Leadership requirements for Lean versus servant leadership in health care: a systematic review of the literature.

PubMed

Aij, Kjeld Harald; Rapsaniotis, Sofia

2017-01-01

As health care organizations face pressures to improve quality and efficiency while reducing costs, leaders are adopting management techniques and tools used in manufacturing and other industries, especially Lean. Successful Lean leaders appear to use a coaching leadership style that shares underlying principles with servant leadership. There is little information about specific similarities and differences between Lean and servant leaderships. We systematically reviewed the literature on Lean leadership, servant leadership, and health care and performed a comparative analysis of attributes using Russell and Stone's leadership framework. We found significant overlap between the two leadership styles, although there were notable differences in origins, philosophy, characteristics and behaviors, and tools. We conclude that both Lean and servant leaderships are promising models that can contribute to the delivery of patient-centered, high-value care. Servant leadership may provide the means to engage and develop employees to become successful Lean leaders in health care organizations.

Manufacturing Enhancement through Reduction of Cycle Time using Different Lean Techniques

NASA Astrophysics Data System (ADS)

Suganthini Rekha, R.; Periyasamy, P.; Nallusamy, S.

2017-08-01

In recent manufacturing system the most important parameters in production line are work in process, TAKT time and line balancing. In this article lean tools and techniques were implemented to reduce the cycle time. The aim is to enhance the productivity of the water pump pipe by identifying the bottleneck stations and non value added activities. From the initial time study the bottleneck processes were identified and then necessary expanding processes were also identified for the bottleneck process. Subsequently the improvement actions have been established and implemented using different lean tools like value stream mapping, 5S and line balancing. The current state value stream mapping was developed to describe the existing status and to identify various problem areas. 5S was used to implement the steps to reduce the process cycle time and unnecessary movements of man and material. The improvement activities were implemented with required suggested and the future state value stream mapping was developed. From the results it was concluded that the total cycle time was reduced about 290.41 seconds and the customer demand has been increased about 760 units.

Applying Value Stream Mapping Technique for Production Improvement in a Manufacturing Company: A Case Study

NASA Astrophysics Data System (ADS)

Jeyaraj, K. L.; Muralidharan, C.; Mahalingam, R.; Deshmukh, S. G.

2013-01-01

The purpose of this paper is to explain how value stream mapping (VSM) is helpful in lean implementation and to develop the road map to tackle improvement areas to bridge the gap between the existing state and the proposed state of a manufacturing firm. Through this case study, the existing stage of manufacturing is mapped with the help of VSM process symbols and the biggest improvement areas like excessive TAKT time, production, and lead time are identified. Some modifications in current state map are suggested and with these modifications future state map is prepared. Further TAKT time is calculated to set the pace of production processes. This paper compares the current state and future state of a manufacturing firm and witnessed 20 % reduction in TAKT time, 22.5 % reduction in processing time, 4.8 % reduction in lead time, 20 % improvement in production, 9 % improvement in machine utilization, 7 % improvement in man power utilization, objective improvement in workers skill level, and no change in the product and semi finished product inventory level. The findings are limited due to the focused nature of the case study. This case study shows that VSM is a powerful tool for lean implementation and allows the industry to understand and continuously improve towards lean manufacturing.

The effect of lean manufacturing (LM) on environmental performance: A review study

NASA Astrophysics Data System (ADS)

Alaa, A. S.; Shaiful, A. I. M.; Zuraidah, M. Z.; Khalaf, A. M.

2017-09-01

Nowadays, lean manufacturing strategy is very much used to eliminate waste on the manufacturing shop floor. Lean manufacturing has been formulated in response to the fluctuating and competitive business environment. Although it first started in the automotive industry, many organizations in different sectors are enthusiastic to adopt it in order to improve their performance in this competitive globalized market. The aim of this paper is to review the current level of implementation of lean manufacturing practices and the affects of these practices on organizational performances in a multitude of sectors in Malaysian industries. The study is carried out through a thorough review of the literature. It is observed that lean manufacturing is increasingly getting the appropriate attention in Malaysian industries. There are also many challenges in the way, of which numerous attempts are undertaken to overcome them.

Lean manufacturing: A better way for enhancement in productivity

NASA Astrophysics Data System (ADS)

Kumar Ahir, Pankaj; Kumar Yadav, Lalit; Singh Chandrawat, Saurabh

2012-03-01

Productivity is the impact of peoples working together. Machines are merely an extended way of collective imagination and energy. Lean Manufacturing is the most used method for continues improvement of business. Organization management philosophy focusing on the reduction of wastage to improve overall customer value. "Lean" operating principles began in manufacturing environments and are known by a variety of synonyms; Lean Manufacturing, Lean Production, Toyota Production System, etc. It is commonly believed that Lean started in Japan "The notable activities in keeping the price of Ford products low is the steady restriction of the production cycle. The longer an article is in the process of manufacture and the more it is moved about, the greater is its ultimate cost." "A systematic approach to identifying and eliminating waste through continuous improvement, flowing the product at the pull of the customer in pursuit of perfection."

Applying the Lean principles of the Toyota Production System to reduce wait times in the emergency department.

PubMed

Ng, David; Vail, Gord; Thomas, Sophia; Schmidt, Nicki

2010-01-01

In recognition of patient wait times, and deteriorating patient and staff satisfaction, we set out to improve these measures in our emergency department (ED) without adding any new funding or beds. In 2005 all staff in the ED at Hôtel-Dieu Grace Hospital began a transformation, employing Toyota Lean manufacturing principles to improve ED wait times and quality of care. Lean techniques such as value-stream mapping, just-in-time delivery techniques, workplace organization, reduction of systemic wastes, use of the worker as the source of quality improvement and ongoing refinement of our process steps formed the basis of our project. Our ED has achieved major improvements in departmental flow without adding any additional ED or inpatient beds. The mean registration to physician time has decreased from 111 minutes to 78 minutes. The number of patients who left without being seen has decreased from 7.1% to 4.3%. The length of stay (LOS) for discharged patients has decreased from a mean of 3.6 to 2.8 hours, with the largest decrease seen in our patients triaged at levels 4 or 5 using the Canadian Emergency Department Triage and Acuity Scale. We noted an improvement in ED patient satisfaction scores following the implementation of Lean principles. Lean manufacturing principles can improve the flow of patients through the ED, resulting in greater patient satisfaction along with reduced time spent by the patient in the ED.

Redesigning assembly stations using ergonomic methods as a lean tool.

PubMed

Eswaramoorthi, M; John, Mervyn; Rajagopal, C Arjun; Prasad, P S S; Mohanram, P V

2010-01-01

With the current state of the global economy, demand for various products plummeting. To sustain in the market, companies have to reduce cost and improve quality. Today, companies have started implementing new philosophies like TQM, TPM, six sigma and lean manufacturing techniques to remain competitive in the market. Lean manufacturing is an emerging philosophy which continuously strives to reduce waste. The main objective of analyzing the assembly line with a lean perspective is to identify the areas related to human interface with other systems that could lead to the generation of waste. Improper workplace design leads to unreasonable mental or physical burden and results in waste generation like slow work (delay and inventory), and defects, which is named as muri waste. An attempt has been made in this paper to locate muri waste and create a "Lean assembly line". The proposed method, based on the use of Rapid Upper Limb Assessment (RULA) with CATIA V5 platform, has allowed the measurement of a large set of operator posture parameters and assessment of ergonomic stresses. Based on the results, the process stations in the assembly line were redesigned to prevent the generation of waste.

Benchmarking performance measurement and lean manufacturing in the rough mill

Treesearch

Dan Cumbo; D. Earl Kline; Matthew S. Bumgardner

2006-01-01

Lean manufacturing represents a set of tools and a stepwise strategy for achieving smooth, predictable product flow, maximum product flexibility, and minimum system waste. While lean manufacturing principles have been successfully applied to some components of the secondary wood products value stream (e.g., moulding, turning, assembly, and finishing), the rough mill is...

Using Lean Process Improvement to Enhance Safety and Value in Orthopaedic Surgery: The Case of Spine Surgery.

PubMed

Sethi, Rajiv; Yanamadala, Vijay; Burton, Douglas C; Bess, Robert Shay

2017-11-01

Lean methodology was developed in the manufacturing industry to increase output and decrease costs. These labor organization methods have become the mainstay of major manufacturing companies worldwide. Lean methods involve continuous process improvement through the systematic elimination of waste, prevention of mistakes, and empowerment of workers to make changes. Because of the profit and productivity gains made in the manufacturing arena using lean methods, several healthcare organizations have adopted lean methodologies for patient care. Lean methods have now been implemented in many areas of health care. In orthopaedic surgery, lean methods have been applied to reduce complication rates and create a culture of continuous improvement. A step-by-step guide based on our experience can help surgeons use lean methods in practice. Surgeons and hospital centers well versed in lean methodology will be poised to reduce complications, improve patient outcomes, and optimize cost/benefit ratios for patient care.

Leadership requirements for Lean versus servant leadership in health care: a systematic review of the literature

PubMed Central

Aij, Kjeld Harald; Rapsaniotis, Sofia

2017-01-01

As health care organizations face pressures to improve quality and efficiency while reducing costs, leaders are adopting management techniques and tools used in manufacturing and other industries, especially Lean. Successful Lean leaders appear to use a coaching leadership style that shares underlying principles with servant leadership. There is little information about specific similarities and differences between Lean and servant leaderships. We systematically reviewed the literature on Lean leadership, servant leadership, and health care and performed a comparative analysis of attributes using Russell and Stone’s leadership framework. We found significant overlap between the two leadership styles, although there were notable differences in origins, philosophy, characteristics and behaviors, and tools. We conclude that both Lean and servant leaderships are promising models that can contribute to the delivery of patient-centered, high-value care. Servant leadership may provide the means to engage and develop employees to become successful Lean leaders in health care organizations. PMID:29355240

Lean sigma--will it work for healthcare?

PubMed

Bahensky, James A; Roe, Janet; Bolton, Romy

2005-01-01

The manufacturing industry has been using Lean Sigma for years in pursuit of continuous improvement to obtain a competitive advantage. The objectives of these efforts are to use the Lean techniques for reducing cycle times and the Six Sigma concepts for reducing product defects. The Iowa Business Council with several advocates worked with the University of Iowa Hospital and Clinics (UIHC) and two other Iowa hospitals to determine whether Lean Sigma is adaptable in healthcare. A team of 15 people at UIHC used the Kaizen Breakthrough Methodology over a five-day period in an aggressive identification and elimination of non-value added activities in Radiology CT scanning. The results exceeded the initial project objectives and indicated that Lean Sigma is applicable in healthcare. Overall, the Lean Sigma project increased revenue by approximately $750,000 per year. The Kaizen process proved to be successful and interesting. Within three days, the team installed new work flow processes. This implementation-oriented approach is what differentiates Lean Sigma from other quality improvement processes.

Using Simulation to Explore Lean Manufacturing Implementation Strategies

ERIC Educational Resources Information Center

Shannon, Patrick W.; Krumwiede, Kip R.; Street, Jeffrey N.

2010-01-01

Lean manufacturing, an outgrowth of the Toyota Production System, has spread far beyond the automobile industry and is seen by many leaders as a key management philosophy in the battle to compete on an international scale. Successful implementation of lean requires that managers and employees be educated in the proper application of lean tools and…

The Applicability of Lean and Six Sigma Techniques to Clinical and Translational Research

PubMed Central

Schweikhart, Sharon A.; Dembe, Allard E

2010-01-01

Background Lean and Six Sigma are business management strategies commonly used in production industries to improve process efficiency and quality. During the past decade, these process improvement techniques increasingly have been applied outside of the manufacturing sector, for example, in health care and in software development. This article concerns the potential use of Lean and Six Sigma to improve the processes involved in clinical and translational research. Improving quality, avoiding delays and errors, and speeding up the time to implementation of biomedical discoveries are prime objectives of the NIH Roadmap for Biomedical Research and the NIH Clinical and Translational Science Award (CTSA) program. Methods This article presents a description of the main principles, practices, and methodologies used in Lean and Six Sigma. Available literature involving applications of Lean and Six Sigma to health care, laboratory science, and clinical and translational research is reviewed. Specific issues concerning the use of these techniques in different phases of translational research are identified. Results Examples are provided of Lean and Six Sigma applications that are being planned at a current CTSA site, which could potentially be replicated elsewhere. We describe how different process improvement approaches are best adapted for particularly translational research phases. Conclusions Lean and Six Sigma process improvement methodologies are well suited to help achieve NIH’s goal of making clinical and translational research more efficient and cost-effective, enhancing the quality of the research, and facilitating the successful adoption of biomedical research findings into practice. PMID:19730130

The applicability of Lean and Six Sigma techniques to clinical and translational research.

PubMed

Schweikhart, Sharon A; Dembe, Allard E

2009-10-01

Lean and Six Sigma are business management strategies commonly used in production industries to improve process efficiency and quality. During the past decade, these process improvement techniques increasingly have been applied outside the manufacturing sector, for example, in health care and in software development. This article concerns the potential use of Lean and Six Sigma in improving the processes involved in clinical and translational research. Improving quality, avoiding delays and errors, and speeding up the time to implementation of biomedical discoveries are prime objectives of the National Institutes of Health (NIH) Roadmap for Medical Research and the NIH's Clinical and Translational Science Award program. This article presents a description of the main principles, practices, and methods used in Lean and Six Sigma. Available literature involving applications of Lean and Six Sigma to health care, laboratory science, and clinical and translational research is reviewed. Specific issues concerning the use of these techniques in different phases of translational research are identified. Examples of Lean and Six Sigma applications that are being planned at a current Clinical and Translational Science Award site are provided, which could potentially be replicated elsewhere. We describe how different process improvement approaches are best adapted for particular translational research phases. Lean and Six Sigma process improvement methods are well suited to help achieve NIH's goal of making clinical and translational research more efficient and cost-effective, enhancing the quality of the research, and facilitating the successful adoption of biomedical research findings into practice.

Building Lean Supply Chain and Manufacturing Skills through an Interactive Case Study

ERIC Educational Resources Information Center

Ozelkan, Ertunga C.; Teng, S. Gary; Johnson, Thomas; Benson, Tom; Nestvogel, Dean

2007-01-01

With the ongoing global pressure to cut costs and focus on quality, many companies have been implementing "lean manufacturing" concepts to survive in the competitive marketplace. Thus it is imperative that engineering and business graduates are equipped with the lean principles, and are ready to take ownership of lean initiatives as they enter the…

Expanding lean thinking to the product and process design and development within the framework of sustainability

NASA Astrophysics Data System (ADS)

Sorli, M.; Sopelana, A.; Salgado, M.; Pelaez, G.; Ares, E.

2012-04-01

Companies require tools to change towards a new way of developing and producing innovative products to be manufactured considering the economic, social and environmental impact along the product life cycle. Based on translating Lean principles in Product Development (PD) from the design stage and, along the entire product life cycle, it is aimed to address both sustainability and environmental issues. The drivers of sustainable culture within a lean PD have been identified and a baseline for future research on the development of appropriate tools and techniques has been provided. This research provide industry with a framework which balance environmental and sustainable factors with lean principles to be considered and incorporated from the beginning of product design and development covering the entire product lifecycle.

Investigating emergency room service quality using lean manufacturing.

PubMed

Abdelhadi, Abdelhakim

2015-01-01

The purpose of this paper is to investigate a lean manufacturing metric called Takt time as a benchmark evaluation measure to evaluate a public hospital's service quality. Lean manufacturing is an established managerial philosophy with a proven track record in industry. A lean metric called Takt time is applied as a measure to compare the relative efficiency between two emergency departments (EDs) belonging to the same public hospital. Outcomes guide managers to improve patient services and increase hospital performances. The patient treatment lead time within the hospital's two EDs (one department serves male and the other female patients) are the study's focus. A lean metric called Takt time is used to find the service's relative efficiency. Findings show that the lean manufacturing metric called Takt time can be used as an effective way to measure service efficiency by analyzing relative efficiency and identifies bottlenecks in different departments providing the same services. The paper presents a new procedure to compare relative efficiency between two EDs. It can be applied to any healthcare facility.

Investigation of the prominent barriers to lean manufacturing implementation in Malaysian food and beverages industry using Rasch Model

NASA Astrophysics Data System (ADS)

Khusaini, N. S.; Ismail, A.; Rashid, A. A.

2016-02-01

This paper presents a preliminary study on the prominent barriers to lean manufacturing implementation in Malaysian Food and Beverages Industry. A survey was carried out to determine the most prominent barriers of lean manufacturing implementation that are currently being faced in this industry. The amount of barriers identified for this study is twenty seven. Out of 1309 available organizations, a total of 300 organizations have been randomly selected as respondents, and 53 organizations responded. From the variable map, the analysis shows that, the negative perception towards lean manufacturing top the list as the most agreeable barrier, while the technical barriers came after it. It can also be seen from the variable map that averagely, lack of vision and direction is the barrier that is being faced. Finally, this is perhaps the first attempt in investigating the prominent barriers to Lean Manufacturing implementation in Malaysian food and beverages industry using Rasch Model.

Application of a mathematical model for ergonomics in lean manufacturing.

PubMed

Botti, Lucia; Mora, Cristina; Regattieri, Alberto

2017-10-01

The data presented in this article are related to the research article "Integrating ergonomics and lean manufacturing principles in a hybrid assembly line" (Botti et al., 2017) [1]. The results refer to the application of the mathematical model for the design of lean processes in hybrid assembly lines, meeting both the lean principles and the ergonomic requirements for safe assembly work. Data show that the success of a lean strategy is possible when ergonomics of workers is a parameter of the assembly process design.

Roadmap for Lean implementation in Indian automotive component manufacturing industry: comparative study of UNIDO Model and ISM Model

NASA Astrophysics Data System (ADS)

Jadhav, J. R.; Mantha, S. S.; Rane, S. B.

2015-06-01

The demands for automobiles increased drastically in last two and half decades in India. Many global automobile manufacturers and Tier-1 suppliers have already set up research, development and manufacturing facilities in India. The Indian automotive component industry started implementing Lean practices to fulfill the demand of these customers. United Nations Industrial Development Organization (UNIDO) has taken proactive approach in association with Automotive Component Manufacturers Association of India (ACMA) and the Government of India to assist Indian SMEs in various clusters since 1999 to make them globally competitive. The primary objectives of this research are to study the UNIDO-ACMA Model as well as ISM Model of Lean implementation and validate the ISM Model by comparing with UNIDO-ACMA Model. It also aims at presenting a roadmap for Lean implementation in Indian automotive component industry. This paper is based on secondary data which include the research articles, web articles, doctoral thesis, survey reports and books on automotive industry in the field of Lean, JIT and ISM. ISM Model for Lean practice bundles was developed by authors in consultation with Lean practitioners. The UNIDO-ACMA Model has six stages whereas ISM Model has eight phases for Lean implementation. The ISM-based Lean implementation model is validated through high degree of similarity with UNIDO-ACMA Model. The major contribution of this paper is the proposed ISM Model for sustainable Lean implementation. The ISM-based Lean implementation framework presents greater insight of implementation process at more microlevel as compared to UNIDO-ACMA Model.

A Simulation of Lean Manufacturing: The Lean Lemonade Tycoon 2

ERIC Educational Resources Information Center

Ncube, Lisa B.

2010-01-01

This article discusses the functions and effectiveness of games and simulations in the learning processes, in particular as an experiential learning methodology. The application of the game Lemonade Tycoon in the development of lean manufacturing concepts is described. This article addresses the use of the game to teach the principles of lean…

Florida hospital saves 5.3 M dollars by adopting principles of lean manufacturing.

PubMed

2005-01-01

Florida hospital saves 5.3M dollars by adopting principles of lean manufacturing. Surgery cancellations have been slashed from 13% of cases to less than 3%, while emergency department admissions have increased by 20%. Those are just two of the results of a quality improvement project at Lee Memorial Health System in Fort Myers, FL, that focused on using the principles of lean manufacturing to improve patient flow in the five-hospital system

Innovation leading the way: application of lean manufacturing to sample management.

PubMed

Allen, M; Wigglesworth, M J

2009-06-01

Historically, sample management successfully focused on providing compound quality and tracking distribution within a diverse geographic. However, if a competitive advantage is to be delivered in a changing environment of outsourcing, efficiency and customer service must now improve or face reconstruction. The authors have used discrete event simulation to model the compound process from chemistry to assay and applied lean manufacturing techniques to analyze and improve these processes. In doing so, they identified a value-adding process time of just 11 min within a procedure that took days. Modeling also allowed the analysis of equipment and human resources necessary to complete the expected demand in an acceptable cycle time. Layout and location of sample management and screening departments are key in allowing process integration, creating rapid flow of work, and delivering these efficiencies. Following this analysis and minor process changes, the authors have demonstrated for 2 programs that solid compounds can be converted to assay-ready plates in less than 4 h. In addition, it is now possible to deliver assay data from these compounds within the same working day, allowing chemistry teams more flexibility and more time to execute the next chemistry round. Additional application of lean manufacturing principles has the potential to further decrease cycle times while using fewer resources.

Qualitative Examination of Strategies to Overcome Resistance to Change in Lean Manufacturing

ERIC Educational Resources Information Center

Burmester, Elizabeth

2017-01-01

Approximately 80% of lean manufacturing program initiatives are abandoned in the first year of implementation. Only 2% of organizations that embark on the lean journey complete it with the results and the sustainability they expected. There is a gap in past research regarding, the leadership strategies organizations can use to overcome resistance…

A Review of Agile and Lean Manufacturing as Issues in Selected International and National Research and Development Programs and Roadmaps

ERIC Educational Resources Information Center

Castro, Helio; Putnik, Goran D.; Shah, Vaibhav

2012-01-01

Purpose: The aim of this paper is to analyze international and national research and development (R&D) programs and roadmaps for the manufacturing sector, presenting how agile and lean manufacturing models are addressed in these programs. Design/methodology/approach: In this review, several manufacturing research and development programs and…

Succesful Lean Manufacturing Implementation: Internal Key Influencing Factors

NASA Astrophysics Data System (ADS)

Virginia, Iuga; Claudiu, Kifor

2015-09-01

Manufacturing sectors and companies all over the world are successfully implementing lean principles within their processes. Nowadays, lean has become an indispensable part of global players. Companies worldwide need to be aware of multiple factors which weigh heavily on the success or failure of lean implementation. This paper focuses on giving a brief and structured overview over the fundamental organizational factors which play a substantial role for the lean manufacturing (LM) implementation process. The study below focuses on internal factors which are indispensable for a successful LM implementation within organizations. It is imperative that these internal factors are known, recognized and taken into consideration during the whole LM implementation process. Ignoring their influence on the process's implementation may lead to endangering the expected results or to making the process more difficult which could result in much higher human resource consumption.

A fuzzy model for achieving lean attributes for competitive advantages development using AHP-QFD-PROMETHEE

NASA Astrophysics Data System (ADS)

Roghanian, E.; Alipour, Mohammad

2014-06-01

Lean production has become an integral part of the manufacturing landscape as its link with superior performance and its ability to provide competitive advantage is well accepted among academics and practitioners. Lean production helps producers in overcoming the challenges organizations face through using powerful tools and enablers. However, most companies are faced with restricted resources such as financial and human resources, time, etc., in using these enablers, and are not capable of implementing all these techniques. Therefore, identifying and selecting the most appropriate and efficient tool can be a significant challenge for many companies. Hence, this literature seeks to combine competitive advantages, lean attributes, and lean enablers to determine the most appropriate enablers for improvement of lean attributes. Quality function deployment in fuzzy environment and house of quality matrix are implemented. Throughout the methodology, fuzzy logic is the basis for translating linguistic judgments required for the relationships and correlation matrix to numerical values. Moreover, for final ranking of lean enablers, a multi-criteria decision-making method (PROMETHEE) is adopted. Finally, a case study in automotive industry is presented to illustrate the implementation of the proposed methodology.

Packages of participation: Swedish employees' experience of Lean depends on how they are involved.

PubMed

Brännmark, Mikael; Holden, Richard J

2013-01-01

Lean Production is a dominant approach in Swedish and global manufacturing and service industries. Studies of Lean's employee effects are few and contradictory. Employee effects from Lean are likely not uniform. This paper investigates the effect of employees' participation on their experiences of Lean. This study investigated how different packages of employee participation in Lean affected manufacturing workers' experiences of Lean. During 2008-2011, qualitative and quantitative data were collected from Swedish manufacturing companies participating in the national Swedish Lean Production program Produktionslyftet. Data from 129 surveys (28 companies), 39 semi-structured interviews, and 30 reports were analyzed. In the main analysis, comparisons were made of the survey-reported Lean experiences of employees in three groups: temporary group employees (N = 36), who participated in Lean mostly through intermittent projects; continuous group employees (N = 69), who participated through standing improvement groups; and combined group employees (N = 24), who participated in both ways. Continuous group employees had the most positive experience of Lean, followed by the combined group. Temporary group employees had the least positive experiences, being less likely than their counterparts to report that Lean improved teamwork, occupational safety, and change-related learning, decision making, and authority. These findings support the importance of continuous, structured opportunities for participation but raise the possibility that more participation may result in greater workload and role overload, mitigating some benefits of employee involvement. Consequently, companies should consider involving employees in change efforts but should attend to the specific design of participation activities.

Evaluation of RFID for Information Visibility Based Job-Shop Scheduling in Lean Manufacturing Environments

ERIC Educational Resources Information Center

Chongwatpol, Jongsawas

2012-01-01

This dissertation investigates the impact of radio frequency identification (RFID) in manufacturing. Two simulation studies of an organization that is considering implementing RFID on a production line are conducted. First, we investigate whether addition of RFID technologies in the manufacturing process can complement Lean initiatives.…

Analytic network process model for sustainable lean and green manufacturing performance indicator

NASA Astrophysics Data System (ADS)

Aminuddin, Adam Shariff Adli; Nawawi, Mohd Kamal Mohd; Mohamed, Nik Mohd Zuki Nik

2014-09-01

Sustainable manufacturing is regarded as the most complex manufacturing paradigm to date as it holds the widest scope of requirements. In addition, its three major pillars of economic, environment and society though distinct, have some overlapping among each of its elements. Even though the concept of sustainability is not new, the development of the performance indicator still needs a lot of improvement due to its multifaceted nature, which requires integrated approach to solve the problem. This paper proposed the best combination of criteria en route a robust sustainable manufacturing performance indicator formation via Analytic Network Process (ANP). The integrated lean, green and sustainable ANP model can be used to comprehend the complex decision system of the sustainability assessment. The finding shows that green manufacturing is more sustainable than lean manufacturing. It also illustrates that procurement practice is the most important criteria in the sustainable manufacturing performance indicator.

Lean Manufacturing Principles Improving the Targeting Process

DTIC Science & Technology

2012-06-08

author has familiarity with Lean manufacturing principles. Third, Lean methods have been used in different industries and have proven adaptable to the...92 The case study also demonstrates the multi organizational application of VSM, JIT and the 5S method ...new members not knowing the process, this will serve as a start point for the developing of understanding. Within the Food industry we observed “the

Three Approaches to Space Systems Acquisitions and their Application to the Defense Department’s Weather Satellite Program

DTIC Science & Technology

2012-03-01

by Toyota in the manufacturing world, such as just-in-time, kaizen , one-piece flow, jidoka, and heijunka. These techniques helped spawn the “lean...relentless reflection (hansei) and continuous improvement ( kaizen ) Similar to Principle 2, this principle shares similarity with space program

Teaching Lean Manufacturing with Simulations and Games: A Survey and Future Directions

ERIC Educational Resources Information Center

Badurdeen, Fazleena; Marksberry, Philip; Hall, Arlie; Gregory, Bob

2010-01-01

Problem-based learning focuses on small groups using authentic problems as a means to help participants obtain knowledge and problem-solving skills. This approach makes problem-based learning ideal for teaching lean manufacturing, which is driven by a culture of problem solving that values learning as one key output of manufacturing production.…

Critical Success Factors for Lean Thinking in the Application of Industrialised Building System (IBS)

NASA Astrophysics Data System (ADS)

Yunus, Riduan; Noor, Siti Rahimah Mohd; Halid Abdullah, Abd; Nagapan, Sasitharan; Hamid, Abdul Rahim Abdul; Tajudin, Saiful Azhar Ahmad; Rohani Mat Jusof, Siti

2017-08-01

Productivity in the manufacturing process of building components can be increased by optimising each advantage that is available in each activity. Identification of critical success factors (CSFs) for lean thinking in the Industrialised Building System (IBS) will be able to minimise cost and reduce time needed to complete a project. The focus of lean thinking in construction is on the production process and the client’s requirement. In developing countries such as Malaysia, the integration of lean thinking in IBS applications is still low and there is a shortage of comprehensive strategies to integrate lean thinking. As key stakeholders, feedback from contractors, manufacturers, developers and the local authority will be able to help the identification of CSFs in integrating lean thinking in IBS applications. The data was collected through a questionnaire survey and analysed quantitatively. There are 31 CSFs for lean thinking in IBS which have been identified in this study. A conceptual model was developed to assist researchers in investigating the influences of CSFs for lean thinking in IBS applications. This study will assist construction players to improvise their manufacturing process in the implementation of IBS to eliminate unnecessary activities and focus instead on significant processes without generating physical and non-physical waste.

Packages of participation: Swedish employees’ experience of Lean depends on how they are involved

PubMed Central

Brännmark, Mikael; Holden, Richard J.

2013-01-01

Background Lean Production is a dominant approach in Swedish and global manufacturing and service industries. Studies of Lean’s employee effects are few and contradictory. Purpose Employee effects from Lean are likely not uniform. This paper investigates the effect of employees' participation on their experiences of Lean. Method This study investigated how different packages of employee participation in Lean affected manufacturing workers’ experiences of Lean. During 2008–2011, qualitative and quantitative data were collected from Swedish manufacturing companies participating in the national Swedish Lean Production program Produktionslyftet. Data from 129 surveys (28 companies), 39 semi-structured interviews, and 30 reports were analyzed. In the main analysis, comparisons were made of the survey-reported Lean experiences of employees in three groups: temporary group employees (N = 36), who participated in Lean mostly through intermittent projects; continuous group employees (N = 69), who participated through standing improvement groups; and combined group employees (N = 24), who participated in both ways. Results Continuous group employees had the most positive experience of Lean, followed by the combined group. Temporary group employees had the least positive experiences, being less likely than their counterparts to report that Lean improved teamwork, occupational safety, and change-related learning, decision making, and authority. Conclusions These findings support the importance of continuous, structured opportunities for participation but raise the possibility that more participation may result in greater workload and role overload, mitigating some benefits of employee involvement. Consequently, companies should consider involving employees in change efforts but should attend to the specific design of participation activities. PMID:24665370

Lean in healthcare: the unfilled promise?

PubMed

Radnor, Zoe J; Holweg, Matthias; Waring, Justin

2012-02-01

In an effort to improve operational efficiency, healthcare services around the world have adopted process improvement methodologies from the manufacturing sector, such as Lean Production. In this paper we report on four multi-level case studies of the implementation of Lean in the English NHS. Our results show that this generally involves the application of specific Lean 'tools', such as 'kaizen blitz' and 'rapid improvement events', which tend to produce small-scale and localised productivity gains. Although this suggests that Lean might not currently deliver the efficiency improvements desired in policy, the evolution of Lean in the manufacturing sector also reveals this initial focus on the 'tool level'. In moving to a more system-wide approach, however, we identify significant contextual differences between healthcare and manufacturing that result in two critical breaches of the assumptions behind Lean. First, the customer and commissioner in the private sector are the one and the same, which is essential in determining 'customer value' that drives process improvement activities. Second, healthcare is predominantly designed to be capacity-led, and hence there is limited ability to influence demand or make full use of freed-up resources. What is different about this research is that these breaches can be regarded as not being primarily 'professional' in origin but actually more 'organisational' and 'managerial' and, if not addressed could severely constrain Lean's impact on healthcare productivity at the systems level. Copyright © 2011 Elsevier Ltd. All rights reserved.

Enhancing Lean Manufacturing Learning Experience through Hands-On Simulation

ERIC Educational Resources Information Center

Elbadawi, Isam; McWilliams, Douglas L.; Tetteh, Edem G.

2010-01-01

Finding appropriate interactive exercises to increase students' learning in technical topic courses is always challenging to educators. In this study, several paper plane hands-on simulation exercises were developed, used, and tested in a lean manufacturing course for beginning college students. A pretest and posttest was used to assess the…

Lean Thinking in Libraries: A Case Study on Improving Shelving Turnaround

ERIC Educational Resources Information Center

Kress, Nancy J.

2007-01-01

The University of Chicago's Joseph Regenstein Library Bookstacks Department has used process mapping and continuous improvement to successfully improve its overall operations. The most recent efforts focus on Lean manufacturing, an initiative centered on eliminating waste in manufacturing processes. The conversion of the Bookstacks Department from…

Developing weighted criteria to evaluate lean reverse logistics through analytical network process

NASA Astrophysics Data System (ADS)

Zagloel, Teuku Yuri M.; Hakim, Inaki Maulida; Krisnawardhani, Rike Adyartie

2017-11-01

Reverse logistics is a part of supply chain that bring materials from consumers back to manufacturer in order to gain added value or do a proper disposal. Nowadays, most companies are still facing several problems on reverse logistics implementation which leads to high waste along reverse logistics processes. In order to overcome this problem, Madsen [Framework for Reverse Lean Logistics to Enable Green Manufacturing, Eco Design 2009: 6th International Symposium on Environmentally Conscious Design and Inverse Manufacturing, Sapporo, 2009] has developed a lean reverse logistics framework as a step to eliminate waste by implementing lean on reverse logistics. However, the resulted framework sets aside criteria used to evaluate its performance. This research aims to determine weighted criteria that can be used as a base on reverse logistics evaluation by considering lean principles. The resulted criteria will ensure reverse logistics are kept off from waste, thus implemented efficiently. Analytical Network Process (ANP) is used in this research to determine the weighted criteria. The result shows that criteria used for evaluation lean reverse logistics are Innovation and Learning (35%), Economic (30%), Process Flow Management (14%), Customer Relationship Management (13%), Environment (6%), and Social (2%).

Readiness for change and job satisfaction in a case of lean management application - a comparative study.

PubMed

Lipińska-Grobelny, Agnieszka; Papieska, Ewelina

2012-09-01

This current study investigates the effect of lean management system on work attitudes of workers of two manufacturing companies. "Lean management" is a concept of work processes and human relations that determines company's productivity and profitability. Workers of two enterprises, the first one with lean production and the second one with old mass production, were compared for their readiness for change and job satisfaction (both emotional and cognitive aspect). The sample of 102 employees completed a battery of instruments such as: the Job Description Inventory by Neuberger and Allerbeck, the Job Affect Scale by Burke et al. and the Change-Readiness Scale by Kriegel and Brandt. Individuals from the lean manufacturing company were characterized by higher level of readiness for change, positive affect at work, and cognitive job satisfaction. In this approach the introduction of lean production positively affected company's human resource attitudes.

Lean health care: what can hospitals learn from a world-class automaker?

PubMed

Kim, Christopher S; Spahlinger, David A; Kin, Jeanne M; Billi, John E

2006-05-01

With health care costs continuing to rise, a variety of process improvement methodologies have been proposed to address the reported inefficiencies in health care delivery. Lean production is one such method. The management philosophy and tools of lean production come from the manufacturing industry, where they were pioneered by Toyota Motor Corporation, which is viewed as the leader in utilizing these performance improvement methods. Lean has already enjoyed tremendous success in improving quality and efficiency in both the manufacturing and the service sector industries. Health care systems have just begun to utilize lean methods, with reports of improvements just beginning to appear in the literature. We describe some of the basic philosophy and principles of lean production methods and how these concepts can be applied in the health care environment. We describe some of the early success stories and ongoing endeavors of lean production in various health care organizations. We believe the hospital is an ideal setting for use of the lean production method, which could significantly affect how health care is delivered to patients. We conclude by discussing some of the potential challenges in introducing and implementing lean production methods in the health care environment. Lean production is a novel approach to delivering high-quality and efficient care to patients, and we believe that the health care sector can anticipate the same high level of success that the manufacturing and service industries have achieved using this approach. Hospitalists are primed to take action in delivering care of greater quality with more efficiency by applying these new principles in the hospital setting. (c) 2006 Society of Hospital Medicine.

Lean-driven improvements slash wait times, drive up patient satisfaction scores.

PubMed

2012-07-01

Administrators at LifePoint Hospitals, based in Brentwood, TN, used lean manufacturing techniques to slash wait times by as much as 30 minutes and achieve double-digit increases in patient satisfaction scores in the EDs at three hospitals. In each case, front-line workers took the lead on identifying opportunities for improvement and redesigning the patient-flow process. As a result of the new efficiencies, patient volume is up by about 25% at all three hospitals. At each hospital, the improvement process began with Kaizen, a lean process that involves bringing personnel together to flow-chart the current system, identify problem areas, and redesign the process. Improvement teams found big opportunities for improvement at the front end of the flow process. Key to the approach was having a plan up front to deal with non-compliance. To sustain improvements, administrators gather and disseminate key metrics on a daily basis.

Are Agile and Lean Manufacturing Systems Employing Sustainability, Complexity and Organizational Learning?

ERIC Educational Resources Information Center

Flumerfelt, Shannon; Siriban-Manalang, Anna Bella; Kahlen, Franz-Josef

2012-01-01

Purpose: This paper aims to peruse theories and practices of agile and lean manufacturing systems to determine whether they employ sustainability, complexity and organizational learning. Design/methodology/approach: The critical review of the comparative operational similarities and difference of the two systems was conducted while the new views…

Does Lean Production Sacrifice Learning in a Manufacturing Environment? An Action Learning Case Study.

ERIC Educational Resources Information Center

Scott, Fiona M.; Butler, Jim; Edwards, John

2001-01-01

An action learning program was implemented by a manufacturer using lean production practices. Action learning practices were accommodated during times of stability, but abandoned in times of crisis. The meaning of work in this organizational culture excluded all practices, such as reflection, that were not visible and targeted at immediate…

Lean thinking across a hospital: redesigning care at the Flinders Medical Centre.

PubMed

Ben-Tovim, David I; Bassham, Jane E; Bolch, Denise; Martin, Margaret A; Dougherty, Melissa; Szwarcbord, Michael

2007-02-01

Lean thinking is a method for organising complex production processes so as to encourage flow and reduce waste. While the principles of lean thinking were developed in the manufacturing sector, there is increasing interest in its application in health care. This case history documents the introduction and development of Redesigning Care, a lean thinking-based program to redesign care processes across a teaching general hospital. Redesigning Care has produced substantial benefits over the first two-and-a-half years of its implementation, making care both safer and more accessible. Redesigning Care has not been aimed at changing the specifics of clinical practice. Rather, it has been concerned with improving the flow of patients through clinical and other systems. Concepts that emerged in the manufacturing sector have been readily translatable into health care. Lean thinking may play an important role in the reform of health care in Australia and elsewhere.

Simulation Design for Off-Line Training of Practical Lean Manufacturing Concepts for Visual Inspection

ERIC Educational Resources Information Center

Tetteh, Edem; McWilliams, Douglas

2010-01-01

Customer needs for high-quality goods and the risk of product-liability litigation against businesses have made companies look for a way to sustain quality assurance in their products and services. Lean manufacturing is the latest and most successful system being used by companies to turn their business around. Visual inspection plays an important…

Lean manufacturing and Toyota Production System terminology applied to the procurement of vascular stents in interventional radiology.

PubMed

de Bucourt, Maximilian; Busse, Reinhard; Güttler, Felix; Wintzer, Christian; Collettini, Federico; Kloeters, Christian; Hamm, Bernd; Teichgräber, Ulf K

2011-08-01

OBJECTIVES: To apply the economic terminology of lean manufacturing and the Toyota Production System to the procurement of vascular stents in interventional radiology. METHODS: The economic- and process-driven terminology of lean manufacturing and the Toyota Production System is first presented, including information and product flow as well as value stream mapping (VSM), and then applied to an interdisciplinary setting of physicians, nurses and technicians from different medical departments to identify wastes in the process of endovascular stent procurement in interventional radiology. RESULTS: Using the so-called seven wastes approach of the Toyota Production System (waste of overproducing, waiting, transport, processing, inventory, motion and waste of defects and spoilage) as well as further waste characteristics (gross waste, process and method waste, and micro waste), wastes in the process of endovascular stent procurement in interventional radiology were identified and eliminated to create an overall smoother process from the procurement as well as from the medical perspective. CONCLUSION: Economic terminology of lean manufacturing and the Toyota Production System, especially VSM, can be used to visualise and better understand processes in the procurement of vascular stents in interventional radiology from an economic point of view.

Lean principles and defense information technology acquisition: An investigation of the determinants of successful application

NASA Astrophysics Data System (ADS)

Haley, M.

The purpose of this study was to investigate whether or not there have been successful applications of lean manufacturing principles in highly variable defense IT environments. Specifically, the study assessed if implementation of the lean philosophies by a defense organization yielded repeatable, predictable results in software release schedules reductions. Additionally, the study set out to determine what potential critical success factors (CSF's) were documented in the secondary data captured for each release, and extracted the variables used in the decision making for acceptability of fielding. In evaluating lean applicability to the high variability environment of USAF IT acquisitions, the research was conducted using non-experimental quantitative methods of archival secondary data. The sample for this case study was compiled from a USAF office that had implemented these techniques in pre-development, development and testing, and fielding phases. Based on the research data, acquisitionists and lean practitioners are inherently interconnected. Therefore, an understanding that critical success factors (CSFs) are integral to successful lean application in DoD IT acquisitions is crucial. Through a combination of synergistic alignments, plyometric CSFs were discovered to maximize the effects of each single CSF to produce rapid results in defense IT acquisitions. These include: (1) Enterprise Incorporation, (2) Team Trust, (3) Transformational Leadership, (4) Recursive Improvement, (5) Integrated Synergy, (6) Customer-Centric Culture and (7) Heuristic Communication.

Lean Government Methods Guide

EPA Pesticide Factsheets

This Guide focuses primarily on Lean production, which is an organizational improvement philosophy and set of methods that originated in manufacturing but has been expanded to government and service sectors.

Filter-based control of particulate matter from a lean gasoline direct injection engine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Parks, II, James E; Lewis Sr, Samuel Arthur; DeBusk, Melanie Moses

New regulations requiring increases in vehicle fuel economy are challenging automotive manufacturers to identify fuel-efficient engines for future vehicles. Lean gasoline direct injection (GDI) engines offer significant increases in fuel efficiency over the more common stoichiometric GDI engines already in the marketplace. However, particulate matter (PM) emissions from lean GDI engines, particularly during stratified combustion modes, are problematic for lean GDI technology to meet U.S. Environmental Protection Agency Tier 3 and other future emission regulations. As such, the control of lean GDI PM with wall-flow filters, referred to as gasoline particulate filter (GPF) technology, is of interest. Since lean GDImore » PM chemistry and morphology differ from diesel PM (where more filtration experience exists), the functionality of GPFs needs to be studied to determine the operating conditions suitable for efficient PM removal. In addition, lean GDI engine exhaust temperatures are generally higher than diesel engines which results in more continuous regeneration of the GPF and less presence of the soot cake layer common to diesel particulate filters. Since the soot layer improves filtration efficiency, this distinction is important to consider. Research on the emission control of PM from a lean GDI engine with a GPF was conducted on an engine dynamometer. PM, after dilution, was characterized with membrane filters, organic vs. elemental carbon characterization, and size distribution techniques at various steady state engine speed and load points. The engine was operated in three primary combustion modes: stoichiometric, lean homogeneous, and lean stratified. In addition, rich combustion was utilized to simulate PM from engine operation during active regeneration of lean NOx control technologies. High (>95%) PM filtration efficiencies were observed over a wide range of conditions; however, some PM was observed to slip through the GPF at high speed and load conditions. The PM characterization at various engine speeds and loads will help enable optimized GPF design and control to achieve more fuel efficient lean GDI vehicles with low PM emissions.« less

Physician strives to create lean, clean health care machine. Studies of manufacturing processes may one day help make your practice more efficient.

PubMed

Hill, D

2001-01-01

Elisabeth Hager, MD, MMM, CPE, is teaming up with scientists and industrialists to teach physicians how to apply principles of lean, total-quality manufacturing to their practices. She believes innovation and efficiencies can help doctors resurrect their profession's image and their control over it--and perhaps even reinvent American health care.

Weaving Action Learning into the Fabric of Manufacturing: The Impact of Humble Inquiry and Structured Reflection in a Cross-Cultural Context

ERIC Educational Resources Information Center

Luckman, Elizabeth A.

2017-01-01

This account of practice examines the implementation of and reactions to action learning through the Lean methodology in a unique, cross-cultural context. I review my time spent as a Lean coach; engaging with, training, and using action learning with employees in a garment manufacturing facility located in Bali, Indonesia. This research addresses…

Lean Principles and Defense Information Technology Acquisition: An Investigation of the Determinants of Successful Application

ERIC Educational Resources Information Center

Haley, M.

2013-01-01

The purpose of this study was to investigate whether or not there have been successful applications of lean manufacturing principles in highly variable defense IT environments. Specifically, the study assessed if implementation of the lean philosophies by a defense organization yielded repeatable, predictable results in software release schedules…

The productive operating theatre and lean thinking systems.

PubMed

Kasivisvanathan, R; Chekairi, A

2014-11-01

The concept of 'lean thinking' first originated in the manufacturing industry as a means of improving productivity whilst maintaining quality through eliminating wasteful processes. The purpose of this article is to demonstrate how the principles of 'lean thinking' are relevant to healthcare and the operating theatre, with reference to our own institutional experience.

Lean manufacturing comes to China: a case study of its impact on workplace health and safety.

PubMed

Brown, Garrett D; O'Rourke, Dara

2007-01-01

Lean manufacturing, which establishes small production "cells," or teams of workers, who complete an entire product from raw material processing through final assembly and shipment, increases health and safety hazards by mixing previously separated exposures to various chemicals (with possible additive and cumulative effects) and noise. The intensification of work leads to greater ergonomic and stress-related adverse health effects, as well as increased safety hazards. The standard industrial hygiene approach of anticipation, recognition, evaluation, and hazard control is applicable to lean operations. A focus on worker participation in identifying and solving problems is critical for reducing negative impacts. A key to worker safety in lean production operations is the development of informed, empowered, and active workers with the knowledge, skills, and opportunity to act in the workplace to eliminate or reduce hazards.

Primary problems associated with the health and welfare of employees observed when implementing lean manufacturing projects.

PubMed

Rampasso, Izabela Simon; Anholon, Rosley; Gonçalves Quelhas, Osvaldo Luiz; Filho, Walter Leal

2017-01-01

Lean philosophy is used by companies to increase productivity and reduce costs. Although uncontested benefits are created, it is necessary to highlight the problems related to employees' health and welfare caused by implementing lean manufacturing projects. The primary objective of this paper is to review the literature and identify the most relevant problems created by lean philosophy for employees. Research about the theme was performed on many international databases over three months, and an initial sample of 77 papers was found. Twenty-seven sources were utilized. We identified 22 categories of problems related to health and welfare of employees. The most cited problem was work intensification, mentioned by thirteen papers. Increased stress and increased responsibilities, demands and, consequently, pressure on the workers are among the primary problems observed in the research.

Implementing lean in Malaysian universities: Lean awareness level in an engineering faculty of a local university

NASA Astrophysics Data System (ADS)

Azim Khairi, M.; Rahman, Mohamed Abd

2018-01-01

Many academic articles were published in Malaysia promoting the goodness of lean in manufacturing and industrial sectors but less attention was apparently given to the possibility of obtaining the same universal benefits when applying lean in non-manufacturing sectors especially higher education. This study aims to determine the level of lean awareness among a local university’s community taking its Faculty of Engineering (FoE) as the case study. It also seeks to identify typical FoE’s staff perception on lean regarding its benefits and the obstacles in implementing it. A web-based survey using questionnaires was carried out for 215 respondents consisting of academic and administrative staff of the faculty. Statistical Package for the Social Science (SPSS) was used to analyze the survey data collected. A total of 13.95% of respondents returned the forms. Slightly more than half of those responded (56.7%) have encountered some of the lean terms with mean 1.43 and standard deviation 0.504. However, the large amount of standard deviation somewhat indicates that the real level of lean awareness of FoE as a group was low. In terms of lean benefits, reduction of waste was favored (93.3%) by the respondents with mean 0.93 and standard deviation 0.254. For obstacles in implementing lean, lack of knowledge was selected by most respondents (86.7%) to be the major factor with mean 0.87 and standard deviation 0.346. Through the analysis done, the study may conclude that level of lean awareness among the university‘s community was low thus may hinder implementation of lean concept.

[Work organisation improvement methods applied to activities of Blood Transfusion Establishments (BTE): Lean Manufacturing, VSM, 5S].

PubMed

Bertholey, F; Bourniquel, P; Rivery, E; Coudurier, N; Follea, G

2009-05-01

Continuous improvement of efficiency as well as new expectations from customers (quality and safety of blood products) and employees (working conditions) imply constant efforts in Blood Transfusion Establishments (BTE) to improve work organisations. The Lean method (from "Lean" meaning "thin") aims at identifying wastages in the process (overproduction, waiting, over-processing, inventory, transport, motion) and then reducing them in establishing a mapping of value chain (Value Stream Mapping). It consists in determining the added value of each step of the process from a customer perspective. Lean also consists in standardizing operations while implicating and responsabilizing all collaborators. The name 5S comes from the first letter of five operations of a Japanese management technique: to clear, rank, keep clean, standardize, make durable. The 5S method leads to develop the team working inducing an evolution of the way in the management is performed. The Lean VSM method has been applied to blood processing (component laboratory) in the Pays de la Loire BTE. The Lean 5S method has been applied to blood processing, quality control, purchasing, warehouse, human resources and quality assurance in the Rhône-Alpes BTE. The experience returns from both BTE shows that these methods allowed improving: (1) the processes and working conditions from a quality perspective, (2) the staff satisfaction, (3) the efficiency. These experiences, implemented in two BTE for different processes, confirm the applicability and usefulness of these methods to improve working organisations in BTE.

Organizational change through Lean Thinking.

PubMed

Tsasis, Peter; Bruce-Barrett, Cindy

2008-08-01

In production and manufacturing plants, Lean Thinking has been used to improve processes by eliminating waste and thus enhancing efficiency. In health care, Lean Thinking has emerged as a comprehensive approach towards improving processes embedded in the diagnostic, treatment and care activities of health-care organizations with cost containment results. This paper provides a case study example where Lean Thinking is not only used to improve efficiency and cost containment, but also as an approach to effective organizational change.

Implications of Lean Manufacturing for Human Resource Strategy.

ERIC Educational Resources Information Center

Forrester, Rosalind

1995-01-01

Lean production changes organizational style and structure, roles of team leaders and members, training needs, problem-solving approaches, labor relations, and pay practices. The profound cultural changes it causes may trigger defenses that cause it to fail. (SK)

Implementation of Lean System on Erbium Doped Fibre Amplifier Manufacturing Process to Reduce Production Time

NASA Astrophysics Data System (ADS)

Maneechote, T.; Luangpaiboon, P.

2010-10-01

A manufacturing process of erbium doped fibre amplifiers is complicated. It needs to meet the customers' requirements under a present economic status that products need to be shipped to customers as soon as possible after purchasing orders. This research aims to study and improve processes and production lines of erbium doped fibre amplifiers using lean manufacturing systems via an application of computer simulation. Three scenarios of lean tooled box systems are selected via the expert system. Firstly, the production schedule based on shipment date is combined with a first in first out control system. The second scenario focuses on a designed flow process plant layout. Finally, the previous flow process plant layout combines with production schedule based on shipment date including the first in first out control systems. The computer simulation with the limited data via an expected value is used to observe the performance of all scenarios. The most preferable resulted lean tooled box systems from a computer simulation are selected to implement in the real process of a production of erbium doped fibre amplifiers. A comparison is carried out to determine the actual performance measures via an analysis of variance of the response or the production time per unit achieved in each scenario. The goodness of an adequacy of the linear statistical model via experimental errors or residuals is also performed to check the normality, constant variance and independence of the residuals. The results show that a hybrid scenario of lean manufacturing system with the first in first out control and flow process plant lay out statistically leads to better performance in terms of the mean and variance of production times.

Use of Process Improvement Tools in Radiology.

PubMed

Rawson, James V; Kannan, Amogha; Furman, Melissa

2016-01-01

Process improvement techniques are common in manufacturing and industry. Over the past few decades these principles have been slowly introduced in select health care settings. This article reviews the Plan, Do, Study, and Act cycle, Six Sigma, the System of Profound Knowledge, Lean, and the theory of constraints. Specific process improvement tools in health care and radiology are presented in the order the radiologist is likely to encounter them in an improvement project. Copyright © 2015 Mosby, Inc. All rights reserved.

Simulation of value stream mapping and discrete optimization of energy consumption in modular construction

NASA Astrophysics Data System (ADS)

Chowdhury, Md Mukul

With the increased practice of modularization and prefabrication, the construction industry gained the benefits of quality management, improved completion time, reduced site disruption and vehicular traffic, and improved overall safety and security. Whereas industrialized construction methods, such as modular and manufactured buildings, have evolved over decades, core techniques used in prefabrication plants vary only slightly from those employed in traditional site-built construction. With a focus on energy and cost efficient modular construction, this research presents the development of a simulation, measurement and optimization system for energy consumption in the manufacturing process of modular construction. The system is based on Lean Six Sigma principles and loosely coupled system operation to identify the non-value adding tasks and possible causes of low energy efficiency. The proposed system will also include visualization functions for demonstration of energy consumption in modular construction. The benefits of implementing this system include a reduction in the energy consumption in production cost, decrease of energy cost in the production of lean-modular construction, and increase profit. In addition, the visualization functions will provide detailed information about energy efficiency and operation flexibility in modular construction. A case study is presented to validate the reliability of the system.

The impact of fit manufacturing on green manufacturing: A review

NASA Astrophysics Data System (ADS)

Qi, Ang Nian; Sin, Tan Chan; Fathullah, M.; Lee, C. C.

2017-09-01

Fit manufacturing and Green manufacturing are a new trend principle and concept. They are getting popular in industrial. This paper is identifying the impact between Fit manufacturing and Green manufacturing. Besides Fit manufacturing, Lean manufacturing, Agile manufacturing and Sustainable manufacturing gives big impacts to Green Manufacturing. On top of that, this paper also discuss the benefits of applying Fit manufacturing and Green manufacturing in industrial as well as environment. Hence, applications of Fit manufacturing and Green Manufacturing are increasing year by year.

Leading with Lean: Getting the Outcomes we Need with the Funding we Have.

PubMed

Merlino, Joseph P; Petit, Jorge; Weisser, Lydia; Bowen, Jill

2015-09-01

Lean and other quality management methodologies have been used by industry and manufacturing for many years. More recently they have been adopted by health care. The authors describe their experience with the lean way of continuous quality improvement, first developed by Toyota, at one of New York's largest behavioral health departments. The relevance and application of these methodologies to the mental health sector is presented.

Lean Manufacturing Improves Emergency Department Throughput and Patient Satisfaction.

PubMed

Kane, Marlena; Chui, Kristen; Rimicci, Janet; Callagy, Patrice; Hereford, James; Shen, Sam; Norris, Robert; Pickham, David

2015-09-01

A multidisciplinary team led by nursing leadership and physicians developed a plan to meet increasing demand and improve the patient experience in the ED without expanding the department's current resources. The approach included Lean tools and engaged frontline staff and physicians. Applying Lean management principles resulted in quicker service, improved patient satisfaction, increased capacity, and reduced resource utilization. Incorporating continuous daily management is necessary for sustainment of continuous improvement activities.

Study on lean thinking among MSMEs in the Machine tool sector in India

NASA Astrophysics Data System (ADS)

Priyaadarshini, R. G.; Sathish Kumar, V. R.; Aishwarya Rajlakshmi, S.

2018-02-01

In the era of stiff competition and customer expectations, manufacturing organizations across the world are struggling hard to minimize their costs and maximise their performance. Micro, Small and Medium enterprises (MSMEs), who are dependent on large corporate for business and support have a tall task of keeping pace quality in processes and output. They are in the constant vigil to adopt new systems and practices so that they can minimise their cost and maximize the productivity. This study has been conducted in the machine tool sector of Coimbatore, India; which houses more than 9000 companies and offers employment to over one lakh employees. They have a tremendous pressure to use scientific processes to increase their product quality and productivity. While Lean manufacturing has been the thrust to improve the competitiveness among MSMEs in India, this study has attempted to understand their attitude towards lean management and understand the extent to which companies practice lean tools and practices. It has been found that most of the organizations in the study possess a culture of lean thinking and possess the support of top management and employees also towards the initiative. It is also seen that the organizations that incorporated lean in their daily operations have been able to scale up their productivity.

A Cross-Disciplinary Partnership to Improve Manufacturing Education.

ERIC Educational Resources Information Center

Stephens, Matthew P.; Kraebber, Henry W.

1998-01-01

An exemplary university/business partnership involved the development of a training program to enhance workplace productivity for a relatively small manufacturing facility. The objectives were to educate the work force in the principles of workplace organization and lean manufacturing practices. (Author/JOW)

Lean leadership attributes: a systematic review of the literature.

PubMed

Aij, Kjeld Harald; Teunissen, Maurits

2017-10-09

Purpose Emphasis on quality and reducing costs has led many health-care organizations to reconfigure their management, process, and quality control infrastructures. Many are lean, a management philosophy with roots in manufacturing industries that emphasizes elimination of waste. Successful lean implementation requires systemic change and strong leadership. Despite the importance of leadership to successful lean implementation, few researchers have probed the question of ideal leadership attributes to achieve lean thinking in health care. The purpose of this paper is to provide insight into applicable attributes for lean leaders in health care. Design/methodology/approach The authors systematically reviewed the literature on principles of leadership and, using Dombrowski and Mielke's (2013) conceptual model of lean leadership, developed a parallel theoretical model for lean leadership in health care. Findings This work contributes to the development of a new framework for describing leadership attributes within lean management of health care. Originality/value The summary of attributes can provide a model for health-care leaders to apply lean in their organizations.

A sustainable manufacturing system design: A fuzzy multi-objective optimization model.

PubMed

Nujoom, Reda; Mohammed, Ahmed; Wang, Qian

2017-08-10

In the past decade, there has been a growing concern about the environmental protection in public society as governments almost all over the world have initiated certain rules and regulations to promote energy saving and minimize the production of carbon dioxide (CO 2 ) emissions in many manufacturing industries. The development of sustainable manufacturing systems is considered as one of the effective solutions to minimize the environmental impact. Lean approach is also considered as a proper method for achieving sustainability as it can reduce manufacturing wastes and increase the system efficiency and productivity. However, the lean approach does not include environmental waste of such as energy consumption and CO 2 emissions when designing a lean manufacturing system. This paper addresses these issues by evaluating a sustainable manufacturing system design considering a measurement of energy consumption and CO 2 emissions using different sources of energy (oil as direct energy source to generate thermal energy and oil or solar as indirect energy source to generate electricity). To this aim, a multi-objective mathematical model is developed incorporating the economic and ecological constraints aimed for minimization of the total cost, energy consumption, and CO 2 emissions for a manufacturing system design. For the real world scenario, the uncertainty in a number of input parameters was handled through the development of a fuzzy multi-objective model. The study also addresses decision-making in the number of machines, the number of air-conditioning units, and the number of bulbs involved in each process of a manufacturing system in conjunction with a quantity of material flow for processed products. A real case study was used for examining the validation and applicability of the developed sustainable manufacturing system model using the fuzzy multi-objective approach.

Odel of Dynamic Integration of Lean Shop Floor Management Within the Organizational Management System

NASA Astrophysics Data System (ADS)

Iuga, Virginia; Kifor, Claudiu

2014-12-01

The key to achieve a sustainable development lies in the customer satisfaction through improved quality, reduced cost, reduced delivery lead times and proper communication. The objective of the lean manufacturing system (LMS) is to identify and eliminate the processes and resources which do not add value to a product. The following paper aims to present a proposal of further development of integrated management systems in organizations through the implementation of lean shop floor management. In the first part of the paper, a dynamic model of the implementation steps will be presented. Furthermore, the paper underlines the importance of implementing a lean culture parallel with each step of integrating the lean methods and tools. The paper also describes the Toyota philosophy, tools, and the supporting lean culture necessary to implementing an efficient lean system in productive organizations

E3 Sustainable Manufacturing Curriculum

EPA Pesticide Factsheets

A short E3 course containing three modules on Environmental Sustainability; Lean Manufacturing and Pollution Prevention; and Energy and Carbon. Each module includes slides, a facilitator's guide with handouts, activities, quizzes, and facilitator's notes.

Faster, better, cheaper: lean labs are the key to future survival.

PubMed

Bryant, Patsy M; Gulling, Richard D

2006-03-28

Process improvement techniques have been used in manufacturing for many years to rein in costs and improve quality. Health care is now grappling with similar challenges. The Department of Laboratory Services at Good Samaritan Hospital, a 560-bed facility in Dayton, OH, used the Lean process improvement method in a 12-week project to streamline its core laboratory processes. By analyzing the flow of samples through the system and identifying value-added and non-value-added steps, both in the laboratory and during the collection process, Good Samaritan's project team redesigned systems and reconfigured the core laboratory layout to trim collection-to-results time from 65 minutes to 40 minutes. As a result, virtually all morning results are available to physicians by 7 a.m., critical values are called to nursing units within 30 minutes, and core laboratory services are optimally staffed for maximum cost-effectiveness.

Lean in service industries: A literature review

NASA Astrophysics Data System (ADS)

V, Vignesh; Suresh, M.; Aramvalarthan, S.

2016-09-01

Lean service is an amalgamation of tools and practices which, if applied appropriately, would definitely improve the existing quality of operations and ensure the generation of a large amount of favourable financial and economic outcomes and improve the behaviour of the workforce. As a result, it assumes of great significance in the fiercely competitive modern world. This article presents a comprehensive bibliographic study about the various lean service practices through a variety of approaches like service improvement, manufacturing, supply chain, market and retailing approaches, etc. Thus it gives a clear view on how the lean services are implemented in various sectors and the contribution of lean service towards improving the quality in the services provided while reducing the costs.

Experimenting "Learn by Doing" and "Learn by Failing"

ERIC Educational Resources Information Center

Pozzi, Rossella; Noè, Carlo; Rossi, Tommaso

2015-01-01

According to the literature, in recent years, developing experiential learning has fulfilled the requirement of a deep understanding of lean philosophy by engineering students, demonstrating the advantages and disadvantages of some of the key principles of lean manufacturing. On the other hand, the literature evidences how some kinds of game-based…

Simulation Modeling of a Facility Layout in Operations Management Classes

ERIC Educational Resources Information Center

Yazici, Hulya Julie

2006-01-01

Teaching quantitative courses can be challenging. Similarly, layout modeling and lean production concepts can be difficult to grasp in an introductory OM (operations management) class. This article describes a simulation model developed in PROMODEL to facilitate the learning of layout modeling and lean manufacturing. Simulation allows for the…

A Systematic Approach to Applying Lean Techniques to Optimize an Office Process at the Y-12 National Security Complex

DOE Office of Scientific and Technical Information (OSTI.GOV)

Credille, Jennifer; Owens, Elizabeth

This capstone offers the introduction of Lean concepts to an office activity to demonstrate the versatility of Lean. Traditionally Lean has been associated with process improvements as applied to an industrial atmosphere. However, this paper will demonstrate that implementing Lean concepts within an office activity can result in significant process improvements. Lean first emerged with the conception of the Toyota Production System. This innovative concept was designed to improve productivity in the automotive industry by eliminating waste and variation. Lean has also been applied to office environments, however the limited literature reveals most Lean techniques within an office are restrictedmore » to one or two techniques. Our capstone confronts these restrictions by introducing a systematic approach that utilizes multiple Lean concepts. The approach incorporates: system analysis, system reliability, system requirements, and system feasibility. The methodical Lean outline provides tools for a successful outcome, which ensures the process is thoroughly dissected and can be achieved for any process in any work environment.« less

Quality improvement in basic histotechnology: the lean approach.

PubMed

Clark, David

2016-01-01

Lean is a comprehensive system of management based on the Toyota production system (TPS), encompassing all the activities of an organization. It focuses management activity on creating value for the end-user by continuously improving operational effectiveness and removing waste. Lean management creates a culture of continuous quality improvement with a strong emphasis on developing the problem-solving capability of staff using the scientific method (Deming's Plan, Do, Check, Act cycle). Lean management systems have been adopted by a number of histopathology departments throughout the world to simultaneously improve quality (reducing errors and shortening turnround times) and lower costs (by increasing efficiency). This article describes the key concepts that make up a lean management system, and how these concepts have been adapted from manufacturing industry and applied to histopathology using a case study of lean implementation and evidence from the literature. It discusses the benefits, limitations, and pitfalls encountered when implementing lean management systems.

The lean service machine.

PubMed

Swank, Cynthia Karen

2003-10-01

Jefferson Pilot Financial, a life insurance and annuities firm, like many U.S. service companies at the end of the 1990s was looking for new ways to grow. Its top managers recognized that JPF needed to differentiate itself in the eyes of its customers, the independent life-insurance advisers who sell and service policies. To establish itself as these advisers' preferred partner, it set out to reduce the turnaround time on policy applications, simplify the submission process, and reduce errors. JPF's managers looked to the "lean production" practices that U.S. manufacturers adopted in response to competition from Japanese companies. Lean production is built around the concept of continuous-flow processing--a departure from traditional production systems, in which large batches are processed at each step. JPF appointed a "lean team" to reengineer its New Business unit's operations, beginning with the creation of a "model cell"--a fully functioning microcosm of JPF's entire process. This approach allowed managers to experiment and smooth out the kinks while working toward an optimal design. The team applied lean-manufacturing practices, including placing linked processes near one another, balancing employees' workloads, posting performance results, and measuring performance and productivity from the customer's perspective. Customer-focused metrics helped erode the employees' "My work is all that matters" mind-set. The results were so impressive that JPF is rolling out similar systems across many of its operations. To convince employees of the value of lean production, the lean team introduced a simulation in which teams compete to build the best paper airplane based on invented customer specifications. This game drives home lean production's basic principles, establishing a foundation for deep and far-reaching changes in the production system.

40 CFR 86.1810-01 - General standards; increase in emissions; unsafe conditions; waivers.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 2 and interim non-Tier 2 ethanol fueled vehicles. (a) Any device, system or element of design... “lean-on-cruise” strategies are incorporated into the vehicle design. A “lean-on-cruise” air-fuel... standard. The Administrator may require the manufacturer to provide comparative test data which clearly...

LEAN SIX SIGMA TECHNIQUES TO IMPROVE OPHTHALMOLOGY CLINIC EFFICIENCY.

PubMed

Ciulla, Thomas A; Tatikonda, Mohan V; ElMaraghi, Yehya A; Hussain, Rehan M; Hill, Amanda L; Clary, Julie M; Hattab, Eyas

2017-07-18

Ophthalmologists serve an increasing volume of a growing elderly population undergoing increasingly complex outpatient medical care, including extensive diagnostic testing and treatment. The resulting prolonged patient visit times ("patient flow times") limit quality, patient and employee satisfaction, and represent waste. Lean Six Sigma process improvement was used in a vitreoretinal practice to decrease patient flow time, demonstrating that this approach can yield significant improvement in health care. Process flow maps were created to determine the most common care pathways within clinic. Three months' visits from the electronic medical record system, which tracks patient task times at each process step in the office were collected. Care tasks and care pathways consuming the greatest time and variation were identified and modified. Follow-up analysis from 6 weeks' visits was conducted to assess improvement. Nearly all patients took one of five paths through the office. Patient flow was redesigned to reduce waiting room time by having staff members immediately start patients into one of those five paths; staffing was adjusted to address high demand tasks, and scheduling was optimized around derived predictors of patient flow times. Follow-up analysis revealed a statistically significant decline in mean patient flow time by 18% and inpatient flow time SD by 4.6%. Patient and employee satisfaction scores improved. Manufacturing industry techniques, such as Lean and Six Sigma, can be used to improve patient care, minimize waste, and enhance patient and staff satisfaction in outpatient clinics.

40 CFR 86.1810-01 - General standards; increase in emissions; unsafe conditions; waivers.

Code of Federal Regulations, 2012 CFR

2012-07-01

... element of design installed on or incorporated in a new motor vehicle to enable such vehicle to conform to... “lean-on-cruise” strategies are incorporated into the vehicle design. A “lean-on-cruise” air-fuel... standard. The Administrator may require the manufacturer to provide comparative test data which clearly...

40 CFR 86.1810-01 - General standards; increase in emissions; unsafe conditions; waivers.

Code of Federal Regulations, 2013 CFR

2013-07-01

... element of design installed on or incorporated in a new motor vehicle to enable such vehicle to conform to... “lean-on-cruise” strategies are incorporated into the vehicle design. A “lean-on-cruise” air-fuel... standard. The Administrator may require the manufacturer to provide comparative test data which clearly...

40 CFR 86.1810-01 - General standards; increase in emissions; unsafe conditions; waivers.

Code of Federal Regulations, 2010 CFR

2010-07-01

... element of design installed on or incorporated in a new motor vehicle to enable such vehicle to conform to... “lean-on-cruise” strategies are incorporated into the vehicle design. A “lean-on-cruise” air-fuel... standard. The Administrator may require the manufacturer to provide comparative test data which clearly...

40 CFR 86.1810-01 - General standards; increase in emissions; unsafe conditions; waivers.

Code of Federal Regulations, 2011 CFR

2011-07-01

... element of design installed on or incorporated in a new motor vehicle to enable such vehicle to conform to... “lean-on-cruise” strategies are incorporated into the vehicle design. A “lean-on-cruise” air-fuel... standard. The Administrator may require the manufacturer to provide comparative test data which clearly...

Individualisation of Lean Concept in Companies Dealing with Mass Production

NASA Astrophysics Data System (ADS)

Bednár, Roman

2012-12-01

The methods of lean manufacturing primarily designed for businesses dealing with serial production, are also used in other types of production. However the concept of lean production was not designed for these types of businesses, they are utilized only partially. Paper focuses on applying methods of lean concept in companies which are dealing with mass production and their options of exchange for other methods in the event of disagreement. Basis of the article is a list of lean methods with its description and its utilization in practice. The questionnaire was utilized to identify information from the practice. Based on this survey were identified the critical methods that are no longer appropriate for companies dealing with mass production. However, there are alternative methods of describing the problem. It is possible to say that companies are trying to get closer to their goal by modification of the basic concepts. And the concept of Lean Enterprise serves as a standard.

78 FR 692 - Notice of Petitions by Firms for Determination of Eligibility To Apply for Trade Adjustment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-04

..., injection 59715. moldings, and tooling. Firm provides services for design, lean manufacturing consulting... Manufacturing, Inc...... 910 E. Saint Andrew 12/20/2012 Firm manufactures steel Street, Rapid City, SD doors..., or threat thereof, and to a decrease in sales or production of each petitioning firm. List of...

The promise of Lean in health care.

PubMed

Toussaint, John S; Berry, Leonard L

2013-01-01

An urgent need in American health care is improving quality and efficiency while controlling costs. One promising management approach implemented by some leading health care institutions is Lean, a quality improvement philosophy and set of principles originated by the Toyota Motor Company. Health care cases reveal that Lean is as applicable in complex knowledge work as it is in assembly-line manufacturing. When well executed, Lean transforms how an organization works and creates an insatiable quest for improvement. In this article, we define Lean and present 6 principles that constitute the essential dynamic of Lean management: attitude of continuous improvement, value creation, unity of purpose, respect for front-line workers, visual tracking, and flexible regimentation. Health care case studies illustrate each principle. The goal of this article is to provide a template for health care leaders to use in considering the implementation of the Lean management system or in assessing the current state of implementation in their organizations. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Addressing the medicinal chemistry bottleneck: a lean approach to centralized purification.

PubMed

Weller, Harold N; Nirschl, David S; Paulson, James L; Hoffman, Steven L; Bullock, William H

2012-09-10

The use of standardized lean manufacturing principles to improve drug discovery productivity is often thought to be at odds with fostering innovation. This manuscript describes how selective implementation of a lean optimized process, in this case centralized purification for medicinal chemistry, can improve operational productivity and increase scientist time available for innovation. A description of the centralized purification process is provided along with both operational and impact (productivity) metrics, which indicate lower cost, higher output, and presumably more free time for innovation as a result of the process changes described.

'Lean' approach gives greater efficiency.

PubMed

Call, Roger

2014-02-01

Adapting the 'Lean' methodologies used for many years by many manufacturers on the production line - such as in the automotive industry - and deploying them in healthcare 'spaces' can, Roger Call, an architect at Herman Miller Healthcare in the US, argues, 'easily remedy many of the inefficiencies' found within a healthcare facility. In an article that first appeared in the September 2013 issue of The Australian Hospital Engineer, he explains how 'Lean' approaches such as the 'Toyota production system', and 'Six Sigma', can be harnessed to good effect in the healthcare sphere.

Assembly line performance and modeling

NASA Astrophysics Data System (ADS)

Rane, Arun B.; Sunnapwar, Vivek K.

2017-09-01

Automobile sector forms the backbone of manufacturing sector. Vehicle assembly line is important section in automobile plant where repetitive tasks are performed one after another at different workstations. In this thesis, a methodology is proposed to reduce cycle time and time loss due to important factors like equipment failure, shortage of inventory, absenteeism, set-up, material handling, rejection and fatigue to improve output within given cost constraints. Various relationships between these factors, corresponding cost and output are established by scientific approach. This methodology is validated in three different vehicle assembly plants. Proposed methodology may help practitioners to optimize the assembly line using lean techniques.

Adoption of Lean Principles in a High-Volume Molecular Diagnostic Microbiology Laboratory

PubMed Central

Mitchell, P. Shawn; Mandrekar, Jayawant N.

2014-01-01

Clinical laboratories are constantly facing challenges to do more with less, enhance quality, improve test turnaround time, and reduce operational expenses. Experience with adopting and applying lean concepts and tools used extensively in the manufacturing industry is described for a high-volume clinical molecular microbiology laboratory, illustrating how operational success and benefits can be achieved. PMID:24829247

Development of a fast, lean and agile direct pelletization process using experimental design techniques.

PubMed

Politis, Stavros N; Rekkas, Dimitrios M

2017-04-01

A novel hot melt direct pelletization method was developed, characterized and optimized, using statistical thinking and experimental design tools. Mixtures of carnauba wax (CW) and HPMC K100M were spheronized using melted gelucire 50-13 as a binding material (BM). Experimentation was performed sequentially; a fractional factorial design was set up initially to screen the factors affecting the process, namely spray rate, quantity of BM, rotor speed, type of rotor disk, lubricant-glidant presence, additional spheronization time, powder feeding rate and quantity. From the eight factors assessed, three were further studied during process optimization (spray rate, quantity of BM and powder feeding rate), at different ratios of the solid mixture of CW and HPMC K100M. The study demonstrated that the novel hot melt process is fast, efficient, reproducible and predictable. Therefore, it can be adopted in a lean and agile manufacturing setting for the production of flexible pellet dosage forms with various release rates easily customized between immediate and modified delivery.

Application of lean thinking to health care: issues and observations

PubMed Central

Joosten, Tom; Bongers, Inge; Janssen, Richard

2009-01-01

Background Incidents and quality problems are a prime cause why health care leaders are calling to redesign health care delivery. One of the concepts used is lean thinking. Yet, lean often leads to resistance. Also, there is a lack of high quality evidence supporting lean premises. In this paper, we present an overview of lean thinking and its application to health care. Development, theory and application of lean thinking to health care Lean thinking evolved from a tool designed to improve operational shop-floor performance at an automotive manufacturer to a management approach with both operational and sociotechnical aspects. Sociotechnical dynamics have until recently not received much attention. At the same time a balanced approach might lead to a situation where operational and sociotechnial improvements are mutually reinforcing. Application to health care has been limited and focussed mainly on operational aspects using original lean tools. A more integrative approach would be to pay more attention to sociotechnical dynamics of lean implementation efforts. Also, the need to use the original lean tools may be limited, because health care may have different instruments and tools already in use that are in line with lean thinking principles. Discussion We believe lean thinking has the potential to improve health care delivery. At the same time, there are methodological and practical considerations that need to be taken into account. Otherwise, lean implementation will be superficial and fail, adding to existing resistance and making it more difficult to improve health care in the long term. PMID:19696048

Using data to make decisions and drive results: a LEAN implementation strategy.

PubMed

Panning, Rick

2005-03-28

During the process of facility planning, Fairview Laboratory Services utilized LEAN manufacturing to maximize efficiency, simplify processes, and improve laboratory support of patient care services. By incorporating the LEAN program's concepts in our pilot program, we were able to reduce turnaround time by 50%, improve productivity by greater than 40%, reduce costs by 31%, save more than 440 square feet of space, standardize work practices, reduce errors and error potential, continuously measure performance, eliminate excess unused inventory and visual noise, and cross-train 100% of staff in the core laboratory. In addition, we trained a core team of people that is available to coordinate future LEAN projects in the laboratory and other areas of the organization.

The Influencing Factor Analysis on the Performance Evaluation of Assembly Line Balancing Problem Level 1 (SALBP-1) Based on ANOVA Method

NASA Astrophysics Data System (ADS)

Chen, Jie; Hu, Jiangnan

2017-06-01

Industry 4.0 and lean production has become the focus of manufacturing. A current issue is to analyse the performance of the assembly line balancing. This study focus on distinguishing the factors influencing the assembly line balancing. The one-way ANOVA method is applied to explore the significant degree of distinguished factors. And regression model is built to find key points. The maximal task time (tmax ), the quantity of tasks (n), and degree of convergence of precedence graph (conv) are critical for the performance of assembly line balancing. The conclusion will do a favor to the lean production in the manufacturing.

An integrated lean-methods approach to hospital facilities redesign.

PubMed

Nicholas, John

2012-01-01

Lean production methods for eliminating waste and improving processes in manufacturing are now being applied in healthcare. As the author shows, the methods are appropriate for redesigning hospital facilities. When used in an integrated manner and employing teams of mostly clinicians, the methods produce facility designs that are custom-fit to patient needs and caregiver work processes, and reduce operational costs. The author reviews lean methods and an approach for integrating them in the redesign of hospital facilities. A case example of the redesign of an emergency department shows the feasibility and benefits of the approach.

Lean management-the journey from toyota to healthcare.

PubMed

Teich, Sorin T; Faddoul, Fady F

2013-04-01

The evolution of production systems is tightly linked to the story of Toyota Motor Company (TMC) that has its roots around 1918. The term "lean" was coined in 1990 following the exploration of the Toyota model that led to the "transference" thesis sustaining the concept that manufacturing problems and technologies are universal problems faced by management and that these concepts can be emulated in non-Japanese enterprises. Lean is a multi-faceted concept and requires organizations to exert effort along several dimensions simultaneously; some consider a successful implementation either achieving major strategic components of lean, implementing practices to support operational aspects, or providing evidence that the improvements are sustainable in the long term. The article explores challenges and opportunities faced by organizations that intend incorporating lean management principles and presents the specific context of the healthcare industry. Finally, the concepts of "essential few" and customer value are illustrated through a simple example of process change following lean principles, which was implemented in a dental school in the United States.

Ergonomics and Kaizen as strategies for competitiveness: a theoretical and practical in an automotive industry.

PubMed

Vieira, Leandro; Balbinotti, Giles; Varasquin, Adriano; Gontijo, Leila

2012-01-01

With increased international competitiveness in the automotive industry, came the concern of the companies save costs and lower production costs. For this purpose many ways are designed to reduce costs and waste of raw materials and reduce activities that do not aggregate value to manufacturing processes. In the early XVII appears the manufacturing system, which processes were hard with little concern for the health and safety of employees and conditions of the workplace. After the advent of the production system called lean manufacturing, a new paradigm in terms of production system capable of providing high levels of productivity and quality. It is based on waste elimination that occur during the production process. After began a new way of thinking, creating a culture of continuous improvement and lean process with no waste and reducing costs, without neglecting the welfare worker and improving the conditions of their work environment. This paper presents a reflection on the application of ergonomics in a lean production system of an automotive industry, using methodology based on the Kaizen (Continuous Improvement) to gain performance and improving the conditions of the workplace, also will be presented with positive and negative points in using this methodology in relation to ergonomics. The research will be conducted by collecting data 'in loco' and interviews with workers. Some studies show that in companies that are lean system and using the methodology of Kaizen, the results of product quality, levels of absenteeism and accidents are better than those obtained in companies that do not apply the same concept.

Healthcare Lean.

PubMed

Long, John C

2003-01-01

Lean Thinking is an integrated approach to designing, doing and improving the work of people that have come together to produce and deliver goods, services and information. Healthcare Lean is based on the Toyota production system and applies concepts and techniques of Lean Thinking to hospitals and physician practices.

Adoption of lean principles in a high-volume molecular diagnostic microbiology laboratory.

PubMed

Mitchell, P Shawn; Mandrekar, Jayawant N; Yao, Joseph D C

2014-07-01

Clinical laboratories are constantly facing challenges to do more with less, enhance quality, improve test turnaround time, and reduce operational expenses. Experience with adopting and applying lean concepts and tools used extensively in the manufacturing industry is described for a high-volume clinical molecular microbiology laboratory, illustrating how operational success and benefits can be achieved. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Overview of Automotive Core Tools: Applications and Benefits

NASA Astrophysics Data System (ADS)

Doshi, Jigar A.; Desai, Darshak

2017-08-01

Continuous improvement of product and process quality is always challenging and creative task in today's era of globalization. Various quality tools are available and used for the same. Some of them are successful and few of them are not. Considering the complexity in the continuous quality improvement (CQI) process various new techniques are being introduced by the industries, as well as proposed by researchers and academia. Lean Manufacturing, Six Sigma, Lean Six Sigma is some of the techniques. In recent years, there are new tools being opted by the industry, especially automotive, called as Automotive Core Tools (ACT). The intention of this paper is to review the applications and benefits along with existing research on Automotive Core Tools with special emphasis on continuous quality improvement. The methodology uses an extensive review of literature through reputed publications—journals, conference proceedings, research thesis, etc. This paper provides an overview of ACT, its enablers, and exertions, how it evolved into sophisticated methodologies and benefits used in organisations. It should be of value to practitioners of Automotive Core Tools and to academics who are interested in how CQI can be achieved using ACT. It needs to be stressed here that this paper is not intended to scorn Automotive Core Tools, rather, its purpose is limited only to provide a balance on the prevailing positive views toward ACT.

Applying value stream mapping techniques to eliminate non-value-added waste for the procurement of endovascular stents.

PubMed

Teichgräber, Ulf K; de Bucourt, Maximilian

2012-01-01

OJECTIVES: To eliminate non-value-adding (NVA) waste for the procurement of endovascular stents in interventional radiology services by applying value stream mapping (VSM). The Lean manufacturing technique was used to analyze the process of material and information flow currently required to direct endovascular stents from external suppliers to patients. Based on a decision point analysis for the procurement of stents in the hospital, a present state VSM was drawn. After assessment of the current status VSM and progressive elimination of unnecessary NVA waste, a future state VSM was drawn. The current state VSM demonstrated that out of 13 processes for the procurement of stents only 2 processes were value-adding. Out of the NVA processes 5 processes were unnecessary NVA activities, which could be eliminated. The decision point analysis demonstrated that the procurement of stents was mainly a forecast driven push system. The future state VSM applies a pull inventory control system to trigger the movement of a unit after withdrawal by using a consignment stock. VSM is a visualization tool for the supply chain and value stream, based on the Toyota Production System and greatly assists in successfully implementing a Lean system. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Planning and design of a knowledge based system for green manufacturing management

NASA Astrophysics Data System (ADS)

Kamal Mohd Nawawi, Mohd; Mohd Zuki Nik Mohamed, Nik; Shariff Adli Aminuddin, Adam

2013-12-01

This paper presents a conceptual design approach to the development of a hybrid Knowledge Based (KB) system for Green Manufacturing Management (GMM) at the planning and design stages. The research concentrates on the GMM by using a hybrid KB system, which is a blend of KB system and Gauging Absences of Pre-requisites (GAP). The hybrid KB/GAP system identifies all potentials elements of green manufacturing management issues throughout the development of this system. The KB system used in the planning and design stages analyses the gap between the existing and the benchmark organizations for an effective implementation through the GAP analysis technique. The proposed KBGMM model at the design stage explores two components, namely Competitive Priority and Lean Environment modules. Through the simulated results, the KBGMM System has identified, for each modules and sub-module, the problem categories in a prioritized manner. The System finalized all the Bad Points (BP) that need to be improved to achieve benchmark implementation of GMM at the design stage. The System provides valuable decision making information for the planning and design a GMM in term of business organization.

Considerations for Using Agile in DoD Acquisition

DTIC Science & Technology

2010-04-01

successfully used in manufacturing throughout the world for decades, such as ―just-in- time,‖ Lean, Kanban , and work-flow-based planning. Another new...of this analysis is provided in Table 2. 29 Kanban / lean style of Agile might be the most relevant for this phase. 31 | CMU/SEI-2010-TN-002...family of approaches, including Kanban [14], Rational Unified Process (RUP), Personal Software Process (PSP), Team Software Process (TSP), and Cleanroom

Lean in healthcare from employees' perspectives.

PubMed

Drotz, Erik; Poksinska, Bozena

2014-01-01

The purpose of this paper is to contribute toward a deeper understanding of the new roles, responsibilities, and job characteristics of employees in Lean healthcare organizations. The paper is based on three cases studies of healthcare organizations that are regarded as successful examples of Lean applications in the healthcare context. Data were collected by methods including interviews, observations, and document studies. The implementation of Lean in healthcare settings has had a great influence on the roles, responsibilities, and job characteristics of the employees. The focus has shifted from healthcare professionals, where clinical autonomy and professional skills have been the guarding principles of patient care, to process improvement and teamwork. Different job characteristics may make it difficult to implement certain Lean practices in healthcare. Teamwork and decentralization of authority are examples of Lean practices that could be considered countercultural because of the strong professional culture and uneven power distribution, with doctors as the dominant decision makers. Teamwork, value flow orientation, and company-wide involvement in CI were associated with positive effects on the organizations' working environment, staff development, and organizational performance. In order to succeed with Lean healthcare, it is important to understand and recognize the differences in job characteristics between Lean manufacturing and healthcare. This paper provides insights into how Lean implementation changes the roles, responsibilities, and job characteristics of healthcare staff and the challenges and implications that may follow from this.

Design of production process main shaft process with lean manufacturing to improve productivity

NASA Astrophysics Data System (ADS)

Siregar, I.; Nasution, A. A.; Andayani, U.; Anizar; Syahputri, K.

2018-02-01

This object research is one of manufacturing companies that produce oil palm machinery parts. In the production process there is delay in the completion of the Main shaft order. Delays in the completion of the order indicate the low productivity of the company in terms of resource utilization. This study aimed to obtain a draft improvement of production processes that can improve productivity by identifying and eliminating activities that do not add value (non-value added activity). One approach that can be used to reduce and eliminate non-value added activity is Lean Manufacturing. This study focuses on the identification of non-value added activity with value stream mapping analysis tools, while the elimination of non-value added activity is done with tools 5 whys and implementation of pull demand system. Based on the research known that non-value added activity on the production process of the main shaft is 9,509.51 minutes of total lead time 10,804.59 minutes. This shows the level of efficiency (Process Cycle Efficiency) in the production process of the main shaft is still very low by 11.89%. Estimation results of improvement showed a decrease in total lead time became 4,355.08 minutes and greater process cycle efficiency that is equal to 29.73%, which indicates that the process was nearing the concept of lean production.

Can lean save lives?

PubMed

Fillingham, David

2007-01-01

The purpose of this paper is to show how over the last 18 months Bolton Hospitals NHS Trust have been exploring whether or not lean methodologies, often known as the Toyota Production System, can indeed be applied to healthcare. This paper is a viewpoint. One's early experience is that lean really can save lives. The Toyota Production System is an amazingly successful way of manufacturing cars. It cannot be simply translated unthinkingly into a hospital but lessons can be learned from it and the method can be adapted and developed so that it becomes owned by healthcare staff and focused towards the goal of improved patient care. Working in healthcare is a stressful and difficult thing. Everyone needs a touch of inspiration and encouragement. Applying lean to healthcare in Bolton seems to be achieving just that for those who work there.

Implementing "lean" principles to improve the efficiency of the endoscopy department of a community hospital: a case study.

PubMed

Laing, Karen; Baumgartner, Katherine

2005-01-01

Many endoscopy units are looking for ways to improve their efficiency without increasing the number of staff, purchasing additional equipment, or making the patients feel as if they have been rushed through the care process. To accomplish this, a few hospitals have looked to other industries for help. Recently, "lean" methods and tools from the manufacturing industry, have been applied successfully in health care systems, and have proven to be an effective way to eliminate waste and redundancy in workplace processes. The "lean" method and tools in service organizations focuses on providing the most efficient and effective flow of service and products. This article will describe the journey of one endoscopy department within a community hospital to illustrate application of "lean" methods and tools and results.

Lead-time reduction utilizing lean tools applied to healthcare: the inpatient pharmacy at a local hospital.

PubMed

Al-Araidah, Omar; Momani, Amer; Khasawneh, Mohammad; Momani, Mohammed

2010-01-01

The healthcare arena, much like the manufacturing industry, benefits from many aspects of the Toyota lean principles. Lean thinking contributes to reducing or eliminating nonvalue-added time, money, and energy in healthcare. In this paper, we apply selected principles of lean management aiming at reducing the wasted time associated with drug dispensing at an inpatient pharmacy at a local hospital. Thorough investigation of the drug dispensing process revealed unnecessary complexities that contribute to delays in delivering medications to patients. We utilize DMAIC (Define, Measure, Analyze, Improve, Control) and 5S (Sort, Set-in-order, Shine, Standardize, Sustain) principles to identify and reduce wastes that contribute to increasing the lead-time in healthcare operations at the pharmacy understudy. The results obtained from the study revealed potential savings of > 45% in the drug dispensing cycle time.

Northwest Manufacturing Initiative

DTIC Science & Technology

2012-03-27

crack growth and threshold stress corrosion cracking evaluation. Threshold stress corrosion cracking was done using the rising step load method with...Group Technology methods to establish manufacturing cells for production efficiency, to develop internal Lean Champions, and to implement rapid... different levels, advisory, core, etc. VI. Core steering committee composed of members that have a significant vested interest. Action Item: Draft

Rational Choice or Leap of Faith? The Creation and Defence of a Management Orthodoxy

ERIC Educational Resources Information Center

Oliver, Nick

2008-01-01

Purpose: In the 1980s and 1990s enthusiasm for Japanese or "lean" manufacturing methods swept through Western industry. At the time, commentators argued that these methods represented a new paradigm of manufacturing, a radical break with traditional methods. The purpose of this paper is to explore the process of conversion from one…

Lean Management—The Journey from Toyota to Healthcare

PubMed Central

Teich, Sorin T.; Faddoul, Fady F.

2013-01-01

The evolution of production systems is tightly linked to the story of Toyota Motor Company (TMC) that has its roots around 1918. The term “lean” was coined in 1990 following the exploration of the Toyota model that led to the “transference” thesis sustaining the concept that manufacturing problems and technologies are universal problems faced by management and that these concepts can be emulated in non-Japanese enterprises. Lean is a multi-faceted concept and requires organizations to exert effort along several dimensions simultaneously; some consider a successful implementation either achieving major strategic components of lean, implementing practices to support operational aspects, or providing evidence that the improvements are sustainable in the long term. The article explores challenges and opportunities faced by organizations that intend incorporating lean management principles and presents the specific context of the healthcare industry. Finally, the concepts of “essential few” and customer value are illustrated through a simple example of process change following lean principles, which was implemented in a dental school in the United States. PMID:23908857

Control your inventory in a world of lean retailing.

PubMed

Abernathy, F H; Dunlop, J T; Hammond, J H; Weil, D

2000-01-01

As retailers adopt lean retailing practices, manufacturers are feeling the pinch. Retailers no longer place large seasonal orders for goods in advance-instead, they require ongoing replenishment of stock, forcing manufacturers to predict demand and then hold substantial inventories indefinitely. Manufacturers now carry the cost of inventory risk--the possibility that demand will dry up and goods will have to be sold below cost. And as product proliferation increases, customer demand becomes harder to predict. Most manufacturers apply one inventory policy for all stock-keeping units in a product line. But the inventory demand for SKUs within the same product line can vary significantly. SKUs with high volume typically have little variation in weekly sales, while slow-selling SKUs can vary enormously in weekly sales. The greater the variation, the larger the inventory the manufacturer must hold relative to an SKU's expected weekly sales. By differentiating inventory policies at the SKU level, manufacturers can reduce inventories for the high-volume SKUs and increase them for the low-volume ones--and thereby improve the profit-ability of the entire line. SKU-level differentiation can also be applied to sourcing strategies. Instead of producing all the SKUs for a product line at a single location, either offshore at low cost or close to market at higher cost, manufacturers can typically do better by going for a mixed allocation. Low-variation goods should be produced mainly offshore, while high-variation goods are best made close to markets.

Comparative study of lean practices between Japanese and Malaysia automotive service centres

NASA Astrophysics Data System (ADS)

Ahmad, Md Fauzi; Ting, Neo Yeong; Nor, Nik Hisyamudin Muhd; Wei, Chan Shiau; Hassan, Mohd Fahrul; Hamid, Nor Aziati Abdul

2017-10-01

Nowadays, lean practices are implemented in many manufacturing and services companies. Lean practices are implemented in order to minimize wastes while maximise the overall performances in an organisation. In service sector, lean practices are importance to ensure value added services can be delivered to customers. However, Malaysia automotive companies cannot compete with Japanese automotive companies in terms of their customer satisfaction. The purpose of this study is to compare the lean practice between Japanese and Malaysia automotive service centres. A total of 80 questionnaires out of 100 distributed questionnaires were responded and this represented as 80% of response rate. The Mann-Whitney test result shows that there were four out of five factors of lean practices have significant differences between Japanese and Malaysia automotive service centres, which are TPM, JIT, Kanban, and 5S. VSM has not significant difference between ownerships. In addition, TPM, JIT, Kanban, VSM and 5S were higher practices in Japanese companies against Malaysia companies. Many Malaysia companies are still in the journey of lean practices and they need recommendation guidance to compete with other long-term established companies. Based on the survey result, the significant differences are identified as weak points of Malaysia companies as an opportunity to improve. Moreover, the significance of this study can help researchers and industry players to improve lean practices in automotive service industry.

A Work-Based Research Assessment of the Impact of "Lean Manufacturing" on Health and Safety Education within an SME

ERIC Educational Resources Information Center

Nikolou-Walker, Elda; Lavery, Kathy

2009-01-01

Globalisation has had a major impact on the engineering industry as Pacific Rim countries undercut manufacturing costs and provide a more cost-effective location for many businesses. Engineering in Northern Ireland has mostly declined owing to increased competition from these countries. Engineering companies are now forced to streamline their…

Applying lean techniques in the delivery of transportation infrastructure construction projects.

DOT National Transportation Integrated Search

2011-07-01

It is well documented that construction productivity has been declining since the 1960s. Additionally, studies have shown that only : 40% of construction workers time is considered to be value-added work. Interest in the use of Lean techniques ...

Structural Integrity of an Electron Beam Melted Titanium Alloy.

PubMed

Lancaster, Robert; Davies, Gareth; Illsley, Henry; Jeffs, Spencer; Baxter, Gavin

2016-06-14

Advanced manufacturing encompasses the wide range of processes that consist of "3D printing" of metallic materials. One such method is Electron Beam Melting (EBM), a modern build technology that offers significant potential for lean manufacture and a capability to produce fully dense near-net shaped components. However, the manufacture of intricate geometries will result in variable thermal cycles and thus a transient microstructure throughout, leading to a highly textured structure. As such, successful implementation of these technologies requires a comprehensive assessment of the relationships of the key process variables, geometries, resultant microstructures and mechanical properties. The nature of this process suggests that it is often difficult to produce representative test specimens necessary to achieve a full mechanical property characterisation. Therefore, the use of small scale test techniques may be exploited, specifically the small punch (SP) test. The SP test offers a capability for sampling miniaturised test specimens from various discrete locations in a thin-walled component, allowing a full characterisation across a complex geometry. This paper provides support in working towards development and validation strategies in order for advanced manufactured components to be safely implemented into future gas turbine applications. This has been achieved by applying the SP test to a series of Ti-6Al-4V variants that have been manufactured through a variety of processing routes including EBM and investigating the structural integrity of each material and how this controls the mechanical response.

Lean consumption.

PubMed

Womack, James P; Jones, Daniel T

2005-03-01

During the past 20 years, the real price of most consumer goods has fallen worldwide, the variety of goods and the range of sales channels offering them have continued to grow, and product quality has steadily improved. So why is consumption often so frustrating? It doesn't have to be--and shouldn't be--the authors say. They argue that it's time to apply lean thinking to the processes of consumption--to give consumers the full value they want from goods and services with the greatest efficiency and the least pain. Companies may think they save time and money by off-loading work to the consumer but, in fact, the opposite is true. By streamlining their systems for providing goods and services, and by making it easier for customers to buy and use those products and services, a growing number of companies are actually lowering costs while saving everyone time. In the process, these businesses are learning more about their customers, strengthening consumer loyalty, and attracting new customers who are defecting from less user-friendly competitors. The challenge lies with the retailers, service providers, manufacturers, and suppliers that are not used to looking at total cost from the standpoint of the consumer and even less accustomed to working with customers to optimize the consumption process. Lean consumption requires a fundamental shift in the way companies think about the relationship between provision and consumption, and the role their customers play in these processes. It also requires consumers to change the nature of their relationships with the companies they patronize. Lean production has clearly triumphed over similar obstacles in recent years to become the dominant global manufacturing model. Lean consumption, its logical companion, can't be far behind.

Workplace ergonomics in lean production environments: A literature review.

PubMed

Arezes, Pedro M; Dinis-Carvalho, José; Alves, Anabela Carvalho

2015-01-01

Lean Production Systems (LPS) have become very popular among manufacturing industries, services and large commercial areas. A LPS must develop and consider a set of work features to bring compatibility with workplace ergonomics, namely at a muscular, cognitive and emotional demands level. Identify the most relevant impacts of the adoption of LPS from the ergonomics point of view and summarizes some possible drawbacks for workplace ergonomics due to a flawed application of the LPS. The impacts identified are focused in four dimensions: work pace, intensity and load; worker motivation, satisfaction and stress; autonomy and participation; and health outcome. This paper also discusses the influence that the work organization model has on workplace ergonomics and on the waste elimination previewed by LPS. Literature review focused LPS and its impact on occupational ergonomics conditions, as well as on the Health and Safety of workers. The main focus of this research is on LPS implementations in industrial environments and mainly in manufacturing industry workplaces. This is followed by a discussion including the authors' experience (and previous research). From the reviewed literature it seems that there is no consensus on how Lean principles affect the workplace ergonomics since most authors found positive (advantages) and negative (disadvantages) impacts. The negative impacts or disadvantages of LPS implementations reviewed may result from the misunderstanding of the Lean principles. Possibly, they also happen due to partial Lean implementations (when only one or two tools were implemented) that may be effective in a specific work context but not suitable to all possible situations as the principles of LPS should not lead, by definition, to any of the reported drawbacks in terms of workplace ergonomics.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Romm, J.J.

Many American companies have found that saving energy and cutting pollution dramatically improves the bottom line. But beyond these gains, businesses that launch energy efficiency programs to save money are often astonished to discover unforeseen benefits: energy efficient lighting, heating, cooling, motors, and industrial processes can increase worker productivity, decrease absenteeism, and improve the quality of work performed. Profits created by the jump in worker productivity can exceed energy savings by a factor of ten. Energy efficiency and pollution prevention represent the next wave in manufacturing, following the quality revolution launched by the Japanese in the 1960s. Unless America leadsmore » the lean and clean revolution, economic health will be undermined as other countries develop clean processes and products and US companies suffer competitively. Also, developing countries will leapfrog their wasteful model and buy products and manufacturing processes from foreign firms already practicing lean and clean.« less

Ares Launch Vehicles Lean Practices Case Study

NASA Technical Reports Server (NTRS)

Doreswamy, Rajiv; Self, Timothy A.

2007-01-01

The Ares launch vehicles team, managed by the Ares Projects Office (APO) at NASA Marshall Space Flight Center, has completed the Ares I Crew Launch Vehicle System Requirements Review and System Definition Review and early design work for the Ares V Cargo Launch Vehicle. This paper provides examples of how Lean Manufacturing, Kaizen events, and Six Sigma practices are helping APO deliver a new space transportation capability on time and within budget, while still meeting stringent technical requirements. For example, Lean philosophies have been applied to numerous process definition efforts and existing process improvement activities, including the Ares I-X test flight Certificate of Flight Readiness (CoFR) process, risk management process, and review board organization and processes. Ares executives learned Lean practices firsthand, making the team "smart buyers" during proposal reviews and instilling the team with a sense of what is meant by "value-added" activities. Since the goal of the APO is to field launch vehicles at a reasonable cost and on an ambitious schedule, adopting Lean philosophies and practices will be crucial to the Ares Project's long-term SUCCESS.

Application of kaizen methodology to foster departmental engagement in quality improvement.

PubMed

Knechtges, Paul; Decker, Michael Christopher

2014-12-01

The Toyota Production System, also known as Lean, is a structured approach to continuous quality improvement that has been developed over the past 50 years to transform the automotive manufacturing process. In recent years, these techniques have been successfully applied to quality and safety improvement in the medical field. One of these techniques is kaizen, which is the Japanese word for "good change." The central tenant of kaizen is the quick analysis of the small, manageable components of a problem and the rapid implementation of a solution with ongoing, real-time reassessment. Kaizen adds an additional "human element" that all stakeholders, not just management, must be involved in such change. Because of the small size of the changes involved in a kaizen event and the inherent focus on human factors and change management, a kaizen event can serve as good introduction to continuous quality improvement for a radiology department. Copyright © 2014. Published by Elsevier Inc.

Applying Value Stream Mapping to reduce food losses and wastes in supply chains: A systematic review.

PubMed

De Steur, Hans; Wesana, Joshua; Dora, Manoj K; Pearce, Darian; Gellynck, Xavier

2016-12-01

The interest to reduce food losses and wastes has grown considerably in order to guarantee adequate food for the fast growing population. A systematic review was used to show the potential of Value Stream Mapping (VSM) not only to identify and reduce food losses and wastes, but also as a way to establish links with nutrient retention in supply chains. The review compiled literature from 24 studies that applied VSM in the agri-food industry. Primary production, processing, storage, food service and/or consumption were identified as susceptible hotspots for losses and wastes. Results further revealed discarding and nutrient loss, most especially at the processing level, as the main forms of loss/waste in food, which were adapted to four out of seven lean manufacturing wastes (i.e. defect, unnecessary inventory, overproduction and inappropriate processing). This paper presents the state of the art of applying lean manufacturing practices in the agri-food industry by identifying lead time as the most applicable performance indicator. VSM was also found to be compatible with other lean tools such as Just-In-Time and 5S which are continuous improvement strategies, as well as simulation modelling that enhances adoption. In order to ensure successful application of lean practices aimed at minimizing food or nutrient losses and wastes, multi-stakeholder collaboration along the entire food supply chain is indispensable. Copyright © 2016 Elsevier Ltd. All rights reserved.

Implementation of lean thinking: one health system's journey.

PubMed

Kim, Christopher S; Spahlinger, David A; Kin, Jeanne M; Coffey, Richard J; Billi, John E

2009-08-01

Lean Thinking is a management philosophy derived from the manufacturing industry, where Toyota has long been the gold standard. Health care organizations have started to apply this approach to patient care. After initial experimentation, the University of Michigan Health System (UMHS) has adopted Lean Thinking as its uniform approach to quality improvement and is striving to become a complete Lean organization. In 2005, the senior leadership selected an initial set of projects in areas that traced the patient's journey across different care settings within our health system. Four of the projects were as follows: orthopedic surgery clinic scheduling, radiation oncology therapy, peripherally inserted central catheter (PICC) services, and coordination of care to the outpatient setting. Lean Thinking encourages service providers to focus on value as defined by the customer and the relentless elimination of waste that impedes the flow of value. A series of learning projects were conducted to test whether Lean methods would work at UMHS. The following factors were found to be key to LEAN PROJECT SUCCESS: expert guidance for initial efforts, leadership in the form of clinical champions and senior management support of the improvement work, frontline worker engagement in mapping out "current state" processes, identifying waste and designing an improved "future state," using metrics to develop and track interventions, and defining realistic project scope. As UMHS's experience applying Lean Thinking to our patient care processes has grown, so have support, enthusiasm, and expertise within the organization. UMHS's Lean Thinking system, now known as the Michigan Quality System, has emerged as the core improvement strategy.

Illusion or delusion--Lean management in the health sector.

PubMed

McIntosh, Bryan; Sheppy, Bruce; Cohen, Ivan

2014-01-01

There has been considerable interest in the implementation of practices imported from manufacturing into healthcare as a solution to rising healthcare spending and disappointing patient safety indicators. One approach that has attracted particular interest is Lean management and the purpose of this paper is to engage with this topic. Secondary research. Despite widespread enthusiasm about the potential of Lean management processes, evidence about its contribution to higher organisational performance remains inconsistent. This paper engages with the major Lean concepts of operations management and human resource management, including just-in-time, total quality management, total productive maintenance and does not engage in-depth with concepts related to employee empowerment, and training This paper contributes to the organisational management literature in healthcare by showing that although Lean management seems to have the potential to improve organisational performance it is far from a panacea against under performing hospitals. It informs policy making by suggesting that a progressive managerial philosophy has a stronger impact on healthcare performance than the adoption of practices from any particular managerial approach. This paper provides a critical evaluation of the impact of Lean practices in informing healthcare policy. The paper contributes to the organisational management literature in healthcare by showing that even though Lean management in healthcare appears to have the potential to improve organisational performance; there remain problems with its application.

Implementation of lean manufacturing for frozen fish process at PT. XYZ

NASA Astrophysics Data System (ADS)

Setiyawan, D. T.; Pertiwijaya, H. R.; Effendi, U.

2018-03-01

PT. XYZ is a company specialized in the processing of fishery products particularly in frozen fish fillet. The purpose of this research was to identify the type of waste and determine the recommendations of minimizing waste Lean manufacturing approach was used in the identification of waste by describing the Value Stream Mapping (VSM) and selecting tools in the Value Stream Analysis Tools (VALSAT). The results of this research showed that the highest waste that generated was the defect of leak packaging on fillet products with an average of 1.21%. In addition to defect, other insufficiencies were found such as: unnecessary motion, unnecessary overhead, and waiting time. Recommendations for improvements that given include reduction of time at several stages of the process, making production schedules, and conducting regular machine maintenance. VSM analysis shows reduced lead time of 582.04 minutes to 572.01 minutes.

An exploratory investigation of teaching innovations and learning factors in a lean manufacturing systems engineering course

NASA Astrophysics Data System (ADS)

Choomlucksana, Juthamas; Doolen, Toni L.

2017-11-01

The use of collaborative activities and simulation sessions in engineering education has been explored previously. However, few studies have investigated the relationship of these types of teaching innovations with other learner characteristics, such as self-efficacy and background knowledge. This study explored the effects of collaborative activities and simulation sessions on learning and the relationships between self-efficacy beliefs, background knowledge, and learning. Data were collected from two different terms in an upper division engineering course entitled Lean Manufacturing Systems Engineering. Findings indicated that the impact of collaborative activities and simulation sessions appears to be different, depending on the concepts being taught. Simulation sessions were found to have a significant effect on self-efficacy beliefs, and background knowledge had a mixed effect on learning. Overall the results of this study highlight the complex set of relationships between classroom innovations, learner characteristics, and learning.

Leanergy(TM): how lean manufacturing can improve energy efficiency.

PubMed

Riche, Jean-Pierre

2013-01-01

Energy efficiency has become a competitive issue for industrial companies. The evolution of energy prices and regulation will make this issue even more important in the future. For several years, the energy-intensive chemical industry has been implementing corrective actions. Helped by the absorption of base load energy consumption by larger production volumes, specific energy consumption (KWh per production unit) has been significantly reduced in recent years. However, most plants have reached the end of their first action plan based on improving the utilities performance. The Leanergy(TM) method developed by the consultancy company Okavango-energy, is a structured approach based on lean manufacturing which widens the scope of saving sources to process and operations. Starting from the analysis of actual production requirements, Okavango is able to adjust consumption to minimum requirements and so remove any energy consumption that does not contribute to the added value creation.

Lean practices for quality results: a case illustration.

PubMed

Hwang, Pauline; Hwang, David; Hong, Paul

2014-01-01

Increasingly, healthcare providers are implementing lean practices to achieve quality results. Implementing lean healthcare practices is unique compared to manufacturing and other service industries. The purpose of this paper is to present a model that identifies and defines the lean implementation key success factors in healthcare organisations. The model is based on an extant literature review and a case illustration that explores actual lean implementation in a major USA hospital located in a Midwestern city (approximately 300,000 people). An exploratory/descriptive study using observation and follow-up interviews was conducted to identify lean practices in the hospital. Lean practice key drivers include growing elderly populations, rising medical expenses, decreasing insurance coverage and decreasing management support. Effectively implementing lean practices to increase bottom-line results and improve organisational integrity requires sharing goals and processes among healthcare managers and professionals. An illustration explains the model and the study provides a sound foundation for empirical work. Practical implications are included. Lean practices minimise waste and unnecessary hospital stays while simultaneously enhancing customer values and deploying resources in supply systems. Leadership requires clear project targets based on sound front-end planning because initial implementation steps involve uncertainty and ambiguity (i.e. fuzzy front-end planning). Since top management support is crucial for implementing lean practices successfully, a heavyweight manager, who communicates well both with top managers and project team members, is an important success factor when implementing lean practices. Increasingly, green orientation and sustainability initiatives are phrases that replaced lean practices. Effective results; e.g. waste reduction, employee satisfaction and customer values are applicable to bigger competitive challenges arising both in specific organisations and inter-organisational networks. Healthcare managers are adopting business practices that improve efficiency and productivity while ensuring their healthcare mission and guaranteeing that customer values are achieved. Shared understanding about complex goals (e.g. reducing waste and enhancing customer value) at the front-end is crucial for implementing successful lean practices. In particular, this study shows that nursing practices, which are both labour intensive and technology enabled, are good candidates for lean practice.

The impact of lean production and related new systems of work organization on worker health.

PubMed

Landsbergis, P A; Cahill, J; Schnall, P

1999-04-01

New systems of work organization, such as lean production and total quality management, have been introduced by employers throughout the industrialized world to improve productivity, quality, and profitability. However, few studies have examined the impact of such systems on occupational injuries or illnesses or on job characteristics related to job strain, which has been linked to hypertension and cardiovascular disease. The studies reviewed provide little evidence to support the hypothesis that lean production "empowers" auto workers. In fact, auto industry studies suggest that lean production creates intensified work pace and demands. Increases in decision authority and skill levels are modest or temporary, whereas decision latitude typically remains low. Thus, such work can be considered to have job strain. In jobs with ergonomic stressors, intensification of labor appears to lead to increases in musculoskeletal disorders. The evidence for adverse health effects remains inconclusive for related new work systems in other industries, such as modular manufacturing or patient-focused care.

Structural Integrity of an Electron Beam Melted Titanium Alloy

PubMed Central

Lancaster, Robert; Davies, Gareth; Illsley, Henry; Jeffs, Spencer; Baxter, Gavin

2016-01-01

Advanced manufacturing encompasses the wide range of processes that consist of “3D printing” of metallic materials. One such method is Electron Beam Melting (EBM), a modern build technology that offers significant potential for lean manufacture and a capability to produce fully dense near-net shaped components. However, the manufacture of intricate geometries will result in variable thermal cycles and thus a transient microstructure throughout, leading to a highly textured structure. As such, successful implementation of these technologies requires a comprehensive assessment of the relationships of the key process variables, geometries, resultant microstructures and mechanical properties. The nature of this process suggests that it is often difficult to produce representative test specimens necessary to achieve a full mechanical property characterisation. Therefore, the use of small scale test techniques may be exploited, specifically the small punch (SP) test. The SP test offers a capability for sampling miniaturised test specimens from various discrete locations in a thin-walled component, allowing a full characterisation across a complex geometry. This paper provides support in working towards development and validation strategies in order for advanced manufactured components to be safely implemented into future gas turbine applications. This has been achieved by applying the SP test to a series of Ti-6Al-4V variants that have been manufactured through a variety of processing routes including EBM and investigating the structural integrity of each material and how this controls the mechanical response. PMID:28773590

Comparing Textbook Coverage of Lean Management to Academic Research and Industry Practitioner Perceptions

ERIC Educational Resources Information Center

Marley, Kathryn A.; Stodnick, T. Michael; Heyl, Jeff

2013-01-01

Within operations management courses, most instructors choose to devote classroom time to teaching the topic of lean management. However, because the amount of time available for instructors to devote to this topic varies considerably, there is a great deal of latitude on which specific lean tools and techniques should be discussed. The authors…

The impact of Lean bundles on hospital performance: does size matter?

PubMed

Al-Hyari, Khalil; Abu Hammour, Sewar; Abu Zaid, Mohammad Khair Saleem; Haffar, Mohamed

2016-10-10

Purpose The purpose of this paper is to study the effect of the implementation of Lean bundles on hospital performance in private hospitals in Jordan and evaluate how much the size of organization can affect the relationship between Lean bundles implementation and hospital performance. Design/methodology/approach The research is considered as quantitative method (descriptive and hypothesis testing). Three statistical techniques were adopted to analyse the data. Structural equation modeling techniques and multi-group analysis were used to examine the research's hypothesis, and to perform the required statistical analysis of the data from the survey. Reliability analysis and confirmatory factor analysis were used to test the construct validity, reliability and measurement loadings that were performed. Findings Lean bundles have been identified as an effective approach that can dramatically improve the organizational performance of private hospitals in Jordan. Main Lean bundles - just in time, human resource management, and total quality management are applicable to large, small and medium hospitals without significant differences in advantages that depend on size. Originality/value According to the researchers' best knowledge, this is the first research that studies the impact of Lean bundles implementation in healthcare sector in Jordan. This research also makes a significant contribution for decision makers in healthcare to increase their awareness of Lean bundles.

Visualization and minimization of clustering of micro-pillars and walls due to liquid film evaporation

NASA Astrophysics Data System (ADS)

Kim, Tae-Hong; Kim, Jungchul; Kim, Ho-Young

2013-11-01

The spin drying, in which a rinsing liquid deposited on a wafer is rapidly dried by wafer spinning, is an essential step in the semiconductor manufacturing process. While the liquid evaporates, its meniscus straddles neighboring submicron-size patterns such as pillars and walls. Then the capillary effects that pull the patterns together may lead to direct contact of the patterns, which is often referred to as pattern leaning. This poses a problem becoming more and more serious as the pattern size shrinks and the aspect ratio of the patterns increases. While the clustering behavior of high-aspect-ratio micro- and nanopillars was investigated before, a technical strategy to prevent such clustering has been pursed in industrial practices without being supported by the recently established theory of elastocapillarity. Here we visualize the clustering behavior of polymer micropatterns with the evaporation of liquid film while varying the sizes and temperature of the micropatterns. We find a critical role of substrate temperature in preventing the leaning of the patterns via changing the evaporation rate and behavior of the liquid film. Also, we construct a regime map that guides us to find a process condition to avoid pattern leaning in semiconductor manufacturing. This work was supported by the National Research Foundation of Korea (grant no. 2012-008023).

A Hybrid Fuzzy Model for Lean Product Development Performance Measurement

NASA Astrophysics Data System (ADS)

Osezua Aikhuele, Daniel; Mohd Turan, Faiz

2016-02-01

In the effort for manufacturing companies to meet up with the emerging consumer demands for mass customized products, many are turning to the application of lean in their product development process, and this is gradually moving from being a competitive advantage to a necessity. However, due to lack of clear understanding of the lean performance measurements, many of these companies are unable to implement and fully integrated the lean principle into their product development process. Extensive literature shows that only few studies have focus systematically on the lean product development performance (LPDP) evaluation. In order to fill this gap, the study therefore proposed a novel hybrid model based on Fuzzy Reasoning Approach (FRA), and the extension of Fuzzy-AHP and Fuzzy-TOPSIS methods for the assessment of the LPDP. Unlike the existing methods, the model considers the importance weight of each of the decision makers (Experts) since the performance criteria/attributes are required to be rated, and these experts have different level of expertise. The rating is done using a new fuzzy Likert rating scale (membership-scale) which is designed such that it can address problems resulting from information lost/distortion due to closed-form scaling and the ordinal nature of the existing Likert scale.

Dudrick Research Symposium 2015-Lean Tissue and Protein in Health and Disease.

PubMed

Earthman, Carrie P; Wolfe, Robert R; Heymsfield, Steven B

2017-02-01

The 2015 Dudrick Research Symposium "Lean Tissue and Protein in Health and Disease: Key Targets and Assessment Strategies" was held on February 16, 2015, at Clinical Nutrition Week in Long Beach, California. The Dudrick Symposium honors the many pivotal and innovative contributions to the development and advancement of parenteral nutrition made by Dr Stanley J. Dudrick, physician scientist, academic leader, and a founding member of the American Society for Parenteral and Enteral Nutrition. As the 2014 recipient of the Dudrick award, Dr Carrie Earthman chaired the symposium and was the first of 3 speakers, followed by Dr Robert Wolfe and Dr Steven Heymsfield. The symposium addressed the importance of lean tissue to health and response to disease and injury, as well as the many opportunities and challenges in its assessment at the bedside. Lean tissue assessment is beneficial to clinical care in chronic and acute care clinical settings, given the strong relationship between lean tissue and outcomes, including functional status. Currently available bioimpedance techniques, including the use of bioimpedance parameters, for lean tissue and nutrition status assessment were presented. The connection between protein requirements and lean tissue was discussed, highlighting the maintenance of lean tissue as one of the most important primary end points by which protein requirements can be estimated. The various tracer techniques to establish protein requirements were presented, emphasizing the importance of practical considerations in research protocols aimed to establish protein requirements. Ultrasound and other new and emerging technologies that may be used for lean tissue assessment were discussed, and areas for future research were highlighted.

E3 Success Story - Reducing Electrical Demand in San Antonio, TX

EPA Pesticide Factsheets

To meet its goal of reducing electrical demand by 9 megawatts CPS Energy in San Antonio, TX partnered with the Texas Manufacturing Assistance Center (TMAC) and the Southwest Research Institute to provide lean, clean and energy efficiency training.

Future Software Sizing Metrics and Estimation Challenges

DTIC Science & Technology

2011-07-01

systems 4. Ultrahigh software system assurance 5. Legacy maintenance and Brownfield development 6. Agile and Lean/ Kanban development. This paper...refined as the design of the maintenance modifications or Brownfield re-engineering is determined. VII. 6. AGILE AND LEAN/ KANBAN DEVELOPMENT The...difficulties of software maintenance estimation can often be mitigated by using lean workflow management techniques such as Kanban [25]. In Kanban

Lean premixed/prevaporized combustion

NASA Technical Reports Server (NTRS)

Lefebvre, A. H. (Editor)

1977-01-01

Recommendations were formulated on the status and application of lean premixed/prevaporized combustion to the aircraft gas turbine for the reduction of pollutant emissions. The approach taken by the NASA Stratospheric Cruise Emission Reduction Program (SCERP) in pursuing the lean premixed/prevaporized combustion technique was also discussed. The proceedings contains an overview of the SCERP program, the discussions and recommendations of the participants, and an overall summary.

Understanding waste for lean health information systems: a preliminary review.

PubMed

Kalong, Nadia Awang; Yusof, Maryati Mohd

2013-01-01

Despite the rapid application of the Lean method in healthcare, its study in IT environments, particularly in Health Information Systems (HIS), is still limited primarily by a lack of waste identification. This paper aims to review the literature to provide an insight into the nature of waste in HIS from the perspective of Lean management. Eight waste frameworks within the context of healthcare and information technology were reviewed. Based on the review, it was found that all the seven waste categories from the manufacturing sector also exist in both the healthcare and IT domains. However, the nature of the waste varied depending on the processes of the domains. A number of additional waste categories were also identified. The findings reveal that the traditional waste model can be adapted to identify waste in both the healthcare and IT sectors.

Gas Phase Nanoparticle Synthesis

NASA Astrophysics Data System (ADS)

Granqvist, Claes; Kish, Laszlo; Marlow, William

This book deals with gas-phase nanoparticle synthesis and is intended for researchers and research students in nanomaterials science and engineering, condensed matter physics and chemistry, and aerosol science. Gas-phase nanoparticle synthesis is instrumental to nanotechnology - a field in current focus that raises hopes for environmentally benign, resource-lean manufacturing. Nanoparticles can be produced by many physical, chemical, and even biological routes. Gas-phase synthesis is particularly interesting since one can achieve accurate manufacturing control and hence industrial viability.

Mechanical, thermal and morphological characterization of polycarbonate/oxidized carbon nanofiber composites produced with a lean 2-step manufacturing process.

PubMed

Lively, Brooks; Kumar, Sandeep; Tian, Liu; Li, Bin; Zhong, Wei-Hong

2011-05-01

In this study we report the advantages of a 2-step method that incorporates an additional process pre-conditioning step for rapid and precise blending of the constituents prior to the commonly used melt compounding method for preparing polycarbonate/oxidized carbon nanofiber composites. This additional step (equivalent to a manufacturing cell) involves the formation of a highly concentrated solid nano-nectar of polycarbonate/carbon nanofiber composite using a solution mixing process followed by melt mixing with pure polycarbonate. This combined method yields excellent dispersion and improved mechanical and thermal properties as compared to the 1-step melt mixing method. The test results indicated that inclusion of carbon nanofibers into composites via the 2-step method resulted in dramatically reduced ( 48% lower) coefficient of thermal expansion compared to that of pure polycarbonate and 30% lower than that from the 1-step processing, at the same loading of 1.0 wt%. Improvements were also found in dynamic mechanical analysis and flexural mechanical properties. The 2-step approach is more precise and leads to better dispersion, higher quality, consistency, and improved performance in critical application areas. It is also consistent with Lean Manufacturing principles in which manufacturing cells are linked together using less of the key resources and creates a smoother production flow. Therefore, this 2-step process can be more attractive for industry.

Applied Space Systems Engineering. Chapter 17; Manage Technical Data

NASA Technical Reports Server (NTRS)

Kent, Peter

2008-01-01

Effective space systems engineering (SSE) is conducted in a fully electronic manner. Competitive hardware, software, and system designs are created in a totally digital environment that enables rapid product design and manufacturing cycles, as well as a multitude of techniques such as modeling, simulation, and lean manufacturing that significantly reduce the lifecycle cost of systems. Because the SSE lifecycle depends on the digital environment, managing the enormous volumes of technical data needed to describe, build, deploy, and operate systems is a critical factor in the success of a project. This chapter presents the key aspects of Technical Data Management (TDM) within the SSE process. It is written from the perspective of the System Engineer tasked with establishing the TDM process and infrastructure for a major project. Additional perspectives are reflected from the point of view of the engineers on the project who work within the digital engineering environment established by the TDM toolset and infrastructure, and from the point of view of the contactors who interface via the TDM infrastructure. Table 17.1 lists the TDM process as it relates to SSE.

Lean interventions in healthcare: do they actually work? A systematic literature review.

PubMed

Moraros, John; Lemstra, Mark; Nwankwo, Chijioke

2016-04-01

Lean is a widely used quality improvement methodology initially developed and used in the automotive and manufacturing industries but recently expanded to the healthcare sector. This systematic literature review seeks to independently assess the effect of Lean or Lean interventions on worker and patient satisfaction, health and process outcomes, and financial costs. We conducted a systematic literature review of Medline, PubMed, Cochrane Library, CINAHL, Web of Science, ABI/Inform, ERIC, EMBASE and SCOPUS. Peer reviewed articles were included if they examined a Lean intervention and included quantitative data. Methodological quality was assessed using validated critical appraisal checklists. Publically available data collected by the Saskatchewan Health Quality Council and the Saskatchewan Union of Nurses were also analysed and reported separately. Data on design, methods, interventions and key outcomes were extracted and collated. Our electronic search identified 22 articles that passed methodological quality review. Among the accepted studies, 4 were exclusively concerned with health outcomes, 3 included both health and process outcomes and 15 included process outcomes. Our study found that Lean interventions have: (i) no statistically significant association with patient satisfaction and health outcomes; (ii) a negative association with financial costs and worker satisfaction and (iii) potential, yet inconsistent, benefits on process outcomes like patient flow and safety. While some may strongly believe that Lean interventions lead to quality improvements in healthcare, the evidence to date simply does not support this claim. More rigorous, higher quality and better conducted scientific research is required to definitively ascertain the impact and effectiveness of Lean in healthcare settings. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care.

Lean interventions in healthcare: do they actually work? A systematic literature review

PubMed Central

Moraros, John; Lemstra, Mark; Nwankwo, Chijioke

2016-01-01

Purpose Lean is a widely used quality improvement methodology initially developed and used in the automotive and manufacturing industries but recently expanded to the healthcare sector. This systematic literature review seeks to independently assess the effect of Lean or Lean interventions on worker and patient satisfaction, health and process outcomes, and financial costs. Data sources We conducted a systematic literature review of Medline, PubMed, Cochrane Library, CINAHL, Web of Science, ABI/Inform, ERIC, EMBASE and SCOPUS. Study selection Peer reviewed articles were included if they examined a Lean intervention and included quantitative data. Methodological quality was assessed using validated critical appraisal checklists. Publically available data collected by the Saskatchewan Health Quality Council and the Saskatchewan Union of Nurses were also analysed and reported separately. Data extraction Data on design, methods, interventions and key outcomes were extracted and collated. Results of data synthesis Our electronic search identified 22 articles that passed methodological quality review. Among the accepted studies, 4 were exclusively concerned with health outcomes, 3 included both health and process outcomes and 15 included process outcomes. Our study found that Lean interventions have: (i) no statistically significant association with patient satisfaction and health outcomes; (ii) a negative association with financial costs and worker satisfaction and (iii) potential, yet inconsistent, benefits on process outcomes like patient flow and safety. Conclusion While some may strongly believe that Lean interventions lead to quality improvements in healthcare, the evidence to date simply does not support this claim. More rigorous, higher quality and better conducted scientific research is required to definitively ascertain the impact and effectiveness of Lean in healthcare settings. PMID:26811118

Using Innovative Methodologies From Technology and Manufacturing Companies to Reduce Heart Failure Readmissions.

PubMed

Johnson, Amber E; Winner, Laura; Simmons, Tanya; Eid, Shaker M; Hody, Robert; Sampedro, Angel; Augustine, Sharon; Sylvester, Carol; Parakh, Kapil

2016-05-01

Heart failure (HF) patients have high 30-day readmission rates with high costs and poor quality of life. This study investigated the impact of a framework blending Lean Sigma, design thinking, and Lean Startup on 30-day all-cause readmissions among HF patients. This was a prospective study in an academic hospital in Baltimore, Maryland. Thirty-day all-cause readmission was assessed using the hospital's electronic medical record. The baseline readmission rate for HF was 28.4% in 2010 with 690 discharges. The framework was developed and interventions implemented in the second half of 2011. The impact of the interventions was evaluated through 2012. The rate declined to 18.9% among 703 discharges (P < .01). There was no significant change for non-HF readmissions. This study concluded that methodologies from technology and manufacturing companies can reduce 30-day readmissions in HF, demonstrating the potential of this innovations framework to improve chronic disease care. © The Author(s) 2014.

Microstructural Developments and Tensile Properties of Lean Fe-Mn-Al-C Lightweight Steels

NASA Astrophysics Data System (ADS)

Sohn, S. S.; Lee, S.; Lee, B.-J.; Kwak, J.-H.

2014-09-01

Concepts of Fe-Al-Mn-C-based lightweight steels are fairly simple, but primary metallurgical issues are complicated. In this study, recent studies on lean-composition lightweight steels were reviewed, summarized, and emphasized by their microstructural development and mechanical properties. The lightweight steels containing a low-density element of Al were designed by thermodynamic calculation and were manufactured by conventional industrial processes. Their microstructures consisted of various secondary phases as κ-carbide, martensite, and austenite in the ferrite matrix according to manufacturing and annealing procedures. The solidification microstructure containing segregations of C, Mn, and Al produced a banded structure during the hot rolling. The (ferrite + austenite) duplex microstructure was formed after the annealing, and the austenite was retained at room temperature. It was because the thermal stability of austenite nucleated from fine κ-carbide was quite high due to fine grain size of austenite. Because these lightweight steels have outstanding properties of strength and ductility as well as reduced density, they give a promise for automotive applications requiring excellent properties.

Elimination of waste: creation of a successful Lean colonoscopy program at an academic medical center.

PubMed

Damle, Aneel; Andrew, Nathan; Kaur, Shubjeet; Orquiola, Alan; Alavi, Karim; Steele, Scott R; Maykel, Justin

2016-07-01

Lean processes involve streamlining methods and maximizing efficiency. Well established in the manufacturing industry, they are increasingly being applied to health care. The objective of this study was to determine feasibility and effectiveness of applying Lean principles to an academic medical center colonoscopy unit. Lean process improvement involved training endoscopy personnel, observing patients, mapping the value stream, analyzing patient flow, designing and implementing new processes, and finally re-observing the process. Our primary endpoint was total colonoscopy time (minutes from check-in to discharge) with secondary endpoints of individual segment times and unit colonoscopy capacity. A total of 217 patients were included (November 2013-May 2014), with 107 pre-Lean and 110 post-Lean intervention. Pre-Lean total colonoscopy time was 134 min. After implementation of the Lean process, mean colonoscopy time decreased by 10 % to 121 min (p = 0.01). The three steps of the process affected by the Lean intervention (time to achieve adequate sedation, time to recovery, and time to discharge) decreased from 3.7 to 2.4 min (p < 0.01), 4.0 to 3.4 min (p = 0.09), and 41.2 to 35.4 min (p = 0.05), respectively. Overall, unit capacity of colonoscopies increased from 39.6 per day to 43.6. Post-Lean patient satisfaction surveys demonstrated an average score of 4.5/5.0 (n = 73) regarding waiting time, 4.9/5.0 (n = 60) regarding how favorably this experienced compared to prior colonoscopy experiences, and 4.9/5.0 (n = 74) regarding professionalism of staff. One hundred percentage of respondents (n = 69) stated they would recommend our institution to a friend for colonoscopy. With no additional utilization of resources, a single Lean process improvement cycle increased productivity and capacity of our colonoscopy unit. We expect this to result in increased patient access and revenue while maintaining patient satisfaction. We believe these results are widely generalizable to other colonoscopy units as well as other process-based interventions in health care.

Experimenting `learn by doing' and `learn by failing'

NASA Astrophysics Data System (ADS)

Pozzi, Rossella; Noè, Carlo; Rossi, Tommaso

2015-01-01

According to the literature, in recent years, developing experiential learning has fulfilled the requirement of a deep understanding of lean philosophy by engineering students, demonstrating the advantages and disadvantages of some of the key principles of lean manufacturing. On the other hand, the literature evidences how some kinds of game-based experiential learning overlook daily difficulties, which play a central role in manufacturing systems. To fill the need of a game overcoming such lack of vision, an innovative game direct in-field, named Kart Factory, has been developed. Actual production shifts are simulated, while keeping all the elements peculiar to a real production set (i.e. complexity, effort, safety). The working environment is a real pedal car assembly department, the products to be assembled have relevant size and weight (i.e. up to 35 kg approximately), and the provided tools are real production equipment (e.g. keys, screwdrivers, trans-pallets, etc.). Due to the need to maximise the impact on students, a labour-intensive process characterises the production department. The whole training process is based on three educational principles: Experience Value Principle, Error Value Principle, and Team Value Principle. As the 'learn by doing' and 'learn by failing' are favoured, the theory follows the practice, while crating the willingness to 'do' instead of just designing or planning. The gathered data prove the Kart Factory's effectiveness in reaching a good knowledge of lean concepts, notwithstanding the students' initial knowledge level.

E3 Success Story - San Antonio E3 Case Study: UEMC “Now Hiring”

EPA Pesticide Factsheets

exas Manufacturing Assistance Center conducted an E3 assessment as part of the local Lean-Clean-Energy program in October of 2009. Overall, UEMC has reduced demand by approximately 30kw and reduced consumption by over 100,000 kwh/year.

Quality initiatives: lean approach to improving performance and efficiency in a radiology department.

PubMed

Kruskal, Jonathan B; Reedy, Allen; Pascal, Laurie; Rosen, Max P; Boiselle, Phillip M

2012-01-01

Many hospital radiology departments are adopting "lean" methods developed in automobile manufacturing to improve operational efficiency, eliminate waste, and optimize the value of their services. The lean approach, which emphasizes process analysis, has particular relevance to radiology departments, which depend on a smooth flow of patients and uninterrupted equipment function for efficient operation. However, the application of lean methods to isolated problems is not likely to improve overall efficiency or to produce a sustained improvement. Instead, the authors recommend a gradual but continuous and comprehensive "lean transformation" of work philosophy and workplace culture. Fundamental principles that must consistently be put into action to achieve such a transformation include equal involvement of and equal respect for all staff members, elimination of waste, standardization of work processes, improvement of flow in all processes, use of visual cues to communicate and inform, and use of specific tools to perform targeted data collection and analysis and to implement and guide change. Many categories of lean tools are available to facilitate these tasks: value stream mapping for visualizing the current state of a process and identifying activities that add no value; root cause analysis for determining the fundamental cause of a problem; team charters for planning, guiding, and communicating about change in a specific process; management dashboards for monitoring real-time developments; and a balanced scorecard for strategic oversight and planning in the areas of finance, customer service, internal operations, and staff development. © RSNA, 2012.

TQM and lean strategy deployment in Italian hospitals.

PubMed

Chiarini, Andrea; Baccarani, Claudio

2016-10-03

Purpose This paper aims to contribute to the debate concerning total quality management (TQM)-Lean strategy in public healthcare by analyzing the deployment path for implementation, the possible benefits that can be achieved and the encountered pitfalls. Design/methodology/approach Three case studies are drawn from three large Italian hospitals with more than 500 beds each and structured with many departments. The hospitals are located in Tuscany, Italy. These three hospitals have embraced TQM and Lean, starting from strategic objectives and their deployment. At the same time, they have also implemented many TQM-Lean tools. The case studies are based on interviews held with four managers in each of these three public hospitals. Findings Results from the interviews show that there is a specific deployment path for TQM-Lean implementation. The hospitals have also achieved benefits linked to patient satisfaction and improved organizational performances. Problems related to organizational and cultural issues, such as senior managers' commitment, staff management, manufacturing culture and tools adaptation, could affect the benefits. Research limitations/implications The research has been carried out in just three Italian public hospitals. Hence, similar investigations could be managed in other countries. Researchers could also use a larger sample and investigate these issues by means of quantitative inquiry. Practical implications Practitioners could try to apply the deployment path revealed by these case studies in other public and private hospitals. Originality/value The results of this research show that there is a specific, new deployment path for implementing TQM-Lean strategy in some public hospitals.

Consumer Perception of Retail Pork Bacon Attributes Using Adaptive Choice-based Conjoint Analysis and Maximum Differential Scaling.

PubMed

McLean, K G; Hanson, D J; Jervis, S M; Drake, M A

2017-11-01

Bacon is one of the most recognizable consumer pork products and is differentiated by appearance, flavor, thickness, and several possible product claims. The objective of this study was to explore the attributes of retail bacon that influence consumers to purchase and consume bacon. An Adaptive Choice-Based Conjoint (ACBC) survey was designed for attributes of raw American-style bacon. An ACBC survey (N = 1410 consumers) and Kano questioning were applied to determine the key attributes that influenced consumer purchase. Attributes included package size, brand, thickness, label claims, flavor, price, and images of the bacon package displaying fat:lean ratio. Maximum Difference Scaling (MaxDiff) was used to rank appeal of 20 different bacon images with variable fat:lean ration and slice shape. The most important attribute for bacon purchase was price followed by fat:lean appearance and then flavor. Three consumer clusters were identified with distinct preferences. For 2 clusters, price was not the primary attribute. Understanding preferences of distinct consumer clusters will enable manufacturers to target consumers and make more appealing bacon. Adaptive Choice-Based Conjoint (ACBC) is a research technique that allows consumers to react to assembled products and identify product attributes that they prefer. Kano questions allow researchers to look at the individual aspects of a product and understand consumer sentiment and expectations towards those product qualities while Maximum Difference scaling allows consumers to directly rank single attributes of a product relative to one another. A combination of these 3 approaches can provide key understandings on consumer perception of retail bacon allowing companies to optimize and maximize their development and advertising resources. © 2017 Institute of Food Technologists®.

The use of Lean and Six Sigma methodologies in surgery: a systematic review.

PubMed

Mason, S E; Nicolay, C R; Darzi, A

2015-04-01

Lean and Six Sigma are improvement methodologies developed in the manufacturing industry and have been applied to healthcare settings since the 1990 s. They use a systematic and reproducible approach to provide Quality Improvement (QI), with a flexible process that can be applied to a range of outcomes across different patient groups. This review assesses the literature with regard to the use and utility of Lean and Six Sigma methodologies in surgery. MEDLINE, Embase, PsycINFO, Allied and Complementary Medicine Database, British Nursing Index, Cumulative Index to Nursing and Allied Health Literature, Health Business Elite and the Health Management Information Consortium were searched in January 2014. Experimental studies were included if they assessed the use of Lean or Six Sigma on the ability to improve specified outcomes in surgical patients. Of the 124 studies returned, 23 were suitable for inclusion with 11 assessing Lean, 6 Six Sigma and 6 Lean Six Sigma. The broad range of outcomes can be collated into six common aims: to optimise outpatient efficiency, to improve operating theatre efficiency, to decrease operative complications, to reduce ward-based harms, to reduce mortality and to limit unnecessary cost and length of stay. The majority of studies (88%) demonstrate improvement; however high levels of systematic bias and imprecision were evident. Lean and Six Sigma QI methodologies have the potential to produce clinically significant improvement for surgical patients. However there is a need to conduct high-quality studies with low risk of systematic bias in order to further understand their role. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Body composition of collegiate football players: bioelectrical impedance and skinfolds compared to hydrostatic weighing.

PubMed

Oppliger, R A; Nielsen, D H; Shetler, A C; Crowley, E T; Albright, J P

1992-01-01

The need for simple, valid techniques of body composition assessment among athletes is a growing concern of the physical therapist. This paper reports on several common methods applied to university football players. Body composition analysis was conducted on 28 Division IA football players using three different bioelectrical impedance analysis (BIA) systems, skinfolds (SF), and hydrostatic weighing (HYDRO). Correlations for all methods with HYDRO were high (>.88), but BIA significantly overpredicted body fatness. In contrast, three SF equations showed small differences with HYDRO and reasonable measurement error. Clinicians should exercise caution when using BIA based on the existing manufacturers' equations with athletic populations. Adjustments to BIA regression equations by including modifying or anthropometric variables could enhance the predictive accuracy of these methods with lean, athletic males. J Orthop Sports Phys Ther 1992;15(4):187-192.

Axiomatic Design of a Framework for the Comprehensive Optimization of Patient Flows in Hospitals

PubMed Central

Matt, Dominik T.

2017-01-01

Lean Management and Six Sigma are nowadays applied not only to the manufacturing industry but also to service industry and public administration. The manifold variables affecting the Health Care system minimize the effect of a narrow Lean intervention. Therefore, this paper aims to discuss a comprehensive, system-based approach to achieve a factual holistic optimization of patient flows. This paper debates the efficacy of Lean principles applied to the optimization of patient flows and related activities, structures, and resources, developing a theoretical framework based on the principles of the Axiomatic Design. The demand for patient-oriented and efficient health services leads to use these methodologies to improve hospital processes. In the framework, patients with similar characteristics are clustered in families to achieve homogeneous flows through the value stream. An optimization checklist is outlined as the result of the mapping between Functional Requirements and Design Parameters, with the right sequence of the steps to optimize the patient flow according to the principles of Axiomatic Design. The Axiomatic Design-based top-down implementation of Health Care evidence, according to Lean principles, results in a holistic optimization of hospital patient flows, by reducing the complexity of the system. PMID:29065578

Axiomatic Design of a Framework for the Comprehensive Optimization of Patient Flows in Hospitals.

PubMed

Arcidiacono, Gabriele; Matt, Dominik T; Rauch, Erwin

2017-01-01

Lean Management and Six Sigma are nowadays applied not only to the manufacturing industry but also to service industry and public administration. The manifold variables affecting the Health Care system minimize the effect of a narrow Lean intervention. Therefore, this paper aims to discuss a comprehensive, system-based approach to achieve a factual holistic optimization of patient flows. This paper debates the efficacy of Lean principles applied to the optimization of patient flows and related activities, structures, and resources, developing a theoretical framework based on the principles of the Axiomatic Design. The demand for patient-oriented and efficient health services leads to use these methodologies to improve hospital processes. In the framework, patients with similar characteristics are clustered in families to achieve homogeneous flows through the value stream. An optimization checklist is outlined as the result of the mapping between Functional Requirements and Design Parameters, with the right sequence of the steps to optimize the patient flow according to the principles of Axiomatic Design. The Axiomatic Design-based top-down implementation of Health Care evidence, according to Lean principles, results in a holistic optimization of hospital patient flows, by reducing the complexity of the system.

Lean production and work-related musculoskeletal disorders: overviews of international and Swedish studies.

PubMed

Brännmark, Mikael; Håkansson, Malin

2012-01-01

This paper aimed at summarizing the knowledge of the relationship between Lean and work related musculoskeletal disorders (WMSD), and WMSD risk factors, in manufacturing companies. Literature search processes identified 23 publications studying this, in scientific journals. Eight included measurements of WMSD; three were mostly negative, two showed mixed results, one showed no results and two were mostly positive. Eighteen publications included measurements of WMSD risk factors; seven showed mostly negative results, eight showed mixed results, two showed mostly positive results and one was inconclusive. Three literature reviews were identified, which studied this question; two were mostly negative, while the third was inconclusive. Also, 12 publications of grey literature studying Lean and WMSD risk factors in Swedish organizations were identified; nine showed mixed results, two showed mostly positive results and one showed mostly negative results. Due to the varying quality and study design of the publications, together with the few identified studies, it is difficult to compare them. The context and the implementation also likely affect the results. The general conclusion was that a Lean implementation may increase the risk of WMSD and risk factors for WMSD, if it is not accompanied with an ergonomic intervention.

Axiomatic Design of a Framework for the Comprehensive Optimization of Patient Flows in Hospitals

PubMed

Arcidiacono, Gabriele; Matt, Dominik T.; Rauch, Erwin

2017-01-01

Lean Management and Six Sigma are nowadays applied not only to the manufacturing industry but also to service industry and public administration. The manifold variables affecting the Health Care system minimize the effect of a narrow Lean intervention. Therefore, this paper aims to discuss a comprehensive, system-based approach to achieve a factual holistic optimization of patient flows. This paper debates the efficacy of Lean principles applied to the optimization of patient flows and related activities, structures, and resources, developing a theoretical framework based on the principles of the Axiomatic Design. The demand for patient-oriented and efficient health services leads to use these methodologies to improve hospital processes. In the framework, patients with similar characteristics are clustered in families to achieve homogeneous flows through the value stream. An optimization checklist is outlined as the result of the mapping between Functional Requirements and Design Parameters, with the right sequence of the steps to optimize the patient flow according to the principles of Axiomatic Design. The Axiomatic Design-based top-down implementation of Health Care evidence, according to Lean principles, results in a holistic optimization of hospital patient flows, by reducing the complexity of the system. © 2017 Gabriele Arcidiacono et al.

Lean NOx catalysis for gasoline fueled European cars

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1997-02-01

There is increasing interest in operating gasoline fueled passenger cars lean of the stoichiometric air/fuel (A/F) ratio to improve fuel economy. These types of engines will operate at lean A/F ratios while cruising at partial load, and return to stoichiometric or even rich conditions when more power is required. The challenge for the engine and catalyst manufacturer is to develop a system which will combine the high activity rates of a state-of-the-art three-way catalyst (TWC) with the ability to reduce nitrogen oxides (NOx) in the presence of excess oxygen. The objective is to achieve the future legislative limits (EURO III/IV)more » in the European Union. Recent developments in automotive pollution control catalysis show that the use of NOx adsorption materials is a suitable way to reduce NOx emissions of gasoline-fueled lean-burn engines. However, the primary task for the implementation of this technology in the European market will be to improve the catalyst`s high-temperature stability and to decrease its susceptibility to sulfur poisoning. Outlined here are results of a recent R and D program to achieve NOx reduction under lean-burn gasoline engine conditions. Model gas test results as well as engine bench data are used for discussion of the parameters which control NOx adsorption efficiency under various conditions.« less

Evaluation de l'effet des concepts de la production allegee dans une entreprise aeronautique

NASA Astrophysics Data System (ADS)

Moknine, Myriam

This research focuses on a project to implement a Lean approach in Quebec's aerospace business, that of Bombardier Aerospace. Developed for the automobile industry since the 1950s, the Lean has expanded its practices to various industry sectors, including the international aircraft industry, and more specifically the Quebec aircraft industry. Today, numerous companies turn more and more to the Lean Manufacturing approach to improve their competitiveness and their performance levels. The review of the literature on the Lean has allowed us to further understand the topic and more specifically its application in the aerospace sector. The Lean approach allows the improvement of operational performance indicators such as the reduction of production costs, cycle times, travel and inventories, as well as the improvement of the versatility of employees. The Lean has succeeded where many other organisational models have failed. Several success factors such as employee involvement, leadership commitment, proper integration of all tools and many others must be used in the implementation of such production practice. However, this approach is sometimes criticized by some authors who suggest that the improvements made by the Lean result in an increase in the workload of employees and a deterioration of their stress levels. Our research on the Lean has revealed gaps in available and existing research and data on the subject, particularly in the aerospace sector. This research has helped to fill this important gap, by documenting the context and highlighting the impact of the Lean on a production system in the Quebec aerospace components. A machining center having deployed a Lean approach was chosen to conduct a case study in post-implantation. Tools for data collection such as observations on the production floor, semi-structured interviews, as well as the Lean checklist, were used to perform this case study. The case study has confirmed the positive impact of Lean on operational performance indicators of the company. The results of this case study showed a reduction of cycle time of 49%, a reduction of unnecessary employee travels of 50% and a reduction of production costs by about 50%. In addition to these positive discoveries, our study has highlighted an important human benefit in the business such as an improvement in the versatility of employees by 25%. In addition, the study also demonstrated that the integration and assimilation of the Lean concepts is made with a proven success. Indeed, analysis on results from the checklist showed that the level of Lean concepts maturity progressed favorably in the period from pre-project until that in post-project. This research brings an added value to the scientific literature. It thus helps to disseminate data in a Lean implementation in a production area of Quebec aerospace products.

Developing a performance data suite to facilitate lean improvement in a chemotherapy day unit.

PubMed

Lingaratnam, Senthil; Murray, Danielle; Carle, Amber; Kirsa, Sue W; Paterson, Rebecca; Rischin, Danny

2013-07-01

A multidisciplinary team from the Peter MacCallum Cancer Centre in Melbourne, Australia, developed a performance data suite to support a service improvement project based on lean manufacturing principles in its 19-chair chemotherapy day unit (CDU) and cytosuite chemotherapy production facility. The aims of the project were to reduce patient wait time and improve equity of access to the CDU. A project team consisting of a pharmacist and CDU nurse supported the management team for 10 months in engaging staff and customers to identify waste in processes, analyze root causes, eliminate non-value-adding steps, reduce variation, and level workloads to improve quality and flow. Process mapping, staff and patient tracking and opinion surveys, medical record audits, and interrogation of electronic treatment records were undertaken. This project delivered a 38% reduction in median wait time on the day (from 32 to 20 minutes; P < .01), 7-day reduction in time to commencement of treatment for patients receiving combined chemoradiotherapy regimens (from 25 to 18 days; P < .01), and 22% reduction in wastage associated with expired drug and pharmacy rework (from 29% to 7%; P < .01). Improvements in efficiency enabled the cytosuite to increase the percentage of product manufactured within 10 minutes of appointment times by 29% (from 47% to 76%; P < .01). A lean improvement methodology provided a robust framework for improved understanding and management of complex system constraints within a CDU, resulting in improved access to treatment and reduced waiting times on the day.

The positive impact of simultaneous implementation of the BD FocalPoint GS Imaging System and lean principles on the operation of gynecologic cytology.

PubMed

Wong, Rebecca; Levi, Angelique W; Harigopal, Malini; Schofield, Kevin; Chhieng, David C

2012-02-01

Our cytology laboratory, like many others, is under pressure to improve quality and provide test results faster while decreasing costs. We sought to address these issues by introducing new technology and lean principles. To determine the combined impact of the FocalPoint Guided Screener (GS) Imaging System (BD Diagnostics-TriPath, Burlington, North Carolina) and lean manufacturing principles on the turnaround time (TAT) and productivity of the gynecologic cytology operation. We established a baseline measure of the TAT for Papanicolaou tests. We then compared that to the performance after implementing the FocalPoint GS Imaging System and lean principles. The latter included value-stream mapping, workflow modification, and a first in-first out policy. The mean (SD) TAT for Papanicolaou tests before and after the implementation of FocalPoint GS Imaging System and lean principles was 4.38 (1.28) days and 3.20 (1.32) days, respectively. This represented a 27% improvement in the average TAT, which was statistically significant (P < .001). In addition, the productivity of staff improved 17%, as evidenced by the increase in slides screened from 8.85/h to 10.38/h. The false-negative fraction decreased from 1.4% to 0.9%, representing a 36% improvement. In our laboratory, the implementation of FocalPoint GS Imaging System in conjunction with lean principles resulted in a significant decrease in the average TAT for Papanicolaou tests and a substantial increase in the productivity of cytotechnologists while maintaining the diagnostic quality of gynecologic cytology.

Lean methodology improves efficiency in outpatient academic uro-oncology clinics.

PubMed

Skeldon, Sean C; Simmons, Andrea; Hersey, Karen; Finelli, Antonio; Jewett, Michael A; Zlotta, Alexandre R; Fleshner, Neil E

2014-05-01

To determine if lean methodology, an industrial engineering tool developed to optimize manufacturing efficiency, can successfully be applied to improve efficiencies and quality of care in a hospital-based high-volume uro-oncology clinic. Before the lean initiative, baseline data were collected on patient volumes, wait times, cycle times (patient arrival to discharge), nursing assessment time, patient teaching, and physician ergonomics (via spaghetti diagram). Value stream analysis and a rapid improvement event were carried out, and significant changes were made to patient check-in, work areas, and nursing face time. Follow-up data were obtained at 30, 60, and 90 days. The Student t test was used for analysis to compare performance metrics with baseline. The median cycle time before the lean initiative was 46 minutes. This remained stable at 46 minutes at 30 days but improved to 35 minutes at 60 days and 41 minutes at 90 days. Shorter wait times allowed for increased nursing and physician face time. The average length of the physician assessment increased from 7.5 minutes at baseline to 10.6 minutes at 90 days. The average proportion of value-added time compared with the entire clinic visit increased from 30.6% at baseline to 66.3% at 90 days. Using lean methodology, we were able to shorten the patient cycle time and the time to initial assessment as well as integrate both an initial registered nurse assessment and registered nurse teaching to each visit. Lean methodology can effectively be applied to improve efficiency and patient care in an academic outpatient uro-oncology clinic setting. Copyright © 2014 Elsevier Inc. All rights reserved.

Improvement of laboratory turnaround time using lean methodology.

PubMed

Gupta, Shradha; Kapil, Sahil; Sharma, Monica

2018-05-14

Purpose The purpose of this paper is to discuss the implementation of lean methodology to reduce the turnaround time (TAT) of a clinical laboratory in a super speciality hospital. Delays in report delivery lead to delayed diagnosis increased waiting time and decreased customer satisfaction. The reduction in TAT will lead to increased patient satisfaction, quality of care, employee satisfaction and ultimately the hospital's revenue. Design/methodology/approach The generic causes resulting in increasing TAT of clinical laboratories were identified using lean tools and techniques such as value stream mapping (VSM), Gemba, Pareto Analysis and Root Cause Analysis. VSM was used as a tool to analyze the current state of the process and further VSM was used to design the future state with suggestions for process improvements. Findings This study identified 12 major non-value added factors for the hematology laboratory and 5 major non-value added factors for the biochemistry lab which were acting as bottlenecks resulting in limiting throughput. A four-month research study by the authors together with hospital quality department and laboratory staff members led to reduction of the average TAT from 180 to 95minutes in the hematology lab and from 268 to 208 minutes in the biochemistry lab. Practical implications Very few improvement initiatives in Indian healthcare are based on industrial engineering tools and techniques, which might be due to a lack of interaction between healthcare and engineering. The study provides a positive outcome in terms of improving the efficiency of services in hospitals and identifies a scope for lean in the Indian healthcare sector. Social implications Applying lean in the Indian healthcare sector gives its own potential solution to the problem caused, due to a wide gap between lean accessibility and lean implementation. Lean helped in changing the mindset of an organization toward providing the highest quality of services with faster delivery at an optimal cost. Originality/value This paper is an effort to reduce the gap between healthcare and industrial engineering and enhancing the use of lean practices in Indian healthcare. The study is motivated toward implementing lean methodology successfully in services.

You say "lean finely textured beef," I say "pink slime".

PubMed

Reid, Rita-Marie Cain

2014-01-01

In 2012, American Broadcasting Companies, Inc. (ABC) broadcast a segment on its evening news show regarding the manufacture of "lean finely textured beef" by Beef Products, Inc. (BPI). The broadcast, as well as follow-up reports and social media communications, repeatedly referred to the product as "pink slime," a term originated by a United States Department of Agriculture (USDA) employee for the processed meat. The market backlash against the product was immediate and intense. Ultimately, BPI closed three processing plants, cut hundreds of jobs, and filed for bankruptcy. BPI sued ABC and others for food libel, defamation, and tortious interference. This research analyzes those claims and defenses and discusses the future of such cases.

An Exploratory Investigation of Teaching Innovations and Learning Factors in a Lean Manufacturing Systems Engineering Course

ERIC Educational Resources Information Center

Choomlucksana, Juthamas; Doolen, Toni L.

2017-01-01

The use of collaborative activities and simulation sessions in engineering education has been explored previously. However, few studies have investigated the relationship of these types of teaching innovations with other learner characteristics, such as self-efficacy and background knowledge. This study explored the effects of collaborative…

Lean Six Sigma Implementation for Military Logistics to Improve Readiness

DTIC Science & Technology

2007-04-30

mistake-proofing ( poka - yoke ). Lean, as a management philosophy, is also very focused on creating a better workplace through the Toyota principle...Techniques • Pull System • Visual Control • Mistake proofing ( poka yoke ) • Equipment Changeover 37 Pull System • Issuance of an RFI engine would “trigger

Numerical Study of Low Emission Gas Turbine Combustor Concepts

NASA Technical Reports Server (NTRS)

Yang, Song-Lin

2002-01-01

To further reduce pollutant emissions, such as CO, NO(x), UHCs, etc., in the next few decades, innovative concepts of gas turbine combustors must be developed. Several concepts, such as the LIPP (Lean- Premixed- Prevaporized), RQL (Rich-Burn Quick-Quench Lean-Burn), and LDI (Lean-Direct-Injection), have been under study for many years. To fully realize the potential of these concepts, several improvements, such as inlet geometry, air swirler, aerothermochemistry control, fuel preparation, fuel injection and injector design, etc., must be made, which can be studied through the experimental method and/or the numerical technique. The purpose of this proposal is to use the CFD technique to study, and hence, to guide the design process for low emission gas turbine combustors. A total of 13 technical papers have been (or will be) published.

Car Assembly Line Efficiency Improvement by Lean Principle

NASA Astrophysics Data System (ADS)

Sawassalung, Suwalee; Chutima, Parames

2017-06-01

This research aimed to increase the efficiency of actual working time to compare to design standard time ratio (DSTR) as per analysing process of Lean System of the assembly line in a car manufacturer in Thailand. Currently, the case study factory and its group of factories, which have many branches all over the world, have competed with each other on quality, delivered time and production cost. The production cost which can reduce without affecting quality and acceptable by clients is the manpower cost. The index of competition is DSTR. The factory now has DSTR of 6.13 and DSTR of the assembly department is 4.24 which is very high comparing to other departments. The low DSTR indicates that the factory has good quality. The ways to solve the problem are to apply the following tools, i.e. Lean principle, Value Stream Mapping (VSM), Waste Analysis and ECRS. After implementing the above tools, the results showed that DSTR decreased from 4.24 to 4.06 or 4.25%.

Lean methodology in health care.

PubMed

Kimsey, Diane B

2010-07-01

Lean production is a process management philosophy that examines organizational processes from a customer perspective with the goal of limiting the use of resources to those processes that create value for the end customer. Lean manufacturing emphasizes increasing efficiency, decreasing waste, and using methods to decide what matters rather than accepting preexisting practices. A rapid improvement team at Lehigh Valley Health Network, Allentown, Pennsylvania, implemented a plan, do, check, act cycle to determine problems in the central sterile processing department, test solutions, and document improved processes. By using A3 thinking, a consensus building process that graphically depicts the current state, the target state, and the gaps between the two, the team worked to improve efficiency and safety, and to decrease costs. Use of this methodology has increased teamwork, created user-friendly work areas and processes, changed management styles and expectations, increased staff empowerment and involvement, and streamlined the supply chain within the perioperative area. Copyright (c) 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

A waste walk through clinical pharmacy: how do the 'seven wastes' of Lean techniques apply to the practice of clinical pharmacists.

PubMed

Green, Christopher F; Crawford, Victoria; Bresnen, Gaynor; Rowe, Philip H

2015-02-01

This study used a 'Lean' technique, the 'waste walk' to evaluate the activities of clinical pharmacists with reference to the seven wastes described in 'Lean' including 'defects', 'unnecessary motion', 'overproduction', 'transport of products or material', 'unnecessary waiting', 'unnecessary inventory' and 'inappropriate processing'. The objectives of the study were to categorise the activities of ward-based clinical pharmacists into waste and non-waste, provide detail around what constitutes waste activity and quantify the proportion of time attributed to each category. This study was carried out in a district general hospital in the North West of England. Staff were observed using work-sampling techniques, to categorise activity into waste and non-waste, with waste activities being allocated to each of the seven wastes described earlier and subdivided into recurrent themes. Twenty different pharmacists were observed for 1 h on two separate occasions. Of 1440 observations, 342 (23.8%) were categorised as waste with 'defects' and 'unnecessary motion' accounting for the largest proportions of waste activity. Observation of clinical pharmacists' activities has identified that a significant proportion of their time could be categorised as 'waste'. There are practical steps that could be implemented in order to ensure their time is used as productively as possible. Given the challenges facing the UK National Health Service, the adoption of 'Lean' techniques provides an opportunity to improve quality and productivity while reducing costs. © 2014 Royal Pharmaceutical Society.

Optical diagnostics in gas turbine combustors

NASA Astrophysics Data System (ADS)

Woodruff, Steven D.

1999-01-01

Deregulation of the power industry and increasingly tight emission controls are pushing gas turbine manufacturers to develop engines operating at high pressure for efficiency and lean fuel mixtures to control NOx. This combination also gives rise to combustion instabilities which threaten engine integrity through acoustic pressure oscillations and flashback. High speed imaging and OH emission sensors have been demonstrated to be invaluable tools in characterizing and monitoring unstable combustion processes. Asynchronous imaging technique permit detailed viewing of cyclic flame structure in an acoustic environment which may be modeled or utilized in burner design . The response of the flame front to the acoustic pressure cycle may be tracked with an OH emission monitor using a sapphire light pipe for optical access. The OH optical emission can be correlated to pressure sensor data for better understanding of the acoustical coupling of the flame. Active control f the combustion cycle can be implemented using an OH emission sensor for feedback.

From Toyota to the bedside: nurses can lead the lean way in health care reform.

PubMed

Johnson, Joyce E; Smith, Amy L; Mastro, Kari A

2012-01-01

The advent of health care reform means new pressures on American hospitals, which will be forced to do more with less. In the next decade, increased use of "Lean" principles and practices in hospitals can create real value by reducing waste and improving productivity, costs, quality, and the timely delivery of patient care services. In 2010, the Institute of Medicine recommended that nurses lead collaborative quality improvement efforts and assume a major role in redesigning health care in the United States. In this article, we provide an overview of the use of Lean techniques in health care and 2 case studies of successful, nurse-directed Lean initiatives at the Robert Wood Johnson University Hospital. The article concludes with some lessons we have learned and implications for nursing education in the future that must include the concepts, tools, and skills required for adapting Lean to the patient care environment.

Feasibility study for converting traditional line assembly into work cells for termination of fiber optics cable

NASA Astrophysics Data System (ADS)

Caldeira, Rylan; Honnungar, Sunilkumar

2018-04-01

Most of small to medium industries tend to follow traditional systems of manufacturing which aims at maximum resource utilization irrespective of giving attention to customers volatile demand. In recent times manufacturing is being shifted to be consumers centered, with intense competition among industries to satisfy the customer needs in the required quantity and at the right time. To achieve this, companies investigate the possibility of implementation of cellular manufacturing which is characterized by high variety with optimum usage of resources. Cellular layout coupled with the application of lean methodology, places focus on the production process rather than the production methods so as to identify the wastage and apply methods to further improve productivity.

Proposal for a Conceptual Model for Evaluating Lean Product Development Performance: A Study of LPD Enablers in Manufacturing Companies

NASA Astrophysics Data System (ADS)

Osezua Aikhuele, Daniel; Mohd Turan, Faiz

2016-02-01

The instability in today's market and the emerging demands for mass customized products by customers, are driving companies to seek for cost effective and time efficient improvements in their production system and this have led to real pressure for the adaptation of new developmental architecture and operational parameters to remain competitive in the market. Among such developmental architecture adopted, is the integration of lean thinking in the product development process. However, due to lack of clear understanding of the lean performance and its measurements, many companies are unable to implement and fully integrate the lean principle into their product development process and without a proper performance measurement, the performance level of the organizational value stream will be unknown and the specific area of improvement as it relates to the LPD program cannot be tracked. Hence, it will result in poor decision making in the LPD implementation. This paper therefore seeks to present a conceptual model for evaluation of LPD performances by identifying and analysing the core existing LPD enabler (Chief Engineer, Cross-functional teams, Set-based engineering, Poka-yoke (mistakeproofing), Knowledge-based environment, Value-focused planning and development, Top management support, Technology, Supplier integration, Workforce commitment and Continuous improvement culture) for assessing the LPD performance.

Stratospheric cruise emission reduction program

NASA Technical Reports Server (NTRS)

Diehl, L. A.; Reck, G. M.; Marek, C. J.; Szaniszlo, A. J.

1977-01-01

A recently implemented NASA effort specifically aimed at reducing cruise oxides of nitrogen from high-altitude aircraft is discussed. The desired emission levels and the combustor technology required to achieve them are discussed. A brief overview of the SCERP operating plan is given. Lean premixed-prevaporized combustion and some of the potential difficulties that are associated with applying this technique to gas turbine combustors are examined. Base technology was developed in several key areas. These fundamental studies are viewed as a requirement for successful implementation of the lean premixed combustion technique.

Implementing a Lean Management System in Primary Care: Facilitators and Barriers From the Front Lines.

PubMed

Hung, Dorothy; Martinez, Meghan; Yakir, Maayan; Gray, Caroline

2015-01-01

Although Lean management techniques are increasingly used in health care to improve quality and reduce costs, lessons about how to successfully implement this approach on the front lines of care delivery are not well documented. In this study, we highlight key facilitators and barriers to implementing Lean among frontline primary care providers. This case study took place at a large, ambulatory care delivery system serving nearly 1 million patients. In-depth interviews were conducted with primary care physicians, staff, and administrators to identify key factors impacting Lean redesigns in primary care. Overall, staff engagement and performance management, sensitivity to the professional values and culture of medicine, and perceived adequacy of organizational resources were critical when introducing Lean changes. Specific drivers of change included empowerment of staff at all levels, visual display of performance metrics, and a culture of innovation and collaboration. Barriers included physician resistance to standardized work, difficulty transferring management responsibilities to non-physician staff, and time and staffing required for participating in improvement efforts. Although Lean offers a new approach to delivering care, the implementation process itself is both complex and crucial to success. Understanding early facilitators and barriers can maximize Lean's, potential to improve health care delivery.

Developing a Performance Data Suite to Facilitate Lean Improvement in a Chemotherapy Day Unit

PubMed Central

Lingaratnam, Senthil; Murray, Danielle; Carle, Amber; Kirsa, Sue W.; Paterson, Rebecca; Rischin, Danny

2013-01-01

Purpose: A multidisciplinary team from the Peter MacCallum Cancer Centre in Melbourne, Australia, developed a performance data suite to support a service improvement project based on lean manufacturing principles in its 19-chair chemotherapy day unit (CDU) and cytosuite chemotherapy production facility. The aims of the project were to reduce patient wait time and improve equity of access to the CDU. Methods: A project team consisting of a pharmacist and CDU nurse supported the management team for 10 months in engaging staff and customers to identify waste in processes, analyze root causes, eliminate non–value-adding steps, reduce variation, and level workloads to improve quality and flow. Process mapping, staff and patient tracking and opinion surveys, medical record audits, and interrogation of electronic treatment records were undertaken. Results: This project delivered a 38% reduction in median wait time on the day (from 32 to 20 minutes; P < .01), 7-day reduction in time to commencement of treatment for patients receiving combined chemoradiotherapy regimens (from 25 to 18 days; P < .01), and 22% reduction in wastage associated with expired drug and pharmacy rework (from 29% to 7%; P < .01). Improvements in efficiency enabled the cytosuite to increase the percentage of product manufactured within 10 minutes of appointment times by 29% (from 47% to 76%; P < .01). Conclusion: A lean improvement methodology provided a robust framework for improved understanding and management of complex system constraints within a CDU, resulting in improved access to treatment and reduced waiting times on the day. PMID:23942927

"The largest Lean transformation in the world": the implementation and evaluation of lean in Saskatchewan healthcare.

PubMed

Kinsman, Leigh; Rotter, Thomas; Stevenson, Katherine; Bath, Brenna; Goodridge, Donna; Harrison, Liz; Dobson, Roy; Sari, Nazmi; Jeffery, Cathy; Bourassa, Carrie; Westhorp, Gill

2014-01-01

The Saskatchewan Ministry of Health has committed to a multi-million dollar investment toward the implementation of Lean methodology across the province's healthcare system. Originating as a production line discipline (the Toyota Production System), Lean has evolved to encompass process improvements including inventory management, waste reduction and quality improvement techniques. With an initial focus on leadership, strategic alignment, training and the creation of a supportive infrastructure (Lean promotion offices), the goal in Saskatchewan is a whole health system transformation that produces "better health, better value, better care, and better teams." Given the scope and scale of the initiative and the commitment of resources, it is vital that a comprehensive, longitudinal evaluation plan be implemented to support ongoing decision-making and program design. The nature of the initiative also offers a unique opportunity to contribute to health quality improvement science by advancing our understanding of the implementation and evaluation of complex, large-scale healthcare interventions. The purpose of this article is to summarize the background to Lean in Saskatchewan and the proposed evaluation methods. Copyright © 2014 Longwoods Publishing.

Digitally-Enabled Organizational Routines at the Organization-Environment Boundary: Buffering and the Role of Technology

ERIC Educational Resources Information Center

Hillison, Derek William

2009-01-01

Boundary units of an organization uniquely experience the tension between adaptation to environmental variation and maintaining stable outcomes for the rest of the organization. In our world of just-in-time supply chain systems, lot-sizes of one, lean manufacturing and an increasing focus on services, traditional forms of buffering such as queuing…

Lessons from industry: one school's transformation toward "lean" curricular governance.

PubMed

Stratton, Terry D; Rudy, David W; Sauer, Marlene J; Perman, Jay A; Jennings, C Darrell

2007-04-01

As medical education grapples with organizational calls for centralized curricular oversight, programs may be compelled to respond by establishing highly vertical, stacked governance structures. Although these models offer discrete advantages over the horizontal, compartmentalized structures they are designed to replace, they pose new challenges to ensuring curricular quality and the educational innovations that drive the curricula. The authors describe a hybrid quality-assurance (QA) governance structure introduced in 2003 at the University of Kentucky College of Medicine (UKCOM) that ensures centralized curricular oversight of the educational product while allowing individualized creative control over the educational process. Based on a Lean production model, this approach draws on industry experiences that strategically separate institutional accountability (management) for a quality curriculum from the decision-making processes required to ensure it (production). In so doing, the authors acknowledge general similarities and key differences between overseeing the manufacture of a complex product versus the education of a physician-emphasizing the structured, sequential, and measurable nature of each process. Further, the authors briefly trace the emergence of quality approaches in manufacturing and discuss the philosophical changes that accompany transition to an institutional governance system that relies on vigorous, robust performance measures to offer continuous feedback on curricular quality.

Lean manufacturing analysis to reduce waste on production process of fan products

NASA Astrophysics Data System (ADS)

Siregar, I.; Nasution, A. A.; Andayani, U.; Sari, R. M.; Syahputri, K.; Anizar

2018-02-01

This research is based on case study that being on electrical company. One of the products that will be researched is the fan, which when running the production process there is a time that is not value-added, among others, the removal of material which is not efficient in the raw materials and component molding fan. This study aims to reduce waste or non-value added activities and shorten the total lead time by using the tools Value Stream Mapping. Lean manufacturing methods used to analyze and reduce the non-value added activities, namely the value stream mapping analysis tools, process mapping activity with 5W1H, and tools 5 whys. Based on the research note that no value-added activities in the production process of a fan of 647.94 minutes of total lead time of 725.68 minutes. Process cycle efficiency in the production process indicates that the fan is still very low at 11%. While estimates of the repair showed a decrease in total lead time became 340.9 minutes and the process cycle efficiency is greater by 24%, which indicates that the production process has been better.

AUTOMATING ASSET KNOWLEDGE WITH MTCONNECT.

PubMed

Venkatesh, Sid; Ly, Sidney; Manning, Martin; Michaloski, John; Proctor, Fred

2016-01-01

In order to maximize assets, manufacturers should use real-time knowledge garnered from ongoing and continuous collection and evaluation of factory-floor machine status data. In discrete parts manufacturing, factory machine monitoring has been difficult, due primarily to closed, proprietary automation equipment that make integration difficult. Recently, there has been a push in applying the data acquisition concepts of MTConnect to the real-time acquisition of machine status data. MTConnect is an open, free specification aimed at overcoming the "Islands of Automation" dilemma on the shop floor. With automated asset analysis, manufacturers can improve production to become lean, efficient, and effective. The focus of this paper will be on the deployment of MTConnect to collect real-time machine status to automate asset management. In addition, we will leverage the ISO 22400 standard, which defines an asset and quantifies asset performance metrics. In conjunction with these goals, the deployment of MTConnect in a large aerospace manufacturing facility will be studied with emphasis on asset management and understanding the impact of machine Overall Equipment Effectiveness (OEE) on manufacturing.

Superplasticity in a lean Fe-Mn-Al steel.

PubMed

Han, Jeongho; Kang, Seok-Hyeon; Lee, Seung-Joon; Kawasaki, Megumi; Lee, Han-Joo; Ponge, Dirk; Raabe, Dierk; Lee, Young-Kook

2017-09-29

Superplastic alloys exhibit extremely high ductility (>300%) without cracks when tensile-strained at temperatures above half of their melting point. Superplasticity, which resembles the flow behavior of honey, is caused by grain boundary sliding in metals. Although several non-ferrous and ferrous superplastic alloys are reported, their practical applications are limited due to high material cost, low strength after forming, high deformation temperature, and complicated fabrication process. Here we introduce a new compositionally lean (Fe-6.6Mn-2.3Al, wt.%) superplastic medium Mn steel that resolves these limitations. The medium Mn steel is characterized by ultrafine grains, low material costs, simple fabrication, i.e., conventional hot and cold rolling, low deformation temperature (ca. 650 °C) and superior ductility above 1300% at 850 °C. We suggest that this ultrafine-grained medium Mn steel may accelerate the commercialization of superplastic ferrous alloys.Research in new alloy compositions and treatments may allow the increased strength of mass-produced, intricately shaped parts. Here authors introduce a superplastic medium manganese steel which has an inexpensive lean chemical composition and which is suited for conventional manufacturing processes.

Comprehensive Study on Wastages of Supply Chain Information Sharing in Automotive Industries

NASA Astrophysics Data System (ADS)

Sendhil Kumar, R.; Pugazhendhi, S.; Muralidharan, C.; Murali, S.

2017-03-01

A supply chain is a very extensive concept, which encompasses many problems and features when it comes to controlling. Now a day’s lean concept is a very common method to several areas, such as service sectors and manufacturing. Applying the lean concept to supply chain management is a very popular study part, it has attracted many industrial practices and researchers with different applications. Information sharing and technology remain one of the key factors of integrating the supply chain members. Current scenario the competition is no longer between the competing companies, but it happens between the supply chains. So the efficiency of the supply chain is very important. And the effective sharing of information can enhance the supply chain efficiency through minimizing the inventories and Information sharing can increase supply chain efficiency by reducing inventories and stabilizing the production. This paper describes and discusses about the seven deadly wastes of supply chain information with the comparative principle of Toyota production system (TPS) principle approach. How the TPS can be applied to supply chain information sharing And lean tool of 5S concept possibility improve the information sharing.

The lean ergonomics in green design of crude palm oil plant

NASA Astrophysics Data System (ADS)

Huda, L. N.; Matondang, R.

2018-02-01

Ergonomics can help manufacturing and industrial engineersmaximum work output without physical harm to workers.Physiology, biomechanics, anthropometrics, and allocation are the areas of ergonomics most useful to manufacturing in apllying the concept of Lean and Green in manufacturing. These systems require efficient production and low use of resources such as energy and material. Its philosophy encourage worker to look at waste. This concept is applied in one of national plant of Crude Palm Oil (CPO) that located in North Sumatera. The problem found in the company are the working posture and excessive workload of the workers. These conditions are affects to the their job performance. The study was carried out by evaluated the worker body position using the Work Posture Assesment (WPA) and Biomechanics method. The WPA results shows the operator’s working position was mostly bent more than 30 degrees. This indicates that almost all workers are felt musculoskeletal disorders during work hours. While the biomechanics analysis found the significant relation between the values of Recommended Weight Limit (RWL) and Lifting Index (LI) which the increase of RWL value will decrease the LI value. This indicated that the recommended load for a worker under certain circumstances affects the appointment made so as not to contain the risk of spinal injury. In fact these condition are due to in-efficiency in production which can be maintaned the green design of CPO plant by improving the existing work.

Measuring and managing radiologist workload: application of lean and constraint theories and production planning principles to planning radiology services in a major tertiary hospital.

PubMed

MacDonald, Sharyn L S; Cowan, Ian A; Floyd, Richard; Mackintosh, Stuart; Graham, Rob; Jenkins, Emma; Hamilton, Richard

2013-10-01

We describe how techniques traditionally used in the manufacturing industry (lean management, the theory of constraints and production planning) can be applied to planning radiology services to reduce the impact of constraints such as limited radiologist hours, and to subsequently reduce delays in accessing imaging and in report turnaround. Targets for imaging and reporting were set aligned with clinical needs. Capacity was quantified for each modality and for radiologists and recorded in activity lists. Demand was quantified and forecasting commenced based on historical referral rates. To try and mitigate the impact of radiologists as a constraint, lean management processes were applied to radiologist workflows. A production planning process was implemented. Outpatient waiting times to access imaging steadily decreased. Report turnaround times improved with the percentage of overnight/on-call reports completed by a 1030 target time increased from approximately 30% to 80 to 90%. The percentage of emergency and inpatient reports completed within one hour increased from approximately 15% to approximately 50% with 80 to 90% available within 4 hours. The number of unreported cases on the radiologist work-list at the end of the working day reduced. The average weekly accuracy for demand forecasts for emergency and inpatient CT, MRI and plain film imaging was 91%, 83% and 92% respectively. For outpatient CT, MRI and plain film imaging the accuracy was 60%, 55% and 77% respectively. Reliable routine weekly and medium to longer term service planning is now possible. Tools from industry can be successfully applied to diagnostic imaging services to improve performance. They allow an accurate understanding of the demands on a service, capacity, and can reliably predict the impact of changes in demand or capacity on service delivery. © 2013 The Royal Australian and New Zealand College of Radiologists.

Reference standards for lean mass measures using GE dual energy x-ray absorptiometry in Caucasian adults

PubMed Central

Imboden, Mary T.; Swartz, Ann M.; Finch, Holmes W.; Harber, Matthew P.; Kaminsky, Leonard A.

2017-01-01

Body composition assessments commonly focus predominantly on fat mass, however lean mass (LM) measurements also provide useful information regarding clinical and nutritional status. LM measurements help predict health outcomes and diagnose sarcopenia, which has been associated with frailty. Dual energy x-ray absorptiometry (DXA) is an established technique used in clinical and research settings to assess body composition including total and regional LM. Currently, there are no reference values available that were derived from GE-Healthcare DXA systems directly for US adults for LM, LM index (LMI), percent LM (%LM), and appendicular lean mass index (ALMI) and it is known that whole-body and regional LM measures differ by DXA manufacturer. Objective To develop reference values by age and sex for LM measures using GE-Healthcare DXA systems. Methods A de-identified sample was obtained from Ball State University’s Clinical Exercise Physiology Laboratory and University of Wisconsin-Milwaukee’s Physical Activity & Health Research Laboratory. DXA scans of 2,076 women and 1,251 men were completed using a GE Lunar Prodigy or iDXA. Percentiles (%ile) were calculated for all variables of interest (LM, LMI, %LM, and ALMI) and a factorial ANOVA was used to assess differences for each variable between 10-year age groups and sex, as well as the interaction between age and sex. Results Men had higher mean total LM, %LM, LMI, and ALMI than women (p<0.01), across all age groups. All LM variables decreased significantly over the 5 decades in men, however in women only total LM, %LM, and ALMI decreased from the youngest to oldest age groups (p<0.01). Conclusion These reference values provide for a more accurate interpretation of GE-Healthcare DXA-derived LM measurements offering clinicians and researchers with an initial resource to aid in the early detection and assessment of LM deficits. PMID:28426779

A Hospital Is Not Just a Factory, but a Complex Adaptive System-Implications for Perioperative Care.

PubMed

Mahajan, Aman; Islam, Salim D; Schwartz, Michael J; Cannesson, Maxime

2017-07-01

Many methods used to improve hospital and perioperative services productivity and quality of care have assumed that the hospital is essentially a factory, and therefore, that industrial engineering and manufacturing-derived redesign approaches such as Six Sigma and Lean can be applied to hospitals and perioperative services just as they have been applied in factories. However, a hospital is not merely a factory but also a complex adaptive system (CAS). The hospital CAS has many subsystems, with perioperative care being an important one for which concepts of factory redesign are frequently advocated. In this article, we argue that applying only factory approaches such as lean methodologies or process standardization to complex systems such as perioperative care could account for difficulties and/or failures in improving performance in care delivery. Within perioperative services, only noncomplex/low-variance surgical episodes are amenable to manufacturing-based redesign. On the other hand, complex surgery/high-variance cases and preoperative segmentation (the process of distinguishing between normal and complex cases) can be viewed as CAS-like. These systems tend to self-organize, often resist or react unpredictably to attempts at control, and therefore require application of CAS principles to modify system behavior. We describe 2 examples of perioperative redesign to illustrate the concepts outlined above. These examples present complementary and contrasting cases from 2 leading delivery systems. The Mayo Clinic example illustrates the application of manufacturing-based redesign principles to a factory-like (high-volume, low-risk, and mature practice) clinical program, while the Kaiser Permanente example illustrates the application of both manufacturing-based and self-organization-based approaches to programs and processes that are not factory-like but CAS-like. In this article, we describe how factory-like processes and CAS can coexist within a hospital and how self-organization-based approaches can be used to improve care delivery in many situations where manufacturing-based approaches may not be appropriate.

[Lean logistics management in healthcare: a case study].

PubMed

Aguilar-Escobar, V G; Garrido-Vega, P

2013-01-01

To study the applicability of the principles of Lean Production to manage the supply chain of a hospital. In particular, to determine which Lean practices and principles are applicable, the benefits obtained and the main barriers for its implementation. Managing the hospital supply chain is an important issue, both for its effect on the quality of care and its impact on costs. This study is based on a case study. 2005-10. Hospital Virgen Macarena in Seville. Process of implementing a comprehensive logistics management plan based on Lean principles and technological investments. The implementation of the comprehensive plan has reduced inventory, decreased lead times and improved service quality. Also, there have been other important improvements: enhanced employee satisfaction and increased staff productivity, both dedicated to health and the logistics. The experience analysed has shown the applicability and appropriateness of Lean principles and some of its techniques in managing the logistics of hospitals. It also identifies some of the main difficulties that may arise. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

Lean direct wall fuel injection method and devices

NASA Technical Reports Server (NTRS)

Choi, Kyung J. (Inventor); Tacina, Robert (Inventor)

2000-01-01

A fuel combustion chamber, and a method of and a nozzle for mixing liquid fuel and air in the fuel combustion chamber in lean direct injection combustion for advanced gas turbine engines, including aircraft engines. Liquid fuel in a form of jet is injected directly into a cylindrical combustion chamber from the combustion chamber wall surface in a direction opposite to the direction of the swirling air at an angle of from about 50.degree. to about 60.degree. with respect to a tangential line of the cylindrical combustion chamber and at a fuel-lean condition, with a liquid droplet momentum to air momentum ratio in the range of from about 0.05 to about 0.12. Advanced gas turbines benefit from lean direct wall injection combustion. The lean direct wall injection technique of the present invention provides fast, uniform, well-stirred mixing of fuel and air. In addition, in order to further improve combustion, the fuel can be injected at a venturi located in the combustion chamber at a point adjacent the air swirler.

The effect of technique change on knee loads during sidestep cutting.

PubMed

Dempsey, Alasdair R; Lloyd, David G; Elliott, Bruce C; Steele, Julie R; Munro, Bridget J; Russo, Kylie A

2007-10-01

To identify the effect of modifying sidestep cutting technique on knee loads and predict what impact such change would have on the risk of noncontact anterior cruciate ligament injury. A force platform and motion-analysis system were used to record ground-reaction forces and track the trajectories of markers on 15 healthy males performing sidestep cutting tasks using their normal technique and nine different imposed techniques. A kinematic and inverse dynamic model was used to calculate the three-dimensional knee postures and moments. The imposed techniques of foot wide and torso leaning in the opposite direction to the cut resulted in increased peak valgus moments experienced in weight acceptance. Higher peak internal rotation moments were found for the foot wide and torso rotation in the opposite direction to the cut techniques. The foot rotated in technique resulted in lower mean flexion/extension moments, whereas the foot wide condition resulted in higher mean flexion/extension moments. The flexed knee, torso rotated in the opposite direction to the cut and torso leaning in the same direction as the cut techniques had significantly more knee flexion at heel strike. Sidestep cutting technique had a significant effect on loads experienced at the knee. The techniques that produced higher valgus and internal rotation moments at the knee, such as foot wide, torso leaning in the opposite direction to the cut and torso rotating in the opposite direction to the cut, may place an athlete at higher risk of injury because these knee loads have been shown to increase the strain on the anterior cruciate ligament. Training athletes to avoid such body positions may result in a reduced risk of noncontact anterior cruciate ligament injures.

NO{sub x}-abatement potential of lean-premixed GT combustors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sattelmayer, T.; Polifke, W.; Winkler, D.

1998-01-01

The influence of the structure of perfectly premixed flames on NO{sub x} formation is investigated theoretically. Since a network of reaction kinetics modules and model flames is used for this purpose, the results obtained are independent of specific burner geometries. Calculations are presented for a mixture temperature of 630 K, an adiabatic flame temperature of 1840 K, and 1 and 15 bars combustor pressure. In particular, the following effects are studied separately from each other: molecular diffusion of temperature and species, flame strain, local quench in highly strained flames and subsequent reignition, turbulent diffusion (no preferential diffusion), and small scalemore » mixing (stirring) in the flame front. Either no relevant influence or an increase in NO{sub x} burners is to avoid excessive turbulent stirring in the flame front. Turbulent flames that exhibit locally and instantaneously near laminar structures (flamelets) appear to be optimal. Using the same methodology, the scope of the investigation is extended to lean-lean staging, since a higher NO{sub x}-abatement potential can be expected in principle. As long as the chemical reactions of the second stage take place in the boundary between the fresh mixture of the second stage and the combustion products from upstream, no advantage can be expected from lean-lean staging. Only if the preliminary burner exhibits much poorer mixing than the second stage can lean-lean staging be beneficial. In contrast, if full mixing between the two stages prior to afterburning can be achieved (lean-mix-lean technique), the combustor outlet temperature can in principle be increased somewhat without NO penalty.« less

Precision Strike Training in Lean Manufacturing: A Workplace Literacy Guidebook [and] Final Report on Precision Strike Workplace Literacy Training at CertainTeed Corporation.

ERIC Educational Resources Information Center

National Alliance of Business, Inc., Washington, DC.

CertainTeed's Precision Strike training program was designed to close the gaps between the current status of its workplace and where that work force needed to be to compete successfully in global markets. Precision Strike included Skills and Knowledge in Lifelong Learning (SKILL) customized, computerized lessons in basic skills, one-on-one…

Lean Stability augmentation study

NASA Technical Reports Server (NTRS)

Mcvey, J. B.; Kennedy, J. B.

1979-01-01

An analytical and experimental program was conducted to investigate techniques and develop technology for improving the lean combustion limits of premixing, prevaporizing combustors applicable to gas turbine engine main burners. Three concepts for improving lean stability limits were selected for experimental evaluation among twelve approaches considered. Concepts were selected on the basis of the potential for improving stability limits and achieving emission goals, the technological risks associated with development of practical burners employing the concepts, and the penalties to airline direct operating costs resulting from decreased combustor performance, increased engine cost, increased maintenance cost and increased engine weight associated with implementation of the concepts. Tests of flameholders embodying the selected concepts were conducted.

How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children's hospital, Stockholm, Sweden

PubMed Central

2012-01-01

Background There is growing interest in applying lean thinking in healthcare, yet, there is still limited knowledge of how and why lean interventions succeed (or fail). To address this gap, this in-depth case study examines a lean-inspired intervention in a Swedish pediatric Accident and Emergency department. Methods We used a mixed methods explanatory single case study design. Hospital performance data were analyzed using analysis of variance (ANOVA) and statistical process control techniques to assess changes in performance one year before and two years after the intervention. We collected qualitative data through non-participant observations, semi-structured interviews, and internal documents to describe the process and content of the lean intervention. We then analyzed empirical findings using four theoretical lean principles (Spear and Bowen 1999) to understand how and why the intervention worked in its local context as well as to identify its strengths and weaknesses. Results Improvements in waiting and lead times (19-24%) were achieved and sustained in the two years following lean-inspired changes to employee roles, staffing and scheduling, communication and coordination, expertise, workspace layout, and problem solving. These changes resulted in improvement because they: (a) standardized work and reduced ambiguity, (b) connected people who were dependent on one another, (c) enhanced seamless, uninterrupted flow through the process, and (d) empowered staff to investigate problems and to develop countermeasures using a "scientific method". Contextual factors that may explain why not even greater improvement was achieved included: a mismatch between job tasks, licensing constraints, and competence; a perception of being monitored, and discomfort with inter-professional collaboration. Conclusions Drawing on Spear and Bowen's theoretical propositions, this study explains how a package of lean-like changes translated into better care process management. It adds new knowledge regarding how lean principles can be beneficially applied in healthcare and identifies changes to professional roles as a potential challenge when introducing lean thinking there. This knowledge may enable health care organizations and managers in other settings to configure their own lean program and to better understand the reasons behind lean's success (or failure). PMID:22296919

How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children's hospital, Stockholm, Sweden.

PubMed

Mazzocato, Pamela; Holden, Richard J; Brommels, Mats; Aronsson, Håkan; Bäckman, Ulrika; Elg, Mattias; Thor, Johan

2012-02-01

There is growing interest in applying lean thinking in healthcare, yet, there is still limited knowledge of how and why lean interventions succeed (or fail). To address this gap, this in-depth case study examines a lean-inspired intervention in a Swedish pediatric Accident and Emergency department. We used a mixed methods explanatory single case study design. Hospital performance data were analyzed using analysis of variance (ANOVA) and statistical process control techniques to assess changes in performance one year before and two years after the intervention. We collected qualitative data through non-participant observations, semi-structured interviews, and internal documents to describe the process and content of the lean intervention. We then analyzed empirical findings using four theoretical lean principles (Spear and Bowen 1999) to understand how and why the intervention worked in its local context as well as to identify its strengths and weaknesses. Improvements in waiting and lead times (19-24%) were achieved and sustained in the two years following lean-inspired changes to employee roles, staffing and scheduling, communication and coordination, expertise, workspace layout, and problem solving. These changes resulted in improvement because they: (a) standardized work and reduced ambiguity, (b) connected people who were dependent on one another, (c) enhanced seamless, uninterrupted flow through the process, and (d) empowered staff to investigate problems and to develop countermeasures using a "scientific method". Contextual factors that may explain why not even greater improvement was achieved included: a mismatch between job tasks, licensing constraints, and competence; a perception of being monitored, and discomfort with inter-professional collaboration. Drawing on Spear and Bowen's theoretical propositions, this study explains how a package of lean-like changes translated into better care process management. It adds new knowledge regarding how lean principles can be beneficially applied in healthcare and identifies changes to professional roles as a potential challenge when introducing lean thinking there. This knowledge may enable health care organizations and managers in other settings to configure their own lean program and to better understand the reasons behind lean's success (or failure).

Modelling Lean and Green Supply Chain

NASA Astrophysics Data System (ADS)

Duarte, Susana Carla Vieira Lino Medina

The success of an organization depends on the effective control of its supply chain. It is important to recognize new opportunities for organization and its supply chain. In the last few years the approach to lean, agile, resilient and green supply chain paradigms has been addressed in the scientific literature. Research in this field shows that the integration of these concepts revealed some contradictions among so many paradigms. This thesis is mainly focused on the lean and green approaches. Thirteen different management frameworks, embodied in awards, standards and tools were studied to understand if they could contribute for the modelling process of a lean and green approach. The study reveals a number of categories that are common in most management frameworks, providing adequate conditions for a lean and green supply chain transformation. A conceptual framework for the evaluation of a lean and green organization`s supply chain was proposed. The framework considers six key criteria, namely, leadership, people, strategic planning, stakeholders, processes and results. It was proposed an assessment method considering a criteria score for each criterion. The purpose is to understand how lean and green supply chain can be compatible, using principles, practices, techniques or tools (i.e. elements) that support both, a lean and a green approach, in all key criteria. A case study in the automotive upstream supply chain was performed to understand more deeply if the elements proposed for the conceptual framework could be implemented in a real-scenario. Based on the conceptual framework and the case study, a roadmap to achieve a lean-green transformation is presented. The proposed roadmap revealed its contribution to the understanding on how and when an organization`s supply chain should apply the lean and green elements. This study is relevant to practice, as it may assist managers in the adoption of a lean and green supply chain approach, giving insights for the implementation of a hybrid supply chain.

Improving the medical records department processes by lean management.

PubMed

Ajami, Sima; Ketabi, Saeedeh; Sadeghian, Akram; Saghaeinnejad-Isfahani, Sakine

2015-01-01

Lean management is a process improvement technique to identify waste actions and processes to eliminate them. The benefits of Lean for healthcare organizations are that first, the quality of the outcomes in terms of mistakes and errors improves. The second is that the amount of time taken through the whole process significantly improves. The purpose of this paper is to improve the Medical Records Department (MRD) processes at Ayatolah-Kashani Hospital in Isfahan, Iran by utilizing Lean management. This research was applied and an interventional study. The data have been collected by brainstorming, observation, interview, and workflow review. The study population included MRD staff and other expert staff within the hospital who were stakeholders and users of the MRD. The MRD were initially taught the concepts of Lean management and then formed into the MRD Lean team. The team then identified and reviewed the current processes subsequently; they identified wastes and values, and proposed solutions. The findings showed that the MRD units (Archive, Coding, Statistics, and Admission) had 17 current processes, 28 wastes, and 11 values were identified. In addition, they offered 27 comments for eliminating the wastes. The MRD is the critical department for the hospital information system and, therefore, the continuous improvement of its services and processes, through scientific methods such as Lean management, are essential. The study represents one of the few attempts trying to eliminate wastes in the MRD.

Lean Six Sigma Applied to Ultrasound Guided Needle Biopsy in the Head and Neck.

PubMed

Matt, Bruce H; Woodward-Hagg, Heather K; Wade, Christopher L; Butler, Penny D; Kokoska, Mimi S

2014-07-01

(1) Confirm the positive value stream of office-based ultrasound using Lean Six Sigma; (2) demonstrate how ultrasound reduces time to diagnosis, costs, patient inconvenience and travel, exposure to ionizing radiation, intravenous contrast, and laboratory tests. Case series with historical controls using chart review. Tertiary Veterans Administration Hospital (university-affiliated). Patients with a consult request or decision for ultrasound guided fine needle aspiration (USFNA) from 2006 to 2012. Process evaluation using Lean Six Sigma methodologies; years study conducted: 2006-2012; outcome measurements: type of diagnostic tests and imaging studies including CT scans with associated radiation exposure, time to preliminary and final cytopathologic diagnosis, episodes of patient travel. Value stream mapping prior to and after implementing office-based ultrasound confirmed the time from consult request or decision for USFNA to completion of the USFNA was reduced from a range of 0 to 286 days requiring a maximum 17 steps to a range of 0 to 48 days, necessitating only a maximum of 9 steps. Office-based USFNA for evaluation of head and neck lesions reduced costs, time to diagnosis, risks and inconvenience to patients, radiation exposure, unnecessary laboratory, and patient complaints while increasing staff satisfaction. In addition, office-based ultrasound also changed the clinical management of specific patients. Lean Six Sigma reduces waste and optimizes quality and accuracy in manufacturing. This is the first known application of Lean Six Sigma to office-based USFNA in the evaluation of head and neck lesions. The literature supports the value of office-based ultrasound to patients and health care systems. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

Lean stability augmentation study. [on gas turbine combustion chambers

NASA Technical Reports Server (NTRS)

Mcvey, J. B.; Kennedy, J. B.

1979-01-01

An analytical conceptual design study and an experimental test program were conducted to investigate techniques and develop technology for improving the lean combustion limits of premixing, prevaporizing combustors applicable to gas turbine engine main burners. The use of hot gas pilots, catalyzed flameholder elements, and heat recirculation to augment lean stability limits was considered in the conceptual design study. Tests of flameholders embodying selected concepts were conducted at a pressure of 10 arm and over a range of entrance temperatures simulating conditions to be encountered during stratospheric cruise. The tests were performed using an axisymmetric flametube test rig having a nominal diameter of 10.2 cm. A total of sixteen test configurations were examined in which lean blowout limits, pollutant emission characteristics, and combustor performance were evaluated. The use of a piloted perforated plate flameholder employing a pilot fuel flow rate equivalent to 4 percent of the total fuel flow at a simulated cruise condition resulted in a lean blowout equivalence ratio of less than 0.25 with a design point (T sub zero = 600k, Phi = 0.6) NOx emission index of less than 1.0 g/kg.

Lean Manufacturing and the Infantry: Retaining Quality during Total Mobilization

DTIC Science & Technology

United States last decisive war against a peer threat, World War II, required significant manpower resources. Prioritizing quality manpower ...distribution to technical jobs resulted in the degradation of the infantry, which then required the Army to implement corrective measures to reverse the...deficiency in quality. Should another decisive war occur in the future, the lethality and speed of modern warfare will increase the demand for manpower , which

Analysis of production flow process with lean manufacturing approach

NASA Astrophysics Data System (ADS)

Siregar, Ikhsan; Arif Nasution, Abdillah; Prasetio, Aji; Fadillah, Kharis

2017-09-01

This research was conducted on the company engaged in the production of Fast Moving Consumer Goods (FMCG). The production process in the company are still exists several activities that cause waste. Non value added activity (NVA) in the implementation is still widely found, so the cycle time generated to make the product will be longer. A form of improvement on the production line is by applying lean manufacturing method to identify waste along the value stream to find non value added activities. Non value added activity can be eliminated and reduced by utilizing value stream mapping and identifying it with activity mapping process. According to the results obtained that there are 26% of value-added activities and 74% non value added activity. The results obtained through the current state map of the production process of process lead time value of 678.11 minutes and processing time of 173.94 minutes. While the results obtained from the research proposal is the percentage of value added time of 41% of production process activities while non value added time of the production process of 59%. While the results obtained through the future state map of the production process of process lead time value of 426.69 minutes and processing time of 173.89 minutes.

AUTOMATING ASSET KNOWLEDGE WITH MTCONNECT

PubMed Central

Venkatesh, Sid; Ly, Sidney; Manning, Martin; Michaloski, John; Proctor, Fred

2017-01-01

In order to maximize assets, manufacturers should use real-time knowledge garnered from ongoing and continuous collection and evaluation of factory-floor machine status data. In discrete parts manufacturing, factory machine monitoring has been difficult, due primarily to closed, proprietary automation equipment that make integration difficult. Recently, there has been a push in applying the data acquisition concepts of MTConnect to the real-time acquisition of machine status data. MTConnect is an open, free specification aimed at overcoming the “Islands of Automation” dilemma on the shop floor. With automated asset analysis, manufacturers can improve production to become lean, efficient, and effective. The focus of this paper will be on the deployment of MTConnect to collect real-time machine status to automate asset management. In addition, we will leverage the ISO 22400 standard, which defines an asset and quantifies asset performance metrics. In conjunction with these goals, the deployment of MTConnect in a large aerospace manufacturing facility will be studied with emphasis on asset management and understanding the impact of machine Overall Equipment Effectiveness (OEE) on manufacturing. PMID:28691121

Differences in fairness and trust between lean and corpulent men.

PubMed

Kubera, B; Klement, J; Wagner, C; Rädel, C; Eggeling, J; Füllbrunn, S; Kaczmarek, M C; Levinsky, R; Peters, A

2016-11-01

Employment disparities are known to exist between lean and corpulent people, for example, corpulent people are less likely to be hired and get lower wages. The reasons for these disparities between weight groups are not completely understood. We hypothesize (i) that economic decision making differs between lean and corpulent subjects, (ii) that these differences are influenced by peoples' blood glucose concentrations and (iii) by the body weight of their opponents. A total of 20 lean and 20 corpulent men were examined, who performed a large set of economic games (ultimatum game, trust game and risk game) under euglycemic and hypoglycemic conditions induced by the glucose clamp technique. In the ultimatum game, lean men made less fair decisions and offered 16% less money than corpulent men during euglycemia (P=0.042). During hypoglycemia, study participants of both weight groups accepted smaller amounts of money than during euglycemia (P=0.031), indicating that a lack of energy makes subjects to behave more like a Homo Economicus. In the trust game, lean men allocated twice as much money to lean than to corpulent trustees during hypoglycemia (P<0.001). Risk-seeking behavior did not differ between lean and corpulent men. Our data show that economic decision making is affected by both, the body weight of the participants and the body weight of their opponents, and that blood glucose concentrations should be taken into consideration when analyzing economic decision making. When relating these results to the working environment, the weight bias in economic decision making may be also relevant for employment disparities.

Improvement of emergency department patient flow using lean thinking.

PubMed

Sánchez, Miquel; Suárez, Montse; Asenjo, María; Bragulat, Ernest

2018-05-01

To apply lean thinking in triage acuity level-3 patients in order to improve emergency department (ED) throughtput and waiting time. A prospective interventional study. An ED of a tertiary care hospital. Triage acuity level-3 patients. To apply lean techniques such as value stream mapping, workplace organization, reduction of wastes and standardization by the frontline staff. Two periods were compared: (i) pre-lean: April-September, 2015; and (ii) post-lean: April-September, 2016. Variables included: median process time (time from beginning of nurse preparation to the end of nurse finalization after doctor disposition) of both discharged and transferred to observation patients; median length of stay; median waiting time; left without being seen, 72-h revisit and mortality rates, and daily number of visits. There was no additional staff or bed after lean implementation. Despite an increment in the daily number of visits (+8.3%, P < 0.001), significant reductions in process time of discharged (182 vs 160 min, P < 0.001) and transferred to observation (186 vs 176 min, P < 0.001) patients, in length of stay (389 vs 329 min, P < 0.001), and in waiting time (71 vs 48 min, P < 0.001) were achieved after lean implementation. No significant differences were registered in left without being seen rate (5.23% vs 4.95%), 72-h revisit rate (3.41% vs 3.93%), and mortality rate (0.23% vs 0.15%). Lean thinking is a methodology that can improve triage acuity level-3 patient flow in the ED, resulting in better throughput along with reduced waiting time.

Developing a lean culture in the laboratory.

PubMed

Napoles, Leyda; Quintana, Maria

2006-07-25

The Director of Pathology at Jackson Memorial Hospital was interested in improving the operational efficiencies of the department in order to enhance the department's level of service in conjunction with the expansion of the overall health system. The decision was made to implement proven Lean practices in the laboratory under the direction of a major consulting firm. This article details the scope of the initial project as well as the operating principles of Lean manufacturing practices as applied to the clinical laboratory. The goals of the project were to improve turnaround times of laboratory results, reduce inventory and supply costs, improve staff productivity, maximize workflow, and eliminate waste. Extensive data gathering and analysis guided the work process by highlighting the areas of highest opportunity. This systematic approach resulted in recommendations for the workflow and physical layout of the laboratory. It also included the introduction of "standard workflow" and "visual controls" as critical items that streamlined operational efficiencies. The authors provide actual photographs and schematics of the reorganization and improvements to the physical layout of the laboratory. In conclusion, this project resulted in decreased turnaround times and increased productivity, as well as significant savings in the overall laboratory operations.

Participatory design in lean production: which contribution from employees? For what end?

PubMed

Perez Toralla, M S; Falzon, P; Morais, A

2012-01-01

The proponents of lean production have pointed to the positive effects of the work organization on employees in terms of autonomy, enhanced skills and empowerment mainly by their participation into the continuous improvement of work process. But studies that have examined this issue suggest that the increase in autonomy is not sufficient to compensate for increases work intensity. Participatory design has grown extensively in manufacturing since the 1980's under the impulsion of the Scandinavian socio-technical system approach and it's central in the model of lean production performance. Its main objectives are to improve quality, increase productivity and safety through employee's participation to the reduction of non-value added activities, such as defined by lean production. In the line of the studies on participatory design and continuous improvement the present study examines the functioning of work groups, based on the kaizen model, the aim of which was to improve the proportion of "value-added activities" and working conditions, essentially physical constraints. The main results are consistent with the literature and show that accelerated forms of re-conception activities give employees limited room for maneuver to elaborate solutions based on the analysis of the real activity. This study is part of a broader initiative that goes in the direction of continuous improvement of the design process itself so that it integrates the real constraints of work and propose changes bases on work as it actually takes place, beyond pre-established performance goals bases on the reduction of "non added value activities".

Relationships between body composition, body dimensions, and peak speed in cross-country sprint skiing.

PubMed

Stoggl, Thomas; Enqvist, Jonas; Muller, Erich; Holmberg, Hans-Christer

2010-01-01

In modern sprint cross-country skiing, strength and maximal speed are major determinants of performance. The aims of this study were to ascertain the anthropometric characteristics of world-class sprint skiers and to evaluate whether a specific body composition and/or body dimension characterizes a successful sprint skier. Our hypothesis was that body height and lean body mass are related to peak speed in double poling and diagonal stride. Fourteen male national and international elite skiers performed two peak speed tests in double poling and diagonal stride roller skiing on a treadmill and were analysed using dual-energy X-ray absorptiometry to determine body composition and body dimensions. Relative pole length was positively correlated with both techniques (double poling: r = 0.77, P < 0.01; diagonal stride: r = 0.60, P < 0.05) and was the only variable that was part of the multiple regression model for both double poling and diagonal stride peak speed. Body height was not correlated with any technique, whereas lean trunk mass (r = 0.75, P < 0.01), body mass index (r = 0.66, P < 0.01), total lean mass (r = 0.69, P < 0.01), and body mass (r = 0.57, P < 0.05) were positively related to double poling peak speed. Total lean mass (absolute: r = 0.58, P < 0.05; relative: r = 0.76, P < 0.001) and relative lean mass of the trunk, arms (both r = 0.72, P < 0.01), and legs (r = 0.54, P < 0.05) were positively related to diagonal stride peak speed. In conclusion, skiers should aim to achieve a body composition with a high percentage of lean mass and low fat mass. A focus on trunk mass through increased muscle mass appears to be important, especially for double poling. The use of longer poles (percent body height) seems to be advantageous for both double poling and diagonal stride peak speed, whereas body dimensions do not appear to be a predictive factor.

Improving the medical records department processes by lean management

PubMed Central

Ajami, Sima; Ketabi, Saeedeh; Sadeghian, Akram; Saghaeinnejad-Isfahani, Sakine

2015-01-01

Background: Lean management is a process improvement technique to identify waste actions and processes to eliminate them. The benefits of Lean for healthcare organizations are that first, the quality of the outcomes in terms of mistakes and errors improves. The second is that the amount of time taken through the whole process significantly improves. Aims: The purpose of this paper is to improve the Medical Records Department (MRD) processes at Ayatolah-Kashani Hospital in Isfahan, Iran by utilizing Lean management. Materials and Methods: This research was applied and an interventional study. The data have been collected by brainstorming, observation, interview, and workflow review. The study population included MRD staff and other expert staff within the hospital who were stakeholders and users of the MRD. Statistical Analysis Used: The MRD were initially taught the concepts of Lean management and then formed into the MRD Lean team. The team then identified and reviewed the current processes subsequently; they identified wastes and values, and proposed solutions. Results: The findings showed that the MRD units (Archive, Coding, Statistics, and Admission) had 17 current processes, 28 wastes, and 11 values were identified. In addition, they offered 27 comments for eliminating the wastes. Conclusion: The MRD is the critical department for the hospital information system and, therefore, the continuous improvement of its services and processes, through scientific methods such as Lean management, are essential. Originality/Value: The study represents one of the few attempts trying to eliminate wastes in the MRD. PMID:26097862

Integration of Energy Consumption and CO2 Emissions into the DES Tool with Lean Thinking

NASA Astrophysics Data System (ADS)

Nujoom, Reda; Wang, Qian

2018-01-01

Products are often made by accomplishing a number of manufacturing processes on a sequential flow line which is also known as manufacturing systems. In a traditional way, design or evaluation of a manufacturing system involves a determination or an analysis of the system performance by adjusting system parameters relating to such as system capacity, material processing time, material-handling and transportation and shop-floor layout. Environment related parameters, however, are not considered or considered as separate issues. In the past decade, there has been a growing concern about the environmental protection and governments almost in all over the world enforced certain rules and regulation to promote energy saving and reduce carbon dioxide (CO2) emissions in manufacturing industry. To date, development of a sustainable manufacturing system requires designers who need not merely to apply traditional methods of improving system efficiency and productivity but also examine the environmental issues in production of the developed manufacturing system. Most researchers, however, focused on operational systems, which do not incorporate the effect of environmental factors that may also affect the system performance. This paper presents a research work aiming to addresses these issues in design and evaluation of sustainable manufacturing systems incorporating parameters of energy consumption and CO2 emissions into a DES (discrete event simulation) tool.

DMSO Production and Logistics Functional Working Group workshop. Proceedings held in McLean, VA on 16-18 Nov 1992

DTIC Science & Technology

1993-04-02

Issues and other environmental Impact concerns r ation: Manufacturing ateIgoJy: Technology Timaame: Near term Imoact of not MTeetln reaulrement...simulation (M&S needs of the defense M&S community. This community is partitioned into five major areas: Education , Training and Military Operations (ETMO...requirements throughout the community. The five DMSO Functional Work Groups ( Education , Training and Military Operations; Research and Development

2006 DoD Diminishing Manufacturing Sources and Material Shortages (DMSMS) Conference, Exhibition and Workshop

DTIC Science & Technology

2006-07-13

echnology T ervicesS Integrated Systems & Solutions Integrated yste s S olutionsS • 30,000 Employees • 5 Principal Businesses Organized Into 3 Major...Solutions -Data Sources -Search Engine -Notification Policy -DSCC/IST Lead -Industry Capabilities - Organic Capabilities -Pro-active upgrades -DMEA Lead...needs to TLCSM EC. Cathi Crabtree Voting Members Accomplishments WG Organization we can build on DAU Distance Leaning Modules WG Strategic Plan Re

Redesigning care at the Flinders Medical Centre: clinical process redesign using "lean thinking".

PubMed

Ben-Tovim, David I; Bassham, Jane E; Bennett, Denise M; Dougherty, Melissa L; Martin, Margaret A; O'Neill, Susan J; Sincock, Jackie L; Szwarcbord, Michael G

2008-03-17

*The Flinders Medical Centre (FMC) Redesigning Care program began in November 2003; it is a hospital-wide process improvement program applying an approach called "lean thinking" (developed in the manufacturing sector) to health care. *To date, the FMC has involved hundreds of staff from all areas of the hospital in a wide variety of process redesign activities. *The initial focus of the program was on improving the flow of patients through the emergency department, but the program quickly spread to involve the redesign of managing medical and surgical patients throughout the hospital, and to improving major support services. *The program has fallen into three main phases, each of which is described in this article: "getting the knowledge"; "stabilising high-volume flows"; and "standardising and sustaining". *Results to date show that the Redesigning Care program has enabled the hospital to provide safer and more accessible care during a period of growth in demand.

Scaling Lean in primary care: impacts on system performance.

PubMed

Hung, Dorothy Y; Harrison, Michael I; Martinez, Meghan C; Luft, Harold S

2017-03-01

We examined a wide range of performance outcomes after Lean methodology-a leading strategy to enhance efficiency and patient value-was implemented and scaled across all primary care clinics in a nonprofit, ambulatory care delivery system. Using a stepped wedge approach, we assessed changes associated with the phased introduction of Lean-based redesigns across 46 primary care departments in 17 different clinic locations. Longitudinal analysis of operational metrics included: workflow efficiency, physician productivity, operating expenses, clinical quality, and satisfaction among patients, physicians, and staff. We used interrupted time series analysis with generalized linear mixed models to estimate Lean impacts over time. Projected outcomes in the absence of changes (ie, counterfactuals) were compared with observed outcomes after Lean redesigns were implemented, and mean differences were assessed using 95% bias-corrected bootstrap confidence intervals (CIs). We observed systemwide improvements in workflow efficiencies (eg, 95% CI, 5.8-10.4) and physician productivity (95% CI, 3.9-27.2), with no adverse effects on clinical quality. Patient satisfaction increased with respect to access to care (95% CI, 15.2-20.7), handling of personal issues (95% CI, 2.1-6.9), and overall experience of care (95% CI, 11.0-17.0), but decreased with respect to interactions with care providers (95% CI, -13.4 to -5.7). Departmental operating costs decreased, and annual staff and physician satisfaction scores increased particularly among early adopters, with key improvements in employee engagement, connection to purpose, relationships with staff, and physician time spent working. Lean redesigns can benefit primary care patients, physicians, and staff without negatively impacting the quality of clinical care. Study results may lead other delivery system leaders to innovate using Lean techniques and may further enhance support for Lean learning among public and private payers.

Dual implantation of a radio-telemeter and vascular access port allows repeated hemodynamic and pharmacological measures in conscious lean and obese rats.

PubMed

Bussey, C T; Leeuw, A E de; Cook, R F; Ashley, Z; Schofield, J; Lamberts, R R

2014-07-01

Expansion of physiological knowledge increasingly requires examination of processes in the normal, conscious state. The current study describes a novel approach combining surgical implantation of radio-telemeters with vascular access ports (VAPs) to allow repeated hemodynamic and pharmacological measures in conscious rats. Dual implantation was conducted on 16-week-old male lean and obese Zucker rats. Continued viability one month after surgery was observed in 67% of lean and 44% of obese animals, giving an overall 54% completion rate. Over the five-week measurement period, reliable and reproducible basal mean arterial pressure and heart rate measures were observed. VAP patency and receptor-independent vascular reactivity were confirmed by consistent hemodynamic responses to sodium nitroprusside (6.25 µg/kg). Acutely, minimal hemodynamic responses to repeated bolus administration of 0.2 mL saline indicated no significant effect of increased blood volume or administration stress, making repeated acute measures viable. Similarly, repeated administration of the β-adrenoceptor agonist dobutamine (30 µg/kg) at 10 min intervals resulted in reproducible hemodynamic changes in both lean and obese animals. Therefore, our study demonstrates that this new approach is viable for the acute and chronic assessment of hemodynamic and pharmacological responses in both lean and obese conscious rats. This technique reduces the demand for animal numbers and allows hemodynamic measures with minimal disruption to animals' welfare, while providing reliable and reproducible results over several weeks. In conclusion, dual implantation of a radio-telemeter and VAP introduces a valuable technique for undertaking comprehensive studies involving repeated pharmacological tests in conscious animals to address important physiological questions. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Impact of Lean on patient cycle and waiting times at a rural district hospital in KwaZulu-Natal

PubMed Central

Naidoo, Logandran

2016-01-01

Background Prolonged waiting time is a source of patient dissatisfaction with health care and is negatively associated with patient satisfaction. Prolonged waiting times in many district hospitals result in many dissatisfied patients, overworked and frustrated staff, and poor quality of care because of the perceived increased workload. Aim The aim of the study was to determine the impact of Lean principles techniques, and tools on the operational efficiency in the outpatient department (OPD) of a rural district hospital. Setting The study was conducted at the Catherine Booth Hospital (CBH) – a rural district hospital in KwaZulu-Natal, South Africa. Methods This was an action research study with pre-, intermediate-, and post-implementation assessments. Cycle and waiting times were measured by direct observation on two occasions before, approximately two-weekly during, and on two occasions after Lean implementation. A standardised data collection tool was completed by the researcher at each of the six key service nodes in the OPD to capture the waiting times and cycle times. Results All six service nodes showed a reduction in cycle times and waiting times between the baseline assessment and post-Lean implementation measurement. Significant reduction was achieved in cycle times (27%; p < 0.05) and waiting times (from 11.93 to 10 min; p = 0.03) at the Investigations node. Although the target reduction was not achieved for the Consulting Room node, there was a significant reduction in waiting times from 80.95 to 74.43 min, (p < 0.001). The average efficiency increased from 16.35% (baseline) to 20.13% (post-intervention). Conclusion The application of Lean principles, tools and techniques provides hospital managers with an evidence-based management approach to resolving problems and improving quality indicators. PMID:27543283

Validation of double Langmuir probe in-orbit performance onboard a nano-satellite

NASA Astrophysics Data System (ADS)

Tejumola, Taiwo Raphael; Zarate Segura, Guillermo Wenceslao; Kim, Sangkyun; Khan, Arifur; Cho, Mengu

2018-03-01

Many plasma measurement systems have been proposed and used onboard different satellites to characterize space plasma. Most of these systems employed the technique of Langmuir probes either using the single or double probes methods. Recent growth of lean satellites has positioned it on advantage to be used for space science missions using Langmuir probes because of its simplicity and convenience. However, single Langmuir probes are not appropriate to be used on lean satellites because of their limited conducting area which leads to spacecraft charging and drift of the instrument's electrical ground during measurement. Double Langmuir probes technique can overcome this limitation, as a measurement reference in relation to the spacecraft is not required. A double Langmuir probe measurement system was designed and developed at Kyushu Institute of Technology for HORYU-IV satellite, which is a 10 kg, 30 cm cubic class lean satellite launched into Low Earth Orbit on 17th February 2016. This paper presents the on-orbit performance and validation of the double Langmuir probe measurement using actual on-orbit measured data and computer simulations.

Advanced Light-Duty SI Engine Fuels Research: Multiple Optical Diagnostics of Well-mixed and Stratified Operation.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sjoberg, Carl Magnus Goran; Vuilleumier, David

Ever tighter fuel economy standards and concerns about energy security motivate efforts to improve engine efficiency and to develop alternative fuels. This project contributes to the science base needed by industry to develop highly efficient direct injection spark ignition (DISI) engines that also beneficially exploit the different properties of alternative fuels. Here, the emphasis is on lean operation, which can provide higher efficiencies than traditional non-dilute stoichiometric operation. Since lean operation can lead to issues with ignition stability, slow flame propagation and low combustion efficiency, the focus is on techniques that can overcome these challenges. Specifically, fuel stratification is usedmore » to ensure ignition and completeness of combustion but this technique has soot and NOx emissions challenges. For ultra-lean well-mixed operation, turbulent deflagration can be combined with controlled end-gas autoignition to render mixed-mode combustion for sufficiently fast heat release. However, such mixed-mode combustion requires very stable inflammation, motivating studies on the effects of near-spark flow and turbulence, and the use of small amounts of fuel stratification near the spark plug.« less

Effects of porous insert on flame dynamics in a lean premixed swirl-stabilized combustor

NASA Astrophysics Data System (ADS)

Brown, Marcus; Agrawal, Ajay; Allen, James; Kornegay, John

2016-11-01

In this study, we investigated different methods of determining the effect a porous insert has on flame dynamics during lean premixed combustion. A metallic porous insert is used to mitigate instabilities in a swirl-stabilized combustor. Thermoacoustic instabilities are seen as negative consequences of lean premixed combustion and eliminating them is the motivation for our research. Three different diagnostics techniques with high-speed Photron SA5 cameras were used to monitor flame characteristics. Particle image velocimetry (PIV) was used to observe vortical structures and recirculation zones within the combustor. Using planar laser induced fluorescence (PLIF), we were able to observe changes in the reaction zones during instabilities. Finally, utilizing a color high-speed camera, visual images depicting a flame's oscillations during the instability were captured. Using these monitoring techniques, we are able to support the claims made in previous studies stating that the porous insert in the combustor significantly reduces the thermoacoustic instability. Funding for this research was provided by the NSF REU site Grant EEC 1358991 and NASA Grant NNX13AN14A.

Lean principles optimize on-time vascular surgery operating room starts and decrease resident work hours.

PubMed

Warner, Courtney J; Walsh, Daniel B; Horvath, Alexander J; Walsh, Teri R; Herrick, Daniel P; Prentiss, Steven J; Powell, Richard J

2013-11-01

Lean process improvement techniques are used in industry to improve efficiency and quality while controlling costs. These techniques are less commonly applied in health care. This study assessed the effectiveness of Lean principles on first case on-time operating room starts and quantified effects on resident work hours. Standard process improvement techniques (DMAIC methodology: define, measure, analyze, improve, control) were used to identify causes of delayed vascular surgery first case starts. Value stream maps and process flow diagrams were created. Process data were analyzed with Pareto and control charts. High-yield changes were identified and simulated in computer and live settings prior to implementation. The primary outcome measure was the proportion of on-time first case starts; secondary outcomes included hospital costs, resident rounding time, and work hours. Data were compared with existing benchmarks. Prior to implementation, 39% of first cases started on time. Process mapping identified late resident arrival in preoperative holding as a cause of delayed first case starts. Resident rounding process inefficiencies were identified and changed through the use of checklists, standardization, and elimination of nonvalue-added activity. Following implementation of process improvements, first case on-time starts improved to 71% at 6 weeks (P = .002). Improvement was sustained with an 86% on-time rate at 1 year (P < .001). Resident rounding time was reduced by 33% (from 70 to 47 minutes). At 9 weeks following implementation, these changes generated an opportunity cost potential of $12,582. Use of Lean principles allowed rapid identification and implementation of perioperative process changes that improved efficiency and resulted in significant cost savings. This improvement was sustained at 1 year. Downstream effects included improved resident efficiency with decreased work hours. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Barriers of lean construction implementation in the Moroccan construction industry

NASA Astrophysics Data System (ADS)

Bajjou, Mohamed Saad; Chafi, Anas

2018-04-01

Improving the production system performance has become a fundamental pillar that must be taken into consideration in the construction industry. Recent developments in the construction sector have led to renewed interest in new techniques of management. Lean Construction is a very effective approach that has gained a high popularity by its ability to eliminate waste and maximize the value for the customer. Although both developed and developing countries have gained large benefits by implementing Lean Construction approach, several experiences showed many barriers that are hindering its implementation especially in developing countries. This paper aims to assess the critical barriers to the successful implementation in the Moroccan construction industry. Based on a literature review, followed by an analysis of data collected from a questionnaire survey which targeted 330 practitioners in the Moroccan construction field, several barriers were identified as key barriers. The findings of this investigation revealed that there are significant barriers such as Lack of knowledge about Lean Construction concepts, Unskilled Human Resources, and insufficient financial resources.

LPG gaseous phase electronic port injection on performance, emission and combustion characteristics of Lean Burn SI Engine

NASA Astrophysics Data System (ADS)

Bhasker J, Pradeep; E, Porpatham

2016-08-01

Gaseous fuels have always been established as an assuring way to lessen emissions in Spark Ignition engines. In particular, LPG resolved to be an affirmative fuel for SI engines because of their efficient combustion properties, lower emissions and higher knock resistance. This paper investigates performance, emission and combustion characteristics of a microcontroller based electronic LPG gaseous phase port injection system. Experiments were carried out in a single cylinder diesel engine altered to behave as SI engine with LPG as fuel at a compression ratio of 10.5:1. The engine was regulated at 1500 rpm at a throttle position of 20% at diverse equivalence ratios. The test results were compared with that of the carburetion system. The results showed that there was an increase in brake power output and brake thermal efficiency with LPG gas phase injection. There was an appreciable extension in the lean limit of operation and maximum brake power output under lean conditions. LPG injection technique significantly reduces hydrocarbon and carbon monoxide emissions. Also, it extremely enhances the rate of combustion and helps in extending the lean limit of LPG. There was a minimal increase of NOx emissions over the lean operating range due to higher temperature. On the whole it is concluded that port injection of LPG is best suitable in terms of performance and emission for LPG fuelled lean burn SI engine.

Application of lean manufacturing concepts to drug discovery: rapid analogue library synthesis.

PubMed

Weller, Harold N; Nirschl, David S; Petrillo, Edward W; Poss, Michael A; Andres, Charles J; Cavallaro, Cullen L; Echols, Martin M; Grant-Young, Katherine A; Houston, John G; Miller, Arthur V; Swann, R Thomas

2006-01-01

The application of parallel synthesis to lead optimization programs in drug discovery has been an ongoing challenge since the first reports of library synthesis. A number of approaches to the application of parallel array synthesis to lead optimization have been attempted over the years, ranging from widespread deployment by (and support of) individual medicinal chemists to centralization as a service by an expert core team. This manuscript describes our experience with the latter approach, which was undertaken as part of a larger initiative to optimize drug discovery. In particular, we highlight how concepts taken from the manufacturing sector can be applied to drug discovery and parallel synthesis to improve the timeliness and thus the impact of arrays on drug discovery.

Estimation of lipids and lean mass of migrating sandpipers

USGS Publications Warehouse

Skagen, Susan K.; Knopf, Fritz L.; Cade, Brian S.

1993-01-01

Estimation of lean mass and lipid levels in birds involves the derivation of predictive equations that relate morphological measurements and, more recently, total body electrical conductivity (TOBEC) indices to known lean and lipid masses. Using cross-validation techniques, we evaluated the ability of several published and new predictive equations to estimate lean and lipid mass of Semipalmated Sandpipers (Calidris pusilla) and White-rumped Sandpipers (C. fuscicollis). We also tested ideas of Morton et al. (1991), who stated that current statistical approaches to TOBEC methodology misrepresent precision in estimating body fat. Three published interspecific equations using TOBEC indices predicted lean and lipid masses of our sample of birds with average errors of 8-28% and 53-155%, respectively. A new two-species equation relating lean mass and TOBEC indices revealed average errors of 4.6% and 23.2% in predicting lean and lipid mass, respectively. New intraspecific equations that estimate lipid mass directly from body mass, morphological measurements, and TOBEC indices yielded about a 13% error in lipid estimates. Body mass and morphological measurements explained a substantial portion of the variance (about 90%) in fat mass of both species. Addition of TOBEC indices improved the predictive model more for the smaller than for the larger sandpiper. TOBEC indices explained an additional 7.8% and 2.6% of the variance in fat mass and reduced the minimum breadth of prediction intervals by 0.95 g (32%) and 0.39 g (13%) for Semipalmated and White-rumped Sandpipers, respectively. The breadth of prediction intervals for models used to predict fat levels of individual birds must be considered when interpreting the resultant lipid estimates.

Comparison of muscle/lean mass measurement methods: correlation with functional and biochemical testing.

PubMed

Buehring, B; Siglinsky, E; Krueger, D; Evans, W; Hellerstein, M; Yamada, Y; Binkley, N

2018-03-01

DXA-measured lean mass is often used to assess muscle mass but has limitations. Thus, we compared DXA lean mass with two novel methods-bioelectric impedance spectroscopy and creatine (methyl-d3) dilution. The examined methodologies did not measure lean mass similarly and the correlation with muscle biomarkers/function varied. Muscle function tests predict adverse health outcomes better than lean mass measurement. This may reflect limitations of current mass measurement methods. Newer approaches, e.g., bioelectric impedance spectroscopy (BIS) and creatine (methyl-d3) dilution (D3-C), may more accurately assess muscle mass. We hypothesized that BIS and D3-C measured muscle mass would better correlate with function and bone/muscle biomarkers than DXA measured lean mass. Evaluations of muscle/lean mass, function, and serum biomarkers were obtained in older community-dwelling adults. Mass was assessed by DXA, BIS, and orally administered D3-C. Grip strength, timed up and go, and jump power were examined. Potential muscle/bone serum biomarkers were measured. Mass measurements were compared with functional and serum data using regression analyses; differences between techniques were determined by paired t tests. Mean (SD) age of the 112 (89F/23M) participants was 80.6 (6.0) years. The lean/muscle mass assessments were correlated (.57-.88) but differed (p < 0.0001) from one another with DXA total body less head being highest at 37.8 (7.3) kg, D3-C muscle mass at 21.1 (4.6) kg, and BIS total body intracellular water at 17.4 (3.5) kg. All mass assessment methods correlated with grip strength and jump power (R = 0.35-0.63, p < 0.0002), but not with gait speed or repeat chair rise. Lean mass measures were unrelated to the serum biomarkers measured. These three methodologies do not similarly measure muscle/lean mass and should not be viewed as being equivalent. Functional tests assessing maximal muscle strength/power (grip strength and jump power) correlated with all mass measures whereas gait speed was not. None of the selected serum measures correlated with mass. Efforts to optimize muscle mass assessment and identify their relationships with health outcomes are needed.

Effect of Alloying Type and Lean Sintering Atmosphere on the Performance of PM Components

NASA Astrophysics Data System (ADS)

Sundaram, M. Vattur; Shvab, R.; Millot, S.; Hryha, E.; Nyborg, L.

2017-12-01

In order to be cost effective and to meet increasing performance demands, powder metallurgy steel components require continuous improvement in terms of materials and process development. This study demonstrates the feasibility of manufacturing structural components using two different alloys systems, i.e. lean Cr-prealloyed and diffusion bonded water atomised powders with different processing conditions. The components were sintered at two different temperatures, i.e. 1120 and 1250 °C for 30 minutes in three different atmospheres: vacuum, N2- 10%H2 atmosphere as well as lean N2-5%H2-0.5%CO-(0.1-0.4)%CH4 sintering atmosphere. Components after sintering were further processed by either low pressure carburizing, sinterhardening or case hardening. All trials were performed in the industrial furnaces to simulate the actual production of the components. Microstructure, fractography, apparent and micro hardness analyses were performed close to the surface and in the middle of the sample to characterize the degree of sintering (temperature and atmosphere) and the effect of heat treatment. In all cases, components possess mostly martensitic microstructure with a few bainitic regions. The fracture surface shows well developed sinter necks. Inter- and trans-granular ductile and cleavage fracture modes are dominant and their fraction is determined by the alloy and processing route.

Analysis of Agility Performance of Supply Chain: A Case Study on Indian Automotive Manufacturer

NASA Astrophysics Data System (ADS)

Routroy, S.; Sharma, S.; Bhardwaj, A.

2018-04-01

Manufacturing companies should understand the changing customer needs and expectations, access and defend the competitive pressure, anticipate and manage the uncertain demand and supply chain risk, and implement the appropriate technology to survive and excel in today’s marketplace. Therefore, they are moving away from mass production (i.e. lean supply chain) to one based on fast-responsiveness and flexibility, capitalizing on the rapid advancement in internet technologies and factory-on-demand mode of production (i.e. agile supply chain). It is observed that manufacturing companies in India in general and automotive supply chain in specific are compelled to cultivate supply chain agility for enhancing its performance level on continuous basis and comparing its supply chain agility performance with competitors to survive and sustain in the competitive business environment. Therefore, a methodology is proposed to evaluate the supply chain agility of a manufacturing supply chain and compare its performance level with competitors using Fuzzy Analytic Hierarchy Process and Taguchi Loss Function. A case study is developed and the proposed methodology is applied to Indian automotive supply chain for explaining the salient features of it.

Basins of attraction in human balance

NASA Astrophysics Data System (ADS)

Smith, Victoria A.; Lockhart, Thurmon E.; Spano, Mark L.

2017-12-01

Falls are a recognized risk factor for unintentional injuries among older adults, accounting for a large proportion of fractures, emergency department visits, and urgent hospitalizations. Human balance and gait research traditionally uses linear or qualitative tests to assess and describe human motion; however, human motion is neither a simple nor a linear process. The objective of this research is to identify and to learn more about what factors affect balance using nonlinear dynamical techniques, such as basin boundaries. Human balance data was collected using dual force plates for leans using only ankle movements as well as for unrestricted leans. Algorithms to describe the basin boundary were created and compared based on how well each method encloses the experimental data points as well as captures the differences between the two leaning conditions.

Throughput Optimization of Continuous Biopharmaceutical Manufacturing Facilities.

PubMed

Garcia, Fernando A; Vandiver, Michael W

2017-01-01

In order to operate profitably under different product demand scenarios, biopharmaceutical companies must design their facilities with mass output flexibility in mind. Traditional biologics manufacturing technologies pose operational challenges in this regard due to their high costs and slow equipment turnaround times, restricting the types of products and mass quantities that can be processed. Modern plant design, however, has facilitated the development of lean and efficient bioprocessing facilities through footprint reduction and adoption of disposable and continuous manufacturing technologies. These development efforts have proven to be crucial in seeking to drastically reduce the high costs typically associated with the manufacturing of recombinant proteins. In this work, mathematical modeling is used to optimize annual production schedules for a single-product commercial facility operating with a continuous upstream and discrete batch downstream platform. Utilizing cell culture duration and volumetric productivity as process variables in the model, and annual plant throughput as the optimization objective, 3-D surface plots are created to understand the effect of process and facility design on expected mass output. The model shows that once a plant has been fully debottlenecked it is capable of processing well over a metric ton of product per year. Moreover, the analysis helped to uncover a major limiting constraint on plant performance, the stability of the neutralized viral inactivated pool, which may indicate that this should be a focus of attention during future process development efforts. LAY ABSTRACT: Biopharmaceutical process modeling can be used to design and optimize manufacturing facilities and help companies achieve a predetermined set of goals. One way to perform optimization is by making the most efficient use of process equipment in order to minimize the expenditure of capital, labor and plant resources. To that end, this paper introduces a novel mathematical algorithm used to determine the most optimal equipment scheduling configuration that maximizes the mass output for a facility producing a single product. The paper also illustrates how different scheduling arrangements can have a profound impact on the availability of plant resources, and identifies limiting constraints on the plant design. In addition, simulation data is presented using visualization techniques that aid in the interpretation of the scientific concepts discussed. © PDA, Inc. 2017.

Relationship-centered health care as a Lean intervention.

PubMed

Dunsford, Jennifer; Reimer, Laura E

2017-12-01

Continuous improvement efforts, recognized in much literature as Lean management techniques have been used in efforts to improve efficiency in democratic health care contexts for some time to varying degrees of success. The complexity of the health care system is magnified by the sheer number of processes and sub processes required to deliver value within a bureaucratic environment, while maintaining some level of compassionate and personalized care. There is inherent tension between what is required to be efficient and what is required to be caring and this conflict presses against Lean practice at the level of delivery.Administration and care intersect at the point of the patient's experience. In order to achieve the dual goals of improved value and lower costs, the application of Lean thinking for meaningful health care reform must acknowledge the fundamental dichotomy between the impersonal tasks required to provide health services, and human interactions. Meaningful health care reform requires an acknowledgement of this distinction, currently not recognized in literature. While administrative process improvements are necessary, they are insufficient to achieve a sustainable and caring health care system. Lean thinking must be applied differently for administrative processes and patient care encounters, because these are fundamentally different processes. In this way, Lean principles will effectively contribute to sustainable health system improvements. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The effect of short-term fasting on liver and skeletal muscle lipid, glucose, and energy metabolism in healthy women and men

PubMed Central

Browning, Jeffrey D.; Baxter, Jeannie; Satapati, Santhosh; Burgess, Shawn C.

2012-01-01

Fasting promotes triglyceride (TG) accumulation in lean tissues of some animals, but the effect in humans is unknown. Additionally, fasting lipolysis is sexually dimorphic in humans, suggesting that lean tissue TG accumulation and metabolism may differ between women and men. This study investigated lean tissue TG content and metabolism in women and men during extended fasting. Liver and muscle TG content were measured by magnetic resonance spectroscopy during a 48-h fast in healthy men and women. Whole-body and hepatic carbohydrate, lipid, and energy metabolism were also evaluated using biochemical, calorimetric, and stable isotope tracer techniques. As expected, postabsorptive plasma fatty acids (FAs) were higher in women than in men but increased more rapidly in men with the onset of early starvation. Concurrently, sexual dimorphism was apparent in lean tissue TG accumulation during the fast, occurring in livers of men but in muscles of women. Despite differences in lean tissue TG distribution, men and women had identical fasting responses in whole-body and hepatic glucose and oxidative metabolism. In conclusion, TG accumulated in livers of men but in muscles of women during extended fasting. This sexual dimorphism was related to differential fasting plasma FA concentrations but not to whole body or hepatic utilization of this substrate. PMID:22140269

Monte-Carlo computation of turbulent premixed methane/air ignition

NASA Astrophysics Data System (ADS)

Carmen, Christina Lieselotte

The present work describes the results obtained by a time dependent numerical technique that simulates the early flame development of a spark-ignited premixed, lean, gaseous methane/air mixture with the unsteady spherical flame propagating in homogeneous and isotropic turbulence. The algorithm described is based upon a sub-model developed by an international automobile research and manufacturing corporation in order to analyze turbulence conditions within internal combustion engines. Several developments and modifications to the original algorithm have been implemented including a revised chemical reaction scheme and the evaluation and calculation of various turbulent flame properties. Solution of the complete set of Navier-Stokes governing equations for a turbulent reactive flow is avoided by reducing the equations to a single transport equation. The transport equation is derived from the Navier-Stokes equations for a joint probability density function, thus requiring no closure assumptions for the Reynolds stresses. A Monte-Carlo method is also utilized to simulate phenomena represented by the probability density function transport equation by use of the method of fractional steps. Gaussian distributions of fluctuating velocity and fuel concentration are prescribed. Attention is focused on the evaluation of the three primary parameters that influence the initial flame kernel growth-the ignition system characteristics, the mixture composition, and the nature of the flow field. Efforts are concentrated on the effects of moderate to intense turbulence on flames within the distributed reaction zone. Results are presented for lean conditions with the fuel equivalence ratio varying from 0.6 to 0.9. The present computational results, including flame regime analysis and the calculation of various flame speeds, provide excellent agreement with results obtained by other experimental and numerical researchers.

Lean management in academic surgery.

PubMed

Collar, Ryan M; Shuman, Andrew G; Feiner, Sandra; McGonegal, Amy K; Heidel, Natalie; Duck, Mary; McLean, Scott A; Billi, John E; Healy, David W; Bradford, Carol R

2012-06-01

Lean is a management system designed to enhance productivity by eliminating waste. Surgical practice offers many opportunities for improving efficiency. Our objective was to determine whether systematic implementation of lean thinking in an academic otolaryngology operating room improves efficiency and profitability and preserves team morale and educational opportunities. In an 18-month prospective quasi-experimental study, a multidisciplinary task force systematically implemented lean thinking within an otolaryngology operating room of an academic health system. Operating room turnover time and turnaround time were measured during a baseline period; an observer-effect period in which workers were made aware that their efficiency was being measured but before implementing lean changes; and an intervention period after redesign principles had been used. The impact on teamwork, morale, and surgical resident education were measured during the baseline and intervention periods through validated surveys. A profit model was applied to estimate the financial implications of the study. There was no difference between the baseline and observer-effect periods of the study for turnover time (p = 0.98) or turnaround time (p = 0.20). During the intervention period, the mean turnover time and turnaround time were significantly shorter than during the baseline period (29 vs 38 minutes; p < 0.001 and 69 vs 89 minutes; p < 0.001, respectively). The composite morale score suggested improved morale after implementation (p = 0.011). Educational metrics were unchanged before and after implementation. The annual opportunity revenue for the involved operating room is $330,000; when extrapolated throughout the operating rooms, lean thinking could create 6,500 hours of capacity annually. Application of lean management techniques to a single operating room and surgical service improved operating room efficiency and morale, sustained resident education, and can provide considerable financial gains when scaled to an entire academic surgical suite. Copyright © 2012. Published by Elsevier Inc.

Installation and testing of a cummins Qsk19 lean burn natural gas engine

NASA Astrophysics Data System (ADS)

Sutley, Franklin H.

The goal for a more efficient engine will never disappear. Over the years many different techniques have been explored within the common goal of higher efficiency. Lean combustion has proven to be effective at increasing efficiencies as well as reducing emissions. The purpose of this thesis is to install a modern Cummins QSK19G and perform certain test that will explore the lean combustion limits and other methods that could possibly increase efficiency even more. The entire installation and instrumentation process is documented within this thesis. The engine was installed in the Engines and Energy Conversion Laboratory at Colorado State University. The engine was installed with the hopes of instilling the desire for endless future tests from Cummins as well as other companies seeking this type of research engine. The lean limit was explored in the most detail. Cummins supplied a test plan that satisfied their desired stopping at a lean limit when the coefficient of variance of indicated mean effective pressure reached 5%. For the curiosity of others involved and this thesis, the lean limit was explored further until the engine could no longer ignite the ultra-lean combustion mixture. Friction accounts for a significant loss in a modern internal combustion engine. One role of the engine oil is to reduce these frictional losses as much as possible without causing increased wear. A test was conducted on the QSK19G to explore the effects of varying the engine oil viscosity. Frictional losses of two different viscosity oils were compared to the stock engine oil losses. The fact that reducing oil viscosity reduces frictional losses was proven in the test.

Anthropometric and computerized tomographic measurements of lower extremity lean body mass.

PubMed

Buckley, D C; Kudsk, K A; Rose, B S; Fatzinger, P; Koetting, C A; Schlatter, M

1987-02-01

The loss of lean muscle mass is one of the hallmarks of protein-calorie malnutrition. Anthropometry is a standardized technique used to assess the response of muscle mass to nutrition therapy by quantifying the muscle and fat compartments. That technique does not accurately reflect actual limb composition, whereas computerized tomography does. Twenty lower extremities on randomly chosen men and women patients were evaluated by anthropometry and computerized tomography. Total area, muscle plus bone area, total volume, and muscle plus bone volume were correlated, using Heymsfield's equation and computerized tomography-generated areas. Anthropometrics overestimated total and muscle plus bone cross-sectional areas at almost every level. Anthropometry overestimated total area and total volume by 5% to 10% but overestimated muscle plus bone area and muscle plus bone volume by as much as 40%. Anthropometry, while easily performed and useful in large population groups for epidemiological studies, offers a poor assessment of lower extremity composition. On the other hand, computerized tomography is also easily performed and, while impractical for large population groups, does offer an accurate assessment of the lower extremity tissue compartments and is an instrument that might be used in research on lean muscle mass.

Using Lean principles to manage throughput on an inpatient rehabilitation unit.

PubMed

Chiodo, Anthony; Wilke, Ruste; Bakshi, Rishi; Craig, Anita; Duwe, Doug; Hurvitz, Edward

2012-11-01

Performance improvement is a mainstay of operations management and maintenance of certification. In this study at a University Hospital inpatient rehabilitation unit, Lean management techniques were used to manage throughput of patients into and out of the inpatient rehabilitation unit. At the start of this process, the average admission time to the rehabilitation unit was 5:00 p.m., with a median time of 3:30 p.m., and no patients received therapy on the day of admission. Within 8 mos, the mean admission time was 1:22 p.m., 50% of the patients were on the rehabilitation unit by 1:00 p.m., and more than 70% of all patients received therapy on the day of admission. Negative variance from this performance was evaluated, the identification of inefficient discharges holding up admissions as a problem was identified, and a Lean workshop was initiated. Once this problem was tackled, the prime objective of 70% of patients receiving therapy on the date of admission was consistently met. Lean management tools are effective in improving throughput on an inpatient rehabilitation unit.

Improving ED specimen TAT using Lean Six Sigma.

PubMed

Sanders, Janet H; Karr, Tedd

2015-01-01

Lean and Six Sigma are continuous improvement methodologies that have garnered international fame for improving manufacturing and service processes. Increasingly these methodologies are demonstrating their power to also improve healthcare processes. The purpose of this paper is to discuss a case study for the application of Lean and Six Sigma tools in the reduction of turnaround time (TAT) for Emergency Department (ED) specimens. This application of the scientific methodologies uncovered opportunities to improve the entire ED to lab system for the specimens. This case study provides details on the completion of a Lean Six Sigma project in a 1,000 bed tertiary care teaching hospital. Six Sigma's Define, Measure, Analyze, Improve, and Control methodology is very similar to good medical practice: first, relevant information is obtained and assembled; second, a careful and thorough diagnosis is completed; third, a treatment is proposed and implemented; and fourth, checks are made to determine if the treatment was effective. Lean's primary goal is to do more with less work and waste. The Lean methodology was used to identify and eliminate waste through rapid implementation of change. The initial focus of this project was the reduction of turn-around-times for ED specimens. However, the results led to better processes for both the internal and external customers of this and other processes. The project results included: a 50 percent decrease in vials used for testing, a 50 percent decrease in unused or extra specimens, a 90 percent decrease in ED specimens without orders, a 30 percent decrease in complete blood count analysis (CBCA) Median TAT, a 50 percent decrease in CBCA TAT Variation, a 10 percent decrease in Troponin TAT Variation, a 18.2 percent decrease in URPN TAT Variation, and a 2-5 minute decrease in ED registered nurses rainbow draw time. This case study demonstrated how the quantitative power of Six Sigma and the speed of Lean worked in harmony to improve the blood draw process for a 1,000 bed tertiary care teaching hospital. The blood draw process is a standard process used in hospitals to collect blood chemistry and hematology information for clinicians. The methods used in this case study demonstrated valuable and practical applications of process improvement methodologies that can be used for any hospital process and/or service environment. While this is not the first case study that has demonstrated the use of continuous process improvement methodologies to improve a hospital process, it is unique in the way in which it utilizes the strength of the project focussed approach that adheres more to the structure and rigor of Six Sigma and relied less on the speed of lean. Additionally, the application of these methodologies in healthcare is emerging research.

Optimizing The DSSC Fabrication Process Using Lean Six Sigma

NASA Astrophysics Data System (ADS)

Fauss, Brian

Alternative energy technologies must become more cost effective to achieve grid parity with fossil fuels. Dye sensitized solar cells (DSSCs) are an innovative third generation photovoltaic technology, which is demonstrating tremendous potential to become a revolutionary technology due to recent breakthroughs in cost of fabrication. The study here focused on quality improvement measures undertaken to improve fabrication of DSSCs and enhance process efficiency and effectiveness. Several quality improvement methods were implemented to optimize the seven step individual DSSC fabrication processes. Lean Manufacturing's 5S method successfully increased efficiency in all of the processes. Six Sigma's DMAIC methodology was used to identify and eliminate each of the root causes of defects in the critical titanium dioxide deposition process. These optimizations resulted with the following significant improvements in the production process: 1. fabrication time of the DSSCs was reduced by 54 %; 2. fabrication procedures were improved to the extent that all critical defects in the process were eliminated; 3. the quantity of functioning DSSCs fabricated was increased from 17 % to 90 %.

A practical guide to applying lean tools and management principles to health care improvement projects.

PubMed

Simon, Ross W; Canacari, Elena G

2012-01-01

Manufacturing organizations have used Lean management principles for years to help eliminate waste, streamline processes, and cut costs. This pragmatic approach to structured problem solving can be applied to health care process improvement projects. Health care leaders can use a step-by-step approach to document processes and then identify problems and opportunities for improvement using a value stream process map. Leaders can help a team identify problems and root causes and consider additional problems associated with methods, materials, manpower, machinery, and the environment by using a cause-and-effect diagram. The team then can organize the problems identified into logical groups and prioritize the groups by impact and difficulty. Leaders must manage action items carefully to instill a sense of accountability in those tasked to complete the work. Finally, the team leaders must ensure that a plan is in place to hold the gains. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Use of lean and six sigma methodology to improve operating room efficiency in a high-volume tertiary-care academic medical center.

PubMed

Cima, Robert R; Brown, Michael J; Hebl, James R; Moore, Robin; Rogers, James C; Kollengode, Anantha; Amstutz, Gwendolyn J; Weisbrod, Cheryl A; Narr, Bradly J; Deschamps, Claude

2011-07-01

Operating rooms (ORs) are resource-intense and costly hospital units. Maximizing OR efficiency is essential to maintaining an economically viable institution. OR efficiency projects often focus on a limited number of ORs or cases. Efforts across an entire OR suite have not been reported. Lean and Six Sigma methodologies were developed in the manufacturing industry to increase efficiency by eliminating non-value-added steps. We applied Lean and Six Sigma methodologies across an entire surgical suite to improve efficiency. A multidisciplinary surgical process improvement team constructed a value stream map of the entire surgical process from the decision for surgery to discharge. Each process step was analyzed in 3 domains, ie, personnel, information processed, and time. Multidisciplinary teams addressed 5 work streams to increase value at each step: minimizing volume variation; streamlining the preoperative process; reducing nonoperative time; eliminating redundant information; and promoting employee engagement. Process improvements were implemented sequentially in surgical specialties. Key performance metrics were collected before and after implementation. Across 3 surgical specialties, process redesign resulted in substantial improvements in on-time starts and reduction in number of cases past 5 pm. Substantial gains were achieved in nonoperative time, staff overtime, and ORs saved. These changes resulted in substantial increases in margin/OR/day. Use of Lean and Six Sigma methodologies increased OR efficiency and financial performance across an entire operating suite. Process mapping, leadership support, staff engagement, and sharing performance metrics are keys to enhancing OR efficiency. The performance gains were substantial, sustainable, positive financially, and transferrable to other specialties. Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Impact of Lean on patient cycle and waiting times at a rural district hospital in KwaZulu-Natal.

PubMed

Naidoo, Logandran; Mahomed, Ozayr H

2016-07-26

Prolonged waiting time is a source of patient dissatisfaction with health care and is negatively associated with patient satisfaction. Prolonged waiting times in many district hospitals result in many dissatisfied patients, overworked and frustrated staff, and poor quality of care because of the perceived increased workload. The aim of the study was to determine the impact of Lean principles techniques, and tools on the operational efficiency in the outpatient department (OPD) of a rural district hospital. The study was conducted at the Catherine Booth Hospital (CBH) - a rural district hospital in KwaZulu-Natal, South Africa. This was an action research study with pre-, intermediate-, and post-implementation assessments. Cycle and waiting times were measured by direct observation on two occasions before, approximately two-weekly during, and on two occasions after Lean implementation. A standardised data collection tool was completed by the researcher at each of the six key service nodes in the OPD to capture the waiting times and cycle times. All six service nodes showed a reduction in cycle times and waiting times between the baseline assessment and post-Lean implementation measurement. Significant reduction was achieved in cycle times (27%; p < 0.05) and waiting times (from 11.93 to 10 min; p = 0.03) at the Investigations node. Although the target reduction was not achieved for the Consulting Room node, there was a significant reduction in waiting times from 80.95 to 74.43 min, (p < 0.001). The average efficiency increased from 16.35% (baseline) to 20.13% (post-intervention). The application of Lean principles, tools and techniques provides hospital managers with an evidence-based management approach to resolving problems and improving quality indicators.

Postprandial response of ghrelin and PYY and indices of low-grade chronic inflammation in lean young women with polycystic ovary syndrome.

PubMed

Zwirska-Korczala, K; Sodowski, K; Konturek, S J; Kuka, D; Kukla, M; Brzozowski, T; Cnota, W; Woźniak-Grygiel, E; Jaworek, J; Bułdak, R; Rybus-Kalinowska, B; Fryczowski, M

2008-08-01

The aim of the study were to answer the question 1.) Whether circulating pro-inflammatory markers of endothelial dysfunction and due to chronic low-grade inflammation of obesity, are altered in untreated lean, young relatively healthy polycystic ovary syndrome (PCOS) patients in comparison with healthy controls; 2.) Whether postprandial plasma concentration pattern of ghrelin and PYY can be predictable as risk factors for atherosclerosis and depend of obesity. Forty young women with PCOS were divided in two groups: 19 lean and 21 obese. The control group included 20 lean, healthy volunteers. Plasma total and active ghrelin, total PYY and PYY(3-36), serum adiponectin and insulin were measured using RIA technique, serum sCD40L, visfatin, sP-, sE-selectins, resistin by EIA. Composition of test meal was: 527 kcal total and consisted of 24.1% fat, 54.4% carbohydrate and 21.5% protein. Total and active ghrelin and total PYY were significantly lower in obese PCOS women, whereas active ghrelin was also significantly lower in lean PCOS women compared to controls. Postprandial plasma total ghrelin levels decrease were blunted in lean and obese compared to controls (12.8 % and 18.2% vs 28.2 %). Postprandial plasma active ghrelin decreased in lean and obese PCOS groups (49.9 % and 44.1 %) and controls (63.8 %). PCOS subjects exhibited smaller rises in postprandial levels of total PYY. Postprandial plasma PYY(3-36) levels increased in obese PCOS women (30.9 %) and controls (41%), whereas lean PCOS women exhibited blunted increase (11.5%). sCD40L levels increased, whereas adiponectin decreased in PCOS groups independently, whereas rise in visfatin, sE- and sP-selectin and the fall in adiponectin was associated with obesity. sP- and sE -selectins correlated positively with obesity. In summary, our study provides the first evidence that lean untreated young PCOS women contribute to the so called "pancreatic islet adaptation to insulin resistance" because of ghrelin and PYY profiles. We confirmed existing of low-grade chronic inflammation in early stage of visceral obesity in lean PCOS patients. The lost endogenous "islet adaptation to insulin resistance" may lead to endothelial dysfunction and promote acceleration of atherosclerosis.

How to Reduce Head CT Orders in Children with Hydrocephalus Using the Lean Six Sigma Methodology: Experience at a Major Quaternary Care Academic Children's Center.

PubMed

Tekes, A; Jackson, E M; Ogborn, J; Liang, S; Bledsoe, M; Durand, D J; Jallo, G; Huisman, T A G M

2016-06-01

Lean Six Sigma methodology is increasingly used to drive improvement in patient safety, quality of care, and cost-effectiveness throughout the US health care delivery system. To demonstrate our value as specialists, radiologists can combine lean methodologies along with imaging expertise to optimize imaging elements-of-care pathways. In this article, we describe a Lean Six Sigma project with the goal of reducing the relative use of pediatric head CTs in our population of patients with hydrocephalus by 50% within 6 months. We applied a Lean Six Sigma methodology using a multidisciplinary team at a quaternary care academic children's center. The existing baseline imaging practice for hydrocephalus was outlined in a Kaizen session, and potential interventions were discussed. An improved radiation-free workflow with ultrafast MR imaging was created. Baseline data were collected for 3 months by using the departmental radiology information system. Data collection continued postintervention and during the control phase (each for 3 months). The percentage of neuroimaging per technique (head CT, head ultrasound, ultrafast brain MR imaging, and routine brain MR imaging) was recorded during each phase. The improved workflow resulted in a 75% relative reduction in the percentage of hydrocephalus imaging performed by CT between the pre- and postintervention/control phases (Z-test, P = .0001). Our lean interventions in the pediatric hydrocephalus care pathway resulted in a significant reduction in head CT orders and increased use of ultrafast brain MR imaging. © 2016 by American Journal of Neuroradiology.

Error-free pathology: applying lean production methods to anatomic pathology.

PubMed

Condel, Jennifer L; Sharbaugh, David T; Raab, Stephen S

2004-12-01

The current state of our health care system calls for dramatic changes. In their pathology department, the authors believe these changes may be accomplished by accepting the long-term commitment of applying a lean production system. The ideal state of zero pathology errors is one that should be pursued by consistently asking, "Why can't we?" The philosophy of lean production systems began in the manufacturing industry: "All we are doing is looking at the time from the moment the customer gives us an order to the point when we collect the cash. And we are reducing that time line by removing non-value added wastes". The ultimate goals in pathology and overall health care are not so different. The authors' intention is to provide the patient (customer) with the most accurate diagnostic information in a timely and efficient manner. Their lead histotechnologist recently summarized this philosophy: she indicated that she felt she could sleep better at night knowing she truly did the best job she could. Her chances of making an error (in cutting or labeling) were dramatically decreased in the one-by-one continuous flow work process compared with previous practices. By designing a system that enables employees to be successful in meeting customer demand, and by empowering the frontline staff in the development and problem solving processes, one can meet the challenges of eliminating waste and build an improved, efficient system.

Concept of Operations Visualization for Ares I Production

NASA Technical Reports Server (NTRS)

Chilton, Jim; Smith, David Alan

2008-01-01

Establishing Computer Aided Design models of the Ares I production facility, tooling and vehicle components and integrating them into manufacturing visualizations/simulations allows Boeing and NASA to collaborate real time early in the design/development cycle. This collaboration identifies cost effective and lean solutions that can be easily shared with Ares stakeholders (e.g., other NASA Centers and potential science users). These Ares I production visualizations and analyses by their nature serve as early manufacturing improvement precursors for other Constellation elements to be built at the Michoud Assembly Facility such as Ares V and the Altair Lander. Key to this Boeing and Marshall Space Flight Center collaboration has been the use of advanced virtual manufacturing tools to understand the existing Shuttle era infrastructure and trade potential modifications to support Ares I production. These approaches are then used to determine an optimal manufacturing configuration in terms of labor efficiency, safety and facility enhancements. These same models and tools can be used in an interactive simulation of Ares I and V flight to the Space Station or moon to educate the human space constituency (e.g., government, academia, media and the public) in order to increase national and international understanding of Constellation goals and benefits.

A collaborative approach to lean laboratory workstation design reduces wasted technologist travel.

PubMed

Yerian, Lisa M; Seestadt, Joseph A; Gomez, Erron R; Marchant, Kandice K

2012-08-01

Lean methodologies have been applied in many industries to reduce waste. We applied Lean techniques to redesign laboratory workstations with the aim of reducing the number of times employees must leave their workstations to complete their tasks. At baseline in 68 workflows (aggregates or sequence of process steps) studied, 251 (38%) of 664 tasks required workers to walk away from their workstations. After analysis and redesign, only 59 (9%) of the 664 tasks required technologists to leave their workstations to complete these tasks. On average, 3.4 travel events were removed for each workstation. Time studies in a single laboratory section demonstrated that workers spend 8 to 70 seconds in travel each time they step away from the workstation. The redesigned workstations will allow employees to spend less time travelling around the laboratory. Additional benefits include employee training in waste identification, improved overall laboratory layout, and identification of other process improvement opportunities in our laboratory.

Network model of project "Lean Production"

NASA Astrophysics Data System (ADS)

Khisamova, E. D.

2018-05-01

Economical production implies primarily new approaches to culture of management and organization of production and offers a set of tools and techniques that allows reducing losses significantly and making the process cheaper and faster. Economical production tools are simple solutions that allow one to see opportunities for improvement of all aspects of the business, to reduce losses significantly, to constantly improve the whole spectrum of business processes, to increase significantly the transparency and manageability of the organization, to take advantage of the potential of each employee of the company, to increase competitiveness, and to obtain significant economic benefits without making large financial expenditures. Each of economical production tools solves a specific part of the problems, and only application of their combination will allow one to solve the problem or minimize it to acceptable values. The research of the governance process project "Lean Production" permitted studying the methods and tools of lean production and developing measures for their improvement.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barasinski, Anaies; Leygue, Adrien; Poitou, Arnaud

The thermoplastic tape placement process offers the possibility of manufacturing large laminated composite parts with all kinds of geometries (double curved i.e.). This process is based on the fusion bonding of a thermoplastic tape on a substrate. It has received a growing interest during last years because of its non autoclave abilities.In order to control and optimize the quality of the manufactured part, we need to predict the temperature field throughout the processing of the laminate. In this work, we focus on a thermal modeling of this process which takes in account the imperfect bonding existing between the different layersmore » of the substrate by introducing thermal contact resistance in the model. This study is leaning on experimental results which inform us that the value of the thermal resistance evolves with temperature and pressure applied on the material.« less

A Case Study: Using Delmia at Kennedy Space Center to Support NASA's Constellation Program

NASA Technical Reports Server (NTRS)

Kickbusch, Tracey; Humeniuk, Bob

2010-01-01

The presentation examines the use of Delmia (Digital Enterprise Lean Manufacturing Interactive Application) for digital simulation in NASA's Constellation Program. Topics include an overview of the Kennedy Space Center (KSC) Design Visualization Group tasks, NASA's Constellation Program, Ares 1 ground processing preliminary design review, and challenges and how Delmia is used at KSC, Challenges include dealing with large data sets, creating and maintaining KSC's infrastructure, gathering customer requirements and meeting objectives, creating life-like simulations, and providing quick turn-around on varied products,

Efficient Project Delivery Using Lean Principles - An Indian Case Study

NASA Astrophysics Data System (ADS)

Kovvuri, P. Ramachandra Reddy; Sawhney, Anil; Ahuja, Ritu; Sreekumar, Aiswarya

2016-03-01

Construction industry in India is growing at a rapid pace. Along with this growth, the industry is facing numerous challenges that are making delivery of projects inefficient. Experts believe that capacity constraints in the industry need to be addressed immediately. Government has recommended `introduction of efficient technologies and modern management techniques' to increase the productivity of the industry. In this context, lean principles can act as a lever to make project delivery more efficient and provide the much needed impetus to the Indian construction sector. Around the globe lean principles are showing positive results on the projects. Project teams are reporting improvements in construction time, cost and quality along with softer benefits of enhanced collaboration, coordination and trust in project teams. Can adoption of lean principles provide similar benefits in the Indian construction sector? This research was conducted to answer this question. Using an action research approach a key lean construction tool called Last Planner System (LPS) was tested on a large Indian construction project. The work described in this work investigates the improvements achieved in project delivery by adopting LPS in Indian construction sector. Comparison in pre- and post-implementation data demonstrates increase in the certainty of work-flow and improves schedule compliance. This is measured through a simple LPS metric called percent plan complete. Explicit improvements in schedule performance are seen during 8 week LPS implementation along with implicit improvements in coordination, collaboration and trust in the project team. This work reports the findings of LPS implementation on the case study project outlining the barriers and drivers to adoption, strategies needed to ensure successful implementation and roadmap for implementation. Based on the findings the authors envision that lean construction can make project delivery more efficient in India.

Verticalization of behavior elicited by dopaminergic mobilization is qualitatively different between C57BL/6J and DBA/2J mice.

PubMed

Tirelli, E; Witkin, J M

1994-10-01

Behavioral effects of dopaminergic stimulation were evaluated in C57BL/6J mice and compared to the effects occurring in DBA/2J mice, an inbred strain with reduced densities of striatal dopamine receptors. Effects of apomorphine (0.5-64 mg/kg) alone and in combination with cocaine (30 mg/kg) were assessed using a time-sampling technique that classified climbing and leaning in separate categories. Locomotion was also assessed in a separate experiment. Climbing occurred in DBA/2J mice only at doses of apomorphine that were 16 times higher than the smallest effective dose in C57BL/6J mice; nevertheless, relative to baseline values, effects were fairly comparable. By contrast, whereas DBA/2J mice showed dose-dependent leaning under apomorphine, C57BL/6J mice exhibited little leaning even at doses not producing climbing, and only after the highest apomorphine dose was leaning significantly increased. Apomorphine was equipotent in inducing gnawing across strains, although somewhat less efficacious in DBA/2J mice. When given alone, cocaine produced significant climbing, but not leaning or gnawing, in either strain. Whereas cocaine potentiated apomorphine-induced climbing and gnawing in both strains, apomorphine-induced leaning was not consistently changed by cocaine in either strain. These effects were not indirectly due to hyperkinesia, since neither apomorphine alone nor apomorphine and cocaine in combination was stimulant; apomorphine alone reduced locomotor activity and attenuated cocaine-induced hyperkinesia. The present data do not support a unitary, purely quantitative, account of insensitivity to dopaminergic stimulation based upon low densities of striatal dopamine receptors in DBA/2J mice. Rather, this constellation of results is suggestive of qualitative interstrain dissimilarities in dopaminergic responsiveness that could reflect organizational differences in receptor populations.

Improving a Dental School's Clinic Operations Using Lean Process Improvement.

PubMed

Robinson, Fonda G; Cunningham, Larry L; Turner, Sharon P; Lindroth, John; Ray, Deborah; Khan, Talib; Yates, Audrey

2016-10-01

The term "lean production," also known as "Lean," describes a process of operations management pioneered at the Toyota Motor Company that contributed significantly to the success of the company. Although developed by Toyota, the Lean process has been implemented at many other organizations, including those in health care, and should be considered by dental schools in evaluating their clinical operations. Lean combines engineering principles with operations management and improvement tools to optimize business and operating processes. One of the core concepts is relentless elimination of waste (non-value-added components of a process). Another key concept is utilization of individuals closest to the actual work to analyze and improve the process. When the medical center of the University of Kentucky adopted the Lean process for improving clinical operations, members of the College of Dentistry trained in the process applied the techniques to improve inefficient operations at the Walk-In Dental Clinic. The purpose of this project was to reduce patients' average in-the-door-to-out-the-door time from over four hours to three hours within 90 days. Achievement of this goal was realized by streamlining patient flow and strategically relocating key phases of the process. This initiative resulted in patient benefits such as shortening average in-the-door-to-out-the-door time by over an hour, improving satisfaction by 21%, and reducing negative comments by 24%, as well as providing opportunity to implement the electronic health record, improving teamwork, and enhancing educational experiences for students. These benefits were achieved while maintaining high-quality patient care with zero adverse outcomes during and two years following the process improvement project.

Effect of walking speed on the gait of king penguins: An accelerometric approach.

PubMed

Willener, Astrid S T; Handrich, Yves; Halsey, Lewis G; Strike, Siobhán

2015-12-21

Little is known about non-human bipedal gaits. This is probably due to the fact that most large animals are quadrupedal and that non-human bipedal animals are mostly birds, whose primary form of locomotion is flight. Very little research has been conducted on penguin pedestrian locomotion with the focus instead on their associated high energy expenditure. In animals, tri-axial accelerometers are frequently used to estimate physiological energy cost, as well as to define the behaviour pattern of a species, or the kinematics of swimming. In this study, we showed how an accelerometer-based technique could be used to determine the biomechanical characteristics of pedestrian locomotion. Eight king penguins, which represent the only family of birds to have an upright bipedal gait, were trained to walk on a treadmill. The trunk tri-axial accelerations were recorded while the bird was walking at four different speeds (1.0, 1.2, 1.4 and 1.6km/h), enabling the amplitude of dynamic body acceleration along the three axes (amplitude of DBAx, DBAy and DBAz), stride frequency, waddling and leaning amplitude, as well as the leaning angle to be defined. The magnitude of the measured variables showed a significant increase with increasing speed, apart from the backwards angle of lean, which decreased with increasing speed. The variability of the measured variables also showed a significant increase with speed apart from the DBAz amplitude, the waddling amplitude, and the leaning angle, where no significant effect of the walking speed was found. This paper is the first approach to describe 3D biomechanics with an accelerometer on wild animals, demonstrating the potential of this technique. Copyright © 2015 Elsevier Ltd. All rights reserved.

Microvascular Endothelial Dysfunction in Sedentary, Obese Humans is mediated by NADPH Oxidase; Influence of Exercise Training

PubMed Central

La Favor, Justin D.; Dubis, Gabriel S.; Yan, Huimin; White, Joseph D.; Nelson, Margaret A.M.; Anderson, Ethan J.; Hickner, Robert C.

2016-01-01

Objective The objectives of this study were to determine the impact of in vivo reactive oxygen species (ROS) on microvascular endothelial function in obese human subjects and to determine the efficacy of an aerobic exercise intervention on alleviating obesity-associated dysfunctionality. Approach and Results Young, sedentary men and women were divided into lean (BMI 18–25; n=14), intermediate (BMI 28–32.5; n=13), and obese (BMI 33–40; n=15) groups. A novel microdialysis technique was utilized to detect elevated interstitial hydrogen peroxide (H2O2) and superoxide levels in the vastus lateralis of obese compared to both lean and intermediate subjects. Nutritive blood flow was monitored in the vastus lateralis via the microdialysis-ethanol technique. A decrement in acetylcholine-stimulated blood flow revealed impaired microvascular endothelial function in the obese subjects. Perfusion of apocynin, an NADPH oxidase (Nox) inhibitor, lowered (normalized) H2O2 and superoxide levels and reversed microvascular endothelial dysfunction in obese subjects. Following 8-weeks of exercise, H2O2 levels were decreased in the obese subjects and microvascular endothelial function in these subjects was restored to levels similar to lean subjects. Skeletal muscle protein expression of the Nox subunits p22phox, p47phox, and p67phox were increased in obese relative to lean subjects, where p22phox and p67phox expression was attenuated by exercise training in obese subjects. Conclusions This study implicates Nox as a source of excessive ROS production in skeletal muscle of obese individuals, and links excessive Nox derived ROS to microvascular endothelial dysfunction in obesity. Furthermore, aerobic exercise training proved to be an effective strategy for alleviating these maladies. PMID:27765769

Building a Competitive Edge with Additive Manufacturing

DTIC Science & Technology

2013-02-14

construct ceramic molds for complex metal parts using a 3D printing technique. They estimate the new 6 technique could eliminate all of the...processes. They include 3D printing and Additive Beam Techniques.15 Most Additive Manufacturing techniques are specific to certain classes of materials...9 Example Additive Manufacturing Techniques16 3D Printing Additive Beam Stereolithography (SLA) Direct Metal Laser Sintering (DMLS

An improved tree height measurement technique tested on mature southern pines

Treesearch

Don C. Bragg

2008-01-01

Virtually all techniques for tree height determination follow one of two principles: similar triangles or the tangent method. Most people apply the latter approach, which uses the tangents of the angles to the top and bottom and a true horizontal distance to the subject tree. However, few adjust this method for ground slope, tree lean, crown shape, and crown...

Mixed-Potential NO x and NH 3 Sensors Fabricated by Commercial Manufacturing Methods [Mixed-Potential Sensors NO x and NH 3 Fabricated by Commercial Manufacturing Methods

DOE PAGES

Kreller, Cortney R.; Spernjak, Dusan; Li, Wenxia; ...

2014-08-12

Meeting EPA Tier 3 emissions reduction requirements while simultaneously increasing fuel economy to meet new CAFE standards will require optimization of advanced combustion strategies and emissions control technologies. There is an immediate need for suitable exhaust gas sensor technologies to monitor internal combustion engine tailpipe emissions and to control and maintain efficient operation of the engine and exhaust after treatment systems. NH 3, NO x, and HC sensors could enable onboard diagnostics and combustion control in lean-burn engines, analogous to the role of O 2 sensors in stoichiometric burn engines. Commercial manufacturing methods have been used to fabricate self-heated mixed-potentialmore » sensors in a planar automotive configuration. By altering materials composition and operating conditions, we are able to obtain sensitivity/selectivity to each NH 3, NO x and HCs. In addition, these devices exhibit stable performance over months of testing as a result of the stable morphology of the electrode/electrolyte/gas three-phase interface.« less

Basal ganglia systems in ritualistic social displays: reptiles and humans; function and illness.

PubMed

Baxter, Lewis R

2003-08-01

Complex, situation-specific territorial maintenance routines are similar across living terrestrial vertebrates (=amniotes). Decades ago, Paul MacLean et al., at the Laboratory of Brain Evolution and Behavior of the National Institute of Mental Health, postulated that these are evolutionarily conserved behaviors whose expression is mediated by the similarly conserved amniote basal ganglia and related brain systems (BG systems). Therefore, they undertook studies in nonhuman primates and in small social lizards (the common green anole, Anolis carolinensis) to examine this idea. MacLean et al. also postulated that when BG systems misfunction in humans, behavioral abnormalities result, some of them under the rubric of psychiatric illnesses. Obsessive-compulsive disorder (OCD) was singled out as one likely candidate. In the last dozen years, functional brain imaging studies of OCD patients have validated the contention that this is, in fact, a condition involving dysfunctioning BG systems. Inspired by the MacLean group's original investigations, my colleagues and I have now applied related functional imaging techniques in naturalistic experiments using Anolis to better understand BG systems' roles in the mediation of complex behavioral routines in healthy amniotes. Here, I will review this functional imaging work in primates (man, and a little in monkey) and in lizards. I believe the literature not only supports MacLean et al.'s contentions about BG systems and behavior in general, but also validates Paul MacLean's life-long contention that human behavioral medicine can profit from a broad comparative approach.

Using Innovative Technologies for Manufacturing and Evaluating Rocket Engine Hardware

NASA Technical Reports Server (NTRS)

Betts, Erin M.; Hardin, Andy

2011-01-01

Many of the manufacturing and evaluation techniques that are currently used for rocket engine component production are traditional methods that have been proven through years of experience and historical precedence. As we enter into a new space age where new launch vehicles are being designed and propulsion systems are being improved upon, it is sometimes necessary to adopt new and innovative techniques for manufacturing and evaluating hardware. With a heavy emphasis on cost reduction and improvements in manufacturing time, manufacturing techniques such as Direct Metal Laser Sintering (DMLS) and white light scanning are being adopted and evaluated for their use on J-2X, with hopes of employing both technologies on a wide variety of future projects. DMLS has the potential to significantly reduce the processing time and cost of engine hardware, while achieving desirable material properties by using a layered powdered metal manufacturing process in order to produce complex part geometries. The white light technique is a non-invasive method that can be used to inspect for geometric feature alignment. Both the DMLS manufacturing method and the white light scanning technique have proven to be viable options for manufacturing and evaluating rocket engine hardware, and further development and use of these techniques is recommended.

Toward Body Composition Reference Data for Infants, Children, and Adolescents123

PubMed Central

Wells, Jonathan C. K.

2014-01-01

Growth charts for weight and height have provided the basis for assessment of children’s nutritional status for over half a century, with charts for body mass index (BMI) introduced in the 1990s. However, BMI does not provide information on the proportions of fat and lean mass; and within the past decade, growth charts for children’s body composition have been produced by using techniques such as skinfold thicknesses, body circumferences, bioelectrical impedance analysis (BIA), and dual-energy X-ray absorptiometry (DXA). For public health research, BIA and skinfold thicknesses show negligible average bias but have wider limits of agreement than specialized techniques. For patients, DXA is the best individual method, but multicomponent models remain ideal because they address perturbations in lean mass composition. Data can be expressed in age- and sex-specific SD scores, in some cases adjusting for height. Most such reference data derive from high-income countries, but techniques such as air-displacement plethysmography allow infant body composition growth charts to be developed in low- and middle-income settings, where the data may improve understanding of the effects of low birth weight, wasting, and stunting on body composition. Recent studies suggest that between-population variability in body composition may derive in part from genetic factors, suggesting a universal human body composition reference may not be viable. Body composition growth charts may be extended into adult life to evaluate changes in fat and lean mass through the entire life course. These reference data will improve the understanding of the association between growth, body composition, health, and disease. PMID:24829484

Toward body composition reference data for infants, children, and adolescents.

PubMed

Wells, Jonathan C K

2014-05-01

Growth charts for weight and height have provided the basis for assessment of children's nutritional status for over half a century, with charts for body mass index (BMI) introduced in the 1990s. However, BMI does not provide information on the proportions of fat and lean mass; and within the past decade, growth charts for children's body composition have been produced by using techniques such as skinfold thicknesses, body circumferences, bioelectrical impedance analysis (BIA), and dual-energy X-ray absorptiometry (DXA). For public health research, BIA and skinfold thicknesses show negligible average bias but have wider limits of agreement than specialized techniques. For patients, DXA is the best individual method, but multicomponent models remain ideal because they address perturbations in lean mass composition. Data can be expressed in age- and sex-specific SD scores, in some cases adjusting for height. Most such reference data derive from high-income countries, but techniques such as air-displacement plethysmography allow infant body composition growth charts to be developed in low- and middle-income settings, where the data may improve understanding of the effects of low birth weight, wasting, and stunting on body composition. Recent studies suggest that between-population variability in body composition may derive in part from genetic factors, suggesting a universal human body composition reference may not be viable. Body composition growth charts may be extended into adult life to evaluate changes in fat and lean mass through the entire life course. These reference data will improve the understanding of the association between growth, body composition, health, and disease. © 2014 American Society for Nutrition.

Pitfalls in the measurement of muscle mass: a need for a reference standard

PubMed Central

Landi, Francesco; Cesari, Matteo; Fielding, Roger A.; Visser, Marjolein; Engelke, Klaus; Maggi, Stefania; Dennison, Elaine; Al‐Daghri, Nasser M.; Allepaerts, Sophie; Bauer, Jurgen; Bautmans, Ivan; Brandi, Maria Luisa; Bruyère, Olivier; Cederholm, Tommy; Cerreta, Francesca; Cherubini, Antonio; Cooper, Cyrus; Cruz‐Jentoft, Alphonso; McCloskey, Eugene; Dawson‐Hughes, Bess; Kaufman, Jean‐Marc; Laslop, Andrea; Petermans, Jean; Reginster, Jean‐Yves; Rizzoli, René; Robinson, Sian; Rolland, Yves; Rueda, Ricardo; Vellas, Bruno; Kanis, John A.

2018-01-01

Abstract Background All proposed definitions of sarcopenia include the measurement of muscle mass, but the techniques and threshold values used vary. Indeed, the literature does not establish consensus on the best technique for measuring lean body mass. Thus, the objective measurement of sarcopenia is hampered by limitations intrinsic to assessment tools. The aim of this study was to review the methods to assess muscle mass and to reach consensus on the development of a reference standard. Methods Literature reviews were performed by members of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis working group on frailty and sarcopenia. Face‐to‐face meetings were organized for the whole group to make amendments and discuss further recommendations. Results A wide range of techniques can be used to assess muscle mass. Cost, availability, and ease of use can determine whether the techniques are better suited to clinical practice or are more useful for research. No one technique subserves all requirements but dual energy X‐ray absorptiometry could be considered as a reference standard (but not a gold standard) for measuring muscle lean body mass. Conclusions Based on the feasibility, accuracy, safety, and low cost, dual energy X‐ray absorptiometry can be considered as the reference standard for measuring muscle mass. PMID:29349935

Characterization of Liquid Fuel Evaporation of a Lifted Methanol Spray Flame in a Vitiated Coflow Burner

NASA Technical Reports Server (NTRS)

Cabra, Ricardo; Dibble, Robert W.; Chen, Jyh-Yuan

2002-01-01

An experimental investigation of lifted spray flames in a coflow of hot, vitiated gases is presented. The vitiated coflow burner is a spray flame that issues into a coaxial flow of hot combustion products from a lean, premixed H2/Air flame. The spray flame in a vitiated coflow emulates the combustion that occurs in many advanced combustors without the detailed fluid mechanics. Two commercially available laser diagnostic systems are used to characterize the spray flame and to demonstrate the vitiated coflow burner's amenability to optical investigation. The Ensemble Particle Concentration and Size (EPCS) system is used to measure the path-average droplet size distribution and liquid volume fraction at several axial locations while an extractive probe instrument named the Real-time Fuel-air Analyzer (RFA) is used to measure the air to fuel ratio downstream of the spray nozzle with high temporal and spatial resolution. The effect of coflow conditions (stoichiometry) and dilution of the fuel with water was studied with the EPCS optical system. As expected, results show that water retards the evaporation and combustion of fuels. Measurements obtained by the RFA extractive probe show that while the Delavan manufactured nozzle does distribute the fuel over the manufacturer specified spray angle, it unfortunately does not distribute the fuel uniformly, providing conditions that may result in the production of unwanted NOx. Despite some limitations due to the inherent nature of the experimental techniques, the two diagnostics can be readily applied to spray flames in the vitiated coflow environment.

Reducing door-to-needle times using Toyota's lean manufacturing principles and value stream analysis.

PubMed

Ford, Andria L; Williams, Jennifer A; Spencer, Mary; McCammon, Craig; Khoury, Naim; Sampson, Tomoko R; Panagos, Peter; Lee, Jin-Moo

2012-12-01

Earlier tissue-type plasminogen activator (tPA) treatment for acute ischemic stroke increases efficacy, prompting national efforts to reduce door-to-needle times. We used lean process improvement methodology to develop a streamlined intravenous tPA protocol. In early 2011, a multidisciplinary team analyzed the steps required to treat patients with acute ischemic stroke with intravenous tPA using value stream analysis (VSA). We directly compared the tPA-treated patients in the "pre-VSA" epoch with the "post-VSA" epoch with regard to baseline characteristics, protocol metrics, and clinical outcomes. The VSA revealed several tPA protocol inefficiencies: routing of patients to room, then to CT, then back to the room; serial processing of workflow; and delays in waiting for laboratory results. On March 1, 2011, a new protocol incorporated changes to minimize delays: routing patients directly to head CT before the patient room, using parallel process workflow, and implementing point-of-care laboratories. In the pre and post-VSA epochs, 132 and 87 patients were treated with intravenous tPA, respectively. Compared with pre-VSA, door-to-needle times and percent of patients treated ≤60 minutes from hospital arrival were improved in the post-VSA epoch: 60 minutes versus 39 minutes (P<0.0001) and 52% versus 78% (P<0.0001), respectively, with no change in symptomatic hemorrhage rate. Lean process improvement methodology can expedite time-dependent stroke care without compromising safety.

Reducing Door-to-Needle Times using Toyota’s Lean Manufacturing Principles and Value Stream Analysis

PubMed Central

Ford, Andria L.; Williams, Jennifer A.; Spencer, Mary; McCammon, Craig; Khoury, Naim; Sampson, Tomoko; Panagos, Peter; Lee, Jin-Moo

2012-01-01

Background Earlier tPA treatment for acute ischemic stroke increases efficacy, prompting national efforts to reduce door-to-needle times (DNTs). We utilized lean process improvement methodology to develop a streamlined IV tPA protocol. Methods In early 2011, a multi-disciplinary team analyzed the steps required to treat acute ischemic stroke patients with IV tPA, utilizing value stream analysis (VSA). We directly compared the tPA-treated patients in the “pre-VSA” epoch to the “post-VSA” epoch with regard to baseline characteristics, protocol metrics, and clinical outcomes. Results The VSA revealed several tPA protocol inefficiencies: routing of patients to room, then to CT, then back to room; serial processing of work flow; and delays in waiting for lab results. On 3/1/2011, a new protocol incorporated changes to minimize delays: routing patients directly to head CT prior to patient room, utilizing parallel process work-flow, and implementing point-of-care labs. In the pre-and post-VSA epochs, 132 and 87 patients were treated with IV tPA, respectively. Compared to pre-VSA, DNTs and percent of patients treated ≤60 minutes from hospital arrival were improved in the post-VSA epoch: 60 min vs. 39 min (p<0.0001) and 52% vs. 78% (p<0.0001), respectively, with no change in symptomatic hemorrhage rate. Conclusions Lean process improvement methodology can expedite time-dependent stroke care, without compromising safety. PMID:23138440

A Buoyancy-based Method of Determining Fat Levels in Drosophila.

PubMed

Hazegh, Kelsey E; Reis, Tânia

2016-11-01

Drosophila melanogaster is a key experimental system in the study of fat regulation. Numerous techniques currently exist to measure levels of stored fat in Drosophila, but most are expensive and/or laborious and have clear limitations. Here, we present a method to quickly and cheaply determine organismal fat levels in L3 Drosophila larvae. The technique relies on the differences in density between fat and lean tissues and allows for rapid detection of fat and lean phenotypes. We have verified the accuracy of this method by comparison to body fat percentage as determined by neutral lipid extraction and gas chromatography coupled with mass spectrometry (GCMS). We furthermore outline detailed protocols for the collection and synchronization of larvae as well as relevant experimental recipes. The technique presented below overcomes the major shortcomings in the most widely used lipid quantitation methods and provides a powerful way to quickly and sensitively screen L3 larvae for fat regulation phenotypes while maintaining the integrity of the larvae. This assay has wide applications for the study of metabolism and fat regulation using Drosophila.

Low Cost Structures, but How Much are we Paying for Them?

NASA Astrophysics Data System (ADS)

Gomez Molinero, Vincent

2014-06-01

Based on more than 37 years developing spacecraft structures - both for launchers starting with Ariane-1 up to the most modern ones and for satellites of any type - a critical review of the current trends, aiming specially to low cost solutions, will be presented.Airbus Defence and Space (CASA Espacio previously) has been developing structures for launchers and satellites during more than 4 decades. All types of spacecraft structures - primary and secondary ones, high stability ones and special critical cases like antenna reflectors, high stiffness structures and load carrying ones - have been developed using different types of materials and structural constructions. Although our main expertise is concentrated on composite structures, we have also developed many types of metallic ones, when the best solution was that one, not necessarily only based on pure technical reasons.From that perspective and experience, this paper tries to review the current trend of imposing the low cost as the main requirement for the development of satellites and launchers and its intrinsic characteristic of being a non- ending process: the spacecraft structures are never sufficiently cheaper.The main ways used today to justify low cost spacecraft structures will be reviewed trying to understand their rationale and some prejudices always present when the trade-off studies are performed. Some of the reviewed cost-killing factors will be (non-exhaustive list) Material type (i.e.: metallic vs composite). Low cost materials in general. Manufacturing process (i.e.: autoclave curing vs out-of-autoclave one). Automation in manufacturing. Automation in assembly. Automation in inspection and verification. Lean manufacturing techniques. Standardization. Some insight about how to solve this problem without losing our distinctive nature (we are developing high performance systems many of them unique prototypes and thought to work in environments not perfectly known and highly unknown in some cases) will be provided from the author's point of view.

Lean energy analysis of CNC lathe

NASA Astrophysics Data System (ADS)

Liana, N. A.; Amsyar, N.; Hilmy, I.; Yusof, MD

2018-01-01

The industrial sector in Malaysia is one of the main sectors that have high percentage of energy demand compared to other sector and this problem may lead to the future power shortage and increasing the production cost of a company. Suitable initiatives should be implemented by the industrial sectors to solve the issues such as by improving the machining system. In the past, the majority of the energy consumption in industry focus on lighting, HVAC and office section usage. Future trend, manufacturing process is also considered to be included in the energy analysis. A study on Lean Energy Analysis in a machining process is presented. Improving the energy efficiency in a lathe machine by enhancing the cutting parameters of turning process is discussed. Energy consumption of a lathe machine was analyzed in order to identify the effect of cutting parameters towards energy consumption. It was found that the combination of parameters for third run (spindle speed: 1065 rpm, depth of cut: 1.5 mm, feed rate: 0.3 mm/rev) was the most preferred and ideal to be used during the turning machining process as it consumed less energy usage.

Effect of the type of fat on the physicochemical, instrumental and sensory characteristics of reduced fat non-acid fermented sausages.

PubMed

Mora-Gallego, Héctor; Serra, Xavier; Guàrdia, Maria Dolors; Miklos, Rikke; Lametsch, René; Arnau, Jacint

2013-03-01

Four batches of reduced fat non-acid fermented sausages were manufactured with pork-ham lean, and the addition of no fat (Lean), 5% pork backfat (BF), 5% sunflower oil (SO) and 5% diacylglycerols (DAGs). The effect of the type of fat as pork-fat substitute on some physicochemical parameters, instrumental color and texture and sensory attributes of the sausages was studied. Results showed that reduced fat non-acid fermented sausages containing less than 12.5% of fat (BF, SO and DAGs) had a good overall sensory quality. This means a fat reduction of more than 70% compared with the average fat content of standard fermented sausages of similar characteristics. Sausages with SO showed higher sensory ratings in desirable ripened odor and flavor attributes and improved texture defined by lower hardness and chewiness (both sensory and instrumental) and higher crumbliness. Sausages with DAGs showed a similar behavior to that of BF, so they could be a good alternative to produce healthier reduced fat non-acid fermented sausages. Copyright © 2012 Elsevier Ltd. All rights reserved.

Performance excellence: using Lean Six Sigma tools to improve the US Army behavioral health surveillance process, boost team morale, and maximize value to customers and stakeholders.

PubMed

Watkins, Eren Youmans; Kemeter, Dave M; Spiess, Anita; Corrigan, Elizabeth; Kateley, Keri; Wills, John V; Mancha, Brent Edward; Nichols, Jerrica; Bell, Amy Millikan

2014-01-01

Lean Six Sigma (LSS) is a process improvement, problem-solving methodology used in business and manufacturing to improve the speed, quality, and cost of products. LSS can also be used to improve knowledge-based products integral to public health surveillance. An LSS project by the Behavioral Social Health Outcomes Program of the Army Institute of Public Health reduced the number of labor hours spent producing the routine surveillance of suicidal behavior publication. At baseline, the total number of labor hours was 448; after project completion, total labor hours were 199. Based on customer feedback, publication production was reduced from quarterly to annually. Process improvements enhanced group morale and established best practices in the form of standard operating procedures and business rules to ensure solutions are sustained. LSS project participation also fostered a change in the conceptualization of tasks and projects. These results demonstrate that LSS can be used to inform the public health process and should be considered a viable method of improving knowledge-based products and processes.

Using Lean Six Sigma Methodology to Improve a Mass Immunizations Process at the United States Naval Academy.

PubMed

Ha, Chrysanthy; McCoy, Donald A; Taylor, Christopher B; Kirk, Kayla D; Fry, Robert S; Modi, Jitendrakumar R

2016-06-01

Lean Six Sigma (LSS) is a process improvement methodology developed in the manufacturing industry to increase process efficiency while maintaining product quality. The efficacy of LSS application to the health care setting has not been adequately studied. This article presents a quality improvement project at the U.S. Naval Academy that uses LSS to improve the mass immunizations process for Midshipmen during in-processing. The process was standardized to give all vaccinations at one station instead of giving a different vaccination at each station. After project implementation, the average immunizations lead time decreased by 79% and staffing decreased by 10%. The process was shown to be in control with a capability index of 1.18 and performance index of 1.10, resulting in a defect rate of 0.04%. This project demonstrates that the LSS methodology can be applied successfully to the health care setting to make sustainable process improvements if used correctly and completely. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Additive Manufacturing Infrared Inspection

NASA Technical Reports Server (NTRS)

Gaddy, Darrell

2014-01-01

Additive manufacturing is a rapid prototyping technology that allows parts to be built in a series of thin layers from plastic, ceramics, and metallics. Metallic additive manufacturing is an emerging form of rapid prototyping that allows complex structures to be built using various metallic powders. Significant time and cost savings have also been observed using the metallic additive manufacturing compared with traditional techniques. Development of the metallic additive manufacturing technology has advanced significantly over the last decade, although many of the techniques to inspect parts made from these processes have not advanced significantly or have limitations. Several external geometry inspection techniques exist such as Coordinate Measurement Machines (CMM), Laser Scanners, Structured Light Scanning Systems, or even traditional calipers and gages. All of the aforementioned techniques are limited to external geometry and contours or must use a contact probe to inspect limited internal dimensions. This presentation will document the development of a process for real-time dimensional inspection technique and digital quality record of the additive manufacturing process using Infrared camera imaging and processing techniques.

Metal/metal oxide doped oxide catalysts having high deNOx selectivity for lean NOx exhaust aftertreatment systems

DOEpatents

Park, Paul W.

2004-03-16

A lean NOx catalyst and method of preparing the same is disclosed. The lean NOx catalyst includes a ceramic substrate, an oxide support material, preferably .gamma.-alumina, deposited on the substrate and a metal promoter or dopant introduced into the oxide support material. The metal promoters or dopants are selected from the group consisting of indium, gallium, tin, silver, germanium, gold, nickel, cobalt, copper, iron, manganese, molybdenum, chromium, cerium, vanadium, oxides thereof, and combinations thereof. The .gamma.-alumina preferably has a pore volume of from about 0.5 to about 2.0 cc/g; a surface area of between about 80 to 350 m.sup.2 /g; an average pore size diameter of between about 3 to 30 nm; and an impurity level of less than or equal to 0.2 weight percent. In a preferred embodiment the .gamma.-alumina is prepared by a sol-gel method, with the metal doping of the .gamma.-alumina preferably accomplished using an incipient wetness impregnation technique.

Concept of Operations Visualization in Support of Ares I Production

NASA Technical Reports Server (NTRS)

Chilton, James H.; Smith, Daid Alan

2008-01-01

Boeing was selected in 2007 to manufacture Ares I Upper Stage and Instrument Unit according to NASA's design which would require the use of the latest manufacturing and integration processes to meet NASA budget and schedule targets. Past production experience has established that the majority of the life cycle cost is established during the initial design process. Concept of Operations (CONOPs) visualizations/simulations help to reduce life cycle cost during the early design stage. Production and operation visualizations can reduce tooling, factory capacity, safety, and build process risks while spreading program support across government, academic, media and public constituencies. The NASA/Boeing production visualization (DELMIA; Digital Enterprise Lean Manufacturing Interactive Application) promotes timely, concurrent and collaborative producibility analysis (Boeing)while supporting Upper Stage Design Cycles (NASA). The DELMIA CONOPs visualization reduced overall Upper Stage production flow time at the manufacturing facility by over 100 man-days to 312.5 man-days and helped to identify technical access issues. The NASA/Boeing Interactive Concept of Operations (ICON) provides interactive access to Ares using real mission parameters, allows users to configure the mission which encourages ownership and identifies areas for improvement, allows mission operations or spacecraft detail to be added as needed, and provides an effective, low coast advocacy, outreach and education tool.

Integrating Safety and Mission Assurance in Design

NASA Technical Reports Server (NTRS)

Cianciola, Chris; Crane, Kenneth

2008-01-01

This presentation describes how the Ares Projects are learning from the successes and failures of previous launch systems in order to maximize safety and reliability while maintaining fiscal responsibility. The Ares Projects are integrating Safety and Mission Assurance into design activities and embracing independent assessments by Quality experts in thorough reviews of designs and processes. Incorporating Lean thinking into the design process, Ares is also streamlining existing processes and future manufacturing flows which will yield savings during production. Understanding the value of early involvement of Quality experts, the Ares Projects are leading launch vehicle development into the 21st century.

Successful integration of ergonomics into continuous improvement initiatives.

PubMed

Monroe, Kimberly; Fick, Faye; Joshi, Madina

2012-01-01

Process improvement initiatives are receiving renewed attention by large corporations as they attempt to reduce manufacturing costs and stay competitive in the global marketplace. These initiatives include 5S, Six Sigma, and Lean. These programs often take up a large amount of available time and budget resources. More often than not, existing ergonomics processes are considered separate initiatives by upper management and struggle to gain a seat at the table. To effectively maintain their programs, ergonomics program managers need to overcome those obstacles and demonstrate how ergonomics initiatives are a natural fit with continuous improvement philosophies.

Agile rediscovering values: Similarities to continuous improvement strategies

NASA Astrophysics Data System (ADS)

Díaz de Mera, P.; Arenas, J. M.; González, C.

2012-04-01

Research in the late 80's on technological companies that develop products of high value innovation, with sufficient speed and flexibility to adapt quickly to changing market conditions, gave rise to the new set of methodologies known as Agile Management Approach. In the current changing economic scenario, we considered very interesting to study the similarities of these Agile Methodologies with other practices whose effectiveness has been amply demonstrated in both the West and Japan. Strategies such as Kaizen, Lean, World Class Manufacturing, Concurrent Engineering, etc, would be analyzed to check the values they have in common with the Agile Approach.

Advanced Material Intelligent Processing Center: Next Generation Scalable Lean Manufacturing

DTIC Science & Technology

2012-09-04

spacing) and initial resin distribution. This research is currently focused on characterizing Gurit® Single Sprint © ST94 Out-of-Autoclave prepreg for...consolidation). 200 400 600 Time (s) 1000 Figure 24. Images of ST 94 prepreg corresponding to the graph of the quantified area of resin observed...s) 1000 2kPa; 55C 4kPa; 55C 6kPa; 55C 15kPa.55C 30kPa. 55C 41kPa;55C 400 600 Time (s) 800 1000 Figure 25. (a) Effect of temperature and

Muscle strength and areal bone mineral density at the hip in women: a cross-sectional study.

PubMed

Pasco, Julie A; Holloway, Kara L; Brennan-Olsen, Sharon L; Moloney, David J; Kotowicz, Mark A

2015-05-24

Muscle strengthening exercises are promoted for building and maintaining a healthy skeleton. We aimed to investigate the relationship between muscle strength and areal bone mineral density (BMD) at the hip in women aged 26-97 years. This cross-sectional study utilises data from 863 women assessed for the Geelong Osteoporosis Study. Measures of hip flexor and abductor strength were made using a hand-held dynamometer (Nicholas Manual Muscle Tester). The maximal measure from three trials on each leg was used for analyses. BMD was measured at the hip using dual energy x-ray absorptiometry (DXA; Lunar DPX-L). Total lean mass, body fat mass and appendicular lean mass were determined from whole body DXA scans. Linear regression techniques were used with muscle strength as the independent variable and BMD as the dependent variable. Models were adjusted for age and indices of body composition. Measures of age-adjusted hip flexor strength and hip abductor strength were positively associated with total hip BMD. For each standard deviation (SD) increase in hip flexor strength, the increase in mean total hip BMD (SD) was 10.4 % (p = 0.009). A similar pattern was observed for hip abductor strength, with an increase in mean total hip BMD of 22.8 % (p = 0.025). All associations between hip muscle strength and total hip BMD were independent of height, but were nullified after adjusting for appendicular lean mass or total lean mass. There was a positive association observed between muscle strength and BMD at the hip. However, this association was explained by measures of lean mass.

Lean techniques for the improvement of patients’ flow in emergency department

PubMed Central

Chan, HY; Lo, SM; Lee, LLY; Lo, WYL; Yu, WC; Wu, YF; Ho, ST; Yeung, RSD; Chan, JTS

2014-01-01

BACKGROUND: Emergency departments (EDs) face problems with overcrowding, access block, cost containment, and increasing demand from patients. In order to resolve these problems, there is rising interest to an approach called “lean” management. This study aims to (1) evaluate the current patient flow in ED, (2) to identify and eliminate the non-valued added process, and (3) to modify the existing process. METHODS: It was a quantitative, pre- and post-lean design study with a series of lean management work implemented to improve the admission and blood result waiting time. These included structured re-design process, priority admission triage (PAT) program, enhanced communication with medical department, and use of new high sensitivity troponin-T (hsTnT) blood test. Triage waiting time, consultation waiting time, blood result time, admission waiting time, total processing time and ED length of stay were compared. RESULTS: Among all the processes carried out in ED, the most time consuming processes were to wait for an admission bed (38.24 minutes; SD 66.35) and blood testing result (mean 52.73 minutes, SD 24.03). The triage waiting time and end waiting time for consultation were significantly decreased. The admission waiting time of emergency medical ward (EMW) was significantly decreased from 54.76 minutes to 24.45 minutes after implementation of PAT program (P<0.05). CONCLUSION: The application of lean management can improve the patient flow in ED. Acquiescence to the principle of lean is crucial to enhance high quality emergency care and patient satisfaction. PMID:25215143

Design and additive manufacture for flow chemistry.

PubMed

Capel, Andrew J; Edmondson, Steve; Christie, Steven D R; Goodridge, Ruth D; Bibb, Richard J; Thurstans, Matthew

2013-12-07

We review the use of additive manufacturing (AM) as a novel manufacturing technique for the production of milli-scale reactor systems. Five well-developed additive manufacturing techniques: stereolithography (SL), multi-jet modelling (MJM), selective laser melting (SLM), laser sintering (LS) and fused deposition modelling (FDM) were used to manufacture a number of miniaturised reactors which were tested using a range of organic and inorganic reactions.

Advanced Manufacturing Processes in the Motor Vehicle Industry

DOT National Transportation Integrated Search

1983-05-01

Advanced manufacturing processes, which include a range of automation and management techniques, are aiding U.S. motor vehicle manufacturers to reduce vehicle costs. This report discusses these techniques in general and their specific applications in...

Pitfalls in the measurement of muscle mass: a need for a reference standard.

PubMed

Buckinx, Fanny; Landi, Francesco; Cesari, Matteo; Fielding, Roger A; Visser, Marjolein; Engelke, Klaus; Maggi, Stefania; Dennison, Elaine; Al-Daghri, Nasser M; Allepaerts, Sophie; Bauer, Jurgen; Bautmans, Ivan; Brandi, Maria Luisa; Bruyère, Olivier; Cederholm, Tommy; Cerreta, Francesca; Cherubini, Antonio; Cooper, Cyrus; Cruz-Jentoft, Alphonso; McCloskey, Eugene; Dawson-Hughes, Bess; Kaufman, Jean-Marc; Laslop, Andrea; Petermans, Jean; Reginster, Jean-Yves; Rizzoli, René; Robinson, Sian; Rolland, Yves; Rueda, Ricardo; Vellas, Bruno; Kanis, John A

2018-04-01

All proposed definitions of sarcopenia include the measurement of muscle mass, but the techniques and threshold values used vary. Indeed, the literature does not establish consensus on the best technique for measuring lean body mass. Thus, the objective measurement of sarcopenia is hampered by limitations intrinsic to assessment tools. The aim of this study was to review the methods to assess muscle mass and to reach consensus on the development of a reference standard. Literature reviews were performed by members of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis working group on frailty and sarcopenia. Face-to-face meetings were organized for the whole group to make amendments and discuss further recommendations. A wide range of techniques can be used to assess muscle mass. Cost, availability, and ease of use can determine whether the techniques are better suited to clinical practice or are more useful for research. No one technique subserves all requirements but dual energy X-ray absorptiometry could be considered as a reference standard (but not a gold standard) for measuring muscle lean body mass. Based on the feasibility, accuracy, safety, and low cost, dual energy X-ray absorptiometry can be considered as the reference standard for measuring muscle mass. © 2018 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

Effusion plate using additive manufacturing methods

DOEpatents

Johnson, Thomas Edward; Keener, Christopher Paul; Ostebee, Heath Michael; Wegerif, Daniel Gerritt

2016-04-12

Additive manufacturing techniques may be utilized to construct effusion plates. Such additive manufacturing techniques may include defining a configuration for an effusion plate having one or more internal cooling channels. The manufacturing techniques may further include depositing a powder into a chamber, applying an energy source to the deposited powder, and consolidating the powder into a cross-sectional shape corresponding to the defined configuration. Such methods may be implemented to construct an effusion plate having one or more channels with a curved cross-sectional geometry.

Additive Manufacturing Infrared Inspection

NASA Technical Reports Server (NTRS)

Gaddy, Darrell; Nettles, Mindy

2015-01-01

The Additive Manufacturing Infrared Inspection Task started the development of a real-time dimensional inspection technique and digital quality record for the additive manufacturing process using infrared camera imaging and processing techniques. This project will benefit additive manufacturing by providing real-time inspection of internal geometry that is not currently possible and reduce the time and cost of additive manufactured parts with automated real-time dimensional inspections which deletes post-production inspections.

Systematic review of the application of quality improvement methodologies from the manufacturing industry to surgical healthcare.

PubMed

Nicolay, C R; Purkayastha, S; Greenhalgh, A; Benn, J; Chaturvedi, S; Phillips, N; Darzi, A

2012-03-01

The demand for the highest-quality patient care coupled with pressure on funding has led to the increasing use of quality improvement (QI) methodologies from the manufacturing industry. The aim of this systematic review was to identify and evaluate the application and effectiveness of these QI methodologies to the field of surgery. MEDLINE, the Cochrane Database, Allied and Complementary Medicine Database, British Nursing Index, Cumulative Index to Nursing and Allied Health Literature, Embase, Health Business(™) Elite, the Health Management Information Consortium and PsycINFO(®) were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Empirical studies were included that implemented a described QI methodology to surgical care and analysed a named outcome statistically. Some 34 of 1595 articles identified met the inclusion criteria after consensus from two independent investigators. Nine studies described continuous quality improvement (CQI), five Six Sigma, five total quality management (TQM), five plan-do-study-act (PDSA) or plan-do-check-act (PDCA) cycles, five statistical process control (SPC) or statistical quality control (SQC), four Lean and one Lean Six Sigma; 20 of the studies were undertaken in the USA. The most common aims were to reduce complications or improve outcomes (11), to reduce infection (7), and to reduce theatre delays (7). There was one randomized controlled trial. QI methodologies from industry can have significant effects on improving surgical care, from reducing infection rates to increasing operating room efficiency. The evidence is generally of suboptimal quality, and rigorous randomized multicentre studies are needed to bring evidence-based management into the same league as evidence-based medicine. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Pharmacy Dashboard: An Innovative Process for Pharmacy Workload and Productivity.

PubMed

Kinney, Ashley; Bui, Quyen; Hodding, Jane; Le, Jennifer

2017-03-01

Background: Innovative approaches, including LEAN systems and dashboards, to enhance pharmacy production continue to evolve in a cost and safety conscious health care environment. Furthermore, implementing and evaluating the effectiveness of these novel methods continues to be challenging for pharmacies. Objective: To describe a comprehensive, real-time pharmacy dashboard that incorporated LEAN methodologies and evaluate its utilization in an inpatient Central Intravenous Additives Services (CIVAS) pharmacy. Methods: Long Beach Memorial Hospital (462 adult beds) and Miller Children's and Women's Hospital of Long Beach (combined 324 beds) are tertiary not-for-profit, community-based hospitals that are served by one CIVAS pharmacy. Metrics to evaluate the effectiveness of CIVAS were developed and implemented on a dashboard in real-time from March 2013 to March 2014. Results: The metrics that were designed and implemented to evaluate the effectiveness of CIVAS were quality and value, financial resilience, and the department's people and culture. Using a dashboard that integrated these metrics, the accuracy of manufacturing defect-free products was ≥99.9%, indicating excellent quality and value of CIVAS. The metric for financial resilience demonstrated a cost savings of $78,000 annually within pharmacy by eliminating the outsourcing of products. People and value metrics on the dashboard focused on standard work, with an overall 94.6% compliance to the workflow. Conclusion: A unique dashboard that incorporated metrics to monitor 3 important areas was successfully implemented to improve the effectiveness of CIVAS pharmacy. These metrics helped pharmacy to monitor progress in real-time, allowing attainment of production goals and fostering continuous quality improvement through LEAN work.

Pharmacy Dashboard: An Innovative Process for Pharmacy Workload and Productivity

PubMed Central

Bui, Quyen; Hodding, Jane; Le, Jennifer

2017-01-01

Background: Innovative approaches, including LEAN systems and dashboards, to enhance pharmacy production continue to evolve in a cost and safety conscious health care environment. Furthermore, implementing and evaluating the effectiveness of these novel methods continues to be challenging for pharmacies. Objective: To describe a comprehensive, real-time pharmacy dashboard that incorporated LEAN methodologies and evaluate its utilization in an inpatient Central Intravenous Additives Services (CIVAS) pharmacy. Methods: Long Beach Memorial Hospital (462 adult beds) and Miller Children's and Women's Hospital of Long Beach (combined 324 beds) are tertiary not-for-profit, community-based hospitals that are served by one CIVAS pharmacy. Metrics to evaluate the effectiveness of CIVAS were developed and implemented on a dashboard in real-time from March 2013 to March 2014. Results: The metrics that were designed and implemented to evaluate the effectiveness of CIVAS were quality and value, financial resilience, and the department's people and culture. Using a dashboard that integrated these metrics, the accuracy of manufacturing defect-free products was ≥99.9%, indicating excellent quality and value of CIVAS. The metric for financial resilience demonstrated a cost savings of $78,000 annually within pharmacy by eliminating the outsourcing of products. People and value metrics on the dashboard focused on standard work, with an overall 94.6% compliance to the workflow. Conclusion: A unique dashboard that incorporated metrics to monitor 3 important areas was successfully implemented to improve the effectiveness of CIVAS pharmacy. These metrics helped pharmacy to monitor progress in real-time, allowing attainment of production goals and fostering continuous quality improvement through LEAN work. PMID:28439134

An analysis of mobile whole blood collection labor efficiency.

PubMed

Rose, William N; Dayton, Paula J; Raife, Thomas J

2011-07-01

Labor efficiency is desirable in mobile blood collection. There are few published data on labor efficiency. The variability in the labor efficiency of mobile whole blood collections was analyzed. We determined to improve our labor efficiency using lean manufacturing principles. Workflow changes in mobile collections were implemented with the goal of minimizing labor expenditures. To measure success, data on labor efficiency measured by units/hour/full-time equivalent (FTE) were collected. The labor efficiency in a 6-month period before the implementation of changes, and in months 1 to 6 and 7 to 12 after implementation was analyzed and compared. Labor efficiency in the 6-month period preceding implementation was 1.06 ± 0.4 units collected/hour/FTE. In months 1 to 6, labor efficiency declined slightly to 0.92 ± 0.4 units collected/hour/FTE (p = 0.016 vs. preimplementation). In months 7 to 12, the mean labor efficiency returned to preimplementation levels of 1.09 ±0.4 units collected/hour/FTE. Regression analysis correlating labor efficiency with total units collected per drive revealed a strong correlation (R(2) = 0.48 for the aggregate data from all three periods), indicating that nearly half of labor efficiency was associated with drive size. The lean-based changes in workflow were subjectively favored by employees and donors. The labor efficiency of our mobile whole blood drives is strongly influenced by size. Larger drives are more efficient, with diminishing returns above 40 units collected. Lean-based workflow changes were positively received by employees and donors. © 2011 American Association of Blood Banks.

Managing a Public Library. Parts I and II.

ERIC Educational Resources Information Center

Aronoff, Carol; Cart, Michael

1985-01-01

Discusses factors that contribute to Santa Monica Public Library's excellence, including supportive city government and citizenry, city council, library board, lean top management, and the basic management team. Specific management principles and techniques, public relations, and measures of service at Beverly Hills Public Library are also…

The mechanisms of flame holding in the wake of a bluff body

NASA Technical Reports Server (NTRS)

Strehlow, R. A.; Malik, S.

1985-01-01

The flame holding mechanism for lean methane- and lean propane-air flames is examined under conditions where the recirculation zone is absent. The main objective of this work is to study the holding process in detail in an attempt to determine the mechanism of flame holding and also the conditions where this mechanism is viable and when it fails and blow-off occurs. Inverted flames held in the wake of a flat strip were studied. Experiments with different sizes of flame holders were performed. The velocity flow field was determined using a laser Doppler velocimetry technique. Equation of continuity was used to calculate the flame temperature from the change in area of flow streamlines before and after the flame. Observations of the inverted flame itself were obtained using schlieren and direct photography. Results show that there are different mechanisms operative at the time of blow-off for lean propane and methane flames. Blow-off or extinction occurs for lean propane-air flame in spite of the reaction going to completion and the disparity between the heat loss and the gain in mass diffusion in the reaction zone i.e., Le 1.0 causes the flame to blow-off. For methane-air flame the controlling factor or blow-off is incomplete reaction due to higher blowing rate leading to reduced residence time in the reaction zone.

Acoustic Benefits of Stator Sweep and Lean for a High Tip Speed Fan

NASA Technical Reports Server (NTRS)

Woodward, Richard P.; Gazzaniga, John A.; Bartos, Linda J.; Hughes, Christopher E.

2002-01-01

A model high-speed fan stage was acoustically tested in the NASA Glenn 9- by 15-Foot Low Speed Wind Tunnel at takeoff/approach flight conditions. The fan was designed for a corrected rotor tip speed of 442 m/s (1450 ft/s), and had a powered core, or booster stage, giving the model a nominal bypass ratio of 5. The model also had a simulated engine pylon and nozzle bifurcation contained within the bypass duct. The fan was tested with three stator sets to evaluate acoustic benefits associated with a swept and leaned stator and with a swept integral vane/frame stator which incorporated some of the swept and leaned features as well as eliminated some of the downstream support structure. The baseline fan with the wide chord rotor and baseline stator approximated a current GEAE CF6 engine. A flyover effective perceived noise level (EPNL) code was used to generate relative EPNL values for the various configurations. Flyover effective perceived noise levels (EPNL) were computed from the model data to help project noise benefits. A tone removal study was also performed. The swept and leaned stator showed a 3 EPNdB reduction at lower fan speeds relative to the baseline stator; while the swept integral vane/frame stator showed lowest noise levels at intermediate fan speeds. Removal of the bypass blade passage frequency rotor tone (BPF) showed a 4 EPNdB reduction for the baseline and swept and leaned stators, and a 6 EPNdB reduction for the swept integral vane/ frame stator. Therefore, selective tone removal techniques such as active noise control and/or tuned liner could be particularly effective in reducing noise levels for certain fan speeds.

Manipulation of Muscle Creatine and Glycogen Changes Dual X-ray Absorptiometry Estimates of Body Composition.

PubMed

Bone, Julia L; Ross, Megan L; Tomcik, Kristyen A; Jeacocke, Nikki A; Hopkins, Will G; Burke, Louise M

2017-05-01

Standardizing a dual x-ray absorptiometry (DXA) protocol is thought to provide a reliable measurement of body composition. We investigated the effects of manipulating muscle glycogen and creatine content independently and additively on DXA estimates of lean mass. Eighteen well-trained male cyclists undertook a parallel group application of creatine loading (n = 9) (20 g·d for 5 d loading; 3 g·d maintenance) or placebo (n = 9) with crossover application of glycogen loading (12 v 6 g·kg BM per day for 48 h) as part of a larger study involving a glycogen-depleting exercise protocol. Body composition, total body water, muscle glycogen and creatine content were assessed via DXA, bioelectrical impedance spectroscopy and standard biopsy techniques. Changes in the mean were assessed using the following effect-size scale: >0.2 small, >0.6, moderate, >1.2 large and compared with the threshold for the smallest worthwhile effect of the treatment. Glycogen loading, both with and without creatine loading, resulted in substantial increases in estimates of lean body mass (mean ± SD; 3.0% ± 0.7% and 2.0% ± 0.9%) and leg lean mass (3.1% ± 1.8% and 2.6% ± 1.0%) respectively. A substantial decrease in leg lean mass was observed after the glycogen depleting condition (-1.4% ± 1.6%). Total body water showed substantial increases after glycogen loading (2.3% ± 2.3%), creatine loading (1.4% ± 1.9%) and the combined treatment (2.3% ± 1.1%). Changes in muscle metabolites and water content alter DXA estimates of lean mass during periods in which minimal change in muscle protein mass is likely. This information needs to be considered in interpreting the results of DXA-derived estimates of body composition in athletes.

Lean and Six Sigma in acute care: a systematic review of reviews.

PubMed

Deblois, Simon; Lepanto, Luigi

2016-01-01

The purpose of this paper is to present a systematic review of literature reviews, summarizing how Lean and Six Sigma management techniques have been implemented in acute care settings to date, and assessing their impact. To aid decision makers who wish to use these techniques by identifying the sectors of activity most often targeted, the main results of the interventions, as well as barriers and facilitators involved. To identify areas of future research. A literature search was conducted, using eight databases. The methodological quality of the selected reviews was appraised with AMSTAR. A narrative synthesis was performed according to the guidelines proposed by Popay et al. (2006). Data were reported according to PRISMA. The literature search identified 149 publications published from 1999 to January 2015. Seven literature reviews were included into the systematic review, upon appraisal. The overall quality of the evidence was poor to fair. The clinical settings most described were specialized health care services, including operating suites, intensive care units and emergency departments. The outcomes most often appraised related to processes and quality. The evidence suggests that Lean and Six Sigma are better adapted to settings where processes involve a linear sequence of events. There is a need for more studies of high methodological quality to better understand the effects of these approaches as well as the factors of success and barriers to their implementation. Field studies comparing the effects of Lean and Six Sigma to those of other process redesign or quality improvement efforts would bring a significant contribution to the body of knowledge. Lean and Six Sigma can be considered valuable process optimization approaches in acute health care settings. The success of their implementation requires significant participation of clinical personnel from the frontline as well as clinical leaders and managers. More research is needed to better understand the factors of success and the barriers to their implementation, as well as their long-term impact. This is the first broad systematic review of reviews, synthesizing data pertaining to implementation issues and results in acute care settings, to be published. It will benefit health care managers assessing the potential of these approaches and the potential drawbacks associated with their implementation. Moreover, it identifies directions for future research.

Facilitating process changes in meal delivery and radiological testing to improve inpatient insulin timing using six sigma method.

PubMed

Yamamoto, J Jay; Malatestinic, Bill; Lehman, Angela; Juneja, Rattan

2010-01-01

The objective of this project was to improve the timing of inpatient insulin administration related to meal delivery and the scheduling of radiology tests by Lean Six Sigma method. A multidisciplinary hospital team and a Six Sigma team from a pharmaceutical manufacturer collaborated to evaluate food delivery and radiology scheduling processes related to the timing of insulin administration. Key factors leading to problems within each system were addressed to improve the efficiency of each process while improving the timeliness of glucose testing and insulin administration. Standardizing the food delivery schedule and utilizing scorecards to track on-time meal deliveries to the floor enabled nursing to more accurately administer insulin in coordination with the delivery of meals. Increasing communication and restricting the scheduling of inpatient procedures during mealtimes reduced disruptions to insulin administration. Data at 6 months postimplementation demonstrated that the institution met goals for most primary outcome metrics including increasing on-time meal delivery and the proportion of patients taking insulin scheduled for radiology tests during appropriate times. By implementing the recommendations identified via Lean Six Sigma, this collaborative effort improved the timing of inpatient insulin administration related to meal delivery and radiology testing.

Ares Project Overview - Quality in Design

NASA Technical Reports Server (NTRS)

Cianciola, Chris; Crane, Kenneth

2008-01-01

This presentation introduces the audience to the overall goals of the Ares Project, which include providing human access to low-Earth orbit, the Moon, and beyond. The presentation also provides an overview of with the vehicles that will execute those goals and progress made on the vehicles to date. The briefing will provide an introduction to Lean, Six Sigma, and Kaizen practices Ares will use to improve the overall effectiveness and quality of its efforts. Finally, the briefing includes a summary of Safety and Mission Assurance practices being implemented within[Ares to ensure safety and quality early in the design process. Integrating Safety and Mission Assurance in Design: This presentation describes how the Ares Projects are learning from the successes and failures of previous launch systems in order to maximize safety and reliability while maintaining fiscal responsibility. The Ares Projects are integrating Safer T and Mission Assurance into design activities and embracing independent assessments by Quality experts in thorough reviews of designs and processes. Incorporating Lean thinking into the design process, Ares is also streamlining existing processes and future manufacturing flows which will yield savings during production. Understanding the value of early involvement of Quality experts, the Ares Projects are leading launch vehicle development into the 21st century.

What Matters in College to Students: Critical Incidents in the Undergraduate Experience

ERIC Educational Resources Information Center

Vianden, Jörg

2015-01-01

This article advances that undergraduates are partners to higher education institutions in establishing the educational enterprise. Leaning on student relationship management as a theoretical construct and the critical incident technique as method, the study found 58 undergraduates' interpersonal interactions with faculty, staff, and peers…

Textile sensors for stab and cut detection

NASA Astrophysics Data System (ADS)

Graßmann, C.; Obermann, M.; Lempa, E.; Bache, T.; Siegel, P. K.; Freyer, T.; Paschko, S.; Beyer, T.; Kirsche, M.; Schwarz-Pfeiffer, A.

2017-10-01

Manufacturers are aiming for more flexible and lightweight protective clothing to increase wearing comfort. A cardigan with a knitted stab-resistant inlay and an alarm system is presented. The stab-resistant inlay is based on a multilayer ultra-high molecular weight poly ethylene (UHMW-PE) fabric. Stab resistance was evaluated according to the standard of the Association of Test Laboratories for Bullet, Stab or Pike Resistant Materials and Construction Standard (VPAM 2011). Furthermore sensors for the detection of cuts and pressure were integrated. Both sensors can trigger alarms if the wearer is attacked. Normal pressure occurring through leaning on a wall or sitting is filtered out and does not trigger an alarm.

Manufacturing process scale-up of optical grade transparent spinel ceramic at ArmorLine Corporation

NASA Astrophysics Data System (ADS)

Spilman, Joseph; Voyles, John; Nick, Joseph; Shaffer, Lawrence

2013-06-01

While transparent Spinel ceramic's mechanical and optical characteristics are ideal for many Ultraviolet (UV), visible, Short-Wave Infrared (SWIR), Mid-Wave Infrared (MWIR), and multispectral sensor window applications, commercial adoption of the material has been hampered because the material has historically been available in relatively small sizes (one square foot per window or less), low volumes, unreliable supply, and with unreliable quality. Recent efforts, most notably by Technology Assessment and Transfer (TA and T), have scaled-up manufacturing processes and demonstrated the capability to produce larger windows on the order of two square feet, but with limited output not suitable for production type programs. ArmorLine Corporation licensed the hot-pressed Spinel manufacturing know-how of TA and T in 2009 with the goal of building the world's first dedicated full-scale Spinel production facility, enabling the supply of a reliable and sufficient volume of large Transparent Armor and Optical Grade Spinel plates. With over $20 million of private investment by J.F. Lehman and Company, ArmorLine has installed and commissioned the largest vacuum hot press in the world, the largest high-temperature/high-pressure hot isostatic press in the world, and supporting manufacturing processes within 75,000 square feet of manufacturing space. ArmorLine's equipment is capable of producing window blanks as large as 50" x 30" and the facility is capable of producing substantial volumes of material with its Lean configuration and 24/7 operation. Initial production capability was achieved in 2012. ArmorLine will discuss the challenges that were encountered during scale-up of the manufacturing processes, ArmorLine Optical Grade Spinel optical performance, and provide an overview of the facility and its capabilities.

Ares Launch Vehicles Lean Practices Case Study

NASA Technical Reports Server (NTRS)

Doreswamy, Rajiv, N.; Self, Timothy A.

2008-01-01

This viewgraph presentation describes test strategies and lean philisophies and practices that are applied to Ares Launch Vehicles. The topics include: 1) Testing strategy; 2) Lean Practices in Ares I-X; 3) Lean Practices Applied to Ares I-X Schedule; 4) Lean Event Results; 5) Lean, Six Sigma, and Kaizen Practices in the Ares Projects Office; 6) Lean and Kaizen Success Stories; and 7) Ares Six Sigma Practices.

Risk of Disordered Eating Among Division I Female College Athletes

PubMed Central

WELLS, ELIZABETH K.; CHIN, ALEXANDRA D.; TACKE, JENNIFER A.; BUNN, JENNIFER A.

2015-01-01

The purpose of this study was to assess the risk of disordered eating (DE) among female athletes in lean and non-lean sports using the ATHLETE survey. The ATHLETE survey is divided into six different constructs, and a high score indicates a high risk for DE. Eighty-three varsity female athletes from eight Campbell University sports teams completed the survey and a medical history form anonymously. The sports were divided into sports that traditionally have a high risk for DE (lean sports) and those with a low risk (non-lean sports). The lean sports included: cheerleading, cross country/track and field, swimming, and volleyball. The non-lean sports included: basketball, golf, soccer, and softball. The total mean score of the ATHLETE survey for the lean sports was 100.1 ± 17.4, compared to the non-lean sports scoring 90.1 ± 16.9, p = 0.011. The two constructs that showed significant difference between lean and non-lean sports were Social Pressure on Body Shape (lean: 12.2 ± 3.9, non-lean: 9.4 ± 4.6, p = 0.005) and Team Trust (lean: 7.4 ± 3.3, non-lean: 5.6 ± 2.2, p = 0.004). The results indicate that lean sports exhibited a higher risk for development of DE compared to athletes participating in non-lean sports. It appears that the primary influence of DE in these female athletes came from external social pressures that may therefore dictate their exercise and nutritional habits. PMID:27293502

Evaluating Lean in healthcare.

PubMed

Burgess, Nicola; Radnor, Zoe

2013-01-01

The purpose of this paper is to present findings relating to how Lean is implemented in English hospitals. Lean implementation snapshots in English hospitals were conducted by content analysing all annual reports and web sites over two time periods, giving a thorough analysis of Lean's status in English healthcare. The article identifies divergent approaches to Lean implementation in English hospitals. These approaches are classified into a typology to facilitate an evaluation of how Lean is implemented. The findings suggest that implementation tends to be isolated rather than system-wide. A second dataset conveys Lean implementation trajectory across the time period. These data signal Lean's increasing use by English hospitals and shows progression towards an increasingly systemic approach. Data were collected using content analysis methods, which relies on how "Lean" methods were articulated within the annual report and/or on the organisation's web site, which indicates approaches taken by hospital staff implementing Lean. This research is the first to examine more closely "how" Lean is implemented in English hospitals. The emergent typology could prove relevant to other public sector organizations and service organisations more generally. The research also presents a first step to understanding Lean thinking in the English NHS. This article empirically analyses Lean implementation in English hospitals. It identifies divergent approaches that allow inferences about how far Lean is implemented in an organisation. Data represent a baseline for further analysis so that Lean implementation can be tracked.

What Is Lean Management in Health Care? Development of an Operational Definition for a Cochrane Systematic Review.

PubMed

Rotter, Thomas; Plishka, Christopher; Lawal, Adegboyega; Harrison, Liz; Sari, Nazmi; Goodridge, Donna; Flynn, Rachel; Chan, James; Fiander, Michelle; Poksinska, Bonnie; Willoughby, Keith; Kinsman, Leigh

2018-01-01

Industrial improvement approaches such as Lean management are increasingly being adopted in health care. Synthesis is necessary to ensure these approaches are evidence based and requires operationalization of concepts to ensure all relevant studies are included. This article outlines the process utilized to develop an operational definition of Lean in health care. The literature search, screening, data extraction, and data synthesis processes followed the recommendations outlined by the Cochrane Collaboration. Development of the operational definition utilized the methods prescribed by Kinsman et al. and Wieland et al. This involved extracting characteristics of Lean, synthesizing similar components to establish an operational definition, applying this definition, and updating the definition to address shortcomings. We identified two defining characteristics of Lean health-care management: (1) Lean philosophy, consisting of Lean principles and continuous improvement, and (2) Lean activities, which include Lean assessment activities and Lean improvement activities. The resulting operational definition requires that an organization or subunit of an organization had integrated Lean philosophy into the organization's mandate, guidelines, or policies and utilized at least one Lean assessment activity or Lean improvement activity. This operational definition of Lean management in health care will act as an objective screening criterion for our systematic review. To our knowledge, this is the first evidence-based operational definition of Lean management in health care.

Effects of blood glucose on delay discounting, food intake and counterregulation in lean and obese men.

PubMed

Klement, Johanna; Kubera, Britta; Eggeling, Jonas; Rädel, Christin; Wagner, Christin; Park, Soyoung Q; Peters, Achim

2018-03-01

Delay discounting as a measure of impulsivity has been shown to be higher in obesity with an association of increased food intake. Moreover, obese humans showed a higher wanting for high-calorie food than lean men when blood glucose concentrations were low. First studies linking blood glucose levels to delay discounting yielded mixed results. We hypothesized that obese people - in comparison to lean men - have a relative lack of energy, especially when blood glucose levels are low, that results in higher levels of delay discounting, food intake and hormonal counterregulation. We investigated 20 lean and 20 obese healthy young men in a single-blind balanced cross-over design. With a standardized glucose clamp technique, subjects underwent a hypoglycemic state in one condition and a euglycemic state in the control condition. Regularly, blood was sampled for assessment of hormonal status, and questionnaires were filled out to assess delay discounting and symptom awareness. After normalizing blood glucose concentrations, subjects were free to eat from a standardized test buffet, followed by a snack test. Delay discounting was higher in obese than in lean men throughout experiments (p < 0.03). However, we did not observe significant discounting differences between glucose conditions (p > 0.1). Furthermore, the discounting performance did not correlate with food intake from the test buffet or snack test (p > 0.3). As a response to hypoglycemia, hormonal counterregulation was pronounced in both weight groups (p < 0.03), but responses of ACTH, norepinephrine and glucagon were stronger in obese compared to lean men (p < 0.03). Also, intake from the high-calorie buffet after hypoglycemia compared to euglycemia was higher in obese subjects (p < 0.02) but comparable in lean men (p > 0.5). Our data suggest that augmented delay discounting is a robust feature in obesity that is not linked to glucose levels or actual food intake. With our systematically controlled approach, combining performance in delay discounting with regard to distinct blood glucose levels, different weight groups, counterregulatory behavior and food intake, our results imply that delay discounting is not susceptible to fluctuations of blood glucose and do not support the assumption that a low body's energy content leads to increased impulsivity. Further replications including women and larger sample sizes are needed to corroborate our data. Copyright © 2018 Elsevier Ltd. All rights reserved.

Antecedents and characteristics of lean thinking implementation in a Swedish hospital: a case study.

PubMed

Ulhassan, Waqar; Sandahl, Christer; Westerlund, Hugo; Henriksson, Peter; Bennermo, Marie; von Thiele Schwarz, Ulrica; Thor, Johan

2013-01-01

Despite the reported success of Lean in health care settings, it is unclear why and how organizations adopt Lean and how Lean transforms work design and, in turn, affects employees' work. This study investigated a cardiology department's journey to adopt and adapt Lean. The investigation was focused on the rationale and evolution of the Lean adoption to illuminate how a department with a long quality improvement history arrived at the decision to introduce Lean, and how Lean influenced employees' daily work. This is an explanatory single case study based on semistructured interviews, nonparticipant observations, and document studies. Guided by a Lean model, we undertook manifest content analysis of the data. We found that previous improvement efforts may facilitate the introduction of Lean but may be less important when forecasting whether Lean will be sustained over time. Contextual factors seemed to influence both what Lean tools were implemented and how well the changes were sustained. For example, adoption of Lean varied with the degree to which staff saw a need for change. Work redesign and teamwork were found helpful to improve patient care whereas problem solving was found helpful in keeping the staff engaged and sustaining the results over time.

Contribution to the Optimization of Strategy of Maintenance by Lean Six Sigma

NASA Astrophysics Data System (ADS)

Youssouf, Ayadi; Rachid, Chaib; Ion, Verzea

The efficiency of the maintenance of the industrial systems is a major economic stake for their business concern. The main difficulties and the sources of ineffectiveness live in the choice of the actions of maintenance especially when the machine plays a vital role in the process of production. But as Algeria has embarked on major infrastructure projects in transport, housing, automobile, manufacturing industry and construction (factories, housing, highway, subway, tram, etc.) requiring new implications on maintenance strategies that meet industry requirements imposed by the exploitation. From then on and seen the importance of the maintenance on the economic market and sound impacts on the performances of the installations, methods of optimization were developed. For this purpose, to ensure the survival of businesses, be credible, contributing and competitive in the market, maintenance services must continually adapt to the progress of technical areas, technological and organizational even help maintenance managers to construct or to modify maintenance strategies, objective of this work. Our contribution in this work focuses on the optimization of maintenance for industrial systems by the use of Lean six Sigma bases. Lean Six Sigma is a method of improving the quality and profitability based on mastering statically of process and it is also a management style that based on a highly regulated organization dedicated to managing project. The method is based on five main steps summarized in the acronym (DMAIC): Define Measure, Analyze, Improve and Control. Application of the method on the maintenance processes with using maintenance methods during the five phases of the method will help to reduce costs and losses in order to strive for optimum results in terms of profit and quality.

Canine body composition quantification using 3 tesla fat-water MRI.

PubMed

Gifford, Aliya; Kullberg, Joel; Berglund, Johan; Malmberg, Filip; Coate, Katie C; Williams, Phillip E; Cherrington, Alan D; Avison, Malcolm J; Welch, E Brian

2014-02-01

To test the hypothesis that a whole-body fat-water MRI (FWMRI) protocol acquired at 3 Tesla combined with semi-automated image analysis techniques enables precise volume and mass quantification of adipose, lean, and bone tissue depots that agree with static scale mass and scale mass changes in the context of a longitudinal study of large-breed dogs placed on an obesogenic high-fat, high-fructose diet. Six healthy adult male dogs were scanned twice, at weeks 0 (baseline) and 4, of the dietary regiment. FWMRI-derived volumes of adipose tissue (total, visceral, and subcutaneous), lean tissue, and cortical bone were quantified using a semi-automated approach. Volumes were converted to masses using published tissue densities. FWMRI-derived total mass corresponds with scale mass with a concordance correlation coefficient of 0.931 (95% confidence interval = [0.813, 0.975]), and slope and intercept values of 1.12 and -2.23 kg, respectively. Visceral, subcutaneous and total adipose tissue masses increased significantly from weeks 0 to 4, while neither cortical bone nor lean tissue masses changed significantly. This is evidenced by a mean percent change of 70.2% for visceral, 67.0% for subcutaneous, and 67.1% for total adipose tissue. FWMRI can precisely quantify and map body composition with respect to adipose, lean, and bone tissue depots. The described approach provides a valuable tool to examine the role of distinct tissue depots in an established animal model of human metabolic disease. Copyright © 2013 Wiley Periodicals, Inc.

Cooking methods and the formation of PhIP (2-Amino, 1-methyl, 6-phenylimidazo[4,5-b] pyridine) in the crust of the habitually consumed meat in Argentina.

PubMed

Reartes, Gabriela Angelina; Di Paola Naranjo, Romina Daniela; Eynard, Aldo Renato; Muñoz, Sonia Edith

2016-06-01

Content of carcinogenic molecules like, 2-Amino, 1-methyl, 6-phenylimidazo[4,5-b] pyridine in meals is one of the main mutagenic substances formed during meat cooking, and it can be used as a dietary exposure marker. Our objective was to estimate the amount of PhIP consumed from habitual Argentinean diet, rich in red meats, comparing different cooking procedures and meat type. Samples (n = 240) of lean and fatty beef, chicken, pork, and fish were cooked using different methods: griddle, grill, sauté pan, and oven. Samples were: Overcooked, or cooked with a microbiologically suitable or "healthy technique" (HT). The PhIP was determined by HPLC-MS. Meats cooked using HT formed little crust amounts and PhIP was below the detection levels. In overcooked meats, large amounts of crust were formed in lean meats, fatty beef, fatty chicken and baked pork. PhIP was measured in lean meats sauted or cooked on a griddle, a method reaching temperatures until 250 °C.It was estimated that Argentine people eats about 12,268.0 ng/day of PhIP being these values above those tolerated limits for total dietary heterocyclic amines in some developed countries. Hence, cooking small meat portions, at medium temperature, avoiding prolonged cooking and preferring baked lean meats could be recommended as a healthier habit. Copyright © 2016. Published by Elsevier Ltd.

FY2015 Annual Report for Alternative Fuels DISI Engine Research.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sjöberg, Carl-Magnus G.

2016-01-01

Climate change and the need to secure energy supplies are two reasons for a growing interest in engine efficiency and alternative fuels. This project contributes to the science-base needed by industry to develop highly efficient DISI engines that also beneficially exploit the different properties of alternative fuels. Our emphasis is on lean operation, which can provide higher efficiencies than traditional non-dilute stoichiometric operation. Since lean operation can lead to issues with ignition stability, slow flame propagation and low combustion efficiency, we focus on techniques that can overcome these challenges. Specifically, fuel stratification is used to ensure ignition and completeness ofmore » combustion but has soot- and NOx- emissions challenges. For ultralean well-mixed operation, turbulent deflagration can be combined with controlled end-gas auto-ignition to render mixed-mode combustion that facilitates high combustion efficiency. However, the response of both combustion and exhaust emissions to these techniques depends on the fuel properties. Therefore, to achieve optimal fuel-economy gains, the engine combustion-control strategies must be adapted to the fuel being utilized.« less

Correlation of X-ray computed tomography with quantitative nuclear magnetic resonance methods for pre-clinical measurement of adipose and lean tissues in living mice.

PubMed

Metzinger, Matthew N; Miramontes, Bernadette; Zhou, Peng; Liu, Yueying; Chapman, Sarah; Sun, Lucy; Sasser, Todd A; Duffield, Giles E; Stack, M Sharon; Leevy, W Matthew

2014-10-08

Numerous obesity studies have coupled murine models with non-invasive methods to quantify body composition in longitudinal experiments, including X-ray computed tomography (CT) or quantitative nuclear magnetic resonance (QMR). Both microCT and QMR have been separately validated with invasive techniques of adipose tissue quantification, like post-mortem fat extraction and measurement. Here we report a head-to-head study of both protocols using oil phantoms and mouse populations to determine the parameters that best align CT data with that from QMR. First, an in vitro analysis of oil/water mixtures was used to calibrate and assess the overall accuracy of microCT vs. QMR data. Next, experiments were conducted with two cohorts of living mice (either homogenous or heterogeneous by sex, age and genetic backgrounds) to assess the microCT imaging technique for adipose tissue segmentation and quantification relative to QMR. Adipose mass values were obtained from microCT data with three different resolutions, after which the data were analyzed with different filter and segmentation settings. Strong linearity was noted between the adipose mass values obtained with microCT and QMR, with optimal parameters and scan conditions reported herein. Lean tissue (muscle, internal organs) was also segmented and quantified using the microCT method relative to the analogous QMR values. Overall, the rigorous calibration and validation of the microCT method for murine body composition, relative to QMR, ensures its validity for segmentation, quantification and visualization of both adipose and lean tissues.

The mechanisms of flame holding in the wake of a bluff body

NASA Technical Reports Server (NTRS)

Strehlow, R. A.; Malik, S.

1984-01-01

The flame holding mechanism for lean methane and lean propane air flames is examined under conditions where the recirculation zone is absent. The holding process is studied in detail in an attempt to determine the mechanism of flame holding and also the conditions where this mechanism is viable and when it fails and blow off occurs. Inverted flames held in the wake of a flat strip are studied. The velocity flow field is determined using a Laser Doppler Velocimetry technique. Equation of continuity is used to calculate the flame temperature from the change in area of flow streamlines before and after the flame. For methane air flame the controlling factor for blow off is incomplete reaction due to higher blowing rate leading to reduced residence time in the reaction zone.

TRUNK LEAN DURING A SINGLE-LEG SQUAT IS ASSOCIATED WITH TRUNK LEAN DURING PITCHING.

PubMed

Plummer, Hillary A; Oliver, Gretchen D; Powers, Christopher M; Michener, Lori A

2018-02-01

Impaired trunk motion during pitching may be a risk factor for upper extremity injuries. Specifically, increased forces about the shoulder and elbow have been observed in pitchers with excessive contralateral trunk lean during pitching. Because of the difficulty in identifying abnormal trunk motions during a high-speed task such as pitching, a clinical screening test is needed to identify pitchers who have impaired trunk motion during pitching. The purpose of this study was to determine the relationship between the degree of lateral trunk lean during the single-leg squat and amount of trunk lean during pitching and if trunk lean during pitching can be predicted from lean during the single-leg squat. Controlled Laboratory Study; Cross-sectional. Seventy-three young baseball pitchers (11.4 ± 1.7 years; 156.3 ± 11.9 cm; 50.5 ± 8.8 kg) participated. An electromagnetic tracking system was used to obtain trunk kinematic data during a single-leg squat task (lead leg) and at maximum shoulder external rotation of a fastball pitch. Pearson correlation coefficients for trunk lean during the single-leg squat and pitching were calculated. A linear regression analysis was performed to determine if trunk lean during pitching can be predicted from lean during the single-leg squat. There was a positive correlation between trunk lean during the single-leg squat and trunk lean during pitching (r = 0.53; p<0.001). Lateral trunk lean during the single-leg squat predicted the amount of lateral trunk lean during pitching (R 2 = 0.28; p < 0.001). A moderate positive correlation was observed between trunk lean during an SLS and pitching. Trunk lean during the single-leg squat explained 28% of the variance in trunk lean during pitching. Diagnosis, level 3.

TRUNK LEAN DURING A SINGLE-LEG SQUAT IS ASSOCIATED WITH TRUNK LEAN DURING PITCHING

PubMed Central

Oliver, Gretchen D.; Powers, Christopher M.; Michener, Lori A.

2018-01-01

Background Impaired trunk motion during pitching may be a risk factor for upper extremity injuries. Specifically, increased forces about the shoulder and elbow have been observed in pitchers with excessive contralateral trunk lean during pitching. Because of the difficulty in identifying abnormal trunk motions during a high-speed task such as pitching, a clinical screening test is needed to identify pitchers who have impaired trunk motion during pitching. Hypothesis/Purpose The purpose of this study was to determine the relationship between the degree of lateral trunk lean during the single-leg squat and amount of trunk lean during pitching and if trunk lean during pitching can be predicted from lean during the single-leg squat. Study Design Controlled Laboratory Study; Cross-sectional. Methods Seventy-three young baseball pitchers (11.4 ± 1.7 years; 156.3 ± 11.9 cm; 50.5 ± 8.8 kg) participated. An electromagnetic tracking system was used to obtain trunk kinematic data during a single-leg squat task (lead leg) and at maximum shoulder external rotation of a fastball pitch. Pearson correlation coefficients for trunk lean during the single-leg squat and pitching were calculated. A linear regression analysis was performed to determine if trunk lean during pitching can be predicted from lean during the single-leg squat. Results There was a positive correlation between trunk lean during the single-leg squat and trunk lean during pitching (r = 0.53; p<0.001). Lateral trunk lean during the single-leg squat predicted the amount of lateral trunk lean during pitching (R2 = 0.28; p < 0.001). Conclusions A moderate positive correlation was observed between trunk lean during an SLS and pitching. Trunk lean during the single-leg squat explained 28% of the variance in trunk lean during pitching. Level of Evidence Diagnosis, level 3 PMID:29484242

An In-Depth Review on Direct Additive Manufacturing of Metals

NASA Astrophysics Data System (ADS)

Azam, Farooq I.; Rani, Ahmad Majdi Abdul; Altaf, Khurram; Rao, T. V. V. L. N.; Aimi Zaharin, Haizum

2018-03-01

Additive manufacturing (AM), also known as 3D Printing, is a revolutionary manufacturing technique which has been developing rapidly in the last 30 years. The evolution of this precision manufacturing process from rapid prototyping to ready-to-use parts has significantly alleviated manufacturing constraints and design freedom has been outstandingly widened. AM is a non-conventional manufacturing technique which utilizes a 3D CAD model data to build parts by adding one material layer at a time, rather than removing it and fulfills the demand for manufacturing parts with complex geometric shapes, great dimensional accuracy, and easy to assemble parts. Additive manufacturing of metals has become the area of extensive research, progressing towards the production of final products and replacing conventional manufacturing methods. This paper provides an insight to the available metal additive manufacturing technologies that can be used to produce end user products without using conventional manufacturing methods. The paper also includes the comparison of mechanical and physical properties of parts produced by AM with the parts manufactured using conventional processes.

Using Innovative Techniques for Manufacturing Rocket Engine Hardware

NASA Technical Reports Server (NTRS)

Betts, Erin M.; Reynolds, David C.; Eddleman, David E.; Hardin, Andy

2011-01-01

Many of the manufacturing techniques that are currently used for rocket engine component production are traditional methods that have been proven through years of experience and historical precedence. As we enter into a new space age where new launch vehicles are being designed and propulsion systems are being improved upon, it is sometimes necessary to adopt new and innovative techniques for manufacturing hardware. With a heavy emphasis on cost reduction and improvements in manufacturing time, manufacturing techniques such as Direct Metal Laser Sintering (DMLS) are being adopted and evaluated for their use on J-2X, with hopes of employing this technology on a wide variety of future projects. DMLS has the potential to significantly reduce the processing time and cost of engine hardware, while achieving desirable material properties by using a layered powder metal manufacturing process in order to produce complex part geometries. Marshall Space Flight Center (MSFC) has recently hot-fire tested a J-2X gas generator discharge duct that was manufactured using DMLS. The duct was inspected and proof tested prior to the hot-fire test. Using the Workhorse Gas Generator (WHGG) test setup at MSFC?s East Test Area test stand 116, the duct was subject to extreme J-2X gas generator environments and endured a total of 538 seconds of hot-fire time. The duct survived the testing and was inspected after the test. DMLS manufacturing has proven to be a viable option for manufacturing rocket engine hardware, and further development and use of this manufacturing method is recommended.

Response mechanisms of attached premixed flames subjected to harmonic forcing

NASA Astrophysics Data System (ADS)

Shreekrishna

The persistent thrust for a cleaner, greener environment has prompted air pollution regulations to be enforced with increased stringency by environmental protection bodies all over the world. This has prompted gas turbine manufacturers to move from nonpremixed combustion to lean, premixed combustion. These lean premixed combustors operate quite fuel-lean compared to the stochiometric, in order to minimize CO and NOx productions, and are very susceptible to oscillations in any of the upstream flow variables. These oscillations cause the heat release rate of the flame to oscillate, which can engage one or more acoustic modes of the combustor or gas turbine components, and under certain conditions, lead to limit cycle oscillations. This phenomenon, called thermoacoustic instabilities, is characterized by very high pressure oscillations and increased heat fluxes at system walls, and can cause significant problems in the routine operability of these combustors, not to mention the occasional hardware damages that could occur, all of which cumulatively cost several millions of dollars. In a bid towards understanding this flow-flame interaction, this research works studies the heat release response of premixed flames to oscillations in reactant equivalence ratio, reactant velocity and pressure, under conditions where the flame preheat zone is convectively compact to these disturbances, using the G-equation. The heat release response is quantified by means of the flame transfer function and together with combustor acoustics, forms a critical component of the analytical models that can predict combustor dynamics. To this end, low excitation amplitude (linear) and high excitation amplitude (nonlinear) responses of the flame are studied in this work. The linear heat release response of lean, premixed flames are seen to be dominated by responses to velocity and equivalence ratio fluctuations at low frequencies, and to pressure fluctuations at high frequencies which are in the vicinity of typical screech frequencies in gas turbine combustors. The nonlinear response problem is exclusively studied in the case of equivalence ratio coupling. Various nonlinearity mechanisms are identified, amongst which the crossover mechanisms, viz., stoichiometric and flammability crossovers, are seen to be responsible in causing saturation in the overall heat release magnitude of the flame. The response physics remain the same across various preheat temperatures and reactant pressures. Finally, comparisons between the chemiluminescence transfer function obtained experimentally and the heat release transfer functions obtained from the reduced order model (ROM) are performed for lean, CH4/Air swirl-stabilized, axisymmetric V-flames. While the comparison between the phases of the experimental and theoretical transfer functions are encouraging, their magnitudes show disagreement at lower Strouhal number gains show disagreement.

A Web-Based Lean Simulation Game for Office Operations: Training the Other Side of a Lean Enterprise

ERIC Educational Resources Information Center

Kuriger, Glenn W.; Wan, Huang-da; Mirehei, S. Moussa; Tamma, Saumya; Chen, F. Frank

2010-01-01

This research proposes a Web-based version of a lean office simulation game (WeBLOG). The game is designed to be used to train lean concepts to office and administrative personnel. This group belongs to the frequently forgotten side of a lean enterprise. Over four phases, the game presents the following seven lean tools: one-piece flow,…

Laser 3D micro-manufacturing

NASA Astrophysics Data System (ADS)

Piqué, Alberto; Auyeung, Raymond C. Y.; Kim, Heungsoo; Charipar, Nicholas A.; Mathews, Scott A.

2016-06-01

Laser-based materials processing techniques are gaining widespread use in micro-manufacturing applications. The use of laser microfabrication techniques enables the processing of micro- and nanostructures from a wide range of materials and geometries without the need for masking and etching steps commonly associated with photolithography. This review aims to describe the broad applications space covered by laser-based micro- and nanoprocessing techniques and the benefits offered by the use of lasers in micro-manufacturing processes. Given their non-lithographic nature, these processes are also referred to as laser direct-write and constitute some of the earliest demonstrations of 3D printing or additive manufacturing at the microscale. As this review will show, the use of lasers enables precise control of the various types of processing steps—from subtractive to additive—over a wide range of scales with an extensive materials palette. Overall, laser-based direct-write techniques offer multiple modes of operation including the removal (via ablative processes) and addition (via photopolymerization or printing) of most classes of materials using the same equipment in many cases. The versatility provided by these multi-function, multi-material and multi-scale laser micro-manufacturing processes cannot be matched by photolithography nor with other direct-write microfabrication techniques and offer unique opportunities for current and future 3D micro-manufacturing applications.

Application of lean methods improves surgical clinic experience.

PubMed

Waldhausen, John H T; Avansino, Jeffrey R; Libby, Arlene; Sawin, Robert S

2010-07-01

A quality visit in high volume surgery clinics is challenging. There is variability in numbers of patients seen and care provider behavior. Documentation, regulatory and compliance issues and computerization of patient care systems may decrease clinic efficiency and throughput. We tried to reduce variability and improve patient experience. Baseline data included: patients seen, time in exam rooms, and spent with providers, and patient satisfaction surveys. Two Rapid Process Improvement Workshops (RPIWs) were conducted to apply lean methods. 5S techniques helped standardize exam rooms. Similar data were collected at 30 days, 60 days, and 1 year. Satisfaction surveys were followed at 6 months and 1 year. Median pre-RPIW room time was 49 minutes. Post-RPIW times were 33 minutes at 30 days, 41 minutes at 60 days, and 42 minutes at 1 year. Face to face provider-patient time increased 30% to 61% at 30 days, 58% at 60 days, and 59% at 1 year. The median number of patients in a 4-hour clinic increased from 10 to 12. Satisfaction survey Problem Scores improved and were sustained. Lean methodology may be used to improve clinic efficiency as well as patient and staff's experience. Copyright 2010. Published by Elsevier Inc.

Design of Ski Boots for Alpine Ski Racing Based on Leg Frame of the Skier

NASA Astrophysics Data System (ADS)

Suzuki, Soichiro; Hayashi, Sueyoshi

A ski boot is important to make progress in ski turning technique as an interface between a skier and a ski. Especially in alpine ski races, suitability of design of the boots for racers becomes more important to achieve accurate and quick lean of the leg in ski turns. This study is aimed at building a new design concept of a ski boot that can improve the results of alpine ski races. In this paper, new design of an upper shell of a ski boot that was adjusted to the features of the frame of alpine ski racers was experimentally examined. As a result, it was demonstrated that a front and a rear part of the upper shell of a ski boot should be separately adjusted to the length of a shank of each player for well-balanced quick lean of the leg in the ski turn. Finally, the effect of new design of an upper shell was examined in giant slalom and slalom tests by Japanese alpine ski racers of the first rank. Consequently, the results showed that lean angle during turns was increased and finish time was shortened when the skiers wore the newly designed boots.

Cull sow knife-separable lean content evaluation at harvest and lean mass content prediction equation development.

PubMed

Abell, Caitlyn E; Stalder, Kenneth J; Hendricks, Haven B; Fitzgerald, Robert F

2012-07-01

The objectives of this study were to develop a prediction equation for carcass knife-separable lean within and across USDA cull sow market weight classes (MWC) and to determine carcass and individual primal cut knife separable lean content from cull sows. There were significant percent lean and fat differences in the primal cuts across USDA MWC. The two lighter USDA MWC had a greater percent carcass lean and lower percent fat compared to the two heavier MWC. In general, hot carcass weight explained the majority of carcass lean variation. Additionally, backfat was a significant variation source when predicting cull sow carcass lean. The findings support using a single lean prediction equation across MWC to assist processors when making cull sow purchasing decisions and determine the mix of animals from various USDA MWC that will meet their needs when making pork products with defined lean:fat content. Copyright © 2012 Elsevier Ltd. All rights reserved.

Prevalence and hemodynamic effects of leaning during CPR

PubMed Central

Niles, Dana E.; Sutton, Robert M.; Nadkarni, Vinay M.; Glatz, Andrew; Zuercher, Mathias; Maltese, Matthew R.; Eilevstjønn, Joar; Abella, Benjamin S.; Becker, Lance B.; Berg, Robert A.

2013-01-01

Background Cardiopulmonary resuscitation (CPR) guidelines recommend complete release between chest compressions (CC). Objective Evaluate the hemodynamic effects of leaning (incomplete chest wall release) during CPR and the prevalence of leaning during CPR. Results In piglet ventricular fibrillation cardiac arrests, 10% and 20% (1.8 kg and 3.6 kg, respectively), leaning during CPR increased right atrial pressures, decreased coronary perfusion pressures, and decreased cardiac index and left ventricular myocardial blood flow by nearly 50%. In contrast, residual leaning of a 260 g accelerometer/ force feedback device did not adversely affect cardiac index or myocardial blood flow. Among 108 adult in-hospital CPR events, leaning ≥2.5 kg was demonstrable in 91% of the events and 12% of the evaluated CC. For 12 children with in-hospital CPR, 28% of CC had residual leaning ≥2.5 kg and 89% had residual leaning ≥0.5 kg. Conclusions Leaning during CPR increases intrathoracic pressure, decreases coronary perfusion pressure, and decreases cardiac output and myocardial blood flow. Leaning is common during CPR. PMID:22208173

Manufacturing Process Developments for Regeneratively-Cooled Channel Wall Rocket Nozzles

NASA Technical Reports Server (NTRS)

Gradl, Paul; Brandsmeier, Will

2016-01-01

Regeneratively cooled channel wall nozzles incorporate a series of integral coolant channels to contain the coolant to maintain adequate wall temperatures and expand hot gas providing engine thrust and specific impulse. NASA has been evaluating manufacturing techniques targeting large scale channel wall nozzles to support affordability of current and future liquid rocket engine nozzles and thrust chamber assemblies. The development of these large scale manufacturing techniques focus on the liner formation, channel slotting with advanced abrasive water-jet milling techniques and closeout of the coolant channels to replace or augment other cost reduction techniques being evaluated for nozzles. NASA is developing a series of channel closeout techniques including large scale additive manufacturing laser deposition and explosively bonded closeouts. A series of subscale nozzles were completed evaluating these processes. Fabrication of mechanical test and metallography samples, in addition to subscale hardware has focused on Inconel 625, 300 series stainless, aluminum alloys as well as other candidate materials. Evaluations of these techniques are demonstrating potential for significant cost reductions for large scale nozzles and chambers. Hot fire testing is planned using these techniques in the future.

Development of an Assessment Model for Sustainable Supply Chain Management in Batik Industry

NASA Astrophysics Data System (ADS)

Mubiena, G. F.; Ma’ruf, A.

2018-03-01

This research proposes a dynamic assessment model for sustainable supply chain management in batik industry. The proposed model identifies the dynamic relationship between economic aspect, environment aspect and social aspect. The economic aspect refers to the supply chain operation reference model. The environment aspect uses carbon emissions and liquid waste as the attribute assessment, while the social aspect focus on employee’s welfare. Lean manufacturing concept was implemented as an alternative approach to sustainability. The simulation result shows that the average of sustainability score for 5 years increased from 65,3% to 70%. Future experiments will be conducted on design improvements to reach the company target on sustainability score.

The PCOS Patients differ in Lipid Profile According to their Phenotypes.

PubMed

Spałkowska, Magdalena; Mrozińska, Sandra; Gałuszka-Bednarczyk, Anna; Gosztyła, Katarzyna; Przywara, Agnieszka; Guzik, Justyna; Janeczko, Marek; Milewicz, Tomasz; Wojas-Pelc, Anna

2018-01-31

Polycystic ovary syndrome (PCOS) affects 4-18% of women of reproductive age. The number of reports exploring the lipid profiles among PCOS patients and number of studied patients are limited. The aim of our study was to assess the lipid profile separately in lean and non-lean women with polycystic ovary syndrome divided according to hyperandrogenemia, defined as free androgen index (FAI)≥5. The second aim was to compare the lipid profiles among lean and non-lean PCOS patients with respect to hyperandrogenemia and regularity of menstruation cycles. We evaluated 232 patients from Department of Endocrinological Gynecology, Jagiellonian University Medical College in Krakow diagnosed with PCOS. The population consisted of 166 lean and 66 non-lean women. We observed higher levels of total cholesterol, high-density lipoprotein cholesterol (HDL-C) in lean patients with FAI<5 than in lean patients with FAI≥5. There were no differences in lipid profile between non-lean patients with FAI≥5 and non-lean patients with FAI<5. Among lean patients higher total cholesterol levels were observed in those with irregular menstruation cycles and FAI<5 than in patients with FAI≥5 and regular cycles. There were no differences in lipid profiles between four phenotypes among non-lean PCOS patients. The results of our study showed differences in lipid profile between lean PCOS patients according to their phenotype based on androgens' level. This effect was abandoned by fat tissue mass in non-lean ones. Further studies should be conducted to explore these associations. © Georg Thieme Verlag KG Stuttgart · New York.

A review of techniques to determine alternative selection in design for remanufacturing

NASA Astrophysics Data System (ADS)

Noor, A. Z. Mohamed; Fauadi, M. H. F. Md; Jafar, F. A.; Mohamad, N. R.; Yunos, A. S. Mohd

2017-10-01

This paper discusses the techniques used for optimization in manufacturing system. Although problem domain is focused on sustainable manufacturing, techniques used to optimize general manufacturing system were also discussed. Important aspects of Design for Remanufacturing (DFReM) considered include indexes, weighted average, grey decision making and Fuzzy TOPSIS. The limitation of existing techniques are most of them is highly based on decision maker’s perspective. Different experts may have different understanding and eventually scale it differently. Therefore, the objective of this paper is to determine available techniques and identify the lacking feature in it. Once all the techniques have been reviewed, a decision will be made by create another technique which should counter the lacking of discussed techniques. In this paper, shows that the hybrid computation of Fuzzy Analytic Hierarchy Process (AHP) and Artificial Neural Network (ANN) is suitable and fill the gap of all discussed technique.

Proton magnetic resonance spectroscopy for assessment of human body composition.

PubMed

Kamba, M; Kimura, K; Koda, M; Ogawa, T

2001-02-01

The usefulness of magnetic resonance spectroscopy (MRS)-based techniques for assessment of human body composition has not been established. We compared a proton MRS-based technique with the total body water (TBW) method to determine the usefulness of the former technique for assessment of human body composition. Proton magnetic resonance spectra of the chest to abdomen, abdomen to pelvis, and pelvis to thigh regions were obtained from 16 volunteers by using single, free induction decay measurement with a clinical magnetic resonance system operating at 1.5 T. The MRS-derived metabolite ratio was determined as the ratio of fat methyl and methylene proton resonance to water proton resonance. The peak areas for the chest to abdomen and the pelvis to thigh regions were normalized to an external reference (approximately 2200 g benzene) and a weighted average of the MRS-derived metabolite ratios for the 2 positions was calculated. TBW for each subject was determined by the deuterium oxide dilution technique. The MRS-derived metabolite ratios were significantly correlated with the ratio of body fat to lean body mass estimated by TBW. The MRS-derived metabolite ratio for the abdomen to pelvis region correlated best with the ratio of body fat to lean body mass on simple regression analyses (r = 0.918). The MRS-derived metabolite ratio for the abdomen to pelvis region and that for the pelvis to thigh region were selected for a multivariate regression model (R = 0.947, adjusted R(2) = 0.881). This MRS-based technique is sufficiently accurate for assessment of human body composition.

Computer-assisted versus conventional free fibula flap technique for craniofacial reconstruction: an outcomes comparison.

PubMed

Seruya, Mitchel; Fisher, Mark; Rodriguez, Eduardo D

2013-11-01

There has been rising interest in computer-aided design/computer-aided manufacturing for preoperative planning and execution of osseous free flap reconstruction. The purpose of this study was to compare outcomes between computer-assisted and conventional fibula free flap techniques for craniofacial reconstruction. A two-center, retrospective review was carried out on patients who underwent fibula free flap surgery for craniofacial reconstruction from 2003 to 2012. Patients were categorized by the type of reconstructive technique: conventional (between 2003 and 2009) or computer-aided design/computer-aided manufacturing (from 2010 to 2012). Demographics, surgical factors, and perioperative and long-term outcomes were compared. A total of 68 patients underwent microsurgical craniofacial reconstruction: 58 conventional and 10 computer-aided design and manufacturing fibula free flaps. By demographics, patients undergoing the computer-aided design/computer-aided manufacturing method were significantly older and had a higher rate of radiotherapy exposure compared with conventional patients. Intraoperatively, the median number of osteotomies was significantly higher (2.0 versus 1.0, p=0.002) and the median ischemia time was significantly shorter (120 minutes versus 170 minutes, p=0.004) for the computer-aided design/computer-aided manufacturing technique compared with conventional techniques; operative times were shorter for patients undergoing the computer-aided design/computer-aided manufacturing technique, although this did not reach statistical significance. Perioperative and long-term outcomes were equivalent for the two groups, notably, hospital length of stay, recipient-site infection, partial and total flap loss, and rate of soft-tissue and bony tissue revisions. Microsurgical craniofacial reconstruction using a computer-assisted fibula flap technique yielded significantly shorter ischemia times amidst a higher number of osteotomies compared with conventional techniques. Therapeutic, III.

Automated array assembly

NASA Technical Reports Server (NTRS)

Williams, B. F.

1976-01-01

Manufacturing techniques are evaluated using expenses based on experience and studying basic cost factors for each step to evaluate expenses from a first-principles point of view. A formal cost accounting procedure is developed which is used throughout the study for cost comparisons. The first test of this procedure is a comparison of its predicted costs for array module manufacturing with costs from a study which is based on experience factors. A manufacturing cost estimate for array modules of $10/W is based on present-day manufacturing techniques, expenses, and materials costs.

Development of framework for sustainable Lean implementation: an ISM approach

NASA Astrophysics Data System (ADS)

Jadhav, Jagdish Rajaram; Mantha, S. S.; Rane, Santosh B.

2014-07-01

The survival of any organization depends upon its competitive edge. Even though Lean is one of the most powerful quality improvement methodologies, nearly two-thirds of the Lean implementations results in failures and less than one-fifth of those implemented have sustained results. One of the most significant tasks of top management is to identify, understand and deploy the significant Lean practices like quality circle, Kanban, Just-in-time purchasing, etc. The term `bundle' is used to make groups of inter-related and internally consistent Lean practices. Eight significant Lean practice bundles have been identified based on literature reviewed and opinion of the experts. The order of execution of Lean practice bundles is very important. Lean practitioners must be able to understand the interrelationship between these practice bundles. The objective of this paper is to develop framework for sustainable Lean implementation using interpretive structural modelling approach.

Improving Performance of Your CMMI Mature Organization Through Lean and Agile Techniques

DTIC Science & Technology

2011-05-01

difficulty CMM Level 3 many years ago; 2008 CMMI Level 3 2008 CMMI motivation : •Vice-President (VP) understood could use CMMI to address changing customer...Integration Scrum– Not an acronym, mechanisms in game of rugby for getting an out-of-play ball back into play Copyright by PEM Systems 2011 35

Evaluation of Learning Unit Design with Use of Page Flip Information Analysis

ERIC Educational Resources Information Center

Horikoshi, Izumi; Noguchi, Masato; Tamura, Yasuhisa

2016-01-01

In this paper, the authors attempted to evaluate design of leaning units with use of Learning Analytics technique on page flip information. Traditional formative assessment has been carried out by giving assignments and evaluating their results. However, the information that teacher can get from the evaluation is limited and coarse-grained. The…

Applying Lean Six Sigma to improve medication management.

PubMed

Nayar, Preethy; Ojha, Diptee; Fetrick, Ann; Nguyen, Anh T

2016-01-01

A significant proportion of veterans use dual care or health care services within and outside the Veterans Health Administration (VHA). In this study conducted at a VHA medical center in the USA, the authors used Lean Six Sigma principles to develop recommendations to eliminate wasteful processes and implement a more efficient and effective process to manage medications for dual care veteran patients. The purpose of this study is to: assess compliance with the VHA's dual care policy; collect data and describe the current process for co-management of dual care veterans' medications; and draft recommendations to improve the current process for dual care medications co-management. Input was obtained from the VHA patient care team members to draw a process map to describe the current process for filling a non-VHA prescription at a VHA facility. Data were collected through surveys and direct observation to measure the current process and to develop recommendations to redesign and improve the process. A key bottleneck in the process that was identified was the receipt of the non-VHA medical record which resulted in delays in filling prescriptions. The recommendations of this project focus on the four domains of: documentation of dual care; veteran education; process redesign; and outreach to community providers. This case study describes the application of Lean Six Sigma principles in one urban Veterans Affairs Medical Center (VAMC) in the Mid-Western USA to solve a specific organizational quality problem. Therefore, the findings may not be generalizable to other organizations. The Lean Six Sigma general principles applied in this project to develop recommendations to improve medication management for dual care veterans are applicable to any process improvement or redesign project and has valuable lessons for other VAMCs seeking to improve care for their dual care veteran patients. The findings of this project will be of value to VA providers and policy makers and health care managers who plan to apply Lean Six Sigma techniques in their organizations to improve the quality of care for their patients.

Additive direct-write microfabrication for MEMS: A review

NASA Astrophysics Data System (ADS)

Teh, Kwok Siong

2017-12-01

Direct-write additive manufacturing refers to a rich and growing repertoire of well-established fabrication techniques that builds solid objects directly from computer- generated solid models without elaborate intermediate fabrication steps. At the macroscale, direct-write techniques such as stereolithography, selective laser sintering, fused deposition modeling ink-jet printing, and laminated object manufacturing have significantly reduced concept-to-product lead time, enabled complex geometries, and importantly, has led to the renaissance in fabrication known as the maker movement. The technological premises of all direct-write additive manufacturing are identical—converting computer generated three-dimensional models into layers of two-dimensional planes or slices, which are then reconstructed sequentially into threedimensional solid objects in a layer-by-layer format. The key differences between the various additive manufacturing techniques are the means of creating the finished layers and the ancillary processes that accompany them. While still at its infancy, direct-write additive manufacturing techniques at the microscale have the potential to significantly lower the barrier-of-entry—in terms of cost, time and training—for the prototyping and fabrication of MEMS parts that have larger dimensions, high aspect ratios, and complex shapes. In recent years, significant advancements in materials chemistry, laser technology, heat and fluid modeling, and control systems have enabled additive manufacturing to achieve higher resolutions at the micrometer and nanometer length scales to be a viable technology for MEMS fabrication. Compared to traditional MEMS processes that rely heavily on expensive equipment and time-consuming steps, direct-write additive manufacturing techniques allow for rapid design-to-prototype realization by limiting or circumventing the need for cleanrooms, photolithography and extensive training. With current direct-write additive manufacturing technologies, it is possible to fabricate unsophisticated micrometer scale structures at adequate resolutions and precisions using materials that range from polymers, metals, ceramics, to composites. In both academia and industry, direct-write additive manufacturing offers extraordinary promises to revolutionize research and development in microfabrication and MEMS technologies. Importantly, direct-write additive manufacturing could appreciably augment current MEMS fabrication technologies, enable faster design-to-product cycle, empower new paradigms in MEMS designs, and critically, encourage wider participation in MEMS research at institutions or for individuals with limited or no access to cleanroom facilities. This article aims to provide a limited review of the current landscape of direct-write additive manufacturing techniques that are potentially applicable for MEMS microfabrication.

Lost in translation: a case-study of the travel of lean thinking in a hospital.

PubMed

Andersen, Hege; Røvik, Kjell Arne

2015-09-21

Lean thinking as a quality improvement approach is introduced in hospitals worldwide, although evidence for its impact is scarce. Lean initiatives are social, complex and context-dependent. This calls for a shift from cause-effect to conditional attributions to understand how lean works. In this study, we bring attention to the transformative power of local translation, which creates different versions of lean in different contexts, and thereby affect the evidence for lean as well as the success of lean initiatives within and among hospitals. We explored the travel of lean within a hospital in Norway by identifying local actors' perceptions of lean through their images of enablers for successful interventions. These attributions describe the characteristics of lean in use, i.e. the prevailing version of lean. Local actors' perceptions of enablers for lean interventions were collected through focus group interviews with three groups of stakeholders: managers, internal consultants and staff. A questionnaire was used to reveal the enablers relative importance. The enablers known from the literature were retrieved at the case hospital. The only exception was that external expert change agents were not believed to promote lean. In addition, the stakeholders added a number of new and supplementary enablers. Two-thirds of the most important enablers for success were novel, local ones. Among these were a problem, not method focus, a bottom-up approach, the need of internal consultants, credibility, realism and patience. The local actors told different stories about local enablers and had different images of lean depending on their hierarchical level. By comparing and analyzing the findings from the literature review, the focus groups and the survey, we deduced that the travel of lean within the hospital was affected by three principles of translation: the practical, the pragmatic, and the sceptical. Further, three logics of translation were in play: translation as a funnel, a conscious sell-in, and a wash-out. This resulted in various local versions of lean. We conclude that lean, introduced by the management, communicated by the internal consultants, and used by the staff, is transformed more than once within the hospital. Translation is part of the explanation for the lack of evidence for lean, and translation can be decisive for outcomes.

Post Processing Methods used to Improve Surface Finish of Products which are Manufactured by Additive Manufacturing Technologies: A Review

NASA Astrophysics Data System (ADS)

Kumbhar, N. N.; Mulay, A. V.

2016-08-01

The Additive Manufacturing (AM) processes open the possibility to go directly from Computer-Aided Design (CAD) to a physical prototype. These prototypes are used as test models before it is finalized as well as sometimes as a final product. Additive Manufacturing has many advantages over the traditional process used to develop a product such as allowing early customer involvement in product development, complex shape generation and also save time as well as money. Additive manufacturing also possess some special challenges that are usually worth overcoming such as Poor Surface quality, Physical Properties and use of specific raw material for manufacturing. To improve the surface quality several attempts had been made by controlling various process parameters of Additive manufacturing and also applying different post processing techniques on components manufactured by Additive manufacturing. The main objective of this work is to document an extensive literature review in the general area of post processing techniques which are used in Additive manufacturing.

Modeling and simulation of combustion dynamics in lean-premixed swirl-stabilized gas-turbine engines

NASA Astrophysics Data System (ADS)

Huang, Ying

This research focuses on the modeling and simulation of combustion dynamics in lean-premixed gas-turbines engines. The primary objectives are: (1) to establish an efficient and accurate numerical framework for the treatment of unsteady flame dynamics; and (2) to investigate the parameters and mechanisms responsible for driving flow oscillations in a lean-premixed gas-turbine combustor. The energy transfer mechanisms among mean flow motions, periodic motions and background turbulent motions in turbulent reacting flow are first explored using a triple decomposition technique. Then a comprehensive numerical study of the combustion dynamics in a lean-premixed swirl-stabilized combustor is performed. The analysis treats the conservation equations in three dimensions and takes into account finite-rate chemical reactions and variable thermophysical properties. Turbulence closure is achieved using a large-eddy-simulation (LES) technique. The compressible-flow version of the Smagorinsky model is employed to describe subgrid-scale turbulent motions and their effect on large-scale structures. A level-set flamelet library approach is used to simulate premixed turbulent combustion. In this approach, the mean flame location is modeled using a level-set G-equation, where G is defined as a distance function. Thermophysical properties are obtained using a presumed probability density function (PDF) along with a laminar flamelet library. The governing equations and the associated boundary conditions are solved by means of a four-step Runge-Kutta scheme along with the implementation of the message passing interface (MPI) parallel computing architecture. The analysis allows for a detailed investigation into the interaction between turbulent flow motions and oscillatory combustion of a swirl-stabilized injector. Results show good agreement with an analytical solution and experimental data in terms of acoustic properties and flame evolution. A study of flame bifurcation from a stable state to an unstable state indicates that the inlet flow temperature and equivalence ratio are the two most important variables determining the stability characteristics of the combustor. Under unstable operating conditions, several physical processes responsible for driving combustion instabilities in the chamber have been identified and quantified. These processes include vortex shedding and acoustic interaction, coupling between the flame evolution and local flow oscillations, vortex and flame interaction and coupling between heat release and acoustic motions. The effects of inlet swirl number on the flow development and flame dynamics in the chamber are also carefully studied. In the last part of this thesis, an analytical model is developed using triple decomposition techniques to model the combustion response of turbulent premixed flames to acoustic oscillations.

Lean thinking in emergency departments: concepts and tools for quality improvement.

PubMed

Bruno, Frances

2017-10-12

The lean approach is a viable framework for reducing costs and enhancing the quality of patient care in emergency departments (EDs). Reports on lean-inspired quality improvement initiatives are rapidly growing but there is little emphasis on the philosophy behind the processes, which is the essential ingredient in sustaining transformation. This article describes lean philosophy, also referred to as lean, lean thinking and lean healthcare, and its main concepts, to enrich the knowledge and vocabulary of nurses involved or interested in quality improvement in EDs. The article includes examples of lean strategies to illustrate their practical application in EDs. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

The effect of incomplete fuel-air mixing on the lean blowout limit, lean stability limit and NO(x) emissions in lean premixed gas turbine combustors

NASA Technical Reports Server (NTRS)

Shih, W.-P.; Lee, J. G.; Santavicca, D. A.

1994-01-01

Gas turbine engines for both land-based and aircraft propulsion applications are facing regulations on NOx emissions which cannot be met with current combustor technology. A number of alternative combustor strategies are being investigated which have the potential capability of achieving ultra-low NOx emissions, including lean premixed combustors, direct injection combustors, rich burn-quick quench-lean burn combustors and catalytic combustors. The research reported in this paper addresses the effect of incomplete fuel-air mixing on the lean limit performance and the NOx emissions characteristics of lean premixed combustors.

Reliability of the EchoMRI-Infant System for Water and Fat Measurements in Newborns

PubMed Central

Toro-Ramos, Tatiana; Paley, Charles; Wong, William W.; Pi-Sunyer, F. Xavier; Yu, W.; Thornton, John; Gallagher, Dympna

2017-01-01

Objective The precision and accuracy of a quantitative magnetic resonance (EchoMRI-Infants™) system in newborn was determined. Methods: Canola oil and drinking water phantoms (increments of 10g to 1.9kg) were scanned four times. Instrument reproducibility was assessed from 3 scans (within 10-minutes) in 42 healthy term newborns (12–70 hours post-birth). Instrument precision was determined from the coefficient of variation (CV) of repeated scans for total water, lean, and fat measures for newborns and the mean difference between weight and measurement for phantoms. In newborns, the system accuracy for total body water (TBW) was tested against deuterium dilution (D2O). Results In phantoms, the repeatability and accuracy of fat and water measurements increased as the weight of oil and water increased. TBW was overestimated in amounts >200g. In newborns weighing 3.14kg, fat, lean and TBW were 0.52kg (16.48%), 2.28kg and 2.40kg, respectively. EchoMRI’s reproducibility (CV) was 3.27%, 1.83% and 1.34% for total body fat, lean, and TBW, respectively. EchoMRI-TBW values did not differ from D2O; mean difference − 1.95±6.76%, p=0.387; mean bias (limits of agreement) 0.046 kg (−0.30 to 0.39 kg). Conclusions EchoMRI infant system’s precision and accuracy for total body fat and lean are better than established techniques and equivalent to D2O for TBW in phantoms and newborns. PMID:28712143

The prevalence of chest compression leaning during in-hospital cardiopulmonary resuscitation

PubMed Central

Fried, David A.; Leary, Marion; Smith, Douglas A.; Sutton, Robert M.; Niles, Dana; Herzberg, Daniel L.; Becker, Lance B.; Abella, Benjamin S.

2011-01-01

Objective Successful resuscitation from cardiac arrest requires the delivery of high-quality chest compressions, encompassing parameters such as adequate rate, depth, and full recoil between compressions. The lack of compression recoil (“leaning” or “incomplete recoil”) has been shown to adversely affect hemodynamics in experimental arrest models, but the prevalence of leaning during actual resuscitation is poorly understood. We hypothesized that leaning varies across resuscitation events, possibly due to rescuer and/or patient characteristics and may worsen over time from rescuer fatigue during continuous chest compressions. Methods This was an observational clinical cohort study at one academic medical center. Data were collected from adult in-hospital and Emergency Department arrest events using monitor/defibrillators that record chest compression characteristics and provide real-time feedback. Results We analyzed 112,569 chest compressions from 108 arrest episodes from 5/2007 to 2/2009. Leaning was present in 98/108 (91%) cases; 12% of all compressions exhibited leaning. Leaning varied widely across cases: 41/108 (38%) of arrest episodes exhibited <5% leaning yet 20/108 (19%) demonstrated >20% compression leaning. When evaluating blocks of continuous compressions (>120 sec), only 4/33 (12%) had an increase in leaning over time and 29/33 (88%) showed a decrease (p<0.001). Conclusions Chest compression leaning was common during resuscitation care and exhibited a wide distribution, with most leaning within a subset of resuscitations. Leaning decreased over time during continuous chest compression blocks, suggesting that either leaning may not be a function of rescuer fatiguing, or that it may have been mitigated by automated feedback provided during resuscitation episodes. PMID:21482010

Risk Factors for the Loss of Lean Body Mass After Gastrectomy for Gastric Cancer.

PubMed

Aoyama, Toru; Sato, Tsutomu; Segami, Kenki; Maezawa, Yukio; Kano, Kazuki; Kawabe, Taiichi; Fujikawa, Hirohito; Hayashi, Tsutomu; Yamada, Takanobu; Tsuchida, Kazuhito; Yukawa, Norio; Oshima, Takashi; Rino, Yasushi; Masuda, Munetaka; Ogata, Takashi; Cho, Haruhiko; Yoshikawa, Takaki

2016-06-01

Lean body mass loss after surgery, which decreases the compliance of adjuvant chemotherapy, is frequently observed in gastric cancer patients who undergo gastrectomy for gastric cancer. However, the risk factors for loss of lean body mass remain unclear. The current study retrospectively examined the patients who underwent curative gastrectomy for gastric cancer between June 2010 and March 2014 at Kanagawa Cancer Center. All the patients received perioperative care for enhanced recovery after surgery. The percentage of lean body mass loss was calculated by the percentile of lean body mass 1 month after surgery to preoperative lean body mass. Severe lean body mass loss was defined as a lean body mass loss greater than 5 %. Risk factors for severe lean body mass loss were determined by both uni- and multivariate logistic regression analyses. This study examined 485 patients. The median loss of lean body mass was 4.7 %. A lean body mass loss of 5 % or more occurred for 225 patients (46.4 %). Both uni- and multivariate logistic analyses demonstrated that the significant independent risk factors for severe lean body mass loss were surgical complications with infection or fasting (odds ratio [OR] 3.576; p = 0.001), total gastrectomy (OR 2.522; p = 0.0001), and gender (OR 1.928; p = 0.001). Nutritional intervention or control of surgical invasion should be tested in future clinical trials for gastric cancer patients with these risk factors to maintain lean body mass after gastrectomy.

An experimental and theoretical investigation of a fuel system tuner for the suppression of combustion driven oscillations

NASA Astrophysics Data System (ADS)

Scarborough, David E.

Manufacturers of commercial, power-generating, gas turbine engines continue to develop combustors that produce lower emissions of nitrogen oxides (NO x) in order to meet the environmental standards of governments around the world. Lean, premixed combustion technology is one technique used to reduce NOx emissions in many current power and energy generating systems. However, lean, premixed combustors are susceptible to thermo-acoustic oscillations, which are pressure and heat-release fluctuations that occur because of a coupling between the combustion process and the natural acoustic modes of the system. These pressure oscillations lead to premature failure of system components, resulting in very costly maintenance and downtime. Therefore, a great deal of work has gone into developing methods to prevent or eliminate these combustion instabilities. This dissertation presents the results of a theoretical and experimental investigation of a novel Fuel System Tuner (FST) used to damp detrimental combustion oscillations in a gas turbine combustor by changing the fuel supply system impedance, which controls the amplitude and phase of the fuel flowrate. When the FST is properly tuned, the heat release oscillations resulting from the fuel-air ratio oscillations damp, rather than drive, the combustor acoustic pressure oscillations. A feasibility study was conducted to prove the validity of the basic idea and to develop some basic guidelines for designing the FST. Acoustic models for the subcomponents of the FST were developed, and these models were experimentally verified using a two-microphone impedance tube. Models useful for designing, analyzing, and predicting the performance of the FST were developed and used to demonstrate the effectiveness of the FST. Experimental tests showed that the FST reduced the acoustic pressure amplitude of an unstable, model, gas-turbine combustor over a wide range of operating conditions and combustor configurations. Finally, combustor acoustic pressure amplitude measurements made in using the model combustor were used in conjunction with model predicted fuel system impedances to verify the developed design rules. The FST concept and design methodology presented in this dissertation can be used to design fuel system tuners for new and existing gas turbine combustors to reduce, or eliminate altogether, thermo-acoustic oscillations.

NOx results from two combustors tested on medium BTU coal gas

NASA Technical Reports Server (NTRS)

Sherlock, T. P.; Carl, D. E.; Vermes, G.; Schwab, J.; Notardonato, J. J.

1982-01-01

The results of tests of two combustor configurations using coal gas from a 25 ton/day fluidized bed coal gasifier are reported. The trials were run with a ceramic-lined, staged rich/lean burner and an integral, all metal multiannular swirl burner (MASB) using a range of temperatures and pressures representative of industrial turbine inlet conditions. A lean mixture was examined at 104, 197, and 254 Btu/Scf, yielding NO(x) emissions of 5, 20, and 70 ppmv, respectively. The MASB was employed only with a gas rated at 220-270 Btu/Scf, producing 80 ppmv NO(x) at rated engine conditions. The results are concluded to be transferrable to current machines. Further tests on the effects of gas composition, the scaling of combustors to utility size, and the development of improved wall cooling techniques and variable geometry are indicated.

Lean leadership: an ethnographic study.

PubMed

Aij, Kjeld Harald; Visse, Merel; Widdershoven, Guy A M

2015-01-01

The purpose of this study is to provide a critical analysis of contemporary Lean leadership in the context of a healthcare practice. The Lean leadership model supports professionals with a leading role in implementing Lean. This article presents a case study focusing specifically on leadership behaviours and issues that were experienced, observed and reported in a Dutch university medical centre. This ethnographic case study provides auto-ethnographic accounts based on experiences, participant observation, interviews and document analysis. Characteristics of Lean leadership were identified to establish an understanding of how to achieve successful Lean transformation. This study emphasizes the importance for Lean leaders to go to the gemba, to see the situation for one's own self, empower health-care employees and be modest. All of these are critical attributes in defining the Lean leadership mindset. In this case study, Lean leadership is specifically related to healthcare, but certain common leadership characteristics are relevant across all fields. This article shows the value of an auto-ethnographic view on management learning for the analysis of Lean leadership. The knowledge acquired through this research is based on the first author's experiences in fulfilling his role as a health-care leader. This may help the reader examining his/her own role and reflecting on what matters most in the field of Lean leadership.

EPA Lean Government Initiative: How to Replicate Lean Successes

EPA Pesticide Factsheets

This Lean Replication Primer describes how EPA Offices and Regions can identify and adapt successful practices from previous Lean projects to “replicate” their successes and generate further improvements.

Tip-Based Nanofabrication for Scalable Manufacturing

DOE PAGES

Hu, Huan; Kim, Hoe; Somnath, Suhas

2017-03-16

Tip-based nanofabrication (TBN) is a family of emerging nanofabrication techniques that use a nanometer scale tip to fabricate nanostructures. Here in this review, we first introduce the history of the TBN and the technology development. We then briefly review various TBN techniques that use different physical or chemical mechanisms to fabricate features and discuss some of the state-of-the-art techniques. Subsequently, we focus on those TBN methods that have demonstrated potential to scale up the manufacturing throughput. Finally, we discuss several research directions that are essential for making TBN a scalable nano-manufacturing technology.

Tip-Based Nanofabrication for Scalable Manufacturing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hu, Huan; Kim, Hoe; Somnath, Suhas

Tip-based nanofabrication (TBN) is a family of emerging nanofabrication techniques that use a nanometer scale tip to fabricate nanostructures. Here in this review, we first introduce the history of the TBN and the technology development. We then briefly review various TBN techniques that use different physical or chemical mechanisms to fabricate features and discuss some of the state-of-the-art techniques. Subsequently, we focus on those TBN methods that have demonstrated potential to scale up the manufacturing throughput. Finally, we discuss several research directions that are essential for making TBN a scalable nano-manufacturing technology.

A Methodology for the Assessment of Experiential Learning Lean: The Lean Experience Factory Study

ERIC Educational Resources Information Center

De Zan, Giovanni; De Toni, Alberto Felice; Fornasier, Andrea; Battistella, Cinzia

2015-01-01

Purpose: The purpose of this paper is to present a methodology to assess the experiential learning processes of learning lean in an innovative learning environment: the lean model factories. Design/methodology/approach: A literature review on learning and lean management literatures was carried out to design the methodology. Then, a case study…

Lean and Information Technology Toolkit

EPA Pesticide Factsheets

The Lean and Information Technology Toolkit is a how-to guide which provides resources to environmental agencies to help them use Lean Startup, Lean process improvement, and Agile tools to streamline and automate processes.

Ultrasonographic extended-view technique for evaluation of abdominal fat distribution in lean women with polycystic ovary syndrome.

PubMed

Battaglia, Cesare; Battaglia, Bruno; Mancini, Fulvia; Paradisi, Roberto; Fabbri, Raffaella; Venturoli, Stefano

2011-06-01

To estimate whether, by using a new ultrasonographic technique (extended view; XTD view), young lean women with polycystic ovary syndrome (PCOS) have a more android fat distribution in comparison with normally menstruating women with ultrasonographic evidence of polycystic ovaries (PCO) and healthy control subjects, matched for both age and body mass index. Prospective observational study. University Hospital. Forty-nine lean women with PCOS, 42 eumenorrheic women with bilateral PCO and 40 healthy volunteers with regular ovulatory cycles. Fasting blood sampling, ultrasonographic and Doppler analyses and blood pressure monitoring. Medical examination, biochemical and hormonal parameters, ultrasonographic abdominal fat measurements, ultrasonographic evaluation of carotid intima-media thickness and Doppler analysis of ophthalmic artery. An oral glucose tolerance test was performed to analyze glucose, insulin and C-peptide levels. The XTD ultrasonographic preperitoneal area was significantly larger in women with PCOS than in control subjects (p=0.011). The preperitoneal/subcutaneous ratio was significantly higher in women with PCOS (1.1±0.26) compared with women with PCO (0.84±0.13; p=0.05) and control women (0.67±0.13; p<0.001). The mean pulsatility index of ophthalmic arteries was higher in the PCOS women (1.93±0.57) than in control subjects (1.84±0.38; p=0.041). Total cholesterol, triglycerides and LDL cholesterol were significantly higher in women with PCOS than in those with PCO and in control subjects. Women with PCOS have an android fat pattern correlated with an age-dependent increased risk of cardiovascular diseases. © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

Hip Structural Analysis in Adolescent Boys With Anorexia Nervosa and Controls

PubMed Central

Katzman, Debra K.; Clarke, Hannah; Snelgrove, Deirdre; Brigham, Kathryn; Miller, Karen K.; Klibanski, Anne

2013-01-01

Context: We have reported lower hip bone mineral density (BMD) in adolescent boys with anorexia nervosa (AN) compared with controls. Although studies have described bone structure in girls with AN, these data are not available for boys. Hip structural analysis (HSA) using dual-energy x-ray absorptiometry is a validated technique to assess hip geometry and strength while avoiding radiation associated with quantitative computed tomography. Objective: We hypothesized that boys with AN would have impaired hip structure/strength (assessed by HSA) compared with controls. Design and Setting: We conducted a cross-sectional study at a clinical research center. Subjects and Intervention: We used HSA techniques on hip dual-energy x-ray absorptiometry scans in 31 previously enrolled boys, 15 with AN and 16 normal-weight controls, 12 to 19 years old. Results: AN boys had lower body mass index SD score (P < .0001), testosterone (P = .0005), and estradiol (P = .006) than controls. A larger proportion of AN boys had BMD Z-scores <−1 at the femoral neck (60% vs 12.5%, P = 0008). Using HSA, at the narrow neck and trochanter region, boys with AN had lower cross-sectional area (P = .03, 0.02) and cortical thickness (P = .02, 0.03). Buckling ratio at the trochanter region was higher in AN (P = .008). After controlling for age and height, subperiosteal width at the femoral shaft, cross-sectional moment of inertia (narrow neck and femoral shaft), and section modulus (all sites) were lower in AN. The strongest associations of HSA measures were observed with lean mass, testosterone, and estradiol. On multivariate analysis, lean mass remained associated with most HSA measures. Conclusions: Boys with AN have impaired hip geometric parameters, associated with lower lean mass. PMID:23653430

System-wide lean implementation in health care: A multiple case study.

PubMed

Centauri, Federica; Mazzocato, Pamela; Villa, Stefano; Marsilio, Marta

2018-05-01

Background Lean practices have been widely used by health care organizations to meet efficiency, performance and quality improvement needs. The lean health care literature shows that the effective implementation of lean requires a holistic system-wide approach. However, there is still limited evidence on what drives effective system-wide lean implementation in health care. The existing literature suggests that a deeper understanding of how lean interventions interact with the organizational context is necessary to identify the critical variables to successfully sustain system-wide lean strategies. Purpose and methodology: A multiple case study of three Italian hospitals is conducted with the aim to explore the organizational conditions that are relevant for an effective system-wide lean implementation. A conceptual framework, built on socio-technical system schemas, is used to guide data collection and analysis. The analysis points out the importance to support lean implementation with an integrated and coordinated strategy involving the social, technical, and external components of the overall hospital system.

The effect of five weeks of Tribulus terrestris supplementation on muscle strength and body composition during preseason training in elite rugby league players.

PubMed

Rogerson, Shane; Riches, Christopher J; Jennings, Carl; Weatherby, Robert P; Meir, Rudi A; Marshall-Gradisnik, Sonya M

2007-05-01

Tribulus terrestris is an herbal nutritional supplement that is promoted to produce large gains in strength and lean muscle mass in 5-28 days (15, 18). Although some manufacturers claim T. terrestris will not lead to a positive drug test, others have suggested that T. terrestris may increase the urinary testosterone/epitestosterone (T/E) ratio, which may place athletes at risk of a positive drug test. The purpose of the study was to determine the effect of T. terrestris on strength, fat free mass, and the urinary T/E ratio during 5 weeks of preseason training in elite rugby league players. Twenty-two Australian elite male rugby league players (mean +/- SD; age = 19.8 +/- 2.9 years; weight = 88.0 +/- 9.5 kg) were match-paired and randomly assigned in a double-blind manner to either a T. terrestris (n = 11) or placebo (n = 11) group. All subjects performed structured heavy resistance training as part of the club's preseason preparations. A T. terrestris extract (450 mg.d(-1)) or placebo capsules were consumed once daily for 5 weeks. Muscular strength, body composition, and the urinary T/E ratio were monitored prior to and after supplementation. After 5 weeks of training, strength and fat free mass increased significantly without any between-group differences. No between-group differences were noted in the urinary T/E ratio. It was concluded that T. terrestris did not produce the large gains in strength or lean muscle mass that many manufacturers claim can be experienced within 5-28 days. Furthermore, T. terrestris did not alter the urinary T/E ratio and would not place an athlete at risk of testing positive based on the World Anti-Doping Agency's urinary T/E ratio limit of 4:1.

Future Automotive Aftertreatment Solutions: The 150°C Challenge Workshop Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zammit, Michael; DiMaggio, Craig L.; Kim, Chang H.

2013-10-15

With future fuel economy standards enacted, the U.S. automotive manufacturers (OEMs) are committed to pursuing a variety of high risk/highly efficient stoichiometric and lean combustion strategies to achieve superior performance. In recognition of this need, the U.S. Department of Energy (DOE) has partnered with domestic automotive manufacturers through U.S. DRIVE to develop these advanced technologies. However, before these advancements can be introduced into the U.S. market, they must also be able to meet increasingly stringent emissions requirements. A significant roadblock to this implementation is the inability of current catalyst and aftertreatment technologies to provide the required activity at the muchmore » lower exhaust temperatures that will accompany highly efficient combustion processes and powertrain strategies. Therefore, the goal of this workshop and report is to create a U.S. DRIVE emission control roadmap that will identify new materials and aftertreatment approaches that offer the potential for 90% conversion of emissions at low temperature (150°C) and are consistent with highly efficient combustion technologies currently under investigation within U.S. DRIVE Advanced Combustion and Emission Control (ACEC) programs.« less

Uncertainty in the analysis of the overall equipment effectiveness on the shop floor

NASA Astrophysics Data System (ADS)

Rößler, M. P.; Abele, E.

2013-06-01

In this article an approach will be presented which supports transparency regarding the effectiveness of manufacturing equipment by combining the fuzzy set theory with the method of the overall equipment effectiveness analysis. One of the key principles of lean production and also a fundamental task in production optimization projects is the prior analysis of the current state of a production system by the use of key performance indicators to derive possible future states. The current state of the art in overall equipment effectiveness analysis is usually performed by cumulating different machine states by means of decentralized data collection without the consideration of uncertainty. In manual data collection or semi-automated plant data collection systems the quality of derived data often diverges and leads optimization teams to distorted conclusions about the real optimization potential of manufacturing equipment. The method discussed in this paper is to help practitioners to get more reliable results in the analysis phase and so better results of optimization projects. Under consideration of a case study obtained results are discussed.

Lean Management Systems in Radiology: Elements for Success.

PubMed

Schultz, Stacy R; Ruter, Royce L; Tibor, Laura C

2016-01-01

This article is a review of the literature on Lean and Lean Management Systems and how they have been implemented in healthcare organizations and particularly in radiology departments. The review focuses on the elements required for a successful implementation of Lean by applying the principles of a Lean Management System instead of a Lean tools-only approach. This review shares the successes and failures from healthcare organizations' efforts to improve the quality and safety of the services they provide. There are a limited number of healthcare organizations in the literature who have shared their experiences and additional research is necessary to determine whether a Lean Management System is a viable alternative to the current management structure in healthcare.

Manufacturing engineering: Principles for optimization

NASA Astrophysics Data System (ADS)

Koenig, Daniel T.

Various subjects in the area of manufacturing engineering are addressed. The topics considered include: manufacturing engineering organization concepts and management techniques, factory capacity and loading techniques, capital equipment programs, machine tool and equipment selection and implementation, producibility engineering, methods, planning and work management, and process control engineering in job shops. Also discussed are: maintenance engineering, numerical control of machine tools, fundamentals of computer-aided design/computer-aided manufacture, computer-aided process planning and data collection, group technology basis for plant layout, environmental control and safety, and the Integrated Productivity Improvement Program.

Alcohol produces distinct hepatic lipidome and eicosanoid signature in lean and obese[S

PubMed Central

Puri, Puneet; Xu, Jun; Vihervaara, Terhi; Katainen, Riikka; Ekroos, Kim; Daita, Kalyani; Min, Hae-Ki; Joyce, Andrew; Mirshahi, Faridoddin; Tsukamoto, Hidekazu; Sanyal, Arun J.

2016-01-01

Alcohol- and obesity-related liver diseases often coexist. The hepatic lipidomics due to alcohol and obesity interaction is unknown. We characterized the hepatic lipidome due to 1) alcohol consumption in lean and obese mice and 2) obesity and alcohol interactions. In the French-Tsukamoto mouse model, intragastric alcohol or isocaloric dextrose were fed with either chow (lean) or high-fat, high-cholesterol diet (obese). Four groups (lean, lean alcohol, obese, and obese alcohol) were studied. MS was performed for hepatic lipidomics, and data were analyzed. Alcohol significantly increased hepatic cholesteryl esters and diacyl­glycerol in lean and obese but was more pronounced in obese. Alcohol produced contrasting changes in hepatic phospholipids with significant enrichment in lean mice versus significant decrease in obese mice, except phosphatidylglycerol, which was increased in both lean and obese alcohol groups. Most lysophospholipids were increased in lean alcohol and obese mice without alcohol use only. Prostaglandin E2; 5-, 8-, and 11-hydroxyeicosatetraenoic acids; and 9- and 13-hydroxyoctadecadienoic acids were considerably increased in obese mice with alcohol use. Alcohol consumption produced distinct changes in lean and obese with profound effects of obesity and alcohol interaction on proinflammatory and oxidative stress-related eicosanoids. PMID:27020313

Improving first case start times using Lean in an academic medical center.

PubMed

Deldar, Romina; Soleimani, Tahereh; Harmon, Carol; Stevens, Larry H; Sood, Rajiv; Tholpady, Sunil S; Chu, Michael W

2017-06-01

Lean is a process improvement strategy that can improve efficiency of the perioperative process. The purpose of this study was to identify etiologies of late surgery start times, implement Lean interventions, and analyze their effects. A retrospective review of all first-start surgery cases was performed. Lean was implemented in May 2015, and cases 7 months before and after implementation were analyzed. A total of 4,492 first-start cases were included; 2,181 were pre-Lean and 2,311 were post-Lean. The post-Lean group had significantly higher on-time starts than the pre-Lean group (69.0% vs 57.0%, P < .01). The most common delay etiology was surgeon-related for both groups. Delayed post-Lean cases were significantly less likely to be due to preoperative assessment (14.9% vs 9.9%, P < .01) and more likely due to patient-related (16.5% vs 22.3%, P < .01) or chaplain (1.8% vs 4.0%, P < .01) factors. Delayed starts occurred more often on snowy and cold days, and less often on didactic days (P < .01). Modifying preoperative tasks using Lean methods can improve operating room efficiency and increase on-time starts. Copyright © 2016 Elsevier Inc. All rights reserved.

Sire carcass breeding values affect body composition in lambs - 1. Effects on lean weight and its distribution within the carcass as measured by computed tomography.

PubMed

Anderson, F; Williams, A; Pannier, L; Pethick, D W; Gardner, G E

2015-10-01

Data are obtained from computed tomography scanning of 1665 lambs at locations around Australia. Lambs were progeny of Terminal, Maternal and Merino sires with known Australian Sheep Breeding Values for post weaning c-site eye muscle depth (mm; PEMD) and fat depth (mm; PFAT), and post weaning weight (kg; PWWT). Across the 7.8 unit range of sire PEMD, carcass lean weight increased by 7.7%. This lean was distributed to the saddle section (mid-section) where lean became 3.8% heavier, with fore section lean becoming 3.5% lighter. Reducing sire PFAT across its 5.1 unit range increased carcass lean weight by 9.5%, and distributed lean to the saddle section which was 3.7% heavier. Increasing sire PWWT increased lean at some sites in some years, and on average increased saddle lean by 4% across the 24.7 unit PWWT range. Changes in lean weight and distribution due to selection for carcass breeding values will increase carcass value, particularly through increased weight of high value loin cuts. Copyright © 2015. Published by Elsevier Ltd.

Prevalence of Suspected Nonalcoholic Fatty Liver Disease In Lean Adolescents In The United States.

PubMed

Selvakumar, Praveen Kumar Conjeevaram; Kabbany, Mohammad Nasser; Lopez, Rocio; Rayas, Maria S; Lynch, Jane L; Alkhouri, Naim

2018-03-21

Nonalcoholic fatty liver disease (NAFLD) can develop in lean subjects referred to as lean NAFLD. We aim to evaluate the prevalence and risk factors of NAFLD in lean adolescents in the United States (US). Cross sectional data from 1482 lean subjects (body mass index < 85 percentile) aged between 12 and 18 years, who were enrolled in the National Health and Examination Survey during the 2005-2014 cycles were included. We defined suspected NAFLD as alanine aminotransferase > 25.8 U/L for boys and > 22.1 U/L for girls; hypertriglyceridemia as triglycerides ≥ 150 mg/dL; low HDL as HDL < 40 mg/dL and insulin resistance (IR) as homeostatic model assessment of IR ≥ 3. The mean weighted prevalence of suspected NAFLD among lean adolescents during 2005-2014 cycles was 8% (95% CI: 6.2, 9.9). Lean subjects with suspected NAFLD were significantly older compared to lean non-NAFLD subjects (15.5 vs. 15 years, p-value < 0.05). Low HDL (15.5% vs. 6.8%; p-value 0.016) and hypertriglyceridemia (10% vs. 3.9%; p-value 0.028) were also found to be more common among lean NAFLD subjects compared to their non-NAFLD counterparts. Presence of IR increased the risk of having suspected NAFLD by 4-fold among lean adolescents. Non-Hispanic black lean adolescents were less likely to have suspected NAFLD compared to non-Hispanic white lean adolescents. The estimated prevalence of suspected NAFLD among lean adolescents in the US was found to be 8% with evidence of metabolic derangements such as low HDL, hypertriglyceridemia and IR.

Gene expression microarray profiles of cumulus cells in lean and overweight-obese polycystic ovary syndrome patients.

PubMed

Kenigsberg, Shlomit; Bentov, Yaakov; Chalifa-Caspi, Vered; Potashnik, Gad; Ofir, Rivka; Birk, Ohad S

2009-02-01

The aim of this work was to study gene expression patterns of cultured cumulus cells from lean and overweight-obese polycystic ovary syndrome (PCOS) patients using genome-wide oligonucleotide microarray. The study included 25 patients undergoing in vitro fertilization and intra-cytoplasmic sperm injection: 12 diagnosed with PCOS and 13 matching controls. Each of the groups was subdivided into lean (body mass index (BMI) < 24) and overweight (BMI > 27) subgroups. The following comparisons of gene expression data were made: lean PCOS versus lean controls, lean PCOS versus overweight PCOS, all PCOS versus all controls, overweight PCOS versus overweight controls, overweight controls versus lean controls and all overweight versus all lean. The largest number of differentially expressed genes (DEGs), with fold change (FC) |FC| >or= 1.5 and P-value < 0.01, was found in the lean PCOS versus lean controls comparison (487) with most of these genes being down-regulated in PCOS. The second largest group of DEGs originated from the comparison of lean PCOS versus overweight PCOS (305). The other comparisons resulted in a much smaller number of DEGs (174, 109, 125 and 12, respectively). In the comparison of lean PCOS with lean controls, most DEGs were transcription factors and components of the extracellular matrix and two pathways, Wnt/beta-catenin and mitogen-activated protein kinase. When comparing overweight PCOS with overweight controls, most DEGs were of pathways related to insulin signaling, metabolism and energy production. The finding of unique gene expression patterns in cumulus cells from the two PCOS subtypes is in agreement with other studies that have found the two to be separate entities with potentially different pathophysiologies.

Effects of organizational context on Lean implementation in five hospital systems.

PubMed

Harrison, Michael I; Paez, Kathryn; Carman, Kristin L; Stephens, Jennifer; Smeeding, Lauren; Devers, Kelly J; Garfinkel, Steven

2016-01-01

Despite broad agreement among researchers about the value of examining how context shapes implementation of improvement programs and projects, limited attention has been paid to contextual effects on implementation of Lean. To help reduce gaps in knowledge of effects of intraorganizational context, we researched Lean implementation initiatives in five organizations and examined 12 of their Lean rapid improvement projects. All projects aimed at improving clinical care delivery. On the basis of the literature on Lean, innovation, and quality improvement, we developed a framework of factors likely to affect Lean implementation and outcomes. Drawing on the framework, we conducted semistructured interviews and applied qualitative codes to the transcribed interviews. Available documents, data, and observations supplemented the interviews. We constructed case studies of Lean implementation in each organization, compared implementation across organizations, and compared the 12 projects. Intraorganizational characteristics affecting organization-wide Lean initiatives and often also shaping project outcomes included CEO commitment to Lean and active support for it, prior organizational capacity for quality improvement-based performance improvement, alignment of the Lean initiative with the organizational mission, dedication of resources and experts to Lean, staff training before and during projects, establishment of measurable and relevant project targets, planning of project sequences that enhance staff capabilities and commitment without overburdening them, and ensuring communication between project members and other affected staff. Dependence of projects on inputs of new information technology was a barrier to project success. Incremental implementation of Lean produced reported improvements in operational efficiency and occasionally in care quality. However, even under the relatively favorable circumstances prevailing in our study sites, incremental implementation did not readily change organizational culture. This study should alert researchers, managers, and teachers of management to ways that contexts shape Lean implementation and may affect other types of process redesign and quality improvement.

A low cost technique to evaluate usable product for small manufacturing companies: a case study on Garcia robot.

PubMed

An, Vatana; Soares, Marcelo

2012-01-01

A usability evaluation technique to evaluate user interfaces is introduces. The technique is effective and affordable for small manufacturing companies. By using this technique, an integration of users' feedbacks and some usability concepts, a product can be 3 times easier to use among potential users and more than 5 times easier to use among motivated users. In addition, the technique can be implemented with the company's employees as participants.

Non-alcoholic Fatty Liver Disease in Lean Subjects: Characteristics and Implications.

PubMed

Kumar, Ramesh; Mohan, Shantam

2017-09-28

Non-alcoholic fatty liver disease (NAFLD) is commonly diagnosed in obese subjects; however, it is not rare among lean individuals. Given the absence of traditional risk factors, it tends to remain under-recognised. The metabolic profiles of lean NAFLD patients are frequently comparable to those of obese NAFLD patients. Though results from several studies have been mixed, it has been generally revealed that lean subjects with NAFLD have minor insulin resistance compared to that in obese NAFLD. Several genetic variants are associated with NAFLD without insulin resistance. Some data suggest that the prevalence of steatohepatitis and advanced fibrosis do not differ significantly between lean and obese NAFLD; however, the former tend to have less severe disease at presentation. The underlying pathophysiology of lean NAFLD may be quite different. Genetic predispositions, fructose- and cholesterol-rich diet, visceral adiposity and dyslipidaemia have potential roles in the pathogenic underpinnings. Lean NAFLD may pose a risk for metabolic disturbances, cardiovascular morbidity or overall mortality. Secondary causes of hepatic steatosis are also needed to be ruled out in lean subjects with NAFLD. The effectiveness of various treatment modalities, such as exercise and pharmacotherapy, on lean NAFLD is not known. Weight loss is expected to help lean NAFLD patients who have visceral obesity. Further investigation is needed for many aspects of lean NAFLD, including mechanistic pathogenesis, risk assessment, natural history and therapeutic approach.

Non-alcoholic Fatty Liver Disease in Lean Subjects: Characteristics and Implications

PubMed Central

Kumar, Ramesh; Mohan, Shantam

2017-01-01

Abstract Non-alcoholic fatty liver disease (NAFLD) is commonly diagnosed in obese subjects; however, it is not rare among lean individuals. Given the absence of traditional risk factors, it tends to remain under-recognised. The metabolic profiles of lean NAFLD patients are frequently comparable to those of obese NAFLD patients. Though results from several studies have been mixed, it has been generally revealed that lean subjects with NAFLD have minor insulin resistance compared to that in obese NAFLD. Several genetic variants are associated with NAFLD without insulin resistance. Some data suggest that the prevalence of steatohepatitis and advanced fibrosis do not differ significantly between lean and obese NAFLD; however, the former tend to have less severe disease at presentation. The underlying pathophysiology of lean NAFLD may be quite different. Genetic predispositions, fructose- and cholesterol-rich diet, visceral adiposity and dyslipidaemia have potential roles in the pathogenic underpinnings. Lean NAFLD may pose a risk for metabolic disturbances, cardiovascular morbidity or overall mortality. Secondary causes of hepatic steatosis are also needed to be ruled out in lean subjects with NAFLD. The effectiveness of various treatment modalities, such as exercise and pharmacotherapy, on lean NAFLD is not known. Weight loss is expected to help lean NAFLD patients who have visceral obesity. Further investigation is needed for many aspects of lean NAFLD, including mechanistic pathogenesis, risk assessment, natural history and therapeutic approach. PMID:28936403

Method for rubblizing an oil shale deposit for in situ retorting

DOEpatents

Lewis, Arthur E.

1977-01-01

A method for rubblizing an oil shale deposit that has been formed in alternate horizontal layers of rich and lean shale, including the steps of driving a horizontal tunnel along the lower edge of a rich shale layer of the deposit, sublevel caving by fan drilling and blasting of both rich and lean overlying shale layers at the distal end of the tunnel to rubblize the layers, removing a substantial amount of the accessible rubblized rich shale to permit the overlying rubblized lean shale to drop to tunnel floor level to form a column of lean shale, performing additional sublevel caving of rich and lean shale towards the proximate end of the tunnel, removal of a substantial amount of the additionally rubblized rich shale to allow the overlying rubblized lean shale to drop to tunnel floor level to form another column of rubblized lean shale, similarly performing additional steps of sublevel caving and removal of rich rubble to form additional columns of lean shale rubble in the rich shale rubble in the tunnel, and driving additional horizontal tunnels in the deposit and similarly rubblizing the overlying layers of rich and lean shale and forming columns of rubblized lean shale in the rich, thereby forming an in situ oil shale retort having zones of lean shale that remain permeable to hot retorting fluids in the presence of high rubble pile pressures and high retorting temperatures.

Use of acousto-ultrasonic techniques to determine properties of remanufactured particleboards made solely from recycled particles

Treesearch

Sumire Kawamoto; James H. Muehl; R. Sam Williams

2005-01-01

Properties of particleboard manufactured entirely from recycled particleboard were tested The method for processing three-layer particleboard from all-recycled particles was described. Dynamic MOE (modulus of elasticity) before and after re-manufacturing was tested by a longitudinal stress wave technique. Some stress wave techniques were compared. Nondestructive AU (...

High intake of fatty fish, but not of lean fish, affects serum concentrations of TAG and HDL-cholesterol in healthy, normal-weight adults: a randomised trial.

PubMed

Hagen, Ingrid V; Helland, Anita; Bratlie, Marianne; Brokstad, Karl A; Rosenlund, Grethe; Sveier, Harald; Mellgren, Gunnar; Gudbrandsen, Oddrun A

2016-08-01

The aim of the present study was to examine whether high intake of lean or fatty fish (cod and farmed salmon, respectively) by healthy, normal-weight adults would affect risk factors of type 2 diabetes and CVD when compared with lean meat (chicken). More knowledge is needed concerning the potential health effects of high fish intake (>300 g/week) in normal-weight adults. In this randomised clinical trial, thirty-eight young, healthy, normal-weight participants consumed 750 g/week of lean or fatty fish or lean meat (as control) for 4 weeks at dinner according to provided recipes to ensure similar ways of preparations and choices of side dishes between the groups. Energy and macronutrient intakes at baseline and end point were similar in all groups, and there were no changes in energy and macronutrient intakes within any of the groups during the course of the study. High intake of fatty fish, but not lean fish, significantly reduced TAG and increased HDL-cholesterol concentrations in fasting serum when compared with lean meat intake. When compared with lean fish intake, fatty fish intake increased serum HDL-cholesterol. No differences were observed between lean fish, fatty fish and lean meat groups regarding fasting and postprandial glucose regulation. These findings suggest that high intake of fatty fish, but not of lean fish, could beneficially affect serum concentrations of TAG and HDL-cholesterol, which are CVD risk factors, in healthy, normal-weight adults, when compared with high intake of lean meat.

Applying the Toyota Production System: using a patient safety alert system to reduce error.

PubMed

Furman, Cathie; Caplan, Robert

2007-07-01

In 2002, Virginia Mason Medical Center (VMMC) adapted the Toyota Production System, also known as lean manufacturing. To translate the techniques of zero defects and stopping the line into health care, the Patient Safety Alert (PSA) system requires any employee who encounters a situation that is likely to harm a patient to make an immediate report and to cease any activity that could cause further harm (stopping the line). IMPLEMENTING THE PSA SYSTEM--STOPPING THE LINE: If any VMMC employee's practice or conduct is deemed capable of causing harm to a patient, a PSA can cause that person to be stopped from working until the problem is resolved. A policy statement, senior executive commitment, dedicated resources, a 24-hour hotline, and communication were all key features of implementation. As of December 2006, 6,112 PSA reports were received: 20% from managers, 8% from physicians, 44% from nurses, and 23% from nonclinical support personnel, for example. The number of reports received per month increased from an average of 3 in 2002 to 285 in 2006. Most reports were processed within 24 hours and were resolved within 2 to 3 weeks. Implementing the PSA system has drastically increased the number of safety concerns that are resolved at VMMC, while drastically reducing the time it takes to resolve them. Transparent discussion and feedback have helped promote staff acceptance and participation.

Debates Regarding Lean Patients with Polycystic Ovary Syndrome: A Narrative Review.

PubMed

Goyal, Manu; Dawood, Ayman S

2017-01-01

Polycystic ovary syndrome (PCOS) is a complex syndrome showing the clinical features of an endocrine/metabolic disorder, including hyperinsulinemia and hyperandrogenism. Two phenotypes are present, either lean or obese, with different biochemical, hormonal, and metabolic profiles. Evidence suggests many treatment modalities that can be applied. However, many of these modalities were found to be not suitable for the lean phenotype of PCOS. Much contradictory research was found regarding lean patients with PCOS. The aim of this narrative review is to shed light on the debate prevailing regarding characteristics, as well as metabolic, hematological, and potential management modalities. Literature review was performed from January 1, 2000 to March 31, 2017 with specific word search such as lean PCOS, hormonal abnormalities in lean PCOS, and the management of lean PCOS. All retrieved articles were carefully assessed, and data were obtained. We could conclude that the debate is still prevailing regarding this specific lean population with PCOS, especially with regard to their characteristics and management modalities. Further studies are still required to resolve this debate on the presence of PCOS in lean women.

Debates Regarding Lean Patients with Polycystic Ovary Syndrome: A Narrative Review

PubMed Central

Goyal, Manu; Dawood, Ayman S.

2017-01-01

Polycystic ovary syndrome (PCOS) is a complex syndrome showing the clinical features of an endocrine/metabolic disorder, including hyperinsulinemia and hyperandrogenism. Two phenotypes are present, either lean or obese, with different biochemical, hormonal, and metabolic profiles. Evidence suggests many treatment modalities that can be applied. However, many of these modalities were found to be not suitable for the lean phenotype of PCOS. Much contradictory research was found regarding lean patients with PCOS. The aim of this narrative review is to shed light on the debate prevailing regarding characteristics, as well as metabolic, hematological, and potential management modalities. Literature review was performed from January 1, 2000 to March 31, 2017 with specific word search such as lean PCOS, hormonal abnormalities in lean PCOS, and the management of lean PCOS. All retrieved articles were carefully assessed, and data were obtained. We could conclude that the debate is still prevailing regarding this specific lean population with PCOS, especially with regard to their characteristics and management modalities. Further studies are still required to resolve this debate on the presence of PCOS in lean women. PMID:29142442

Combustion oscillation: Chemical control showing mechanistic link to recirculation zone purge time

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gemmen, R.S.; Richards, G.A.; Yip, M.J.

1995-12-01

Active control mechanisms are being examined for lean premix combustion applications, such as gas turbine generators. Lean premix combustors are susceptible to large combustion oscillations, particularly when driven very lean to achieve low NOx. While past design work has been focussed on understanding the source of the oscillation and modifying the combustor to avoid such oscillations, commercial combustion designers have more recently considered applying new control elements. As part of the U.S. Department of Energy`s Advanced Gas Turbine Systems Program, the Morgantown Energy Technology Center is investigating various active control techniques. This paper presents results from experiments studying the effectmore » of pilot fuel modulation on combustor oscillation and pollutant emissions for a pilot stabilized dump swirl combustor, typical of gas turbine combustors. The results show that a significant level of attenuation can be achieved in the combustor pressure oscillation (50 to 90 percent) while only moderately affecting pollutant emissions. The control mechanism producing the attenuation is shown to be purely chemical in nature, rather than fluid mechanic. In addition, the frequency region over which control is obtained is shown to be related to the recirculation zone purge time. For this reason, control can be achieved at control frequencies much lower than the frequency of oscillation.« less

No association between LRP5 gene polymorphisms and bone and obesity phenotypes in Chinese male-offspring nuclear families.

PubMed

Yu, Jin-bo; Ke, Yao-hua; He, Jin-wei; Zhang, Hao; Hu, Wei-wei; Hu, Yun-qiu; Li, Miao; Liu, Yu-juan; Gu, Jie-mei; Fu, Wen-zhen; Gao, Gao; Yue, Hua; Xiao, Wen-jin; Zhang, Zhen-lin

2010-11-01

To investigate the effect of low-density lipoprotein receptor-related protein 5 (LRP5) gene polymorphisms on bone and obesity phenotypes in young Chinese men. A total of 1244 subjects from 411 Chinese nuclear families were genotyped by using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique at the Q89R, N740N, and A1330V sites in the LRP5 gene. Bone mineral density (BMD) in the lumbar spine and the hip, total fat mass and total lean mass were measured using dual-energy X-ray absorptiometry. The association between LRP5 gene polymorphisms and peak BMD, body mass index (BMI), total fat mass, total lean mass and percentage of fat mass was assessed using a quantitative transmission disequilibrium test (QTDT). No significant within-family associations were found between genotypes or haplotypes of the LRP5 gene and peak BMD, BMI, total fat mass, total lean mass and percentage of fat mass. The 1000 permutations that were subsequently simulated were in agreement with these within-family association results. Our results suggest that common polymorphic variations of the LRP5 gene do not influence peak bone mass acquisition and obesity phenotypes in young Chinese men.

Selected nutrient contents, fatty acid composition, including conjugated linoleic acid, and retention values in separable lean from lamb rib loins as affected by external fat and cooking method.

PubMed

Badiani, Anna; Montellato, Lara; Bochicchio, Davide; Anfossi, Paola; Zanardi, Emanuela; Maranesi, Magda

2004-08-11

Proximate composition and fatty acid profile, conjugated linoleic acid (CLA) isomers included, were determined in separable lean of raw and cooked lamb rib loins. The cooking methods compared, which were also investigated for cooking yields and true nutrient retention values, were dry heating of fat-on cuts and moist heating of fat-off cuts; the latter method was tested as a sort of dietetic approach against the more traditional former type. With significantly (P < 0.05) lower cooking losses, dry heating of fat-on rib-loins produced slightly (although only rarely significantly) higher retention values for all of the nutrients considered, including CLA isomers. On the basis of the retention values obtained, both techniques led to a minimum migration of lipids into the separable lean, which was higher (P < 0.05) in dry heating than in moist heating, and was characterized by the prevalence of saturated and monounsaturated fatty acids. On the whole, the response to cooking of the class of CLA isomers (including that of the nutritionally most important isomer cis-9,trans-11) was more similar to that of the monounsaturated than the polyunsaturated fatty acids.

Process for manufacture of semipermeable silicon nitride membranes

DOEpatents

Galambos, Paul Charles; Shul, Randy J.; Willison, Christi Gober

2003-12-09

A new class of semipermeable membranes, and techniques for their fabrication, have been developed. These membranes, formed by appropriate etching of a deposited silicon nitride layer, are robust, easily manufacturable, and compatible with a wide range of silicon micromachining techniques.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tate, John G.; Richardson, Bradley S.; Love, Lonnie J.

ORNL worked with the Schaeffler Group USA to explore additive manufacturing techniques that might be appropriate for prototyping of bearing cages. Multiple additive manufacturing techniques were investigated, including e-beam, binder jet and multiple laser based processes. The binder jet process worked best for the thin, detailed cages printed.

Alcohol produces distinct hepatic lipidome and eicosanoid signature in lean and obese.

PubMed

Puri, Puneet; Xu, Jun; Vihervaara, Terhi; Katainen, Riikka; Ekroos, Kim; Daita, Kalyani; Min, Hae-Ki; Joyce, Andrew; Mirshahi, Faridoddin; Tsukamoto, Hidekazu; Sanyal, Arun J

2016-06-01

Alcohol- and obesity-related liver diseases often coexist. The hepatic lipidomics due to alcohol and obesity interaction is unknown. We characterized the hepatic lipidome due to 1) alcohol consumption in lean and obese mice and 2) obesity and alcohol interactions. In the French-Tsukamoto mouse model, intragastric alcohol or isocaloric dextrose were fed with either chow (lean) or high-fat, high-cholesterol diet (obese). Four groups (lean, lean alcohol, obese, and obese alcohol) were studied. MS was performed for hepatic lipidomics, and data were analyzed. Alcohol significantly increased hepatic cholesteryl esters and diacyl-glycerol in lean and obese but was more pronounced in obese. Alcohol produced contrasting changes in hepatic phospholipids with significant enrichment in lean mice versus significant decrease in obese mice, except phosphatidylglycerol, which was increased in both lean and obese alcohol groups. Most lysophospholipids were increased in lean alcohol and obese mice without alcohol use only. Prostaglandin E2; 5-, 8-, and 11-hydroxyeicosatetraenoic acids; and 9- and 13-hydroxyoctadecadienoic acids were considerably increased in obese mice with alcohol use. Alcohol consumption produced distinct changes in lean and obese with profound effects of obesity and alcohol interaction on proinflammatory and oxidative stress-related eicosanoids. Copyright © 2016 by the American Society for Biochemistry and Molecular Biology, Inc.

Loss of lean body mass affects low bone mineral density in patients with rheumatoid arthritis - results from the TOMORROW study.

PubMed

Okano, Tadashi; Inui, Kentaro; Tada, Masahiro; Sugioka, Yuko; Mamoto, Kenji; Wakitani, Shigeyuki; Koike, Tatsuya; Nakamura, Hiroaki

2017-11-01

Osteoporosis is one of the complications for patients with rheumatoid arthritis (RA). Rheumatoid cachexia, the loss of lean body mass, is another. However, the relationship between decreased lean body mass and reduced bone mineral density (BMD) in patients with RA has not been well studied. This study included 413 participants, comprising 208 patients with RA and 205 age- and sex-matched healthy volunteers. Clinical data, BMD, bone metabolic markers (BMM) and body composition, such as lean body mass and percent fat, were collected. Risk factors for osteoporosis in patients with RA including the relationship BMD and body composition were analyzed. Patients with RA showed low BMD and high BMM compared with controls. Moreover, lean body mass was lower and percent fat was higher in patients with RA. Lean body mass correlated positively and percent fat negatively with BMD. Lean body mass was a positive and disease duration was a negative independent factor for BMD in multivariate statistical analysis. BMD and lean body mass were significantly lower in patients with RA compared to healthy controls. Lean body mass correlated positively with BMD and decreased lean body mass and disease duration affected low BMD in patients with RA. [UMIN Clinical Trials Registry, http://www.umin.ac.jp/ctr/ , UMIN000003876].

Life history differences between fat and lean morphs of lake charr (Salvelinus namaycush) in Great Slave Lake, Northwest Territories, Canada

USGS Publications Warehouse

Hansen, Michael J.; Nate, Nancy A.; Chavarie, Louise; Muir, Andrew M.; Zimmerman, Mara S.; Krueger, Charles C.

2016-01-01

Life history characteristics (size, age, plumpness, buoyancy, survival, growth, and maturity) were compared between fat and lean morphs of lake charr Salvelinus namaycush in Great Slave Lake, Canada, to determine if differences may reflect effects of resource polymorphism. Lake charr were sampled using graded-mesh gill nets set in three depth strata. Of 236 lake charr captured, 122 were a fat morph and 114 were a lean morph. Males and females did not differ from each other in any attributes for either fat or lean morphs. The fat morph averaged 15 mm longer, 481 g heavier, and 4.7 years older than the lean morph. The fat morph averaged 26% heavier and 48% more buoyant at length than the lean morph. Survival of the fat morph was 1.7% higher than that of the lean morph. The fat morph grew at a slower annual rate to a shorter asymptotic length than the lean morph. Fat and lean morphs matured at similar lengths and ages. We concluded that the connection between resource polymorphism and life histories in lean versus fat lake charr suggests that morph-specific restoration objectives may be needed in lakes where lake charr diversity is considered to be a restoration goal.

Potential of Continuous Manufacturing for Liposomal Drug Products.

PubMed

Worsham, Robert D; Thomas, Vaughan; Farid, Suzanne S

2018-05-21

Over the last several years, continuous manufacturing of pharmaceuticals has evolved from bulk APIs and solid oral dosages into the more complex realm of biologics. The development of continuous downstream processing techniques has allowed biologics manufacturing to realize the benefits (e.g. improved economics, more consistent quality) that come with continuous processing. If relevant processing techniques and principles are selected, the opportunity arises to develop continuous manufacturing designs for additional pharmaceutical products including liposomal drug formulations. Liposome manufacturing has some inherent aspects that make it favorable for a continuous process. Other aspects such as formulation refinement, materials of construction, and aseptic processing need development, but present an achievable challenge. This paper reviews the current state of continuous manufacturing technology applicable to liposomal drug product manufacturing and an assessment of the challenges and potential of this application. This article is protected by copyright. All rights reserved.

Assessment of an approach to printed polymer lenses

NASA Astrophysics Data System (ADS)

Marasco, Peter L.; Foote, Bob

2017-05-01

Additive manufacturing is proving its relevancy across a wide spectrum of development, prototyping and manufacturing in the US. However, there is a desire to move the capability beyond modeling and structural components. The use of additive manufacturing techniques to fabricate low-cost optics and optical systems is highly desirable in a number of markets. But processes and techniques for successfully printing an optic are currently very new. This paper discusses early advances in printing optics suitable for commercial and military applications. Data from and analysis of early prototype lenses fabricated using one possible technique will be included and discussed. The potential for additive manufacturing of optics to open the design space for complex optics and reduce development time, lowering cost and speeding up time to market, will also be discussed.

Evaluation of Air Coupled Ultrasound for Composite Aerospace Structure

NASA Astrophysics Data System (ADS)

Tat, H.; Georgeson, G.; Bossi, R.

2009-03-01

Non-contact air coupled ultrasound suffers from the high acoustic impedance mismatch characteristics of air to solid interfaces. Advances in transducer technology, particularly MEMS, have improved the acoustic impedance match at the transmission stage and the signal to noise at the reception stage. Comparisons of through transmission (TTU) scanning of laminate and honeycomb test samples using conventional piezoelectric air coupled transducers, new MEMS air coupled transducers, and standard water coupled inspections have been performed to assess the capability. An additional issue for air coupled UT inspection is the need for a lean implementation for both manufacturing and in-service operations. Concepts and applications utilizing magnetic coupling of transducers have been developed that allows air coupled inspection operations in compact low cost configurations.

[Metalworking industry management evolution].

PubMed

Mattucci, Massimo

2011-01-01

Analysis of the evolution drivers of the management systems in the metalworking industry, mainly characterized as "automotive", starting with the "mass production" model, followed for the development of Italian industry in the '50. Through the socio-economic changes of the '90/10, the metalworking plants were deeply restructured with the introduction of computers in the production systems, and then with the first global benchmarks such as the "lean production", towards the needed operational flexibility to respond to the market dynamics. Plants change radically, company networks become real, ICT services are fundamental elements for the integration. These trends help visualizing a new "Factory of the Future" for the years 2020/30, where the competition will be based on the socio-economical, technological and environmental factors included in the "Competitive Sustainable Manufacturing" paradigm.

Large meta-analysis of genome-wide association studies identifies five loci for lean body mass.

PubMed

Zillikens, M Carola; Demissie, Serkalem; Hsu, Yi-Hsiang; Yerges-Armstrong, Laura M; Chou, Wen-Chi; Stolk, Lisette; Livshits, Gregory; Broer, Linda; Johnson, Toby; Koller, Daniel L; Kutalik, Zoltán; Luan, Jian'an; Malkin, Ida; Ried, Janina S; Smith, Albert V; Thorleifsson, Gudmar; Vandenput, Liesbeth; Hua Zhao, Jing; Zhang, Weihua; Aghdassi, Ali; Åkesson, Kristina; Amin, Najaf; Baier, Leslie J; Barroso, Inês; Bennett, David A; Bertram, Lars; Biffar, Rainer; Bochud, Murielle; Boehnke, Michael; Borecki, Ingrid B; Buchman, Aron S; Byberg, Liisa; Campbell, Harry; Campos Obanda, Natalia; Cauley, Jane A; Cawthon, Peggy M; Cederberg, Henna; Chen, Zhao; Cho, Nam H; Jin Choi, Hyung; Claussnitzer, Melina; Collins, Francis; Cummings, Steven R; De Jager, Philip L; Demuth, Ilja; Dhonukshe-Rutten, Rosalie A M; Diatchenko, Luda; Eiriksdottir, Gudny; Enneman, Anke W; Erdos, Mike; Eriksson, Johan G; Eriksson, Joel; Estrada, Karol; Evans, Daniel S; Feitosa, Mary F; Fu, Mao; Garcia, Melissa; Gieger, Christian; Girke, Thomas; Glazer, Nicole L; Grallert, Harald; Grewal, Jagvir; Han, Bok-Ghee; Hanson, Robert L; Hayward, Caroline; Hofman, Albert; Hoffman, Eric P; Homuth, Georg; Hsueh, Wen-Chi; Hubal, Monica J; Hubbard, Alan; Huffman, Kim M; Husted, Lise B; Illig, Thomas; Ingelsson, Erik; Ittermann, Till; Jansson, John-Olov; Jordan, Joanne M; Jula, Antti; Karlsson, Magnus; Khaw, Kay-Tee; Kilpeläinen, Tuomas O; Klopp, Norman; Kloth, Jacqueline S L; Koistinen, Heikki A; Kraus, William E; Kritchevsky, Stephen; Kuulasmaa, Teemu; Kuusisto, Johanna; Laakso, Markku; Lahti, Jari; Lang, Thomas; Langdahl, Bente L; Launer, Lenore J; Lee, Jong-Young; Lerch, Markus M; Lewis, Joshua R; Lind, Lars; Lindgren, Cecilia; Liu, Yongmei; Liu, Tian; Liu, Youfang; Ljunggren, Östen; Lorentzon, Mattias; Luben, Robert N; Maixner, William; McGuigan, Fiona E; Medina-Gomez, Carolina; Meitinger, Thomas; Melhus, Håkan; Mellström, Dan; Melov, Simon; Michaëlsson, Karl; Mitchell, Braxton D; Morris, Andrew P; Mosekilde, Leif; Newman, Anne; Nielson, Carrie M; O'Connell, Jeffrey R; Oostra, Ben A; Orwoll, Eric S; Palotie, Aarno; Parker, Stephen C J; Peacock, Munro; Perola, Markus; Peters, Annette; Polasek, Ozren; Prince, Richard L; Räikkönen, Katri; Ralston, Stuart H; Ripatti, Samuli; Robbins, John A; Rotter, Jerome I; Rudan, Igor; Salomaa, Veikko; Satterfield, Suzanne; Schadt, Eric E; Schipf, Sabine; Scott, Laura; Sehmi, Joban; Shen, Jian; Soo Shin, Chan; Sigurdsson, Gunnar; Smith, Shad; Soranzo, Nicole; Stančáková, Alena; Steinhagen-Thiessen, Elisabeth; Streeten, Elizabeth A; Styrkarsdottir, Unnur; Swart, Karin M A; Tan, Sian-Tsung; Tarnopolsky, Mark A; Thompson, Patricia; Thomson, Cynthia A; Thorsteinsdottir, Unnur; Tikkanen, Emmi; Tranah, Gregory J; Tuomilehto, Jaakko; van Schoor, Natasja M; Verma, Arjun; Vollenweider, Peter; Völzke, Henry; Wactawski-Wende, Jean; Walker, Mark; Weedon, Michael N; Welch, Ryan; Wichmann, H-Erich; Widen, Elisabeth; Williams, Frances M K; Wilson, James F; Wright, Nicole C; Xie, Weijia; Yu, Lei; Zhou, Yanhua; Chambers, John C; Döring, Angela; van Duijn, Cornelia M; Econs, Michael J; Gudnason, Vilmundur; Kooner, Jaspal S; Psaty, Bruce M; Spector, Timothy D; Stefansson, Kari; Rivadeneira, Fernando; Uitterlinden, André G; Wareham, Nicholas J; Ossowski, Vicky; Waterworth, Dawn; Loos, Ruth J F; Karasik, David; Harris, Tamara B; Ohlsson, Claes; Kiel, Douglas P

2017-07-19

Lean body mass, consisting mostly of skeletal muscle, is important for healthy aging. We performed a genome-wide association study for whole body (20 cohorts of European ancestry with n = 38,292) and appendicular (arms and legs) lean body mass (n = 28,330) measured using dual energy X-ray absorptiometry or bioelectrical impedance analysis, adjusted for sex, age, height, and fat mass. Twenty-one single-nucleotide polymorphisms were significantly associated with lean body mass either genome wide (p < 5 × 10 -8 ) or suggestively genome wide (p < 2.3 × 10 -6 ). Replication in 63,475 (47,227 of European ancestry) individuals from 33 cohorts for whole body lean body mass and in 45,090 (42,360 of European ancestry) subjects from 25 cohorts for appendicular lean body mass was successful for five single-nucleotide polymorphisms in/near HSD17B11, VCAN, ADAMTSL3, IRS1, and FTO for total lean body mass and for three single-nucleotide polymorphisms in/near VCAN, ADAMTSL3, and IRS1 for appendicular lean body mass. Our findings provide new insight into the genetics of lean body mass.Lean body mass is a highly heritable trait and is associated with various health conditions. Here, Kiel and colleagues perform a meta-analysis of genome-wide association studies for whole body lean body mass and find five novel genetic loci to be significantly associated.

Serum Predictors of Percent Lean Mass in Young Adults.

PubMed

Lustgarten, Michael S; Price, Lori L; Phillips, Edward M; Kirn, Dylan R; Mills, John; Fielding, Roger A

2016-08-01

Lustgarten, MS, Price, LL, Phillips, EM, Kirn, DR, Mills, J, and Fielding, RA. Serum predictors of percent lean mass in young adults. J Strength Cond Res 30(8): 2194-2201, 2016-Elevated lean (skeletal muscle) mass is associated with increased muscle strength and anaerobic exercise performance, whereas low levels of lean mass are associated with insulin resistance and sarcopenia. Therefore, studies aimed at obtaining an improved understanding of mechanisms related to the quantity of lean mass are of interest. Percent lean mass (total lean mass/body weight × 100) in 77 young subjects (18-35 years) was measured with dual-energy x-ray absorptiometry. Twenty analytes and 296 metabolites were evaluated with the use of the standard chemistry screen and mass spectrometry-based metabolomic profiling, respectively. Sex-adjusted multivariable linear regression was used to determine serum analytes and metabolites significantly (p ≤ 0.05 and q ≤ 0.30) associated with the percent lean mass. Two enzymes (alkaline phosphatase and serum glutamate oxaloacetate aminotransferase) and 29 metabolites were found to be significantly associated with the percent lean mass, including metabolites related to microbial metabolism, uremia, inflammation, oxidative stress, branched-chain amino acid metabolism, insulin sensitivity, glycerolipid metabolism, and xenobiotics. Use of sex-adjusted stepwise regression to obtain a final covariate predictor model identified the combination of 5 analytes and metabolites as overall predictors of the percent lean mass (model R = 82.5%). Collectively, these data suggest that a complex interplay of various metabolic processes underlies the maintenance of lean mass in young healthy adults.

Does Lean healthcare improve patient satisfaction? A mixed-method investigation into primary care.

PubMed

Poksinska, Bozena Bonnie; Fialkowska-Filipek, Malgorzata; Engström, Jon

2017-02-01

Lean healthcare is claimed to contribute to improved patient satisfaction, but there is limited evidence to support this notion. This study investigates how primary-care centres working with Lean define and improve value from the patient's perspective, and how the application of Lean healthcare influences patient satisfaction. This paper contains two qualitative case studies and a quantitative study based on results from the Swedish National Patient Survey. Through the case studies, we investigated how primary-care organisations realised the principle of defining and improving value from the patient's perspective. In the quantitative study, we compared results from the patient satisfaction survey for 23 primary-care centres working with Lean with a control group of 23 care centres not working with Lean. We also analysed changes in patient satisfaction over time. Our case studies reveal that Lean healthcare implementations primarily target efficiency and little attention is paid to the patient's perspective. The quantitative study shows no significantly better results in patient satisfaction for primary-care centres working with Lean healthcare compared with those not working with Lean. Further, care centres working with Lean show no significant improvements in patient satisfaction over time. Lean healthcare implementations seem to have a limited impact on improving patient satisfaction. Care providers need to pay more attention to integrating the patient's perspective in the application of Lean healthcare. Value needs to be defined and value streams need to be improved based on both the knowledge and clinical expertise of care providers, and the preferences and needs of patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Carbon-On-Carbon Manufacturing

NASA Technical Reports Server (NTRS)

Mungas, Gregory S. (Inventor); Buchanan, Larry (Inventor); Banzon, Jr., Jose T. (Inventor)

2017-01-01

The presently disclosed technology relates to carbon-on-carbon (C/C) manufacturing techniques and the resulting C/C products. One aspect of the manufacturing techniques disclosed herein utilizes two distinct curing operations that occur at different times and/or using different temperatures. The resulting C/C products are substantially non-porous, even though the curing operation(s) substantially gasify a liquid carbon-entrained filler material that saturates a carbon fabric that makes up the C/C products.

Thermoplastic composite parts manufacture at Du Pont

NASA Astrophysics Data System (ADS)

Medwin, Steven J.; Coyle, Edward J.

1993-01-01

Low-cost routes to the manufacture of complex shaped composite parts have been defined using metal forming techniques and Du Pont's long discontinuous fiber (LDF) Technology. These manufacturing techniques include roll forming, stretch forming, and press forming. Near equivalence between the static, dynamic, and damage tolerance properties of LDF and continuous fiber composites have been demonstrated. Several examples are cited which demonstrate the potential for this technology to significantly reduce the cost of aerospace components.

Manufacturing techniques for Gravity Probe B gyroscopes

NASA Technical Reports Server (NTRS)

Rasquin, J. R.

1978-01-01

Additional and improved techniques for the manufacture of Gravity Probe B gyroscopes are reported. Improvements discussed include the redesign of the housings, new techniques for indentation of the electrode surfaces, and a new rotor ball lapping machine. These three items represent a significant improvement in operation of the gyroscope and also make possible the fabrication of a gyroscope which will meet flight requirements.

Optical Measurements in a Combustor Using a 9-Point Swirl-Venturi Fuel Injector

NASA Technical Reports Server (NTRS)

Hicks, Yolanda R.; Anderson, Robert C.; Locke, Randy J.

2007-01-01

This paper highlights the use of two-dimensional data to characterize a multipoint swirl-venturi injector. The injector is based on a NASA-conceived lean direct injection concept. Using a variety of advanced optical diagnostic techniques, we examine the flows resultant from multipoint, lean-direct injectors that have nine injection sites arranged in a 3 x 3 grid. The measurements are made within an optically-accessible, jet-A-fueled, 76-mm by 76-mm flame tube combustor. Combustion species mapping and velocity measurements are obtained using planar laser-induced fluorescence of OH and fuel, planar laser scatter of liquid fuel, chemiluminescence from CH*, NO*, and OH*, and particle image velocimetry of seeded air (non-fueled). These measurements are used to study fuel injection, mixedness, and combustion processes and are part of a database of measurements that will be used for validating computational combustion models.

Method of preparing doped oxide catalysts for lean NOx exhaust

DOEpatents

Park, Paul W.

2004-03-09

The lean NOx catalyst includes a substrate, an oxide support material, preferably .gamma.-alumina deposited on the substrate and a metal or metal oxide promoter or dopant introduced into the oxide support material. The metal promoters or dopants are selected from the group consisting of indium, gallium, tin, silver, germanium, gold, nickel, cobalt, copper, iron, manganese, molybdenum, chromium cerium, and vanadium, and oxides thereof, and any combinations thereof. The .gamma.-alumina preferably has a pore volume of from about 0.5 to about 2.0 cc/g; a surface area of between 80 and 350 m.sup.2 /g; an average pore size diameter of between about 3 to 30 nm; and an impurity level of less than or equal to about 0.2 weight percent. In a preferred embodiment the .gamma.-alumina is prepared by a sol-gel method, with the metal doping of the .gamma.-alumina preferably accomplished using an incipient wetness impregnation technique.

Effect of House Cricket (Acheta domesticus) Flour Addition on Physicochemical and Textural Properties of Meat Emulsion Under Various Formulations.

PubMed

Kim, Hyun-Wook; Setyabrata, Derico; Lee, YongJae; Jones, Owen G; Kim, Yuan H Brad

2017-12-01

The objective of this study was to determine the effect of house cricket (Acheta domesticus) flour addition on physicochemical and textural properties of meat emulsion under various formulations. As an initial marker of functionality, protein solubility, water absorption, emulsifying capacity, and gel formation ability of house cricket flour were determined at pH (2 to 10) and NaCl concentrations (0 to 2.10 M). Control emulsion was formulated with 60% lean pork, 20% back fat, and 20% ice. Six treatment emulsions were prepared with replacement of lean pork and/or back fat portions with spray-dried house cricket flour at 5% and 10% levels, based on a total sample weight. The protein solubility of house cricket flour (67 g protein/100 g) was significantly altered depending upon pH (P < 0.0001) and NaCl concentration (P = 0.0421). Similar water absorption capacity, emulsifying capacity, and gel formation ability of house cricket flour were found between 0 and 2.10 M NaCl concentration (P > 0.05). The replacement of lean meat/fat portion with house cricket flour within 10% level could fortify protein and some micronutrients (phosphorus, potassium, and magnesium) in meat emulsion, without negative impacts on cooking yield and textural properties. Our results suggest that house cricket flour can be used as an effective nonmeat functional ingredient to manufacture emulsified meat products. To better utilize house cricket flour as a food ingredient in wide application, understanding its technological properties in various pH, and ionic strength conditions is a pivotal step. Protein solubility of house cricket flour would be considerably affected by the varying pH and NaCl concentrations of applied conventional foods. In the case of meat emulsion, within 10% lean meat and/or fat portions could be successfully substituted with house cricket flour without detectable adverse impacts on technological properties associated with cooking yield and instrumental analysis of texture. Thus, our findings suggest that house cricket flour possess the necessary physical properties to be used as an alternative nonmeat ingredient for incorporation within emulsified meat products, which could be further explored in subsequent sensory-based studies. © 2017 Institute of Food Technologists®.

Four-way-leaning test shows larger limits of stability than a circular-leaning test.

PubMed

Thomsen, Mikkel Højgaard; Støttrup, Nicolai; Larsen, Frederik Greve; Pedersen, Ann-Marie Sydow Krogh; Poulsen, Anne Grove; Hirata, Rogerio Pessoto

2017-01-01

Limits of stability (LOS) have extensive clinical and rehabilitational value yet no standard consensus on measuring LOS exists. LOS measured using a leaning or a circling protocol is commonly used in research and clinical settings, however differences in protocols and reliability problems exist. This study measured LOS using a four-way-leaning test and a circular-leaning test to test which showed larger LOS measurements. Furthermore, number of adaptation trials needed for consistent results was assessed. Limits of stability were measured using a force plate (Metitur Good Balance System ® ) sampling at 50Hz. Thirty healthy subjects completed 30 trials assessing LOS alternating between four-way-leaning test and circular-leaning test. A main effect of methods (ANOVA:F(1,28)=45.86, P<0.01) with the four-way-leaning test showing larger values than the circular-leaning test (NK, P<0.01). An interaction between method×directions was found (ANOVA:F(3, 84)=24.87, P<0.01). The four-way-leaning test showed larger LOS in anterior (NK, P<0.05), right (NK, P<0.01) and left direction (NK, P<0.01). Analysis of LOS for the four-way-leaning test showed a difference between trials (ANOVA:F(14,392)=7.81, P<0.01). Differences were found between trial 1 and 7 (NK, P<0.03), trial 6 and 8 (NK, P<0.02) and trial 7 and 15 (NK, P<0.02). Four-way-leaning test showed high correlation (ICC>0.87) between first and second trial for all directions. Four-way-leaning test yields larger LOS in anterior, right and left direction making it more reliable when measuring LOS. A learning effect was found up to the 8th trial, which suggests using 8 adaptation trials before reliable LOS is measured. Copyright © 2016 Elsevier B.V. All rights reserved.

Correlates of increased lean muscle mass in women with polycystic ovary syndrome.

PubMed

Carmina, E; Guastella, E; Longo, R A; Rini, G B; Lobo, R A

2009-10-01

Muscle mass plays an important role in determining cardiovascular and metabolic risks in polycystic ovary syndrome (PCOS). In addition, whether lean mass influences carotid intima-media thickness (IMT) in PCOS has not been assessed. Prospective investigation. Ninety-five women with PCOS were age- and weight-matched to 90 ovulatory controls. All women had dual X-ray absorptiometry for lean, fat and bone mass, and bone mass density (BMD). Serum testosterone, sex hormone-binding globulin, insulin, and glucose and carotid IMT were determined. Free androgen index (FAI) and insulin resistance (by QUICKI) were calculated. In PCOS, waist circumference and insulin were higher and QUICKI lower than in controls (P<0.01). Trunk fat mass, % trunk fat, and lean mass were higher in PCOS compared to controls (P<0.01), while total bone mass and BMD were similar. IMT was increased in PCOS (P<0.01) but only 15% of PCOS patients had abnormal (> or = 0.9 mm) values. Lean mass correlated with fat parameters, insulin, QUICKI, and FAI, but not with total testosterone; and after adjustments for insulin and QUICKI, lean mass still correlated with fat mass (P<0.01) but not FAI. Lean mass correlated with IMT (P<0.01), but this was dependent on insulin. However, excluding those patients with abnormal IMT values, IMT correlated with lean mass independently of insulin. Bone mass correlated with lean and fat mass, but not with insulin or androgen. PCOS patients with 'pathological' IMT values had higher % trunk fat, lean mass, and insulin, lower QUICKI, and higher testosterone and FAI compared with those with normal IMT. Lean mass is increased in PCOS, while bone mass is similar to that of matched controls. The major correlates of lean mass are fat mass and insulin but not androgen. Lean mass also correlated with IMT, and although influenced by insulin, small changes in IMT may partially reflect changes in muscle mass, while clearly abnormal values relate to more severe abnormalities of PCOS.

7 CFR 59.200 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... these same swine. Average lean percentage. The term “average lean percentage” means the value equal to the average percentage of the carcass weight comprised of lean meat for the swine slaughtered during the applicable reporting period. Whenever the packer changes the manner in which the average lean...

7 CFR 59.200 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... these same swine. Average lean percentage. The term “average lean percentage” means the value equal to the average percentage of the carcass weight comprised of lean meat for the swine slaughtered during the applicable reporting period. Whenever the packer changes the manner in which the average lean...

The human side of lean teams.

PubMed

Wackerbarth, Sarah B; Strawser-Srinath, Jamie R; Conigliaro, Joseph C

2015-05-01

Organizations use lean principles to increase quality and decrease costs. Lean projects require an understanding of systems-wide processes and utilize interdisciplinary teams. Most lean tools are straightforward, and the biggest barrier to successful implementation is often development of the team aspect of the lean approach. The purpose of this article is to share challenges experienced by a lean team charged with improving a hospital discharge process. Reflection on the experience provides an opportunity to highlight lessons from The Team Handbook by Peter Scholtes and colleagues. To improve the likelihood that process improvement initiatives, including lean projects, will be successful, organizations should consider providing training in organizational change principles and team building. The authors' lean team learned these lessons the hard way. Despite the challenges, the team successfully implemented changes throughout the organization that have had a positive impact. Training to understand the psychology of change might have decreased the resistance faced in implementing these changes. © 2014 by the American College of Medical Quality.

SLAE–CPS: Smart Lean Automation Engine Enabled by Cyber-Physical Systems Technologies

PubMed Central

Ma, Jing; Wang, Qiang; Zhao, Zhibiao

2017-01-01

In the context of Industry 4.0, the demand for the mass production of highly customized products will lead to complex products and an increasing demand for production system flexibility. Simply implementing lean production-based human-centered production or high automation to improve system flexibility is insufficient. Currently, lean automation (Jidoka) that utilizes cyber-physical systems (CPS) is considered a cost-efficient and effective approach for improving system flexibility under shrinking global economic conditions. Therefore, a smart lean automation engine enabled by CPS technologies (SLAE–CPS), which is based on an analysis of Jidoka functions and the smart capacity of CPS technologies, is proposed in this study to provide an integrated and standardized approach to design and implement a CPS-based smart Jidoka system. A set of comprehensive architecture and standardized key technologies should be presented to achieve the above-mentioned goal. Therefore, a distributed architecture that joins service-oriented architecture, agent, function block (FB), cloud, and Internet of things is proposed to support the flexible configuration, deployment, and performance of SLAE–CPS. Then, several standardized key techniques are proposed under this architecture. The first one is for converting heterogeneous physical data into uniform services for subsequent abnormality analysis and detection. The second one is a set of Jidoka scene rules, which is abstracted based on the analysis of the operator, machine, material, quality, and other factors in different time dimensions. These Jidoka rules can support executive FBs in performing different Jidoka functions. Finally, supported by the integrated and standardized approach of our proposed engine, a case study is conducted to verify the current research results. The proposed SLAE–CPS can serve as an important reference value for combining the benefits of innovative technology and proper methodology. PMID:28657577

SLAE-CPS: Smart Lean Automation Engine Enabled by Cyber-Physical Systems Technologies.

PubMed

Ma, Jing; Wang, Qiang; Zhao, Zhibiao

2017-06-28

In the context of Industry 4.0, the demand for the mass production of highly customized products will lead to complex products and an increasing demand for production system flexibility. Simply implementing lean production-based human-centered production or high automation to improve system flexibility is insufficient. Currently, lean automation (Jidoka) that utilizes cyber-physical systems (CPS) is considered a cost-efficient and effective approach for improving system flexibility under shrinking global economic conditions. Therefore, a smart lean automation engine enabled by CPS technologies (SLAE-CPS), which is based on an analysis of Jidoka functions and the smart capacity of CPS technologies, is proposed in this study to provide an integrated and standardized approach to design and implement a CPS-based smart Jidoka system. A set of comprehensive architecture and standardized key technologies should be presented to achieve the above-mentioned goal. Therefore, a distributed architecture that joins service-oriented architecture, agent, function block (FB), cloud, and Internet of things is proposed to support the flexible configuration, deployment, and performance of SLAE-CPS. Then, several standardized key techniques are proposed under this architecture. The first one is for converting heterogeneous physical data into uniform services for subsequent abnormality analysis and detection. The second one is a set of Jidoka scene rules, which is abstracted based on the analysis of the operator, machine, material, quality, and other factors in different time dimensions. These Jidoka rules can support executive FBs in performing different Jidoka functions. Finally, supported by the integrated and standardized approach of our proposed engine, a case study is conducted to verify the current research results. The proposed SLAE-CPS can serve as an important reference value for combining the benefits of innovative technology and proper methodology.

Flashback Detection Sensor for Hydrogen Augmented Natural Gas Combustion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thornton, J.D.; Chorpening, B.T.; Sidwell, T.

2007-05-01

The use of hydrogen augmented fuel is being investigated by various researchers as a method to extend the lean operating limit, and potentially reduce thermal NOx formation in natural gas fired lean premixed (LPM) combustion systems. The resulting increase in flame speed during hydrogen augmentation, however, increases the propensity for flashback in LPM systems. Real-time in-situ monitoring of flashback is important for the development of control strategies for use of hydrogen augmented fuel in state-of-the-art combustion systems, and for the development of advanced hydrogen combustion systems. The National Energy Technology Laboratory (NETL) and Woodward Industrial Controls are developing a combustionmore » control and diagnostics sensor (CCADS), which has already been demonstrated as a useful sensor for in-situ monitoring of natural gas combustion, including detection of important combustion events such as flashback and lean blowoff. Since CCADS is a flame ionization sensor technique, the low ion concentration produced in pure hydrogen combustion raises concerns of whether CCADS can be used to monitor flashback in hydrogen augmented combustion. This paper discusses CCADS tests conducted at 0.2-0.6 MPa (2-6 atm), demonstrating flashback detection with fuel compositions up to 80% hydrogen (by volume) mixed with natural gas. NETL’s Simulation Validation (SimVal) combustor offers full optical access to pressurized combustion during these tests. The CCADS data and high-speed video show the reaction zone moves upstream into the nozzle as the hydrogen fuel concentration increases, as is expected with the increased flame speed of the mixture. The CCADS data and video also demonstrate the opportunity for using CCADS to provide the necessary in-situ monitor to control flashback and lean blowoff in hydrogen augmented combustion applications.« less

Planning and Scheduling of Software Manufacturing Projects

DTIC Science & Technology

1991-03-01

based on the previous results in social analysis of computing, operations research in manufacturing, artificial intelligence in manufacturing...planning and scheduling, and the traditional approaches to planning in artificial intelligence, and extends the techniques that have been developed by them...social analysis of computing, operations research in manufacturing, artificial intelligence in manufacturing planning and scheduling, and the

Applying lean management principles to the creation of a postpartum hemorrhage care bundle.

PubMed

Faulkner, Beth

2013-10-01

A lean management process is a set of interventions, each of which creates value for the customer. Lean management is not a new concept, but is relatively new to health care. Postpartum hemorrhage (PPH) is the most common cause of maternal death worldwide in both developing and developed countries. We applied lean management principles as an innovative approach to improving outcomes in patients with PPH. Initial results using principles of lean management indicated significant improvements in response time and family-centered care. When applied rigorously and throughout the organization, lean principles can have a dramatic effect on productivity, cost and quality. © 2013 AWHONN.

Escape from rich-to-lean transitions: Stimulus change and timeout.

PubMed

Retzlaff, Billie J; Parthum, Elizabeth T P; Pitts, Raymond C; Hughes, Christine E

2017-01-01

Extended pausing during discriminable transitions from rich-to-lean conditions can be viewed as escape (i.e., rich-to-lean transitions function aversively). In the current experiments, pigeons' key pecking was maintained by a multiple fixed-ratio fixed-ratio schedule of rich or lean reinforcers. Pigeons then were provided with another, explicit, mechanism of escape by changing the stimulus from the transition-specific stimulus used in the multiple schedule to a mixed-schedule stimulus (Experiment 1) or by producing a period of timeout in which the stimulus was turned off and the schedule was suspended (Experiment 2). Overall, escape was under joint control of past and upcoming reinforcer magnitudes, such that responses on the escape key were most likely during rich-to-lean transitions, and second-most likely during lean-to-lean transitions. Even though pigeons pecked the escape key, they paused before doing so, and the latency to begin the fixed ratio (i.e., the pause) remained extended during rich-to-lean transitions. These findings suggest that although the stimulus associated with rich-to-lean transitions functioned aversively, pausing is more than simply escape responding from the stimulus. © 2017 Society for the Experimental Analysis of Behavior.

LEAN thinking in Finnish healthcare.

PubMed

Jorma, Tapani; Tiirinki, Hanna; Bloigu, Risto; Turkki, Leena

2016-01-01

Purpose - The purpose of this study is to evaluate how LEAN thinking is used as a management and development tool in the Finnish public healthcare system and what kind of outcomes have been achieved or expected by using it. The main focus is in managing and developing patient and treatment processes. Design/methodology/approach - A mixed-method approach incorporating the Webropol survey was used. Findings - LEAN is quite a new concept in Finnish public healthcare. It is mainly used as a development tool to seek financial savings and to improve the efficiency of patient processes, but has not yet been deeply implemented. However, the experiences from LEAN initiatives have been positive, and the methodology is already quite well-known. It can be concluded that, because of positive experiences from LEAN, the environment in Finnish healthcare is ready for the deeper implementation of LEAN. Originality/value - This paper evaluates the usage of LEAN thinking for the first time in the public healthcare system of Finland as a development tool and a management system. It highlights the implementation and achieved results of LEAN thinking when used in the healthcare environment. It also highlights the expectations for LEAN thinking in Finnish public healthcare.

The Role of the Clinical Laboratory in the Future of Health Care: Lean Microbiology

PubMed Central

Samuel, Linoj

2014-01-01

This commentary will introduce lean concepts into the clinical microbiology laboratory. The practice of lean in the clinical microbiology laboratory can remove waste, increase efficiency, and reduce costs. Lean, Six Sigma, and other such management initiatives are useful tools and can provide dividends but must be accompanied by organizational leadership commitment to sustaining the lean culture in the laboratory setting and providing resources and time to work through the process. PMID:24574289

Apparatus and method for burning a lean, premixed fuel/air mixture with low NOx emission

DOEpatents

Kostiuk, Larry W.; Cheng, Robert K.

1996-01-01

An apparatus for enabling a burner to stably burn a lean fuel/air mixture. The burner directs the lean fuel/air mixture in a stream. The apparatus comprises an annular flame stabilizer; and a device for mounting the flame stabilizer in the fuel/air mixture stream. The burner may include a body having an internal bore, in which case, the annular flame stabilizer is shaped to conform to the cross-sectional shape of the bore, is spaced from the bore by a distance greater than about 0.5 mm, and the mounting device mounts the flame stabilizer in the bore. An apparatus for burning a gaseous fuel with low NOx emissions comprises a device for premixing air with the fuel to provide a lean fuel/air mixture; a nozzle having an internal bore through which the lean fuel/air mixture passes in a stream; and a flame stabilizer mounted in the stream of the lean fuel/air mixture. The flame stabilizer may be mounted in the internal bore, in which case, it is shaped and is spaced from the bore as just described. In a method of burning a lean fuel/air mixture, a lean fuel/air mixture is provided, and is directed in a stream; an annular eddy is created in the stream of the lean fuel/air mixture; and the lean fuel/air mixture is ignited at the eddy.

The current state of Lean implementation in health care: literature review.

PubMed

Poksinska, Bozena

2010-01-01

The purpose of this article is to discuss the current state of implementation of Lean production in health care. The study focuses on the definition of Lean in health care and implementation process, barriers, challenges, enablers, and outcomes of implementing Lean production methods in health care. A comprehensive search of the literature concerning the implementation of Lean production in health care was used to generate a synthesis of the literature around the chosen research questions. Lean production in health care is mostly used as a process improvement approach and focuses on 3 main areas: (1) defining value from the patient point of view, (2) mapping value streams, and (3) eliminating waste in an attempt to create continuous flow. Value stream mapping is the most frequently applied Lean tool in health care. The usual implementation steps include conducting Lean training, initiating pilot projects, and implementing improvements using interdisciplinary teams. One of the barriers is lack of educators and consultants who have their roots in the health care sector and can provide support by sharing experience and giving examples from real-life applications of Lean in health care. The enablers of Lean in health care seem not to be different from the enablers of any other change initiative. The outcomes can be divided into 2 broad areas: the performance of the health care system and the development of employees and work environment.

COMPARISON OF ANALYTICAL TECHNIQUES FOR MEASURING HYDROCARBON EMISSIONS FROM THE MANUFACTURE OF FIBERGLASS-REINFORCED PLASTICS

EPA Science Inventory

The paper discusses several projects to measure hydrocarbon emissions associated with the manufacture of fiberglass-reinforced plastics. The main purpose of the projects was to evaluate pollution prevention techniques to reduce emissions by altering raw materials, application equ...

Lean and Efficient Software: Whole-Program Optimization of Executables

DTIC Science & Technology

2015-09-30

libraries. Many levels of library interfaces—where some libraries are dynamically linked and some are provided in binary form only—significantly limit...software at build time. The opportunity: Our objective in this project is to substantially improve the performance, size, and robustness of binary ...executables by using static and dynamic binary program analysis techniques to perform whole-program optimization directly on compiled programs

Using Innovative Technologies for Manufacturing Rocket Engine Hardware

NASA Technical Reports Server (NTRS)

Betts, E. M.; Eddleman, D. E.; Reynolds, D. C.; Hardin, N. A.

2011-01-01

Many of the manufacturing techniques that are currently used for rocket engine component production are traditional methods that have been proven through years of experience and historical precedence. As the United States enters into the next space age where new launch vehicles are being designed and propulsion systems are being improved upon, it is sometimes necessary to adopt innovative techniques for manufacturing hardware. With a heavy emphasis on cost reduction and improvements in manufacturing time, rapid manufacturing techniques such as Direct Metal Laser Sintering (DMLS) are being adopted and evaluated for their use on NASA s Space Launch System (SLS) upper stage engine, J-2X, with hopes of employing this technology on a wide variety of future projects. DMLS has the potential to significantly reduce the processing time and cost of engine hardware, while achieving desirable material properties by using a layered powder metal manufacturing process in order to produce complex part geometries. Marshall Space Flight Center (MSFC) has recently hot-fire tested a J-2X gas generator (GG) discharge duct that was manufactured using DMLS. The duct was inspected and proof tested prior to the hot-fire test. Using a workhorse gas generator (WHGG) test fixture at MSFC's East Test Area, the duct was subjected to extreme J-2X hot gas environments during 7 tests for a total of 537 seconds of hot-fire time. The duct underwent extensive post-test evaluation and showed no signs of degradation. DMLS manufacturing has proven to be a viable option for manufacturing rocket engine hardware, and further development and use of this manufacturing method is recommended.

Lean blowoff detection sensor

DOEpatents

Thornton, Jimmy [Morgantown, WV; Straub, Douglas L [Morgantown, WV; Chorpening, Benjamin T [Morgantown, WV; Huckaby, David [Morgantown, WV

2007-04-03

Apparatus and method for detecting incipient lean blowoff conditions in a lean premixed combustion nozzle of a gas turbine. A sensor near the flame detects the concentration of hydrocarbon ions and/or electrons produced by combustion and the concentration monitored as a function of time are used to indicate incipient lean blowoff conditions.

What Do Organizational Leaders Need from Lean Graduate Programming

ERIC Educational Resources Information Center

Flumerfelt, Shannon; Alves, Anabela Carvalho; Leão, Celina Pinto; Wade, Dennis L.

2016-01-01

Purpose: This paper aims to assess the needs for a lean continuous improvement professional certificate and/or lean leadership cognate for a Doctorate of Education in leadership focused in three main research questions: "What do organizational leaders need from a Lean graduate programming?"; "What are the preferable methods of…

77 FR 72205 - Testing and Labeling Pertaining to Product Certification Regarding Representative Samples for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-05

... testing periodically and when there has been a material change in the product's design or manufacturing... control data during product manufacture; and using manufacturing techniques with intrinsic manufacturing... sample in the production population an equal probability of being selected (75 FR at 28349 through 28350...

Getting 'Lean': hardwiring process excellence into Northeast Health.

PubMed

Brown, Tricia; Duthe, Robert

2009-01-01

Many healthcare organizations are turning to the "Lean" Toyota Production System as a means to hardwire process excellence into their organizations. Northeast Health, an integrated delivery system in New York's capital region, introduced the Lean concept into its culture in 2004. After four years, the organization is beginning to see its staff hardwire Lean thinking into day-to-day behaviors. This paper focuses on the approach used by Northeast Health to introduce Lean concepts into its culture, challenges faced, lessons learned and the factors critical to success.

Advanced engine management of individual cylinders for control of exhaust species

DOEpatents

Graves, Ronald L [Knoxville, TN; West, Brian H [Knoxville, TN; Huff, Shean P [Knoxville, TN; Parks, II, James E

2008-12-30

A method and system controls engine-out exhaust species of a combustion engine having a plurality of cylinders. The method typically includes various combinations of steps such as controlling combustion parameters in individual cylinders, grouping the individual cylinders into a lean set and a rich set of one or more cylinders, combusting the lean set in a lean combustion parameter condition having a lean air:fuel equivalence ratio, combusting the rich set in a rich combustion parameter condition having a rich air:fuel equivalence ratio, and adjusting the lean set and the rich set of one or more cylinders to generate net-lean combustion. The exhaust species may have elevated concentrations of hydrogen and oxygen.

3D printing for the design and fabrication of polymer-based gradient scaffolds.

PubMed

Bracaglia, Laura G; Smith, Brandon T; Watson, Emma; Arumugasaamy, Navein; Mikos, Antonios G; Fisher, John P

2017-07-01

To accurately mimic the native tissue environment, tissue engineered scaffolds often need to have a highly controlled and varied display of three-dimensional (3D) architecture and geometrical cues. Additive manufacturing in tissue engineering has made possible the development of complex scaffolds that mimic the native tissue architectures. As such, architectural details that were previously unattainable or irreproducible can now be incorporated in an ordered and organized approach, further advancing the structural and chemical cues delivered to cells interacting with the scaffold. This control over the environment has given engineers the ability to unlock cellular machinery that is highly dependent upon the intricate heterogeneous environment of native tissue. Recent research into the incorporation of physical and chemical gradients within scaffolds indicates that integrating these features improves the function of a tissue engineered construct. This review covers recent advances on techniques to incorporate gradients into polymer scaffolds through additive manufacturing and evaluate the success of these techniques. As covered here, to best replicate different tissue types, one must be cognizant of the vastly different types of manufacturing techniques available to create these gradient scaffolds. We review the various types of additive manufacturing techniques that can be leveraged to fabricate scaffolds with heterogeneous properties and discuss methods to successfully characterize them. Additive manufacturing techniques have given tissue engineers the ability to precisely recapitulate the native architecture present within tissue. In addition, these techniques can be leveraged to create scaffolds with both physical and chemical gradients. This work offers insight into several techniques that can be used to generate graded scaffolds, depending on the desired gradient. Furthermore, it outlines methods to determine if the designed gradient was achieved. This review will help to condense the abundance of information that has been published on the creation and characterization of gradient scaffolds and to provide a single review discussing both methods for manufacturing gradient scaffolds and evaluating the establishment of a gradient. Copyright © 2017. Published by Elsevier Ltd.

Teaching Special Decisions in a Lean Accounting Environment

ERIC Educational Resources Information Center

Haskin, Daniel

2010-01-01

Lean accounting has become increasingly important as more and more companies adopt the lean enterprise model or some variation of it. Cost and managerial accounting textbooks continue to use, almost exclusively, models based on standard overhead absorption, which if used in a lean environment will not accurately reflect the benefits from the…

Healthcare workers' perceptions of lean: a context-sensitive, mixed methods study in three Swedish hospitals.

PubMed

Holden, Richard J; Eriksson, Andrea; Andreasson, Jörgen; Williamsson, Anna; Dellve, Lotta

2015-03-01

As the application of lean in healthcare expands, further research is needed in at least two areas: first, on the role of context in shaping lean and its consequences and second, on how healthcare workers perceive lean. Accordingly, this context-sensitive, mixed methods study addressed how hospital workers' perceptions of lean varied across contexts in three Swedish hospitals. Registered nurses and physicians at the hospitals and across units differing in acuity completed standardized surveys (N = 236, 57% response rate) about their perceptions of hospital-wide lean implementation. Perceptions varied by: hospital context, with one hospital's employees reporting the least favorable perceptions; unit acuity, with higher-acuity units reporting more favorable perceptions; and professional role, with nurses reporting more favorable perceptions than physicians. Individual interviews, group interviews, and observations provided insight about these dissimilar contexts and possible explanations for context-specific variability. Findings are discussed with respect to strategies for implementing lean in healthcare; the importance of attending to levels, context, and worker consequences of lean; and directions for future research. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Healthcare workers' perceptions of lean: A context-sensitive, mixed methods study in three Swedish hospitals

PubMed Central

Holden, Richard J.; Eriksson, Andrea; Andreasson, Jörgen; Williamsson, Anna; Dellve, Lotta

2014-01-01

As the application of lean in healthcare expands, further research is needed in at least two areas: first, on the role of context in shaping lean and its consequences and second, on how healthcare workers perceive lean. Accordingly, this context-sensitive, mixed methods study addressed how hospital workers' perceptions of lean varied across contexts in three Swedish hospitals. Registered nurses and physicians at the hospitals and across units differing in acuity completed standardized surveys (N=236, 57% response rate) about their perceptions of hospital-wide lean implementation. Perceptions varied by: hospital context, with one hospital's employees reporting the least favorable perceptions; unit acuity, with higher-acuity units reporting more favorable perceptions; and professional role, with nurses reporting more favorable perceptions than physicians. Individual interviews, group interviews, and observations provided insight about these dissimilar contexts and possible explanations for context-specific variability. Findings are discussed with respect to strategies for implementing lean in healthcare; the importance of attending to levels, context, and worker consequences of lean; and directions for future research. PMID:25479987

Waste in health information systems: a systematic review.

PubMed

Awang Kalong, Nadia; Yusof, Maryati

2017-05-08

Purpose The purpose of this paper is to discuss a systematic review on waste identification related to health information systems (HIS) in Lean transformation. Design/methodology/approach A systematic review was conducted on 19 studies to evaluate Lean transformation and tools used to remove waste related to HIS in clinical settings. Findings Ten waste categories were identified, along with their relationships and applications of Lean tool types related to HIS. Different Lean tools were used at the early and final stages of Lean transformation; the tool selection depended on the waste characteristic. Nine studies reported a positive impact from Lean transformation in improving daily work processes. The selection of Lean tools should be made based on the timing, purpose and characteristics of waste to be removed. Research limitations/implications Overview of waste and its category within HIS and its analysis from socio-technical perspectives enabled the identification of its root cause in a holistic and rigorous manner. Practical implications Understanding waste types, their root cause and review of Lean tools could subsequently lead to the identification of mitigation approach to prevent future error occurrence. Originality/value Specific waste models for HIS settings are yet to be developed. Hence, the identification of the waste categories could guide future implementation of Lean transformations in HIS settings.

Readiness factors for lean implementation in healthcare settings--a literature review.

PubMed

Al-Balushi, S; Sohal, A S; Singh, P J; Al Hajri, A; Al Farsi, Y M; Al Abri, R

2014-01-01

The purpose of this paper is to determine the readiness factors that are critical to the application and success of lean operating principles in healthcare organizations through a review of relevant literature. A comprehensive review of literature focussing on lean and lean healthcare was conducted. Leadership, organizational culture, communication, training, measurement, and reward systems are all commonly attributed readiness factors throughout general change management and lean literature. However, directly related to the successful implementation of lean in healthcare is that a setting is able to authorize a decentralized management style and undertake an end-to-end process view. These can be particularly difficult initiatives for complex organizations such as healthcare settings. The readiness factors identified are based on a review of the published literature. The external validity of the findings could be enhanced if tested using an empirical study. The readiness factors identified will enable healthcare practitioners to be better prepared as they begin their lean journeys. Sustainability of the lean initiative will be at stake if these readiness factors are not addressed. To the best of the knowledge, this is the first paper that provides a consolidated list of key lean readiness factors that can guide practice, as well as future theory and empirical research.

Thin edge-defined film-fed growth (EFG) octagons

NASA Astrophysics Data System (ADS)

Kalejs, J. P.

1992-03-01

Mobil Solar Energy Corp. investigated manufacturing crystalline silicon wafers using the edge-defined film-fed growth (EFG) technique. This report identifies the following: (1) current capabilities for manufacturing 200-micron-thick crystalline silicon wafers (10 cm x 10 cm) produced by growing octagons using the EFG technique and laser cutting them into wafers; (2) potential manufacturing improvements from decreasing the thickness of the wafers, improving the quality of the laser cut edge, and increasing cutting speed, all of which lead to reduce manufacturing costs, improved performance, and increased production capacities; (3) problems that impede achieving these potentials; and (4) costs and other requirements involved in overcoming the problems.

Investigation of microstructure in additive manufactured Inconel 625 by spatially resolved neutron transmission spectroscopy

DOE PAGES

Tremsin, Anton S.; Gao, Yan; Dial, Laura C.; ...

2016-07-08

Non-destructive testing techniques based on neutron imaging and diffraction can provide information on the internal structure of relatively thick metal samples (up to several cm), which are opaque to other conventional non-destructive methods. Spatially resolved neutron transmission spectroscopy is an extension of traditional neutron radiography, where multiple images are acquired simultaneously, each corresponding to a narrow range of energy. The analysis of transmission spectra enables studies of bulk microstructures at the spatial resolution comparable to the detector pixel. In this study we demonstrate the possibility of imaging (with ~100 μm resolution) distribution of some microstructure properties, such as residual strain,more » texture, voids and impurities in Inconel 625 samples manufactured with an additive manufacturing method called direct metal laser melting (DMLM). Although this imaging technique can be implemented only in a few large-scale facilities, it can be a valuable tool for optimization of additive manufacturing techniques and materials and for correlating bulk microstructure properties to manufacturing process parameters. Additionally, the experimental strain distribution can help validate finite element models which many industries use to predict the residual stress distributions in additive manufactured components.« less

Investigation of microstructure in additive manufactured Inconel 625 by spatially resolved neutron transmission spectroscopy.

PubMed

Tremsin, Anton S; Gao, Yan; Dial, Laura C; Grazzi, Francesco; Shinohara, Takenao

2016-01-01

Non-destructive testing techniques based on neutron imaging and diffraction can provide information on the internal structure of relatively thick metal samples (up to several cm), which are opaque to other conventional non-destructive methods. Spatially resolved neutron transmission spectroscopy is an extension of traditional neutron radiography, where multiple images are acquired simultaneously, each corresponding to a narrow range of energy. The analysis of transmission spectra enables studies of bulk microstructures at the spatial resolution comparable to the detector pixel. In this study we demonstrate the possibility of imaging (with ~100 μm resolution) distribution of some microstructure properties, such as residual strain, texture, voids and impurities in Inconel 625 samples manufactured with an additive manufacturing method called direct metal laser melting (DMLM). Although this imaging technique can be implemented only in a few large-scale facilities, it can be a valuable tool for optimization of additive manufacturing techniques and materials and for correlating bulk microstructure properties to manufacturing process parameters. In addition, the experimental strain distribution can help validate finite element models which many industries use to predict the residual stress distributions in additive manufactured components.

Investigation of microstructure in additive manufactured Inconel 625 by spatially resolved neutron transmission spectroscopy

NASA Astrophysics Data System (ADS)

Tremsin, Anton S.; Gao, Yan; Dial, Laura C.; Grazzi, Francesco; Shinohara, Takenao

2016-01-01

Non-destructive testing techniques based on neutron imaging and diffraction can provide information on the internal structure of relatively thick metal samples (up to several cm), which are opaque to other conventional non-destructive methods. Spatially resolved neutron transmission spectroscopy is an extension of traditional neutron radiography, where multiple images are acquired simultaneously, each corresponding to a narrow range of energy. The analysis of transmission spectra enables studies of bulk microstructures at the spatial resolution comparable to the detector pixel. In this study we demonstrate the possibility of imaging (with 100 μm resolution) distribution of some microstructure properties, such as residual strain, texture, voids and impurities in Inconel 625 samples manufactured with an additive manufacturing method called direct metal laser melting (DMLM). Although this imaging technique can be implemented only in a few large-scale facilities, it can be a valuable tool for optimization of additive manufacturing techniques and materials and for correlating bulk microstructure properties to manufacturing process parameters. In addition, the experimental strain distribution can help validate finite element models which many industries use to predict the residual stress distributions in additive manufactured components.

Investigation of microstructure in additive manufactured Inconel 625 by spatially resolved neutron transmission spectroscopy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tremsin, Anton S.; Gao, Yan; Dial, Laura C.

Non-destructive testing techniques based on neutron imaging and diffraction can provide information on the internal structure of relatively thick metal samples (up to several cm), which are opaque to other conventional non-destructive methods. Spatially resolved neutron transmission spectroscopy is an extension of traditional neutron radiography, where multiple images are acquired simultaneously, each corresponding to a narrow range of energy. The analysis of transmission spectra enables studies of bulk microstructures at the spatial resolution comparable to the detector pixel. In this study we demonstrate the possibility of imaging (with ~100 μm resolution) distribution of some microstructure properties, such as residual strain,more » texture, voids and impurities in Inconel 625 samples manufactured with an additive manufacturing method called direct metal laser melting (DMLM). Although this imaging technique can be implemented only in a few large-scale facilities, it can be a valuable tool for optimization of additive manufacturing techniques and materials and for correlating bulk microstructure properties to manufacturing process parameters. Additionally, the experimental strain distribution can help validate finite element models which many industries use to predict the residual stress distributions in additive manufactured components.« less

Investigation of microstructure in additive manufactured Inconel 625 by spatially resolved neutron transmission spectroscopy

PubMed Central

Tremsin, Anton S.; Gao, Yan; Dial, Laura C.; Grazzi, Francesco; Shinohara, Takenao

2016-01-01

Abstract Non-destructive testing techniques based on neutron imaging and diffraction can provide information on the internal structure of relatively thick metal samples (up to several cm), which are opaque to other conventional non-destructive methods. Spatially resolved neutron transmission spectroscopy is an extension of traditional neutron radiography, where multiple images are acquired simultaneously, each corresponding to a narrow range of energy. The analysis of transmission spectra enables studies of bulk microstructures at the spatial resolution comparable to the detector pixel. In this study we demonstrate the possibility of imaging (with ~100 μm resolution) distribution of some microstructure properties, such as residual strain, texture, voids and impurities in Inconel 625 samples manufactured with an additive manufacturing method called direct metal laser melting (DMLM). Although this imaging technique can be implemented only in a few large-scale facilities, it can be a valuable tool for optimization of additive manufacturing techniques and materials and for correlating bulk microstructure properties to manufacturing process parameters. In addition, the experimental strain distribution can help validate finite element models which many industries use to predict the residual stress distributions in additive manufactured components. PMID:27877885

Does lean muddy the quality improvement waters? A qualitative study of how a hospital management team understands lean in the context of quality improvement.

PubMed

Savage, Carl; Parke, Louise; von Knorring, Mia; Mazzocato, Pamela

2016-10-19

Health care has experimented with many different quality improvement (QI) approaches with greater variation in name than content. This has been dubbed pseudoinnovation. However, it could also be that the subtleties and differences are not clearly understood. To explore this further, the purpose of this study was to explore how hospital managers perceive lean in the context of QI. We used a qualitative study design with semi-structured interviews to explore twelve top managers' perceptions of the relationship between lean and quality improvement (QI) at a university-affiliated hospital. Managers described that QI and lean shared the same overall purpose: focus on patient needs and improve efficiency and effectiveness. Employee involvement was emphasized in both strategies, as well as the support offered by managers of staff initiatives. QI was perceived as a strategy that could support structural changes at the organizational level whereas lean was seen as applicable at the operational level. Moreover, lean carried a negative connotation, lacked the credibility of QI, and was perceived as a management fad. Aspects of QI and lean were misunderstood. In a context where lean remains an abstract term, and staff associate lean with automotive applications and cost reduction, it may be fruitful for managers to invest time and resources to develop a strategy for continual improvement and utilize vocabulary that resonates with health care staff. This could reduce the risk that improvement efforts are rejected out of hand.

Incorporation of lean methodology into pharmacy residency programs.

PubMed

John, Natalie; Snider, Holly; Edgerton, Lisa; Whalin, Laurie

2017-03-15

The implementation of lean methodology into pharmacy residency programs at a community teaching hospital is described. New Hanover Regional Medical Center, a community teaching hospital in southeastern North Carolina, fully adopted a lean culture in 2010. Given the success of lean strategies organizationally, this methodology was used to assist with the evaluation and development of its pharmacy residency programs in 2014. Lean tools and activities have also been incorporated into residency requirements and rotation learning activities. The majority of lean events correspond to the required competency areas evaluating leadership and management, teaching, and education. These events have included participation in and facilitation of various lean problem-solving and communication tools. The application of the 4 rules of lean has resulted in enhanced management of the programs and provides a set of tools by which continual quality improvement can be ensured. Regular communication and direct involvement of all invested parties have been critical in developing and sustaining new improvements. In addition to program enhancements, lean methodology offers novel methods by which residents may be incorporated into leadership activities. The incorporation of lean methodology into pharmacy residency programs has translated into a variety of realized and potential benefits for the programs, the preceptors and residents, and the health system. Specific areas of growth have included quality-improvement processes, the expansion of leadership opportunities for residents, and improved communication among program directors, preceptors, and residents. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Estimation of lean and fat composition of pork ham using image processing measurements

NASA Astrophysics Data System (ADS)

Jia, Jiancheng; Schinckel, Allan P.; Forrest, John C.

1995-01-01

This paper presents a method of estimating the lean and fat composition in pork ham from cross-sectional area measurements using image processing technology. The relationship between the quantity of ham lean and fat mass with the ham lean and fat areas was studied. The prediction equations for pork ham composition based on the ham cross-sectional area measurements were developed. The results show that ham lean weight was related to the ham lean area (r equals .75, P < .0001) while ham fat weight was related tot the ham fat area (r equals .79, P equals .0001). Ham lean weight was highly related to the product of ham total weight times percentage ham lean area (r equals .96, P < .0001). Ham fat weight was highly related to the product of ham total weight times percentage ham fat area (r equals .88, P < .0001). The best combination of independent variables for estimating ham lean weight was trimmed wholesale ham weight and percentage ham fat area with a coefficient of determination of 92%. The best combination of independent variables for estimating ham fat weight was trimmed wholesale ham weight and percentage ham fat area with a coefficient of determination of 78%. Prediction equations with either two or three independent variables did not significantly increase the accuracy of prediction. The results of this study indicate that the weight of ham lean and fat could be predicted from ham cross-sectional area measurements using image analysis in combination with wholesale ham weight.

Increased Coagulation and Decreased Fibrinolysis as Measured with Overall Hemostatic Potential Are Dependent on BMI and Not Associated with PCOS.

PubMed

Rakusa, Matej; Jensterle, Mojca; Božič-Mijovski, Mojca; Janez, Andrej

2017-05-01

Overall hemostatic potential (OHP) captures all factors that affect coagulation and fibrinolysis cascade. It has not yet been assessed in polycystic ovary syndrome (PCOS). The aim of the study was to identify the relationship of OHP with a syndrome per se and body mass index (BMI). In 90 women with PCOS aged 30.9 ± 8.1 years (50 obese, 13 overweight, and 27 lean) and 21 healthy age-matched controls (11 obese and 10 lean), OHP with overall coagulation potential (OCP) and overall fibrinolytic potential (OFP) was determined spectrophotometrically. OFP was calculated. OHP increased with BMI in PCOS (9.6 ± 2.3 in lean, 12.5 ± 5.1 in overweight, and 15.5 ± 3.8 Abs-sum in obese) and in controls (9.1 ± 1.0 in lean and 17.3 ± 4.6 Abs-sum in obese). There was significant difference between lean and obese PCOS (P < 0.001) and between lean and obese controls (P < 0.001). OCP also increased with BMI in PCOS (P < 0.001 for lean vs. obese) and in controls (P < 0.001 for lean vs. obese). OFP decreased with BMI in PCOS (P < 0.001 for obese vs. overweight vs. lean) and in controls (P < 0.001 for obese vs. lean). OHP in healthy obese and obese PCOS did not differ significantly, while OHP for healthy obese was increased in comparison to overweight and lean PCOS (P < 0.001). PCOS was not associated with increased OHP compared with BMI and age-matched controls. However, increase in OHP was positively associated with BMI in PCOS and healthy women.

Validation of a skinfold based index for tracking proportional changes in lean mass

PubMed Central

Slater, G J; Duthie, G M; Pyne, D B; Hopkins, W G

2006-01-01

Background The lean mass index (LMI) is a new empirical measure that tracks within‐subject proportional changes in body mass adjusted for changes in skinfold thickness. Objective To compare the ability of the LMI and other skinfold derived measures of lean mass to monitor changes in lean mass. Methods 20 elite rugby union players undertook full anthropometric profiles on two occasions 10 weeks apart to calculate the LMI and five skinfold based measures of lean mass. Hydrodensitometry, deuterium dilution, and dual energy x ray absorptiometry provided a criterion choice, four compartment (4C) measure of lean mass for validation purposes. Regression based measures of validity, derived for within‐subject proportional changes through log transformation, included correlation coefficients and standard errors of the estimate. Results The correlation between change scores for the LMI and 4C lean mass was moderate (0.37, 90% confidence interval −0.01 to 0.66) and similar to the correlations for the other practical measures of lean mass (range 0.26 to 0.42). Standard errors of the estimate for the practical measures were in the range of 2.8–2.9%. The LMI correctly identified the direction of change in 4C lean mass for 14 of the 20 athletes, compared with 11 to 13 for the other practical measures of lean mass. Conclusions The LMI is probably as good as other skinfold based measures for tracking lean mass and is theoretically more appropriate. Given the impracticality of the 4C criterion measure for routine field use, the LMI may offer a convenient alternative for monitoring physique changes, provided its utility is established under various conditions. PMID:16505075

Guiding inpatient quality improvement: a systematic review of Lean and Six Sigma.

PubMed

Glasgow, Justin M; Scott-Caziewell, Jill R; Kaboli, Peter J

2010-12-01

Two popular quality improvement (QI) approaches in health care are Lean and Six Sigma. Hospitals continue to adopt these QI approaches-or the hybrid Lean Sigma approach-with little knowledge on how well they produce sustainable improvements. A systematic literature review was conducted to determine whether Lean, Six Sigma, or Lean Sigma have been effectively used to create and sustain improvements in the acute care setting. Databases were searched for articles published in the health care, business, and engineering literatures. Study inclusion criteria required identification of a Six Sigma, Lean, or Lean Sigma project; QI efforts focused on hospitalized patients; descriptions of project improvements; and reported results. Depending on the quality of data reported, articles were classified as summary reports, pre-post observational studies, or time-series reports. Database searches identified 539 potential articles. After review of titles, abstracts, and full text, 47 articles met inclusion criteria--10 articles summarized multiple projects, 12 reported Lean projects, 20 reported Six Sigma projects, and 5 reported Lean Sigma projects. Generally, the studies provided limited data, with only 15 articles providing any sort of follow-up data; of the 15, only 3 report a follow-up period greater than two years. Lean, Six Sigma, and Lean Sigma as QI approaches can aid institutions in tackling a wide variety of problems encountered in acute care. However, the true impact of these approaches is difficult to judge, given that the lack of rigorous evaluation or clearly sustained improvements provides little evidence supporting broad adoption. There is still a need for future work that will improve the evidence base for understanding more about QI approaches and how to achieve sustainable improvement.

Lean thinking in hospitals: is there a cure for the absence of evidence? A systematic review of reviews

PubMed Central

Andersen, Hege; Røvik, Kjell Arne; Ingebrigtsen, Tor

2014-01-01

Objective Lean interventions aim to improve quality of healthcare by reducing waste and facilitate flow in work processes. There is conflicting evidence on the outcomes of lean thinking, with quantitative and qualitative studies often contradicting each other. We suggest that reviewing the literature within the approach of a new contextual framework can deepen our understanding of lean as a quality-improvement method. This article theorises the concept of context by establishing a two-dimensional conceptual framework acknowledging lean as complex social interventions, deployed in different organisational dimensions and domains. The specific aim of the study was to identify factors facilitating intended outcomes from lean interventions, and to understand when and how different facilitators contribute. Design A two-dimensional conceptual framework was developed by combining Shortell's Dimensions of capability with Walshes’ Domains of an intervention. We then conducted a systematic review of lean review articles concerning hospitals, published in the period 2000–2012. The identified lean facilitators were categorised according to the intervention domains and dimensions of capability provided by the framework. Results We provide a framework emphasising context by relating facilitators to domains and dimensions of capability. 23 factors enabling a successful lean intervention in hospitals were identified in the systematic review, where management and a supportive culture, training, accurate data, physicians and team involvement were most frequent. Conclusions In the absence of evidence, the two-dimensional framework, incorporating the context, may prove useful for future research on variation in outcomes from lean interventions. Findings from the review suggest that characteristics and local application of lean, in addition to strategic and cultural capability, should be given further attention in healthcare quality improvement. PMID:24435890

Wood lens design philosophy based on a binary additive manufacturing technique

NASA Astrophysics Data System (ADS)

Marasco, Peter L.; Bailey, Christopher

2016-04-01

Using additive manufacturing techniques in optical engineering to construct a gradient index (GRIN) optic may overcome a number of limitations of GRIN technology. Such techniques are maturing quickly, yielding additional design degrees of freedom for the engineer. How best to employ these degrees of freedom is not completely clear at this time. This paper describes a preliminary design philosophy, including assumptions, pertaining to a particular printing technique for GRIN optics. It includes an analysis based on simulation and initial component measurement.

Physical activity modifies the association between dietary protein and lean mass of postmenopausal women

PubMed Central

Martinez, Jessica A.; Wertheim, Betsy C.; Thomson, Cynthia A.; Bea, Jennifer W.; Wallace, Robert; Allison, Matthew; Snetselaa, Linda; Chen, Zhao; Nassir, Rami; Thompson, Patricia A.

2016-01-01

Background Maintenance of lean muscle mass and related strength is associated with lower risk for numerous chronic diseases of aging in women. Objective To evaluate whether the association between dietary protein and lean mass differs by physical activity level, amino acid composition, and body mass index categories. Design Cross-sectional analysis of a prospective cohort. Participants/setting Postmenopausal women from the Women’s Health Initiative with body composition measurements by dual-energy X-ray absorptiometry (n=8,298). Main outcome measures Percent lean mass, percent fat mass and lean body mass index. Statistical analyses performed Linear regression models adjusted for scanner serial number, age, calibrated energy intake, race/ethnicity, neighborhood socioeconomic status, and recreational physical activity were used to determine the relationship between protein intake and body composition measures. Likelihood ratio tests and stratified analysis were used to investigate physical activity and body mass index as potential effect modifiers. Results Biomarker-calibrated protein intake was positively associated with percent lean mass; women in the highest protein quintile had 6.3 percentage points higher lean mass than the lowest quintile (P < 0.001). This difference rose to 8.5 percentage points for physically active women in the highest protein quintile (Pinteraction = 0.023). Percent fat mass and lean body mass index were both inversely related to protein intake (both P < 0.001). Physical activity further reduced percent fat mass (Pinteraction = 0.022) and lean body mass index (Pinteraction = 0.011). Leucine intake was associated with lean mass, as were branched chain amino acids combined (both P < 0.001), but not independent of total protein. All associations were observed for normal-weight, overweight, and obese women. Conclusions Protein consumption up to 2.02 g/kg body weight daily is positively associated with lean mass in postmenopausal women. Importantly, those that also engage in physical activity have the highest lean mass across body mass index categories. PMID:27914915

Cardiovascular and metabolic responses to fasting and thermoneutrality are conserved in obese Zucker rats.

PubMed

Overton, J M; Williams, T D; Chambers, J B; Rashotte, M E

2001-04-01

The primary purpose of the study was to test the hypothesis that reduced leptin signaling is necessary to elicit the cardiovascular and metabolic responses to fasting. Lean (Fa/?; normal leptin receptor; n = 7) and obese (fa/fa; mutated leptin receptor; n = 8) Zucker rats were instrumented with telemetry transmitters and housed in metabolic chambers at 23 degrees C (12:12-h light-dark cycle) for continuous (24 h) measurement of metabolic and cardiovascular variables. Before fasting, mean arterial pressure (MAP) was higher (MAP: obese = 103 +/- 3; lean = 94 +/- 1 mmHg), whereas oxygen consumption (VO(2): obese = 16.5 +/- 0.3; lean = 18.6 +/- 0.2 ml. min(-1). kg(-0.75)) was lower in obese Zucker rats compared with their lean controls. Two days of fasting had no effect on MAP in either lean or obese Zucker rats, whereas VO(2) (obese = -3.1 +/- 0.3; lean = -2.9 +/- 0.1 ml. min(-1). kg(-0.75)) and heart rate (HR: obese = -56 +/- 4; lean = -42 +/- 4 beats/min) were decreased markedly in both groups. Fasting increased HR variability both in lean (+1.8 +/- 0.4 ms) and obese (+2.6 +/- 0.3 ms) Zucker rats. After a 6-day period of ad libitum refeeding, when all parameters had returned to near baseline levels, the cardiovascular and metabolic responses to 2 days of thermoneutrality (ambient temperature 29 degrees C) were determined. Thermoneutrality reduced VO(2) (obese = -2.4 +/- 0.2; lean = -3.3 +/- 0.2 ml. min(-1). kg(-0.75)), HR (obese = -46 +/- 5; lean = -55 +/- 4 beats/min), and MAP (obese = -13 +/- 6; lean = -10 +/- 1 mmHg) similarly in lean and obese Zucker rats. The results indicate that the cardiovascular and metabolic responses to fasting and thermoneutrality are conserved in Zucker rats and suggest that intact leptin signaling may not be requisite for the metabolic and cardiovascular responses to reduced energy intake.

The Finnish healthcare services lean management.

PubMed

Hihnala, Susanna; Kettunen, Lilja; Suhonen, Marjo; Tiirinki, Hanna

2018-02-05

Purpose The purpose of this paper is to discuss health services managers' experiences of management in a special health-care unit and development efforts from the point of view of the Lean method. Additionally, the aim is to deepen the knowledge of the managers' work and nature of the Lean method development processes in the workplace. The research focuses on those aspects and results of Lean method that are currently being used in health-care environments. Design/methodology/approach These data were collected through a number of thematic interviews. The participants were nurse managers ( n = 7) and medical managers ( n = 7) who applied Lean management in their work at the University Hospital in the Northern Ostrobothnia Health Care District. The data were analysed with a qualitative content analysis. Findings A common set of values in specialized health-care services, development of activities and challenges for management in the use of the Lean manager development model to improve personal management skills. Practical implications Managers in specialized health-care services can develop and systematically manage with the help of the Lean method. This emphasizes assumptions, from the point of view of management, about systems development when the organization uses the Lean method. The research outcomes originate from specialized health-care settings in Finland in which the Lean method and its associated management principles have been implemented and applied to the delivery of health care. Originality/value The study shows that the research results and in-depth knowledge on Lean method principles can be applied to health-care management and development processes. The research also describes health services managers' experiences of using the Lean method. In the future, these results can be used to improve Lean management skills, identify personal professional competencies and develop skills required in development processes. Also, the research findings can be used in the training of health services managers in the health-care industry worldwide and to help them survive the pressure to change repeatedly.

Physical Activity Modifies the Association between Dietary Protein and Lean Mass of Postmenopausal Women.

PubMed

Martinez, Jessica A; Wertheim, Betsy C; Thomson, Cynthia A; Bea, Jennifer W; Wallace, Robert; Allison, Matthew; Snetselaar, Linda; Chen, Zhao; Nassir, Rami; Thompson, Patricia A

2017-02-01

Maintenance of lean muscle mass and related strength is associated with lower risk for numerous chronic diseases of aging in women. Our aim was to evaluate whether the association between dietary protein and lean mass differs by physical activity level, amino acid composition, and body mass index categories. We performed a cross-sectional analysis of a prospective cohort. Participants were postmenopausal women from the Women's Health Initiative with body composition measurements by dual-energy x-ray absorptiometry (n=8,298). Our study measured percent lean mass, percent fat mass, and lean body mass index. Linear regression models adjusted for scanner serial number, age, calibrated energy intake, race/ethnicity, neighborhood socioeconomic status, and recreational physical activity were used to determine the relationship between protein intake and body composition measures. Likelihood ratio tests and stratified analysis were used to investigate physical activity and body mass index as potential effect modifiers. Biomarker-calibrated protein intake was positively associated with percent lean mass; women in the highest protein quintile had 6.3 percentage points higher lean mass than the lowest quintile (P<0.001). This difference rose to 8.5 percentage points for physically active women in the highest protein quintile (P interaction =0.023). Percent fat mass and lean body mass index were both inversely related to protein intake (both P<0.001). Physical activity further reduced percent fat mass (P interaction =0.022) and lean body mass index (P interaction =0.011). Leucine intake was associated with lean mass, as were branched chain amino acids combined (both P<0.001), but not independent of total protein. All associations were observed for normal-weight, overweight, and obese women. Protein consumption up to 2.02 g/kg body weight daily is positively associated with lean mass in postmenopausal women. Importantly, those that also engage in physical activity have the highest lean mass across body mass index categories. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Birth weight and growth from infancy to late adolescence in relation to fat and lean mass in early old age: findings from the MRC National Survey of Health and Development.

PubMed

Bann, D; Wills, A; Cooper, R; Hardy, R; Aihie Sayer, A; Adams, J; Kuh, D

2014-01-01

High birth weight and greater weight gain in infancy have been associated with increased risk of obesity as assessed using body mass index, but few studies have examined associations with direct measures of fat and lean mass. This study examined associations of birth weight and weight and height gain in infancy, childhood and adolescence with fat and lean mass in early old age. A total of 746 men and 812 women in England, Scotland and Wales from the MRC National Survey of Health and Development whose heights and weights had been prospectively ascertained across childhood and adolescence and who had dual energy X-ray absorptiometry measures at age 60-64 years. Associations of birth weight and standardised weight and height (0-2 (weight only), 2-4, 4-7, 7-11, 11-15, 15-20 years) gain velocities with outcome measures were examined. Higher birth weight was associated with higher lean mass and lower android/gynoid ratio at age 60-64 years. For example, the mean difference in lean mass per 1 standard deviation increase in birth weight was 1.54 kg in males (95% confidence interval=1.04, 2.03) and 0.78 kg in females (0.41, 1.14). Greater weight gain in infancy was associated with higher lean mass, whereas greater gains in weight in later childhood and adolescence were associated with higher fat and lean mass, and fat/lean and android/gynoid ratios. Across growth intervals greater height gain was associated with higher lean but not fat mass, and with lower fat/lean and android/gynoid ratios. Findings suggest that growth in early life may have lasting effects on fat and lean mass. Greater weight gain before birth and in infancy may be beneficial by leading to higher lean mass, whereas greater weight gain in later childhood and adolescence may be detrimental by leading to higher fat/lean and android/gynoid ratios.

Interactions between lean management and the psychosocial work environment in a hospital setting - a multi-method study.

PubMed

Ulhassan, Waqar; von Thiele Schwarz, Ulrica; Thor, Johan; Westerlund, Hugo

2014-10-22

As health care struggles to meet increasing demands with limited resources, Lean has become a popular management approach. It has mainly been studied in relation to health care performance. The empirical evidence as to how Lean affects the psychosocial work environment has been contradictory. This study aims to study the interaction between Lean and the psychosocial work environment using a comprehensive model that takes Lean implementation information, as well as Lean theory and the particular context into consideration. The psychosocial work environment was measured twice with the Copenhagen Psychosocial Questionnaire (COPSOQ) employee survey during Lean implementations on May-June 2010 (T1) (n = 129) and November-December 2011 (T2) (n = 131) at three units (an Emergency Department (ED), Ward-I and Ward-II). Information based on qualitative data analysis of the Lean implementations and context from a previous paper was used to predict expected change patterns in the psychosocial work environment from T1 to T2 and subsequently compared with COPSOQ-data through linear regression analysis. Between T1 and T2, qualitative information showed a well-organized and steady Lean implementation on Ward-I with active employee participation, a partial Lean implementation on Ward-II with employees not seeing a clear need for such an intervention, and deterioration in already implemented Lean activities at ED, due to the declining interest of top management. Quantitative data analysis showed a significant relation between the expected and actual results regarding changes in the psychosocial work environment. Ward-I showed major improvements especially related to job control and social support, ED showed a major decline with some exceptions while Ward-II also showed improvements similar to Ward-I. The results suggest that Lean may have a positive impact on the psychosocial work environment given that it is properly implemented. Also, the psychosocial work environment may even deteriorate if Lean work deteriorates after implementation. Employee managers and researchers should note the importance of employee involvement in the change process. Employee involvement may minimize the intervention's harmful effects on psychosocial work factors. We also found that a multi-method may be suitable for investigating relations between Lean and the psychosocial work environment.

An automated technique for manufacturing thermoplastic stringers in continuous length

NASA Astrophysics Data System (ADS)

Pantelakis, Sp.; Baxevani, E.; Spelz, U.

In the present work an automated Continuous Compression Moulding Technique for the manufacture of stringers in continuous length is presented. The method combines pultrusion and hot-pressing. The technique is utilized for the production of L-shape stringers which are widely applied in aerospace constructions. The investigation was carried out on carbon reinforced PEEK (C/PEEK), as well as, for comparison, on the thermoplastic composites carbon reinforced polyethersulfon (C/PES), glass and carbon reinforced polyphenylene-sulfide (G/PPS, C/PPS) and Kevlar reinforced Polyamide 6 (K/PA 6). For the materials investigated the optimized process parameters for manufacturing the L-shape stringers were derived experimentally. To achieve this goal, the quality of the produced parts was controlled by using non-destructive testing techniques. Parts providing satisfactory quality were also tested destructively to measure their mechanical properties. The investigation results have shown the suitability of the technique to produce continuous length stringers.

Total lipid extraction of homogenized and intact lean fish muscles using pressurized fluid extraction and batch extraction techniques.

PubMed

Isaac, Giorgis; Waldebäck, Monica; Eriksson, Ulla; Odham, Göran; Markides, Karin E

2005-07-13

The reliability and efficiency of pressurized fluid extraction (PFE) technique for the extraction of total lipid content from cod and the effect of sample treatment on the extraction efficiency have been evaluated. The results were compared with two liquid-liquid extraction methods, traditional and modified methods according to Jensen. Optimum conditions were found to be with 2-propanol/n-hexane (65:35, v/v) as a first and n-hexane/diethyl ether (90:10, v/v) as a second solvent, 115 degrees C, and 10 min of static time. PFE extracts were cleaned up using the same procedure as in the methods according to Jensen. When total lipid yields obtained from homogenized cod muscle using PFE were compared yields obtained with original and modified Jensen methods, PFE gave significantly higher yields, approximately 10% higher (t test, P < 0.05). Infrared and NMR spectroscopy suggested that the additional material that inflates the gravimetric results is rather homogeneous and is primarily consists of phospholipid with headgroups of inositidic and/or glycosidic nature. The comparative study demonstrated that PFE is an alternative suitable technique to extract total lipid content from homogenized cod (lean fish) and herring (fat fish) muscle showing a precision comparable to that obtained with the traditional and modified Jensen methods. Despite the necessary cleanup step, PFE showed important advantages in the solvent consumption was cut by approximately 50% and automated extraction was possible.

Obesity resistant mechanisms in the Lean polygenic mouse model as indicated by liver transcriptome and expression of selected genes in skeletal muscle

PubMed Central

2011-01-01

Background Divergently selected Lean and Fat mouse lines represent unique models for a polygenic form of resistance and susceptibility to obesity development. Previous research on these lines focused mainly on obesity-susceptible factors in the Fat line. This study aimed to examine the molecular basis of obesity-resistant mechanisms in the Lean line by analyzing various fat depots and organs, the liver transcriptome of selected metabolic pathways, plasma and lipid homeostasis and expression of selected skeletal muscle genes. Results Expression profiling using our custom Steroltalk v2 microarray demonstrated that Lean mice exhibit a higher hepatic expression of cholesterol biosynthesis genes compared to the Fat line, although this was not reflected in elevation of total plasma or liver cholesterol. However, FPLC analysis showed that protective HDL cholesterol was elevated in Lean mice. A significant difference between the strains was also found in bile acid metabolism. Lean mice had a higher expression of Cyp8b1, a regulatory enzyme of bile acid synthesis, and the Abcb11 bile acid transporter gene responsible for export of acids to the bile. Additionally, a higher content of blood circulating bile acids was observed in Lean mice. Elevated HDL and upregulation of some bile acids synthesis and transport genes suggests enhanced reverse cholesterol transport in the Lean line - the flux of cholesterol out of the body is higher which is compensated by upregulation of endogenous cholesterol biosynthesis. Increased skeletal muscle Il6 and Dio2 mRNA levels as well as increased activity of muscle succinic acid dehydrogenase (SDH) in the Lean mice demonstrates for the first time that changes in muscle energy metabolism play important role in the Lean line phenotype determination and corroborate our previous findings of increased physical activity and thermogenesis in this line. Finally, differential expression of Abcb11 and Dio2 identifies novel strong positional candidate genes as they map within the quantitative trait loci (QTL) regions detected previously in crosses between the Lean and Fat mice. Conclusion We identified novel candidate molecular targets and metabolic changes which can at least in part explain resistance to obesity development in the Lean line. The major difference between the Lean and Fat mice was in increased liver cholesterol biosynthesis gene mRNA expression, bile acid metabolism and changes in selected muscle genes' expression in the Lean line. The liver Abcb11 and muscle Dio2 were identified as novel positional candidate genes to explain part of the phenotypic difference between the Lean and Fat lines. PMID:21291556

Manufacture of high aspect ratio micro-pillar wall shear stress sensor arrays

NASA Astrophysics Data System (ADS)

Gnanamanickam, Ebenezer P.; Sullivan, John P.

2012-12-01

In the field of experimental fluid mechanics the measurement of unsteady, distributed wall shear stress has proved historically challenging. Recently, sensors based on an array of flexible micro-pillars have shown promise in carrying out such measurements. Similar sensors find use in other applications such as cellular mechanics. This work presents a manufacturing technique that can manufacture micro-pillar arrays of high aspect ratio. An electric discharge machine (EDM) is used to manufacture a micro-drilling tool. This micro-drilling tool is used to form holes in a wax sheet which acts as the mold for the micro-pillar array. Silicone rubber is cast in these molds to yield a micro-pillar array. Using this technique, micro-pillar arrays with a maximum aspect ratio of about 10 have been manufactured. Manufacturing issues encountered, steps to alleviate them and the potential of the process to manufacture similar micro-pillar arrays in a time-efficient manner are also discussed.

Performance modeling of automated manufacturing systems

NASA Astrophysics Data System (ADS)

Viswanadham, N.; Narahari, Y.

A unified and systematic treatment is presented of modeling methodologies and analysis techniques for performance evaluation of automated manufacturing systems. The book is the first treatment of the mathematical modeling of manufacturing systems. Automated manufacturing systems are surveyed and three principal analytical modeling paradigms are discussed: Markov chains, queues and queueing networks, and Petri nets.

Using Dynamic Value Stream Mapping and Lean Accounting Box Scores to Support Lean Implementation

ERIC Educational Resources Information Center

Woehrle, Stephen L.; Abou-Shady, Louay

2010-01-01

Lean has proven to be an effective management philosophy for improving businesses in a competitive market by eliminating waste and improving operations. An impact of implementing lean projects is the rapid reduction in inventory levels, which gives management the false impression that profits are decreasing while workers on the shop floor observe…

[Application of digital design and three-dimensional printing technique on individualized medical treatment].

PubMed

Qin, Mian; Liu, Yaxiong; He, Jiankang; Wang, Ling; Lian, Qin; Li, Dichen; Jin, Zhongmin; He, Sanhu; Li, Gang; Liu, Yanpu; Wang, Zhen

2014-03-01

To summarize the latest research development of the application of digital design and three-dimensional (3-D) printing technique on individualized medical treatment. Recent research data and clinical literature about the application of digital design and 3-D printing technique on individualized medical treatment in Xi'an Jiaotong University and its cooperation unit were summarized, reviewed, and analyzed. Digital design and 3-D printing technique can design and manufacture individualized implant based on the patient's specific disease conditions. And the implant can satisfy the needs of specific shape and function of the patient, reducing dependence on the level of experience required for the doctor. So 3-D printing technique get more and more recognition of the surgeon on the individualized repair of human tissue. Xi'an Jiaotong University is the first unit to develop the commercial 3-D printer and conduct depth research on the design and manufacture of individualized medical implant. And complete technological processes and quality standards of product have been developed. The individualized medical implant manufactured by 3-D printing technique can not only achieve personalized match but also meet the functional requirements and aesthetic requirements of patients. In addition, the individualized medical implant has the advantages of accurate positioning, stable connection, and high strength. So 3-D printing technique has broad prospects in the manufacture and application of individualized implant.

Cleaning Process Development for Metallic Additively Manufactured Parts

NASA Technical Reports Server (NTRS)

Tramel, Terri L.; Welker, Roger; Lowery, Niki; Mitchell, Mark

2014-01-01

Additive Manufacturing of metallic components for aerospace applications offers many advantages over traditional manufacturing techniques. As a new technology, many aspects of its widespread utilization remain open to investigation. Among these are the cleaning processes that can be used for post finishing of parts and measurements to verify effectiveness of the cleaning processes. Many cleaning and drying processes and measurement methods that have been used for parts manufactured using conventional techniques are candidates that may be considered for cleaning and verification of additively manufactured parts. Among these are vapor degreasing, ultrasonic immersion and spray cleaning, followed by hot air drying, vacuum baking and solvent displacement drying. Differences in porosity, density, and surface finish of additively manufactured versus conventionally manufactured parts may introduce new considerations in the selection of cleaning and drying processes or the method used to verify their effectiveness. This presentation will review the relative strengths and weaknesses of different candidate cleaning and drying processes as they may apply to additively manufactured metal parts for aerospace applications. An ultrasonic cleaning technique for exploring the cleanability of parts will be presented along with an example using additively manufactured Inconel 718 test specimens to illustrate its use. The data analysis shows that this ultrasonic cleaning approach results in a well-behaved ultrasonic cleaning/extraction behavior. That is, it does not show signs of accelerated cavitation erosion of the base material, which was later confirmed by neutron imaging. In addition, the analysis indicated that complete cleaning would be achieved by ultrasonic immersion cleaning at approximately 5 minutes, which was verified by subsequent cleaning of additional parts.

The development of additive manufacturing technique for nickel-base alloys: A review

NASA Astrophysics Data System (ADS)

Zadi-Maad, Ahmad; Basuki, Arif

2018-04-01

Nickel-base alloys are an attractive alloy due to its excellent mechanical properties, a high resistance to creep deformation, corrosion, and oxidation. However, it is a hard task to control performance when casting or forging for this material. In recent years, additive manufacturing (AM) process has been implemented to replace the conventional directional solidification process for the production of nickel-base alloys. Due to its potentially lower cost and flexibility manufacturing process, AM is considered as a substitute technique for the existing. This paper provides a comprehensive review of the previous work related to the AM techniques for Ni-base alloys while highlighting current challenges and methods to solving them. The properties of conventionally manufactured Ni-base alloys are also compared with the AM fabricated alloys. The mechanical properties obtained from tension, hardness and fatigue test are included, along with discussions of the effect of post-treatment process. Recommendations for further work are also provided.

Using Laser Ultrasound to Detect Subsurface Defects in Metal Laser Powder Bed Fusion Components

NASA Astrophysics Data System (ADS)

Everton, Sarah; Dickens, Phill; Tuck, Chris; Dutton, Ben

2018-03-01

Laser powder bed fusion offers many advantages over conventional manufacturing methods, such as the integration of multiple parts that can result in significant weight-savings. The increased design freedom that layer-wise manufacture allows has also been seen to enhance component performance at little or no added cost. For such benefits to be realized, however, the material quality must first be assured. Laser ultrasonic testing is a noncontact inspection technique that has been proposed as suitable for in situ monitoring of metal additive manufacturing processes. This article explores the current capability of this technique to detect manufactured, subsurface defects in Ti-6Al-4V samples, ex situ. The results are compared with x-ray computed tomography reconstructions and focus variation microscopy. Although laser ultrasound has been used to identify material discontinuities, further work is required before this technique could be implemented in situ.

JPRS Report, West Europe.

DTIC Science & Technology

1988-03-11

press . This is an absolute crime in Raes’ eyes. Using the "umbrella technique" with consummate art, officials lost no time in informing against...company, which was publishing 200 copies of the INFO- REP bulletin, a daily press review, anti-communist in leaning, was housed in the same...12. Engines: 2 450-hp engines 13. Speed: 13 knots 14. Weapons: 2 machineguns the press , relay information to participating boats, func- "The Naval

Synchronization of workshops, using facilities planning

NASA Astrophysics Data System (ADS)

Zineb, Britel; Abdelghani, Cherkaoui

2017-08-01

In this paper, we will present a methodology used for the synchronization of two workshops of a sheet metal department. These two workshops have a supplier-customer relationship. The aim of the study is to synchronise the two workshops as a step towards creating a better material flow, reduced inventory and achieving Just in time and lean production. To achieve this, we used a different set of techniques: SMED, Facilities planning…

In healthy elderly postmenopausal women variations in BMD and BMC at various skeletal sites are associated with differences in weight and lean body mass rather than by variations in habitual physical activity, strength or VO2max.

PubMed

Schöffl, I; Kemmler, W; Kladny, B; Vonstengel, S; Kalender, W A; Engelke, K

2008-01-01

The objective of this study was an integrated cross-sectional investigation for answering the question whether differences in bone mineral density in elderly postmenopausal women are associated with differences in habitual physical activity and unspecific exercise levels. Two hundred and ninety nine elderly women (69-/+3 years), without diseases or medication affecting bone metabolism were investigated. The influence of weight, body composition and physical activity on BMD was measured at multiple sites using different techniques (DXA, QCT, and QUS). Physical activity and exercise level were assessed by questionnaire, maximum strength of the legs and aerobic capacity. Variations in physical activity or habitual exercise had no effect on bone. The only significant univariate relation between strength/VO(2)max and BMD/BMC that remained after adjusting for confounding variables was between arm BMD (DXA) and hand-grip strength. The most important variable for explaining BMD was weight and for cortical BMC of the femur (QCT) lean body mass. Weight and lean body mass emerge as predominant predictors of BMD in normal elderly women, whereas the isolated effect of habitual physical activity, unspecific exercise participation, and muscle strength on bone parameters is negligible. Thus, an increase in the amount of habitual physical activity will probably have no beneficial impact on bone.

Application of Lean Sigma to the Audiology Clinic at a Large Academic Center.

PubMed

Huddle, Matthew G; Tirabassi, Amy; Turner, Laurie; Lee, Emily; Ries, Kathryn; Lin, Sandra Y

2016-04-01

To apply Lean Sigma--a quality improvement strategy to eliminate waste and reduce variation and defects--to improve audiology scheduling and utilization in a large tertiary care referral center. The project goals included an increase in utilization rates of audiology block time and a reduction in appointment lead time. Prospective quality improvement study. Academic tertiary care center. All patients scheduling audiology clinic visits July 2013 to July 2014. Value stream mapping was performed for the audiology scheduling process, and wasteful steps were identified for elimination. Interventions included a 2-week block release, audiology template revision, and reduction of underutilized blocks. Schedule utilization and lead time for new patient diagnostic audiogram were measured for 5 months postintervention and compared with 5 months preintervention. Overall, 2995 preintervention and 3714 postintervention booked appointments were analyzed. Block utilization increased from 77% to 90% after intervention (P < .0001). Utilization of joint-with-provider visits increased from 39% to 67% (P < .0001). Booked appointments increased from 2995 to 3714, with joint-with-provider booked appointments increasing from 317 to 1193. Appointment lead time averaged 24 days postintervention, compared with 29 days preintervention (P = .06). Average monthly relative value units measured 13,321 preintervention and 14,778 postintervention (P = .09). Lean Sigma techniques were successfully used to increase appointment block utilization and streamline scheduling practices. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Comparison of the gut microbial community between obese and lean peoples using 16S gene sequencing in a Japanese population.

PubMed

Andoh, Akira; Nishida, Atsushi; Takahashi, Kenichiro; Inatomi, Osamu; Imaeda, Hirotsugu; Bamba, Shigeki; Kito, Katsuyuki; Sugimoto, Mitsushige; Kobayashi, Toshio

2016-07-01

Altered gut microbial ecology contributes to the development of metabolic diseases including obesity. In this study, we performed 16S rRNA sequence analysis of the gut microbiota profiles of obese and lean Japanese populations. The V3-V4 hypervariable regions of 16S rRNA of fecal samples from 10 obese and 10 lean volunteers were sequenced using the Illumina MiSeq(TM)II system. The average body mass index of the obese and lean group were 38.1 and 16.6 kg/m(2), respectively (p<0.01). The Shannon diversity index was significantly higher in the lean group than in the obese group (p<0.01). The phyla Firmicutes and Fusobacteria were significantly more abundant in obese people than in lean people. The abundance of the phylum Bacteroidetes and the Bacteroidetes/Firmicutes ratio were not different between the obese and lean groups. The genera Alistipes, Anaerococcus, Corpococcus, Fusobacterium and Parvimonas increased significantly in obese people, and the genera Bacteroides, Desulfovibrio, Faecalibacterium, Lachnoanaerobaculum and Olsenella increased significantly in lean people. Bacteria species possessing anti-inflammatory properties, such as Faecalibacterium prausnitzii, increased significantly in lean people, but bacteria species possessing pro-inflammatory properties increased in obese people. Obesity-associated gut microbiota in the Japanese population was different from that in Western people.

Lean Six Sigma implementation and organizational culture.

PubMed

Knapp, Susan

2015-01-01

The purpose of this paper is to examine the relationship between four organizational cultural types defined by the Competing Values Framework and three Lean Six Sigma implementation components - management involvement, use of Lean Six Sigma methods and Lean Six Sigma infrastructure. The study involved surveying 446 human resource and quality managers from 223 hospitals located in Maine, New Hampshire, Vermont, Massachusetts and Rhode Island using the Organizational Culture Assessment Instrument. Findings - In total, 104 completed responses were received and analyzed using multivariate analysis of variance. Follow-up analysis of variances showed management support was significant, F(3, 100)=4.89, p < 0.01, η2=1.28; infrastructure was not significant, F(3, 100)=1.55, p=0.21, η2=0.05; and using Lean Six Sigma methods was also not significant, F(3, 100)=1.34, p=0.26, η2=0.04. Post hoc analysis identified group and development cultures having significant interactions with management support. The relationship between organizational culture and Lean Six Sigma in hospitals provides information on how specific cultural characteristics impact the Lean Six Sigma initiative key components. This information assists hospital staff who are considering implementing quality initiatives by providing an understanding of what cultural values correspond to effective Lean Six Sigma implementation. Managers understanding the quality initiative cultural underpinnings, are attentive to the culture-shared values and norm's influence can utilize strategies to better implement Lean Six Sigma.

Characterization of Metal Powders Used for Additive Manufacturing.

PubMed

Slotwinski, J A; Garboczi, E J; Stutzman, P E; Ferraris, C F; Watson, S S; Peltz, M A

2014-01-01

Additive manufacturing (AM) techniques can produce complex, high-value metal parts, with potential applications as critical parts, such as those found in aerospace components. The production of AM parts with consistent and predictable properties requires input materials (e.g., metal powders) with known and repeatable characteristics, which in turn requires standardized measurement methods for powder properties. First, based on our previous work, we assess the applicability of current standardized methods for powder characterization for metal AM powders. Then we present the results of systematic studies carried out on two different powder materials used for additive manufacturing: stainless steel and cobalt-chrome. The characterization of these powders is important in NIST efforts to develop appropriate measurements and standards for additive materials and to document the property of powders used in a NIST-led additive manufacturing material round robin. An extensive array of characterization techniques was applied to these two powders, in both virgin and recycled states. The physical techniques included laser diffraction particle size analysis, X-ray computed tomography for size and shape analysis, and optical and scanning electron microscopy. Techniques sensitive to structure and chemistry, including X-ray diffraction, energy dispersive analytical X-ray analysis using the X-rays generated during scanning electron microscopy, and X-Ray photoelectron spectroscopy were also employed. The results of these analyses show how virgin powder changes after being exposed to and recycled from one or more Direct Metal Laser Sintering (DMLS) additive manufacturing build cycles. In addition, these findings can give insight into the actual additive manufacturing process.

An update on coating/manufacturing techniques of microneedles.

PubMed

Tarbox, Tamara N; Watts, Alan B; Cui, Zhengrong; Williams, Robert O

2017-12-29

Recently, results have been published for the first successful phase I human clinical trial investigating the use of dissolving polymeric microneedles… Even so, further clinical development represents an important hurdle that remains in the translation of microneedle technology to approved products. Specifically, the potential for accumulation of polymer within the skin upon repeated application of dissolving and coated microneedles, combined with a lack of safety data in humans, predicates a need for further clinical investigation. Polymers are an important consideration for microneedle technology-from both manufacturing and drug delivery perspectives. The use of polymers enables a tunable delivery strategy, but the scalability of conventional manufacturing techniques could arguably benefit from further optimization. Micromolding has been suggested in the literature as a commercially viable means to mass production of both dissolving and swellable microneedles. However, the reliance on master molds, which are commonly manufactured using resource intensive microelectronics industry-derived processes, imparts notable material and design limitations. Further, the inherently multi-step filling and handling processes associated with micromolding are typically batch processes, which can be challenging to scale up. Similarly, conventional microneedle coating processes often follow step-wise batch processing. Recent developments in microneedle coating and manufacturing techniques are highlighted, including micromilling, atomized spraying, inkjet printing, drawing lithography, droplet-born air blowing, electro-drawing, continuous liquid interface production, 3D printing, and polyelectrolyte multilayer coating. This review provides an analysis of papers reporting on potentially scalable production techniques for the coating and manufacturing of microneedles.

Extension of the Vane Pump-Grinder Technology to Manufacture Finely Dispersed Meat Batters.

PubMed

Irmscher, Stefan B; Gibis, Monika; Herrmann, Kurt; Oechsle, Anja Maria; Kohlus, Reinhard; Weiss, Jochen

2016-03-01

A vane pump-grinder system was extended to enable the manufacture of finely dispersed emulsion-type sausages by constructing and attaching a high-shear homogenizer at the outlet. We hypothesized that the dispersing capabilities of the extended system may be improved to the point of facilitating meat-fat emulsification due to an overall increased volumetric energy input EV . Coarsely ground raw material mixtures were processed to yield meat batters at varying volume flow rates (10 to 60 L/min) and rotational rotor speeds of the homogenizer nrotor (1000 to 3400 rpm). The normalized torques acting on pump, grinder, and homogenizer motors were recorded and unit power consumptions were calculated. The structure of the manufactured meat batters and sausages were analyzed via image analysis. Key physicochemical properties of unheated and heated batters, that is, texture, water-binding, color, and solubilized protein were determined. The mean diameter d10 of the visible lean meat particles varied between 352 and 406 μm whereas the mean volume-surface diameter d32 varied between 603 and 796 μm. The lightness L* ranged from 66.2 to 70.7 and correlated with the volumetric energy input and product structure. By contrast, varying process parameters did not impact color values a* (approximately 11) and b* (approximately 8). Interestingly, water-binding and protein solubilization were not affected. An exponential process-structure relationship was identified allowing manufacturers to predict product properties as a function of applied process parameters. Raw material mixtures can be continuously comminuted, emulsified, and subsequently filled into casings using an extended vane pump-grinder. © 2016 Institute of Food Technologists®

Strategies of performance self-monitoring in automotive production.

PubMed

Faye, Hélène; Falzon, Pierre

2009-09-01

Production in the automotive industry, based on assembly line work, is now characterized by lean manufacturing and customization. This results in greater flexibility and increased quality demands, including worker performance self-monitoring. The objectives of this study are to refine the concept of performance self-monitoring and to characterize the strategies developed by operators to achieve it. Data were collected based on the method of individual auto-confrontation, consisting of two steps: eleven assembly-line operators of a French automotive company were individually observed and video-taped while they were working; an interview then allowed each operator to discuss his/her activity based on the video-tape. This study expands the concept of performance self-monitoring by highlighting three types of strategies directly oriented toward quality: prevention, feedback control and control action strategies.

Trunk lean gait decreases multi-segmental coordination in the vertical direction.

PubMed

Tokuda, Kazuki; Anan, Masaya; Sawada, Tomonori; Tanimoto, Kenji; Takeda, Takuya; Ogata, Yuta; Takahashi, Makoto; Kito, Nobuhiro; Shinkoda, Koichi

2017-11-01

[Purpose] The strategy of trunk lean gait to reduce external knee adduction moment (KAM) may affect multi-segmental synergy control of center of mass (COM) displacement. Uncontrolled manifold (UCM) analysis is an evaluation index to understand motor variability. The purpose of this study was to investigate how motor variability is affected by using UCM analysis on adjustment of the trunk lean angle. [Subjects and Methods] Fifteen healthy young adults walked at their preferred speed under two conditions: normal and trunk lean gait. UCM analysis was performed with respect to the COM displacement during the stance phase. The KAM data were analyzed at the points of the first KAM peak during the stance phase. [Results] The KAM during trunk lean gait was smaller than during normal gait. Despite a greater segmental configuration variance with respect to mediolateral COM displacement during trunk lean gait, the synergy index was not significantly different between the two conditions. The synergy index with respect to vertical COM displacement during trunk lean gait was smaller than that during normal gait. [Conclusion] These results suggest that trunk lean gait is effective in reducing KAM; however, it may decrease multi-segmental movement coordination of COM control in the vertical direction.

The impact of genetics on retail meat value in Australian lamb.

PubMed

Anderson, F; Pethick, D W; Gardner, G E

2016-07-01

Lean (muscle), fat, and bone composition of 1554 lamb carcasses from Maternal, Merino and Terminal sired lambs was measured using computed tomography scanning. Lamb sires were diverse in their range of Australian Sheep Breeding Values for post weaning c-site eye muscle depth (PEMD) and fat depth (PFAT), and post weaning weight (PWWT). Lean value, representing predicted lean weight multiplied by retail value, was determined for lambs at the same carcass weight or the same age. At the same carcass weight, lean value was increased the most by reducing sire PFAT, followed by increasing PEMD and PWWT. However for lambs of the same age, increasing sire PWWT increased lean value the most. Terminal sired lambs, on average, had greater lean value irrespective of whether comparisons were made at the same age or weight. Lean value was greater in Merino compared to Maternal sired lambs at equal carcass weight, however the reverse was true when comparisons were made at the same age. Copyright © 2016 Elsevier Ltd. All rights reserved.

Aluminum space frame technology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Birch, S.

This article examines the increased application of aluminum to the construction of automobile frames. The topics of the article include a joint venture between Audi and Alcoa, forms in which aluminum is used, new alloys and construction methods, meeting rigidity and safety levels, manufacturing techniques, the use of extrusions, die casting, joining techniques, and pollution control during manufacturing.

A comparison of outcomes involving highly cohesive, form-stable breast implants from two manufacturers in patients undergoing primary breast augmentation.

PubMed

Jewell, Mark L; Jewell, James L

2010-01-01

Although there have been reports of single-surgeon outcomes with highly cohesive, form-stable silicone gel implants in women undergoing primary breast augmentation, there has been only one study published that compares the outcomes between the Allergan 410 and the Mentor CPG devices. The goal of the study is to compare outcomes in each cohort and to determine if quality systems and processes would have an impact on lowering the surgical revision rate, as compared to published reports for round gel implants and form-stable implants. Patients selected for the study were required to meet predefined inclusion criteria and general indications for breast augmentation. All subjects were treated uniformly with extensive informed consent prior to surgery. The entire process of breast augmentation (patient assessment, informed consent, the surgical procedure itself and postoperative instructions) was identical between the two groups. Patients were not randomized, as the studies did not start at the same time. The process for management of each patient was based on adaptation of the Toyota Production System and Lean Manufacturing, with emphasis on achieving operational excellence in the use of planning templates for surgery, including accurate management of patient expectations regarding size outcome. Outcomes data included physical breast measurements, quality of life metrics, and patient/surgeon satisfaction assessment. Adverse events were compared against published data for breast implants. Follow-up ranged between 20-77 months (Allergan 410) and 16-77 months (Mentor CPG). The outcome data indicate that these devices produce natural-appearing breasts with extremely low aggregate reoperation rate (4.2%). Only 0.8% of the reoperations were attributable to surgeon-related factors. There were no reoperations to correct mismanaged size expectations during the course of each study. There were 13 pregnancies and no difficulties with lactation were reported. Rippling (lateral/medial, palpable and/or visible) was encountered in both cohorts. The Mentor CPG cohort had a fivefold greater incidence of rippling (37.3% versus 7.6% in Allergan 410 cohort). This was highly statistically significant (P < .001). Provided that there is adherence to core principles and avoidance of errors in planning, patient expectations, and surgery, highly cohesive, form-stable breast implants can deliver excellent long term outcomes in primary breast augmentation in a diverse patient population. The impact of quality processes such as Toyota Production System and Lean Manufacturing was substantive in delivering operational excellence in primary breast augmentation.

Leaning to the left makes the Eiffel Tower seem smaller: posture-modulated estimation.

PubMed

Eerland, Anita; Guadalupe, Tulio M; Zwaan, Rolf A

2011-12-01

In two experiments, we investigated whether body posture influences people's estimation of quantities. According to the mental-number-line theory, people mentally represent numbers along a line with smaller numbers on the left and larger numbers on the right. We hypothesized that surreptitiously making people lean to the right or to the left would affect their quantitative estimates. Participants answered estimation questions while standing on a Wii Balance Board. Posture was manipulated within subjects so that participants answered some questions while they leaned slightly to the left, some questions while they leaned slightly to the right, and some questions while they stood upright. Crucially, participants were not aware of this manipulation. Estimates were significantly smaller when participants leaned to the left than when they leaned to the right.

Automotive Manufacturing Processes. Volume II - Manufacturing Processes for Passive Restraint Systems

DOT National Transportation Integrated Search

1981-02-01

Extensive material substitution and resizing of the domestic automotive fleet, as well as the introduction of new technologies, will require major changes in the techniques and equipment used in the various manufacturing processes employed in the pro...

Producing Hybrid Metal Composites by Combining Additive Manufacturing and Casting

DOE PAGES

Pawlowski, Alex E.; Splitter, Derek A.; Muth, Thomas R.; ...

2017-10-01

Additive manufacturing by itself provides many benefits, but by combining different materials processing techniques like traditional casting with additive manufacturing to create hybrid processes, custom materials can be tailor-made and mass produced for applications with specific performance needs.

Design and manufacturing of the CFRP lightweight telescope structure

NASA Astrophysics Data System (ADS)

Stoeffler, Guenter; Kaindl, Rainer

2000-06-01

Design of earthbound telescopes is normally based on conventional steel constructions. Several years ago thermostable CFRP Telescope and reflector structures were developed and manufacturing for harsh terrestrial environments. The airborne SOFIA TA requires beyond thermostability an excessive stiffness to mass ratio for the structure fulfilling performance and not to exceed mass limitations by the aircraft Boeing 747 SP. Additional integration into A/C drives design of structure subassemblies. Thickness of CFRP Laminates, either filament wound or prepreg manufactured need special attention and techniques to gain high material quality according to aerospace requirements. Sequential shop assembly of the structure subassemblies minimizes risk for assembling TA. Design goals, optimization of layout and manufacturing techniques and results are presented.

The Lean and Environment Toolkit

EPA Pesticide Factsheets

This Lean and Environment Toolkit assembles practical experience collected by the U.S. Environmental Protection Agency (EPA) and partner companies and organizations that have experience with coordinating Lean implementation and environmental management.

Wide range operation of advanced low NOx aircraft gas turbine combustors

NASA Technical Reports Server (NTRS)

Roberts, P. B.; Fiorito, R. J.; Butze, H. F.

1978-01-01

The paper summarizes the results of an experimental test rig program designed to define and demonstrates techniques which would allow the jet-induced circulation and vortex air blast combustors to operate stably with acceptable emissions at simulated engine idle without compromise to the low NOx emissions under the high-altitude supersonic cruise condition. The discussion focuses on the test results of the key combustor modifications for both the simulated engine idle and cruise conditions. Several range-augmentation techniques are demonstrated that allow the lean-reaction premixed aircraft gas turbine combustor to operate with low NOx emissons at engine cruise and acceptable CO and UHC levels at engine idle. These techniques involve several combinations, including variable geometry and fuel switching designs.

Exploring the Development of Competence in Lean Management through Action Learning Groups: A Study of the Introduction of Lean to a Facilities Management Function

ERIC Educational Resources Information Center

Wyton, Paul; Payne, Robin

2014-01-01

The introduction of a Lean approach to management requires the development of understanding and capability. This in turn requires a structured training intervention and other supporting activities. This paper explores, through a case study, the way in which action learning groups (ALGs) supported the development of Lean capabilities in the…

Lean and leadership practices: development of an initial realist program theory.

PubMed

Goodridge, Donna; Westhorp, Gill; Rotter, Thomas; Dobson, Roy; Bath, Brenna

2015-09-07

Lean as a management system has been increasingly adopted in health care settings in an effort to enhance quality, capacity and safety, while simultaneously containing or reducing costs. The Ministry of Health in the province of Saskatchewan, Canada has made a multi-million dollar investment in Lean initiatives to create "better health, better value, better care, and better teams", affording a unique opportunity to advance our understanding of the way in which Lean philosophy, principles and tools work in health care. In order to address the questions, "What changes in leadership practices are associated with the implementation of Lean?" and "When leadership practices change, how do the changed practices contribute to subsequent outcomes?", we used a qualitative, multi-stage approach to work towards developing an initial realist program theory. We describe the implications of realist assumptions for evaluation of this Lean initiative. Formal theories including Normalization Process Theory, Theories of Double Loop and Organization Leaning and the Theory of Cognitive Dissonance help understand this initial rough program theory. Data collection included: key informant consultation; a stakeholder workshop; documentary review; 26 audiotaped and transcribed interviews with health region personnel; and team discussions. A set of seven initial hypotheses regarding the manner in which Lean changes leadership practices were developed from our data. We hypothesized that Lean, as implemented in this particular setting, changes leadership practices in the following ways. Lean: a) aligns the aims and objectives of health regions; b) authorizes attention and resources to quality improvement and change management c) provides an integrated set of tools for particular tasks; d) changes leaders' attitudes or beliefs about appropriate leadership and management styles and behaviors; e) demands increased levels of expertise, accountability and commitment from leaders; f) measures and uses data effectively to identify actual and relevant local problems and the root causes of those problems; and g) creates or supports a 'learning organization' culture. This study has generated initial hypotheses and realist program theory that can form the basis for future evaluation of Lean initiatives. Developing leadership capacity and culture is theorized to be a necessary precursor to other systemic and observable changes arising from Lean initiatives.

Experiences of leaders in the implementation of Lean in a teaching hospital—barriers and facilitators in clinical practices: a qualitative study

PubMed Central

Aij, Kjeld Harald; Simons, Frederique Elisabeth; Widdershoven, Guy A M; Visse, Merel

2013-01-01

Objectives To date, experiences of leaders in the implementation of Lean after a Lean Training Programme have not been systematically investigated within teaching hospitals. Existing studies have identified barriers and facilitators only from an improvement programme perspective and have not considered the experiences of leaders themselves. This study aims to bridge this gap. Design Semistructured, indepth interviews. Setting One of largest teaching hospitals in the Netherlands. Participants 31 medical, surgical and nursing professionals with an average of 19.2 years of supervisory experience. All professionals were appointed to a Lean Training Programme and were directly involved in the implementation of Lean. Results The evidence obtained in this study shows that, from the perspectives of participants, leadership management support, a continuous learning environment and cross-departmental cooperation play a significant role in successful Lean implementation. The results suggest that a Lean Training Programme contributed to positive outcomes in personal and professional skills that were evident during the first 4 months after programme completion. Conclusions Implementing Lean in a teaching hospital setting is a challenge because of the ambiguous and complex environment of a highly professionalised organisation. The study found that leadership management support and a continuous learning environment are important facilitators of Lean implementation. To increase the successful outcomes of leadership actions, training should be supplemented with actions to remove perceived barriers. This requires the involvement of all professionals, the crossing of departmental boundaries and a focus on meaning-making processes rather than simply ‘implementing’ facts. Therefore, this research suggests that programme participants, such as staff members and leaders, can mutually explore the meanings of Lean thinking and working for their own contexts. By entering this shared learning process (eg, learning on the job) the ownership of Lean implementation could also increase. PMID:24171938

A questionnaire measuring staff perceptions of Lean adoption in healthcare: development and psychometric testing.

PubMed

Kaltenbrunner, Monica; Bengtsson, Lars; Mathiassen, Svend Erik; Engström, Maria

2017-03-24

During the past decade, the concept of Lean has spread rapidly within the healthcare sector, but there is a lack of instruments that can measure staff's perceptions of Lean adoption. Thus, the aim of the present study was to develop a questionnaire measuring Lean in healthcare, based on Liker's description of Lean, by adapting an existing instrument developed for the service sector. A mixed-method design was used. Initially, items from the service sector instrument were categorized according to Liker's 14 principles describing Lean within four domains: philosophy, processes, people and partners and problem-solving. Items were lacking for three of Liker's principles and were therefore developed de novo. Think-aloud interviews were conducted with 12 healthcare staff from different professions to contextualize and examine the face validity of the questionnaire prototype. Thereafter, the adjusted questionnaire's psychometric properties were assessed on the basis of a cross-sectional survey among 386 staff working in primary care. The think-aloud interviews led to adjustments in the questionnaire to better suit a healthcare context, and the number of items was reduced. Confirmatory factor analysis of the adjusted questionnaire showed a generally acceptable correspondence with Liker's description of Lean. Internal consistency, measured using Cronbach's alpha, for the factors in Liker's description of Lean was 0.60 for the factor people and partners, and over 0.70 for the three other factors. Test-retest reliability measured by the intra-class correlation coefficient ranged from 0.77 to 0.88 for the four factors. We designed a questionnaire capturing staff's perceptions of Lean adoption in healthcare on the basis of Liker's description. This Lean in Healthcare Questionnaire (LiHcQ) showed generally acceptable psychometric properties, which supports its usability for measuring Lean adoption in healthcare. We suggest that further research focus on verifying the usability of LiHcQ in other healthcare settings, and on adjusting the instrument if needed.