| 1. |
- Goienetxea Uriarte, Ainhoa, 1983-, et al.
(författare)
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Lean, Simulation and Optimization : A Win-Win combination
- 2016
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Ingår i: Proceedings of the 2015 Winter Simulation Conference. - Piscataway, New Jersey : IEEE Computer Society. - 9781467397438 - 9781467397414 - 9781467397421 ; , s. 2227-2238
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Konferensbidrag (refereegranskat)abstract
- Lean and simulation analysis are driven by the same objective, how to better design and improve processes making the companies more competitive. The adoption of lean has been widely spread in companies from public to private sectors and simulation is nowadays becoming more and more popular. Several authors have pointed out the benefits of combining simulation and lean, however, they are still rarely used together in practice. Optimization as an additional technique to this combination is even a more powerful approach especially when designing and improving complex processes with multiple conflicting objectives. This paper presents the mutual benefits that are gained when combining lean, simulation and optimization and how they overcome each other´s limitations. A framework including the three concepts, some of the barriers for its implementation and a real-world industrial example are also described.
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| 2. |
- Grandahl, Maria, et al.
(författare)
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A population based survey of school nurses' attitudes to the implemented HPV vaccination programme in Sweden
- 2015
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Ingår i: Eurogin 2015. ; , s. 168-168
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Konferensbidrag (refereegranskat)abstract
- Objective: To investigate school nurses’ attitudes to, and experiences of the school-based HPV vaccination programme,one year after its implementation in Sweden.Methods: Data were collected using a web-based questionnaire in spring 2013, and 83.1% (851/1024) of the nursesanswered the questionnaire.Results: The majority (88.9%, n=756) agreed that HPV vaccinations should be the school nurses’ responsibility, and mostalso agreed (81.5%, n=693) that boys also should be offered the vaccine. Two thirds, 66.9% (n=570), stated that they hadexperienced difficulties with the vaccination and of these 59.1% (n=337) considered the task time-consuming. Three outof four nurses, 76.1% (n=648), had been contacted by parents who raised questions regarding the vaccine. The most commonquestions were related to side effects. There were strong associations between the nurses’ received education aboutthe HPV vaccine and perceived knowledge about the HPV vaccine and a favourable attitude towards vaccination (both p<0.001). A school nurse with a high level of received education was 9.8 times more likely to have a positive attitude to HPVvaccination compared to a nurse with a low level of received education (p<0.001). Nurses with high perceived knowledgewere 2.5 times more likely to have a positive attitude compared to those with a low level of perceived knowledge(p=0.006).Conclusions: HPV vaccination is a complex and time-consuming task and the school nurses need adequate knowledge,education, skills and time in order to address questions and concerns from parents, as well as informing about HPV.
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| 3. |
- Haney, Michael, et al.
(författare)
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Scandinavian SSAI clinical practice guideline on choice of first-line vasopressor for patients with acute circulatory failure
- 2016
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Ingår i: Acta Anaesthesiologica Scandinavica. - : WILEY-BLACKWELL. - 0001-5172 .- 1399-6576. ; 60:10, s. 1347-1366
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Forskningsöversikt (refereegranskat)abstract
- BackgroundAdult critically ill patients often suffer from acute circulatory failure, necessitating use of vasopressor therapy. The aim of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) task force for Acute Circulatory Failure was to present clinically relevant, evidence-based treatment recommendations on this topic. MethodsThis guideline was developed according to standards for trustworthy guidelines, including a systematic review of the literature and use of the GRADE methodology for assessment of the quality of evidence and for moving from evidence to recommendations. We assessed the following subpopulations of patients with acute circulatory failure: 1) shock in general, 2) septic shock, 3) cardiogenic shock, 4) hypovolemic shock and 5) other types of shock, including vasodilatory shock. We assessed patient-important outcome measures, including mortality, serious adverse reactions and quality-of-life. ResultsFor patients with shock in general and those with septic shock, we recommend using norepinephrine rather than dopamine, and we suggest using norepinephrine rather than epinephrine, vasopressin analogues, and phenylephrine. For patients with cardiogenic shock and those with hypovolemic shock, we suggest using norepinephrine rather than dopamine, and we provide no recommendations/suggestions of norepinephrine vs. epinephrine, vasopressin analogues, and phenylephrine. For patients with other types of shock, including vasodilatory shock, we suggest using norepinephrine rather than dopamine, epinephrine, vasopressin analogues, and phenylephrine. ConclusionsWe recommend using norepinephrine rather than other vasopressors as first-line treatment for the majority of adult critically ill patients with acute circulatory failure.
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| 4. |
- Lam, Y. Y., et al.
(författare)
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Effects of dietary fat profile on gut permeability and microbiota and their relationships with metabolic changes in mice
- 2015
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Ingår i: Obesity. - : Wiley. - 1930-7381. ; 23:7, s. 1429-1439
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo distinguish the effects of dietary fat profile on gut parameters and their relationships with metabolic changes and to determine the capacity of n-3 fatty acids to modify gut variables in the context of diet-induced metabolic dysfunctions. MethodsMice received control or high-fat diets emphasizing saturated (HFD-sat), n-6 (HFD-n6), or n-3 (HFD-n3) fatty acids for 8 weeks. In another cohort, mice that were maintained on HFD-sat received n-3-rich fish oil or resolvin D1 supplementation. ResultsHFD-sat and HFD-n6 induced similar weight gain, but only HFD-sat increased index of insulin resistance (HOMA-IR), colonic permeability, and mesenteric fat inflammation. Hydrogen sulfide-producing bacteria were one of the major groups driving the diet-specific changes in gut microbiome, with the overall microbial profile being associated with changes in body weight, HOMA-IR, and gut permeability. In mice maintained on HFD-sat, fish oil and resolvin D1 restored barrier function and reduced inflammation in the colon but were unable to normalize HOMA-IR. ConclusionsDifferent dietary fat profiles led to distinct intestinal and metabolic outcomes that are independent of obesity. Interventions targeting inflammation successfully restored gut health but did not reverse systemic aspects of diet-induced metabolic dysfunction, implicating separation between gut dysfunctions and disease-initiating and/or -maintaining processes.
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| 5. |
- Latva-Rasku, Aino, et al.
(författare)
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The SGLT2 Inhibitor Dapagliflozin Reduces Liver Fat but Does Not Affect Tissue Insulin Sensitivity : A Randomized, Double-Blind, Placebo-Controlled Study With 8-Week Treatment in Type 2 Diabetes Patients.
- 2019
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Ingår i: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 42:5, s. 931-937
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to investigate tissue-specific effects of dapagliflozin on insulin sensitivity and liver and body fat in patients with type 2 diabetes.RESEARCH DESIGN AND METHODS: This randomized, double-blind, parallel group, placebo-controlled study recruited 32 patients with type 2 diabetes. Enrolled patients were to have HbA1c 6.5-10.5% (48-91 mmol/mol) and ≥3 months of stable treatment with metformin, dipeptidyl peptidase 4 inhibitor, or their combination. Patients were randomized 1:1 to receive 10 mg dapagliflozin or placebo daily for 8 weeks. Before and after the intervention, tissue insulin sensitivity was measured using [18F]-fluorodeoxyglucose and positron emission tomography during hyperinsulinemic-euglycemic clamp. Liver proton density fat fraction (PDFF) and adipose tissue volumes were assessed using MRI, and blood biomarkers were analyzed.RESULTS: After 8 weeks, glycemic control was improved by dapagliflozin (placebo-corrected change in HbA1c -0.39%, P < 0.01), but whole-body glucose uptake was not increased (P = 0.90). Tissue-specific insulin-stimulated glucose uptake did not change in skeletal muscle, liver, myocardium, or white and brown adipose tissue, and endogenous glucose production remained unaffected. However, there were significant placebo-corrected decreases in liver PDFF (-3.74%, P < 0.01), liver volume (-0.10 L, P < 0.05), visceral adipose tissue volume (-0.35 L, P < 0.01), interleukin-6 (-1.87 pg/mL, P < 0.05), and N-terminal prohormone of brain natriuretic peptide (-96 ng/L, P = 0.03).CONCLUSIONS: In this study, 8 weeks of treatment with dapagliflozin reduced liver PDFF and the volume of visceral adipose tissue in obese patients with type 2 diabetes. Although glycemic control was improved, no effect on tissue-level insulin sensitivity was observed.
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| 6. |
- Lindkvist, Björn, et al.
(författare)
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Importance of pancreatic exocrine dysfunction in patients with type 2 diabetes: A randomized crossover study
- 2018
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Ingår i: Pancreatology. - : Elsevier BV. - 1424-3903. ; 18:5, s. 550-558
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Tidskriftsartikel (refereegranskat)abstract
- Background: Levels of faecal elastase-1 (FE-1), a marker of exocrine pancreatic function, are lower in patients with type 2 diabetes than without diabetes. We aimed to investigate the association between FE-1 and nutritional status, gastrointestinal symptoms, and lipid absorption. Methods: This randomized, open-label, crossover study included 315 patients with type 2 diabetes aged 18-70 years treated with oral antidiabetics, with HbA(1c) 6.59.0% and BMI 1840 kg/m(2). Assessments included levels of FE-1 and blood biomarkers of nutrition, and Bristol Stool Scale and Gastrointestinal Symptom Rating Scale (GSRS) scores. Plasma exposure of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) after oral administration of free omega-3 carboxylic acids or ethyl esters with breakfast was investigated in patients with low, intermediate, and normal FE-1 levels. Results: The prevalence of low and intermediate FE-1 levels was 5.2% and 4.9%, respectively. Bristol Stool Scale scores and mean values of GSRS Diarrhoea and Indigestion domain symptoms were similar across groups, but patients with low FE-1 were heavier and reported lower stool frequency. FE-1 levels correlated positively with plasma levels of amylase, lipase, 25-hydroxy vitamin D, and albumin. Mean EPA + DHA exposure was similarly higher after intake of free vs. esterified omega-3 fatty acids in all FE-1 groups. Conclusions: The prevalence of low FE-1 (< 100 mu g/g) as a measure of pancreatic exocrine insufficiency was infrequent in type 2 diabetes. Except for low plasma concentrations of EPA and 25-hydroxy vitamin D, type 2 diabetes patients with low FE-1 had no other signs of malabsorption or gastrointestinal disorders. Plasma levels of EPA and DHA after the intake of esterified versus free EPA and DHA did not correlate with FE-1 levels. (C) 2018 IAP and EPC. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license.
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| 7. |
- Morshedzadeh, Iman, 1979-, et al.
(författare)
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Multi-level management of discrete event simulation models in a product lifecycle management framework
- 2018
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Ingår i: Procedia Manufacturing. - : Elsevier. - 2351-9789. ; 25, s. 74-81
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Tidskriftsartikel (refereegranskat)abstract
- Discrete event simulation (DES) models imitates the behavior of a production system. Models can be developed to reflect different levels of the production system, e.g supply chain level or manufacturing line level. Product Lifecycle Management (PLM) systems have been developed in order to manage product and manufacturing related data. DES models is one kind of product lifecycle’s data which can be managed by a PLM system. This paper presents a method and its implementation for management of interacting multi-level models utilizing a PLM system.
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| 8. |
- Morshedzadeh, Iman, 1979-, et al.
(författare)
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Product lifecycle management with provenance management and virtual models : an industrial use-case study
- 2018
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Ingår i: Procedia CIRP. - : Elsevier. - 2212-8271. ; 72, s. 1190-1195
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Tidskriftsartikel (refereegranskat)abstract
- Saving and managing virtual models’ provenance information (models’ history) can increase the level of reusability of those models. This paper describes a provenance management system (PMS) that has been developed based on an industrial case study.The product lifecycle management (PLM) system, as a main data management system, is responsible for receiving virtual models and their related data from Computer-Aided technologies (CAx) and providing this information for the PMS. In this paper, the management of discrete event simulation data with the PLM system will be demonstrated as the first link of provenance data management chain (CAx-PLM-PMS).
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| 9. |
- Morshedzadeh, Iman, 1979-, et al.
(författare)
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Real World Data Identification and Classification for Support of Virtual Confidence
- 2016
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Konferensbidrag (refereegranskat)abstract
- Shortening of the product development process time is one of the main approaches for all enterprises to offer their products to the market. Virtual manufacturing tools can help companies to reduce their time to market, by reduction of the engineering lead time. Extensive use of virtual engineering models results in a need for verification of the model’s accuracy. This virtual engineering usability and assessment have been named virtual confidence. The two main factors of the achievement of this confidence are the accuracy of the virtual models and the virtual engineering results.For controlling of both above factors, a complete virtual model and related virtual model knowledge are needed. These knowledges can be tacit or explicit. For exploring explicit knowledge, a data and information collection from different disciplines in the organization is needed.In this paper, a data map with focus on the manufacturing engineering scope will be presented. This data map is generated from different data sources at a manufacturing plant, and gives an overview of different data that exist at different data sources, in the area of manufacturing. Combining real world data from different sources with virtual engineering model data supports, amongst others, establishment of virtual confidence.
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