Applying SMED methodology in cork stoppers production

Organizations are increasingly required to have a high level of quality and flexibility in production. In order to remain in the market and become competitive, the working methods practiced must be reliable and efficient. The present project sought the improvement of an equipment of the cork industry by introducing a variation, through the application of Lean methods. The equipment under study performs the union of a cork stopper to a capsule, which is done by gluing it with hot-melt glue. The amount of production makes the changeover activity a regular process. The method followed in this work was the study and collection of information on the Lean production philosophy and its application in the cork industry. The working conditions of the assembly machine were also analyzed in order to find opportunities for improvement. Thus, the tool used was the Value Stream Mapping (VSM) technique in order to acknowledge the processes that really add value to the product. The SMED (Single Minute of Exchange of Die) methodology was applied in a way to reduce the downtime caused by tool changes, and a reduction of 43% in total changeover time was obtained. It was also created an A3 model to monitor the entire development of the SMED project, Finally, the OEE (Overall Equipment Efficiency) calculation was implemented as an indicator of overall equipment efficiency, in order to improve the monitoring of possible deviations during production. The feedback also proves that lean tools are a powerful method to get solid returns without large investments.info:eu-repo/semantics/publishedVersio

A Kinematic Analysis of the Basketball Shot Performed with Different Ball Sizes

In youth basketball, the ball’s size is adapted to fit the participants’ physical capacities and improve the development of manipulative skills. The current study compared the kinematic param eters of the basketball shot (BS) performed with two different ball sizes. Twenty-seven adolescent females aged 12.1 ± 0.9 years (height: 153.3 ± 8.0 cm; body mass: 48.8 ± 12.8 kg) completed 10 BS trials from a frontal position at 5.75 m from the basket with two ball sizes: a smaller and lighter ball (size five, 480 g) and the standard ball size for their age (size six, 566 g). No statistically significant differences were observed for ball release variables or efficacy levels. Significantly greater shoulder flexion was detected at release while shooting with a size six ball (F = 2.982, p ≤ 0.01). The shoulder’s angular velocity at release was significantly lower while performing with a size six ball (F = 3.089, p ≤ 0.01). No significant differences were found for the elbow or knee angles or angular velocities. Stature and upper-body strength were significantly correlated with selected kinematic parameters. A change in ball size may be a helpful strategy for coaches seeking to promote optimal shoot ing patterns, enhancing effectiveness and enjoyment, particularly among young people and more inexperienced players.info:eu-repo/semantics/publishedVersio

Meningomyeloradiculitis as an Unusual Presentation of Neuroborreliosis in Childhood

We report a pediatric case of Lyme neuroborreliosis-associated meningomyeloradiculitis with atypical manifestations and negative initial cerebrospinal fluid borrelial antibodies. Transverse myelitis and painful radiculoneuritis have rarely been described in pediatric neuroborreliosis. Clinical manifestations are wide ranging and nonspecific, and the serologic diagnosis is often delayed in the acute phase.info:eu-repo/semantics/publishedVersio

Síndrome Inflamatória Multissistémica em Crianças Associada a COVID-19 num Hospital de Nível III em Portugal

Introduction: Multisystem inflammatory syndrome in children (MIS-C) is a rare and severe manifestation of coronavirus disease 2019 (COVID-19). The aim of this study was to describe the characteristics of children with MIS-C admitted to a pediatric tertiary hospital in Portugal. Material and methods: Observational descriptive study of MIS-C patients admitted between April 2020 and April 2021. Demographic and clinical characteristics, diagnostic tests, and treatment data were collected. The diagnosis of MIS-C was based on the World Health Organization and Centers for Disease Control and Prevention criteria. Results: We reported 45 children with MIS-C. The median age was seven years (IQR 4 - 10 years) and 60.0% were previously healthy. SARS-CoV-2 infection was confirmed in 77.8% by RT-PCR or antibody testing for SARS-CoV-2, and in 73.3%, an epidemiological link was confirmed. All the patients had a fever and organ system involvement: hematologic (100%), cardiovascular (97.8%), gastrointestinal (97.8%), mucocutaneous (86.7%), respiratory (26.7%), neurologic (15.6%), and renal (13.3%) system. Neurological (p = 0.035) and respiratory (p = 0.035) involvement were observed in patients with a more severe presentation. There was a significant difference of medians when comparing disease severity groups, namely in the values of hemoglobin (p = 0.015), lymphocytes (p = 0.030), D-dimer (p = 0.019), albumin (p < 0.001), NT-proBNP (p = 0.005), ferritin (p = 0.048), CRP (p = 0.006), procalcitonin (p = 0.005) and IL-6 (p = 0.002). From the total number of children, 93.3% received intravenous immunoglobulin, 91.1% methylprednisolone, and one patient (2.2%) received anakinra. Thirteen patients (28.8%) required intensive care and there were no deaths. Of the 21 patients evaluated, 90.4% had reduction of exercise capacity and of the 15 patients who underwent cardiac magnetic resonance, 53.3% had sequelae of cardiac injury. Conclusion: We observed a large spectrum of disease presentation in a group of patients where most were previously healthy. A small percentage of patients (28.9%) had a severe presentation of the disease. MIS-C is a challenge in current clinical practice and its diagnosis requires a high level of clinical suspicion as the timely initiation of therapy is essential to prevent complications. However, there is no scientific consensus on the treatment and follow-up of these patients.info:eu-repo/semantics/publishedVersio

Effect of scan strategies and use of support structures on surface quality and hardness of L-PBF AlSi10Mg parts

Additive manufacturing allows for a great degree of design freedom and is rapidly becoming a mainstream manufacturing process. However, as in all manufacturing processes, it has its limitations and specificities. Equipping engineers with this knowledge allows for a higher degree of optimization, extracting the most out of this technology. Therefore, a specific part design was devised and created via L-PBF (Laser Powder Bed Fusion) using AlSi10Mg powder. Certain parameters were varied to identify the influence on material density, hardness, roughness, residual stress and microstructures. It was found that on heat treated parts laser pattern strategy is one of the most influential aspects, showing that chessboard and stripes 67° improved outcome; average Ra roughness varied between 8-12 μm, residual stress was higher on vertical surfaces than horizontal surfaces, with the combination of support structures and stripes 67° strategies generating the lowest residual stress (205 MPa on a lateral/vertical face), hardness was non-orientation dependent and larger on samples with chessboard fabrication strategies, while microstructures were composed of α-Al dendrites surrounded by Si particles. The distribution and grain size of the microstructure is dependent on location regarding melt pool and HAZ area. Furthermore, Al-Mg oxides were encountered on the surface, along with pores generating from lack of fusion

Effect of Hemodynamic Changes in Plasma Propofol Concentrations Associated with Knee-Chest Position in Spinal Surgery: A Prospective Study

Background: Anesthesia induction and maintenance with propofol can be guided by target-controlled infusion (TCI) systems using pharmacokinetic (Pk) models. Physiological variables, such as changes in cardiac output (CO), can influence propofol pharmacokinetics. Knee-chest (KC) surgical positioning can result in CO changes. Objectives: This study aimed to evaluate the relationship between propofol plasma concentration prediction and CO changes after induction and KC positioning. Methods: This two-phase prospective cohort study included 20 patients scheduled for spinal surgery. Two different TCI anesthesia protocols were administered after induction. In phase I (n = 9), the loss of consciousness (LOC) concentration was set as the propofol target concentration and CO changes following induction and KC positioning were quantified. In phase II (n = 11), based on data from phase I, two reductions in the propofol target concentration on the pump were applied after LOC and before KC positioning. Propofol plasma concentrations were measured at different moments in both phases: after induction and after KC positioning. Results: Schnider Pk model showed a good performance in predicting propofol concentration after induction; however, after KC positioning, when a significant drop in CO occurred, the measured propofol concentrations were markedly underestimated. Intended reductions in the propofol target concentration did not attenuate HD changes. In the KC position, there was no correlation between the propofol concentration estimated by the Pk model and the measured concentration in plasma, as the latter was much higher (P = 0.013) while CO and BIS decreased significantly (P < 0.001 and P = 0.004, respectively). Conclusions: Our study showed that the measured propofol plasma concentrations during the KC position were significantly underestimated by the Schnider Pk model and were associated with significant CO decrease. When placing patients in the KC position, anesthesiologists must be aware of pharmacokinetic changes and, in addition to standard monitoring, the use of depth of anesthesia and cardiac output monitors may be considered in high-risk patients.This work was partially funded by the Foundation for Science and Technology, FCT, through national (MEC) and European structural (FEDER) funds, in the scope of the research projects UID/MAT/04106/2019 (CIDMA/UA), UID/CEC/00127/2019 (IEETA/UA) and UID/MAT/00144/2019 (CMUP/UP). This work was also partially suported by Portugal 2020 under the Competitiveness and Internationalization Operational Program, and by the European Regional Development Fund through project SOCA-Smart Open Campus (CENTRO-01-0145-FEDER-000010), acknowledgements from Sonia Gouveia. Aura Silva also acknowledges the postdoctoral grant by FCT (ref. SFRH/BPD/75697/2011).info:eu-repo/semantics/publishedVersio

White-matter microstructural changes in episodic menstrual migraine compared with hormonal controls

Question: Do patients with episodic menstrual migraine exhibit white-matter microstructural changes? Methods: 14 women with episodic menstrual migraine (35±8yrs) were assessed during interictal phase together with 11 healthy women (29±10yrs) during a matching phase of their menstrual cycle (post-ovulation). 2D-EPI multi-shell DWI data were acquired on a 3T Siemens Vida (64-ch coil) and preprocessed using DESIGNER [1]. Diffusion tensor / kurtosis imaging (DTI/DKI) parameter maps were estimated and skeletonised [2] and histogram-metrics were computed for each subject: median, peak height, width, and value. Results: Voxelwise statistical analysis [3] revealed multiple whitematter regions with lower MD and AD in patients, with no differences in FA and RD. Interestingly, migraineurs showed increased MK, AK and RK. Moreover, significant groups differences (Mann- Whitney test with Bonferroni correction) were found in histogram-metrics MD peak value, AD median and peak height and AK median. Median AK was positively associated (Spearman correlation) with disease duration but not with attack frequency and pain intensity. Conclusion: Our findings extended previous reports of whitematter microstructural changes in migraineurs across multiple brain regions [4, 5]. DKI histogram-metrics showed potential as disease biomarkers.info:eu-repo/semantics/publishedVersio