17 research outputs found

    Automating Production Process Data Acquisition Towards Spaghetti Chart 4.0

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    Automation of logistics and production processes is one of the significant goals of the Industry 4.0 movement. Thus, this study uses the automatic data acquisition approach to automatically create Spaghetti Charts (SC), decrease the required time spent on collecting data, and provide a fast analysis (feedback). Smartphone technology used for drawing the automated spaghetti diagram has potential drawbacks related to safety, security, the privacy of organizations, and independency. So, Method Time Measurement 4.0 and RStudio software are used to collect the real data and draw the spaghetti chart, respectively, as an alternative solution. The experiment results for four scenarios (different Facility layouts and processes) prove that the approach is competitive, with cycle time reduction exceeding 40% less than the conventional facility layout and process plan. The proposed solution of the wearable device is promising for replacing smartphone technology with smart spaghetti chart systems

    Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

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    PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

    Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

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    PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

    Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

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    This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

    Analysis of drivers for solving facility layout problems: Literature review

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    Facility layout problems have a significant impact on the productivity and efficiency of the manufacturing systems. Generally, layout problems deal with the optimization of facility space and locations (e. g. machines, departments) and are oriented to optimize the system's performance within the facility space. Many research works discussed facility layout problems, and there are several literature reviews classified the problems, characteristics, solution methods, and mathematical models. In this paper, different aspects closely related to layout problem solutions and decision making are analyzed and reviewed. These aspects are organized as layout drivers: enabling technologies, tools and techniques, manufacturing systems, and supporting factors. Analyzing these four layout drivers will lead to suggest new ideas for optimizing the solution and obtaining robust and sustainable facility layout/re-layout design through integrating the industrial information. This review paper illustrates the trends, gaps, challenges and suggests some recommendations; the present analysis shall guide interested researchers and practitioners for integrating research works and developing new perspectives for future facility layout problem solutions and layout designs

    An FCM-based dynamic modeling of operability and maintainability barriers in road projects

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    Building a new road infrastructure in the country leads to economic and industrial growth. A massive amount of money is paid by governments to build them; however, they fail due to many reasons related to operability and maintainability (O&M) issues. They are not also completed within the expected budget, time, and quality; so they are not justifiable. As these factors have a strong impact on projects, to reduce the final cost and other mentioned problems, it is necessary to identify the existing O&M barriers, their interrelationships, and their effects on the three mentioned factors. An in-depth literature review is conducted to identify the barriers. The fuzzy cognitive mapping (FCM) technique is used to model O&M barriers using real case data analyses. The findings reveal that managerial factors have more significanct impacts on the project’s success compared to other factors such as organizational, human resource, technology, and project management. Therefore, management methods are very important in developing integration in the project. Identifying, classifying, and determining the effects of barriers to entry of O&M contractors on the cost, time, and quality of road infrastructure projects show the signifcance of conducting this research, which is necessary to deal with the existing barriers. All these ultimately increase quality and reduce time and cost in road infrastructure projects

    Therapeutic mammaplasty is a safe and effective alternative to mastectomy with or without immediate breast reconstruction

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    Background: Therapeutic mammaplasty (TM) may be an alternative to mastectomy, but few well designed studies have evaluated the success of this approach or compared the short-term outcomes of TM with mastectomy with or without immediate breast reconstruction (IBR). Data from the national iBRA-2 and TeaM studies were combined to compare the safety and short-term outcomes of TM and mastectomy with or without IBR. Methods: The subgroup of patients in the TeaM study who underwent TM to avoid mastectomy were identified, and data on demographics, complications, oncology and adjuvant treatment were compared with those of patients undergoing mastectomy with or without IBR in the iBRA-2 study. The primary outcome was the percentage of successful breast-conserving procedures in the TM group. Secondary outcomes included postoperative complications and time to adjuvant therapy. Results: A total of 2916 patients (TM 376; mastectomy 1532; mastectomy and IBR 1008) were included in the analysis. Patients undergoing TM were more likely to be obese and to have undergone bilateral surgery than those having IBR. However, patients undergoing mastectomy with or without IBR were more likely to experience complications than the TM group (TM: 79, 21·0 per cent; mastectomy: 570, 37·2 per cent; mastectomy and IBR: 359, 35·6 per cent; P < 0·001). Breast conservation was possible in 87·0 per cent of patients who had TM, and TM did not delay adjuvant treatment. Conclusion: TM may allow high-risk patients who would not be candidates for IBR to avoid mastectomy safely. Further work is needed to explore the comparative patient-reported and cosmetic outcomes of the different approaches, and to establish long-term oncological safety

    The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

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    The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery
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