Six sigma has long been used as an effective way to restructure a company's management process. A number of successful cases have been reported of six-sigma-based management activities dramatically enhancing a company's strategic performance over study periods of several years. However, while there are abundant case studies in the literature regarding six sigma, there is a lack of empirical studies that adopt statistical approaches. To fill this void, this study proposes a research model to test whether six-sigma-based management activities improve corporate competitiveness. We applied a structural equation model to 161 valid questionnaires collected from managers in a number of Samsung companies that have introduced six sigma and have been actively applying its activities for several years. Empirical results showed that six sigma activities do indeed contribute to process management refreshment, quality improvement, and finally corporate competitiveness. We hope that this study enables further rigorous studies investigating six sigma as a major strategic activity.

BackgroundConclusive evidence indicating an effective treatment for carpal tunnel syndrome (CTS), a common entrapment neuropathy, is lacking. Ultrasound therapy (US therapy) has long been used as one of the combination treatments for CTS. In addition, paraffin bath therapy has been applied widely as a physical modality in treating patients with hand conditions. The purpose of this randomized trial was to compare the efficacy of combining a wrist orthosis with either US therapy or paraffin bath therapy in treating CTS patients.MethodsPatients with CTS were randomized into two groups. All patients received a wrist orthosis. Twice per week, one group underwent paraffin therapy, and the other group underwent ultrasound therapy. Each patient received a questionnaire, physical examination and nerve conduction study of the upper extremities before and after treatment for eight weeks.ResultsSixty patients were recruited, and 47 completed the study. Statistical analysis revealed significant improvements in symptom severity scores in both groups. After adjusting for age, gender and baseline data, the analysis of covariance revealed a significant difference in the functional status score between two groups.ConclusionsThe combination of ultrasound therapy with a wrist orthosis may be more effective than paraffin therapy with a wrist orthosis.Trial registrationClinicaltrial.gov: NCT02278289 Oct 28, 2014Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-399) contains supplementary material, which is available to authorized users.

Conventional approaches to business-to-business (B2B) negotiation use primary negotiation terms (PNTs) such as price or order quantity for modeling and analysis, but pay little attention to such secondary negotiation terms (SNTs) as resource availability and corporate culture. This paper argues that SNTs also contribute to good negotiation decisions because PNTs and SNTs are closely interlinked in the form of causal relationships. Moreover, B2B negotiation demands a practical and useful framework that can reuse past negotiation knowledge and perform "what-if" analysis. This paper proposes a framework that consists of formalization, reuse, and problem-solving phases. The framework first formalizes TAKBN (tacit knowledge about B2B negotiation) with both PNTs and SNTs using a cognitive map and casebased reasoning, then stores them in case bases as cases that can be retrieved for later use and problem solving. This framework provides a platform with which decision makers can study past B2B negotiation cases, apply them to current B2B negotiation problems, and simulate different negotiation situations before making decisions. The framework has been tested using two practical scenarios. A structured, 13-item questionnaire was rigorously developed and applied to evaluate the validity of the proposed framework based on 16 B2B negotiation experts' judgments. Statistical tests Downloaded by [New York University] at 09:51 26 May 2015 338 KUN-CHANG LEE AND SOON-JAE KWON proved that the proposed framework could improve decision performance significantly in B2B negotiations.

No abstract

Dysphagia is present in 25–50% of patients with stroke. Therefore, studying the probability of nasogastric tube removal in such patients before discharge from the rehabilitation ward is crucial. In this study, we developed a model to predict the outcome of dysphagia in patients with stroke. A retrospective study was performed from May 2015 to December 2018. We reviewed the medical charts of all patients with a diagnosis of stroke receiving nasogastric tube feeding. Patients were divided into weaned and nonweaned groups to compare baseline characteristics and functional status. The weaned and nonweaned groups comprised 55 and 65 patients, respectively. In the final logistic regression analysis model, the Barthel index at admission, lip closing status, ability to answer simple questions and functional independence before stroke were used to develop a predictive model (Logit = 0.8942 × functional independence before this stroke + 1.1279 × ability to answer simple question + 0.5345 × lip-close status + 0.0546 × Barthel index at admission − 2.2805). The optimal cutoff point based on Youden’s index was more than −0.8403 with a sensitivity and specificity of 85.45 and 73.85%, respectively. The positive predicted value was 73.44%. In patients with stroke and dysphagia, a high Barthel index, intact lip closing status, ability to answer simple questions and better functional status before stroke appeared to affect nasogastric tube removal before discharge from the rehabilitation ward. Based on the final regression model, the proposed equation will help physicians and speech pathologists in planning patient care.