Lean management in healthcare sector

Purpose – The purpose of this study is to describe an understanding of Lean in healthcare try to identify barriers in successful implementation of lean in healthcare, as it has achieved in mass manufacturing. Methodology – Systematic literature review approach is adopted for this paper and literatures are classified into categories, based on the quality aims of healthcare proposed by IOM in 2001. Findings – A total of 52 literatures in lean healthcare are reviewed, classified and analyzed. Several barriers are found in literatures including lost in translation of lean lingos, difficulty to define customers in healthcare settings, narrow application of Lean instead of broad pictures, the lack of pursuit in continuous perfection of lean and readiness of Lean before implementation. Value – The finding of this study indicates what should be paid attention to for a successful implementation of lean in healthcare.Objetivo - O objetivo deste estudo é descrever uma compreensão do Lean na área de saúde, tentando identificar barreiras na implementação bem-sucedida do Lean na área da saúde, como foi alcançado na fabricação em massa. Metodologia - Adota-se a abordagem de revisão sistemática da literatura para este trabalho e as literaturas são classificadas em categorias, com base nos objetivos de qualidade da saúde propostos pela OIM em 2001. Resultados - Um total de 52 literaturas em saúde lean são revisados, classificados e analisados. Várias barreiras são encontradas nas literaturas, incluindo a perda na tradução de jargões enxutos, a dificuldade de definir clientes em ambientes de saúde, a aplicação restrita do Lean ao invés de imagens amplas, a falta de busca na perfeição contínua do lean e prontidão do Lean antes da implementação. Valor - A constatação deste estudo indica o que deve ser prestado atenção para uma implementação bem sucedida de Lean na área da saúde

Genetic Basis of Thermal Divergence in Saccharomyces species

The genetic architecture of phenotypic divergence is a central question in evolutionary biology. Genetic architecture is impacted by whether evolution occurs through accumulation of many small-effect or a few large-effect changes, the relative contribution of coding and cis-regulatory changes, and the prevalence of epistatic effects. Our empirical understanding of the genetic basis of evolutionary change remains incomplete, largely because reproductive barriers limit genetic analysis to those phenotypes that distinguish closely related species. In this dissertation, I use hybrid genetic analysis to examine the basis of thermal divergence between two post-zygotically isolated species, Saccharomyces cerevisiae and S. uvarum. S. cerevisiae is relatively heat tolerant, whereas S. uvarum is heat sensitive but outperforms S. cerevisiae at 4 degree C. Gene expression analysis with an S. cerevisiae and S. uvarum hybrid revealed a small set of 136 genes with temperature-dependent cis-acting differences, suggesting that the temperature divergence has not caused widespread cis-regulatory divergence. Using a genome-wide non-complementation screen, I found a single nuclear-encoded gene with a modest contribution to heat tolerance, and a large effect of the species\u27 mitochondrial DNA (mitotype). Recombinant mitotypes and allele replacements indicate multiple mitochondria-encoded genes contribute to thermal divergence, with the coding sequence of COX1 showing a moderate effect on both heat and cold tolerance. The non-complementation approach also identified allele differences of CUP2, a copper-binding transcription factor, in copper resistance of S. cerevisiae and S. uvarum. Chimeric alleles showed that multiple changes underlie the resistance of S. cerevisiae CUP2, with cis-regulatory changes having a larger effect than coding changes. Taken together, my findings suggest that evolution of interspecific phenotypic differences often involves accumulation of small-to-medium effect changes, such as those in mitochondrial DNA and CUP2, and can occur through both coding and cis-regulatory changes

Length to diameter ratio effect on heat transfer performance of simple and compound angle holes in thin-wall airfoil cooling

Heat transfer coefficients on a flat plate surface downstream a row of simple and compound angle cylindrical holes are investigated using high-resolution thermographic liquid crystal technique. A variation of flow parameters including blowing ratio, and geometry parameters including compound angle and length-to-diameter ratio are examined. Blowing ratios (M) ranging from 0.3 to 2, length to diameter ratios (L/D) from 0.5 to 5, and two compound angle (β: 0°, 45°) are employed composing a test matrix of 70 test cases. Detailed local, spanwise averaged, and area averaged heat transfer coefficients hf/h0 are presented to illustrate the effect of length-to-diameter ratio and compound angle. The film cooling performance is also evaluated using NHFR method and Δφ method by combining adiabatic film effectiveness and heat transfer coefficient data. Results indicate that Δφ method has superiority in evaluating film cooling performance due to its direct reflection of temperature reduction by film protection

Experimental investigation of wall thickness and hole shape variation effects on full-coverage film cooling performance for a gas turbine vane

The effects of wall thickness and hole shape variation on a full-coverage film cooled turbine vane are investigated in a stationary and linear cascade utilizing the pressure sensitive paint technique. The varied wall thickness produces hole length-to-diameter ratio (L/D) in a range from L/D = 2 to 5, and holes tested include simple angle hole, compound angle hole, and fan-shaped hole. Five rows of holes are provided on the pressure side while three rows of holes are provided on the suction side, with six rows of cylindrical holes drilled on the leading edge to construct showerhead film cooling. The tested blowing ratios for the showerhead, pressure side, and suction side range from 0.25 to 1.5, with a density ratio of 1.5. The freestream Reynolds number is 1.35 × 105, based on the axial chord length and the inlet velocity, with a freestream turbulence intensity level of 3.5% at the cascade inlet. The results indicate that the wall thickness variation produces significant influence on the pressure side film cooling effectiveness, while only marginal effect on the showerhead and suction side film cooling. Also observed is that the fan-shaped hole generates the highest film cooling effectiveness on pressure or suction side. Also discussed is the surface curvature effect, combining with effects of wall thickness and hole shape variations, on the film cooling effectiveness in comparison to the flat-plate data

Research on Personnel control and early warning technology of industrial and trade enterprises based on UWB positioning

This paper is engaged in the industry and trade enterprises based on UWB positioning personnel control early warning technology discussion. After a brief introduction of UWB positioning technology, combined with the adjustment of industrial and trade enterprises based on UWB positioning of personnel control early warning needs are analyzed. Then, demand-oriented, this paper discusses how to realize personnel real-time positioning, action track playback, video linkage and other functions based on UWB positioning technology. Only in this paper, for China’s industry and trade enterprises for reference and reference, industrial and trade enterprises to provide technical support for the construction of safe and stable production environment

On the uniqueness of variable coefficient Schr\"odinger equations

We prove unique continuation properties for linear variable coefficient Schr\"odinger equations with bounded real potentials. Under certain smallness conditions on the leading coefficients, we prove that solutions decaying faster than any cubic exponential rate at two different times must be identically zero. Assuming an extra structural condition, we recover the sharp Gaussian (quadratic exponential) rate in the series of works by Escauriaza-Kenig-Ponce-Vega [9, 12, 13]

Mitochondria-encoded genes contribute to evolution of heat and cold tolerance in yeast

Genetic analysis of phenotypic differences between species is typically limited to interfertile species. Here, we conducted a genome-wide noncomplementation screen to identify genes that contribute to a major difference in thermal growth profile between two reproductively isolated yeast species, Saccharomyces cerevisiae and Saccharomyces uvarum. The screen identified only a single nuclear-encoded gene with a moderate effect on heat tolerance, but, in contrast, revealed a large effect of mitochondrial DNA (mitotype) on both heat and cold tolerance. Recombinant mitotypes indicate that multiple genes contribute to thermal divergence, and we show that protein divergence in COX1 affects both heat and cold tolerance. Our results point to the yeast mitochondrial genome as an evolutionary hotspot for thermal divergence.This work was supported by the NIH (grant GM080669) to J.C.F. Additional support to C.T.H. was provided by the USDA National Institute of Food and Agriculture (Hatch project 1003258), the National Science Foundation (DEB-1253634), and the DOE Great Lakes Bioenergy Research Center (DOE BER Office of Science DE-SC0018409 and DE-FC02-07ER64494 to T. J. Donohue). C.T.H. is a Pew Scholar in the Biomedical Sciences and a Vilas Faculty Early Career Investigator, supported by the Pew Charitable Trusts and the Vilas Trust Estate, respectively. D.P. is a Marie Sklodowska-Curie fellow of the European Union’s Horizon 2020 research and innovation programme (grant agreement no. 747775).Peer reviewe