scholarly journals A pioneering healthcare model applying large-scale production concepts: Principles and performance after more than 11,000 transplants at Hospital do Rim

2016 ◽  
Vol 62 (7) ◽  
pp. 664-671 ◽  
Author(s):  
José Medina Pestana
Keyword(s):  
Health Care ◽  
Large Scale ◽  
Organ Procurement ◽  
Clinical Results ◽  
Scientific Management ◽  
Scale Production ◽  
High Productivity ◽  
Unified Health System ◽  
Healthcare Model ◽  
And Performance

Summary The kidney transplant program at Hospital do Rim (hrim) is a unique healthcare model that applies the same principles of repetition of processes used in industrial production. This model, devised by Frederick Taylor, is founded on principles of scientific management that involve planning, rational execution of work, and distribution of responsibilities. The expected result is increased efficiency, improvement of results and optimization of resources. This model, almost completely subsidized by the Unified Health System (SUS, in the Portuguese acronym), has been used at the hrim in more than 11,000 transplants over the last 18 years. The hrim model consists of eight interconnected modules: organ procurement organization, preparation for the transplant, admission for transplant, surgical procedure, post-operative period, outpatient clinic, support units, and coordination and quality control. The flow of medical activities enables organized and systematic care of all patients. The improvement of the activities in each module is constant, with full monitoring of various administrative, health care, and performance indicators. The continuous improvement in clinical results confirms the efficiency of the program. Between 1998 and 2015, an increase was noted in graft survival (77.4 vs. 90.4%, p<0.001) and patient survival (90.5 vs. 95.1%, p=0.001). The high productivity, efficiency, and progressive improvement of the results obtained with this model suggest that it could be applied to other therapeutic areas that require large-scale care, preserving the humanistic characteristic of providing health care activity.

scholarly journals Smoking control: challenges and achievements

2016 ◽  
Vol 42 (4) ◽  
pp. 290-298 ◽  
Author(s):  
Luiz Carlos Corrêa da Silva ◽  
Alberto José de Araújo ◽  
Ângela Maria Dias de Queiroz ◽  
Maria da Penha Uchoa Sales ◽  
Maria Vera Cruz de Oliveira Castellano
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Large Scale ◽  
Scale Production ◽  
Large Scale Production ◽  
Care Policies ◽  
Promising Area ◽  
Health Care Policies ◽  
Smoking Control

ABSTRACT Smoking is the most preventable and controllable health risk. Therefore, all health care professionals should give their utmost attention to and be more focused on the problem of smoking. Tobacco is a highly profitable product, because of its large-scale production and great number of consumers. Smoking control policies and treatment resources for smoking cessation have advanced in recent years, showing highly satisfactory results, particularly in Brazil. However, there is yet a long way to go before smoking can be considered a controlled disease from a public health standpoint. We can already perceive that the behavior of our society regarding smoking is changing, albeit slowly. Therefore, pulmonologists have a very promising area in which to work with their patients and the general population. We must act with greater impetus in support of health care policies and social living standards that directly contribute to improving health and quality of life. In this respect, pulmonologists can play a greater role as they get more involved in treating smokers, strengthening anti-smoking laws, and demanding health care policies related to lung diseases.

scholarly journals Environmental Impacts of Distributed Manufacturing from 3-D Printing of Polymer Components and Products

2013 ◽  
Vol 1492 ◽  
pp. 85-90 ◽  
Author(s):  
Megan Kreiger ◽  
Joshua M. Pearce
Keyword(s):  
Environmental Impact ◽  
Open Source ◽  
Large Scale ◽  
Low Cost ◽  
Acrylonitrile Butadiene Styrene ◽  
Mass Scale ◽  
Embodied Energy ◽  
Scale Production ◽  
Distributed Manufacturing ◽  
And Performance

ABSTRACTAlthough additive layer manufacturing is well established for rapid prototyping the low throughput and historic costs have prevented mass-scale adoption. The recent development of the RepRap, an open source self-replicating rapid prototyper, has made low-cost 3-D printers readily available to the public at reasonable prices (<$1,000). The RepRap (Prusa Mendell variant) currently prints 3-D objects in a 200x200x140 square millimeters build envelope from acrylonitrile butadiene styrene (ABS) and polylactic acid (PLA). ABS and PLA are both thermoplastics that can be injection-molded, each with their own benefits, as ABS is rigid and durable, while PLA is plant-based and can be recycled and composted. The melting temperature of ABS and PLA enable use in low-cost 3-D printers, as these temperature are low enough to use in melt extrusion in the home, while high enough for prints to retain their shape at average use temperatures. Using 3-D printers to manufacture provides the ability to both change the fill composition by printing voids and fabricate shapes that are impossible to make using tradition methods like injection molding. This allows more complicated shapes to be created while using less material, which could reduce environmental impact.As the open source 3-D printers continue to evolve and improve in both cost and performance, the potential for economically-viable distributed manufacturing of products increases. Thus, products and components could be customized and printed on-site by individual consumers as needed, reversing the historical trend towards centrally mass-manufactured and shipped products. Distributed manufacturing reduces embodied transportation energy from the distribution of conventional centralized manufacturing, but questions remain concerning the potential for increases in the overall embodied energy of the manufacturing due to reduction in scale. In order to quantify the environmental impact of distributed manufacturing using 3-D printers, a life cycle analysis was performed on a plastic juicer. The energy consumed and emissions produced from conventional large-scale production overseas are compared to experimental measurements on a RepRap producing identical products with ABS and PLA. The results of this LCA are discussed in relation to the environmental impact of distributed manufacturing with 3-D printers and polymer selection for 3-D printing to reduce this impact. The results of this study show that distributed manufacturing uses less energy than conventional manufacturing due to the RepRap's unique ability to reduce fill composition. Distributed manufacturing also has less emissions than conventional manufacturing when using PLA and when using ABS with solar photovoltaic power. The results of this study indicate that open-source additive layer distributed manufacturing is both technically viable and beneficial from an ecological perspective.

scholarly journals Replacement of a Metabolic Pathway for Large-Scale Production of Lactic Acid from Engineered Yeasts

1999 ◽  
Vol 65 (9) ◽  
pp. 4211-4215 ◽  
Author(s):  
Danilo Porro ◽  
Michele M. Bianchi ◽  
Luca Brambilla ◽  
Rossella Menghini ◽  
Davide Bolzani ◽  
...  
Keyword(s):  
Lactic Acid ◽  
Large Scale ◽  
Kluyveromyces Lactis ◽  
Lactic Acid Production ◽  
Pyruvate Decarboxylase ◽  
Polymer Materials ◽  
Efficient Production ◽  
Scale Production ◽  
High Productivity ◽  
Large Scale Production

ABSTRACT Interest in the production of l-(+)-lactic acid is presently growing in relation to its applications in the synthesis of biodegradable polymer materials. With the aim of obtaining efficient production and high productivity, we introduced the bovinel-lactate dehydrogenase gene (LDH) into a wild-type Kluyveromyces lactis yeast strain. The observed lactic acid production was not satisfactory due to the continued coproduction of ethanol. A further restructuring of the cellular metabolism was obtained by introducing the LDH gene into aK. lactis strain in which the unique pyruvate decarboxylase gene had been deleted. With this modified strain, in which lactic fermentation substituted completely for the pathway leading to the production of ethanol, we obtained concentrations, productivities, and yields of lactic acid as high as 109 g liter−1, 0.91 g liter−1 h−1, and 1.19 mol per mole of glucose consumed, respectively. The organic acid was also produced at pH levels lower than those usual for bacterial processes.

Recent Advances in 3D Weaving for Textile Preforming

2000 ◽  
Author(s):  
Larry Dickinson ◽  
Mansour Mohamed
Keyword(s):  
Large Scale ◽  
Three Dimensions ◽  
Scale Production ◽  
Recent Advances ◽  
Large Scale Production ◽  
Problems And Solutions ◽  
Weaving Technology ◽  
And Performance ◽  
Woven Structure ◽  
3D Weaving

Abstract There have been many publications on “3D Weaving”, and there are numerous patents on a variety of devices that may be used to make a “3D Woven” structure. The majority of the 3D woven products that are currently commercially available are formed by a 2D weaving process that is used to build up a preform with fibers oriented in three dimensions. Recent advances have lead to multiple insertion 3D weaving, i.e. 3D fabric formation with each process cycle, or multi-layers at one time. The 3Weaving™ process is a multiple insertion 3D weaving technology that is different from traditional weaving. These distinctions about the different processes will be detailed in this paper. Additionally, the economics, manufacturing and performance of 3D woven textile preforms for composites will be discussed. Problems and solutions in each of these areas that prevent the large scale production of advanced composites will be presented. The advantage of 3D textile preforming is the ability to take complexity and labor out of manually intensive and expensive composites fabrication processes, and put it in the relatively inexpensive automated preforming process.

scholarly journals Effects of post-lithography cleaning on the yield and performance of CVD graphene-based devices

2019 ◽  
Vol 10 ◽  
pp. 349-355 ◽  
Author(s):  
Eduardo Nery Duarte de Araujo ◽  
Thiago Alonso Stephan Lacerda de Sousa ◽  
Luciano de Moura Guimarães ◽  
Flavio Plentz
Keyword(s):  
Electrical Transport ◽  
Large Scale ◽  
Scale Production ◽  
Production Methods ◽  
Cvd Graphene ◽  
Large Scale Production ◽  
Conventional Production ◽  
Protection Layer ◽  
And Performance ◽  
Graphene Devices

The large-scale production of high-quality and clean graphene devices, aiming at technological applications, has been a great challenge over the last decade. This is due to the high affinity of graphene with polymers that are usually applied in standard lithography processes and that, inevitably, modify the electrical proprieties of graphene. By Raman spectroscopy and electrical-transport investigations, we correlate the room-temperature carrier mobility of graphene devices with the size of well-ordered domains in graphene. In addition, we show that the size of these well-ordered domains is highly influenced by post-photolithography cleaning processes. Finally, we show that by using poly(dimethylglutarimide) (PMGI) as a protection layer, the production yield of CVD graphene devices is enhanced. Conversely, their electrical properties are deteriorated as compared with devices fabricated by conventional production methods.

scholarly journals Modification and Performance Evaluation of a Floating Drum Biogas Digester

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
F. Uthman
Keyword(s):  
Large Scale ◽  
Constant Pressure ◽  
Industrial Wastes ◽  
Cattle Dung ◽  
Scale Production ◽  
Inlet Pipe ◽  
Animal Dung ◽  
Large Scale Production ◽  
Accumulated Temperature ◽  
And Performance

Biogas is a renewable source of energy that is obtained from the anaerobic digestion of agricultural residues, animal dung, energy crops, domestic wastes and industrial wastes. These categories of waste that produce biogas are promising sources of energy and the biotechnology process of biofuel is environmentally friendly. This study aimed at modifying, fabricating and evaluating a floating drum digester. The modified floating drum digester consists of the digester tank, gas holder tank, feeding inlet pipe, gas collector outlet, slurry outlet, thermometer and hose. The gas holder tank was inserted into the digester tank while the biogas is generated in the digester tank by pressure. The biogas was produced from the mixture of cattle dung 30 % and 50 % plant wastes. Hence, the organic waste mixed with water in the ratio of 1: 2 for the digestion process. The digestion temperature was recorded daily for a period of 21 days at constant pressure of 1.32 KN/m2 throughout the experiment. The result revealed that the minimum and maximum average temperatures are 25 to 33 oC. This shows that the ambient temperature affects the temperature in the digester and the amount of gas produced is a function of the accumulated temperature in the digester. It was observed that the biogas generated increase as temperature rise. The modified floating drum digester is affordable and it is recommended for small- and large-scale production.

scholarly journals Plant pathology in the Czech Republic

2002 ◽  
Vol 38 (SI 1 - 6th Conf EFPP 2002) ◽  
pp. S1-S8 ◽  
Author(s):  
V. Kůdela
Keyword(s):  
Health Care ◽  
Plant Pathology ◽  
Czech Republic ◽  
Research And Development ◽  
Large Scale ◽  
Plant Health ◽  
Weak Links ◽  
Scale Production ◽  
The Czech Republic ◽  
The Eu

An outline of past achievements in plant pathology in the CR and main recent problems of Czech plant pathologists are given. A description of the present state in plant pathology in the CR is preceded by data on the structure of CR, on its agriculture, research and development. The outstanding feature of the Czech agriculture is large-scale production. However, the CR still lags behind the EU in yields per hectare. Compared with the EU member states, the CR devotes less money (less then 0.7% of GDP) to research and development (R&amp;D). The trend of state subsidies to R&amp;D in the agriculture sector in current prices is stagnant. It represents an actual decline in the fixed prices. In the Czech Republic, approximately six hundreds persons are professionally engaged in plant health. It represents 6 professionals per 100 hundreds citizens in the CR. Around 160 persons deal with the research and/or teaching of plant pathology. Public service in the field of plant health (advisory work, extension or outreach activities) is one of the weak links in the system of plant health care in the CR. The reason is the lack of commitment for this field of plant health care activity together with absence of sufficient financial support. Minimum requirements for education should be set on advisors and provider of services in the field of plant health at the EU level. In the CR, there exists still some gap in scientific expertise of nematology and integrated pest management. The Czech Lands are proud of the role of some Bohemian and Moravian scientists who have been prominent in the development of plant pathology and related disciplines. These include: AUGUSTUS CARL JOSEPH CORDA and FRANTIŠEK BUBÁK in mycology, GREGOR JOHANN MENDEL in genetics, FRANTIŠEK KRÁL in bacteriology, BOHUMIL NĚMEC and EDUARD BAUDYŠ in plant pathology.

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