region noted in shells, which suggests partial shell dissolution; this trend was further supported by the parallel increase of the levels of both pH and Chemical Oxygen Demand. Although the shells of
C.
fluminea
were found inadequate as a sink for the organic components present in OOMW, the abundance of the resource and previous evidence of its absorption capacity for different contaminants support the need for extended research on the use of this biomaterial as a sorption agent in bioremediation.
Three phthalocyanines (Pcs) conjugated with α-, β- and γ-cyclodextrins (CDs) were prepared and their application as photosensitizer (PS) agents was assessed by photophysical, photochemical and in ...vitro photobiological studies. The photoactivity of Pc-α-CD and Pc-γ-CD ensures their potential as PDT drugs against UM-UC-3 human bladder cancer cells.
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Bioengineered soft tissues on any meaningful scale or complexity must incorporate aspects of the functional tissue, namely a vasculature, providing cells oxygen and nutrients critical ...for their survival. However, the ability of tissue engineering strategies to promote a fast revascularization is critically limited. Particularly in endodontic regenerative therapies, the complicated anatomy of the root canal system, and the narrow apical access limit the supply of new blood vessels and pulp tissue ingrowth.
Here we characterize the viscoelastic and microstructural properties of a class of injectable hyaluronic acid (HA) hydrogels formed in situ, reinforced with cellulose nanocrystals (CNCs) and enriched with platelet lysate (PL), and test its ability to promote cells recruitment and proangiogenic activity in vitro. The incorporation of CNCs enhanced the stability of the materials against hydrolytic and enzymatic degradation. Moreover, the release of the chemotactic and pro-angiogenic growth factors (GFs) (PDGF and VEGF) from the PL-laden hydrogels showed an improved sustained profile proportional to the amount of incorporated CNCs. The PL-laden hydrogels exhibited preferential supportive properties of encapsulated human dental pulp cells (hDPCs) in in vitro culture conditions.
Finally, PL-laden hydrogels stimulated chemotactic and pro-angiogenic activity by promoting hDPCs recruitment and cell sprouting in hDPCs/human umbilical vein endothelial cell co-cultures in vitro, and in an ex vivo model. These results support the use of the combined system as a scaffold for GFs delivery and cells recruitment, thereby exhibiting great clinical potential in treating injuries in vascularized tissues.
Innovative strategies for improved chemotactic and pro-angiogenic features of TE constructs are needed. In this study, we developed an injectable HA/CNC/PL hydrogel with improved structural and biologic properties, that not only provide a sustained release of chemotactic and proangiogenic GFs from PL but also enhance the cells’ viability and angiogenic activity. As a result of their unique traits, the developed hydrogels are ideally suited to simultaneously act as a GFs controlled delivery system and as a supportive matrix for cell culture, recruitment, and revascularization induction, holding great potential for the regeneration of vascularized soft tissues, such as the dentin-pulp complex.
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