Parametric Models and Process Map for Alternating Current Square-Waveform Welding of Heat-Resistant Steel

The demand for efficient processes through a comprehensive understanding and optimization of welding conditions continues to grow in the manufacturing industry. This study involves heat-resistant 2.25 Cr-1 Mo V-groove steel welding using the square-waveform alternating cur-rent. Experiments were conducted to build the relationship between input variables—such as current, frequency, electrode negativity ratio, and welding speed—and process performance, such as penetration, bay area, deposition rate, melting efficiency, percentage dilution, flux–wire ratio, and heat input. The process was analyzed in light of the defect-free high-deposition weld groove weld, the sensitivity to process parameters, and the optimization and development of the process map. The study proposes an innovative approach to reducing the cost and time of optimizing the one-pass-each-layer V-groove welding process using bead-on-plate welds. Square waveform welding creates a metallurgical notch in the form of a bay at the fusion boundary that can be minimized by selecting appropriate welding conditions. The square waveform submerged arc welding is more sensitive towards changes in current and welding speed than the frequency and electrode negativity ratio; however, the electrode negativity ratio and frequency are minor but helpful parameters to achieve optimal results. The proximity of the planned and experimental results to within 3% confirms the validity of the proposed approach. The investigation shows that 90% of the maximum deposition rate is possible for one-pass-each-layer V-groove welds within heat input and weld width constraints.

MANAGEMENT PROCESSES IN A PUBLIC ORGANIZATION PROVIDING SERVICES TO CITIZENS

The scientific paper proposes a pragmatic perspective of presenting some theoretical and practical aspects regarding a new approach within the studied organization, a process-based approach. The point of view submitted is a small part of the possibilities to implement the process-based approach. For an overview, I did a presentation of the organization in which I carry out my activity, the Sibiu County Directorate for the Registration of Persons, I showed the place and the role of the organization. Later, I explained the way, was organized and the activities that take place in the organization. An important aspect was the realization, in the organization, of personal analysis to make a new, process-based approach. Based on these processes we have made a current map of processes. A further direction of research is building a new process map following analysis to improve the processes within the studied public organization. Subsequently, we intend to execute the modeling of processes with a method that we will establish later.

Task-shifting to optimize outpatient neurological care in Zambia

Objective To investigate opportunities for task shifting to decongest an outpatient neurology clinic in Zambia by describing current patient flow through the clinic and potential nodes for intervention using process mapping. Background Zambia has a population of approximately 18 million people with 4 full-time adult neurologists, as of 2018, who all practice at the University Teaching Hospital (UTH), the main tertiary care center in the country. As a result of this provider-to-patient ratio, the outpatient neurology clinic is overcrowded and overbooked. Task-shifting programs have shown to improve efficiency, access and quality of care through the use of less specialized healthcare workers in low- and middle-income countries (LMIC). Methods We evaluated patient flow in the UTH neurology outpatient clinic through the development and analysis of a process map. The characteristics of the clinic population between 2014 and 2018 were retrospectively reviewed from the clinic register. Between July and August 2018, we prospectively collected appointment lag times and time each patient spent waiting at various points in the clinic process. We conducted interviews with clinic staff and neurologists to generate a detailed process map of current pathways to care within the clinic. We then devised task-shifting strategies to help reduce patient wait times based on the overview of clinic process mapping and patient demographics. Results From 2014 to 2018, there were 4701 outpatients seen in the neurology clinic. The most common neurological diagnoses were epilepsy (39.2%), headache (21.5%) and cerebrovascular disease (16.7%). During prospective data collection, patients waited an average of 57.8 (SD 73.4) days to be seen by a neurologist. The average wait time from arrival in the clinic to departure was 4.0 (SD 2.5) h. The process map and interviews with clinic staff revealed long waiting times due to a paucity of providers. Nurses and clerks represent an influential stakeholder group, but are not actively involved in any activity to reduce wait times. A large proportion of follow-up patients were stable and seen solely to obtain medication refills. Conclusions Epilepsy, headache, and stroke make up the largest percentage of outpatient neurological illness in Zambia. Targeting stable patients in these diagnostic categories for a task-shifting intervention may lead to substantially decreased patient wait times. Potential interventions include shifting clinical follow-ups and medication refills to less specialized healthcare workers.

Assessment of cost management practices of civil engineering (project procurement) organisations in Ondo State, Nigeria

Purpose The purpose of the work presented here is to assess the cost management practices of civil engineering organisations in Nigeria, with an overall aim of developing a generic cost management process map. The first objective is to compare existing frameworks theoretically to highlight their strengths and weaknesses. The second objective is to use the findings of the first objective to assess or benchmark the developed process map obtained from the multiple cases. The third objective is to compare the generic process map with the traditional building cost management process map to evaluate the strengths and shortcomings of the generic process map, which resulted in conclusions and recommendations made at the end of the research. Design/methodology/approach Data for the work was collected via semi-structured interviews, review of literature and official documents of the civil engineering organisations visited. To achieve the stated objectives, comparative analysis technique was used to compare existing frameworks on cost management to obtain the basis to benchmark the generic process map. The single case narrative technique was used to present each case; and the cross-case synthesis technique was used to present the multiple cases on each cost management process examined. Then, process maps were deployed to represent the homogeneous sets of civil engineering organisations, out of which the generic process map was developed. Comparative analysis was again deployed to compare the generic process map with the traditional building process map of cost management practice to evaluate the findings. Findings It was found out that the generic civil engineering process map is not as detailed and effective as the building process map in providing best value for money, accurate early cost estimates, accurate cost certainty and post-contract cost control. Originality/value This research study provides an industrial impetus to push for the involvement of more quantity surveyors (QS) as cost management process owners in the procurement of civil engineering projects in Nigeria, hence encouraging government’s efforts in the enforcement of more accurate project cost estimates and promoting the QS’s project-specific advice on capital, operational, maintenance and life cycle costs.

Pathology molecular reflex testing improves turn-around-time and overall molecular testing rates in NSCLC.

e13507 Background: Dozens of genetic aberrations have become druggable targets or act as biomarkers of diseases for which pts may qualify for precision medicine treatment options. Biomarker informed treatments can lead to vast improvements in patient outcomes over traditional approaches like chemo. However, comprehensive molecular profiling (CMP) to identify eligible pts is not always accomplished, particularly in the community setting where molecular testing is often outsourced to third party laboratories. Here we report our experience with reflex testing protocols, where a pathology department has responsibility for initiating biomarker testing without the need for direct oncologist involvement. In this study we investigate and report how pathologist initiated reflex protocols influences access to molecular biomarker testing and assessed changes in testing rates, result tracking, and timeliness of results. Methods: We reviewed a reflex testing protocol at Hoag Hospital (Newport Beach, California), for NSCLC pts. A process map was generated to identify pts who qualified for reflex testing. After developing the process map, we used VIPER software that gathers data from electronic medical records and pathology systems to perform our analysis. We evaluated protocol adherence, failures, QNS rates, and TAT from test ordering to sample receipt and processing and ultimately all the way to results being received and compared patients that followed the reflex protocol as compared to those that did not to determine any differences. Data analysis was performed to understand how effective the reflex system was in ensuring the appropriate patients received CMP and any benefits in efficiency that resulted. Results: We evaluated 300 NSCLC pts over a 12-month timeframe for their reflex testing statuses. 78.5% of those pts tested received Next Generation Sequencing (NGS) tests, vs. 21.5% receiving non-NGS based tests. We also found over 75% of the pts that were qualified for reflex testing had complete tests, while 25% were not able to be completed. Of those who did not meet reflex criteria, only 28% went on to receive CMP. The primary reason for a patient who qualified for reflex testing but did not have testing initiated was due to insurance or reimbursement concerns (42%). The average time from a reflex test being ordered to results available was 25.9 days. Without reflex the TAT averaged 40.5 days (15.4 days difference). For reflexed cases, 78% of CMP results were available prior to treatment initiation. Conclusions: We demonstrate that implementation of a CMP reflex testing program is feasible and can ensure that a higher percentage of NSCLC pts receive molecular testing and that these results can be provided nearly two times sooner than without such programs. Our next steps are to automate this process to allow practices that do not have the personnel to manage such programs can still benefit via technology assistance.

Influences of Process Parameters on the Microstructure and Mechanical Properties of CoCrFeNiTi Based High-Entropy Alloy in a Laser Powder Bed Fusion Process

Recently, high-entropy alloys (HEAs) have attracted much attention because of their superior properties, such as high strength and corrosion resistance. This study aimed to investigate the influences of process parameters on the microstructure and mechanical properties of CoCrFe NiTiMo HEAs using a laser-based powder bed fusion (LPBF) process. In terms of laser power and scan speed, a process map was constructed by evaluating the density and surface roughness of the as-built specimen to optimize the process parameters of the products. The mechanical properties of the as-built specimens fabricated at the optimum fabrication condition derived from the process map were evaluated. Consequently, the optimum laser power and scan speed could be obtained using the process map evaluated by density and surface roughness. The as-built specimen fabricated at the optimum fabrication condition presented a relative density of more than 99.8%. The microstructure of the as-built specimen exhibited anisotropy along the build direction. The tensile strength and elongation of the as-built specimen were around 1150 MPa and more than 20%, respectively.