Implementation of Six Sigma in a Manufacturing Process: A Case Study

This paper presents a Six Sigma project conducted at a semiconductor company dedicated to the manufacture of circuit cartridges for inkjet printers. They are tested electrically in the final stage of the process measuring electrical characteristics to accept or reject them. Electrical failures accounted for about 50% of all defects. Therefore, it is crucial to establish the main problems, causes and actions to reduce the level of defects. With the implementation of Six Sigma, it was possible to determine the key factors, identify the optimum levels or tolerances and improvement opportunities. The major factors that were found through a design of experiments 3 factors and 2 levels were: abrasive pressure (90-95 psi), height of the tool (0.06-0.05) and cycle time (7000-8000 msec.). The improvement was a reduction in the electrical failures of around 50%. The results showed that with proper application of this methodology, and support for the team and staff of the organization, a positive impact on the quality and other features critical to customer satisfaction can be achieve

Six Sigma Improvement Project for Automotive Speakers in an Assembly Process

This Six Sigma application examined an automotive speaker production process in a multinational corporation twin plant. The process was a semiautomatic assembly operation. A six index assembler chemically bonded a coil to a diaphragm.  The problem is described in the first part of the paper, which pinpoints the separation between those two parts. This is a critical process characteristic that was not properly controlled. Operations were malfunctioning. High scrap and rework rates, and high levels of in process inventory as well as inspection stations all contributed to the problem. Variables were measured to determine the problem with accuracy. The fixture and tool capabilities were estimated in the analysis as well. The authors found that the large variation could be attributed to the product and operator procedure. Variation in the product was determined to be explained by unsuitable fixtures and tools. This resulted in having the fixtures and tools re-dimensioned and re-designed. Measurements were then taken to determine whether the improved process design would make significant contributions.  A control process and operating procedures were established to insure that the initial process conditions would not be repeated.                  

Rediseño del sistema de aire acondicionado y ventilación mecánica para cumplir la RM N°040-2020-MINSA en el HEAV - 2022

El sistema de ventilación y aire acondicionado del área de Trauma shock del Hospital Emergencia Ate Vitarte en el cual se atienden pacientes con COVID-19 actualmente cuenta con un sistema que no se ajusta a los parámetros exigidos por la RM N°040-2020-MINSA, por lo que no garantiza la calidad de aire en las etapas de inyección y la extracción del sistema hacia el medio ambiente. Debido a la problemática, en una reunión conjunta las áreas de administración y servicios generales del HEAV han visto conveniente que es imprescindible realizar el rediseño del sistema de aire acondicionado y ventilación mecánica en el área de trauma shock en la cual se atienden pacientes con COVID-19. Para realizar el rediseño utilizaremos la metodología provista por la ASHRAE (American Society of Heating, Refrigerating & Air-Conditioning Enginners) en su Handbook 2017 y normas aplicables como lo son: ANSI/ASHRAE 55 “Thermal Environmental Condition For Human Occupancy” y ASHRAE 170 “Ventilation of Health Care Facilities”. Se realizará el cálculo de las cargas térmicas exteriores en paredes, techos y ventanas mediante el uso del método de las series radiantes (RTS del inglés Radiant Times Series) para poder realizar el cálculo de las cargas térmicas internas debido a la ocupación de las personas en una habitación. Finalmente se llegará al cálculo de los ductos siguiendo los parámetros establecidos por la RM N°040-2020-MINSA que nos indica que tiene que tener doce (12) cambios por hora como mínimo. Además, se utilizaron herramientas de dibujo en AutoCad 2020 para generar planos 2D, planos de ductería e informe de cargas. Los ductos rectángulos dimensionados varían en 250 y 500 mm, con espesores entre los 0,5 – 0,7 mm, fabricados de plancha galvanizad

Continuous glucose monitoring as an additional tool in early cystic fibrosis-related diabetes monitoring and in evaluation of short-term sitagliptin response

Cystic fibrosis-related diabetes (CFRD) is a complication associated with a negative prognosis in patients with cystic fibrosis (CF). Although the oral glucose tolerance test (OGTT) is the widely recommended screening test for CFRD diagnosis, continuous glucose monitoring (CGM) is increasingly considered a useful and easy-to-perform test for diagnosis and follow-up in clinical practice. Regarding CFRD treatment, although insulin is the classic approved pharmacological option, incretins could also be a helpful alternative in early stages. CGM could be also a useful tool to measure the early response to this therapy. METHODS: We studied 25 CF patients with abnormal OGTT results and compared glucose and insulin levels during the OGTTs with CGM results as a tool for early CFRD diagnosis. In addition, we evaluated glycaemic control with CGM before and after treatment with sitagliptin. RESULTS: A correlation was found between lower plasma insulin levels during the OGTTs and higher average sensor glucose (p = 0.009) and hyperglycaemic excursions (p = 0.017). The CGM data on sitagliptin treatment (n = 25) showed an average glycaemic improvement from 124.2 to 117.2 mg/dL (p = 0.002) with a 5.6-point standard deviation of glucose decrease (p < 0.001). Hyperglycaemic excursions ≥200 mg/dL diminished 57.1% (p = 0.021). Both time in range and time above 180 mg/dL improved during treatment (p = 0.036 and p = 0.006, respectively). CONCLUSION: CGM is a useful tool that offers valuable information for both the diagnosis and the management of CFRD. Lower plasma insulin levels during OGTTs are associated with a poor ambulatory glucose profile in CGM. Sitagliptin could play an important role in the treatment of the early stages of CFRDThis work was funded by Proyectos de Investigacion en Salud (FIS) PI19-00584 and PI22/01404 (funded by Instituto de Salud Carlos III), TIRONET2-CM, B2017/BMD-3724, iTIRONET. P2022/BMD7379 (funded by Comunidad de Madrid), and co-financed by FEDER funds to Mónica Marazuela Azpiro

Technology-assisted stroke rehabilitation in Mexico: a pilot randomized trial comparing traditional therapy to circuit training in a Robot/technology-assisted therapy gym

Background Stroke rehabilitation in low- and middle-income countries, such as Mexico, is often hampered by lack of clinical resources and funding. To provide a cost-effective solution for comprehensive post-stroke rehabilitation that can alleviate the need for one-on-one physical or occupational therapy, in lower and upper extremities, we proposed and implemented a technology-assisted rehabilitation gymnasium in Chihuahua, Mexico. The Gymnasium for Robotic Rehabilitation (Robot Gym) consisted of low- and high-tech systems for upper and lower limb rehabilitation. Our hypothesis is that the Robot Gym can provide a cost- and labor-efficient alternative for post-stroke rehabilitation, while being more or as effective as traditional physical and occupational therapy approaches. Methods A typical group of stroke patients was randomly allocated to an intervention (n = 10) or a control group (n = 10). The intervention group received rehabilitation using the devices in the Robot Gym, whereas the control group (n = 10) received time-matched standard care. All of the study subjects were subjected to 24 two-hour therapy sessions over a period of 6 to 8 weeks. Several clinical assessments tests for upper and lower extremities were used to evaluate motor function pre- and post-intervention. A cost analysis was done to compare the cost effectiveness for both therapies. Results No significant differences were observed when comparing the results of the pre-intervention Mini-mental, Brunnstrom Test, and Geriatric Depression Scale Test, showing that both groups were functionally similar prior to the intervention. Although, both training groups were functionally equivalent, they had a significant age difference. The results of all of the upper extremity tests showed an improvement in function in both groups with no statistically significant differences between the groups. The Fugl-Meyer and the 10 Meters Walk lower extremity tests showed greater improvement in the intervention group compared to the control group. On the Time Up and Go Test, no statistically significant differences were observed pre- and post-intervention when comparing the control and the intervention groups. For the 6 Minute Walk Test, both groups presented a statistically significant difference pre- and post-intervention, showing progress in their performance. The robot gym therapy was more cost-effective than the traditional one-to-one therapy used during this study in that it enabled therapist to train up to 1.5 to 6 times more patients for the approximately same cost in the long term. Conclusions The results of this study showed that the patients that received therapy using the Robot Gym had enhanced functionality in the upper extremity tests similar to patients in the control group. In the lower extremity tests, the intervention patients showed more improvement than those subjected to traditional therapy. These results support that the Robot Gym can be as effective as traditional therapy for stroke patients, presenting a more cost- and labor-efficient option for countries with scarce clinical resources and funding. Trial registration ISRCTN98578807