A lean elvek alkalmazása az egészségügyi folyamatok fejlesztésében = Applying lean principles in healthcare process development

A fejlett társadalmak egészségügyi szolgáltató rendszerei napjainkban kettős kihívással néznek szembe: miközben a társadalom a szolgáltatási színvonal emelkedését, a hibák számának a csökkenését várja el, addig a költségvetési terhek miatt a költségcsökkentés is feltétlenül szükséges. Ez a kihívás nagyságában összevethető azzal, amellyel az USA autóipara nézett szembe az 1970-es évektől. A megoldást az autóipar esetében a konkurens „lean” menedzsment elvek és eszközök megértése és alkalmazása jelentette. A tanulmány arra keresi a választ, hogy vajon lehetséges-e ennek a megoldásnak az alkalmazása az egészségügy esetében is. A cikk az egészségügy problémájának bemutatása után tárgyalja a lean menedzsment kialakulását és hogy milyen módon került köztudatba. A tanulmány második felében a szakirodalomban fellelhető, a témával kapcsolatos tapasztalatokat foglalja össze, majd levonja a következtetéseket. = In developed societies healthcare service systems are facing double challenge; society expects service level to rise and the number of mistakes to drop, but at the same time, because of the overloaded budgets, cutting cost is also absolutely necessary. This challenge compares to the one the US automotive industry was facing in the 1970-s. In case of the automotive industry the solution was the comprehension and application of the principles and the tools of lean management. This study aims to answer the question whether it is possible to apply this solution also in the case of the healthcare system. The article first introduces the problems in the healthcare system, than describes the formation of lean management concept and its wide spread. The second half of the study summarizes the available knowledge in the literature and drives conclusions.

The use of methane as automotive fuel – a step to sustainable economy?

The introduction of CNG (Compressed Natural Gas) as automotive fuel began in Italy as early as in mid- 1930s, and ever since the Italian market has always been highly advanced in this regard. Many other countries followed, some of them quite recently, but nevertheless with impressive results. The appeal of this automotive fuel is based on the fact that compared to gasoline, diesel and LPG (Liquefied Petroleum Gas), CNG is cleaner and cheaper; even more so, this fuel is renewable – it can be produced locally from biogas. Despite its obvious benefits, CNG is barely present in Hungary. This article provides an insight into the topic, highlights obstacles to introduction and suggests appropriate governmental steps. The information is intended to support the activities and the decision-making process of governmental officials, municipalities, car-fleet managers, car dealers and their service departments.

Advanced Non-Destructive Inspections focused on composite materials application for the automotive and marine sectors

The goal of this master thesis is to explain in detail the application of Non-Destructive-Inspection on the Automotive and the Marine sectors. Nowadays, these two particular industries faces many challenges, including increased global competition, the need for higher performance, a reduction in costs and tighter environmental and safety requirements. The materials used for these applications play key roles in overcoming these challenges. So, also an NDI procedure need to be planned in order to avoid problems during the manufacturing process and the after sale life of the structures. The entire thesis work has been done in collaboration with Vetorix Engineering.

Consapevolezza e qualità in process: applicazine della UNI ISO/TS 16949:2009 nel reparto produttivo di pressatura in Sinteris Spa

Lo studio nasce dalla necessità di verificare l’applicazione di alcuni punti della ISO/TS 16949:2009 nel reparto di pressatura dell’azienda. Era importante valutare il livello di consapevolezza dei dipendenti relativamente al problema qualità in un’azienda automotive. Perciò, a partire dalla normativa, è stata fatta un’Indagine di Consapevolezza tra tutti i dipendenti il cui lavoro ha influenza sulla qualità del processo produttivo e del prodotto realizzato. Inoltre, serviva controllare se la logistica del reparto di pressatura fosse adeguata per permettere agli operatori di svolgere al meglio l’ autocontrollo, ossia un controllo in process delle quote geometriche e dimensionali durante la produzione di serie. È stata verificata l’adeguatezza delle unità di carico per la movimentazione dei prodotti, sia a livello logistico che di carico di lavoro per chi le deve movimentare. È risultato che le UdC attualmente in uso, ossia carrelli mossi manualmente, non possono essere sostituite, ma le si può rendere più maneggevoli cambiandone le ruote. Si è studiato il carico di lavoro del reparto di pressatura, per valutare se fosse possibile introdurre misure che diano la possibilità agli operatori di reparto di svolgere i controlli in process con più accuratezza, ipotizzando l’introduzione di una figura specifica, l’Operatore dell’Autocontrollo, che possa occuparsi solo di questo incarico, sollevando gli altri operatori da tale incombenza. Infine, ci si è posti il problema di ridurre l’utilizzo dei carrelli elevatori all’interno del reparto. È risultato necessario mantenerne l’uso per poter garantire la grande flessibilità nella produzione di quest’azienda, ma si è ipotizzato di separare il reparto in due diverse zone al momento del rinnovo del parco macchine, in modo da eliminarne l’utilizzo in una delle due zone e concentrarlo nell’altra, rendendoli indispensabili solo per un determinato tipo di produzione che si svolga in un settore ben definito del reparto.

A long-term energy efficiency prediction model for the Brazilian automotive industry

According to law number 12.715/2012, Brazilian government instituted guidelines for a program named Inovar-Auto. In this context, energy efficiency is a survival requirement for Brazilian automotive industry from September 2016. As proposed by law, energy efficiency is not going to be calculated by models only. It is going to be calculated by the whole universe of new vehicles registered. In this scenario, the composition of vehicles sold in market will be a key factor on profits of each automaker. Energy efficiency and its consequences should be taken into consideration in all of its aspects. In this scenario, emerges the following question: which is the efficiency curve of one automaker for long term, allowing them to adequate to rules, keep balancing on investment in technologies, increasing energy efficiency without affecting competitiveness of product lineup? Among several variables to be considered, one can highlight the analysis of manufacturing costs, customer value perception and market share, which characterizes this problem as a multi-criteria decision-making. To tackle the energy efficiency problem required by legislation, this paper proposes a framework of multi-criteria decision-making. The proposed framework combines Delphi group and Analytic Hierarchy Process to identify suitable alternatives for automakers to incorporate in main Brazilian vehicle segments. A forecast model based on artificial neural networks was used to estimate vehicle sales demand to validate expected results. This approach is demonstrated with a real case study using public vehicles sales data of Brazilian automakers and public energy efficiency data.

Terminal defect analysis and classification methodology for automotive industry

The impact of end customer quality complaints with direct relationship with automotive components has presented negative trend at European level for the entire automotive industry. Thus, this research proposal is to concentrate efforts on the most important items of Pareto chart and understand the failure type and the mechanism involved, link and impact of the project and parameters on the process, ending it with the development of one of the company’s most desired tool, that hosted this project – European methodology of terminals defects classification, and listing real opportunities for improvement based on measurement and analysis of actual data. Through the development of terminals defects classification methodology, which is considered a valuable asset to the company, all the other companies of the YAZAKI’s group will be able to characterize terminals as brittle or ductile, in order to put in motion, more efficiently, all the other different existing internal procedures for the safeguarding of the components, improving manufacturing efficiency. Based on a brief observation, nothing can be said in absolute sense, concerning the failure causes. Base materials, project, handling during manufacture and storage, as well as the cold work performed by plastic deformation, all play an important role. However, it was expected that this failure has been due to a combination of factors, in detriment of the existence of a single cause. In order to acquire greater knowledge about this problem, unexplored by the company up to the date of commencement of this study, was conducted a thorough review of existing literature on the subject, real production sites were visited and, of course, the actual parts were tested in lab environment. To answer to many of the major issues raised throughout the investigation, were used extensively some theoretical concepts focused on the literature review, with a view to realizing the relationship existing between the different parameters concerned. Should here be stated that finding technical studies on copper and its alloys is really hard, not being given all the desirable information. This investigation has been performed as a YAZAKI Europe Limited Company project and as a Master Thesis for Instituto Superior de Engenharia do Porto, conducted during 9 months between 2012/2013.

Development of numerical methodologies to predict the liquid fuel sprays - wall interaction to optimize the mixing process of direct injection spark ignition engines

Nowadays the development of new Internal Combustion Engines is mainly driven by the need to reduce tailpipe emissions of pollutants, Green-House Gases and avoid the fossil fuels wasting. The design of dimension and shape of the combustion chamber together with the implementation of different injection strategies e.g., injection timing, spray targeting, higher injection pressure, play a key role in the accomplishment of the aforementioned targets. As far as the match between the fuel injection and evaporation and the combustion chamber shape is concerned, the assessment of the interaction between the liquid fuel spray and the engine walls in gasoline direct injection engines is crucial. The use of numerical simulations is an acknowledged technique to support the study of new technological solutions such as the design of new gasoline blends and of tailored injection strategies to pursue the target mixture formation. The current simulation framework lacks a well-defined best practice for the liquid fuel spray interaction simulation, which is a complex multi-physics problem. This thesis deals with the development of robust methodologies to approach the numerical simulation of the liquid fuel spray interaction with walls and lubricants. The accomplishment of this task was divided into three tasks: i) setup and validation of spray-wall impingement three-dimensional CFD spray simulations; ii) development of a one-dimensional model describing the liquid fuel – lubricant oil interaction; iii) development of a machine learning based algorithm aimed to define which mixture of known pure components mimics the physical behaviour of the real gasoline for the simulation of the liquid fuel spray interaction.

Advanced voxel-based CAD modelling for FSI simulations for automotive structures design

Additive Manufacturing (AM) is nowadays considered an important alternative to traditional manufacturing processes. AM technology shows several advantages in literature as design flexibility, and its use increases in automotive, aerospace and biomedical applications. As a systematic literature review suggests, AM is sometimes coupled with voxelization, mainly for representation and simulation purposes. Voxelization can be defined as a volumetric representation technique based on the model’s discretization with hexahedral elements, as occurs with pixels in the 2D image. Voxels are used to simplify geometric representation, store intricated details of the interior and speed-up geometric and algebraic manipulation. Compared to boundary representation used in common CAD software, voxel’s inherent advantages are magnified in specific applications such as lattice or topologically structures for visualization or simulation purposes. Those structures can only be manufactured with AM employment due to their complex topology. After an accurate review of the existent literature, this project aims to exploit the potential of the voxelization algorithm to develop optimized Design for Additive Manufacturing (DfAM) tools. The final aim is to manipulate and support mechanical simulations of lightweight and optimized structures that should be ready to be manufactured with AM with particular attention to automotive applications. A voxel-based methodology is developed for efficient structural simulation of lattice structures. Moreover, thanks to an optimized smoothing algorithm specific for voxel-based geometries, a topological optimized and voxelized structure can be transformed into a surface triangulated mesh file ready for the AM process. Moreover, a modified panel code is developed for simple CFD simulations using the voxels as a discretization unit to understand the fluid-dynamics performances of industrial components for preliminary aerodynamic performance evaluation. The developed design tools and methodologies perfectly fit the automotive industry’s needs to accelerate and increase the efficiency of the design workflow from the conceptual idea to the final product.

Development of a Computer-Based methodology for tolerance selection and optimization applied to the automotive sector

The design optimization of industrial products has always been an essential activity to improve product quality while reducing time-to-market and production costs. Although cost management is very complex and comprises all phases of the product life cycle, the control of geometrical and dimensional variations, known as Dimensional Management (DM), allows compliance with product and process requirements. Hence, the tolerance-cost optimization becomes the main practice to provide an effective application of Design for Tolerancing (DfT) and Design to Cost (DtC) approaches by enabling a connection between product tolerances and associated manufacturing costs. However, despite the growing interest in this topic, a profitable application in the industry of these techniques is hampered by their complexity: the definition of a systematic framework is the key element to improving design optimization, enhancing the concurrent use of Computer-Aided tools and Model-Based Definition (MBD) practices. The present doctorate research aims to define and develop an integrated methodology for product/process design optimization, to better exploit the new capabilities of advanced simulations and tools. By implementing predictive models and multi-disciplinary optimization, a Computer-Aided Integrated framework for tolerance-cost optimization has been proposed to allow the integration of DfT and DtC approaches and their direct application for the design of automotive components. Several case studies have been considered, with the final application of the integrated framework on a high-performance V12 engine assembly, to achieve both functional targets and cost reduction. From a scientific point of view, the proposed methodology provides an improvement for the tolerance-cost optimization of industrial components. The integration of theoretical approaches and Computer-Aided tools allows to analyse the influence of tolerances on both product performance and manufacturing costs. The case studies proved the suitability of the methodology for its application in the industrial field, providing the identification of further areas for improvement and refinement.

Development and application of a computer-based methodology for design for additive manufacturing of automotive components

The research project aims to improve the Design for Additive Manufacturing of metal components. Firstly, the scenario of Additive Manufacturing is depicted, describing its role in Industry 4.0 and in particular focusing on Metal Additive Manufacturing technologies and the Automotive sector applications. Secondly, the state of the art in Design for Additive Manufacturing is described, contextualizing the methodologies, and classifying guidelines, rules, and approaches. The key phases of product design and process design to achieve lightweight functional designs and reliable processes are deepened together with the Computer-Aided Technologies to support the approaches implementation. Therefore, a general Design for Additive Manufacturing workflow based on product and process optimization has been systematically defined. From the analysis of the state of the art, the use of a holistic approach has been considered fundamental and thus the use of integrated product-process design platforms has been evaluated as a key element for its development. Indeed, a computer-based methodology exploiting integrated tools and numerical simulations to drive the product and process optimization has been proposed. A validation of CAD platform-based approaches has been performed, as well as potentials offered by integrated tools have been evaluated. Concerning product optimization, systematic approaches to integrate topology optimization in the design have been proposed and validated through product optimization of an automotive case study. Concerning process optimization, the use of process simulation techniques to prevent manufacturing flaws related to the high thermal gradients of metal processes is developed, providing case studies to validate results compared to experimental data, and application to process optimization of an automotive case study. Finally, an example of the product and process design through the proposed simulation-driven integrated approach is provided to prove the method's suitability for effective redesigns of Additive Manufacturing based high-performance metal products. The results are then outlined, and further developments are discussed.

Laser cladding and its potential to reduce particulate matter emissions from the automotive and locomotive sector

Laser Cladding (LC) is an emerging technology which is used both for coating applications as well as near-net shape fabrication. Despite its significant advantages, such as low dilution and metallurgical bond with the substrate, it still faces issues such as process control and repeatability, which restricts the extension to its applications. The following thesis evaluates the LC technology and tests its potential to be applied to reduce particulate matter emissions from the automotive and locomotive sector. The evaluation of LC technology was carried out for the deposition of multi-layer and multi-track coatings. 316L stainless steel coatings were deposited to study the minimisation of geometric distortions in thin-walled samples. Laser power, as well as scan strategy, were the main variables to achieve this goal. The use of constant power, reduction at successive layers, a control loop control system, and two different scan strategies were studied. The closed-loop control system was found to be practical only when coupled with the correct scan strategy for the deposition of thin walls. Three overlapped layers of aluminium bronze were deposited onto a structural steel pipe for multitrack coatings. The effect of laser power, scan speed and hatch distance on the final geometry of coating were studied independently, and a combined parameter was established to effectively control each geometrical characteristic (clad width, clad height and percentage of dilution). LC was then applied to coat commercial GCI brake discs with tool steel. The optical micrography showed that even with preheating, the cracks that originated from the substrate towards the coating were still present. The commercial brake discs emitted airborne particles whose concentration and size depended on the test conditions used for simulation in the laboratory. The contact of LC cladded wheel with rail emitted significantly less ultra-fine particles while maintaining the acceptable values of coefficient of friction.

Design and testing of innovative, artificial intelligence-based techniques to model and control the combustion process and to reduce the Co2 emissions in modern, high-performance, gasoline direct injection engines

This work deals with the development of calibration procedures and control systems to improve the performance and efficiency of modern spark ignition turbocharged engines. The algorithms developed are used to optimize and manage the spark advance and the air-to-fuel ratio to control the knock and the exhaust gas temperature at the turbine inlet. The described work falls within the activity that the research group started in the previous years with the industrial partner Ferrari S.p.a. . The first chapter deals with the development of a control-oriented engine simulator based on a neural network approach, with which the main combustion indexes can be simulated. The second chapter deals with the development of a procedure to calibrate offline the spark advance and the air-to-fuel ratio to run the engine under knock-limited conditions and with the maximum admissible exhaust gas temperature at the turbine inlet. This procedure is then converted into a model-based control system and validated with a Software in the Loop approach using the engine simulator developed in the first chapter. Finally, it is implemented in a rapid control prototyping hardware to manage the combustion in steady-state and transient operating conditions at the test bench. The third chapter deals with the study of an innovative and cheap sensor for the in-cylinder pressure measurement, which is a piezoelectric washer that can be installed between the spark plug and the engine head. The signal generated by this kind of sensor is studied, developing a specific algorithm to adjust the value of the knock index in real-time. Finally, with the engine simulator developed in the first chapter, it is demonstrated that the innovative sensor can be coupled with the control system described in the second chapter and that the performance obtained could be the same reachable with the standard in-cylinder pressure sensors.

IDeS methodology applied to automotive component re-engineering focused on lightweight and high-strength by additive manufacturing

The project aims to gather an understanding of additive manufacturing and other manufacturing 4.0 techniques with an eyesight for industrialization. First the internal material anisotropy of elements created with the most economically feasible FEM technique was established. An understanding of the main drivers for variability for AM was portrayed, with the focus on achieving material internal isotropy. Subsequently, a technique for deposition parameter optimization was presented, further procedure testing was performed following other polymeric materials and composites. A replicability assessment by means of the use of technology 4.0 was proposed, and subsequent industry findings gathered the ultimate need of developing a process that demonstrate how to re-engineer designs in order to show the best results with AM processing. The latest study aims to apply the Industrial Design and Structure Method (IDES) and applying all the knowledge previously stacked into fully reengineer a product with focus of applying tools from 4.0 era, from product feasibility studies, until CAE – FEM analysis and CAM – DfAM. These results would help in making AM and FDM processes a viable option to be combined with composites technologies to achieve a reliable, cost-effective manufacturing method that could also be used for mass market, industry applications.

High-strength steels manufactured via Laser Powder Bed Fusion: effect of post-process heat treatments and surface finishing on microstructure and mechanical properties

Laser Powder Bed Fusion (LPBF) permits the manufacturing of parts with optimized geometry, enabling lightweight design of mechanical components in aerospace and automotive and the production of tools with conformal cooling channels. In order to produce parts with high strength-to-weight ratio, high-strength steels are required. To date, the most diffused high-strength steels for LPBF are hot-work tool steels, maraging and precipitation-hardening stainless steels, featuring different composition, feasibility and properties. Moreover, LPBF parts usually require a proper heat treatment and surface finishing, to develop the desired properties and reduce the high roughness resulting from LPBF. The present PhD thesis investigates the effect of different heat treatments and surface finishing on the microstructure and mechanical properties of a hot-work tool steel and a precipitation-hardening stainless steel manufactured via LPBF. The bibliographic section focuses on the main aspects of LPBF, hot-work tool steels and precipitation-hardening stainless steels. The experimental section is divided in two parts. Part A addresses the effect of different heat treatments and surface finishing on the microstructure, hardness, tensile and fatigue behaviour of a LPBF manufactured hot-work tool steel, to evaluate its feasibility for automotive and racing components. Results indicated the possibility to achieve high hardness and strength, comparable to the conventionally produced steel, but a great sensitivity of fatigue strength on defects and surface roughness resulting from LPBF. Part B investigates the effect of different heat treatments on the microstructure, hardness, tensile and notch-impact behaviour of a LPBF produced precipitation-hardening stainless steel, to assess its feasibility for tooling applications. Results indicated the possibility to achieve high hardness and strength also through a simple Direct Aging, enabling heat treatment simplification by exploiting the microstructural features resulting from LPBF.

[meanings Of The Sickening Process For Patients With Systemic Lupus Erythematosus: A Review Of The Literature.]

Systemic lupus erythematosus is an autoimmune disease that causes many psychological repercussions that have been studied through qualitative research. These are considered relevant, since they reveal the amplitude experienced by patients. Given this importance, this study aims to map the qualitative production in this theme, derived from studies of experiences of adult patients of both genders and that had used as a tool a semi-structured interview and/or field observations, and had made use of a sampling by a saturation criterion to determine the number of participants in each study. The survey was conducted in Pubmed, Lilacs, Psycinfo e Cochrane databases, searching productions in English and Portuguese idioms published between January 2005 and June 2012. The 19 revised papers that have dealt with patients in the acute phase of the disease showed themes that were categorized into eight topics that contemplated the experienced process at various stages, from the onset of the disease, extending through the knowledge of the diagnosis and the understanding of the manifestations of the disease, drug treatment and general care, evolution and prognosis. The collected papers also point to the difficulty of understanding, of the patients, on what consists the remission phase, revealing also that this is a clinical stage underexplored by psychological studies.