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Purpose – The purpose of this paper is to conduct a comprehensive review and assessment of the extant Six Sigma healthcare literature, focusing on: application, process changes initiated and outcomes, including improvements in process metrics, cost and revenue. Design/methodology/approach – Data were obtained from an extensive literature search. Healthcare Six Sigma applications were categorized by functional area and department, key process metric, cost savings and revenue generation (if any) and other key implementation characteristics. Findings – Several inpatient care areas have seen most applications, including admission, discharge, medication administration, operating room (OR), cardiac and intensive care. About 42.1 percent of the applications have error rate as their driving metric, with the remainder focusing on process time (38 percent) and productivity (18.9 percent). While 67 percent had initial improvement in the key process metric, only 10 percent reported sustained improvement. Only 28 percent reported cost savings and 8 percent offered revenue enhancement. These results do not favorably assess Six Sigma's overall effectiveness and the value it offers healthcare. Results are based on reported applications. Future research can include directly surveying healthcare organizations to provide additional data for assessment. Practical implications – Future application should emphasize obtaining improvements that lead to significant and sustainable value. Healthcare staff can use the results to target promising areas. Originality/value – This article comprehensively assesses Six Sigma healthcare applications and impact.

Identifying the different concentration regimes in polyelectrolytes is helpful for tuning the viscosity in personal care products, as well as in creating other polymer materials, including anion exchange membranes. Viscosity scaling distinguishes various concentration regimes in polyelectrolyte solutions, which change in the presence of salt. Here, the first objective was to measure the viscosity scaling for two cationic polyelectrolytes in water, acid (0.1 M HCl), and salt (0.1 M NaCl) solutions. Two polymers containing the same cationic group were compared, namely, a copolymer poly(acrylamide- co -diallyldimethylammonium chloride) (PAAcDMAC) and a homopolymer poly(diallyldimethylammonium chloride) (PDADMAC). Polyelectrolyte concentrations from 0.25 to 18 wt% spanned from dilute to entangled concentration regimes depending on the polyelectrolyte. Acid and salt had comparable effects on the polyelectrolytes’ viscosity. Specifically, the viscosity of the PAAcDMAC in 0.1 M NaCl in the dilute region decreased by 57% compared to DI water. Since salt ions screen the electrostatic interactions, polymer chains assume a more compact conformation. Little difference in zero-shear viscosity existed in the semi-dilute regimes for DI water and 0.1 M NaCl solution of PAAcDMAC. However, zero-shear rate viscosity increased by up to 18% with salt addition in the entangled regime. Since the rheology of entangled polyelectrolytes has not been extensively studied, small and large amplitude oscillatory experiments were completed to elucidate differences in viscoelasticity upon the addition of salt. Subtle differences in viscoelastic properties of 18 wt% PAAcDMAC solution were found upon salt addition in entangled regime. For example, large amplitude oscillatory experiments measured changes in maximum and minimum storage moduli upon NaCl addition. Thus, a disproportional change to the elastic behavior was captured upon salt addition. Graphical abstract

Wax deposition is a challenge in crude oil transportation. Wax deposition is affected by many factors, including cooling rate and wax concentration. However, the effect of shear rate on wax appearance temperature (WAT) is less studied, so an investigation of a model waxy oil system, mineral oil and paraffin wax, was undertaken. Wax appearance temperature was depressed by different extents by increasing shear rate, increasing cooling rate, and decreasing wax concentration. Corroborating other studies, wax concentration significantly affected WAT. Changing concentration from 5 to 50 wt% resulted in ~ 20 °C increase in WAT. Two types of rheological measurements were completed for determining WAT under shear, either a temperature ramp or isothermal steps. Both techniques found WAT within 1 °C of the other. Overall, shear rate has a small, quantifiable effect on WAT of ~ 2 °C when changing from 1 to 1000 s −1 at the same cooling rate. Similarly, a decrease in cooling rate from 10 to 0.2 °C/min under 100 s −1 shear increased WAT ~ 4 °C. In addition, yield stress decreased from 416 to 8 Pa with increasing shear upon wax formation from 0 to 1000 s −1 . Increasing cooling rate from 0.2 to 5 °C/min increased yield stress from 5 to 505 Pa when formed at 10 s −1 . Wax appearance studies using rheology were corroborated by static techniques, including calorimetry and phase behavior. Overall, adding shear rate to the phase diagrams of waxy oils could help the industry address their flow assurance needs.

Shear thickening behavior in colloidal dispersions occurs at a wide range of shear rates and concentrations. Using a small gap, parallel plate rheology allows access to shear rates up to 200,000 s −1 . Fumed silica suspensions exhibited irreversible shear thickening at critical shear rates above 10,000 s −1 , which depended strongly on silica concentration. Introducing 10 nm and 110 nm spherical silica particles to 180 nm fumed silica solutions resulted in increasing the critical thickening shear rate along with reducing the magnitude of thickening. The introduction of sufficient spherical particles to the fumed silica solutions via particle addition at 2 wt% or particle replacement at 7 wt% resulted in no shear thickening or formation of agglomerates. Although shear thickening was tuned by varying the concentration and particle size of spherical silica; hysteresis, i.e., the irreversibility of thickening, remained. In addition, rheo-small-angle light scattering measured the formation of agglomerates greater than 1 μm after shear thickening.

The paracrine and autocrine processes of the host response play an integral role in the success of scaffold-based tissue regeneration. Recently, the immunomodulatory scaffolds have received huge attention for modulating inflammation around the host tissue through releasing anti-inflammatory cytokine. However, controlling the inflammation and providing a sustained release of anti-inflammatory cytokine from the scaffold in the digestive inflammatory environment are predicated upon a comprehensive understanding of three fundamental questions. (1) How does the release rate of cytokine from the scaffold change in the digestive inflammatory environment? (2) Can we prevent the premature scaffold degradation and burst release of the loaded cytokine in the digestive inflammatory environment? (3) How does the scaffold degradation prevention technique affect the immunomodulatory capacity of the scaffold? This study investigated the impacts of the digestive inflammatory environment on scaffold degradation and how pre-mature degradation can be prevented using genipin crosslinking and how genipin crosslinking affects the interleukin-4 (IL-4) release from the scaffold and differentiation of naïve macrophages (M0). Our results demonstrated that the digestive inflammatory environment (DIE) attenuates protein retention within the scaffold. Over 14 days, the encapsulated protein released 46% more in DIE than in phosphate buffer saline (PBS), which was improved through genipin crosslinking. We have identified the 0.5 (w/v) genipin concentration as an optimal concentration for improved IL-4 released from the scaffold, cell viability, mechanical strength, and scaffold porosity, and immunomodulation studies. The IL-4 released from the injectable scaffold could differentiate naïve macrophages to an anti-inflammatory (M2) lineage; however, upon genipin crosslinking, the immunomodulatory capacity of the scaffold diminished significantly, and pro-inflammatory markers were expressed dominantly.

The increasing use of data-driven decision making and big data is leading organizations to invest in analytics software and services. However, little is known about the type of analytics capabilities within IT that are required and whether there is a common progression or development model of analytics capabilities. Also unknown is how the level of analytics capabilities and other factors influence a firm's decision to invest in analytics. The purpose of this research is to explore the relationships between levels of distinct analytics capabilities and to understand how they and other factors influence the analytics investment decision. The findings suggest that there is a distinct progression in the development of analytics capabilities, and that firm size is associated with increased capability. The results suggest that firms more likely to invest in analytics have higher current levels of specific analytics capabilities, are larger, and are located in less-competitive industries.

To be a chemical engineer is to be a problem solver. However, the problems facing chemical engineers are growing in complexity. The variety of rapidly evolving problems requires new solutions that satisfy technical, safety, environmental, regulatory, economic, and social needs. Vital to the most successful solutions is balancing technological innovation with the needs of various stakeholders. In order to prepare chemical engineering students for this complex work, chemical engineering educators are incorporating an entrepreneurial mindset in their teaching and research. Here, Liberatore et al discuss what it means to have an entrepreneurial mindset and give examples of this mindset in research, education, and career development.

The conversion of biomass, specifically lignocellulosic biomass, into fuels and chemicals has recently gained national attention as an alternative to the use of fossil fuels. Increasing the concentration of the biomass solids during biochemical conversion has a large potential to reduce production costs. These concentrated biomass slurries have highly viscous, non-Newtonian behavior that poses several technical challenges to the conversion process. A collaborative effort to measure the rheology of a biomass slurry at four separate laboratories has been undertaken. A comprehensive set of rheological properties were measured using several different rheometers, flow geometries, and experimental methods. The tendency for settling, water evaporation, and wall slip required special care when performing the experiments. The rheological properties were measured at different concentrations up to 30% insoluble solids by mass. The slurry was found to be strongly shear-thinning, to be viscoelastic, and to have a significant concentration-dependent yield stress. The elastic modulus was found to be almost an order of magnitude larger than the loss modulus and weakly dependent on frequency. The techniques and results of this work will be useful to characterize other biomass slurries and in the design of biochemical conversion processing steps that operate at high solids concentrations.

The move toward green, sustainable, natural products has been growing in the cosmetic and personal care industry. Ingredients derived from marine organisms and algae are present in many cosmetic products. In this study, a new green ingredient, a wax (i.e., long-chain alkenones) derived from Isochyrsis sp., was evaluated as an alternative for cosmetic waxes. First, the melting point was determined (71.1–77.4 °C), then the alkenones’ thickening capability in five emollients was evaluated and compared to microcrystalline wax and ozokerite. Alkenones were compatible with three emollients and thickened the emollients similarly to the other waxes. Then, lipsticks and lip balms were formulated with and without alkenones. All products remained stable at room temperature for 10 weeks. Lipstick formulated with alkenones was the most resistant to high temperature. Finally, alkenones were compared to three cosmetic thickening waxes in creams. Viscosity, rheology, and stability of the creams were evaluated. All creams had a gel-like behavior. Both viscosity and storage modulus increased in the same order: cream with alkenones < cetyl alcohol < stearic acid < glyceryl monostearate. Overall, alkenones’ performance was comparable to the other three waxes. Alkenones can thus offer a potential green choice as a new cosmetic structuring agent.