Applying Toyota production systemprinciples and tools at the Ghent University hospital

For the last decades many organizations started using Lean as their major business strategy for organizing and improving their operational activities. Results in manufacturing have been very good, but nowadays also service and office environments start to realize that the Toyota Production System, which is the basis of Lean, is a universal approach. Healthcare institutions in the U.K. and the U.S.A. have already been applying lean principles to some degree. This paper describes the findings of our exploratory research on lean in service and healthcare showing how one department from the Ghent University Hospital in Belgium started to implement lean, resulting in significant performance improvements. After a brief discussion on the different elements of the Toyota Production System, we will show how they were adapted and applied in a service environment

Plasmon dispersion of a weakly degenerate nonideal one-component plasma

Classical Molecular Dynamics simulations (MD) for a one-component weakly degenerate plasma are presented. Using an effective quantum pair potential (Kelbg potential), the dynamic structure factor and the dispersion of Langmuir waves are computed. The influence of the coupling strength $\Gamma$ and degree of degeneracy $\rho \Lambda^3$ on these properties is discussed. The results are compared with predictions of mean-field theories.Comment: 5 pages, 3 eps figures, uses cpp2e style (included), submitted to Contrib. Plasma Phy

Probabilistic priority assessment of nurse calls

Current nurse call systems are very static. Call buttons are fixed to the wall, and systems do not account for various factors specific to a situation. We have developed a software platform, the ontology-based Nurse Call System (oNCS), which supports the transition to mobile and wireless nurse call buttons and uses an intelligent algorithm to address nurse calls. This algorithm dynamically adapts to the situation at hand by taking the profile information of staff and patients into account by using an ontology. This article describes a probabilistic extension of the oNCS that supports a more sophisticated nurse call algorithm by dynamically assigning priorities to calls based on the risk factors of the patient and the kind of call. The probabilistic oNCS is evaluated through implementation of a prototype and simulations, based on a detailed dataset obtained from 3 nursing departments of Ghent University Hospital. The arrival times of nurses at the location of a call, the workload distribution of calls among nurses, and the assignment of priorities to calls are compared for the oNCS and the current nurse call system. Additionally, the performance of the system and the parameters of the priority assignment algorithm are explored. The execution time of the nurse call algorithm is on average 50.333 ms. Moreover, the probabilistic oNCS significantly improves the assignment of nurses to calls. Calls generally result in a nurse being present more quickly, the workload distribution among the nurses improves, and the priorities and kinds of calls are taken into account

Isochromosome 12p formation regulates vitamin D metabolism in testicular cancer

Isochromosome 12p (iChr12p) is typical in almost all invasive testicular cancers. Increased copy number of genes on 12p is associated with the development of a clinically manifest tumor; however, the causative genes have not yet been identified. Chromosome 12 harbors many genes involved in Vitamin D metabolism. RNAseq analysis of Vitamin D receptor (VDR) genes from the TCGA cohort revealed that clustering of VDR expression signatures could differentiate between pure seminomas and non-seminomatous germ cell tumors (NSGCT). Using TCGA mRNA expression of anabolic (CYP2R1, CYP27A1 and CYP27B1) and catabolic (CYP24A1) Vitamin D enzymes, positive (PTHLH, IFNG, and TNF) and negative (FGF23) feedback regulators could also clearly distinguish between pure seminomas and NSGCT. We hypothesize that the regulation of Vitamin D metabolism might be disturbed through iChr12p formation, influencing testicular carcinogenesis via increased FGF23 and PTHLH expression. While FGF23 represses CYP27B1 and activates catabolism of active hormone, increased PTHLH secretion can lead to hypercalcemia via inactivation of VDR. In conclusion, testicular cancer is associated with extensive modifications in intratesticular Vitamin D homeostasis. Further research is needed to clarify whether Vitamin D deficiency causes the formation of iChr12p and whether Vitamin D deficiency via iChr12p genomic aberration is involved in testicular carcinogenesis

An ontology-based nurse call management system (oNCS) with probabilistic priority assessment

<p>Abstract</p> <p>Background</p> <p>The current, place-oriented nurse call systems are very static. A patient can only make calls with a button which is fixed to a wall of a room. Moreover, the system does not take into account various factors specific to a situation. In the future, there will be an evolution to a mobile button for each patient so that they can walk around freely and still make calls. The system would become person-oriented and the available context information should be taken into account to assign the correct nurse to a call.</p> <p>The aim of this research is (1) the design of a software platform that supports the transition to mobile and wireless nurse call buttons in hospitals and residential care and (2) the design of a sophisticated nurse call algorithm. This algorithm dynamically adapts to the situation at hand by taking the profile information of staff members and patients into account. Additionally, the priority of a call probabilistically depends on the risk factors, assigned to a patient.</p> <p>Methods</p> <p>The <it>ontology-based Nurse Call System (oNCS) </it>was developed as an extension of a <it>Context-Aware Service Platform</it>. An ontology is used to manage the profile information. Rules implement the novel nurse call algorithm that takes all this information into account. Probabilistic reasoning algorithms are designed to determine the priority of a call based on the risk factors of the patient.</p> <p>Results</p> <p>The <it>oNCS </it>system is evaluated through a prototype implementation and simulations, based on a detailed dataset obtained from Ghent University Hospital. The arrival times of nurses at the location of a call, the workload distribution of calls amongst nurses and the assignment of priorities to calls are compared for the <it>oNCS </it><it>system </it>and the current, place-oriented nurse call system. Additionally, the performance of the system is discussed.</p> <p>Conclusions</p> <p>The execution time of the nurse call algorithm is on average 50.333 ms. Moreover, the <it>oNCS system </it>significantly improves the assignment of nurses to calls. Calls generally have a nurse present faster and the workload-distribution amongst the nurses improves.</p

Set-up reduction for lean cells and multi-machine situations

Set-up reduction is a key requirement nowadays for many lean implementations. Current set-up reduction methodologies, most of them based on Shingo's SMED, focus merely on simple one machine-one person situations, where as many value streams contain long multi-stage machine lines (e.g., in food industry) or multi-machine cells (e.g., in metal industry). In these situations, using SMED is not enough, one needs to look at reducing and optimizing all set-up activities across all available persons and machines. This paper presents a comprehensive approach for these situations (MMSUR) that yields very good results and that is easy to apply with any improvement team of operators. A real life case study will be used to illustrate the approach and the results

La littérature russe, espace privilégié des passagers clandestins de l’existence

De façon générale l’homme de trop de la littérature russe est considéré comme un phénomène social indissoluble de la réalité russe du 19ième siècle. Cette thèse est difficile à maintenir si nous reconnaissons dans l’homme de trop le prédécesseur de l’homme du souterrain de Dostoïevski, annonçant à son tour le souterrain dans lequel le Maître de Boulgakov écrit son roman sur Ponce Pilate. Dans ce cas les catégories sociales ne suffisent plus à expliquer le phénomène. Il faut avoir recours à des critères existentiels et se demander dans quelle mesure la lignée des hommes superflus et souterrains souffre d’un mal spécifiquement russe, dû au contexte social russe, ou si le problème abordé est d’ordre universel et, par conséquence, de nature à concerner tout être humain, quelle que soit sa nationalité. Dans un premier temps il s’agit de cerner le problème. Y-a-t-il un lien entre l’homme de trop et l’homme du souterrain ? Le Maître s’inscrit-il dans la lignée des hommes du souterrain ? Si oui, ce personnage récurrent traduit-il un type de pensée clandestine ? Cet homme de trop, est-il, comme le suggère son qualificatif, un élément superflu dont nous n’avons pas à tenir compte ? Cet homme du souterrain est-il un rabat-joie qui se met lui-même hors jeu ? Ou faut-il, au contraire, faire confiance à ce sentiment de rejet qui l’anime et, si rejet il y a, se demander quel est l’objet de rejet. La pensée souterraine et clandestine du Maître relance le débat que l’on croyait clos. Nous sommes au vingtième siècle et les questions posées au 19ième se heurtent à de nouveaux éléments, à de nouvelles intuitions. Le souterrain a évolué, la tanière est devenue refuge. Les valeurs établies du 19ième ont perdu la face. Son représentant, Ponce Pilate, a mal de tête. Le bien n’est plus le bien et le mal n’est plus le mal. La pensée clandestine, elle, se voit soutenue et encouragée par le représentant du mal, par le diable en personne. Le contexte politique du 20ième siècle suffit-il à expliquer cet étrange roman ou faut-il chercher au-delà du politique, tout comme il a fallu chercher au-delà du social pour pouvoir comprendre l’homme de trop ? Et enfin, doit-on parler d’un archétype russe ou d’un archétype universel mis en évidence par la littérature russe et escamoté par la littérature européenne ? Mais alors pourquoi cette mise en évidence, pourquoi cet escamotage ?status: publishe

Natsional'nye stili kommoenikatsii

As part of the project « The culture of communication and national communicative behaviour: a comparative analysis of Russian and foreign traditions” coordinated by T.V. Larina, and as an introduction to such an analysis, this article explores common and opposite features of Russian and French mentality. In order to understand the Russian-French relations, it is necessary to analyse the similarities and the differences between these two cultures against the background of the very active interplay between them that has characterized the eighteenth and nineteenth centuries. It is interesting to examine cultural parameters common to Russian and French, such as the centripetal behaviour or the social awareness and through them to try to trace the moment of discrepancy between the ways these two cultures understand the world.status: publishe

Poniatie 'vremia' v russkom i vo frantsuzkom iazyke

Russian culture is usually considered as being more polychronic than French culture. This is an assumption which will be used as an axiom for the present purposes, not as a hypothesis to be supported with evidence. If, indeed, Russian time-perception is more polychronic than the French one, it is interesting to analyze some lecicographic approaches in the light of this distinction between the two languages.status: publishe