957 resultados para Project 2002-035-C : Linking Best-Value Procurement Assessment to Outcome Performance Indicators
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In machine design we always want to save space, save energy and produce as much power as possible. We can often reduce accelerations, inertial loads and energy consumption by changing construction. In this study the old cardan gear mechanism (hypocycloid mechanism) has been compared with the conventional slider-crank mechanism in air pumps and four-stroke engines. Comprehensive Newtonian dynamics has been derived for the both mechanisms. First the slidercrank and the cardan gear machines have been studied as lossless systems. Then the friction losses have been added to the calculations. The calculation results show that the cardan gear machines can be more efficient than the slider-crank machines. The smooth running, low mass inertia, high pressures and small frictional power losses make the cardan gear machines clearly better than the slider-crank machines. The dynamic tooth loads of the original cardan gear construction do not rise very high when the tooth clearances are kept tight. On the other hand the half-size crank length causes high bearing forces in the cardan gear machines. The friction losses of the cardan gear machines are generally quite small. The mechanical efficiencies are much higher in the cardan gear machines than in the slider-crank machines in normal use. Crankshaft torques and power needs are smaller in the cardan gear air pumps than in the equal slider-crank air pumps. The mean crankshaft torque and the mean output power are higher in the cardan gear four-stroke engines than in the slider-crank four-stroke engines in normal use. The cardan gear mechanism is at its best, when we want to build a pump or an engine with a long connecting rod (≈ 5⋅crank length) and a thin piston (≈ 1.5⋅crank length) rotating at high angular velocity and intermittently high angular acceleration. The cardan gear machines can be designed also as slide constructions without gears. Suitable applications of the cardan gear machines are three-cylinder half-radial engines for motorcycles, sixcylinder radial engines for airplanes and six-cylinder double half-radial engines for sport cars. The applied equations of Newtonian dynamics, comparative calculations, calculation results (tables, curves and surface plots) and recommendations presented in this study hold novelty value and are unpublished before. They have been made and written by the author first time in this study.
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BACKGROUND: Immune checkpoint inhibitors targeting programmed cell death 1 (PD1) or its ligand (PD-L1) showed activity in several cancer types. METHODS: We performed immunohistochemistry for CD3, CD8, CD20, HLA-DR, phosphatase and tensin homolog (PTEN), PD-1, and PD-L1 and pyrosequencing for assessment of the O6-methylguanine-methyltransferase (MGMT) promoter methylation status in 135 glioblastoma specimens (117 initial resection, 18 first local recurrence). PD-L1 gene expression was analyzed in 446 cases from The Cancer Genome Atlas. RESULTS: Diffuse/fibrillary PD-L1 expression of variable extent, with or without interspersed epithelioid tumor cells with membranous PD-L1 expression, was observed in 103 of 117 (88.0%) newly diagnosed and 13 of 18 (72.2%) recurrent glioblastoma specimens. Sparse-to-moderate density of tumor-infiltrating lymphocytes (TILs) was found in 85 of 117 (72.6%) specimens (CD3+ 78/117, 66.7%; CD8+ 52/117, 44.4%; CD20+ 27/117, 23.1%; PD1+ 34/117, 29.1%). PD1+ TIL density correlated positively with CD3+ (P < .001), CD8+ (P < .001), CD20+ TIL density (P < .001), and PTEN expression (P = .035). Enrichment of specimens with low PD-L1 gene expression levels was observed in the proneural and G-CIMP glioblastoma subtypes and in specimens with high PD-L1 gene expression in the mesenchymal subtype (P = 5.966e-10). No significant differences in PD-L1 expression or TIL density between initial and recurrent glioblastoma specimens or correlation of PD-L1 expression or TIL density with patient age or outcome were evident. CONCLUSION: TILs and PD-L1 expression are detectable in the majority of glioblastoma samples but are not related to outcome. Because the target is present, a clinical study with specific immune checkpoint inhibitors seems to be warranted in glioblastoma.
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SKI-l/SlP protease is a member of the proprotein convertase family, with several functions in cellular metabolism and homeostasis. It is responsible for the processing of several cellular substrates, including ATF6, SREBPs, and GlcNAc-1- phosphotranspherase. Furthermore, SKI-1/SlP is also responsible for maturation of arenavirus surface glycoprotein into GP1 and GP2 subunits. This processing is a strict requirement in order to achieve fully mature and fusion-competent virions. Furthermore, SKI-1/SlP itself is synthesized as an inactive zymogen, requiring sequential autocatalytic processing at several sites (B'/B and C) in its prodomain in order to mature and become fully active. Our project focused on the analysis of SKI- 1/S1P prodomain in the biogenesis of the active enzyme. In this context we have additionally developed and characterized a novel cell-based sensor for assessment of cellular activity of the enzyme, with a potential application in screening for novel SKI- 1/S1P inhibitors. In a first aim we have analysed the relevance of cleavage motifs found in the enzyme prodomain. Using molecular and biochemistry tools we have identified and characterized a novel C' maturation site. Furthermore, we found that SKI-1/SlP autoprocessing results in intermediates whose catalytic domain remains associated with prodomain fragments of different lengths. Contrasting with other proprotein convertases, incompletely matured intermediates of SKI-1/SlP exhibit full catalytic activity toward selected substrates. In a second aim, we turned our attention to the structural basis of SKI-1/SlP N- terminus assisted folding. Studying the folding and activity of prodomain-truncated forms of the enzyme we found that a minimal folding unit is contained in the AB region. Deletion of the BC sequence affected auto-maturation but not folding, and partial activity was retained. However, the BC region seemed required for complete and full activity. Phylogenetic analyses showed that the AB sequence is highly conserved, while the BC fragment is variable in sequence and length. Specifically, replacement of the human prodomain with that of Drosophila, resulted in a fully mature and active chimeric enzyme, suggesting an evolution process of SKI-1/SlP prodomain towards a more complex arrangement and steps of activation. Overall, the additional data we have produced might provide fundamental knowledge crucial for the development of novel SKI-1/SlP inhibitors while also providing new SKI- 1/S1P variants with potential use in crystallization purpose. -- SKI-l/SlP est une protéase membre de la famille des proprotéines convertases (PCs), avec plusieurs fonctions dans le métabolisme cellulaire et de l'homéostasie. Il est responsable pour la maturation de plusieurs substrats cellulaires, y compris ATF6, SREBPs et GlcNAc-1-phosphotranspherase. SKI-l/SlP est également responsable pour la maturation de la glycoprotéine des arénavirus, une exigence stricte pour atteindre des virions infectieuse. Synthétisé comme un zymogène inactif, SKI-l/SlP nécessite d'un traitement autocatalytique séquentiel sur plusieurs sites (B'/B et C) de son prodomaine afin de devenir pleinement active. Notre projet était axé sur l'analyse de SKI-l/SlP prodomaine dans la biogenèse de l'enzyme. Dans ce contexte, nous avons développé un nouveau senseur-cellulaire pour l'évaluation de l'activité de l'enzyme. Ce dernier pourrait avoir une potentielle application dans l'identification de nouveaux inhibiteurs de SKI-l/SlP. Premièrement, nous avons analysé la pertinence des motifs de clivage trouvés dans le prodomaine de l'enzyme. En utilisant des outils moléculaires et biochimiques, nous avons identifié et caractérisé un nouveau site de maturation (C'). Aussi, nous avons constaté que la maturation de SKI-l/SlP a des intermédiaires dont le domaine catalytique reste associé à des fragments du prodomaine de différentes longueurs. Contrastant avec d'autres PCs, les intermédiaires partiellement matures de SKI-1 / SIP présentent une activité catalytique complète envers des substrats spécifiques. Dans un deuxième but nous avons tourné notre attention sur la base structurelle du pliage de SKI-l/SlP assisté par son N-terminus: En étudiant l'activité et pliage des formes tronquées dans le prodomaine de l'enzyme, nous avons constaté qu'une unité de pliage minimale est contenue dans la région de l'AB. La suppression de la séquence d'auto-BC affecte la maturation mais pas le pliage, et l'activité partielle est maintenue. Cependant, la région BC semble nécessaire pour une activité complète. Les analyses phylogénétiques ont montré que la séquence AB est fortement conservée, tandis que le fragment de BC est variable en longueur et en séquence. En particulier, le remplacement du prodomaine humain avec celui de la drosophile, a donné lieu à une enzyme chimérique complètement mature et active. Suggérant un processus d'évolution du prodomaine vers un arrangement et des mesures d'activation plus complexe. Globalement, ces donnees supplémentaires augment les connaissances fondamentales cruciales pour le développement de nouveaux inhibiteurs de SKI-1/ SIP, tout en offrant de nouvelles variantes SKI-1 / SIP dans le but d'obtenir la structure cristallographique de l'enzyme.
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OBJECTIVES: Direct-acting antiviral agents (DAAs) have become the standard of care for the treatment of chronic hepatitis C virus (HCV) infection. We aimed to assess treatment uptake and efficacy in routine clinical settings among HIV/HCV coinfected patients after the introduction of the first generation DAAs. METHODS: Data on all Swiss HIV Cohort Study (SHCS) participants starting HCV protease inhibitor (PI) treatment between September 2011 and August 2013 were collected prospectively. The uptake and efficacy of HCV therapy were compared with those in the time period before the availability of PIs. RESULTS: Upon approval of PI treatment in Switzerland in September 2011, 516 SHCS participants had chronic HCV genotype 1 infection. Of these, 57 (11%) started HCV treatment during the following 2 years with either telaprevir, faldaprevir or boceprevir. Twenty-seven (47%) patients were treatment-naïve, nine (16%) were patients with relapse and 21 (37%) were partial or null responders. Twenty-nine (57%) had advanced fibrosis and 15 (29%) had cirrhosis. End-of-treatment virological response was 84% in treatment-naïve patients, 88% in patients with relapse and 62% in previous nonresponders. Sustained virological response was 78%, 86% and 40% in treatment-naïve patients, patients with relapse and nonresponders, respectively. Treatment uptake was similar before (3.8 per 100 patient-years) and after (6.1 per 100 patient-years) the introduction of PIs, while treatment efficacy increased considerably after the introduction of PIs. CONCLUSIONS: The introduction of PI-based HCV treatment in HIV/HCV-coinfected patients improved virological response rates, while treatment uptake remained low. Therefore, the introduction of PIs into the clinical routine was beneficial at the individual level, but had only a modest effect on the burden of HCV infection at the population level.
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Aim: Bevacizumab is a monoclonal antibody directed against the vascular endothelial growth factor (VEGF). The previous phase II trial ABIGAIL (Reck, 2010) suggested circulating VEGF as a prognostic, but not predictive, biomarker for patients (pts) with non-small cell lung cancer (NSCLC) treated with bevacizumab. We prospectively measured VEGF in the multicenter phase II trial SAKK19/09 (NCT01116219). Methods: SAKK19/09 enrolled 77 evaluable patients (pts) with previously untreated, advanced nonsquamous NSCLC and EGFR wild type. Pts received 4 cycles of cisplatin 75mg/m2 (or carboplatin AUC5), pemetrexed 500mg/m2 and bevacizumab 7.5mg/kg, followed by maintenance therapy with pemetrexed and bevacizumab until progression by RECIST1.1. Follow-up CT scans were performed every 6 weeks until week 54 and every 12 weeks thereafter. Baseline EDTA blood samples were sent by same-day courier to the central laboratory for centrifugation, aliquoting, and freezing. Upon completion of enrollment, aliquots were thawed, and VEGF quantification was performed centrally using Luminex® Performance Assay Human Base Kit A (R&D Systems, Abingdon, UK). The mean value was used to stratify pts into two groups (low versus high VEGF). Best response rate assessed by RECIST1.1 (CR + PR versus SD + PD). Results: Clinical results of the SAKK19/09 trial were reported previously (Gautschi, 2013). Baseline plasma VEGF was detectable in 71 of 77 (92%) evaluable patients treated with chemotherapy and bevacizumab. The mean value was 74.9 pg/ml, the median 47.5 pg/ml, and the range 3.55 to 310 pg/ml. Using the mean as a predefined cutoff value, 50 patients had low VEGF levels and 21 patients had high VEGF levels. High VEGF was significantly associated with shorter PFS (4.1 vs 8.3 months, HR = 2.56; 95%CI: 1.43- 4.57; p = 0.0015) and OS (8.7 vs 17.5 months, HR = 2.67; 95% CI: 1.37-5.20; p = 0.0041), but not with best response rate ( p = 0.2256). Conclusions: Consistent with the ABIGAIL trial, circulating VEGF was prognostic, but not predictive for response, in the current trial. Further work is ongoing to identify potentially predictive biomarkers for bevacizumab, using comprehensive proteomic analyses. Disclosure: S.I. Rothschild: I received honoraria for the participation in advisory boards from Eli Lilly and Roche and for presentations at scientific symposiums sponsored by Roche; O. Gautschi: Honoraria for advisory boards of Eli Lilly and Roche; R. Cathomas: Advisory board member: Eli Lilly. All other authors have declared no conflicts of interest.
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Chlamydia psittaci and Chlamydia abortus are closely related intracellular bacteria exhibiting different tissue tropism that may cause severe but distinct infection in humans. C. psittaci causes psittacosis, a respiratory zoonotic infection transmitted by birds. C. abortus is an abortigenic agent in small ruminants, which can also colonize the human placenta and lead to foetal death and miscarriage. Infections caused by C. psittaci and C. abortus are underestimated mainly due to diagnosis difficulties resulting from their strict intracellular growth. We developed a duplex real-time PCR to detect and distinguish these two bacteria in clinical samples. The first PCR (PCR1) targeted a sequence of the 16S-23S rRNA operon allowing the detection of both C. psittaci and C. abortus. The second PCR (PCR2) targeted the coding DNA sequence CPSIT_0607 unique to C. psittaci. The two PCRs showed 100 % detection for ≥ 10 DNA copies per reaction (1000 copies ml- 1). Using a set of 120 samples, including bacterial reference strains, clinical specimens and infected cell culture material, we monitored 100 % sensitivity and 100 % specificity for the detection of C. psittaci and C. abortus for PCR1. When PCR1 was positive, PCR2 could discriminate C. psittaci from C. abortus with a positive predictive value of 100 % and a negative predictive value of 88 %. In conclusion, this new duplex PCR represents a low-cost and time-saving method with high-throughput potential, expected to improve the routine diagnosis of psittacosis and pregnancy complication in large-scale screening programs and also during outbreaks.
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BACKGROUND: While reduction of DUP (Duration of Untreated Psychosis) is a key goal in early intervention strategies, the predictive value of DUP on outcome has been questioned. We planned this study in order to explore the impact of three different definition of "treatment initiation" on the predictive value of DUP on outcome in an early psychosis sample. METHODS: 221 early psychosis patients aged 18-35 were followed-up prospectively over 36 months. DUP was measured using three definitions for treatment onset: Initiation of antipsychotic medication (DUP1); engagement in a specialized programme (DUP2) and combination of engagement in a specialized programme and adherence to medication (DUP3). RESULTS: 10% of patients never reached criteria for DUP3 and therefore were never adequately treated over the 36-month period of care. While DUP1 and DUP2 had a limited predictive value on outcome, DUP3, based on a more restrictive definition for treatment onset, was a better predictor of positive and negative symptoms, as well as functional outcome at 12, 24 and 36 months. Globally, DUP3 explained 2 to 5 times more of the variance than DUP1 and DUP2, with effect sizes falling in the medium range according to Cohen. CONCLUSIONS: The limited predictive value of DUP on outcome in previous studies may be linked to problems of definitions that do not take adherence to treatment into account. While they need replication, our results suggest effort to reduce DUP should continue and aim both at early detection and development of engagement strategies.
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OBJECTIVE: To identify reliable predictors of outcome in comatose patients after cardiac arrest using a single routine EEG and standardized interpretation according to the terminology proposed by the American Clinical Neurophysiology Society. METHODS: In this cohort study, 4 EEG specialists, blinded to outcome, evaluated prospectively recorded EEGs in the Target Temperature Management trial (TTM trial) that randomized patients to 33°C vs 36°C. Routine EEG was performed in patients still comatose after rewarming. EEGs were classified into highly malignant (suppression, suppression with periodic discharges, burst-suppression), malignant (periodic or rhythmic patterns, pathological or nonreactive background), and benign EEG (absence of malignant features). Poor outcome was defined as best Cerebral Performance Category score 3-5 until 180 days. RESULTS: Eight TTM sites randomized 202 patients. EEGs were recorded in 103 patients at a median 77 hours after cardiac arrest; 37% had a highly malignant EEG and all had a poor outcome (specificity 100%, sensitivity 50%). Any malignant EEG feature had a low specificity to predict poor prognosis (48%) but if 2 malignant EEG features were present specificity increased to 96% (p < 0.001). Specificity and sensitivity were not significantly affected by targeted temperature or sedation. A benign EEG was found in 1% of the patients with a poor outcome. CONCLUSIONS: Highly malignant EEG after rewarming reliably predicted poor outcome in half of patients without false predictions. An isolated finding of a single malignant feature did not predict poor outcome whereas a benign EEG was highly predictive of a good outcome.
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Abstract Objective: To assess the cutoff values established by ROC curves to classify18F-NaF uptake as normal or malignant. Materials and Methods: PET/CT images were acquired 1 hour after administration of 185 MBq of18F-NaF. Volumes of interest (VOIs) were drawn on three regions of the skeleton as follows: proximal right humerus diaphysis (HD), proximal right femoral diaphysis (FD) and first vertebral body (VB1), in a total of 254 patients, totalling 762 VOIs. The uptake in the VOIs was classified as normal or malignant on the basis of the radiopharmaceutical distribution pattern and of the CT images. A total of 675 volumes were classified as normal and 52 were classified as malignant. Thirty-five VOIs classified as indeterminate or nonmalignant lesions were excluded from analysis. The standardized uptake value (SUV) measured on the VOIs were plotted on an ROC curve for each one of the three regions. The area under the ROC (AUC) as well as the best cutoff SUVs to classify the VOIs were calculated. The best cutoff values were established as the ones with higher result of the sum of sensitivity and specificity. Results: The AUCs were 0.933, 0.889 and 0.975 for UD, FD and VB1, respectively. The best SUV cutoffs were 9.0 (sensitivity: 73%; specificity: 99%), 8.4 (sensitivity: 79%; specificity: 94%) and 21.0 (sensitivity: 93%; specificity: 95%) for UD, FD and VB1, respectively. Conclusion: The best cutoff value varies according to bone region of analysis and it is not possible to establish one value for the whole body.
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Due to source contamination and wearing of instrument components problems caused by the direct insertion probe technique, a new way of introduction of low volatile compounds into mass spectrometer was tested. This new scheme comprises the introduction of the low volatile compounds solutions via a six port valve connected to a particle beam interface. Solutions of isatin were injected into this system and the best results were obtained with CH2Cl2, CH3OH and CH3CN. The solution inlet system has shown to be advantageous over the conventional way of direct insertion probe introduction.
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The present study explores relationships between project marketers and their customers in project marketing context. The purpose of the study is to increase the understanding on supplier’s position in project marketing networks. Project marketing is representing a high volume in the international business, and the industrial network approach and the project marketing research cannot fully explain a supplier’s position in project marketing networks. Increased knowledge on project networks can also contribute to industrial marketing research more generally. Data for the present study was collected firstly during the pilot case study from project buyers in the paper and the steel industry in interviews. Secondly an entire project marketing case concerning a steel industry case was used as a data source. The data included interviews, correspondence between the supplier and the buyer, and project documents. The data of the pilot case was analysed with contents analysis, and in the case a deeper analysis based on the developed Stage Dimension framework was used. Supplier’s position in project marketing networks is a hierarchical and dynamic concept including a supplier’s position on the highest level. The dimensions of the position concept are the intermediate level, and the dimensions are based on the underlying components. Supplier’s position is composed from four organization related dimensions, and two individual actor related dimensions. The composition of the supplier’s position varies during the project marketing process, and consequently the relative importance of the dimensions is changing over the process. Supplier’s position in project marketing networks is shaped by incremental and radical changes. Radical changes are initiated by critical events. The study contributes to the research of industrial networks and project marketing. The theoretical contribution of the study is threefold: firstly it proposes a structure of the position concept in project marketing networks, secondly it proposes the Position Stage Dimension Component (PSDC) model for the development of supplier’s position during the project marketing process, and thirdly the study widens the critical event concept to cover the project marketing process both on the organizational and individual level. In addition to the theoretical contributions there are several managerial implications for planning and implementing marketing strategies in the project context.
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El concepte Internet de les Coses va néixer fa molt poc, cap a l’any 2010, i es refereix a la connexió d’objectes a Internet, de manera que puguin interactuar en xarxa entre ells o amb les persones per transmetre o rebre informació, i realitzar, així, les accions programades en funció de les dades disponibles. Des de llavors la gran majoria d’institucions, tant públiques com privades, s’han interessat en aquest concepte, ja que pot suposar un augment molt important de la qualitat de vida de les persones, un estalvi de recursos i beneficis econòmics. D’aquí neix aquest Treball Final de Grau, ja que des de la Fundació Eduard Soler de Ripoll tenen el desig d’introduir-se en aquest camp. L’objectiu principal d’aquest Treball Final de Grau és crear una xarxa sense fils que pugui controlar la temperatura i la il·luminació de l’edifici C de la Fundació Eduard Soler i que, a més, es pugui connectar a Internet. Una de les conclusions a què he arribat gràcies a aquest treball és que la utilització d’eines de baix cost (Arduino, Xbee, MySQL, PHP...) permet introduir-se en l’apassionant món de l’Internet de les Coses i, a més, aconseguir molt bons resultats.
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Cation exchange capabilities of a Brazilian natural zeolite, identified as scolecite, were evaluated for application in wastewater control. We investigated the process of sorption of chromium(III), nickel(II), cadmium(II) and manganese(II) in synthetic aqueous effluents, including adsorption isotherms of single-metal solutions. The natural zeolite showed the ability to take up the tested heavy metals in the order Cr(III) > Cd(II) > Ni(II) > Mn(II), and this could be related to the valence and the hydration radius of the metal cations. The influence of temperature (25, 40 and 60 ºC) and initial pH value (from 4 to 6) was also evaluated. It was found that the adsorption increased substantially when the temperature was raised to 60 ºC and that maximum adsorption capacity was observed at pH 6. These results demonstrate that scolecite can be used for removal of heavy metals from aqueous effluents, under optimized conditions.
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Este artículo es una síntesis del proyecto realizado en INBio (Instituto Nacional de Biodiversidad), Costa Rica, cuyo objetivo principal fue la mejora de la Interpretación Ambiental de INBioparque, un parque temático de biodiversidad dentro de la institución. INBioparque está situado en Santo Domingo de Heredia, provincia de Heredia, Costa Rica. Éste pretende hacer una pequeña representación de los principales ecosistemas que se encuentran en el país. El parque se divide en diferentes zonas: Bosque del Valle Central, Bosque Húmedo, Bosque Seco, Humedal y Finca. En esta última, la Finca (ecosistema basado en la biodiversidad domesticada) es dónde se ha centrado todo el proyecto, debido a que presentaba una mayor necesidad de mejora en su interpretación ambiental. La Interpretación ambiental traduce el lenguaje técnico de los profesionales a términos e ideas más entendedoras para todos los públicos. Pretende promover una nueva conciencia sobre el valor de la biodiversidad, lograr su conservación y mejorar la calidad de vida del ser humano. El proyecto propone la mejora de la interpretación ambiental a través de las fichas técnicas elaboradas de las diferentes especies vegetales de la Finca, así como la renovación o creación de rótulos explicativos. Se propone también un recorrido guiado y auto guiado para hacer más entendedora la visita, además de algunas actividades y talleres.
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Tämän työn tarkoituksena oli selvittää miksi kohdeyrityksen erään avainkomponentin, kehäpyörän, kovasorvauksen vaiheajoissa on niin paljon vaihtelua ja kuinka sitä saataisiin vähennettyä. Samalla pyrittiin lyhentämään keskimääräisiä vaiheaikoja. Tutkimus aloitettiin tuotannon nykytilan kartoituksella, jossa selvitettiin yrityksen toimintatapoja ja tuotannon tehokkuutta heikentäviä ongelmia. Tämän jälkeen aloitettiin varsinainen kehitysprojekti, joka perustui Lean-ajatteluun. Lean-ajattelu on tuotannon kehittämiseen tähtäävä filosofia, jossa pyritään tekemään enemmän vähemmällä, poistamalla tuotannosta kaikki ylimääräinen arvoa lisäämätön toiminta. Tuotantoon pyritään saamaan aikaiseksi tuotteiden jatkuva virtaus tuotantoa tahdistamalla. Erinomaisuutta tavoitellaan jatkuvalla parantamisella. Kohdeyrityksen tuotannon ongelmien tarkemmaksi selvittämiseksi toteutettiin erilaisia seurantoja, niin paikan päällä tuotannossa, kuin automaattista tiedonkeruuohjelmistoa hyväksi käyttäen. Seurantojen tuloksena selvisi, että pääsyyt tuotannon vaiheaikojen vaihteluun löytyvät teknisen järjestelmän sijaan ihmisten asenteista ja osaamisesta. Kun kehitystyön tuloksena toteutetaan muutoksia, kohdataan usein muutosvastarintaa. Tällöin tarvitaan tehokasta muutosjohtamista. Muutostyössä on tärkeä hallita tietoa sen jakamisen lisäksi myös sen keräämisessä. Muutoksiin johtavan tiedon tulee olla aina relevanttia ja faktapohjaista. Muutosjohtamisen tavoitteena on saada aikaiseksi tietoa luova organisaatio, joka kestää itsekritiikkiä ja jolla on poisoppimisen taito. Työsuoritusten parantamiseksi toteutettiin pilottihanke, jossa testattiin tässä työssä kehitettyä palautejärjestelmää. Palaute perustui automaattisen tiedonkeruuohjelmiston keräämään dataan. Samalla selvitettiin työtä hidastaneita ongelmia yhteistyössä työntekijöiden kanssa. Pilottihankkeen tulokset ovat lupaavia, sillä seurannassa olleen kehäpyörämallin viikoittaisten vaiheaikojen keskiarvo laski 32,6 % ja kehäpyörän puolikkaiden kovasorvauksen vaiheaikojen vaihtelut vähenivät 18,1 ja 26,8 %. Tämän tutkimuksen tulosten perusteella päivittäisten työmäärien tarkempaa seurantaa kannattaa jatkaa ja palautejärjestelmää kehittää edelleen.