900 resultados para Condition Monitoring, Asset Management, Maintenance, Ultrasound, Diagnosis


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Avarias em rolamentos são causas comuns de falhas em máquinas e equipamentos industriais. Portanto, é importante a aplicação de técnicas que permitam a deteção e a identificação do problema o mais cedo possível a fim de evitar a destruição do rolamento e consequente paragem da máquina. Logo, o processo de monitorização do estado dos rolamentos deve receber uma atenção especial no plano de manutenção de qualquer indústria. Este trabalho tem, assim, como principal objetivo a caracterização das partículas de desgaste provenientes de rolamentos através da análise dos seus lubrificantes por ferrometria e ferrografia analítica. Estas técnicas permitem identificar e caracterizar as várias partículas de desgaste presentes numa amostra de lubrificante, permitindo não só avaliar o grau de severidade do desgaste mas também identificar o tipo de desgaste predominante (fadiga, abrasão, corrosão,etc.), e até identificar os diferentes materiais das partículas que se podem associar a componentes específicos com falhas. A criação de uma base de dados para armazenar os resultados, os comentários e as informações mais importantes obtidos nos ensaios experimentais, assim como a análise de alguns casos práticos, foram também realizados no âmbito deste trabalho. Para desenvolver um conhecimento mais profundo sobre as técnicas utilizadas foi importante fazer uma análise aos diversos tipos de rolamentos, a sua lubrificação e as causas e tipos principais de avarias encontradas.

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Dissertation to obtain the degree of Master in Electrical and Computer Engineering

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Background and objective: Therapeutic Drug Monitoring (TDM) has been introduced early 1970 in our hospital (CHUV). It represents nowadays an important routine activity of the Division of Clinical Pharmacology and Toxicology (PCL), and its impact and utility for clinicians required assessment. This study thus evaluated the impact of TDM recommendations in terms of dosage regimen adaptation. Design: A prospective observational study was conducted over 5 weeks. The primary objective was to evaluate the application of our TDM recommendations and to identify potential factors associated to variations in their implementation. The secondary objective was to identify pre-analytical problems linked to the collection and processing of blood samples. Setting: Four representative clinical units at CHUV. Main outcome measure: Clinical data, drug related data (intake, collection and processing) and all information regarding the implementation of clinical recommendations were collected and analyzed by descriptive statistics. Results: A total of 241 blood measurement requests were collected, among which 105 triggered a recommendation. 37% of the recommendations delivered were applied, 25 % partially applied and 34% not applied. In 4% it was not applicable. The factors determinant for implementation were the clinical unit and the mode of transmission of the recommendation (written vs oral). No clear difference between types of drugs could be detected. Pre-analytical problems were not uncommon, mostly related to completion of request forms and delays in blood sampling (equilibration or steady-state not reached). We have identified 6% of inappropriate and unusable drug level measurements that could cause a substantial cost for the hospital. Conclusion: This survey highlighted a better implementation of TDM recommendations in clinical units where this routine is well integrated and understood by the medical staff. Our results emphasize the importance of communication with the nurse or the physician in charge, either to transmit clinical recommendations or to establish consensual therapeutic targets in specific conditions. Development of strong partnerships between clinical pharmacists or pharmacologists and clinical units would be beneficial to improve the impact of this clinical activity.

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QUESTIONS UNDER STUDY/PRINCIPLES: After arterial ischemic stroke (AIS) an early diagnosis helps preserve treatment options that are no longer available later. Paediatric AIS is difficult to diagnose and often the time to diagnosis exceeds the time window of 6 hours defined for thrombolysis in adults. We investigated the delay from the onset of symptoms to AIS diagnosis in children and potential contributing factors. METHODS: We included children with AIS below 16 years from the population-based Swiss Neuropaediatric Stroke Registry (2000-2006). We evaluated the time between initial medical evaluation for stroke signs/symptoms and diagnosis, risk factors, co-morbidities and imaging findings. RESULTS: A total of 91 children (61 boys), with a median age of 5.3 years (range: 0.2-16.2), were included. The time to diagnosis (by neuro-imaging) was <6 hours in 32 (35%), 6-12 hours in 23 (25%), 12-24 hours in 15 (16%) and >24 hours in 21 (23%) children. Of 74 children not hospitalised when the stroke occurred, 42% had adequate outpatient management. Delays in diagnosis were attributed to: parents/caregivers (n = 20), physicians of first referral (n = 5) and tertiary care hospitals (n = 8). A co-morbidity hindered timely diagnosis in eight children. No other factors were associated with delay to diagnosis. A total of 17 children were inpatients at AIS onset. CONCLUSIONS: One-third of children with AIS were diagnosed within six hours. Diagnostic delay was predominately caused by insufficient recognition of stroke symptoms. Increased public and expert awareness and immediate access to diagnostic imaging are essential. The ability of parents/caregivers and health professionals to recognise stroke symptoms in a child needs to be improved.

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The DOT monitors performance of five core functions, under which are eight services, products and activities (SPAs). In all, 56 measures are used to monitor the core functions and SPAs in the DOT’s performance plan. (See Iowa DOT Performance Report – FY2009, pages 1A-9A.) Overall, DOT’s performance was good in fiscal year 2009. Of the 56 measures in the DOT’s performance plan, 43 measures (77%) met or exceeded their targets. Of the 13 measures falling short, ten were within four percent of their target. This means 95 percent of DOT measures met or exceeded 96 percent of their preset target. Performance measures monitoring the core functions of Physical Asset Management and Resource Management showed the DOT did a good job managing resources. A total of 11 of the 14 (79%) core function and SPA measures met or exceeded their predetermined targets. Two of the three measures falling short were within four percent of its target. Core function and SPA measures within the Transportation Systems core function indicated good performance. A total of 22 of the 30 (73%) core function and SPA measures met or exceeded their predetermined targets. Overall, six of the eight measures falling short were within four percent of their target. Performance measures monitoring the core functions of Enforcement and Investigation and Regulation and Compliance showed the DOT performed well. A total of 10 of the 12 (83%) core function and SPA measures met or exceeded their predetermined targets. Both of the measures falling short were within four percent of their target.

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Geographic information systems (GIS) and artificial intelligence (AI) techniques were used to develop an intelligent snow removal asset management system (SRAMS). The system has been evaluated through a case study examining snow removal from the roads in Black Hawk County, Iowa, for which the Iowa Department of Transportation (Iowa DOT) is responsible. The SRAMS is comprised of an expert system that contains the logical rules and expertise of the Iowa DOT’s snow removal experts in Black Hawk County, and a geographic information system to access and manage road data. The system is implemented on a mid-range PC by integrating MapObjects 2.1 (a GIS package), Visual Rule Studio 2.2 (an AI shell), and Visual Basic 6.0 (a programming tool). The system could efficiently be used to generate prioritized snowplowing routes in visual format, to optimize the allocation of assets for plowing, and to track materials (e.g., salt and sand). A test of the system reveals an improvement in snowplowing time by 1.9 percent for moderate snowfall and 9.7 percent for snowstorm conditions over the current manual system.

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In June 2001, the Iowa Department of Transportation announced the imminent closure and disposal of selected highway maintenance facilities as part of cost-cutting measures mandated by the Iowa legislature, an action that was to be completed by July 31, 2001. The DOT recognized that some of these facilities might be "historical sites," which in the Iowa Code are defined as any district, site, building or structure listed on the National Register of Historic Places or identified as eligible for listing in the National Register by the State Historic Preservation Office. Section 303 of the Code requires state agencies to "enter into an agreement with the Department of Cultural Affairs [in which the SHPO is located] to ensure the proper management, maintenance and development of historical sites." The DOT saw this disposal action as an opportunity to compile information about its highway maintenance facilities that could be employed in development of a management program for historic highway maintenance facilities in the future. Subsequently, the DOT authorized a similar study of highway weigh stations.

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BACKGROUND: Pharmacists can play a decisive role in the management of ambulatory patients with depression who have poor adherence to antidepressant drugs. OBJECTIVE: To systematically evaluate the effectiveness of pharmacist care in improving adherence of depressed outpatients to antidepressants. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. RCTs were identified through electronic databases (MEDLINE, Cochrane Central Register of Controlled Trials, Institute for Scientific Information Web of Knowledge, and Spanish National Research Council) from inception to April 2010, reference lists were checked, and experts were consulted. RCTs that evaluated the impact of pharmacist interventions on improving adherence to antidepressants in depressed patients in an outpatient setting (community pharmacy or pharmacy service) were included. Methodologic quality was assessed and methodologic details and outcomes were extracted in duplicate. RESULTS: Six RCTs were identified. A total of 887 patients with an established diagnosis of depression who were initiating or maintaining pharmacologic treatment with antidepressant drugs and who received pharmacist care (459 patients) or usual care (428 patients) were included in the review. The most commonly reported interventions were patient education and monitoring, monitoring and management of toxicity and adverse effects, adherence promotion, provision of written or visual information, and recommendation or implementation of changes or adjustments in medication. Overall, no statistical heterogeneity or publication bias was detected. The pooled odds ratio, using a random effects model, was 1.64 (95% CI 1.24 to 2.17). Subgroup analysis showed no statistically significant differences in results by type of pharmacist involved, adherence measure, diagnostic tool, or analysis strategy. CONCLUSIONS: These results suggest that pharmacist intervention is effective in the improvement of patient adherence to antidepressants. However, data are still limited and we would recommend more research in this area, specifically outside of the US.

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Työn tavoitteena oli selvittää ja varmistaa uuden pakkauskoneen riittävä käyttövarmuus. Käyttövarmuuden selvittämistä varten tutustuttiin käyttövarmuuden käsitteisiin jatunnuslukuihin, sekä selvitettiin kunnossapidon merkitystä käyttövarmuuteen. Pakkauskoneen käyttövarmuutta analysoitiin vikapuumallin avulla. Analysointia varten laadittu vikapuumalli koostuu 391 perustapahtumasta ja yhteensä 629 tapahtumasta. Käyttövarmuusanalyysi suoritettiin kvalitatiivisesti ja kvantitatiivisesti. Analysointi painottuu kuitenkin kvantitatiiviseen simulointiin. Käyttövarmuusanalysoinnin apuna käytettiin simulointiohjelmaa. Käyttövarmuusvaatimukseksi asetettiin 99 % käytettävyys vuoden käyttöjakson aikana. Vikapuuanalyysin tuloksena saatiin arvio pakkauskoneen kokonaiskäytettävyydestä. Kokonaiskäytettävyydeksi muodostui 96,44 %, joka ei täytä käyttövarmuusvaatimusta. Yksittäisistä komponenttityypeistä epäluotettavimpia olivat liimalaitteiston ja paineilmajärjestelmän komponentit. Analysointityökalun avulla voitiin osoittaa käyttövarmuutta parantavien osatekijöiden vaikutukset saatuun kokonaiskäytettävyyteen. Käyttövarmuuteen voitiin vaikuttaa kunnossapidon avulla, lyhentämällä korjausaikaa ja varmentamalla komponentteja. Esitettyjen keinojen avulla käytettävyyttä on mahdollista nostaa n. 2,18 prosenttiyksikköä. Toimenpidesuositukset esitettiin saatujen tulosten ja työssä havainnoitujen asioiden perusteella. Käytettävyyden parantamiseksi ja varmistamiseksi suositetaan oikeanlaisia kunnossapitotoimenpiteitä, tehokkaan vikadiagnostiikan rakentamista sekä antureiden varmentamista. Käyttökunnonvalvonta suositetaan suoritettavaksi määräaikaistarkastuksina. Käyttökuntoa on aloitettava seuraamaan pidemmällä aikavälillä tapahtuvina häiriöraportointeina. Lisäksi tulevaisuudessa on vaadittava käyttövarmuustakuut toimittajilta laitehankintojen yhteydessä.

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Reaaliaikainen, ennakoiva kunnonvalvonta on erittäin tärkeä osa modernin tehtaan tai tuotantolinjan toimintaa. Diplomityön teettäjä haluaa edelleen kehittää akustiseen emissioon perustuvaa kunnonvalvonta järjestelmäänsä, jotta siitä olisi enemmän hyötyä asiakkaalle. Diplomityö sisältää johdannonakustiseen emissioon ja akustisiin emissio sensoreihin. Työn tavoitteena oli kehittää päätöksentekojärjestelmä, jota käytettäisiin työn teettäjän valmistamien sensoreiden antaman tiedon automatisoituun analysointiin. Työssä on vertailtu kolmea eri ohjelmistotoimittajaa ja heidän ohjelmiaan, ja tehty ehdotus hankittavasta ohjelmistosta. Lisäksi työssä on kehitetty ohjeita, joiden avulla ohjelmisto ohjelmoidaan tuottamaan reaaliaikaista tietoa ja huolto-ohjeita sen käyttäjille. Lisäksi työssä annetaan ehdotuksia kunnonvalvonta- ja päätöksentekojärjestelmän edelleen kehittämiseen.

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To complement the existing treatment guidelines for all tumour types, ESMO organises consensus conferences to focus on specific issues in each type of tumour. The 2nd ESMO Consensus Conference on Lung Cancer was held on 11-12 May 2013 in Lugano. A total of 35 experts met to address several questions on non-small-cell lung cancer (NSCLC) in each of four areas: pathology and molecular biomarkers, first-line/second and further lines of treatment in advanced disease, early-stage disease and locally advanced disease. For each question, recommendations were made including reference to the grade of recommendation and level of evidence. This consensus paper focuses on locally advanced disease.

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Objective To investigate the process of learning on human resource management in the radiology residency program at Escola Paulista de Medicina – Universidade Federal de São Paulo, aiming at improving radiologists' education. Materials and Methods Exploratory study with a quantitative and qualitative approach developed with the faculty staff, preceptors and residents of the program, utilizing a Likert questionnaire (46), taped interviews (18), and categorization based on thematic analysis. Results According to 71% of the participants, residents have clarity about their role in the development of their activities, and 48% said that residents have no opportunity to learn how to manage their work in a multidisciplinary team. Conclusion Isolation at medical records room, little interactivity between sectors with diversified and fixed activities, absence of a previous culture and lack of a training program on human resources management may interfere in the development of skills for the residents' practice. There is a need to review objectives of the medical residency in the field of radiology, incorporating, whenever possible, the commitment to the training of skills related to human resources management thus widening the scope of abilities of the future radiologists.

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Työssä tutkitaan asennetun laitekannan kunnossapitopalveluun perustuvan yritysten välisen yhteistyösuhteen kehittämisen edellytyksiä. Tutkimus pohjautuu teollisten palveluiden, yritysten välisten yhteistyösuhteiden ja palveluiden kehittämisen osatekijöiden ja menestystekijöiden teoreettiseen tarkasteluun, sekä kohdeyrityksille suoritetun kvalitatiivisen haastattelututkimuksen tulosten analysointiin teoreettisen viitekehyksen valossa. Tavoitteena on muodostaa ehjä ja hallittava kokonaisuus monialaisen ongelmakentän kriittisistä osatekijöistä, sekä niiden keskinäisistä kausaliteeteista. Yritysten välisen yhteistyön lähtökohtana on, että kaikki yhteistyön osapuolet saavuttavat toiminnalla hyötyjä omasta näkökulmastaan tarkasteltuna. Yhteistyösuhteen kehittäminen ja yhteisen arvon toteutuminen edellyttää näin ollen, että tarjottavan palvelukokonaisuuden sisältämät potentiaaliset hyödyt ja toisaalta myös niitä vastaavat riskit ymmärretään sekä palveluntarjoajan että asiakkaan organisaatiossa. Yhteistyösuhteen kehittäminen edellyttää edelleen myös, että suhteen kehittymistä ja saavutettavia hyötyjä pystytään mittaamaan relevanttien mittareiden avulla. Tutkimuksessa keskitytään hyötypotentiaalin selvittämisen edellytyksiin, sekä hyötyjen viestimisen haasteisiin molempia osapuolia palvelevasta objektiivisesta näkökulmasta. Haastattelututkimuksessa havaittujen ongelmakohtien pohjalta eritellään kehityskohteita ja ratkaisuehdotuksia päätöksenteon tueksi sekä laajojen palvelukokonaisuuksien ja niihin liittyvän ongelmakentän hahmottamisen ja hallinnan helpottamiseksi.

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Stora Enson Kotkan tehtaiden paperikone yksi on pieni erikoislaatuja tekevä paperikone, jonka hy6tysuhteen parantamiseen on etsitty keinoja kunnossapidon toimesta. Kansainvälisen kilpailun kiristyessä sekä raaka aineiden ja energian kallistuessa paperikoneen hy6tysuhteen tulee olla korkealla tasolla. Tämän diplomity6n kirjallisuusosassa on perehdytty yleisesti kunnossapidon käsitteisiin ja toimintatapoihin. Vikaantumisen osiossa on pyritty l6ytamaan mekanismi laakereiden vikaantumiseen ja kunnonvalvonnalla keinot laakereiden vikaantumisen ehkäisyyn. Työn käytännön osiossa tutkittiin paperikoneen häiriökirjauksia vuosilta 2006 ja 2007 tehtaan toiminnanohjausjärjestelmistä. Samanaikaisesti selvitettiin toimenpidekirjauksia ja tehtyjä korjauksia samoihin kohteisiin, joissa vikaantumista tapahtuu. Tavoitteena oli selvittää syyt suuriin hairi6seisokkiaikoihin sekä analysoida suunniteltujen ja suunnittelemattomien seisokkien suhdetta. Tutkimuksessa havaittiin häiriökirjauksien puutteellisuus ja kirjauksien merkitys häiriöiden ennaltaehkäisyssä.