Sample records for lean stability limit

  1. 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.

  2. 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.

  3. 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.

  4. Experimental study of the effects of secondary air on the emissions and stability of a lean premixed combustor

    NASA Technical Reports Server (NTRS)

    Roffe, G.; Raman, R. S. V.

    1981-01-01

    Tests were run using a perforated plate flameholder with a relatively short attached recirculation zone and a vee gutter flameholder with a relatively long attached recirculation zone. Combustor streamlines were traced in cold flow tests at ambient pressure. The amount of secondary air entrainment in the recirculation zones of the flameholders was determined by tracer gas testing at cold flow ambient pressure conditions. Combustion tests were caried out at entrance conditions of 0.5 MPa/630K and emission of NOx, CO and unburned hydrocarbons were measured along with lean stability and flashback limits. The degree of entrainment increases as dilution air injection decreases. Flashback appears to be a function of overall equivalence ratio and resistance to flashback increases with increasing combustor entrance velocity. Lean stability limit appears to be a function of both primary zone and flameholder recirculation zone equivalence ratios and resistance to lean blowout increases with increasing combustor entrance velocity.

  5. 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.

  6. Laboratory studies of lean combustion

    NASA Technical Reports Server (NTRS)

    Sawyer, R. F.; Schefer, R. W.; Ganji, A. R.; Daily, J. W.; Pitz, R. W.; Oppenheim, A. K.; Angeli, J. W.

    1977-01-01

    The fundamental processes controlling lean combustion were observed for better understanding, with particular emphasis on the formation and measurement of gas-phase pollutants, the stability of the combustion process (blowout limits), methods of improving stability, and the application of probe and optical diagnostics for flow field characterization, temperature mapping, and composition measurements. The following areas of investigation are described in detail: (1) axisymmetric, opposed-reacting-jet-stabilized combustor studies; (2) stabilization through heat recirculation; (3) two dimensional combustor studies; and (4) spectroscopic methods. A departure from conventional combustor design to a premixed/prevaporized, lean combustion configuration is attractive for the control of oxides of nitrogen and smoke emissions, the promotion of uniform turbine inlet temperatures, and, possibly, the reduction of carbon monoxide and hydrocarbons at idle.

  7. Increasing Operational Stability in Low NOX GT Combustor Using Fuel Rich Concentric Pilot Combustor

    NASA Astrophysics Data System (ADS)

    Levy, Yeshayahou; Erenburg, Vladimir; Sherbaum, Valery; Ovcharenko, Vitali; Rosentsvit, Leonid; Chudnovsky, Boris; Herszage, Amiel; Talanker, Alexander

    2012-03-01

    Lean combustion is a method in which combustion takes place under low equivalence ratio and relatively low combustion temperatures. As such, it has the potential to lower the effect of the relatively high activation energy nitrogen-oxygen reactions which are responsible for substantial NOX formation during combustion processes. However, lowering temperature reduces the reaction rate and deteriorates combustion stability. The objective of the present study is to reduce the lower equivalence ratio limit of the stable combustion operational boundary in lean Gas Turbine (GT) combustors while still maintaining combustion stability. A lean premixed gaseous combustor was equipped with a surrounding concentric pilot flame operating under rich conditions, thus generating a hot stream of combustion products with significant amount of reactive radicals. The main combustor's fuel-air composition was varied from stoichiometric to lean mixtures. The pilot's mixture composition was also varied by changing the air flow rate, within a limited rich mixtures range. The pilot fuel flow rate was always lower than five percent of the total fuel supply at the specific stage of the experiments.

  8. Postural Stability When Leaning from Perceived Upright

    NASA Technical Reports Server (NTRS)

    Vanya, Robert D.; Grounds, John F.; Wood, Scott J.

    2011-01-01

    The transition between quiet stance and gait requires the volitional movement of one?s center of mass (COM) toward a limit of stability (LOS). The goal of this study was to measure the effect of leaning from perceived upright on postural stability when voluntarily maintaining fixed stance positions and during perturbations of the support surface. The COM was derived from force plate data in 12 healthy subjects while standing with feet positioned so that lateral base of support was equal to foot length. For all conditions, arms were folded and subjects were instructed to lean without bending at the hips or lifting their feet. The LOS was determined during maximal voluntary leans with eyes open and closed. The COM was then displayed on a monitor located in front of the subject. Subjects were visually guided to lean toward a target position, maintain this position for 10s, return to upright, and then repeat the same targeted lean maneuver with eyes closed. Targets were randomly presented at 2? in 8 directions and between 2-6? in these same directions according to the asymmetric LOS. Subjects were then verbally guided to lean between 2? back and 4? forward prior to a perturbation of the support surface in either a forward or backward direction. The average LOS was 5.8? forward, 2.9? back, and 4.8? in left/right directions, with no significant difference between eyes open and closed. Center of pressure (COP) velocity increased as subjects maintained fixed stance positions farther from upright, with increased variability during eyes closed conditions. The time to stability and COP path length increased as subjects leaned opposite to the direction of the support surface perturbations. We conclude that postural stability is compromised as subjects lean away from perceived upright, except for perturbations that induce sway in the direction opposite the lean. The asymmetric LOS relative to perceived upright favors postural stability for COM movements in the forward direction.

  9. Lean Blow-out Studies in a Swirl Stabilized Annular Gas Turbine Combustor

    NASA Astrophysics Data System (ADS)

    Mishra, R. K.; Kishore Kumar, S.; Chandel, Sunil

    2015-05-01

    Lean blow out characteristics in a swirl stabilized aero gas turbine combustor have been studied using computational fluid dynamics. For CFD analysis, a 22.5° sector of an annular combustor is modeled using unstructured tetrahedral meshes comprising 1.2 × 106 elements. The governing equations are solved using the eddy dissipation combustion model in CFX. The primary combustion zone is analyzed by considering it as a well stirred reactor. The analysis has been carried out for different operating conditions of the reactants entering into the control volume. The results are treated as the base-line or reference values. Combustion lean blow-out limits are further characterized studying the behavior of combustion zone during transient engine operation. The validity of the computational study has been established by experimental study on a full-scale annular combustor in an air flow test facility that is capable of simulating different conditions at combustor inlet. The experimental result is in a good agreement with the analytical predictions. Upon increasing the combustor mass flow, the lean blow out limit increases, i.e., the blow out occurs at higher fuel-air ratios. In addition, when the operating pressure decreases, the lean blow out limit increases, i.e., blow out occurs at higher fuel-air ratios.

  10. A ring stabilizer for lean premixed turbulent flames

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

    Johnson, M.R.; Kostiuk, L.W.; Cheng, R.K.

    1998-08-01

    In previous experiments on conical flame behavior in microgravity, which were conducted in drop-towers and in airplanes, the use of a pilot flame was not an option. To permit combustion of stable lean premixed conical flames without a pilot, a ring stabilizer was developed. Although similar types of bluff-body stabilization have been used in the past, the ring stabilizer is somewhat unique. It is designed to fit inside the burner exit port and has demonstrated to be highly effective in stabilizing flames over a very wide range of conditions (including ultra-lean flames at high flow-rates) without adversely affecting flame emissions.more » Unlike a simple rod stabilizer or a stagnation flame system, the benefit of having the stabilizer conform to the burner port is that there is very little leakage of the unburned fuel. The purpose of this brief communication is to offer this simple and highly useful device to the combustion research community. Presented are highlights of a parametric study that measured the stabilization limits and pollutant emissions of several different rings, and demonstrated their potential for use in practical systems.« less

  11. Influence of nanosecond repetitively pulsed discharges on the stability of a swirled propane/air burner representative of an aeronautical combustor

    PubMed Central

    Barbosa, S.; Pilla, G.; Lacoste, D. A.; Scouflaire, P.; Ducruix, S.; Laux, C. O.; Veynante, D.

    2015-01-01

    This paper reports on an experimental study of the influence of a nanosecond repetitively pulsed spark discharge on the stability domain of a propane/air flame. This flame is produced in a lean premixed swirled combustor representative of an aeronautical combustion chamber. The lean extinction limits of the flame produced without and with plasma are determined and compared. It appears that only a low mean discharge power is necessary to increase the flame stability domain. Lastly, the effects of several parameters (pulse repetition frequency, global flowrate, electrode location) are studied. PMID:26170424

  12. Premixing quality and flame stability: A theoretical and experimental study

    NASA Technical Reports Server (NTRS)

    Radhakrishnan, K.; Heywood, J. B.; Tabaczynski, R. J.

    1979-01-01

    Models for predicting flame ignition and blowout in a combustor primary zone are presented. A correlation for the blowoff velocity of premixed turbulent flames is developed using the basic quantities of turbulent flow, and the laminar flame speed. A statistical model employing a Monte Carlo calculation procedure is developed to account for nonuniformities in a combustor primary zone. An overall kinetic rate equation is used to describe the fuel oxidation process. The model is used to predict the lean ignition and blow out limits of premixed turbulent flames; the effects of mixture nonuniformity on the lean ignition limit are explored using an assumed distribution of fuel-air ratios. Data on the effects of variations in inlet temperature, reference velocity and mixture uniformity on the lean ignition and blowout limits of gaseous propane-air flames are presented.

  13. Experimental study of the effect of cycle pressure on lean combustion emissions

    NASA Technical Reports Server (NTRS)

    Roffe, G.; Venkataramani, K. S.

    1978-01-01

    Experiments were conducted in which a stream of premixed propane and air was burned under conditions representative of gas turbine operation. Emissions of NOx, CO, and unburned hydrocarbons (UHC) were measured over a range of combustor inlet temperature, pressure, and residence time at equivalence ratios from 0.7 down to the lean stability limit. At an inlet temperature of 600 K, observed NOx levels dropped markedly with decreasing pressure for pressures below 20 atm. The NOx levels are proportional to combustor residence time and formation rates were principally a function of adiabatic flame temperature. For adiabatic flame temperatures of 2050 K and higher, CO reached chemical equilibrium within 2 msec. Unburned hydrocarbon species dropped to a negligible level within 2 msec regardless of inlet temperature, pressure, or equivalence ratio. For a combustor residence time of 2.5 msec, combustion inefficiency became less than 0.01% at an adiabatic flame temperature of 2050 K. The maximum combustion inefficiency observed was on the order of 1% and corresponded to conditions near the lean stability limit. Using a perforated plate flameholder, this limit is well represented by the condition of 1800 K adiabatic flame temperature.

  14. 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.

  15. Effects of percentage of blockage and flameholder downstream counterbores on lean combustion limits of premixed, prevaporized propane-air mixture

    NASA Technical Reports Server (NTRS)

    Fernandez, M. A. B.

    1983-01-01

    Lean combustion limits were determined for a premixed prevaporized propane air mixture with flat plate flame stabilizers. Experiments were conducted in a constant area flame tube combustor utilizing flameholders of varying percentages of blockage and downstream counterbores. Combustor inlet air velocity at ambient conditions was varied from 4 to 9 meters per second. Flameholders with a center hole and four half holes surrounding it were tested with 63, 73, and 85 percent blockage and counterbore diameters of 112 and 125 percent of the thru hole diameter, in addition to the no counterbore configuration. Improved stability was obtained by using counterbore flameholders and higher percentages of blockage. Increases in mixture velocity caused the equivalence ratio at blowout to increase in all cases.

  16. Low NO(x) potential of gas turbine engines

    NASA Technical Reports Server (NTRS)

    Tacina, Robert R.

    1990-01-01

    The purpose is to correlate emission levels of gas turbine engines. The predictions of NO(x) emissions are based on a review of the literature of previous low NO(x) combustor programs and analytical chemical kinetic calculations. Concepts included in the literature review consisted of lean-premixed-prevaporized (LPP), rich burn/quick quench/lean burn (RQL), and direct injection. The NO(x) emissions were found to be an exponential function of adiabatic combustion temperature over a wide range of inlet temperatures, pressures and (lean) fuel-air ratios. A simple correlation of NO(x) formation with time was not found. The LPP and direct injection (using gaseous fuels) concepts have the lowest NO(x) emissions of the three concepts. The RQL data has higher values of NO(x) than the LPP concept, probably due to the stoichiometric temperatures and NO(x) production that occur during the quench step. Improvements in the quick quench step could reduce the NO(x) emissions to the LPP levels. The low NO(x) potential of LPP is offset by the operational disadvantages of its narrow stability limits and its susceptibility to autoignition/flashback. The Rich-Burn/Quick-Quench/Lean-Burn (RQL) and the direct injection concepts have the advantage of wider stability limits comparable to conventional combustors.

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

    Sevik, James; Wallner, Thomas; Pamminger, Michael

    The efficiency improvement and emissions reduction potential of lean and exhaust gas recirculation (EGR)-dilute operation of spark-ignition gasoline engines is well understood and documented. However, dilute operation is generally limited by deteriorating combustion stability with increasing inert gas levels. The combustion stability decreases due to reduced mixture flame speeds resulting in significantly increased combustion initiation periods and burn durations. A study was designed and executed to evaluate the potential to extend lean and EGR-dilute limits using a low-energy transient plasma ignition system. The low-energy transient plasma was generated by nanosecond pulses and its performance compared to a conventional transistorized coilmore » ignition (TCI) system operated on an automotive, gasoline direct-injection (GDI) single-cylinder research engine. The experimental assessment was focused on steady-state experiments at the part load condition of 1500 rpm 5.6 bar indicated mean effective pressure (IMEP), where dilution tolerance is particularly critical to improving efficiency and emission performance. Experimental results suggest that the energy delivery process of the low-energy transient plasma ignition system significantly improves part load dilution tolerance by reducing the early flame development period. Statistical analysis of relevant combustion metrics was performed in order to further investigate the effects of the advanced ignition system on combustion stability. Results confirm that at select operating conditions EGR tolerance and lean limit could be improved by as much as 20% (from 22.7 to 27.1% EGR) and nearly 10% (from λ = 1.55 to 1.7) with the low-energy transient plasma ignition system.« less

  18. Emission characteristics of a premix combustor fueled with a simulated partial-oxidation product gas

    NASA Technical Reports Server (NTRS)

    Clayton, R. M.

    1979-01-01

    A two-stage gas turbine combustor concept employing a very fuel-rich partial oxidation stage is being explored for broadening the combustion margin between ultralow emissions and the lean stability limit. Combustion and emission results are presented for a series of experiments where a simulated partial oxidation product gas was used in a premix combustor operated with inlet air state conditions typical of cruise power for high-performance aviation engines (12 atm and 850 F). Ultralow NOx, CO, and HC emissions and an extended lean burning limit were achieved simultaneously.

  19. Extending lean operating limit and reducing emissions of methane spark-ignited engines using a microwave-assisted spark plug

    DOE PAGES

    Rapp, Vi H.; DeFilippo, Anthony; Saxena, Samveg; ...

    2012-01-01

    Amore » microwave-assisted spark plug was used to extend the lean operating limit (lean limit) and reduce emissions of an engine burning methane-air. In-cylinder pressure data were collected at normalized air-fuel ratios of λ = 1.46, λ = 1.51, λ = 1.57, λ = 1.68, and λ = 1.75. For each λ , microwave energy (power supplied to the magnetron per engine cycle) was varied from 0 mJ (spark discharge alone) to 1600 mJ. At lean conditions, the results showed adding microwave energy to a standard spark plug discharge increased the number of complete combustion cycles, improving engine stability as compared to spark-only operation. Addition of microwave energy also increased the indicated thermal efficiency by 4% at λ = 1.68. At λ = 1.75, the spark discharge alone was unable to consistently ignite the air-fuel mixture, resulting in frequent misfires. Although microwave energy produced more consistent ignition than spark discharge alone at λ = 1.75, 59% of the cycles only partially burned. Overall, the microwave-assisted spark plug increased engine performance under lean operating conditions (λ = 1.68) but did not affect operation at conditions closer to stoichiometric.« less

  20. Effect of gravity on the stability and structure of lean hydrogen-air flames

    NASA Technical Reports Server (NTRS)

    Patnaik, G.; Kailasanath, K.

    1991-01-01

    Detailed, time-dependent, 2D numerical simulations with full hydrogen-oxygen chemistry are used to investigate the effects of gravity on the stability and structure of laminar flames in lean, premixed hydrogen-air mixtures. The calculations show that the effects of gravity becomes more important as the lean flammability limit is approached. In a 12 percent hydrogen-air mixture, gravity plays only a secondary role in determining the multidimensional structure of the flame with the stability and structure of the flame controlled primarily by the thermo-diffusive instability mechanism. However, in leaner hydrogen-air mixtures gravity becomes more important. Upward-propagating flames are highly curved and evolve into a bubble rising upwards in the tube. Downward-propagating flames are flat or even oscillate between structures with concave and convex curvatures. The zero-gravity flame shows only cellular structures. Cellular structures which are present in zero gravity can be suppressed by the effect of buoyancy for mixtures leaner than 11 percent hydrogen. These observations are explained on the basis of an interaction between the processes leading to buoyancy-induced Rayleigh-Taylor instability and the thermo-diffusive instability.

  1. Numerical Simulation And Experimental Investigation Of The Lift-Off And Blowout Of Enclosed Laminar Flames

    NASA Technical Reports Server (NTRS)

    Venuturmilli, Rajasekhar; Zhang, Yong; Chen, Lea-Der

    2003-01-01

    Enclosed flames are found in many industrial applications such as power plants, gas-turbine combustors and jet engine afterburners. A better understanding of the burner stability limits can lead to development of combustion systems that extend the lean and rich limits of combustor operations. This paper reports a fundamental study of the stability limits of co-flow laminar jet diffusion flames. A numerical study was conducted that used an adaptive mesh refinement scheme in the calculation. Experiments were conducted in two test rigs with two different fuels and diluted with three inert species. The numerical stability limits were compared with microgravity experimental data. Additional normal-gravity experimental results were also presented.

  2. Lean blowout limits of a gas turbine combustor operated with aviation fuel and methane

    NASA Astrophysics Data System (ADS)

    Xiao, Wei; Huang, Yong

    2016-05-01

    Lean blowout (LBO) limits is critical to the operational performance of combustion systems in propulsion and power generation. The swirl cup plays an important role in flame stability and has been widely used in aviation engines. Therefore, the effects of swirl cup geometry and flow dynamics on LBO limits are significant. An experiment was conducted for studying the lean blowout limits of a single dome rectangular model combustor with swirl cups. Three types of swirl cup (dual-axial swirl cup, axial-radial swirl cup, dual-radial swirl cup) were employed in the experiment which was operated with aviation fuel (Jet A-1) and methane under the idle condition. Experimental results showed that, with using both Jet A-1 and methane, the LBO limits increase with the air flow of primary swirler for dual-radial swirl cup, while LBO limits decrease with the air flow of primary swirler for dual-axial swirl cup. In addition, LBO limits increase with the swirl intensity for three swirl cups. The experimental results also showed that the flow dynamics instead of atomization poses a significant influence on LBO limits. An improved semi-empirical correlation of experimental data was derived to predict the LBO limits for gas turbine combustors.

  3. Pulverized coal burner

    DOEpatents

    Sivy, J.L.; Rodgers, L.W.; Koslosy, J.V.; LaRue, A.D.; Kaufman, K.C.; Sarv, H.

    1998-11-03

    A burner is described having lower emissions and lower unburned fuel losses by implementing a transition zone in a low NO{sub x} burner. The improved burner includes a pulverized fuel transport nozzle surrounded by the transition zone which shields the central oxygen-lean fuel devolatilization zone from the swirling secondary combustion air. The transition zone acts as a buffer between the primary and the secondary air streams to improve the control of near-burner mixing and flame stability by providing limited recirculation regions between primary and secondary air streams. These limited recirculation regions transport evolved NO{sub x} back towards the oxygen-lean fuel pyrolysis zone for reduction to molecular nitrogen. Alternate embodiments include natural gas and fuel oil firing. 8 figs.

  4. Pulverized coal burner

    DOEpatents

    Sivy, Jennifer L.; Rodgers, Larry W.; Koslosy, John V.; LaRue, Albert D.; Kaufman, Keith C.; Sarv, Hamid

    1998-01-01

    A burner having lower emissions and lower unburned fuel losses by implementing a transition zone in a low NO.sub.x burner. The improved burner includes a pulverized fuel transport nozzle surrounded by the transition zone which shields the central oxygen-lean fuel devolatilization zone from the swirling secondary combustion air. The transition zone acts as a buffer between the primary and the secondary air streams to improve the control of near-burner mixing and flame stability by providing limited recirculation regions between primary and secondary air streams. These limited recirculation regions transport evolved NO.sub.x back towards the oxygen-lean fuel pyrolysis zone for reduction to molecular nitrogen. Alternate embodiments include natural gas and fuel oil firing.

  5. Stability of leaning column at Devils Tower National Monument, Wyoming

    USGS Publications Warehouse

    Harp, Edwin L.; Lindsay, Charles R.

    2006-01-01

    In response to reports from climbers that an 8-meter section (referred to as the leaning column) of the most popular climbing route on Devils Tower in northeastern Wyoming is now moving when being climbed, scientists from the U.S. Geological Survey inspected the site to determine the stability of the column and the underlying column that serves as a support pedestal. Evidence of a recent tensile spalling failure was observed on the pedestal surface immediately beneath the contact with the overlying leaning column. The spalling of a flake-shaped piece of the pedestal, probably due to the high stress concentration exerted by the weight of the leaning column along a linear contact with the pedestal, is likely causing the present movement of the leaning column. Although it is unlikely that climbers will dislodge the leaning column by their weight alone, the possibility exists that additional spalling failures may occur from the pedestal surface and further reduce the stability of the leaning column and result in its toppling. To facilitate detection of further spalling failures from the pedestal, its surface has been coated with a layer of paint. Any new failures from the pedestal could result in the leaning column toppling onto the climbing route or onto the section of the Tower trail below.

  6. Prediction of Pork Longissimus Lean Color Stability Using VIS/NIR

    USDA-ARS?s Scientific Manuscript database

    Insufficient case-life is a costly problem facing pork processors. To assess Visible and Near-Infrared (VIS/NIR) spectroscopy as a technology to sort pork loins according to lean color stability, center-cut pork loins (n = 1208) were selected from the boning lines of four large-scale pork processor...

  7. Influence of mitochondrial efficiency on beef lean color stability

    USDA-ARS?s Scientific Manuscript database

    Loss of electrons in the electron transport chain has been implicated as a source of variation in feed efficiency of meat producing animals. The present study was conducted to evaluate the effects of electron loss during electron transport on beef lean color stability. Beef carcasses (n = 91) were...

  8. Advances in Turbulent Combustion Dynamics Simulations in Bluff-Body Stabilized Flames-Body Stabilized Flames

    DTIC Science & Technology

    2015-11-30

    Master’s Thesis 3. DATES COVERED (From - To) 01 Nov 2015 – 30 Nov 2015 4. TITLE AND SUBTITLE Advances in Turbulent Combustion Dynamics Simulations...the three main aspects of bluff-body stabilized flames: stationary combustion , lean blow-out, and thermo-acoustic instabilities. For the cases of...stationary combustion and lean blow-out, an improved version of the Linear Eddy Model approach is used, while in the case of thermo-acoustic

  9. Interaction of turbulent premixed flames with combustion products: Role of stoichiometry

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

    Coriton, Bruno Rene Leon; Frank, Jonathan H.; Gomez, Alessandro

    Stabilization methods of turbulent flames often involve mixing of reactants with hot products of combustion. The stabilizing effect of combustion product enthalpy has been long recognized, but the role played by the chemical composition of the product gases is typically overlooked. We employ a counterflow system to pinpoint the effects of the combustion product stoichiometry on the structure of turbulent premixed flames under conditions of both stable burning and local extinction. To that end, a turbulent jet of lean-to-rich, CH 4/O 2/N 2-premixed reactants at a turbulent Reynolds number of 1050 was opposed to a stream of hot products ofmore » combustion that were generated in a preburner. While the combustion product stream temperature was kept constant, its stoichiometry was varied independently from that of the reactant stream, leading to reactant-to-product stratification of relevance to practical combustion systems. The detailed structure of the turbulent flame front was analyzed in two series of experiments using laser-induced fluorescence (LIF): joint CH 2O LIF and OH LIF measurements and joint CO LIF and OH LIF measurements. Results revealed that a decrease in local CH 2O+OH and CO+OH reaction rates coincide with the depletion of OH radicals in the vicinity of the combustion product stream. These critical combustion reaction rates were more readily quenched in the presence of products of combustion from a stoichiometric flame, whereas they were favored by lean combustion products. As a result, stoichiometric combustion products contributed to a greater occurrence of local extinction. Furthermore, they limited the capacity of premixed reactants to ignite and of the turbulent premixed flames to stabilize. In contrast, lean and rich combustion products facilitated flame ignition and stability and reduced the rate of local extinction. The influence of the combustion product stream on the turbulent flame front was limited to a zone of approximately two millimeters from the gas mixing layer interface (GMLI) of the product stream. As a result, flame fronts that were separated from the GMLI by larger distances were unaffected by the product stream stoichiometry.« less

  10. Interaction of turbulent premixed flames with combustion products: Role of stoichiometry

    DOE PAGES

    Coriton, Bruno Rene Leon; Frank, Jonathan H.; Gomez, Alessandro

    2016-05-30

    Stabilization methods of turbulent flames often involve mixing of reactants with hot products of combustion. The stabilizing effect of combustion product enthalpy has been long recognized, but the role played by the chemical composition of the product gases is typically overlooked. We employ a counterflow system to pinpoint the effects of the combustion product stoichiometry on the structure of turbulent premixed flames under conditions of both stable burning and local extinction. To that end, a turbulent jet of lean-to-rich, CH 4/O 2/N 2-premixed reactants at a turbulent Reynolds number of 1050 was opposed to a stream of hot products ofmore » combustion that were generated in a preburner. While the combustion product stream temperature was kept constant, its stoichiometry was varied independently from that of the reactant stream, leading to reactant-to-product stratification of relevance to practical combustion systems. The detailed structure of the turbulent flame front was analyzed in two series of experiments using laser-induced fluorescence (LIF): joint CH 2O LIF and OH LIF measurements and joint CO LIF and OH LIF measurements. Results revealed that a decrease in local CH 2O+OH and CO+OH reaction rates coincide with the depletion of OH radicals in the vicinity of the combustion product stream. These critical combustion reaction rates were more readily quenched in the presence of products of combustion from a stoichiometric flame, whereas they were favored by lean combustion products. As a result, stoichiometric combustion products contributed to a greater occurrence of local extinction. Furthermore, they limited the capacity of premixed reactants to ignite and of the turbulent premixed flames to stabilize. In contrast, lean and rich combustion products facilitated flame ignition and stability and reduced the rate of local extinction. The influence of the combustion product stream on the turbulent flame front was limited to a zone of approximately two millimeters from the gas mixing layer interface (GMLI) of the product stream. As a result, flame fronts that were separated from the GMLI by larger distances were unaffected by the product stream stoichiometry.« less

  11. Experimental study of the effects of flameholder geometry on emissions and performance of lean premixed combustors

    NASA Technical Reports Server (NTRS)

    Roffe, G.; Venkataramani, K. S.

    1978-01-01

    Emissions of NOx, CO, and unburned hydrocarbons (UHC) are reported for a lean premixed propane-air system at inlet conditions of 800K and 1MPa using twelve flameholder designs. The flameholders tested represent six design concepts with two values of blockage for each concept. Data were obtained at reference velocities of 35 m/s, 25 m/s and 20 m/s at combustor stations 10 cm and 30 cm downstream of the flameholders. Flameholder pressure drop was found to be a principal determinant of emissions performance. Designs producing larger pressure drops also produced less NOx, CO, and UHC emissions. The lean stability limit equivalence ratio was found to be approximately 0.35 for all designs. Flashback velocities (axial components in the flameholder passages) varied between 30 m/s and 40 m/s. A perforated plate flameholder was operated with a velocity as low as 23 m/s through the perforations at equivalence ratio 0.7 without producing flashback.

  12. Effect of Air Swirler Configuration on Lean Direct Injector Flow Structure and Combustion Performance with a 7-Point Lean Direct Injector Array

    NASA Technical Reports Server (NTRS)

    Hicks, Yolanda R.; Tacina, Kathleen M.; Anderson, Robert C.

    2017-01-01

    This paper examines the fundamentals of fuel-air mixing in a lean direct injection concept. Results are presented to investigate the effects of air swirler angle, element spacing, and center element offset on recirculation zone formation, flame stability and gaseous emissions.

  13. Lean Premixed Combustion Stabilized by Low Swirl a Promising Concept for Practical Applications

    NASA Technical Reports Server (NTRS)

    Cheng, R. K.

    1999-01-01

    Since its inception, the low-swirl burner (LSB) has shown to be a useful laboratory apparatus for fundamental studies of premixed turbulent flames. The LSB operates under wide ranges of equivalence ratios, flow rates, and turbulence intensities. Its flame is lifted and detached from the burner and allows easy access for laser diagnostics. The flame brush is axisymmetric and propagates normal to the incident reactants. Therefore, the LSB is well suited for investigating detailed flame structures and empirical coefficients such as flame speed, turbulence transport, and flame generated turbulence. Due to its capability to stabilize ultra-lean premixed turbulent flames (phi approx. = 0.55), the LSB has generated interest from the gas appliance industry for use as an economical low-NO(x) burner. Lean premixed combustion emits low levels of NO(x), due primarily to the low flame temperature. Therefore, it is a very effective NO(x) prevention method without involving selective catalytic reduction (SCR), fuel-air staging, or flue gas recirculation (FGR). En the gas turbine industry, substantial research efforts have already been undertaken and engines with lean premixed combustors are already in use. For commercial and residential applications, premixed pulsed combustors and premixed ceramic matrix burners are commercially available. These lean premixed combustion technologies, however, tend to be elaborate but have relatively limited operational flexibility, and higher capital, operating and maintenance costs. Consequently, these industries are continuing the development of lean premixed combustion technologies as well as exploring new concepts. This paper summarizes the research effects we have undertaken in the past few years to demonstrate the feasibility of applying the low-swirl flame stabilization method for a wide range of heating and power generation systems. The principle of flame stabilization by low-swirl is counter to the conventional high-swirl methods that rely on a recirculation zone to anchor the flame. In LSBS, flow recirculation is not promoted to allow the premixed turbulent flames to propagate freely. A LSB with an air-jet swirler is essentially an open tube with the swirler at its mid section. The small air-jets generate swirling motion only in the annular region and leaving the central core of the flow undisturbed, When this flow exits the burner tube, the angular momentum generates radial mean pressure gradient to diverge the non-swirling reactants stream. Consequently, the mean flow velocity decreases linearly. Propagating against this decelerating flow, the flame self-sustains at the position where the local flow velocity equals the flame speed, S(sub f). The LSB operates with a swirl number, S, between 0.02 to 0.1. This is much lower than the minimum S of 0.6 required for the high-swirl burners. We found that the swirl number needed for flame stabilization varies only slightly with fuel type, flow velocity, turbulent conditions and burner dimensions (i.e. throat diameter and swirl injection angle).

  14. An experimental study of flame stability in a directly-fueled wall cavity with a supersonic free stream

    NASA Astrophysics Data System (ADS)

    Rasmussen, Chadwick Clifford

    An extensive study of flame stability in a cavity-based fuel injector/flameholder has been performed. Flames were stabilized in cavities with two different aft wall configurations and length to depth ratios of 3 and 4. Fuel was injected directly into the cavity using two injector configurations. Fuel injected from the aft wall of the cavity entered directly into the recirculation zone and provided desirable performance near the lean blowout limit. At high fuel flowrates, the cavity became flooded with fuel and rich blowout occurred. When fuel was injected from the floor of the cavity, excess fuel was directed out of the cavity which allowed for flame stabilization at extremely high fuel flowrates; however, this phenomenon also resulted in suboptimal performance near the lean limit where the blowout point was less predictable. Images of planar laser-induced fluorescence (PLIF) of CH, OH, and formaldehyde give insight into the flameholding mechanisms. CH layers in the cavity are thin and continuous and show structure that is comparable to lifted jet flames, while broad CH zones are sometimes observed in the shear layer. OH PLIF images show that hot recirculated products are always present at the location of flame stabilization, whereas images of formaldehyde indicate that partial premixing takes place in the shear layer portion of the flame. Nonreacting measurements of the boundary layer and the free stream velocity profiles were obtained to provide necessary boundary conditions for computational modeling. Mean and instantaneous velocity profiles were determined for the nonreacting flow using particle image velocimetry (PIV). A correlation of the blowout points for a directly-fueled cavity in a supersonic flow was accomplished using a Damkohler number and an equivalence ratio based upon an effective air mass flowrate. The chemical time was formulated using a generic measure of the reaction rate, tauc ˜ alpha/ S2L , which was found to be adequate for correlating lean blowout data from methane, ethylene, acetylene, and hydrogen flames. Blowout data was collected at a number of conditions with varied pressure and temperature and Mach numbers of 2, 2.4, and 3. The effective air mass flowrate was determined using scaling laws for compressible mixing layers, which correctly incorporated the impact of compressibility on air entrainment.

  15. 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

  16. Characteristics of a trapped-vortex (TV) combustor

    NASA Technical Reports Server (NTRS)

    Hsu, K.-Y.; Gross, L. P.; Trump, D. D.; Roquemore, W. M.

    1994-01-01

    The characteristics of a Trapped-Vortex (TV) combustor are presented. A vortex is trapped in the cavity established between two disks mounted in tandem. Fuel and air are injected directly into the cavity in such a way as to increase the vortex strength. Some air from the annular flow is also entrained into the recirculation zone of the vortex. Lean blow-out limits of the combustor are determined for a wide range of annular air flow rates. These data indicate that the lean blow-out limits are considerably lower for the TV combustor than for flames stabilized using swirl or bluff-bodies. The pressure loss through the annular duct is also low, being less than 2% for the flow conditions in this study. The instantaneous shape of the recirculation zone of the trapped vortex is measured using a two-color PIV technique. Temperature profiles obtained with CARS indicate a well mixed recirculation zone and demonstrate the impact of primary air injection on the local equivalence ratio.

  17. Impulsive-choice patterns for food in genetically lean and obese Zucker rats

    PubMed Central

    Boomhower, Steven R.; Rasmussen, Erin B.; Doherty, Tiffany S.

    2012-01-01

    Behavioral-economic studies have shown that differences between lean and obese Zuckers in food consumption depend on the response requirement for food. Since a response requirement inherently increases the delay to reinforcement, differences in sensitivity to delay may also be a relevant mechanism of food consumption in the obese Zucker rat. Furthermore, the endocannabinoid neurotransmitter system has been implicated in impulsivity, but studies that attempt to characterize the effects of cannabinoid drugs (e.g., rimonabant) on impulsive choice may be limited by floor effects. The present study aimed to characterize impulsive-choice patterns for sucrose using an adjusting-delay procedure in genetically lean and obese Zuckers. Ten lean and ten obese Zucker rats chose between one lever that resulted in one pellet after a standard delay (either 1 s or 5 s) and a second lever that resulted in two or three pellets after an adjusting delay. After behavior stabilized under baseline, rimonabant (0–10 mg/kg) was administered prior to some choice sessions in the two-pellet condition. Under baseline, obese Zuckers made more impulsive choices than leans in three of the four standard-delay/pellet conditions. Additionally, in the 2-pellet condition, rimonabant increased impulsive choice in lean rats in the 1-s standard-delay condition; however, rimonabant decreased impulsive choice in obese rats in the 1-s and 5-s standard-delay conditions. These data suggest that genetic factors that influence impulsive choice are stronger in some choice conditions than others, and that the endocannabinoid system may be a relevant neuromechanism. PMID:23261877

  18. Impulsive-choice patterns for food in genetically lean and obese Zucker rats.

    PubMed

    Boomhower, Steven R; Rasmussen, Erin B; Doherty, Tiffany S

    2013-03-15

    Behavioral-economic studies have shown that differences between lean and obese Zuckers in food consumption depend on the response requirement for food. Since a response requirement inherently increases the delay to reinforcement, differences in sensitivity to delay may also be a relevant mechanism of food consumption in the obese Zucker rat. Furthermore, the endocannabinoid neurotransmitter system has been implicated in impulsivity, but studies that attempt to characterize the effects of cannabinoid drugs (e.g., rimonabant) on impulsive choice may be limited by floor effects. The present study aimed to characterize impulsive-choice patterns for sucrose using an adjusting-delay procedure in genetically lean and obese Zuckers. Ten lean and ten obese Zucker rats chose between one lever that resulted in one pellet after a standard delay (either 1 s or 5 s) and a second lever that resulted in two or three pellets after an adjusting delay. After behavior stabilized under baseline, rimonabant (0-10 mg/kg) was administered prior to some choice sessions in the two-pellet condition. Under baseline, obese Zuckers made more impulsive choices than leans in three of the four standard-delay/pellet conditions. Additionally, in the 2-pellet condition, rimonabant increased impulsive choice in lean rats in the 1-s standard-delay condition; however, rimonabant decreased impulsive choice in obese rats in the 1-s and 5-s standard-delay conditions. These data suggest that genetic factors that influence impulsive choice are stronger in some choice conditions than others, and that the endocannabinoid system may be a relevant neuromechanism. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Effect of Spray Cone Angle on Flame Stability in an Annular Gas Turbine Combustor

    NASA Astrophysics Data System (ADS)

    Mishra, R. K.; Kumar, S. Kishore; Chandel, Sunil

    2016-04-01

    Effect of fuel spray cone angle in an aerogas turbine combustor has been studied using computational fluid dynamics (CFD) and full-scale combustor testing. For CFD analysis, a 22.5° sector of an annular combustor is modeled and the governing equations are solved using the eddy dissipation combustion model in ANSYS CFX computational package. The analysis has been carried out at 125 kPa and 303 K inlet conditions for spray cone angles from 60° to 140°. The lean blowout limits are established by studying the behavior of combustion zone during transient engine operation from an initial steady-state condition. The computational study has been followed by testing the practical full-scale annular combustor in an aerothermal test facility. The experimental result is in a good agreement with the computational predictions. The lean blowout fuel-air ratio increases as the spray cone angle is decreased at constant operating pressure and temperature. At higher spray cone angle, the flame and high-temperature zone moves upstream close to atomizer face and a uniform flame is sustained over a wide region causing better flame stability.

  20. Reduction of gaseous pollutant emissions from gas turbine combustors using hydrogen-enriched jet fuel

    NASA Technical Reports Server (NTRS)

    Clayton, R. M.

    1976-01-01

    Recent progress in an evaluation of the applicability of the hydrogen enrichment concept to achieve ultralow gaseous pollutant emission from gas turbine combustion systems is described. The target emission indexes for the program are 1.0 for oxides of nitrogen and carbon monoxide, and 0.5 for unburned hydrocarbons. The basic concept utilizes premixed molecular hydrogen, conventional jet fuel, and air to depress the lean flammability limit of the mixed fuel. This is shown to permit very lean combustion with its low NOx production while simulataneously providing an increased flame stability margin with which to maintain low CO and HC emission. Experimental emission characteristics and selected analytical results are presented for a cylindrical research combustor designed for operation with inlet-air state conditions typical for a 30:1 compression ratio, high bypass ratio, turbofan commercial engine.

  1. Field Effects of Buoyancy on Lean Premixed Turbulent Flames

    NASA Technical Reports Server (NTRS)

    Cheng, R. K.; Johnson, M. R.; Greenberg, P. S.; Wernet, M. P.

    2003-01-01

    The study of field effects of buoyancy on premixed turbulent flames is directed towards the advancement of turbulent combustion theory and the development of cleaner combustion technologies. Turbulent combustion is considered the most important unsolved problem in combustion science and laboratory studies of turbulence flame processes are vital to theoretical development. Although buoyancy is dominant in laboratory flames, most combustion models are not yet capable to consider buoyancy effects. This inconsistency has impeded the validation of theories and numerical simulations with experiments. Conversely, the understanding of buoyancy effects is far too limited to help develop buoyant flame models. Our research is also relevant to combustion technology because lean premixed combustion is a proven method to reduce the formation of oxides of nitrogen (NOx). In industrial lean premixed combustion systems, their operating conditions make them susceptible to buoyancy thus affecting heat distribution, emissions, stability, flashback and blowoff. But little knowledge is available to guide combustion engineers as to how to avoid or overcome these problems. Our hypothesis is that through its influence on the mean pressure field, buoyancy has direct and indirect effects on local flame/turbulence interactions. Although buoyancy acts on the hot products in the farfield the effect is also felt in the nearfield region upstream of the flame. These changes also influence the generation and dissipation of turbulent kinetic energy inside the flame brush and throughout the flowfield. Moreover, the plume of an open flame is unstable and the periodic fluctuations make additional contributions to flame front dynamics in the farfield. Therefore, processes such as flame wrinkling, flow acceleration due to heat release and flame- generated vorticity are all affected. Other global flame properties (e.g. flame stabilization limits and flame speed) may all be coupled to buoyancy. This problem poses major challenges to combustion modeling due to its need for a computation domain extending into the farfield and full specifications of upstream, wall and downstream boundary conditions.

  2. 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/.

  3. Behavior of the lean methane-air flame at zero-gravity

    NASA Technical Reports Server (NTRS)

    Noe, K. A.; Strehlow, R. A.

    1985-01-01

    A special rig was designed and constructed to be compatible with the NASA Lewis Research Center Airborne Research Laboratory to allow the study of the effect of gravity on the behavior of lean limit in a standard 50.4 mm (2 in.) internal diameter tube when the mixtures are ignited at the open end and propagate towards the closed end of the tube. The lean limit at zero gravity was found to be 5.10% methane and the flame was found to extenguish in a manner previously observed for downward propagating flames at one g. It was observed that g-jitter could be maintained at less than + or 0.04 g on most zero g trajectories. All of propagating lean limit flames were found to be sporadically cellularly unstable at zero g. There was no observable correlation between the occurrence of g-jitter and the lean limit, average propagation speed of the flame through the tube or the occurrence of cellular instability.

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

    Tucker, J. D.; Miller, M. K.; Young, G. A.

    Duplex stainless steels are desirable for use in power generation systems due to their attractive combination of strength, corrosion resistance, and cost. However, thermal embrittlement at intermediate homologous temperatures of ~887°F (475°C) and below, via spinodal decomposition, limits upper service temperatures for many applications. New lean grade duplex alloys have improved thermal stability over standard grades and potentially increase the upper service temperature or the lifetime at a given temperature for this class of material. The present work compares the thermal stability of lean grade, alloy 2003 to standard grade, alloy 2205, through a series of isothermal agings between 500°Fmore » (260°C) and 900°F (482°C) for times between 1 and 10,000 hours. Aged samples were characterized by changes in microhardness and impact toughness. Additionally, atom probe tomography was performed to illustrate the evolution of the α-α' phase separation in both alloys at select conditions. Atom probe tomography confirmed that phase separation occurs via spinodal decomposition for both alloys and identified the formation of Ni-Cu-Si-Mn-P clusters in alloy 2205 that may contribute to embrittlement of this alloy. The impact toughness model predictions for upper service temperature show that alloy 2003 can be considered for use in 550°F applications for 80 year service lifetimes based on a Charpy V-notch criteria of 35 ft-lbs at 70°F. Alloy 2205 should be limited to 500°F applications.« less

  5. 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

  6. Pollutant Emissions and Lean Blowoff Limits of Fuel Flexible Burners Operating on Gaseous Renewable and Fossil Fuels

    NASA Astrophysics Data System (ADS)

    Colorado, Andres

    This study provides an experimental and numerical examination of pollutant emissions and stability of gaseous fueled reactions stabilized with two premixed-fuel-flexible and ultra-low NOx burner technologies. Both burners feature lean combustion technology to control the formation of nitrogen oxides (NOx). The first fuel--flexible burner is the low-swirl burner (LSB), which features aerodynamic stabilization of the reactions with a divergent flow-field; the second burner is the surface stabilized combustion burner (SSCB), which features the stabilization of the reactions on surface patterns. For combustion applications the most commonly studied species are: NOx, carbon monoxide (CO), and unburned hydrocarbons (UHC). However these are not the only pollutants emitted when burning fossil fuels; other species such as nitrous oxide (N2O), ammonia (NH3) and formaldehyde (CH2O) can be directly emitted from the oxidation reactions. Yet the conditions that favor the emission of these pollutants are not completely understood and require further insight. The results of this dissertation close the gap existing regarding the relations between emission of pollutants species and stability when burning variable gaseous fuels. The results of this study are applicable to current issues such as: 1. Current combustion systems operating at low temperatures to control formation of NOx. 2. Increased use of alternative fuels such as hydrogen, synthetic gas and biogas. 3. Increasing recognition of the need/desire to operate combustion systems in a transient manner to follow load and to offset the intermittency of renewable power. 4. The recent advances in measurement methods allow us to quantify other pollutants, such as N 2O, NH3 and CH2O. Hence in this study, these pollutant species are assessed when burning natural gas (NG) and its binary mixtures with other gaseous fuels such as hydrogen (H2), carbon dioxide (CO2), ethane (C 2H6) and propane (C3H8) at variable operation modes including: ignition; lean blowoff; and variable air to fuel ratio. Some remarkable results of this dissertation include: • At a fixed fire rate (117kW) the addition of hydrogen to NG raises the emission of NO x for the reactions stabilized with the LSB. Under the same conditions, the addition of H2 to NG will reduce the emission levels of the reactions stabilized with the SSCB. • It was found experimentally that nitrous oxide (N2O) is emitted during ignition and blowoff events. • Ammonia (NH3) is also emitted during ignition and blowoff events. • It was found experimentally that at high concentrations of hydrogen in NG (H2>70%), reactions aerodynamically stabilized with the LSB will emit significant amounts of N2O.

  7. Cow biological type affects ground beef colour stability.

    PubMed

    Raines, Christopher R; Hunt, Melvin C; Unruh, John A

    2009-12-01

    To determine the effects of cow biological type on colour stability of ground beef, M. semimembranosus from beef-type (BSM) and dairy-type (DSM) cows was obtained 5d postmortem. Three blends (100% BSM, 50% BSM+50% DSM, 100% DSM) were adjusted to 90% and 80% lean points using either young beef trim (YBT) or beef cow trim (BCT), then packaged in high oxygen (High-O(2); 80% O(2)) modified atmosphere (MAP). The BSM+YBT patties had the brightest colour initially, but discoloured rapidly. Although DSM+BCT patties had the darkest colour initially, they discoloured least during display. Metmyoglobin reducing ability of ground DSM was up to fivefold greater than ground BSM, and TBARS values of BSM was twofold greater than DSM by the end of display (4d). Though initially darker than beef cow lean, dairy cow lean has a longer display colour life and may be advantageous to retailers using High-O(2) MAP.

  8. 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…

  9. The lightest organic radical cation for charge storage in redox flow batteries

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

    Huang, Jinhua; Pan, Baofei; Duan, Wentao

    2016-08-25

    Electrochemically reversible fluids of high energy density are promising materials for capturing the electrical energy generated from intermittent sources like solar and wind. To meet this technological challenge there is a need to understand the fundamental limits and interplay of electrochemical potential, stability and solubility in “lean” derivatives of redox-active molecules. Here we describe the process of molecular pruning, illustrated for 2,5-di-tert-butyl-1,4-bis(2-methoxyethoxy)benzene, a molecule known to produce a persistently stable, high-potential radical cation. By systematically shedding molecular fragments considered important for radical cation steric stabilization, we discovered a minimalistic structure that retains long-term stability in its oxidized form. Interestingly, wemore » find the tert-butyl groups are unnecessary; high stability of the radical cation and high solubility are both realized in derivatives having appropriately positioned arene methyl groups. These stability trends are rationalized by mechanistic considerations of the postulated decomposition pathways. We suggest that the molecular pruning approach will uncover lean redox active derivatives for electrochemical energy storage leading to materials with long-term stability and high intrinsic capacity.« less

  10. Plasma-assisted combustion in lean, high-pressure, preheated air-methane mixtures

    NASA Astrophysics Data System (ADS)

    Sommerer, Timothy; Herbon, John; Saddoughi, Seyed; Deminsky, Maxim; Potapkin, Boris

    2013-09-01

    We combine a simplified physical model with a detailed plasma-chemical reaction mechanism to analyze the use of plasmas to improve flame stability in a gas turbine used for electric power generation. For this application the combustion occurs in a lean mixture of air and methane at high pressure (18.6 atm) and at ``preheat'' temperature 700 K, and the flame zone is both recirculating and turbulent. The system is modeled as a sequence of reactors: a pulsed uniform plasma (Boltzmann), an afterglow region (plug-flow), a flame region (perfectly-stirred), and a downstream region (plug-flow). The plasma-chemical reaction mechanism includes electron-impact on the feedstock species, relaxation in the afterglow to neutral molecules and radicals, and methane combustion chemistry (GRI-Mech 3.0), with extensions to properly describe low-temperature combustion 700-1000 K [M Deminsky et al., Chem Phys 32, 1 (2013)]. We find that plasma treatment of the incoming air-fuel mixture can improve the stability of lean flames, expressed as a reduction in the adiabatic flame temperature at lean blow-out, but that the plasma also generates oxides of nitrogen at the preheat temperature through the reactions e + N2 --> N + N and N + O2 --> NO + O. We find that flame stability is improved with less undesirable NOx formation when the plasma reduced-electric-field E/ N is smaller. A portion of this work was supported by the US Dept of Energy under Award Number DE-FC26-08NT05868.

  11. Assessment of thermal embrittlement in duplex stainless steels 2003 and 2205 for nuclear power applications

    DOE PAGES

    Tucker, J. D.; Miller, M. K.; Young, G. A.

    2015-04-01

    Duplex stainless steels are desirable for use in power generation systems due to their attractive combination of strength, corrosion resistance, and cost. However, thermal embrittlement at intermediate homologous temperatures of ~887°F (475°C) and below, via spinodal decomposition, limits upper service temperatures for many applications. New lean grade duplex alloys have improved thermal stability over standard grades and potentially increase the upper service temperature or the lifetime at a given temperature for this class of material. The present work compares the thermal stability of lean grade, alloy 2003 to standard grade, alloy 2205, through a series of isothermal agings between 500°Fmore » (260°C) and 900°F (482°C) for times between 1 and 10,000 hours. Aged samples were characterized by changes in microhardness and impact toughness. Additionally, atom probe tomography was performed to illustrate the evolution of the α-α' phase separation in both alloys at select conditions. Atom probe tomography confirmed that phase separation occurs via spinodal decomposition for both alloys and identified the formation of Ni-Cu-Si-Mn-P clusters in alloy 2205 that may contribute to embrittlement of this alloy. The impact toughness model predictions for upper service temperature show that alloy 2003 can be considered for use in 550°F applications for 80 year service lifetimes based on a Charpy V-notch criteria of 35 ft-lbs at 70°F. Alloy 2205 should be limited to 500°F applications.« less

  12. 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.

  13. Advantages of MgAlOx over gamma-Al2O3 as a support material for potassium-based high temperature lean NOx traps

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

    Luo, Jinyong; Gao, Feng; Karim, Ayman M.

    MgAlOx mixed oxides were employed as supports for potassium-based lean NOx traps (LNTs) targeted for high temperature applications. Effects of support compositions, K/Pt loadings, thermal aging and catalyst regeneration on NOx storage capacity were systematically investigated. The catalysts were characterized by XRD, NOx-TPD, TEM, STEM-HAADF and in-situ XAFS. The results indicate that MgAlOx mixed oxides have significant advantages over conventional gamma-Al2O3-supports for LNT catalysts, in terms of high temperature NOx trapping capacity and thermal stability. First, as a basic support, MgAlOx stabilizes stored nitrates (in the form of KNO3) to much higher temperatures than mildly acidic gamma-Al2O3. Second, MgAlOx minimizesmore » Pt sintering during thermal aging, which is not possible for gamma-Al2O3 supports. Notably, combined XRD, in-situ XAFS and STEM-HAADF results indicate that Pt species in the thermally aged Pt/MgAlOx samples are finely dispersed in the oxide matrix as isolated atoms. This strong metal-support interaction stabilizes Pt and minimizes the extent of sintering. However, such strong interactions result in Pt oxidation via coordination with the support so that NO oxidation activity can be adversely affected after aging which, in turn, decreases NOx trapping ability for these catalysts. Interestingly, a high-temperature reduction treatment regenerates essentially full NOx trapping performance. In fact, regenerated Pt/K/MgAlOx catalyst exhibits much better NOx trapping performance than fresh Pt/K/Al2O3 LNTs over the entire temperature range investigated here. In addition to thermal aging, Pt/K loading effects were systemically studied over the fresh samples. The results indicate that NOx trapping is kinetically limited at low temperatures, while thermodynamically limited at high temperatures. A simple conceptual model was developed to explain the Pt and K loading effects on NOx storage. An optimized K loading, which allows balancing between the stability of nitrates and exposed Pt surface, gives the best NOx trapping capability.« less

  14. 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.

  15. Analysis of Lean Premixed/Prevaporized Combustion with KIVA-2

    NASA Technical Reports Server (NTRS)

    Deur, J. M.; Kundu, K. P.; Darling, D. D.; Cline, M. C.; Micklow, G. J.; Harper, M. R.; Simons, T. A.

    1994-01-01

    Requirements to reduce the emissions of pollutants from gas turbines used in aircraft propulsion and ground based power generation have led to consideration of lean premixed/prevaporized (LPP) combustion concept. This paper describes some of the LPP flame tube analyses performed at the NASA Research Center with KIVA-2, a well-known multi-dimensional CFD code for problems including sprays, turbulence, and combustion. Modifications to KIVA-2's boundary condition and chemistry treatments have been made to meet the needs of the present study. The study itself focuses on two key aspects of the LPP concept, low emissions and flame stability (including flashback and lean blowoff.

  16. Exhaust gas emissions of a vortex breakdown stabilized combustor

    NASA Technical Reports Server (NTRS)

    Yetter, R. A.; Gouldin, F. C.

    1976-01-01

    Exhaust gas emission data are described for a swirl stabilized continuous combustor. The combustor consists of confined concentric jets with premixed fuel and air in the inner jet and air in the outer jet. Swirl may be induced in both inner and outer jets with the sense of rotation in the same or opposite directions (co-swirl and counter-swirl). The combustor limits NO emissions by lean operation without sacrificing CO and unburned hydrocarbon emission performance, when commercial-grade methane and air fired at one atmosphere without preheat are used. Relative swirl direction and magnitude are found to have significant effects on exhaust gas concentrations, exit temperatures, and combustor efficiencies. Counter-swirl gives a large recirculation zone, a short luminous combustion zone, and large slip velocities in the interjet shear layer. For maximum counter-swirl conditions, the efficiency is low.

  17. Review of modern low emissions combustion technologies for aero gas turbine engines

    NASA Astrophysics Data System (ADS)

    Liu, Yize; Sun, Xiaoxiao; Sethi, Vishal; Nalianda, Devaiah; Li, Yi-Guang; Wang, Lu

    2017-10-01

    Pollutant emissions from aircraft in the vicinity of airports and at altitude are of great public concern due to their impact on environment and human health. The legislations aimed at limiting aircraft emissions have become more stringent over the past few decades. This has resulted in an urgent need to develop low emissions combustors in order to meet legislative requirements and reduce the impact of civil aviation on the environment. This article provides a comprehensive review of low emissions combustion technologies for modern aero gas turbines. The review considers current high Technologies Readiness Level (TRL) technologies including Rich-Burn Quick-quench Lean-burn (RQL), Double Annular Combustor (DAC), Twin Annular Premixing Swirler combustors (TAPS), Lean Direct Injection (LDI). It further reviews some of the advanced technologies at lower TRL. These include NASA multi-point LDI, Lean Premixed Prevaporised (LPP), Axially Staged Combustors (ASC) and Variable Geometry Combustors (VGC). The focus of the review is placed on working principles, a review of the key technologies (includes the key technology features, methods of realising the technology, associated technology advantages and design challenges, progress in development), technology application and emissions mitigation potential. The article concludes the technology review by providing a technology evaluation matrix based on a number of combustion performance criteria including altitude relight auto-ignition flashback, combustion stability, combustion efficiency, pressure loss, size and weight, liner life and exit temperature distribution.

  18. Effect of aging on dynamic postural stability and variability during a multi-directional lean and reach object transportation task.

    PubMed

    Huntley, Andrew H; Zettel, John L; Vallis, Lori Ann

    2016-01-01

    A "reach and transport object" task that represents common activities of daily living may provide improved insight into dynamic postural stability and movement variability deficits in older adults compared to previous lean to reach and functional reach tests. Healthy young and older, community dwelling adults performed three same elevation object transport tasks and two multiple elevation object transport tasks under two self-selected speeds, self-paced and fast-paced. Dynamic postural stability and movement variability was quantified by whole-body center of mass motion. Older adults demonstrated significant decrements in frontal plane stability during the multiple elevation tasks while exhibiting the same movement variability as their younger counterparts, regardless of task speed. Interestingly, older adults did not exhibit a tradeoff in maneuverability in favour of maintaining stability throughout the tasks, as has previously been reported. In conclusion, the multi-planar, ecologically relevant tasks employed in the current study were specific enough to elucidate decrements in dynamic stability, and thus may be useful for assessing fall risk in older adults with suspected postural instability. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Use of visible and near-infrared spectroscopy to predict pork longissimus lean color stability.

    PubMed

    King, D A; Shackelford, S D; Wheeler, T L

    2011-12-01

    This study evaluated the use of visible and near-infrared (VISNIR) spectroscopy to predict lean color stability in pork loin chops. Spectra were collected immediately after and approximately 1 h after rib removal on 1,208 loins. Loins were aged for 14 d before a 2.54-cm chop was placed in simulated retail display. Spectra were collected on aged loins immediately after removal from the vacuum package and on chops 10 min after cutting. Instrumental color measurements [L*, a*, b*, hue angle, chroma, and E (overall color change)] were determined on d 0, 1, 7, 11, and 14 of display. Principal components analysis of display d 0 and 14 values of these traits identified a factor (first principal component; PC1) explaining 67% of the variance that was related to color change. Partial least squares regression was used to develop 3 models to predict PC1 values by using VISNIR spectra collected in the plant, on aged loins, and on chops. Loins with predicted PC1 values less than 0 were classified as having a stable color, whereas values greater than 0 were classified as having a labile lean color. Loins classified as stable by the in-plant model had smaller (P < 0.05) L* values than those classified as labile. Hue angle and ΔE values were less (P < 0.05) and a* and chroma values were greater (P < 0.05) after d 7 of display in loins predicted to have a stable color than in loins predicted to have a labile lean color. Similarly, chops from loins classified as stable using the aged loin model had smaller (P < 0.05) L* values than those from loins classified as labile. Furthermore, loins predicted to be stable had smaller (P < 0.05) hue angle and ΔE values and greater (P < 0.05) a* and chroma values after d 7 of display than did loins predicted to be labile. Results for the chop model were similar to those from the 2 loin models. Chops predicted to have a stable lean color had smaller (P < 0.05) L* values than did those predicted to have a labile lean color. Chops classified as stable had smaller (P < 0.05) hue angle and ΔE values and greater (P < 0.05) a* and chroma values after d 7 of display compared with chops classified as labile. All 3 models effectively segregated chops based on color stability, particularly with regard to redness. Regardless of the model being used, d 14 display values for a*, hue angle, and ΔE in loins classified as stable were similar to the d 7 values of loins classified as labile. Thus, these results suggest that VISNIR spectroscopy would be an effective technology for sorting pork loins with regard to lean color stability.

  20. 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.

  1. 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

  2. Implementing Lean Six Sigma to achieve inventory control in supply chain management

    NASA Astrophysics Data System (ADS)

    Hong, Chen

    2017-11-01

    The inventory cost has important impact on the production cost. In order to get the maximum circulation of funds of enterprise with minimum inventory cost, the inventory control with Lean Six Sigma is presented in supply chain management. The inventory includes both the raw material and the semi-finished parts in manufacturing process. Though the inventory is often studied, the inventory control in manufacturing process is seldom mentioned. This paper reports the inventory control from the perspective of manufacturing process by using statistical techniques including DMAIC, Control Chart, and Statistical Process Control. The process stability is evaluated and the process capability is verified with Lean Six Sigma philosophy. The demonstration in power meter production shows the inventory is decreased from 25% to 0.4%, which indicates the inventory control can be achieved with Lean Six Sigma philosophy and the inventory cost in production can be saved for future sustainable development in supply chain management.

  3. 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.

  4. Flame Stability Limit and Exhaust Emissions of Low Calorific Fuel Combustion in Turbulent Diffusion Combustor for a Small-Scale Fuel Cell

    NASA Astrophysics Data System (ADS)

    Koseki, Hidenori

    This paper describes an investigation conducted on flame stability and exhaust emissions from a turbulent diffusion combustor, fueled with low-calorific gas, for a small-scale fuel cell. It is important to maintain flame stability in the combustor, even under lean fuel conditions, and to suppress CO emission in the exhaust gas. An imitation off-gas, in which hydrogen and methane were diluted by adding nitrogen, with Wobbe indices ranging from ca. 4400-8700, corresponding to the fuel utility ratio of 90%-60%in the fuel cell, was supplied to the combustor, and the blow-off limits, CO, and NOx emissions were experimentally investigated. The results show that the blow-off excess air ratios increases with an increasing Wobbe index and with decreasing fuel input to the combustor, and that they are proportional to the hydrogen concentration in the fuel to the power of 0.5-1.0. In addition, it was found that the Damköhler numbers at blow-off limits decreased with decreasing fuel input and with increasing Wobbe indices, and that the product of (SS / V·M)A[H2][O2]0.5 was constant at blow-off limits. Furthermore, NOx emissions from the combustor were low, less than 20ppmV (O2=0%), it was also found that the apparent activation energy of NOx emission derived from Arrhenius plots was almost equal to that of prompt NO in the combustion of imitation off-gas.

  5. Lean Limit Phenomena

    NASA Technical Reports Server (NTRS)

    Law, C. K.

    1983-01-01

    The influence of stretch and preferential diffusion on premixed flame extinction and stability was investigated via two model flame configurations, namely the stagnation flame and the bunsen flame. Using a counterflow burner and a stagnation flow burner with a water-cooled wall, the effect of downstream heat loss on the extinction of a stretched premixed flame investigated for lean and rich propane/air and methane/air mixtures. It was demonstrated that extinction by stretch alone is possible only when the deficient reactant is the less mobile one. When it is the more mobile one, downstream heat loss or incomplete reaction is also needed to achieve extinction. The local extinction of bunsen flame tips and edges of hydrocarbon/air premixtures was investigated using a variety of burners. Results show that, while for both rich propane/air and butane/air mixtures tip opening occurs at a constant fuel equivalence ratio of 1.44 and is therefore independent of the intensity, uniformity, and configuration of the approach flow, for rich methane/air flames burning is intensified at the tip and therefore opening is not possible.

  6. Why Lean doesn't work for everyone.

    PubMed

    Kaplan, Gary S; Patterson, Sarah H; Ching, Joan M; Blackmore, C Craig

    2014-12-01

    Popularisation of Lean in healthcare has led to emphasis on Lean quality improvement tools in isolation, with inconsistent results. We argue that delivery of safer, more efficient, and higher quality-patient focused care requires organisational transformation of which the Lean toolkit is only one component. To successfully facilitate system transformation toward higher quality care at lower cost, Lean tools must be part of a comprehensive management system, within a supportive institutional culture, and with committed leadership. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. The Role of Lean Process Improvement in Implementation of Evidence-Based Practices in Behavioral Health Care.

    PubMed

    Steinfeld, Bradley; Scott, Jennifer; Vilander, Gavin; Marx, Larry; Quirk, Michael; Lindberg, Julie; Koerner, Kelly

    2015-10-01

    To effectively implement evidence-based practices (EBP) in behavioral health care, an organization needs to have operating structures and processes that can address core EBP implementation factors and stages. Lean, a widely used quality improvement process, can potentially address the factors crucial to successful implementation of EBP. This article provides an overview of Lean and the relationship between Lean process improvement steps, and EBP implementation models. Examples of how Lean process improvement methodologies can be used to help plan and carry out implementation of EBP in mental health delivery systems are presented along with limitations and recommendations for future research and clinical application.

  8. 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.

  9. Improving Emergency Department Door to Doctor Time and Process Reliability

    PubMed Central

    El Sayed, Mazen J.; El-Eid, Ghada R.; Saliba, Miriam; Jabbour, Rima; Hitti, Eveline A.

    2015-01-01

    Abstract The aim of this study is to determine the effectiveness of using lean management methods on improving emergency department door to doctor times at a tertiary care hospital. We performed a before and after study at an academic urban emergency department with 49,000 annual visits after implementing a series of lean driven interventions over a 20 month period. The primary outcome was mean door to doctor time and the secondary outcome was length of stay of both admitted and discharged patients. A convenience sample from the preintervention phase (February 2012) was compared to another from the postintervention phase (mid-October to mid-November 2013). Individual control charts were used to assess process stability. Postintervention there was a statistically significant decrease in the mean door to doctor time measure (40.0 minutes ± 53.44 vs 25.3 minutes ± 15.93 P < 0.001). The postintervention process was more statistically in control with a drop in the upper control limits from 148.8 to 72.9 minutes. Length of stay of both admitted and discharged patients dropped from 2.6 to 2.0 hours and 9.0 to 5.5 hours, respectively. All other variables including emergency department visit daily volumes, hospital occupancy, and left without being seen rates were comparable. Using lean change management techniques can be effective in reducing door to doctor time in the Emergency Department and improving process reliability. PMID:26496278

  10. Textural attributes and oxidative stability of pork longissimus muscle injected with marbling-like emulsified lipids.

    PubMed

    Ma, Lizhen; Xiong, Youling L

    2011-10-01

    The objective of the study was to create marbling-like fat in lean pork with acceptable oxidative stability through the injection of canola/olive oil-substituted emulsions. Pork loins were injected with 5% water as control (CW) or 5% emulsion containing no tocopherols (E) or 0.07% tocopherols (ET) and stored at 2 °C in an oxygen-enriched package for up to 3 weeks. Lipid oxidation was totally inhibited in ET pork but increased 3-fold to 0.20mg malonaldehyde/kg in CW and E pork after 3 weeks. ET treatment also had a positive effect on meat red color. Emulsion-containing pork, showing less protein oxidation (carbonyl and disulfide formation), had reduced drip loss and shear force than CW samples (P<0.05). The results indicated that incorporation of antioxidant-containing emulsions could create marbling-like texture in lean pork without compromising oxidative stability. Copyright © 2011. Published by Elsevier Ltd.

  11. 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.

  12. The effect of incomplete fuel-air mixing on the lean limit and emissions characteristics of a Lean Prevaporized Premixed (LPP) combustor

    NASA Technical Reports Server (NTRS)

    Santavicca, D. A.; Steinberger, R. L.; Gibbons, K. A.; Citeno, J. V.; Mills, S.

    1993-01-01

    Results are presented from an experimental study of the effect of incomplete fuel-air mixing on the lean limit and emissions characteristics of a lean, prevaporized, premixed (LPP), coaxial mixing tube combustor. Two-dimensional exciplex fluorescence was used to characterize the degree of fuel vaporization and mixing at the combustor inlet under non-combusting conditions. These tests were conducted at a pressure of 4 atm., a temperature of 400 C, a mixer tube velocity of 100 m/sec and an equivalence ratio of .8, using a mixture of tetradecane, 1 methyl naphthalene and TMPD as a fuel simulant. Fuel-air mixtures with two distinct spatial distributions were studied. The exciplex measurements showed that there was a significant amount of unvaporized fuel at the combustor entrance in both cases. One case, however, exhibited a very non-uniform distribution of fuel liquid and vapor at the combustor entrance, i.e., with most of the fuel in the upper half of the combustor tube, while in the other case, both the fuel liquid and vapor were much more uniformly distributed across the width of the combustor entrance. The lean limit and emissions measurements were all made at a pressure of 4 atm. and a mixer tube velocity of 100 m/sec, using Jet A fuel and both fuel-air mixture distributions. Contrary to what was expected, the better mixed case was found to have a substantially leaner operating limit. The two mixture distributions also unexpectedly resulted in comparable NO(x) emissions, for a given equivalence ratio and inlet temperature, however, lower NO(x) emissions were possible in the better mixed case due to its leaner operating limit.

  13. Dietary Protein Intake and Lean Muscle Mass in Survivors of Childhood Acute Lymphoblastic Leukemia: Report From the St. Jude Lifetime Cohort Study

    PubMed Central

    Boland, Alexandra M.; Gibson, Todd M.; Lu, Lu; Kaste, Sue C.; DeLany, James P.; Partin, Robyn E.; Lanctot, Jennifer Q.; Howell, Carrie R.; Nelson, Heather H.; Chemaitilly, Wassim; Pui, Ching-Hon; Robison, Leslie L.; Mulrooney, Daniel A.; Hudson, Melissa M.

    2016-01-01

    Background Survivors of childhood acute lymphoblastic leukemia (ALL) are at risk for low lean muscle mass and muscle weakness, which may contribute to inactivity and early development of chronic diseases typically seen in older adults. Although increasing protein intake, in combination with resistance training, improves lean muscle mass in other populations, it is not known whether muscular tissue among survivors of ALL, whose impairments are treatment-related, will respond similarly. Objective The aim of this study was to evaluate associations among dietary protein intake, resistance training, and lean muscle mass in survivors of ALL and age-, sex-, and race-matched controls. Design This was a cross-sectional study. Methods Lean muscle mass was determined with dual-energy x-ray absorptiometry, dietary information with 24-hour recalls, and participation in resistance training with a questionnaire. Participants were 365 survivors of ALL (52% male; 87% white; median age=28.5 years, range=23.6–31.7) and 365 controls with no previous cancer. Results Compared with controls, survivors of ALL had lower lean muscle mass (55.0 versus 57.2 kg, respectively) and lower percentage of lean muscle mass (68.6% versus 71.4%, respectively) than controls. Similar proportions of survivors (71.1%) and controls (69.7%) met recommended dietary protein intake (0.8 g/kg/d). Survivors (45.4%) were less likely to report resistance training than controls (53.8%). In adjusted models, 1-g higher protein intake per kilogram of body mass per day was associated with a 7.9% increase and resistance training ≥1×wk, with a 2.8% increase in lean muscle mass. Limitations The cross-sectional study design limits temporal evaluation of the association between protein intake and lean muscle mass. Conclusions The findings suggest that survivors of childhood ALL with low lean muscle mass may benefit from optimizing dietary protein intake in combination with resistance training. Research is needed to determine whether resistance training with protein supplementation improves lean muscle mass in survivors of childhood ALL. PMID:26893509

  14. Microcombustor

    DOEpatents

    Gardner, Timothy J.; Manginelli, Ronald P.; Lewis, Patrick R.; Frye-Mason, Gregory C.; Colburn, Chris

    2004-09-07

    A microcombustor comprises a microhotplate and a catalyst for sustained combustion on the microscale. The microhotplate has very low heat capacity and thermal conductivity that mitigate large heat losses arising from large surface-to-volume ratios typical of the microdomain. The heated catalyst enables flame ignition and stabilization, permits combustion with lean fuel/air mixtures, extends a hydrocarbon's limits of flammability, and lowers the combustion temperature. The reduced operating temperatures enable a longer microcombustor lifetime and the reduced fuel consumption enables smaller fuel supplies, both of which are especially important for portable microsystems applications. The microcombustor can be used for on-chip thermal management and for sensor applications, such as heating of a micro gas chromatography column and for use as a micro flame ionization detector.

  15. Assessment of adult body composition using bioelectrical impedance: comparison of researcher calculated to machine outputted values.

    PubMed

    Franco-Villoria, Maria; Wright, Charlotte M; McColl, John H; Sherriff, Andrea; Pearce, Mark S

    2016-01-07

    To explore the usefulness of Bioelectrical Impedance Analysis (BIA) for general use by identifying best-evidenced formulae to calculate lean and fat mass, comparing these to historical gold standard data and comparing these results with machine-generated output. In addition, we explored how to best to adjust lean and fat estimates for height and how these overlapped with body mass index (BMI). Cross-sectional observational study within population representative cohort study. Urban community, North East England Sample of 506 mothers of children aged 7-8 years, mean age 36.3 years. Participants were measured at a home visit using a portable height measure and leg-to-leg BIA machine (Tanita TBF-300MA). Height, weight, bioelectrical impedance (BIA). Lean and fat mass calculated using best-evidenced published formulae as well as machine-calculated lean and fat mass data. Estimates of lean mass were similar to historical results using gold standard methods. When compared with the machine-generated values, there were wide limits of agreement for fat mass and a large relative bias for lean that varied with size. Lean and fat residuals adjusted for height differed little from indices of lean (or fat)/height(2). Of 112 women with BMI >30 kg/m(2), 100 (91%) also had high fat, but of the 16 with low BMI (<19 kg/m(2)) only 5 (31%) also had low fat. Lean and fat mass calculated from BIA using published formulae produces plausible values and demonstrate good concordance between high BMI and high fat, but these differ substantially from the machine-generated values. Bioelectrical impedance can supply a robust and useful field measure of body composition, so long as the machine-generated output is not used. 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/

  16. 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.

  17. Lean NOx Trap Catalysis for Lean Natural Gas Engine Applications

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

    Parks, II, James E; Storey, John Morse; Theiss, Timothy J

    Distributed energy is an approach for meeting energy needs that has several advantages. Distributed energy improves energy security during natural disasters or terrorist actions, improves transmission grid reliability by reducing grid load, and enhances power quality through voltage support and reactive power. In addition, distributed energy can be efficient since transmission losses are minimized. One prime mover for distributed energy is the natural gas reciprocating engine generator set. Natural gas reciprocating engines are flexible and scalable solutions for many distributed energy needs. The engines can be run continuously or occasionally as peak demand requires, and their operation and maintenance ismore » straightforward. Furthermore, system efficiencies can be maximized when natural gas reciprocating engines are combined with thermal energy recovery for cooling, heating, and power applications. Expansion of natural gas reciprocating engines for distributed energy is dependent on several factors, but two prominent factors are efficiency and emissions. Efficiencies must be high enough to enable low operating costs, and emissions must be low enough to permit significant operation hours, especially in non-attainment areas where emissions are stringently regulated. To address these issues the U.S. Department of Energy and the California Energy Commission launched research and development programs called Advanced Reciprocating Engine Systems (ARES) and Advanced Reciprocating Internal Combustion Engines (ARICE), respectively. Fuel efficiency and low emissions are two primary goals of these programs. The work presented here was funded by the ARES program and, thus, addresses the ARES 2010 goals of 50% thermal efficiency (fuel efficiency) and <0.1 g/bhp-hr emissions of oxides of nitrogen (NOx). A summary of the goals for the ARES program is given in Table 1-1. ARICE 2007 goals are 45% thermal efficiency and <0.015 g/bhp-hr NOx. Several approaches for improving the efficiency and emissions of natural gas reciprocating engines are being pursued. Approaches include: stoichiometric engine operation with exhaust gas recirculation and three-way catalysis, advanced combustion modes such as homogeneous charge compression ignition, and extension of the lean combustion limit with advanced ignition concepts and/or hydrogen mixing. The research presented here addresses the technical approach of combining efficient lean spark-ignited natural gas combustion with low emissions obtained from a lean NOx trap catalyst aftertreatment system. This approach can be applied to current lean engine technology or advanced lean engines that may result from related efforts in lean limit extension. Furthermore, the lean NOx trap technology has synergy with hydrogen-assisted lean limit extension since hydrogen is produced from natural gas during the lean NOx trap catalyst system process. The approach is also applicable to other lean engines such as diesel engines, natural gas turbines, and lean gasoline engines; other research activities have focused on those applications. Some commercialization of the technology has occurred for automotive applications (both diesel and lean gasoline engine vehicles) and natural gas turbines for stationary power. The research here specifically addresses barriers to commercialization of the technology for large lean natural gas reciprocating engines for stationary power. The report presented here is a comprehensive collection of research conducted by Oak Ridge National Laboratory (ORNL) on lean NOx trap catalysis for lean natural gas reciprocating engines. The research was performed in the Department of Energy's ARES program from 2003 to 2007 and covers several aspects of the technology. All studies were conducted at ORNL on a Cummins C8.3G+ natural gas engine chosen based on industry input to simulate large lean natural gas engines. Specific technical areas addressed by the research include: NOx reduction efficiency, partial oxidation and reforming chemistry, and the effects of sulfur poisons on the partial oxidation, reformer, and lean NOx trap catalysts. The initial work on NOx reduction efficiency demonstrated that NOx emissions <0.1 g/bhp-hr (the ARES goal) can be achieved with the lean NOx trap catalyst technology. Subsequent work focused on cost and size optimization and durability issues which addressed two specific ARES areas of interest to industry ('Cost of Power' and 'Availability, Reliability, and Maintainability', respectively). Thus, the research addressed the approach of the lean NOx trap catalyst technology toward the ARES goals as shown in Table 1-1.« less

  18. Lean limit phenomena

    NASA Technical Reports Server (NTRS)

    Law, C. K.

    1984-01-01

    The concept of flammability limits in the presence of flame interaction, and the existence of negative flame speeds are discussed. Downstream interaction between two counterflow premixed flames of different stoichiometries are experimentally studied. Various flame configurations are observed and quantified; these include the binary system of two lean or rich flames, the triplet system of a lean and a rich flame separated by a diffusion flame, and single diffusion flames with some degree of premixedness. Extinction limits are determined for methane/air and butane/air mixtures over the entire range of mixture concentrations. The results show that the extent of flame interaction depends on the separation distance between the flames which are functions of the mixtures' concentrations, the stretch rate, and the effective Lewis numbers (Le). In particular, in a positively-stretched flow field Le 1 ( 1) mixtures tend to interact strongly (weakly), while the converse holds for flames in a negatively-stretched flow. Also established was the existence of negative flames whose propagation velocity is in the same general direction as that of the bulk convective flow, being supported by diffusion alone. Their existence demonstrates the tendency of flames to resist extinction, and further emphasizes the possibility of very lean or rich mixtures to undergo combustion.

  19. 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.

  20. 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.

  1. 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.

  2. Anthropometry profiles of elite rugby players: quantifying changes in lean mass.

    PubMed

    Duthie, G M; Pyne, D B; Hopkins, W G; Livingstone, S; Hooper, S L

    2006-03-01

    To demonstrate the utility of a practical measure of lean mass for monitoring changes in the body composition of athletes. Between 1999 and 2003 body mass and sum of seven skinfolds were recorded for 40 forwards and 32 backs from one Super 12 rugby union franchise. Players were assessed on 13 (7) occasions (mean (SD)) over 1.9 (1.3) years. Mixed modelling of log transformed variables provided a lean mass index (LMI) of the form mass/skinfolds(x), for monitoring changes in mass controlled for changes in skinfold thickness. Mean effects of phase of season and time in programme were modelled as percentage changes. Effects were standardised for interpretation of magnitudes. The exponent x was 0.13 for forwards and 0.14 for backs (90% confidence limits +/-0.03). The forwards had a small decrease in skinfolds (5.3%, 90% confidence limits +/-2.2%) between preseason and competition phases, and a small increase (7.8%, 90% confidence limits +/-3.1%) during the club season. A small decrease in LMI (approximately 1.5%) occurred after one year in the programme for forwards and backs, whereas increases in skinfolds for forwards became substantial (4.3%, 90% confidence limits +/-2.2%) after three years. Individual variation in body composition was small within a season (within subject SD: body mass, 1.6%; skinfolds, 6.8%; LMI, 1.1%) and somewhat greater for body mass (2.1%) and LMI (1.7%) between seasons. Despite a lack of substantial mean changes, there was substantial individual variation in lean mass within and between seasons. An index of lean mass based on body mass and skinfolds is a potentially useful tool for assessing body composition of athletes.

  3. Anthropometry profiles of elite rugby players: quantifying changes in lean mass

    PubMed Central

    Duthie, G M; Pyne, D B; Hopkins, W G; Livingstone, S; Hooper, S L

    2006-01-01

    Objective To demonstrate the utility of a practical measure of lean mass for monitoring changes in the body composition of athletes. Methods Between 1999 and 2003 body mass and sum of seven skinfolds were recorded for 40 forwards and 32 backs from one Super 12 rugby union franchise. Players were assessed on 13 (7) occasions (mean (SD)) over 1.9 (1.3) years. Mixed modelling of log transformed variables provided a lean mass index (LMI) of the form mass/skinfoldsx, for monitoring changes in mass controlled for changes in skinfold thickness. Mean effects of phase of season and time in programme were modelled as percentage changes. Effects were standardised for interpretation of magnitudes. Results The exponent x was 0.13 for forwards and 0.14 for backs (90% confidence limits ±0.03). The forwards had a small decrease in skinfolds (5.3%, 90% confidence limits ±2.2%) between preseason and competition phases, and a small increase (7.8%, 90% confidence limits ±3.1%) during the club season. A small decrease in LMI (∼1.5%) occurred after one year in the programme for forwards and backs, whereas increases in skinfolds for forwards became substantial (4.3%, 90% confidence limits ±2.2%) after three years. Individual variation in body composition was small within a season (within subject SD: body mass, 1.6%; skinfolds, 6.8%; LMI, 1.1%) and somewhat greater for body mass (2.1%) and LMI (1.7%) between seasons. Conclusions Despite a lack of substantial mean changes, there was substantial individual variation in lean mass within and between seasons. An index of lean mass based on body mass and skinfolds is a potentially useful tool for assessing body composition of athletes. PMID:16505074

  4. Low NOx, Lean Direct Wall Injection Combustor Concept Developed

    NASA Technical Reports Server (NTRS)

    Tacina, Robert R.; Wey, Changlie; Choi, Kyung J.

    2003-01-01

    The low-emissions combustor development at the NASA Glenn Research Center is directed toward advanced high-pressure aircraft gas turbine applications. The emphasis of this research is to reduce nitrogen oxides (NOx) at high-power conditions and to maintain carbon monoxide and unburned hydrocarbons at their current low levels at low-power conditions. Low-NOx combustors can be classified into rich burn and lean burn concepts. Lean burn combustors can be further classified into lean-premixed-prevaporized (LPP) and lean direct injection (LDI) combustors. In both concepts, all the combustor air, except for liner cooling flow, enters through the combustor dome so that the combustion occurs at the lowest possible flame temperature. The LPP concept has been shown to have the lowest NOx emissions, but for advanced high-pressure-ratio engines, the possibly of autoignition or flashback precludes its use. LDI differs from LPP in that the fuel is injected directly into the flame zone and, thus, does not have the potential for autoignition or flashback and should have greater stability. However, since it is not premixed and prevaporized, the key is good atomization and mixing of the fuel quickly and uniformly so that flame temperatures are low and NOx formation levels are comparable to those of LPP.

  5. Effects of Fuel Laminar Flame Speed Compared to Engine Tumble Ratio, Ignition Energy, and Injection Strategy on Lean and EGR Dilute Spark Ignition Combustion

    DOE PAGES

    Kolodziej, Christopher P.; Pamminger, Michael; Sevik, James; ...

    2017-03-28

    Previously we show that fuels with higher laminar flame speed also have increased tolerance to EGR dilution. In this work, the effects of fuel laminar flame speed on both lean and EGR dilute spark ignition combustion stability were examined. Fuels blends of pure components (iso-octane, n-heptane, toluene, ethanol, and methanol) were derived at two levels of laminar flame speed. Each fuel blend was tested in a single-cylinder spark-ignition engine under both lean-out and EGR dilution sweeps until the coefficient of variance of indicated mean effective pressure increased above thresholds of 3% and 5%. The relative importance of fuel laminar flamemore » speed to changes to engine design parameters (spark ignition energy, tumble ratio, and port vs. direct injection) was also assessed. Our results showed that fuel laminar flame speed can have as big an effect on lean or EGR dilute engine operation as engine design parameters, with the largest effects seen during EGR dilute operation and when changes were made to cylinder charge motion.« less

  6. Effects of Fuel Laminar Flame Speed Compared to Engine Tumble Ratio, Ignition Energy, and Injection Strategy on Lean and EGR Dilute Spark Ignition Combustion

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

    Kolodziej, Christopher P.; Pamminger, Michael; Sevik, James

    Previously we show that fuels with higher laminar flame speed also have increased tolerance to EGR dilution. In this work, the effects of fuel laminar flame speed on both lean and EGR dilute spark ignition combustion stability were examined. Fuels blends of pure components (iso-octane, n-heptane, toluene, ethanol, and methanol) were derived at two levels of laminar flame speed. Each fuel blend was tested in a single-cylinder spark-ignition engine under both lean-out and EGR dilution sweeps until the coefficient of variance of indicated mean effective pressure increased above thresholds of 3% and 5%. The relative importance of fuel laminar flamemore » speed to changes to engine design parameters (spark ignition energy, tumble ratio, and port vs. direct injection) was also assessed. Our results showed that fuel laminar flame speed can have as big an effect on lean or EGR dilute engine operation as engine design parameters, with the largest effects seen during EGR dilute operation and when changes were made to cylinder charge motion.« less

  7. Flame Stability in a Trapped-Vortex Spray-Combustor

    NASA Astrophysics Data System (ADS)

    Chakka, P.; Mancilla, P. C.; Acharya, S.

    1999-11-01

    Flame stabilization mechanisms in a Trapped-Vortex (TV) cavity is investigated experimentally and computationally in the current research. The TV-cavity is placed coaxially in the combustor and the flame is maintained through injection of liquid fuel spray and air from the inside face of the afterbody. This concept was introduced by Roquemore and company of Wright-Patterson AFB for gaseous fuel injection into the cavity and is extended for liquid fuel sprays in the current research. The flame holding capability of the TV-cavity is studied for different equivalence ratios of the secondary injection and overall Lean Blow-Out (LBO) limits are presented for different primary and secondary flow rates. The interaction and mixing of the main flow with the secondary vortex flow is investigated through the Laser Doppler Velocimetry measurements taken through a quartz window near the cavity. Also, temperature distribution through IR measurements and pressure fluctuations inside the chamber are presented for complete performance analysis of the TV cavity combustor.

  8. Negativly streched premixed flames

    NASA Astrophysics Data System (ADS)

    Krikunova, A. I.; Saveliev, A. S.; Son, E. E.

    2018-01-01

    An experimental study of gravity effect on the blow-off and flash-back borders of the conical methane-air flame (normal and ring-stabilized) was performed. The influence of the preferential diffusion on the flame behavior in vicinity of flash-back boundaries was observed. Under conditions at Lewis number Le > 1, the radius of curvature of the flame tip increased gradually approaching flash-back boundaries while for the lean methane-air flames (Le < 1) the radius decreased abruptly. It was shown that the burning velocity for lean flames is less than that for reach ones, so the flash-back occurs at higher strains.

  9. Premix fuels study applicable to duct burner conditions for a variable cycle engine

    NASA Technical Reports Server (NTRS)

    Venkataramani, K. S.

    1978-01-01

    Emission levels and performance of a premixing Jet-A/air duct burner were measured at reference conditions representative of take-off and cruise for a variable cycle engine. In a parametric variation sequence of tests, data were obtained at inlet temperatures of 400, 500 and 600K at equivalence ratios varying from 0.9 to the lean stability limit. Ignition was achieved at all the reference conditions although the CO levels were very high. Significant nonuniformity across the combustor was observed for the emissions at the take-off condition. At a reference Mach number of 0.117 and an inlet temperature of 600K, corresponding to a simulated cruise condition, the NOx emission level was approximately 1 gm/kg-fuel.

  10. Lean burn natural gas fueled S.I. engine and exhaust emissions

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

    Varde, K.S.; Patro, N.; Drouillard, K.

    1995-12-31

    An experimental study was undertaken to study exhaust emission from a lean-burn natural gas spark ignition engine. The possibility that such an engine may help to reduce exhaust emissions substantially by taking advantage of natural gas fuel properties, such as its antiknock properties and extended lean flammability limit compared to gasoline, was the main motivation behind the investigation. A four cylinder, automotive type spark ignition engine was used in the investigation. The engine was converted to operate on natural gas by replacing its fuel system with a gaseous carburetion system. A 3-way metal metrix catalytic converter was used in themore » engine exhaust system to reduce emission levels. The engine operated satisfactorily at an equivalence ratio as lean as 0.6, at all speeds and loads. As a result NOx emissions were significantly reduced. However, hydrocarbon emissions were high, particularly at very lean conditions and light loads. Most of these hydrocarbons were made up of methane with small concentrations of ethane and propane. Coefficient of variations in hydrocarbons were generally high at very lean operating conditions and light loads, but decreased with increasing equivalence ratio and engine speed. Methane concentrations in the engine exhaust decreased with increasing load and equivalence ratio. At lean air-to-fuel ratios and light loads oxidation of methane in the catalyst was substantially limited and no NOx reduction was achieved. In addition, the proportion of nitric oxide in oxides of nitrogen increased with increasing amount of NOx in the engine exhaust. A major problem encountered in the study was the inability of the fuel system to maintain near constant air-to-fuel ratios at steady operating conditions.« less

  11. Large Eddy Simulations of the Vortex-Flame Interaction in a Turbulent Swirl Burner

    NASA Astrophysics Data System (ADS)

    Lu, Zhen; Elbaz, Ayman M.; Hernandez Perez, Francisco E.; Roberts, William L.; Im, Hong G.

    2017-11-01

    A series of swirl-stabilized partially premixed flames are simulated using large eddy simulation (LES) along with the flamelet/progress variable (FPV) model for combustion. The target burner has separate and concentric methane and air streams, with methane in the center and the air flow swirled through the tangential inlets. The flame is lifted in a straight quarl, leading to a partially premixed state. By fixing the swirl number and air flow rate, the fuel jet velocity is reduced to study flame stability as the flame approaches the lean blow-off limit. Simulation results are compared against measured data, yielding a generally good agreement on the velocity, temperature, and species mass fraction distributions. The proper orthogonal decomposition (POD) method is applied on the velocity and progress variable fields to analyze the dominant unsteady flow structure, indicating a coupling between the precessing vortex core (PVC) and the flame. The effects of vortex-flame interactions on the stabilization of the lifted swirling flame are also investigated. For the stabilization of the lifted swirling flame, the effects of convection, enhanced mixing, and flame stretching introduced by the PVC are assessed based on the numerical results. This research work was sponsored by King Abdullah University of Science and Technology (KAUST) and used computational resources at KAUST Supercomputing Laboratory.

  12. Lean mixture engine testing and evaluation program. [for automobile engine pollution and fuel performances

    NASA Technical Reports Server (NTRS)

    Dowdy, M. W.; Hoehn, F. W.; Griffin, D. C.

    1975-01-01

    Experimental results for fuel consumption and emissions are presented for a 350 CID (5.7 liter) Chevrolet V-8 engine modified for lean operation with gasoline. The lean burn engine achieved peak thermal efficiency at an equivalence ratio of 0.75 and a spark advance of 60 deg BTDC. At this condition the lean burn engine demonstrated a 10% reduction in brake specific fuel consumption compared with the stock engine; however, NOx and hydrocarbon emissions were higher. With the use of spark retard and/or slightly lower equivalence ratios, the NOx emissions performance of the stock engine was matched while showing a 6% reduction in brake specific fuel consumption. Hydrocarbon emissions exceeded the stock values in all cases. Diagnostic data indicate that lean performance in the engine configuration tested is limited by ignition delay, cycle-to-cycle pressure variations, and cylinder-to-cylinder distribution.

  13. Application of controllable pulverized-coal rich/lean combustion technology at the Hebi Wanhe Power Generation Co. Ltd.

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

    Jianzhong, L.; Xiang, Z.; Junhu, Z.

    1999-07-01

    The No.2 unit (670/H, 200MW) at Hebi Wanhe Power Generation C o. Ltd., was put into use in 1992. This is a coal-fired boiler with tangential fired method. The design coal is Hebi lean coal. To stabilize the combustion without oil at low load, eight original designed burners placed to No. 2 and 3 level on the No.2 boiler were replaced with the controllable pulverized rich/lean ones developed by the Institute for Thermal Power Engineering (ITPE) of Zhejiang University. The practice of successive operation shows that stable combustion can be achieved at 50% load without support oil, even at 45%more » load. The combustible matter in fly ash decreased to 1.12% and 1.17% from 1.83% and 1.32%, respectively at full load (200MW) and half load (100MW). The application has obvious economic benefits.« less

  14. Development of a bedside viable ultrasound protocol to quantify appendicular lean tissue mass.

    PubMed

    Paris, Michael T; Lafleur, Benoit; Dubin, Joel A; Mourtzakis, Marina

    2017-10-01

    Ultrasound is a non-invasive and readily available tool that can be prospectively applied at the bedside to assess muscle mass in clinical settings. The four-site protocol, which images two anatomical sites on each quadriceps, may be a viable bedside method, but its ability to predict musculature has not been compared against whole-body reference methods. Our primary objectives were to (i) compare the four-site protocol's ability to predict appendicular lean tissue mass from dual-energy X-ray absorptiometry; (ii) optimize the predictability of the four-site protocol with additional anatomical muscle thicknesses and easily obtained covariates; and (iii) assess the ability of the optimized protocol to identify individuals with low lean tissue mass. This observational cross-sectional study recruited 96 university and community dwelling adults. Participants underwent ultrasound scans for assessment of muscle thickness and whole-body dual-energy X-ray absorptiometry scans for assessment of appendicular lean tissue. Ultrasound protocols included (i) the nine-site protocol, which images nine anterior and posterior muscle groups in supine and prone positions, and (ii) the four-site protocol, which images two anterior sites on each quadriceps muscle group in a supine position. The four-site protocol was strongly associated (R 2  = 0.72) with appendicular lean tissue mass, but Bland-Altman analysis displayed wide limits of agreement (-5.67, 5.67 kg). Incorporating the anterior upper arm muscle thickness, and covariates age and sex, alongside the four-site protocol, improved the association (R 2  = 0.91) with appendicular lean tissue and displayed narrower limits of agreement (-3.18, 3.18 kg). The optimized protocol demonstrated a strong ability to identify low lean tissue mass (area under the curve = 0.89). The four-site protocol can be improved with the addition of the anterior upper arm muscle thickness, sex, and age when predicting appendicular lean tissue mass. This optimized protocol can accurately identify low lean tissue mass, while still being easily applied at the bedside. © 2017 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.

  15. Development of a bedside viable ultrasound protocol to quantify appendicular lean tissue mass

    PubMed Central

    Paris, Michael T.; Lafleur, Benoit; Dubin, Joel A.

    2017-01-01

    Abstract Background Ultrasound is a non‐invasive and readily available tool that can be prospectively applied at the bedside to assess muscle mass in clinical settings. The four‐site protocol, which images two anatomical sites on each quadriceps, may be a viable bedside method, but its ability to predict musculature has not been compared against whole‐body reference methods. Our primary objectives were to (i) compare the four‐site protocol's ability to predict appendicular lean tissue mass from dual‐energy X‐ray absorptiometry; (ii) optimize the predictability of the four‐site protocol with additional anatomical muscle thicknesses and easily obtained covariates; and (iii) assess the ability of the optimized protocol to identify individuals with low lean tissue mass. Methods This observational cross‐sectional study recruited 96 university and community dwelling adults. Participants underwent ultrasound scans for assessment of muscle thickness and whole‐body dual‐energy X‐ray absorptiometry scans for assessment of appendicular lean tissue. Ultrasound protocols included (i) the nine‐site protocol, which images nine anterior and posterior muscle groups in supine and prone positions, and (ii) the four‐site protocol, which images two anterior sites on each quadriceps muscle group in a supine position. Results The four‐site protocol was strongly associated (R 2 = 0.72) with appendicular lean tissue mass, but Bland–Altman analysis displayed wide limits of agreement (−5.67, 5.67 kg). Incorporating the anterior upper arm muscle thickness, and covariates age and sex, alongside the four‐site protocol, improved the association (R 2 = 0.91) with appendicular lean tissue and displayed narrower limits of agreement (−3.18, 3.18 kg). The optimized protocol demonstrated a strong ability to identify low lean tissue mass (area under the curve = 0.89). Conclusions The four‐site protocol can be improved with the addition of the anterior upper arm muscle thickness, sex, and age when predicting appendicular lean tissue mass. This optimized protocol can accurately identify low lean tissue mass, while still being easily applied at the bedside. PMID:28722298

  16. 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.

  17. Trimetazidine therapy for diabetic mouse hearts subjected to ex vivo acute heart failure.

    PubMed

    Breedt, Emilene; Lacerda, Lydia; Essop, M Faadiel

    2017-01-01

    Acute heart failure (AHF) is the most common primary diagnosis for hospitalized heart diseases in Africa. As increased fatty acid β-oxidation (FAO) during heart failure triggers detrimental effects on the myocardium, we hypothesized that trimetazidine (TMZ) (partial FAO inhibitor) offers cardioprotection under normal and obese-related diabetic conditions. Hearts were isolated from 12-14-week-old obese male and female diabetic (db/db) mice versus lean non-diabetic littermates (db/+) controls. The Langendorff retrograde isolated heart perfusion system was employed to establish an ex vivo AHF model: a) Stabilization phase-Krebs Henseleit buffer (10 mM glucose) at 100 mmHg (25 min); b) Critical Acute Heart Failure (CAHF) phase-(1.2 mM palmitic acid, 2.5 mM glucose) at 20 mmHg (25 min); and c) Recovery Acute Heart Failure phase (RAHF)-(1.2 mM palmitic acid, 10 mM glucose) at 100 mmHg (25 min). Treated groups received 5 μM TMZ in the perfusate during either the CAHF or RAHF stage for the full duration of each respective phase. Both lean and obese males benefited from TMZ treatment administered during the RAHF phase. Sex differences were observed only in lean groups where the phases of the estrous cycle influenced therapy; only the lean follicular female group responded to TMZ treatment during the CAHF phase. Lean luteal females rather displayed an inherent cardioprotection (without treatments) that was lost with obesity. However, TMZ treatment initiated during RAHF was beneficial for obese luteal females. TMZ treatment triggered significant recovery for male and obese female hearts when administered during RAHF. There were no differences between lean and obese male hearts, while lean females displayed a functional recovery advantage over lean males. Thus TMZ emerges as a worthy therapeutic target to consider for AHF treatment in normal and obese-diabetic individuals (for both sexes), but only when administered during the recovery phase and not during the very acute stages.

  18. An exploratory analysis for Lean and Six Sigma implementation in hospitals: Together is better?

    PubMed

    Lee, Jung Young; McFadden, Kathleen L; Gowen, Charles R

    Despite the increasing interest for Lean and Six Sigma implementations in hospitals, there has been little empirical evidence that goes beyond descriptive case studies to address the current status and the effectiveness of the implementations. The aim of this study was to explore existing patterns of Lean and Six Sigma implementation in U.S. hospitals and compare the performance of the different patterns. We collected data from 215 U.S. hospitals via a survey that includes measurement items developed from related literature. Using the cross-sectional data, we conducted a cluster analysis, followed by t tests, chi-square tests, and regression analyses for cluster verification. The cluster analysis identifies two clusters, a Moderate Six Sigma group and a Lean Six Sigma group. Results show that the Lean Six Sigma group outperforms the Moderate Six Sigma group across many performance dimensions: responsiveness capability, patient safety, and possibly cost saving. In addition, the Lean Six Sigma group tends to be composed of larger, private teaching hospitals located in more urban areas, and they employ more resources for quality improvement. Our research contributes to the quality management literature by supporting the possible complementary relationship between Lean and Six Sigma in hospitals. Our study encourages practitioners and managers to pay more attention to Lean implementation. Although Lean seems to be conducted in a limited fashion in many hospitals, it should be expanded and combined with Six Sigma for better results.

  19. Distinct skeletal muscle fiber characteristics and gene expression in diet-sensitive versus diet-resistant obesity.

    PubMed

    Gerrits, Martin F; Ghosh, Sujoy; Kavaslar, Nihan; Hill, Benjamin; Tour, Anastasia; Seifert, Erin L; Beauchamp, Brittany; Gorman, Shelby; Stuart, Joan; Dent, Robert; McPherson, Ruth; Harper, Mary-Ellen

    2010-08-01

    Inter-individual variability in weight gain and loss under energy surfeit and deficit conditions, respectively, are well recognized but poorly understood phenomena. We documented weight loss variability in an intensively supervised clinical weight loss program and assessed skeletal muscle gene expression and phenotypic characteristics related to variable response to a 900 kcal regimen. Matched pairs of healthy, diet-compliant, obese diet-sensitive (ODS) and diet-resistant (ODR) subjects were defined as those in the highest and lowest quintiles for weight loss rate. Physical activity energy expenditure was minimal and comparable. Following program completion and weight stabilization, skeletal muscle biopsies were obtained. Gene expression analysis of rectus femoris and vastus lateralis indicated upregulation of genes and gene sets involved in oxidative phosphorylation and glucose and fatty acid metabolism in ODS compared with ODR. In vastus lateralis, there was a higher proportion of oxidative (type I) fibers in ODS compared with ODR women and lean controls, fiber hypertrophy in ODS compared with ODR women and lean controls, and lower succinate dehydrogenase in oxidative and oxidative-glycolytic fibers in all obese compared with lean subjects. Intramuscular lipid content was generally higher in obese versus lean, and specifically higher in ODS vs. lean women. Altogether, our findings demonstrate differences in muscle gene expression and fiber composition related to clinical weight loss success.

  20. Distinct skeletal muscle fiber characteristics and gene expression in diet-sensitive versus diet-resistant obesity

    PubMed Central

    Gerrits, Martin F.; Ghosh, Sujoy; Kavaslar, Nihan; Hill, Benjamin; Tour, Anastasia; Seifert, Erin L.; Beauchamp, Brittany; Gorman, Shelby; Stuart, Joan; Dent, Robert; McPherson, Ruth; Harper, Mary-Ellen

    2010-01-01

    Inter-individual variability in weight gain and loss under energy surfeit and deficit conditions, respectively, are well recognized but poorly understood phenomena. We documented weight loss variability in an intensively supervised clinical weight loss program and assessed skeletal muscle gene expression and phenotypic characteristics related to variable response to a 900 kcal regimen. Matched pairs of healthy, diet-compliant, obese diet-sensitive (ODS) and diet-resistant (ODR) subjects were defined as those in the highest and lowest quintiles for weight loss rate. Physical activity energy expenditure was minimal and comparable. Following program completion and weight stabilization, skeletal muscle biopsies were obtained. Gene expression analysis of rectus femoris and vastus lateralis indicated upregulation of genes and gene sets involved in oxidative phosphorylation and glucose and fatty acid metabolism in ODS compared with ODR. In vastus lateralis, there was a higher proportion of oxidative (type I) fibers in ODS compared with ODR women and lean controls, fiber hypertrophy in ODS compared with ODR women and lean controls, and lower succinate dehydrogenase in oxidative and oxidative-glycolytic fibers in all obese compared with lean subjects. Intramuscular lipid content was generally higher in obese versus lean, and specifically higher in ODS vs. lean women. Altogether, our findings demonstrate differences in muscle gene expression and fiber composition related to clinical weight loss success. PMID:20332421

  1. 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.

  2. Incidental rewarding cues influence economic decisions in people with obesity.

    PubMed

    Simmank, Jakob; Murawski, Carsten; Bode, Stefan; Horstmann, Annette

    2015-01-01

    Recent research suggests that obesity is linked to prominent alterations in learning and decision-making. This general difference may also underlie the preference for immediately consumable, highly palatable but unhealthy and high-calorie foods. Such poor food-related inter-temporal decision-making can explain weight gain; however, it is not yet clear whether this deficit can be generalized to other domains of inter-temporal decision-making, for example financial decisions. Further, little is known about the stability of decision-making behavior in obesity, especially in the presence of rewarding cues. To answer these questions, obese and lean participants (n = 52) completed two sessions of a novel priming paradigm including a computerized monetary delay discounting task. In the first session, general differences between groups in financial delay discounting were measured. In the second session, we tested the general stability of discount rates. Additionally, participants were primed by affective visual cues of different contextual categories before making financial decisions. We found that the obese group showed stronger discounting of future monetary rewards than the lean group, but groups did not differ in their general stability between sessions nor in their sensitivity toward changes in reward magnitude. In the obese group, a fast decrease of subjective value over time was directly related to a higher tendency for opportunistic eating. Obese in contrast to lean people were primed by the affective cues, showing a sex-specific pattern of priming direction. Our findings demonstrate that environments rich of cues, aiming at inducing unhealthy consumer decisions, can be highly detrimental for obese people. It also underscores that obesity is not merely a medical condition but has a strong cognitive component, meaning that current dietary and medical treatment strategies may fall too short.

  3. Incidental rewarding cues influence economic decisions in people with obesity

    PubMed Central

    Simmank, Jakob; Murawski, Carsten; Bode, Stefan; Horstmann, Annette

    2015-01-01

    Recent research suggests that obesity is linked to prominent alterations in learning and decision-making. This general difference may also underlie the preference for immediately consumable, highly palatable but unhealthy and high-calorie foods. Such poor food-related inter-temporal decision-making can explain weight gain; however, it is not yet clear whether this deficit can be generalized to other domains of inter-temporal decision-making, for example financial decisions. Further, little is known about the stability of decision-making behavior in obesity, especially in the presence of rewarding cues. To answer these questions, obese and lean participants (n = 52) completed two sessions of a novel priming paradigm including a computerized monetary delay discounting task. In the first session, general differences between groups in financial delay discounting were measured. In the second session, we tested the general stability of discount rates. Additionally, participants were primed by affective visual cues of different contextual categories before making financial decisions. We found that the obese group showed stronger discounting of future monetary rewards than the lean group, but groups did not differ in their general stability between sessions nor in their sensitivity toward changes in reward magnitude. In the obese group, a fast decrease of subjective value over time was directly related to a higher tendency for opportunistic eating. Obese in contrast to lean people were primed by the affective cues, showing a sex-specific pattern of priming direction. Our findings demonstrate that environments rich of cues, aiming at inducing unhealthy consumer decisions, can be highly detrimental for obese people. It also underscores that obesity is not merely a medical condition but has a strong cognitive component, meaning that current dietary and medical treatment strategies may fall too short. PMID:26528158

  4. Increased Butyrate Production During Long-Term Fermentation of In Vitro-Digested High Amylose Cornstarch Residues with Human Feces.

    PubMed

    Li, Li; Jiang, Hongxin; Kim, Hyun-Jung; Yum, Man-Yu; Campbell, Mark R; Jane, Jay-Lin; White, Pamela J; Hendrich, Suzanne

    2015-09-01

    An in vitro semi-continuous long-term (3 wk) anaerobic incubation system simulating lower gut fermentation was used to determine variability in gut microbial metabolism between 4 predigested high amylose-resistant starch residues (SR): SRV, SRVI, SRVII, and SRGEMS in human fecal samples. Subjects participated twice, 5 mo apart: 30 in Phase I (15 lean, 9 overweight and 6 obese), 29 in Phase II (15 lean, 9 overweight, 5 obese); 13 of 15 lean subjects participated in both phases. Of the 4 SRs, SRV displayed the highest gelatinization temperature, peak temperature, enthalpy changes, and the least digestibility compared with the other SRs. In both phases, compared with blank controls, all SRs increased butyrate ∼2-fold which stabilized at week 2 and only SRV caused greater propionate concentration (∼30%) after 3 wk which might have been partly mediated by its lesser digestibility. Fecal samples from lean and overweight/obese subjects incubated with SRs showed similar short-chain fatty acid production across both time points, which suggests that resistant starch may benefit individuals across BMIs. © 2015 Institute of Food Technologists®

  5. Real-Time Control of Lean Blowout in a Turbine Engine for Minimizing No(x) Emissions

    NASA Technical Reports Server (NTRS)

    Zinn, Ben

    2004-01-01

    This report describes research on the development and demonstration of a controlled combustor operates with minimal NO, emissions, thus meeting one of NASA s UEET program goals. NO(x) emissions have been successfully minimized by operating a premixed, lean burning combustor (modeling a lean prevaporized, premixed LPP combustor) safely near its lean blowout (LBO) limit over a range of operating conditions. This was accomplished by integrating the combustor with an LBO precursor sensor and closed-loop, rule-based control system that allowed the combustor to operate far closer to the point of LBO than an uncontrolled combustor would be allowed to in a current engine. Since leaner operation generally leads to lower NO, emissions, engine NO, was reduced without loss of safety.

  6. A DNS study on the stabilization mechanism of a turbulent lifted ethylene jet flame in highly-heated coflow

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

    Yoo, Chun S

    2011-01-01

    Direct numerical simulation (DNS) of the near-field of a three-dimensional spatially-developing turbulent ethylene jet flame in highly-heated coflow is performed with a reduced mechanism to determine the stabilization mechanism. The DNS was performed at a jet Reynolds number of 10,000 with over 1.29 billion grid points. The results show that auto-ignition in a fuel-lean mixture at the flame base is the main source of stabilization of the lifted jet flame. The Damkoehler number and chemical explosive mode (CEM) analysis also verify that auto-ignition occurs at the flame base. In addition to auto-ignition, Lagrangian tracking of the flame base reveals themore » passage of large-scale flow structures and their correlation with the fluctuations of the flame base similar to a previous study (Yoo et al., J. Fluid Mech. 640 (2009) 453-481) with hydrogen/air jet flames. It is also observed that the present lifted flame base exhibits a cyclic 'saw-tooth' shaped movement marked by rapid movement upstream and slower movement downstream. This is a consequence of the lifted flame being stabilized by a balance between consecutive auto-ignition events in hot fuel-lean mixtures and convection induced by the high-speed jet and coflow velocities. This is confirmed by Lagrangian tracking of key variables including the flame-normal velocity, displacement speed, scalar dissipation rate, and mixture fraction at the stabilization point.« less

  7. A DNS study on the stabilization mechanism of a turbulent lifted ethylene jet flame in highly-heated coflow

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

    Yoo, C. S.; Richardson, E.; Sankaran, R.

    2011-01-01

    Direct numerical simulation (DNS) of the near-field of a three-dimensional spatially-developing turbulent ethylene jet flame in highly-heated coflow is performed with a reduced mechanism to determine the stabilization mechanism. The DNS was performed at a jet Reynolds number of 10,000 with over 1.29 billion grid points. The results show that auto-ignition in a fuel-lean mixture at the flame base is the main source of stabilization of the lifted jet flame. The Damköhler number and chemical explosive mode (CEM) analysis also verify that auto-ignition occurs at the flame base. In addition to auto-ignition, Lagrangian tracking of the flame base reveals themore » passage of large-scale flow structures and their correlation with the fluctuations of the flame base similar to a previous study (Yoo et al., J. Fluid Mech. 640 (2009) 453–481) with hydrogen/air jet flames. It is also observed that the present lifted flame base exhibits a cyclic ‘saw-tooth’ shaped movement marked by rapid movement upstream and slower movement downstream. This is a consequence of the lifted flame being stabilized by a balance between consecutive auto-ignition events in hot fuel-lean mixtures and convection induced by the high-speed jet and coflow velocities. This is confirmed by Lagrangian tracking of key variables including the flame-normal velocity, displacement speed, scalar dissipation rate, and mixture fraction at the stabilization point.« less

  8. Flow-combustion interactions in ducted flameholder-stabilized premixed flames

    NASA Astrophysics Data System (ADS)

    Soteriou, Marios; Arienti, Marco; Erickson, Robert

    2006-11-01

    Turbulent premixed combustion is present in many power generation and propulsion systems due to its large energy conversion rate (as compared to non-premixed combustion) and its potential for reduced emissions (at the lean limit). As a result, the study of turbulent premixed flames has received substantial attention in the past through experiment, analysis and simulation. In the recent past, unsteady Computational Fluid Dynamics (CFD) based models have been increasingly leveraged towards the in depth study of the physics of turbulent premixed flames. The bulk of this effort focuses on the response of the flame to turbulence. In contrast, we focus on the opposite problem, i.e. the modification of the turbulent flowfield by the flame. This topic has also received some attention but with a strong emphasis on planar (in the mean), flames propagating normal to the flow. Instead, we focus on flameholder-stabilized ducted flames, i.e. ones in which the flame is confined and substantially inclined to the incoming flow. The fundamental mechanisms by which the flame impacts the flow, i.e. dilatation, baroclinic vorticity generation and molecular diffusion enhancement are discussed in detail and their relative impact quantified. Limitations of modeling these mechanisms in current state of the art CFD models are also addressed.

  9. Plaintiffs' and Defendants' Preliminary Outlines of the Legal Issues and Proof, McLean v. Arkansas.

    ERIC Educational Resources Information Center

    Thomas, William A., Ed.

    1982-01-01

    Presents edited versions of plaintiff and defendant outlines of legal issues and proof (views of cases set to limit issues argued during trials) and trial briefs (comprehensive presentations of legal precedents and arguments) in McLean v. Arkansas Board of Education case focusing on balanced treatment of creationism/evolution in public schools.…

  10. 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

  11. 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).

  12. 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.

  13. Gaseous Non-Premixed Flame Research Planned for the International Space Station

    NASA Technical Reports Server (NTRS)

    Stocker, Dennis P.; Takahashi, Fumiaki; Hickman, J. Mark; Suttles, Andrew C.

    2014-01-01

    Thus far, studies of gaseous diffusion flames on the International Space Station (ISS) have been limited to research conducted in the Microgravity Science Glovebox (MSG) in mid-2009 and early 2012. The research was performed with limited instrumentation, but novel techniques allowed for the determination of the soot temperature and volume fraction. Development is now underway for the next experiments of this type. The Advanced Combustion via Microgravity Experiments (ACME) project consists of five independent experiments that will be conducted with expanded instrumentation within the stations Combustion Integrated Rack (CIR). ACMEs goals are to improve our understanding of flame stability and extinction limits, soot control and reduction, oxygen-enriched combustion which could enable practical carbon sequestration, combustion at fuel lean conditions where both optimum performance and low emissions can be achieved, the use of electric fields for combustion control, and materials flammability. The microgravity environment provides longer residence times and larger length scales, yielding a broad range of flame conditions which are beneficial for simplified analysis, e.g., of limit behaviour where chemical kinetics are important. The detailed design of the modular ACME hardware, e.g., with exchangeable burners, is nearing completion, and it is expected that on-orbit testing will begin in 2016.

  14. Technology Being Developed at Lawrence Berkeley National Laboratory: Ultra-Low- Emission Combustion Technologies for Heat and Power Generation

    NASA Technical Reports Server (NTRS)

    Cheng, Robert K.

    2001-01-01

    The Combustion Technologies Group at Lawrence Berkeley National Laboratory has developed simple, low-cost, yet robust combustion technologies that may change the fundamental design concept of burners for boilers and furnaces, and injectors for gas turbine combustors. The new technologies utilize lean premixed combustion and could bring about significant pollution reductions from commercial and industrial combustion processes and may also improve efficiency. The technologies are spinoffs of two fundamental research projects: An inner-ring burner insert for lean flame stabilization developed for NASA- sponsored reduced-gravity combustion experiments. A low-swirl burner developed for Department of Energy Basic Energy Sciences research on turbulent combustion.

  15. The Stability and Structure of Lean Hydrogen-Air Flames: Effects of Gravity

    DTIC Science & Technology

    1990-05-17

    INTRODUCTION ................................................................................................. 1 MULTIDIMENSIONAL FLAME MODEL ...combustion, molecular diffusion between the reactants, intermediates, and products, thermal conduction, convection, and gravity. Such a detailed model allows...instabil- ity, generally called the Rayleigh-Taylor instability5 . A numerical model of the premixed hydrogen flame that includes all the physical

  16. Flight Investigation of the Knock-Limited Performance of a Triptane Blend, a Toluene Blend, and 28-R Fuel in an R-1830-75 Engine

    NASA Technical Reports Server (NTRS)

    Blackman, Calvin C.

    1946-01-01

    Knock-limited performance data were obtained for three fuels on an R-1830-75 engine in a B-24D airplane at engine speeds of 1800, 2250, and 2600 rpm, a spark advance of 25 degrees B.T.C., and carburetor-air temperatures of 85 F for 1800 and 2250 rpm and 100 F for 2600 rpm. The test fuels were a blend of 80 percent 28-R plus 20 percent triptane (leaded to 4.5 ml TEL/gal), a blend of 80 percent 28-R plus 15 percent toluene (leaded to 4.5 ml TEL / gal), and 28-R fuel. The knock-limited manifold pressure of the toluene blend depreciated more in the lean region than the triptane blend or 28-R fuel. The knock-limited brake horsepower for the triptane blend varied from 16 to 25 percent higher than 28-R in the lean region and 18 to 30 percent higher in the rich region. The knock-limited brake horsepower of the toluene blend was approximately 15 percent higher than that of 28-R in the rich region and varied from 2 to 10 percent higher in the lean region. Knock limits of the triptane blend and 28-R fuel tested in the R-1830-75 engine agreed with limits for the same fuels determined with the R-1830-94 engine for engine speeds of 1800 and 2250 rpm.

  17. 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.

  18. Effect of lean red meat from lamb v. lean white meat from chicken on the serum lipid profile: a randomised, cross-over study in women.

    PubMed

    Mateo-Gallego, Rocio; Perez-Calahorra, Sofia; Cenarro, Ana; Bea, Ana M; Andres, Eva; Horno, Jaime; Ros, Emilio; Civeira, Fernando

    2012-05-01

    The main dietary guidelines recommend restricting total and saturated fat intake in the management of high blood cholesterol levels for cardiovascular risk. These recommendations are usually oversimplified by considering that all red meats should be limited and replaced by white meats. However, lean red meat can be as low in fat as white meat. We examined the effects of red meat (lean breed lamb) and lean white meat (chicken) intake on the lipid profile of a group of women with stable life conditions (nuns living in convents). An open-label, randomised, cross-over study was carried out in thirty-six nuns who consumed either lamb or chicken three times per week for 5-week periods with their usual diet. Clinical, dietary and biochemical variables were evaluated at baseline and the end of each diet period. A validated FFQ was used to assess nutrient intake and monitor compliance. The results showed neither between-diet differences in lipid responses nor differences from baseline in total cholesterol, LDL-cholesterol or TAG for any diet period. In conclusion, consumption of lean red meat (lamb) or lean white meat (chicken) as part of the usual diet is associated with a similar lipid response. These two foods can be exchanged in a healthy diet to increase palatability.

  19. Effects of equivalence ratio variation on lean, stratified methane-air laminar counterflow flames

    NASA Astrophysics Data System (ADS)

    Richardson, E. S.; Granet, V. E.; Eyssartier, A.; Chen, J. H.

    2010-11-01

    The effects of equivalence ratio variations on flame structure and propagation have been studied computationally. Equivalence ratio stratification is a key technology for advanced low emission combustors. Laminar counterflow simulations of lean methane-air combustion have been presented which show the effect of strain variations on flames stabilized in an equivalence ratio gradient, and the response of flames propagating into a mixture with a time-varying equivalence ratio. 'Back supported' lean flames, whose products are closer to stoichiometry than their reactants, display increased propagation velocities and reduced thickness compared with flames where the reactants are richer than the products. The radical concentrations in the vicinity of the flame are modified by the effect of an equivalence ratio gradient on the temperature profile and thermal dissociation. Analysis of steady flames stabilized in an equivalence ratio gradient demonstrates that the radical flux through the flame, and the modified radical concentrations in the reaction zone, contribute to the modified propagation speed and thickness of stratified flames. The modified concentrations of radical species in stratified flames mean that, in general, the reaction rate is not accurately parametrized by progress variable and equivalence ratio alone. A definition of stratified flame propagation based upon the displacement speed of a mixture fraction dependent progress variable was seen to be suitable for stratified combustion. The response times of the reaction, diffusion, and cross-dissipation components which contribute to this displacement speed have been used to explain flame response to stratification and unsteady fluid dynamic strain.

  20. Combustion characteristics of hydrogen. Carbon monoxide based gaseous fuels

    NASA Technical Reports Server (NTRS)

    Notardonato, J. J.; White, D. J.; Kubasco, A. J.; Lecren, R. T.

    1981-01-01

    An experimental rig program was conducted with the objective of evaluating the combuston performance of a family of fuel gases based on a mixture of hydrogen and carbon monoxide. These gases, in addition to being members of a family, were also representative of those secondary fuels that could be produced from coal by various gasification schemes. In particular, simulated Winkler, Lurgi, and Blue-water low and medium energy content gases were used as fuels in the experimental combustor rig. The combustor used was originally designed as a low NOx rich-lean system for burning liquid fuels with high bound nitrogen levels. When used with the above gaseous fuels this combustor was operated in a lean-lean mode with ultra long residence times. The Blue-water gas was also operated in a rich-lean mode. The results of these tests indicate the possibility of the existence of an 'optimum' gas turbine hydrogen - carbon monoxide based secondary fuel. Such a fuel would exhibit NOx and high efficiency over the entire engine operating range. It would also have sufficient stability range to allow normal light-off and engine acceleration. Solar Turbines Incorporated would like to emphasize that the results presented here have been obtained with experimental rig combustors. The technologies generated could, however, be utilized in future commercial gas turbines.

  1. Are we prepared to implement a Lean philosophy within cancer-care service in Oman?

    PubMed

    Mehdi, Itrat; Al Bahrani, Bassim J

    2017-07-01

    Lean, as it applies to business, has come to signify simplicity, swift response, and efficiency. The concept is to do more with less; namely, to use resources in the most productive way possible through the elimination of all types of waste. The Lean approach can be applied to any field, including healthcare, in which the exponential growth of costs is widespread. Hospitals began experimenting with Lean healthcare in 1990s.  Equal accessibility to healthcare is consistent with the tenets of social justice and a society's duty to ensure basic healthcare to everyone. However, the gap between a state's constitutional responsibility and resource availability is widening, creating a need for an evolution in healthcare provision based on relevance, objectivity, and impartiality. Health-services providers must juggle limited resources to ensure even-handed healthcare availability to all in the era of cost explosion.

  2. Are we prepared to implement a Lean philosophy within cancer-care service in Oman?

    PubMed Central

    Mehdi, Itrat; Bahrani, Bassim J. Al

    2017-01-01

    Lean, as it applies to business, has come to signify simplicity, swift response, and efficiency. The concept is to do more with less; namely, to use resources in the most productive way possible through the elimination of all types of waste. The Lean approach can be applied to any field, including healthcare, in which the exponential growth of costs is widespread. Hospitals began experimenting with Lean healthcare in 1990s. Equal accessibility to healthcare is consistent with the tenets of social justice and a society’s duty to ensure basic healthcare to everyone. However, the gap between a state’s constitutional responsibility and resource availability is widening, creating a need for an evolution in healthcare provision based on relevance, objectivity, and impartiality. Health-services providers must juggle limited resources to ensure even-handed healthcare availability to all in the era of cost explosion. PMID:28674713

  3. Considerations concerning the definition of sarcopenia.

    PubMed

    Dawson-Hughes, B; Bischoff-Ferrari, H

    2016-11-01

    In this commentary, we describe the sarcopenia spectrum that results in frailty and consider the impact of several components of the frailty definition on its global prevalence. We review proposed operational definitions of sarcopenia and the extent to which they have been shown to predict hard clinical outcomes, such as hip fracture, falls, and mortality. A head-to-head comparison of nine proposed operational definitions of sarcopenia as predictors of falls revealed that the definition involving appendicular lean mass (ALM)/ht 2 alone was a significant predictor; the prevalence of sarcopenia by this definition was 11 %. We consider the strengths and limitations of definitions that include functional measurements, such as gait speed and grip strength, along with measures of lean tissue mass. The functional assessments are harder to standardize than the more objective ALM measurements. The prevalence of sarcopenia by definitions that include functional and lean mass measurements tends to be lower than the prevalence by definitions that include lean mass alone. A low prevalence limits opportunity for early identification and application of prevention strategies. For these and other reasons, it seems advantageous to base the operational definition of sarcopenia on ALM/ht 2 alone. This commentary addresses the importance of a globally applicable operational definition of sarcopenia and both desirable and undesirable features of such a definition.

  4. 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.

  5. Storage length, storage temperature, and lean formulation influence the shelf-life and stability of traditionally packaged ground beef.

    PubMed

    Martin, J N; Brooks, J C; Brooks, T A; Legako, J F; Starkey, J D; Jackson, S P; Miller, M F

    2013-11-01

    The effect of storage length and temperature on the shelf life of three ground beef formulations (lean:fat: 73:27, 81:19 and 91:9) was investigated. Coarsely ground beef was stored at -1.7 or 2.3°C for up to 28d. Traditional overwrap packages were produced every 7d prior to retail display for 24h. Lipid oxidation (TBARS), subjective color, instrumental color, and aerobic bacteria were evaluated after 0 and 24h of display. Formulation influenced initial L* and subjective color values (P<0.05). Storage temperature did not affect initial color, but product stored at 2.3°C was more discolored after 24h (P<0.05). Aerobic bacteria increased as storage d and temperature increased (P<0.05). Initial TBARS increased through d 21, but were lower after 28d. Overall, initial characteristics depended on formulation; however, ground beef shelf-life and stability were largely influenced by storage length and storage temperature. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Pre-menarcheal physical activity predicts post-menarcheal lean mass and core strength, but not fat mass

    PubMed Central

    Day, M.A.; Dowthwaite, J.N.; Rosenbaum, P.F.; Roedel, G.G.; Brocker, A.A.; Scerpella, T.A.

    2015-01-01

    Objectives: Youth exercise is associated with improved body composition, but details regarding timing and persistence are limited. We examined pre- and circum-menarcheal organized physical activity exposure (PA) as a factor in development of early post-menarcheal lean mass, fat mass and muscle strength. Methods: Participants in a longitudinal study of musculoskeletal growth using dual energy X-ray absorptiometry (DXA) were included based on: 1) Whole body DXA scans: 0.5-1.5 years pre-menarche, 0.5-1.5 years post-menarche; 2) PA records for ≥6 months preceding the first DXA (PREPA) and for the inter-DXA interval (CIRCUMPA). Dominant arm grip strength and sit-ups tests coincided with DXA scans; PA, height and maturity were recorded semi-annually. Regressions correlated PA with lean mass/fat mass/strength, accounting for maturity, body size, and baseline values. Results Seventy girls [baseline: 11.8 yrs (sd 1.0), follow-up: 13.9 years (sd 1.0)] demonstrated circum-menarcheal gains of 25-29% for lean and fat mass and 33% for grip strength. PREPA correlated with pre- and post-menarcheal lean mass, sit-ups and pre-menarcheal fat mass (p<0.05), but not grip strength. CIRCUMPA correlated with only post-menarcheal sub-head lean mass (p=0.03). Conclusions: Lean mass and core strength at 1-year post-menarche were more strongly predicted by pre-menarcheal organized PA than by recent circum-menarcheal PA. PMID:26636280

  7. Strong Relation between Muscle Mass Determined by D3-creatine Dilution, Physical Performance and Incidence of Falls and Mobility Limitations in a Prospective Cohort of Older Men.

    PubMed

    Cawthon, Peggy M; Orwoll, Eric S; Peters, Katherine E; Ensrud, Kristine E; Cauley, Jane A; Kado, Deborah M; Stefanick, Marcia L; Shikany, James M; Strotmeyer, Elsa S; Glynn, Nancy W; Caserotti, Paolo; Shankaran, Mahalakshmi; Hellerstein, Marc; Cummings, Steven R; Evans, William J

    2018-06-12

    Direct assessment of skeletal muscle mass in older adults is clinically challenging. Relationships between lean mass and late-life outcomes have been inconsistent. The D3-creatine dilution method provides a direct assessment of muscle mass. Muscle mass was assessed by D3-creatine (D3Cr) dilution in 1,382 men (mean age, 84.2 yrs). Participants completed the Short Physical Performance Battery (SPPB); usual walking speed (6 meters); and DXA lean mass. Men self-reported mobility limitations (difficulty walking 2-3 blocks or climbing 10 steps); recurrent falls (2+); and serious injurious falls in the subsequent year. Across quartiles of D3Cr muscle mass/body mass, multivariate linear models calculated means for SPPB and gait speed; multivariate logistic models calculated odds ratios for incident mobility limitations or falls. Compared to men in the highest quartile, those in the lowest quartile of D3Cr muscle mass/body mass had slower gait speed (Q1: 1.04 vs Q4: 1.17 m/s); lower SPPB (Q1: 8.4 vs Q4: 10.4 points); greater likelihood of incident serious injurious falls (OR Q1 vs Q4: 2.49, 95% CI: 1.37, 4.54); prevalent mobility limitation (OR Q1 vs Q4,: 6.1, 95%CI: 3.7, 10.3) and incident mobility limitation (OR Q1 vs Q4: 2.15 95% CI: 1.42, 3.26); p for trend <.001 for all. Results for incident recurrent falls were in the similar direction (p=0.156). DXA lean mass had weaker associations with the outcomes. Unlike DXA lean mass, low D3Cr muscle mass/body mass is strongly related to physical performance, mobility and incident injurious falls in older me.

  8. SUCCESSFUL IMPLEMENTATION OF LEAN AS A MANAGERIAL PRINCIPLE IN HEALTH CARE: A CONCEPTUAL ANALYSIS FROM SYSTEMATIC LITERATURE REVIEW.

    PubMed

    Maijala, Riikka; Eloranta, Sini; Reunanen, Tero; Ikonen, Tuija S

    2018-01-01

    The aim of this study was to identify and analyze the characteristics of leadership and management associated with a successful Lean thinking adaptation in healthcare. A systematic literature review was undertaken using electronic databases: PubMed, PubMed Systematic Review, ABI/INFORM, Business Source Complete, Emerald, JBI, and Cinahl. Inclusion criteria were: (i) a description of Lean management or leadership in health care, (ii) a reference to Lean thinking, (iii) a peer-reviewed original research article or a literature review, and (iv) a full text article available in English. Among the 1,754 peer-reviewed articles identified, nine original articles and three systematic reviews met the inclusion criteria. Data on informants, methods, and settings were extracted and collated. Content analysis was used to conduct a review of the nine original studies describing and analyzing the success factors of Lean adaptation. The characteristics of leadership and management were analyzed by using the concept of a managerial windshield that divides leadership and management into four ontological dimensions: activities, style, focus, and purpose, each with typical developmental stages of skills and capabilities. The current study has some limitations: some papers from the journals not indexed in the searched databases may have been overlooked and the literature searches were carried out only for a 5-year period. Considering the results using the windshield concept emphasizes the philosophy, principles, and tools of Lean thinking. Lean leadership and management factors in health care were mainly conceptualized as skills and capabilities such as problem solving, making changes occur, empowering, communicating, coaching, supporting, facilitating, being democratic, organizational learning, and organizational success, all of which represented middle-stage or advanced managerial skills and capabilities. A conceptual analysis of systematically reviewed studies of Lean leadership and management point to certain traits as being typical when adapting Lean thinking to health care. The concept of a managerial windshield is useful when categorizing and analyzing essential managerial skills and capabilities for Lean implementation. Findings are beneficial when learning and educating the skills required for Lean transformation in healthcare organizations.

  9. Dietary Protein Intake and Lean Muscle Mass in Survivors of Childhood Acute Lymphoblastic Leukemia: Report From the St. Jude Lifetime Cohort Study.

    PubMed

    Boland, Alexandra M; Gibson, Todd M; Lu, Lu; Kaste, Sue C; DeLany, James P; Partin, Robyn E; Lanctot, Jennifer Q; Howell, Carrie R; Nelson, Heather H; Chemaitilly, Wassim; Pui, Ching-Hon; Robison, Leslie L; Mulrooney, Daniel A; Hudson, Melissa M; Ness, Kirsten K

    2016-07-01

    Survivors of childhood acute lymphoblastic leukemia (ALL) are at risk for low lean muscle mass and muscle weakness, which may contribute to inactivity and early development of chronic diseases typically seen in older adults. Although increasing protein intake, in combination with resistance training, improves lean muscle mass in other populations, it is not known whether muscular tissue among survivors of ALL, whose impairments are treatment-related, will respond similarly. The aim of this study was to evaluate associations among dietary protein intake, resistance training, and lean muscle mass in survivors of ALL and age-, sex-, and race-matched controls. This was a cross-sectional study. Lean muscle mass was determined with dual-energy x-ray absorptiometry, dietary information with 24-hour recalls, and participation in resistance training with a questionnaire. Participants were 365 survivors of ALL (52% male; 87% white; median age=28.5 years, range=23.6-31.7) and 365 controls with no previous cancer. Compared with controls, survivors of ALL had lower lean muscle mass (55.0 versus 57.2 kg, respectively) and lower percentage of lean muscle mass (68.6% versus 71.4%, respectively) than controls. Similar proportions of survivors (71.1%) and controls (69.7%) met recommended dietary protein intake (0.8 g/kg/d). Survivors (45.4%) were less likely to report resistance training than controls (53.8%). In adjusted models, 1-g higher protein intake per kilogram of body mass per day was associated with a 7.9% increase and resistance training ≥1×wk, with a 2.8% increase in lean muscle mass. The cross-sectional study design limits temporal evaluation of the association between protein intake and lean muscle mass. The findings suggest that survivors of childhood ALL with low lean muscle mass may benefit from optimizing dietary protein intake in combination with resistance training. Research is needed to determine whether resistance training with protein supplementation improves lean muscle mass in survivors of childhood ALL. © 2016 American Physical Therapy Association.

  10. Mechanical swirler for a low-NO{sub x}, weak-swirl burner

    DOEpatents

    Cheng, R.K.; Yegian, D.T.

    1999-03-09

    Disclosed is a mechanical swirler for generating diverging flow in lean premixed fuel burners. The swirler of the present invention includes a central passage with an entrance for accepting a feed gas, a flow balancing insert that introduces additional pressure drop beyond that occurring in the central passage in the absence of the flow balancing insert, and an exit aligned to direct the feed gas into a combustor. The swirler also has an annular passage about the central passage and including one or more vanes oriented to impart angular momentum to feed gas exiting the annular passage. The diverging flow generated by the swirler stabilizes lean combustion thus allowing for lower production of pollutants, particularly oxides of nitrogen. 16 figs.

  11. Mechanical swirler for a low-NO.sub.x, weak-swirl burner

    DOEpatents

    Cheng, Robert K.; Yegian, Derek T.

    1999-01-01

    Disclosed is a mechanical swirler for generating diverging flow in lean premixed fuel burners. The swirler of the present invention includes a central passage with an entrance for accepting a feed gas, a flow balancing insert that introduces additional pressure drop beyond that occurring in the central passage in the absence of the flow balancing insert, and an exit aligned to direct the feed gas into a combustor. The swirler also has an annular passage about the central passage and including one or more vanes oriented to impart angular momentum to feed gas exiting the annular passage. The diverging flow generated by the swirler stabilizes lean combustion thus allowing for lower production of pollutants, particularly oxides of nitrogen.

  12. Theory for broadband Noise of Rotor and Stator Cascades with Inhomogeneous Inflow Turbulence Including Effects of Lean and Sweep

    NASA Technical Reports Server (NTRS)

    Hanson, Donald B.

    2001-01-01

    The problem of broadband noise generated by turbulence impinging on a downstream blade row is examined from a theoretical viewpoint. Equations are derived for sound power spectra in terms of 3 dimensional wavenumber spectra of the turbulence. Particular attention is given to issues of turbulence inhomogeneity associated with the near field of the rotor and variations through boundary layers. Lean and sweep of the rotor or stator cascade are also handled rigorously with a full derivation of the relevant geometry and definitions of lean and sweep angles. Use of the general theory is illustrated by 2 simple theoretical spectra for homogeneous turbulence. Limited comparisons are made with data from model fans designed by Pratt & Whitney, Allison, and Boeing. Parametric studies for stator noise are presented showing trends with Mach number, vane count, turbulence scale and intensity, lean, and sweep. Two conventions are presented to define lean and sweep. In the "cascade system" lean is a rotation out of its plane and sweep is a rotation of the airfoil in its plane. In the "duct system" lean is the leading edge angle viewing the fan from the front (along the fan axis) and sweep is the angle viewing the fan from the side (,perpendicular to the axis). It is shown that the governing parameter is sweep in the plane of the airfoil (which reduces the chordwise component of Mach number). Lean (out of the plane of the airfoil) has little effect. Rotor noise predictions are compared with duct turbulence/rotor interaction noise data from Boeing and variations, including blade tip sweep and turbulence axial and transverse scales are explored.

  13. Flame Interactions and Thermoacoustics in Multiple-Nozzle Combustors

    NASA Astrophysics Data System (ADS)

    Dolan, Brian

    The first major chapter of original research (Chapter 3) examines thermoacoustic oscillations in a low-emission staged multiple-nozzle lean direct injection (MLDI) combustor. This experimental program investigated a relatively practical combustor sector that was designed and built as part of a commercial development program. The research questions are both practical, such as under what conditions the combustor can be safely operated, and fundamental, including what is most significant to driving the combustion oscillations in this system. A comprehensive survey of operating conditions finds that the low-emission (and low-stability) intermediate and outer stages are necessary to drive significant thermoacoustics. Phase-averaged and time-resolved OH* imaging show that dramatic periodic strengthening and weakening of the reaction zone downstream of the low-emission combustion stages. An acoustic modal analysis shows the pressure wave shapes and identifies the dominant thermoacoustic behavior as the first longitudinal mode for this combustor geometry. Finally, a discussion of the likely significant coupling mechanisms is given. Periodic reaction zone behavior in the low-emission fuel stages is the primary contributor to unsteady heat release. Differences between the fuel stages in the air swirler design, the fuel number of the injectors, the lean blowout point, and the nominal operating conditions all likely contribute to the limit cycle behavior of the low-emission stages. Chapter 4 investigates the effects of interaction between two adjacent swirl-stabilized nozzles using experimental and numerical tools. These studies are more fundamental; while the nozzle hardware is the same as the lean direct injection nozzles used in the MLDI combustion concept, the findings are generally applicable to other swirl-stabilized combustion systems as well. Much of the work utilizes a new experiment where the distance between nozzles was varied to change the level of interaction between the two nozzles. A decrease in inter-nozzle spacing resulted in a penalty to the lean blowout point and NO X emissions. Particle image velocimetry shows that the nozzle spacing also has an important effect on the flowfield of the nozzles including the shape of the recirculation region and the quantitative flow velocities. In particular, interaction in the tangential velocity between the two nozzles has large effects on the swirl number and the recirculation zone. Numerical simulations of the isothermal airflows of two pilot nozzles are validated using experimental measurements and used to provide flowfield information outside of the measurement domain. At wider inter-nozzle spacings under certain reacting conditions, an alternating flow pattern develops in the combustion chamber. The shear layers of one nozzle extent into the combustion chamber whereas the inlet reactants from the other nozzle attach near the dome wall to create a very wide recirculation region. Combustion properties, including the fuel type, are shown experimentally to affect whether or not a system will develop an alternating pattern. Simplified computational models of two interacting swirling flows are used to parametrically study the effects of nozzle exit geometry and swirl number on an alternating pattern. Both parameters are shown to be potential drivers of an alternating pattern under some conditions. A hypothesis that proposes a physical mechanism explaining the alternating flow pattern, consistent with the work in this proposal and the research of other groups, is presented. When the nozzle design, flow, or combustion characteristics cause the shear layers of the adjacent nozzles to become sufficiently opposite in direction, the two flows can no longer mix. Instead, one shear layer goes underneath the other which results in the differing flow features of the adjacent nozzles.

  14. 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

  15. 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.

  16. Prior caloric restriction increases survival of prepubertal obese- and PCOS-prone rats exposed to a challenge of time-limited feeding and physical activity.

    PubMed

    Diane, Abdoulaye; Vine, Donna F; Heth, C Donald; Russell, James C; Proctor, Spencer D; Pierce, W David

    2013-05-01

    We hypothesized that a polycystic ovary syndrome (PCOS) background associated with obese-prone genotype, coupled with preconditioning by caloric restriction, would confer a survival benefit in genetically prepubertal obese/PCOS (O/PCOS)-prone rats faced with an unpredictable challenge of food shortage. Female, juvenile JCR:LA-cp rats, O/PCOS- and lean-prone, were exposed to 1.5 h of daily meals and 22.5 h of voluntary wheel-running, a procedure that leads to activity anorexia (AA). One week before the AA challenge (AAC), O/PCOS-prone rats were freely fed (O/PCOS-FF) or pair fed (O/PCOS-FR) to lean-prone, free-feeding animals (Lean-FF). O/PCOS-FR and lean-prone, food-restricted (Lean-FR) groups were matched on relative average caloric intake. Animals were removed from protocol at 75% of initial body weight (starvation criterion) or after 14 days (survival criterion). The AAC induced weight loss in all rats, but there were significant effects of both genotype and feeding history on weight loss (lean-prone rats exhibited a higher rate of weight loss than O/PCOS-prone; P < 0.001), and rats with prior caloric restriction retained more weight than those free fed previously (90.68 ± 0.59% vs. 85.47 ± 0.46%; P < 0.001). The daily rate of running was higher in lean-prone rats compared with O/PCOS-prone. This difference in running rate correlated with differences in mean days of survival. All O/PCOS-FR rats survived at day 14. O/PCOS-FF rats survived longer (10.00 ± 0.97 days) than Lean-FR (6.17 ± 1.58 days) and Lean-FF (4.33 ± 0.42 days) rats (P < 0.05). Thus preconditioning by caloric restriction induces a substantial survival advantage, beyond genotype alone, in prepubertal O/PCOS-prone rats.

  17. Assessment of adult body composition using bioelectrical impedance: comparison of researcher calculated to machine outputted values

    PubMed Central

    Franco-Villoria, Maria; Wright, Charlotte M; McColl, John H; Sherriff, Andrea; Pearce, Mark S

    2016-01-01

    Objectives To explore the usefulness of Bioelectrical Impedance Analysis (BIA) for general use by identifying best-evidenced formulae to calculate lean and fat mass, comparing these to historical gold standard data and comparing these results with machine-generated output. In addition, we explored how to best to adjust lean and fat estimates for height and how these overlapped with body mass index (BMI). Design Cross-sectional observational study within population representative cohort study. Setting Urban community, North East England Participants Sample of 506 mothers of children aged 7–8 years, mean age 36.3 years. Methods Participants were measured at a home visit using a portable height measure and leg-to-leg BIA machine (Tanita TBF-300MA). Measures Height, weight, bioelectrical impedance (BIA). Outcome measures Lean and fat mass calculated using best-evidenced published formulae as well as machine-calculated lean and fat mass data. Results Estimates of lean mass were similar to historical results using gold standard methods. When compared with the machine-generated values, there were wide limits of agreement for fat mass and a large relative bias for lean that varied with size. Lean and fat residuals adjusted for height differed little from indices of lean (or fat)/height2. Of 112 women with BMI >30 kg/m2, 100 (91%) also had high fat, but of the 16 with low BMI (<19 kg/m2) only 5 (31%) also had low fat. Conclusions Lean and fat mass calculated from BIA using published formulae produces plausible values and demonstrate good concordance between high BMI and high fat, but these differ substantially from the machine-generated values. Bioelectrical impedance can supply a robust and useful field measure of body composition, so long as the machine-generated output is not used. PMID:26743700

  18. Obese and Lean Zucker Rats Demonstrate Differential Sensitivity to Rates of Food Reinforcement in a Choice Procedure

    PubMed Central

    Buckley, Jessica L.; Rasmussen, Erin B.

    2012-01-01

    The obese Zucker rat carries two recessive fa alleles that result in the expression of an obese phenotype. Obese Zuckers have higher food intake than lean controls in free-feed studies in which rats have ready access to a large amount of one type of food. The present study examined differences in obese and lean Zucker rats using concurrent schedules of reinforcement, which more ecologically models food selection using two food choices that have limited, but generally predictable, availability. Lever-pressing of ten lean (Fa/Fa or Fa/fa) and ten obese (fa/fa) Zucker rats was placed under three concurrent variable interval variable interval (conc VI VI) schedules of sucrose and carrot reinforcement, in which the reinforcer ratios for 45-mg food pellets were 5:1, 1:1, and 1:5. Allocation of responses to the two food alternatives was characterized using the generalized matching equation, which allows sensitivity to reinforcer rates (a) and bias toward one alternative (log k) to be quantified. All rats showed a bias to sucrose, though there were no differences between lean and obese Zucker rats. In addition, obese Zucker rats exhibited higher sensitivity to reinforcement rates than lean rats. This efficient pattern of responding was related to overall higher deliveries of food pellets. Effective matching for food, then, may be another behavioral pattern that contributes to an obese phenotype. PMID:23046726

  19. Hydrogen enrichment for low-emission jet combustion

    NASA Technical Reports Server (NTRS)

    Clayton, R. M.

    1978-01-01

    Simultaneous gaseous pollutant emission indexes (g pollutant/kg fuel) for a research combustor with inlet air at 120,900 N/sq m (11.9 atm) pressure and 727 K (849 F) temperature are as low as 1.0 for NOx and CO and 0.5 for unburned HC. Emissions data are presented for hydrogen/jet fuel (JP-5) mixes and for jet fuel only for premixed equivalence ratios from lean blowout to 0.65. Minimized emissions were achieved at an equivalence ratio of 0.38 using 10-12 mass percent hydrogen in the total fuel to depress the lean blowout limit. They were not achievable with jet fuel alone because of the onset of lean blowout at an equivalence ratio too high to reduce the NOx emission sufficiently.

  20. Glucose metabolism in obese and lean adolescents with polycystic ovary syndrome.

    PubMed

    Poomthavorn, Preamrudee; Chaya, Weerapong; Mahachoklertwattana, Pat; Sukprasert, Matchuporn; Weerakiet, Sawaek

    2013-01-01

    Data on glucose metabolism in Asian adolescents with polycystic ovary syndrome (PCOS) are limited. Glucose metabolism assessment using an oral glucose tolerance test (OGTT) in obese and lean Thai adolescents with PCOS, and a comparison between the two groups were done. Thirty-one patients (19 obese, 12 lean) were enrolled. Their median (range) age was 14.9 (11.0-21.0) years. Eighteen patients had abnormal glucose metabolism (13 hyperinsulinemia, 4 impaired glucose tolerance, and 1 diabetes). Compared between obese [median (range) BMI Z-score, 1.6 (1.2-2.6)] and lean [median (range) BMI Z-score, 0.1 (-1.4 to 0.6)] patients, the frequencies of each abnormal OGTT category, areas under the curves of glucose and insulin levels, and insulinogenic index were not different; however, insulin resistance was greater in the obese group. In conclusion, a high proportion of our adolescents with PCOS had abnormal glucose metabolism. Therefore, OGTT should be performed in adolescents with PCOS for the early detection of abnormal glucose metabolism.

  1. THE EFFECT OF SULFUR ON METHANE PARTIAL OXIDATION AND REFORMING PROCESSES FOR LEAN NOX TRAP CATALYSIS

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

    Parks, II, James E; Ponnusamy, Senthil

    2006-01-01

    Lean NOx trap catalysis has demonstrated the ability to reduce NOx emissions from lean natural gas reciprocating engines by >90%. The technology operates in a cyclic fashion where NOx is trapped on the catalyst during lean operation and released and reduced to N2 under rich exhaust conditions; the rich cleansing operation of the cycle is referred to as "regeneration" since the catalyst is reactivated for more NOx trapping after NOx purge. Creating the rich exhaust conditions for regeneration can be accomplished by catalytic partial oxidation of methane in the exhaust system. Furthermore, catalytic reforming of partial oxidation exhaust can enablemore » increased quantities of H2 which is an excellent reductant for lean NOx trap regeneration. It is critical to maintain clean and efficient partial oxidation and reforming processes to keep the lean NOx trap functioning properly and to reduce extra fuel consumption from the regeneration process. Although most exhaust constituents do not impede partial oxidation and reforming, some exhaust constituents may negatively affect the catalysts and result in loss of catalytic efficiency. Of particular concern are common catalyst poisons sulfur, zinc, and phosphorous. These poisons form in the exhaust through combustion of fuel and oil, and although they are present at low concentrations, they can accumulate to significant levels over the life of an engine system. In the work presented here, the effects of sulfur on the partial oxidation and reforming catalytic processes were studied to determine any durability limitations on the production of reductants for lean NOx trap catalyst regeneration.« less

  2. Skeletal muscle tissue transcriptome differences in lean and obese female beagle dogs.

    PubMed

    Grant, R W; Vester Boler, B M; Ridge, T K; Graves, T K; Swanson, K S

    2013-08-01

    Skeletal muscle is a large and insulin-sensitive tissue that is an important contributor to metabolic homeostasis and energy expenditure. Many metabolic processes are altered with obesity, but the contribution of muscle tissue in this regard is unclear. A limited number of studies have compared skeletal muscle gene expression of lean and obese dogs. Using microarray technology, our objective was to identify genes and functional classes differentially expressed in skeletal muscle of obese (14.6 kg; 8.2 body condition score; 44.5% body fat) vs. lean (8.6 kg; 4.1 body condition score; 22.9% body fat) female beagle adult dogs. Alterations in 77 transcripts was observed in genes pertaining to the functional classes of signaling, transport, protein catabolism and proteolysis, protein modification, development, transcription and apoptosis, cell cycle and differentiation. Genes differentially expressed in obese vs. lean dog skeletal muscle indicate oxidative stress and altered skeletal muscle cell differentiation. Many genes traditionally associated with lipid, protein and carbohydrate metabolism were not altered in obese vs. lean dogs, but genes pertaining to endocannabinoid metabolism, insulin signaling, type II diabetes mellitus and carnitine transport were differentially expressed. The relatively small response of skeletal muscle could indicate that changes are occurring at a post-transcriptional level, that other tissues (e.g., adipose tissue) were buffering skeletal muscle from metabolic dysfunction or that obesity-induced changes in skeletal muscle require a longer period of time and that the length of our study was not sufficient to detect them. Although only a limited number of differentially expressed genes were detected, these results highlight genes and functional classes that may be important in determining the etiology of obesity-induced derangement of skeletal muscle function. © 2013 The Authors, Animal Genetics © 2013 Stichting International Foundation for Animal Genetics.

  3. 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.

  4. Propagation of a Free Flame in a Turbulent Gas Stream

    NASA Technical Reports Server (NTRS)

    Mickelsen, William R; Ernstein, Norman E

    1956-01-01

    Effective flame speeds of free turbulent flames were measured by photographic, ionization-gap, and photomultiplier-tube methods, and were found to have a statistical distribution attributed to the nature of the turbulent field. The effective turbulent flame speeds for the free flame were less than those previously measured for flames stabilized on nozzle burners, Bunsen burners, and bluff bodies. The statistical spread of the effective turbulent flame speeds was markedly wider in the lean and rich fuel-air-ratio regions, which might be attributed to the greater sensitivity of laminar flame speed to flame temperature in those regions. Values calculated from the turbulent free-flame-speed analysis proposed by Tucker apparently form upper limits for the statistical spread of free-flame-speed data. Hot-wire anemometer measurements of the longitudinal velocity fluctuation intensity and longitudinal correlation coefficient were made and were employed in the comparison of data and in the theoretical calculation of turbulent flame speed.

  5. Examining the effects of postural constraints on estimating reach.

    PubMed

    Gabbard, Carl; Cordova, Alberto; Lee, Sunghan

    2007-07-01

    The tendency to overestimate has consistently been reported in studies of reachability estimation. According to one of the more prominent explanations, the postural stability hypothesis, the perceived reaching limit depends on the individual's perceived postural constraints. To test that proposition, the authors compared estimates of reachability of 38 adults (a) in the seated posture (P1) and (b) in the more demanding posture of standing on one foot and leaning forward (P2). Although there was no difference between conditions for total error, results for the distribution and direction of error indicated that participants overestimated in the P1 condition and underestimated in the P2 condition. It therefore appears that perceived postural constraints could be a factor in judgments of reachability. When participants in the present study perceived greater postural demands, they may have elected to program a more conservative strategy that resulted in underestimation.

  6. The behavior of fuel-lean premixed flames in a standard flammability limit tube under controlled gravity conditions

    NASA Technical Reports Server (NTRS)

    Wherley, B. L.; Strehlow, R. A.

    1986-01-01

    Fuel-lean flames in methane-air mixtures from 4.90 to 6.20 volume percent fuel and propane-air mixtures from 1.90 to 3.00 volume percent fuel were studied in the vicinity of the limit for a variety of gravity conditions. The limits were determined and the behavior of the flames studied for one g upward, one g downward, and zero g propagation. Photographic records of all flammability tube firings were obtained. The structure and behavior of these flames were detailed including the variations of the curvature of the flame front, the skirt length, and the occurrence of cellular instabilities with varying gravity conditions. The effect of ignition was also discussed. A survey of flame speeds as a function of mixture strength was made over a range of lean mixture compositions for each of the fuels studied. The results were presented graphically with those obtained by other researchers. The flame speed for constant fractional gravity loadings were plotted as a function of gravity loadings from 0.0 up to 2.0 g's against flame speeds extracted from the transient gravity flame histories for corresponding gravity loadings. The effects of varying gravity conditions on the extinguishment process for upward and downward propagating flames were investigated.

  7. 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.

  8. 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.

  9. Genetic variation in efficiency to deposit fat and lean meat in Norwegian Landrace and Duroc pigs.

    PubMed

    Martinsen, K H; Ødegård, J; Olsen, D; Meuwissen, T H E

    2015-08-01

    Feed costs amount to approximately 70% of the total costs in pork production, and feed efficiency is, therefore, an important trait for improving pork production efficiency. Production efficiency is generally improved by selection for high lean growth rate, reduced backfat, and low feed intake. These traits have given an effective slaughter pig but may cause problems in piglet production due to sows with limited body reserves. The aim of the present study was to develop a measure for feed efficiency that expressed the feed requirements per 1 kg deposited lean meat and fat, which is not improved by depositing less fat. Norwegian Landrace ( = 8,161) and Duroc ( = 7,202) boars from Topigs Norsvin's testing station were computed tomography scanned to determine their deposition of lean meat and fat. The trait was analyzed in a univariate animal model, where total feed intake in the test period was the dependent variable and fat and lean meat were included as random regression cofactors. These cofactors were measures for fat and lean meat efficiencies of individual boars. Estimation of fraction of total genetic variance due to lean meat or fat efficiency was calculated by the ratio between the genetic variance of the random regression cofactor and the total genetic variance in total feed intake during the test period. Genetic variance components suggested there was significant genetic variance among Norwegian Landrace and Duroc boars in efficiency for deposition of lean meat (0.23 ± 0.04 and 0.38 ± 0.06) and fat (0.26 ± 0.03 and 0.17 ± 0.03) during the test period. The fraction of the total genetic variance in feed intake explained by lean meat deposition was 12% for Norwegian Landrace and 15% for Duroc. Genetic fractions explained by fat deposition were 20% for Norwegian Landrace and 10% for Duroc. The results suggested a significant part of the total genetic variance in feed intake in the test period was explained by fat and lean meat efficiency. These new efficiency measures may give the breeders opportunities to select for animals with a genetic potential to deposit lean meat efficiently and at low feed costs in slaughter pigs rather than selecting for reduced the feed intake and backfat.

  10. Association of Low Lean Mass With Frailty and Physical Performance: A Comparison Between Two Operational Definitions of Sarcopenia-Data From the Berlin Aging Study II (BASE-II).

    PubMed

    Spira, Dominik; Buchmann, Nikolaus; Nikolov, Jivko; Demuth, Ilja; Steinhagen-Thiessen, Elisabeth; Eckardt, Rahel; Norman, Kristina

    2015-06-01

    For prevention and treatment of sarcopenia, defined as a decline in lean mass, reliable diagnostic criteria and cutpoints reflecting a clinically relevant threshold are indispensable. As of yet, various parameters have been proposed but no gold standard exists. The aim of this study was to compare cutpoints of appendicular lean mass related to body mass index (ALMBMI) or height (ALM/height(2)) regarding their association with self-reported physical limitations and frailty status in a sample of community-dwelling older adults. A total of 1,343 participants from the Berlin Aging Study II were included. ALM index was assessed with dual-energy X-ray absorptiometry. Limitations in physical performance were assessed via questionnaire and frailty status was defined according to the Fried criteria. In a risk factor-adjusted analysis, participants with an ALMBMI below the cutpoints had 1.4-2.8 times higher odds of difficulties in several domains of physical activity (p = .031 to p < .0001) compared with participants with normal ALMBMI. In participants with low ALM/height(2), no associations with physical limitations were found. Moreover, the odds of being prefrail/frail were statistically significant for the low ALMBMI group only (odds ratio = 2.403, 95% confidence interval: 1.671-3.454, p < .0001) and not for the low ALM/height(2) group. This study showed striking differences between the two operational criteria ALM/height(2) and ALMBMI concerning their association with physical limitations and prefrailty/frailty. The low ALMBMI cutpoints seem suitable to detect patients at risk for negative outcomes such as frailty who might benefit from interventions targeted at improving lean mass. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Performance of a Laser Ignited Multicylinder Lean Burn Natural Gas Engine

    DOE PAGES

    Almansour, Bader; Vasu, Subith; Gupta, Sreenath B.; ...

    2017-06-06

    Market demands for lower fueling costs and higher specific powers in stationary natural gas engines has engine designs trending towards higher in-cylinder pressures and leaner combustion operation. However, Ignition remains as the main limiting factor in achieving further performance improvements in these engines. Addressing this concern, while incorporating various recent advances in optics and laser technologies, laser igniters were designed and developed through numerous iterations. Final designs incorporated water-cooled, passively Q-switched, Nd:YAG micro-lasers that were optimized for stable operation under harsh engine conditions. Subsequently, the micro-lasers were installed in the individual cylinders of a lean-burn, 350 kW, inline 6-cylinder, open-chamber,more » spark ignited engine and tests were conducted. To the best of our knowledge, this is the world’s first demonstration of a laser ignited multi-cylinder natural gas engine. The engine was operated at high-load (298 kW) and rated speed (1800 rpm) conditions. Ignition timing sweeps and excess-air ratio (λ) sweeps were performed while keeping the NOx emissions below the USEPA regulated value (BSNOx < 1.34 g/kW-hr), and while maintaining ignition stability at industry acceptable values (COV_IMEP <5 %). Through such engine tests, the relative merits of (i) standard electrical ignition system, and (ii) laser ignition system were determined. In conclusion, a rigorous combustion data analysis was performed and the main reasons leading to improved performance in the case of laser ignition were identified.« less

  12. Performance of a Laser Ignited Multicylinder Lean Burn Natural Gas Engine

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

    Almansour, Bader; Vasu, Subith; Gupta, Sreenath B.

    Market demands for lower fueling costs and higher specific powers in stationary natural gas engines has engine designs trending towards higher in-cylinder pressures and leaner combustion operation. However, Ignition remains as the main limiting factor in achieving further performance improvements in these engines. Addressing this concern, while incorporating various recent advances in optics and laser technologies, laser igniters were designed and developed through numerous iterations. Final designs incorporated water-cooled, passively Q-switched, Nd:YAG micro-lasers that were optimized for stable operation under harsh engine conditions. Subsequently, the micro-lasers were installed in the individual cylinders of a lean-burn, 350 kW, inline 6-cylinder, open-chamber,more » spark ignited engine and tests were conducted. To the best of our knowledge, this is the world’s first demonstration of a laser ignited multi-cylinder natural gas engine. The engine was operated at high-load (298 kW) and rated speed (1800 rpm) conditions. Ignition timing sweeps and excess-air ratio (λ) sweeps were performed while keeping the NOx emissions below the USEPA regulated value (BSNOx < 1.34 g/kW-hr), and while maintaining ignition stability at industry acceptable values (COV_IMEP <5 %). Through such engine tests, the relative merits of (i) standard electrical ignition system, and (ii) laser ignition system were determined. In conclusion, a rigorous combustion data analysis was performed and the main reasons leading to improved performance in the case of laser ignition were identified.« less

  13. Influence of H2O2 on LPG fuel performance evaluation

    NASA Astrophysics Data System (ADS)

    Khan, Muhammad Saad; Ahmed, Iqbal; Mutalib, Mohammad Ibrahim bin Abdul; Nadeem, Saad; Ali, Shahid

    2014-10-01

    The objective of this mode of combustion is to insertion of hydrogen peroxide (H2O2) to the Liquefied Petroleum Gas (LPG) combustion on spark plug ignition engines. The addition of hydrogen peroxide may probably decrease the formation of NOx, COx and unburned hydrocarbons. Hypothetically, Studies have shown that addition of hydrogen peroxide to examine the performance of LPG/H2O2 mixture in numerous volumetric compositions starting from lean LPG until obtaining a better composition can reduce the LPG fuel consumption. The theory behind this idea is that, the addition of H2O2 can cover the lean operation limit, increase the lean burn ability, diminution the burn duration along with controlling the exhaust emission by significantly reducing the greenhouse gaseous.

  14. Insight of DFT and ab initio atomistic thermodynamics on the surface stability and morphology of In2O3

    NASA Astrophysics Data System (ADS)

    Zhang, Minhua; Wang, Wenyi; Chen, Yifei

    2018-03-01

    In2O3 catalysts show remarkable activity and selectivity in methanol synthesis from CO2 hydrogenation. In order to get insight into the surface stability of this catalyst, density functional theory and ab initio atomistic thermodynamics method were used to investigate the surface free energies of various facets as a function of oxygen chemical potential, as well as the influences of temperature, pressure and gas compositions. The results show that the (111) facet presents lowest surface free energy under oxygen-rich condition, while the indium-terminated (100) facet is the most stable one under oxygen-lean condition. Moreover, we applied Wulff construction to determine the equilibrium shape of In2O3 with different oxygen chemical potentials. The equilibrium shape under oxygen-lean condition is cubic, which only expose (100) facet, while, the equilibrium shape under oxygen-rich condition is octahedron, which only expose (111) facet. Meanwhile, the results agree well with what is observed experimentally. It is further predicted that Wulff shape of In2O3 exists in a truncated octahedron morphology in which the (100) surface becomes predominant plane under CO2 hydrogenation reaction conditions.

  15. Effects of Buoyancy on the Flowfields of Lean Premixed Turbulent V-Flames

    NASA Technical Reports Server (NTRS)

    Cheng, R. K.; Greenberg, P.; Bedat, B.; Yegian, D. T.

    1999-01-01

    Open laboratory turbulent flames used for investigating fundament flame turbulence interactions are greatly affected by buoyancy. Though much of our current knowledge is based on observations made in these open flames, the effects of buoyancy are usually not included in data interpretation, numerical analysis or theories. This inconsistency remains an obstacle to merging experimental observations and theoretical predictions. To better understanding the effects of buoyancy, our research focuses on steady lean premixed flames propagating in fully developed turbulence. We hypothesize that the most significant role of buoyancy forces on these flames is to influence their flowfields through a coupling with mean and fluctuating pressure fields. Changes in flow pattern alter the mean aerodynamic stretch and in turn affect turbulence fluctuation intensities both upstream and downstream of the flame zone. Consequently, flame stabilization, reaction rates, and turbulent flame processes are all affected. This coupling relates to the elliptical problem that emphasizes the importance of the upstream, wall and downstream boundary conditions in determining all aspects of flame propagation. Therefore, buoyancy has the same significance as other parameters such as flow configuration, flame geometry, means of flame stabilization, flame shape, enclosure size, mixture conditions, and flow conditions.

  16. 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.

  17. Management simulations for Lean healthcare: exploiting the potentials of role-playing.

    PubMed

    Barnabè, Federico; Giorgino, Maria Cleofe; Guercini, Jacopo; Bianciardi, Caterina; Mezzatesta, Vincenzo

    2018-04-09

    Purpose The purpose of this paper is to investigate the potentials of role-playing (RP) both in training healthcare (HC) professionals to implement tools and improvement actions based on Lean principles, and in supporting group discussion and the sharing of different competencies for the development of Lean HC. Design/methodology/approach The paper presents the case study of an RP simulation called LEAN HEALTHCARE LAB, which is used to train HC professionals at Siena University Hospital. The paper reports and discusses the results of a specific two-day simulation session and of a questionnaire that was distributed to gather feedback from the participants. Findings The paper verifies the potentials of RP to be a powerful educational and training tool that is able to stimulate the HC participants to apply Lean thinking principles and share their competencies in collaborative decision-making processes. Research limitations/implications The study provides data in reference to one single simulation session, although the game has already been applied several times in different HC organizations with very similar outcomes. Moreover, a more in-depth analysis of players' perceptions and decisions could be performed using different tools in addition to the adopted questionnaire. Practical implications RP games (RPGs) are effective training and educational tools for HC professionals. They offer benefits and learning conditions which are definitely different if compared with more conventional education programs for HC professionals. Originality/value While previous studies have extensively discussed the potentialities of RPG and simulations in training programs, only a few articles have discussed the RP adoption for Lean thinking and even less to educate HC professionals on Lean principles and tools.

  18. 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.

  19. Effects of Partial Substitution of Lean Meat with Pork Backfat or Canola Oil on Sensory Properties of Korean Traditional Meat Patties (Tteokgalbi)

    PubMed Central

    Imm, Bue-Young; Kim, Chung Hwan; Imm, Jee-Young

    2014-01-01

    Korean traditional meat patties (Tteokgalbi) were prepared by replacing part of the lean meat content with either pork backfat or canola oil and the effect of substitution on sensory quality of the meat patties was investigated. Compared to the control patties, pork-loin Tteokgalbi with 10% pork backfat or 10% canola oil had significantly higher overall acceptability and higher perceived intensity of meat flavor, sweetness, umami, and oiliness. The pork-loin patties containing 10% fat also had lower perceived firmness, toughness, and chalkiness of than the control Tteokgalbi. The chicken breast Tteokgalbi with 10% canola oil had the lowest perceived firmness and chalkiness (control > pork backfat > canola oil). No significant difference was noted in the overall acceptability of chicken breast patties with 10% pork backfat and those with 10% canola oil. These results indicate that substituting 10% of lean meat of Tteokgalbi with fat improved the sensory acceptability of the product for Korean customers regardless of the lean meat and/or fat source used in the patties. Lean meat patties formulated with a limited amount of vegetable oil such as canola oil can be a healthy option for Korean consumers by providing desirable fatty acid profiles without sacrificing sensory quality of the product. PMID:26761287

  20. Effects of Partial Substitution of Lean Meat with Pork Backfat or Canola Oil on Sensory Properties of Korean Traditional Meat Patties (Tteokgalbi).

    PubMed

    Imm, Bue-Young; Kim, Chung Hwan; Imm, Jee-Young

    2014-01-01

    Korean traditional meat patties (Tteokgalbi) were prepared by replacing part of the lean meat content with either pork backfat or canola oil and the effect of substitution on sensory quality of the meat patties was investigated. Compared to the control patties, pork-loin Tteokgalbi with 10% pork backfat or 10% canola oil had significantly higher overall acceptability and higher perceived intensity of meat flavor, sweetness, umami, and oiliness. The pork-loin patties containing 10% fat also had lower perceived firmness, toughness, and chalkiness of than the control Tteokgalbi. The chicken breast Tteokgalbi with 10% canola oil had the lowest perceived firmness and chalkiness (control > pork backfat > canola oil). No significant difference was noted in the overall acceptability of chicken breast patties with 10% pork backfat and those with 10% canola oil. These results indicate that substituting 10% of lean meat of Tteokgalbi with fat improved the sensory acceptability of the product for Korean customers regardless of the lean meat and/or fat source used in the patties. Lean meat patties formulated with a limited amount of vegetable oil such as canola oil can be a healthy option for Korean consumers by providing desirable fatty acid profiles without sacrificing sensory quality of the product.

  1. Prioritizing lean management practices in public and private hospitals.

    PubMed

    Hussain, Matloub; Malik, Mohsin

    2016-05-16

    Purpose - The purpose of this paper is to prioritize 21 healthcare wastes in public and private hospitals of United Arab Emirates (UAE). Design/methodology/approach - Seven healthcare wastes linked with lean management are further decomposed in to sub-criteria and to deal with this complexity of multi criteria decision-making process, analytical hierarchical process (AHP) method is used in this research. Findings - AHP framework for this study resulted in a ranking of 21 healthcare wastes in public and private hospitals of UAE. It has been found that management in private healthcare systems of UAE is putting more emphasis on the inventory waste. On the other hand, over processing waste has got highest weight in public hospitals of UAE. Research limitations/implications - The future directions of this research would be to apply a lean set of tools for the value stream optimization of the prioritized key improvement areas. Practical implications - This is a contribution to the continuing research into lean management, giving practitioners and designers a practical way for measuring and implementing lean practices across health organizations. Originality/value - The contribution of this research, through successive stages of data collection, measurement analysis and refinement, is a set of reliable and valid framework that can be subsequently used in conceptualization, prioritization of the waste reduction strategies in healthcare management.

  2. Influence of cooled exhaust gas recirculation on performance, emissions and combustion characteristics of LPG fuelled lean burn SI engine

    NASA Astrophysics Data System (ADS)

    Ravi, K.; Pradeep Bhasker, J.; Alexander, Jim; Porpatham, E.

    2017-11-01

    On fuel perspective, Liquefied Petroleum Gas (LPG) provides cleaner emissions and also facilitates lean burn signifying less fuel consumption and emissions. Lean burn technology can attain better efficiencies and lesser combustion temperatures but this temperature is quite sufficient to facilitate formation of nitrogen oxide (NOx). Exhaust Gas Recirculation (EGR) for NOx reduction has been considered allover but extremely little literatures exist on the consequence of EGR on lean burn LPG fuelled spark ignition (SI) engine. The following research is carried out to find the optimal rate of EGR addition to reduce NOx emissions without settling on performance and combustion characteristics. A single cylinder diesel engine is altered to operate as LPG fuelled SI engine at a compression ratio of 10.5:1 and arrangements to provide different ratios of cooled EGR in the intake manifold. Investigations are done to arrive at optimum ratio of the EGR to reduce emissions without compromising on performance. Significant reductions in NOx emissions alongside HC and CO emissions were seen. Higher percentages of EGR further diluted the charge and lead to improper combustion and thus increased hydrocarbon emissions. Cooled EGR reduced the peak in-cylinder temperature which reduced NOx emissions but lead to misfire at lower lean limits.

  3. Experimental study of the effects of secondary air on the emissions and stability of a lean premixed combustor

    NASA Technical Reports Server (NTRS)

    Roffe, G.; Raman, R. S. V.; Marek, C. J.

    1982-01-01

    A study of the effects of secondary air addition on the stability and emissions of a gas turbine combustor has been performed. Tests were conducted with two types of flameholders and varying amounts of dilution air addition. Results indicate that NO(x) decreases with increasing dilution air injection, whereas CO is independent of the amount of dilution air and is related to the gas temperature near the walls. The axial location of the dilution air addition has no effect on the performance or stability. Results also indicate that the amount of secondary air entrained by the flameholder recirculation zone is dependent on the amount of dilution air and flameholder geometry.

  4. The Investigation and Semi-Empirical Modeling of Thermoacoustic Phase Relationships in a Lean Premixed Prevapourized Combustor at Elevated Pressure

    NASA Astrophysics Data System (ADS)

    Cirtwill, Joseph Daniel Maxim

    This document presents an investigation of the self-excited coupling mechanisms that occur to produce both low-amplitude intermittent, as well as high-amplitude limit-cycle pressure oscillations in an aeronautical gas turbine combustor. Measurements of a lean premixed prevapourized combustor at elevated pressure were conducted using OH* chemiluminescence, pressure transducers, stereoscopic particle image velocimetry and droplet laser scattering. Analysis of the spectra and phase relationships between the measured variables is performed to determine and describe the coupling mechanisms. A semi-empirical model is presented to explain differences in the limit-cycle pressure amplitudes observed under nominally identical operating conditions. Evidence suggests that an oscillating flux of fuel into the combustor is responsible for both intermittent and limit-cycle oscillations, though different coupling relationships are observed in each case. The final amplitude of limit-cycle oscillations is shown to be correlated with changes in the phase difference between the fuel oscillations and the pressure.

  5. Osteological evidence of genetic divergence of lake trout (Salvelinus namaycush) in Lake Superior

    USGS Publications Warehouse

    Burnham-Curtis, Mary K.; Smith, Gerald R.

    1994-01-01

    Three phenotypes of Salvelinus namaycush in Lake Superior, the lean, siscowet, and bumper, are traditionally identified primarily by fat content and body shape. Their taxonomic status is in question because of intermediates as well as the possibility that the diagnostic characters are ecophenotypic. Two osteological characters, the dorsal opercular notch (first recorded by Agassiz in his description of the siscowet) and radii on the anterodorsal part of the supraethmoid, differ between most leans and siscowets. The notch in the opercle near its articulation with the hyomandibular bone is present in humpers, usually present in siscowets, and usually absent in leans. Radii on the anterodorsal surface of the supraethmoid bone usually are found in siscowets and humpers but usually are absent in leans. The correlations among these characters and other features of the phenotype indicate a significant level of differentiation between the three phenotypes. Available evidence suggests that the differentiation is genetic. The frequency of mixed phenotypes is evidence of limited gene flow among the phenotypes. The siscowet and humper phenotypes apparently originated in Lake Superior in postglacial time.

  6. Lean Mission Operations Systems Design - Using Agile and Lean Development Principles for Mission Operations Design and Development

    NASA Technical Reports Server (NTRS)

    Trimble, Jay Phillip

    2014-01-01

    The Resource Prospector Mission seeks to rove the lunar surface with an in-situ resource utilization payload in search of volatiles at a polar region. The mission operations system (MOS) will need to perform the short-duration mission while taking advantage of the near real time control that the short one-way light time to the Moon provides. To maximize our use of limited resources for the design and development of the MOS we are utilizing agile and lean methods derived from our previous experience with applying these methods to software. By using methods such as "say it then sim it" we will spend less time in meetings and more time focused on the one outcome that counts - the effective utilization of our assets on the Moon to meet mission objectives.

  7. 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.

  8. Lean flammability limit of downward propagating hydrogen-air flames

    NASA Technical Reports Server (NTRS)

    Patnaik, G.; Kailasanath, K.

    1992-01-01

    Detailed multidimensional numerical simulations that include the effects of wall heat losses have been performed to study the dynamics of downward flame propagation and extinguishment in lean hydrogen-air mixtures. The computational results show that a downward propagating flame in an isothermal channel has a flammability limit of around 9.75 percent. This is in excellent agreement with experimental results. Also in excellent agreement are the detailed observations of the flame behavior at the point of extinguishment. The primary conclusion of this work is that detailed numerical simulations that include wall heat losses and the effect of gravity can adequately simulate the dynamics of the extinguishment process in downward-propagating hydrogen-air flames. These simulations can be examined in detail to gain understanding of the actual extinction process.

  9. Ghrelin treatment causes increased food intake and retention of lean body mass in a rat model of cancer cachexia.

    PubMed

    DeBoer, Mark D; Zhu, Xin Xia; Levasseur, Peter; Meguid, Michael M; Suzuki, Susumu; Inui, Akio; Taylor, John E; Halem, Heather A; Dong, Jesse Z; Datta, Rakesh; Culler, Michael D; Marks, Daniel L

    2007-06-01

    Cancer cachexia is a debilitating syndrome of anorexia and loss of lean body mass that accompanies many malignancies. Ghrelin is an orexigenic hormone with a short half-life that has been shown to improve food intake and weight gain in human and animal subjects with cancer cachexia. We used a rat model of cancer cachexia and administered human ghrelin and a synthetic ghrelin analog BIM-28131 via continuous infusion using sc osmotic minipumps. Tumor-implanted rats receiving human ghrelin or BIM-28131 exhibited a significant increase in food consumption and weight gain vs. saline-treated animals. We used dual-energy x-ray absorptiometry scans to show that the increased weight was due to maintenance of lean mass vs. a loss of lean mass in saline-treated animals. Also, BIM-28131 significantly limited the loss of fat mass normally observed in tumor-implanted rats. We further performed real-time PCR analysis of the hypothalami and brainstems and found that ghrelin-treated animals exhibited a significant increase in expression of orexigenic peptides agouti-related peptide and neuropeptide Y in the hypothalamus and a significant decrease in the expression of IL-1 receptor-I transcript in the hypothalamus and brainstem. We conclude that ghrelin and a synthetic ghrelin receptor agonist improve weight gain and lean body mass retention via effects involving orexigenic neuropeptides and antiinflammatory changes.

  10. Field Effects of Buoyancy on a Premixed Turbulent Flame Studied by Particle Image Velocimetry

    NASA Technical Reports Server (NTRS)

    Cheng, Robert K.

    2003-01-01

    Typical laboratory flames for the scientific investigation of flame/turbulence interactions are prone to buoyancy effects. Buoyancy acts on these open flame systems and provides upstream feedbacks that control the global flame properties as well as local turbulence/flame interactions. Consequently the flame structures, stabilization limits, and turbulent reaction rates are directly or indirectly coupled with buoyancy. The objective of this study is to characterize the differences between premixed turbulent flames pointing upwards (1g), pointing downwards (-1g), and in microgravity (mg). The configuration is an inverted conical flame stabilized by a small cone-shaped bluff body that we call CLEAN Flames (Cone-Stabilized Lean Flames). We use two laser diagnostics to capture the velocity and scalar fields. Particle image velocimetry (PIV) measures the mean and root mean square velocities and planar imaging by the flame fronts method outlines the flame wrinkle topology. The results were obtained under typical conditions of small domestic heating systems such as water heaters, ovens, and furnaces. Significant differences between the 1g and -1g flames point to the need for including buoyancy contributions in theoretical and numerical calculations. In Earth gravity, there is a complex coupling of buoyancy with the turbulent flow and heat release in the flame. An investigation of buoyancy-free flames in microgravity will provide the key to discern gravity contributions. Data obtained in microgravity flames will provide the benchmark for interpreting and analyzing 1g and -1g flame results.

  11. Getting Ready for Pregnancy

    MedlinePlus

    ... acid from food, like fortified bread, breakfast cereal, pasta and products made from a kind of flour ... foods , like fruits, vegetables, whole-grain bread and pasta, and lean meat and chicken. Limit sweets, salty ...

  12. Determination of the NOx Loading of an Automotive Lean NOx Trap by Directly Monitoring the Electrical Properties of the Catalyst Material Itself

    PubMed Central

    Fremerey, Peter; Reiß, Sebastian; Geupel, Andrea; Fischerauer, Gerhard; Moos, Ralf

    2011-01-01

    Recently, it has been shown that the degree of loading of several types of automotive exhaust aftertreatment devices can be directly monitored in situ and in a contactless way by a microwave-based method. The goal of this study was to clarify whether this method can also be applied to NOx storage and reduction catalysts (lean NOx traps) in order to obtain further knowledge about the reactions occurring in the catalyst and to compare the results with those obtained by wirebound NOx loading sensors. It is shown that both methods are able to detect the different catalyst loading states. However, the sensitivity of the microwave-based method turned out to be small compared to that previously observed for other exhaust aftertreatment devices. This may limit the practical applicability of the microwave-based NOx loading detection in lean NOx traps. PMID:22164074

  13. National Combustion Code Validated Against Lean Direct Injection Flow Field Data

    NASA Technical Reports Server (NTRS)

    Iannetti, Anthony C.

    2003-01-01

    Most combustion processes have, in some way or another, a recirculating flow field. This recirculation stabilizes the reaction zone, or flame, but an unnecessarily large recirculation zone can result in high nitrogen oxide (NOx) values for combustion systems. The size of this recirculation zone is crucial to the performance of state-of-the-art, low-emissions hardware. If this is a large-scale combustion process, the flow field will probably be turbulent and, therefore, three-dimensional. This research dealt primarily with flow fields resulting from lean direct injection (LDI) concepts, as described in Research & Technology 2001. LDI is a concept that depends heavily on the design of the swirler. The LDI concept has the potential to reduce NOx values from 50 to 70 percent of current values, with good flame stability characteristics. It is cost effective and (hopefully) beneficial to do most of the design work for an LDI swirler using computer-aided design (CAD) and computer-aided engineering (CAE) tools. Computational fluid dynamics (CFD) codes are CAE tools that can calculate three-dimensional flows in complex geometries. However, CFD codes are only beginning to correctly calculate the flow fields for complex devices, and the related combustion models usually remove a large portion of the flow physics.

  14. Pollutant formation in fuel lean recirculating flows. Ph.D. Thesis. Final Report; [in an Opposed Reacting Jet Combustor

    NASA Technical Reports Server (NTRS)

    Schefer, R. W.; Sawyer, R. F.

    1976-01-01

    An opposed reacting jet combustor (ORJ) was tested at a pressure of 1 atmosphere. A premixed propane/air stream was stabilized by a counterflowing jet of the same reactants. The resulting intensely mixed zone of partially reacted combustion products produced stable combustion at equivalence ratios as low as 0.45. Measurements are presented for main stream velocities of 7.74 and 13.6 m/sec with an opposed jet velocity of 96 m/sec, inlet air temperatures from 300 to 600 K, and equivalence ratios from 0.45 to 0.625. Fuel lean premixed combustion was an effective method of achieving low NOx emissions and high combustion efficiencies simultaneously. Under conditions promoting lower flame temperature, NO2 constituted up to 100 percent of the total NOx. At higher temperatures this percentage decreased to a minimum of 50 percent.

  15. Great (Flame) Balls of Fire! Structure of Flame Balls at Low Lewis-number-2 (SOFBALL-2)

    NASA Technical Reports Server (NTRS)

    Ronney, Paul; Weiland, Karen J.; Over, Ann (Technical Monitor)

    2002-01-01

    Everyone knows that an automobile engine wastes fuel and energy when it runs with a fuel-rich mixture. 'Lean' burning, mixing in more air and less fuel, is better for the environment. But lean mixtures also lead to engine misfiring and rough operation. No one knows the ultimate limits for lean operation, for 'weak' combustion that is friendly to the environment while still moving us around. This is where the accidental verification of a decades-old prediction may have strong implications for designing and running low-emissions engines in the 21st century. In 1944, Soviet physicist Yakov Zeldovich predicted that stationary, spherical flames are possible under limited conditions in lean fuel-air mixtures. Dr. Paul Ronney of the University of Southern California accidentally discovered such 'flame balls' in experiments with lean hydrogen-air mixtures in 1984 during drop-tower experiments that provided just 2.2 seconds of near weightlessness. Experiments aboard NASA's low-g aircraft confirmed the results, but a thorough investigation was hampered by the aircraft's bumpy ride. And stable flame balls can only exist in microgravity. The potential for investigating combustion at the limits of flammability, and the implications for spacecraft fire safety, led to the Structure of Flame Balls at Low Lewis-number (SOFBALL) experiment flown twice aboard the Space Shuttle on the Microgravity Sciences Laboratory-1 (MSL-1) in 1997. Success there led to the planned reflight on STS-107. Flame balls are the weakest fires yet produced in space or on Earth. Typically each flame ball produced only 1 watt of thermal power. By comparison, a birthday candle produces 50 watts. The Lewis-number measures the rate of diffusion of fuel into the flame ball relative to the rate of diffusion of heat away from the flame ball. Lewis-number mixtures conduct heat poorly. Hydrogen and methane are the only fuels that provide low enough Lewis-numbers to produce stable flame balls, and even then only for very weak, barely flammable mixtures. Nevertheless, under these conditions flame balls give scientists the opportunity to test models in one of the simplest combustion experiments possible. SOFBALL-2 science objectives include: Improving our understanding of the flame ball phenomenon; Determining the conditions under which flame balls exist; Testing predictions of flame ball lifetimes; Acquiring more precise data for critical model comparison.

  16. Ammonia Generation and Utilization in a Passive SCR (TWC+SCR) System on Lean Gasoline Engine

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

    Prikhodko, Vitaly Y.; James E. Parks, II; Pihl, Josh A.

    Lean gasoline engines offer greater fuel economy than the common stoichiometric gasoline engine, but the current three way catalyst (TWC) on stoichiometric engines is unable to control nitrogen oxide (NOX) emissions in oxidizing exhaust. For these lean gasoline engines, lean NOX emission control is required to meet existing Tier 2 and upcoming Tier 3 emission regulations set by the U.S. Environmental Protection Agency (EPA). While urea-based selective catalytic reduction (SCR) has proven effective in controlling NOX from diesel engines, the urea storage and delivery components can add significant size and cost. As such, onboard NH 3 production via a passivemore » SCR approach is of interest. In a passive SCR system, NH 3 is generated over a close-coupled TWC during periodic slightly rich engine operation and subsequently stored on an underfloor SCR catalyst. Upon switching to lean operation, NOX passes through the TWC and is reduced by the stored NH 3 on the SCR catalyst. In this work, a passive SCR system was evaluated on a 2.0-liter BMW lean burn gasoline direct injection engine to assess NH 3 generation over a Pd-only TWC and utilization over a Cu-based SCR catalyst. System NOX reduction efficiency and fuel efficiency improvement compared to stoichiometric engine operation were measured. A feedback control strategy based on cumulative NH 3 produced by the TWC during rich operation and NOX emissions during lean operation was implemented on the engine to control lean/rich cycle timing. At an SCR average inlet temperature of 350 °C, an NH 3:NOX ratio of 1.15:1 (achieved through longer rich cycle timing) resulted in 99.7 % NOX conversion. Increasing NH 3 generation further resulted in even higher NOX conversion; however, tailpipe NH 3 emissions resulted. At higher underfloor temperatures, NH 3 oxidation over the SCR limited NH 3 availability for NOX reduction. At the engine conditions studied, greater than 99 % NOX conversion was achieved with passive SCR while delivering fuel efficiency benefits ranging between 6-11 % compared with stoichiometric operation.« less

  17. Ammonia Generation and Utilization in a Passive SCR (TWC+SCR) System on Lean Gasoline Engine

    DOE PAGES

    Prikhodko, Vitaly Y.; James E. Parks, II; Pihl, Josh A.; ...

    2016-04-05

    Lean gasoline engines offer greater fuel economy than the common stoichiometric gasoline engine, but the current three way catalyst (TWC) on stoichiometric engines is unable to control nitrogen oxide (NOX) emissions in oxidizing exhaust. For these lean gasoline engines, lean NOX emission control is required to meet existing Tier 2 and upcoming Tier 3 emission regulations set by the U.S. Environmental Protection Agency (EPA). While urea-based selective catalytic reduction (SCR) has proven effective in controlling NOX from diesel engines, the urea storage and delivery components can add significant size and cost. As such, onboard NH 3 production via a passivemore » SCR approach is of interest. In a passive SCR system, NH 3 is generated over a close-coupled TWC during periodic slightly rich engine operation and subsequently stored on an underfloor SCR catalyst. Upon switching to lean operation, NOX passes through the TWC and is reduced by the stored NH 3 on the SCR catalyst. In this work, a passive SCR system was evaluated on a 2.0-liter BMW lean burn gasoline direct injection engine to assess NH 3 generation over a Pd-only TWC and utilization over a Cu-based SCR catalyst. System NOX reduction efficiency and fuel efficiency improvement compared to stoichiometric engine operation were measured. A feedback control strategy based on cumulative NH 3 produced by the TWC during rich operation and NOX emissions during lean operation was implemented on the engine to control lean/rich cycle timing. At an SCR average inlet temperature of 350 °C, an NH 3:NOX ratio of 1.15:1 (achieved through longer rich cycle timing) resulted in 99.7 % NOX conversion. Increasing NH 3 generation further resulted in even higher NOX conversion; however, tailpipe NH 3 emissions resulted. At higher underfloor temperatures, NH 3 oxidation over the SCR limited NH 3 availability for NOX reduction. At the engine conditions studied, greater than 99 % NOX conversion was achieved with passive SCR while delivering fuel efficiency benefits ranging between 6-11 % compared with stoichiometric operation.« less

  18. Effects of spark plug configuration on combustion and emission characteristics of a LPG fuelled lean burn SI engine

    NASA Astrophysics Data System (ADS)

    Ravi, K.; Khan, Manazir Ahmed; Pradeep Bhasker, J.; Porpatham, E.

    2017-11-01

    Introduction of technological innovation in automotive engines in reducing pollution and increasing efficiency have been under contemplation. Gaseous fuels have proved to be a promising way to reduce emissions in Spark Ignition (SI) engines. In particular, LPG settled to be a favourable fuel for SI engines because of their higher hydrogen to carbon ratio, octane rating and lower emissions. Wide ignition limits and efficient combustion characteristics make LPG suitable for lean burn operation. But lean combustion technology has certain drawbacks like poor flame propagation, cyclic variations etc. Based on copious research it was found that location, types and number of spark plug significantly influence in reducing cyclic variations. In this work the influence of single and dual spark plugs of conventional and surface discharge electrode type were analysed. Dual surface discharge electrode spark plug enhanced the brake thermal efficiency and greatly reduced the cyclic variations. The experimental results show that rate of heat release and pressure rise was more and combustion duration was shortened in this configuration. On the emissions front, the NOx emission has increased whereas HC and CO emissions were reduced under lean condition.

  19. Examining the functionality of the DeLone and McLean information system success model as a framework for synthesis in nursing information and communication technology research.

    PubMed

    Booth, Richard G

    2012-06-01

    In this review, studies examining information and communication technology used by nurses in clinical practice were examined. Overall, a total of 39 studies were assessed spanning a time period from 1995 to 2008. The impacts of the various health information and communication technology evaluated by individual studies were synthesized using the DeLone and McLean's six-dimensional framework for evaluating information systems success (ie, System Quality, Information Quality, Service Quality, Use, User Satisfaction, and Net Benefits). Overall, the majority of researchers reported results related to the overall Net Benefits (positive, negative, and indifferent) of the health information and communication technology used by nurses. Attitudes and user satisfaction with technology were also commonly measured attributes. The current iteration of DeLone and McLean model is effective at synthesizing basic elements of health information and communication technology use by nurses. Regardless, the current model lacks the sociotechnical sensitivity to capture deeper nurse-technology relationalities. Limitations and recommendations are provided for researchers considering using the DeLone and McLean model for evaluating health information and communication technology used by nurses.

  20. Skeletal muscle mass and exercise performance in stable ambulatory patients with heart failure.

    PubMed

    Lang, C C; Chomsky, D B; Rayos, G; Yeoh, T K; Wilson, J R

    1997-01-01

    The purpose of this study was to determine whether skeletal muscle atrophy limits the maximal exercise capacity of stable ambulatory patients with heart failure. Body composition and maximal exercise capacity were measured in 100 stable ambulatory patients with heart failure. Body composition was assessed by using dual-energy X-ray absorption. Peak exercise oxygen consumption (VO2peak) and the anaerobic threshold were measured by using a Naughton treadmill protocol and a Medical Graphics CardioO2 System. VO2peak averaged 13.4 +/- 3.3 ml.min-1.kg-1 or 43 +/- 12% of normal. Lean body mass averaged 52.9 +/- 10.5 kg and leg lean mass 16.5 +/- 3.6 kg. Leg lean mass correlated linearly with VO2peak (r = 0.68, P < 0.01), suggesting that exercise performance is influences by skeletal muscle mass. However, lean body mass was comparable to levels noted in 1,584 normal control subjects, suggesting no decrease in muscle mass. Leg muscle mass was comparable to levels noted in 34 normal control subjects, further supporting this conclusion. These findings suggest that exercise intolerance in stable ambulatory patients with heart failure is not due to skeletal muscle atrophy.

  1. Systems Design and Experimental Evaluation of a High-Altitude Relight Test Facility

    NASA Astrophysics Data System (ADS)

    Paxton, Brendan

    Novel advances in gas turbine engine combustor technology, led by endeavors into fuel efficiency and demanding environmental regulations, have been fraught with performance and safety concerns. While the majority of low emissions gas turbine engine combustor technology has been necessary for power generation applications, the push for ultra-low NOx combustion in aircraft jet engines has been ever present. Recent state-of-the-art combustor designs notably tackle historic emissions challenges by operating at fuel-lean conditions, which are characterized by an increase in the amount of air flow sent to the primary combustion zone. While beneficial in reducing NOx emissions, the fuel-lean mechanisms that characterize these combustor designs rely heavily upon high-energy and high-velocity air flows to sufficiently mix and atomize fuel droplets, ultimately leading to flame stability concerns during low-power operation. When operating at high-altitude conditions, these issues are further exacerbated by the presence of low ambient air pressures and temperatures, which can lead to engine flame-out situations and hamper engine relight attempts. To aid academic and industrial research ventures into improving the high-altitude lean blow-out and relight performance of modern gas turbine engine combustor technologies, the High-Altitude Relight Test Facility (HARTF) was designed and constructed at the University of Cincinnati (UC) Combustion and Fire Research Laboratory (CFRL). Following its construction, an experimental evaluation of its abilities to facilitate optically-accessible ignition, combustion, and spray testing for gas turbine engine combustor hardware at simulated high-altitude conditions was performed. In its evaluation, performance limit references were established through testing of the HARTF vacuum and cryogenic air-chilling capabilities. These tests were conducted with regard to end-user control---the creation and the maintenance of a realistic high-altitude environment simulation. To evaluate future testing applications, as well as to understand the abilities of the HARTF to accommodate different sizes and configurations of industrial gas turbine engine combustor hardware, ignition testing was conducted at challenging high-altitude windmilling conditions with a linearly-arranged five-swirler array, replicating the implementation of a multi-cup combustor sector.

  2. Evaluation of the clinical process in a critical care information system using the Lean method: a case study

    PubMed Central

    2012-01-01

    Background There are numerous applications for Health Information Systems (HIS) that support specific tasks in the clinical workflow. The Lean method has been used increasingly to optimize clinical workflows, by removing waste and shortening the delivery cycle time. There are a limited number of studies on Lean applications related to HIS. Therefore, we applied the Lean method to evaluate the clinical processes related to HIS, in order to evaluate its efficiency in removing waste and optimizing the process flow. This paper presents the evaluation findings of these clinical processes, with regards to a critical care information system (CCIS), known as IntelliVue Clinical Information Portfolio (ICIP), and recommends solutions to the problems that were identified during the study. Methods We conducted a case study under actual clinical settings, to investigate how the Lean method can be used to improve the clinical process. We used observations, interviews, and document analysis, to achieve our stated goal. We also applied two tools from the Lean methodology, namely the Value Stream Mapping and the A3 problem-solving tools. We used eVSM software to plot the Value Stream Map and A3 reports. Results We identified a number of problems related to inefficiency and waste in the clinical process, and proposed an improved process model. Conclusions The case study findings show that the Value Stream Mapping and the A3 reports can be used as tools to identify waste and integrate the process steps more efficiently. We also proposed a standardized and improved clinical process model and suggested an integrated information system that combines database and software applications to reduce waste and data redundancy. PMID:23259846

  3. Lean management in health care: definition, concepts, methodology and effects reported (systematic review protocol).

    PubMed

    Lawal, Adegboyega K; Rotter, Thomas; Kinsman, Leigh; Sari, Nazmi; Harrison, Liz; Jeffery, Cathy; Kutz, Mareike; Khan, Mohammad F; Flynn, Rachel

    2014-09-19

    Lean is a set of operating philosophies and methods that help create a maximum value for patients by reducing waste and waits. It emphasizes the consideration of the customer's needs, employee involvement and continuous improvement. Research on the application and implementation of lean principles in health care has been limited. This is a protocol for a systematic review, following the Cochrane Effective Practice and Organisation of Care (EPOC) methodology. The review aims to document, catalogue and synthesize the existing literature on the effects of lean implementation in health care settings especially the potential effects on professional practice and health care outcomes. We have developed a Medline keyword search strategy, and this focused strategy will be translated into other databases. All search strategies will be provided in the review. The method proposed by the Cochrane EPOC group regarding randomized study designs, non-randomised controlled trials controlled before and after studies and interrupted time series will be followed. In addition, we will also include cohort, case-control studies, and relevant non-comparative publications such as case reports. We will categorize and analyse the review findings according to the study design employed, the study quality (low- versus high-quality studies) and the reported types of implementation in the primary studies. We will present the results of studies in a tabular form. Overall, the systematic review aims to identify, assess and synthesize the evidence to underpin the implementation of lean activities in health care settings as defined in this protocol. As a result, the review will provide an evidence base for the effectiveness of lean and implementation methodologies reported in health care. PROSPERO CRD42014008853.

  4. Lean management in health care: definition, concepts, methodology and effects reported (systematic review protocol)

    PubMed Central

    2014-01-01

    Background Lean is a set of operating philosophies and methods that help create a maximum value for patients by reducing waste and waits. It emphasizes the consideration of the customer’s needs, employee involvement and continuous improvement. Research on the application and implementation of lean principles in health care has been limited. Methods This is a protocol for a systematic review, following the Cochrane Effective Practice and Organisation of Care (EPOC) methodology. The review aims to document, catalogue and synthesize the existing literature on the effects of lean implementation in health care settings especially the potential effects on professional practice and health care outcomes. We have developed a Medline keyword search strategy, and this focused strategy will be translated into other databases. All search strategies will be provided in the review. The method proposed by the Cochrane EPOC group regarding randomized study designs, non-randomised controlled trials controlled before and after studies and interrupted time series will be followed. In addition, we will also include cohort, case–control studies, and relevant non-comparative publications such as case reports. We will categorize and analyse the review findings according to the study design employed, the study quality (low- versus high-quality studies) and the reported types of implementation in the primary studies. We will present the results of studies in a tabular form. Discussion Overall, the systematic review aims to identify, assess and synthesize the evidence to underpin the implementation of lean activities in health care settings as defined in this protocol. As a result, the review will provide an evidence base for the effectiveness of lean and implementation methodologies reported in health care. Systematic review registration PROSPERO CRD42014008853 PMID:25238974

  5. Evaluation of the clinical process in a critical care information system using the Lean method: a case study.

    PubMed

    Yusof, Maryati Mohd; Khodambashi, Soudabeh; Mokhtar, Ariffin Marzuki

    2012-12-21

    There are numerous applications for Health Information Systems (HIS) that support specific tasks in the clinical workflow. The Lean method has been used increasingly to optimize clinical workflows, by removing waste and shortening the delivery cycle time. There are a limited number of studies on Lean applications related to HIS. Therefore, we applied the Lean method to evaluate the clinical processes related to HIS, in order to evaluate its efficiency in removing waste and optimizing the process flow. This paper presents the evaluation findings of these clinical processes, with regards to a critical care information system (CCIS), known as IntelliVue Clinical Information Portfolio (ICIP), and recommends solutions to the problems that were identified during the study. We conducted a case study under actual clinical settings, to investigate how the Lean method can be used to improve the clinical process. We used observations, interviews, and document analysis, to achieve our stated goal. We also applied two tools from the Lean methodology, namely the Value Stream Mapping and the A3 problem-solving tools. We used eVSM software to plot the Value Stream Map and A3 reports. We identified a number of problems related to inefficiency and waste in the clinical process, and proposed an improved process model. The case study findings show that the Value Stream Mapping and the A3 reports can be used as tools to identify waste and integrate the process steps more efficiently. We also proposed a standardized and improved clinical process model and suggested an integrated information system that combines database and software applications to reduce waste and data redundancy.

  6. Nanoparticle-based electrochemical sensors for the detection of lactate and hydrogen peroxide

    NASA Astrophysics Data System (ADS)

    Uzunoglu, Aytekin

    In the present study, electrochemical sensors for the detection of lactate and hydrogen peroxide were constructed by exploiting the physicochemical properties of metal ad metal oxide nanoparticles. This study can be divided into two main sections. While chapter 2, 3, and 4 report on the construction of electrochemical lactate biosensors using CeO2 and CeO2-based mixed metal oxide nanoparticles, chapter 5 and 6 show the development of electrochemical hydrogen peroxide sensors by the decoration of the electrode surface with palladium-based nanoparticles. First generation oxidase enzyme-based sensors suffer from oxygen dependency which results in errors in the response current of the sensors in O2-lean environments. To address this challenge, the surface of the sensors must be modified with oxygen rich materials. In this regard, we developed a novel electrochemical lactate biosensor design by exploiting the oxygen storage capacity of CeO2 and CeO 2-CuO nanoparticles. By the introduction of CeO2 nanoparticles into the enzyme layer of the sensors, negative interference effect of ascorbate which resulted from the formation of oxygen-lean regions was eliminated successfully. When CeO2-based design was exposed to higher degree of O2 -depleted environments, however, the response current of the biosensors experienced an almost 21 % decrease, showing that the OSC of CeO2 was not high enough to sustain the enzymatic reactions. When CeO2-CuO nanoparticles, which have 5 times higher OSC than pristine CeO2, were used as an oxygen supply in the enzyme layer, the biosensors did not show any drop in the performance when moving from oxygen-rich to oxygen-lean conditions. In the second part of the study, PdCu/SPCE and PdAg/rGO-based electrochemical H2O2 sensors were designed and their performances were evaluated to determine their sensitivity, linear range, detection limit, and storage stability. In addition, practical applicability of the sensors was studied in human serum. The chronoamperometry results showed that the PdCu/SPCE sensors yielded a high sensitivity (396.7 microA mM -1 cm-2), a wide linear range (0.5 -11 mM), and a low limit of detection (0.7 microM) at the applied potential of -0.3 V. For PdAg/rGO sensors, a high sensitivity of 247.6 +/- 2.7 microA˙mM -1˙cm-2 was obtained towards H2O 2 in a linear range of 0.05 mM to 28 mM.

  7. 40 CFR 63.6100 - What emission and operating limitations must I meet?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... stationary combustion turbine, a lean premix oil-fired stationary combustion turbine, a diffusion flame gas-fired stationary combustion turbine, or a diffusion flame oil-fired stationary combustion turbine as...

  8. 40 CFR 63.6100 - What emission and operating limitations must I meet?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... stationary combustion turbine, a lean premix oil-fired stationary combustion turbine, a diffusion flame gas-fired stationary combustion turbine, or a diffusion flame oil-fired stationary combustion turbine as...

  9. 40 CFR 63.6100 - What emission and operating limitations must I meet?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... stationary combustion turbine, a lean premix oil-fired stationary combustion turbine, a diffusion flame gas-fired stationary combustion turbine, or a diffusion flame oil-fired stationary combustion turbine as...

  10. Prechamber equipped laser ignition for improved performance in natural gas engines

    DOE PAGES

    Almansour, Bader; Vasu, Subith; Gupta, Sreenath B.; ...

    2017-04-25

    Lean-burn operation of stationary natural gas engines offers lower NO x emissions and improved efficiency. A proven pathway to extend lean-burn operation has been to use laser ignition instead of standard spark ignition. However, under lean conditions, flame speed reduces thereby offsetting any efficiency gains resulting from the higher ratio of specific heats, γ. The reduced flame speeds, in turn, can be compensated with the use of a prechamber to result in volumetric ignition, and thereby lead to faster combustion. In this study, the optimal geometry of PCLI was identified through several tests in a single-cylinder engine as a compromisemore » between autoignition, NO x and soot formation within the prechamber. Subsequently, tests were conducted in a single-cylinder natural gas engine comparing the performance of three ignition systems: standard electrical spark ignition (SI), single-point laser ignition (LI), and prechamber equipped laser ignition (PCLI). Out of the three, the performance of PCLI was far superior compared to the other two. Efficiency gain of 2.1% points could be achieved while complying with EPA regulation (BSNO x < 1.34 kW-hr) and the industry standard for ignition stability (COV_IMEP < 5%). Finally, test results and data analysis are presented identifying the combustion mechanisms leading to the improved performance.« less

  11. 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

  12. Cellular structure of lean hydrogen flames in microgravity

    NASA Technical Reports Server (NTRS)

    Patnaik, G.; Kailasanath, K.

    1990-01-01

    Detailed, time-dependent, two-dimensional numerical simulations of premixed laminar flames have been used to study the initiation and subsequent development of cellular structures in lean hydrogen-air flames. The model includes detailed hydrogen-oxygen combustion with 24 elementary reactions of eight reactive species and a nitrogen diluent, molecular diffusion of all species, thermal conduction, viscosity, and convection. This model has been used to study the nonlinear evolution of cellular flame structure and shows that cell splitting, as observed in experiments, can be predicted numerically for sufficiently reactive mixtures. The structures that evolved also resembled the cellular structures observed in experiments. The present study shows that the 'cell-split limit' postulated from experimental observations is an intrinsic property of the mixture and that external factors such as heat losses are not necessary to cause this limit.

  13. Analysis of Cyclic Variability of Heat Release for High-EGR GDI Engine Operation with Observations on Implications for Effective Control

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

    Kaul, Brian C; Wagner, Robert M; Green Jr, Johney Boyd

    2013-01-01

    Operation of spark-ignition (SI) engines with high levels of charge dilution through exhaust gas recirculation (EGR) achieves significant engine efficiency gains while maintaining stoichiometric operation for compatibility with three-way catalysts. Dilution levels, however, are limited by cyclic variability-including significant numbers of misfires-that becomes more pronounced with increasing dilution. This variability has been shown to have both stochastic and deterministic components. Stochastic effects include turbulence, mixing variations, and the like, while the deterministic effect is primarily due to the nonlinear dependence of flame propagation rates and ignition characteristics on the charge composition, which is influenced by the composition of residual gasesmore » from prior cycles. The presence of determinism implies that an increased understanding the dynamics of such systems could lead to effective control approaches that allow operation near the edge of stability, effectively extending the dilution limit. This nonlinear dependence has been characterized previously for homogeneous charge, port fuel-injected (PFI) SI engines operating fuel-lean as well as with inert diluents such as bottled N2 gas. In this paper, cyclic dispersion in a modern boosted gasoline direct injection (GDI) engine using a cooled external EGR loop is examined, and the potential for improvement with effective control is evaluated through the use of symbol sequence statistics and other techniques from chaos theory. Observations related to the potential implications of these results for control approaches that could effectively enable engine operation at the edge of combustion stability are noted.« less

  14. Sex and race/ethnic disparities in the cross-sectional association between depressive symptoms and muscle mass: the Multi-ethnic Study of Atherosclerosis.

    PubMed

    Remigio-Baker, Rosemay A; Allison, Matthew A; Schreiner, Pamela J; Carnethon, Mercedes R; Nettleton, Jennifer A; Mujahid, Mahasin S; Szklo, Moyses; Crum, Rosa M; Leuotsakos, Jeannie-Marie; Franco, Manuel; Jensky, Nicole; Golden, Sherita Hill

    2015-09-18

    The cross-sectional area of total muscle mass has been reported to decrease by about 40% for those 20-60 years of age. Depressive symptoms may discourage motivation to engage in physical activity such as strength training shown to negate muscle loss. Inflammation related to depressive symptoms may also contribute to muscle atrophy. Physiological differences by sex and race/ethnicity may also modify the association between depression and muscle mass. Evidence on the relationship between depression (or depressive symptoms) and adiposity has been mounting; however, little is known about the depressive symptoms-muscle mass association. We sought to determine the association between elevated depressive symptoms (EDS) and lean muscle mass and whether this varies by sex and race/ethnicity. Evaluating 1605 adults (45-84 years of age) from the Multi-ethnic Study of Atherosclerosis Abdominal Body Composition, Inflammation and Cardiovascular Disease Study, we examined the cross-sectional association between EDS (Center for Epidemiologic Studies for Depression Scale score≥16 and/or antidepressant use) and computed tomography-measured abdominal lean muscle mass using linear regression. Muscles were evaluated as a whole and by functionality (locomotion vs. stabilization/posture). Covariates included height, body mass index, sociodemographics, comorbidities, inflammatory markers and health behaviors (pack-years of smoking, alcohol locomotion compared to men, total intentional exercise, daily caloric intake). Sex and race/ethnicity were assessed as potential modifiers. Statistical significance was at a p<0.05 for main effects and <0.20 for interaction. Men with elevated depressive symptoms had 5.9 cm2 lower lean muscle mass for locomotion compared to men without EDS, fully-adjusted (CI=-10.5, -1.4, p=0.011). This was statistically significantly different from the null finding among women (interaction p=0.05). Chinese participants with EDS had 10.2 cm2 lower abdominal lean muscle mass for locomotion compared to those without EDS (fully-adjusted, CI=-18.3, -2.1, p=0.014), which was significantly different from the null relationship among White participants (interaction p=0.04). No association was observed between elevated depressive symptoms and muscle for stabilization/posture evaluating the whole population or stratified by sex or race/ethnicity. In the presence of elevated depressive symptoms, men and Chinese participants may have lower muscle mass, particularly for locomotion.

  15. 40 CFR 63.6100 - What emission and operating limitations must I meet?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... combustion turbine, a lean premix oil-fired stationary combustion turbine, a diffusion flame gas-fired stationary combustion turbine, or a diffusion flame oil-fired stationary combustion turbine as defined by...

  16. 40 CFR 63.6100 - What emission and operating limitations must I meet?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... combustion turbine, a lean premix oil-fired stationary combustion turbine, a diffusion flame gas-fired stationary combustion turbine, or a diffusion flame oil-fired stationary combustion turbine as defined by...

  17. Food-specific response inhibition, dietary restraint and snack intake in lean and overweight/obese adults: a moderated-mediation model

    PubMed Central

    Price, M; Lee, M; Higgs, S

    2016-01-01

    Background/Objectives: The relationship between response inhibition and obesity is currently unclear. This may be because of inconsistencies in methodology, design limitations and the use of narrow samples. In addition, dietary restraint has not been considered, yet restraint has been reported to moderate performance on behavioural tasks of response inhibition. The aim of this study was to investigate performance on both a food-based and a neutral stimuli go/no-go task, which addresses current design limitations, in lean and overweight/obese adults. The moderating role of dietary restraint in the relationship between body composition, response inhibition and snack intake was also measured. Subjects/Methods: Lean and overweight/obese, males and females (N=116) completed both a food-based and neutral category control go/no-go task, in a fully counterbalanced repeated-measures design. A bogus taste-test was then completed, followed by a self-report measure of dietary restraint. Results: PROCESS moderated-mediation analysis showed that overweight/obese, compared with lean, participants made more errors on the food-based (but not the neutral) go/no-go task, but only when they were low in dietary restraint. Performance on the food-based go/no-go task predicted snack intake across the sample. Increased intake in the overweight, low restrainers was fully mediated by increased errors on the food-based (but not the neutral) go/no-go task. Conclusions: Distinguishing between high and low restrained eaters in the overweight/obese population is crucial in future obesity research incorporating food-based go/no-go tasks. Poor response inhibition to food cues predicts overeating across weight groups, suggesting weight loss interventions and obesity prevention programmes should target behavioural inhibition training in such individuals. PMID:26592733

  18. Food-specific response inhibition, dietary restraint and snack intake in lean and overweight/obese adults: a moderated-mediation model.

    PubMed

    Price, M; Lee, M; Higgs, S

    2016-05-01

    The relationship between response inhibition and obesity is currently unclear. This may be because of inconsistencies in methodology, design limitations and the use of narrow samples. In addition, dietary restraint has not been considered, yet restraint has been reported to moderate performance on behavioural tasks of response inhibition. The aim of this study was to investigate performance on both a food-based and a neutral stimuli go/no-go task, which addresses current design limitations, in lean and overweight/obese adults. The moderating role of dietary restraint in the relationship between body composition, response inhibition and snack intake was also measured. Lean and overweight/obese, males and females (N=116) completed both a food-based and neutral category control go/no-go task, in a fully counterbalanced repeated-measures design. A bogus taste-test was then completed, followed by a self-report measure of dietary restraint. PROCESS moderated-mediation analysis showed that overweight/obese, compared with lean, participants made more errors on the food-based (but not the neutral) go/no-go task, but only when they were low in dietary restraint. Performance on the food-based go/no-go task predicted snack intake across the sample. Increased intake in the overweight, low restrainers was fully mediated by increased errors on the food-based (but not the neutral) go/no-go task. Distinguishing between high and low restrained eaters in the overweight/obese population is crucial in future obesity research incorporating food-based go/no-go tasks. Poor response inhibition to food cues predicts overeating across weight groups, suggesting weight loss interventions and obesity prevention programmes should target behavioural inhibition training in such individuals.

  19. Ultralean combustion in general aviation piston engines

    NASA Technical Reports Server (NTRS)

    Chirivella, J. E.

    1979-01-01

    The role of ultralean combustion in achieving fuel economy in general aviation piston engines was investigated. The aircraft internal combustion engine was reviewed with regard to general aviation requirements, engine thermodynamics and systems. Factors affecting fuel economy such as those connected with an ideal leanout to near the gasoline lean flammability limit (ultralean operation) were analyzed. A Lycoming T10-541E engine was tested in that program (both in the test cell and in flight). Test results indicate that hydrogen addition is not necessary to operate the engine ultralean. A 17 percent improvement in fuel economy was demonstrated in flight with the Beechcraft Duke B60 by simply leaning the engine at constant cruiser power and adjusting the ignition for best timing. No detonation was encountered, and a 25,000 ft ceiling was available. Engine roughness was shown to be the limiting factor in the leanout.

  20. Improving timeliness and efficiency in the referral process for safety net providers: application of the Lean Six Sigma methodology.

    PubMed

    Deckard, Gloria J; Borkowski, Nancy; Diaz, Deisell; Sanchez, Carlos; Boisette, Serge A

    2010-01-01

    Designated primary care clinics largely serve low-income and uninsured patients who present a disproportionate number of chronic illnesses and face great difficulty in obtaining the medical care they need, particularly the access to specialty physicians. With limited capacity for providing specialty care, these primary care clinics generally refer patients to safety net hospitals' specialty ambulatory care clinics. A large public safety net health system successfully improved the effectiveness and efficiency of the specialty clinic referral process through application of Lean Six Sigma, an advanced process-improvement methodology and set of tools driven by statistics and engineering concepts.

  1. Effect of an alternating electric field on the polluting emission from propane flame.

    NASA Astrophysics Data System (ADS)

    Ukradiga, I.; Turlajs, D.; Purmals, M.; Barmina, I.; Zake, M.

    2001-12-01

    The experimental investigations of the AC field effect on the propane combustion and processes that cause the formation of polluting emissions (NO_x, CO, CO_2) are performed. The AC-enhanced variations of the temperature and composition of polluting emissions are studied for the fuel-rich and fuel-lean conditions of the flame core. The results show that the AC field-enhanced mixing of the fuel-rich core with the surrounding air coflow enhances the propane combustion with increase in the mass fraction of NO_x and CO_2 in the products. The reverse field effect on the composition of polluting emissions is observed under the fuel-lean conditions in the flame core. The field-enhanced CO_2 destruction is registered when the applied voltage increase. The destruction of CO_2 leads to a correlating increase in the mass fraction of CO in the products and enhances the process of NO_x formation within the limit of the fuel lean and low temperature combustion. Figs 11, Refs 18.

  2. 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.

  3. Enhanced activity and stability of La-doped CeO2 monolithic catalysts for lean-oxygen methane combustion.

    PubMed

    Zhu, Wenjun; Jin, Jianhui; Chen, Xiao; Li, Chuang; Wang, Tonghua; Tsang, Chi-Wing; Liang, Changhai

    2018-02-01

    Effective utilization of coal bed methane is very significant for energy utilization and environment protection. Catalytic combustion of methane is a promising way to eliminate trace amounts of oxygen in the coal bed methane and the key to this technology is the development of high-efficiency catalysts. Herein, we report a series of Ce 1-x La x O 2-δ (x = 0-0.8) monolithic catalysts for the catalytic combustion of methane, which are prepared by citric acid method. The structural characterization shows that the substitution of La enhance the oxygen vacancy concentration and reducibility of the supports and promote the migration of the surface oxygen, as a result improve the catalytic activity of CeO 2 . M-Ce 0.8 La 0.2 O 2-δ (monolithic catalyst, Ce 0.8 La 0.2 O 2-δ coated on cordierite honeycomb) exhibits outstanding activity for methane combustion, and the temperature for 10 and 90% methane conversion are 495 and 580 °C, respectively. Additionally, Ce 0.8 La 0.2 O 2-δ monolithic catalyst presents excellent stability at high temperature. These Ce 1-x La x O 2-δ monolithic materials with a small amount of La incorporation therefore show promises as highly efficient solid solution catalysts for lean-oxygen methane combustion. Graphical abstract ᅟ.

  4. Type of packaging affects the colour stability of vitamin E enriched beef.

    PubMed

    Nassu, Renata T; Uttaro, Bethany; Aalhus, Jennifer L; Zawadski, Sophie; Juárez, Manuel; Dugan, Michael E R

    2012-12-01

    Colour stability is a very important parameter for meat retail display, as appearance of the product is the deciding factor for consumers at time of purchase. This study investigated the possibility of extending appearance shelf-life through the combined use of packaging method (overwrapping - OVER, modified atmosphere - MAP, vacuum skin packaging - VSP and a combination of modified atmosphere and vacuum skin packaging - MAPVSP) and antioxidants (vitamin E enriched beef). Retail attributes (appearance, lean colour, % surface discolouration), as well as colour space analysis of images for red, green and blue parameters were measured over 18days. MAPVSP provided the most desirable retail appearance during the first 4days of retail display, while VSP-HB had the best colour stability. Overall, packaging type was more influential than α-tocopherol levels on meat colour stability, although α-tocopherol levels (>4μgg(-1) meat) had a protective effect when using high oxygen packaging methods. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  5. Research and Development of Natural Draft Ultra-Low Emissions Burners for Gas Appliances

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

    Therkelsen, Peter; Cheng, Robert; Sholes, Darren

    Combustion systems used in residential and commercial cooking appliances must be robust and easy to use while meeting air quality standards. Current air quality standards for cooking appliances are far greater than other stationary combustion equipment. By developing an advanced low emission combustion system for cooking appliances, the air quality impacts from these devices can be reduced. This project adapted the Lawrence Berkeley National Laboratory (LBNL) Ring-Stabilizer Burner combustion technology for residential and commercial natural gas fired cooking appliances (such as ovens, ranges, and cooktops). LBNL originally developed the Ring-Stabilizer Burner for a NASA funded microgravity experiment. This natural draftmore » combustion technology reduces NOx emissions significantly below current SCAQMD emissions standards without post combustion treatment. Additionally, the Ring-Stabilizer Burner technology does not require the assistance of a blower to achieve an ultra-low emission lean premix flame. The research team evaluated the Ring-Stabilizer Burner and fabricated the most promising designs based on their emissions and turndown.« less

  6. Limits of Stability and Adaptation to Wearing Rocker Bottom Shoes.

    PubMed

    Vieira, Edgar Ramos; Guerrero, Gerardo; Holt, Daniel; Arreaza, Monica; Veroes, Valentina; Brunt, Denis

    2014-06-01

    Stability and balance are fundamental during static and dynamic activities. The effects of wearing rocker bottom sole (RBS) shoes on the limits of stability (LOS) and adaptation to wearing RBS shoes need to be investigated. The objectives of this study were to evaluate the LOS when wearing RBS shoes, and to evaluate if people improve their stability while wearing RBS shoes over time. Eleven female subjects with no lower extremity impairments participated in the study. The LOS were tested at baseline and weeks 3 and 6 using a Neurocom SMART EquiTest equipment. Center of pressure (CoP) was determined using force plates, and the center of gravity (CoG) position was estimated from the CoP measures and subjects' anthropometry. Subjects performed a series of tasks that involved leaning in different directions so as to move the vertical projection of their CoG. End-point excursions of the CoG floor projection were calculated as a percentage of the distance between the starting position and the target. Considering the body as an inverted pendulum, we recorded the average angular velocity of the inverted pendulum during the movements and quantified directional control as a percentage of movement toward versus away from the target. Shoe types were compared using paired t tests, and sessions were compared using repeated measures ANOVA. The angular velocities of the inverted pendulum (ie, CoG velocity) were not significantly different between shoe conditions in the front and back directions at baseline (4 ± 3 with RBS vs 5 ± 2 deg/sec with regular shoes, and 4 ± 1 vs 6 ± 4 deg/sec). Front directional control of the CoG was significantly worse with RBS shoes at weeks 3 and 6 ( P < .015). Front end-point excursions were also lower with RBS shoes both at baseline and week 6 ( P < .014). There were no significant changes over time. The findings indicate that the LOS were negatively affected by wearing RBS shoes and that people do not improve their stability while wearing these shoes even after a 6-week period of use. This study shows that wearing RBS shoes increase instability and the instability remains even after wearing these shoes for six weeks.

  7. Gout Diet

    MedlinePlus

    ... provide complex carbohydrates. Avoid foods and beverages with high-fructose corn syrup, and limit consumption of naturally sweet fruit juices. Water. Stay well-hydrated by drinking water. Fats. Cut back on saturated ... fatty poultry and high-fat dairy products. Proteins. Focus on lean meat ...

  8. Postural control and freezing of gait in Parkinson's disease.

    PubMed

    Schlenstedt, Christian; Muthuraman, Muthuraman; Witt, Karsten; Weisser, Burkhard; Fasano, Alfonso; Deuschl, Günther

    2016-03-01

    The relationship between freezing of gait (FOG) and postural instability in Parkinson's disease (PD) is unclear. We analyzed the impact of FOG on postural control. 31 PD patients with FOG (PD+FOG), 27 PD patients without FOG (PD-FOG) and 22 healthy control (HC) were assessed in the ON state. Postural control was measured with the Fullerton Advanced Balance (FAB) scale and with center of pressure (COP) analysis during quiet stance and maximal voluntary forward/backward leaning. The groups were balanced concerning age, disease duration and disease severity. PD+FOG performed significantly worse in the FAB scale (21.8 ± 5.8) compared to PD-FOG (25.6 ± 5.0) and HC (34.9 ± 2.4) (mean ± SD, p < 0.01). PD+FOG had impaired ability to voluntary lean forward, difficulties to stand on foam with eyes closed and reduced limits of stability compared to PD-FOG (p < 0.05). During quiet stance the average anterior-posterior COP position was significantly displaced towards posterior in PD+FOG in comparison to PD-FOG and HC (p < 0.05). The COP position correlated with severity of FOG (p < 0.01). PD+FOG and PD-FOG did not differ in average COP sway excursion, sway velocity, sway regularity and postural control asymmetry. PD+FOG have reduced postural control compared to PD-FOG and HC. Our results show a relationship between the anterior-posterior COP position during quiet stance and FOG. The COP shift towards posterior in PD+FOG leads to a restricted precondition to generate forward progression during gait initiation. This may contribute to the occurrence of FOG or might be a compensatory strategy to avoid forward falls. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Effects of uneven-aged and diameter-limit management on West Virginia tree and wood quality

    Treesearch

    Michael C. Wiemann; Thomas M. Schuler; John E. Baumgras

    2004-01-01

    Uneven-aged and diameter-limit management were compared with an unmanaged control on the Fernow Experimental Forest near Parsons, West Virginia, to determine how treatment affects the quality of red oak (Quercus rubra L.), sugar maple (Acer saccharum Marsh.), and yellow-poplar (Liriodendron tulipifera L.). Periodic harvests slightly increased stem lean, which often...

  10. Ammonia Generation and Utilization in a Passive SCR (TWC+SCR) System on Lean Gasoline Engine

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

    Prikhodko, Vitaly Y; Parks, II, James E; Pihl, Josh A

    Lean gasoline engines offer greater fuel economy than the common stoichiometric gasoline engine, but the current three-way catalyst (TWC) on stoichiometric engines is unable to control nitrogen oxide (NOX) emissions in the oxygen-rich exhaust. Thus, lean NOX emission control is required to meet existing Tier 2 and upcoming Tier 3 emission regulations set by the U.S. Environmental Protection Agency (EPA). While urea-based selective catalytic reduction (SCR) has proven effective in controlling NOX from diesel engines, the urea storage and delivery components can add significant size and cost. As such, onboard NH3 production via a passive SCR approach is of interest.more » In a passive SCR system, NH3 is generated over a close-coupled TWC during periodic slightly rich engine operation and subsequently stored on an underfloor SCR catalyst. Upon switching to lean operation, NOX passes through the TWC and is reduced by the stored NH3 on the SCR catalyst. In this work, a passive SCR system was evaluated on a 2.0-liter BMW lean burn gasoline direct injection engine to assess NH3 generation over a Pd-only TWC and utilization over a Cu-based SCR catalyst. System NOX reduction efficiency and fuel efficiency improvement compared to stoichiometric engine operation were measured. A feedback control strategy based on cumulative NH3 produced by the TWC during rich operation and NOX emissions during lean operation was implemented on the engine to control lean/rich cycle timing. 15% excess NH3 production over a 1:1 NH3:NOX ratio was required (via longer rich cycle timing) to achieve 99.7% NOX conversion at an SCR average inlet temperature of 350 C. Increasing NH3 generation further resulted in even higher NOX conversion; however, tailpipe NH3 emissions resulted. At higher temperatures, NH3 oxidation becomes important and limits NH3 availability for NOX reduction. At the engine conditions studied here, greater than 99% NOX conversion was achieved with passive SCR while delivering fuel efficiency benefits ranging between 6-11% compared with stoichiometric operation.« less

  11. Total and Lower Extremity Lean Mass Percentage Positively Correlates With Jump Performance.

    PubMed

    Stephenson, Mitchell L; Smith, Derek T; Heinbaugh, Erika M; Moynes, Rebecca C; Rockey, Shawn S; Thomas, Joi J; Dai, Boyi

    2015-08-01

    Strength and power have been identified as valuable components in both athletic performance and daily function. A major component of strength and power is the muscle mass, which can be assessed with dual-energy x-ray absorptiometry (DXA). The primary purpose of this study was to quantify the relationship between total body lean mass percentage (TBLM%) and lower extremity lean mass percentage (LELM%) and lower extremity force/power production during a countermovement jump (CMJ) in a general population. Researchers performed a DXA analysis on 40 younger participants aged 18-35 years, 28 middle-aged participants aged 36-55 years, and 34 older participants aged 56-75 years. Participants performed 3 CMJ on force platforms. Correlations revealed significant and strong relationships between TBLM% and LELM% compared with CMJ normalized peak vertical ground reaction force (p < 0.001, r = 0.59), normalized peak vertical power (p < 0.001, r = 0.73), and jump height (p < 0.001, r = 0.74) for the combined age groups. Most relationships were also strong within each age group, with some relationships being relatively weaker in the middle-aged and older groups. Minimal difference was found between correlation coefficients of TBLM% and LELM%. Coefficients of determination were all below 0.6 for the combined group, indicating that between-participant variability in CMJ measures cannot be completely explained by lean mass percentages. The findings have implications in including DXA-assessed lean mass percentage as a component for evaluating lower extremity strength and power. A paired DXA analysis and CMJ jump test may be useful for identifying neuromuscular deficits that limit performance.

  12. Is obesity protective against wound healing complications in pilon surgery? Soft tissue envelope and pilon fractures in the obese.

    PubMed

    Graves, Matthew L; Porter, Scott E; Fagan, Bryan C; Brien, Glenn A; Lewis, Matthew W; Biggers, Marcus D; Woodall, James R; Russell, George V

    2010-08-11

    Open treatment of pilon fractures is associated with wound healing complications. A traumatized, limited soft tissue envelope contributes to wound healing complications. Obese patients have larger soft tissue envelopes around the ankle, theoretically providing a greater area for energy distribution and more accommodation to implants. This led us to test 2 hypotheses: (1) ankle dimensions in obese patients are larger than in lean patients, and (2) the increased soft tissue envelope volume translates into fewer wound complications. A consecutive series of 176 pilon fractures treated from March 2002 to December 2007 were retrospectively reviewed. Inclusion criteria were adults who received a preoperative computed tomography (CT) scan and were treated with a staged protocol including plating. Patients with body mass index (BMI) >30 were compared to those with BMI <30 for CT-derived ankle dimensions and wound complications. Comorbidities were evaluated for their role as potential confounders. Thirty-one fractures in obese patients were compared to 83 in lean patients. The average ratio of bone area to soft tissue area at the tibial plafond was 0.35 for the obese group and 0.38 for the lean group (P=.012). There were 8 major wound-healing complications. Four occurred in the obese group (incidence 13%), and 4 in the lean group (incidence 5%) (P=.252). Ankle dimensions in clinically obese patients are larger than in lean patients. Obesity does not appear to be protective of wound-healing complications, but rather there is a trend toward the opposite. Copyright 2010, SLACK Incorporated.

  13. Impact of finite rate chemistry on the hydrodynamic stability of shear flows in turbulent lean premixed combustion

    NASA Astrophysics Data System (ADS)

    Dagan, Yuval; Ghoniem, Ahmed

    2017-11-01

    Recent experimental observations show that the dynamic response of a reactive flow is strongly impacted by the fuel chemistry. In order to gain insight into some of the underlying mechanisms we formulate a new linear stability model that incorporates the impact of finite rate chemistry on the hydrodynamic stability of shear flows. Contrary to previous studies which typically assume that the velocity field is independent of the kinetic rates, the velocity field in our study is coupled with the temperature field. Using this formulation, we reproduce previous results, e.g., most unstable global modes, obtained for non-reacting shear flow. Moreover, we show that these modes are significantly altered in frequency and gain by the presence of a reaction region within the shear layer. This qualitatively agrees with results of our recent experimental and numerical studies, which show that the flame surface location relative to the shear layer influences the stability characteristics in combustion tunnels. This study suggests a physical explanation for the observed impact of finite rate chemistry on shear flow stability.

  14. Experimental and Computational Study of Trapped Vortex Combustor Sector Rig with Tri-pass Diffuser

    NASA Technical Reports Server (NTRS)

    Hendricks, Robert C.; Shouse, D. T.; Roquemore, W. M.; Burrus, D. L.; Duncan, B. S.; Ryder, R. C.; Brankovic, A.; Liu, N.-S.; Gallagher, J. R.; Hendricks, J. A.

    2001-01-01

    The Trapped Vortex Combustor (TVC) potentially offers numerous operational advantages over current production gas turbine engine combustors. These include lower weight, lower pollutant emissions, effective flame stabilization, high combustion efficiency, excellent high altitude relight capability, and operation in the lean burn or RQL (Rich burn/Quick mix/Lean burn) modes of combustion. The present work describes the operational principles of the TVC, and provides detailed performance data on a configuration featuring a tri-pass diffusion system. Performance data include EINOx (NO(sub x) emission index) results for various fuel-air ratios and combustor residence times, combustion efficiency as a function of combustor residence time, and combustor lean blow-out (LBO) performance. Computational fluid dynamics (CFD) simulations using liquid spray droplet evaporation and combustion modeling are performed and related to flow structures observed in photographs of the combustor. The CFD results are used to understand the aerodynamics and combustion features under different fueling conditions. Performance data acquired to date are favorable in comparison to conventional gas turbine combustors. Further testing over a wider range of fuel-air ratios, fuel flow splits, and pressure ratios is in progress to explore the TVC performance. In addition, alternate configurations for the upstream pressure feed, including bi-pass diffusion schemes, as well as variations on the fuel injection patterns, are currently in test and evaluation phases.

  15. Wide range operation of advanced low NOx combustors for supersonic high-altitude aircraft gas turbines

    NASA Technical Reports Server (NTRS)

    Roberts, P. B.; Fiorito, R. J.

    1977-01-01

    An initial rig program tested the Jet Induced Circulation (JIC) and Vortex Air Blast (VAB) systems in small can combustor configurations for NOx emissions at a simulated high altitude, supersonic cruise condition. The VAB combustor demonstrated the capability of meeting the NOx goal of 1.0 g NO2/kg fuel at the cruise condition. In addition, the program served to demonstrate the limited low-emissions range available from the lean, premixed combustor. A follow-on effort was concerned with the problem of operating these lean, premixed combustors with acceptable emissions at simulated engine idle conditions. Various techniques have been demonstrated that allow satisfactory operation on both the JIC and VAB combustors at idle with CO emissions below 20 g/kg fuel. The VAB combustor was limited by flashback/autoignition phenomena at the cruise conditions to a pressure of 8 atmospheres. The JIC combustor was operated up to the full design cruise pressure of 14 atmospheres without encountering an autoignition limitation although the NOx levels, in the 2-3 g NO2/kg fuel range, exceeded the program goal.

  16. Control of Early Flame Kernel Growth by Multi-Wavelength Laser Pulses for Enhanced Ignition

    DOE PAGES

    Dumitrache, Ciprian; VanOsdol, Rachel; Limbach, Christopher M.; ...

    2017-08-31

    The present contribution examines the impact of plasma dynamics and plasma-driven fluid dynamics on the flame growth of laser ignited mixtures and shows that a new dual-pulse scheme can be used to control the kernel formation process in ways that extend the lean ignition limit. We do this by performing a comparative study between (conventional) single-pulse laser ignition (λ = 1064 nm) and a novel dual-pulse method based on combining an ultraviolet (UV) pre-ionization pulse (λ = 266 nm) with an overlapped near-infrared (NIR) energy addition pulse (λ = 1064 nm). We employ OH* chemiluminescence to visualize the evolution ofmore » the early flame kernel. For single-pulse laser ignition at lean conditions, the flame kernel separates through third lobe detachment, corresponding to high strain rates that extinguish the flame. In this work, we investigate the capabilities of the dual-pulse to control the plasma-driven fluid dynamics by adjusting the axial offset of the two focal points. In particular, we find there exists a beam waist offset whereby the resulting vorticity suppresses formation of the third lobe, consequently reducing flame stretch. With this approach, we demonstrate that the dual-pulse method enables reduced flame speeds (at early times), an extended lean limit, increased combustion efficiency, and decreased laser energy requirements.« less

  17. Control of Early Flame Kernel Growth by Multi-Wavelength Laser Pulses for Enhanced Ignition

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

    Dumitrache, Ciprian; VanOsdol, Rachel; Limbach, Christopher M.

    The present contribution examines the impact of plasma dynamics and plasma-driven fluid dynamics on the flame growth of laser ignited mixtures and shows that a new dual-pulse scheme can be used to control the kernel formation process in ways that extend the lean ignition limit. We do this by performing a comparative study between (conventional) single-pulse laser ignition (λ = 1064 nm) and a novel dual-pulse method based on combining an ultraviolet (UV) pre-ionization pulse (λ = 266 nm) with an overlapped near-infrared (NIR) energy addition pulse (λ = 1064 nm). We employ OH* chemiluminescence to visualize the evolution ofmore » the early flame kernel. For single-pulse laser ignition at lean conditions, the flame kernel separates through third lobe detachment, corresponding to high strain rates that extinguish the flame. In this work, we investigate the capabilities of the dual-pulse to control the plasma-driven fluid dynamics by adjusting the axial offset of the two focal points. In particular, we find there exists a beam waist offset whereby the resulting vorticity suppresses formation of the third lobe, consequently reducing flame stretch. With this approach, we demonstrate that the dual-pulse method enables reduced flame speeds (at early times), an extended lean limit, increased combustion efficiency, and decreased laser energy requirements.« less

  18. Combustor technology for future small gas turbine aircraft

    NASA Technical Reports Server (NTRS)

    Lyons, Valerie J.; Niedzwiecki, Richard W.

    1993-01-01

    Future engine cycles proposed for advanced small gas turbine engines will increase the severity of the operating conditions of the combustor. These cycles call for increased overall engine pressure ratios which increase combustor inlet pressure and temperature. Further, the temperature rise through the combustor and the corresponding exit temperature also increase. Future combustor technology needs for small gas turbine engines is described. New fuel injectors with large turndown ratios which produce uniform circumferential and radial temperature patterns will be required. Uniform burning will be of greater importance because hot gas temperatures will approach turbine material limits. The higher combustion temperatures and increased radiation at high pressures will put a greater heat load on the combustor liners. At the same time, less cooling air will be available as more of the air will be used for combustion. Thus, improved cooling concepts and/or materials requiring little or no direct cooling will be required. Although presently there are no requirements for emissions levels from small gas turbine engines, regulation is expected in the near future. This will require the development of low emission combustors. In particular, nitrogen oxides will increase substantially if new technologies limiting their formation are not evolved and implemented. For example, staged combustion employing lean, premixed/prevaporized, lean direct injection, or rich burn-quick quench-lean burn concepts could replace conventional single stage combustors.

  19. Control of Early Flame Kernel Growth by Multi-Wavelength Laser Pulses for Enhanced Ignition.

    PubMed

    Dumitrache, Ciprian; VanOsdol, Rachel; Limbach, Christopher M; Yalin, Azer P

    2017-08-31

    The present contribution examines the impact of plasma dynamics and plasma-driven fluid dynamics on the flame growth of laser ignited mixtures and shows that a new dual-pulse scheme can be used to control the kernel formation process in ways that extend the lean ignition limit. We perform a comparative study between (conventional) single-pulse laser ignition (λ = 1064 nm) and a novel dual-pulse method based on combining an ultraviolet (UV) pre-ionization pulse (λ = 266 nm) with an overlapped near-infrared (NIR) energy addition pulse (λ = 1064 nm). We employ OH* chemiluminescence to visualize the evolution of the early flame kernel. For single-pulse laser ignition at lean conditions, the flame kernel separates through third lobe detachment, corresponding to high strain rates that extinguish the flame. In this work, we investigate the capabilities of the dual-pulse to control the plasma-driven fluid dynamics by adjusting the axial offset of the two focal points. In particular, we find there exists a beam waist offset whereby the resulting vorticity suppresses formation of the third lobe, consequently reducing flame stretch. With this approach, we demonstrate that the dual-pulse method enables reduced flame speeds (at early times), an extended lean limit, increased combustion efficiency, and decreased laser energy requirements.

  20. Modern Management Principles Come to the Dental School.

    PubMed

    Wataha, John C; Mouradian, Wendy E; Slayton, Rebecca L; Sorensen, John A; Berg, Joel H

    2016-04-01

    The University of Washington School of Dentistry may be the first dental school in the nation to apply lean process management principles as a primary tool to re-engineer its operations and curriculum to produce the dentist of the future. The efficiencies realized through re-engineering will better enable the school to remain competitive and viable as a national leader of dental education. Several task forces conducted rigorous value stream analyses in a highly collaborative environment led by the dean of the school. The four areas undergoing evaluation and re-engineering were organizational infrastructure, organizational processes, curriculum, and clinic operations. The new educational model was derived by thoroughly analyzing the current state of dental education in order to design and achieve the closest possible ideal state. As well, the school's goal was to create a lean, sustainable operational model. This model aims to ensure continued excellence in restorative dental instruction and to serve as a blueprint for other public dental schools seeking financial stability in this era of shrinking state support and rising costs.

  1. 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.

  2. [Anthropometry, body composition and functional limitations in the elderly].

    PubMed

    Arroyo, Patricia; Lera, Lydia; Sánchez, Hugo; Bunout, Daniel; Santos, José Luis; Albala, Cecilia

    2007-07-01

    Functional limitations limit the independence and jeopardize the quality of life of elderly subjects. To assess the association between anthropometric measures and body composition with functional limitations in community-living older people. Cross-sectional survey of 377 people > or = 6 5 years old (238 women), randomly selected from the SABE/Chile project. Complete anthropometric measurements were done. Handgrip muscle strength was measured using dynamometers. Body composition was determined using Dual-Energy X-Ray Absorptiometry. Functional limitations were assessed using self reported and observed activities. Body mass index was strongly associated with fat mass (men r =0.87; women r =0.91) and with lean mass (men r =0.55; women r =0.62). Males had significantly greater lean mass (48.9 kg vs 34.9 kg), and bone mass than females (2.6 kg vs 1.8 kg) and women had higher fat mass than men (26.3 kg vs 22.9 kg). The prevalence of functional limitations was high, affecting more women than men (63.7% vs 37.5%, p <0.01). Functional limitations were associated with lower handgrip strength in both sexes. In the multiple regression models, with functional limitations as dependent variable and anthropometric measures as contributing variables, only hand grip strength had a significant association (negative) with functional limitations in both genders. Age was also a significant risk factor for functional limitations among women. Hand grip strength was strongly and inversely associated with functional limitations. Handgrip dynamometry is an easy, cheap and low time-consuming indicator for the assessment of functional limitations and the evaluation of geriatric interventions aimed to improve functional ability.

  3. 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.

  4. Seated limits-of-stability of athletes with disabilities with regard to competitive levels and sport classification.

    PubMed

    Santos, P B R; Vigário, P S; Mainenti, M R M; Ferreira, A S; Lemos, T

    2017-12-01

    In this study, we asked whether wheelchair rugby (WR) classification and competitive level influence trunk function of athletes with disabilities, in terms of seated limits-of-stability (LoS). Twenty-eight athletes were recruited from international- and national-level WR teams, with each group exhibiting marked differences in years of sports practice and training volume. Athletes were also distributed into three groups according their classification: low-point (0.5-1.5-point); mid-point (2.0-2.5-point); and high-point (3.0-3.5-point). Athletes were asked to sit on a force platform and to lean the body as far as possible in eight predefined directions. Center of pressure (COP) coordinates were calculated from the ground reaction forces acquired with the force platform. LoS were computed as the area of ellipse adjusted to maximal COP excursion achieved for the eight directions. ANOVAs reveal that LoS were not different when international- and national-level players were compared (P=.744). Nevertheless, LoS were larger in players from the high-point group than from the low-point group (P=.028), with the mid-point group being not different from both (P>.194). In summary, (i) competitive level does not impact LoS measures and (ii) LoS are remarkably distinct when comparing both extremes of the WR classification range. Our results suggest that, as a training-resistant measure, LoS could be a valid assessment of trunk impairment, potentially contributing to the development of an evidence-based WR classification. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. 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

  6. Modeling and Simulation of Swirl Stabilized Turbulent Non-Premixed Flames

    NASA Astrophysics Data System (ADS)

    Badillo-Rios, Salvador; Karagozian, Ann

    2017-11-01

    Flame stabilization is an important design criterion for many combustion chambers, especially at lean conditions and/or high power output, where insufficient stabilization can result in dangerous oscillations and noisy or damaged combustors. At high flow rates, swirling flow can offer a suitable stabilization mechanism, although understanding the dynamics of swirl-stabilized turbulent flames remains a significant challenge. Utilizing the General Equation and Mesh Solver (GEMS) code, which solves the Navier-Stokes equations along with the energy equation and five species equations, 2D axisymmetric and full 3D parametric studies and simulations are performed to guide the design and development of an experimental swirl combustor configuration and to study the effects of swirl on statistically stationary combustion. Results show that as the momentum of air is directed into the inner air inlet rather than the outer inlet of the swirl combustor, the central recirculating region becomes stronger and more unsteady, improving mixing and burning efficiency in that region. A high temperature region is found to occur as a result of burning of the trapped fuel from the central toroidal vortex. The effects of other parameters on flowfield and flame-stabilization dynamics are explored. Supported by ERC, Inc. (PS150006) and AFOSR (Dr. Chiping Li).

  7. Potential roles of force cues in human stance control.

    PubMed

    Cnyrim, Christian; Mergner, Thomas; Maurer, Christoph

    2009-04-01

    Human stance is inherently unstable. A small deviation from upright body orientation is enough to yield a gravitational component in the ankle joint torque, which tends to accelerate the body further away from upright ('gravitational torque'; magnitude is related to body-space lean angle). Therefore, to maintain a given body lean position, a corresponding compensatory torque must be generated. It is well known that subjects use kinematic sensory information on body-space lean from the vestibular system for this purpose. Less is known about kinetic cues from force/torque receptors. Previous work indicated that they are involved in compensating external contact forces such as a pull or push having impact on the body. In this study, we hypothesized that they play, in addition, a role when the vestibular estimate of the gravitational torque becomes erroneous. Reasons may be sudden changes in body mass, for instance by a load, or an impairment of the vestibular system. To test this hypothesis, we mimicked load effects on the gravitational torque in normal subjects and in patients with chronic bilateral vestibular loss (VL) with eyes closed. We added/subtracted extra torque to the gravitational torque by applying an external contact force (via cable winches and a body harness). The extra torque was referenced to body-space lean, using different proportionality factors. We investigated how it affected body-space lean responses that we evoked using sinusoidal tilts of the support surface (motion platform) with different amplitudes and frequencies (normals +/-1 degrees, +/-2 degrees, and +/-4 degrees at 0.05, 0.1, 0.2, and 0.4 Hz; patients +/-1 degrees and +/-2 degrees at 0.05 and 0.1 Hz). We found that added/subtracted extra torque scales the lean response in a systematic way, leading to increase/decrease in lean excursion. Expressing the responses in terms of gain and phase curves, we compared the experimental findings to predictions obtained from a recently published sensory feedback model. For the trials in which the extra torque tended to endanger stance control, predictions in normals were better when the model included force cues than without these cues. This supports our notion that force cues provide an automatic 'gravitational load compensation' upon changes in body mass in normals. The findings in the patients support our notion that the presumed force cue mechanism provides furthermore vestibular loss compensation. Patients showed a body-space stabilization that cannot be explained by ankle angle proprioception, but must involve graviception, most likely by force cues. Our findings suggest that force cues contribute considerably to the redundancy and robustness of the human stance control system.

  8. 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.

  9. 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.

  10. Maternal fat, but not lean, mass is increased among overweight/obese women with excess gestational weight gain.

    PubMed

    Berggren, Erica K; Groh-Wargo, Sharon; Presley, Larraine; Hauguel-de Mouzon, Sylvie; Catalano, Patrick M

    2016-06-01

    Weight gain in pregnancy is an essential physiologic adaptation that supports growth and development of a fetus and is distributed among lean mass that includes total body water and fat mass gains. Although gestational weight gain provides a source of energy for the mother and fetus, excess gestational weight gain may underlie reported associations between parity and future metabolic disorders and is linked to postpartum weight retention and insulin resistance. Although weight gain often is proposed as a modifiable variable to mitigate adverse maternal and offspring health outcomes, our knowledge of specific maternal body composition changes with weight gain and the potential metabolic consequences is limited. Furthermore, although gestational weight gain alters maternal body composition, the impact of excess weight gain on fat and lean mass is not well-studied. Understanding the accrual of fat and lean body mass may improve our understanding of the role of excessive gestational weight gain and metabolic dysfunction. The purpose of our study was to quantify the relationship between gestational weight gain and maternal fat and lean body mass accrual and to compare fat and lean body mass accrual according to the 2009 Institute of Medicine Guidelines for Gestational Weight Gain in Pregnancy adherence. We hypothesized that exceeding current weight gain guidelines would be associated with greater fat, compared with lean body, mass accrual. This is a secondary analysis of a randomized controlled trial of 49 overweight/obese women; all 49 are included in this secondary analysis. Maternal weight and body composition were collected in early (13 0/6 to 16 6/7 weeks gestation) and late (34 0/7 to 36 6/7 weeks gestation) pregnancy with the use of air densitometry. Correlations were drawn between gestational weight gain and change in fat and lean body mass. We compared change in fat and lean body mass by adherence to the 2009 Institute of Medicine Guidelines for Gestational Weight Gain in Pregnancy. Nonparametric tests and chi-square analyses were performed; a probability value of <.05 was significant. Early pregnancy body mass index was 30.3 kg/m(2) (interquartile range [IQR], 28.5-35.2 kg/m(2)); women gained 9.0 kg (IQR, 5.3-13.2 kg). Overweight and obese women were equally likely to gain excess weight (48% vs 35%; P = .6). Weight gain correlated strongly with fat mass change (r = 0.87; P < .001); women with excess vs adequate vs inadequate weight gain had greater fat mass change overall (5.2 [IQR, 4.2-8.1] vs 0.2 [IQR, -0.4-2.2] vs -2.7 [IQR, -5.2- -0.7] kg, respectively; P < .001) and in all pairwise comparisons. Weight gain also correlated with lean body mass change (r = 0.52; P = .001), but women with excess vs adequate weight gain had similar lean body mass change (8.4 [IQR, 7.2-10.1] vs 7.8 [IQR, 6.0-8.7] kg; P = .1). Excess gestational weight gain is associated primarily with maternal fat, but not with lean body mass accrual. Our results may help explain the reason that excess gestational weight gain or fat mass accrual is associated with long-term obesity, metabolic dysfunction, and cardiovascular disease risk. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Effect of fuel composition and differential diffusion on flame stabilization in reacting syngas jets in turbulent cross-flow

    DOE PAGES

    Minamoto, Yuki; Kolla, Hemanth; Grout, Ray W.; ...

    2015-07-24

    Here, three-dimensional direct numerical simulation results of a transverse syngas fuel jet in turbulent cross-flow of air are analyzed to study the influence of varying volume fractions of CO relative to H 2 in the fuel composition on the near field flame stabilization. The mean flame stabilizes at a similar location for CO-lean and CO-rich cases despite the trend suggested by their laminar flame speed, which is higher for the CO-lean condition. To identify local mixtures having favorable mixture conditions for flame stabilization, explosive zones are defined using a chemical explosive mode timescale. The explosive zones related to flame stabilizationmore » are located in relatively low velocity regions. The explosive zones are characterized by excess hydrogen transported solely by differential diffusion, in the absence of intense turbulent mixing or scalar dissipation rate. The conditional averages show that differential diffusion is negatively correlated with turbulent mixing. Moreover, the local turbulent Reynolds number is insufficient to estimate the magnitude of the differential diffusion effect. Alternatively, the Karlovitz number provides a better indicator of the importance of differential diffusion. A comparison of the variations of differential diffusion, turbulent mixing, heat release rate and probability of encountering explosive zones demonstrates that differential diffusion predominantly plays an important role for mixture preparation and initiation of chemical reactions, closely followed by intense chemical reactions sustained by sufficient downstream turbulent mixing. The mechanism by which differential diffusion contributes to mixture preparation is investigated using the Takeno Flame Index. The mean Flame Index, based on the combined fuel species, shows that the overall extent of premixing is not intense in the upstream regions. However, the Flame Index computed based on individual contribution of H 2 or CO species reveals that hydrogen contributes significantly to premixing, particularly in explosive zones in the upstream leeward region, i.e. at the preferred flame stabilization location. Therefore, a small amount of H 2 diffuses much faster than CO, creating relatively homogeneous mixture pockets depending on the competition with turbulent mixing. These pockets, together with high H 2 reactivity, contribute to stabilizing the flame at a consistent location regardless of the CO concentration in the fuel for the present range of DNS conditions.« less

  12. 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.

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

    Rangaraj, D; Chan, K; Boddu, S

    Lean thinking has revolutionized the manufacturing industry. Toyota has pioneered and leveraged this aspect of Lean thinking. Application of Lean thinking and Lean Six Sigma techniques into Healthcare and in particular in Radiation Oncology has its merits and challenges. To improve quality, safety and patient satisfaction with available resources or reducing cost in terms of time, staff and resources is demands of today's healthcare. Radiation oncology treatment involves many processes and steps, identifying and removing the non-value added steps in a process can significantly improve the efficiency. Real projects undertaken in radiation oncology department in cutting down the procedure timemore » for MRI guided brachytherapy to 40% less using lean thinking will be narrated. Simple Lean tools and techniques such as Gemba walk, visual control, daily huddles, standard work, value stream mapping, error-proofing, etc. can be applied with existing resources and how that improved the operation in a Radiation Oncology department's two year experience will be discussed. Lean thinking focuses on identifying and solving the root-cause of a problem by asking “Why” and not “Who” and this requires a culture change of no blame. Role of leadership in building lean culture, employee empowerment and trains and develops lean thinkers will be presented. Why Lean initiatives fail and how to implement lean successfully in your clinic will be discussed. Learning Objectives: Concepts of lean management or lean thinking. Lean tools and techniques applied in Radiation Oncology. Implement no blame culture and focus on system and processes. Leadership role in implementing lean culture. Challenges for Lean thinking in healthcare.« less

  14. Metabolomic analysis reveals altered skeletal muscle amino acid and fatty acid handling in obese humans.

    PubMed

    Baker, Peter R; Boyle, Kristen E; Koves, Timothy R; Ilkayeva, Olga R; Muoio, Deborah M; Houmard, Joseph A; Friedman, Jacob E

    2015-05-01

    Investigate the effects of obesity and high-fat diet (HFD) exposure on fatty acid oxidation and TCA cycle intermediates and amino acids in skeletal muscle to better characterize energy metabolism. Plasma and skeletal muscle metabolomic profiles were measured from lean and obese males before and after a 5-day HFD in the 4 h postprandial condition. At both time points, plasma short-chain acylcarnitine species (SCAC) were higher in the obese subjects, while the amino acids glycine, histidine, methionine, and citrulline were lower in skeletal muscle of obese subjects. Skeletal muscle medium-chain acylcarnitines (MCAC) C6, C8, C10:2, C10:1, C10, and C12:1 increased in obese subjects, but decreased in lean subjects, from pre- to post-HFD. Plasma content of C10:1 was also decreased in the lean but increased in the obese subjects from pre- to post-HFD. CD36 increased from pre- to post-HFD in obese but not lean subjects. Lower skeletal muscle amino acid content and accumulation of plasma SCAC in obese subjects could reflect increased anaplerosis for TCA cycle intermediates, while accumulation of MCAC suggests limitations in β-oxidation. These measures may be important markers of or contributors to dysregulated metabolism observed in skeletal muscle of obese humans. © 2015 The Obesity Society.

  15. Drive cycle simulation of high efficiency combustions on fuel economy and exhaust properties in light-duty vehicles

    DOE PAGES

    Gao, Zhiming; Curran, Scott J.; Parks, James E.; ...

    2015-04-06

    We present fuel economy and engine-out emissions for light-duty (LD) conventional and hybrid vehicles powered by conventional and high-efficiency combustion engines. Engine technologies include port fuel-injected (PFI), direct gasoline injection (GDI), reactivity controlled compression ignition (RCCI) and conventional diesel combustion (CDC). In the case of RCCI, the engine utilized CDC combustion at speed/load points not feasible with RCCI. The results, without emissions considered, show that the best fuel economies can be achieved with CDC/RCCI, with CDC/RCCI, CDC-only, and lean GDI all surpassing PFI fuel economy significantly. In all cases, hybridization significantly improved fuel economy. The engine-out hydrocarbon (HC), carbon monoxidemore » (CO), nitrogen oxides (NOx), and particulate matter (PM) emissions varied remarkably with combustion mode. The simulated engine-out CO and HC emissions from RCCI are significantly higher than CDC, but RCCI makes less NOx and PM emissions. Hybridization can improve lean GDI and RCCI cases by increasing time percentage for these more fuel efficient modes. Moreover, hybridization can dramatically decreases the lean GDI and RCCI engine out emissions. Importantly, lean GDI and RCCI combustion modes decrease exhaust temperatures, especially for RCCI, which limits aftertreatment performance to control tailpipe emissions. Overall, the combination of engine and hybrid drivetrain selected greatly affects the emissions challenges required to meet emission regulations.« less

  16. Intrinsic ankle stiffness during standing increases with ankle torque and passive stretch of the Achilles tendon

    PubMed Central

    Gill, Jaspret

    2018-01-01

    Individuals may stand with a range of ankle angles. Furthermore, shoes or floor surfaces may elevate or depress their heels. Here we ask how these situations impact ankle stiffness and balance. We performed two studies (each with 10 participants) in which the triceps surae, Achilles tendon and aponeurosis were stretched either passively, by rotating the support surface, or actively by leaning forward. Participants stood freely on footplates which could rotate around the ankle joint axis. Brief, small stiffness-measuring perturbations (<0.7 deg; 140 ms) were applied at intervals of 4–5 s. In study 1, participants stood at selected angles of forward lean. In study 2, normal standing was compared with passive dorsiflexion induced by 15 deg toes-up tilt of the support surface. Smaller perturbations produced higher stiffness estimates, but for all perturbation sizes stiffness increased with active torque or passive stretch. Sway was minimally affected by stretch or lean, suggesting that this did not underlie the alterations in stiffness. In quiet stance, maximum ankle stiffness is limited by the tendon. As tendon strain increases, it becomes stiffer, causing an increase in overall ankle stiffness, which would explain the effects of leaning. However, stiffness also increased considerably with passive stretch, despite a modest torque increase. We discuss possible explanations for this increase. PMID:29558469

  17. Characterization of flame stabilization technologies

    NASA Astrophysics Data System (ADS)

    Bush, Scott Matthew

    To experimentally explore and characterize a V-gutter stabilized flame, this research study developed a Combustion Wind Tunnel Test Facility capable of effectively simulating the freestream Mach #'s and temperatures achieved within the back end of a gas turbine jet engine. After validating this facility, it was then used to gain a better understanding of the flow dynamics and combustion dynamics associated with the V-gutter configuration. The motivation for studying the V-gutter stabilized flame is due to the concern in industry today with combustion instabilities that are encountered in military aircraft. To gain a better understanding of the complex flow field associated with the V-gutter stabilized flame, this research study utilized Particle Image Velocimetry to capture both non-reacting and reacting instantaneous and mean flow structures formed in the wake region of the three dimensional V-gutter bluff body. The results of this study showed significant differences between the non-reacting and reacting flow fields. The non-reacting case resulted in asymmetric shedding of large scale vortices from the V-gutter edges while the reacting case resulted in a combination of both symmetric and asymmetric shedding of smaller scale vortical structures. A comparison of the mean velocity components shows that the reacting case results in a larger region of reversed flow, experiences an acceleration of the freestream flow due to combustion, and results in a slower dissipation of the wake region. Simultaneous dynamic pressure and CH* chemiluminescence measurements were also recorded to determine the coupling between the flow dynamics and combustion dynamics. The results of this study showed that only low frequency combustion instabilities were encountered at various conditions within the envelope of stable operation because of the interaction between longitudinal acoustic waves and unsteady heat release. When approaching rich blow out, rms pressure amplitudes were as high as 2 psi, and approaching lean blow out lead to rms pressure amplitudes around 0.2 psi. These studies also showed the instability frequency increasing with increases in either inlet temperature or inlet Mach #. Additionally, increasing the inlet velocity or the DeZubay parameter reduced the stability limits of operation for the V-gutter stabilized flame.

  18. Serum betaine is inversely associated with low lean mass mainly in men in a Chinese middle-aged and elderly community-dwelling population.

    PubMed

    Huang, Bi-Xia; Zhu, Ying-Ying; Tan, Xu-Ying; Lan, Qiu-Ye; Li, Chun-Lei; Chen, Yu-Ming; Zhu, Hui-Lian

    2016-06-01

    Previous studies have demonstrated that betaine supplements increase lean body mass in livestock and improve muscle performance in human beings, but evidence for its effect on human lean mass is limited. Our study assessed the association of circulating betaine with lean mass and its composition in Chinese adults. A community-based study was conducted on 1996 Guangzhou residents (weight/mass: 1381/615) aged 50-75 years between 2008 and 2010. An interviewer-administered questionnaire was used to collect general baseline information. Fasting serum betaine was assessed using HPLC-MS. A total of 1590 participants completed the body composition analysis performed using dual-energy X-ray absorptiometry during a mean of 3·2 years of follow-up. After adjustment for age, regression analyses demonstrated a positive association of serum betaine with percentage of lean mass (LM%) of the entire body, trunk and limbs in men (all P<0·05) and LM% of the trunk in women (P=0·016). Each sd increase in serum betaine was associated with increases in LM% of 0·609 (whole body), 0·811 (trunk), 0·422 (limbs), 0·632 (arms) and 0·346 (legs) in men and 0·350 (trunk) in women. Multiple logistic regression analysis revealed that the prevalence of lower LM% decreased by 17 % (whole body) and 14 % (trunk) in women and 23 % (whole body), 28 % (trunk), 22 % (arms) and 26 % (percentage skeletal muscle index) in men with each sd increment in serum betaine. Elevated circulating betaine was associated with a higher LM% and lower prevalence of lower LM% in middle-aged and elderly Chinese adults, particularly men.

  19. 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.

  20. Allometric modelling of peak oxygen uptake in male soccer players of 8-18 years of age.

    PubMed

    Valente-Dos-Santos, João; Coelho-E-Silva, Manuel J; Tavares, Óscar M; Brito, João; Seabra, André; Rebelo, António; Sherar, Lauren B; Elferink-Gemser, Marije T; Malina, Robert M

    2015-03-01

    Peak oxygen uptake (VO2peak) is routinely scaled as mL O2 per kilogram body mass despite theoretical and statistical limitations of using ratios. To examine the contribution of maturity status and body size descriptors to age-associated inter-individual variability in VO2peak and to present static allometric models to normalize VO2peak in male youth soccer players. Total body and estimates of total and regional lean mass were measured with dual energy X-ray absorptiometry in a cross-sectional sample of Portuguese male soccer players. The sample was divided into three age groups for analysis: 8-12 years, 13-15 years and 16-18 years. VO2peak was estimated using an incremental maximal exercise test on a motorized treadmill. Static allometric models were used to normalize VO2peak. The independent variables with the best statistical fit explained 72% in the younger group (lean body mass: k = 1.07), 52% in mid-adolescent players (lean body mass: k = 0.93) and 31% in the older group (body mass: k = 0.51) of variance in VO2peak. The inclusion of the exponential term pubertal status marginally increased the explained variance in VO2peak (adjusted R(2 )= 36-75%) and provided statistical adjustments to the size descriptors coefficients. The allometric coefficients and exponents evidenced the varying inter-relationship among size descriptors and maturity status with aerobic fitness from early to late-adolescence. Lean body mass, lean lower limbs mass and body mass combined with pubertal status explain most of the inter-individual variability in VO2peak among youth soccer players.

  1. Powdered Magnesium-Carbon Dioxide Rocket Combustion Technology for In Situ Mars Propulsion

    NASA Technical Reports Server (NTRS)

    Foote, J. P.; Litchford, R. J.

    2007-01-01

    Powdered magnesium (Mg) carbon dioxide (CO2) combustion is examined as a potential in situ propellant combination for Mars propulsion. Although this particular combination has relatively low performance in comparison to traditional bipropellants, it remains attractive as a potential basis for future martian mobility systems, since it could be partially or wholly manufactured from indigenous planetary resources. As a means of achieving high mobility during long-duration Mars exploration missions, the poorer performing in situ combination can, in fact, become a superior alternative to conventional storable propellants, which would need to be entirely transported from Earth. Thus, the engineering aspects of powdered metal combustion devices are discussed including transport/injection of compacted powder, ignition, combustion efficiency, combustion stability, dilution effects, lean burn limits, and slag formation issues. It is suggested that these technological issues could be effectively addressed through a multiphase research and development effort beginning with basic feasibility tests using an existing dump configured atmospheric pressure burner. Follow-on phases would involve the development and testing of a pressurized research combustor and technology demonstration tests of a prototypical rocket configuration.

  2. "Powdered Magnesium: Carbon Dioxide Combustion for Mars Propulsion"

    NASA Technical Reports Server (NTRS)

    Foote, John P.; Litchford, Ron J.

    2005-01-01

    Powdered magnesium - carbon dioxide combustion is examined as a potential in-situ propellant combination for Mars propulsion. Although this particular combination has relatively low performance in comparison to traditional bi-propellants, it remains attractive as a potential basis for future Martian mobility systems since it could be partially or wholly manufactured from indigenous planetary resources. As a means of achieving high mobility during long-duration Mars exploration missions, the poorer performing in-situ combination can, in fact, become a superior alternative to conventional storable propellants, which would need to be entirely transported from earth. Thus, the engineering aspects of powdered metal combustion devices are discussed including transport/injection of compacted powder, ignition, combustion efficiency, combustion stability, dilution effects, lean burn limits, and slag formation issues. It is suggested that these technological issues could be effectively addressed through a multi-phase research and development effort beginning with basic feasibility tests using an existing dump configured atmospheric pressure burner. Follow-on phases would involve the development and testing of a pressurized research combustor and technology demonstration tests of a prototypical rocket configuration.

  3. Body Composition Remodeling and Incident Mobility Limitations in African Ancestry Men.

    PubMed

    Santanasto, Adam J; Miljkovic, Iva; Cvejkus, Ryan C; Gordon, Christopher L; Bunker, Clareann H; Patrick, Allen L; Wheeler, Victor W; Zmuda, Joseph M

    2018-04-05

    Mobility limitations are common, with higher prevalence in African Americans compared to whites, and are associated with disability, institutionalization and death. Aging is associated with losses of lean mass and a shift to central adiposity, which are more pronounced in African Americans. We aimed to examine the association of body composition remodeling with incident mobility limitations in older men of African Ancestry. Seven-year changes in body composition were measured using peripheral computed tomography (pQCT) of the calf and whole-body dual x-ray absorptiometry (DXA) in 505 African Ancestry men aged ≥60 years and free of self-reported mobility limitations at baseline. Self-reported incident mobility limitations were assessed at 7-year follow-up. Odds of developing mobility limitations associated with baseline and change in body composition were quantified using separate logistic regression models. Seventy-five men (14.9%) developed incident mobility limitations over 6.2±0.6 years. Baseline body composition was not associated with incident mobility limitations. After adjustment for covariates, gaining total and intermuscular fat were associated with incident mobility limitations a (OR: 1.60; 95% CI: 1.21-2.13; OR: 1.51; 95% CI: 1.18-1.94). Changes in DXA lean mass were not related to mobility limitations; however, maintaining pQCT calf muscle area was protective against mobility limitations (OR: 0.65; 95% CI: 0.48-0.87). Increases in body fat, and particularly intermuscular fat, and decreases in calf skeletal muscle were associated with a higher risk of developing mobility limitations. Our findings emphasize the importance of body composition remodeling in the development of mobility limitations among African ancestry men.

  4. 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.

  5. 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

  6. 40 CFR 86.1232-96 - Vehicle preconditioning.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... preconditioned separately. If production evaporative canisters are equipped with a functional service port... production evaporative canisters are equipped with a functional service port designed for vapor load or purge... provides at least a 4:1 safety factor against the lean flammability limit. (iii) The FID hydrocarbon...

  7. A Lean Approach to Scheduling Systems Engineering Resources

    DTIC Science & Technology

    2013-05-01

    The CoS that have been identified for the heath care system KSS Network are presented in Table 1. The definition of initial WIP Limits, collaboration...Garry Roedler (Lockheed Martin), Karl Scotland (Rally Software, UK), Alan Shalloway (NetObjectives), Neil Shirk (Lockheed Martin), Neil Siegel

  8. Equilibrium Passive Sampling of POP in Lipid-Rich and Lean Fish Tissue: Quality Control Using Performance Reference Compounds.

    PubMed

    Rusina, Tatsiana P; Carlsson, Pernilla; Vrana, Branislav; Smedes, Foppe

    2017-10-03

    Passive sampling is widely used to measure levels of contaminants in various environmental matrices, including fish tissue. Equilibrium passive sampling (EPS) of persistent organic pollutants (POP) in fish tissue has been hitherto limited to application in lipid-rich tissue. We tested several exposure methods to extend EPS applicability to lean tissue. Thin-film polydimethylsiloxane (PDMS) passive samplers were exposed statically to intact fillet and fish homogenate and dynamically by rolling with cut fillet cubes. The release of performance reference compounds (PRC) dosed to passive samplers prior to exposure was used to monitor the exchange process. The sampler-tissue exchange was isotropic, and PRC were shown to be good indicators of sampler-tissue equilibration status. The dynamic exposures demonstrated equilibrium attainment in less than 2 days for all three tested fish species, including lean fish containing 1% lipid. Lipid-based concentrations derived from EPS were in good agreement with lipid-normalized concentrations obtained using conventional solvent extraction. The developed in-tissue EPS method is robust and has potential for application in chemical monitoring of biota and bioaccumulation studies.

  9. Detailed Multidimensional Simulations of the Structure and Dynamics of Flames

    NASA Technical Reports Server (NTRS)

    Patnaik, G.; Kailasanath, K.

    1999-01-01

    Numerical simulations in which the various physical and chemical processes can be independently controlled can significantly advance our understanding of the structure, stability, dynamics and extinction of flames. Therefore, our approach has been to use detailed time-dependent, multidimensional, multispecies numerical models to perform carefully designed computational experiments of flames on Earth and in microgravity environments. Some of these computational experiments are complementary to physical experiments performed under the Microgravity Program while others provide a fundamental understanding that cannot be obtained from physical experiments alone. In this report, we provide a brief summary of our recent research highlighting the contributions since the previous microgravity combustion workshop. There are a number of mechanisms that can cause flame instabilities and result in the formation of dynamic multidimensional structures. In the past, we have used numerical simulations to show that it is the thermo-diffusive instability rather than an instability due to preferential diffusion that is the dominant mechanism for the formation of cellular flames in lean hydrogen-air mixtures. Other studies have explored the role of gravity on flame dynamics and extinguishment, multi-step kinetics and radiative losses on flame instabilities in rich hydrogen-air flames, and heat losses on burner-stabilized flames in microgravity. The recent emphasis of our work has been on exploring flame-vortex interactions and further investigating the structure and dynamics of lean hydrogen-air flames in microgravity. These topics are briefly discussed after a brief discussion of our computational approach for solving these problems.

  10. 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,…

  11. 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.

  12. 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.

  13. 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

  14. A comprehensive model to determine the effects of temperature and species fluctuations on reaction rates in turbulent reacting flows

    NASA Technical Reports Server (NTRS)

    Goldstein, D.; Magnotti, F.; Chinitz, W.

    1983-01-01

    Reaction rates in turbulent, reacting flows are reviewed. Assumed probability density functions (pdf) modeling of reaction rates is being investigated in relation to a three variable pdf employing a 'most likely pdf' model. Chemical kinetic mechanisms treating hydrogen air combustion is studied. Perfectly stirred reactor modeling of flame stabilizing recirculation regions was used to investigate the stable flame regions for silane, hydrogen, methane, and propane, and for certain mixtures thereof. It is concluded that in general, silane can be counted upon to stabilize flames only when the overall fuel air ratio is close to or greater than unity. For lean flames, silane may tend to destabilize the flame. Other factors favoring stable flames are high initial reactant temperatures and system pressure.

  15. Laser controlled flame stabilization

    DOEpatents

    Early, James W.; Thomas, Matthew E.

    2001-01-01

    A method and apparatus is provided for initiating and stabilizing fuel combustion in applications such as gas turbine electrical power generating engines and jet turbine engines where it is desired to burn lean fuel/air mixtures which produce lower amounts of NO.sub.x. A laser induced spark is propagated at a distance from the fuel nozzle with the laser ignitor being remotely located from the high temperature environment of the combustion chamber. A laser initiating spark generated by focusing high peak power laser light to a sufficiently tight laser spot within the fuel to cause the ionization of air and fuel into a plasma is unobtrusive to the flow dynamics of the combustion chamber of a fuel injector, thereby facilitating whatever advantage can be taken of flow dynamics in the design of the fuel injector.

  16. Strength exercise improves muscle mass and hepatic insulin sensitivity in obese youth

    USDA-ARS?s Scientific Manuscript database

    Data on the metabolic effects of resistance exercise (strength training) in adolescents are limited. The objective of this study was to determine whether a controlled resistance exercise program without dietary intervention or weight loss reduces body fat accumulation, increases lean body mass, and ...

  17. An Experimental Investigation of Self-Excited Combustion Dynamics in a Single Element Lean Direct Injection (LDI) Combustor

    NASA Astrophysics Data System (ADS)

    Gejji, Rohan M.

    The management of combustion dynamics in gas turbine combustors has become more challenging as strict NOx/CO emission standards have led to engine operation in a narrow, lean regime. While premixed or partially premixed combustor configurations such as the Lean Premixed Pre-vaporized (LPP), Rich Quench Lean burn (RQL), and Lean Direct Injection (LDI) have shown a potential for reduced NOx emissions, they promote a coupling between acoustics, hydrodynamics and combustion that can lead to combustion instabilities. These couplings can be quite complex, and their detailed understanding is a pre-requisite to any engine development program and for the development of predictive capability for combustion instabilities through high-fidelity models. The overarching goal of this project is to assess the capability of high-fidelity simulation to predict combustion dynamics in low-emissions gas turbine combustors. A prototypical lean-direct-inject combustor was designed in a modular configuration so that a suitable geometry could be found by test. The combustor comprised a variable length air plenum and combustion chamber, air swirler, and fuel nozzle located inside a subsonic venturi. The venturi cross section and the fuel nozzle were consistent with previous studies. Test pressure was 1 MPa and variables included geometry and acoustic resonance, inlet temperatures, equivalence ratio, and type of liquid fuel. High-frequency pressure measurements in a well-instrumented metal chamber yielded frequencies and mode shapes as a function of inlet air temperature, equivalence ratio, fuel nozzle placement, and combustor acoustic resonances. The parametric survey was a significant effort, with over 105 tests on eight geometric configurations. A good dataset was obtained that could be used for both operating-point-dependent quantitative comparisons, and testing the ability of the simulation to predict more global trends. Results showed a very strong dependence of instability amplitude on the geometric configuration of the combustor, i.e., its acoustic resonance characteristics, with measured pressure fluctuation amplitudes ranged from 5 kPa (0.5% of mean pressure) to 200 kPa ( 20% of mean pressure) depending on combustor geometry. The stability behavior also showed a consistent and pronounced dependence on equivalence ratio and inlet air temperature. Instability amplitude increased with higher equivalence ratio and with lower inlet air temperature. A pronounced effect of fuel nozzle location on the combustion dynamics was also observed. Combustion instabilities with the fuel nozzle at the throat of the venturi throat were stronger than in the configuration with fuel nozzle 2.6 mm upstream of the nozzle. A second set of dynamics data was based on high-response-rate laser-based combustion diagnostics using an optically accessible combustor section. High-frequency measurements of OH*-chemiluminescence and OH-PLIF and velocity fields using PIV were obtained at a relatively stable, low equivalence ratio case and a less stable case at higher equivalence ratio. PIV measurements were performed at 5 kHz for non-reacting flow but glare from the cylindrical quartz chamber limited the field of view to a small region in the combustor. Quantitative and qualitative comparisons were made for five different combinations of geometry and operating condition that yielded discriminating stability behavior in the experiment with simulations that were carried out concurrently. Comparisons were made on the basis of trends and pressure mode data as well as with OH-PLIF measurements for the baseline geometry at equivalence ratios of 0.44 and 0.6. Overall, the ability of the simulation to match experimental data and trends was encouraging. Dynamic Mode Decomposition (DMD) analysis was performed on two sets of computations - a global 2-step chemistry mechanism and an 18-step chemistry mechanism - and the OH-PLIF images to allow comparison of dynamic patterns of heat release and OH distribution in the combustion zone. The DMD analysis was able to identify similar dominant unstable modes in the combustor. Recommendations for future work are based on the continued requirement for quantitative and spatio-temporally resolved data for direct comparison with computational efforts to develop predictive capabilities for combustion instabilities at relevant operating conditions. Discriminating instability behavior for the prototypical combustor demonstrated in this study is critical for any robust validation effort Unit physics based scaling of the current effort to multi-element combustors along with improvement in diagnostic techniques and analysis efforts are recommended for advancement in understanding of the complex physics in the multi-phase, three dimensional and turbulent combustion processes in the LDI combustor.

  18. Recent advances in automotive catalysis for NOx emission control by small-pore microporous materials

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

    Beale, Andrew M.; Gao, Feng; Lezcano-Gonzalez, Ines

    The ever increasing demand to develop highly fuel efficient engines coincides with the need to minimize air pollution originating from the exhaust gases of internal combustion engines. Dramatically improved fuel efficiency can be achieved at air-to-fuel ratios much higher than stoichiometric. In the presence of oxygen in large excess, however, traditional three-way catalysts are unable to reduce NOx. Among the number of lean-NOx reduction technologies, selective catalytic reduction (SCR) of NOx by NH3 over Cu- and Fe-ion exchanged zeolite catalysts has been extensively studied over the past 30+ years. Despite the significant advances in developing a viable practical zeolite-based catalystmore » for lean NOx reduction, the insufficient hydrothermal stabilities of the zeolite structures considered cast doubts about their real-world applicability. During the past decade a renewed interest in zeolite-based lean NOx reduction was spurred by the discovery of the very high activity of Cu-SSZ-13 (and the isostructural Cu-SAPO-34) in the NH3 SCR of NOx. These new, small-pore zeolite-based catalysts not only exhibited very high NOx conversion and N2 selectivity, but also exhibited exceptional high hydrothermal stability at high temperatures. In this review we summarize the key discoveries of the past ~5 years that lead to the introduction of these catalysts into practical application. The review first briefly discusses the structure and preparation of the CHA structure-based zeolite catalysts, and then summarizes the key learnings of the rather extensive (but not complete) characterisation work. Then we summarize the key findings of reaction kinetics studies, and provide some mechanistic details emerging from these investigations. At the end of the review we highlight some of the issues that are still need to be addressed in automotive exhaust control catalysis. Funding A.M.B. and I.L.G. would like to thank EPSRC for funding. F.G., C.H.F.P. and J.Sz. gratefully acknowledge financial support from the US Department of Energy (DOE), Office of Energy Efficiency and Renewable Energy, Vehicle Technologies Program.« less

  19. A case study on Measurement of Degree of Performance of an Industry by using Lean Score Technique

    NASA Astrophysics Data System (ADS)

    Srinivasa Rao, P.; Niraj, Malay

    2016-09-01

    Lean manufacturing concept is becoming a very important strategy for both academicians and practitioners in the recent times, and Japanese are using this practice for more than a decade. In this present scenario, this paper describes an innovative approach for lean performance evaluation by using fuzzy membership functions before and after implementing lean manufacturing techniques and formulating a model to establish the lean score through the lean attributes by eliminating major losses. It shows a systematic lean performance measurement by producing a final integrated unit less-score.

  20. 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.

  1. 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.

  2. Video image analysis in the Australian meat industry - precision and accuracy of predicting lean meat yield in lamb carcasses.

    PubMed

    Hopkins, D L; Safari, E; Thompson, J M; Smith, C R

    2004-06-01

    A wide selection of lamb types of mixed sex (ewes and wethers) were slaughtered at a commercial abattoir and during this process images of 360 carcasses were obtained online using the VIAScan® system developed by Meat and Livestock Australia. Soft tissue depth at the GR site (thickness of tissue over the 12th rib 110 mm from the midline) was measured by an abattoir employee using the AUS-MEAT sheep probe (PGR). Another measure of this thickness was taken in the chiller using a GR knife (NGR). Each carcass was subsequently broken down to a range of trimmed boneless retail cuts and the lean meat yield determined. The current industry model for predicting meat yield uses hot carcass weight (HCW) and tissue depth at the GR site. A low level of accuracy and precision was found when HCW and PGR were used to predict lean meat yield (R(2)=0.19, r.s.d.=2.80%), which could be improved markedly when PGR was replaced by NGR (R(2)=0.41, r.s.d.=2.39%). If the GR measures were replaced by 8 VIAScan® measures then greater prediction accuracy could be achieved (R(2)=0.52, r.s.d.=2.17%). A similar result was achieved when the model was based on principal components (PCs) computed from the 8 VIAScan® measures (R(2)=0.52, r.s.d.=2.17%). The use of PCs also improved the stability of the model compared to a regression model based on HCW and NGR. The transportability of the models was tested by randomly dividing the data set and comparing coefficients and the level of accuracy and precision. Those models based on PCs were superior to those based on regression. It is demonstrated that with the appropriate modeling the VIAScan® system offers a workable method for predicting lean meat yield automatically.

  3. 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.

  4. 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.

  5. Boys with Eating Disorders

    ERIC Educational Resources Information Center

    Hatmaker, Grace

    2005-01-01

    Although commonly associated with girls and women, eating disorders do not discriminate. School nurses need to be aware that male students also can suffer from the serious health effects of anorexia nervosa, bulimia, anorexia athletica, and eating disorders not otherwise specified. Sports that focus on leanness and weight limits can add to a…

  6. Gut microbiome composition in lean patients with NASH is associated with liver damage independent of caloric intake: A prospective pilot study.

    PubMed

    Duarte, S M B; Stefano, J T; Miele, L; Ponziani, F R; Souza-Basqueira, M; Okada, L S R R; de Barros Costa, F G; Toda, K; Mazo, D F C; Sabino, E C; Carrilho, F J; Gasbarrini, A; Oliveira, C P

    2018-04-01

    The aim of the study was to compare the gut microbiomes from obese and lean patients with or without NASH to outline phenotypic differences. We performed a cross-sectional pilot study comprising biopsy-proven NASH patients grouped according to BMI. Microbiome DNA was extracted from stool samples, and PCR amplification was performed using primers for the V4 region of the 16S rRNA gene. The amplicons were sequenced using the Ion PGM Torrent platform, and data were analyzed using QIIME software. Macronutrient consumption was analyzed by a 7-day food record. Liver fibrosis ≥ F2 was associated with increased abundance of Lactobacilli (p = 0.0007). NASH patients showed differences in Faecalibacterium, Ruminococcus, Lactobacillus and Bifidobacterium abundance compared with the control group. Lean NASH patients had a 3-fold lower abundance of Faecalibacterium and Ruminococcus (p = 0.004), obese NASH patients were enriched in Lactobacilli (p = 0.002), and overweight NASH patients had reduced Bifidobacterium (p = 0.018). Moreover, lean NASH patients showed a deficiency in Lactobacillus compared with overweight and obese NASH patients. This group also appeared similar to the control group with regard to gut microbiome alpha diversity. Although there were qualitative differences between lean NASH and overweight/obese NASH, they were not statistically significant (p = 0.618). The study limitations included a small sample size, a food questionnaire that collected only qualitative and semi-quantitative data, and variations in group gender composition that may influence differences in FXR signaling, bile acids metabolism and the composition of gut microbiota. Our preliminary finding of a different pathogenetic process in lean NASH patients needs to be confirmed by larger studies, including those with patient populations stratified by sex and dietary habits. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  7. Use of a service evaluation and lean thinking transformation to redesign an NHS 111 refer to community Pharmacy for Emergency Repeat Medication Supply Service (PERMSS).

    PubMed

    Nazar, Hamde; Nazar, Zachariah; Simpson, Jill; Yeung, Andre; Whittlesea, Cate

    2016-08-26

    To demonstrate the contribution of community pharmacy from NHS 111 referrals out of hours (OOH) for emergency supply repeat medication requests via presentation of service activity, community pharmacist feedback and lean thinking transformation. Descriptive service evaluation using routine service activity data over the pilot period; survey of community pharmacists, and service redesign through lean thinking transformation. North East of England NHS 111 provider and accredited community pharmacies across the North East of England. Patients calling the North East of England NHS 111 provider during OOH with emergency repeat medication supply requests. NHS 111 referral to community pharmacies for assessment and if appropriate, supply of emergency repeat medication. Number of emergency repeat medication supply referrals, completion rates, reasons for rejections, time of request, reason for access, medication(s), pharmaceutical advice and services provided. Secondary outcomes were community pharmacist feedback and lean thinking transformation of the patient pathway. NHS 111 referred 1468 patients to 114 community pharmacies (15/12/2014-7/4/2015). Most patients presented on Saturdays, with increased activity over national holidays. Community pharmacists completed 951 (64.8%) referrals providing 2297 medications; 412 were high risk. The most common reason for rejecting referrals was no medication in stock. Community pharmacists were positive about the provision of this service. The lean thinking transformation reduced the number of non-added value steps, waits and bottlenecks in the patient pathway. NHS 111 can redirect callers OOH from urgent and emergency care services to community pharmacy for management of emergency repeat medication supply. Existing IT and community pharmacy regulations allowed patients to receive a medication supply and pharmaceutical advice. Community pharmacists supported integration into the NHS OOH services. Adopting lean thinking provided a structured framework to evaluate and redesign the service with the aim to improve effectiveness and efficiency. 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/

  8. Flame balls dynamics in divergent channel

    NASA Astrophysics Data System (ADS)

    Fursenko, R.; Minaev, S.

    2011-12-01

    A three-dimensional reaction-diffusion model for lean low-Lewis-number premixed flames with radiative heat losses propagating in divergent channel is studied numerically. Effects of inlet gas velocity and heat-loss intensity on flame structure at low Lewis numbers are investigated. It is found that continuous flame front exists at small heat losses and the separate flame balls settled within restricted domain inside the divergent channel at large heat losses. It is shown that the time averaged flame balls coordinate may be considered as important characteristic analogous to coordinate of continuous flame stabilized in divergent channel.

  9. The effect of perindopril on postural instability in older people with a history of falls-a randomised controlled trial.

    PubMed

    Sumukadas, Deepa; Price, Rosemary; McMurdo, Marion E T; Rauchhaus, Petra; Struthers, Allan; McSwiggan, Stephen; Arnold, Graham; Abboud, Rami; Witham, Miles

    2018-01-01

    double-blind, parallel group, placebo-controlled randomised trial. we recruited people aged >65 years with at least one fall in the previous year. Participants received 4 mg perindopril or placebo daily for 15 weeks. The primary outcome was the between-group difference in force-plate measured anteroposterior (AP) sway at 15 weeks. Secondary outcomes included other measures of postural sway, limits of stability during maximal forward, right and left leaning, blood pressure, muscle strength, 6-min walk distance and falls. The primary outcome was assessed using two-way ANOVA, adjusted for baseline factors. we randomised 80 participants. Mean age was 78.0 (SD 7.4) years; 60 (75%) were female. About 77/80 (96%) completed the trial. At 15 weeks there were no significant between-group differences in AP sway with eyes open (mean difference 0 mm, 95% CI -8 to 7 mm, P = 0.91) or eyes closed (mean difference 2 mm, 95% CI -7 to 12 mm, P = 0.59); no differences in other measures of postural stability, muscle strength or function. About 16/40 (42%) of patients in each group had orthostatic hypotension at follow-up. The median number (IQR) of falls was 1 (0,4) in the perindopril versus 1 (0,2) in the placebo group (P = 0.24). perindopril did not improve postural sway in older people at risk of falls. ISRCTN58995463. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.

  10. 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

  11. 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.

  12. 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.

  13. 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".

  14. 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

  15. Low weight and overweightness in older adults: risk and clinical management.

    PubMed

    Jahangir, Eiman; De Schutter, Alban; Lavie, Carl J

    2014-01-01

    The prevalence of individuals who are overweight or obese is growing exponentially in the United States and worldwide. This growth is concerning, as both overweightness and obesity lead to impaired physical function, decreased quality of life, and increased risk of chronic diseases. Additionally, overweightness and obesity are related to increased mortality among young and middle-aged adults. This weight-related risk of mortality is more ambiguous among older adults. In fact, obesity may be protective in this population, a relationship described as the "obesity paradox". In this review we discuss the effects of overweightness and obesity among the elderly on cardiovascular disease and all-cause mortality, along with the risks of low weight. We conclude by discussing the goal of weight management among older adults, focusing particularly on benefits of preserving lean body mass and muscular strength while stabilizing body fat. Ideally, overweight or mildly obese elderly individuals should devise a plan with their physicians to maintain their weight, while increasing lean body mass through a plan of healthy diet, behavioral therapy, and physical activity. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Relationships between HMG-CoA reductase inhibitors (statin) use and strength, balance and falls in older people.

    PubMed

    Haerer, W; Delbaere, K; Bartlett, H; Lord, S R; Rowland, J

    2012-12-01

    To investigate associations between HMG-CoA reductase inhibitor (statin) use and muscle strength, balance, mobility and falls in older people. Five hundred community-dwelling people aged 70-90 years provided information about their medication use and undertook tests of lower limb strength, postural sway, leaning balance (maximal balance range and coordinated stability tests) and functional mobility. Participants were then followed up for 12 months with respect to falls. After adjusting for general health in analyses of covariance procedures, statin users had poorer maximal balance range than non-statin users (P = 0.017). Statin and non-statin users did not differ with respect to strength, postural sway, mobility or falls experienced in the follow-up year. In a sample of healthy older people, statin use was not associated with muscle weakness, postural sway, reduced mobility or falls. Statin users, however, had poorer leaning balance which may potentially increase fall risk in this group. © 2011 The Authors; Internal Medicine Journal © 2011 Royal Australasian College of Physicians.

  17. Flame stabilization and mixing characteristics in a Stagnation Point Reverse Flow combustor

    NASA Astrophysics Data System (ADS)

    Bobba, Mohan K.

    A novel combustor design, referred to as the Stagnation Point Reverse-Flow (SPRF) combustor, was recently developed that is able to operate stably at very lean fuel-air mixtures and with low NOx emissions even when the fuel and air are not premixed before entering the combustor. The primary objective of this work is to elucidate the underlying physics behind the excellent stability and emissions performance of the SPRF combustor. The approach is to experimentally characterize velocities, species mixing, heat release and flame structure in an atmospheric pressure SPRF combustor with the help of various optical diagnostic techniques: OH PLIF, chemiluminescence imaging, PIV and Spontaneous Raman Scattering. Results indicate that the combustor is primarily stabilized in a region downstream of the injector that is characterized by low average velocities and high turbulence levels; this is also the region where most of the heat release occurs. High turbulence levels in the shear layer lead to increased product entrainment levels, elevating the reaction rates and thereby enhancing the combustor stability. The effect of product entrainment on chemical timescales and the flame structure is illustrated with simple reactor models. Although reactants are found to burn in a highly preheated (1300 K) and turbulent environment due to mixing with hot product gases, the residence times are sufficiently long compared to the ignition timescales such that the reactants do not autoignite. Turbulent flame structure analysis indicates that the flame is primarily in the thin reaction zones regime throughout the combustor, and it tends to become more flamelet like with increasing distance from the injector. Fuel-air mixing measurements in case of non-premixed operation indicate that the fuel is shielded from hot products until it is fully mixed with air, providing nearly premixed performance without the safety issues associated with premixing. The reduction in NOx emissions in the SPRF combustor are primarily due to its ability to stably operate under ultra lean (and nearly premixed) condition within the combustor. Further, to extend the usefulness of this combustor configuration to various applications, combustor geometry scaling rules were developed with the help of simplified coaxial and opposed jet models.

  18. 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.

  19. 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.

  20. 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…

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. Application of lean manufacturing techniques in the Emergency Department.

    PubMed

    Dickson, Eric W; Singh, Sabi; Cheung, Dickson S; Wyatt, Christopher C; Nugent, Andrew S

    2009-08-01

    "Lean" is a set of principles and techniques that drive organizations to continually add value to the product they deliver by enhancing process steps that are necessary, relevant, and valuable while eliminating those that fail to add value. Lean has been used in manufacturing for decades and has been associated with enhanced product quality and overall corporate success. To evaluate whether the adoption of Lean principles by an Emergency Department (ED) improves the value of emergency care delivered. Beginning in December 2005, we implemented a variety of Lean techniques in an effort to enhance patient and staff satisfaction. The implementation followed a six-step process of Lean education, ED observation, patient flow analysis, process redesign, new process testing, and full implementation. Process redesign focused on generating improvement ideas from frontline workers across all departmental units. Value-based and operational outcome measures, including patient satisfaction, expense per patient, ED length of stay (LOS), and patient volume were compared for calendar year 2005 (pre-Lean) and periodically after 2006 (post-Lean). Patient visits increased by 9.23% in 2006. Despite this increase, LOS decreased slightly and patient satisfaction increased significantly without raising the inflation adjusted cost per patient. Lean improved the value of the care we delivered to our patients. Generating and instituting ideas from our frontline providers have been the key to the success of our Lean program. Although Lean represents a fundamental change in the way we think of delivering care, the specific process changes we employed tended to be simple, small procedure modifications specific to our unique people, process, and place. We, therefore, believe that institutions or departments aspiring to adopt Lean should focus on the core principles of Lean rather than on emulating specific process changes made at other institutions.

  9. 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.

  10. 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

  11. 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.

  12. Relationship Between Lean Production and Operational Performance in the Manufacturing Industry

    NASA Astrophysics Data System (ADS)

    Rasi, Raja Zuraidah R. M.; Syamsyul Rakiman, Umol; Ahmad, Md Fauzi Bin

    2015-05-01

    Nowadays, more and more manufacturing firms have started to implement lean production system in their operations. Lean production viewed as one of the mechanism to maintain the organisation's position and to compete globally. However, many fail to apply the lean concepts successfully in their operations. Based on previous studies, implementation of lean production in the manufacturing industry is more focused on the relationship between Lean and Operational Performance of one dimension only. Therefore, this study attempted to examine the relationship between Lean Production (LP) and Operational Performance in 4 dimensions which are quality, delivery, cost and flexibility. This study employed quantitative study using questionnaires. Data was collected from 50 manufacturing industries. The data was analysed using Statistical Package for Social Science (SPSS) 22.0. This study is hoped to shed new understanding on the concept of Lean Production (LP) in regards of Operational Performance covering the 4 dimensions.

  13. Creating a Bio-Inspired Solution to Prevent Erosion

    NASA Astrophysics Data System (ADS)

    Reher, R.; Martinez, A.; Cola, J.; Frost, D.

    2016-12-01

    Through the study of geophysical sciences, lessons can be developed which allow for the introduction of bio-inspired design and art concepts to K-5 elementary students. Students are placed into an engineering mindset in which they must apply the concepts of bio-geotechnics to observe how we can use nature to prevent and abate erosion. Problems are staged for students using realistic engineering scenarios such as erosion prevention through biomimicry and the study of anchorage characteristics of root structures in regard to stability of soil. Specifically, a lesson is introduced where students research, learn, and present information about bio-inspired designs to understand these concepts. They lean how plant roots differ in size and shape to stabilize soil. In addition, students perform a series of hands-on experiments which demonstrate how bio-cements and roots can slow erosion.

  14. 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.

  15. Lean waste classification model to support the sustainable operational practice

    NASA Astrophysics Data System (ADS)

    Sutrisno, A.; Vanany, I.; Gunawan, I.; Asjad, M.

    2018-04-01

    Driven by growing pressure for a more sustainable operational practice, improvement on the classification of non-value added (waste) is one of the prerequisites to realize sustainability of a firm. While the use of the 7 (seven) types of the Ohno model now becoming a versatile tool to reveal the lean waste occurrence. In many recent investigations, the use of the Seven Waste model of Ohno is insufficient to cope with the types of waste occurred in industrial practices at various application levels. Intended to a narrowing down this limitation, this paper presented an improved waste classification model based on survey to recent studies discussing on waste at various operational stages. Implications on the waste classification model to the body of knowledge and industrial practices are provided.

  16. Phase Separation in Lean Grade Duplex Stainless Steel 2101

    DOE PAGES

    Garfinkel, D.; Poplawsky, Jonathan D.; Guo, Wei; ...

    2015-08-19

    The use of duplex stainless steels (DSS) in nuclear power generation systems is limited by thermal instability that leads to embrittlement in the temperature range of 204°C - 538°C. New lean grade alloys, such as 2101, offer the potential to mitigate these effects. Thermal embrittlement was quantified through impact toughness and hardness testing on samples of alloy 2101 after aging at 427°C for various durations (1-10,000 hours). Additionally, atom probe tomography (APT) was utilized in order to observe the kinetics of α-α’ separation and G-phase formation. Mechanical testing and APT data for two other DSS alloys, 2003 and 2205 weremore » used as a reference to 2101. The results show that alloy 2101 exhibits superior performance compared to the standard grade DSS alloy, 2205, but inferior to the lean grade alloy, 2003, in mechanical testing. APT data demonstrates that the degree of α-α’ separation found in alloy 2101 closely resembles that of 2205, and greatly exceeds 2003. Additionally, contrary to what was observed in 2003, 2101 demonstrated G-phase like precipitates after long aging times, though precipitates were not as abundant as was observed in 2205.« less

  17. 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.

  18. 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

  19. Spreading a medical home redesign: effects on emergency department use and hospital admissions.

    PubMed

    Reid, Robert J; Johnson, Eric A; Hsu, Clarissa; Ehrlich, Kelly; Coleman, Katie; Trescott, Claire; Erikson, Michael; Ross, Tyler R; Liss, David T; Cromp, DeAnn; Fishman, Paul A

    2013-01-01

    The patient-centered medical home (PCMH) is being rapidly deployed in many settings to strengthen US primary care, improve quality, and control costs; however, evidence supporting this transformation is still lacking. We describe the Group Health experience in attempting to replicate the effects on health care use seen in a PCMH prototype clinic via a systemwide spread using Lean as the change strategy. We used an interrupted time series analysis with a patient-month unit of analysis over a 4-year period that included baseline, implementation, and stabilization periods for 412,943 patients. To account for secular trends across these periods, we compared changes in use of face-to-face primary care visits, emergency department visits, and inpatient admissions with those of a nonequivalent comparison group of patients served by community network practices. After accounting for secular trends among network patients, patients empaneled to the PCMH clinics had 5.1% and 6.7% declines in primary care office visits in early and later stabilization years, respectively, after the implementation year. This trend was accompanied by a 123% increase in the use of secure electronic message threads and a 20% increase in telephone encounters. Declines were also seen in emergency department visits at 1 and 2 years (13.7% and 18.5%) compared with what would be expected based on secular trends in network practices. No statistically significant changes were found for hospital admissions. The Group Health experience shows it is possible to reduce emergency department use with PCMH transformation across a diverse set of clinics using a clear change strategy (Lean) and sufficient resources and supports.

  20. Smart Class-Size Policies for Lean Times. SREB Policy Brief

    ERIC Educational Resources Information Center

    Gagne, Jeff

    2012-01-01

    Most states nationwide have had policies for several decades that limit the number of students assigned to public K-12 classrooms. Southern Regional Education Board (SREB) states, led by Tennessee and Texas, spearheaded this effort in the 1980s, and SREB's own "Legislative Briefings" have marked the growth of class-size policies across…

  1. 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.

  2. 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].

  3. 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.

  4. Gravity Effects Observed In Partially Premixed Flames

    NASA Technical Reports Server (NTRS)

    Puri, Ishwar K.; Aggarwal, Suresh K.; Lock, Andrew J.; Gauguly, Ranjan; Hegde, Uday

    2003-01-01

    Partially premixed flames (PPFs) contain a rich premixed fuel air mixture in a pocket or stream, and, for complete combustion to occur, they require the transport of oxidizer from an appropriately oxidizer-rich (or fuel-lean) mixture that is present in another pocket or stream. Partial oxidation reactions occur in fuel-rich portions of the mixture and any remaining unburned fuel and/or intermediate species are consumed in the oxidizer-rich portions. Partial premixing, therefore, represents that condition when the equivalence ratio (phi) in one portion of the flowfield is greater than unity, and in another section its value is less than unity. In general, for combustion to occur efficiently, the global equivalence ratio is in the range fuel-lean to stoichiometric. These flames can be established by design by placing a fuel-rich mixture in contact with a fuel-lean mixture, but they also occur otherwise in many practical systems, which include nonpremixed lifted flames, turbulent nonpremixed combustion, spray flames, and unwanted fires. Other practical applications of PPFs are reported elsewhere. Although extensive experimental studies have been conducted on premixed and nonpremixed flames under microgravity, there is a absence of previous experimental work on burner stabilized PPFs in this regard. Previous numerical studies by our group employing a detailed numerical model showed gravity effects to be significant on the PPF structure. We report on the results of microgravity experiments conducted on two-dimensional (established on a Wolfhard-Parker slot burner) and axisymmetric flames (on a coannular burner) that were investigated in a self-contained multipurpose rig. Thermocouple and radiometer data were also used to characterize the thermal transport in the flame.

  5. Characteristics of Pt-K/MgAl2O4 lean NOx trap catalysts

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

    Kim, Do Heui; Mudiyanselage, Kumudu K.; Szanyi, Janos

    2012-04-30

    We report the various characteristics of Pt-K/MgAl{sub 2}O{sub 4} lean NOx trap (LNT) catalysts including the effect of K loading on nitrate formation/decomposition, NOx storage activity and durability. Upon the adsorption of NO{sub 2} on K/MgAl{sub 2}O{sub 4} samples, potassium nitrates formed on Mg-related sites in MgAl{sub 2}O{sub 4} support are observed, in addition to the typical two potassium nitrates (ionic and bidentate) formed also on Al{sub 2}O{sub 3} supported sample. Based on NO{sub 2} TPD and FTIR results, the Mg-bound KNO{sub 3} thermally decompose at higher temperature than Al-bound KNO{sub 3}, implying its superior thermal stability. At a potassiummore » loading of 5wt%, the temperature of maximum NOx uptake (T{sub max}) is 300 C. Increasing the potassium loading from 5wt% to 10 wt%, the T{sub max} gradually shifted from 300 C to 450 C, indicating the dependence of T{sub max} on the potassium loading. However, increase in potassium loading above 10 wt% only gives rise to the reduction in the overall NOx storage capacity. This work also underlines the obstacles these materials have prior to their practical application (e.g., durability and sulfur poisoning/ removal). This work provides fundamental understanding of Pt-K/MgAl{sub 2}O{sub 4}-based lean NOx trap catalysts, which could be good candidates for high temperature LNT applications.« less

  6. Tests of linkage and/or association of the LEPR gene polymorphisms with obesity phenotypes in Caucasian nuclear families.

    PubMed

    Liu, Yong-Jun; Rocha-Sanchez, Sonia M S; Liu, Peng-Yuan; Long, Ji-Rong; Lu, Yan; Elze, Leo; Recker, Robert R; Deng, Hong-Wen

    2004-04-13

    Genetic variations in the leptin receptor (LEPR) gene have been conceived to affect body weight in general populations. In this study, using the tests implemented in the statistical package QTDT, we evaluated association and/or linkage of the LEPR gene with obesity phenotypes in a large sample comprising 1,873 subjects from 405 Caucasian nuclear families. Obesity phenotypes tested include body mass index (BMI), fat mass, percentage fat mass (PFM), and lean mass, with the latter three measured by dual-energy X-ray absorptiometry (DXA). Three single nucleotide polymorphisms (SNPs), namely Lys109Arg (A/G), Lys656Asn (G/C), Pro1019Pro (G/A), in the LEPR gene were analyzed. Significant linkage disequilibrium (0.394 < or = |D'| < or = 0.688, P < 0.001) was observed between pairs of the three SNPs. No significant population stratification was found for any SNP/phenotype. In single-locus analyses, evidence of association was observed for Lys656Asn with lean mass (P = 0.002) and fat mass (P = 0.015). The contribution of this polymorphism to the phenotypic variation of lean mass and fat mass was 2.63% and 1.15%, respectively. Subjects carrying allele G at the Lys656Asn site had, on average, 3.16% higher lean mass and 2.71% higher fat mass than those without it. In the analyses for haplotypes defined by the three SNPs, significant associations were detected between haplotype GCA (P = 0.005) and lean mass. In addition, marginally significant evidence of association was observed for this haplotype with fat mass (P = 0.012). No statistically significant linkage was found, largely due to the limited power of the linkage approach to detect small genetic effects in our data sets. Our results suggest that the LEPR gene polymorphisms contribute to variation in obesity phenotypes.

  7. Whole body BMC in pediatric Crohn disease: independent effects of altered growth, maturation, and body composition.

    PubMed

    Burnham, Jon M; Shults, Justine; Semeao, Edisio; Foster, Bethany; Zemel, Babette S; Stallings, Virginia A; Leonard, Mary B

    2004-12-01

    Whole body BMC was assessed in 104 children and young adults with CD and 233 healthy controls. CD was associated with significant deficits in BMC and lean mass, relative to height. Adjustment for lean mass eliminated the bone deficit in CD. Steroid exposure was associated with short stature but not bone deficits relative to height. Children with Crohn disease (CD) have multiple risk factors for impaired bone accrual. The confounding effects of poor growth and delayed maturation limit the interpretation of prior studies of bone health in CD. The objective of this study was to assess BMC relative to growth, body composition, and maturation in CD compared with controls. Whole body BMC and lean mass were assessed by DXA in 104 CD subjects and 233 healthy controls, 4-26 years of age. Multivariable linear regression models were developed to sequentially adjust for differences in skeletal size, pubertal maturation, and muscle mass. BMC-for-height z scores were derived to determine CD-specific covariates associated with bone deficits. Subjects with CD had significantly lower height z score, body mass index z score, and lean mass relative to height compared with controls (all p < 0.0001). After adjustment for group differences in age, height, and race, the ratio of BMC in CD relative to controls was significantly reduced in males (0.86; 95% CI, 0.83, 0.94) and females (0.91; 95% CI, 0.85, 0.98) with CD. Adjustment for pubertal maturation did not alter the estimate; however, addition of lean mass to the model eliminated the bone deficit. Steroid exposure was associated with short stature but not bone deficits. This study shows the importance of considering differences in body size and composition when interpreting DXA data in children with chronic inflammatory conditions and shows an association between deficits in muscle mass and bone in pediatric CD.

  8. Prospects of lean ignition with the quarter wave coaxial cavity igniter

    NASA Astrophysics Data System (ADS)

    Pertl, Franz Andreas Johannes

    New ignition sources are needed to operate the next generation of lean high efficiency internal combustion engines. A significant environmental and economic benefit could be obtained from these lean engines. Toward this goal, the quarter wave coaxial cavity resonator, QWCCR, igniter was examined. A detailed theoretical analysis of the resonator was performed relating geometric and material parameters to performance characteristics, such as resonator quality factor and developed tip electric field. The analysis provided for the construction and evaluation of a resonator for ignition testing. The evaluation consisted of ignition tests with liquefied-petroleum-gas (LPG) air mixtures of varying composition. The combustion of these mixtures was contained in a closed steel vessel with a precombustion pressure near one atmosphere. The resonator igniter was fired in this vessel with a nominal 150 W microwave pulse of varying duration, to determine ignition energy limits for various mixtures. The mixture compositions were determined by partial pressure measurement and the ideal gas law. Successful ignition was determined through observation of the combustion through a view port. The pulse and reflected microwave power were captured in real time with a high-speed digital storage oscilloscope. Ignition energies and power levels were calculated from these measurements. As a comparison, these ignition experiments were also carried out with a standard non-resistive spark plug, where gap voltage and current were captured for energy calculations. The results show that easily ignitable mixtures around stoichiometric and slightly rich compositions are ignitable with the QWCCR using the similar kinds of energies as the conventional spark plug in the low milli-Joule range. Energies for very lean mixtures could not be determined reliably for the QWCCR for this prototype test, but could be lower than that for a conventional spark. Given the capability of high power, high energy delivery, and opportunity for optimization, the QWCCR has the potential to deliver more energy per unit time than a conventional spark plug and thus should be considered be as a lean ignition source.

  9. Model Development and Process Analysis for Lean Cellular Design Planning in Aerospace Assembly and Manufacturing

    NASA Astrophysics Data System (ADS)

    Hilburn, Monty D.

    Successful lean manufacturing and cellular manufacturing execution relies upon a foundation of leadership commitment and strategic planning built upon solid data and robust analysis. The problem for this study was to create and employ a simple lean transformation planning model and review process that could be used to identify functional support staff resources required to plan and execute lean manufacturing cells within aerospace assembly and manufacturing sites. The lean planning model was developed using available literature for lean manufacturing kaizen best practices and validated through a Delphi panel of lean experts. The resulting model and a standardized review process were used to assess the state of lean transformation planning at five sites of an international aerospace manufacturing and assembly company. The results of the three day, on-site review were compared with baseline plans collected from each of the five sites to determine if there analyzed, with focus on three critical areas of lean planning: the number and type of manufacturing cells identified, the number, type, and duration of planned lean and continuous kaizen events, and the quantity and type of functional staffing resources planned to support the kaizen schedule. Summarized data of the baseline and on-site reviews was analyzed with descriptive statistics. ANOVAs and paired-t tests at 95% significance level were conducted on the means of data sets to determine if null hypotheses related to cell, kaizen event, and support resources could be rejected. The results of the research found significant differences between lean transformation plans developed by site leadership and plans developed utilizing the structured, on-site review process and lean transformation planning model. The null hypothesis that there was no difference between the means of pre-review and on-site cell counts was rejected, as was the null hypothesis that there was no significant difference in kaizen event plans. These factors are critical inputs into the support staffing resources calculation used by the lean planning model. Null hypothesis related to functional support staff resources was rejected for most functional groups, indicating that the baseline site plan inadequately provided for cross-functional staff involvement to support the lean transformation plan. Null hypotheses related to total lean transformation staffing could not be rejected, indicating that while total staffing plans were not significantly different than plans developed during the on-site review and through the use of the lean planning model, the allocation of staffing among various functional groups such as engineering, production, and materials planning was an issue. The on-site review process and simple lean transformation plan developed was determined to be useful in identifying short-comings in lean transformation planning within aerospace manufacturing and assembly sites. It was concluded that the differences uncovered were likely contributing factors affecting the effectiveness of aerospace manufacturing sites' implementation of lean cellular manufacturing.

  10. 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.

  11. 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.

  12. 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.

  13. Cyclic variations of fuel-droplet distribution during the early intake stroke of a lean-burn stratified-charge spark-ignition engine

    NASA Astrophysics Data System (ADS)

    Aleiferis, P. G.; Hardalupas, Y.; Taylor, A. M. K. P.; Ishii, K.; Urata, Y.

    2005-11-01

    Lean-burn spark-ignition engines exhibit higher efficiency and lower specific emissions in comparison with stoichiometrically charged engines. However, as the air-to-fuel (A/F) ratio of the mixture is made leaner than stoichiometric, cycle-by-cycle variations in the early stages of in-cylinder combustion, and subsequent indicated mean effective pressure (IMEP), become more pronounced and limit the range of lean-burn operation. Viable lean-burn engines promote charge stratification, the mixture near the spark plug being richer than the cylinder volume averaged value. Recent work has shown that cycle-by-cycle variations in the early stages of combustion in a stratified-charge engine can be associated with variations in both the local value of A/F ratio near the spark plug around ignition timing, as well as in the volume averaged value of the A/F ratio. The objective of the current work was to identify possible sources of such variability in A/F ratio by studying the in-cylinder field of fuel-droplet distribution during the early intake stroke. This field was visualised in an optical single-cylinder 4-valve pentroof-type spark-ignition engine by means of laser-sheet illumination in planes parallel to the cylinder head gasket 6 and 10 mm below the spark plug. The engine was run with port-injected isooctane at 1500 rpm with 30% volumetric efficiency and air-to-fuel ratio corresponding to both stoichiometric firing (A/F=15, Φ =1.0) and mixture strength close to the lean limit of stable operation (A/F=22, Φ =0.68). Images of Mie intensity scattered by the cloud of fuel droplets were acquired on a cycle-by-cycle basis. These were studied in order to establish possible correlations between the cyclic variations in size, location and scattered-light intensity of the cloud of droplets with the respective variations in IMEP. Because of the low level of Mie intensity scattered by the droplets and because of problems related to elastic scattering on the walls of the combustion chamber, as well as problems related to engine “rocking” at the operating conditions close to the misfire limit, the acquired images were processed for background subtraction by using a PIV-based data correction algorithm. After this processing, the arrival and leaving timings of fuel droplets into the illuminated plane were found not to vary significantly on a cycle-by-cycle basis but the recorded cycle-by-cycle variations in Mie intensity suggested that the amount of fuel in the cylinder could have been 6 26% greater for the “strong” cycles with IMEP 115% higher than the average IMEP, than the ones imaged for “weak” cycles at less than 85% the average IMEP. This would correspond to a maximum cyclic variability in the in-cylinder equivalence ratio Φ of the order of 0.17.

  14. Case study of lean manufacturing application in a die casting manufacturing company

    NASA Astrophysics Data System (ADS)

    Ching, Ng Tan; Hoe, Clarence Chan Kok; Hong, Tang Sai; Ghobakhloo, Morteza; Pin, Chen Kah

    2015-05-01

    The case study of lean manufacturing aims to study the application of lean manufacturing in a die casting manufacturing company located in Pulau Penang, Malaysia. This case study describes mainly about the important concepts and applications of lean manufacturing which could gradually help the company in increasing the profit by studying and analyzing their current manufacturing process and company culture. Many approaches of lean manufacturing are studied in this project which includes: 5S housekeeping, Kaizen, and Takt Time. Besides, the lean tools mentioned, quality tool such as the House of Quality is being used as an analysis tool to continuously improve the product quality. In short, the existing lean culture in the company is studied and analyzed, with recommendations written at the end of this paper.

  15. Implementing Lean Manufacturing in Malaysian Small and Medium Startup Pharmaceutical Company

    NASA Astrophysics Data System (ADS)

    Ibrahim, Wan Mohd Khairi bin Wan; Rahman, Mohamed Abdul; Abu Bakar, Mohd Rushdi bin

    2017-03-01

    Domestic pharmaceutical industry has been identified by the Malaysian government as an industry to be developed under its 11th economic development plan. Most homegrown pharmaceutical companies fall under the category of small and medium enterprises (SME) and therefore need to be highly efficient in their operations to compete with the multinationals. Though lean manufacturing is a well-known methodology to achieve an efficient operation, only a small percentage of the local SMEs implement it. The study aims to determine the real success factors in lean implementation through systematic review of relevant literature on lean manufacturing implementation in local companies, onsite observation of a selected SME company, Global Factor Sdn. Bhd. (GFSB), that successfully implemented lean manufacturing followed by actual implementation of lean project at IKOP Sdn. Bhd., a small startup pharmaceutical company. Lean tools like Gemba, value stream map (VSM) and spaghetti diagram were used to analyze and improve a process at IKOP Sdn. Bhd. The literature review showed that the implementation of lean manufacturing at Malaysian SMEs involved in pharmaceutical industry is at its infancy. Study at GFSB indicated that successful implementation of lean manufacturing stems from management support, employee’s commitment, government support and knowledge on lean among employees. Application of lean tools in IKOP Sdn. Bhd. to improve the process cycle efficiency of hand sanitizer, i-Hand 4.0, has shown that the GMP guidelines are not jeopardized. The Kaizen improvement project resulted in 46.3% reduction in lead time. It may be concluded that implementing lean manufacturing in any small local startup pharmaceutical company is beneficial in reducing operational costs and increasing the efficiency and effectiveness and does not conflict with the existing GMP guidelines.

  16. 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.

  17. Patient-specific lean body mass can be estimated from limited-coverage computed tomography images.

    PubMed

    Devriese, Joke; Beels, Laurence; Maes, Alex; van de Wiele, Christophe; Pottel, Hans

    2018-06-01

    In PET/CT, quantitative evaluation of tumour metabolic activity is possible through standardized uptake values, usually normalized for body weight (BW) or lean body mass (LBM). Patient-specific LBM can be estimated from whole-body (WB) CT images. As most clinical indications only warrant PET/CT examinations covering head to midthigh, the aim of this study was to develop a simple and reliable method to estimate LBM from limited-coverage (LC) CT images and test its validity. Head-to-toe PET/CT examinations were retrospectively retrieved and semiautomatically segmented into tissue types based on thresholding of CT Hounsfield units. LC was obtained by omitting image slices. Image segmentation was validated on the WB CT examinations by comparing CT-estimated BW with actual BW, and LBM estimated from LC images were compared with LBM estimated from WB images. A direct method and an indirect method were developed and validated on an independent data set. Comparing LBM estimated from LC examinations with estimates from WB examinations (LBMWB) showed a significant but limited bias of 1.2 kg (direct method) and nonsignificant bias of 0.05 kg (indirect method). This study demonstrates that LBM can be estimated from LC CT images with no significant difference from LBMWB.

  18. 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.

  19. 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...

  20. 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...

  1. 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.

  2. 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.

  3. 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

  4. Body composition in lean women with polycystic ovary syndrome: effect of ethinyl estradiol and drospirenone combination.

    PubMed

    Aydin, Kadriye; Cinar, Nese; Aksoy, Duygu Yazgan; Bozdag, Gurkan; Yildiz, Bulent Okan

    2013-03-01

    Limited data are available regarding the potential effects of oral contraceptives (OCs) on body fat distribution particularly in lean women with polycystic ovary syndrome (PCOS). In the current study, we aimed to evaluate the influence of ethinyl estradiol and drospirenone on body composition. Participants included 28 lean patients with PCOS and 28 age- and body mass index (BMI)-matched healthy women. The PCOS patients received ethinyl estradiol 30 mcg/drospirenone 3 mg for 6 months. Body composition parameters were assessed by bioelectrical impedance analysis. Serum androgens, lipids, insulin resistance and glucose metabolism measures were also determined. At baseline, the PCOS patients and controls had similar body composition, lipids, insulin resistance and glucose metabolism parameters. Total and trunk fat percentages were negatively correlated with sex hormone binding globulin and were positively correlated with homeostatic model assessment of insulin resistance and free androgen index in the PCOS group.. After 6 months of treatment in the PCOS patients, total fat percentage increased from 24.5%±7.1% to 26.0%±6.1% (p=.035) and trunk fat percentage increased from 20.2%±8.9% to 22.2%±7.1% (p=.014), although weight, BMI and waist to hip ratio (WHR) remained unchanged. Lean women with PCOS have similar body composition compared to healthy women. OC therapy for 6 months in PCOS patients results in an increased total and trunk fat percentage despite no change in clinical anthropometric measures including weight, BMI and WHR. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. 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.

  6. 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.

  7. 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.

  8. Direct Numerical Simulation of a Cavity-Stabilized Ethylene/Air Premixed Flame

    NASA Astrophysics Data System (ADS)

    Chen, Jacqueline; Konduri, Aditya; Kolla, Hemanth; Rauch, Andreas; Chelliah, Harsha

    2016-11-01

    Cavity flame holders have been shown to be important for flame stabilization in scramjet combustors. In the present study the stabilization of a lean premixed ethylene/air flame in a rectangular cavity at thermo-chemical conditions relevant to scramjet combustors is simulated using a compressible reacting multi-block direct numerical simulation solver, S3D, incorporating a 22 species ethylene-air reduced chemical model. The fuel is premixed with air to an equivalence ratio of 0.4 and enters the computational domain at Mach numbers between 0.3 and 0.6. An auxiliary inert channel flow simulation is used to provide the turbulent velocity profile at the inlet for the reacting flow simulation. The detailed interaction between intense turbulence, nonequilibrium concentrations of radical species formed in the cavity and mixing with the premixed main stream under density variations due to heat release rate and compressibility effects is quantified. The mechanism for flame stabilization is quantified in terms of relevant non-dimensional parameters, and detailed analysis of the flame and turbulence structure will be presented. We acknowledge the sponsorship of the AFOSR-NSF Joint Effort on Turbulent Combustion Model Assumptions and the DOE Office of Basic Energy Sciences, Division of Chemical Sciences, Geosciences, and Biosciences.

  9. Experimental and Numerical Investigation of Vortical Structures in Lean Premixed Swirl-Stabilized Combustion

    NASA Astrophysics Data System (ADS)

    Taamallah, Soufien; Chakroun, Nadim; Shanbhogue, Santosh; Kewlani, Gaurav; Ghoniem, Ahmed

    2015-11-01

    A combined experimental and LES investigation is performed to identify the origin of major flow dynamics and vortical structures in a model gas turbine's swirl-stabilized turbulent combustor. Swirling flows in combustion lead to the formation of complex flow dynamics and vortical structures that can interact with flames and influence its stabilization. Our experimental results for non-reacting flow show the existence of large scale precession motion. The precessing vortex core (PVC) dynamics disappears with combustion but only above a threshold of equivalence ratio. In addition, large scale vortices along the inner shear layer (ISL) are observed. These structures interact with the ISL stabilized flame and contribute to its wrinkling. Next, the LES setup is validated against the flow field's low-order statistics and point temperature measurement in relevant areas of the chamber. Finally, we show that LES is capable of predicting the precession motion as well as the ISL vortices in the reacting case: we find that ISL vortices originate from a vortex core that is formed right downstream of the swirler's centerbody. The vortex core has a conical spiral shape resembling a corkscrew that interacts - as it winds out - with the flame when it reaches the ISL.

  10. 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

  11. 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.

  12. Lean Six Sigma Project - Defense Logistics Agency/Honeywell Long-Term Contract Model Using One-Pass Pricing for Sole-Source Spare Parts

    DTIC Science & Technology

    2011-02-18

    Control Limit Lower Control Limit Reaction Plan 1 Complaints from other suppliers (synopsis, award) SCG During award process Identify Sole- Source...Parts 0.0 1.0 0.0 Evaluate complaint, if valid remove item from contract. 2 Tracking timeline for procurement/reviews SCG During pre- award process...Review Solicitation 100.0 Determine where the document stands in the approval process. Adjust milestones and followup . 3 FAR/DPAP guidance SCG

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. 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…

  18. Combustion-acoustic stability analysis for premixed gas turbine combustors

    NASA Technical Reports Server (NTRS)

    Darling, Douglas; Radhakrishnan, Krishnan; Oyediran, Ayo; Cowan, Lizabeth

    1995-01-01

    Lean, prevaporized, premixed combustors are susceptible to combustion-acoustic instabilities. A model was developed to predict eigenvalues of axial modes for combustion-acoustic interactions in a premixed combustor. This work extends previous work by including variable area and detailed chemical kinetics mechanisms, using the code LSENS. Thus the acoustic equations could be integrated through the flame zone. Linear perturbations were made of the continuity, momentum, energy, chemical species, and state equations. The qualitative accuracy of our approach was checked by examining its predictions for various unsteady heat release rate models. Perturbations in fuel flow rate are currently being added to the model.

  19. 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.

  20. 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.

  1. 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.

  2. Evaluating the contribution of differences in lean mass compartments for resting energy expenditure in African American and Caucasian American children.

    PubMed

    Broadney, M M; Shareef, F; Marwitz, S E; Brady, S M; Yanovski, S Z; DeLany, J P; Yanovski, J A

    2018-04-26

    Resting energy expenditure (REE), adjusted for total lean mass (LM), is lower in African American (AA) than Caucasian American (CA) children. Some adult studies suggest that AA-CA differences in lean mass compartments explain this REE difference. Similar data are limited in children. To evaluate differences in compartment-specific lean mass between AA and CA children and examine the individual contributions of high-metabolic rate-at-rest trunk lean mass (TrLM) and low-metabolic-rate-at-rest appendicular lean mass (AppLM) for AA-CA differences in REE. We studied a convenience sample of 594 AA (n = 281) and CA (n = 313) children. REE was measured by using indirect calorimetry; dual-energy X-ray absorptiometry was used to assess body composition. ANCOVAs were performed to examine AA-CA differences in TrLM, AppLM and REE. After accounting for age, sex, height, pubertal development, bone mass and adiposity, REE was evaluated adjusting for total LM (model A) and separately adjusting for TrLM and AppLM (model B). African American children had greater adjusted AppLM (17.8 ± 0.2 [SE] vs. 16.0 ± 0.2 kg, p < 0.001) and lower TrLM (17.2 ± 0.2 vs. 17.7 ± 0.2 kg, p = 0.022) than CA children. REE adjusted for total LM was 77 ± 16 kcal/d lower in AA than CA (p < 0.001). However, after accounting separately for AppLM and TrLM, the discrepancy in REE between the groups declined to 28 ± 19 kcal/d (p = 0.14). In the adjusted model, both TrLM (p < 0.001) and AppLM (p < 0.027) were independently associated with REE. In children, AA-CA differences in REE appear mostly attributable to differences in body composition. Lower REE in AA children is likely due to lower TrLM and greater AppLM. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

  3. A DXA Whole Body Composition Cross-Calibration Experience: Evaluation With Humans, Spine, and Whole Body Phantoms.

    PubMed

    Krueger, Diane; Libber, Jessie; Sanfilippo, Jennifer; Yu, Hui Jing; Horvath, Blaine; Miller, Colin G; Binkley, Neil

    2016-01-01

    New densitometer installation requires cross-calibration for accurate longitudinal assessment. When replacing a unit with the same model, the International Society for Clinical Densitometry recommends cross-calibrating by scanning phantoms 10 times on each instrument and states that spine bone mineral density (BMD) should be within 1%, whereas total body lean, fat, and %fat mass should be within 2% of the prior instrument. However, there is limited validation that these recommendations provide adequate total body cross-calibration. Here, we report a total body cross-calibration experience with phantoms and humans. Cross-calibration between an existing and new Lunar iDXA was performed using 3 encapsulated spine phantoms (GE [GE Lunar, Madison, WI], BioClinica [BioClinica Inc, Princeton, NJ], and Hologic [Hologic Inc, Bedford, MA]), 1 total body composition phantom (BioClinica), and 30 human volunteers. Thirty scans of each phantom and a total body scan of human volunteers were obtained on each instrument. All spine phantom BMD means were similar (within 1%; <-0.010 g/cm2 bias) between the existing and new dual-energy X-ray absorptiometry unit. The BioClinica body composition phantom (BBCP) BMD and bone mineral content (BMC) values were within 2% with biases of 0.005 g/cm2 and -3.4 g. However, lean and fat mass and %fat differed by 4.6%-7.7% with biases of +463 g, -496 g, and -2.8%, respectively. In vivo comparison supported BBCP data; BMD and BMC were within ∼2%, but lean and fat mass and %fat differed from 1.6% to 4.9% with biases of +833 g, -860 g, and -1.1%. As all body composition comparisons exceeded the recommended 2%, the new densitometer was recalibrated. After recalibration, in vivo bias was lower (<0.05%) for lean and fat; -23 and -5 g, respectively. Similarly, BBCP lean and fat agreement improved. In conclusion, the BBCP behaves similarly, but not identical, to human in vivo measurements for densitometer cross-calibration. Spine phantoms, despite good BMD and BMC agreement, did not detect substantial lean and fat differences observed using BBCP and in vivo assessments. Consequently, spine phantoms are inadequate for dual-energy X-ray absorptiometry whole body composition cross-calibration. Copyright © 2016 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

  4. Urinary excretion of the ß-adrenergic feed additives ractopamine and zilpaterol in breast and lung cancer patients

    USDA-ARS?s Scientific Manuscript database

    Background: ß-agonists have been legally used in the U.S. for almost two decades to increase lean muscle mass in meat animals. Despite a cardiotoxic effect after high-dose exposure, there has been limited research on human ß-agonist exposures related to meat consumption. Objectives: We quantified u...

  5. Efficacy of whey protein supplementation on resistance exercise-induced changes in muscle strength, lean mass, and function in mobility-limited older adults

    USDA-ARS?s Scientific Manuscript database

    Whey protein supplementation may augment resistance exercise-induced increases in muscle strength and mass. Further studies are required to determine whether this effect extends to functionally compromised older adults. The objectives of the study were to compare the effects of whey protein concent...

  6. 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…

  7. A Lean, Fast Mars Round-trip Mission Architecture: Using Current Technologies for a Human Mission in the 2030s

    NASA Technical Reports Server (NTRS)

    Bailey, Lora; Folta, David; Barbee, Brent W.; Vaughn, Frank; Kirchman, Frank; Englander, Jacob; Campbell, Bruce; Thronson, Harley; Lin, Tzu Yu

    2013-01-01

    We present a lean fast-transfer architecture concept for a first human mission to Mars that utilizes current technologies and two pivotal parameters: an end-to-end Mars mission duration of approximately one year, and a deep space habitat of approximately 50 metric tons. These parameters were formulated by a 2012 deep space habitat study conducted at the NASA Johnson Space Center (JSC) that focused on a subset of recognized high- engineering-risk factors that may otherwise limit space travel to destinations such as Mars or near-Earth asteroid (NEA)s. With these constraints, we model and promote Mars mission opportunities in the 2030s enabled by a combination of on-orbit staging, mission element pre-positioning, and unique round-trip trajectories identified by state-of-the-art astrodynamics algorithms.

  8. 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.

  9. 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…

  10. 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…

  11. 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.

  12. 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

  13. 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.

  14. Gas turbine power plant with supersonic shock compression ramps

    DOEpatents

    Lawlor, Shawn P [Bellevue, WA; Novaresi, Mark A [San Diego, CA; Cornelius, Charles C [Kirkland, WA

    2008-10-14

    A gas turbine engine. The engine is based on the use of a gas turbine driven rotor having a compression ramp traveling at a local supersonic inlet velocity (based on the combination of inlet gas velocity and tangential speed of the ramp) which compresses inlet gas against a stationary sidewall. The supersonic compressor efficiently achieves high compression ratios while utilizing a compact, stabilized gasdynamic flow path. Operated at supersonic speeds, the inlet stabilizes an oblique/normal shock system in the gasdynamic flow path formed between the rim of the rotor, the strakes, and a stationary external housing. Part load efficiency is enhanced by use of a lean pre-mix system, a pre-swirl compressor, and a bypass stream to bleed a portion of the gas after passing through the pre-swirl compressor to the combustion gas outlet. Use of a stationary low NOx combustor provides excellent emissions results.

  15. Impact of high pressure treatment and intramuscular fat content on colour changes and protein and lipid oxidation in sliced and vacuum-packaged Iberian dry-cured ham.

    PubMed

    Fuentes, Verónica; Utrera, Mariana; Estévez, Mario; Ventanas, Jesús; Ventanas, Sonia

    2014-08-01

    The effect of high hydrostatic pressure (HHP) (600MPa) and intramuscular fat content (IMF) on colour parameters and oxidative stability of lipids and proteins in sliced vacuum-packaged Iberian dry-cured ham during refrigerated storage (120 days at 2°C) was investigated. Several studies have investigated the influence of HHP on lipid oxidation of meat products. However, its effects on protein carbonylation, as also the influence of IMF content on this carbonylation are poorly understood. HHP treatment had a significant effect on lean lightness after 0 and 120 days of storage while IMF content increased lightness and yellowness over time. Regarding oxidative stability, the effect of HHP treatment depended on IMF content samples with a high IMF having greater lipid instability while samples with a low IMF underwent more protein carbonylation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Exhaust gas measurements in a propane fueled swirl stabilized combustor

    NASA Technical Reports Server (NTRS)

    Aanad, M. S.

    1982-01-01

    Exhaust gas temperature, velocity, and composition are measured and combustor efficiencies are calculated in a lean premixed swirl stabilized laboratory combustor. The radial profiles of the data between the co- and the counter swirl cases show significant differences. Co-swirl cases show evidence of poor turbulent mixing across the combustor in comparison to the counter-swirl cases. NO sub x levels are low in the combustor but substantial amounts of CO are present. Combustion efficiencies are low and surprisingly constant with varying outer swirl in contradiction to previous results under a slightly different inner swirl condition. This difference in the efficiency trends is expected to be a result of the high sensitivity of the combustor to changes in the inner swirl. Combustor operation is found to be the same for propane and methane fuels. A mechanism is proposed to explain the combustor operation and a few important characteristics determining combustor efficiency are identified.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. 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

  3. 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

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. Optimizing clinical operations as part of a global emergency medicine initiative in Kumasi, Ghana: application of Lean manufacturing principals to low-resource health systems.

    PubMed

    Carter, Patrick M; Desmond, Jeffery S; Akanbobnaab, Christopher; Oteng, Rockefeller A; Rominski, Sarah D; Barsan, William G; Cunningham, Rebecca M

    2012-03-01

    Although many global health programs focus on providing clinical care or medical education, improving clinical operations can have a significant effect on patient care delivery, especially in developing health systems without high-level operations management. Lean manufacturing techniques have been effective in decreasing emergency department (ED) length of stay, patient waiting times, numbers of patients leaving without being seen, and door-to-balloon times for ST-elevation myocardial infarction in developed health systems, but use of Lean in low to middle income countries with developing emergency medicine (EM) systems has not been well characterized. To describe the application of Lean manufacturing techniques to improve clinical operations at Komfo Anokye Teaching Hospital (KATH) in Ghana and to identify key lessons learned to aid future global EM initiatives. A 3-week Lean improvement program focused on the hospital admissions process at KATH was completed by a 14-person team in six stages: problem definition, scope of project planning, value stream mapping, root cause analysis, future state planning, and implementation planning. The authors identified eight lessons learned during our use of Lean to optimize the operations of an ED in a global health setting: 1) the Lean process aided in building a partnership with Ghanaian colleagues; 2) obtaining and maintaining senior institutional support is necessary and challenging; 3) addressing power differences among the team to obtain feedback from all team members is critical to successful Lean analysis; 4) choosing a manageable initial project is critical to influence long-term Lean use in a new environment; 5) data intensive Lean tools can be adapted and are effective in a less resourced health system; 6) several Lean tools focused on team problem-solving techniques worked well in a low-resource system without modification; 7) using Lean highlighted that important changes do not require an influx of resources; and 8) despite different levels of resources, root causes of system inefficiencies are often similar across health care systems, but require unique solutions appropriate to the clinical setting. Lean manufacturing techniques can be successfully adapted for use in developing health systems. Lessons learned from this Lean project will aid future introduction of advanced operations management techniques in low- to middle-income countries. © 2012 by the Society for Academic Emergency Medicine.

  10. Optimizing Clinical Operations as part of a Global Emergency Medicine Initiative in Kumasi, Ghana: Application of Lean Manufacturing Principals to Low Resource Health Systems

    PubMed Central

    Carter, Patrick M.; Desmond, Jeffery S.; Akanbobnaab, Christopher; Oteng, Rockefeller A.; Rominski, Sarah; Barsan, William G.; Cunningham, Rebecca

    2012-01-01

    Background Although many global health programs focus on providing clinical care or medical education, improving clinical operations can have a significant effect on patient care delivery, especially in developing health systems without high-level operations management. Lean manufacturing techniques have been effective in decreasing emergency department (ED) length of stay, patient waiting times, numbers of patients leaving without being seen, and door-to-balloon times for ST-elevation myocardial infarction in developed health systems; but use of Lean in low to middle income countries with developing emergency medicine systems has not been well characterized. Objectives To describe the application of Lean manufacturing techniques to improve clinical operations at Komfo Anokye Teaching Hospital in Ghana and to identify key lessons learned to aid future global EM initiatives. Methods A three-week Lean improvement program focused on the hospital admissions process at Komfo Anokye Teaching Hospital was completed by a 14-person team in six stages: problem definition, scope of project planning, value stream mapping, root cause analysis, future state planning, and implementation planning. Results The authors identified eight lessons learned during our use of Lean to optimize the operations of an ED in a global health setting: 1) the Lean process aided in building a partnership with Ghanaian colleagues; 2) obtaining and maintaining senior institutional support is necessary and challenging; 3) addressing power differences among the team to obtain feedback from all team members is critical to successful Lean analysis; 4) choosing a manageable initial project is critical to influence long-term Lean use in a new environment; 5) data intensive Lean tools can be adapted and are effective in a less resourced health system; 6) several Lean tools focused on team problem solving techniques worked well in a low resource system without modification; 7) using Lean highlighted that important changes do not require an influx of resources; 8) despite different levels of resources, root causes of system inefficiencies are often similar across health care systems, but require unique solutions appropriate to the clinical setting. Conclusions Lean manufacturing techniques can be successfully adapted for use in developing health systems. Lessons learned from this Lean project will aid future introduction of advanced operations management techniques in low to middle income countries. PMID:22435868

  11. 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

  12. Associations between lower extremity muscle mass and multiplanar knee laxity and stiffness: a potential explanation for sex differences in frontal and transverse plane knee laxity.

    PubMed

    Shultz, Sandra J; Pye, Michele L; Montgomery, Melissa M; Schmitz, Randy J

    2012-12-01

    Compared with men, women have disproportionally greater frontal (varus-valgus) and transverse (internal-external) plane laxity and lower stiffness, despite having similar sagittal (anterior-posterior) plane laxity and stiffness. While the underlying cause is unclear, the amount of lower extremity lean mass (LELM) may be a contributing factor. Lower extremity lean mass would be a stronger predictor of frontal and transverse plane laxity and incremental stiffness than the sagittal plane. Associations between LELM and stiffness would be stronger at lower force increments. Descriptive laboratory study. Sixty-three women and 30 men with no history of ligament injury were measured for knee laxity and incremental stiffness in the sagittal (-90- to 130-N posterior-to-anterior directed loads), frontal (±10-N·m varus-valgus torques), and transverse (±5-N·m internal-external rotation torques) planes and underwent dual-energy X-ray absorptiometry scans to measure LELM. Linear regressions examined the extent to which LELM predicted each laxity and stiffness value, while also accounting for a person's sex. Females (vs males) had greater laxity and less stiffness in the frontal and transverse planes but not the sagittal plane. Lower extremity lean mass was a poor predictor of sagittal laxity and stiffness (R (2) range = .021-.081; P > .06) but was a stronger predictor of frontal (R (2) range = .215-.567; P < .01) and transverse (R (2) range = .224-.356; P < .01) plane laxity and stiffness. Associations were stronger for low (R (2) = .495-.504) versus high (R (2) = .215-.435) frontal plane stiffness but were similar for low (R (2) = .233-.293) versus high (R (2) = .224-.356) transverse plane stiffness. Once we accounted for a person's LELM, sex had little effect on laxity and stiffness (change in R (2) after removal = .01-.08; P = .027-.797). Less LELM was associated with greater laxity and less stiffness in frontal and transverse planes, which may contribute to the disproportionally higher laxities and reduced stiffnesses observed in females in these planes. Frontal and transverse plane laxity and stiffness may be modifiable through strength training interventions that promote changes in muscle characteristics (eg, muscle cross-sectional area, stiffness) that may contribute to static knee joint stability, thus dynamic joint stability during sport activity.

  13. Body composition changes over 9 years in healthy elderly subjects and impact of physical activity.

    PubMed

    Genton, Laurence; Karsegard, Véronique L; Chevalley, Thierry; Kossovsky, Michel P; Darmon, Patrice; Pichard, Claude

    2011-08-01

    Age-related changes of body composition affect health status. This study aims at clarifying body composition changes in healthy elderly subjects, and evaluating the impact of physical activity on these changes. In 1999, 213 subjects ≥ 65 years recruited through advertisements underwent assessment of health state, energy expenditure by physical activity, body composition by bioimpedance analysis and body cell mass by total body potassium. In 2008, 112 of them repeated these assessments with additional determination of Barthel index, Mini Mental State Examination and Geriatric Depression Score. Lean tissues decreased in both genders (p < 0.05). Compared to subjects aged 65-74 years at baseline, those aged ≥75 years lost more body weight (men: -3.7 ± 5.4 vs. 0.4 ± 5.4 kg, women: -3.6 ± 5.5 vs. 0.3 ± 5.2 kg, both p < 0.05), and fat-free mass (men: -3.6 ± 3.3 vs. -0.4 ± 2.7 kg, women: -1.8 ± 2.3 vs. -0.1 ± 2.5 kg, both p < 0.05). Plotting of fat-free mass evolution against age at baseline showed an exponential loss of fat-free mass. Increased physical activity limited lean tissue loss in men but not in women. Loss of lean tissues occurs exponentially with aging. Further research should confirm these changes in subjects over 80 years. Increasing physical activity limits fat-free mass loss in men but not women. Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  14. Meal-based enhancement of protein quality and quantity during weight loss in obese older adults with mobility limitations: rationale and design for the MEASUR-UP trial.

    PubMed

    McDonald, Shelley R; Porter Starr, Kathryn N; Mauceri, Luisa; Orenduff, Melissa; Granville, Esther; Ocampo, Christine; Payne, Martha E; Pieper, Carl F; Bales, Connie W

    2015-01-01

    Obese older adults with even modest functional limitations are at a disadvantage for maintaining their independence into late life. However, there is no established intervention for obesity in older individuals. The Measuring Eating, Activity, and Strength: Understanding the Response - Using Protein (MEASUR-UP) trial is a randomized controlled pilot study of obese women and men aged ≥60 years with mild to moderate functional impairments. Changes in body composition (lean and fat mass) and function (Short Physical Performance Battery) in an enhanced protein weight reduction (Protein) arm will be compared to those in a traditional weight loss (Control) arm. The Protein intervention is based on evidence that older adults achieve optimal rates of muscle protein synthesis when consuming about 25-30 g of high quality protein per meal; these participants will consume ~30 g of animal protein at each meal via a combination of provided protein (beef) servings and diet counseling. This trial will provide information on the feasibility and efficacy of enhancing protein quantity and quality in the context of a weight reduction regimen and determine the impact of this intervention on body weight, functional status, and lean muscle mass. We hypothesize that the enhancement of protein quantity and quality in the Protein arm will result in better outcomes for function and/or lean muscle mass than in the Control arm. Ultimately, we hope our findings will help identify a safe weight loss approach that can delay or prevent late life disability by changing the trajectory of age-associated functional impairment associated with obesity. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Adenovirus 36 seropositivity is strongly associated with race and gender, but not obesity, among US military personnel.

    PubMed

    Broderick, M P; Hansen, C J; Irvine, M; Metzgar, D; Campbell, K; Baker, C; Russell, K L

    2010-02-01

    Although several studies have shown a positive association between evidence of anti-adenovirus 36 (Ad-36) antibodies (Ad-36 exposure) and (1) obesity and (2) serum cholesterol in animals, there is limited research demonstrating this association in humans. There is also limited research on transmission, presentation and demographics of Ad-36 infection. (1) Body mass (body mass index (BMI)), (2) fasting serum cholesterol and triglyceride levels and (3) demographic characteristics were compared between Ad-36 seropositive and seronegative groups. The majority of subjects were matched as cases versus controls on a number of demographic variables. A total of 150 obese and 150 lean active-duty military personnel were studied. Subjects completed a questionnaire regarding demographic and behavioral characteristics. Subject serum samples were tested by serum neutralization assay for the presence of anti-Ad-36 antibodies. In all, 34% of obese and 39% of lean subjects had Ad-36 exposure, an insignificant difference. Serum cholesterol and triglyceride levels were significantly higher among the obese subjects than among the lean, but there were no associations between serum cholesterol and triglyceride levels and Ad-36 exposure. Positive associations were found between Ad-36 exposure and age, race and gender. The study stands in contrast to previous work that has shown a positive relationship between Ad-36 exposure and (1) obesity, and (2) levels of serum cholesterol and triglycerides. In this study there was no association in either case. Unanticipated relationships between Ad-36 exposure and age, race and gender were found, and this is the first time that such a link between Ad-36 exposure and demographics has been found.

  16. A randomized trial of adjunct testosterone for cancer‐related muscle loss in men and women

    PubMed Central

    Wright, Traver J.; Dillon, E. Lichar; Durham, William J.; Chamberlain, Albert; Randolph, Kathleen M.; Danesi, Christopher; Horstman, Astrid M.; Gilkison, Charles R.; Willis, Maurice; Richardson, Gwyn; Hatch, Sandra S.; Jupiter, Daniel C.; McCammon, Susan; Urban, Randall J.

    2018-01-01

    Abstract Background Cancer cachexia negatively impacts cancer‐related treatment options, quality of life, morbidity, and mortality, yet no established therapies exist. We investigated the anabolic properties of testosterone to limit the loss of body mass in late stage cancer patients undergoing standard of care cancer treatment. Methods A randomized, double‐blind, placebo‐controlled phase II clinical trial was undertaken to assess the potential therapeutic role of adjunct testosterone to limit loss of body mass in patients with squamous cell carcinoma of the cervix or head and neck undergoing standard of care treatment including chemotherapy and chemoradiation. Patients were randomly assigned in blocks to receive weekly injections of either 100 mg testosterone enanthate or placebo for 7 weeks. The primary outcome was per cent change in lean body mass, and secondary outcomes included assessment of quality of life, tests of physical performance, muscle strength, daily activity levels, resting energy expenditure, nutritional intake, and overall survival. Results A total of 28 patients were enrolled, 22 patients were studied to completion, and 21 patients were included in the final analysis (12 placebo, nine testosterone). Adjunct testosterone increased lean body mass by 3.2% (95% confidence interval [CI], 0–7%) whereas those receiving placebo lost 3.3% (95% CI, −7% to 1%, P = 0.015). Although testosterone patients maintained more favourable body condition, sustained daily activity levels, and showed meaningful improvements in quality of life and physical performance, overall survival was similar in both treatment groups. Conclusions In patients with advanced cancer undergoing the early phase of standard of care therapy, adjunct testosterone improved lean body mass and was also associated with increased quality of life, and physical activity compared with placebo. PMID:29654645

  17. Hydrogen-Induced Delayed Cracking in TRIP-Aided Lean-Alloyed Ferritic-Austenitic Stainless Steels.

    PubMed

    Papula, Suvi; Sarikka, Teemu; Anttila, Severi; Talonen, Juho; Virkkunen, Iikka; Hänninen, Hannu

    2017-06-03

    Susceptibility of three lean-alloyed ferritic-austenitic stainless steels to hydrogen-induced delayed cracking was examined, concentrating on internal hydrogen contained in the materials after production operations. The aim was to study the role of strain-induced austenite to martensite transformation in the delayed cracking susceptibility. According to the conducted deep drawing tests and constant load tensile testing, the studied materials seem not to be particularly susceptible to delayed cracking. Delayed cracks were only occasionally initiated in two of the materials at high local stress levels. However, if a delayed crack initiated in a highly stressed location, strain-induced martensite transformation decreased the crack arrest tendency of the austenite phase in a duplex microstructure. According to electron microscopy examination and electron backscattering diffraction analysis, the fracture mode was predominantly cleavage, and cracks propagated along the body-centered cubic (BCC) phases ferrite and α'-martensite. The BCC crystal structure enables fast diffusion of hydrogen to the crack tip area. No delayed cracking was observed in the stainless steel that had high austenite stability. Thus, it can be concluded that the presence of α'-martensite increases the hydrogen-induced cracking susceptibility.

  18. The Effect of Military Load Carriage on Postural Sway, Forward Trunk Lean, and Pelvic Girdle Motion

    PubMed Central

    STRUBE, EILEEN M.; SUMNER, ANDREA; KOLLOCK, ROGER; GAMES, KENNETH E.; LACKAMP, MARIE A.; MIZUTANI, MASAHIRO; SEFTON, JOELLEN M.

    2017-01-01

    Musculoskeletal injuries are a common occurrence in military service members. It is believed that the load carried by the service member impedes stability and alters back and pelvis kinematics, increasing their susceptibility to musculoskeletal injuries, specifically in the lower extremities. The purpose of this study was to examine the effects of two different loads on postural sway, forward trunk lean, and pelvic girdle motion in United States Army Cadets. Twenty male Army Reserve Officers’ Training Corps Cadets participated in this study. Each participant performed the Modified Clinical Testing of Sensory Interaction (mCTSIB) Protocol and the Unilateral Stance (ULS) Protocol under three different rucksack load conditions (unloaded, 16.0 kg, and 20.5 kg loads). Mean postural sway velocity was recorded along with 2-D kinematics of the trunk in the sagittal plane and the pelvis in the frontal and sagittal planes. External loads of 16.0 kg (p < 0.001) and 20.5 kg (p ≤ 0.003) significantly increased mean sway velocity by 16% to 52% depending on stance and visual condition, but did not produce significant changes in trunk and pelvic kinematics. PMID:28479946

  19. Hydrogen-Induced Delayed Cracking in TRIP-Aided Lean-Alloyed Ferritic-Austenitic Stainless Steels

    PubMed Central

    Papula, Suvi; Sarikka, Teemu; Anttila, Severi; Talonen, Juho; Virkkunen, Iikka; Hänninen, Hannu

    2017-01-01

    Susceptibility of three lean-alloyed ferritic-austenitic stainless steels to hydrogen-induced delayed cracking was examined, concentrating on internal hydrogen contained in the materials after production operations. The aim was to study the role of strain-induced austenite to martensite transformation in the delayed cracking susceptibility. According to the conducted deep drawing tests and constant load tensile testing, the studied materials seem not to be particularly susceptible to delayed cracking. Delayed cracks were only occasionally initiated in two of the materials at high local stress levels. However, if a delayed crack initiated in a highly stressed location, strain-induced martensite transformation decreased the crack arrest tendency of the austenite phase in a duplex microstructure. According to electron microscopy examination and electron backscattering diffraction analysis, the fracture mode was predominantly cleavage, and cracks propagated along the body-centered cubic (BCC) phases ferrite and α’-martensite. The BCC crystal structure enables fast diffusion of hydrogen to the crack tip area. No delayed cracking was observed in the stainless steel that had high austenite stability. Thus, it can be concluded that the presence of α’-martensite increases the hydrogen-induced cracking susceptibility. PMID:28772975

  20. Martensite Formation in Partially and Fully Austenitic Plain Carbon Steels

    NASA Astrophysics Data System (ADS)

    van Bohemen, S. M. C.; Sietsma, J.

    2009-05-01

    The progress of martensite formation in plain carbon steels Fe-0.46C, Fe-0.66C, and Fe-0.80C has been investigated by dilatometry. It is demonstrated that carbon enrichment of the remaining austenite due to intercritical annealing of Fe-0.46C and Fe-0.66C does not only depress the start temperature for martensite, but also slows the progress of the transformation with temperature compared to full austenitization. In contrast, such a change of kinetics is not observed when the remaining austenite of lean-Si steel Fe-0.80C is stabilized due to a partial transformation to bainite, which suggests that the stabilization is not of a chemical but of a mechanical nature. The growth of bainite and martensite is accompanied by a shape change at the microstructural scale, which leads to plastic deformation and thus strengthening of the surrounding austenite. Based on this stabilizing mechanism, the athermal transformation kinetics is rationalized by balancing the increase in driving force corresponding to a temperature decrease with the increase in strain energy required for the formation of martensite in the strengthened remaining austenite.

  1. Floating wind turbine system

    NASA Technical Reports Server (NTRS)

    Viterna, Larry A. (Inventor)

    2009-01-01

    A floating wind turbine system with a tower structure that includes at least one stability arm extending therefrom and that is anchored to the sea floor with a rotatable position retention device that facilitates deep water installations. Variable buoyancy for the wind turbine system is provided by buoyancy chambers that are integral to the tower itself as well as the stability arm. Pumps are included for adjusting the buoyancy as an aid in system transport, installation, repair and removal. The wind turbine rotor is located downwind of the tower structure to allow the wind turbine to follow the wind direction without an active yaw drive system. The support tower and stability arm structure is designed to balance tension in the tether with buoyancy, gravity and wind forces in such a way that the top of the support tower leans downwind, providing a large clearance between the support tower and the rotor blade tips. This large clearance facilitates the use of articulated rotor hubs to reduced damaging structural dynamic loads. Major components of the turbine can be assembled at the shore and transported to an offshore installation site.

  2. 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…

  3. 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…

  4. Sector Tests of a Low-NO(sub x), Lean, Direct- Injection, Multipoint Integrated Module Combustor Concept Conducted

    NASA Technical Reports Server (NTRS)

    Tacina, Robert R.; Wey, Chang-Lie; Laing, Peter; Mansour, Adel

    2002-01-01

    The low-emissions combustor development described is directed toward advanced high pressure aircraft gas-turbine applications. The emphasis of this research is to reduce nitrogen oxides (NOx) at high-power conditions and to maintain carbon monoxide and unburned hydrocarbons at their current low levels at low power conditions. Low-NOx combustors can be classified into rich-burn and lean-burn concepts. Lean-burn combustors can be further classified into lean-premixed-prevaporized (LPP) and lean direct injection (LDI) concepts. In both concepts, all the combustor air, except for liner cooling flow, enters through the combustor dome so that the combustion occurs at the lowest possible flame temperature. The LPP concept has been shown to have the lowest NOx emissions, but for advanced high-pressure-ratio engines, the possibility of autoignition or flashback precludes its use. LDI differs from LPP in that the fuel is injected directly into the flame zone, and thus, it does not have the potential for autoignition or flashback and should have greater stability. However, since it is not premixed and prevaporized, good atomization is necessary and the fuel must be mixed quickly and uniformly so that flame temperatures are low and NOx formation levels are comparable to those of LPP. The LDI concept described is a multipoint fuel injection/multiburning zone concept. Each of the multiple fuel injectors has an air swirler associated with it to provide quick mixing and a small recirculation zone for burning. The multipoint fuel injection provides quick, uniform mixing and the small multiburning zones provide for reduced burning residence time, resulting in low NOx formation. An integrated-module approach was used for the construction where chemically etched laminates, diffusion bonded together, combine the fuel injectors, air swirlers, and fuel manifold into a single element. The multipoint concept combustor was demonstrated in a 15 sector test. The configuration tested had 36 fuel injectors and fuel-air mixers that replaced two fuel injectors in a conventional dual-annular combustor. During tests, inlet temperatures were up to 870 K and inlet pressures were up to 5400 kPa. A correlation was developed that related the NOx emissions with the inlet temperature, inlet pressure, fuel-air ratio, and pressure drop. At low-power conditions, fuel staging was used so that high combustion efficiency was obtained with only one-fourth of the fuel injectors flowing. The test facility had optical access, and visual images showed the flame to be very short, approximately 25 mm long.

  5. Development and validation of a predictive equation for lean body mass in children and adolescents.

    PubMed

    Foster, Bethany J; Platt, Robert W; Zemel, Babette S

    2012-05-01

    Lean body mass (LBM) is not easy to measure directly in the field or clinical setting. Equations to predict LBM from simple anthropometric measures, which account for the differing contributions of fat and lean to body weight at different ages and levels of adiposity, would be useful to both human biologists and clinicians. To develop and validate equations to predict LBM in children and adolescents across the entire range of the adiposity spectrum. Dual energy X-ray absorptiometry was used to measure LBM in 836 healthy children (437 females) and linear regression was used to develop sex-specific equations to estimate LBM from height, weight, age, body mass index (BMI) for age z-score and population ancestry. Equations were validated using bootstrapping methods and in a local independent sample of 332 children and in national data collected by NHANES. The mean difference between measured and predicted LBM was - 0.12% (95% limits of agreement - 11.3% to 8.5%) for males and - 0.14% ( - 11.9% to 10.9%) for females. Equations performed equally well across the entire adiposity spectrum, as estimated by BMI z-score. Validation indicated no over-fitting. LBM was predicted within 5% of measured LBM in the validation sample. The equations estimate LBM accurately from simple anthropometric measures.

  6. Faecal microbiota in lean and obese dogs.

    PubMed

    Handl, Stefanie; German, Alexander J; Holden, Shelley L; Dowd, Scot E; Steiner, Jörg M; Heilmann, Romy M; Grant, Ryan W; Swanson, Kelly S; Suchodolski, Jan S

    2013-05-01

    Previous work has shown obesity to be associated with changes in intestinal microbiota. While obesity is common in dogs, limited information is available about the role of the intestinal microbiota. The aim of this study was to investigate whether alterations in the intestinal microbiota may be associated with canine obesity. Using 16S rRNA gene pyrosequencing and quantitative real-time PCR, we evaluated the composition of the faecal microbiota in 22 lean and 21 obese pet dogs, as well as in five research dogs fed ad libitum and four research dogs serving as lean controls. Firmicutes, Fusobacteria and Actinobacteria were the predominant bacterial phyla. The phylum Actinobacteria and the genus Roseburia were significantly more abundant in the obese pet dogs. The order Clostridiales significantly increased under ad libitum feeding in the research dogs. Canine intestinal microbiota is highly diverse and shows considerable interindividual variation. In the pet dogs, influence on the intestinal microbiota besides body condition, like age, breed, diet or lifestyle, might have masked the effect of obesity. The study population of research dogs was small, and further work is required before the role of the intestinal microbiota in canine obesity is clarified. © 2013 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

  7. A Comparison of Three Second-generation Swirl-Venturi Lean Direct Injection Combustor Concepts

    NASA Technical Reports Server (NTRS)

    Tacina, Kathleen M.; Podboy, Derek P.; He, Zhuohui Joe; Lee, Phil; Dam, Bidhan; Mongia, Hukam

    2016-01-01

    Three variations of a low emissions aircraft gas turbine engine combustion concept were developed and tested. The concept is a second generation swirl-venturi lean direct injection (SV-LDI) concept. LDI is a lean-burn combustion concept in which the fuel is injected directly into the flame zone. All three variations were based on the baseline 9- point SV-LDI configuration reported previously. The three second generation SV-LDI variations are called the 5-recess configuration, the flat dome configuration, and the 9- recess configuration. These three configurations were tested in a NASA Glenn Research Center medium pressure flametube. All three second generation variations had better low power operability than the baseline 9-point configuration. All three configurations had low NO(sub x) emissions, with the 5-recess configuration generally having slightly lower NO(x) than the flat dome or 9-recess configurations. Due to the limitations of the flametube that prevented testing at pressures above 20 atm, correlation equations were developed for the at dome and 9-recess configurations so that the landing-takeoff NO(sub x) emissions could be estimated. The flat dome and 9-recess landing-takeoff NO(x) emissions are estimated to be 81-88% below the CAEP/6 standards, exceeding the project goal of 75% reduction.

  8. 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.

  9. Rimonabant’s Reductive Effects on High Densities of Food Reinforcement, but not Palatability, in Lean and Obese Zucker Rats

    PubMed Central

    Buckley, Jessica Lynn; Rasmussen, Erin B.

    2014-01-01

    Rationale Cannabinoid antagonists purportedly have greater effects in reducing the intake of highly palatable food compared to less palatable food. However, this assertion is based on free-feeding studies in which the amount of palatable food eaten under baseline conditions is often confounded with other variables, such as unequal access to both food options and differences in qualitative features of the foods. Objective We attempted to reduce these confounds by using a model of choice that programmed the delivery rates of sucrose and carrot-flavored pellets. Methods Lever-pressing of ten lean (Fa/Fa or Fa/fa) and ten obese (fa/fa) Zucker rats was placed under three conditions in which programmed ratios for food pellets on two levers were 5:1, 1:1, and 1:5. In Phase 1, responses on the two levers produced one type of pellet (sucrose or carrot); in Phase 2, responses on one lever produced sucrose pellets and on the other lever produced carrot pellets. After responses stabilized under each food ratio, acute doses of rimonabant (0, 3, and 10 mg/kg) were administered before experimental sessions. The number of reinforcers and responses earned per session under each ratio and from each lever was compared. Results and Conclusions Rimonabant reduced reinforcers in 1:5 and 5:1 food ratios in Phase 1, and across all ratios in Phase 2. Rimonabant reduced sucrose and carrot-flavored pellet consumption similarly; rimonabant did not affect bias toward sucrose, but increased sensitivity to amount differences in lean rats. This suggests that relative amount of food, not palatability, may be an important behavioral mechanism in the effects of rimonabant. PMID:24398820

  10. Rimonabant's reductive effects on high densities of food reinforcement, but not palatability, in lean and obese Zucker rats.

    PubMed

    Buckley, Jessica L; Rasmussen, Erin B

    2014-05-01

    Cannabinoid antagonists purportedly have greater effects in reducing the intake of highly palatable food compared to less palatable food. However, this assertion is based on free-feeding studies in which the amount of palatable food eaten under baseline conditions is often confounded with other variables, such as unequal access to both food options and differences in qualitative features of the foods. We attempted to reduce these confounds by using a model of choice that programmed the delivery rates of sucrose and carrot-flavored pellets. Lever pressing of ten lean (Fa/Fa or Fa/fa) and ten obese (fa/fa) Zucker rats was placed under three conditions in which programmed ratios for food pellets on two levers were 5:1, 1:1, and 1:5. In phase 1, responses on the two levers produced one type of pellet (sucrose or carrot); in phase 2, responses on one lever produced sucrose pellets and on the other lever produced carrot pellets. After responses stabilized under each food ratio, acute doses of rimonabant (0, 3, and 10 mg/kg) were administered before experimental sessions. The number of reinforcers and responses earned per session under each ratio and from each lever was compared. Rimonabant reduced reinforcers in 1:5 and 5:1 food ratios in phase 1, and across all ratios in phase 2. Rimonabant reduced sucrose and carrot-flavored pellet consumption similarly; rimonabant did not affect bias toward sucrose, but increased sensitivity to amount differences in lean rats. This suggests that relative amount of food, not palatability, may be an important behavioral mechanism in the effects of rimonabant.

  11. Rimonabant reduces the essential value of food in the genetically obese Zucker rat: an exponential demand analysis.

    PubMed

    Rasmussen, Erin B; Reilly, William; Buckley, Jessica; Boomhower, Steven R

    2012-02-01

    Research on free-food intake suggests that cannabinoids are implicated in the regulation of feeding. Few studies, however, have characterized how environmental factors that affect food procurement interact with cannabinoid drugs that reduce food intake. Demand analysis provides a framework to understand how cannabinoid blockers, such as rimonabant, interact with effort in reducing demand for food. The present study examined the effects rimonabant had on demand for sucrose in obese Zucker rats when effort to obtain food varied and characterized the data using the exponential ("essential value") model of demand. Twenty-nine male (15 lean, 14 obese) Zucker rats lever-pressed under eight fixed ratio (FR) schedules of sucrose reinforcement, in which the number of lever-presses to gain access to a single sucrose pellet varied between 1 and 300. After behavior stabilized under each FR schedule, acute doses of rimonabant (1-10mg/kg) were administered prior to some sessions. The number of food reinforcers and responses in each condition was averaged and the exponential and linear demand equations were fit to the data. These demand equations quantify the value of a reinforcer by its sensitivity to price (FR) increases. Under vehicle conditions, obese Zucker rats consumed more sucrose pellets than leans at smaller fixed ratios; however, they were equally sensitive to price increases with both models of demand. Rimonabant dose-dependently reduced reinforcers and responses for lean and obese rats across all FR schedules. Data from the exponential analysis suggest that rimonabant dose-dependently increased elasticity, i.e., reduced the essential value of sucrose, a finding that is consistent with graphical depictions of normalized demand curves. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. Eye Movement Patterns of the Elderly during Stair Descent:Effect of Illumination

    NASA Astrophysics Data System (ADS)

    Kasahara, Satoko; Okabe, Sonoko; Nakazato, Naoko; Ohno, Yuko

    The relationship between the eye movement pattern during stair descent and illumination was studied in 4 elderly people in comparison with that in 5 young people. The illumination condition was light (85.0±30.9 lx) or dark (0.7±0.3 lx), and data of eye movements were obtained using an eye mark recorder. A flight of 15 steps was used for the experiment, and data on 3 steps in the middle, on which the descent movements were stabilized, were analyzed. The elderly subjects pointed their eyes mostly directly in front in the facial direction regardless of the illumination condition, but the young subjects tended to look down under the light condition. The young subjects are considered to have confirmed the safety of the front by peripheral vision, checked the stepping surface by central vision, and still maintained the upright position without leaning forward during stair descent. The elderly subjects, in contrast, always looked at the visual target by central vision even under the light condition and leaned forward. The range of eye movements was larger vertically than horizontally in both groups, and a characteristic eye movement pattern of repeating a vertical shuttle movement synchronous with descent of each step was observed. Under the dark condition, the young subjects widened the range of vertical eye movements and reduced duration of fixation. The elderly subjects showed no change in the range of eye movements but increased duration of fixation during stair descent. These differences in the eye movements are considered to be compensatory reactions to narrowing of the vertical visual field, reduced dark adaptation, and reduced dynamic visual acuity due to aging. These characteristics of eye movements of the elderly lead to an anteriorly leaned posture and lack of attention to the front during stair descent.

  13. Effect of vitamin C concentration and co-injection with calcium chloride on beef retail display color.

    PubMed

    Wheeler, T L; Koohmaraie, M; Shackelford, S D

    1996-08-01

    The objectives of these experiments were to determine 1) the most effective vitamin C concentration to stabilize color of beef cuts during retail display and 2) the effect on color of incorporating vitamin C into a calcium chloride (CaCl2) injection solution. Top round cuts (semimembranosus and adductor) were injected with 5% by weight of a 0, .25, .5, 1, 2, or 4% sodium ascorbate solution (Exp. 1) or a 0, .5, 1, or 1.5% sodium ascorbate solution (Exp. 2). In Exp. 1, vitamin C resulted in more (P < .05) stable lean color during 9 degrees C display, and .5, 1, and 2% vitamin C were most (P < .05) effective. In Exp. 2, all concentrations of vitamin C maintained redder (P < .05) steaks after 3, 5, and 7 d of display than control steaks and had a lower (P < .05) percentage of surface discoloration after 5 and 7 d of display at 1 degree C. Experiment 3 used beef bottom round cuts (biceps femoris) to compare control, vitamin C- (1%), CaCl2-(200 mM) and vitamin C + CaCl2-treated steaks displayed at 1 degree C. Calcium chloride-treated steaks were more (P < .05) brown and had a higher (P < .05) percentage of surface discoloration on d 5 and 7 than control steaks, whereas steaks treated with vitamin C or vitamin C + CaCl2 were more (P < .05) red and had lower (P < .05) discoloration on d 5 and 7 than control steaks. Vitamin C can be injected into beef subprimals to enhance lean color stability and extend retail display life. Vitamin C also can be used in combination with CaCl2 to offset potential color deterioration, after 5 d of display, due to salt-induced oxidation.

  14. Spreading a Medical Home Redesign: Effects on Emergency Department Use and Hospital Admissions

    PubMed Central

    Reid, Robert J.; Johnson, Eric A.; Hsu, Clarissa; Ehrlich, Kelly; Coleman, Katie; Trescott, Claire; Erikson, Michael; Ross, Tyler R.; Liss, David T.; Cromp, DeAnn; Fishman, Paul A.

    2013-01-01

    PURPOSE The patient-centered medical home (PCMH) is being rapidly deployed in many settings to strengthen US primary care, improve quality, and control costs; however, evidence supporting this transformation is still lacking. We describe the Group Health experience in attempting to replicate the effects on health care use seen in a PCMH prototype clinic via a systemwide spread using Lean as the change strategy. METHODS We used an interrupted time series analysis with a patient-month unit of analysis over a 4-year period that included baseline, implementation, and stabilization periods for 412,943 patients. To account for secular trends across these periods, we compared changes in use of face-to-face primary care visits, emergency department visits, and inpatient admissions with those of a nonequivalent comparison group of patients served by community network practices. RESULTS After accounting for secular trends among network patients, patients empaneled to the PCMH clinics had 5.1% and 6.7% declines in primary care office visits in early and later stabilization years, respectively, after the implementation year. This trend was accompanied by a 123% increase in the use of secure electronic message threads and a 20% increase in telephone encounters. Declines were also seen in emergency department visits at 1 and 2 years (13.7% and 18.5%) compared with what would be expected based on secular trends in network practices. No statistically significant changes were found for hospital admissions. CONCLUSIONS The Group Health experience shows it is possible to reduce emergency department use with PCMH transformation across a diverse set of clinics using a clear change strategy (Lean) and sufficient resources and supports. PMID:23690382

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. The challenges of lean manufacturing implementation in kitting assembly

    NASA Astrophysics Data System (ADS)

    Fansuri, A. F. H.; Rose, A. N. M.; Nik Mohamed, N. M. Z.; Ahmad, H.

    2017-10-01

    Literature studies shows that lean manufacturing goes way back with the original founder Eli Whitney in year 1799. The main purpose of lean manufacturing is to identify and eliminate waste in production. The application of lean manufacturing can be carried out in any industrial processes with regards to the understanding of lean principles, theories and practices. Kitting is one of the important aspects in a successful production. The continuous supply of materials from store to production has to be systematic and able to achieve lean standard for it to be successful. The objective of this paper is to review the implementation of lean manufacturing in kitting assembly. Previous papers show that, the implementation of lean manufacturing in kitting assembly may be beneficial to the organization such as reduce in space occupancy, part shortages, lead time and manpower. Based on previous research, some industries may tend to change between kitting and line stocking which are due to lack of understanding when implementing kitting and causes longer lead time and materials overflow in store. With a proper understanding on what to kit, where to kit, how to kit, why to kit and who kits the material with a standardised process flow may ensure the success of kitting.

  20. 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

  1. 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.

  2. Method for automatically evaluating a transition from a batch manufacturing technique to a lean manufacturing technique

    DOEpatents

    Ivezic, Nenad; Potok, Thomas E.

    2003-09-30

    A method for automatically evaluating a manufacturing technique comprises the steps of: receiving from a user manufacturing process step parameters characterizing a manufacturing process; accepting from the user a selection for an analysis of a particular lean manufacturing technique; automatically compiling process step data for each process step in the manufacturing process; automatically calculating process metrics from a summation of the compiled process step data for each process step; and, presenting the automatically calculated process metrics to the user. A method for evaluating a transition from a batch manufacturing technique to a lean manufacturing technique can comprise the steps of: collecting manufacturing process step characterization parameters; selecting a lean manufacturing technique for analysis; communicating the selected lean manufacturing technique and the manufacturing process step characterization parameters to an automatic manufacturing technique evaluation engine having a mathematical model for generating manufacturing technique evaluation data; and, using the lean manufacturing technique evaluation data to determine whether to transition from an existing manufacturing technique to the selected lean manufacturing technique.

  3. 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.

  4. 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.

  5. 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.

  6. Predicted body weight relationships for protective ventilation - unisex proposals from pre-term through to adult.

    PubMed

    Martin, Dion C; Richards, Glenn N

    2017-05-23

    The lung-protective ventilation bundle has been shown to reduce mortality in adult acute respiratory distress syndrome (ARDS). This concept has expanded to other areas of acute adult ventilation and is recommended for pediatric ventilation. A component of lung-protective ventilation relies on a prediction of lean body weight from height. The predicted body weight (PBW) relationship employed in the ARDS Network trial is considered valid only for adults, with a dedicated formula required for each sex. No agreed PBW formula applies to smaller body sizes. This analysis investigated whether it might be practical to derive a unisex PBW formula spanning all body sizes, while retaining relevance to established adult protective ventilation practice. Historic population-based growth charts were adopted as a reference for lean body weight, from pre-term infant through to adult median weight. The traditional ARDSNet PBW formulae acted as the reference for prevailing protective ventilation practice. Error limits for derived PBW models were relative to these references. The ARDSNet PBW formulae typically predict weights heavier than the population median, therefore no single relationship could satisfy both references. Four alternate piecewise-linear lean body-weight predictive formulae were presented for consideration, each with different balance between the objectives. The 'PBWuf + MBW' model is proposed as an appropriate compromise between prevailing practice and simplification, while also better representing lean adult body-weight. This model applies the ARDSNet 'female' formula to both adult sexes, while providing a tight fit to median body weight at smaller statures down to pre-term. The 'PBWmf + MBW' model retains consistency with current practice over the adult range, while adding prediction for small statures.

  7. Center of mass trajectory and orientation to ankle and knee in sagittal plane is maintained with forward lean when backpack load changes during treadmill walking.

    PubMed

    Caron, Robert R; Wagenaar, Robert C; Lewis, Cara L; Saltzman, Elliot; Holt, Kenneth G

    2013-01-04

    Maintaining the normal shape and amplitude of the vertical trajectory of the center of mass (COM) during stance has been shown to maximize the efficiency of unloaded gait. Kinematic adaptations to load carriage, such as forward lean have yet to be understood in relation to COM movement. The purpose of this study is to better understand how load impacts the vertical COM(TSYS) trajectory and to clarify the impact of forward lean as it relates to the dynamics of sagittal plane COM(TSYS) movement during stance with changing load. 17 subjects walked on treadmill at a constant preferred walking velocity while nine different loads ranging from 12.5% to 40% bodyweight were systematically added and removed from a backpack. Kinematic data were collected using an Optotrak, three-dimensional motion analysis system and used to estimate position of the COM as well as segment and COM-to-joint vector orientation angles. The shape and amplitude of the COM vertical trajectory was maintained across all loaded conditions. The orientations of COM-to-ankle and -knee vectors were maintained in all loaded conditions except the heaviest load (40% BW). Results suggest that forward lean changed linearly with changes in load to maintain the COM-to-ankle and -knee vector orientations. COM vertical trajectory was maintained by a combination of invariants including lower-limb segment angles and a constant direction of toe-off impulse vector. The kinematic invariants found suggest a simplified control mechanism by which the system limits degrees of freedom and potentially minimizes torque about lower-extremity joints with added load. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Lower limb muscle moments and power during recovery from forward loss of balance in male and female single and multiple steppers.

    PubMed

    Carty, Christopher P; Cronin, Neil J; Lichtwark, Glen A; Mills, Peter M; Barrett, Rod S

    2012-12-01

    Studying recovery responses to loss of balance may help to explain why older adults are susceptible to falls. The purpose of the present study was to assess whether male and female older adults, that use a single or multiple step recovery strategy, differ in the proportion of lower limb strength used and power produced during the stepping phase of balance recovery. Eighty-four community-dwelling older adults (47 men, 37 women) participated in the study. Isometric strength of the ankle, knee and hip joint flexors and extensors was assessed using a dynamometer. Loss of balance was induced by releasing participants from a static forward lean (4 trials at each of 3 forward lean angles). Participants were instructed to recover with a single step and were subsequently classified as using a single or multiple step recovery strategy for each trial. (1) Females were weaker than males and the proportion of females that were able to recover with a single step were lower than for males at each lean magnitude. (2) Multiple compared to single steppers used a significantly higher proportion of their hip extension strength and produced less knee and ankle joint peak power during stepping, at the intermediate lean angle. Strength deficits in female compared to male participants may explain why a lower proportion of female participants were able to recover with a single step. The inability to generate sufficient power in the stepping limb appears to be a limiting factor in single step recovery from forward loss of balance. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  9. Deficiency of angiotensinogen in hepatocytes markedly decreases blood pressure in lean and obese male mice.

    PubMed

    Yiannikouris, Frederique; Wang, Yu; Shoemaker, Robin; Larian, Nika; Thompson, Joel; English, Victoria L; Charnigo, Richard; Su, Wen; Gong, Ming; Cassis, Lisa A

    2015-10-01

    We recently demonstrated that adipocyte deficiency of angiotensinogen (AGT) ablated high-fat diet-induced elevations in plasma angiotensin II (Ang II) concentrations and obesity-hypertension in male mice. Hepatocytes are the predominant source of systemic AGT. Therefore, in this study, we defined the contribution of hepatocyte-derived AGT to obesity-induced elevations in plasma AGT concentrations and hypertension. Male Agt(fl/fl) mice expressing albumin-driven Cre recombinase were bred to female Agt(fl/fl) mice to generate Agt(fl/fl) or hepatocyte AGT-deficient male mice (Agt(Alb)). Mice were fed a low-fat or high-fat diet for 16 weeks. Hepatocyte AGT deficiency had no significant effect on body weight. Plasma AGT concentrations were increased in obese Agt(fl/fl) mice. Hepatocyte AGT deficiency markedly reduced plasma AGT and Ang II concentrations in lean and obese mice. Moreover, hepatocyte AGT deficiency reduced the content and release of AGT from adipose explants. Systolic blood pressure was markedly decreased in lean (by 18 mm Hg) and obese Agt(Alb) mice (by 54 mm Hg) compared with Agt(fl/fl) controls. To define mechanisms, we quantified effects of Ang II on mRNA abundance of megalin, an AGT uptake transporter, in 3T3-L1 adipocytes. Ang II stimulated adipocyte megalin mRNA abundance and decreased media AGT concentrations. These results demonstrate that hepatocytes are the predominant source of systemic AGT in both lean and obese mice. Moreover, reductions in plasma angiotensin concentrations in obese hepatocyte AGT-deficient mice may have limited megalin-dependent uptake of AGT into adipocytes for the production of Ang II in the development of obesity-hypertension. © 2015 American Heart Association, Inc.

  10. 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

  11. The prospective association between different types of exercise and body composition

    PubMed Central

    Drenowatz, Clemens; Hand, Gregory A.; Sagner, Michael; Shook, Robin P.; Burgess, Stephanie; Blair, Steven N.

    2015-01-01

    Purpose Despite the widely accepted benefits of exercise on chronic disease risk, there remains controversy on the role of exercise in weight loss. This study examined the effect of different exercise types on measures of adiposity across different fat categories. Methods A total of 348 young adults (49% male; 28±4 years), participating in an ongoing observational study, provided valid data over a period of 12 months. Fat mass (FM) and lean mass (LM) were measured via dual x-ray absorptiometry every 3 months. Percent body fat (BF) was calculated and used to differentiate between normal fat, over fat and obese participants. At each measurement time point participants reported engagement (min/week) in aerobic exercise, resistance exercise and other exercise. Results Most participants (93%) reported some exercise participation during the observation period. Total exercise or specific exercise types did not significantly affect subsequent BMI after adjusting for sex, ethnicity, age and baseline values of adiposity and exercise. Resistance exercise affected lean mass (p<0.01) and fat mass (p<0.01), while aerobic exercise only affected fat mass (p<0.01). Any exercise type positively affected lean mass in normal fat participants (p<0.04). In overfat and obese participants fat mass was reduced with increasing resistance exercise (p≤0.02) but not with aerobic exercise (p≥0.09). Additionally adjusting for objectively assessed total physical activity level did not change these results. Conclusion Despite the limited effects on BMI, exercise was associated with beneficial changes in body composition. Exercise increased lean mass in normal fat participants and reduced fat mass in overfat and obese adults. Adults with excess body fat may benefit particularly from resistance exercise. PMID:25970664

  12. 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.

  13. Toward a Broader Dialectic: Joining Marxism with Mailer to Forge a Multilectics That Advances Teaching and Learning

    ERIC Educational Resources Information Center

    Fellner, Gene

    2014-01-01

    I contrast the lenses that Norman Mailer, Herbert Marcuse, and Karl Marx bring to their analyses of social life, exploring the contributions and limits of their respective approaches. I then propose what I call a "multilectical" theoretical lens that encompasses the strengths of all three and leans on the insights of post-Marxist…

  14. 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.

  15. Myeloid-Cell-Derived VEGF Maintains Brain Glucose Uptake and Limits Cognitive Impairment in Obesity.

    PubMed

    Jais, Alexander; Solas, Maite; Backes, Heiko; Chaurasia, Bhagirath; Kleinridders, André; Theurich, Sebastian; Mauer, Jan; Steculorum, Sophie M; Hampel, Brigitte; Goldau, Julia; Alber, Jens; Förster, Carola Y; Eming, Sabine A; Schwaninger, Markus; Ferrara, Napoleone; Karsenty, Gerard; Brüning, Jens C

    2016-05-05

    High-fat diet (HFD) feeding induces rapid reprogramming of systemic metabolism. Here, we demonstrate that HFD feeding of mice downregulates glucose transporter (GLUT)-1 expression in blood-brain barrier (BBB) vascular endothelial cells (BECs) and reduces brain glucose uptake. Upon prolonged HFD feeding, GLUT1 expression is restored, which is paralleled by increased expression of vascular endothelial growth factor (VEGF) in macrophages at the BBB. In turn, inducible reduction of GLUT1 expression specifically in BECs reduces brain glucose uptake and increases VEGF serum concentrations in lean mice. Conversely, myeloid-cell-specific deletion of VEGF in VEGF(Δmyel) mice impairs BBB-GLUT1 expression, brain glucose uptake, and memory formation in obese, but not in lean mice. Moreover, obese VEGF(Δmyel) mice exhibit exaggerated progression of cognitive decline and neuroinflammation on an Alzheimer's disease background. These experiments reveal that transient, HFD-elicited reduction of brain glucose uptake initiates a compensatory increase of VEGF production and assign obesity-associated macrophage activation a homeostatic role to restore cerebral glucose metabolism, preserve cognitive function, and limit neurodegeneration in obesity. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. 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.

  17. 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…

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. Relationship Between Changes in Fat and Lean Depots Following Weight Loss and Changes in Cardiovascular Disease Risk Markers.

    PubMed

    Clifton, Peter M

    2018-04-04

    Gluteofemoral fat mass has been associated with improved cardiovascular disease risk factors. It is not clear if loss of this protective fat during weight loss partially negates the effect of loss of visceral fat. The aim of this study was to examine regional fat loss in a large weight-loss cohort from one center and to determine if fat loss in the leg and total lean tissue loss is harmful. We combined the data from 7 of our previously published 3-month weight-loss studies and examined the relationship between regional fat and lean tissue loss and changes in cardiovascular disease risk factors in 399 participants. At baseline, leg fat was positively associated with high-density lipoprotein cholesterol in women and inversely with fasting triglyceride level in both sexes. Abdominal lean tissue was also related to systolic blood pressure in men. Changes in regional fat and lean tissue were positively associated with changes in glucose, insulin, total cholesterol, triglycerides, low-density lipoprotein cholesterol and systolic and diastolic blood pressure ( r =0.11-0.22, P <0.05) with leg fat and arm lean tissue dominating in multivariate regression. After adjustment for total weight or total fat change, these relationships disappeared except for a positive relationship between arm and lean leg mass loss and changes in triglycerides and systolic blood pressure. Loss of leg fat and leg lean tissue was directly associated with beneficial changes in cardiovascular disease risk markers. Loss of lean tissue may not have an adverse effect on cardiovascular disease risk, and measures to retain lean tissue during weight loss may not be necessary. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  3. The effect of high-fat diet on the composition of the gut microbiota in cloned and non-cloned pigs of lean and obese phenotype

    PubMed Central

    Pedersen, Rebecca; Andersen, Anders Daniel; Hermann-Bank, Marie Louise; Stagsted, Jan; Boye, Mette

    2013-01-01

    The aim of this study was to investigate the effect of high-far-high-energy diet on cloned and non-cloned domestic pigs of both lean and obese phenotype and to evaluate if the lean cloned pigs had a lower inter-individual variation as compared with non-cloned pigs. The microbiota of colon and terminal ileum was investigated in cloned and non-cloned pigs that received a high-far-high-energy diet with either restricted or ad libitum access to feed, resulting in lean and obese phenotypes, respectively. The fecal microbiota of lean pigs was investigated by terminal restriction fragment length polymorphism (T-RFLP). The intestinal microbiota of lean and obese cloned and non-cloned pigs was analyzed by quantitative real time PCR and a novel high-throughput qPCR platform (Fluidigm). Principal component analysis (PCA) of the T-RFLP profiles revealed that lean cloned and non-cloned pigs had a different overall composition of their gut microbiota. The colon of lean cloned pigs contained relatively more bacteria belonging to the phylum Firmicutes and less from the phylum Bacteroidetes than obese cloned pigs as estimated by qPCR. Fluidigm qPCR results revealed differences in specific bacterial groups in the gut microbiota of both lean and obese pigs. Our results suggest that high-far-high-energy diet is associated with changes in the gut microbiota even in the absence of obesity. Overall, the cloned pigs had a different gut microbiota from that of non-cloned pigs. To our knowledge this is the first study to investigate the gut microbiota of cloned domestic pigs of lean and obese phenotype. PMID:23974297

  4. Clinical and Metabolic Characterization of Lean Caucasian Subjects With Non-alcoholic Fatty Liver.

    PubMed

    Feldman, Alexandra; Eder, Sebastian K; Felder, Thomas K; Kedenko, Lyudmyla; Paulweber, Bernhard; Stadlmayr, Andreas; Huber-Schönauer, Ursula; Niederseer, David; Stickel, Felix; Auer, Simon; Haschke-Becher, Elisabeth; Patsch, Wolfgang; Datz, Christian; Aigner, Elmar

    2017-01-01

    Non-alcoholic fatty liver disease (NAFLD) is closely linked to obesity; however, 5-8% of lean subjects also have evidence of NAFLD. We aimed to investigate clinical, genetic, metabolic and lifestyle characteristics in lean Caucasian subjects with NAFLD. Data from 187 subjects allocated to one of the three groups according to body mass index (BMI) and hepatic steatosis on ultrasound were obtained: lean healthy (BMI≤25 kg/m 2 , no steatosis, N=71), lean NAFLD (BMI≤25 kg/m 2 , steatosis, N=55), obese NAFLD (BMI≥30 kg/m 2 , steatosis; N=61). All subjects received a detailed clinical and laboratory examination including oral glucose tolerance test. The serum metabolome was assessed using the Metabolomics AbsoluteIDQ p180 kit (BIOCRATES Life Sciences). Genotyping for single-nucleotide polymorphisms (SNPs) associated with NAFLD was performed. Lean NAFLD subjects had fasting insulin concentrations similar to lean healthy subjects but had markedly impaired glucose tolerance. Lean NAFLD subjects had a higher rate of the mutant PNPLA3 CG/GG variant compared to lean controls (P=0.007). Serum adiponectin concentrations were decreased in both NAFLD groups compared to controls (P<0.001 for both groups) The metabolomics study revealed a potential role for various lysophosphatidylcholines (lyso-PC C18:0, lyso-PC C17:0) and phosphatidylcholines (PCaa C36:3; false discovery rate (FDR)-corrected P-value<0.001) as well as lysine, tyrosine, and valine (FDR<0.001). Lean subjects with evidence of NAFLD have clinically relevant impaired glucose tolerance, low adiponectin concentrations and a distinct metabolite profile with an increased rate of PNPLA3 risk allele carriage.

  5. Weight-adjusted lean body mass and calf circumference are protective against obesity-associated insulin resistance and metabolic abnormalities.

    PubMed

    Takamura, Toshinari; Kita, Yuki; Nakagen, Masatoshi; Sakurai, Masaru; Isobe, Yuki; Takeshita, Yumie; Kawai, Kohzo; Urabe, Takeshi; Kaneko, Shuichi

    2017-07-01

    To test the hypothesis that preserved muscle mass is protective against obesity-associated insulin resistance and metabolic abnormalities, we analyzed the relationship of lean body mass and computed tomography-assessed sectional areas of specific skeletal muscles with insulin resistance and metabolic abnormalities in a healthy cohort. A total of 195 subjects without diabetes who had completed a medical examination were included in this study. Various anthropometric indices such as circumferences of the arm, waist, hip, thigh, and calf were measured. Body composition (fat and lean body mass) was determined by bioelectrical impedance analysis. Sectional areas of specific skeletal muscles (iliopsoas, erector spinae, gluteus, femoris, and rectus abdominis muscles) were measured using computed tomography. Fat and lean body mass were significantly correlated with metabolic abnormalities and insulin resistance indices. When adjusted by weight, relationships of fat and lean body mass with metabolic parameters were mirror images of each other. The weight-adjusted lean body mass negatively correlated with systolic and diastolic blood pressures; fasting plasma glucose, HbA1c, alanine aminotransferase, and triglyceride, and insulin levels; and hepatic insulin resistance indices, and positively correlated with HDL-cholesterol levels and muscle insulin sensitivity indices. Compared with weight-adjusted lean body mass, weight-adjusted sectional areas of specific skeletal muscles showed similar, but not as strong, correlations with metabolic parameters. Among anthropometric measures, the calf circumference best reflected lean body mass, and weight-adjusted calf circumference negatively correlated with metabolic abnormalities and insulin resistance indices. Weight-adjusted lean body mass and skeletal muscle area are protective against weight-associated insulin resistance and metabolic abnormalities. The calf circumference reflects lean body mass and may be useful as a protective marker against obesity-associated metabolic abnormalities.

  6. The effect of high-fat diet on the composition of the gut microbiota in cloned and non-cloned pigs of lean and obese phenotype.

    PubMed

    Pedersen, Rebecca; Andersen, Anders Daniel; Hermann-Bank, Marie Louise; Stagsted, Jan; Boye, Mette

    2013-01-01

    The aim of this study was to investigate the effect of high-far-high-energy diet on cloned and non-cloned domestic pigs of both lean and obese phenotype and to evaluate if the lean cloned pigs had a lower inter-individual variation as compared with non-cloned pigs. The microbiota of colon and terminal ileum was investigated in cloned and non-cloned pigs that received a high-far-high-energy diet with either restricted or ad libitum access to feed, resulting in lean and obese phenotypes, respectively. The fecal microbiota of lean pigs was investigated by terminal restriction fragment length polymorphism (T-RFLP). The intestinal microbiota of lean and obese cloned and non-cloned pigs was analyzed by quantitative real time PCR and a novel high-throughput qPCR platform (Fluidigm). Principal component analysis (PCA) of the T-RFLP profiles revealed that lean cloned and non-cloned pigs had a different overall composition of their gut microbiota. The colon of lean cloned pigs contained relatively more bacteria belonging to the phylum Firmicutes and less from the phylum Bacteroidetes than obese cloned pigs as estimated by qPCR. Fluidigm qPCR results revealed differences in specific bacterial groups in the gut microbiota of both lean and obese pigs. Our results suggest that high-far-high-energy diet is associated with changes in the gut microbiota even in the absence of obesity. Overall, the cloned pigs had a different gut microbiota from that of non-cloned pigs. To our knowledge this is the first study to investigate the gut microbiota of cloned domestic pigs of lean and obese phenotype.

  7. Effects of age and lean direction on the threshold of single-step balance recovery in younger, middle-aged and older adults.

    PubMed

    Carbonneau, Evelyne; Smeesters, Cécile

    2014-01-01

    Several studies have quantified and compared balance recovery between healthy younger and older adults, using a variety of large postural perturbations and loss of balance directions. However, to the best of our knowledge, no studies at the threshold of balance recovery, where avoiding a fall is not always possible, have included middle-aged adults. We thus determined the maximum lean angle from which 20 younger, 16 middle-aged and 16 older healthy adults could be suddenly released and still recover balance using a single step for forward, sideways and backward leans. Results showed that the maximum lean angles of younger adults were 23% greater than middle-aged adults and 48% greater than older adults. The maximum lean angles for forward leans were 23% greater than sideways leans and 22% greater than backward leans. These declines with age and lean direction were associated with declines in response initiation, execution and geometry. Finally exponential regressions showed that the critical ages at which the ability to recover balance and avoid a fall significantly decreases were 51.0, 60.6 and 69.9 yrs for forward, sideways and backward leans, respectively. Therefore, we have demonstrated that age affects the ability to recover balance nearly a decade earlier than the rate of falls. Future studies should thus not only include older adults over 65 yrs, but also middle-aged adults under 65 yrs, or recruit all ages from 18 to 85 yrs. Finally, the critical ages identified in this study may justify an earlier screening of aging adults to prevent future falls, especially the first fall. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. Adipokines, oxidized low-density lipoprotein, and C-reactive protein levels in lean, overweight, and obese portuguese patients with type 2 diabetes.

    PubMed

    Neuparth, Maria João; Proença, Jorge Brandão; Santos-Silva, Alice; Coimbra, Susana

    2013-01-01

    Aim. Our aim was to study how different BMI scores may influence the levels of inflammation, oxidative stress, adipogenesis, glucose, and lipid metabolism, in lean, overweight, and obese Portuguese patients with type 2 diabetes mellitus (T2DM). Methods. We studied 28 lean, 38 overweight, and 17 obese patients with T2DM and 20 controls (gender and age matched). The circulating levels of oxLDL, CRP, and some adipokines-adiponectin, leptin, and chemerin-and the lipid profile were evaluated. Results. Obese patients presented significantly lower levels of adiponectin and higher leptin, oxLDL, and chemerin levels, as compared to the overweight, lean, and control groups. Overweight, compared to lean and control, subjects showed significantly lower adiponectin and higher leptin and chemerin levels; oxLDL values were significantly higher in overweight than in lean patients. Lean patients presented significantly higher chemerin values than the control. Obese patients presented significantly higher CRP values, as compared to lean patients and the control group. Obese and overweight patients presented significantly higher triglycerides values than lean patients. Except for CRP, all the observed significant changes between control and patients remained significant after statistical adjustment for the body mass index (BMI). Conclusion. The levels of leptin, adiponectin, oxLDL, CRP, and triglycerides in patients with T2DM seem to be more associated with obesity and less with diabetes. Chemerin levels were raised in lean, overweight, and obese patients, suggesting that, independently of BMI, an adipocyte dysfunction occurs. Moreover, chemerin may provide an important early biomarker of adipocyte dysfunction and a link between obesity and type 2 diabetes mellitus.

  9. Adipokines, Oxidized Low-Density Lipoprotein, and C-Reactive Protein Levels in Lean, Overweight, and Obese Portuguese Patients with Type 2 Diabetes

    PubMed Central

    Neuparth, Maria João; Proença, Jorge Brandão; Santos-Silva, Alice; Coimbra, Susana

    2013-01-01

    Aim. Our aim was to study how different BMI scores may influence the levels of inflammation, oxidative stress, adipogenesis, glucose, and lipid metabolism, in lean, overweight, and obese Portuguese patients with type 2 diabetes mellitus (T2DM). Methods. We studied 28 lean, 38 overweight, and 17 obese patients with T2DM and 20 controls (gender and age matched). The circulating levels of oxLDL, CRP, and some adipokines—adiponectin, leptin, and chemerin—and the lipid profile were evaluated. Results. Obese patients presented significantly lower levels of adiponectin and higher leptin, oxLDL, and chemerin levels, as compared to the overweight, lean, and control groups. Overweight, compared to lean and control, subjects showed significantly lower adiponectin and higher leptin and chemerin levels; oxLDL values were significantly higher in overweight than in lean patients. Lean patients presented significantly higher chemerin values than the control. Obese patients presented significantly higher CRP values, as compared to lean patients and the control group. Obese and overweight patients presented significantly higher triglycerides values than lean patients. Except for CRP, all the observed significant changes between control and patients remained significant after statistical adjustment for the body mass index (BMI). Conclusion. The levels of leptin, adiponectin, oxLDL, CRP, and triglycerides in patients with T2DM seem to be more associated with obesity and less with diabetes. Chemerin levels were raised in lean, overweight, and obese patients, suggesting that, independently of BMI, an adipocyte dysfunction occurs. Moreover, chemerin may provide an important early biomarker of adipocyte dysfunction and a link between obesity and type 2 diabetes mellitus. PMID:24634792

  10. 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.

  11. Lean muscle mass in classic or ovulatory PCOS: association with central obesity and insulin resistance.

    PubMed

    Mario, F M; do Amarante, F; Toscani, M K; Spritzer, P M

    2012-10-01

    This age-matched case-control study assessed total and segmental lean muscle mass in classic or ovulatory polycystic ovary syndrome (PCOS) patients and investigated whether lean mass is associated with hormone and metabolic features. Participants underwent anthropometric and clinical evaluation. Habitual physical activity was assessed with a digital pedometer, and body composition by dual-energy X-ray absorptiometry. Laboratory measurements included total cholesterol, cholesterol fractions, triglycerides, glucose, total serum testosterone, serum insulin, estradiol, luteinizing hormone, and SHBG. Energy intake was calculated using a food frequency questionnaire. Classic PCOS patients had higher body mass index (BMI), waist circumference, testosterone and lipid accumulation product values than ovulatory PCOS and controls. Energy consumption, homeostasis model assessment index, SHBG, free androgen index and triglycerides, total and trunk lean mass were higher only in classic PCOS women vs. controls. Arm, leg, trunk, total or limb lean masses were not correlated with hormone levels in any of the groups. However, in PCOS women lipid accumulation product was positively correlated with total (r=0.56, p=0.001), trunk (r=0.59, p=0.001), arm (r=0.54, p=0.001), leg (r=0.44, p=0.03) and limb (r=0.48, p=0.001) lean masses. BMI was positively correlated with all lean mass segments and independently associated with total lean mass. Lipid accumulation product and BMI were independently associated with trunk lean mass variation. The increase in lean mass in classic PCOS appears to be associated with insulin resistance and central obesity rather than with energy intake, physical activity or androgens. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

  12. Lean in Air Permitting Guide

    EPA Pesticide Factsheets

    The Lean in Air Permitting Guide is designed to help air program managers at public agencies better understand the potential value and results that can be achieved by applying Lean improvement methods to air permitting processes.

  13. Drive for leanness and health-related behavior within a social/cultural perspective.

    PubMed

    Tod, David; Edwards, Christian; Hall, Gareth

    2013-09-01

    We examined relationships between drive for leanness and perceived media pressure to change appearance, internalization of an ideal physique, exercise frequency, and dieting. Men and women (N=353) completed the Drive for Leanness Scale, the Sociocultural Attitudes Toward Appearance Questionnaire-3, the Eating Attitudes Test-26, and a demographic inventory. Drive for leanness was significantly correlated with athletic internalization (.52), pressure to attain an ideal physique (.25), exercise frequency (.36), and dieting (.25). Structural equation modeling revealed a good fitting model (χ(2)=2.85, p<.241; CFI=.99; NNFI=.98; RMSEA=.04; SRMR=.02) with internalization predicting drive for leanness, which in turn predicted dieting and exercise. Results reveal social/cultural theory helps enhance the understanding of the drive for leanness and its relationship with health-related behavior. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Effect of hormone therapy on lean body mass, falls, and fractures: Six-year results from the Women’s Health Initiative Hormone Trials

    PubMed Central

    Bea, Jennifer W.; Zhao, Qiuhong; Cauley, Jane A.; LaCroix, Andrea Z.; Bassford, Tamsen; Lewis, Cora E.; Jackson, Rebecca D.; Tylavsky, Frances A.; Chen, Zhao

    2010-01-01

    Objective Loss of lean body mass with aging may contribute to falls and fractures. The objective of this analysis was to determine if taking postmenopausal hormone therapy (HT: estrogen plus progestogen therapy, EPT or estrogen therapy alone, ET) favorably affects age-related changes in lean body mass and if these changes partially account for decreased falls or fractures with HT. Methods Participants randomly assigned to either EPT (n=543) or control (n=471) and ET (n= 453) or control (n= 474) and receiving dual-energy X-ray absorptiometry (DXA) scans to estimate body composition during the Women’s Health Initiative (WHI) were evaluated. Falls and fracture occurrence were obtained by annual self-report. Fractures were confirmed by clinical chart review. Results At 6yrs post-randomization, lean body mass was not different between HT and control groups. Although lean body mass positively influenced BMD, independent of HT status, the preserved lean body mass observed in the HT arms in the first 3 years did not significantly contribute to models evaluating HT influence on falls and fractures between years 3 and 6. Women taking at least 80% of their medication in the HT arms demonstrated fewer falls compared to placebo; this difference was not attributable to change in lean body mass. Conclusions Despite early preservation of lean body mass with HT (3years), HT did not ameliorate long-term (6 years) loss in lean body mass with aging. PMID:20689466

  15. Effect of hormone therapy on lean body mass, falls, and fractures: 6-year results from the Women's Health Initiative hormone trials.

    PubMed

    Bea, Jennifer W; Zhao, Qiuhong; Cauley, Jane A; LaCroix, Andrea Z; Bassford, Tamsen; Lewis, Cora E; Jackson, Rebecca D; Tylavsky, Frances A; Chen, Zhao

    2011-01-01

    Loss of lean body mass with aging may contribute to falls and fractures. The objective of this analysis was to determine if taking postmenopausal hormone therapy (or HT: estrogen plus progestogen therapy or estrogen therapy alone) favorably affects age-related changes in lean body mass and if these changes partially account for decreased falls or fractures with HT. Participants randomly assigned to either estrogen plus progestogen therapy (n = 543) or control (n = 471) and estrogen therapy alone (n = 453) or control (n = 474) and receiving dual-energy x-ray absorptiometry scans to estimate body composition during the Women's Health Initiative were evaluated. Falls and fracture occurrence were obtained by annual self-report. Fractures were confirmed by a clinical chart review. At 6 years postrandomization, lean body mass was not different between HT and control groups. Although lean body mass positively influenced bone mineral density, independent of HT status, the preserved lean body mass observed in the HT arms in the first 3 years did not significantly contribute to models evaluating HT influence on falls and fractures between years 3 and 6. Women taking at least 80% of their medication in the HT arms demonstrated fewer falls compared with placebo; this difference was not attributable to change in lean body mass. Despite early preservation of lean body mass with HT (3 y), HT did not ameliorate long-term (6 y) loss in lean body mass with aging.

  16. Serum visfatin in relation to insulin resistance and markers of hyperandrogenism in lean and obese women with polycystic ovary syndrome.

    PubMed

    Kowalska, Irina; Straczkowski, Marek; Nikolajuk, Agnieszka; Adamska, Agnieszka; Karczewska-Kupczewska, Monika; Otziomek, Elzbieta; Wolczynski, Slawomir; Gorska, Maria

    2007-07-01

    Visfatin, a protein secreted by adipose tissue, is suggested to play a role in pathogenesis of insulin resistance. In polycystic ovary syndrome (PCOS), insulin resistance might be involved in the development of endocrine and metabolic abnormalities. The aim of the study was to asses the relation between serum visfatin concentration and insulin sensitivity and markers of hyperandrogenism in lean and obese PCOS patients. The study group consisted of 70 women with PCOS (23 lean and 47 obese) and 45 healthy women (25 lean and 20 obese). Euglycemic hyperinsulinemic clamp and the measurements of serum visfatin, sex hormones were performed. The PCOS group had lower insulin sensitivity (P=0.00049) and higher serum visfatin (P=0.047) in comparison to the control group. The decrease in insulin sensitivity was present in both the lean (P=0.019) and obese (P=0.0077) PCOS subjects, whereas increase in serum visfatin was observed only in lean PCOS subjects (P=0.012). In the whole group, serum visfatin was negatively correlated with insulin sensitivity (r=-0.27, P=0.004). This relationship was also observed in the subgroup of lean (r=-0.30, P=0.038), but not obese women. Additionally, in lean women, visfatin was associated with serum testosterone (r=0.47, P=0.002) and free androgen index (r=0.48, P=0.002), independently of other potential confounding factors. Visfatin is associated with insulin resistance and markers of hyperandrogenism in lean PCOS patients.

  17. Experimental Assessment of the Emissions Control Potential of a Rich/Quench/Lean Combustor for High Speed Civil Transport Aircraft Engines

    NASA Technical Reports Server (NTRS)

    Rosfjord, T. J.; Padget, F. C.; Tacina, Robert R. (Technical Monitor)

    2001-01-01

    In support of Pratt & Whitney efforts to define the Rich burn/Quick mix/Lean burn (RQL) combustor for the High Speed Civil Transport (HSCT) aircraft engine, UTRC conducted a flametube-scale study of the RQL concept. Extensive combustor testing was performed at the Supersonic Cruise (SSC) condition of a HSCT engine cycle, Data obtained from probe traverses near the exit of the mixing section confirmed that the mixing section was the critical component in controlling combustor emissions. Circular-hole configurations, which produced rapidly-, highly-penetrating jets, were most effective in limiting NOx. The spatial profiles of NOx and CO at the mixer exit were not directly interpretable using a simple flow model based on jet penetration, and a greater understanding of the flow and chemical processes in this section are required to optimize it. Neither the rich-combustor equivalence ratio nor its residence time was a direct contributor to the exit NOx. Based on this study, it was also concluded that (1) While NOx formation in both the mixing section and the lean combustor contribute to the overall emission, the NOx formation in the mixing section dominates. The gas composition exiting the rich combustor can be reasonably represented by the equilibrium composition corresponding to the rich combustor operating condition. Negligible NOx exits the rich combustor. (2) At the SSC condition, the oxidation processes occurring in the mixing section consume 99 percent of the CO exiting the rich combustor. Soot formed in the rich combustor is also highly oxidized, with combustor exit SAE Smoke Number <3. (3) Mixing section configurations which demonstrated enhanced emissions control at SSC also performed better at part-power conditions. Data from mixer exit traverses reflected the expected mixing behavior for off-design jet to crossflow momentum-flux ratios. (4) Low power operating conditions require that the RQL combustor operate as a lean-lean combustor to achieve low CO and high efficiency. (5) A RQL combustor can achieve the emissions goal of EINOX = 5 at the Supersonic Cruise operating condition for a HSCT engine.

  18. Experimental Assessment of the Emissions Control Potential of a Rich/Quench/ Lean Combustor for High Speed Civil Transport Aircraft Engines

    NASA Technical Reports Server (NTRS)

    Tacina, Robert R. (Technical Monitor); Rosfjord, T. J.; Padget, F. C.

    2001-01-01

    In support of Pratt & Whitney efforts to define the Rich burn/Quick mix/Lean burn (RQL) combustor for the High Speed Civil Transport (HSCT) aircraft engine, UTRC conducted a flametube-scale study of the RQL concept. Extensive combustor testing was performed at the Supersonic Cruise (SSC) condition of an HSCT engine cycle. Data obtained from probe traverses near the exit of the mixing section confirmed that the mixing section was the critical component in controlling combustor emissions. Circular-hole configurations, which produced rapidly-, highly-penetrating jets, were most effective in limiting NO(x). The spatial profiles of NO(x) and CO at the mixer exit were not directly interpretable using a simple flow model based on jet penetration, and a greater understanding of the flow and chemical processes in this section are required to optimize it. Neither the rich-combustor equivalence ratio nor its residence time was a direct contributor to the exit NO(x). Based on this study, it was also concluded that: (1) While NO(x) formation in both the mixing section and the lean combustor contribute to the overall emission, the NOx formation in the mixing section dominates. The gas composition exiting the rich combustor can be reasonably represented by the equilibrium composition corresponding to the rich combustor operating condition. Negligible NO(x) exits the rich combustor. (2) At the SSC condition, the oxidation processes occurring in the mixing section consume 99 percent of the CO exiting the rich combustor. Soot formed in the rich combustor is also highly oxidized, with combustor exit SAE Smoke Number <3. (3) Mixing section configurations which demonstrated enhanced emissions control at SSC also performed better at part-power conditions. Data from mixer exit traverses reflected the expected mixing behavior for off-design jet to crossflow momentum-flux ratios. (4) Low power operating conditions require that the RQL combustor operate as a lean-lean combustor to achieve low CO and high efficiency. (5) An RQL combustor can achieve the emissions goal of EINO(x) = 5 at the Supersonic Cruise operating condition for an HSCT engine.

  19. Accuracy of Body Mass Index Versus Lean Mass Index for Prediction of Sarcopenia in Older Women.

    PubMed

    Benton, M J; Silva-Smith, A L

    2018-01-01

    We compared accuracy of body mass index (BMI) versus lean mass index (LMI) to predict sarcopenia in 58 community-dwelling women (74.1±0.9 years). Lean mass was measured with multi-frequency bioelectrical impedance analysis, and strength was measured with Arm Curl test, Chair Stand test, and handgrip dynamometry. Sarcopenia was defined as low LMI. When categorized by BMI, normal women had less absolute lean mass (37.6±1.0 vs. 42.6±0.9 kg; P<0.001) and less relative lean mass (14.1±0.2 vs. 16.1±0.2 kg/m2; P<0.001) compared to overweight/obese women, but no differences in strength. When categorized by LMI, normal women had more absolute lean mass (44.0±0.7 vs. 35.7±0.7 kg; P<0.001), more relative lean mass (16.2±0.2 vs. 13.8±0.2 kg/m2; P<0.001), and greater upper body strength (16.7±0.9 vs. 14.2±0.6 arm curls; P<0.05) compared to women with low LMI. BMI failed to accurately predict low values of lean mass and strength. For clinical assessment, calculation of LMI rather than BMI is appropriate.

  20. 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.

  1. Performance, Efficiency, and Emissions Characterization of Reciprocating Internal Combustion Engines Fueled with Hydrogen/Natural Gas Blends

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

    Kirby S. Chapman; Amar Patil

    2007-06-30

    Hydrogen is an attractive fuel source not only because it is abundant and renewable but also because it produces almost zero regulated emissions. Internal combustion engines fueled by compressed natural gas (CNG) are operated throughout a variety of industries in a number of mobile and stationary applications. While CNG engines offer many advantages over conventional gasoline and diesel combustion engines, CNG engine performance can be substantially improved in the lean operating region. Lean operation has a number of benefits, the most notable of which is reduced emissions. However, the extremely low flame propagation velocities of CNG greatly restrict the leanmore » operating limits of CNG engines. Hydrogen, however, has a high flame speed and a wide operating limit that extends into the lean region. The addition of hydrogen to a CNG engine makes it a viable and economical method to significantly extend the lean operating limit and thereby improve performance and reduce emissions. Drawbacks of hydrogen as a fuel source, however, include lower power density due to a lower heating value per unit volume as compared to CNG, and susceptibility to pre-ignition and engine knock due to wide flammability limits and low minimum ignition energy. Combining hydrogen with CNG, however, overcomes the drawbacks inherent in each fuel type. Objectives of the current study were to evaluate the feasibility of using blends of hydrogen and natural gas as a fuel for conventional natural gas engines. The experiment and data analysis included evaluation of engine performance, efficiency, and emissions along with detailed in-cylinder measurements of key physical parameters. This provided a detailed knowledge base of the impact of using hydrogen/natural gas blends. A four-stroke, 4.2 L, V-6 naturally aspirated natural gas engine coupled to an eddy current dynamometer was used to measure the impact of hydrogen/natural gas blends on performance, thermodynamic efficiency and exhaust gas emissions in a reciprocating four stroke cycle engine. The test matrix varied engine load and air-to-fuel ratio at throttle openings of 50% and 100% at equivalence ratios of 1.00 and 0.90 for hydrogen percentages of 10%, 20% and 30% by volume. In addition, tests were performed at 100% throttle opening, with an equivalence ratio of 0.98 and a hydrogen blend of 20% to further investigate CO emission variations. Data analysis indicated that the use of hydrogen/natural gas fuel blend penalizes the engine operation with a 1.5 to 2.0% decrease in torque, but provided up to a 36% reduction in CO, a 30% reduction in NOX, and a 5% increase in brake thermal efficiency. These results concur with previous results published in the open literature. Further reduction in emissions can be obtained by retarding the ignition timing.« less

  2. Defects, Entropy, and the Stabilization of Alternative Phase Boundary Orientations in Battery Electrode Particles

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

    Heo, Tae Wook; Tang, Ming; Chen, Long-Qing

    Using a novel statistical approach that efficiently explores the space of possible defect configurations, our present study investigates the chemomechanical coupling between interfacial structural defects and phase boundary alignments within phase-separating electrode particles. Applied to the battery cathode material Li XFePO 4 as an example, the theoretical analysis reveals that small, defect-induced deviations from an ideal interface can lead to dramatic shifts in the orientations of phase boundaries between Li-rich and Li-lean phases, stabilizing otherwise unfavorable orientations. Significantly, this stabilization arises predominantly from configurational entropic factors associated with the presence of the interfacial defects rather than from absolute energetic considerations.more » The specific entropic factors pertain to the diversity of defect configurations and their contributions to rotational/orientational rigidity of phase boundaries. Comparison of the predictions with experimental observations indicates that the additional entropy contributions indeed play a dominant role under actual cycling conditions, leading to the conclusion that interfacial defects must be considered when analyzing the stability and evolution kinetics of the internal phase microstructure of strongly phase-separating systems. Possible implications for tuning the kinetics of (de)lithiation based on selective defect incorporation are discussed. Ultimately, this understanding can be generalized to the chemomechanics of other defective solid phase boundaries.« less

  3. Gaze and viewing angle influence visual stabilization of upright posture

    PubMed Central

    Ustinova, KI; Perkins, J

    2011-01-01

    Focusing gaze on a target helps stabilize upright posture. We investigated how this visual stabilization can be affected by observing a target presented under different gaze and viewing angles. In a series of 10-second trials, participants (N = 20, 29.3 ± 9 years of age) stood on a force plate and fixed their gaze on a figure presented on a screen at a distance of 1 m. The figure changed position (gaze angle: eye level (0°), 25° up or down), vertical body orientation (viewing angle: at eye level but rotated 25° as if leaning toward or away from the participant), or both (gaze and viewing angle: 25° up or down with the rotation equivalent of a natural visual perspective). Amplitude of participants’ sagittal displacement, surface area, and angular position of the center of gravity (COG) were compared. Results showed decreased COG velocity and amplitude for up and down gaze angles. Changes in viewing angles resulted in altered body alignment and increased amplitude of COG displacement. No significant changes in postural stability were observed when both gaze and viewing angles were altered. Results suggest that both the gaze angle and viewing perspective may be essential variables of the visuomotor system modulating postural responses. PMID:22398978

  4. Defects, Entropy, and the Stabilization of Alternative Phase Boundary Orientations in Battery Electrode Particles

    DOE PAGES

    Heo, Tae Wook; Tang, Ming; Chen, Long-Qing; ...

    2016-01-04

    Using a novel statistical approach that efficiently explores the space of possible defect configurations, our present study investigates the chemomechanical coupling between interfacial structural defects and phase boundary alignments within phase-separating electrode particles. Applied to the battery cathode material Li XFePO 4 as an example, the theoretical analysis reveals that small, defect-induced deviations from an ideal interface can lead to dramatic shifts in the orientations of phase boundaries between Li-rich and Li-lean phases, stabilizing otherwise unfavorable orientations. Significantly, this stabilization arises predominantly from configurational entropic factors associated with the presence of the interfacial defects rather than from absolute energetic considerations.more » The specific entropic factors pertain to the diversity of defect configurations and their contributions to rotational/orientational rigidity of phase boundaries. Comparison of the predictions with experimental observations indicates that the additional entropy contributions indeed play a dominant role under actual cycling conditions, leading to the conclusion that interfacial defects must be considered when analyzing the stability and evolution kinetics of the internal phase microstructure of strongly phase-separating systems. Possible implications for tuning the kinetics of (de)lithiation based on selective defect incorporation are discussed. Ultimately, this understanding can be generalized to the chemomechanics of other defective solid phase boundaries.« less

  5. lean-ISD.

    ERIC Educational Resources Information Center

    Wallace, Guy W.

    2001-01-01

    Explains lean instructional systems design/development (ISD) as it relates to curriculum architecture design, based on Japan's lean production system. Discusses performance-based systems; ISD models; processes for organizational training and development; curriculum architecture to support job performance; and modular curriculum development. (LRW)

  6. A Cultural Resources Inventory of Eastern Portions of Lake Sakakawea, North Dakota (Mercer and McLean Counties).

    DTIC Science & Technology

    1982-09-15

    34esources Inventory of Eastern Portions of Lake Sakakawee, North Dakota (Mercer and McLean August - September 1982 Counties ) 6. PERFORMING ORG. REPORT...of Lake Sakakawea (Mercer and McLean Counties ), North Dakota, Identif ied 56 sites. The site types include: stone circles (36), stone cairn (1), linear...9 A CULTURAL RESOURCES INVENTORY OF EASTERN PORTIONS OF LAUE SAKAKAWRA, NORTH DAKOTA (MERCER AND XcLEAN COUNTIES

  7. A healthcare Lean Six Sigma System for postanesthesia care unit workflow improvement.

    PubMed

    Kuo, Alex Mu-Hsing; Borycki, Elizabeth; Kushniruk, Andre; Lee, Te-Shu

    2011-01-01

    The aim of this article is to propose a new model called Healthcare Lean Six Sigma System that integrates Lean and Six Sigma methodologies to improve workflow in a postanesthesia care unit. The methodology of the proposed model is fully described. A postanesthesia care unit case study is also used to demonstrate the benefits of using the Healthcare Lean Six Sigma System model by combining Lean and Six Sigma methodologies together. The new model bridges the service gaps between health care providers and patients, balances the requirements of health care managers, and delivers health care services to patients by taking the benefits of the Lean speed and Six Sigma high-quality principles. The full benefits of the new model will be realized when applied at both strategic and operational levels. For further research, we will examine how the proposed model is used in different real-world case studies.

  8. 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."

  9. 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.

  10. 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.

  11. Effect of strength and speed of torque development on balance recovery with the ankle strategy.

    PubMed

    Robinovitch, Stephen N; Heller, Britta; Lui, Andrew; Cortez, Jeffrey

    2002-08-01

    In the event of an unexpected disturbance to balance, the ability to recover a stable upright stance should depend not only on the magnitude of torque that can be generated by contraction of muscles spanning the lower extremity joints but also on how quickly these torques can be developed. In the present study, we used a combination of experimental and mathematical models of balance recovery by sway (feet in place responses) to test this hypothesis. Twenty-three young subjects participated in experiments in which they were supported in an inclined standing position by a horizontal tether and instructed to recover balance by contracting only their ankle muscles. The maximum lean angle where they could recover balance without release of the tether (static recovery limit) averaged 14.9 +/- 1.4 degrees (mean +/- SD). The maximum initial lean angle where they could recover balance after the tether was unexpectedly released and the ankles were initially relaxed (dynamic recovery limit) averaged 5.9 +/- 1.1 degrees, or 60 +/- 11% smaller than the static recovery limit. Peak ankle torque did not differ significantly between the two conditions (and averaged 116 +/- 32 Nm), indicating the strong effect on recovery ability of latencies in the onset and subsequent rates of torque generation (which averaged 99 +/- 13 ms and 372 +/- 267 N. m/s, respectively). Additional experiments indicated that dynamic recovery limits increased 11 +/- 14% with increases in the baseline ankle torques prior to release (from an average value of 31 +/- 18 to 54 +/- 24 N. m). These trends are in agreement with predictions from a computer simulation based on an inverted pendulum model, which illustrate the specific combinations of baseline ankle torque, rate of torque generation, and peak ankle torque that are required to attain target recovery limits.

  12. Dual specificity phosphatase 6 deficiency is associated with impaired systemic glucose tolerance and reversible weight retardation in mice

    PubMed Central

    Schriever, Sonja C.; Müller, Timo D.; Tschöp, Matthias H.

    2017-01-01

    Here, we aimed to investigate the potential role of DUSP6, a dual specificity phosphatase, that specifically inactivates extracellular signal-regulated kinase (ERK), for the regulation of body weight and glucose homeostasis. We further assessed whether metabolic challenges affect Dusp6 expression in selected brain areas or white adipose tissue. Hypothalamic Dusp6 mRNA levels remained unchanged in chow-fed lean vs. high fat diet (HFD) fed obese C57Bl/6J mice, and in C57Bl/6J mice undergoing prolonged fasting or refeeding with fat free diet (FFD) or HFD. Similarly, Dusp6 expression levels were unchanged in selected brain regions of Lepob mice treated with 1 mg/kg of leptin for 6 days, compared to pair-fed or saline-treated Lepob controls. Dusp6 expression levels remained unaltered in vitro in primary adipocytes undergoing differentiation, but were increased in eWAT of HFD-fed obese C57Bl/6J mice, compared to chow-fed lean controls. Global chow-fed DUSP6 KO mice displayed reduced body weight and lean mass and slightly increased fat mass at a young age, which is indicative for early-age weight retardation. Subsequent exposure to HFD led to a significant increase in lean mass and body weight in DUSP6 deficient mice, compared to WT controls. Nevertheless, after 26 weeks of high-fat diet exposure, we observed comparable body weight, fat and lean mass in DUSP6 WT and KO mice, suggesting overall normal susceptibility to develop obesity. In line with the increased weight gain to compensate for early-age weight retardation, HFD-fed DUSP6 KO displayed increased expression levels of anabolic genes involved in lipid and cholesterol metabolism in the epididymal white adipose tissue (eWAT), compared to WT controls. Glucose tolerance was perturbed in both chow-fed lean or HFD-fed obese DUSP6 KO, compared to their respective WT controls. Overall, our data indicate that DUSP6 deficiency has limited impact on the regulation of energy metabolism, but impairs systemic glucose tolerance. Our data are in conflict to earlier reports that propose protection from diet-induced obesity and glucose intolerance in DUSP6 deficient mice. Reasons for the discrepancies remain elusive, but may entail differential genetic backgrounds, environmental factors such as the type and source of HFD, or alterations in the gut microbiome between facilities. PMID:28873424

  13. Dietary Variety and Decline in Lean Mass and Physical Performance in Community-Dwelling Older Japanese: A 4-year Follow-Up Study.

    PubMed

    Yokoyama, Y; Nishi, M; Murayama, H; Amano, H; Taniguchi, Y; Nofuji, Y; Narita, M; Matsuo, E; Seino, S; Kawano, Y; Shinkai, S

    2017-01-01

    To examine associations of dietary variety with changes in lean mass and physical performance during a 4-year period in an elderly Japanese population. Four-year prospective study. The Hatoyama Cohort Study and Kusatsu Longitudinal Study, Japan. 935 community-dwelling Japanese aged 65 years or older. Dietary variety was assessed using a 10-item food frequency questionnaire. Body composition was determined by multifrequency bioelectrical impedance analysis, and physical performance (grip strength and usual gait speed) was measured in surveys at baseline and 4 years later. Longitudinal analysis included only participants who were originally in the upper three quartiles of lean body mass, appendicular lean mass, grip strength, and usual gait speed. The outcome measures were decline in lean body mass, appendicular lean mass, grip strength, and usual gait speed, defined as a decrease to the lowest baseline quartile level at the 4-year follow-up survey. Associations of dietary variety with the outcome measures were examined by logistic regression analysis adjusted for potential confounders. In the fully adjusted model, the odds ratios for decline in grip strength and usual gait speed were 0.43 (95% confidence interval, 0.19-0.99) and 0.43 (confidence interval, 0.19-0.99), respectively, for participants in the highest category of dietary variety score as compared with those in the lowest category. Dietary variety was not significantly associated with changes in lean body mass or appendicular lean mass. Among older adults, greater dietary variety may help maintain physical performance, such as grip strength and usual gait speed, but not lean mass.

  14. 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.

  15. The impact of lean production on musculoskeletal and psychosocial risks: an examination of sociotechnical trends over 20 years.

    PubMed

    Koukoulaki, Theoni

    2014-03-01

    This paper provides an extensive review of studies carried out in lean production environments in the last 20 years. It aims to identify the effects of lean production (negative or positive) on occupational health and related risk factors. Thirty-six studies of lean effects were accepted from the literature search and sorted by sector and type of outcome. Lean production was found to have a negative effect on health and risk factors; the most negative outcomes being found in the earliest studies in the automotive industry. However, examples of mixed and positive effects were also found in the literature. The strongest correlations of lean production with stress were found for characteristics found in Just-In-Time production that related to reduced cycle time and reduction of resources. Increased musculoskeletal risk symptoms were related to increases of work pace and lack of recovery time also found in Just-In-Time systems. An interaction model is developed to propose a pathway from lean production characteristics to musculoskeletal and psychosocial risk factors and also positive outcomes. An examination is also made of the changing focus of studies investigating the consequences of lean production over a 20-year period. Theories about the effects of lean production have evolved from a conceptualization that it is an inherently harmful management system, to a view that it can have mixed effects depending on the management style of the organization and the specific way it is implemented. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  16. 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.

  17. Lean healthcare in developing countries: evidence from Brazilian hospitals.

    PubMed

    Costa, Luana Bonome Message; Filho, Moacir Godinho; Rentes, Antonio Freitas; Bertani, Thiago Moreno; Mardegan, Ronaldo

    2017-01-01

    The present study evaluates how five sectors of two Brazilian hospitals have implemented lean healthcare concepts in their operations. The main characteristics of the implementation process are analyzed in the present study: the motivational factor for implementation, implementation time, form (consultancy or internal), team (hospital and consultants), lean implementation continuity/sustainability, lean healthcare tools and methods implemented, problems/improvement opportunities, lean healthcare barriers faced during the implementation process, and critical factors that affected the implementation and the results obtained in each case. The case studies indicate that reducing patient lead times and costs and making financial improvements were the primary factors that motivated lean healthcare implementation in the hospitals studied. Several tools and methods were used in the cases studied, especially value stream mapping and DMAIC. The barriers found in both hospitals are primarily associated with the human factor. Additionally, the results obtained after implementation were analyzed and improvements in financial aspects, productivity and capacity, and lead time reduction of the analyzed sectors were observed. Further, this study also exhibited four propositions elaborated from the results obtained from the cases that highlighted barriers and challenges to lean healthcare implementation in developing countries. Two of these barriers are hospital organizational structure (and, consequently, how the senior management works with medical staff), and outsourcing hospital activities. This study also concluded that the initialization and maintenance of lean healthcare implementation rely heavily on external support because lean healthcare subject knowledge is not yet available in the healthcare organization, which represents a challenge. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  18. 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

  19. Role of insulin in the hyperandrogenemia of lean women with polycystic ovary syndrome and normal insulin sensitivity.

    PubMed

    Baillargeon, Jean-Patrice; Carpentier, André

    2007-10-01

    To determine the effect of reducing insulin secretion on hyperandrogenemia in lean normoinsulinemic women with polycystic ovary syndrome (PCOS) and normal metabolic insulin sensitivity. Transversal assessment at baseline and prospective follow-up of lean PCOS group after 8 days of diazoxide, which reduces insulin secretion, and 1 month of leuprolide, which suppresses LH. Clinical research center of an academic hospital. Nine lean women (body mass index

  20. 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

  1. 75 FR 29727 - Federal Advisory Committee; Military Leadership Diversity Commission (MLDC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-27

    ... Steven A. Hady, Designated Federal Officer, MLDC, at (703) 602-0838, 1851 South Bell Street, Suite 532... seating is limited. DATES: The meeting will be held on June 16, 2010 (from 8 a.m. to 5:30 p.m.) and on June 17, 2010 (from 8 a.m. to 6:15 p.m.). ADDRESSES: The meeting will be held at the Hilton McLean...

  2. Lean Mixture Engines Testing and Evaluation Program : Volume 3. Appendices.

    DOT National Transportation Integrated Search

    1975-01-01

    This report is aimed at defining analytically and demonstrating experimentally the potential of the 'lean-burn concept.' Fuel consumption and emissions data are obtained on the engine dynamometer for the baseline engine, and two lean-burn configurati...

  3. Kit para aplicar la metodología de Lean en el gobierno

    EPA Pesticide Factsheets

    Este Kit para comenzar a aplicar la metodología Lean (Gobierno optimizado) ofrece información para ayudar a las agencias de protección ambiental a planificar e implementar iniciativas Lean exitosas.

  4. Direct Determination of Lean Body Mass by CT in F-18 FDG PET/CT Studies: Comparison with Estimates Using Predictive Equations.

    PubMed

    Kim, Chang Guhn; Kim, Woo Hyoung; Kim, Myoung Hyoun; Kim, Dae-Weung

    2013-06-01

    The purpose of this study was to estimate lean body mass (LBM) using CT (LBM CTs) and compare the results with LBM estimates of four different predictive equations (LBM PEs) to assess whether LBM CTs and LBM PEs can be used interchangeably for SUV normalization. Whole-body F-18 FDG PET/CT studies were conducted on 392 patients. LBM CT1 is modified adipose tissue-free body mass, and LBM CT2 is adipose tissue-free body mass. Four different PEs were used for comparison (LBM PE1-4). Agreement between the two measurement methods was assessed by Bland-Altman analysis. We calculated the difference between two methods (bias), the percentage of difference, and the limits of agreement, expressed as a percentage. For LBM CTs vs. LBM PEs, except LBM PE3, the ranges of biases and limits of agreement were -3.77 to 3.81 kg and 26.60-35.05 %, respectively, indicating the wide limits of agreement and differing magnitudes of bias. For LBM CTs vs. LBM PE3, LBM PE3 had wider limits of agreement and greater positive bias (44.28-46.19 % and 10.49 to 14.04 kg, respectively), showing unacceptably large discrepancies between LBM CTs and LBM PE3. This study demonstrated that there are substantial discrepancies between individual LBM CTs and LBM PEs, and this should be taken into account when LBM CTs and LBM PEs are used interchangeably between patients.

  5. 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.

  6. ED becomes 'lean' and cuts LBTC, LOS times.

    PubMed

    2008-04-01

    Lean manufacturing techniques, first developed by Toyota, can be successfully adapted to help improve processes in your ED. St. Luke's Episcopal Hospital in Houston, has used Lean to reduce median length of stay, frequency of diversions, and the percentage of patients who left before treatment was complete (LBTC). Here's why "Lean" can help improve the performance of your ED: It enables you and your staff to see things from the patient's point of view. Lean tools enable you to view the status of your department in real-time and to compare that status with your performance goals. Exercises help identify areas where your processes break down and determine the most likely solutions.

  7. [Four awareness of clinical lean management].

    PubMed

    Xiong, L Z; Zhang, C F

    2017-01-20

    Along with changes of medical model, hospitals need to provide best outcome with lowest cost and best patient's experience rather than merely medical treatments. It is the cultivation of lean awareness to the doctors that could acquire such outcome. The healthcare lean awareness can be summarized as responsibility awareness, digitalized awareness, detail awareness, and outstanding awareness. Through the cultivation of lean awareness, humanism can immerse into the doctors'practice, which is conducive to train for the great masters of the medicine.

  8. 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.

  9. Medical and scientific writing: Time to go lean and mean.

    PubMed

    Bhardwaj, Payal; Sinha, Sudip; Yadav, Raj Kumar

    2017-01-01

    The Lean Six Sigma methodology for process improvements and driving efficiency is old, but lean writing was adopted late by the pharmaceutical world in terms of size of the documents. The documents were lean earlier, and then became voluminous, and now we are about to complete a full circle in this regard, i.e., coming back to the lean documents again using e-formats and hyperlinking. Furthermore, writing has become more and more precise over time. The need for this lean and mean medical and scientific writing arose from voluminous research globally, both industry and academia which are abuzz with skyrocketing regulatory and scientific submission volumes. The quantum of literature is so much that reviewers or information seekers firmly believe that going through even selected and relevant literature has become highly challenging. Considering this, there has been much insistence on downsizing the medical writing documents, which could be tempting enough to be leveraged for scientific publications as well. Here, we present the need for lean and mean medical writing, discuss this concept in relation to the pharmaceutical industry, and how to apply this to key documents. Furthermore, presented is the proposed algorithm for lean and mean clinical study reports and manuscripts. These thoughts are aligned to the recently established concept of data transparency, and can be easily achieved by web links between the protocols and clinical trial results disclosed publicly, and the corresponding manuscripts.

  10. 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.

  11. Medical and scientific writing: Time to go lean and mean

    PubMed Central

    Bhardwaj, Payal; Sinha, Sudip; Yadav, Raj Kumar

    2017-01-01

    The Lean Six Sigma methodology for process improvements and driving efficiency is old, but lean writing was adopted late by the pharmaceutical world in terms of size of the documents. The documents were lean earlier, and then became voluminous, and now we are about to complete a full circle in this regard, i.e., coming back to the lean documents again using e-formats and hyperlinking. Furthermore, writing has become more and more precise over time. The need for this lean and mean medical and scientific writing arose from voluminous research globally, both industry and academia which are abuzz with skyrocketing regulatory and scientific submission volumes. The quantum of literature is so much that reviewers or information seekers firmly believe that going through even selected and relevant literature has become highly challenging. Considering this, there has been much insistence on downsizing the medical writing documents, which could be tempting enough to be leveraged for scientific publications as well. Here, we present the need for lean and mean medical writing, discuss this concept in relation to the pharmaceutical industry, and how to apply this to key documents. Furthermore, presented is the proposed algorithm for lean and mean clinical study reports and manuscripts. These thoughts are aligned to the recently established concept of data transparency, and can be easily achieved by web links between the protocols and clinical trial results disclosed publicly, and the corresponding manuscripts. PMID:28828305

  12. Comparison of effects of Wasabia japonica and allyl isothiocyanate on the growth of four strains of Vibrio parahaemolyticus in lean and fatty tuna meat suspensions.

    PubMed

    Hasegawa, N; Matsumoto, Y; Hoshino, A; Iwashita, K

    1999-08-01

    Lean tuna meat suspensions (LEAN), with a fat content of 0.006%, and fatty tuna meat suspension (FATTY), with a fat content of 3.0% were inoculated with four strains of Vibrio parahaemolyticus and wasabi (Wasabia japonica Matsumura) or allyl isothiocyanate (AIT) was added before incubation at 37 degrees C. During the incubation, viable Vibrio counts were determined on TCBS agar plates. Both LEAN and FATTY suspensions were inoculated with V. parahaemolyticus AOTO-81, (1.28+/-0.20) x 10(2) CFU/ml, followed by addition of 20 mg wasabi/ml, and incubation for 8 h. The viable Vibrio counts were (7.76+/-5.93) x 10(5) CFU/ml in LEAN and (3.50+/-2.65) x 10(1) CFU/ml in FATTY. When the same strain, at (1.18+/-0.22) x 10(2) CFU/ml, was incubated for 8 h with 50.9 microg AIT/ml, viable Vibrio counts were (4.79+/-1.78) x 10(4) CFU/ml in LEAN and (1.80+/-1.30) x 10(1) CFU/ml in FATTY. Growth of the other three strains with wasabi or AIT was shown to be less in FATTY than in LEAN. These results indicate that growth of V. parahaemolyticus is inhibited more in FATTY than in LEAN by wasabi and allyl isothiocyanate.

  13. Blunted Suppression of Acyl-Ghrelin in Response to Fructose Ingestion in Obese Adolescents: the Role of Insulin Resistance

    PubMed Central

    Van Name, Michelle; Giannini, Cosimo; Santoro, Nicola; Jastreboff, Ania; Kubat, Jessica; Li, Fangyong; Kursawe, Romy; Savoye, Mary; Duran, Elvira; Dziura, James; Sinha, Rajita; Sherwin, Robert; Cline, Gary; Caprio, Sonia

    2015-01-01

    Objective Fructose consumption has risen alongside obesity and diabetes. Gut hormones involved in hunger and satiety (ghrelin and PYY) may respond differently to fructose compared to glucose ingestion. We evaluated the effects of glucose and fructose ingestion on ghrelin and PYY in lean and obese adolescents with differing insulin sensitivity. Methods Adolescents were divided into lean (n=14), obese insulin sensitive (n=12) (OIS), and obese insulin resistant (n=15) (OIR). In a double-blind, cross-over design, subjects drank 75g of glucose or fructose in random order, serum was obtained every 10 minutes for 60 minutes. Results Baseline acyl-ghrelin was highest in lean and lowest in OIR (p=0.02). After glucose ingestion acyl-ghrelin decreased similarly in lean and OIS, but appeared lower in OIR (vs lean p=0.03). Suppression differences were more pronounced after fructose (lean vs. OIS p=0.008, lean vs. OIR p<0.001). OIS became significantly hungrier after fructose (p=0.015). PYY was not significantly different at baseline, varied minimally after glucose, and rose after fructose. Conclusion Compared to lean, OIS adolescents have impaired acyl-ghrelin responses to fructose but not glucose, whereas OIR adolescents have blunted responses to both. Diminished suppression of acyl-ghrelin in childhood obesity, particularly if accompanied by insulin resistance, may promote hunger and overeating. PMID:25645909

  14. Calculation of Glucose Dose for Intraperitoneal Glucose Tolerance Tests in Lean and Obese Mice.

    PubMed

    Jørgensen, Mikkel S; Tornqvist, Kristina S; Hvid, Henning

    2017-01-01

    Glucose tolerance tests are used frequently in nonclinical research with laboratory animals, for example during characterization of obese phenotypes. Despite published standard operating procedures for glucose tolerance tests in rodents, how glucose doses should be calculated when obese and lean animals are compared is not well documented. Typically the glucose dose is calculated as 2 g/kg body weight, regardless of body composition. With this approach, obese mice receive larger glucose doses than do lean animals, potentially leading to overestimation of glucose intolerance in obese animals. In this study, we performed intraperitoneal glucose tolerance tests in mice with diet-induced obesity and their lean controls, with glucose doses based on either the total body weight or the lean body mass of the animals. To determine glucose tolerance, we determined the blood glucose AUC during the glucose tolerance test. We found that the blood glucose AUC was increased significantly in obese mice compared with lean mice by 75% on average when glucose was dosed according to the lean body mass and by 87% when the glucose dose was calculated according to total body weight. Therefore, mice with diet-induced obesity were approximately equally glucose intolerant between the 2 dose-calculation protocols. However, we recommend calculating the glucose dose according to the lean body mass of the mice, because doing so eliminates the concern regarding overdosing of obese animals.

  15. Contribution of genetic influences to animal-to-animal variation in myoglobin content and beef lean color stability.

    PubMed

    King, D A; Shackelford, S D; Kuehn, L A; Kemp, C M; Rodriguez, A B; Thallman, R M; Wheeler, T L

    2010-03-01

    Longissimus thoracis steaks from steers (n = 464) with 0 to 50% inheritance of Angus, Charolais, Gelbvieh, Hereford, Limousin, Red Angus, and Simmental were evaluated during 6 d of display to assess genetic contributions to color stability. Color space values [CIE L* (lightness), a* (redness), b* (yellowness)], chroma, color change (DeltaE), and surface metmyoglobin (K/S 572/525) were determined on d 0 and 6 of display. Myoglobin concentration was highly heritable (0.85), but ultimate pH was weakly heritable (0.06). Day 0 L* values were moderately heritable (0.24). Variation in metmyoglobin, L*, and DeltaE on d 6 was moderately explained by genetic factors (41, 40, and 29%, respectively). Change during display was moderately heritable for a* (0.31), b* (0.23), chroma (0.35), and surface metmyoglobin (0.29). At the start of display, Angus steaks had greater (P < 0.05) L* values than those from all breeds except Charolais. On d 6, Angus steaks had greater (P < 0.05) L* (50.0) values than Gelbvieh, Hereford, and Simmental steaks (46.1, 44.0, and 44.5, respectively). Day 0 values for a*, b*, chroma, and DeltaE were not affected by breed (P > 0.05). On d 6, a* values were greater (P < 0.05) for Charolais and Limousin steaks (31.1 and 30.5) than Angus, Hereford, and Red Angus steaks (27.4, 27.7, and 26.3, respectively). Thus, a* changed less (P < 0.05) in Charolais and Limousin steaks (1.8 and 2.6, respectively) vs. steaks from other breeds. Day 6 b* values were greater (P < 0.05) in Charolais (24.5) and Limousin steaks (24.0) vs. Gelbvieh (22.2), Hereford (21.9), and Red Angus steaks (21.4). Thus, b* values changed less (P < 0.05) in Charolais and Limousin steaks (1.5 and 1.7, respectively) than in Angus, Gelbvieh, Hereford, and Red Angus steaks (4.3, 3.8, 4.4, and 5.1, respectively). After 6 d of display, Charolais and Limousin steaks had greater chroma (P < 0.05; 39.5 and 38.8, respectively) compared with Angus, Hereford, and Red Angus steaks (35.4, 35.3, and 33.9, respectively). Less (P < 0.05) change in chroma occurred for Charolais and Limousin (2.1 and 2.8, respectively) than in Angus, Gelbvieh, Hereford, and Red Angus steaks (7.1, 6.6, 7.4, and 9.0, respectively). Myoglobin concentration was less for Charolais and Limousin (P < 0.05; 2.77 and 2.72, respectively) compared with Gelbvieh, Red Angus, and Simmental steaks (3.62, 3.43, and 3.71, respectively). Breeds did not differ in pH (P > 0.05). These data suggest Charolais- and Limousin-carcasses produced steaks with greater lean color stability than Angus, Hereford, and Red Angus carcasses. Furthermore, these findings suggest that genetics contribute substantially to animal-to-animal variation in lean color, particularly in maintaining color.

  16. 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.

  17. Changes in Body Composition According to Age and Sex among Young Non-Diabetic Korean Adults: The Kangbuk Samsung Health Study.

    PubMed

    Kim, Seul Ki; Kwon, Yu Hyun; Cho, Jung Hwan; Lee, Da Young; Park, Se Eun; Oh, Hyung Geun; Park, Cheol Young; Lee, Won Young; Oh, Ki Won; Park, Sung Woo; Rhee, Eun Jung

    2017-12-01

    Age-related decreases in lean mass represent a serious health problem. We aimed to analyze the risks of rapid decreases in lean mass by age and sex in relatively young Korean adults during a 4-year follow-up study. A total of 65,856 non-diabetic participants (59.5% men, mean age 39.1 years) in a health screening program were subjected to bioimpedance body composition analyses and metabolic parameter analyses at baseline and after 4 years. The participants were sub-divided according to age, and additionally to six groups by age and the degree of body weight change over the 4-year period. The actual changes in body weight, lean mass, and fat mass and the percent changes over the 4-year period were assessed. The percent change in lean mass decreased and the percent change of fat mass increased with increasing age in every age and sex group. However, the annual percent decrease in lean mass and percent increase in fat mass were significantly higher among women than among men (-0.26% vs. -0.15% and 0.34% vs. 0.42%, respectively; P<0.01). Participants who were older than 50 years and had a weight loss <-5% during the 4 years had significantly greater decreases in lean mass and smaller decreases in fat mass, compared to those who were younger than 50 years. An odds ratio analysis to determine the lowest quartile of the percent change in lean mass according to age group revealed that participants older than 60 years had a significantly increased risk of a rapid decrease in the lean mass percentage (2.081; 95% confidence interval, 1.678 to 2.581). Even in this relatively young study population, the lean mass decreased significantly with age, and the risk of a rapid decrease in lean mass was higher among women than among men. Furthermore, the elderly exhibited a significantly more rapid decrease in lean mass, compared with younger participants. Copyright © 2017 Korean Endocrine Society

  18. Lean Mixture Engines Testing and Evaluation Program : Volume 2. Comprehensive Discussion.

    DOT National Transportation Integrated Search

    1975-11-01

    This report is aimed at defining analytically and demonstrating experimentally the potential of the 'lean-burn concept.' Fuel consumption and emissions data are obtained on the engine dynamometer for the baseline engine, and two lean-burn configurati...

  19. Lean Mixture Engines Testing and Evaluation Program : Volume 1. Executive Summary.

    DOT National Transportation Integrated Search

    1975-01-01

    This report is aimed at defining analytically and demonstrating experimentally the potential of the 'lean-burn concept'. Fuel consumption and emissions data are obtained on the engine dynamometer for the baseline engine, and two lean-burn configurati...

  20. Environmental Professional’s Guide to Lean and Six Sigma: Executive Summary

    EPA Pesticide Factsheets

    Introduction to the guide that describes how Lean and Six Sigma relate to the environment and provides guidance on how environmental professionals can connect with Lean and Six Sigma activities to generate better environmental and operational results.

  1. Plasma boron and the effects of boron supplementation in males.

    PubMed Central

    Green, N R; Ferrando, A A

    1994-01-01

    Recently, a proliferation of athletic supplements has been marketed touting boron as an ergogenic aid capable of increasing testosterone. The effect of boron supplementation was investigated in male bodybuilders. Ten male bodybuilders (aged 20 to 26) were given a 2.5-mg boron supplement, while nine male bodybuilders (aged 21 to 27) were given a placebo for 7 weeks. Plasma total and free testosterone, plasma boron, lean body mass, and strength measurements were determined on day 1 and day 49 of the study. A microwave digestion procedure followed by inductively coupled argon plasma spectroscopy was used for boron determination. Twelve subjects had boron values at or above the detection limit with median value of 25 ng/ml (16 ng/ml lower quartile and 33 ng/ml upper quartile). Of the ten subjects receiving boron supplements, six had an increase in their plasma boron. Analysis of variance indicated no significant effect of boron supplementation on any of the other dependent variables. Both groups demonstrated significant increases in total testosterone (p < 0.01), lean body mass (p < 0.01), and one repetition maximum (RM) squat (p < 0.001) and one RM bench press (p < 0.01). The findings suggest that 7 weeks of bodybuilding can increase total testosterone, lean body mass, and strength in lesser-trained bodybuilders, but boron supplementation affects these variables not at all. PMID:7889885

  2. Developmental Programming Mediated by Complementary Roles of Imprinted Grb10 in Mother and Pup

    PubMed Central

    Cowley, Michael; Garfield, Alastair S.; Madon-Simon, Marta; Charalambous, Marika; Clarkson, Richard W.; Smalley, Matthew J.; Kendrick, Howard; Isles, Anthony R.; Parry, Aled J.; Carney, Sara; Oakey, Rebecca J.; Heisler, Lora K.; Moorwood, Kim; Wolf, Jason B.; Ward, Andrew

    2014-01-01

    Developmental programming links growth in early life with health status in adulthood. Although environmental factors such as maternal diet can influence the growth and adult health status of offspring, the genetic influences on this process are poorly understood. Using the mouse as a model, we identify the imprinted gene Grb10 as a mediator of nutrient supply and demand in the postnatal period. The combined actions of Grb10 expressed in the mother, controlling supply, and Grb10 expressed in the offspring, controlling demand, jointly regulate offspring growth. Furthermore, Grb10 determines the proportions of lean and fat tissue during development, thereby influencing energy homeostasis in the adult. Most strikingly, we show that the development of normal lean/fat proportions depends on the combined effects of Grb10 expressed in the mother, which has the greater effect on offspring adiposity, and Grb10 expressed in the offspring, which influences lean mass. These distinct functions of Grb10 in mother and pup act complementarily, which is consistent with a coadaptation model of imprinting evolution, a model predicted but for which there is limited experimental evidence. In addition, our findings identify Grb10 as a key genetic component of developmental programming, and highlight the need for a better understanding of mother-offspring interactions at the genetic level in predicting adult disease risk. PMID:24586114

  3. Ambulatory Blood Pressure Monitoring in Lean, Obese and Diabetic Children and Adolescents

    PubMed Central

    Shikha, Deep; Singla, Montish; Walia, Rachna; Potter, Natia; Umpaichitra, Vatcharapan; Mercado, Arlene; Winer, Nathaniel

    2015-01-01

    Aim To determine if children and adolescents who have obesity (Ob) or type 2 diabetes (T2DM) of relatively short duration have impaired cardiovascular function compared with lean subjects using 24-hour ambulatory blood pressure as a surrogate measure of evaluation. Methods We enrolled 100 African-Caribbean subjects (45 males/55 females), mean ages 14.4-15.2 years (range 11.8-18.5 years) and Tanner stage 4.2-4.8. Mean BMI for the Ob (n = 40), T2DM (n = 39) and lean (n = 21) groups were 40.3, 34.2 and 20.8, respectively (p < 0.01, Ob and T2DM vs. lean). Mean hemoglobin A1c in lean and Ob was 5.4 and 5.5% compared to 8.8% in T2DM (p < 0.001, T2DM vs. lean and Ob). Ambulatory blood pressure was recorded every 20 min over 24 h using Spacelabs 70207. Results Mean 24-hour, daytime and nighttime systolic blood pressure was significantly higher in Ob and T2DM compared with lean subjects (mean 24-hour 117 and 120 vs. 109 mm Hg; daytime 121 and 123 vs. 113 mm Hg; and nighttime 109 and 115 vs. 101 mm Hg; p < 0.01 for all time periods). The nocturnal systolic dip in Ob and T2DM did not differ from that of lean, whereas nocturnal diastolic dip decreased significantly in Ob and T2DM compared to lean (11.5 and 10.4 vs. 20.6 mm Hg; p < 0.01). Mean pulse pressure was significantly increased in the Ob and T2DM groups compared to lean subjects (51 and 54 vs. 45 mm Hg; p < 0.01). Conclusion Adolescent Ob and T2DM groups share adverse risk factors, which may be harbingers of adult cardiovascular events. PMID:26195970

  4. Acceptance of lean redesigns in primary care: A contextual analysis.

    PubMed

    Hung, Dorothy; Gray, Caroline; Martinez, Meghan; Schmittdiel, Julie; Harrison, Michael I

    Lean is a leading change strategy used in health care to achieve short-term efficiency and quality improvement while promising longer-term system transformation. Most research examines Lean intervention to address isolated problems, rather than to achieve broader systemic changes to care delivery. Moreover, no studies examine contextual influences on system-wide Lean implementation efforts in primary care. The aim of this study was to identify contextual factors most critical to implementing and scaling Lean redesigns across all primary care clinics in a large, ambulatory care delivery system. Over 100 interviews and focus groups were conducted with frontline physicians, clinical staff, and operational leaders. Data analysis was guided by a modified Consolidated Framework for Implementation Research (CFIR), a popular implementation science framework. On the basis of expert recommendations, the modified framework targets factors influencing the implementation of process redesigns. This modified framework, the CFIR-PR, informed our identification of contextual factors that most impacted Lean acceptance among frontline physicians and staff. Several domains identified by the CFIR-PR were critical to acceptance of Lean redesigns. Regarding the implementation process acceptance was influenced by time and intensity of exposure to changes, "top-down" versus "bottom-up" implementation styles, and degrees of employee engagement in developing new workflows. Important factors in the inner setting were the clinic's culture and style of leadership, along with availability of information about Lean's effectiveness. Last, implementation efforts were impacted by individual and team characteristics regarding changed work roles and related issues of professional identity, authority, and autonomy. This study underscores the need for change leaders to consider the contextual factors that surround efforts to implement Lean in primary care. As Lean redesigns are scaled across a system, special attention is warranted with respect to the implementation approach, internal clinic setting, and implications for professional roles and identities of physicians and staff.

  5. Systematic review with meta-analysis: the significance of histological disease severity in lean patients with nonalcoholic fatty liver disease.

    PubMed

    Sookoian, S; Pirola, C J

    2018-01-01

    Current evidence suggests that lean and obese patients with nonalcoholic fatty liver disease (NAFLD) share an altered metabolic and cardiovascular profile. However, there is an incomplete understanding of the natural history of "lean-NAFLD." Indeed, an unanswered question is whether lean (BMI ≤ 25 Kg/m 2 ) NAFLD-patients are protected from severe histological outcomes. To perform a meta-analysis with the goal of providing a quantitative estimation of the magnitude of fibrosis, as well as histological features associated with the disease severity, in lean versus overweight/obese-NAFLD patients. Through a systematic search up to July 2017, we identified eight studies that compared histological outcomes in lean (n = 493) versus overweight/obese (n = 2209) patients. Relative to lean-NAFLD, overweight/obese-NAFLD patients showed significantly (P = .032) higher fibrosis scores; the observed difference in means between the two groups, which is the absolute difference between the mean value of fibrosis score [0-4] ± standard error, was 0.28 ± 0.13. The risk of having nonalcoholic steatohepatitis-NASH (OR 0.58 95% CI 0.34-0.97) was significantly lower in lean-NAFLD (n = 322) than in overweight/obese-NAFLD (n = 1357), P = .04. Relative to lean-NAFLD, overweight/obese-NAFLD patients also have significantly greater NAFLD activity (difference in means ± SE: 0.58 ± 0.16, P = .0004) and steatosis (difference in means ± SE: 0.23 ± 0.07, P = .002) scores. Lean-NAFLD patients tend to show less severe histological features as compared to overweight/obese-NAFLD patients. Subsequent longitudinal assessment is needed to understand the clinical impact of these findings; however, the significant ~ 25% increment of mean fibrosis score in overweight/obese patients suggests that obesity could predict a worse long-term prognosis. © 2017 John Wiley & Sons Ltd.

  6. Insulin-induced capillary recruitment is impaired in both lean and obese women with PCOS.

    PubMed

    Ketel, I J G; Serné, E H; Ijzerman, R G; Korsen, T J M; Twisk, J W; Hompes, P G A; Smulders, Y M; Homburg, R; Vorstermans, L; Stehouwer, C D A; Lambalk, C B

    2011-11-01

    Insulin resistance, i.e. impaired insulin-mediated glucose uptake (IMGU), is a major risk factor for type 2 diabetes in women with polycystic ovary syndrome (PCOS). Insulin-induced capillary recruitment (IICR) is considered a significant determinant of IMGU. We investigated whether IICR is a determinant IMGU in obese and lean women with and without PCOS. The study included 36 women with PCOS (20 lean, BMI 21.9 ± 2.3 kg/m(2) and 16 obese, BMI 35.9 ± 6.0 kg/m(2)) and 27 age-matched healthy controls (14 lean, BMI 22.2 ± 1.8 kg/m(2) and 13 obese, BMI 40.5 ± 7.0 kg/m(2)). IICR was evaluated by capillary microscopy during an isoglycemic-hyperinsulinemic clamp. IMGU was expressed as M/I value. The M/I value was significantly lower in obese PCOS women compared with obese controls [0.5 (0.2-1.1) versus 0.8 (0.3-1.4) (mg kg(-1) min(-1) pmol l(-1)) × 100, P < 0.01], whereas the small difference between lean PCOS and lean control women was non-significant [1.5 (0.5-2.6) versus 1.7 (1.0-3.7) (mg kg(-1) min(-1) pmol l(-1)) × 100, P = 0.17]. Hyperinsulinemia increased capillary recruitment in lean controls (53.5 ± 20.3 versus 64.9 ± 27.4 n/mm(2), P < 0.05), but not in either PCOS group nor in obese controls. IICR and androgens were a determinant of M/I value only in lean women with or without PCOS. PCOS per se is associated with impaired IICR. Obese women with PCOS, in part independent of obesity, demonstrated a profound insulin resistance, whereas the difference between lean PCOS women and healthy controls was small and statistically non-significant. IICR was a determinant of IMGU in lean, but not in obese, women regardless of the presence of PCOS.

  7. 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.

  8. β cell function and insulin resistance in lean cases with polycystic ovary syndrome.

    PubMed

    Pande, Arunkumar R; Guleria, Ashwani Kumar; Singh, Sudhanshu Dev; Shukla, Manoj; Dabadghao, Preeti

    2017-11-01

    Obesity is a major factor in development of insulin resistance (IR) and metabolic features in polycystic ovary syndrome (PCOS) patients. Nearly two-thirds patients with PCOS (30 of 37 confirmed cases of PCOS) in our previous community based study were lean, in contrast to Caucasians. Metabolic parameters including IR and β cell function have not been characterized well in this group of lean PCOS. To study the metabolic features including IR and β cell function in lean PCOS patients, 53 patients with BMI, <23 kg/m 2 were compared with 71 obese PCOS and 45 age and body mass index matched controls. Lean patients had similar β cell function and IR as compared to controls and obese patients, though the latter group had more metabolic abnormality. Fasting c-peptide and its ratio to glucose were significantly higher in lean patients compared to controls. In subset of subjects with five point OGTT, disposition index and Matsuda index (MI) showed significant negative correlation with BMI and blood pressure. MI also negatively correlated with waist, WHR, and HOMAB. High fasting C-peptide is probably a class effect as is seen in both lean and obese PCOS.

  9. 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.

  10. Mechanisms of lower maintenance dose of tacrolimus in obese patients.

    PubMed

    Sawamoto, Kazuki; Huong, Tran T; Sugimoto, Natsumi; Mizutani, Yuka; Sai, Yoshimichi; Miyamoto, Ken-ichi

    2014-01-01

    A retrospective analysis suggested that blood tacrolimus concentrations were consistent among patients with a body mass index (BMI) that was lean (<18.5), normal (≥ 18.5 and <25) or overweight/obese (≥ 25). The average maintenance dose of tacrolimus in patients with BMI ≥ 25 was significantly lower compared with that in patients with a BMI of less than 25. Lean and obese Zucker rats fed a normal diet were given tacrolimus intravenously or orally. The blood concentrations of tacrolimus in obese rats were significantly higher than those in lean rats after administration via both routes. The moment analysis has suggested that CLtot and Vdss of tacrolimus were not significantly different between lean and obese rats. The bioavailability was higher in obese rats, compared with that in lean rats. The protein expression of Cyp3a2 in the liver was significantly decreased in obese rats, compared with lean rats, while P-gp in the small intestine was also significantly decreased in obese rats. These results suggested that the steady-state trough concentration of tacrolimus in obese patients was well maintained by a relatively low dose compared with that in normal and lean patients, presumably due to increased bioavailability.

  11. Do children perceive postural constraints when estimating reach or action planning?

    PubMed

    Gabbard, Carl; Cordova, Alberto; Lee, Sunghan

    2009-03-01

    Estimation of whether an object is reachable from a specific body position constitutes an important aspect in effective motor planning. Researchers who estimate reachability by way of motor imagery with adults consistently report the tendency to overestimate, with some evidence of a postural effect (postural stability hypothesis). This idea suggests that perceived reaching limits depend on an individual's perceived postural constraints. Based on previous work with adults, the authors expected a significant postural effect with the Reach 2 condition, as evidenced by reduced overestimation. Furthermore, the authors hypothesized that the postural effect would be greater in younger children. They then tested these propositions among children aged 7, 9, and 11 years by asking them to estimate reach while seated (Reach 1) and in the more demanding posture of standing on 1 foot and leaning forward (Reach 2). Results indicated no age or condition difference, therefore providing no support for a postural effect. When the authors compared these data to a published report of adults, a developmental difference emerged. That is, adults recognize the perceived postural constraint of the standing position resulting in under- rather than overestimation, as displayed in the seated condition. Although preliminary, these observations suggest that estimates of reach (action planning) continue to be refined between late childhood and young adulthood.

  12. Lean methodology: supporting battlefield medical fitness by cutting process waste.

    PubMed

    Huggins, Elaine J

    2010-01-01

    Healthcare has long looked at decreasing risk in communication and patient care processes. Increasing the simplicity in communication and patient care process is a newer concept contained in Lean methodology. Lean is a strategy for achieving improvement in performance through the elimination of steps that use resources without contributing to customer value. This is known as cutting waste or nonvalue added steps. This article outlines how the use of Lean improved a key process that supports battlefield medical fitness.

  13. The Effect of Special Operations Training on Testosterone, Lean Body Mass, and Strength and the Potential for Therapeutic Testosterone Replacement: A Review of the Literature

    DTIC Science & Technology

    2016-07-01

    Effects of Testosterone or Anabolic Androgenic Steroid on Body Mass, Lean Body Mass, and Strength in Patients with Disease or Muscle Wasting...of Ranger training reportedly decreased body mass, fat mass, and lean body mass (LBM), with reductions in field measures of strength and power of...Table 3. Effects of Testosterone or Anabolic Androgenic Steroid with Resistance Training on Lean Body Mass and Strength Source Subjects Treatment

  14. Use of leaning vanes in a two stage fan

    NASA Technical Reports Server (NTRS)

    Rao, G. V. R.; Digumarthi, R. V.

    1975-01-01

    The use of leaning vanes for tone noise reduction was examined in terms of their application in a typical two-stage high pressure ratio fan. In particular for stages designed with outlet guide vanes and zero swirl between stages, leaning the vanes of the first stage stator was studied, since increasing the number of vanes and the gap between stages do not provide the desired advantage. It was shown that noise reduction at higher harmonics of blade passing frequency can be obtained by leaning the vanes.

  15. Experimental and Computational Study of Trapped Vortex Combustor Sector Rig With Tri-Pass Diffuser

    NASA Technical Reports Server (NTRS)

    Hendricks, R. C.; Shouse, D. T.; Roquernore, W. M.; Burrus, D. L.; Duncan, B. S.; Ryder, R. C.; Brankovic, A.; Liu, N.-S.; Gallagher, J. R.; Hendricks, J. A.

    2004-01-01

    The Trapped Vortex Combustor (TVC) potentially offers numerous operational advantages over current production gas turbine engine combustors. These include lower weight, lower pollutant emissions, effective flame stabilization, high combustion efficiency, excellent high altitude relight capability, and operation in the lean burn or RQL modes of combustion. The present work describes the operational principles of the TVC, and extends diffuser velocities toward choked flow and provides system performance data. Performance data include EINOx results for various fuel-air ratios and combustor residence times, combustion efficiency as a function of combustor residence time, and combustor lean blow-out (LBO) performance. Computational fluid dynamics (CFD) simulations using liquid spray droplet evaporation and combustion modeling are performed and related to flow structures observed in photographs of the combustor. The CFD results are used to understand the aerodynamics and combustion features under different fueling conditions. Performance data acquired to date are favorable compared to conventional gas turbine combustors. Further testing over a wider range of fuel-air ratios, fuel flow splits, and pressure ratios is in progress to explore the TVC performance. In addition, alternate configurations for the upstream pressure feed, including bi-pass diffusion schemes, as well as variations on the fuel injection patterns, are currently in test and evaluation phases.

  16. Analytical evaluation of the impact of broad specification fuels on high bypass turbofan engine combustors

    NASA Technical Reports Server (NTRS)

    Lohmann, R. P.; Szetela, E. J.; Vranos, A.

    1978-01-01

    The impact of the use of broad specification fuels on the design, performance durability, emissions and operational characteristics of combustors for commercial aircraft gas turbine engines was assessed. Single stage, vorbix and lean premixed prevaporized combustors, in the JT9D and an advanced energy efficient engine cycle were evaluated when operating on Jet A and ERBS (Experimental Referee Broad Specification) fuels. Design modifications, based on criteria evolved from a literature survey, were introduced and their effectiveness at offsetting projected deficiencies resulting from the use of ERBS was estimated. The results indicate that the use of a broad specification fuel such as ERBS, will necessitate significant technology improvements and redesign if deteriorated performance, durability and emissions are to be avoided. Higher radiant heat loads are projected to seriously compromise liner life while the reduced thermal stability of ERBS will require revisions to the engine-airframe fuel system to reduce the thermal stress on the fuel. Smoke and emissions output are projected to increase with the use of broad specification fuels. While the basic geometry of the single stage and vorbix combustors are compatible with the use of ERBS, extensive redesign of the front end of the lean premixed prevaporized burner will be required to achieve satisfactory operation and optimum emissions.

  17. Influence of diet, exercise and serum vitamin D on sarcopenia in post-menopausal women

    PubMed Central

    Mason, Caitlin; Xiao, Liren; Imayama, Ikuyo; Duggan, Catherine R.; Foster-Schubert, Karen E.; Kong, Angela; Campbell, Kristin L.; Wang, Ching-Yun; Villasenor, Adriana; Neuhouser, Marian L.; Alfano, Catherine M.; Blackburn, George L.; McTiernan, Anne

    2012-01-01

    Purpose To investigate the effects of 12 months of dietary weight loss and/or aerobic exercise on lean mass and the measurements defining sarcopenia in postmenopausal women, and to examine the potential moderating effect of serum 25-hydroxyvitamin D (25(OH)D) and age. Methods 439 overweight and obese postmenopausal women were randomized to: diet modification (N=118); exercise (N=117), diet+exercise (N=117), or control (N=87). The diet intervention was a group-based program with a 10% weight loss goal. The exercise intervention was 45 mins/day, 5 days/week of moderate-to-vigorous intensity aerobic activity. Total and appendicular lean mass were quantified by dual Xray absorptiometry (DXA) at baseline and 12 months. A skeletal muscle index (SMI=appendicular lean mass (kg)/m2) and the prevalence of sarcopenia (SMI<5.67 kg/m2) were calculated. Serum 25(OH)D was assayed using a competitive chemiluminescent immunoassay. Results Dietary weight loss resulted in a significant decrease in lean mass, and a borderline significant decrease in appendicular lean mass and SMI compared to controls. In contrast, aerobic exercise significantly preserved appendicular lean mass and SMI. Diet + exercise attenuated the loss of appendicular lean mass and SMI compared to diet alone, and did not result in significant loss of total- or appendicular lean mass compared to controls. Neither serum 25(OH)D nor age were significant moderators of the intervention effects. Conclusions Aerobic exercise added to dietary weight loss can attenuate the loss of appendicular lean mass during weight loss, and may be effective for the prevention and treatment of sarcopenia among overweight and obese postmenopausal women. PMID:23190588

  18. Nutritional Status of Maintenance Dialysis Patients: Low Lean Body Mass Index and Obesity Are Common, Protein-Energy Wasting Is Uncommon.

    PubMed

    Koefoed, Mette; Kromann, Charles Boy; Juliussen, Sophie Ryberg; Hvidtfeldt, Danni; Ekelund, Bo; Frandsen, Niels Erik; Marckmann, Peter

    2016-01-01

    Maintenance dialysis patients are at increased risk of abnormal nutritional status due to numerous causative factors, both nutritional and non-nutritional. The present study assessed the current prevalence of protein-energy wasting, low lean body mass index and obesity in maintenance dialysis patients, and compared different methods of nutritional assessment. In a cross-sectional study conducted in 2014 at Roskilde Hospital, Denmark, we performed anthropometry (body weight, skinfolds, mid-arm, waist, and hip circumferences), and determined plasma albumin and normalized protein catabolic rate in order to assess the prevalence of protein-energy wasting, low lean body mass index and obesity in these patients. Seventy-nine eligible maintenance dialysis patients participated. The prevalence of protein-energy wasted patients was 4% (95% CI: 2-12) as assessed by the coexistence of low lean body mass index and low fat mass index. Low lean body mass index was seen in 32% (95% CI: 22-44). Obesity prevalence as assessed from fat mass index was 43% (95% CI: 32-55). Coexistence of low lean body mass index and obesity was seen in 10% (95% CI: 5-19). The prevalence of protein-energy wasting and obesity varied considerably, depending on nutritional assessment methodology. Our data indicate that protein-energy wasting is uncommon, whereas low lean body mass index and obesity are frequent conditions among patients in maintenance dialysis. A focus on how to increase and preserve lean body mass in dialysis patients is suggested in the future. In order to clearly distinguish between shortage, sufficiency and abundance of protein and/or fat deposits in maintenance dialysis patients, we suggest the simple measurements of lean body mass index and fat mass index.

  19. Effective management of patients with acute ischemic stroke based on lean production on thrombolytic flow optimization.

    PubMed

    Liang, Zhuoyuan; Ren, Lijie; Wang, Ting; Hu, Huoyou; Li, Weiping; Wang, Yaping; Liu, Dehong; Lie, Yi

    2016-12-01

    The efficacy of thrombolytic therapy for acute ischemic stroke (AIS) decreases when the administration of tissue plasminogen activator (tPA) is delayed. Derived from Toyota Production System, lean production aims to create top-quality products with high-efficiency procedures, a concept that easily applies to emergency medicine. In this study, we aimed to determine whether applying lean principles to flow optimization could hasten the initiation of thrombolysis. A multidisciplinary team (Stroke Team) was organized to implement an ongoing, continuous loop of lean production that contained the following steps: decomposition, recognition, intervention, reengineering and assessment. The door-to-needle time (DNT) and the percentage of patients with DNT ≤ 60 min before and after the adoption of lean principles were used to evaluate the efficiency of our flow optimization. Thirteen patients with AIS in the pre-lean period and 43 patients with AIS in the lean period (23 in lean period I and 20 patients in lean period II) were consecutively enrolled in our study. After flow optimization, we reduced DNT from 90 to 47 min (p < 0.001 ¤ ). In addition, the percentage of patients treated ≤60 min after hospital arrival increased from 38.46 to 75.0 % (p = 0.015 ¤ ). Adjusted analysis of covariance confirmed a significant influence of optimization on delay of tPA administration (p < 0.001). The patients were more likely to have a good prognosis (mRS ≤ 2 at 90 days) after the flow optimization (30.77-75.00 %, p = 0.012 ¤ ). Our study may offer an effective approach for optimizing the thrombolytic flow in the management of AIS.

  20. Relative Importance of Lean and Fat Mass on Bone Mineral Density in Iranian Children and Adolescents.

    PubMed

    Jeddi, Marjan; Dabbaghmanesh, Mohammad Hossein; Ranjbar Omrani, Gholamhossein; Ayatollahi, Sayed Mohammad Taghi; Bagheri, Zahra; Bakhshayeshkaram, Marzieh

    2015-07-01

    Body weight is made up of lean and fat mass and both are involved in growth and development. Impression of these two components in bone density accrual has been controversial. The aim of this study was to evaluate the relationship between fat and lean mass and bone density in Iranian children and adolescents. A cross-sectional study was performed on 472 subjects (235 girls, 237 boys) aged 9-18 years old in Fars Province. The participants' weight, height, waist circumference, stage of puberty, and level of physical activity were recorded. Bone Mineral Content (BMC), Bone Mineral Density (BMD), total body fat and lean mass were measured using dual-energy X-ray absorptiometry. Results showed that 12.2% of boys and 12.3% of girls were overweight and 5.5% of boys and 4.7% of girls were obese. Obese individuals had greater total body BMD (0.96 ± 0.11) than normal-weight ones (0.86 ± 0.11) (P < 0.001). We found the greatest correlation between total body BMD and total body lean mass (R = 0.78. P < 0.001) and the least correlation with total body fat percentage (R = 0.03, P = 0.44). Total lean mass in more active boys was 38.1 ± 10.9 and in less active boys was 32.3 ± 11.0 (P < 0.001). The results of multiple regression analysis showed that age and total body lean mass were independent factors of BMD in growing children and adolescents. These findings suggest that lean mass was the most important predictor of BMD in both genders. Physical activity appears to positively impact on lean mass and needs to be considered in physical education and health-enhancing programs in Iranian school children.

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