Nutritional Status of Maintenance Dialysis Patients: Low Lean Body Mass Index and Obesity Are Common, Protein-Energy Wasting Is Uncommon.

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Mette Koefoed

Full Text Available Maintenance dialysis patients are at increased risk of abnormal nutritional status due to numerous causative factors, both nutritional and non-nutritional. The present study assessed the current prevalence of protein-energy wasting, low lean body mass index and obesity in maintenance dialysis patients, and compared different methods of nutritional assessment.In a cross-sectional study conducted in 2014 at Roskilde Hospital, Denmark, we performed anthropometry (body weight, skinfolds, mid-arm, waist, and hip circumferences, and determined plasma albumin and normalized protein catabolic rate in order to assess the prevalence of protein-energy wasting, low lean body mass index and obesity in these patients.Seventy-nine eligible maintenance dialysis patients participated. The prevalence of protein-energy wasted patients was 4% (95% CI: 2-12 as assessed by the coexistence of low lean body mass index and low fat mass index. Low lean body mass index was seen in 32% (95% CI: 22-44. Obesity prevalence as assessed from fat mass index was 43% (95% CI: 32-55. Coexistence of low lean body mass index and obesity was seen in 10% (95% CI: 5-19. The prevalence of protein-energy wasting and obesity varied considerably, depending on nutritional assessment methodology.Our data indicate that protein-energy wasting is uncommon, whereas low lean body mass index and obesity are frequent conditions among patients in maintenance dialysis. A focus on how to increase and preserve lean body mass in dialysis patients is suggested in the future. In order to clearly distinguish between shortage, sufficiency and abundance of protein and/or fat deposits in maintenance dialysis patients, we suggest the simple measurements of lean body mass index and fat mass index.

Nutritional Status of Maintenance Dialysis Patients: Low Lean Body Mass Index and Obesity Are Common, Protein-Energy Wasting Is Uncommon.

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Koefoed, Mette; Kromann, Charles Boy; Juliussen, Sophie Ryberg; Hvidtfeldt, Danni; Ekelund, Bo; Frandsen, Niels Erik; Marckmann, Peter

2016-01-01

Maintenance dialysis patients are at increased risk of abnormal nutritional status due to numerous causative factors, both nutritional and non-nutritional. The present study assessed the current prevalence of protein-energy wasting, low lean body mass index and obesity in maintenance dialysis patients, and compared different methods of nutritional assessment. In a cross-sectional study conducted in 2014 at Roskilde Hospital, Denmark, we performed anthropometry (body weight, skinfolds, mid-arm, waist, and hip circumferences), and determined plasma albumin and normalized protein catabolic rate in order to assess the prevalence of protein-energy wasting, low lean body mass index and obesity in these patients. Seventy-nine eligible maintenance dialysis patients participated. The prevalence of protein-energy wasted patients was 4% (95% CI: 2-12) as assessed by the coexistence of low lean body mass index and low fat mass index. Low lean body mass index was seen in 32% (95% CI: 22-44). Obesity prevalence as assessed from fat mass index was 43% (95% CI: 32-55). Coexistence of low lean body mass index and obesity was seen in 10% (95% CI: 5-19). The prevalence of protein-energy wasting and obesity varied considerably, depending on nutritional assessment methodology. Our data indicate that protein-energy wasting is uncommon, whereas low lean body mass index and obesity are frequent conditions among patients in maintenance dialysis. A focus on how to increase and preserve lean body mass in dialysis patients is suggested in the future. In order to clearly distinguish between shortage, sufficiency and abundance of protein and/or fat deposits in maintenance dialysis patients, we suggest the simple measurements of lean body mass index and fat mass index.

Body imaging and sexual behavior in lean women with polycystic ovary syndrome.

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Morotti, Elena; Persico, Nicola; Battaglia, Bruno; Fabbri, Raffaella; Meriggiola, Maria Cristina; Venturoli, Stefano; Battaglia, Cesare

2013-11-01

In women with polycystic ovary syndrome (PCOS), changes in body appearance may influence the feminine identity of the patients with possible consequent depression and sexual dysfunction. The study aims to examine the differences in mood, perceived body image, sexual behavior, and clitoral vascularization between lean PCOS patients and healthy eumenorrheic controls. Thirty-three lean PCOS women (Group I) and 22 healthy nonhirsute volunteers (Group II) were submitted, on day 3-5 of the cycle, to ultrasonographic (US) and Doppler analyses, to clinical, hormonal, and biochemical evaluations, and to psychometric tests. Main outcome measures are Ferriman-Gallwey score (FG), clitoral volume, clitoral artery Pulsatility Index, the two-factor Italian McCoy female questionnaire (MFSQ), the Stunkard Figure Rating Scale (FRS), and the Beck Depression Inventory (BDI) questionnaire. The FG score and the androgens resulted, as expected, more elevated in PCOS patients than in controls. However, the US assessment of the clitoral body volume and the resistances registered at the level of the dorsal clitoral artery did not show any difference between Group I and Group II patients. Moreover, the two-factor Italian MFSQ, the FRS, and the BDI were similar in both groups. It seems that in lean PCOS women, the moderate hirsutism and hyperandrogenism do not have any important influence on body image and self-esteem and, as a consequence, on sexual function. © 2013 International Society for Sexual Medicine.

Body size and lean mass of brown bears across and within four diverse ecosystems

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Hilderbrand, Grant V.; Gustine, David; Mangipane, Buck A.; Joly, Kyle; Leacock, William; Mangipane, Lindsey S.; Erlenbach, Joy; Sorum, Mathew; Cameron, Matthew; Belant, Jerrold L.; Cambier, Troy

2018-01-01

Variation in body size across populations of brown bears (Ursus arctos) is largely a function of the availability and quality of nutritional resources while plasticity within populations reflects utilized niche width with implications for population resiliency. We assessed skull size, body length, and lean mass of adult female and male brown bears in four Alaskan study areas that differed in climate, primary food resources, population density, and harvest regime. Full body-frame size, as evidenced by asymptotic skull size and body length, was achieved by 8 to 14 years of age across populations and sexes. Lean body mass of both sexes continued to increase throughout their life. Differences between populations existed for all morphological measures in both sexes, bears in ecosystems with abundant salmon were generally larger. Within all populations, broad variation was seen in body size measures of adults with females displaying roughly a 2-fold difference in lean mass and males showing a 3- to 4-fold difference. The high level of intraspecific variation seen across and within populations suggests the presence of multiple life-history strategies and niche variation relative to resource partitioning, risk tolerance or aversion, and competition. Further, this level of variation indicates broad potential to adapt to changes within a given ecosystem and across the species’ range.

Weight-adjusted lean body mass and calf circumference are protective against obesity-associated insulin resistance and metabolic abnormalities

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Toshinari Takamura

2017-07-01

Interpretation: Weight-adjusted lean body mass and skeletal muscle area are protective against weight-associated insulin resistance and metabolic abnormalities. The calf circumference reflects lean body mass and may be useful as a protective marker against obesity-associated metabolic abnormalities.

Standardized uptake value of FDG corrected by lean body mass measured by DEXA

International Nuclear Information System (INIS)

Guirao, M.A.; Sanchez, A.M.; Saravi, F.D.; Mosconi, S.; Frias, L.

2002-01-01

Evaluating the metabolic activity of tumor lesion sometimes becomes important to evaluate grading of malignancy, prognosis, or response to therapy. The most used measure of the metabolic activity of [18F]-Fluorodeoxiglucose (FDG) in clinical PET is the Standardized Uptake Value (SUV). It relates the activity measured by the PET scan to the injected dose of FDG divided by the body mass. This approach overestimates SUV in 'heavy' patients, as the proportion of the 'low avid of FDG' fat mass increases. For this reason, different approaches are being evaluated to obtain a more accurate SUV measure. Aims: to compare the measured lean body mass by Dual X-Ray Absorptiometry with the previous methods of correction, to assess the more independent to the body constitution. Material and Methods: FDG metabolism was studied to 15 patients of both sexes, age between 28 and 72 y.o., body weight 55 to 92 Kg. One hour after the IV injection of 0.0045mCi/Kg of FDG, a whole body emission and transmission scan was performed to each subject in a positron emission tomograph (QUEST 250, GE-UGM, USA) for over 1 hour. Body lean mass composition was measured the same or next day by DEXA (Lunar DPX-L, USA.) ROIs were drawn on brain, liver and muscle. SUVbw =[(corrected mCi/g of tissue) / (mCi injected / body weight in grams)] was calculated for each tissue, and then recalculated replacing body weight with the measured lean body mass (SUVlm), calculated lean mass (SUVlc), body mass index (SUVmi) and body surface area (SUVsa). Corrected SUVs were normalized to each SUVbw average for a comparable visualization of results. Results: obtained data was analyzed by linear regression and curve estimation for each case in all tissues with the SPSS statistical software. A positive correlation between SUVbw and subject weight was confirmed for the 3 tissues. In Muscle and liver there was no significant correlation. The liver scanning time was variable ( 90 to 123 minutes after injection). Relating liver

Psoas muscle cross-sectional area as a measure of whole body lean muscle mass in maintenance hemodialysis patients

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Morrell, Glen R.; Ikizler, Talat A.; Chen, Xiaorui; Heilbrun, Marta E.; Wei, Guo; Boucher, Robert; Beddhu, Srinivasan

2016-01-01

Objective We investigate whether psoas or paraspinous muscle area measured on a single L4–5 image is a useful measure of whole lean body mass compared to dedicated mid-thigh magnetic resonance imaging (MRI). Design Observational study. Setting Outpatient dialysis units and a research clinic. Subjects 105 adult participants on maintenance hemodialysis. No control group was used. Exposure variables Psoas muscle area, paraspinous muscle area, and mid-thigh muscle area (MTMA) were measured by MRI. Main outcome measure Lean body mass was measured by dual-energy absorptiometry (DEXA) scan. Results In separate multivariable linear regression models, psoas, paraspinous, and mid-thigh muscle area were associated with increase in lean body mass. In separate multivariate logistic regression models, c-statistics for diagnosis of sarcopenia (defined as lean body mass) were 0.69 for paraspinous muscle area, 0.81 for psoas muscle area, and 0.89 for mid-thigh muscle area. With sarcopenia defined as lean body mass, the corresponding c-statistics were 0.71, 0.92, and 0.94. Conclusions We conclude that psoas muscle area provides a good measure of whole body muscle mass, better than paraspinous muscle area but slightly inferior to mid thigh measurement. Hence, in body composition studies a single axial MR image at the L4–L5 level can be used to provide information on both fat and muscle and may eliminate the need for time-consuming measurement of muscle area in the thigh. PMID:26994780

Subcutaneous oxyntomodulin analogue administration reduces body weight in lean and obese rodents.

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Liu, Y-L; Ford, H E; Druce, M R; Minnion, J S; Field, B C T; Shillito, J C; Baxter, J; Murphy, K G; Ghatei, M A; Bloom, S R

2010-12-01

To determine the efficacy of a long-acting oxyntomodulin (OXM) analogue, OXM6421, in inhibiting food intake and decreasing body weight in lean and diet-induced obese (DIO) rodents. The glucagon-like peptide-1 (GLP-1) receptor binding affinity and efficacy, sensitivity to enzymatic degradation in vitro and persistence in the circulation after peripheral administration were investigated for OXM6421 and compared with native OXM. The chronic effect of OXM6421 on food intake, body weight and energy expenditure was examined in lean rats, and its anti-obesity potential was evaluated in DIO mice. OXM6421 showed enhanced GLP-1 receptor binding affinity and cyclic adenosine monophosphate (cAMP) stimulation, and higher resistance to enzymatic degradation by dipeptidyl peptidase IV (DPP-IV) and neutral endopeptidase (NEP) compared with native OXM. OXM6421 persisted longer in the circulation than OXM after peripheral administration. Acute administration of OXM6421 potently inhibited food intake in lean rodents, with cumulative effects lasting up to 24 h. In lean rats, daily subcutaneous (s.c.) administration of OXM6421 caused greater weight loss than the pair-fed animals, and a higher rate of oxygen consumption than both the pair-fed and the saline controls. In DIO mice, continuous s.c. infusion of OXM6421 resulted in a significant weight loss, accompanied by an improvement in glucose homeostasis and an increase in circulating adiponectin levels. Once-daily s.c. administration of OXM6421 for 21 days caused sustained weight loss in DIO mice. OXM6421 induces negative energy balance in both lean and obese rodents, suggesting that long-acting OXM analogues may represent a potential therapy for obesity.

The effect of progressive resistance training on lean body mass in post-treatment cancer patients – A systematic review

International Nuclear Information System (INIS)

Lønbro, Simon

2014-01-01

Loss of lean body mass is a common problem in many post-treatment cancer patients and may negatively affect physical capacity in terms of maximal muscle strength and functional performance. The purpose of this study was to systematically review the scientific evidence on the effect of progressive resistance training on lean body mass in post-treatment cancer patients. A comprehensive literature search was conducted and ultimately 12 studies were included. Methodological quality of the included studies was evaluated using the PEDro scale and the effect of progressive resistance training was reported as the range of mean changes among RCTs and non-RCTs. Six RCTs and six non-RCTs were included in the study. In the RCTs the change in lean body mass in the progressive resistance training groups relative to control groups ranged from −0.4% to 3.9%, and in four of six trials the training effect was significantly larger than the change in the control groups. In the six non-RCTs, the mean change in lean body mass over time ranged from −0.01 to 11.8% which was significant in two of the trials. The included studies reported no or very limited adverse events following progressive resistance training. Based on 12 heterogenic studies there is moderate evidence supporting a positive effect of progressive resistance training on lean body mass in post-treatment cancer patients

Increased protein intake reduces lean body mass loss during weight loss in athletes.

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Mettler, Samuel; Mitchell, Nigel; Tipton, Kevin D

2010-02-01

To examine the influence of dietary protein on lean body mass loss and performance during short-term hypoenergetic weight loss in athletes. In a parallel design, 20 young healthy resistance-trained athletes were examined for energy expenditure for 1 wk and fed a mixed diet (15% protein, 100% energy) in the second week followed by a hypoenergetic diet (60% of the habitual energy intake), containing either 15% (approximately 1.0 g x kg(-1)) protein (control group, n = 10; CP) or 35% (approximately 2.3 g x kg(-1)) protein (high-protein group, n = 10; HP) for 2 wk. Subjects continued their habitual training throughout the study. Total, lean body, and fat mass, performance (squat jump, maximal isometric leg extension, one-repetition maximum (1RM) bench press, muscle endurance bench press, and 30-s Wingate test) and fasting blood samples (glucose, nonesterified fatty acids (NEFA), glycerol, urea, cortisol, free testosterone, free Insulin-like growth factor-1 (IGF-1), and growth hormone), and psychologic measures were examined at the end of each of the 4 wk. Total (-3.0 +/- 0.4 and -1.5 +/- 0.3 kg for the CP and HP, respectively, P = 0.036) and lean body mass loss (-1.6 +/- 0.3 and -0.3 +/- 0.3 kg, P = 0.006) were significantly larger in the CP compared with those in the HP. Fat loss, performance, and most blood parameters were not influenced by the diet. Urea was higher in HP, and NEFA and urea showed a group x time interaction. Fatigue ratings and "worse than normal" scores on the Daily Analysis of Life Demands for Athletes were higher in HP. These results indicate that approximately 2.3 g x kg(-1) or approximately 35% protein was significantly superior to approximately 1.0 g x kg(-1) or approximately 15% energy protein for maintenance of lean body mass in young healthy athletes during short-term hypoenergetic weight loss.

Measurement of body potassium with a whole-body counter: relationship between lean body mass and resting energy expenditure

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Jensen, M.D.; Braun, J.S.; Vetter, R.J.; Marsh, H.M.

1988-01-01

We conducted studies to determine whether the Mayo whole-body counter could be used to measure body potassium, and thus lean body mass (LBM), and whether moderate obesity alters resting energy expenditure when corrected for LBM. Twenty-four nonobese and 18 moderately obese adults underwent body potassium (40K) counting, as well as tritiated water space measurement and indirect calorimetry. LBM values predicted from 40K counting and tritiated water space measurements were highly correlated (P = 0.001; r = 0.88). Resting energy expenditure was closely related to LBM (P less than 0.0001; r = 0.78): kcal/day = 622 kcal + (LBM.20.0 kcal/kg LBM). In this relationship, the obese subjects did not differ from nonobese subjects. In summary, the Mayo whole-body counter can accurately measure LBM, and moderate obesity has no detectable effect on corrected resting energy expenditure

Oral Supplementation with Beta-Hydroxy-Beta-Methylbutyrate, Arginine, and Glutamine Improves Lean Body Mass in Healthy Older Adults.

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Ellis, Amy C; Hunter, Gary R; Goss, Amy M; Gower, Barbara A

2018-04-19

Oral intake of beta-hydroxy-beta-methylbutyrate (HMB), arginine, and glutamine may ameliorate muscle loss by stimulating protein synthesis and decreasing protein degradation while simultaneously decreasing inflammation. Previous studies provide evidence for improvement in body composition with dietary supplementation of these ingredients among patients with muscle-wasting diseases. The objectives of this study were to examine the effects of this amino acid mixture on lean body mass, muscle volume, and physical function among healthy older adults. Thirty-one community-dwelling men and women, aged 65-89 years, were randomized to either two oral doses of the amino acid supplement (totaling 3 g HMB, 14 g arginine, 14 g glutamine) or placebo daily for six months. At baseline and month six, lean body mass was measured by air displacement plethysmography, dual-energy X-ray absorptiometry (DXA), and four-compartment model. Muscle volume of quadriceps was quantified by magnetic resonance imaging (MRI), and participants performed a battery of tests to assess physical function. As compared to the placebo group, the treatment group exhibited improvement in a timed stair climb (p =.016) as well as significant increases in lean body mass by all methods of assessment (p lean mass in the supplement group only (p =.035). However, no change was observed in MRI-derived quadriceps volume. Dietary supplementation with HMB, arginine, and glutamine improved total body lean mass among a small sample of healthy older adults. Further research is indicated to elucidate mechanisms of action and to determine whether supplementation may benefit frail elders. Registered under ClinicalTrials.gov identifier no. NCT01057082.

The effect of progressive resistance training on lean body mass in post-treatment cancer patients - A systematic review

DEFF Research Database (Denmark)

Lønbro, Simon

2014-01-01

Loss of lean body mass is a common problem in many post-treatment cancer patients and may negatively affect physical capacity in terms of maximal muscle strength and functional performance. The purpose of this study was to systematically review the scientific evidence on the effect of progressive...... resistance training on lean body mass in post-treatment cancer patients. A comprehensive literature search was conducted and ultimately 12 studies were included. Methodological quality of the included studies was evaluated using the PEDro scale and the effect of progressive resistance training was reported...... as the range of mean changes among RCTs and non-RCTs. Six RCTs and six non-RCTs were included in the study. In the RCTs the change in lean body mass in the progressive resistance training groups relative to control groups ranged from -0.4% to 3.9%, and in four of six trials the training effect...

Lean body mass and muscle function in head and neck cancer patients and healthy individuals - results from the DAHANCA 25 study

DEFF Research Database (Denmark)

Lønbro, Simon; Dalgas, Ulrik; Primdahl, Hanne

2013-01-01

Abstract Introduction. Loss of lean body mass is common following radiotherapy in patients with head and neck squamous cell carcinoma (HNSCC) and may reduce maximal muscle strength and functional performance. However, the associations between lean body mass, muscle strength and functional...... m max gait speed, 30 s chair rise, 30 s arm curl, stair climb) from HNSCC patients from the DAHANCA 25 trials and data from 24 healthy individuals were included. Results. Lean body mass and maximal muscle strength were significantly associated according to the gender and age-adjusted linear...... regression model (p regression analyses showed that HNSCC patients expressed significant lower levels of the investigated variables after radiotherapy...

The effect of boron supplementation on lean body mass, plasma testosterone levels, and strength in male bodybuilders

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Ferrando, A. A.; Green, N. R.

1993-01-01

The effect of boron supplementation was investigated in 19 male bodybuilders ages 20-27 years. Ten were given a 2.5-mg boron supplement while 9 were given a placebo every day for 7 weeks. Plasma total and free testosterone, plasma boron, lean body mass, and strength measurements were determined on Days 1 and 49 of the study. Plasma boron values were significantly (p bodybuilding can increase total testosterone, lean body mass, and strength in lesser trained bodybuilders, and that boron supplementation had no effect on these measures.

Lean body mass, interleukin 18, and metabolic syndrome in apparently healthy Chinese.

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Liang Sun

Full Text Available OBJECTIVE: We aimed to investigate how lean body mass is related to circulating Interleukin 18 (IL-18 and its association with metabolic syndrome (MetS among apparently healthy Chinese. METHODS: A population-based sample of 1059 Chinese men and women aged 35-54 years was used to measure plasma IL-18, glucose, insulin, lipid profile, inflammatory markers and high-molecular-weight (HMW-adiponectin. Fat mass index (FMI and lean mass index (LMI were measured by dual-energy X-ray absorptiometry. MetS was defined by the updated National Cholesterol Education Program Adult Treatment Panel III criteria for Asian-Americans. RESULTS: Circulating IL-18 was positively correlated with LMI after adjustment for FMI (correlation coefficient = 0.11, P<0.001. The association with the MetS (odds ratio 3.43, 95% confidence interval 2.01-5.85 was substantially higher in the highest than the lowest quartile of IL-18 after multiple adjustments including body mass index. In the stratified multivariable regression analyses, the positive association between IL-18 and MetS was independent of tertiles of FMI, inflammatory markers and HMW-adiponectin, but significantly interacted with tertile of LMI (P for interaction = 0.010. CONCLUSION: Elevated plasma IL-18 was associated with higher MetS prevalence in apparently healthy Chinese, independent of traditional risk factors, FMI, inflammatory markers and HMW-adiponectin. More studies are needed to clarify the role of lean mass in IL-18 secretion and its associated cardio-metabolic disorders.

Body composition in lean women with polycystic ovary syndrome: effect of ethinyl estradiol and drospirenone combination.

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Aydin, Kadriye; Cinar, Nese; Aksoy, Duygu Yazgan; Bozdag, Gurkan; Yildiz, Bulent Okan

2013-03-01

Limited data are available regarding the potential effects of oral contraceptives (OCs) on body fat distribution particularly in lean women with polycystic ovary syndrome (PCOS). In the current study, we aimed to evaluate the influence of ethinyl estradiol and drospirenone on body composition. Participants included 28 lean patients with PCOS and 28 age- and body mass index (BMI)-matched healthy women. The PCOS patients received ethinyl estradiol 30 mcg/drospirenone 3 mg for 6 months. Body composition parameters were assessed by bioelectrical impedance analysis. Serum androgens, lipids, insulin resistance and glucose metabolism measures were also determined. At baseline, the PCOS patients and controls had similar body composition, lipids, insulin resistance and glucose metabolism parameters. Total and trunk fat percentages were negatively correlated with sex hormone binding globulin and were positively correlated with homeostatic model assessment of insulin resistance and free androgen index in the PCOS group.. After 6 months of treatment in the PCOS patients, total fat percentage increased from 24.5%±7.1% to 26.0%±6.1% (p=.035) and trunk fat percentage increased from 20.2%±8.9% to 22.2%±7.1% (p=.014), although weight, BMI and waist to hip ratio (WHR) remained unchanged. Lean women with PCOS have similar body composition compared to healthy women. OC therapy for 6 months in PCOS patients results in an increased total and trunk fat percentage despite no change in clinical anthropometric measures including weight, BMI and WHR. Copyright © 2013 Elsevier Inc. All rights reserved.

Caloric Restriction in Lean and Obese Strains of Laboratory Rat: Effects on Body Composition, Metabolism, Growth, and Overall Health

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NEW FINDINGS: What is the central question of this study? How do lean and obese rats respond physiologically to caloric restriction? What is the main finding and its importance? Obese rats show marked benefits compared with lean animals. Reduced body fat is associated with improv...

Novel Equations for Estimating Lean Body Mass in Peritoneal Dialysis Patients.

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Dong, Jie; Li, Yan-Jun; Xu, Rong; Yang, Zhi-Kai; Zheng, Ying-Dong

2015-12-01

♦ To develop and validate equations for estimating lean body mass (LBM) in peritoneal dialysis (PD) patients. ♦ Two equations for estimating LBM, one based on mid-arm muscle circumference (MAMC) and hand grip strength (HGS), i.e., LBM-M-H, and the other based on HGS, i.e., LBM-H, were developed and validated with LBM obtained by dual-energy X-ray absorptiometry (DEXA). The developed equations were compared to LBM estimated from creatinine kinetics (LBM-CK) and anthropometry (LBM-A) in terms of bias, precision, and accuracy. The prognostic values of LBM estimated from the equations in all-cause mortality risk were assessed. ♦ The developed equations incorporated gender, height, weight, and dialysis duration. Compared to LBM-DEXA, the bias of the developed equations was lower than that of LBM-CK and LBM-A. Additionally, LBM-M-H and LBM-H had better accuracy and precision. The prognostic values of LBM in all-cause mortality risk based on LBM-M-H, LBM-H, LBM-CK, and LBM-A were similar. ♦ Lean body mass estimated by the new equations based on MAMC and HGS was correlated with LBM obtained by DEXA and may serve as practical surrogate markers of LBM in PD patients. Copyright © 2015 International Society for Peritoneal Dialysis.

The role of pyridoxine as a countermeasure for in-flight loss of lean body mass

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Gilbert, Joyce A.

1992-01-01

Ground based and in flight research has shown that humans, under conditions of microgravity, sustain a loss of lean body tissue (protein) and changes in several biological processes including, reductions in red blood cell mass, and neurotransmitters. The maintenance of muscle mass, the major component of lean body mass, is required to meet the needs of space station EVAs. Central to the biosynthesis of amino acids, the building blocks of protein, is pyridoxine (vitamin B-6). Muscle mass integrity requires the availability of vitamin B-6 for protein metabolism and neurotransmitter synthesis. Furthermore, the formation of red blood cells require pyridoxine as a cofactor in the biosynthesis of hemoglobin, a protein that carries oxygen to tissues. In its active form, pyridoxal-5'-phosphate (PLP), vitamin B-6 serves as a link between amino acid and carbohydrate metabolism through intermediates of glycolysis and the tricarboxylic acid cycle. In addition to its role in energy metabolism, PLP is involved in the biosynthesis of hemoglobin and neurotransmitter which are necessary for neurological functions. Alterations in pyridoxine metabolism may affect countermeasures designed to overcome some of these biochemical changes. The focus of this research is to determine the effects of microgravity on the metabolic utilization of vitamin B-6, integrating nutrition as an integral component of the countermeasure (exercise) to maintain lean body mass and muscle strength. The objectives are: 1) to determine whether microgravity effects the metabolic utilization of pyridoxine and 2) to quantitate changes in B-6 vitamer distribution in tissue and excreta relative to loss of lean body tissue. The rationale for this study encompasses the unique challenge to control biochemical mechanisms effected during space travel and the significance of pyridoxine to maintain and counter muscle integrity for EVA activities. This experiment will begin to elucidate the importance of biochemical

Lean rats gained more body weight than obese ones from a high-fibre diet.

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Li, Shaoting; Zhang, Cheng; Gu, Yingyi; Chen, Long; Ou, Shiyi; Wang, Yong; Peng, Xichun

2015-10-28

There is controversy over previous findings that a high ratio of Firmicutes to Bacteriodetes helps obese animals harvest energy from the diet. To further investigate the relationship between microbial composition and energy harvest, microbial adaptation to diet and time should be considered. In this study, lean and obese rats were successfully induced with low-fat and high-fat diets. An 8-week high soyabean fibre (HSF)-containing diet was then fed to investigate the interaction between the diet and the rats' gut microbiota, as well as their influence on rats' growth. Rats' body weight (BW) was recorded weekly; their plasma lipids and their gut microbiota at week 11, 15 and 19 were analysed. After the consumption of the HSF diet, BW of lean rats increased significantly (Pcontent of plasma cholesterol was lowered and that of TAG was upgraded in both the groups when fed the HSF diet. There was no significant difference observed at each period between lean and obese rats. In the group of lean rats, the diversity of gut microbiota was elevated strongly (Pbacterial diversity and composition in obese rats were less altered after the HSF diet control. In conclusion, the increased Firmicutes and Bacteriodetes might relate to lean rats' higher BW gain; 'obese microbiota' could not help the hosts harvest more energy from the HSF diet.

Hubungan tingkat kecukupan zat gizi, lean body mass, dan aktivitas fisik dengan kepadatan tulang pada mahasiswa Universitas Udayana Denpasar

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Ni Putu Puspita Adhytiarini Dewi

2016-12-01

Full Text Available Background: Bone formation and peak bone mass determine with bone density in adulthood related with osteopenia or osteoporosis. It could be influenced by nutrition intakes, lean body mass, and physical activity. Objective: to analyze the correlation between nutritional adequacy, lean body mass, physical activity and bone mineral density in Udayana University Economic’s students, Denpasar. Methods: Cross-sectional study design was done to female students of Faculty of Economic and Business, Udayana University, Denpasar. Seventy five subjects were choosen by simple random sampling. Results: Research subjects were aged 20-25 years old. The mean t-score of bone mineral density is -0,363 ± 1,057. Research subjects were classified as low bone density (osteopenia 26,7% and 73,3% are normal. Intakes of animal protein (p = 0,042 and lean body mass (p = 0,011 are related with bone mineral density protein (p = 0,955 but not on intakes of vitamin A (p = 0,249, vitamin C (p = 0,632, vitamin D (p = 0,864, calcium (p = 0,724, iron (p = 0,768, magnesium (p = 0,689, phosphorus (p = 0,716, and physical activity (p = 0,254. There were a positive trend on the level of protein, vitamin A, vitamin C, vitamin D, calcium, iron, magnesium and phosphorus sufficiency. Conclusions: Intakes of Animal protein, lean body mass and physical activity related with bone mineral density but not on protein, vitamin A, vitamin C, vitamin D, calcium, iron, magnesium, and phosphorus intake.

Progressive resistance training rebuilds lean body mass in head and neck cancer patients after radiotherapy – Results from the randomized DAHANCA 25B trial

International Nuclear Information System (INIS)

Lønbro, Simon; Dalgas, Ulrik; Primdahl, Hanne; Johansen, Jørgen; Nielsen, Jakob Lindberg; Aagaard, Per; Hermann, Anne Pernille; Overgaard, Jens; Overgaard, Kristian

2013-01-01

Purpose: The critical weight loss observed in head and neck squamous cell carcinoma (HNSCC) patients following radiotherapy is mainly due to loss of lean body mass. This is associated with decreases in muscle strength, functional performance and Quality of Life (QoL). The present study investigated the effect of progressive resistance training (PRT) on lean body mass, muscle strength and functional performance in HNSCC patients following radiotherapy. Patients and methods: Following radiotherapy HNSCC patients were randomized into two groups: Early Exercise (EE, n = 20) initiated 12 weeks of PRT followed by 12 weeks of self-chosen physical activity. Delayed Exercise (DE, n = 21) initiated 12 weeks of self-chosen physical activity followed by 12 weeks of PRT. Lean body mass, muscle strength, functional performance and QoL were evaluated at baseline and after week 12 and 24. Results: In the first 12 weeks lean body mass increased by 4.3% in EE after PRT and in the last 12 weeks by 4.2% in DE after PRT. These increases were significantly larger than the changes after self-chosen physical activity (p ⩽ 0.005). Regardless of PRT start-up time, the odds ratio of increasing lean body mass by more than 4% after PRT was 6.26 (p < 0.05). PRT significantly increased muscle strength, whereas functional performance increased significantly more than after self-chosen physical activity only after delayed onset of PRT. Overall QoL improved significantly more in EE than DE from baseline to week 12. Conclusion: PRT effectively increased lean body mass and muscle strength in HNSCC patients following radiotherapy, irrespectively of early or delayed start-up

Soy versus whey protein bars: Effects on exercise training impact on lean body mass and antioxidant status

Directory of Open Access Journals (Sweden)

Babaknia Ari

2004-12-01

Full Text Available Abstract Background Although soy protein may have many health benefits derived from its associated antioxidants, many male exercisers avoid soy protein. This is due partly to a popular, but untested notion that in males, soy is inferior to whey in promoting muscle weight gain. This study provided a direct comparison between a soy product and a whey product. Methods Lean body mass gain was examined in males from a university weight training class given daily servings of micronutrient-fortified protein bars containing soy or whey protein (33 g protein/day, 9 weeks, n = 9 for each protein treatment group. Training used workouts with fairly low repetition numbers per set. A control group from the class (N = 9 did the training, but did not consume either type protein bar. Results Both the soy and whey treatment groups showed a gain in lean body mass, but the training-only group did not. The whey and training only groups, but not the soy group, showed a potentially deleterious post-training effect on two antioxidant-related related parameters. Conclusions Soy and whey protein bar products both promoted exercise training-induced lean body mass gain, but the soy had the added benefit of preserving two aspects of antioxidant function.

Mechanical muscle function and lean body mass during supervised strength training and testosterone therapy in aging men with low-normal testosterone levels

DEFF Research Database (Denmark)

Kvorning, Thue; Christensen, Louise L; Madsen, Klavs

2013-01-01

To examine the effect of strength training and testosterone therapy on mechanical muscle function and lean body mass (LBM) in aging men with low-normal testosterone levels in a randomized, double-blind, placebo-controlled 24-week study.......To examine the effect of strength training and testosterone therapy on mechanical muscle function and lean body mass (LBM) in aging men with low-normal testosterone levels in a randomized, double-blind, placebo-controlled 24-week study....

Accuracy of Body Mass Index Versus Lean Mass Index for Prediction of Sarcopenia in Older Women.

Science.gov (United States)

Benton, M J; Silva-Smith, A L

2018-01-01

We compared accuracy of body mass index (BMI) versus lean mass index (LMI) to predict sarcopenia in 58 community-dwelling women (74.1±0.9 years). Lean mass was measured with multi-frequency bioelectrical impedance analysis, and strength was measured with Arm Curl test, Chair Stand test, and handgrip dynamometry. Sarcopenia was defined as low LMI. When categorized by BMI, normal women had less absolute lean mass (37.6±1.0 vs. 42.6±0.9 kg; Plean mass (14.1±0.2 vs. 16.1±0.2 kg/m2; Plean mass (44.0±0.7 vs. 35.7±0.7 kg; Plean mass (16.2±0.2 vs. 13.8±0.2 kg/m2; Plean mass and strength. For clinical assessment, calculation of LMI rather than BMI is appropriate.

Effects of intestinal bypass surgery on appetite, food intake, and body weight in obese and lean rats.

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Sclafani, A; Koopmans, H S; Vasselli, J R; Reichman, M

1978-04-01

Jejunoileal bypass surgery or sham surgery was performed in female rats made obese with ventromedial hypothalamic (VMH) knife cuts, and in lean control rats. After bypass surgery, the VMH rats underate and lost weight until they reached the body weight of the control sham rats, and they then maintained their weight at control levels. Bypass surgery in lean rats produced much smaller reductions in food intake and body weight. Both bypass groups initially consumed less of a sucrose solution and milk diet during 1 h/day tests, but their intakes returned to near normal levels during the second postoperative month. Reconnection of the intestinal tract in the VMH-bypass rats led to renewed hyperphagia and return to obese body weights. A second experiment revealed that bypass surgery reduces food intake and body weight in genetically obese (fatty) rats, but this effect is not as pronounced as that displayed by VMH rats. These results confirm recent clinical observations that reduced appetite and caloric intake are the major causes of the weight loss produced by intestinal bypass surgery.

Oral administration of O-2 lean, an anti-obesity herbal composition increased 5-HT metabolism, decreased food intake and body weight in overweight rats

International Nuclear Information System (INIS)

Bano, F.; Akhtar, N.; Haleem, D.J.

2012-01-01

Feeding behavior is complex processes controlled by the neruroendocrine system.5-HT play an important role in regulation of energy balance by suppressing food intake. Depletion of brain serotonin increase feeding behavior and develop obesity. Many serotoninergic compounds are available in market for the management of body weight. 02-Lean is an anti-obesity herbal formulation prepared by combination of different herbs. Oral administration of aqueous suspension of 02-Lean caused a significant decrease in body weight, food intake, and increase in whole brain 5-HT 5HIAA, tryptophan and plasma tryptophan in over weight rats treated with 0.096g/2ml 02-Lean in comparison to control group. (author)

Development and validation of a predictive equation for lean body mass in children and adolescents.

Science.gov (United States)

Foster, Bethany J; Platt, Robert W; Zemel, Babette S

2012-05-01

Lean body mass (LBM) is not easy to measure directly in the field or clinical setting. Equations to predict LBM from simple anthropometric measures, which account for the differing contributions of fat and lean to body weight at different ages and levels of adiposity, would be useful to both human biologists and clinicians. To develop and validate equations to predict LBM in children and adolescents across the entire range of the adiposity spectrum. Dual energy X-ray absorptiometry was used to measure LBM in 836 healthy children (437 females) and linear regression was used to develop sex-specific equations to estimate LBM from height, weight, age, body mass index (BMI) for age z-score and population ancestry. Equations were validated using bootstrapping methods and in a local independent sample of 332 children and in national data collected by NHANES. The mean difference between measured and predicted LBM was - 0.12% (95% limits of agreement - 11.3% to 8.5%) for males and - 0.14% ( - 11.9% to 10.9%) for females. Equations performed equally well across the entire adiposity spectrum, as estimated by BMI z-score. Validation indicated no over-fitting. LBM was predicted within 5% of measured LBM in the validation sample. The equations estimate LBM accurately from simple anthropometric measures.

Ghrelin treatment causes increased food intake and retention of lean body mass in a rat model of cancer cachexia.

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DeBoer, Mark D; Zhu, Xin Xia; Levasseur, Peter; Meguid, Michael M; Suzuki, Susumu; Inui, Akio; Taylor, John E; Halem, Heather A; Dong, Jesse Z; Datta, Rakesh; Culler, Michael D; Marks, Daniel L

2007-06-01

Cancer cachexia is a debilitating syndrome of anorexia and loss of lean body mass that accompanies many malignancies. Ghrelin is an orexigenic hormone with a short half-life that has been shown to improve food intake and weight gain in human and animal subjects with cancer cachexia. We used a rat model of cancer cachexia and administered human ghrelin and a synthetic ghrelin analog BIM-28131 via continuous infusion using sc osmotic minipumps. Tumor-implanted rats receiving human ghrelin or BIM-28131 exhibited a significant increase in food consumption and weight gain vs. saline-treated animals. We used dual-energy x-ray absorptiometry scans to show that the increased weight was due to maintenance of lean mass vs. a loss of lean mass in saline-treated animals. Also, BIM-28131 significantly limited the loss of fat mass normally observed in tumor-implanted rats. We further performed real-time PCR analysis of the hypothalami and brainstems and found that ghrelin-treated animals exhibited a significant increase in expression of orexigenic peptides agouti-related peptide and neuropeptide Y in the hypothalamus and a significant decrease in the expression of IL-1 receptor-I transcript in the hypothalamus and brainstem. We conclude that ghrelin and a synthetic ghrelin receptor agonist improve weight gain and lean body mass retention via effects involving orexigenic neuropeptides and antiinflammatory changes.

Caloric restriction in lean and obese strains of laboratory rat: effects on body composition, metabolism, growth and overall health

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U.S. Environmental Protection Agency — Data related to obese and lean strains of rat commonly used in the laboratory that are calorically restricted and its effects on physiologic parameters (Body...

Thermogenesis induced by a high-carbohydrate meal in fasted lean and overweight young men: insulin, body fat, and sympathetic nervous system involvement.

Science.gov (United States)

Marques-Lopes, Iva; Forga, Luis; Martínez, J Alfredo

2003-01-01

This dietary trial was designed to evaluate the effect of an experimental short-term fasting period followed by a high-carbohydrate meal on energy expenditure, thermogenesis, and sympathetic nervous system activity in normal (body mass index 27 kg/m(2)) men who were healthy, non-diabetic or with no other endocrine disease, non-smokers, not taking oral prescription medications, and with a stable body weight for the previous 3 mo. Fasting and fed energy expenditures and diet-induced thermogenesis were measured after a high-carbohydrate meal in seven overweight and six lean young male subjects by indirect calorimetry. Heart rate, urinary excretion of catecholamines, serum glucose, and insulin were also measured over the experimental fasting (7.5 h) and postprandial (4 h) periods. After carbohydrate intake, overweight men showed a significantly higher energy production (kJ/kg of fat-free mass) than did lean individuals, and the diet-induced thermogenesis (percentage of energy intake) was positively correlated with body fat (kg), percentage of body fat, fat-free mass (kg), and fasting pre-meal serum insulin levels. Postprandial cumulative energy expenditure was directly associated with postprandial insulin response and with mean postprandial heart rate values. No significant differences in urinary catecholamines were found between lean and overweight men at basal conditions or during the study period. Overweight individuals showed similar short-term sympathetic nervous system responses induced by an experimental fasting period. Although diet-induced thermogenesis after carbohydrate intake was not statistically different between lean and overweight men, the postprandial insulin response and body fat content seemed to be involved in sympathetic nervous system activity.

Comparison of nodal staging with lean body mass based and with total body weight based in lung cancer

International Nuclear Information System (INIS)

Lee, H. Y.; Chung, J. K.; Kang, W. J.; So, Y.; Lee, D. S.; Lee, M. C.

2004-01-01

The standardized uptake (SUV) is semiquantitative evaluation parameter in positron emission tomography (PET). But there is no consensus about the application or process of SUV measurement. In this study, we used measured lean body mass (LBM) and total weight for application in SUV measurement. Also we compared the each nodal staging with SUV between measured LBM, and total weight, in non small cell lung cancer (NSCLC). Total 21 patients with lung cancer were enrolled (M:F=17:4, age 45[+-]8 years). PET-CT was done before operation with Gemini (Philips, Milpitas, U.S.). Each image was reconstructed twice with measured weight and lean body mass. Maximum SUVs of 103 dissected lymph nodes were measured and compared with histological result. For the deciding on the cut off value, receiver operating characteristic (ROC) analysis was done. 14 lymph nodes in the 103 dissected lymph nodes were metastatic lesions. From the ROC analysis, the cut off value of SUV was 1.7 with measured LBM and 2.3 with total weight. With measured LBM, Sensitivity and specificity were 92.5%. 78.2% and area under curve was 0.881. With total weight, sensitivity and specificity was 92.5% and 77%, Area under curve was 0.859. The normalization of SUV could be done with measured LBM. With the normalization of SUV with LBM, the nodal staging of NSCLC using SUV could be more accurate than using total weight in the reconstruction and measurement of SUV for lymph node lesions

Lean maturity, lean sustainability

DEFF Research Database (Denmark)

Jørgensen, Frances; Matthiesen, Rikke; Nielsen, Jacob

2007-01-01

. A framework for describing levels of lean capability is presented, based on a brief review of the literature and experiences from 12 Danish companies currently implementing lean. Although still in its emerging phase, the framework contributes to both theory and practice by describing developmental stages......Although lean is rapidly growing in popularity, its implementation is far from problem free and companies may experience difficulties sustaining long term success. In this paper, it is suggested that sustainable lean requires attention to both performance improvement and capability development...... that support lean capability development and consequently, lean sustainability....

Engineering Probiotics that Improve Warfighter Performance by Maintaining Lean Body Mass and Inhibiting Anxiety

Science.gov (United States)

2017-10-03

From - To) 03/10/2017 Final Technical Report 15-05-14 to 14-05-17 4. TITLE AND SUBTITLE Sa. CONTRACT NUMBER Engineering probiotics that improve...ABSTRACT The overall goal of this work is to engineer "synthetic probiotics": orally-administered gut bacteria that sense and compute the metabolic...Final Technical Report Grant number: ONR N00014-14-1-0487 Title: Engineering probiotics that improve warfighter performance by maintaining lean body

Physical Activity Modifies the Association between Dietary Protein and Lean Mass of Postmenopausal Women.

Science.gov (United States)

Martinez, Jessica A; Wertheim, Betsy C; Thomson, Cynthia A; Bea, Jennifer W; Wallace, Robert; Allison, Matthew; Snetselaar, Linda; Chen, Zhao; Nassir, Rami; Thompson, Patricia A

2017-02-01

Maintenance of lean muscle mass and related strength is associated with lower risk for numerous chronic diseases of aging in women. Our aim was to evaluate whether the association between dietary protein and lean mass differs by physical activity level, amino acid composition, and body mass index categories. We performed a cross-sectional analysis of a prospective cohort. Participants were postmenopausal women from the Women's Health Initiative with body composition measurements by dual-energy x-ray absorptiometry (n=8,298). Our study measured percent lean mass, percent fat mass, and lean body mass index. Linear regression models adjusted for scanner serial number, age, calibrated energy intake, race/ethnicity, neighborhood socioeconomic status, and recreational physical activity were used to determine the relationship between protein intake and body composition measures. Likelihood ratio tests and stratified analysis were used to investigate physical activity and body mass index as potential effect modifiers. Biomarker-calibrated protein intake was positively associated with percent lean mass; women in the highest protein quintile had 6.3 percentage points higher lean mass than the lowest quintile (Plean body mass index were both inversely related to protein intake (both Plean body mass index (P interaction =0.011). Leucine intake was associated with lean mass, as were branched chain amino acids combined (both Plean mass in postmenopausal women. Importantly, those that also engage in physical activity have the highest lean mass across body mass index categories. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Lean body mass correction of standardized uptake value in simultaneous whole-body positron emission tomography and magnetic resonance imaging

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Jochimsen, Thies H.; Schulz, Jessica; Busse, Harald; Werner, Peter; Schaudinn, Alexander; Zeisig, Vilia; Kurch, Lars; Seese, Anita; Barthel, Henryk; Sattler, Bernhard; Sabri, Osama

2015-06-01

This study explores the possibility of using simultaneous positron emission tomography—magnetic resonance imaging (PET-MRI) to estimate the lean body mass (LBM) in order to obtain a standardized uptake value (SUV) which is less dependent on the patients' adiposity. This approach is compared to (1) the commonly-used method based on a predictive equation for LBM, and (2) to using an LBM derived from PET-CT data. It is hypothesized that an MRI-based correction of SUV provides a robust method due to the high soft-tissue contrast of MRI. A straightforward approach to calculate an MRI-derived LBM is presented. It is based on the fat and water images computed from the two-point Dixon MRI primarily used for attenuation correction in PET-MRI. From these images, a water fraction was obtained for each voxel. Averaging over the whole body yielded the weight-normalized LBM. Performance of the new approach in terms of reducing variations of 18F-Fludeoxyglucose SUVs in brain and liver across 19 subjects was compared with results using predictive methods and PET-CT data to estimate the LBM. The MRI-based method reduced the coefficient of variation of SUVs in the brain by 41  ± 10% which is comparable to the reduction by the PET-CT method (35  ± 10%). The reduction of the predictive LBM method was 29  ± 8%. In the liver, the reduction was less clear, presumably due to other sources of variation. In conclusion, employing the Dixon data in simultaneous PET-MRI for calculation of lean body mass provides a brain SUV which is less dependent on patient adiposity. The reduced dependency is comparable to that obtained by CT and predictive equations. Therefore, it is more comparable across patients. The technique does not impose an overhead in measurement time and is straightforward to implement.

[Overweight and obesity in young adults: relevance of job-related changes of exercise on fat, lean body and body mass in students].

Science.gov (United States)

Kemmler, Wolfgang; Kohl, Matthias; Bebenek, Michael; von Stengel, Simon

2015-03-01

Early adulthood is related to changes in lifestyle that negatively affect body weight and health. The aim of the study was to determine the effect of exercise changes on the development of weight and body composition in college students.Sixty-one randomly selected dental (ZMS) and 53 sport students (SLS) were accompanied over 5 years. Body mass, fat and lean body mass (LBM) were determined via DXA-technique. Exercise and physical activity were assessed by questionnaires and interviews.All exercise indices significantly increased in the SLS and significantly decreased in the ZMS. Physical activity slightly increased in both groups. Both cohorts comparably gained body mass, however, the increase in the SLS group can be attributed to LBM-changes with minor changes of fat-mass (2.4 % ± 3.3 % vs. 0.1 ± 1.0 %) whereas ZMS gained fat and LBM in a proportion of 2:1.Maintenance/increase of exercise compensate the negative effects of lifestyle changes on body composition during young adulthood.

Lean Body Mass Harbors Sensing Mechanisms that Allow Safeguarding of Methionine Homeostasis.

Science.gov (United States)

Ingenbleek, Yves

2017-09-20

Protein-depleted states generate allosteric inhibition of liver cystathionine β-synthase (CBS), which governs the first enzymatic step of the transsulfuration cascade, resulting in upstream accretion of homocysteine (Hcy) in body fluids. A similar Hcy increase may arise from normal hepatocytes undergoing experimentally-induced impairment of betaine-homocysteine methyltransferase (BHTM) activity or from components of lean body mass (LBM) submitted to any inflammatory disorder. LBM comprises a composite agglomeration of extrarenal tissues characterized by naturally occurring BHTM inactivity. As a result of cellular injury, LBM releases high concentrations of Hcy into the extracellular space, contrasting with the disruption of normal remethylation pathways. Hyperhomocysteinemia acts as a biomarker, reflecting the severity of insult and operating as an alarm signal. Elevated Hcy levels constitute a precursor pool recognized by a CBS coding region that reacts to meet increased methionine requirements in LBM tissues, using its enhanced production in hepatocytes. Preservation of methionine homeostasis benefits from its high metabolic priority and survival value.

Lean Body Mass Harbors Sensing Mechanisms that Allow Safeguarding of Methionine Homeostasis

Directory of Open Access Journals (Sweden)

Yves Ingenbleek

2017-09-01

Full Text Available Protein-depleted states generate allosteric inhibition of liver cystathionine β-synthase (CBS, which governs the first enzymatic step of the transsulfuration cascade, resulting in upstream accretion of homocysteine (Hcy in body fluids. A similar Hcy increase may arise from normal hepatocytes undergoing experimentally-induced impairment of betaine-homocysteine methyltransferase (BHTM activity or from components of lean body mass (LBM submitted to any inflammatory disorder. LBM comprises a composite agglomeration of extrarenal tissues characterized by naturally occurring BHTM inactivity. As a result of cellular injury, LBM releases high concentrations of Hcy into the extracellular space, contrasting with the disruption of normal remethylation pathways. Hyperhomocysteinemia acts as a biomarker, reflecting the severity of insult and operating as an alarm signal. Elevated Hcy levels constitute a precursor pool recognized by a CBS coding region that reacts to meet increased methionine requirements in LBM tissues, using its enhanced production in hepatocytes. Preservation of methionine homeostasis benefits from its high metabolic priority and survival value.

Lean education an overview of current issues

CERN Document Server

Flumerfelt, Shannon; Kahlen, Franz-Josef

2017-01-01

This edited volume presents a structured approach to a new lean education curriculum, implemented for the education of engineers, managers, administrators as well as human resources developers. The authorship comprises professors and lecturers, trainers and practitioners who educate future professionals in Lean Thinking principles and tools. This edited book provides a platform for authors to share their efforts in building a Body of Knowledge (BoK) for Lean Education. The topical spectrum is state-of-the-art in this field, but the book also includes a glimpse into future developments. This is a highly informative and carefully presented book, providing valuable insight for scholars with an interest in Lean Education.

Leptin production during early starvation in lean and obese women.

Science.gov (United States)

Klein, S; Horowitz, J F; Landt, M; Goodrick, S J; Mohamed-Ali, V; Coppack, S W

2000-02-01

We evaluated abdominal adipose tissue leptin production during short-term fasting in nine lean [body mass index (BMI) 21 +/- 1 kg/m(2)] and nine upper body obese (BMI 36 +/- 1 kg/m(2)) women. Leptin kinetics were determined by arteriovenous balance across abdominal subcutaneous adipose tissue at 14 and 22 h of fasting. At 14 h of fasting, net leptin release from abdominal adipose tissue in obese subjects (10.9 +/- 1.9 ng x 100 g tissue x (-1) x min(-1)) was not significantly greater than the values observed in the lean group (7.6 +/- 2.1 ng x 100 g(-1) x min(-1)). Estimated whole body leptin production was approximately fivefold greater in obese (6.97 +/- 1.18 microg/min) than lean subjects (1.25 +/- 0.28 microg/min) (P production rates decreased in both lean and obese groups (to 3.10 +/- 1.31 and 10.5 +/- 2.3 ng x 100 g adipose tissue(-1) x min(-1), respectively). However, the relative declines in both arterial leptin concentration and local leptin production in obese women (arterial concentration 13.8 +/- 4.4%, local production 10.0 +/- 12.3%) were less (P lean women (arterial concentration 39.0 +/- 5.5%, local production 56.9 +/- 13.0%). This study demonstrates that decreased leptin production accounts for the decline in plasma leptin concentration observed after fasting. However, compared with lean women, the fasting-induced decline in leptin production is blunted in women with upper body obesity. Differences in leptin production during fasting may be responsible for differences in the neuroendocrine response to fasting previously observed in lean and obese women.

Effects of testosterone treatment on body fat and lean mass in obese men on a hypocaloric diet: a randomised controlled trial.

Science.gov (United States)

Ng Tang Fui, Mark; Prendergast, Luke A; Dupuis, Philippe; Raval, Manjri; Strauss, Boyd J; Zajac, Jeffrey D; Grossmann, Mathis

2016-10-07

Whether testosterone treatment has benefits on body composition over and above caloric restriction in men is unknown. We hypothesised that testosterone treatment augments diet-induced loss of fat mass and prevents loss of muscle mass. We conducted a randomised double-blind, parallel, placebo controlled trial at a tertiary referral centre. A total of 100 obese men (body mass index ≥ 30 kg/m 2 ) with a total testosterone level of or below 12 nmol/L and a median age of 53 years (interquartile range 47-60) receiving 10 weeks of a very low energy diet (VLED) followed by 46 weeks of weight maintenance were randomly assigned at baseline to 56 weeks of 10-weekly intramuscular testosterone undecanoate (n = 49, cases) or matching placebo (n = 51, controls). The main outcome measures were the between-group difference in fat and lean mass by dual-energy X-ray absorptiometry, and visceral fat area (computed tomography). A total of 82 men completed the study. At study end, compared to controls, cases had greater reductions in fat mass, with a mean adjusted between-group difference (MAD) of -2.9 kg (-5.7 to -0.2; P = 0.04), and in visceral fat (MAD -2678 mm 2 ; -5180 to -176; P = 0.04). Although both groups lost the same lean mass following VLED (cases -3.9 kg (-5.3 to -2.6); controls -4.8 kg (-6.2 to -3.5), P = 0.36), cases regained lean mass (3.3 kg (1.9 to 4.7), P dieting men receiving placebo lost both fat and lean mass, the weight loss with testosterone treatment was almost exclusively due to loss of body fat. clinicaltrials.gov, identifier NCT01616732 , registration date: June 8, 2012.

A conserved quantity in thin body dynamics

Science.gov (United States)

Hanna, J. A.; Pendar, H.

2016-02-01

Thin, solid bodies with metric symmetries admit a restricted form of reparameterization invariance. Their dynamical equilibria include motions with both rigid and flowing aspects. On such configurations, a quantity is conserved along the intrinsic coordinate corresponding to the symmetry. As an example of its utility, this conserved quantity is combined with linear and angular momentum currents to construct solutions for the equilibria of a rotating, flowing string, for which it is akin to Bernoulli's constant.

Variation in C-reactive protein following weight loss in obese insulin resistant postmenopausal women: is there an independent contribution of lean body mass?

Science.gov (United States)

Barsalani, R; Riesco, É; Perreault, K; Imbeault, P; Brochu, M; Dionne, I J

2015-03-01

We showed that obese insulin resistant postmenopausal women are characterized by higher lean body mass and elevated C-reactive protein. Although counterintuitive, we hypothesized that losses in muscle mass following caloric restriction and increase in muscle quality will be associated with improvements in glucose homeostasis through decreases in C-reactive protein. To determine 1) if improvements in C-reactive protein concentrations occurs through losses in lean body mass; and 2) if decreases in C-reactive protein levels contribute to improvements in insulin sensitivity. 50 postmenopausal women (body mass index>26 kg/m(²)) with impaired glucose disposal (program. Outcome measures were: Glucose disposal rate: M value (by hyperinsulinemic-euglycemic clamp), body composition (total, trunk, and appendicluar). LBM and FM by DXA), LBM index (LBM (kg)/height (m(2)), body fat distribution (VAT and SAT by CT scan) and plasma high-sensitive C-reactive protein (hsCRP) and interleukin-6 (Il-6). Significant correlations were observed between Δ hsCRP levels with Δ Il-6 (r=0.33, p≤0.05), Δ total LBM index (r=0.44, p≤0.01), Δ trunk LBM (r=0.38, p≤0.01) Δ SAT (r=0.35, p≤0.05) and ∆ glucose disposal rate (r=- 0.44, p≤0.01). After including all the correlated variables in Stepwise linear regression model, Δ LBM index was the only independent predictor of the reduction in hsCRP levels (R(2)=0.20, p≤0.01). Losses in total lean body mass are independently associated with improvements in inflammatory state (CRP levels) in obese postmenopausal women with impaired glucose disposal. © Georg Thieme Verlag KG Stuttgart · New York.

Effects of body lean and visual information on the equilibrium maintenance during stance.

Science.gov (United States)

Duarte, Marcos; Zatsiorsky, Vladimir M

2002-09-01

Maintenance of equilibrium was tested in conditions when humans assume different leaning postures during upright standing. Subjects ( n=11) stood in 13 different body postures specified by visual center of pressure (COP) targets within their base of support (BOS). Different types of visual information were tested: continuous presentation of visual target, no vision after target presentation, and with simultaneous visual feedback of the COP. The following variables were used to describe the equilibrium maintenance: the mean of the COP position, the area of the ellipse covering the COP sway, and the resultant median frequency of the power spectral density of the COP displacement. The variability of the COP displacement, quantified by the COP area variable, increased when subjects occupied leaning postures, irrespective of the kind of visual information provided. This variability also increased when vision was removed in relation to when vision was present. Without vision, drifts in the COP data were observed which were larger for COP targets farther away from the neutral position. When COP feedback was given in addition to the visual target, the postural control system did not control stance better than in the condition with only visual information. These results indicate that the visual information is used by the postural control system at both short and long time scales.

A selective androgen receptor modulator with minimal prostate hypertrophic activity restores lean body mass in aged orchidectomized male rats.

Science.gov (United States)

Allan, George; Sbriscia, Tifanie; Linton, Olivia; Lai, Muh-Tsann; Haynes-Johnson, Donna; Bhattacharjee, Sheela; Ng, Raymond; Sui, Zhihua; Lundeen, Scott

2008-06-01

Androgens are required for the maintenance of normal sexual activity in adulthood and for enhancing muscle growth and lean body mass in adolescents and adults. Androgen receptor (AR) ligands with tissue selectivity (selective androgen receptor modulators, or SARMs) have potential for treating muscle wasting, hypogonadism of aging, osteoporosis, female sexual dysfunction, and other indications. JNJ-37654032 is a nonsteroidal AR ligand with mixed agonist and antagonist activity in androgen-responsive cell-based assays. It is an orally active SARM with muscle selectivity in orchidectomized rat models. It stimulated growth of the levator ani muscle with ED(50) 0.8 mg/kg, stimulating maximal growth at a dose of 3mg/kg. In contrast, it stimulated ventral prostate growth to 21% of its full size at 3mg/kg. At the same time, JNJ-37654032 reduced prostate weight in intact rats by 47% at 3mg/kg, while having no inhibitory effect on muscle. Using magnetic resonance imaging to monitor body composition, JNJ-37654032 restored about 20% of the lean body mass lost following orchidectomy in aged rats. JNJ-37654032 reduced follicle-stimulating hormone levels in orchidectomized rats and reduced testis size in intact rats. JNJ-37654032 is a potent prostate-sparing SARM with the potential for clinical benefit in muscle-wasting diseases.

Case Study: The Effect of 32 Weeks of Figure-Contest Preparation on a Self-Proclaimed Drug-Free Female's Lean Body and Bone Mass.

Science.gov (United States)

Petrizzo, John; DiMenna, Frederick J; Martins, Kimberly; Wygand, John; Otto, Robert M

2017-12-01

To achieve the criterion appearance before competing in a physique competition, athletes undergo preparatory regimens involving high-volume intense resistance and aerobic exercise with hypocaloric energy intake. As the popularity of "drug-free" competition increases, more athletes are facing this challenge without the recuperative advantage provided by performance-enhancing drugs. Consequently, the likelihood of loss of lean body and/or bone mass is increased. The purpose of this investigation was to monitor changes in body composition for a 29-year-old self-proclaimed drug-free female figure competitor during a 32-week preparatory regimen comprising high-volume resistance and aerobic exercise with hypocaloric energy intake. We used dual-energy x-ray absorptiometry (DXA) to evaluate regional fat and bone mineral density. During the initial 22 weeks, the subject reduced energy intake and engaged in resistance (4-5 sessions/week) and aerobic (3 sessions/week) training. During the final 10 weeks, the subject increased exercise frequency to 6 (resistance) and 4 (aerobic) sessions/week while ingesting 1130-1380 kcal/day. During this 10-week period, she consumed a high quantity of protein (~55% of energy intake) and nutritional supplements. During the 32 weeks, body mass and fat mass decreased by 12% and 55%, respectively. Conversely, lean body mass increased by 1.5%, an amount that exceeded the coefficient of variation associated with DXA-derived measurement. Total bone mineral density was unchanged throughout. In summary, in preparation for a figure competition, a self-proclaimed drug-free female achieved the low body-fat percentage required for success in competition without losing lean mass or bone density by following a 32-week preparatory exercise and nutritional regimen.

Efficacy of phosphatidic acid ingestion on lean body mass, muscle thickness and strength gains in resistance-trained men

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Hoffman Jay R

2012-10-01

Full Text Available Abstract Background Phosphatidic acid (PA has been reported to activate the mammalian target of rapamycin (mTOR signaling pathway and is thought to enhance the anabolic effects of resistance training. The purpose of this pilot study was to examine if oral phosphatidic acid administration can enhance strength, muscle thickness and lean tissue accruement during an 8-week resistance training program. Methods Sixteen resistance-trained men were randomly assigned to a group that either consumed 750 mg of PA (n = 7, 23.1 ± 4.4 y; 176.7 ± 6.7 cm; 86.5 ± 21.2 kg or a placebo (PL, n = 9, 22.5 ± 2.0 y; 179.8 ± 5.4 cm; 89.4 ± 13.6 kg group. During each testing session subjects were assessed for strength (one repetition maximum [1-RM] bench press and squat and body composition. Muscle thickness and pennation angle were also measured in the vastus lateralis of the subject’s dominant leg. Results Subjects ingesting PA demonstrated a 12.7% increase in squat strength and a 2.6% increase in LBM, while subjects consuming PL showed a 9.3% improvement in squat strength and a 0.1% change in LBM. Although parametric analysis was unable to demonstrate significant differences, magnitude based inferences indicated that the Δ change in 1-RM squat showed a likely benefit from PA on increasing lower body strength and a very likely benefit for increasing lean body mass (LBM. Conclusions Results of this study suggest that a combination of a daily 750 mg PA ingestion, combined with a 4-day per week resistance training program for 8-weeks appears to have a likely benefit on strength improvement, and a very likely benefit on lean tissue accruement in young, resistance trained individuals.

Lean Manufacturing measurement: The relationships between Lean activities and Lean metrics

Directory of Open Access Journals (Sweden)

Diego Fernando Manotas Duque

2007-01-01

Full Text Available Medición en Lean Manufacturing: Relaciones entre Actividades Lean y Métricas Lean Lean Manufacturing fue desarrollada por Toyota para satisfacer sus necesidades específicas en un mercado restringido y en tiempos de estrechez económica. Estos conceptos han sido estudiados y se ha comprobado su aplicabilidad en una amplia variedad de industrias. El objetivo de este artículo es el de integrar un conjunto de métricas que han sido propuestas por diferentes autores, de tal manera que sean consistentes con las etapas y elementos de implementaciones de Lean Manufacturing. Para lograrlo se presentan dos marcos de referencia para implementaciones Lean y los principales factores de éxito se utilizan como base para proponer métricas que identifiquen el avance en estos factores. Posteriormente se propone una tabla que cruza el impacto de las “Actividades Lean” sobre las métricas, postulando que muchos de los supuestos a priori sobre estos impactos deberían ser precisos. Finalmente se proponen algunas ideas para proyectos de investigación hacia el futuro y posibles extensiones de las aplicaciones propuestas aquí.

A conserved quantity in thin body dynamics

International Nuclear Information System (INIS)

Hanna, J.A.; Pendar, H.

2016-01-01

Thin, solid bodies with metric symmetries admit a restricted form of reparameterization invariance. Their dynamical equilibria include motions with both rigid and flowing aspects. On such configurations, a quantity is conserved along the intrinsic coordinate corresponding to the symmetry. As an example of its utility, this conserved quantity is combined with linear and angular momentum currents to construct solutions for the equilibria of a rotating, flowing string, for which it is akin to Bernoulli's constant. - Highlights: • A conserved quantity relevant to the dynamical equilibria of thin structures. • A mixed Lagrangian–Eulerian non-material action principle for fixed windows of axially moving systems. • Analytical solutions for rotating, flowing strings (yarn balloons). • Noether meets Bernoulli in a textile factory.

A conserved quantity in thin body dynamics

Energy Technology Data Exchange (ETDEWEB)

Hanna, J.A., E-mail: hannaj@vt.edu [Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061 (United States); Department of Physics, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061 (United States); Pendar, H. [Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061 (United States)

2016-02-15

Thin, solid bodies with metric symmetries admit a restricted form of reparameterization invariance. Their dynamical equilibria include motions with both rigid and flowing aspects. On such configurations, a quantity is conserved along the intrinsic coordinate corresponding to the symmetry. As an example of its utility, this conserved quantity is combined with linear and angular momentum currents to construct solutions for the equilibria of a rotating, flowing string, for which it is akin to Bernoulli's constant. - Highlights: • A conserved quantity relevant to the dynamical equilibria of thin structures. • A mixed Lagrangian–Eulerian non-material action principle for fixed windows of axially moving systems. • Analytical solutions for rotating, flowing strings (yarn balloons). • Noether meets Bernoulli in a textile factory.

Appendicular and whole body lean mass outcomes are associated with finite element analysis-derived bone strength at the distal radius and tibia in adults aged 40years and older.

Science.gov (United States)

Gibbs, Jenna C; Giangregorio, Lora M; Wong, Andy K O; Josse, Robert G; Cheung, Angela M

2017-10-01

The purpose of this cross-sectional study was to determine how appendicular lean mass index (ALMI), and whole body lean (LMI) and fat mass indices (FMI) associate with estimated bone strength outcomes at the distal radius and tibia in adults aged 40 years and older. Dual energy X-ray absorptiometry (DXA) scans were performed to determine body composition, including whole body lean and fat mass, and appendicular lean mass. ALMI (appendicular lean mass/height 2 ), LMI (lean tissue mass/height 2 ) and FMI (fat mass/height 2 ) were calculated. High-resolution peripheral quantitative computed tomography (HRpQCT) scans were performed to assess bone structural properties at the distal radius and tibia. Using finite element analysis, failure load (N), stiffness (N/mm), ultimate stress (MPa), and cortical-to-trabecular load ratio were estimated from HRpQCT scans. The associations between body composition (ALMI, LMI, FMI) and estimated bone strength were examined using bivariate and multivariable linear regression analyses adjusting for age, sex, and other confounding variables. In 197 participants (127 women; mean±SD, age: 69.5±10.3y, body mass index: 27.95±4.95kg/m 2 , ALMI: 7.31±1.31kg/m 2 ), ALMI and LMI were significantly associated with failure load at the distal radius and tibia (explained 39%-48% of the variance) and remained significant after adjusting for confounding variables and multiple testing (R 2 =0.586-0.645, p<0.001). ALMI, LMI, and FMI did not have significant associations with ultimate stress in our multivariable models. FMI was significantly associated with cortical-to-trabecular load ratio at the distal radius and tibia (explained 6%-12% of the variance) and remained significant after adjusting for confounders and multiple testing (R 2 =0.208-0.243, p<0.001). FMI was no longer significantly associated with failure load after adjusting for confounders. These findings suggest that ALMI and LMI are important determinants of estimated bone strength

The instability characteristics of lean premixed hydrogen and syngas flames stabilized on meso-scale bluff-body

KAUST Repository

Kim, Yu Jeong

2017-01-05

Bluff-body flame stabilization has been used as one of main flame stabilization schemes to improve combustion stability in both large and small scale premixed combustion systems. The detailed investigation of instability characteristics is needed to understand flame stability mechanism. Direct numerical simulations are conducted to investigate flame dynamics on the instability of lean premixed hydrogen/air and syngas/air flames stabilized on a meso-scale bluff-body. A two-dimensional channel of 10 mm height and 10 mm length with a square bluff-body stabilizer of 0.5 mm is considered. The height of domain is chosen as an unconfined condition to minimize the effect of the blockage ratio. Flame/flow dynamics are observed by increasing the mean inflow velocity from a steady stable to unsteady asymmetrical instability, followed by blowoff. Detailed observations between hydrogen and syngas flames with a time scale analysis are presented.

Lean principles applied to software development – avoiding waste

Directory of Open Access Journals (Sweden)

Ionel NAFTANAILA

2009-12-01

Full Text Available Under the current economic conditions many organizations strive to continue the trend towards adopting better software development processes, in order to take advantage of the numerous benefits that these can offer. Those benefits include quicker return on investment, better software quality, and higher customer satisfaction. To date, however, there is little body of research that can guide organizations in adopting modern software development practices, especially when it comes to Lean thinking and principles. To address this situation, the current paper identifies and structures the main wastes (or muda in Lean terms in software development as described by Lean principles, in an attempt to bring into researchers’ and practitioners’ attention Lean Software Development, a modern development methodology based on well-established practices such as Lean Manufacturing or Toyota Production System.

Leg strength and lean mass symmetry influences kicking performance in Australian football.

Science.gov (United States)

Hart, Nicolas H; Nimphius, Sophia; Spiteri, Tania; Newton, Robert U

2014-01-01

Differential loading patterns during game-based participation may produce or exacerbate strength imbalances between the lower limbs. It is currently unknown whether such imbalances are functionally beneficial or detrimental to performance. This study assessed the influence of lower limb strength and lean mass symmetry on kicking accuracy in Australian Football. Thirty-one Australian footballers were required to perform a kicking assessment, producing ten drop punt kicks over twenty metres to a player target. Athletes were subsequently separated into accurate (n = 15) and inaccurate (n = 16) groups, with lower-body lean mass assessed using whole body DXA scans, and lower-body strength assessed using an isometric protocol. Accurate kickers demonstrated significantly higher relative lean mass (~8% to 16%; p = 0. 001 to 0.004) and significantly lower relative fat mass (~21% to 40%; p = 0.001 to 0.024) than inaccurate kickers. Accurate kickers did not contain any significant difference in lean mass or unilateral strength between lower limbs. Inaccurate kickers displayed significant asymmetry in lean mass (~3%; p ≤ 0.003), producing significant imbalances in strength (~8%; p ≤ 0.002) highlighting a deficiency in their support leg. Greater relative strength and improved lower limb symmetry in strength and muscularity could increase the capacity of an athlete to be technically proficient in favour of greater accuracy. Key PointsStrength deficits in the support leg may lead to inaccurate kicking outcomes.An asymmetry of 3% in lean mass generated an 8% imbalance in leg strength.Greater levels of relative lower-body strength and muscle mass are associated with improved kicking accuracy performance.

Football training improves lean body mass in men with prostate cancer undergoing androgen deprivation therapy

DEFF Research Database (Denmark)

Uth, J; Hornstrup, Therese; Schmidt, Jakob Friis

2014-01-01

Androgen deprivation therapy (ADT) remains a cornerstone in the management of patients with prostate cancer (PCa) despite adverse effects on body composition and functional parameters. We compared the effects of football training with standard care in PCa patients managed with ADT (> 6 months......). Fifty-seven men aged 67 (range: 43-74) were randomly assigned to a football group (FG, n = 29) or a usual care control group (CON, n = 28). The primary outcome was change in lean body mass (LBM) assessed by dual-energy X-ray absorptiometry scanning. Secondary outcomes included changes in knee.......7%; 95%CI 1.3-0.0; P = 0.06), but these changes were not significantly different from CON. In conclusion, football training over 12 weeks improved LBM and muscle strength compared with usual care in men with prostate cancer receiving ADT....

Regulation of lean mass, bone mass, and exercise tolerance by the central melanocortin system.

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Theodore P Braun

Full Text Available Signaling via the type 4-melanocortin receptor (MC4R is an important determinant of body weight in mice and humans, where loss of function mutations lead to significant obesity. Humans with mutations in the MC4R experience an increase in lean mass. However, the simultaneous accrual of fat mass in such individuals may contribute to this effect via mechanical loading. We therefore examined the relationship of fat mass and lean mass in mice lacking the type-4 melanocortin receptor (MC4RKO. We demonstrate that MC4RKO mice display increased lean body mass. Further, this is not dependent on changes in adipose mass, as MC4RKO mice possess more lean body mass than diet-induced obese (DIO wild type mice with equivalent fat mass. To examine potential sources of the increased lean mass in MC4RKO mice, bone mass and strength were examined in MC4RKO mice. Both parameters increase with age in MC4RKO mice, which likely contributes to increases in lean body mass. We functionally characterized the increased lean mass in MC4RKO mice by examining their capacity for treadmill running. MC4R deficiency results in a decrease in exercise performance. No changes in the ratio of oxidative to glycolytic fibers were seen, however MC4RKO mice demonstrate a significantly reduced heart rate, which may underlie their impaired exercise performance. The reduced exercise capacity we report in the MC4RKO mouse has potential clinical ramifications, as efforts to control body weight in humans with melanocortin deficiency may be ineffective due to poor tolerance for physical activity.

Designing Workshops for the Introduction of Lean Enablers to Engineering Programs

DEFF Research Database (Denmark)

Gersing, Kilian; Oehmen, Josef; Rebentisch, Eric Rebentisch

2014-01-01

There is a large and growing body of knowledge regarding so-called Lean best practices, including most recently in the area of program management and systems engineering. However, there is little elaboration of how these documented best practices are to be introduced to a professional workforce. ...... the Lean principles. The framework was validated through interactions with training professionals in a large automobile manufacturer, and using subject matter experts from a variety of industrial sectors. © 2014 The Authors. Published by Elsevier B.V.......There is a large and growing body of knowledge regarding so-called Lean best practices, including most recently in the area of program management and systems engineering. However, there is little elaboration of how these documented best practices are to be introduced to a professional workforce...... the systematic design of workshops focused specifically on the introduction of Lean principles and practices to program management and the professional workforce in a program environment. The framework is based on a thorough review of literature on training, workshop delivery, and Lean principles, as well...

The Association of Fat and Lean Tissue With Whole Body and Spine Bone Mineral Density Is Modified by HIV Status and Sex in Children and Youth.

Science.gov (United States)

Jacobson, Denise L; Lindsey, Jane C; Coull, Brent A; Mulligan, Kathleen; Bhagwat, Priya; Aldrovandi, Grace M

2018-01-01

HIV-infected (HIV-pos) male children/youth showed lower bone mineral density at sexual maturity than HIV-uninfected (HIV-neg) females. It is not known whether complications of HIV disease, including abnormal body fat distribution, contribute to lower bone accrual in male HIV-pos adolescents. In a cross-sectional study, we evaluated the relationship between body composition (fat and lean mass) and bone mass in HIV-pos and HIV-neg children/youth and determined if it is modified by HIV status and sex. We used generalized estimating equations to simultaneously model the effect of fat/lean mass on multiple bone outcomes, including total body bone mineral density and bone mineral content and spine bone mineral density. We evaluated effect modification by HIV and sex. The analysis cohort consisted of 143 HIV-neg and 236 HIV-pos, of whom 55% were black non-Hispanic and 53% were male. Ages ranged from 7 to children/youth were at Tanner stage 1 and 20% at Tanner 5. Fat mass was more strongly positively correlated with bone mass in HIV-neg than HIV-pos children/youth and these relationships were more evident for total body bone than spine outcomes. Within HIV strata, fat mass and bone were more correlated in female than male children/youth. The relationship between lean mass and bone varied by sex, but not by HIV status. HIV disease diminishes the positive relationship of greater fat mass on bone mass in children/youth. Disruptions in body fat distribution, which are common in HIV disease, may have an impact on bone accretion during pubertal development.

Lean body mass change over 6 years is associated with dietary leucine intake in an older Danish population

DEFF Research Database (Denmark)

McDonald, Cameron Keith; Ankarfeldt, Mikkel Z.; Capra, Sandra

2016-01-01

Higher protein intake, and particularly higher leucine intake, is associated with attenuated loss of lean body mass (LBM) over time in older individuals. Dietary leucine is thought to be a key mediator of anabolism. This study aimed to assess this relationship over 6 years among younger and older...... corroborates findings from laboratory investigations in relation to protein and leucine intakes and LBM change. A more diverse and larger sample is needed for confirmation of these results....

Correction of Hypothyroidism Leads to Change in Lean Body Mass without Altering Insulin Resistance.

Science.gov (United States)

Sirigiri, Sangeetha; Vaikkakara, Suresh; Sachan, Alok; Srinivasarao, P V L N; Epuri, Sunil; Anantarapu, Sailaja; Mukka, Arun; Chokkapu, Srinivasa Rao; Venkatanarasu, Ashok; Poojari, Ravi

2016-12-01

Hypothyroidism is associated with insulin resistance, dyslipidemia, and abnormal body composition. This study assessed changes in body composition and insulin resistance after thyroxine (T 4 ) replacement in overt hypothyroidism. In this prospective longitudinal study carried out in a tertiary care center, adult nondiabetic patients with overt hypothyroidism were rendered euthyroid on T 4 . Anthropometry including skinfold thickness (SFT) at the triceps and subscapularis was recorded. Patients underwent testing for fasting plasma glucose, creatinine, serum insulin, T 4 , thyrotropin (TSH) and body composition analysis by dual-energy X-ray absorptiometry (DEXA) both before and at 2 months after restoration to the euthyroid state. Twenty-seven patients (20 female and 7 male) aged 35.3 ± 11.0 years (min-max: 17-59 years) with overt hypothyroidism were recruited. Serum T 4 at the time of recruitment was 48.9 ± 24.6 nmol/l (normal range = 64.4-142 nmol/l). All patients had TSH ≥50 µIU/l. Following treatment, there was a mean body weight reduction of 1.7 kg (p = 0.01). Waist circumference as well as triceps and subscapularis SFT decreased significantly (p change in fat mass (FM), percentage of fat (%FM) or bone mineral content in any of the specified regions or in the body as a whole. In contrast, mean lean body mass (LBM) decreased significantly by 0.8 kg (p resistance and level of glycemia were not affected by treatment with T 4 . LBM decreases significantly without affecting FM after correction of hypothyroidism. Insulin resistance was not influenced by T 4 treatment.

The prediction of lean body mass and fat mass from arm anthropometry at diagnosis in children with cancer.

Science.gov (United States)

Webber, Colin; Halton, Jacqueline; Walker, Scott; Young, Andrea; Barr, Ronald D

2013-10-01

Maintenance of adequate nutrition is important in the care of children with cancer. In clinical practice, determination of nutritional status can be accomplished with measurement of body composition by dual-energy x-ray absorptiometry (DXA). However, DXA is seldom available in low-income countries where most children with cancer live. This study sought to provide predictive equations for lean body mass and fat mass, measured by DXA, on the basis of simple arm anthropometry providing measures of mid-upper arm circumference and triceps skin-fold thickness in a population (N=99) of children diagnosed with cancer. Such equations were derived successfully with the inclusion of absolute body weight, the body weight Z-score, and the predicted whole-body bone mineral content on the basis of age and sex. Attempted validation in a small sample (N=7) of children who completed therapy for acute lymphoblastic leukemia revealed disparities reflective of the prevalence of obesity in such survivors. Further validation must be undertaken in large samples of children with a variety of malignant diseases to assess the robustness of the equations predictive of body composition.

Lean body mass in small for gestational age and appropriate for gestational age infants

International Nuclear Information System (INIS)

Petersen, S.; Gotfredsen, A.; Knudsen, F.U.

1988-01-01

Dual photon absorptiometry using 153 Gd in a whole-body scanner was used to measure lean body mass (LBM) in 51 newborn infants. LBM% decreased exponentially with increasing gestational age in both small for gestational age (SGA) and appropriate for gestational age (AGA) infants. In preterm SGA and AGA infants LBM was 104% and 103%, respectively, indicating that no fat was detectable. In term SGA infants LBM was 98%, which corresponded to 48 gm fat on average, and in term AGA infants LBM was 87%, which corresponded to 452 gm fat on average. The LBM%, ponderal index, and skinfold thickness were significantly different between AGA and SGA infants. Infants with clinical signs of intrauterine wastage had significantly higher LBM% than did infants without signs of weight loss. Our results on LBM% by dual photon absorptiometry agree with earlier dissection data; the clinically applicable methods of (1) height combined with weight (i.e., ponderal index), (2) skinfold thickness, and (3) scoring by clinical observations are useful for the estimation of lack of fat as an indicator of intrauterine growth retardation

Patient-specific lean body mass can be estimated from limited-coverage computed tomography images.

Science.gov (United States)

Devriese, Joke; Beels, Laurence; Maes, Alex; van de Wiele, Christophe; Pottel, Hans

2018-06-01

In PET/CT, quantitative evaluation of tumour metabolic activity is possible through standardized uptake values, usually normalized for body weight (BW) or lean body mass (LBM). Patient-specific LBM can be estimated from whole-body (WB) CT images. As most clinical indications only warrant PET/CT examinations covering head to midthigh, the aim of this study was to develop a simple and reliable method to estimate LBM from limited-coverage (LC) CT images and test its validity. Head-to-toe PET/CT examinations were retrospectively retrieved and semiautomatically segmented into tissue types based on thresholding of CT Hounsfield units. LC was obtained by omitting image slices. Image segmentation was validated on the WB CT examinations by comparing CT-estimated BW with actual BW, and LBM estimated from LC images were compared with LBM estimated from WB images. A direct method and an indirect method were developed and validated on an independent data set. Comparing LBM estimated from LC examinations with estimates from WB examinations (LBMWB) showed a significant but limited bias of 1.2 kg (direct method) and nonsignificant bias of 0.05 kg (indirect method). This study demonstrates that LBM can be estimated from LC CT images with no significant difference from LBMWB.

Establishing a Lean Six Sigma Program in Higher Education

KAUST Repository

Svensson, Carsten; Baessa, Mohamed A.; Bakhsh, Majed M.

2013-01-01

Purpose: The objective of this paper is a contribution to the body of Lean Six Sigma knowledge within the vertical of higher education institutions. The paper will review the initial phase of an implementation and highlight future challenges. Approach: The observations presented in this paper, originates from rolling out a large lean six sigma implementation at a newly established university. The paper is supported with secondary data from literature. Findings: The paper will discuss the challenges of applying the lean six sigma method in a complex transactional environment. Research limitations: This paper is based on an empirical study of a single instance and authors’ experiences as practitioners. Originality: This paper is the first description of what is believed to be one of the largest implementations of Lean Six Sigma in higher education.

Establishing a Lean Six Sigma Program in Higher Education

KAUST Repository

Svensson, Carsten

2013-09-12

Purpose: The objective of this paper is a contribution to the body of Lean Six Sigma knowledge within the vertical of higher education institutions. The paper will review the initial phase of an implementation and highlight future challenges. Approach: The observations presented in this paper, originates from rolling out a large lean six sigma implementation at a newly established university. The paper is supported with secondary data from literature. Findings: The paper will discuss the challenges of applying the lean six sigma method in a complex transactional environment. Research limitations: This paper is based on an empirical study of a single instance and authors’ experiences as practitioners. Originality: This paper is the first description of what is believed to be one of the largest implementations of Lean Six Sigma in higher education.

Anthropometry profiles of elite rugby players: quantifying changes in lean mass.

Science.gov (United States)

Duthie, G M; Pyne, D B; Hopkins, W G; Livingstone, S; Hooper, S L

2006-03-01

To demonstrate the utility of a practical measure of lean mass for monitoring changes in the body composition of athletes. Between 1999 and 2003 body mass and sum of seven skinfolds were recorded for 40 forwards and 32 backs from one Super 12 rugby union franchise. Players were assessed on 13 (7) occasions (mean (SD)) over 1.9 (1.3) years. Mixed modelling of log transformed variables provided a lean mass index (LMI) of the form mass/skinfolds(x), for monitoring changes in mass controlled for changes in skinfold thickness. Mean effects of phase of season and time in programme were modelled as percentage changes. Effects were standardised for interpretation of magnitudes. The exponent x was 0.13 for forwards and 0.14 for backs (90% confidence limits +/-0.03). The forwards had a small decrease in skinfolds (5.3%, 90% confidence limits +/-2.2%) between preseason and competition phases, and a small increase (7.8%, 90% confidence limits +/-3.1%) during the club season. A small decrease in LMI (approximately 1.5%) occurred after one year in the programme for forwards and backs, whereas increases in skinfolds for forwards became substantial (4.3%, 90% confidence limits +/-2.2%) after three years. Individual variation in body composition was small within a season (within subject SD: body mass, 1.6%; skinfolds, 6.8%; LMI, 1.1%) and somewhat greater for body mass (2.1%) and LMI (1.7%) between seasons. Despite a lack of substantial mean changes, there was substantial individual variation in lean mass within and between seasons. An index of lean mass based on body mass and skinfolds is a potentially useful tool for assessing body composition of athletes.

Serum Predictors of Percent Lean Mass in Young Adults.

Science.gov (United States)

Lustgarten, Michael S; Price, Lori L; Phillips, Edward M; Kirn, Dylan R; Mills, John; Fielding, Roger A

2016-08-01

Lustgarten, MS, Price, LL, Phillips, EM, Kirn, DR, Mills, J, and Fielding, RA. Serum predictors of percent lean mass in young adults. J Strength Cond Res 30(8): 2194-2201, 2016-Elevated lean (skeletal muscle) mass is associated with increased muscle strength and anaerobic exercise performance, whereas low levels of lean mass are associated with insulin resistance and sarcopenia. Therefore, studies aimed at obtaining an improved understanding of mechanisms related to the quantity of lean mass are of interest. Percent lean mass (total lean mass/body weight × 100) in 77 young subjects (18-35 years) was measured with dual-energy x-ray absorptiometry. Twenty analytes and 296 metabolites were evaluated with the use of the standard chemistry screen and mass spectrometry-based metabolomic profiling, respectively. Sex-adjusted multivariable linear regression was used to determine serum analytes and metabolites significantly (p ≤ 0.05 and q ≤ 0.30) associated with the percent lean mass. Two enzymes (alkaline phosphatase and serum glutamate oxaloacetate aminotransferase) and 29 metabolites were found to be significantly associated with the percent lean mass, including metabolites related to microbial metabolism, uremia, inflammation, oxidative stress, branched-chain amino acid metabolism, insulin sensitivity, glycerolipid metabolism, and xenobiotics. Use of sex-adjusted stepwise regression to obtain a final covariate predictor model identified the combination of 5 analytes and metabolites as overall predictors of the percent lean mass (model R = 82.5%). Collectively, these data suggest that a complex interplay of various metabolic processes underlies the maintenance of lean mass in young healthy adults.

Lean manufacturing measurement: the relationship between lean activities and lean metrics

Directory of Open Access Journals (Sweden)

Manotas Duque Diego Fernando

2007-10-01

Full Text Available Lean Manufacturing was developed by Toyota Motor company to address their specific needs in a restricted market in times of economic trouble. These concepts have been studied and proven to be transferrable and applicable to a wide variety of industries. This paper aims to integrate a set of metrics that have been proposed by different authors in such a way that they are consistent with the different stages and elements of Lean Manufacturing implementations. To achieve this, two frameworks for Lean implementations are presented and then the main factors for success are used as the basis to propose metrics that measure the advance in these factors. A tabular display of the impact of “Lean activities” on the metrics is presented, proposing that many a priori assumptions about the benefits on many different levels of improvement should be accurate. Finally, some ideas for future research and extension of the applications proposed on this paper are presented as closing points.

Comparative Analysis between Lean, Six Sigma and Lean Six Sigma Concepts

Directory of Open Access Journals (Sweden)

Alexandra Mirela Cristina MUNTEANU

2017-06-01

Full Text Available This paper analyzes the benefits of Lean Six Sigma in comparison with Lean and Six Sigma, traditional improvement methodologies. The introduction highlights the appearance of Lean Six Sigma, early 2000s, as well as the benefits brought by the integrated approach. The following parts of the study emphasize the main differences between methodologies and their commonalities based on their synergy. Finally the advantages of Lean Six Sigma versus Lean and Six Sigma are analyzed and systematized by author in order to reveal Lean Six Sigma’s benefits.

Caloric Restriction in Lean and Obese Strains of Laboratory ...

Science.gov (United States)

NEW FINDINGS: What is the central question of this study? How do lean and obese rats respond physiologically to caloric restriction? What is the main finding and its importance? Obese rats show marked benefits compared with lean animals. Reduced body fat is associated with improved longevity with caloric restriction (CR) in rodents. Little is known regarding effects of CR in genetically lean versus obese strains. Long-Evans (LE) and Brown Norway (BN) rats make an ideal comparison for a CR study because the percentage body fat of young adult LE rats is double that of BN rats. Male LE and BN rats were either fed ad libitum (AL) or were caloricallyrestricted to 80 or 90% of their AL weight. The percentages of fat, lean and fluid mass were measured non-invasively at 2- to 4-week intervals. Metabolic rate and respiratory quotient were measured after 3, 6, 9 and 12 months of CR. Overall health was scored monthly. The percentage of fat of the LE strain decreased with CR, whereas the percentage of fat of the BN strain remained above the AL group for several months. The percentage of lean mass increased above the AL for both strains subjected to CR. The percentage offluid was unaffected by CR. The average metabolic rate over 22 h of the BN rats subjected to CR was reduced, whereas that of LE rats was increased slightly above the AL group. The respiratory quotient of BN rats wasdecreased with CR. Overall health of the CR LE group was significantly improved compared with t

Healthcare Lean.

Science.gov (United States)

Long, John C

2003-01-01

Lean Thinking is an integrated approach to designing, doing and improving the work of people that have come together to produce and deliver goods, services and information. Healthcare Lean is based on the Toyota production system and applies concepts and techniques of Lean Thinking to hospitals and physician practices.

EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA); Scientific Opinion on the substantiation of health claims related to very low calorie diets (VLCDs) and reduction in body weight (ID 1410), reduction in the sense of hunger (ID 1411), reduction in body fat mass while maintaining lean

DEFF Research Database (Denmark)

Tetens, Inge

claims in relation to very low calorie diets (VLCDs) and reduction in body weight, reduction in the sense of hunger, reduction in body fat mass while maintaining lean body mass, reduction of post-prandial glycaemic responses, and maintenance of normal blood lipid profile. The scientific substantiation...... that whereas the diet that is the subject of the claim, very low calorie diet, is sufficiently characterised in relation to the following claimed effects: reduction in body weight (ID 1410), reduction in the sense of hunger (ID 1411), and reduction in body fat mass while maintaining lean body mass (ID 1412...... that formula foods for use in very low calorie diets should contain. The Panel concludes that a cause and effect relationship cannot be established between the consumption of a very low calorie diet and reduction of post-prandial glycaemic responses (ID 1414) and maintenance of normal blood lipid profile (ID...

Review of clinically accessible methods to determine lean body mass for normalization of standardized uptake values

International Nuclear Information System (INIS)

DEVRIESE, Joke; POTTEL, Hans; BEELS, Laurence; MAES, Alex; VAN DE WIELE, Christophe; GHEYSENS, Olivier

2016-01-01

With the routine use of 2-deoxy-2-[ 18 F]-fluoro-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) scans, metabolic activity of tumors can be quantitatively assessed through calculation of SUVs. One possible normalization parameter for the standardized uptake value (SUV) is lean body mass (LBM), which is generally calculated through predictive equations based on height and body weight. (Semi-)direct measurements of LBM could provide more accurate results in cancer populations than predictive equations based on healthy populations. In this context, four methods to determine LBM are reviewed: bioelectrical impedance analysis, dual-energy X-ray absorptiometry. CT, and magnetic resonance imaging. These methods were selected based on clinical accessibility and are compared in terms of methodology, precision and accuracy. By assessing each method’s specific advantages and limitations, a well-considered choice of method can hopefully lead to more accurate SUVLBM values, hence more accurate quantitative assessment of 18F-FDG PET images.

Depression-related differences in lean body mass distribution from National Health and Nutrition Examination Survey 2005-2006.

Science.gov (United States)

Li, Ying; Meng, Lu; Li, Yue; Sato, Yasuto

2014-03-01

Although the association between depression and body composition has been widely discussed, the effects of depression on lean body mass (LBM) are unclear. The present study aimed to investigate the association of depression with LBM. The study included 2406 participants aged 18-69 years. The sex and body mass index (BMI) stratified analysis of covariance was performed to compare total LBM and percentage LBM (%LBM) in subjects with different depression score levels. Multiple linear regression analysis was conducted to estimate the association between depression score and serum albumin level. An analysis of covariance stratified by sex showed that participants with moderate-to-severe depression had significantly decreased total LBM and total and regional %LBM in men, except for total LBM and percentage gynoid LBM, which was observed in women. In the BMI stratified analysis of covariance, depression was significantly associated with decreased total and regional %LBM and with increased total and regional percentage fat body mass. In people with BMI≥25kg/m(2), the associations between depression or depressive syndrome and LBM, and total and regional %LBM are stronger compared to those with BMILBM and serum albumin level. Copyright © 2014 Elsevier B.V. All rights reserved.

Lean mass and fat mass predict bone mineral density in middle-aged individuals with noninsulin-requiring type 2 diabetes mellitus.

Science.gov (United States)

Moseley, Kendall F; Dobrosielski, Devon A; Stewart, Kerry J; De Beur, Suzanne M Jan; Sellmeyer, Deborah E

2011-05-01

Despite high bone mineral density (BMD), persons with type 2 diabetes are at greater risk of fracture. The relationship between body composition and BMD in noninsulin-requiring diabetes is unclear. The aim was to examine how fat and lean mass independently affect the skeleton in this population. Subjects for this cross-sectional analysis were men (n = 78) and women (n = 56) aged 40-65 years (56 ± 6 years) with uncomplicated, noninsulin-requiring type 2 diabetes. Total body fat and lean mass, total body, hip and lumbar spine BMD were measured with dual energy X-ray absorptiometry. Magnetic resonance imaging measured total abdominal, visceral and subcutaneous (SQ) fat. Subjects had normal all-site BMD and were obese to overweight (body mass index 29-41 kg/m(2)) with controlled diabetes (HbA1c women 6·6 ± 1·2%, men 6·7 ± 1·6%). Lean mass was positively associated with total body, hip, femoral neck and hip BMD in both sexes. Fat mass, abdominal total and SQ fat were associated with total body and hip BMD in women. In multivariate analyses adjusted for sex, lean mass significantly predicted total, hip and femoral neck BMD in men and women. In unadjusted models, lean mass continued to predict BMD at these sites in men; fat mass also predicted total body, femoral and hip BMD in women. In men and women with uncomplicated, noninsulin-requiring diabetes, lean mass significantly predicted BMD at the total body, hip and femoral neck. Further research is needed to determine whether acquisition or maintenance of lean mass in T2DM can prevent hip fracture in this at-risk population. © 2011 Blackwell Publishing Ltd.

Influence of benzodiazepines on body weight and food intake in obese and lean Zucker rats.

Science.gov (United States)

Blasi, C

2000-05-01

1. The gamma-aminobutyric acid (GABA)-ergic system, which is functionally altered in obese (fa/fa) Zucker rats, plays an important role in controlling energy balance within the central nervous system. 2. GABA receptors seem to be involved in the dysfunction of the hypothalamic energy homeostasis-controlling mechanisms in these animals due to a genetically-induced defect of the leptin-neuropeptide Y system. 3. To shed further light on the possible role played by the GABA system in the pathogenesis of this rat model, two benzodiazepine (BDZ) receptor agonists (diazepam and clonazepam) and one BDZ antagonist (flumazenil) were administered intraperitoneally in obese and lean Zucker rats. 4. Body weight gain was reduced by the BDZ agonists in both phenotypes, and one receptor-agonist (diazepam) lowered insulin concentration in obese rats. In GABA-antagonist-treated obese rats, the daily amount of body weight gain and food intake acquired an oscillatory rhythm similar to that of normal rodents. 5. By demonstrating the role of BDZ receptors, these findings may help clarify the pathophysiology of obesity and insulin resistance in fatty Zucker rats.

Relationship of low lean body mass with body weight increase until one year of age and current lifestyles in Japanese young women.

Science.gov (United States)

Miyamoto, Shoji; Murotani, Kenta; Yanagawa, Takashi; Kato, Atsushi; Matsunaga, Satoshi

2010-06-01

To investigate factors affecting the low lean body mass (LBM) of young women, we focused on the increase in body weight until one year of age and current lifestyles. In 442 young women, the increase in body weight from birth until one year of age, breast-feeding method in infancy, current physique index and body composition, and physique and lifestyles were investigated using a questionnaire. Subjects with an LBM percentile of less than 33.3 (less than 36.8 kg) were classified as having a low LBM (n = 150), and those with a 33.3 or higher LBM percentile as the control (n = 293). Based on body weight changes from birth to days 3 and 7, the subjects were divided into a rapid weight gain group and two non-rapid weight gain groups (groups 1-3). To analyze factors involved in a low LBM, multivariate analysis using a logistic model was employed. The prevalence of a low LBM in the rapid weight gain group was 0.41 times higher than in the others. The prevalence of a low LBM with a low birth weight was 0.58 times higher, indicating that a low birth weight is likely to result in a low LBM. Regarding the lifestyles, the prevalence of a low LBM in subjects with a current breakfasting habit was 0.60 times higher than in those without one. These findings suggest that the thinness of young women characterized by a low LBM is associated with the increase in body weight until one year of age and current lifestyles.

Lean versus Quick Response Manufacturing og andre koncepter - er Lean den eneste ene?

DEFF Research Database (Denmark)

Michelsen, Aage U

2005-01-01

Begrebet Lean har gennem de senere år vundet en enorm udbredelse. Antallet af publikationer om Lean har været eksplosivt stigende, og mange virksomheder har gennemført eller gennemfører Lean-projekter. Er Lean et nyt koncept? Er Lean den eneste løsning? Kan Lean kombineres med tankegange og princ...... løsning af en anden produktionsopgave. I fjerde afsnit skitseres kort relationerne mellem Lean og to andre begreber, Six Sigma og TPM, der begge har samme mål som Lean, men forskellige udgangspunkter og forskellige indfaldsvinkler....

Comparative Analysis between Lean, Six Sigma and Lean Six Sigma Concepts

OpenAIRE

Alexandra Mirela Cristina MUNTEANU

2017-01-01

This paper analyzes the benefits of Lean Six Sigma in comparison with Lean and Six Sigma, traditional improvement methodologies. The introduction highlights the appearance of Lean Six Sigma, early 2000s, as well as the benefits brought by the integrated approach. The following parts of the study emphasize the main differences between methodologies and their commonalities based on their synergy. Finally the advantages of Lean Six Sigma versus Lean and Six Sigma are analyzed and systematized by...

Dietary Supplementation at Home Improves the Regain of Lean Body Mass After Surgery

DEFF Research Database (Denmark)

Jensen, Martin Bach; Hessov, Ib

1997-01-01

Little is known about nutritional intake after discharge though it takes months to regain preoperative weight after gastrointestinal surgery. We studied whether a 4-mo intervention with dietary advice and protein-rich supplements would increase nutritional intake and gain in lean body mass (LBM...... with the intake of the general population that did not increase further. During the 4 m, the intervention patients had an increased intake of protein (+22%) and energy (+16%), and an enhanced gain of LBM after 2 mo (control 0.8 kg versus intervention 2.1 kg; P = 0.009). After the 4-mo intervention, both LBM...... and fat were gained (control 1.7 kg LBM and 0.2 kg fat versus intervention 3.1 kg LBM and 1.5 kg fat; LBM: P = 0.029 and fat: P = 0.056). At discharge patients should increase protein intake to 1.5 g·kg−1·d−1 for 2 mo, e.g., by taking protein-rich liquid supplements....

Downsizing of lean body mass is a key determinant of Alzheimer's disease.

Science.gov (United States)

Ingenbleek, Yves; Bernstein, Larry H

2015-01-01

Lean body mass (LBM) encompasses all metabolically active organs distributed into visceral and structural tissue compartments and collecting the bulk of N and K stores of the human body. Transthyretin (TTR) is a plasma protein mainly secreted by the liver within a trimolecular TTR-RBP-retinol complex revealing from birth to old age strikingly similar evolutionary patterns with LBM in health and disease. TTR is also synthesized by the choroid plexus along distinct regulatory pathways. Chronic dietary methionine (Met) deprivation or cytokine-induced inflammatory disorders generates LBM downsizing following differentiated physiopathological processes. Met-restricted regimens downregulate the transsulfuration cascade causing upstream elevation of homocysteine (Hcy) safeguarding Met homeostasis and downstream drop of hydrogen sulfide (H2S) impairing anti-oxidative capacities. Elderly persons constitute a vulnerable population group exposed to increasing Hcy burden and declining H2S protection, notably in plant-eating communities or in the course of inflammatory illnesses. Appropriate correction of defective protein status and eradication of inflammatory processes may restore an appropriate LBM size allowing the hepatic production of the retinol circulating complex to resume, in contrast with the refractory choroidal TTR secretory process. As a result of improved health status, augmented concentrations of plasma-derived TTR and retinol may reach the cerebrospinal fluid and dismantle senile amyloid plaques, contributing to the prevention or the delay of the onset of neurodegenerative events in elderly subjects at risk of Alzheimer's disease.

Differential Risk of Hypertension Among Lean and Nonlean Rural Subjects in Relation to Decadal Changes in Anthropometry.

Science.gov (United States)

Deshpande-Joshi, Sayali S; Rao, Shobha

2018-02-09

Assessing risk of hypertension in relation to decadal changes in anthropometry among cohort of young rural Indian men. Subjects (n = 140) were measured in 2005 and 2015 for blood pressure, body mass index (BMI), body fat (BF), waist circumference (WC), waist-to-hip ratio (WHR), and additionally for visceral fat (VF) at follow-up. Decadal changes showed significant (p lean (baseline BMI lean but was not significant among nonlean subjects. This was also true for change in other adiposity indicators, indicating greater vulnerability of lean subjects. Further, among lean subjects, ORs reduced considerably after adjusting for VF, whereas among nonlean subjects ORs continued to remain nonsignificant but showing independent significance for VF. For similar level of change in adiposity indicators, lean subjects were at greater risk of hypertension than nonlean subjects, probably due to higher VF deposition.

Negotiating Lean

DEFF Research Database (Denmark)

Rahbek Pedersen, Esben; Muniche, Mahad

2011-01-01

Purpose – The purpose of this paper is to analyse how negotiations between the constituencies affect the processes and outcomes of lean projects in Danish public sector organisations. Design/methodology/approach – The paper is based on a qualitative analysis of interviews with managers...... projects in the Danish public sector. It cannot be concluded that the findings can be generalised to reflect all types of lean projects across organisational and geographical settings. Originality/value – The paper adds value to the relatively scarce literature on lean management in the public sector...... and employees who have participated in lean projects in the Danish public sector. Negotiated order theory serves as the overarching theoretical framework for the analysis. Findings – The paper concludes that the processes and outcomes of lean depend not only on the technology itself, but also the negotiation...

Moderately Low Magnesium Intake Impairs Growth of Lean Body Mass in Obese-Prone and Obese-Resistant Rats Fed a High-Energy Diet

Directory of Open Access Journals (Sweden)

Jesse Bertinato

2016-04-01

Full Text Available The physical and biochemical changes resulting from moderately low magnesium (Mg intake are not fully understood. Obesity and associated co-morbidities affect Mg metabolism and may exacerbate Mg deficiency and physiological effects. Male rats selectively bred for diet-induced obesity (OP, obese-prone or resistance (OR, obese-resistant were fed a high-fat, high-energy diet containing moderately low (LMg, 0.116 ± 0.001 g/kg or normal (NMg, 0.516 ± 0.007 g/kg Mg for 13 weeks. The growth, body composition, mineral homeostasis, bone development, and glucose metabolism of the rats were examined. OP and OR rats showed differences (p < 0.05 in many physical and biochemical measures regardless of diet. OP and OR rats fed the LMg diet had decreased body weight, lean body mass, decreased femoral size (width, weight, and volume, and serum Mg and potassium concentrations compared to rats fed the NMg diet. The LMg diet increased serum calcium (Ca concentration in both rat strains with a concomitant decrease in serum parathyroid hormone concentration only in the OR strain. In the femur, Mg concentration was reduced, whereas concentrations of Ca and sodium were increased in both strains fed the LMg diet. Plasma glucose and insulin concentrations in an oral glucose tolerance test were similar in rats fed the LMg or NMg diets. These results show that a moderately low Mg diet impairs the growth of lean body mass and alters femoral geometry and mineral metabolism in OP and OR rats fed a high-energy diet.

Lean og arbejdsmiljø

DEFF Research Database (Denmark)

Jensen, Kenneth

Bogen tager udgangspunkt i en undersøgelse af 10 private og offentlige virksomheders erfaringer med lean. Undersøgelsen viser at der ikke findes entydige sammenhænge mellem lean og det psykosociale arbejdsmiljø. Bogen forholder sig til sammenhængen mellem lean og ledelse, lean og medarbejderens...... rolle, lean og lean og forandringsprocessen. Bogen kommer desuden med anbefalinger til hvorledes virksomheden kan gribe dialogen an for at opnå et godt lean forløb der inddrager hensynet til og effekterne af et godt psykosocialt arbejdsmiljø....

A Lean Six Sigma program in higher education

KAUST Repository

Svensson, Carsten

2015-01-01

Purpose The objective of this paper is to contribute to the body of Lean Six Sigma knowledge within the field of higher education institutions. The paper will review the initial phase of an implementation and highlight future challenges of applying the Lean Six Sigma method in a complex transactional environment. Design/methodology/approach The observations presented in this paper originate from rolling out a large Lean Six Sigma implementation at a recently established university. The paper is supported with secondary data from literature. Findings The implementation of Lean Six Sigma methodology at King Abdullah University of Science and Technology (KAUST) has resulted in improvements in business processes and efficiency. This has been achieved through project execution and training programs. Approximately 350 staff members have completed awareness training, 50 yellow belts and 150 green belts have been trained, and the first round of seven black belts have completed training of which two have completed certification. Research limitations/implications This paper is based on an empirical study of a single instance and the authors’ experiences as practitioners. Originality/value This paper is the first description of what is believed to be one of the largest implementations of Lean Six Sigma in higher education.

Resistance Training Combined With Diet Decreases Body Fat While Preserving Lean Mass Independent of Resting Metabolic Rate: A Randomized Trial.

Science.gov (United States)

Miller, Todd; Mull, Stephanie; Aragon, Alan Albert; Krieger, James; Schoenfeld, Brad Jon

2018-01-01

The purpose of this study was to determine the effects of resistance training only (RT; n = 10), dietary intervention only (DIET; n = 10), resistance training plus diet (RT+DIET; n = 10), and control (CON; n = 10) on body composition and resting metabolic rate (RMR) in a cohort of 40 premenopausal female volunteers. Subjects in DIET and RT+DIET were provided with daily macronutrient and calorie goals based on DXA and RMR tests, with protein maintained at 3.1 g/kg/day. Subjects in the RT and RT+DIET groups performed a supervised progressive RT program consisting of exercises for all the major muscle groups of the body. Results showed a significant month-by-group interaction for change in fat mass with no significant linear trend for control. The three treatment groups all showed significant linear decreases in fat mass, but the slope of the decrease became progressively steeper from the RT, to DIET, to RT+DIET. A significant linear increase for lean mass was seen for resistance training only. There was a nonsignificant increase in RMR in all groups from Month 0 to Month 4 but no significant month by group interaction. In conclusion, significant reductions in fat mass were achieved by all experimental groups, but results were maximized by RT+DIET. Only the RT group showed significant increases in lean mass.

EDUCATION FOR LEAN & LEAN FOR EDUCATION: A LITERATURE REVIEW

Directory of Open Access Journals (Sweden)

Saveta Vukadinovic

2017-03-01

Full Text Available The purpose of this paper is to investigate and understand how tools and principles of Lean philosophy can be adopted to improve the effectiveness of engineering education by providing services beyond the competition and costs below the competition, and how engineering education can provide better prepared engineering professionals capable to work in dynamic Lean environments by developing multidisciplinary knowledge and skills. Paper will be based on analysis of relevant scientific and professional literature sources, including certain elements of description, classification, explanation and prediction. The authors will use detailed literature review to explain complex relationship and interdependence between Lean philosophy and engineering education and answer the question what benefits modern Lean enterprises may expect from properly educated and qualified engineers and how application of Lean tools and principles can improve the system of engineering education.

Obstacles to lean in healthcare: Mindsets and the nature of work

DEFF Research Database (Denmark)

Edwards, Kasper; Nielsen, Anders Paarup

2009-01-01

The ideas and principles from lean management are now widely being adopted within the health care sector. The interest in lean from managers and policy makers, however, appear to contrast the realized benefits. An analysis of cases reported in literature and three Danish healthcare cases show...... for example laboratory work, logistical issues for patient e.g. emergency room layout, billing processes, and logistics of medical supplies. At first glance an explanation could be found in the conservative nature of the medical community which needs substantial scientific evidence to change behavior....... This is of course not true as new modes of treatment are rapidly implemented when their effect has been documented. The health care sector therefore presents a paradox: Why can changes in treatment be implemented without problems, when lean and thereby changes in work processes are so difficult? This paper will try...

Bevezetés a lean menedzsmentbe – a lean stratégiai alapjai = Introduction to lean management – basic strategic elements of lean

OpenAIRE

Losonci, Dávid

2010-01-01

A lean menedzsment az értékteremtő folyamatok stratégiai és operatív szintjének meghatározó formálójává vált az elmúlt évtizedekben. Jelen tanulmány stratégiai nézőpontból tárgyalja a lean menedzsment teljes bevezetését. Részletes áttekintést ad a Womack és Jones (2003) által lefektetett lean alapelvekről. Az operatív teljesítményjavulásból származó vevői értékteremtés mellett foglalkozik a tulajdonosi értékteremtéssel, az MRP és a lean szinergikus összekapcsolásával, valamint a lean ideális ...

Dynamics of bluff-body-stabilized lean premixed syngas flames in a meso-scale channel

KAUST Repository

Lee, Bok Jik

2016-07-15

Direct numerical simulations are conducted to investigate the dynamics of lean premixed syngas flames stabilized by a bluff-body in a meso-scale channel at near blow-off conditions, in order to provide fundamental insights into the physical mechanisms responsible for the critical phenomena. Flames in a two-dimensional meso-scale channel with a square flame holder are adopted as the model configuration, and a syngas mixture at an equivalence ratio of 0.5 with the CO:H ratio of 1 is considered. As the inlet velocity is increased, the initially stable steady flames undergo a transition to an unsteady mode of regular asymmetric fluctuation. When the inlet velocity is further increased, the flame is eventually blown off. Between the regular fluctuation mode and blow-off limit, there exists a narrow range of the inlet velocity where the flames exhibit periodic local extinction and recovery. Approaching further to the blow-off limit, the recovery mode fails to occur but the flame survives as a short kernel attached to the base of the bluff-body, until it is completely extinguished as the attached flames are gradually shrunk towards the bluff-body. The results are systematically compared with the hydrogen flame results reported in our earlier study. Examination of the characteristic time scales of relevant processes provided understanding of key mechanisms responsible for the observed differences, thereby allowing improved description of the local extinction and re-ignition dynamics that are critical to flame stabilization.

Cycling peak power in obese and lean 6- to 8-year-old girls and boys.

Science.gov (United States)

Aucouturier, Julien; Lazaar, Nordine; Doré, Eric; Meyer, Martine; Ratel, Sebastien; Duché, Pascale

2007-06-01

The purpose of this study was to investigate the possible effect of the difference in percentage body fat (%BF) and fat-free mass (FFM) on cycling peak power (CPP) in 6- to 8-year-old obese and lean untrained girls and boys. Obese (35 girls, 35 boys) and lean (35 girls, 35 boys) children were measured for obesity, %BF, calculated from skinfold measurements. FFM was calculated as body mass (BM) minus body fat. A force-velocity test on a cycle ergometer was used to measure CPP. CPP was related to anthropometric variables using standard and allometric models. CPP in absolute terms was higher in obese children than in lean children irrespective of gender. BM-related CPP was significantly lower in obese children than in lean ones, whereas no effect of obesity appeared on FFM-related CPP. Velocity at CPP (Vopt) was significantly lower and force at CPP (Fopt) was significantly higher in girls than in boys. Muscle power production was unaffected by obesity in children. Low BM-related CPP could explain the difficulty of taking up physical activities that are body-mass related in obese children. Gender difference for Vopt and Fopt shows that girls and boys may have different maturation patterns affecting CPP.

Whole-body bone mineral content, lean body mass, and fat mass measured by dual-energy x-ray absorptiometry in a population of normal Canadian children and adolescents

Energy Technology Data Exchange (ETDEWEB)

Sala, A. [McMaster Children' s Hospital, Hamilton, Ontario (Canada); McMaster Univ., Dept. of Pediatrics, Hamilton, Ontario (Canada); Univ. of Milan-Bicocca, Monza (Italy); Webber, C.E. [Hamilton Health Sciences, Dept. of Nuclear Medicine, Hamilton, Ontario (Canada); McMaster Univ., Dept. of Radiology, Hamilton, Ontario (Canada)]. E-mail: webber@hhsc.ca; Morrison, J. [McMaster Children' s Hospital, Hamilton, Ontario (Canada); Beaumont, L.F. [Hamilton Health Sciences, Dept. of Nuclear Medicine, Hamilton, Ontario (Canada); Barr, R.D. [McMaster Children' s Hospital, Hamilton, Ontario (Canada); McMaster Univ., Dept. of Pediatrics, Hamilton, Ontario (Canada)

2007-02-15

Measurements of body composition have evident value in evaluating growing children and adolescents, and dual-energy X-ray absorptiometry (DXA) is a tool that provides accurate measurements of whole-body bone mineral content (WBBMC), lean body mass (LBM), and fat mass (FM). To interpret such measurements in the context of ill health, normative values must be available. Such information could be expected to be regionally specific because of differences in ethnic, dietary, and physical activity determinants. In this study, DXA was performed with Hologic densitometers in normal girls (n = 91) and boys (n 88) between 3 and 18 years of age. The derivation of normal ranges is presented for boys and girls. The correlation of the sum of WBBMC, LBM, and FM with directly measured body weight was almost perfect (r > 0.997). As expected, FM and body mass index correlated strongly. The normal values for WBBMC, LBM, and FM from this study are compared with other Canadian data and with published normative data from Argentina and the Netherlands, all of which use different densitometers. The results of this study allow the calculation of z scores for each facet of body composition and facilitate the use of DXA to report routine evaluations of body composition in children and adolescents. (author)

Whole-body bone mineral content, lean body mass, and fat mass measured by dual-energy x-ray absorptiometry in a population of normal Canadian children and adolescents

International Nuclear Information System (INIS)

Sala, A.; Webber, C.E.; Morrison, J.; Beaumont, L.F.; Barr, R.D.

2007-01-01

Measurements of body composition have evident value in evaluating growing children and adolescents, and dual-energy X-ray absorptiometry (DXA) is a tool that provides accurate measurements of whole-body bone mineral content (WBBMC), lean body mass (LBM), and fat mass (FM). To interpret such measurements in the context of ill health, normative values must be available. Such information could be expected to be regionally specific because of differences in ethnic, dietary, and physical activity determinants. In this study, DXA was performed with Hologic densitometers in normal girls (n = 91) and boys (n 88) between 3 and 18 years of age. The derivation of normal ranges is presented for boys and girls. The correlation of the sum of WBBMC, LBM, and FM with directly measured body weight was almost perfect (r > 0.997). As expected, FM and body mass index correlated strongly. The normal values for WBBMC, LBM, and FM from this study are compared with other Canadian data and with published normative data from Argentina and the Netherlands, all of which use different densitometers. The results of this study allow the calculation of z scores for each facet of body composition and facilitate the use of DXA to report routine evaluations of body composition in children and adolescents. (author)

Internal lean practitioner's challenges in lean principles ...

African Journals Online (AJOL)

The approach to this paper is to answer the questions such as “how does internal management commitment impact the Lean principles?”, “how does Supply Chain Management practices impact the lean principles?”, “can Supply Chain Management practices be embedded with internal management commitment?

Effects of Eating Fresh Lean Pork on Cardiometabolic Health Parameters

Directory of Open Access Journals (Sweden)

Peter R. C. Howe

2012-07-01

Full Text Available High protein meat-based diets are commonly promoted for weight loss, supposedly by increasing satiety and energy expenditure. Pork is a good source of protein however little information on the metabolic effects of pork consumption exists. This pilot study aimed to examine whether regular consumption of fresh lean pork could improve body composition and cardiovascular risk factors in a 6 month parallel intervention trial. 164 overweight adults (mean BMI 32 were randomly assigned to incorporate up to 1 kg pork/week by substituting for other foods or maintain their habitual diet (control. Plasma levels of lipids, glucose and insulin, BMI, waist/hip circumference, blood pressure, heart rate and arterial compliance were measured at baseline and 3 and 6 months. Body composition was determined using dual energy X-ray absorptiometry. A total of 144 volunteers completed and volunteers in the pork group increased their intake 10 fold by substituting pork for mainly beef and chicken. After 3 months, there were significant (p ≤ 0.01 reductions in weight, BMI, waist circumference, % body fat, fat mass and abdominal fat in the pork group relative to controls, which persisted for 6 months. There was no change in lean mass, indicating that the reduction in weight was due to loss of fat mass. There were no significant effects on other metabolic parameters. Regular consumption of lean fresh pork may improve body composition.

Lean i Norge : opplever norske bedrifter som er mer lean, større økning i kundetilfredshet enn de som er mindre lean?

OpenAIRE

Fagereng, Hanne Eline; Askevold, Elisabeth Cathrine

2010-01-01

Vi ønsker å måle i hvor stor grad norske bedrifter har implementert lean, og for å måle grad av lean har vi utviklet et rammeverk basert på lean teori. Hovedformålet med lean er å øke kundeverdi med minst mulig ressursbruk, anstrengelse, energi, utstyr, tid, plass, material og kapital (Womack, Roos and Jones 2007). Vi vil utforske om høyere grad av lean fører til mer tilfredse kunder enn de som har lavere grad av lean. Altså om hovedformålet med lean blir oppnådd hvis man implementerer lean i...

Lean body mass predicts long-term survival in Chinese patients on peritoneal dialysis.

Directory of Open Access Journals (Sweden)

Jenq-Wen Huang

Full Text Available BACKGROUND: Reduced lean body mass (LBM is one of the main indicators in malnutrition inflammation syndrome among patients on dialysis. However, the influence of LBM on peritoneal dialysis (PD patients' outcomes and the factors related to increasing LBM are seldom reported. METHODS: We enrolled 103 incident PD patients between 2002 and 2003, and followed them until December 2011. Clinical characteristics, PD-associated parameters, residual renal function, and serum chemistry profiles of each patient were collected at 1 month and 1 year after initiating PD. LBM was estimated using creatinine index corrected with body weight. Multiple linear regression analysis, Kaplan-Meier survival analysis, and Cox regression proportional hazard analysis were used to define independent variables and compare survival between groups. RESULTS: Using the median LBM value (70% for men and 64% for women, patients were divided into group 1 (n = 52; low LBM and group 2 (n = 51; high LBM. Group 1 patients had higher rates of peritonitis (1.6 vs. 1.1/100 patient months; p<0.05 and hospitalization (14.6 vs. 9.7/100 patient months; p<0.05. Group 1 patients also had shorter overall survival and technique survival (p<0.01. Each percentage point increase in LBM reduced the hazard ratio for mortality by 8% after adjustment for diabetes, age, sex, and body mass index (BMI. Changes in residual renal function and protein catabolic rate were independently associated with changes in LBM in the first year of PD. CONCLUSIONS: LBM serves as a good parameter in addition to BMI to predict the survival of patients on PD. Preserving residual renal function and increasing protein intake can increase LBM.

Histologically Measured Cardiomyocyte Hypertrophy Correlates with Body Height as Strongly as with Body Mass Index

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Richard E. Tracy

2011-01-01

Full Text Available Cardiac myocytes are presumed to enlarge with left ventricular hypertrophy (LVH. This study correlates histologically measured myocytes with lean and fat body mass. Cases of LVH without coronary heart disease and normal controls came from forensic autopsies. The cross-sectional widths of myocytes in H&E-stained paraffin sections followed log normal distributions almost to perfection in all 104 specimens, with constant coefficient of variation across the full range of ventricular weight, as expected if myocytes of all sizes contribute proportionately to hypertrophy. Myocyte sizes increased with height. By regression analysis, height2.7 as a proxy for lean body mass and body mass index (BMI as a proxy for fat body mass, exerted equal effects in the multiple correlation with myocyte volume, and the equation rejected race and sex. In summary, myocyte sizes, as indexes of LVH, suggest that lean and fat body mass may contribute equally.

Lean mass and insulin resistance in women with polycystic ovary syndrome.

Science.gov (United States)

Comerford, Kevin B; Almario, Rogelio U; Kim, Kyoungmi; Karakas, Sidika E

2012-09-01

Insulin resistance is common in women with polycystic ovary syndrome (PCOS). Muscle is the major tissue utilizing glucose while excess adipose tissue relates to insulin resistance. Thus, body composition is likely to be an important regulator of insulin sensitivity. Thirty-nine PCOS patients (age: 29.9±1.0 years; BMI: 33.8±1.2 kg/m(2)) participated in a cross sectional study. Body composition was measured by dual energy x-ray absorptiometry (DEXA). Insulin resistance and secretion were assessed using oral glucose tolerance test (OGTT) and frequently sampled intravenous glucose tolerance test (FS-IVGTT). In contrast with the conventional expectations, lean mass correlated directly (Plean mass (52.8±1.8 vs 44.4±1.6 kg), those with higher lean mass had a higher glucose response during OGTT (AUC(Glucose); P=.034). In contrast, 17 pairs matched for lean mass (48.7±1.7 and 48.9±1.6 kg) but discordant for fat mass (43.3±2.6 vs 30.3±8.9 kg) showed no differences in insulin resistance parameters. These novel findings indicate that lean mass relates directly to insulin resistance in PCOS. Published by Elsevier Inc.

Lean information management

NARCIS (Netherlands)

Hammer, D.K.

1997-01-01

The concept of a Lean Enterprise has proven to be extremely valuable for making companies fit for today's competitive business environment. Lean Information Management denotes the type of information management that is appropriate for such all organization. According to the paradigm of a Lean

Plasma Transthyretin as a Biomarker of Lean Body Mass and Catabolic States.

Science.gov (United States)

Ingenbleek, Yves; Bernstein, Larry H

2015-09-01

Plasma transthyretin (TTR) is a plasma protein secreted by the liver that circulates bound to retinol-binding protein 4 (RBP4) and its retinol ligand. TTR is the sole plasma protein that reveals from birth to old age evolutionary patterns that are closely superimposable to those of lean body mass (LBM) and thus works as the best surrogate analyte of LBM. Any alteration in energy-to-protein balance impairs the accretion of LBM reserves and causes early depression of TTR production. In acute inflammatory states, cytokines induce urinary leakage of nitrogenous catabolites, deplete LBM stores, and cause an abrupt decrease in TTR and RBP4 concentrations. As a result, thyroxine and retinol ligands are released in free form, creating a second frontline that strengthens that primarily initiated by cytokines. Malnutrition and inflammation thus keep in check TTR and RBP4 secretion by using distinct and unrelated physiologic pathways, but they operate in concert to downregulate LBM stores. The biomarker complex integrates these opposite mechanisms at any time and thereby constitutes an ideally suited tool to determine residual LBM resources still available for metabolic responses, hence predicting outcomes of the most interwoven disease conditions. © 2015 American Society for Nutrition.

Lean production

OpenAIRE

Veselková, Jana

2011-01-01

The goal of this Bachelor's Thesis is to describe the general principles of lean production and afterwards apply these principles in a particular company. Due to the changing conditions on the world market is among companies growing concern about such innovative business systems. The theoretical part of this work deals with the general characteristics of lean production, including their history and focus on Toyota, as the originator of most lean systems. Mentioned are also the economic aspect...

Lean muscle mass in classic or ovulatory PCOS: association with central obesity and insulin resistance.

Science.gov (United States)

Mario, F M; do Amarante, F; Toscani, M K; Spritzer, P M

2012-10-01

This age-matched case-control study assessed total and segmental lean muscle mass in classic or ovulatory polycystic ovary syndrome (PCOS) patients and investigated whether lean mass is associated with hormone and metabolic features. Participants underwent anthropometric and clinical evaluation. Habitual physical activity was assessed with a digital pedometer, and body composition by dual-energy X-ray absorptiometry. Laboratory measurements included total cholesterol, cholesterol fractions, triglycerides, glucose, total serum testosterone, serum insulin, estradiol, luteinizing hormone, and SHBG. Energy intake was calculated using a food frequency questionnaire. Classic PCOS patients had higher body mass index (BMI), waist circumference, testosterone and lipid accumulation product values than ovulatory PCOS and controls. Energy consumption, homeostasis model assessment index, SHBG, free androgen index and triglycerides, total and trunk lean mass were higher only in classic PCOS women vs. controls. Arm, leg, trunk, total or limb lean masses were not correlated with hormone levels in any of the groups. However, in PCOS women lipid accumulation product was positively correlated with total (r=0.56, p=0.001), trunk (r=0.59, p=0.001), arm (r=0.54, p=0.001), leg (r=0.44, p=0.03) and limb (r=0.48, p=0.001) lean masses. BMI was positively correlated with all lean mass segments and independently associated with total lean mass. Lipid accumulation product and BMI were independently associated with trunk lean mass variation. The increase in lean mass in classic PCOS appears to be associated with insulin resistance and central obesity rather than with energy intake, physical activity or androgens. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

EPA Lean Government Initiative: How to Replicate Lean Successes

Science.gov (United States)

This Lean Replication Primer describes how EPA Offices and Regions can identify and adapt successful practices from previous Lean projects to “replicate” their successes and generate further improvements.

Analysis Of Lean Accounting JIT And Balance Scorecard In The Companys Lean Manufacturing

OpenAIRE

Irwan Sutirman Wahdiat

2015-01-01

This research purpose to analyze the concept of Lean Manufacturing which is influenced by the role of JIT. This research uses a theoretical approach. This study portrait thinking companies that have yet to implement lean manufacturing and after doing the concept of lean manufacturing. This study shows that the concept of lean manufacturing can make the company more efficient and effective. This paper shows some lean manufacturing dimensions of the researchers previous researchers. This study ...

Clinical and biochemical profile of lean type 2 diabetes mellitus

OpenAIRE

Barma, Punyakrit Deb; Ranabir, Salam; Prasad, Lallan; Singh, Thangjam Premchand

2011-01-01

Background: Type 2 diabetes mellitus is the most prevalent form of diabetes worldwide. In western countries majority of the cases are obese. The scenario may be different in certain parts of India. Various studies have reported a high prevalence of lean type 2 diabetes mellitus with a body mass index < 19 kg/m 2 . Materials and Methods: We evaluated 100 cases of lean type 2 diabetes mellitus (62 males and 38 females). Results and Conclusion: The mean duration of diabetes was 51.7 months (rang...

Making it lean applying lean practices to the work of it

CERN Document Server

Williams, Howard

2013-01-01

Making IT Lean: Applying Lean Practices to the Work of IT presents Lean concepts and techniques for improving processes and eliminating waste in IT operations and IT Service Management, in a manner that is easy to understand. The authors provide a context for discussing several areas of application within this domain, allowing you to quickly gain insight into IT processes and Lean principles.The text reviews IT Service Management, with reference to the IT Infrastructure Library (ITIL®) as a framework for best practices-explaining how to use it to accommod

TRUNK LEAN DURING A SINGLE-LEG SQUAT IS ASSOCIATED WITH TRUNK LEAN DURING PITCHING.

Science.gov (United States)

Plummer, Hillary A; Oliver, Gretchen D; Powers, Christopher M; Michener, Lori A

2018-02-01

Impaired trunk motion during pitching may be a risk factor for upper extremity injuries. Specifically, increased forces about the shoulder and elbow have been observed in pitchers with excessive contralateral trunk lean during pitching. Because of the difficulty in identifying abnormal trunk motions during a high-speed task such as pitching, a clinical screening test is needed to identify pitchers who have impaired trunk motion during pitching. The purpose of this study was to determine the relationship between the degree of lateral trunk lean during the single-leg squat and amount of trunk lean during pitching and if trunk lean during pitching can be predicted from lean during the single-leg squat. Controlled Laboratory Study; Cross-sectional. Seventy-three young baseball pitchers (11.4 ± 1.7 years; 156.3 ± 11.9 cm; 50.5 ± 8.8 kg) participated. An electromagnetic tracking system was used to obtain trunk kinematic data during a single-leg squat task (lead leg) and at maximum shoulder external rotation of a fastball pitch. Pearson correlation coefficients for trunk lean during the single-leg squat and pitching were calculated. A linear regression analysis was performed to determine if trunk lean during pitching can be predicted from lean during the single-leg squat. There was a positive correlation between trunk lean during the single-leg squat and trunk lean during pitching (r = 0.53; plean during the single-leg squat predicted the amount of lateral trunk lean during pitching (R 2 = 0.28; p lean during an SLS and pitching. Trunk lean during the single-leg squat explained 28% of the variance in trunk lean during pitching. Diagnosis, level 3.

Sport type and interpersonal and intrapersonal predictors of body dissatisfaction in high school female sport participants.

Science.gov (United States)

Karr, Trisha M; Davidson, Denise; Bryant, Fred B; Balague, Gloria; Bohnert, Amy M

2013-03-01

Through multiple group structural equation modeling analyses, path models were used to test the predictive effects of sport type and both interpersonal (i.e., mothers' body dissatisfaction, family dynamics) and intrapersonal factors (i.e., athletic self-efficacy, body mass index [BMI]) on high school female sport participants' (N=627) body dissatisfaction. Sport types were classified as esthetic/lean (i.e., gymnastics), non-esthetic/lean (i.e., cross-country), or non-esthetic/non-lean (i.e., softball). Most participants reported low body dissatisfaction, and body dissatisfaction did not differ across sport types. Nevertheless, mothers' body dissatisfaction was positively associated with daughters' body dissatisfaction for non-esthetic/lean and non-esthetic/non-lean sport participants, and high family cohesion was predictive of body dissatisfaction among non-esthetic/lean sport participants. Across sport types, higher BMI was associated with greater body dissatisfaction, whereas greater athletic self-efficacy was associated with lower body dissatisfaction. These findings highlight the complex relationship between interpersonal and intrapersonal factors and body dissatisfaction in adolescent female sport participants. Copyright © 2012. Published by Elsevier Ltd.

Lean Startup and Lean Canvas Using for Innovative Product Development

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Alena Buchalcevová

2016-06-01

Full Text Available Recently, new approaches to product development have emerged that focus on idea generation techniques and customer itself. One of them is the Lean Startup method that is described in this article along with the Lean Canvas method. The main goal of the article is to demonstrate the application of both methods to an innovative product development focused on providing interactive trips for families with children. The development of the product during individual phases is described and application of the Lean Startup and Lean Canvas principles is demonstrated. Finally, benefits of both methods contributing to the product success are discussed. Similar case studies start emerging worldwide, however in the Czech context are quite rare.

Moving on - beyond lean thinking

OpenAIRE

Koskela, Lauri

2004-01-01

Lean Thinking is currently often positioned as the underlying theory of lean production among practitioners and academics, although its originators, Womack and Jones, seem not to have presented it as a theory. This paper endeavors to analyze whether Lean Thinking can be viewed as a theory of lean production. For this purpose, a critical assessment of Lean Thinking is carried out. Lean Thinking is argued to lack an adequate conceptualization of production, which has led to imprecise concepts, ...

lean-ISD.

Science.gov (United States)

Wallace, Guy W.

2001-01-01

Explains lean instructional systems design/development (ISD) as it relates to curriculum architecture design, based on Japan's lean production system. Discusses performance-based systems; ISD models; processes for organizational training and development; curriculum architecture to support job performance; and modular curriculum development. (LRW)

Lean Leadership - Organizational Buy - Ins

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Dr. Revathi Iyer

2017-05-01

Full Text Available Great organizations have become leaders due to their leadership and sustainable initiatives. One such initiative is adoption of lean leadership to align core strategies with all functional areas of business. Leadership is likely to take place in a lean environment because improvements that happen are continual and can only be supported by leadership which understands this important aspect. The topic of lean leadership organizational buy ins speaks on how lean leadership could affect organizations that adopt lean and other quality tools. Purpose of the study This study has been undertaken to understand When leadership more of is likely to take place in lean . Leadership plays a very important role while adopting lean processes and how lean leadership can address the process problem. Application of leadership lenses to lean processes needs great foresight thought and creativity. It has been also observed that lean management and lean processes can happen only if leadership is able to effectively communicate the thought of continual improvement to bring in a lean organization and a future state of processes where everything of a firm process and procedure is continually improving and the best strategies to manage this change becomes a philosophy. Lean leadership is associated with such a change. This enables leadership vision to be clear as it paves the way for current state and is clear to everyone. It is this leadership vision which enables employees to think and act in a way that perpetrates continual improvement. Hence leadership buys ins for lean are very necessary. The purpose of the study is also to understand how leaders can not only use cost reduction but also reducing time-to-market improving service quality and reducing risk exposure by adopting lean methods . it has been also seen that there is overall productivity and efficiency in organizations holistically when leadership endorses lean methodology. Radnor Z. and Bucci G. 2007

Skeletal muscle tissue transcriptome differences in lean and obese female beagle dogs.

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Grant, R W; Vester Boler, B M; Ridge, T K; Graves, T K; Swanson, K S

2013-08-01

Skeletal muscle is a large and insulin-sensitive tissue that is an important contributor to metabolic homeostasis and energy expenditure. Many metabolic processes are altered with obesity, but the contribution of muscle tissue in this regard is unclear. A limited number of studies have compared skeletal muscle gene expression of lean and obese dogs. Using microarray technology, our objective was to identify genes and functional classes differentially expressed in skeletal muscle of obese (14.6 kg; 8.2 body condition score; 44.5% body fat) vs. lean (8.6 kg; 4.1 body condition score; 22.9% body fat) female beagle adult dogs. Alterations in 77 transcripts was observed in genes pertaining to the functional classes of signaling, transport, protein catabolism and proteolysis, protein modification, development, transcription and apoptosis, cell cycle and differentiation. Genes differentially expressed in obese vs. lean dog skeletal muscle indicate oxidative stress and altered skeletal muscle cell differentiation. Many genes traditionally associated with lipid, protein and carbohydrate metabolism were not altered in obese vs. lean dogs, but genes pertaining to endocannabinoid metabolism, insulin signaling, type II diabetes mellitus and carnitine transport were differentially expressed. The relatively small response of skeletal muscle could indicate that changes are occurring at a post-transcriptional level, that other tissues (e.g., adipose tissue) were buffering skeletal muscle from metabolic dysfunction or that obesity-induced changes in skeletal muscle require a longer period of time and that the length of our study was not sufficient to detect them. Although only a limited number of differentially expressed genes were detected, these results highlight genes and functional classes that may be important in determining the etiology of obesity-induced derangement of skeletal muscle function. © 2013 The Authors, Animal Genetics © 2013 Stichting International Foundation

Performance effect of Lean

DEFF Research Database (Denmark)

Kristensen, Thomas Borup; Israelsen, Poul

2016-01-01

To understand how the practices of Lean affect performance, we tested and validated a system-wide approach using mediating relationships in a structural equation model. We used a cross-sectional survey of 200 Danish companies that indicated that they used Lean. Thus, this study is especially...... relevant to Denmark, but the approach is empirically more generalizable. We show that the effect of Lean standardized flow production practices on performance is mediated by analytical continuous improvement empowerment practices and by delegation of decision rights practices. Thus, standardized flow...... of decision rights. The paper provides evidence that supports the view that middle managers’ actions further enhance performance in Lean companies. The right Lean behavior by middle managers increases the level of analytical continuous improvement empowerment. In total, high-performing Lean companies...

Overweight adult cats have significantly lower voluntary physical activity than adult lean cats.

Science.gov (United States)

de Godoy, Maria Rc; Shoveller, Anna K

2017-12-01

Objectives The objectives of the current pilot study were to evaluate whether body condition score (BCS) and body weight are significantly related to physical activity counts, and to evaluate potential interaction between BCS and voluntary physical activity measured over a 14 day period. Methods Ten (five lean, five overweight), neutered, adult American Shorthair cats were selected for this study (median age 4 ± 0.5 years). Cats with a BCS of ⩽3.0 were considered lean, whereas cats with a BCS >3.0 were considered overweight, using a 5-point scale. Cats were housed in a free-living environment with indoor/outdoor access and were individually fed once daily a commercially available dry extruded diet and allowed 1 h to eat. Voluntary physical activity was measured consecutively for 14 days using the Actical Activity Monitors that were worn parallel to the ribs and attached via a harness. Results Lean cats had a greater mean total daily voluntary physical activity ( P = 0.0059), and a greater voluntary physical activity during light ( P = 0.0023) and dark ( P = 0.0446) periods, with overweight cats having 60% of the physical activity of lean cats. Lean cats were more active before feeding and during animal care procedures. These data suggest that lean cats have a greater anticipatory physical activity prior to feeding and are more eager to have social interaction with humans than overweight cats. A significant interaction was observed between day of physical activity measurement and BCS for total daily voluntary physical activity ( P = 0.0133) and activity during the light period ( P = 0.0016) where lean cats were consistently more active than overweight cats. In general, cats were more active during weekdays vs weekends. Conclusions and relevance The results of this study suggest that overweight cats are less active than lean cats and that voluntary physical activity level appears to be influenced by social interaction with humans.

Effect of fat mass and lean mass on bone mineral density in postmenopausal and perimenopausal Thai women

Directory of Open Access Journals (Sweden)

Namwongprom S

2013-02-01

Full Text Available Sirianong Namwongprom,1 Sattaya Rojanasthien,2 Ampica Mangklabruks,3 Supasil Soontrapa,4 Chanpen Wongboontan,5 Boonsong Ongphiphadhanakul61Clinical Epidemiology Program and Department of Radiology, 2Department of Orthopaedics, 3Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 4Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, 5Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 6Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandBackground: The purpose of this study was to investigate the association between fat mass, lean mass, and bone mineral density (BMD in postmenopausal and perimenopausal Thai women.Methods: A cross-sectional study was conducted in 1579 healthy Thai women aged 40–90 years. Total body, lumbar spine, total femur, and femoral neck BMD and body composition were measured by dual x-ray absorptiometry. To evaluate the associations between fat mass and lean mass and various measures of BMD, multivariable linear regression models were used to estimate the regression coefficients for fat mass and lean mass, first in separate equations and then with both fat mass and lean mass in the same equation.Results: Among the study population, 1448 subjects (91.7% were postmenopausal and 131 (8.3% were perimenopausal. In postmenopausal women, after controlling for age, height, and duration of menopause, both fat mass and lean mass were positively correlated with BMD when they were analyzed independently of each other. When included in the same equation, both fat mass and lean mass continued to show a positive effect, but lean mass had a significantly greater impact on BMD than fat mass at all regions except for total body. Lean mass but not fat mass had a positive effect on BMD at all skeletal sites except the lumbar spine, after controlling for age and height in perimenopausal

Efeito da fisioterapia contra-resistida com relação à massa corporal magra em pacientes no pós-operatório de cirurgia bariátrica Effect of counter resisted physiotherapy in relationship to the lean body mass after bariatric surgery

Directory of Open Access Journals (Sweden)

Denise Serpa Bopp Nassif

2011-09-01

Full Text Available RACIONAL: Cálculos metabólicos e de atividade física são realizados a partir do tecido ativo presente no corpo, conhecido como massa corporal magra, que resulta da soma da massa magra isenta de gordura com a gordura essencial. A cinesioterapia é a musculação terapêutica que auxilia na força e flexibilidade. OBJETIVOS: No paciente submetido a tratamento cirúrgico para obesidade mórbida: 1 avaliar o efeito da fisioterapia contra-resistida na massa magra; 2 avaliar os fatores associados às variações de massa corporal magra com tratamento fisioterapêutico; 3 comparar o grupo de pacientes que perdeu com o que ganhou massa magra com o tratamento fisioterapêutico, analisando as co-morbidades que interferiram para esses resultados. MÉTODO: Foram incluídos 100 pacientes operados pela técnica de Fobi-Capella, ou derivação em Y-de-Roux, sem anel e divididos em grupo A composto por pacientes que perderam massa corporal magra nos dois períodos avaliados (entre 30 dias e três meses e entre três meses e seis meses e o grupo B pelos demais pacientes que apresentaram ganho de massa corporal magra em pelo menos um dos períodos avaliados. A coleta de dados foi realizada através do Protocolo Eletrônico Multiprofissional em Cirurgia Bariátrica e Metabólica com Ênfase em Fisioterapia, identificado pela siga SINPE© (Sistema Integrado de Protocolos Eletrônicos. Os pacientes realizaram avaliação fisioterapêutica pré-operatória e foram acompanhados no período pós-operatório em quatro fases: na internação hospitalar, submetidos à musculação terapêutica em 30 dias após a operação, aos três meses e aos seis meses do pós-operatório. RESULTADOS: Houve diferença significativa entre as três avaliações (pBACKGROUND: Calculations of metabolic and physical activity are carried out from the active tissue in the body, known as lean body mass, which is the sum of fat-free lean mass to essential fat. Kinesiotherapy helps in

An investigation into the potassium body burden in humans with the help of a whole-body counter

International Nuclear Information System (INIS)

Selzer, A.

1981-01-01

The purpose of this study was to examine the available information concerning the potassium body burden of a large number of adults and to find a correlation with other easily measurable body parameters such as mass, height and age so that a normal expected body potassium may be predicted for patients with potassium abnormalities who are also referred to the whole-body counter. The calibration of the whole-body counter to make provision for the differences in geometry and absorption in various body sizes was carried out by injecting a number of people with a small dose of potassium-42 and calculating a correction factor for the potassium standard which is in use daily. All measurements of body potassium were corrected with the calculated correction factor. Fatty tissue in the body contains very little potassium in comparison with muscle tissue and a better correction should therefore be obtained between body potassium and lean body mass. Although it is not possible to predict the smaller potassium abnormalities even when lean body mass is used, the derived regression equation in which lean body mass and age are used, may be viewed as a good first approach in the advance estimation of body potassium

[Effect of anticancer treatment on leptin level, fat body mass (FM) and lean body mass (LBM)].

Science.gov (United States)

Krawczyk-Rybak, Maryna; Muszyńska-Rosłan, Katarzyna; Konstantynowicz, Jerzy; Solarz, Elzbieta; Wołczynski, Sławomir; Protas, Piotr

2004-01-01

Leptin plays an important role in the metabolism of adipose tissue. Considering that malignancy and its treatment cans affect normal development in childhood. We analysed the correlations between serum leptin levels and body composition after anticancer treatment. We studied 33 survivors (24 boys and 9 girls) who before our study, have been treated for acute lymphoblastic leukaemia (ALL) (n=23) and Hodgkin disease (n=10) after 7.15+/-3.5 years. Sixteen patients with ALL received cranial irradiation (12Gy). We measured body mass index (BM1) fat mass (FM) and lean body mass (LBM) using dual energy x-ray absorptiometry (DXA). We compared these results to the results obtained from reference values (SD score). Leptin levels were measured with the RIA method. 1. Mean leptin levels were higher in girls after puberty (10.93 ng/mL+/-8.9) than in boys (3.73 ng/mL+/-3. 7). In boys no differences were found in leptin levels between T2-4 and T5 stages. In girls the leptin values increased after puberty. Leptin SD score levels were higher in boys during (1.55 +/-1.0) and after puberty (1.46+/-0.75) and in girls - after puberty (1.19 +/-1.51). We did not find any influence of cranial irradiation (12Gy) or various methotrexate doses (5 g/m(2) vs. 19/m(2)) leptin values. 2. No difference in BMI SD score was found within the whole study group. 3. FM did not change ill boys during and after puberty, although FM SD score were higher during puberty (2.98 +/-4.8). In girls FM and FM SD score were higher after puberty. In boys and girls LBM augmented with pubertal development but LBM SD score in boys were lower after puberty (-1.67 +/-1.7) in comparison to puberty (0.2 +/-1.7). No differences were found between LBM SD score in girls during and after puberty. 4. We found a correlation between leptin levels and BMI (r=0.59 p=0.001) and FM (r=0.77 p=0.0001). 5. Relation of FM to LBM in boys remained unchanged, however in girls it increased within pubertal development. l. Anticancer

Improving Healthcare through Lean Management

DEFF Research Database (Denmark)

Nielsen, Anders Paarup; Edwards, Kasper

2011-01-01

The ideas and principles from lean management are now widely being adopted within the healthcare sector. The analysis in this paper shows that organizations within healthcare most often only implement a limited set of tools and methods from the lean tool-box. Departing from a theoretical analysis...... of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare....... The paper concludes by discussing the implications of hypothesis two, three, and four for the successful application of lean management within healthcare. Is it concluded that this requires a transformative and contingent approach to lean management where the universal principles of the lean philosophy...

A controlled trial of protein enrichment of meal replacements for weight reduction with retention of lean body mass

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Bowerman Susan

2008-08-01

Full Text Available Abstract Background While high protein diets have been shown to improve satiety and retention of lean body mass (LBM, this study was designed to determine effects of a protein-enriched meal replacement (MR on weight loss and LBM retention by comparison to an isocaloric carbohydrate-enriched MR within customized diet plans utilizing MR to achieve high protein or standard protein intakes. Methods Single blind, placebo-controlled, randomized outpatient weight loss trial in 100 obese men and women comparing two isocaloric meal plans utilizing a standard MR to which was added supplementary protein or carbohydrate powder. MR was used twice daily (one meal, one snack. One additional meal was included in the meal plan designed to achieve individualized protein intakes of either 1 2.2 g protein/kg of LBM per day [high protein diet (HP] or 2 1.1 g protein/kg LBM/day standard protein diet (SP. LBM was determined using bioelectrical impedance analysis (BIA. Body weight, body composition, and lipid profiles were measured at baseline and 12 weeks. Results Eighty-five subjects completed the study. Both HP and SP MR were well tolerated, with no adverse effects. There were no differences in weight loss at 12 weeks (-4.19 ± 0.5 kg for HP group and -3.72 ± 0.7 kg for SP group, p > 0.1. Subjects in the HP group lost significantly more fat weight than the SP group (HP = -1.65 ± 0.63 kg; SP = -0.64 ± 0.79 kg, P = 0.05 as estimated by BIA. There were no significant differences in lipids nor fasting blood glucose between groups, but within the HP group a significant decrease in cholesterol and LDL cholesterol was noted at 12 weeks. This was not seen in the SP group. Conclusion Higher protein MR within a higher protein diet resulted in similar overall weight loss as the standard protein MR plan over 12 weeks. However, there was significantly more fat loss in the HP group but no significant difference in lean body mass. In this trial, subject compliance with both the

Novel Equations for Estimating Lean Body Mass in Patients With Chronic Kidney Disease.

Science.gov (United States)

Tian, Xue; Chen, Yuan; Yang, Zhi-Kai; Qu, Zhen; Dong, Jie

2018-05-01

Simplified methods to estimate lean body mass (LBM), an important nutritional measure representing muscle mass and somatic protein, are lacking in nondialyzed patients with chronic kidney disease (CKD). We developed and tested 2 reliable equations for estimation of LBM in daily clinical practice. The development and validation groups both included 150 nondialyzed patients with CKD Stages 3 to 5. Two equations for estimating LBM based on mid-arm muscle circumference (MAMC) or handgrip strength (HGS) were developed and validated in CKD patients with dual-energy x-ray absorptiometry as referenced gold method. We developed and validated 2 equations for estimating LBM based on HGS and MAMC. These equations, which also incorporated sex, height, and weight, were developed and validated in CKD patients. The new equations were found to exhibit only small biases when compared with dual-energy x-ray absorptiometry, with median differences of 0.94 and 0.46 kg observed in the HGS and MAMC equations, respectively. Good precision and accuracy were achieved for both equations, as reflected by small interquartile ranges in the differences and in the percentages of estimates that were 20% of measured LBM. The bias, precision, and accuracy of each equation were found to be similar when it was applied to groups of patients divided by the median measured LBM, the median ratio of extracellular to total body water, and the stages of CKD. LBM estimated from MAMC or HGS were found to provide accurate estimates of LBM in nondialyzed patients with CKD. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Lean programm as a method of managing lean changes in the company

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Suetina Tatiana Aleksandrovna

2012-12-01

Full Text Available This article is about methods and ways of providing changes on enterprices which introduce instruments of lean production. The main accent is how to use metodology of the project management by providing lean-changes. Lean program is proposed as a program of strategic developement of enterprices.

Eight weeks of pre- and postexercise whey protein supplementation increases lean body mass and improves performance in Division III collegiate female basketball players.

Science.gov (United States)

Taylor, Lemuel W; Wilborn, Colin; Roberts, Michael D; White, Andrew; Dugan, Kristen

2016-03-01

We examined if 8 weeks of whey protein (WP) supplementation improved body composition and performance measures in NCAA Division III female basketball players. Subjects were assigned to consume 24 g WP (n = 8; age, 20 ± 2 years; height, 170 ± 6 cm; weight, 66.0 ± 3.1 kg) or 24 g of maltodextrin (MD) (n = 6; age, 21 ± 3 years; height, 169 ± 6 cm; weight, 68.2 ± 7.6 kg) immediately prior to and following training (4 days/week anaerobic and resistance training) for 8 weeks. Prior to (T1) and 8 weeks following supplementation (T2), subjects underwent dual X-ray absorptiometry body composition assessment as well as performance tests. The WP group gained lean mass from T1 to T2 (+1.4 kg, p = 0.003) whereas the MD group trended to gain lean mass (+0.4 kg, p = 0.095). The WP group also lost fat mass from T1 to T2 (-1.0 kg, p = 0.003) whereas the MD group did not (-0.5 kg, p = 0.41). The WP group presented greater gains in 1-repetition maximum (1RM) bench press (+4.9 kg) compared with the MD group (+2.3 kg) (p agility from T1 to T2 (p = 0.001) whereas the MD group did not (p = 0.38). Both groups equally increased leg press 1RM, vertical jump, and broad jump performances. This study demonstrates that 8 weeks of WP supplementation improves body composition and select performance variables in previously trained female athletes.

Clinical and Metabolic Characterization of Lean Caucasian Subjects With Non-alcoholic Fatty Liver.

Science.gov (United States)

Feldman, Alexandra; Eder, Sebastian K; Felder, Thomas K; Kedenko, Lyudmyla; Paulweber, Bernhard; Stadlmayr, Andreas; Huber-Schönauer, Ursula; Niederseer, David; Stickel, Felix; Auer, Simon; Haschke-Becher, Elisabeth; Patsch, Wolfgang; Datz, Christian; Aigner, Elmar

2017-01-01

Non-alcoholic fatty liver disease (NAFLD) is closely linked to obesity; however, 5-8% of lean subjects also have evidence of NAFLD. We aimed to investigate clinical, genetic, metabolic and lifestyle characteristics in lean Caucasian subjects with NAFLD. Data from 187 subjects allocated to one of the three groups according to body mass index (BMI) and hepatic steatosis on ultrasound were obtained: lean healthy (BMI≤25 kg/m 2 , no steatosis, N=71), lean NAFLD (BMI≤25 kg/m 2 , steatosis, N=55), obese NAFLD (BMI≥30 kg/m 2 , steatosis; N=61). All subjects received a detailed clinical and laboratory examination including oral glucose tolerance test. The serum metabolome was assessed using the Metabolomics AbsoluteIDQ p180 kit (BIOCRATES Life Sciences). Genotyping for single-nucleotide polymorphisms (SNPs) associated with NAFLD was performed. Lean NAFLD subjects had fasting insulin concentrations similar to lean healthy subjects but had markedly impaired glucose tolerance. Lean NAFLD subjects had a higher rate of the mutant PNPLA3 CG/GG variant compared to lean controls (P=0.007). Serum adiponectin concentrations were decreased in both NAFLD groups compared to controls (Pphosphatidylcholines (PCaa C36:3; false discovery rate (FDR)-corrected P-value<0.001) as well as lysine, tyrosine, and valine (FDR<0.001). Lean subjects with evidence of NAFLD have clinically relevant impaired glucose tolerance, low adiponectin concentrations and a distinct metabolite profile with an increased rate of PNPLA3 risk allele carriage.

Almost conserved operators in nearly many-body localized systems

Science.gov (United States)

Pancotti, Nicola; Knap, Michael; Huse, David A.; Cirac, J. Ignacio; Bañuls, Mari Carmen

2018-03-01

We construct almost conserved local operators, that possess a minimal commutator with the Hamiltonian of the system, near the many-body localization transition of a one-dimensional disordered spin chain. We collect statistics of these slow operators for different support sizes and disorder strengths, both using exact diagonalization and tensor networks. Our results show that the scaling of the average of the smallest commutators with the support size is sensitive to Griffiths effects in the thermal phase and the onset of many-body localization. Furthermore, we demonstrate that the probability distributions of the commutators can be analyzed using extreme value theory and that their tails reveal the difference between diffusive and subdiffusive dynamics in the thermal phase.

A selective androgen receptor modulator with minimal prostate hypertrophic activity enhances lean body mass in male rats and stimulates sexual behavior in female rats.

Science.gov (United States)

Allan, George F; Tannenbaum, Pamela; Sbriscia, Tifanie; Linton, Olivia; Lai, Muh-Tsann; Haynes-Johnson, Donna; Bhattacharjee, Sheela; Zhang, Xuqing; Sui, Zhihua; Lundeen, Scott G

2007-08-01

Androgen receptor (AR) ligands with tissue selectivity (selective androgen receptor modulators, or SARMs) have potential for treating muscle wasting, hypogonadism of aging, osteoporosis, female sexual dysfunction, and other indications. JNJ-28330835 is a nonsteroidal AR ligand with mixed agonist and antagonist activity in androgen-responsive cell-based assays. It is an orally active SARM with muscle selectivity in orchidectomized rat models. It stimulated growth of the levator ani muscle, stimulating maximal growth at a dose of 10 mg/kg. At the same time, JNJ-28330835 reduced prostate weight in intact rats by a mean of 30% at 10 mg/kg, while having no inhibitory effect on muscle. Using magnetic resonance imaging (MRI) to monitor body composition, it prevented half of the loss of lean body mass associated with orchidectomy, and restored about 30% of lost lean mass to aged orchidectomized rats. It had agonist effects on markers of both osteoclast and osteoblast activity, suggesting that it reduces bone turnover. In a model of sexual behavior, JNJ-28330835 enhanced the preference of ovariectomized female rats for sexually intact male rats over nonsexual orchidectomized males. JNJ-28330835 is a prostate-sparing SARM with the potential for clinically beneficial effects in muscle-wasting diseases and sexual function disorders.

Implementation of lean leadership

Directory of Open Access Journals (Sweden)

Trenkner Małgorzata

2016-12-01

Full Text Available The Toyota case proves that lean leadership is of critical importance for the successful implementation and permanent functioning of Lean Production System. There is no ready formula for developing Toyota style lean leadership. However, one may gain inspiration from its experience.

Relationships between acylated ghrelin with growth hormone, insulin resistance, lipid profile, and cardio respiratory function in lean and obese men

Directory of Open Access Journals (Sweden)

Hasan Matin Homaee

2011-01-01

Conclusions: Obese and lean inactive young men had different levels of acylated ghrelin, GH, insulin, insulin resistance index, cardiorespiratory function and body fat percent. Body fat percent, insulin, and GH levels appear to be best determinant factors of acylated ghrelin levels. Also, in both obese and lean young men, higher levels of cardiovascular function were associated with higher levels of acylated ghrelin.

Fetuin-A levels in lean and obese women with polycystic ovary syndrome.

Science.gov (United States)

Kozakowski, Jarosław; Jeske, Wojciech; Zgliczyński, Wojciech

2014-01-01

The aim of this study was to estimate serum fetuin-A levels in lean and obese women with polycystic ovary syndrome (PCOS) and to find possible relationships between fetuin-A, metabolic factors and androgens in these patients. In 25 lean (18-38 years, BMI 17.5-25.0 kg/m2) and 15 obese women (20-41 years, BMI 28.1-53.2 kg/m2) with PCOS, anthropometric indices and body composition were measured. Fasting serum fetuin-A, adiponectin, leptin, glucose, lipids, hsCRP, insulin, androgens and SHGB levels were estimated. There was no significant difference in serum fetuin-A levels between lean and obese patients: 0.54 ± 0.13 g/L and 0.60 ± 0.14 g/L, respectively. We noted a correlation between BMI and leptin levels (r = 0.88; p lean patients, we found a correlation between fetuin-A levels and ALT activity (r = 0.44; p lean and obese women with PCOS. We found an association between fetuin-A levels and ALT activity in lean patients and between fetuin-A levels and DHEA-S in all women. The role of fetuin-A in the mechanisms of insulin resistance, and its potential impact on androgenic hormones production in women with PCOS, need to be tested in further studies.

Distribution of α-aminoisobutyric acid in tissues of lean and genetically obese mice

International Nuclear Information System (INIS)

Tews, J.K.; Harper, A.E.

1989-01-01

Distribution of tracer amounts of the nonmetabolizable neutral amino acid α-[1- 14 C]aminoisobutyric acid (AIB) between blood and several tissues was measured in lean and ob/ob mice over an 8-hr period. As AIB was injected on the basis of body weight and as ob/ob mice have a relatively low blood volume, absolute concentrations of AIB in blood and tissues were almost always higher in the obese than the lean mice. However, the ratio of AIB concentration in the tissues to that in the blood was clearly higher in skeletal muscle, diaphragm, and brain, and possibly higher in liver of the lean than of the obese animals. Ratios in heart were similar. The results suggest that lean and genetically obese mice differ in their capacity to transport amino acids between blood and various tissues

Lean leadership: an ethnographic study.

Science.gov (United States)

Aij, Kjeld Harald; Visse, Merel; Widdershoven, Guy A M

2015-01-01

The purpose of this study is to provide a critical analysis of contemporary Lean leadership in the context of a healthcare practice. The Lean leadership model supports professionals with a leading role in implementing Lean. This article presents a case study focusing specifically on leadership behaviours and issues that were experienced, observed and reported in a Dutch university medical centre. This ethnographic case study provides auto-ethnographic accounts based on experiences, participant observation, interviews and document analysis. Characteristics of Lean leadership were identified to establish an understanding of how to achieve successful Lean transformation. This study emphasizes the importance for Lean leaders to go to the gemba, to see the situation for one's own self, empower health-care employees and be modest. All of these are critical attributes in defining the Lean leadership mindset. In this case study, Lean leadership is specifically related to healthcare, but certain common leadership characteristics are relevant across all fields. This article shows the value of an auto-ethnographic view on management learning for the analysis of Lean leadership. The knowledge acquired through this research is based on the first author's experiences in fulfilling his role as a health-care leader. This may help the reader examining his/her own role and reflecting on what matters most in the field of Lean leadership.

Association of lean body mass with nutritional parameters and mortality in hemodialysis patients: A long-term follow-up clinical study.

Science.gov (United States)

Zhou, Dong Chi; Yang, Xiu Hong; Zhan, Xiao Li; Gu, Yan Hong; Guo, Li Li; Jin, Hui Min

2018-06-01

This study aimed to evaluate the correlation between lean body mass (LBM) and nutritional status in hemodialysis (HD) patients to better predict their long-term prognosis. Anthropometric body measurements and biochemical parameters were recorded from 222 patients on maintenance hemodialysis (MHD) at the Shanghai Pudong Hospital Hemodialysis Center. LBM was calculated using the serum creatinine index (LBM-SCR), mid-arm muscle circumference (LBM-MAMC), and dominant-arm hand-grip strength (LBM-HGS). Patient mortality and hospitalization were observed after 24 months. LBMs measured from LBM-SCR and LBM-MAMC were associated with sex, body mass index (BMI), serum albumin, and serum creatinine (SCR) ( p LBM evaluation, low LBM was shown to be associated with a higher mortality in patients undergoing HD ( p LBM-SCR and LBM-HGS are strongly associated with hospitalization and mortality in HD patients, indicating LBM is an important factor in prediction of outcomes in those patients. LBM is associated with nutritional parameters in HD patients, and LBM-SCR, HGS, and MAMC are simple approaches for accurately predicting the patient's risk of hospitalization and/or death.

LEAN and energy efficiency; Lean og energieffektivisering

Energy Technology Data Exchange (ETDEWEB)

Jespersen, Per T; Vesterager Christensen, D; Andersen, Hans [Teknologisk Institut, Energi og Klima, Taastrup (Denmark); Dam Wied, M; Dam, M [NRGi Raadgivning, Aarhus (Denmark); Thorndahl, M [Horsens Kommune, Horsens (Denmark); Weldingh, P [Lokal Energi, Viby J. (Denmark); Maagoee, P; Kristensen, Kenneth T [Viegand og Maagoee, Copenhagen (Denmark); Kirketerp Friis, A [Novozymes, Bagsvaerd (Denmark)

2010-03-15

By means of theoretical reports and three specific cases, the project showed how Lean principles can improve energy consulting efficiency, thus making it easier for end-users and energy consultants to record and document energy savings achieved. The three cases documented various types of extra benefits of integrating energy efficiency improvement in Lean processes. As a result of process optimisation, one manufacturing company successfully reduced both staffing and energy consumption, thus making production in Denmark competitive with out-sourced production in Asia. (LN)

Influence of lean and fat mass on bone mineral density (BMD) in postmenopausal women with osteoporosis.

Science.gov (United States)

Dytfeld, Joanna; Ignaszak-Szczepaniak, Magdalena; Gowin, Ewelina; Michalak, Michał; Horst-Sikorska, Wanda

2011-01-01

Despite known positive association between body mass and bone mineral density (BMD), relative contribution of fat and lean tissue to BMD remains under debate. We aimed at investigating the effect of selected anthropometric parameters, including fat content and lean body mass (LBM) on BMD in postmenopausal, osteoporotic women with body mass index (BMI) > 20 kg/m(2). The study involved 92 never-treated women (mean age 69.5 ± 7.3). L1-L4 and femoral neck (FN) BMD were measured by dual energy X-ray absorptiometry (DEXA). Absolute (kg) and relative (%) fat and LBM were assessed by means of electric bioimpedance method. We showed both FN and L1-L4 BMD were positively correlated with body mass, waist circumference (WC), hip circumference (HC) and LBM (kg). Fat content correlated with FN BMD (r = 0.36, p obese. Obese women displayed the highest BMD. Both L1-L4 and FN BMD were higher in women with WC > 80 cm. In postmenopausal osteoporotic women with BMI > 20 kg/m(2) both fat and lean tissue might contribute to BMD. Positive association between body mass and BMD does not make obesity and osteoporosis mutually exclusive. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

LEAN dig ikke tilbage

DEFF Research Database (Denmark)

Weirsøe, Mathilde

2011-01-01

Fit, slankere, hurtigst. Lean-konceptet ruller ind over de offentlige institutioner, hvor det skal trimme og effektivisere arbejdsprocesser. Men hvor er den maksimale grænse for effektivitet? Er der et ’tipping point’, hvor Lean ikke længere motiverer, men snarere udmatter......Fit, slankere, hurtigst. Lean-konceptet ruller ind over de offentlige institutioner, hvor det skal trimme og effektivisere arbejdsprocesser. Men hvor er den maksimale grænse for effektivitet? Er der et ’tipping point’, hvor Lean ikke længere motiverer, men snarere udmatter...

Orchestrating Lean Implementation

DEFF Research Database (Denmark)

Riis, Jens Ove; Mikkelsen, Hans; Andersen, Jesper Rank

2008-01-01

The notion of Lean Manufacturing is not merely confined to a set of well defined techniques, but represents a broad approach to managing a company. Working with lean entails many aspects, such as production planning and control, production engineering, product development, supply chain......, and organizational issues. To become effective, many functional areas and departments must be involved. At the same time companies are embedded in a dynamic environment. The aim of the paper is to propose a comprehensive approach to better implementation of lean initiatives, based on two empirical studies. The paper...... will discuss how a concerted effort can be staged taking into account the interdependencies among individual improvement initiatives. The notion of orchestration will be introduced, and several means for orchestration will be presented. Critical behavioral issues for lean implementation will be discussed....

Indian girls have higher bone mineral content per unit of lean body than boys through puberty.

Science.gov (United States)

Khadilkar, Anuradha V; Sanwalka, Neha; Mughal, M Zulf; Chiplonkar, Shashi; Khadilkar, Vaman

2018-05-01

Our aim is to describe changes in the muscle-bone unit assessed as a ratio of bone mineral content (BMC) to lean body mass (LBM) through puberty at total body and various skeletal sites in Indian boys and girls. A cross-sectional study was conducted (888 children, 480 boys, aged 5-17 years) in Pune, India. Pubertal staging was assessed. BMC, LBM and fat percentage at the arms, legs, android, gynoid and total body (less the head) were assessed by dual energy X-ray absorptiometry. The amount of BMC per unit LBM (BMC/LBM) was computed. Changes in mean BMC/LBM at 5 Tanner (pubertal) stages after adjustment for age and fat percentage were calculated. In boys, adjusted BMC/LBM was significantly higher with successive Tanner stages [legs (TS-II vs TS-I), android (TS-III vs TS-II, TS-IV vs TS-III) and gynoid region (TS-III vs TS-II and TS-II vs TS-I) (p LBM was significantly higher with successive Tanner stages at total body, legs and gynoid (TS-III vs TS-II; TS-II vs TS-I; TS-V vs TS-IV), arms (TS-I to TS-V) and android regions (TS-V vs TS-IV) (p LBM than girls at earlier Tanner stages (TS-I to TS-III), whereas girls had significantly higher adjusted BMC/LBM than boys at later Tanner stages (TS-IV, TS-V) (p LBM with successive pubertal stages. Girls had higher BMC/LBM than boys which may possibly act as a reservoir for later demands of pregnancy and lactation.

Associations between ACE-Inhibitors, Angiotensin Receptor Blockers, and Lean Body Mass in Community Dwelling Older Women.

Science.gov (United States)

Bea, Jennifer W; Wassertheil-Smoller, Sylvia; Wertheim, Betsy C; Klimentidis, Yann; Chen, Zhao; Zaslavsky, Oleg; Manini, Todd M; Womack, Catherine R; Kroenke, Candyce H; LaCroix, Andrea Z; Thomson, Cynthia A

2018-01-01

Studies suggest that ACE-inhibitors (ACE-I) and angiotensin receptor blockers (ARBs) may preserve skeletal muscle with aging. We evaluated longitudinal differences in lean body mass (LBM) among women diagnosed with hypertension and classified as ACE-I/ARB users and nonusers among Women's Health Initiative participants that received dual energy X-ray absorptiometry scans to estimate body composition ( n =10,635) at baseline and at years 3 and 6 of follow-up. Of those, 2642 were treated for hypertension at baseline. Multivariate linear regression models, adjusted for relevant demographics, behaviors, and medications, assessed ACE-I/ARB use/nonuse and LBM associations at baseline, as well as change in LBM over 3 and 6 years. Although BMI did not differ by ACE-I/ARB use, LBM (%) was significantly higher in ACE-I/ARB users versus nonusers at baseline (52.2% versus 51.3%, resp., p =0.001). There was no association between ACE-I/ARB usage and change in LBM over time. Reasons for higher LBM with ACE-I/ARB use cross sectionally, but not longitundinally, are unclear and may reflect a threshold effect of these medications on LBM that is attenuated over time. Nevertheless, ACE-I/ARB use does not appear to negatively impact LBM in the long term.

The effects of short-term overfeeding on insulin action in lean and reduced-obese individuals.

Science.gov (United States)

Cornier, Marc-Andre; Bergman, Bryan C; Bessesen, Daniel H

2006-09-01

Insulin resistance is clearly associated with obesity. However, the role of excess energy intake per se as opposed to increased fat mass in the development of insulin resistance has not been clearly defined. It may be that the nutrient load provided by short-term overfeeding is sufficient to induce measurable changes in insulin action in skeletal muscle and the liver. We examined the effects of 3 days of overfeeding on insulin action and glucose kinetics in 13 lean (body mass index, 20.9 +/- 2.4 kg/m(2); 6 men, 7 women) and 9 reduced-obese (RO) (body mass index, 29.1 +/- 2.2 kg/m(2); 4 men, 5 women) individuals. A two-step euglycemic hyperinsulinemic clamp study (5 and 40 mU m(-2) min(-1)) with a primed, constant infusion of [6,6-(2)H(2)]glucose was performed after 3 days of a weight-maintenance diet and again after 3 days of overfeeding by 50% (50% carbohydrate, 30% fat, 20% protein). At baseline, lean individuals were more insulin sensitive, as measured by glucose infusion rate, than RO individuals (12.08 +/- 0.8 vs 7.62 +/- 1.0 mg x kg(-1) x min(-1), P lean women being more insulin sensitive than lean men (P lean women (13.37 +/- 1.3 to 11.42 +/- 1.0 mg x kg(-1) x min(-1), P lean men or RO individuals. Basal and insulin-stimulated glucose disposal remained unchanged with overfeeding in all groups. Low-dose insulin suppression of endogenous glucose production was impaired after overfeeding in lean women (euenergetic, 1.92 +/- 0.36 to 0.36 +/- 0.16 mg x kg(-1) x min(-1); overfeeding: 2.13 +/- 0.17 to 0.86 +/- 0.12 mg x kg(-1) x min(-1); P = .04) but remained unchanged in the other groups. These findings demonstrate that insulin action is reduced in lean, obese-resistant women after short-term overfeeding primarily because of an inhibition of insulin-mediated suppression of endogenous glucose production, whereas short-term overfeeding does not appear to effect insulin action in lean men and RO individuals. This response may be indirectly involved in the ability of

Development of a bedside viable ultrasound protocol to quantify appendicular lean tissue mass.

Science.gov (United States)

Paris, Michael T; Lafleur, Benoit; Dubin, Joel A; Mourtzakis, Marina

2017-10-01

Ultrasound is a non-invasive and readily available tool that can be prospectively applied at the bedside to assess muscle mass in clinical settings. The four-site protocol, which images two anatomical sites on each quadriceps, may be a viable bedside method, but its ability to predict musculature has not been compared against whole-body reference methods. Our primary objectives were to (i) compare the four-site protocol's ability to predict appendicular lean tissue mass from dual-energy X-ray absorptiometry; (ii) optimize the predictability of the four-site protocol with additional anatomical muscle thicknesses and easily obtained covariates; and (iii) assess the ability of the optimized protocol to identify individuals with low lean tissue mass. This observational cross-sectional study recruited 96 university and community dwelling adults. Participants underwent ultrasound scans for assessment of muscle thickness and whole-body dual-energy X-ray absorptiometry scans for assessment of appendicular lean tissue. Ultrasound protocols included (i) the nine-site protocol, which images nine anterior and posterior muscle groups in supine and prone positions, and (ii) the four-site protocol, which images two anterior sites on each quadriceps muscle group in a supine position. The four-site protocol was strongly associated (R 2  = 0.72) with appendicular lean tissue mass, but Bland-Altman analysis displayed wide limits of agreement (-5.67, 5.67 kg). Incorporating the anterior upper arm muscle thickness, and covariates age and sex, alongside the four-site protocol, improved the association (R 2  = 0.91) with appendicular lean tissue and displayed narrower limits of agreement (-3.18, 3.18 kg). The optimized protocol demonstrated a strong ability to identify low lean tissue mass (area under the curve = 0.89). The four-site protocol can be improved with the addition of the anterior upper arm muscle thickness, sex, and age when predicting appendicular lean tissue mass

Cultural Aspects when Implementing Lean Production and Lean Product Development – Experiences from a Swedish Perspective

Directory of Open Access Journals (Sweden)

Promporn Wangwacharakul

2014-07-01

Full Text Available Lean principles and methods, originating in a Japanese cultural context, have spread to a large number of companies throughout the world. The aim of this case study research is to identify and compare national cultural aspects that influence Lean Production and Lean Product Development implementation in Swedish companies. Data were collected through questionnaires, interviews and an industrial workshop with Swedish Lean practitioners. The study shows that some sub-areas in Lean, such as value definition, control systems, leadership, team development, knowledge management, and strategies, are highly dependent on contextual factors related to human, cultural and organizational aspects. These are related to the national culture and should be considered to a higher extent for successful sustainable implementation of Lean in different cultural contexts. As for implementing Lean in Sweden, national cultural characteristics, such as individualism, autonomy and supportive management style fit well with Lean thinking.

Effects of Exercise Training on Fat Loss and Lean Mass Gain in Mexican-American and Korean Premenopausal Women

Directory of Open Access Journals (Sweden)

Shenghui Wu

2017-01-01

Full Text Available We investigated the effect of exercise training on body composition change in women. Nineteen Mexican-American and 18 Korean premenopausal overweight/obese women were randomized into one of the following groups: control, low-intensity training group (LI, and high-intensity training group (HI. Subjects completed 12 weeks of training at 50–56% maximal oxygen consumption (LI or 65–70% maximal oxygen consumption (HI. Body composition components were measured at baseline and after training using dual-energy X-ray absorptiometry for Mexican-Americans, while whole-body composition was measured by the direct segmental multifrequency bioelectrical impedance analysis and abdominal fat was measured by single-slice computed tomography for Koreans. Data were analyzed using mixed-model repeated measures independent of age, ethnicity, and body mass index (BMI. Exercise training showed a significant effect on BMI, fat percentage, fat mass, lean mass, and visceral adipose tissue area. HI significantly decreased fat mass and fat percentage but increased lean mass (all P<0.05. LI significantly reduced BMI, fat mass, fat percentage, and visceral adipose tissue area but increased lean mass (all P<0.05. Exercise training had a beneficial effect on reducing BMI, fat percentage, fat mass, and visceral adipose tissue area but had no effect on increasing lean mass for Mexican-American and Korean premenopausal overweight/obese women.

Body composition in normal subjects: relation to lipid and glucose variables

DEFF Research Database (Denmark)

Rosenfalck, A M; Almdal, Thomas Peter; Gotfredsen, A

1996-01-01

-sectional study. SUBJECTS: 173 (84 male and 89 female) healthy subjects, BMI mineral content (TBMC), total bone mineral density (TBMD), lean body soft tissue mass (LTM), total and regional fat mass (FM) were estimated in all......-cholesterol, S-triglyceride, and in males S-insulin was found. CONCLUSION: The present study gives coherent data on bone mineral content, lean body soft tissue mass total and regional fat mass for 173 healthy subjects with a BMI below 30 kg/m2. Total body fat mass increases, and lean mass decreases with age...

Diccionario Lean Manufacturing

OpenAIRE

Muñoz Ellner, Sarah María

2016-01-01

El Diccionario Bilingüe de Lean Manufacturing pretende ser un instrumento de apoyo a todo aquel que tenga la responsabilidad de planear, ejecutar o simplemente algún interés con las actividades de Lean Manufacturing, aportando así también conceptos claros tanto en castellano como en inglés, con el fin de entender de forma integral el alcance mismo que puede llegar a tener dicha filosofía, al igual que se proporcionara una serie de siglas y herramientas para la implementación del Lean Manufact...

Lean management beyond manufacturing a holistic approach

CERN Document Server

Bhasin, Sanjay

2015-01-01

Exploring Lean manufacturing in a holistic manner, this book helps organizations to implement Lean principles successfully by offering theoretical, empirical and practical knowledge. It empirically demonstrates how a successful Lean initiative can improve organizational efficiency, and incorporates valuable primary research to substantiate findings. It argues that Lean principles need to be applied throughout the value chain in order to be successful , and suggests that these tools need to be aligned with culture and change management. Chapters examine issues including Lean cultures, impediments to Lean, Lean and performance measurement, and the impact of Lean. Viewing Lean as a never-ending journey, this book provides a valuable resource to practising Lean managers, and specialist researchers and students, and also offers an important reference for organizations embarking on their Lean voyage.

Whole body BMC in pediatric Crohn disease: independent effects of altered growth, maturation, and body composition.

Science.gov (United States)

Burnham, Jon M; Shults, Justine; Semeao, Edisio; Foster, Bethany; Zemel, Babette S; Stallings, Virginia A; Leonard, Mary B

2004-12-01

Whole body BMC was assessed in 104 children and young adults with CD and 233 healthy controls. CD was associated with significant deficits in BMC and lean mass, relative to height. Adjustment for lean mass eliminated the bone deficit in CD. Steroid exposure was associated with short stature but not bone deficits relative to height. Children with Crohn disease (CD) have multiple risk factors for impaired bone accrual. The confounding effects of poor growth and delayed maturation limit the interpretation of prior studies of bone health in CD. The objective of this study was to assess BMC relative to growth, body composition, and maturation in CD compared with controls. Whole body BMC and lean mass were assessed by DXA in 104 CD subjects and 233 healthy controls, 4-26 years of age. Multivariable linear regression models were developed to sequentially adjust for differences in skeletal size, pubertal maturation, and muscle mass. BMC-for-height z scores were derived to determine CD-specific covariates associated with bone deficits. Subjects with CD had significantly lower height z score, body mass index z score, and lean mass relative to height compared with controls (all p BMC in CD relative to controls was significantly reduced in males (0.86; 95% CI, 0.83, 0.94) and females (0.91; 95% CI, 0.85, 0.98) with CD. Adjustment for pubertal maturation did not alter the estimate; however, addition of lean mass to the model eliminated the bone deficit. Steroid exposure was associated with short stature but not bone deficits. This study shows the importance of considering differences in body size and composition when interpreting DXA data in children with chronic inflammatory conditions and shows an association between deficits in muscle mass and bone in pediatric CD.

Lean approach in knowledge work

Directory of Open Access Journals (Sweden)

Hanna Kropsu-Vehkapera

2018-05-01

Full Text Available Purpose: Knowledge work productivity is a key area of improvement for many organisations. Lean approach is a sustainable way to achieve operational excellence and can be applied in many areas. The purpose of this novel study is to examine the potential of using lean approach for improving knowledge work practices. Design/methodology/approach: A systematic literature review has been carried out to study how lean approach is realised in knowledge work. The research is conceptual in nature and draws upon earlier research findings. Findings: This study shows that lean studies’ in knowledge work is an emerging research area. This study documents the methods and practices implemented in knowledge work to date, and presents a knowledge work continuum, which is an essential framework for effective lean approach deployment and to frame future research focus in knowledge work productivity. Research limitations/implications: This study structures the concept of knowledge work and outlines a concrete concept derived from earlier literature. The study summarises the literature on lean in knowledge work and highlights, which methods are used. More research is needed to understand how lean can be implemented in complex knowledge work environment and not only on the repetitive knowledge work. The limitations of this research are due to the limited availability of previous research. Practical implications: To analyse the nature of knowledge work, we implicate the areas where lean methods especially apply to improving knowledge work productivity. When applying lean in knowledge work context the focus should be using the people better and improving information flow. Originality/value: This study focuses on adapting lean methods into a knowledge work context and summarises earlier research done in this field. The study discusses the potential to improve knowledge work productivity by implementing lean methods and presents a unique knowledge work continuum to

Lean and Information Technology Toolkit

Science.gov (United States)

The Lean and Information Technology Toolkit is a how-to guide which provides resources to environmental agencies to help them use Lean Startup, Lean process improvement, and Agile tools to streamline and automate processes.

Cull sow knife-separable lean content evaluation at harvest and lean mass content prediction equation development.

Science.gov (United States)

Abell, Caitlyn E; Stalder, Kenneth J; Hendricks, Haven B; Fitzgerald, Robert F

2012-07-01

The objectives of this study were to develop a prediction equation for carcass knife-separable lean within and across USDA cull sow market weight classes (MWC) and to determine carcass and individual primal cut knife separable lean content from cull sows. There were significant percent lean and fat differences in the primal cuts across USDA MWC. The two lighter USDA MWC had a greater percent carcass lean and lower percent fat compared to the two heavier MWC. In general, hot carcass weight explained the majority of carcass lean variation. Additionally, backfat was a significant variation source when predicting cull sow carcass lean. The findings support using a single lean prediction equation across MWC to assist processors when making cull sow purchasing decisions and determine the mix of animals from various USDA MWC that will meet their needs when making pork products with defined lean:fat content. Copyright © 2012 Elsevier Ltd. All rights reserved.

Lower Lean Mass Measured by Dual-Energy X-ray Absorptiometry (DXA) is Not Associated with Increased Risk of Hip Fracture in Women: The Framingham Osteoporosis Study.

Science.gov (United States)

McLean, Robert R; Kiel, Douglas P; Berry, Sarah D; Broe, Kerry E; Zhang, Xiaochun; Cupples, L Adrienne; Hannan, Marian T

2018-01-05

Although muscle mass influences strength in older adults, it is unclear whether low lean mass measured by dual-energy X-ray absorptiometry (DXA) is an independent risk factor for hip fracture. Our objective was to determine the association between DXA lean mass and incident hip fracture risk among 1978 women aged 50 years and older participating in the Framingham Study Original and Offspring cohorts. Leg and total body lean mass (kg) were assessed from whole-body DXA scans collected in 1992-2001. Hip fracture follow-up extended from DXA assessment to the occurrence of fracture, death, drop-out, or end of follow-up in 2007. Cox proportional hazards regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) estimating the relative risk of hip fracture associated with a 1-kg increase in baseline lean mass. Mean age was 66 years (range 50-93). Over a median of 8 years of follow-up, 99 hip fractures occurred. In models adjusted for age, height, study cohort, and percent total body fat, neither leg (HR 1.11; 95% CI 0.94, 1.31) nor total body (HR 1.06; 95% CI 0.99, 1.13) lean mass were associated with hip fracture. After further adjustment for femoral neck bone mineral density, leg lean mass results were similar (HR 1.10; 95% CI 0.93, 1.30). In contrast, 1 kg greater total body lean mass was associated with 9% higher hip fracture risk (HR 1.09; 95% CI 1.02, 1.18). Our findings suggest that in women, lower lean mass measured by DXA is not associated with increased risk of hip fracture.

Lean Production : Werkzeuge zur Realisierung

OpenAIRE

Binner, Hartmut F.

2008-01-01

INHALT: l. Einleitung und Standortbestimmung 2. Japanische Wertvorstellungen 3. Inhalte der Lean Production 4. Fertigungssegmentierung 5. Informationsmanagement mit CIM- und Logistik-Komponenten 6. Logistikgerechte Strukturen der Lean Production 7. Realisierung der Lean Production 8. Zusammenfassung

Researching Lean: Methodological Implications of Loose Definitions

Directory of Open Access Journals (Sweden)

Mikael Brännmark

2012-12-01

Full Text Available Recently, Lean Production (Lean has become a prevailing management concept in Sweden. However, previous research seems to show that the Lean concept and the impact of Lean vary considerably between organizations. This paper illustrates some key methodological issues that need to be considered when researching loosely defined management concepts such as Lean. The paper is based on a review of the literature and five comparative Swedish cases studies. Our study indicates that Lean has changed over time and that operationalization and interpretations of the concept vary considerably. This study concludes that future Lean studies should include a thorough assessment of the Lean interventions, study settings, and in particular non-Lean factors mediating the outcomes of Lean-inspired change programs.

Lean Application to Manufacturing Ramp-Up

DEFF Research Database (Denmark)

Christensen, Irene; Rymaszewska, Anna

2016-01-01

. Abstracting from the extant literature, the authors considered the competitiveness of manufacturing companies from two principal perspectives: the leanness of the ramp-up process and the new-value creation of quality managers. While much of the literature fails to acknowledge that the roots of lean actually......This article provides a theoretical overview of the concepts of lean and manufacturing ramp-up in an attempt to conceptualize the strategic areas in which lean philosophy and principles can be applied for continuous improvements. The application of lean principles during the final stage of a new...... product development process, that is, the ramp-up process, is a critical, early enabler of lean manufacturing. The manufacturing strategy literature conceptualizes a state of “leanness in operations,” which can consolidate both the concepts of lean and manufacturing ramp-up, providing a dual perspective...

LEAN thinking in Finnish healthcare.

Science.gov (United States)

Jorma, Tapani; Tiirinki, Hanna; Bloigu, Risto; Turkki, Leena

2016-01-01

Purpose - The purpose of this study is to evaluate how LEAN thinking is used as a management and development tool in the Finnish public healthcare system and what kind of outcomes have been achieved or expected by using it. The main focus is in managing and developing patient and treatment processes. Design/methodology/approach - A mixed-method approach incorporating the Webropol survey was used. Findings - LEAN is quite a new concept in Finnish public healthcare. It is mainly used as a development tool to seek financial savings and to improve the efficiency of patient processes, but has not yet been deeply implemented. However, the experiences from LEAN initiatives have been positive, and the methodology is already quite well-known. It can be concluded that, because of positive experiences from LEAN, the environment in Finnish healthcare is ready for the deeper implementation of LEAN. Originality/value - This paper evaluates the usage of LEAN thinking for the first time in the public healthcare system of Finland as a development tool and a management system. It highlights the implementation and achieved results of LEAN thinking when used in the healthcare environment. It also highlights the expectations for LEAN thinking in Finnish public healthcare.

A DXA Whole Body Composition Cross-Calibration Experience: Evaluation With Humans, Spine, and Whole Body Phantoms.

Science.gov (United States)

Krueger, Diane; Libber, Jessie; Sanfilippo, Jennifer; Yu, Hui Jing; Horvath, Blaine; Miller, Colin G; Binkley, Neil

2016-01-01

New densitometer installation requires cross-calibration for accurate longitudinal assessment. When replacing a unit with the same model, the International Society for Clinical Densitometry recommends cross-calibrating by scanning phantoms 10 times on each instrument and states that spine bone mineral density (BMD) should be within 1%, whereas total body lean, fat, and %fat mass should be within 2% of the prior instrument. However, there is limited validation that these recommendations provide adequate total body cross-calibration. Here, we report a total body cross-calibration experience with phantoms and humans. Cross-calibration between an existing and new Lunar iDXA was performed using 3 encapsulated spine phantoms (GE [GE Lunar, Madison, WI], BioClinica [BioClinica Inc, Princeton, NJ], and Hologic [Hologic Inc, Bedford, MA]), 1 total body composition phantom (BioClinica), and 30 human volunteers. Thirty scans of each phantom and a total body scan of human volunteers were obtained on each instrument. All spine phantom BMD means were similar (within 1%; g/cm2 bias) between the existing and new dual-energy X-ray absorptiometry unit. The BioClinica body composition phantom (BBCP) BMD and bone mineral content (BMC) values were within 2% with biases of 0.005 g/cm2 and -3.4 g. However, lean and fat mass and %fat differed by 4.6%-7.7% with biases of +463 g, -496 g, and -2.8%, respectively. In vivo comparison supported BBCP data; BMD and BMC were within ∼2%, but lean and fat mass and %fat differed from 1.6% to 4.9% with biases of +833 g, -860 g, and -1.1%. As all body composition comparisons exceeded the recommended 2%, the new densitometer was recalibrated. After recalibration, in vivo bias was lower (g, respectively. Similarly, BBCP lean and fat agreement improved. In conclusion, the BBCP behaves similarly, but not identical, to human in vivo measurements for densitometer cross-calibration. Spine phantoms, despite good BMD and BMC agreement, did not detect

Gene expression microarray profiles of cumulus cells in lean and overweight-obese polycystic ovary syndrome patients.

Science.gov (United States)

Kenigsberg, Shlomit; Bentov, Yaakov; Chalifa-Caspi, Vered; Potashnik, Gad; Ofir, Rivka; Birk, Ohad S

2009-02-01

The aim of this work was to study gene expression patterns of cultured cumulus cells from lean and overweight-obese polycystic ovary syndrome (PCOS) patients using genome-wide oligonucleotide microarray. The study included 25 patients undergoing in vitro fertilization and intra-cytoplasmic sperm injection: 12 diagnosed with PCOS and 13 matching controls. Each of the groups was subdivided into lean (body mass index (BMI) 27) subgroups. The following comparisons of gene expression data were made: lean PCOS versus lean controls, lean PCOS versus overweight PCOS, all PCOS versus all controls, overweight PCOS versus overweight controls, overweight controls versus lean controls and all overweight versus all lean. The largest number of differentially expressed genes (DEGs), with fold change (FC) |FC| >or= 1.5 and P-value lean PCOS versus lean controls comparison (487) with most of these genes being down-regulated in PCOS. The second largest group of DEGs originated from the comparison of lean PCOS versus overweight PCOS (305). The other comparisons resulted in a much smaller number of DEGs (174, 109, 125 and 12, respectively). In the comparison of lean PCOS with lean controls, most DEGs were transcription factors and components of the extracellular matrix and two pathways, Wnt/beta-catenin and mitogen-activated protein kinase. When comparing overweight PCOS with overweight controls, most DEGs were of pathways related to insulin signaling, metabolism and energy production. The finding of unique gene expression patterns in cumulus cells from the two PCOS subtypes is in agreement with other studies that have found the two to be separate entities with potentially different pathophysiologies.

Lean Design and Management for Manufactoring

OpenAIRE

NIU, Zhanwen

2009-01-01

Most enterprises inducting lean production were confined by the innate limitations of existing production systems, which make it difficult to fulfill lean production comprehensively. To solve this problem, the theory of lean design and management for the manufacturing enterprise lifecycle was proposed. First, the necessities of lean design were analyzed and its theoretical system was established; second, the principles, process, methods and tools for lean design was introduced. Techniques and...

Comparison of SUVs normalized by lean body mass determined by CT with those normalized by lean body mass estimated by predictive equations in normal tissues

Energy Technology Data Exchange (ETDEWEB)

Kim, Woo Hyoung; Kim, Chang Guhn; Kim, Dae Weung [Wonkwang Univ. School of Medicine, Iksan (Korea, Republic of)

2012-09-15

Standardized uptake values (SUVs)normalized by lean body mass (LBM)determined by CT were compared with those normalized by LBM estimated using predictive equations (PEs)in normal liver, spleen, and aorta using {sup 18}F FDG PET/CT. Fluorine 18 fluorodeoxyglucose (F FDG)positron emission tomography/computed tomography (PET/CT)was conducted on 453 patients. LBM determined by CT was defined in 3 ways (LBM{sup CT1}-3). Five PEs were used for comparison (LBM{sup PE1}-5). Tissue SUV normalized by LBM (SUL) was calculated using LBM from each method (SUL{sup CT1}-3, SUL{sup PE1}-5). Agreement between methods was assessed by Bland Altman analysis. Percentage difference and percentage error were also calculated. For all liver SUL{sup CTS} vs. liver SUL{sup PES} except liver SUL{sup PE3}, the range of biases, SDs of percentage difference and percentage errors were -0.17-0.24 SUL, 6.15-10.17%, and 25.07-38.91%, respectively. For liver SUL{sup CTs} vs. liver SUL{sup PE3}, the corresponding figures were 0.47-0.69 SUL, 10.90-11.25%, and 50.85-51.55%, respectively, showing the largest percentage errors and positive biases. Irrespective of magnitudes of the biases, large percentage errors of 25.07-51.55% were observed between liver SUL{sup CT1}-3 and liver SUL{sup PE1}-5. The results of spleen and aorta SUL{sup CTs} and SUL{sup PEs} comparison were almost identical to those for liver. The present study demonstrated substantial errors in individual SUL{sup PEs} compared with SUL{sup CTs} as a reference value. Normalization of SUV by LBM determined by CT rather than PEs may be a useful approach to reduce errors in individual SUL{sup PEs}.

Comparison of SUVs normalized by lean body mass determined by CT with those normalized by lean body mass estimated by predictive equations in normal tissues

International Nuclear Information System (INIS)

Kim, Woo Hyoung; Kim, Chang Guhn; Kim, Dae Weung

2012-01-01

Standardized uptake values (SUVs)normalized by lean body mass (LBM)determined by CT were compared with those normalized by LBM estimated using predictive equations (PEs)in normal liver, spleen, and aorta using 18 F FDG PET/CT. Fluorine 18 fluorodeoxyglucose (F FDG)positron emission tomography/computed tomography (PET/CT)was conducted on 453 patients. LBM determined by CT was defined in 3 ways (LBM CT1 -3). Five PEs were used for comparison (LBM PE1 -5). Tissue SUV normalized by LBM (SUL) was calculated using LBM from each method (SUL CT1 -3, SUL PE1 -5). Agreement between methods was assessed by Bland Altman analysis. Percentage difference and percentage error were also calculated. For all liver SUL CTS vs. liver SUL PES except liver SUL PE3 , the range of biases, SDs of percentage difference and percentage errors were -0.17-0.24 SUL, 6.15-10.17%, and 25.07-38.91%, respectively. For liver SUL CTs vs. liver SUL PE3 , the corresponding figures were 0.47-0.69 SUL, 10.90-11.25%, and 50.85-51.55%, respectively, showing the largest percentage errors and positive biases. Irrespective of magnitudes of the biases, large percentage errors of 25.07-51.55% were observed between liver SUL CT1 -3 and liver SUL PE1 -5. The results of spleen and aorta SUL CTs and SUL PEs comparison were almost identical to those for liver. The present study demonstrated substantial errors in individual SUL PEs compared with SUL CTs as a reference value. Normalization of SUV by LBM determined by CT rather than PEs may be a useful approach to reduce errors in individual SUL PEs

Sources of variation in estimates of lean body mass by creatinine kinetics and by methods based on body water or body mass index in patients on continuous peritoneal dialysis.

Science.gov (United States)

Tzamaloukas, Antonios H; Murata, Glen H; Piraino, Beth; Raj, Dominic S C; VanderJagt, Dorothy J; Bernardini, Judith; Servilla, Karen S; Sun, Yijuan; Glew, Robert H; Oreopoulos, Dimitrios G

2010-03-01

We identified factors that account for differences between lean body mass computed from creatinine kinetics (LBM(cr)) and from either body water (LBM(V)) or body mass index (LBM(BMI)) in patients on continuous peritoneal dialysis (CPD). We compared the LBM(cr) and LBM(V) or LBM(BMI) in hypothetical subjects and actual CPD patients. We studied 439 CPD patients in Albuquerque, Pittsburgh, and Toronto, with 925 clearance studies. Creatinine production was estimated using formulas derived in CPD patients. Body water (V) was estimated from anthropometric formulas. We calculated LBM(BMI) from a formula that estimates body composition based on body mass index. In hypothetical subjects, LBM values were calculated by varying the determinants of body composition (gender, diabetic status, age, weight, and height) one at a time, while the other determinants were kept constant. In actual CPD patients, multiple linear regression and logistic regression were used to identify factors associated with differences in the estimates of LBM (LBM(cr)LBM(V), or LBM(cr)LBM(BMI)). We sought predictors of the differences LBM(V) - LBM(cr) and LBM(BMI) - LBM(cr). Both LBM(V) (regardless of formula used to estimate V) and LBM(BMI) exceeded LBM(cr) in hypothetical subjects with average body compositions. The sources of differences between LBM estimates in this group involved differences in the coefficients assigned to gender, age, height, weight, presence or absence of diabetes, and serum creatinine concentration. In CPD patients, mean LBM(V) or LBM(BMI) exceeded mean LBM(cr) by 6.2 to 6.9 kg. For example, the LBM(V) obtained from one anthropometric formula was 50.4+/-10.4 kg and the LBM(cr) was 44.1+/-13.6 kg (P LBM(cr)>LBM(V). The differences in determinants of body composition between groups with high versus low LBM(cr) were similar in hypothetical and actual CPD patients. Multivariate analysis in actual CPD patients identified serum creatinine, height, age, gender, weight, and body mass

Lean With a Human Face

DEFF Research Database (Denmark)

Hasle, Peter; Jensen, Per Langaa

2008-01-01

The consequences for quality of work of lean manufacturing is discussed in the international litterature, and several authors suggest increased work speed, stress, and muscoskeletal diseases as a consequence of lean. The Danish experience with lean has been studied through interviews with managers...

A Methodology for the Assessment of Experiential Learning Lean: The Lean Experience Factory Study

Science.gov (United States)

De Zan, Giovanni; De Toni, Alberto Felice; Fornasier, Andrea; Battistella, Cinzia

2015-01-01

Purpose: The purpose of this paper is to present a methodology to assess the experiential learning processes of learning lean in an innovative learning environment: the lean model factories. Design/methodology/approach: A literature review on learning and lean management literatures was carried out to design the methodology. Then, a case study…

Applying lean thinking in construction

Directory of Open Access Journals (Sweden)

Remon Fayek Aziz

2013-12-01

Full Text Available The productivity of the construction industry worldwide has been declining over the past 40 years. One approach for improving the situation is using lean construction. Lean construction results from the application of a new form of production management to construction. Essential features of lean construction include a clear set of objectives for the delivery process, aimed at maximizing performance for the customer at the project level, concurrent design, construction, and the application of project control throughout the life cycle of the project from design to delivery. An increasing number of construction academics and professionals have been storming the ramparts of conventional construction management in an effort to deliver better value to owners while making real profits. As a result, lean-based tools have emerged and have been successfully applied to simple and complex construction projects. In general, lean construction projects are easier to manage, safer, completed sooner, and cost less and are of better quality. Significant research remains to complete the translation to construction of lean thinking in Egypt. This research will discuss principles, methods, and implementation phases of lean construction showing the waste in construction and how it could be minimized. The Last Planner System technique, which is an important application of the lean construction concepts and methodologies and is more prevalent, proved that it could enhance the construction management practices in various aspects. Also, it is intended to develop methodology for process evaluation and define areas for improvement based on lean approach principles.

Total and Lower Extremity Lean Mass Percentage Positively Correlates With Jump Performance.

Science.gov (United States)

Stephenson, Mitchell L; Smith, Derek T; Heinbaugh, Erika M; Moynes, Rebecca C; Rockey, Shawn S; Thomas, Joi J; Dai, Boyi

2015-08-01

Strength and power have been identified as valuable components in both athletic performance and daily function. A major component of strength and power is the muscle mass, which can be assessed with dual-energy x-ray absorptiometry (DXA). The primary purpose of this study was to quantify the relationship between total body lean mass percentage (TBLM%) and lower extremity lean mass percentage (LELM%) and lower extremity force/power production during a countermovement jump (CMJ) in a general population. Researchers performed a DXA analysis on 40 younger participants aged 18-35 years, 28 middle-aged participants aged 36-55 years, and 34 older participants aged 56-75 years. Participants performed 3 CMJ on force platforms. Correlations revealed significant and strong relationships between TBLM% and LELM% compared with CMJ normalized peak vertical ground reaction force (p lean mass percentages. The findings have implications in including DXA-assessed lean mass percentage as a component for evaluating lower extremity strength and power. A paired DXA analysis and CMJ jump test may be useful for identifying neuromuscular deficits that limit performance.

Lean leadership: an ethnographic study

NARCIS (Netherlands)

Aij, K.H.; Visse, M.A.; Widdershoven, G.A.M.

2015-01-01

Purpose – The purpose of this study is to provide a critical analysis of contemporary Lean leadership in the context of a healthcare practice. The Lean leadership model supports professionals with a leading rolein implementing Lean.This article presents a case study focusing specifcally on

Relative contributions of lean and fat mass to bone strength in young Hispanic and non-Hispanic girls.

Science.gov (United States)

Hetherington-Rauth, Megan; Bea, Jennifer W; Blew, Robert M; Funk, Janet L; Hingle, Melanie D; Lee, Vinson R; Roe, Denise J; Wheeler, Mark D; Lohman, Timothy G; Going, Scott B

2018-05-22

With the high prevalence of childhood obesity, especially among Hispanic children, understanding how body weight and its components of lean and fat mass affect bone development is important, given that the amount of bone mineral accrued during childhood can determine osteoporosis risk later in life. The aim of this study was to assess the independent contributions of lean and fat mass on volumetric bone mineral density (vBMD), geometry, and strength in both weight-bearing and non-weight-bearing bones of Hispanic and non-Hispanic girls. Bone vBMD, geometry, and strength were assessed at the 20% distal femur, the 4% and 66% distal tibia, and the 66% distal radius of the non-dominant limb of 326, 9- to 12-year-old girls using peripheral quantitative computed tomography (pQCT). Total body lean and fat mass were measured by dual-energy x-ray absorptiometry (DXA). Multiple linear regression was used to assess the independent relationships of fat and lean mass with pQCT bone measures while adjusting for relevant confounders. Potential interactions between ethnicity and both fat and lean mass were also tested. Lean mass was a significant positive contributor to all bone outcomes (p Lean mass is the main determinant of bone strength for appendicular skeletal sites. Fat mass contributes to bone strength in the weight-bearing skeleton but does not add to bone strength in non-weight-bearing locations and may potentially be detrimental. Bone vBMD, geometry, and strength did not differ between Hispanic and non-Hispanic girls; fat mass may be a stronger contributor to bone strength in weight-bearing bones of Hispanic girls compared to non-Hispanic. Copyright © 2018. Published by Elsevier Inc.

Ares Launch Vehicles Lean Practices Case Study

Science.gov (United States)

Doreswamy, Rajiv, N.; Self, Timothy A.

2008-01-01

This viewgraph presentation describes test strategies and lean philisophies and practices that are applied to Ares Launch Vehicles. The topics include: 1) Testing strategy; 2) Lean Practices in Ares I-X; 3) Lean Practices Applied to Ares I-X Schedule; 4) Lean Event Results; 5) Lean, Six Sigma, and Kaizen Practices in the Ares Projects Office; 6) Lean and Kaizen Success Stories; and 7) Ares Six Sigma Practices.

Lean software development in action

CERN Document Server

Janes, Andrea

2014-01-01

This book illustrates how goal-oriented, automated measurement can be used to create Lean organizations and to facilitate the development of Lean software, while also demonstrating the practical implementation of Lean software development by combining tried and trusted tools. In order to be successful, a Lean orientation of software development has to go hand in hand with a company's overall business strategy. To achieve this, two interrelated aspects require special attention: measurement and experience management. In this book, Janes and Succi provide the necessary knowledge to establish "

Private landowners and environmental conservation: a case study of social-psychological determinants of conservation program participation in Ontario

Directory of Open Access Journals (Sweden)

Michael Drescher

2017-03-01

Full Text Available Preservation of biodiversity and continued provision of ecosystem services increasingly relies on environmental conservation on private lands. Despite a multitude of past studies, our knowledge of the motives, opportunities, and challenges of private land conservation, especially on nonworking lands, where financial incentives are less relevant, remains incomplete. A key reason is that a variety of theoretical approaches, resulting in diverging study results, have been used to investigate private land conservation. To help remedy this problem, the current study rigorously examined several established social-psychological determinants of proenvironmental behaviors and developed a comprehensive model, which merged elements from previous studies, to investigate landowner participation in a government-sponsored private land conservation program for nonworking lands. The results are based on analysis of a mailed survey of 800 program-eligible landowners. Contrasting program participants with nonparticipants, we elicited information such as about values, worldviews, socio-demographic characteristics, and property attributes that led landowners to participate in this conservation program. The results of our study illustrate the complex relationships among values, worldviews, norms, attitudes, and behaviors emphasizing the importance of proenvironmental worldviews and of formal education for increasing the likelihood of enrollment in this government-sponsored private land conservation program. Against expectation, neither personal norms, household income, political leaning, nor the size of the eligible property area were found to be important in directly determining the decision to enroll in this conservation program. However, an association of political leaning with stated personal obligation for private land conservation was found. Our results highlight the relationship between formal education and achievement of private land conservation goals

Lean Management

OpenAIRE

Picot, Arnold

1994-01-01

In this article the possibility of increase of competitiveness of the domestic enterprises by means of Lean management system is considered, and also the analysis of introduction of the mentioned system at the Russian enterprises is carried out. Besides, the key conditions necessary for successful introduction of system are presented. Lean management is a world-spread way of solving the problems, aimed at making the company competitive; it is the organized activity of staff of the company, fo...

Estimation of body-size traits by photogrammetry in large mammals to inform conservation.

Science.gov (United States)

Berger, Joel

2012-10-01

Photography, including remote imagery and camera traps, has contributed substantially to conservation. However, the potential to use photography to understand demography and inform policy is limited. To have practical value, remote assessments must be reasonably accurate and widely deployable. Prior efforts to develop noninvasive methods of estimating trait size have been motivated by a desire to answer evolutionary questions, measure physiological growth, or, in the case of illegal trade, assess economics of horn sizes; but rarely have such methods been directed at conservation. Here I demonstrate a simple, noninvasive photographic technique and address how knowledge of values of individual-specific metrics bears on conservation policy. I used 10 years of data on juvenile moose (Alces alces) to examine whether body size and probability of survival are positively correlated in cold climates. I investigated whether the presence of mothers improved juvenile survival. The posited latter relation is relevant to policy because harvest of adult females has been permitted in some Canadian and American jurisdictions under the assumption that probability of survival of young is independent of maternal presence. The accuracy of estimates of head sizes made from photographs exceeded 98%. The estimates revealed that overwinter juvenile survival had no relation to the juvenile's estimated mass (p < 0.64) and was more strongly associated with maternal presence (p < 0.02) than winter snow depth (p < 0.18). These findings highlight the effects on survival of a social dynamic (the mother-young association) rather than body size and suggest a change in harvest policy will increase survival. Furthermore, photographic imaging of growth of individual juvenile muskoxen (Ovibos moschatus) over 3 Arctic winters revealed annual variability in size, which supports the idea that noninvasive monitoring may allow one to detect how some environmental conditions ultimately affect body growth. �

In vivo measurements of nitrogen, hydrogen, and carbon in genetically obese and lean pigs

International Nuclear Information System (INIS)

Ellis, K.J.; Shypailo, R.J.; Sheng, H.-P.; Pond, W.G.

1992-01-01

Characteristic gamma-rays are emitted promptly by elements during exposure to neutrons. These emissions enable a radioanalytical analysis of the body's composition of protein (nitrogen), water (hydrogen), and fat (carbon). We have used this method in vivo to determine the body composition of obese and lean pigs (10 to 20 kg body wt) fed an altered cholesterol diet. (author) 10 refs.; 5 figs.; 1 tab

Distinct effects of calorie restriction on adipose tissue cytokine and angiogenesis profiles in obese and lean mice

Directory of Open Access Journals (Sweden)

Kurki Eveliina

2012-06-01

Full Text Available Abstract Background Obesity associates with low-grade inflammation and adipose tissue remodeling. Using sensitive high-throughput protein arrays we here investigated adipose tissue cytokine and angiogenesis-related protein profiles from obese and lean mice, and in particular, the influence of calorie restriction (CR. Methods Tissue samples from visceral fat were harvested from obese mice fed with a high-fat diet (60% of energy, lean controls receiving low-fat control diet as well as from obese and lean mice kept under CR (energy intake 70% of ad libitum intake for 50 days. Protein profiles were analyzed using mouse cytokine and angiogenesis protein array kits. Results In obese and lean mice, CR was associated with 11.3% and 15.6% reductions in body weight, as well as with 4.0% and 4.6% reductions in body fat percentage, respectively. Obesity induced adipose tissue cytokine expressions, the most highly upregulated cytokines being IL-1ra, IL-2, IL-16, MCP-1, MIG, RANTES, C5a, sICAM-1 and TIMP-1. CR increased sICAM-1 and TIMP-1 expression both in obese and lean mice. Overall, CR showed distinct effects on cytokine expressions; in obese mice CR largely decreased but in lean mice increased adipose tissue cytokine expressions. Obesity was also associated with increased expressions of angiogenesis-related proteins, in particular, angiogenin, endoglin, endostatin, endothelin-1, IGFBP-3, leptin, MMP-3, PAI-1, TIMP-4, CXCL16, platelet factor 4, DPPIV and coagulation factor III. CR increased endoglin, endostatin and platelet factor 4 expressions, and decreased IGFBP-3, NOV, MMP-9, CXCL16 and osteopontin expressions both in obese and lean mice. Interestingly, in obese mice, CR decreased leptin and TIMP-4 expressions, whereas in lean mice their expressions were increased. CR decreased MMP-3 and PAI-1 only in obese mice, whereas CR decreased FGF acidic, FGF basic and coagulation factor III, and increased angiogenin and DPPIV expression only in lean mice

Implementing lean in Malaysian universities: Lean awareness level in an engineering faculty of a local university

Science.gov (United States)

Azim Khairi, M.; Rahman, Mohamed Abd

2018-01-01

Many academic articles were published in Malaysia promoting the goodness of lean in manufacturing and industrial sectors but less attention was apparently given to the possibility of obtaining the same universal benefits when applying lean in non-manufacturing sectors especially higher education. This study aims to determine the level of lean awareness among a local university’s community taking its Faculty of Engineering (FoE) as the case study. It also seeks to identify typical FoE’s staff perception on lean regarding its benefits and the obstacles in implementing it. A web-based survey using questionnaires was carried out for 215 respondents consisting of academic and administrative staff of the faculty. Statistical Package for the Social Science (SPSS) was used to analyze the survey data collected. A total of 13.95% of respondents returned the forms. Slightly more than half of those responded (56.7%) have encountered some of the lean terms with mean 1.43 and standard deviation 0.504. However, the large amount of standard deviation somewhat indicates that the real level of lean awareness of FoE as a group was low. In terms of lean benefits, reduction of waste was favored (93.3%) by the respondents with mean 0.93 and standard deviation 0.254. For obstacles in implementing lean, lack of knowledge was selected by most respondents (86.7%) to be the major factor with mean 0.87 and standard deviation 0.346. Through the analysis done, the study may conclude that level of lean awareness among the university‘s community was low thus may hinder implementation of lean concept.

Ramadan model of intermittent fasting for 28 d had no major effect on body composition, glucose metabolism, or cognitive functions in healthy lean men

OpenAIRE

Harder-Lauridsen, Nina M.; Rosenberg, Astrid; Benatti, Fabiana B.; Damm, Julie A.; Thomsen, Carsten; Mortensen, Erik L.; Pedersen, Bente K.; Krogh-Madsen, Rikke

2017-01-01

Objectives: There has been a parallel increase in the incidence of obesity and diabetes as well as the number of daily meals. However, evidence is lacking regarding the role of intermittent fasting. The aim of this study was to determine the effects of a Ramadan model of intermittent fasting (RIF; 14 h of daytime abstinence from food and drinking) for 28 d on body composition, glucose metabolism, and cognitive function. Methods: Ten healthy, lean men were included in a nonrandomized, crossove...

A Web-Based Lean Simulation Game for Office Operations: Training the Other Side of a Lean Enterprise

Science.gov (United States)

Kuriger, Glenn W.; Wan, Huang-da; Mirehei, S. Moussa; Tamma, Saumya; Chen, F. Frank

2010-01-01

This research proposes a Web-based version of a lean office simulation game (WeBLOG). The game is designed to be used to train lean concepts to office and administrative personnel. This group belongs to the frequently forgotten side of a lean enterprise. Over four phases, the game presents the following seven lean tools: one-piece flow,…

Muscle strength and regional lean body mass influence on mineral bone health in young male adults.

Science.gov (United States)

Guimarães, Bianca Rosa; Pimenta, Luciana Duarte; Massini, Danilo Alexandre; Dos Santos, Daniel; Siqueira, Leandro Oliveira da Cruz; Simionato, Astor Reis; Dos Santos, Luiz Gustavo Almeida; Neiva, Cassiano Merussi; Pessôa Filho, Dalton Muller

2018-01-01

The relationship between muscle strength and bone mineral content (BMC) and bone mineral density (BMD) is supposed from the assumption of the mechanical stress influence on bone tissue metabolism. However, the direct relationship is not well established in younger men, since the enhancement of force able to produce effective changes in bone health, still needs to be further studied. This study aimed to analyze the influence of muscle strength on BMC and BMD in undergraduate students. Thirty six men (24.9 ± 8.6 y/o) were evaluated for regional and whole-body composition by dual energy X-ray absorptiometry (DXA). One repetition maximum tests (1RM) were assessed on flat bench-press (BP), lat-pull down (LPD), leg-curl (LC), knee extension (KE), and leg-press 45° (LP45) exercises. Linear regression modelled the relationships of BMD and BMC to the regional body composition and 1RM values. Measurements of dispersion and error (R2adj and standard error of estimate (SEE)) were tested, setting ρ at ≤0.05. The BMD mean value for whole-body was 1.12±0.09 g/cm2 and BMC attained 2477.9 ± 379.2 g. The regional lean mass (LM) in upper-limbs (UL) (= 6.80±1.21 kg) was related to BMC and BMD for UL (R2adj = 0.74, pBMC and BMD for LL (R2adj = 0.68, pBMC (R2adj = 0.47, pBMC (R2adj = 0.36, pBMC and BMD in young men, strengthening the relationship between force and LM, and suggesting both to parametrizes bone mineral health.

The maintenance management for lean organization

Directory of Open Access Journals (Sweden)

Daniel D. GEORGESCU

2010-12-01

Full Text Available The goal of lean maintenance approach is to maintain organization international competitiveness. In the spirit of continuously improvement, in the paper it is shown how by adjusting some Lean manufacturing specific techniques for Total Productive Maintenance (TPM system, was born new maintenance system named Lean TPM. This is a systemic approach with three techniques, which don’t exclude specific techniques of TPM pillars, but complete them: the 7Ss as a critical first step in any improvement program; instantaneous maintenance; improvement setup operations. In the spirit of Lean principle, Lean TPM adjusts overall equipment effectiveness concept for all supply-chain from supplier to customer. Maintaining equipment in its optimal state and continually improving its productivity is the whole strategy behind Lean TPM.

A whey-protein supplement increases fat loss and spares lean muscle in obese subjects: a randomized human clinical study

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Ward Loren S

2008-03-01

Full Text Available Abstract Background This study evaluated a specialized whey fraction (Prolibra™, high in leucine, bioactive peptides and milk calcium for use as a dietary supplement to enhance weight loss. Methods This was a randomized, double-blind, parallel-arm, 12-week study. Caloric intake was reduced 500 calories per day. Subjects consumed Prolibra or an isocaloric ready-to-mix beverage 20 minutes before breakfast and 20 minutes before dinner. Body fat and lean muscle tissue were measured by dual-energy x-ray absorptiometry (DEXA. Body weight and anthropometric measurements were recorded every 4 weeks. Blood samples were taken at the beginning and end of the study. Statistical analyses were performed on all subjects that completed (completer analysis and all subjects that lost at least 2.25 kg of body weight (responder analysis. Within group significance was determined at P Results Both groups lost a significant amount of weight and the Prolibra group tended to lose more weight than the control group; however the amount of weight loss was not significantly different between groups after 12 weeks. Prolibra subjects lost significantly more body fat compared to control subjects for both the completer (2.81 vs. 1.62 kg P = 0.03 and responder (3.63 vs. 2.11 kg, P = 0.01 groups. Prolibra subjects lost significantly less lean muscle mass in the responder group (1.07 vs. 2.41 kg, P = 0.02. The ratio of fat to lean loss (kg fat lost/kg lean lost was much larger for Prolibra subjects for both completer (3.75 vs. 1.05 and responder (3.39 vs. 0.88 groups. Conclusion Subjects in both the control and treatment group lost a significant amount of weight with a 500 calorie reduced diet. Subjects taking Prolibra lost significantly more body fat and showed a greater preservation of lean muscle compared to subjects consuming the control beverage. Because subjects taking Prolibra lost 6.1% of their body fat mass, and because a 5% reduction of body fat mass has been shown to

Effects of Whey Protein Alone or as Part of a Multi-ingredient Formulation on Strength, Fat-Free Mass, or Lean Body Mass in Resistance-Trained Individuals: A Meta-analysis.

Science.gov (United States)

Naclerio, Fernando; Larumbe-Zabala, Eneko

2016-01-01

Even though the positive effects of whey protein-containing supplements for optimizing the anabolic responses and adaptations process in resistance-trained individuals have been supported by several investigations, their use continues to be controversial. Additionally, the administration of different multi-ingredient formulations where whey proteins are combined with carbohydrates, other protein sources, creatine, and amino acids or derivatives, has been extensively proposed as an effective strategy to maximize strength and muscle mass gains in athletes. We aimed to systematically summarize and quantify whether whey protein-containing supplements, administered alone or as a part of a multi-ingredient, could improve the effects of resistance training on fat-free mass or lean body mass, and strength in resistance-trained individuals when compared with other iso-energetic supplements containing carbohydrates or other sources of proteins. A structured literature search was conducted on PubMed, Science Direct, Web of Science, Cochrane Libraries, US National Institutes of Health clinicaltrials.gov, SPORTDiscus, and Google Scholar databases. Main inclusion criteria comprised randomized controlled trial study design, adults (aged 18 years and over), resistance-trained individuals, interventions (a resistance training program for a period of 6 weeks or longer, combined with whey protein supplementation administered alone or as a part of a multi-ingredient), and a calorie equivalent contrast supplement from carbohydrates or other non-whey protein sources. Continuous data on fat-free mass and lean body mass, and maximal strength were pooled using a random-effects model. Data from nine randomized controlled trials were included, involving 11 treatments and 192 participants. Overall, with respect to the ingestion of contrast supplements, whey protein supplementation, administered alone or as part of a multi-ingredient, in combination with resistance training, was associated

The human side of lean teams.

Science.gov (United States)

Wackerbarth, Sarah B; Strawser-Srinath, Jamie R; Conigliaro, Joseph C

2015-05-01

Organizations use lean principles to increase quality and decrease costs. Lean projects require an understanding of systems-wide processes and utilize interdisciplinary teams. Most lean tools are straightforward, and the biggest barrier to successful implementation is often development of the team aspect of the lean approach. The purpose of this article is to share challenges experienced by a lean team charged with improving a hospital discharge process. Reflection on the experience provides an opportunity to highlight lessons from The Team Handbook by Peter Scholtes and colleagues. To improve the likelihood that process improvement initiatives, including lean projects, will be successful, organizations should consider providing training in organizational change principles and team building. The authors' lean team learned these lessons the hard way. Despite the challenges, the team successfully implemented changes throughout the organization that have had a positive impact. Training to understand the psychology of change might have decreased the resistance faced in implementing these changes. © 2014 by the American College of Medical Quality.

Industry 4.0 implies lean manufacturing: Research activities in industry 4.0 function as enablers for lean manufacturing

Directory of Open Access Journals (Sweden)

Adam Sanders

2016-09-01

Full Text Available Purpose: Lean Manufacturing is widely regarded as a potential methodology to improve productivity and decrease costs in manufacturing organisations. The success of lean manufacturing demands consistent and conscious efforts from the organisation, and has to overcome several hindrances. Industry 4.0 makes a factory smart by applying advanced information and communication systems and future-oriented technologies. This paper analyses the incompletely perceived link between Industry 4.0 and lean manufacturing, and investigates whether Industry 4.0 is capable of implementing lean. Executing Industry 4.0 is a cost-intensive operation, and is met with reluctance from several manufacturers. This research also provides an important insight into manufacturers’ dilemma as to whether they can commit into Industry 4.0, considering the investment required and unperceived benefits. Design/methodology/approach: Lean manufacturing is first defined and different dimensions of lean are presented. Then Industry 4.0 is defined followed by representing its current status in Germany. The barriers for implementation of lean are analysed from the perspective of integration of resources. Literatures associated with Industry 4.0 are studied and suitable solution principles are identified to solve the abovementioned barriers of implementing lean. Findings: It is identified that researches and publications in the field of Industry 4.0 held answers to overcome the barriers of implementation of lean manufacturing. These potential solution principles prove the hypothesis that Industry 4.0 is indeed capable of implementing lean. It uncovers the fact that committing into Industry 4.0 makes a factory lean besides being smart. Originality/value: Individual researches have been done in various technologies allied with Industry 4.0, but the potential to execute lean manufacturing was not completely perceived. This paper bridges the gap between these two realms, and identifies

Muscle fibre type composition and body composition in hammer throwers.

Science.gov (United States)

Terzis, Gerasimos; Spengos, Konstantinos; Kavouras, Stavros; Manta, Panagiota; Georgiadis, Giorgos

2010-01-01

Aim of the present study was to describe the muscle fibre type composition and body composition of well-trained hammer throwers. Six experienced hammer throwers underwent the following measurements: one repetition maximum in squat, snatch, and clean, standing broad jump, backward overhead shot throw and the hammer throw. Dual x-ray absorptiometry was used for body composition analysis. Fibre type composition and cross sectional area was determined in muscle biopsy samples of the right vastus lateralis. Eight physical education students served as a control group. One repetition maximum in squat, snatch and clean for the hammer throwers was 245 ± 21, 132 ± 13 and 165 ± 12kg, respectively. Lean body mass was higher in hammer throwers (85.9 ± 3. 9kg vs. 62.7 ± 5.1kg (p hammer throwers and 51 ± 8% in the control group (p Hammer throwers had significantly larger type IIA fibres (7703 ± 1171 vs. 5676 ± 1270μm(2), p Hammer throwing performance correlated significantly with lean body mass (r = 0.81, p hammer throwers have larger lean body mass and larger muscular areas occupied by type II fibres, compared with relatively untrained subjects. Moreover, it seems that the enlarged muscle mass of the hammer throwers contributes significantly to the hammer throwing performance. Key pointsWell-trained hammer throwers had increased lean body mass, higher type IIA muscle fibres cross sectional areas, as well as higher bone mineral density, compared to controls.Increased lean body mass was closely related with hammer throwing performance.The relative high percentage of type IIX muscle fibres in vastus lateralis in hammer throwers warrants further investigation.

Relationship between body mass index, fat mass and lean mass with SF-36 quality of life scores in a group of fibromyalgia patients.

Science.gov (United States)

Arranz, Laura; Canela, Miguel Angel; Rafecas, Magda

2012-11-01

Patients suffering from fibromyalgia (FM) had widespread musculoskeletal pain and stiffness, fatigue, sleep disorders, cognitive impairment and other symptoms, which seriously affects their quality of life (QoL), making it difficult to perform normal activities. Moreover, FM has been associated with a higher prevalence of overweight and obesity than in the general population. Weight reduction has been beneficial in both FM and other rheumatic patients. Obesity and overweight have been pointed as playing a relevant role in FM symptoms; however, it is necessary to find out more about this relationship. The objective of this study was to evaluate the relationship between body mass index (BMI), fat mass (fM) and lean mass (lM) with quality of life in a group of FM patients. 103 women, with a mean age of 53.74 ± 7.81, and members of different FM patient associations from Spain participated in our study. Some anthropometric measures were taken like weight, height, BMI, body fat mass and lean mass. FM patients QoL was assessed by the Short-Form Health Survey, SF-36 questionnaire. Statistical reports were based on mean, standard deviation and correlation, but significance was tested by nonparametric methods. BMI, fM and lM correlated differently with the specific SF-36 scores. BMI had a high negative correlation with emotional role, fM with bodily pain and lM almost with all scores but specially with emotional role, vitality and physical role. The outcome of this study reveals some interesting relationships, which need to be further investigated to improve the management of FM patients.

Lean Production Applications in a Manufacturing Company

OpenAIRE

Ali Görener; Humeyra Baser; Ali Turkyilmaz

2013-01-01

Lean production is a production model which comes about the pursuit of companies to be able to meet competition and make effective production. The main purpose of lean production is to get control about the wastage. This study includes the requirements for the success of the lean production and how the lean production system can be established. In this paper, lean production techniques were applied to the electric water heater line. Measurements using lean initiatives were made, operation cyc...

Should insulin resistance be screened in lean hirsute women?

Science.gov (United States)

Arduc, Ayse; Sarıcam, Orkun; Dogan, Bercem Aycicek; Tuna, Mazhar Muslum; Tutuncu, Yasemin Ates; Isik, Serhat; Berker, Dilek; Sennaroglu, Engin; Guler, Serdar

2015-04-01

The role of insulin resistance (IR) is well-documented in obese women with polycystic ovary syndrome (PCOS). Controversies exist concerning the presence of IR in idiopathic hirsutism (IH) or if it is a manifestation of high body mass index (BMI). We aimed to investigate the presence/absence of IR in lean hirsute women. One-hundred fifty-one lean women with hirsutism [96 PCOS (group 1) and 55 IH (group 2)] and 58 age-and BMI-matched healthy controls (group 3) were recruited in the study (mean age 25.21 ± 6.1 versus 26.26 ± 4.6years; BMI 21.79 ± 1.7 versus 22.02 ± 2.2 kg/m(2), respectively). Significantly higher insulin and HOMA-IR, and significantly lower fasting glucose insulin ratio (FGIR), quantitative insulin sensitivity check index (QUICKI), reciprocal insulin, and Raynaud index were detected in groups 1 and 2 than in group 3 (p  2, FGIR lean hirsute women regardless of they having PCOS or IH. IR may contribute to aetiopathogenesis of IH, or may cause some metabolic abnormalities in these patients.

Insulin binding and glucose transport in adipocytes of acarbose-treated Zucker lean and obese rats.

Science.gov (United States)

Vasselli, J R; Flory, T; Fried, S K

1987-01-01

The intestinal glucosidase inhibitor acarbose was administered as a dietary admix (30 mg/100 g chow diet) to male Zucker obese and lean rats. After 15 weeks, epidiymal fat pads were removed and adipocytes isolated by collagenase digestion. Equilibrium binding of A-14 tyrosine 125I-insulin, and transport of U-14C-glucose was determined was adipocytes incubated for 50 min at 37 degrees C in 0-16000 pM insulin. Insulin binding/cell was enhanced two-fold in lean (P less than 0.01) and obese (n.s.) drug groups. In drug-treated leans, increased sensitivity of glucose transport to submaximally stimulating concentrations of insulin was observed (P less than 0.02). For both genotypes, acarbose mildly decreased insulin levels and body weight gain, although adipocyte size was unaffected. Results indicate that enhanced insulin binding accompanies metabolic improvements induced by acarbose in lean Zucker rats.

Comparison of MRI-assessed body fat content between lean women with polycystic ovary syndrome (PCOS) and matched controls: less visceral fat with PCOS.

Science.gov (United States)

Dolfing, Jacoba G; Stassen, Chrit M; van Haard, Paul M M; Wolffenbuttel, Bruce H R; Schweitzer, Dave H

2011-06-01

BACKGROUND Polycystic ovary syndrome (PCOS) is a heterogeneous disorder. However, PCOS has a strong resemblance to the metabolic syndrome, including preponderance of visceral fat deposition. The aim of this study is to compare fat distribution between lean women with PCOS and controls matched for body composition but with regular menstrual cycles and proven fertility. METHODS In this prospective cross-sectional study in a fertility outpatient clinic, 10 Caucasian women with PCOS and 10 controls, all with a BMI between 19 and 25 kg/m(2), were included. Fasting glucose, insulin and C-peptide concentrations, homeostasis model assessment (HOMA), hormonal levels and bioelectrical impedance analysis (BIA) variables were assessed and fat content and ovarian volume determinations were obtained with magnetic resonance imaging (MRI). Multiple axial cross-sections were calculated. RESULTS The age of the PCOS and control groups were [mean (SD)] 28.2 years (2.6) versus 33.7 years (2.3) P PCOS cases had higher ovarian volumes and less visceral fat compared with controls. CONCLUSIONS Lean women with PCOS have higher MRI-determined ovarian volumes and less visceral fat content when compared with control women.

Lean Production Applications in a Manufacturing Company

Directory of Open Access Journals (Sweden)

Ali Görener

2016-01-01

Full Text Available Lean production is a production model which comes about the pursuit of companies to be able to meet competition and make effective production. The main purpose of lean production is to get control about the wastage. This study includes the requirements for the success of the lean production and how the lean production system can be established. In this paper, lean production techniques were applied to the electric water heater line. Measurements using lean initiatives were made, operation cycle times were determined, and Kaizen improvement methods and line balancing methods were applied according to the results. And the last section of study showed conclusion of lean implementation.

The lean service machine.

Science.gov (United States)

Swank, Cynthia Karen

2003-10-01

Jefferson Pilot Financial, a life insurance and annuities firm, like many U.S. service companies at the end of the 1990s was looking for new ways to grow. Its top managers recognized that JPF needed to differentiate itself in the eyes of its customers, the independent life-insurance advisers who sell and service policies. To establish itself as these advisers' preferred partner, it set out to reduce the turnaround time on policy applications, simplify the submission process, and reduce errors. JPF's managers looked to the "lean production" practices that U.S. manufacturers adopted in response to competition from Japanese companies. Lean production is built around the concept of continuous-flow processing--a departure from traditional production systems, in which large batches are processed at each step. JPF appointed a "lean team" to reengineer its New Business unit's operations, beginning with the creation of a "model cell"--a fully functioning microcosm of JPF's entire process. This approach allowed managers to experiment and smooth out the kinks while working toward an optimal design. The team applied lean-manufacturing practices, including placing linked processes near one another, balancing employees' workloads, posting performance results, and measuring performance and productivity from the customer's perspective. Customer-focused metrics helped erode the employees' "My work is all that matters" mind-set. The results were so impressive that JPF is rolling out similar systems across many of its operations. To convince employees of the value of lean production, the lean team introduced a simulation in which teams compete to build the best paper airplane based on invented customer specifications. This game drives home lean production's basic principles, establishing a foundation for deep and far-reaching changes in the production system.

Associations of Bone Mineral Density with Lean Mass, Fat Mass, and Dietary Patterns in Postmenopausal Chinese Women: A 2-Year Prospective Study.

Directory of Open Access Journals (Sweden)

Yongjie Chen

Full Text Available To assess factors associated with bone mineral density (BMD in postmenopausal women in a longitudinal study, and to examine the relative contribution of lean mass, fat mass, dietary patterns, and years since menopause to BMD.Two hundred and eighty-two postmenopausal women were randomly selected from Hongqi Community Health Center, in Harbin City, China. All participants were followed up from 2009 to 2011. Dietary data were collected using a Food Frequency Questionnaire. BMD of the left hip, the lumbar spine, and the total body, and the body composition were measured by dual-energy X-ray absorptiometry at baseline and follow-up.Lean mass and fat mass were positively associated with BMD of the spine, hip, and the total body at both baseline and follow-up. The association between fat mass and BMD at the spine at baseline (P = 0.210 and at the spine (P = 0.116 and hip (P = 0.073 in the second year was not statistically significant when height was adjusted. Six dietary patterns were identified but only cereal grains-fruits pattern (P = 0.001 in the spine, P = 0.037 in hip and milk-root vegetables pattern (P = 0.010 in hip were associated with BMD of the spine and hip. The linear mixed model of follow-up data showed that lean mass, years since menopause, and age of menophania were the significant determinants of BMD of all sites. Moreover, lean mass was the best determinant of BMD (VIP = 1.936.Lean mass, years since menopause, age of menophania and dietary patterns are the important determinants of BMD of the spine, hip, and the total body. Lean mass is the best determinant of BMD.

Differential regulation of lipid and protein metabolism in obese vs. lean subjects before and after a 72-h fast.

Science.gov (United States)

Bak, Ann Mosegaard; Møller, Andreas Buch; Vendelbo, Mikkel Holm; Nielsen, Thomas Svava; Viggers, Rikke; Rungby, Jørgen; Pedersen, Steen Bønløkke; Jørgensen, Jens Otto Lunde; Jessen, Niels; Møller, Niels

2016-07-01

Increased availability of lipids may conserve muscle protein during catabolic stress. Our study was designed to define 1) intracellular mechanisms leading to increased lipolysis and 2) whether this scenario is associated with decreased amino acid and urea fluxes, and decreased muscle amino acid release in obese subjects under basal and fasting conditions. We therefore studied nine lean and nine obese subjects twice, after 12 and 72 h of fasting, using measurements of mRNA and protein expression and phosphorylation of lipolytic and protein metabolic signaling molecules in fat and muscle together with whole body and forearm tracer techniques. Obese subjects displayed increased whole body lipolysis, decreased urea production rates, and decreased forearm muscle protein breakdown per 100 ml of forearm tissue, differences that persisted after 72 h of fasting. Lipolysis per fat mass unit was reduced in obese subjects and, correspondingly, adipose tissue hormone-sensitive lipase (HSL) phosphorylation and mRNA and protein levels of the adipose triglyceride lipase (ATGL) coactivator CGI58 were decreased. Fasting resulted in higher HSL phosphorylations and lower protein levels of the ATGL inhibitor G0S2. Muscle protein expressions of mammalian target of rapamycin (mTOR) and 4EBP1 were lower in obese subjects, and MuRf1 mRNA was higher with fasting in lean but not obese subjects. Phosphorylation and signaling of mTOR decreased with fasting in both groups, whereas ULK1 protein and mRNA levels increased. In summary, obese subjects exhibit increased lipolysis due to a large fat mass with blunted prolipolytic signaling, together with decreased urea and amino acid fluxes both in the basal and 72-h fasted state; this is compatible with preservation of muscle and whole body protein. Copyright © 2016 the American Physiological Society.

A 5-year cohort study of the effects of high protein intake on lean mass and BMC in elderly postmenopausal women.

Science.gov (United States)

Meng, Xingqiong; Zhu, Kun; Devine, Amanda; Kerr, Deborah A; Binns, Colin W; Prince, Richard L

2009-11-01

Long-term effects of high dietary protein intake on muscle and bone structure in the elderly are not clear. The aim of this study was to investigate the relationship between baseline protein intake and lean mass and BMC 5 yr later in a cohort of elderly postmenopausal women. A total of 862 community-dwelling women 75 +/- 3 yr of age provided baseline data including nutrient intake assessed by a food frequency questionnaire. At 5 yr, upper arm muscle area (UAMA) and body composition using DXA were measured. Baseline protein intake was 81 +/- 28 g/d (1.2 +/- 0.4 g/kg/d), contributing 19 +/- 3% of total energy intake. There were positive correlations between baseline protein intake and whole body and appendicular bone-free lean mass and BMC (r = 0.14-0.18, p 87 g/d) had 5.4-6.0% higher whole body and appendicular lean mass and UAMA and 5.3-6.0% higher whole body and appendicular BMC. These effects remained after adjusting for potential confounders. However, the effect on BMC disappeared after further adjustment for lean mass. This study shows that high protein intake is associated with long-term beneficial effects on muscle mass and size and bone mass in elderly women. The protein effect on bone may be partly mediated by its effects on muscle.

Training for successful lean manufacturing implementation

OpenAIRE

Ichimura, Maki; Jahankhani, Hamid; Arunachalam, Subramaniam

2006-01-01

Implementing lean manufacturing is a complex and everlasting task. The workers involving in production processes are the pivot of the lean manufacturing implementation. Training is known as a vehicle to assist the implementation process. Despite awareness of the training importance, so far, a little is available to assist to organise an efficient training. This paper summarises the overview of lean manufacturing and discuss the importance of human resource within lean implementation process. ...

In vivo measurements of nitrogen, hydrogen, carbon and potassium in genetically obese and lean pigs

International Nuclear Information System (INIS)

Ellis, K.J.; Shypailo, R.J.; Sheng, H.P.; Mersmann, H.J.; Pond, W.G.

1991-01-01

Characteristic gamma rays are emitted promptly by elements during exposure to neutrons. Gamma ray emissions enable a radioanalytical analysis of the body's composition of protein (nitrogen), water (hydrogen), fat (carbon), and muscle (natural 40 K). The authors have used this method in vivo to detect changes in the body composition of obese and lean pigs (10-20 kg body wt) in response to an altered cholesterol diet

Lean Six Sigma in financial services

NARCIS (Netherlands)

de Koning, H.; Does, R.J.M.M.; Bisgaard, S.

2008-01-01

Lean Thinking and Six Sigma are typically considered as separate approaches to process innovation, with complementary strengths. When combined as Lean Six Sigma, this approach provides a unified framework for systematically developing innovations. Lean Six Sigma can also bring about significant

Healthy Lean Through HRD

DEFF Research Database (Denmark)

Jørgensen, Frances

2008-01-01

The paper reports on findings from the initial, exploratory phase of a longitudinal research study aimed at developing a framework for implementing lean while ensuring employee well-being. Data from observations and in-depth dialogues with persons involved in lean implementation, along...

Lean management - an effective way to arrange maintenance?; Lean Management - ein effektiver Weg zur Gestaltung der Instandhaltung?

Energy Technology Data Exchange (ETDEWEB)

Tschuschke, W. [Inst. fuer Instandhaltung gGmbH, Iserlohn (Germany)

1996-08-01

Lean management/lean production wishes to attain more through intelligent operation system/production at less expense (personnel, materials, energy, costs). The object is not harder but more intelligent and production work; we do not need to run faster but to find shorter routes. The idea of lean management`s effects and changes have consequences for the field of maintenance as an equivalent and legitimate business area which are discussed in this paper. (orig.) [Deutsch] Lean Management/Lean Production will durch ein intelligentes Arbeitssystem/Produzieren mit weniger Aufwand (Personal, Material, Energie, Kosten) mehr erreichen. Ziel ist nicht das haertere, sondern das intelligentere und produktivere Arbeiten; wir sollen nicht schneller laufen, sondern kuerzere Wege finden. Fuer den Bereich Instandhaltung als gleichwertiger und gleichberechtigter Unternehmensbereich haben die Gedanken des Lean Managements Auswirkungen und Veraenderungen zur Folge, die im Beitrag genannt werden. (orig.)

Lean manufacturing in Indian context: A survey

Directory of Open Access Journals (Sweden)

Rakesh Kumar

2015-04-01

Full Text Available This paper is an attempt to examine the implementation of Lean Manufacturing system in the Indian industries. Predominant elements of Lean Manufacturing, benefits gained after its implementation and obstacles observed by Indian Industry have been recognized. The results of this survey support the opinion that Lean Manufacturing had potential to improve the organizational performance of Indian industries. Nevertheless, Indian industries are required to be passionate to transform their manufacturing by adopting Lean manufacturing to gain the full benefits. A large numbers of literature papers are available on the better side of Lean manufacturing approach and its benefits gained by manufacturing organizations after implementation. But the adverse impacts of Lean manufacturing are not discussed to a great extent. Some drawbacks of Lean manufacturing are also highlighted in this paper.

The Finnish healthcare services lean management.

Science.gov (United States)

Hihnala, Susanna; Kettunen, Lilja; Suhonen, Marjo; Tiirinki, Hanna

2018-02-05

Purpose The purpose of this paper is to discuss health services managers' experiences of management in a special health-care unit and development efforts from the point of view of the Lean method. Additionally, the aim is to deepen the knowledge of the managers' work and nature of the Lean method development processes in the workplace. The research focuses on those aspects and results of Lean method that are currently being used in health-care environments. Design/methodology/approach These data were collected through a number of thematic interviews. The participants were nurse managers ( n = 7) and medical managers ( n = 7) who applied Lean management in their work at the University Hospital in the Northern Ostrobothnia Health Care District. The data were analysed with a qualitative content analysis. Findings A common set of values in specialized health-care services, development of activities and challenges for management in the use of the Lean manager development model to improve personal management skills. Practical implications Managers in specialized health-care services can develop and systematically manage with the help of the Lean method. This emphasizes assumptions, from the point of view of management, about systems development when the organization uses the Lean method. The research outcomes originate from specialized health-care settings in Finland in which the Lean method and its associated management principles have been implemented and applied to the delivery of health care. Originality/value The study shows that the research results and in-depth knowledge on Lean method principles can be applied to health-care management and development processes. The research also describes health services managers' experiences of using the Lean method. In the future, these results can be used to improve Lean management skills, identify personal professional competencies and develop skills required in development processes. Also, the research findings can be used

Ana3 is a conserved protein required for the structural integrity of centrioles and basal bodies.

Science.gov (United States)

Stevens, Naomi R; Dobbelaere, Jeroen; Wainman, Alan; Gergely, Fanni; Raff, Jordan W

2009-11-02

Recent studies have identified a conserved "core" of proteins that are required for centriole duplication. A small number of additional proteins have recently been identified as potential duplication factors, but it is unclear whether any of these proteins are components of the core duplication machinery. In this study, we investigate the function of one of these proteins, Drosophila melanogaster Ana3. We show that Ana3 is present in centrioles and basal bodies, but its behavior is distinct from that of the core duplication proteins. Most importantly, we find that Ana3 is required for the structural integrity of both centrioles and basal bodies and for centriole cohesion, but it is not essential for centriole duplication. We show that Ana3 has a mammalian homologue, Rotatin, that also localizes to centrioles and basal bodies and appears to be essential for cilia function. Thus, Ana3 defines a conserved family of centriolar proteins and plays an important part in ensuring the structural integrity of centrioles and basal bodies.

Serum betaine is inversely associated with low lean mass mainly in men in a Chinese middle-aged and elderly community-dwelling population.

Science.gov (United States)

Huang, Bi-Xia; Zhu, Ying-Ying; Tan, Xu-Ying; Lan, Qiu-Ye; Li, Chun-Lei; Chen, Yu-Ming; Zhu, Hui-Lian

2016-06-01

Previous studies have demonstrated that betaine supplements increase lean body mass in livestock and improve muscle performance in human beings, but evidence for its effect on human lean mass is limited. Our study assessed the association of circulating betaine with lean mass and its composition in Chinese adults. A community-based study was conducted on 1996 Guangzhou residents (weight/mass: 1381/615) aged 50-75 years between 2008 and 2010. An interviewer-administered questionnaire was used to collect general baseline information. Fasting serum betaine was assessed using HPLC-MS. A total of 1590 participants completed the body composition analysis performed using dual-energy X-ray absorptiometry during a mean of 3·2 years of follow-up. After adjustment for age, regression analyses demonstrated a positive association of serum betaine with percentage of lean mass (LM%) of the entire body, trunk and limbs in men (all Pwomen (P=0·016). Each sd increase in serum betaine was associated with increases in LM% of 0·609 (whole body), 0·811 (trunk), 0·422 (limbs), 0·632 (arms) and 0·346 (legs) in men and 0·350 (trunk) in women. Multiple logistic regression analysis revealed that the prevalence of lower LM% decreased by 17 % (whole body) and 14 % (trunk) in women and 23 % (whole body), 28 % (trunk), 22 % (arms) and 26 % (percentage skeletal muscle index) in men with each sd increment in serum betaine. Elevated circulating betaine was associated with a higher LM% and lower prevalence of lower LM% in middle-aged and elderly Chinese adults, particularly men.

Charm-conserving strangeness-changing two body hadronic decays of charmed baryons

International Nuclear Information System (INIS)

Khanna, M.P.

1993-10-01

The charm-conserving strangeness-changing two body hadronic decays of charmed baryons are examined in the SU(4) symmetry scheme. In addition to the 20''-Hamiltonian, we consider a 15-piece of the weak Hamiltonian which may arise due to SU(4) breaking or due to some non-conventional dynamics. The numerical estimates for decay widths of some of the modes are presented. (author). 15 refs, 3 tabs

Skaber lean bedre arbejdsmiljø?

DEFF Research Database (Denmark)

Hansen, Nanette Juhler

2007-01-01

rationalization strategies, among others Lean, claim to improve working conditions. The aim of this thesis is to identify whether the application of Lean strategies leads to a reduction of the occupational health and safety problem repetitive work. Repetitive work is a problem created by the Taylorisation of work......, and therefore it is to be expected that a break with one or more of the Tayloristic principles can lead to a reduction of repetitive work. This thesis points out a number of areas within which Lean breaks with Tayloristic principles, whilst other principles are maintained. These breaks between Lean...... and Taylorism are also found in the study of the case company. By linking breaks with Taylorism with solutions for the reduction of repetitive work, I point out a number of openings in Lean that may lead to a reduction of repetitive work. By using the concept of openings I present the possibilities offered...

Local conservation laws and the structure of the many-body localized states.

Science.gov (United States)

Serbyn, Maksym; Papić, Z; Abanin, Dmitry A

2013-09-20

We construct a complete set of local integrals of motion that characterize the many-body localized (MBL) phase. Our approach relies on the assumption that local perturbations act locally on the eigenstates in the MBL phase, which is supported by numerical simulations of the random-field XXZ spin chain. We describe the structure of the eigenstates in the MBL phase and discuss the implications of local conservation laws for its nonequilibrium quantum dynamics. We argue that the many-body localization can be used to protect coherence in the system by suppressing relaxation between eigenstates with different local integrals of motion.

TOWARDS GREEN THROUGH LEAN/LEAN SIX SIGMA APPROACHES: A LITERATURE REVIEW AT SERVICE INDUSTRY

Directory of Open Access Journals (Sweden)

RODRIGO GOYANNES GUSMÃO CAIADO

2017-08-01

Full Text Available In the last decades, sustainable development have increasingly gained importance to service industry and lean/Six Sigma approaches are becoming more and more outstanding in order to improve sustainability performance. In the post-modern era the integration between those approaches are necessary in order to aid organisations to balance the need for operational efficiency in their production and service systems with environmental commitment and social fairness. Because of that, Lean Six Sigma practices are progressively becoming widespread in studies about service, as way to improve quality, efficiency, effectiveness and sustainability of services. The purpose of this paper is to critically review the Lean and Lean Six Sigma (L6σ methodologies and highlight their importance to achieve sustainable development in service industry. To do this, a systematic literature review (SLR of the subjects under investigation was conducted. We examine the compatibility and divergences of the green, lean and Six Sigma concepts and implications regarding its sustainable implementation in service industry. The study has two major contributions. First, it is one of the first researches that investigate the potential benefits of integrating green, lean and Six Sigma in service sector. Second, it supports and expands current literature, providing both academicians and practitioners a better panorama to understand the present status of L6σ for achieving sustainability in service sector.

Per meal dose and frequency of protein consumption is associated with lean mass and muscle performance.

Science.gov (United States)

Loenneke, Jeremy P; Loprinzi, Paul D; Murphy, Caoileann H; Phillips, Stuart M

2016-12-01

It has been hypothesized that for older adults evenly distributing consumption of protein at 30-40 g per meal throughout the day may result in more favorable retention of lean mass and muscular strength. Such a thesis has not, to our knowledge, been tested outside of short-term studies or acute measures of muscle protein synthesis. To examine whether the number of times an individual consumed a minimum of 30 g of protein at a meal is associated with leg lean mass and knee extensor strength. Data from the 1999-2002 NHANES were used, with 1081 adults (50-85 y) constituting the analytic sample. A "multiple pass" 24-h dietary interview format was used to collect detailed information about the participants' dietary intake. Knee extensor strength was assessed objectively using the Kin Com MP dynamometer. Leg lean mass was estimated from whole-body dual-energy X-ray absorptiometry (DXA) scans. Participants with 1 vs. 0 (β adjusted  = 23.6, p = 0.002) and 2 vs. 0 (β adjusted  = 51.1, p = 0.001) meals of ≥30 g protein/meal had greater strength and leg lean mass (1 vs. 0, β adjusted  = 1160, p frequency with leg lean mass and strength plateaued at ∼45 g protein/meal for those consuming 2 vs. 0 meals above the evaluated protein/meal threshold. However, for those with only 1 meal at or above the evaluated threshold, the response plateaued at 30 g/meal. Leg lean mass mediated the relationship between protein frequency and strength, with the proportion of the total effect mediated being 64%. We found that more frequent consumption of meals containing between 30 and 45 g protein/meal produced the greatest association with leg lean mass and strength. Thus, the consumption of 1-2 daily meals with protein content from 30 to 45 g may be an important strategy for increasing and/or maintaining lean body mass and muscle strength with aging. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Whole-body electromyostimulation as a means to impact muscle mass and abdominal body fat in lean, sedentary, older female adults: subanalysis of the TEST-III trial

Directory of Open Access Journals (Sweden)

Kemmler W

2013-10-01

Full Text Available Wolfgang Kemmler, Simon von StengelInstitute of Medical Physics, University of Erlangen-Nürnberg, Erlangen, GermanyBackground: The primary aim of this study was to determine the effect of 12 months of whole-body electromyostimulation (WB-EMS exercise on appendicular muscle mass and abdominal fat mass in subjects specifically at risk for sarcopenia and abdominal obesity, but unable or unwilling to exercise conventionally.Methods: Forty-six lean, nonsportive (<60 minutes of exercise per week, elderly women (aged 75 ± 4 years with abdominal obesity according to International Diabetes Federation criteria were randomly assigned to either a WB-EMS group (n=23 which performed 18 minutes of intermittent, bipolar WB-EMS (85 Hz three sessions in 14 days or an "active" control group (n=23. Whole-body and regional body composition was assessed by dual energy X-ray absorptiometry to determine appendicular muscle mass, upper leg muscle mass, abdominal fat mass, and upper leg fat mass. Maximum strength of the leg extensors was determined isometrically by force plates.Results: After 12 months, significant intergroup differences were detected for the primary endpoints of appendicular muscle mass (0.5% ± 2.0% for the WB-EMS group versus −0.8% ± 2.0% for the control group, P=0.025 and abdominal fat mass (−1.2% ± 5.9% for the WB-EMS group versus 2.4% ± 5.8% for the control group, P=0.038. Further, upper leg lean muscle mass changed favorably in the WB-EMS group (0.5% ± 2.5% versus −0.9% ± 1.9%, in the control group, P=0.033, while effects for upper leg fat mass were borderline nonsignificant (−0.8% ± 3.5% for the WB-EMS group versus 1.0% ± 2.6% for the control group, P=0.050. With respect to functional parameters, the effects for leg extensor strength were again significant, with more favorable changes in the WB-EMS group (9.1% ± 11.2% versus 1.0% ± 8.1% in the control group, P=0.010.Conclusion: In summary, WB-EMS showed positive effects on the

Exploiting HRM in support of lean manufacturing

DEFF Research Database (Denmark)

Jørgensen, Frances; Matthiesen, Rikke

The purpose of this paper is to investigate the ways in HRM practices are-and could potentially be-exploited to support lean manufacturing in practice. First, a review of the pertinent literature regarding HRM, SHRM, and lean manufacturing is presented to provide an understanding of the mechanisms...... by which HRM practices could, theoretically, be used to support a lean implementation. Data presented in the paper are derived from 1) a longitudinal case study on lean implementation and 2) from managers currently involved with lean manufacturing in a second company. The relevant literature and the data...... depicting the potential role in supporting HRM/lean integrated practices. The analysis of the model with respect to the theoretical background emphasizes a number of areas in which HRM could be more fully exploited in order to more successfully support lean implementation, for example, by stressing HRM...

Lean Transformation Guidance: Why Organizations Fail To Achieve and Sustain Excellence Through Lean Improvement

OpenAIRE

Mohammed Hamed Ahmed

2013-01-01

Many companies are complaining that lean didn’t achieve their long-term goals, and the improvement impact was very short-lived. 7 out of each 10 lean projects fail as companies try to use lean like a toolkit, copying and pasting the techniques without trying to adapt the employee’s culture, manage the improvement process, sustain the results, and develop their leaders. When the Toyota production system was created, the main goal was to remove wastes from the shop floor us...

An empirical review of lean manufacturing and their strategies

Directory of Open Access Journals (Sweden)

Virender Chahal

2017-07-01

Full Text Available The theory of lean manufacturing provides the quality of the products in minimum cost and pro-vides customer satisfaction. Today, the competition level is very high and every industry tries to supply high quality products in nominal cost, so lean is the latest tool to achieve. The objective of this paper is to study different lean concepts under various lean strategies. This study helps to find out the status of lean manufacturing and its ways of implementation. Also in this paper, there is a discussion about lean manufacturing concept, lean waste, lean strategies, lean barriers and cycle of lean implementation. This paper presents a literature review to clear the status of lean manufacturing and their strategies with help of collection of relevant papers.

Implementing Lean Health Reforms in Saskatchewan

Directory of Open Access Journals (Sweden)

Greg Marchildon

2013-07-01

Full Text Available Saskatchewan has gone further than any other Canadian province in implementing health system process improvements using Lean, a production line discipline that originated with the automobile industry. The goal of the Lean reform is to reduce waste and improve quality and overall health system performance by long-term changes in behaviour. Lean enjoys a privileged position on the provincial government’s agenda because of the policy’s championing by the Deputy Minister of Health and the policy’s fit with the government’s patient-centred care agenda. The implementation of reform depends on a major investment of time in the training and Lean-certification of key leaders and managers in the provincial health system. The Saskatchewan Union of Nurses, the union representing the single largest group of health workers in the province, has agreed to co-operate with the provincial government in implementing Lean-type reforms. Thus far, the government has had limited independent evaluation of Lean while internal evaluations claim some successes.

Risk stratification using lean body mass in patients undergoing transcatheter aortic valve replacement.

Science.gov (United States)

Hioki, Hirofumi; Watanabe, Yusuke; Kozuma, Ken; Yamamoto, Masanori; Naganuma, Toru; Araki, Motoharu; Tada, Norio; Shirai, Shinichi; Yamanaka, Futoshi; Higashimori, Akihiro; Mizutani, Kazuki; Tabata, Minoru; Takagi, Kensuke; Ueno, Hiroshi; Hayashida, Kentaro

2018-02-22

The prognostic impact of skeletal muscle mass, assessed using lean body mass (LBM), remain unclear in patients who underwent transcatheter aortic valve replacement (TAVR). The aim of this study to assess prognostic impact of LBM on mortality after TAVR. We assessed 1,613 patients (median age 85 years, 70% female) who underwent TAVI from October 2013 to April 2016 using OCEAN (Optimized transCathEter vAlvular interveNtion)-TAVI registry data. LBM was calculated using the James formula. The primary endpoint was all-cause death after TAVR. Median follow-up period was 287 days (interquartile range 110-462). The Kaplan-Meier analysis demonstrated that patients with low LBM had significantly higher incidence of all-cause death than those with high LBM in male (32.3% vs. 9.9%, log rank P LBM was an independent predictor of all-cause death in male (Hazard ratio [HR] 0.93; 95% confidence interval [CI] 0.89-0.98) and female (HR 0.94; 95% CI 0.89-0.99). Inversely, the assessment using BMI could not identify the high-risk population in a female. The patients with low LBM had the higher incidence of all-cause death after TAVR than those with high LBM, regardless of gender. Thus, the risk stratification using LBM might provide further insight to identify the high-risk TAVR population, compared to conventional risk stratification using BMI. © 2018 Wiley Periodicals, Inc.

Structural imaging of the brain reveals decreased total brain and total gray matter volumes in obese but not in lean women with polycystic ovary syndrome compared to body mass index-matched counterparts.

Science.gov (United States)

Ozgen Saydam, Basak; Has, Arzu Ceylan; Bozdag, Gurkan; Oguz, Kader Karli; Yildiz, Bulent Okan

2017-07-01

To detect differences in global brain volumes and identify relations between brain volume and appetite-related hormones in women with polycystic ovary syndrome (PCOS) compared to body mass index-matched controls. Forty subjects participated in this study. Cranial magnetic resonance imaging and measurements of fasting ghrelin, leptin and glucagon-like peptide 1 (GLP-1), as well as GLP-1 levels during mixed-meal tolerance test (MTT), were performed. Total brain volume and total gray matter volume (GMV) were decreased in obese PCOS compared to obese controls (p lean PCOS and controls did not show a significant difference. Secondary analyses of regional brain volumes showed decreases in GMV of the caudate nucleus, ventral diencephalon and hippocampus in obese PCOS compared to obese controls (p lean patients with PCOS had lower GMV in the amygdala than lean controls (p PCOS, suggests volumetric reductions in global brain areas in obese women with PCOS. Functional studies with larger sample size are needed to determine physiopathological roles of these changes and potential effects of long-term medical management on brain structure of PCOS.

How dieting makes some fatter: from a perspective of human body composition autoregulation.

Science.gov (United States)

Dulloo, Abdul G; Jacquet, Jean; Montani, Jean-Pierre

2012-08-01

Dieting makes you fat - the title of a book published in 1983 - embodies the notion that dieting to control body weight predisposes the individual to acquire even more body fat. While this notion is controversial, its debate underscores the large gap that exists in our understanding of basic physiological laws that govern the regulation of human body composition. A striking example is the key role attributed to adipokines as feedback signals between adipose tissue depletion and compensatory increases in food intake. Yet, the relative importance of fat depletion per se as a determinant of post-dieting hyperphagia is unknown. On the other hand, the question of whether the depletion of lean tissues can provide feedback signals on the hunger-appetite drive is rarely invoked, despite evidence that food intake during growth is dominated by the impetus for lean tissue deposition, amidst proposals for the existence of protein-static mechanisms for the regulation of growth and maintenance of lean body mass. In fact, a feedback loop between fat depletion and food intake cannot explain why human subjects recovering from starvation continue to overeat well after body fat has been restored to pre-starvation values, thereby contributing to 'fat overshooting'. In addressing the plausibility and mechanistic basis by which dieting may predispose to increased fatness, this paper integrates the results derived from re-analysis of classic longitudinal studies of human starvation and refeeding. These suggest that feedback signals from both fat and lean tissues contribute to recovering body weight through effects on energy intake and thermogenesis, and that a faster rate of fat recovery relative to lean tissue recovery is a central outcome of body composition autoregulation that drives fat overshooting. A main implication of these findings is that the risk of becoming fatter in response to dieting is greater in lean than in obese individuals.

Body composition and dietary intake in neoplasic disease

International Nuclear Information System (INIS)

Cohn, S.H.; Gartenhaus, W.; Vartsky, D.; Sawitsky, A.; Zanzi, I.; Vaswani, A.; Yasummure, S.; Rai, K.; Cartes, E.; Ellis, K.J.

1981-01-01

Changes in body composition in 37 cancer patients were studied over a period of 6 months. Initially, the patients were divided into two groups: those who lost body weight (over 10%) and those who maintained or gained body weight before the study. Analysis of body composition indicated that patients who lost body weight has caloric and protein intakes markedly below ''normal'' levels at the beginning of the study. There also appears to be a direct relationship between the protein intake and the total body potassium/total body water ratio in the cancer patients. At the end of the 6-month study, the patients were again placed into two groups on the basis of weight loss or gain (and maintenance). Changes in body composition over the period were analyzed in terms of lean body mass, its protein constituent, water, and fat. Weight loss was found to reflect primarily the loss of fat, water, lean body mass (potassium), and only to a minor extent the protein component of lean body mass (nitrogen). Further, on the basis of the values of the ratios of total body nitrogen/total body potassium/total body water, it was possible to ascertain the relative normalcy of the body tissue gained or lost in the 6-month period. The results of the study suggest that the ratio total body nitrogen/total body potassium may serve as the best indicator of recent or ongoing catabolism or anabolism of the neoplastic process. By means of the application of the techniques used for the determination of body composition, it should be possible to assess regimes of hyperalimentation of cancer patients who lose body weight

Increased prevalence of malnutrition and reduced lean body mass in overweight/obese kidney transplant recipients

Directory of Open Access Journals (Sweden)

Sylwia Małgorzewicz

2012-06-01

Full Text Available Overweight and obesity are common in subjects after kidney transplantation. On the other hand, features of malnutrition are also frequently recognized in this group of patients. The aim of the study was to evaluate the prevalence of both abnormalities in a cohort of stable kidney recipients and to assess whether obesity precludes malnutrition in transplanted patients. We also investigated associations between the nutritional status, graft function and adipokines concentrations. The study was performed in 80 prevalent kidney transplant patients and in a control group which consisted of 23 healthy volunteers. Body composition (% of fat, lean body mass (LBM, water content was measured by multifrequency bioelectrical impedance (Body Composition Manager. Nutritional status was determined by a 7–point Subjective Global Assessment (SGA, anthropometric measurements and s-albumin concentration. C–reactive protein (CRP, Il–6 and plasminogen activator inhibitor–1 (PAI–1 were used as markers of inflammatory status. Concentration of leptin, adiponectin and visfatin were measured by ELISA. Results: Mean age was 52.4±13.9 years (45 men and 35 women. Diabetes mellitus was present in 29% (n=23 of them. Mean time after transplantation (transplantation vintage was 82.5±56.5 months (median=73 months. Mean eGFR was 41.7±14.9 ml/min (4 points MDRD, BMI was 25.7±4.2. Overweight was present in 41% of the patients and obesity in 14%. On the basis of SGA evaluation, signs of malnutrition were observed in 48% of the subjects. Malnutrition was present in 64% (21/33 of the overweight patients and in 91% (10/11 of the obese patients. Transplantation vintage was directly associated with fat mass and inversely associated with LBM. Malnourished patients (SGA had a longer transplantation vintage. Adiponectin levels were significantly lower in transplanted patients as compared to controls. In multivariate analysis, leptin was an independent predictor of serum

Finding the speed of a bicycle in circular motion by measuring the lean angle of the bicycle

Science.gov (United States)

Ben-Abu, Yuval; Wolfson, Ira; Yizhaq, Hezi

2018-05-01

We suggest an activity for measuring the speed of a bicycle going in circular motion by measuring the bicycle’s lean angle. In this activity students will be able to feel the strength that is being activated on their bodies while they are moving in circular motion. They will also understand that it is impossible to ride in a circle without the bicycle leaning at an angle, an action that is performed intuitively.

Lean in healthcare from employees' perspectives.

Science.gov (United States)

Drotz, Erik; Poksinska, Bozena

2014-01-01

The purpose of this paper is to contribute toward a deeper understanding of the new roles, responsibilities, and job characteristics of employees in Lean healthcare organizations. The paper is based on three cases studies of healthcare organizations that are regarded as successful examples of Lean applications in the healthcare context. Data were collected by methods including interviews, observations, and document studies. The implementation of Lean in healthcare settings has had a great influence on the roles, responsibilities, and job characteristics of the employees. The focus has shifted from healthcare professionals, where clinical autonomy and professional skills have been the guarding principles of patient care, to process improvement and teamwork. Different job characteristics may make it difficult to implement certain Lean practices in healthcare. Teamwork and decentralization of authority are examples of Lean practices that could be considered countercultural because of the strong professional culture and uneven power distribution, with doctors as the dominant decision makers. Teamwork, value flow orientation, and company-wide involvement in CI were associated with positive effects on the organizations' working environment, staff development, and organizational performance. In order to succeed with Lean healthcare, it is important to understand and recognize the differences in job characteristics between Lean manufacturing and healthcare. This paper provides insights into how Lean implementation changes the roles, responsibilities, and job characteristics of healthcare staff and the challenges and implications that may follow from this.

Antihypertensive effect of alpha- and beta-adrenergic blockade in obese and lean hypertensive subjects.

Science.gov (United States)

Wofford, M R; Anderson, D C; Brown, C A; Jones, D W; Miller, M E; Hall, J E

2001-07-01

The purpose of this study was to determine the contribution of the adrenergic system in mediating hypertension in obese and lean patients. Thirteen obese, hypertensive patients with a body mass index (BMI) > or =28 kg/m2 (obese) and nine lean patients with a BMI lean) were recruited. After a 1-week washout period, participants underwent daytime ambulatory blood pressure monitoring (ABPM). Participants were then treated with the alpha-adrenergic antagonist doxazosin, titrating to 4 mg QHS in 1 week. In the next week, the beta-adrenergic antagonist atenolol was added at an initial dose of 25 mg/day and titrated to 50 mg/day within 1 week. One month after the addition of atenolol, all patients underwent a second ABPM session. There were no differences between the obese and lean subjects in baseline systolic (SBP), diastolic (DBP), or mean arterial pressures (MAP) measured by office recording or ABPM. However, obese subjects had higher heart rates than lean subjects (87.5+/-2.4 v 76.8+/-4.9 beats/min). After 1 month of treatment with the adrenergic blockers, obese patients had a significantly lower SBP (130.0+/-2.5 v 138.9+/-2.1 mm Hg, P = .02) and MAP (99.6+/-2.3 v 107.0+/-1.5 mm Hg, P = .02) than lean patients. Obese patients also tended to have a lower DBP than lean patients (84.3+/-2.5 v 90.9+/-1.6 mm Hg, P = .057), but there was no significant difference in heart rate after 1 month of adrenergic blockade. These results indicate that blood pressure is more sensitive to adrenergic blockade in obese than in lean hypertensive patients and suggest that increased sympathetic activity may be an important factor in the maintenance of hypertension in obesity.

Lean and the quality of work

DEFF Research Database (Denmark)

Jensen, Per Langaa

2008-01-01

Lean has for the last decade developed as the dominating model for developing productions processes not only within industry but also in health care, administration and service industries in general. With this development a discussion on human factors aspects of lean has developed internationally....... Literature studies documents that it is not possible to establish a clear relation between lean and the psychosocial aspects of work. The studies also indicate that the context and the implementations process play a dominating role in how lean is experienced. This has been the basis for establishing...

Organizational change through Lean Thinking.

Science.gov (United States)

Tsasis, Peter; Bruce-Barrett, Cindy

2008-08-01

In production and manufacturing plants, Lean Thinking has been used to improve processes by eliminating waste and thus enhancing efficiency. In health care, Lean Thinking has emerged as a comprehensive approach towards improving processes embedded in the diagnostic, treatment and care activities of health-care organizations with cost containment results. This paper provides a case study example where Lean Thinking is not only used to improve efficiency and cost containment, but also as an approach to effective organizational change.

Plasma Amino Acids Stimulate Uncoupled Respiration of Muscle Subsarcolemmal Mitochondria in Lean but Not Obese Humans.

Science.gov (United States)

Kras, Katon A; Hoffman, Nyssa; Roust, Lori R; Patel, Shivam H; Carroll, Chad C; Katsanos, Christos S

2017-12-01

Obesity is associated with mitochondrial dysfunction in skeletal muscle. Increasing the plasma amino acid (AA) concentrations stimulates mitochondrial adenosine triphosphate (ATP) production in lean individuals. To determine whether acute elevation in plasma AAs enhances muscle mitochondrial respiration and ATP production in subsarcolemmal (SS) and intermyofibrillar (IMF) mitochondria in obese adults. Assessment of SS and IMF mitochondrial function during saline (i.e., control) and AA infusions. Eligible participants were healthy lean (body mass index, mass index >30 kg/m2; age 35 ± 3 years; n = 11) subjects. Single trial of saline infusion followed by AA infusion. SS and IMF mitochondria were isolated from muscle biopsies collected at the end of the saline and AA infusions. Mitochondrial respiration and ATP production. AA infusion increased adenosine 5'-diphosphate (ADP)-stimulated respiration and ATP production rates of SS mitochondria in the lean (P lean subjects only (P lean or obese subjects (P > 0.05). Increasing the plasma AA concentrations enhances the capacity for respiration and ATP production of muscle SS, but not IMF, mitochondria in lean individuals, in parallel with increases in uncoupled respiration. However, neither of these parameters increases in muscle SS or IMF mitochondria in obese individuals. Copyright © 2017 Endocrine Society

Oxidative stress and inflammation in lean and obese subjects with polycystic ovary syndrome.

Science.gov (United States)

Blair, Sarah A; Kyaw-Tun, Tommy; Young, Ian S; Phelan, Niamh A; Gibney, James; McEneny, Jane

2013-01-01

To determine whether polycystic ovary syndrome (PCOS) independently influences oxidative stress and inflammation or if the culprit is the comorbidities of obesity and/or insulin resistance common to this condition. Thirty women with PCOS were matched for age, body mass index and insulin resistance with 30 control subjects. Oxidative stress was examined by measuring the total oxidant status (TOS) and total antioxidant capacity (TAC) by spectrophotometric assay. The inflammatory biomarkers, C-reactive protein, plasminogen activator inhibitor-1, myeloperoxidase, neopterin, and serum amyloid A were measured by ELISA methodologies. Oxidative status was increased in the PCOS subjects relative to their weight-matched controls (TOS: obese PCOS patients vs. obese controls, 42.42 +/- 4.49 vs. 32.57 +/- 1.97, plean PCOS patients vs. lean controls, 33.69 +/- 1.59 vs. 28.69 +/- 1.18 micromol H2O2 Equiv/L, p lean PCOS group relative to their weight-matched controls (TAC: lean PCOS patients vs. lean controls, 1.10 +/- 0.09 vs. 1.49 +/- 0.03 nmol Trolox Equiv/L, p PCOS independently influenced oxidative stress. Overall, the presence of PCOS may increase cardiovascular risk.

Adiponectin and leptin in overweight/obese and lean women with polycystic ovary syndrome.

Science.gov (United States)

Chen, Chin-I; Hsu, Ming-I; Lin, Shyh-Hsiang; Chang, Yuan-Chin I; Hsu, Chun-Sen; Tzeng, Chii-Ruey

2015-04-01

The objective of this study was to evaluate the adiponectin and leptin levels in overweight/obese and lean women with polycystic ovary syndrome (PCOS). This was a retrospective study. Of the 422 studied patients, 224 women with PCOS and 198 women without PCOS were evaluated. Insulin resistance and the metabolic components were assessed. The adiponectin and leptin levels were also evaluated. Adiponectin was negatively correlated with insulin resistance, body mass index (BMI), and total testosterone, triglyceride, and low-density lipoprotein (LDL) levels; conversely, leptin reversed the aforementioned reaction and was negatively correlated with adiponectin levels. The adiponectin to leptin ratios were significantly lower in PCOS women than in those without PCOS. Compared to women with non-PCOS, overweight/obese women with PCOS had lower serum adiponectin levels than women without PCOS, which was not the case for lean women. Conversely, lean women with PCOS had higher serum leptin levels than those without PCOS, which was not the case for overweight/obese women. Adipose tissue might play an important role in the metabolic complications in women with PCOS. To study the impact of obesity biomarkers in women with PCOS, overweight/obese and lean women should be considered separately.

Lean - set i et historisk perspektiv

DEFF Research Database (Denmark)

Michelsen, Aage U

2006-01-01

I kapitlet redegøres for, hvordan begrebet Lean opstod som en karakteristik af Toyota Production System (TPS), der igen har sin rod i scientific management. Gennem eksempler illustreres det, at centrale Lean-principper således har været anvendt i årtier. Der argumenteres for, at Lean i mange...

Modelling Lean and Green Supply Chain

Science.gov (United States)

Duarte, Susana Carla Vieira Lino Medina

The success of an organization depends on the effective control of its supply chain. It is important to recognize new opportunities for organization and its supply chain. In the last few years the approach to lean, agile, resilient and green supply chain paradigms has been addressed in the scientific literature. Research in this field shows that the integration of these concepts revealed some contradictions among so many paradigms. This thesis is mainly focused on the lean and green approaches. Thirteen different management frameworks, embodied in awards, standards and tools were studied to understand if they could contribute for the modelling process of a lean and green approach. The study reveals a number of categories that are common in most management frameworks, providing adequate conditions for a lean and green supply chain transformation. A conceptual framework for the evaluation of a lean and green organization`s supply chain was proposed. The framework considers six key criteria, namely, leadership, people, strategic planning, stakeholders, processes and results. It was proposed an assessment method considering a criteria score for each criterion. The purpose is to understand how lean and green supply chain can be compatible, using principles, practices, techniques or tools (i.e. elements) that support both, a lean and a green approach, in all key criteria. A case study in the automotive upstream supply chain was performed to understand more deeply if the elements proposed for the conceptual framework could be implemented in a real-scenario. Based on the conceptual framework and the case study, a roadmap to achieve a lean-green transformation is presented. The proposed roadmap revealed its contribution to the understanding on how and when an organization`s supply chain should apply the lean and green elements. This study is relevant to practice, as it may assist managers in the adoption of a lean and green supply chain approach, giving insights for the

The Lean and Environment Toolkit

Science.gov (United States)

This Lean and Environment Toolkit assembles practical experience collected by the U.S. Environmental Protection Agency (EPA) and partner companies and organizations that have experience with coordinating Lean implementation and environmental management.

Lean og professionel autonomi på hospitaler

DEFF Research Database (Denmark)

Hasle, Peter

2014-01-01

Hospitaler står overfor store udfordringer fra voksende krav fra både patienter og samfund samtidig med begrænsede budgetter og stadig flere medicinske muligheder. Hospitalsledelserne anvender lean som en af de væsentligste metoder til at løse disse udfordringer. Lean stammer imidlertid fra...... industrien, og det er spørgsmålet, hvordan lean bliver tilpasset i til en hospitalssammenhæng, og hvilke konsekvenser lean får for medarbejderne. Dette spørgsmål er undersøgt i forbindelse med introduktion af lean i en kræftafdeling på et universitetshospital. Det viste sig vanskeligere end forventet...... at implementere lean, og konsekvenserne for henholdsvis laboranter og sygeplejersker viste sig at være meget forskelligartede. Laboranterne oplevede et forbedret arbejdsmiljø, mens det modsatte var tilfældet for sygeplejerskerne. En mulig forklaring er, at lean øgede kontrollen over eget arbejde for laboranterne...

Lean automation development : applying lean principles to the automation development process

OpenAIRE

Granlund, Anna; Wiktorsson, Magnus; Grahn, Sten; Friedler, Niklas

2014-01-01

By a broad empirical study it is indicated that automation development show potential of improvement. In the paper, 13 lean product development principles are contrasted to the automation development process and it is suggested why and how these principles can facilitate, support and improve the automation development process. The paper summarises a description of what characterises a lean automation development process and what consequences it entails. Main differences compared to current pr...

The Development Of A Theoretical Lean Culture Causal Framework To Support The Effective Implementation Of Lean In Automotive Component Manufacturers

Directory of Open Access Journals (Sweden)

Van der Merwe, Karl Robert

2014-05-01

Full Text Available Although it is generally accepted that lean manufacturing improves operational performance, many organisations are struggling to adapt to the lean philosophy. The purpose of this study is to contribute to a more effective strategy for implementing the lean manufacturing improvement philosophy. The study sets out both to integrate well-researched findings and theories related to generic organisational culture with more recent research and experience related to lean culture, and to examine the role that culture plays in the effective implementation of lean manufacturing principles and techniques. The ultimate aim of this exercise is to develop a theoretical lean culture causal framework.

Changes in body fluid and energy compartments during prolonged hunger strike.

Science.gov (United States)

Faintuch, J; Soriano, F G; Ladeira, J P; Janiszewski, M; Velasco, I T; Gama-Rodrigues, J J

2000-01-01

Prolonged total food deprivation in non-obese adults is rare, and few studies have documented body composition changes in this setting. In a group of eight hunger strikers who refused alimentation for 43 days, water and energy compartments were estimated, aiming to assess the impact of progressive starvation. Measurements included body mass index (BMI), triceps skinfold (TSF), arm muscle circumference (AMC), and bioimpedance (BIA) determinations of water, fat, lean body mass (LBM), and total resistance. Indirect calorimetry was also performed in one occasion. The age of the group was 43.3+/-6.2 years (seven males, one female). Only water, intermittent vitamins and electrolytes were ingested, and average weight loss reached 17.9%. On the last two days of the fast (43rd-44th day) rapid intravenous fluid, electrolyte, and vitamin replenishment were provided before proceeding with realimentation. Body fat decreased approximately 60% (BIA and TSF), whereas BMI reduced only 18%. Initial fat was estimated by BIA as 52.2+/-5.4% of body weight, and even on the 43rd day it was still measured as 19.7+/-3.8% of weight. TSF findings were much lower and commensurate with other anthropometric results. Water was comparatively low with high total resistance, and these findings rapidly reversed upon the intravenous rapid hydration. At the end of the starvation period, BMI (21.5+/-2.6 kg/m2) and most anthropometric determinations were still acceptable, suggesting efficient energy and muscle conservation. 1) All compartments diminished during fasting, but body fat was by far the most affected; 2) Total water was low and total body resistance comparatively elevated, but these findings rapidly reversed upon rehydration; 3) Exaggerated fat percentage estimates from BIA tests and simultaneous increase in lean body mass estimates suggested that this method was inappropriate for assessing energy compartments in the studied population; 4) Patients were not morphologically malnourished after

Changes in body fluid and energy compartments during prolonged hunger strike

Directory of Open Access Journals (Sweden)

Faintuch Joel

2000-01-01

Full Text Available Prolonged total food deprivation in non-obese adults is rare, and few studies have documented body composition changes in this setting. In a group of eight hunger strikers who refused alimentation for 43 days, water and energy compartments were estimated, aiming to assess the impact of progressive starvation. Measurements included body mass index (BMI, triceps skinfold (TSF, arm muscle circumference (AMC, and bioimpedance (BIA determinations of water, fat, lean body mass (LBM, and total resistance. Indirect calorimetry was also performed in one occasion. The age of the group was 43.3±6.2 years (seven males, one female. Only water, intermittent vitamins and electrolytes were ingested, and average weight loss reached 17.9%. On the last two days of the fast (43rd-44th day rapid intravenous fluid, electrolyte, and vitamin replenishment were provided before proceeding with realimentation. Body fat decreased approximately 60% (BIA and TSF, whereas BMI reduced only 18%. Initial fat was estimated by BIA as 52.2±5.4% of body weight, and even on the 43rd day it was still measured as 19.7±3.8% of weight. TSF findings were much lower and commensurate with other anthropometric results. Water was comparatively low with high total resistance, and these findings rapidly reversed upon the intravenous rapid hydration. At the end of the starvation period, BMI (21.5±2.6 kg/m² and most anthropometric determinations were still acceptable, suggesting efficient energy and muscle conservation. Conclusions: 1 All compartments diminished during fasting, but body fat was by far the most affected; 2 Total water was low and total body resistance comparatively elevated, but these findings rapidly reversed upon rehydration; 3 Exaggerated fat percentage estimates from BIA tests and simultaneous increase in lean body mass estimates suggested that this method was inappropriate for assessing energy compartments in the studied population; 4 Patients were not morphologically

High-Intensity Jump Training Is Tolerated during 60 Days of Bed Rest and Is Very Effective in Preserving Leg Power and Lean Body Mass: An Overview of the Cologne RSL Study.

Science.gov (United States)

Kramer, Andreas; Kümmel, Jakob; Mulder, Edwin; Gollhofer, Albert; Frings-Meuthen, Petra; Gruber, Markus

2017-01-01

Space agencies are looking for effective and efficient countermeasures for the degrading effects of weightlessness on the human body. The aim of this study was to assess the effects of a novel jump exercise countermeasure during bed rest on vitals, body mass, body composition, and jump performance. 23 male participants (29±6 years, 181±6 cm, 77±7 kg) were confined to a bed rest facility for 90 days: a 15-day ambulatory measurement phase, a 60-day six-degree head-down-tilt bed rest phase (HDT), and a 15-day ambulatory recovery phase. Participants were randomly allocated to the jump training group (JUMP, n = 12) or the control group (CTRL, n = 11). A typical training session consisted of 4x10 countermovement jumps and 2x10 hops in a sledge jump system. The training group had to complete 5-6 sessions per week. Peak force for the reactive hops (3.6±0.4 kN) as well as jump height (35±4 cm) and peak power (3.1±0.2 kW) for the countermovement jumps could be maintained over the 60 days of HDT. Lean body mass decreased in CTRL but not in JUMP (-1.6±1.9 kg and 0±1.0 kg, respectively, interaction effect p = 0.03). Resting heart rate during recovery was significantly increased for CTRL but not for JUMP (interaction effect pjump training and maintained high peak forces and high power output during 60 days of bed rest. The countermeasure was effective in preserving lean body mass and partly preventing cardiac deconditioning with only several minutes of training per day.

Body Fat, Abdominal Fat, and Body Fat Distribution Is Related to Left Atrial Diameter in Young Children

DEFF Research Database (Denmark)

Dencker, Magnus; Thorsson, Ola; Karlsson, Magnus K

2012-01-01

such as lean body mass, blood pressure, gender, age, and Tanner stage revealed that TBF, AFM, and AFM/TBF were all independently related to LA diameter. Differences in the different body fat measurements explained 6-9% of the variance in LA size. These results demonstrated that both total body fat, AFM...

Prevalence and hemodynamic effects of leaning during CPR

Science.gov (United States)

Niles, Dana E.; Sutton, Robert M.; Nadkarni, Vinay M.; Glatz, Andrew; Zuercher, Mathias; Maltese, Matthew R.; Eilevstjønn, Joar; Abella, Benjamin S.; Becker, Lance B.; Berg, Robert A.

2013-01-01

Background Cardiopulmonary resuscitation (CPR) guidelines recommend complete release between chest compressions (CC). Objective Evaluate the hemodynamic effects of leaning (incomplete chest wall release) during CPR and the prevalence of leaning during CPR. Results In piglet ventricular fibrillation cardiac arrests, 10% and 20% (1.8 kg and 3.6 kg, respectively), leaning during CPR increased right atrial pressures, decreased coronary perfusion pressures, and decreased cardiac index and left ventricular myocardial blood flow by nearly 50%. In contrast, residual leaning of a 260 g accelerometer/ force feedback device did not adversely affect cardiac index or myocardial blood flow. Among 108 adult in-hospital CPR events, leaning ≥2.5 kg was demonstrable in 91% of the events and 12% of the evaluated CC. For 12 children with in-hospital CPR, 28% of CC had residual leaning ≥2.5 kg and 89% had residual leaning ≥0.5 kg. Conclusions Leaning during CPR increases intrathoracic pressure, decreases coronary perfusion pressure, and decreases cardiac output and myocardial blood flow. Leaning is common during CPR. PMID:22208173

Body composition of adult cystic fibrosis patients and control subjects as determined by densitometry, bioelectrical impedance, total-body electrical conductivity, skinfold measurements, and deuterium oxide dilution

International Nuclear Information System (INIS)

Newby, M.J.; Keim, N.L.; Brown, D.L.

1990-01-01

This study contrasts body compositions (by six methods) of eight cystic fibrosis (CF) subjects with those of eight control subjects matched for age, height, and sex. CF subjects weighed 84% as much as control subjects. Densitometry and two bioelectrical impedance-analysis methods suggested that reduced CF weights were due to less lean tissue (10.7, 9.5, and 10.4 kg). Total-body electrical conductivity (TOBEC) and skinfold-thickness measurements indicated that CF subjects were leaner than control subjects and had less fat (5.4 and 3.6 kg) and less lean (5.2 and 7 kg) tissue. D2O dilution showed a pattern similar to TOBEC (8.3 kg less lean, 2.7 kg less fat tissue). Densitometry estimates of fat (mass and percent) were not correlated (r less than 0.74, p greater than 0.05) with any other method for CF subjects but were correlated with all other methods for control subjects. CF subjects contained less fat and lean tissue than did control subjects. Densitometry by underwater weighing is unsuitable for assessing body composition of CF patients

Lean Transformation Guidance: Why Organizations Fail To Achieve and Sustain Excellence Through Lean Improvement

Directory of Open Access Journals (Sweden)

Mohammed Hamed Ahmed

2013-06-01

Full Text Available Many companies are complaining that lean didn’t achieve their long-term goals, and the improvement impact was very short-lived. 7 out of each 10 lean projects fail as companies try to use lean like a toolkit, copying and pasting the techniques without trying to adapt the employee’s culture, manage the improvement process, sustain the results, and develop their leaders. When the Toyota production system was created, the main goal was to remove wastes from the shop floor using some lean techniques and tools. What was not clear is that this required from Toyota a long process of leadership development, and a high commitment to training and coaching their employee. A Failure to achieve and sustain the improvement is a problem of both management and leadership as well as the improper understanding of the human behavior, and the required culture to success.

Lean management in a non-manufacturing organization

Directory of Open Access Journals (Sweden)

Mladen Žvorc

2013-12-01

Full Text Available This paper examines the possibilities of a lean approach to non-manufacturing functions, i.e. a market-oriented organization. This refers to purchasing, shipment, storage, sale and delivery of goods; marketing, etc. A lean approach to business operations is discussed and several lean business methods are developed on the basis of which lean management can be used not only in manufacturing, but also in non-manufacturing organizations.

Lean in Air Permitting Guide

Science.gov (United States)

The Lean in Air Permitting Guide is designed to help air program managers at public agencies better understand the potential value and results that can be achieved by applying Lean improvement methods to air permitting processes.

Lean-Prinzipien für verbesserte Kosteneffizienz: Instandhaltungseffizienz durch Lean Maintenance

OpenAIRE

Bandow, G.; Schmidt, A.

2008-01-01

Die Bedeutung der Instandhaltung nimmt weiter zu. In einem Lean Umfeld mit einer immer verschwendungsärmeren Produktion stehen nicht nur die Kosteneffizienz und Verfügbarkeit der Produktionsmittel im Fokus. Unplanmäßige Stillstände kosten Geld und gefährden häufig auch Personal und Produkt. Lean Maintenance vermeidet Verschwendung und optimiert so die Effektivität und Effizienz der Instandhaltung. Das zielgerichtete Zusammenspiel von Menschen, Prozessen und Technik garantiert dabei den Erfolg...

Aortic and hepatic enhancement at multidetector CT: Evaluation of optimal iodine dose determined by lean body weight

International Nuclear Information System (INIS)

Kondo, Hiroshi; Kanematsu, Masayuki; Goshima, Satoshi; Watanabe, Haruo; Onozuka, Minoru; Moriyama, Noriyuki; Bae, Kyongtae T.

2011-01-01

Purpose: To determine the optimal iodine dose for aortic and hepatic enhancement at MDCT by comparing lean body weight (LBW) with total body weight (TBW). Materials and methods: This study was approved by our institutional review committee. One hundred and thirty-six patients were randomized into four groups: 550, 650, 750 mg iodine/(kg of LBW) and 600 mgI/(kg of TBW). The aortic and hepatic contrast enhancements (ΔHUs) during the portal venous-phase and variances of ΔHUs were compared. Results: Mean ΔHUs for 550, 650, 750 mgI/kg LBW and 600 mgI/kg TBW were: 95.1, 109.9, 122.4, and 131.2 HU, respectively, for the aorta. For the liver, 43.1, 55.4, 60.8, and 63.5 HU. Mean ΔHUs increased with iodine dose per kg LBW (p < 0.01), but no significant difference between 750 mgI/kg LBW and 600 mgI/kg TBW groups. Hepatic enhancement increased by ≥50 HU in 94% of patients with 750 mg/kg LBW. Variance of hepatic enhancement was marginally greater in the 600 mgI/kg TBW than in the 550 and 750 mgI/kg LBW. Conclusion: Hepatic enhancement variation was reduced with iodine doses based on LBW. Iodine dose of 750 mg iodine/kg LBW was appropriate to achieve hepatic enhancement ≥50 HU in 94% of patients.

Aortic and hepatic enhancement at multidetector CT: evaluation of optimal iodine dose determined by lean body weight.

Science.gov (United States)

Kondo, Hiroshi; Kanematsu, Masayuki; Goshima, Satoshi; Watanabe, Haruo; Onozuka, Minoru; Moriyama, Noriyuki; Bae, Kyongtae T

2011-12-01

To determine the optimal iodine dose for aortic and hepatic enhancement at MDCT by comparing lean body weight (LBW) with total body weight (TBW). This study was approved by our institutional review committee. One hundred and thirty-six patients were randomized into four groups: 550, 650, 750 mg iodine/(kg of LBW) and 600 mgI/(kg of TBW). The aortic and hepatic contrast enhancements (Δ HUs) during the portal venous-phase and variances of ΔHUs were compared. Mean ΔHUs for 550, 650, 750 mgI/kg LBW and 600 mgI/kg TBW were: 95.1, 109.9, 122.4, and 131.2HU, respectively, for the aorta. For the liver, 43.1, 55.4, 60.8, and 63.5 HU. Mean Δ HUs increased with iodine dose per kg LBW (p<0.01), but no significant difference between 750 mgI/kg LBW and 600 mgI/kg TBW groups. Hepatic enhancement increased by ≥50 HU in 94% of patients with 750 mg/kg LBW. Variance of hepatic enhancement was marginally greater in the 600 mgI/kg TBW than in the 550 and 750 mgI/kg LBW. Hepatic enhancement variation was reduced with iodine doses based on LBW. Iodine dose of 750 mg iodine/kg LBW was appropriate to achieve hepatic enhancement≥50 HU in 94% of patients. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Cats during gestation and lactation fed with canned food ad libitum: energy and protein intake, development of body weight and body composition.

Science.gov (United States)

Wichert, B; Signer, M; Uebelhart, D

2012-12-01

The NRC recommendations for cats for energy and protein supply during gestation and lactation are based on limited data. This study aimed to answer the question: Can the energy requirement be met with canned food or is the volume restrictive? Therefore, balance trials were conducted in 10 queens before mating, during the 4th and 7th week of gestation and during the 2nd and 6th week of lactation. The cats were fed with canned food ad libitum. Additionally, the body composition of the queens was measured by dual-energy X-ray absorptiometry (Dexa) before mating, after parturition and after weaning. Eight of 10 cats presented increased body fat content and lean body mass during gestation. The weight loss during lactation led to a loss of lean body mass, but only six cats lost body fat of widely differing amounts. It was evident that the queens' dry matter intake was consistent with that of queens fed ad libitum with dry food. The cats lost lean body mass during lactation and had negative protein balances in the 2nd week of lactation. This seems to be physiological in early lactation. Nevertheless, the protein recommendations for lactation seem to be too low. © 2011 Blackwell Verlag GmbH.

TH-C-9A-01: Lean Tools and Methods

International Nuclear Information System (INIS)

Rangaraj, D; Chan, K; Boddu, S; Pawlicki, T; Dieterich, S

2014-01-01

Lean thinking has revolutionized the manufacturing industry. Toyota has pioneered and leveraged this aspect of Lean thinking. Application of Lean thinking and Lean Six Sigma techniques into Healthcare and in particular in Radiation Oncology has its merits and challenges. To improve quality, safety and patient satisfaction with available resources or reducing cost in terms of time, staff and resources is demands of today's healthcare. Radiation oncology treatment involves many processes and steps, identifying and removing the non-value added steps in a process can significantly improve the efficiency. Real projects undertaken in radiation oncology department in cutting down the procedure time for MRI guided brachytherapy to 40% less using lean thinking will be narrated. Simple Lean tools and techniques such as Gemba walk, visual control, daily huddles, standard work, value stream mapping, error-proofing, etc. can be applied with existing resources and how that improved the operation in a Radiation Oncology department's two year experience will be discussed. Lean thinking focuses on identifying and solving the root-cause of a problem by asking “Why” and not “Who” and this requires a culture change of no blame. Role of leadership in building lean culture, employee empowerment and trains and develops lean thinkers will be presented. Why Lean initiatives fail and how to implement lean successfully in your clinic will be discussed. Learning Objectives: Concepts of lean management or lean thinking. Lean tools and techniques applied in Radiation Oncology. Implement no blame culture and focus on system and processes. Leadership role in implementing lean culture. Challenges for Lean thinking in healthcare

TH-C-9A-01: Lean Tools and Methods

Energy Technology Data Exchange (ETDEWEB)

Rangaraj, D [Baylor Scott and White Health, Temple, TX (United States); Chan, K [Princess Margaret Hospital, Toronto (Canada); Boddu, S [Temple, TX (United States); Pawlicki, T [UC San Diego, La Jolla, CA (United States); Dieterich, S [UC Davis Medical Center, Sacramento, CA (United States)

2014-06-15

Lean thinking has revolutionized the manufacturing industry. Toyota has pioneered and leveraged this aspect of Lean thinking. Application of Lean thinking and Lean Six Sigma techniques into Healthcare and in particular in Radiation Oncology has its merits and challenges. To improve quality, safety and patient satisfaction with available resources or reducing cost in terms of time, staff and resources is demands of today's healthcare. Radiation oncology treatment involves many processes and steps, identifying and removing the non-value added steps in a process can significantly improve the efficiency. Real projects undertaken in radiation oncology department in cutting down the procedure time for MRI guided brachytherapy to 40% less using lean thinking will be narrated. Simple Lean tools and techniques such as Gemba walk, visual control, daily huddles, standard work, value stream mapping, error-proofing, etc. can be applied with existing resources and how that improved the operation in a Radiation Oncology department's two year experience will be discussed. Lean thinking focuses on identifying and solving the root-cause of a problem by asking “Why” and not “Who” and this requires a culture change of no blame. Role of leadership in building lean culture, employee empowerment and trains and develops lean thinkers will be presented. Why Lean initiatives fail and how to implement lean successfully in your clinic will be discussed. Learning Objectives: Concepts of lean management or lean thinking. Lean tools and techniques applied in Radiation Oncology. Implement no blame culture and focus on system and processes. Leadership role in implementing lean culture. Challenges for Lean thinking in healthcare.

The impact of insulin resistance on clinical, hormonal and metabolic parameters in lean women with polycystic ovary syndrome.

Science.gov (United States)

Yildizhan, Begum; Anik Ilhan, Gokce; Pekin, Tanju

2016-10-01

This study was performed to assess insulin resistance (IR) in lean women with polycystic ovary syndrome (PCOS). Retrospective analysis of 100 consecutive lean (body mass index PCOS subjects was performed. Subjects were divided into two groups according to homeostasis model assessment IR index (HOMA-IR), as IR + and IR-. A HOMA-IR value >2.5 was used to indicate IR. A total of 100 lean PCOS subjects were enrolled in the study, of which 47% were insulin resistant. Comparison of group means showed significantly higher values for waist-to-hip ratio (WHR), diastolic blood pressure and Ferriman-Gallwey score (FGS) in IR + group. HOMA-IR values were found to be positively correlated with WHR (r = 0.500, p PCOS subjects, the insulin resistant group should be separated as unique and IR should also be evaluated in lean women with PCOS.

Body composition and cardiac dimensions in elite rhythmic gymnasts.

Science.gov (United States)

Galetta, F; Franzoni, F; D'alessandro, C; Piazza, M; Tocchini, L; Fallahi, P; Antonelli, A; Cupisti, F; Santoro, G

2015-09-01

Rhythmic gymnasts are often believed to be a population at risk of malnutrition because of their tendency to keep a low weight and a lean appearance for better athletic performance, and because they start intensive training at a very young age. The purpose of this study was to evaluate in adolescent elite gymnasts the effects of physical activity on body composition and cardiac morphology and function. Sixteen national level rhythmic gymnasts and 16 control adolescent female underwent anthropometric measurements, bioelectric impedance and echocardiography to assess body composition and cardiac morphology and function. As compared to controls, gymnasts had lower body mass index (16.9±1.1 vs. 18.7±1.0, Panalysis showed a lower percentage of body fat in the gymnasts, together with a higher percentage of fat-free mass. Echocardiographic findings indicate that elite rhythmic gymnastics present left ventricular remodeling as training-induced cardiac adaptation. Intensive training, dietary attitude and evident leanness of rhythmic gymnasts are not associated with cardiac abnormalities, as it is the case of pathological leanness.

Estimation of Total Body Fat from Potassium-40 Content

International Nuclear Information System (INIS)

Taha Mohamed Taha Ahmed, T.M.T.

2010-01-01

This paper concerns on estimation of total body fat from potassium 40 content using total body counting technique. The work performed using fast scan whole body counter. Calibration of that system for K-40 was carried out under assumption that uniformity distribution of radioactivity of potassium was distributed in 10 polyethylene bottles phantom. Different body sizes were represented by 2, 4, 6, 8 and 10 polyethylene bottles; each bottle has a volume of 0.04 m3. The counting efficiency for each body size was determined. Lean body weight (LBW) was calculated for ten males and ten females using appropriate mathematical equation. Total Body Potassium, TBK for the same selected group was measured using whole body counter. A mathematical relationship between lean body weight and potassium content was deduced .Fat contents for some individuals were calculated and weight/height ratio was indicated for fatness.

Gravity and body mass regulation

Science.gov (United States)

Warren, L. E.; Horwitz, B. A.; Fuller, C. A.

1997-01-01

The effects of altered gravity on body mass, food intake, energy expenditure, and body composition are examined. Metabolic adjustments are reviewed in maintenance of energy balance, neural regulation, and humoral regulation are discussed. Experiments with rats indicate that genetically obese rats respond differently to hypergravity than lean rats.

The importance of body composition as a primary outcome in trials on MAM

International Nuclear Information System (INIS)

Wells, Jonathan

2014-01-01

Our understanding of the effects of moderate-acute malnutrition (MAM) in early life is primarily based on measures of anthropometry – mostly weight and height, which are often converted to age- and sex-specific z-scores, but which may also be expressed as weight-for-height, or body mass index (BMI), also in z-score format. Another widely used outcome is mid-upper arm circumference (MUAC). These data provide indices of stunting (short stature) and wasting (low weight for age), which are often categorized using cut-offs. Much information can be gained from such measurements, and data can be compared across populations because of the standardized format. However, the ‘abstract’ nature of anthropometry means that much is also concealed by these outcomes. Measurement of body composition represents a novel approach to nutritional status. The simplest approach aims to differentiate fat from lean mass. These two traits have very different implications for short- and long-term outcomes. Fat represents a store of energy that may fund immune function or future growth. Lean tissue represents functional tissue, which may also contribute to immune function. The relative ratio of fat to lean provides an indication of the allocation of energy between ‘completed growth’ and ‘investment potential’. Low levels of fat may indicate reduced resilience to ecological stresses, whereas low levels of lean mass indicate exposure to cumulative stresses. The relative ‘survival’ value of fat versus lean tissue in early life remains uncertain, hence it is unclear what constitutes the optimum pattern of tissue accretion, and whether variation in fat and lean accretion across populations represents local adaptation or pathology. Equally, it remains unclear whether public health interventions should promote lean mass, fat, or a particular ratio of the two. Measurement of body composition in early life is now possible through several techniques. Air displacement plethysmography can

Rethinking Lean Service

Science.gov (United States)

Seddon, John; O'Donovan, Brendan; Zokaei, Keivan

Ever since Levitt's influential Harvard Business Review article 'Production-Line Approach to Service' was published in 1972, it has been common for services to be treated like production lines in both the academic literature and more widely in management practice. The belief that achieving economies of scale will reduce unit costs is a common feature of management decision-making. As technological advancement has produced ever more sophisticated IT and telephony, it has become increasingly easier for firms to standardise and off-shore services. The development of the 'lean' literature has only helped to emphasise the same underlying management assumptions: by managing cost and workers' activity, organisational performance is expected to improve. This chapter argues that through misinterpretation of the core paradigm 'lean' has become subsumed into the 'business as usual' of conventional service management. As a result, 'lean' has become synonymous with 'process efficiency' and the opportunity for significant performance improvement - as exemplified by Toyota - has been missed.

Direct Determination of Lean Body Mass by CT in F-18 FDG PET/CT Studies: Comparison with Estimates Using Predictive Equations.

Science.gov (United States)

Kim, Chang Guhn; Kim, Woo Hyoung; Kim, Myoung Hyoun; Kim, Dae-Weung

2013-06-01

The purpose of this study was to estimate lean body mass (LBM) using CT (LBM CTs) and compare the results with LBM estimates of four different predictive equations (LBM PEs) to assess whether LBM CTs and LBM PEs can be used interchangeably for SUV normalization. Whole-body F-18 FDG PET/CT studies were conducted on 392 patients. LBM CT1 is modified adipose tissue-free body mass, and LBM CT2 is adipose tissue-free body mass. Four different PEs were used for comparison (LBM PE1-4). Agreement between the two measurement methods was assessed by Bland-Altman analysis. We calculated the difference between two methods (bias), the percentage of difference, and the limits of agreement, expressed as a percentage. For LBM CTs vs. LBM PEs, except LBM PE3, the ranges of biases and limits of agreement were -3.77 to 3.81 kg and 26.60-35.05 %, respectively, indicating the wide limits of agreement and differing magnitudes of bias. For LBM CTs vs. LBM PE3, LBM PE3 had wider limits of agreement and greater positive bias (44.28-46.19 % and 10.49 to 14.04 kg, respectively), showing unacceptably large discrepancies between LBM CTs and LBM PE3. This study demonstrated that there are substantial discrepancies between individual LBM CTs and LBM PEs, and this should be taken into account when LBM CTs and LBM PEs are used interchangeably between patients.

Lean consumption.

Science.gov (United States)

Womack, James P; Jones, Daniel T

2005-03-01

During the past 20 years, the real price of most consumer goods has fallen worldwide, the variety of goods and the range of sales channels offering them have continued to grow, and product quality has steadily improved. So why is consumption often so frustrating? It doesn't have to be--and shouldn't be--the authors say. They argue that it's time to apply lean thinking to the processes of consumption--to give consumers the full value they want from goods and services with the greatest efficiency and the least pain. Companies may think they save time and money by off-loading work to the consumer but, in fact, the opposite is true. By streamlining their systems for providing goods and services, and by making it easier for customers to buy and use those products and services, a growing number of companies are actually lowering costs while saving everyone time. In the process, these businesses are learning more about their customers, strengthening consumer loyalty, and attracting new customers who are defecting from less user-friendly competitors. The challenge lies with the retailers, service providers, manufacturers, and suppliers that are not used to looking at total cost from the standpoint of the consumer and even less accustomed to working with customers to optimize the consumption process. Lean consumption requires a fundamental shift in the way companies think about the relationship between provision and consumption, and the role their customers play in these processes. It also requires consumers to change the nature of their relationships with the companies they patronize. Lean production has clearly triumphed over similar obstacles in recent years to become the dominant global manufacturing model. Lean consumption, its logical companion, can't be far behind.

Lean in the supply chain : research and practice

OpenAIRE

Ugochukwu, Paschal

2012-01-01

Lean is a management philosophy that enhances customer value through waste elimination and continuous improvement in a system by applying lean principles, practices, and techniques. The focus on lean implementations and research had been typically a single company without extension to the entire supply chain. When the concept of lean is implemented across the entire supply chain, however, it is referred to as lean supply chain. The purpose of this thesis is to create a structure from theory a...

Many behavioral tendencies associated with right-leaning (conservative) political ideologies are malleable and unrelated to negativity.

Science.gov (United States)

Olivola, Christopher Y; Sussman, Abigail B

2014-06-01

Recent research has identified several judgment and decision making tendencies associated with right-leaning political ideologies that are difficult (if not impossible) to explain in terms of stable, negative affective appraisals because they (1) are uncorrelated with the negativity of the stimuli being considered, (2) do not reflect divergent affective evaluations, and (3) can be eliminated by superficial manipulations and interventions.

A conservative quaternion-based time integration algorithm for rigid body rotations with implicit constraints

DEFF Research Database (Denmark)

Nielsen, Martin Bjerre; Krenk, Steen

2012-01-01

A conservative time integration algorithm for rigid body rotations is presented in a purely algebraic form in terms of the four quaternions components and the four conjugate momentum variables via Hamilton’s equations. The introduction of an extended mass matrix leads to a symmetric set of eight...

Lean Six Sigma in financial services

OpenAIRE

de Koning, H.; Does, R.J.M.M.; Bisgaard, S.

2008-01-01

Lean Thinking and Six Sigma are typically considered as separate approaches to process innovation, with complementary strengths. When combined as Lean Six Sigma, this approach provides a unified framework for systematically developing innovations. Lean Six Sigma can also bring about significant results and breakthrough improvements in financial services, as demonstrated with four case studies from Dutch multinational insurance companies. These cases demonstrate the importance of incremental i...

Lean and psychosocial work environment in manufacturing

DEFF Research Database (Denmark)

Edwards, Kasper; Thye, Nina; Nielsen, Anders P.

2011-01-01

Lean is currently the rationalization method of choice in the Danish manufacturing industry. This paper reports finding from three lean implementation cases. All cases are manufacturing companies focusing on upmarket products produced in small series. Prior to lean production was organized as sel...

Validity of the Microsoft Kinect for providing lateral trunk lean feedback during gait retraining.

Science.gov (United States)

Clark, Ross A; Pua, Yong-Hao; Bryant, Adam L; Hunt, Michael A

2013-09-01

Gait retraining programs are prescribed to assist in the rehabilitation process of many clinical conditions. Using lateral trunk lean modification as the model, the aim of this study was to assess the concurrent validity of kinematic data recorded using a marker-based 3D motion analysis (3DMA) system and a low-cost alternative, the Microsoft Kinect™ (Kinect), during a gait retraining session. Twenty healthy adults were trained to modify their gait to obtain a lateral trunk lean angle of 10°. Real-time biofeedback of the lateral trunk lean angle was provided on a computer screen in front of the subject using data extracted from the Kinect skeletal tracking algorithm. Marker coordinate data were concurrently recorded using the 3DMA system, and the similarity and equivalency of the trunk lean angle data from each system were compared. The lateral trunk lean angle data obtained from the Kinect system without any form of calibration resulted in errors of a high (>2°) magnitude (mean error=3.2±2.2°). Performing global and individualized calibration significantly (Psystem for gait retraining. Given that this system is low-cost, portable and does not require any sensors to be attached to the body, it could provide numerous advantages when compared to laboratory-based gait retraining systems. Copyright © 2013 Elsevier B.V. All rights reserved.

Effects of Chronic Musculoskeletal Pain on Fertility Potential in Lean and Overweight Male Patients

Directory of Open Access Journals (Sweden)

Fereshteh Dardmeh

2017-01-01

Full Text Available Both chronic pain and obesity are known to affect reproductive hormone profiles in male patients. However, the effect of these conditions, alone or in combination, on male fertility potential has received less attention. 20 chronic musculoskeletal pain patients and 20 healthy controls were divided into lean and overweight subgroups according to their BMI. Current level of chronic pain (visual analogue scale and pressure pain thresholds (PPTs in 16 predefined sites, classically described and tested as painful points on the lower body, were measured. Levels of reproductive hormone and lipid profiles were assessed by ELISA. Sperm concentration and motility parameters were analyzed using a computer-aided sperm analysis system. Sperm concentration, progressive motility, and percentage of hyperactivated sperm were generally lower in the chronic pain patients in both lean and overweight groups. The overweight control and the lean chronic pain groups demonstrated a significantly lower percentage of progressively motile sperm compared with the lean control group, suggesting that musculoskeletal chronic pain may have a negative influence on sperm quality in lean patients. However, due to the potential great negative influence of obesity on the sperm parameters, it is difficult to propose if musculoskeletal chronic pain also influenced sperm quality in overweight patients. Further research in chronic pain patients is required to test this hypothesis.

A Sand Cone Model of Lean Implementation

OpenAIRE

Yestemessov, Azamat

2011-01-01

Over the past 20 years Lean Production system has been a focus of researches by different academicians. A numerous works have been written in the field of Lean implementation in manufacturing companies. However, as shown, most of the academic topics relate to the issues of implementing Lean tools and techniques. Critical Success Factors have been also described widely; however, no efforts in systematization have been made. Only several works have a focus on integration of Lean implementation ...

Assessment of insulin resistance and impaired glucose tolerance in lean women with polycystic ovary syndrome.

Science.gov (United States)

Stovall, Dale William; Bailey, Amelia Purser; Pastore, Lisa M

2011-01-01

To analyze insulin resistance (IR) and determine the need for a 2-hour oral glucose tolerance test (OGTT) for the identification of IR and impaired glucose tolerance (IGT) in lean nondiabetic women with polycystic ovary syndrome (PCOS). This was a cross-sectional analysis of treatment-naive women with PCOS who enrolled in a university-based clinical trial. Nondiabetic women with PCOS based on the Eunice Kennedy Shriven National Institute of Child Health and Human Development (NICHD) definition, aged 18-43 years and weighing ≤113 kg, were evaluated. Glucose and insulin levels were assessed at times 0, 30, 60, 90, and 120 minutes after a 75-g glucose load. Lean was defined as body mass index (BMI) women was studied. The prevalence of IR was 0% among lean women vs. 21% among nonlean subjects based on fasting insulin I(0) and 40%-68% based on two different homeostatic model assessment (HOMA) cutoff points (p women with IR had a BMI ≥ 28. Controlling for age and race, BMI explained over 57% of the variation in insulin fasting (I(o)), glucose fasting/Io (G(o)/I(o)), the qualitative insulin sensitivity check index (QUICKI), and HOMA and was a highly significant predictor of these outcomes (p lean PCOS women had IGT based on a 2-hour OGTT, and no lean subjects had IGT based on their fasting blood glucose. Diabetes mellitus, IGT, and IR are far less common in young lean women with PCOS compared with obese women with PCOS. These data imply that it is unnecessary to routinely perform either IR testing or 2-hour OGTT in lean women with PCOS; however, greater subject accumulation is needed to determine if OGTT is necessary in lean women with PCOS. BMI is highly predictive of both insulin and glucose levels in women with PCOS.

Serum antibody responses to vaccinal antigens in lean and obese geriatric dogs.

Science.gov (United States)

Ellis, John; Gow, Sheryl; Rhodes, Carrie; Lacoste, Stacey; Kong, Lyndsay; Musil, Kristyna; Snead, Elisabeth

2016-05-01

The immune responses in control dogs [1 to 4 years of age, body condition score (BCS): 4 to 5 out of 9] were compared to those of aging dogs (based on breed and body size) either categorized as lean (BCS: 4 to 5 out of 9) or obese (BCS: 8 to 9 out of 9). Of interest were the serum titers to the following common agents found in vaccines, canine parainfluenza virus (CPIV), canine parvovirus (CPV), canine distemper virus (CDV), canine respiratory coronavirus (CRCoV), and Bordetella bronchiseptica. There were no statistical differences in the antibodies to CPIV, B. bronchispetica, and CRCoV, among the age/weight categories, nor among the age/weight categories and the time, in days, between the date of sample collection and the date of the last recorded vaccination for CPIV, B. bronchiseptica, CPV, and CDV. For CPV, the control dogs had significantly (P obese geriatric dogs. For CDV SN titers, the only statistically significant (P = 0.01) difference was that the control dogs had higher SN titers than the lean geriatric dogs.

Lean in healthcare: the unfilled promise?

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Radnor, Zoe J; Holweg, Matthias; Waring, Justin

2012-02-01

In an effort to improve operational efficiency, healthcare services around the world have adopted process improvement methodologies from the manufacturing sector, such as Lean Production. In this paper we report on four multi-level case studies of the implementation of Lean in the English NHS. Our results show that this generally involves the application of specific Lean 'tools', such as 'kaizen blitz' and 'rapid improvement events', which tend to produce small-scale and localised productivity gains. Although this suggests that Lean might not currently deliver the efficiency improvements desired in policy, the evolution of Lean in the manufacturing sector also reveals this initial focus on the 'tool level'. In moving to a more system-wide approach, however, we identify significant contextual differences between healthcare and manufacturing that result in two critical breaches of the assumptions behind Lean. First, the customer and commissioner in the private sector are the one and the same, which is essential in determining 'customer value' that drives process improvement activities. Second, healthcare is predominantly designed to be capacity-led, and hence there is limited ability to influence demand or make full use of freed-up resources. What is different about this research is that these breaches can be regarded as not being primarily 'professional' in origin but actually more 'organisational' and 'managerial' and, if not addressed could severely constrain Lean's impact on healthcare productivity at the systems level. Copyright © 2011 Elsevier Ltd. All rights reserved.

Transferring lean management infrastructure for increasing productivity

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Ph.D.Daniel Georgescu

2010-12-01

Full Text Available These years, manufacturing function have been transferred rapidly and globally from matured countries to emerging countries. In this paper is about the critical elements for successful transfer of lean management among sites and countries. Based on this general descriptive analysis, current global transfer activity of Lean as well as its future direction is also described. According to the gradual progress of lean management transfer, necessity of its refinement/reinforcement is recognized and some research subjects are proposed for contributing further encouragement of its global activities. In this paper, based on this understanding, requisites for transfer of lean management are discussed through investigating global activity of Lean and specification of infrastructure enabling its smooth transfer is examined

Lean Implementation : the significance of people and dualism

OpenAIRE

Bengt, Halling

2013-01-01

Lean, with its origins at the Toyota Motor Company, is a concept that is known to increase effectiveness in manufacturing. The Lean concept is now argued to be relevant not only in manufacturing but in service and health-care delivery as well. The reported results of Lean implementation efforts are divided. There are reports that most of the Lean implementation efforts are not reaching the goal; on the other hand, there are reports of promising results. The divided results from Lean implement...

Effects of fasting on insulin action and glucose kinetics in lean and obese men and women.

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Bergman, Bryan C; Cornier, Marc-Andre; Horton, Tracy J; Bessesen, Daniel H

2007-10-01

The development of insulin resistance in the obese individual could impair the ability to appropriately adjust metabolism to perturbations in energy balance. We investigated a 12- vs. 48-h fast on hepatic glucose production (R(a)), peripheral glucose uptake (R(d)), and skeletal muscle insulin signaling in lean and obese subjects. Healthy lean [n = 14; age = 28.0 +/- 1.4 yr; body mass index (BMI) = 22.8 +/- 0.42] and nondiabetic obese (n = 11; age = 34.6 +/- 2.3 yr; BMI = 36.1 +/- 1.5) subjects were studied following a 12- and 48-h fast during 2 h of rest and a 3-h 40 mUxm(-2)xmin(-1) hyperinsulinemic-euglycemic clamp (HEC). Basal glucose R(a) decreased significantly from the 12- to 48-h fast (lean 1.96 +/- 0.23 to 1.63 +/- 0.15; obese 1.23 +/- 0.07 to 1.07 +/- 0.07 mgxkg(-1)xmin(-1); P = 0.004) and was equally suppressed during the HEC after both fasts. The increase in glucose R(d) during the HEC after the 12-h fast was significantly decreased in lean and obese subjects after the 48-h fast (lean 9.03 +/- 1.17 to 4.16 +/- 0.34, obese 6.10 +/- 0.77 to 3.56 +/- 0.30 mgxkg FFM(-1)xmin(-1); P lean than obese subjects. We conclude that 1) 48 h of fasting produces a marked decline in peripheral insulin action, while suppression of hepatic glucose production is maintained in lean and obese men and women; and 2) the magnitude of this decline is greater in lean vs. obese subjects.

Role of insulin in the hyperandrogenemia of lean women with polycystic ovary syndrome and normal insulin sensitivity.

Science.gov (United States)

Baillargeon, Jean-Patrice; Carpentier, André

2007-10-01

To determine the effect of reducing insulin secretion on hyperandrogenemia in lean normoinsulinemic women with polycystic ovary syndrome (PCOS) and normal metabolic insulin sensitivity. Transversal assessment at baseline and prospective follow-up of lean PCOS group after 8 days of diazoxide, which reduces insulin secretion, and 1 month of leuprolide, which suppresses LH. Clinical research center of an academic hospital. Nine lean women (body mass index PCOS and normal insulin levels, as well as 17 lean healthy women. Lean PCOS women were reassessed after 8 days of diazoxide and after 1 month of leuprolide, which suppresses LH. Androgen levels and insulin-stimulated glucose disposal (metabolic insulin sensitivity), determined by euglycemic-hyperinsulinemic clamp (M-value). Mean M-value of lean PCOS women (48.5 micromol/kg.min) was similar to lean control subjects (52.9 micromol/kg.min). They also had comparable anthropometric measures, lipids, fibrinogen, and plasminogen activator inhibitor 1. The LH did not change significantly after diazoxide, but was almost suppressed after leuprolide in the PCOS group. Androstenedione decreased significantly after diazoxide and even more after leuprolide. However, free T significantly decreased only after diazoxide in lean PCOS women. Diazoxide also increased SHBG significantly in this group. In women with typical PCOS and normal insulin levels and metabolic insulin sensitivity, reducing insulin secretion significantly decreased androgen and increased SHBG levels. These results suggest that insulin contributes to hyperandrogenemia even in PCOS women with normal metabolic insulin sensitivity, which might be due to increased sensitivity of their androgenic insulin pathway.

Insights into relationships between body mass, composition and bone: findings in elite rugby players.

Science.gov (United States)

Hind, Karen; Gannon, Lisa; Brightmore, Amy; Beck, Belinda

2015-01-01

Recent reports indicate that bone strength is not proportional to body weight in obese populations. Elite rugby players have a similar body mass index (BMI) to obese individuals but differ markedly with low body fat, high lean mass, and frequent skeletal exposure to loading through weight-bearing exercise. The purpose of this study was to determine relationships between body weight, composition, and bone strength in male rugby players characterized by high BMI and high lean mass. Fifty-two elite male rugby players and 32 nonathletic, age-matched controls differing in BMI (30.2 ± 3.2 vs 24.1 ± 2.1 kg/m²; p = 0.02) received 1 total body and one total hip dual-energy X-ray absorptiometry scan. Hip structural analysis of the proximal femur was used to determine bone mineral density (BMD) and cross-sectional bone geometry. Multiple linear regression was computed to identify independent variables associated with total hip and femoral neck BMD and hip structural analysis-derived bone geometry parameters. Analysis of covariance was used to explore differences between groups. Further comparisons between groups were performed after normalizing parameters to body weight and to lean mass. There was a trend for a positive fat-bone relationship in rugby players, and a negative relationship in controls, although neither reached statistical significance. Correlations with lean mass were stronger for bone geometry (r(2): 0.408-0.520) than for BMD (r(2): 0.267-0.293). Relative to body weight, BMD was 6.7% lower in rugby players than controls (p Rugby players were heavier than controls, with greater lean mass and BMD (p rugby players (p rugby players was reduced in proportion to body weight and lean mass. However, their superior bone geometry suggests that overall bone strength may be adequate for loading demands. Fat-bone interactions in athletes engaged in high-impact sports require further exploration. Copyright © 2015. Published by Elsevier Inc.

Lean Six Sigma implementation and organizational culture.

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Knapp, Susan

2015-01-01

The purpose of this paper is to examine the relationship between four organizational cultural types defined by the Competing Values Framework and three Lean Six Sigma implementation components - management involvement, use of Lean Six Sigma methods and Lean Six Sigma infrastructure. The study involved surveying 446 human resource and quality managers from 223 hospitals located in Maine, New Hampshire, Vermont, Massachusetts and Rhode Island using the Organizational Culture Assessment Instrument. Findings - In total, 104 completed responses were received and analyzed using multivariate analysis of variance. Follow-up analysis of variances showed management support was significant, F(3, 100)=4.89, p cultures having significant interactions with management support. The relationship between organizational culture and Lean Six Sigma in hospitals provides information on how specific cultural characteristics impact the Lean Six Sigma initiative key components. This information assists hospital staff who are considering implementing quality initiatives by providing an understanding of what cultural values correspond to effective Lean Six Sigma implementation. Managers understanding the quality initiative cultural underpinnings, are attentive to the culture-shared values and norm's influence can utilize strategies to better implement Lean Six Sigma.

Lean thinking for a maintenance process

Directory of Open Access Journals (Sweden)

Sherif Mostafa

2015-01-01

Full Text Available The maintenance process shares significant operating costs in an organisation. Lean thinking can be incorporated into maintenance activities through applying its principles and practices/tools. Lean maintenance (LM is a prerequisite for lean manufacturing systems. This research proposes a new structure for LM process based on a systematic literature review of a significant number of related articles that were published on LM. The process structure is designed based on the five lean principles to guide and support organisations to pursue maintenance excellence. This study establishes a scheme for LM tools that are structured into 2 level 4 bundles and 26 lean practices/tools and develops a House of Waste (HoW to demonstrate the association between maintenance wastes and the LM tools. With a successful accomplishment of the proposed scheme, the performance of a maintenance department can create more improvement opportunities over time to reach the maintenance excellence status.

THE LEAN AND SIX SIGMA SINERGY

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Mirko Sokovic

2008-12-01

Full Text Available Many organizations, dealing with continuous improvement methods, have realized that Lean and Six Sigma methodologies complement each other. Lean manufacturing focuses on the remova l of waste so that all processes in the total system add value from the customers' perspectives. The main emphasis of Six Sigma is the application of statistical tools in a disciplined manner, which requires data-driven decision-making. The integration of Lean and Six Sigma provides a synergetic effect, a rapid process improvement strategy for attaining organizational goals. When separated, Lean manufacturing cannot bring a process under statistical control, and Six Sigma cannot dramatically improve cycle time or reduce invested capital. Together, synergistic qualities are created to maximize the potential for a process improvement. The paper deals with Lean and Six Sigma principles and approaches used in modern manufacturing for process improvements, and bring forward benefits that are gained when these two methodologies are integrated.

Performance Improvement through Implementation of Lean Maintenance

OpenAIRE

S. Kolanjiappan; Dr. K. Maran

2011-01-01

Lean Maintenance is a relatively new term, invented in the last decade of the twentieth century, but the principles are well established in Total Productive Maintenance (TPM). Lean Maintenance—taking its lead from Lean Manufacturing—applies some new techniques to TPM concepts to render a more structured implementation path. Tracing its roots back to Henry Ford with modern refinements born in Japanese manufacturing, specifically the Toyota Production System (TPS). Lean seeks to eliminate a...

Lean mass predicts conditioned pain modulation in adolescents across weight status.

Science.gov (United States)

Stolzman, S; Hoeger Bement, M

2016-07-01

There is a wide continuum of conditioned pain modulation (CPM) in adults with older adults experiencing an attenuated CPM response compared with younger adults. Less is known for adolescents and the role of anthropometrics. Fifty-six adolescents (15.1 ± 1.8 years; 32 normal weight and 24 overweight/obese; 27 boys) completed in a CPM session that included anthropometric testing. Pressure pain thresholds were measured at the nailbed and deltoid muscle (test stimuli) with the foot submerged in a cool or ice water bath (conditioning stimulus). Weight status, body composition (Dual-energy X-ray absorptiometry scan), physical activity levels and clinical pain were also evaluated. The CPM response in adolescents was similar across sites (nailbed vs. deltoid), weight status (normal vs. overweight/obese) and sex. CPM measured at the deltoid muscle was positively associated with left arm lean mass but not fat mass; lean mass of the arm uniquely predicted 10% of the CPM magnitude. CPM measured at the nailbed was positively correlated with physical activity levels. These results suggest that lean mass and physical activity levels may contribute to endogenous pain inhibition in adolescents across weight status. © 2016 European Pain Federation - EFIC®

Lean in healthcare: A comprehensive review.

Science.gov (United States)

D'Andreamatteo, Antonio; Ianni, Luca; Lega, Federico; Sargiacomo, Massimo

2015-09-01

Lean seems to be the next revolution for a better, improved, value-based healhcare. In the last 15 years Lean has been increasingly adapted and adopted in healthcare. Accordingly, Lean healthcare has been developing into a major strand of research since the early 2000s. The aim of this work is to present a comprehensive overview of the main issues highlighted by research on implementation of Lean in a complex contest such as the healthcare one. Comprehensive literature review was conducted in order to identify empirical and theoretical articles published up to September 2013. Thematic analysis was performed in order to extract and synthesis data. 243 articles were selected for analysis. Lean is best understood as a means to increase productivity. Hospital is the more explored setting, with emergency and surgery as the pioneer departments. USA appears to be the leading country for number of applications. The theoretical works have been focused mainly on barriers, challenges and success factors. Sustainability, framework for measurement and critical appraisal remain underestimated themes. Evaluations of "system wide approach" are still low in number. Even though Lean results appear to be promising, findings so far do not allow to draw a final word on its positive impacts or challenges when introduced in the healthcare sector. Scholars are called to explore further the potentiality and the weaknesses of Lean, above all as for the magnitude of investments required and for the engagement of the whole organization it represents increasingly strategic choice, whilst health professionals, managers and policy makers could and should learn from research how to play a pivotal role for a more effective implementation of lean in different health contexts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Conservative integration of rigid body motion by quaternion parameters with implicit constraints

DEFF Research Database (Denmark)

Nielsen, Martin Bjerre; Krenk, Steen

2012-01-01

An angular momentum and energy‐conserving time integration algorithm for rigid body rotation is formulated in terms of the quaternion parameters and the corresponding four‐component conjugate momentum vector via Hamilton's equations. The introduction of an extended mass matrix leads to a symmetric...... these equations via the set of momentum equations. Initially, the normalization of the quaternion array is introduced via a Lagrange multiplier. However, this Lagrange multiplier can be expressed explicitly in terms of the gradient of the external load potential, and elimination of the Lagrange multiplier from...... the final format leaves only an explicit projection applied to the external load potential gradient. An algorithm is developed by forming a finite increment of the Hamiltonian. This procedure identifies the proper selection of increments and mean values, and leads to an algorithm with conservation...

Lean Management Systems in Radiology: Elements for Success.

Science.gov (United States)

Schultz, Stacy R; Ruter, Royce L; Tibor, Laura C

2016-01-01

This article is a review of the literature on Lean and Lean Management Systems and how they have been implemented in healthcare organizations and particularly in radiology departments. The review focuses on the elements required for a successful implementation of Lean by applying the principles of a Lean Management System instead of a Lean tools-only approach. This review shares the successes and failures from healthcare organizations' efforts to improve the quality and safety of the services they provide. There are a limited number of healthcare organizations in the literature who have shared their experiences and additional research is necessary to determine whether a Lean Management System is a viable alternative to the current management structure in healthcare.

Lean practices for quality results: a case illustration.

Science.gov (United States)

Hwang, Pauline; Hwang, David; Hong, Paul

2014-01-01

Increasingly, healthcare providers are implementing lean practices to achieve quality results. Implementing lean healthcare practices is unique compared to manufacturing and other service industries. The purpose of this paper is to present a model that identifies and defines the lean implementation key success factors in healthcare organisations. The model is based on an extant literature review and a case illustration that explores actual lean implementation in a major USA hospital located in a Midwestern city (approximately 300,000 people). An exploratory/descriptive study using observation and follow-up interviews was conducted to identify lean practices in the hospital. Lean practice key drivers include growing elderly populations, rising medical expenses, decreasing insurance coverage and decreasing management support. Effectively implementing lean practices to increase bottom-line results and improve organisational integrity requires sharing goals and processes among healthcare managers and professionals. An illustration explains the model and the study provides a sound foundation for empirical work. Practical implications are included. Lean practices minimise waste and unnecessary hospital stays while simultaneously enhancing customer values and deploying resources in supply systems. Leadership requires clear project targets based on sound front-end planning because initial implementation steps involve uncertainty and ambiguity (i.e. fuzzy front-end planning). Since top management support is crucial for implementing lean practices successfully, a heavyweight manager, who communicates well both with top managers and project team members, is an important success factor when implementing lean practices. Increasingly, green orientation and sustainability initiatives are phrases that replaced lean practices. Effective results; e.g. waste reduction, employee satisfaction and customer values are applicable to bigger competitive challenges arising both in specific

Lean Management Genesis

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Parkes Aneta

2015-12-01

Full Text Available Lean Management is a philosophy and management concept, based on reduction of the waste and resources used in the process of producing goods and providing services. Lean Management genesis dates back to scientific management in America (for example concepts of H. Ford and F.W. Taylor and quality management, including development of TQM concept. Japanese Toyota Production System has been inspired by chosen elements of these concepts, and then it evolved towards global concept called Toyota Way (which connects production rules with values and work attitude.

Improving healthcare using Lean processes.

Science.gov (United States)

Baker, G Ross

2014-01-01

For more than a decade, healthcare organizations across Canada have been using Lean management tools to improve care processes, reduce preventable adverse events, increase patient satisfaction and create better work environments. The largest system-wide effort in Canada, and perhaps anywhere, is currently under way in Saskatchewan. The jury is still out on whether Lean efforts in that province, or elsewhere in Canada, are robust enough to transform current delivery systems and sustain new levels of performance. This issue of Healthcare Quarterly features several articles that provide a perspective on Lean methods in healthcare. Copyright © 2014 Longwoods Publishing.

The Hybrid Lean System to Improve Manufacturing Environment

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Ahmad Ahmad Nur Aizat

2017-01-01

Full Text Available Lean manufacturing is a systematic approch could increase manufacturing competitiveness by identifying and elminating waste through lean tools. However, these tools are often categorized into different groups, continues to be difficult for companies to select the most appropriate lean tool to be adopted, especially in respect of the SMEs whose knowledge of lean tools and associated principles are limited. This study is to propose solution on how to implement appropriate lean tools in food manufacturing industry located at Rengit, Johor. Qualitative method is used as a methodology to see the changes after the implementation of lean tools. Interview session also a part of method to collect data from respondents. The finding from this paper shows that implementation of an appropriate lean tool will help to eliminate waste in industry sector, maintain and control the inventory, improve quality of the product and improve overall operational process.

Using Dynamic Value Stream Mapping and Lean Accounting Box Scores to Support Lean Implementation

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Woehrle, Stephen L.; Abou-Shady, Louay

2010-01-01

Lean has proven to be an effective management philosophy for improving businesses in a competitive market by eliminating waste and improving operations. An impact of implementing lean projects is the rapid reduction in inventory levels, which gives management the false impression that profits are decreasing while workers on the shop floor observe…

Age-related changes in body composition of bovine growth hormone transgenic mice.

Science.gov (United States)

Palmer, Amanda J; Chung, Min-Yu; List, Edward O; Walker, Jennifer; Okada, Shigeru; Kopchick, John J; Berryman, Darlene E

2009-03-01

GH has a significant impact on body composition due to distinct anabolic and catabolic effects on lean and fat mass, respectively. Several studies have assessed body composition in mice expressing a GH transgene. Whereas all studies report enhanced growth of transgenic mice as compared with littermate controls, there are inconsistencies in terms of the relative proportion of lean mass to fat mass in these animals. The purpose of this study was to characterize the accumulation of adipose and lean mass with age and according to gender in a bovine (b) GH transgenic mouse line. Weight and body composition measurements were assessed in male and female bGH mice with corresponding littermate controls in the C57BL/6J genetic background. Body composition measurements began at 6 wk and continued through 1 yr of age. At the conclusion of the study, tissue weights were determined and triglyceride content was quantified in liver and kidney. Although body weights for bGH mice were significantly greater than their corresponding littermate controls at all time points, body composition measurements revealed an unexpected transition midway through analyses. That is, younger bGH mice had relatively more fat mass than nontransgenic littermates, whereas bGH mice became significantly leaner than controls by 4 months in males and 6 months in females. These results reveal the importance in timing and gender when conducting studies related to body composition or lean and fat tissue in GH transgenic mice or in other genetically manipulated mouse strains in which body composition may be impacted.

Researching Lean: Methodological implications of loose definitions

DEFF Research Database (Denmark)

Brännmark, Mikael; Langstrand, Jostein; Johansson, Stina

2012-01-01

practices seem to overlap with other popular management concepts, such as High Performance Work Systems, World Class Manufacturing and Total Quality Management. This confusion, combined with different methodological and theoretical traditions, has led to much debate and contradictory conclusions regarding...... Lean. The purpose of the paper is to illustrate some key methodological issues that need to be considered in future Lean research to allow increased understanding of Lean effects for different stakeholders, primarily meaning the customer, employer and employees. Design/methodology/approach – The paper...... on the case studies, we suggest that future investigations describe the Lean interventions in more detail. General descriptions or analogies, e.g. ‘learning organizations’, presumably increase the present confusion regarding Lean impact on different stakeholders. The case studies also illustrate...

Lean leadership attributes: a systematic review of the literature.

Science.gov (United States)

Aij, Kjeld Harald; Teunissen, Maurits

2017-10-09

Purpose Emphasis on quality and reducing costs has led many health-care organizations to reconfigure their management, process, and quality control infrastructures. Many are lean, a management philosophy with roots in manufacturing industries that emphasizes elimination of waste. Successful lean implementation requires systemic change and strong leadership. Despite the importance of leadership to successful lean implementation, few researchers have probed the question of ideal leadership attributes to achieve lean thinking in health care. The purpose of this paper is to provide insight into applicable attributes for lean leaders in health care. Design/methodology/approach The authors systematically reviewed the literature on principles of leadership and, using Dombrowski and Mielke's (2013) conceptual model of lean leadership, developed a parallel theoretical model for lean leadership in health care. Findings This work contributes to the development of a new framework for describing leadership attributes within lean management of health care. Originality/value The summary of attributes can provide a model for health-care leaders to apply lean in their organizations.

High-Intensity Jump Training Is Tolerated during 60 Days of Bed Rest and Is Very Effective in Preserving Leg Power and Lean Body Mass: An Overview of the Cologne RSL Study.

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Andreas Kramer

Full Text Available Space agencies are looking for effective and efficient countermeasures for the degrading effects of weightlessness on the human body. The aim of this study was to assess the effects of a novel jump exercise countermeasure during bed rest on vitals, body mass, body composition, and jump performance.23 male participants (29±6 years, 181±6 cm, 77±7 kg were confined to a bed rest facility for 90 days: a 15-day ambulatory measurement phase, a 60-day six-degree head-down-tilt bed rest phase (HDT, and a 15-day ambulatory recovery phase. Participants were randomly allocated to the jump training group (JUMP, n = 12 or the control group (CTRL, n = 11. A typical training session consisted of 4x10 countermovement jumps and 2x10 hops in a sledge jump system. The training group had to complete 5-6 sessions per week.Peak force for the reactive hops (3.6±0.4 kN as well as jump height (35±4 cm and peak power (3.1±0.2 kW for the countermovement jumps could be maintained over the 60 days of HDT. Lean body mass decreased in CTRL but not in JUMP (-1.6±1.9 kg and 0±1.0 kg, respectively, interaction effect p = 0.03. Resting heart rate during recovery was significantly increased for CTRL but not for JUMP (interaction effect p<0.001.Participants tolerated the near-daily high-intensity jump training and maintained high peak forces and high power output during 60 days of bed rest. The countermeasure was effective in preserving lean body mass and partly preventing cardiac deconditioning with only several minutes of training per day.

Psoas Muscle Cross-sectional Area as a Measure of Whole-body Lean Muscle Mass in Maintenance Hemodialysis Patients.

Science.gov (United States)

Morrell, Glen R; Ikizler, Talat A; Chen, Xiaorui; Heilbrun, Marta E; Wei, Guo; Boucher, Robert; Beddhu, Srinivasan

2016-07-01

We investigate whether psoas or paraspinous muscle area measured on a single L4-L5 image is a useful measure of whole lean body mass (LBM) compared to dedicated midthigh magnetic resonance imaging (MRI). Observational study. Outpatient dialysis units and a research clinic. One hundred five adult participants on maintenance hemodialysis. No control group was used. Psoas muscle area, paraspinous muscle area, and midthigh muscle area (MTMA) were measured by magnetic resonance imaging. LBM was measured by dual-energy absorptiometry scan. In separate multivariable linear regression models, psoas, paraspinous, and MTMA were associated with increase in LBM. In separate multivariate logistic regression models, C statistics for diagnosis of sarcopenia (defined as <25th percentile of LBM) were 0.69 for paraspinous muscle area, 0.81 for psoas muscle area, and 0.89 for MTMA. With sarcopenia defined as <10th percentile of LBM, the corresponding C statistics were 0.71, 0.92, and 0.94. We conclude that psoas muscle area provides a good measure of whole-body muscle mass, better than paraspinous muscle area but slightly inferior to midthigh measurement. Hence, in body composition studies a single axial MR image at the L4-L5 level can be used to provide information on both fat and muscle and may eliminate the need for time-consuming measurement of muscle area in the thigh. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

A Comparison of Regular Consumption of Fresh Lean Pork, Beef and Chicken on Body Composition: A Randomized Cross-Over Trial

Directory of Open Access Journals (Sweden)

Karen J. Murphy

2014-02-01

Full Text Available Pork is the most widely eaten meat in the world and recent evidence shows that diets high in pork protein, with and without energy restriction, may have favourable effects on body composition. However, it is unclear whether these effects on body composition are specific to pork or whether consumption of other high protein meat diets may have the same benefit. Therefore we aimed to compare regular consumption of pork, beef and chicken on indices of adiposity. In a nine month randomised open-labelled cross-over intervention trial, 49 overweight or obese adults were randomly assigned to consume up to 1 kg/week of pork, chicken or beef, in an otherwise unrestricted diet for three months, followed by two further three month periods consuming each of the alternative meat options. BMI and waist/hip circumference were measured and body composition was determined using dual energy x-ray absorptiometry. Dietary intake was assessed using three day weighed food diaries. Energy expenditure was estimated from activity diaries. There was no difference in BMI or any other marker of adiposity between consumption of pork, beef and chicken diets. Similarly there were no differences in energy or nutrient intakes between diets. After three months, regular consumption of lean pork meat as compared to that of beef and chicken results in similar changes in markers of adiposity of overweight and obese Australian middle-aged men and women.

A Comparison of Regular Consumption of Fresh Lean Pork, Beef and Chicken on Body Composition: A Randomized Cross-Over Trial

Science.gov (United States)

Murphy, Karen J.; Parker, Barbara; Dyer, Kathryn A.; Davis, Courtney R.; Coates, Alison M.; Buckley, Jonathan D.; Howe, Peter R. C.

2014-01-01

Pork is the most widely eaten meat in the world and recent evidence shows that diets high in pork protein, with and without energy restriction, may have favourable effects on body composition. However, it is unclear whether these effects on body composition are specific to pork or whether consumption of other high protein meat diets may have the same benefit. Therefore we aimed to compare regular consumption of pork, beef and chicken on indices of adiposity. In a nine month randomised open-labelled cross-over intervention trial, 49 overweight or obese adults were randomly assigned to consume up to 1 kg/week of pork, chicken or beef, in an otherwise unrestricted diet for three months, followed by two further three month periods consuming each of the alternative meat options. BMI and waist/hip circumference were measured and body composition was determined using dual energy x-ray absorptiometry. Dietary intake was assessed using three day weighed food diaries. Energy expenditure was estimated from activity diaries. There was no difference in BMI or any other marker of adiposity between consumption of pork, beef and chicken diets. Similarly there were no differences in energy or nutrient intakes between diets. After three months, regular consumption of lean pork meat as compared to that of beef and chicken results in similar changes in markers of adiposity of overweight and obese Australian middle-aged men and women. PMID:24534884

Risk for development of severe liver disease in lean patients with nonalcoholic fatty liver disease: A long-term follow-up study.

Science.gov (United States)

Hagström, Hannes; Nasr, Patrik; Ekstedt, Mattias; Hammar, Ulf; Stål, Per; Hultcrantz, Rolf; Kechagias, Stergios

2018-01-01

Most patients with nonalcoholic fatty liver disease (NAFLD) are overweight or obese. However, a significant proportion of patients have a normal body mass index (BMI), denoted as lean NAFLD. The long-term prognosis of lean NAFLD is unclear. We conducted a cohort study of 646 patients with biopsy-proven NAFLD. Patients were defined as lean (BMI lean and nonlean NAFLD. Lean NAFLD was seen in 19% of patients, while 52% were overweight and 29% were obese. Patients with lean NAFLD were older, had lower transaminases, lower stages of fibrosis, and lower prevalence of nonalcoholic steatohepatitis at baseline compared to patients with a higher BMI. During a mean follow-up of 19.9 years (range 0.4-40 years) representing 12,631 person years and compared to patients who were overweight, patients with lean NAFLD had no increased risk for overall mortality (hazard ratio 1.06; P =  0.73) while an increased risk for development of severe liver disease was found (hazard ratio 2.69; P =  0.007). Conclusion : Although patients with lean NAFLD have lower stages of fibrosis, they are at higher risk for development of severe liver disease compared to patients with NAFLD and a higher BMI, independent of available confounders. ( Hepatology Communications 2018;2:48-57).

Exact self-energy of the many-body problem from conserving approximations

International Nuclear Information System (INIS)

Takada, Y.

1995-01-01

A procedure is proposed to obtain the exact self-energy in the many-body problem. This algorithm is based on the formal analysis to reach the exact theory by repeated applications of an operator F to an arbitrarily chosen input self-energy represented as a functional of the dressed Green's function. The operator F is so defined that the microscopic conservation law for particle number is satisfied. The rigorous self-energy is obtained by the solution of an eigenfunction of F. Particular attention is paid to the relation between the present procedure and the Baym-Kadanoff framework of conserving approximations. By simplifying the procedure in F with use of the generalized Ward identity, we suggest a practical method to implement this algorithm rather easily in actual systems. In order to suggest future directions to improve on this practical method, the recently developed mean-field theory for the Hubbard model in the limit of high spatial dimensions is also discussed in the context of our theory

Assessment of circulating betatrophin concentrations in lean glucose-tolerant women with polycystic ovary syndrome.

Science.gov (United States)

Erol, Onur; Özel, Mustafa Kemal; Ellidağ, Hamit Yaşar; Toptaş, Tayfun; Derbent, Aysel Uysal; Yılmaz, Necat

2017-07-01

The aims of the current study were to investigate the betatrophin levels in lean glucose-tolerant women with polycystic ovary syndrome (PCOS), and to explore the relationships between these levels and antropometric, hormonal and metabolic parameters. The study population consisted of 50 lean (body mass index [BMI] production and improved glucose tolerance. Few studies have investigated the association between PCOS and betatrophin. However, in contrast to our study, the authors included overweight/obese patients and glucose tolerance was not evaluated before recruitment. What the results of this study add: Our results showed that serum betatrophin levels were significantly higher in lean glucose-tolerant PCOS women than in age- and BMI-matched healthy controls. What are the implications of these findings for clinical practice and/or further research: Elevated betatrophin levels in PCOS women, in the absence of obesity and glucose intolerance, may reflect a compensatory mechanism in order to counteract metabolic syndrome-related risk factors.

Adipocyte triglyceride turnover and lipolysis in lean and overweight subjects.

Science.gov (United States)

Rydén, Mikael; Andersson, Daniel P; Bernard, Samuel; Spalding, Kirsty; Arner, Peter

2013-10-01

Human obesity is associated with decreased triglyceride turnover and impaired lipolysis in adipocytes. We determined whether such defects also occur in subjects with only moderate increase in fat mass. Human abdominal subcutaneous adipose tissue was investigated in healthy, nonobese subjects [body mass index (BMI) > 17 kg/m(2) and BMI lean subjects (P = 0.017) with triglyceride T1/2 of 14 and 9 months, respectively (P = 0.04). Triglyceride age correlated positively with BMI (P = 0.002) but not with adipocyte volume (P = 0.2). Noradrenaline-, isoprenaline- or dibutyryl cyclic AMP-induced lipolysis was inversely correlated with triglyceride age (P maintenance of excess body fat.

Whole body dual X-ray absorptiometry for bone mineral density and body composition using a flat panel detector

International Nuclear Information System (INIS)

Dinten, J.M.; Robert-Coutant, C.; Gonon, G.; Bordy, T.

2003-01-01

Whole-body dual-energy X-ray absorptiometry (DXA) systems are used for the determination of bone mineral density (BMD) but also for body composition estimates (lean mass and fat mass). The calculation is based on the difference in attenuation of body tissues for a low-energy of about 50 KeV and a high-energy of about 80-100 KeV. The measurement of dual-energy projections allows first to compute to the body composition in the non-bone area, and then to extrapolate the fat / lean ratio of soft tissue into the bone area in order to compute the BMD. Since detectors have limited area, a whole body examination requires a scan of the patient and a reconstruction process in order to build up a large field image from smaller radiographs. This reconstruction process must keep the quantitative value of the radiographs, and avoid any distortion which could be a consequence of the conic acquisition geometry. The cone angle is low (6 at maximum) and the large overlap between radiographs helps to reconstruct an image equivalent with a parallel-beam geometry. Scatter is corrected from the radiographs before reconstruction, as described in a previous paper ('Dual-energy X-rays absorptiometry using a 2D digital radiography detector. Application to bone densitometry', SPIE Medical Imaging 2001, Medical Physics). We have developed an original reconstruction method dedicated to whole-body examinations which will be described. Thanks to the quasi-radiologic quality of the detector, reconstructed images are of very good quality and this makes the measurement of BMD and fat / lean masses easier. (author)

Chronic exercise preserves lean muscle mass in masters athletes.

Science.gov (United States)

Wroblewski, Andrew P; Amati, Francesca; Smiley, Mark A; Goodpaster, Bret; Wright, Vonda

2011-09-01

Aging is commonly associated with a loss of muscle mass and strength, resulting in falls, functional decline, and the subjective feeling of weakness. Exercise modulates the morbidities of muscle aging. Most studies, however, have examined muscle-loss changes in sedentary aging adults. This leaves the question of whether the changes that are commonly associated with muscle aging reflect the true physiology of muscle aging or whether they reflect disuse atrophy. This study evaluated whether high levels of chronic exercise prevents the loss of lean muscle mass and strength experienced in sedentary aging adults. A cross-section of 40 high-level recreational athletes ("masters athletes") who were aged 40 to 81 years and trained 4 to 5 times per week underwent tests of health/activity, body composition, quadriceps peak torque (PT), and magnetic resonance imaging of bilateral quadriceps. Mid-thigh muscle area, quadriceps area (QA), subcutaneous adipose tissue, and intramuscular adipose tissue were quantified in magnetic resonance imaging using medical image processing, analysis, and visualization software. One-way analysis of variance was used to examine age group differences. Relationships were evaluated using Spearman correlations. Mid-thigh muscle area (P = 0.31) and lean mass (P = 0.15) did not increase with age and were significantly related to retention of mid-thigh muscle area (P lean mass (P = 0.4) and PT. This study contradicts the common observation that muscle mass and strength decline as a function of aging alone. Instead, these declines may signal the effect of chronic disuse rather than muscle aging. Evaluation of masters athletes removes disuse as a confounding variable in the study of lower-extremity function and loss of lean muscle mass. This maintenance of muscle mass and strength may decrease or eliminate the falls, functional decline, and loss of independence that are commonly seen in aging adults.

The maintenance management for lean organization

OpenAIRE

Daniel D. GEORGESCU

2010-01-01

The goal of lean maintenance approach is to maintain organization international competitiveness. In the spirit of continuously improvement, in the paper it is shown how by adjusting some Lean manufacturing specific techniques for Total Productive Maintenance (TPM) system, was born new maintenance system named Lean TPM. This is a systemic approach with three techniques, which don’t exclude specific techniques of TPM pillars, but complete them: the 7Ss as a critical first step in any improvemen...

Apply Lean Thinking in Project Management

OpenAIRE

Pham Ngoc, Lan

2015-01-01

The purpose of this thesis was to study the effects of Lean Thinking in Project Management and how applying Lean Project Management could enhance the productivity of project work. The study was carried using theoretical research and collecting empirical data from three interviews and one case study at a local company. At the end of the study, the major project management problems at the company were identified and analyzed following Lean Principles. It was also pointed out where there...

Effect of whey protein supplementation on body composition changes in women: a systematic review and meta-analysis.

Science.gov (United States)

Bergia, Robert E; Hudson, Joshua L; Campbell, Wayne W

2018-04-23

A preponderance of evidence supports the beneficial effects of whey protein (WP) supplementation on body composition in men; however, there is currently insufficient evidence to make an equivalent claim in women. This systematic review and meta-analysis assessed the effects of WP supplementation with or without energy restriction (ER) and resistance training (RT) on changes in body mass, lean mass, and fat mass in women. Pubmed, Scopus, Cochrane, and CINAHL were searched using the keywords "whey protein," "body composition," and "lean mass." Two researchers independently screened 1845 abstracts and extracted 276 articles. Thirteen randomized controlled trials with 28 groups met the inclusion criteria. Globally, WP supplementation increased lean mass (WMD, 0.37 kg; 95% confidence interval [CI], 0.06 to 0.67) while not influencing changes in fat mass (-0.20 kg; 95%CI, -0.67 to 0.27) relative to non-WP control. The beneficial effect of WP on lean mass was lost when only studies with RT were included in the analysis (n = 7 comparisons; 0.23 kg; 95%CI, -0.17 to 0.63). The beneficial effect of WP on lean mass was more robust when only studies with an ER component were included (n = 6 comparisons; 0.90 kg; 95%CI, 0.31 to 1.49). There was no effect of WP on lean mass in studies without ER (n = 9 comparisons; 0.22 kg; 95%CI, -0.12 to 0.57). Whey protein supplementation improves body composition by modestly increasing lean mass without influencing changes in fat mass. Body composition improvements from WP are more robust when combined with ER .

Association between obesity and reduced body temperature in dogs.

Science.gov (United States)

Piccione, G; Giudice, E; Fazio, F; Refinetti, R

2011-08-01

Industrialized nations are currently experiencing an obesity epidemic, the causes of which are not fully known. One possible mechanism of enhanced energy efficiency that has received almost no attention is a reduction in the metabolic cost of homeothermy, which could be achieved by a modest lowering of body core temperature. We evaluated the potential of this obesity-inducing mechanism in a canine model of the metabolic syndrome. We compared the rectal temperature of lean dogs and obese dogs by (a) conducting cross-sectional measurements in 287 dogs of many breeds varying greatly in body size, (b) conducting longitudinal measurements in individual dogs over 7-10 years and (c) tracking rectal temperature of lean and obese dogs at 3-h intervals for 48 consecutive hours in the laboratory. We found that larger dogs have lower rectal temperatures than smaller dogs and that, for the same body mass, obese dogs have lower rectal temperatures than lean dogs. The results were consistent in the cross-sectional, longitudinal and around-the-clock measurements. These findings document an association between obesity and reduced body temperature in dogs and support the hypothesis that obesity in this and other species of homeotherms may result from an increase in metabolic efficiency achieved by a regulated lowering of body temperature.

Clinically lean; "cutting the crap".

Science.gov (United States)

Caldwell, G

2012-01-01

Proponents of Lean Philosophy believe that successful businesses must reduce waste in working time and resources to a minimum, and maximise their use in productive work. The productive work of the Acute Medical Unit is to provide effective clinical management to a daily cohort of acutely ill patients. Many Clinicians are cynical about Lean. In this article, Dr Caldwell discusses how many clinicians complain of too much crap in the workplace, which gets in the way of swift, safe high quality clinical care. He argues that "Cutting the Crap" in the Acute Medical Unit is entirely consistent with Lean approaches to management of complex systems.

The relationships between Lean manufacturing, management accounting and firm performance

DEFF Research Database (Denmark)

Kristensen, Thomas Borup; Nielsen, Henrik; Grasso, Lawrency

2016-01-01

with management accounting practices. Specifically, we document that Lean manufacturing is positively associated with Value Stream Costing, Lean visual controls and, more importantly, measures of labor and materials efficiency. Lean manufacturing is positively related to Lean thinking and both are positively...... associated with operational performance and so are Lean visual controls. We also document that the management accounting practices intervene affecting operational performance and they intervene with Lean thinking as well. Lastly, the relationship between Lean manufacturing and measures of labor and materials......Lean manufacturing has been adopted by numerous western companies as an answer to an increasing competitive environment. Lean manufacturing is seen as an enterprise-wide strategy encompassing a transformation of manufacturing practices, affecting companies’ management accounting practices and...

The promise of Lean in health care.

Science.gov (United States)

Toussaint, John S; Berry, Leonard L

2013-01-01

An urgent need in American health care is improving quality and efficiency while controlling costs. One promising management approach implemented by some leading health care institutions is Lean, a quality improvement philosophy and set of principles originated by the Toyota Motor Company. Health care cases reveal that Lean is as applicable in complex knowledge work as it is in assembly-line manufacturing. When well executed, Lean transforms how an organization works and creates an insatiable quest for improvement. In this article, we define Lean and present 6 principles that constitute the essential dynamic of Lean management: attitude of continuous improvement, value creation, unity of purpose, respect for front-line workers, visual tracking, and flexible regimentation. Health care case studies illustrate each principle. The goal of this article is to provide a template for health care leaders to use in considering the implementation of the Lean management system or in assessing the current state of implementation in their organizations. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Lean sigma--will it work for healthcare?

Science.gov (United States)

Bahensky, James A; Roe, Janet; Bolton, Romy

2005-01-01

The manufacturing industry has been using Lean Sigma for years in pursuit of continuous improvement to obtain a competitive advantage. The objectives of these efforts are to use the Lean techniques for reducing cycle times and the Six Sigma concepts for reducing product defects. The Iowa Business Council with several advocates worked with the University of Iowa Hospital and Clinics (UIHC) and two other Iowa hospitals to determine whether Lean Sigma is adaptable in healthcare. A team of 15 people at UIHC used the Kaizen Breakthrough Methodology over a five-day period in an aggressive identification and elimination of non-value added activities in Radiology CT scanning. The results exceeded the initial project objectives and indicated that Lean Sigma is applicable in healthcare. Overall, the Lean Sigma project increased revenue by approximately $750,000 per year. The Kaizen process proved to be successful and interesting. Within three days, the team installed new work flow processes. This implementation-oriented approach is what differentiates Lean Sigma from other quality improvement processes.

Increased rate of osteoporosis, low lean mass, and fragility fractures in COPD patients: association with disease severity.

Science.gov (United States)

Graumam, R Q; Pinheiro, M M; Nery, L E; Castro, C H M

2018-03-21

A very high rate of osteoporosis, fractures, and low lean mass was observed in patients with chronic obstructive pulmonary disease (COPD). Disease severity was associated with bone and muscle adverse outcomes, while age ≥ 63.5 years old, low lean mass, higher iPTH, and a T-score below - 2.5 were all associated with higher risk of fracture. Osteoporosis is frequently neglected in patients with COPD. We aimed at evaluating the rate of osteoporosis, fractures, and low lean mass in patients with COPD. Ninety-nine patients with COPD (53 women, 64.5 ± 9.6 years old, and 46 men, 65.9 ± 8.0 years old) underwent bone densitometry (DXA) with body composition analyses. Healthy individuals (N = 57) not exposed to tobacco matched by sex, age, and body mass index (BMI) were used as controls. Spirometry, routine laboratory workout, and conventional thoracolumbar radiography surveying for vertebral deformities were performed in all patients. Osteoporosis was found in 40.4% of the COPD patients against only 13.0% of the healthy controls (p = 0.001). Vertebral fractures were seen in 24.4% of the men and 22.0% of the women with COPD. Disease severity (GOLD 3 and 4) was significantly associated with higher risk of vitamin D deficiency (p = 0.032), lower BMD (both men and women at all sites), higher frequency of osteoporosis (in women at all sites), lower skeletal mass index, and higher rate of low lean mass (in both men and women) than healthy controls and COPD patients with milder disease (GOLD 1 and 2). Age was a main predictor of vertebral fractures (OR = 1.164 (1.078-9.297); p lean mass were associated with FEV 1% lean mass, high iPTH, and low bone mass were all significantly associated with fractures in COPD patients.

Can lean save lives?

Science.gov (United States)

Fillingham, David

2007-01-01

The purpose of this paper is to show how over the last 18 months Bolton Hospitals NHS Trust have been exploring whether or not lean methodologies, often known as the Toyota Production System, can indeed be applied to healthcare. This paper is a viewpoint. One's early experience is that lean really can save lives. The Toyota Production System is an amazingly successful way of manufacturing cars. It cannot be simply translated unthinkingly into a hospital but lessons can be learned from it and the method can be adapted and developed so that it becomes owned by healthcare staff and focused towards the goal of improved patient care. Working in healthcare is a stressful and difficult thing. Everyone needs a touch of inspiration and encouragement. Applying lean to healthcare in Bolton seems to be achieving just that for those who work there.

A Model to align the organizational culture to Lean

Directory of Open Access Journals (Sweden)

Mehrsa Taherimashhadi

2018-04-01

Full Text Available Purpose: Since the emergence of Lean Manufacturing many organizations strived to implement it. Nonetheless, sustainable Lean transformation is not as easy as to be simply achieved. Several aspects need to be taken into account before Lean implementation which national and organizational culture are important. By considering influences of national culture on the organizational culture, this paper aims at proposing an evaluation model to determine the cultural weaknesses of an organization and give some recommendations to manage people before implementing Lean. Design/methodology/approach: This research has been conducted based on literature review survey and semi-structured interviews. Research papers, conference proceedings, books, and official websites regarding Lean philosophy were reviewed to find the influence of national culture in Lean implementation. Different databases were scrutinized, from 2015 to 2017, containing Scopus and Web of Science with the time period of 1996-2016. A set of key terms and their combinations were used including: Toyota Production system, Lean production, Lean manufacturing, Lean management, Transformation, Implementation, Barriers/ Impediments/Challenges/Difficulties, Human resources, Success factors, Organizational culture, and National culture. Findings: The proposed evaluation model is a guide for organizations to determine cultural misalignments between the corporate culture and the Lean culture before its implementation and gives some managerial recommendations to correct them. Originality/value: This study is the first attempt to integrate the national models   with Lean culture to provide an evaluation model and some recommendations to help the organization to align its culture to Lean culture before its implementation.

Når lean organiserer på hospitalet

DEFF Research Database (Denmark)

Hauge, Amalie Martinus

Lean er kendt og anvendt af mange offentlige organisationer i Danmark. Selv om Leans anvendelighed de fleste steder er slået fast, bliver Lean imidlertid ved med at udfordre og skabe konflikt. Hvorfor det? Dette spørgsmål – og mange andre – bliver belyst i denne rapport, som er baseret på en Ph...

Lean Accounting - An Ingenious Solution for Cost Optimization

OpenAIRE

Dimi Ofileanu; Dan Ioan Topor

2014-01-01

The aim of this work is to present a new concept in accounting management: Lean Accounting. This work explains the way the lean concept was born; its benefits for the production system of the factories and the necessity of applying lean accounting in the factories which have implemented lean production, taking into account both its advantages and the boundaries of the other cost management methods in those factories.

Implementing lean manufacturing system: ISM approach

Directory of Open Access Journals (Sweden)

Naveen Kumar

2013-09-01

Full Text Available Purpose: Lean Manufacturing System has emerged as an important area of research in Indian context. The requirement of Lean Manufacturing has increased due to defects in products (semi finished and finished and subsequent increase in cost. In this context, this study is an attempt to develop a structural model of the variables, important to implement Lean Manufacturing System in Indian automobile industry. Design/Methodology/Approach: Various variables of lean manufacturing system implementation have been identified from literature review and experts’ opinions. Contextual relationship among these identified variables has been set after carrying out brainstorming session. Further, classification of the variables has been carried out based upon the driving power and dependence. In addition to this, a structural model of variables to implement lean concept in Indian automobile industry has also been developed using Interpretive Structural Modeling (ISM technique. Questionnaire based survey has also been conducted to rank these variables. Findings: Eighteen variables have been identified from the literature and subsequent discussions with experts. Out of which, nine variables have been identified as dependent and nine variables have been identified as driver. No variable has been identified as linkage variable and autonomous variable. From the model developed, ‘Relative cost benefits’ has been identified as top level dependent variable and top management commitment as bottom level most independent variable. Research limitations/Implications: The model so developed is a hypothetical model based upon experts’ opinions. The conclusions so drawn may be further modified to apply in real situation. Practical implication: Clear understanding of interactions among these variables will help organizations to prioritize and manage these variables more effectively and efficiently to draw advantage from lean manufacturing system implementation

Lean management in academic surgery.

Science.gov (United States)

Collar, Ryan M; Shuman, Andrew G; Feiner, Sandra; McGonegal, Amy K; Heidel, Natalie; Duck, Mary; McLean, Scott A; Billi, John E; Healy, David W; Bradford, Carol R

2012-06-01

Lean is a management system designed to enhance productivity by eliminating waste. Surgical practice offers many opportunities for improving efficiency. Our objective was to determine whether systematic implementation of lean thinking in an academic otolaryngology operating room improves efficiency and profitability and preserves team morale and educational opportunities. In an 18-month prospective quasi-experimental study, a multidisciplinary task force systematically implemented lean thinking within an otolaryngology operating room of an academic health system. Operating room turnover time and turnaround time were measured during a baseline period; an observer-effect period in which workers were made aware that their efficiency was being measured but before implementing lean changes; and an intervention period after redesign principles had been used. The impact on teamwork, morale, and surgical resident education were measured during the baseline and intervention periods through validated surveys. A profit model was applied to estimate the financial implications of the study. There was no difference between the baseline and observer-effect periods of the study for turnover time (p = 0.98) or turnaround time (p = 0.20). During the intervention period, the mean turnover time and turnaround time were significantly shorter than during the baseline period (29 vs 38 minutes; p improved morale after implementation (p = 0.011). Educational metrics were unchanged before and after implementation. The annual opportunity revenue for the involved operating room is $330,000; when extrapolated throughout the operating rooms, lean thinking could create 6,500 hours of capacity annually. Application of lean management techniques to a single operating room and surgical service improved operating room efficiency and morale, sustained resident education, and can provide considerable financial gains when scaled to an entire academic surgical suite. Copyright © 2012. Published by

Convergence in insulin resistance between very severely obese and lean women at the end of pregnancy.

Science.gov (United States)

Forbes, Shareen; Barr, Sarah M; Reynolds, Rebecca M; Semple, Scott; Gray, Calum; Andrew, Ruth; Denison, Fiona C; Walker, Brian R; Norman, Jane E

2015-11-01

Disrupted intermediary metabolism may contribute to the adverse pregnancy outcomes in women with very severe obesity. Our aim was to study metabolism in such pregnancies. We recruited a longitudinal cohort of very severely obese (n = 190) and lean (n = 118) glucose-tolerant women for anthropometric and metabolic measurements at early, mid and late gestation and postpartum. In case-control studies of very severely obese and lean women we measured glucose and glycerol turnover during low- and high-dose hyperinsulinaemic-euglycaemic clamps (HEC) at early and late pregnancy and in non-pregnant women (each n = 6-9) and body fat distribution by MRI in late pregnancy (n = 10/group). Although greater glucose, insulin, NEFA and insulin resistance (HOMA-IR), and greater weight and % fat mass (FM) was observed in very severely obese vs lean participants, the degree of worsening was attenuated in the very severely obese individuals with advancing gestation, with no difference in triacylglycerol (TG) concentrations between very severely obese and lean women at term. Enhanced glycerol production was observed in early pregnancy only in very severely obese individuals, with similar intrahepatic FM in very severely obese vs lean women by late gestation. Offspring from obese mothers were heavier (p = 0.04). Pregnancies complicated by obesity demonstrate attenuation in weight gain and insulin resistance compared with pregnancies in lean women. Increased glycerol production is confined to obese women in early pregnancy and obese and lean individuals have similar intrahepatic FM by term. When targeting maternal metabolism to treat adverse pregnancy outcomes, therapeutic intervention may be most effective applied early in pregnancy.

Association of fat to lean mass ratio with metabolic dysfunction in women with polycystic ovary syndrome.

Science.gov (United States)

Ezeh, Uche; Pall, Marita; Mathur, Ruchi; Azziz, Ricardo

2014-07-01

Are differences in metabolic dysfunction between polycystic ovary syndrome (PCOS) and control women related to differences in their fat to lean mass (F/L) ratio? Compared with controls of similar body mass index (BMI), women with PCOS demonstrate adverse body composition characterized by increased whole body fat relative to lean mass (i.e. a higher F/L ratio), which is associated with differences in metabolic dysfunction between the two groups. Previous studies examining body composition and insulin resistance (IR) in PCOS have yielded conflicting results. Excess total fat mass (i.e. fat mass index [fat BMI]) correlates with IR, whereas increased total lean mass (i.e. lean BMI) has been associated with higher insulin sensitivity. However, the role of the F/L ratio, which integrates the antagonistic effects of both fat and lean mass depots, on IR in PCOS, has not been investigated. We conducted a prospective cross-sectional study of 120 women between the ages of 22-44 years to study the relation of the F/L ratio with measures of insulin action and secretion in both steady and dynamic states. Sixty PCOS (by NIH, 1990 criteria) and 60 control (age, race and BMI-matched) women were prospectively studied for body composition (by bioelectrical impedance analysis [BIA]) and basal IR and insulin secretion by the homeostasis model assessment (HOMA-IR and HOMA-%β-cell function, respectively) in a tertiary care academic referral center. A subset of 12 PCOS and 12 matched control women also underwent a modified frequently sampled intravenous glucose tolerance test (FSIVGTT) to determine glucose uptake and insulin secretion in dynamic state. Our results indicate that women with PCOS demonstrated greater degrees of hyperandrogenism, and higher waist-to-hip ratio (WHR), %body fat, fat BMI, F/L, fasting insulin levels, and HOMA-IR and HOMA-%β-cell values, than controls. In models adjusted for WHR and free testosterone and diagnostic groups, fasting insulin levels, HOMA-IR, and

Indførelse af Lean principper

DEFF Research Database (Denmark)

Balmer, Christian; Michelsen, Aage U

2004-01-01

I artiklen beskrives, hvorledes lean-principper er indført i en forsikringsvirksomhed samt de opnåede resultater.......I artiklen beskrives, hvorledes lean-principper er indført i en forsikringsvirksomhed samt de opnåede resultater....

LEAN PRACTICES FOR PRODUCT DEVELOPMENT PROCESS

Directory of Open Access Journals (Sweden)

Guilherme Luz Tortorella

2015-06-01

Full Text Available Lean product development (LPD is an approach that comprises lean principles and management practices that aim to reduce waste and improve operational effectiveness throughout the entire value stream in continuous improvement endless journey. Due to that, the ability to innovate, change and learn continuously is a key element in order to minimize product development problems. Several LPD techniques are presented in the literature as possible enablers for lean implementation. However, little has been known about the impact of these enablers on the problems related to product development processes. Thus, this paper aims to examine the relationship between five LPD practices’ constructs and the occurrence frequency of eleven LPD problems’ constructs in companies that are implementing lean. Moreover, the identification of relevant relationships between LPD practices’ and problems’ constructs may contribute to specify the contexts in which problems are expected to occur. The study sample comprises sixty four companies already undergoing lean implementation both in shop floor and offices area. The results indicate that the same practices’ constructs, which are deemed as influential for minimizing LPD problems, present different relationship intensities among them.

Why Lean doesn't work for everyone.

Science.gov (United States)

Kaplan, Gary S; Patterson, Sarah H; Ching, Joan M; Blackmore, C Craig

2014-12-01

Popularisation of Lean in healthcare has led to emphasis on Lean quality improvement tools in isolation, with inconsistent results. We argue that delivery of safer, more efficient, and higher quality-patient focused care requires organisational transformation of which the Lean toolkit is only one component. To successfully facilitate system transformation toward higher quality care at lower cost, Lean tools must be part of a comprehensive management system, within a supportive institutional culture, and with committed leadership. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

High-order conservative discretizations for some cases of the rigid body motion

International Nuclear Information System (INIS)

Kozlov, Roman

2008-01-01

Modified vector fields can be used to construct high-order structure-preserving numerical integrators for ordinary differential equations. In the present Letter we consider high-order integrators based on the implicit midpoint rule, which conserve quadratic first integrals. It is shown that these integrators are particularly suitable for the rigid body motion with an additional quadratic first integral. In this case high-order integrators preserve all four first integrals of motion. The approach is illustrated on the Lagrange top (a rotationally symmetric rigid body with a fixed point on the symmetry axis). The equations of motion are considered in the space fixed frame because in this frame Lagrange top admits a neat description. The Lagrange top motion includes the spherical pendulum and the planar pendulum, which swings in a vertical plane, as particular cases

Application of lean manufacturing techniques in the Emergency Department.

Science.gov (United States)

Dickson, Eric W; Singh, Sabi; Cheung, Dickson S; Wyatt, Christopher C; Nugent, Andrew S

2009-08-01

"Lean" is a set of principles and techniques that drive organizations to continually add value to the product they deliver by enhancing process steps that are necessary, relevant, and valuable while eliminating those that fail to add value. Lean has been used in manufacturing for decades and has been associated with enhanced product quality and overall corporate success. To evaluate whether the adoption of Lean principles by an Emergency Department (ED) improves the value of emergency care delivered. Beginning in December 2005, we implemented a variety of Lean techniques in an effort to enhance patient and staff satisfaction. The implementation followed a six-step process of Lean education, ED observation, patient flow analysis, process redesign, new process testing, and full implementation. Process redesign focused on generating improvement ideas from frontline workers across all departmental units. Value-based and operational outcome measures, including patient satisfaction, expense per patient, ED length of stay (LOS), and patient volume were compared for calendar year 2005 (pre-Lean) and periodically after 2006 (post-Lean). Patient visits increased by 9.23% in 2006. Despite this increase, LOS decreased slightly and patient satisfaction increased significantly without raising the inflation adjusted cost per patient. Lean improved the value of the care we delivered to our patients. Generating and instituting ideas from our frontline providers have been the key to the success of our Lean program. Although Lean represents a fundamental change in the way we think of delivering care, the specific process changes we employed tended to be simple, small procedure modifications specific to our unique people, process, and place. We, therefore, believe that institutions or departments aspiring to adopt Lean should focus on the core principles of Lean rather than on emulating specific process changes made at other institutions.

Leveraging lean in the office: Lean office needs a novel and differentiated approach

OpenAIRE

Rüttimann, Bruno G.; Fischer, Urs P.; Stöckli, Martin T.

2014-01-01

Lean Six Sigma tools have been increasingly employed also in the service industry, however with different success as field studies have shown. The reason not only has to be attributed to a poor Change Management, but can also be attributed to the intrinsic characteristics of the Lean techniques, which have been tailored to sustain a stable customer-takted pull-manufacturing principle. An office workplace shows significant differences to a procedural shop floor environment, as it comprises bot...

Reducing waste in administrative services with lean principles

NARCIS (Netherlands)

Wijnhoven, Alphonsus B.J.M.; Beckers, David; Amrit, Chintan Amrit

2016-01-01

In the last few decades, lean techniques have been developed for removing with waste in manufacturing. More recently, lean is used outside the manufacturing context as well. This article focuses on using lean thinking for reducing waste in administrative services, i.e., business services with

Faecal microbiota in lean and obese dogs.

Science.gov (United States)

Handl, Stefanie; German, Alexander J; Holden, Shelley L; Dowd, Scot E; Steiner, Jörg M; Heilmann, Romy M; Grant, Ryan W; Swanson, Kelly S; Suchodolski, Jan S

2013-05-01

Previous work has shown obesity to be associated with changes in intestinal microbiota. While obesity is common in dogs, limited information is available about the role of the intestinal microbiota. The aim of this study was to investigate whether alterations in the intestinal microbiota may be associated with canine obesity. Using 16S rRNA gene pyrosequencing and quantitative real-time PCR, we evaluated the composition of the faecal microbiota in 22 lean and 21 obese pet dogs, as well as in five research dogs fed ad libitum and four research dogs serving as lean controls. Firmicutes, Fusobacteria and Actinobacteria were the predominant bacterial phyla. The phylum Actinobacteria and the genus Roseburia were significantly more abundant in the obese pet dogs. The order Clostridiales significantly increased under ad libitum feeding in the research dogs. Canine intestinal microbiota is highly diverse and shows considerable interindividual variation. In the pet dogs, influence on the intestinal microbiota besides body condition, like age, breed, diet or lifestyle, might have masked the effect of obesity. The study population of research dogs was small, and further work is required before the role of the intestinal microbiota in canine obesity is clarified. © 2013 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

Genetic variation in efficiency to deposit fat and lean meat in Norwegian Landrace and Duroc pigs.

Science.gov (United States)

Martinsen, K H; Ødegård, J; Olsen, D; Meuwissen, T H E

2015-08-01

Feed costs amount to approximately 70% of the total costs in pork production, and feed efficiency is, therefore, an important trait for improving pork production efficiency. Production efficiency is generally improved by selection for high lean growth rate, reduced backfat, and low feed intake. These traits have given an effective slaughter pig but may cause problems in piglet production due to sows with limited body reserves. The aim of the present study was to develop a measure for feed efficiency that expressed the feed requirements per 1 kg deposited lean meat and fat, which is not improved by depositing less fat. Norwegian Landrace ( = 8,161) and Duroc ( = 7,202) boars from Topigs Norsvin's testing station were computed tomography scanned to determine their deposition of lean meat and fat. The trait was analyzed in a univariate animal model, where total feed intake in the test period was the dependent variable and fat and lean meat were included as random regression cofactors. These cofactors were measures for fat and lean meat efficiencies of individual boars. Estimation of fraction of total genetic variance due to lean meat or fat efficiency was calculated by the ratio between the genetic variance of the random regression cofactor and the total genetic variance in total feed intake during the test period. Genetic variance components suggested there was significant genetic variance among Norwegian Landrace and Duroc boars in efficiency for deposition of lean meat (0.23 ± 0.04 and 0.38 ± 0.06) and fat (0.26 ± 0.03 and 0.17 ± 0.03) during the test period. The fraction of the total genetic variance in feed intake explained by lean meat deposition was 12% for Norwegian Landrace and 15% for Duroc. Genetic fractions explained by fat deposition were 20% for Norwegian Landrace and 10% for Duroc. The results suggested a significant part of the total genetic variance in feed intake in the test period was explained by fat and lean meat efficiency. These new

Lean accounting – as a future accounting system

Directory of Open Access Journals (Sweden)

M.V. Koryagin

2017-12-01

Full Text Available The historical development of lean accounting is researched. The comparison of lean accounting and accounting is carried out. The article determines the lean accounting basic principles, which are the basis for the selection of main ten steps of upgrading to the system of lean accounting: the evaluation of the current situation and the expected development prospects of the enterprise; the development of the principles of implementing lean accounting; the determining the production parameters and methodology of the economic model construction; the organization of lean manufacturing environment and reducing most of the stock; the determining the flow of value creation; the rejection of variable accounting and reverse cancellation of all labor costs and the cost of materials; the rejection of tracking stocks and assign of the costs directly to the costs of sales when occurred; the definition of client-targeted spending; the relationship with suppliers and automation of the accounts payable; the relationship with customers and automation of the payments received.

Quality improvement in basic histotechnology: the lean approach.

Science.gov (United States)

Clark, David

2016-01-01

Lean is a comprehensive system of management based on the Toyota production system (TPS), encompassing all the activities of an organization. It focuses management activity on creating value for the end-user by continuously improving operational effectiveness and removing waste. Lean management creates a culture of continuous quality improvement with a strong emphasis on developing the problem-solving capability of staff using the scientific method (Deming's Plan, Do, Check, Act cycle). Lean management systems have been adopted by a number of histopathology departments throughout the world to simultaneously improve quality (reducing errors and shortening turnround times) and lower costs (by increasing efficiency). This article describes the key concepts that make up a lean management system, and how these concepts have been adapted from manufacturing industry and applied to histopathology using a case study of lean implementation and evidence from the literature. It discusses the benefits, limitations, and pitfalls encountered when implementing lean management systems.

Novel equations to estimate lean body mass in maintenance hemodialysis patients.

Science.gov (United States)

Noori, Nazanin; Kovesdy, Csaba P; Bross, Rachelle; Lee, Martin; Oreopoulos, Antigone; Benner, Deborah; Mehrotra, Rajnish; Kopple, Joel D; Kalantar-Zadeh, Kamyar

2011-01-01

Lean body mass (LBM) is an important nutritional measure representing muscle mass and somatic protein in hemodialysis patients, for whom we developed and tested equations to estimate LBM. A study of diagnostic test accuracy. The development cohort included 118 hemodialysis patients with LBM measured using dual-energy x-ray absorptiometry (DEXA) and near-infrared (NIR) interactance. The validation cohort included 612 additional hemodialysis patients with LBM measured using a portable NIR interactance technique during hemodialysis. 3-month averaged serum concentrations of creatinine, albumin, and prealbumin; normalized protein nitrogen appearance; midarm muscle circumference (MAMC); handgrip strength; and subjective global assessment of nutrition. LBM measured using DEXA in the development cohort and NIR interactance in validation cohorts. In the development cohort, DEXA and NIR interactance correlated strongly (r = 0.94, P < 0.001). DEXA-measured LBM correlated with serum creatinine level, MAMC, and handgrip strength, but not with other nutritional markers. Three regression equations to estimate DEXA-measured LBM were developed based on each of these 3 surrogates and sex, height, weight, and age (and urea reduction ratio for the serum creatinine regression). In the validation cohort, the validity of the equations was tested against the NIR interactance-measured LBM. The equation estimates correlated well with NIR interactance-measured LBM (R² ≥ 0.88), although in higher LBM ranges, they tended to underestimate it. Median (95% confidence interval) differences and interquartile range for differences between equation estimates and NIR interactance-measured LBM were 3.4 (-3.2 to 12.0) and 3.0 (1.1-5.1) kg for serum creatinine and 4.0 (-2.6 to 13.6) and 3.7 (1.3-6.0) kg for MAMC, respectively. DEXA measurements were obtained on a nondialysis day, whereas NIR interactance was performed during hemodialysis treatment, with the likelihood of confounding by volume status

LEAN Tools in the IT Sector

Directory of Open Access Journals (Sweden)

Zoltan VAJNA

2015-05-01

Full Text Available Nowadays the LEAN tools with their proven efficiency are indispensable parts of the production management. I think there is no producing enterprise that cannot utilize a wide variety of these LEAN tools. The question now is how these tools can support companies in increasing the efficiency of their supporting IT processes. In this study I will demonstrate how these well-known LEAN tools from production management can be used in IT management to create more cost-effective, efficient and transparent solutions during the IT system development and IT operation activities. I will show respectively without attempting to be comprehensive the most important tools of the LEAN management and I will analyse how these tools can be used in the IT sector. At the end of this study I will demonstrate what the IT managers think about the practical use of these tools.

Lean in service industries: A literature review

Science.gov (United States)

V, Vignesh; Suresh, M.; Aramvalarthan, S.

2016-09-01

Lean service is an amalgamation of tools and practices which, if applied appropriately, would definitely improve the existing quality of operations and ensure the generation of a large amount of favourable financial and economic outcomes and improve the behaviour of the workforce. As a result, it assumes of great significance in the fiercely competitive modern world. This article presents a comprehensive bibliographic study about the various lean service practices through a variety of approaches like service improvement, manufacturing, supply chain, market and retailing approaches, etc. Thus it gives a clear view on how the lean services are implemented in various sectors and the contribution of lean service towards improving the quality in the services provided while reducing the costs.

Getting 'Lean': hardwiring process excellence into Northeast Health.

Science.gov (United States)

Brown, Tricia; Duthe, Robert

2009-01-01

Many healthcare organizations are turning to the "Lean" Toyota Production System as a means to hardwire process excellence into their organizations. Northeast Health, an integrated delivery system in New York's capital region, introduced the Lean concept into its culture in 2004. After four years, the organization is beginning to see its staff hardwire Lean thinking into day-to-day behaviors. This paper focuses on the approach used by Northeast Health to introduce Lean concepts into its culture, challenges faced, lessons learned and the factors critical to success.

The metabolic clearance rate of corticosterone in lean and obese male Zucker rats

International Nuclear Information System (INIS)

White, B.D.; Corll, C.B.; Porter, J.R.

1989-01-01

The obese Zucker rat is an animal model of human juvenile-onset obesity. These rats exhibit numerous endocrine and metabolic abnormalities. Adrenalectomy of obese rats has been shown to reduce or reverse several of these abnormalities, thereby implying that corticosterone may contribute to the expression of obesity in this animal. Furthermore, it has been shown that the circadian rhythm of plasma corticosterone is disturbed in obese Zucker rats resulting in elevated morning plasma corticosterone concentrations in obese rats as compared to lean rats. In a effort to better elucidate the mechanism of the elevated morning levels of plasma corticosterone, the metabolic clearance rate of corticosterone was determined in the morning for lean and obese male Zucker rats (12 to 20 weeks). Additionally, the biliary and urinary excretion of labeled corticosterone and/or its metabolites were determined. The metabolic clearance rate of corticosterone was significantly greater in obese rats than in their lean counterparts. Both the metabolic clearance rate and the volume of compartments significantly correlated with body weight. No correlation was found between body weight and the elimination rate constant. The increased metabolic clearance rate of obese rats appeared to be due to an increase in the physiologic distribution of corticosterone and not to an alteration in the enzymes responsible for corticosterone metabolism. It appears that the metabolic clearance rate of corticosterone in obese Zucker rats does not contribute to elevated morning concentrations of plasma corticosterone previously observed in these animals. It suggests that the adrenal corticosterone secretion rate must actually be greater than one would expect from the plasma corticosterone concentrations alone

Dietary B vitamin needs of strains of pigs with high and moderate lean growth.

Science.gov (United States)

Stahly, T S; Williams, N H; Lutz, T R; Ewan, R C; Swenson, S G

2007-01-01

Ten sets of 5 littermate pigs from each of 2 genetic strains were utilized to determine the impact of the dietary concentration of 5 B vitamins (riboflavin, niacin, pantothenic acid, cobalamin, and folacin) on growth from 9 to 28 kg of BW in pigs with high or moderate capacity for lean growth. All pigs (penned individually) were reared via a segregated, early weaning scheme, so that the lean growth potential of each strain could be expressed. The basal diet provided the 5 test vitamins at concentrations of total and estimated bioavailability equivalent to a minimum of 100 and 70%, respectively, of their estimated requirements (NRC, 1998) for 5- to 10-kg pigs. At a BW of 9 +/- 0.9 kg, pigs within each litter were allotted to the basal diet supplemented with sources of the 5 test vitamins equivalent to an additional 0, 100, 200, 300, or 400% (bioavailable) of the NRC requirements. Pigs from the high lean strain consumed less feed (P vitamin concentrations were increased. However, the dietary B vitamin concentrations needed to optimize G:F were greater (P 470% of NRC, 1998) vs. moderate (270%) lean strain. Based on these data, the dietary needs for 1 or more of the 5 B vitamins are greater than current NRC (1998) estimates, particularly in pigs expressing a high rate of lean tissue growth. The greater need for these vitamins is not associated with greater dietary energy intake or body energy accretion rate but is potentially due to shifts in the predominant metabolic pathways.

In healthy elderly postmenopausal women variations in BMD and BMC at various skeletal sites are associated with differences in weight and lean body mass rather than by variations in habitual physical activity, strength or VO2max.

Science.gov (United States)

Schöffl, I; Kemmler, W; Kladny, B; Vonstengel, S; Kalender, W A; Engelke, K

2008-01-01

The objective of this study was an integrated cross-sectional investigation for answering the question whether differences in bone mineral density in elderly postmenopausal women are associated with differences in habitual physical activity and unspecific exercise levels. Two hundred and ninety nine elderly women (69-/+3 years), without diseases or medication affecting bone metabolism were investigated. The influence of weight, body composition and physical activity on BMD was measured at multiple sites using different techniques (DXA, QCT, and QUS). Physical activity and exercise level were assessed by questionnaire, maximum strength of the legs and aerobic capacity. Variations in physical activity or habitual exercise had no effect on bone. The only significant univariate relation between strength/VO(2)max and BMD/BMC that remained after adjusting for confounding variables was between arm BMD (DXA) and hand-grip strength. The most important variable for explaining BMD was weight and for cortical BMC of the femur (QCT) lean body mass. Weight and lean body mass emerge as predominant predictors of BMD in normal elderly women, whereas the isolated effect of habitual physical activity, unspecific exercise participation, and muscle strength on bone parameters is negligible. Thus, an increase in the amount of habitual physical activity will probably have no beneficial impact on bone.

Lean body mass as an independent determinant of dose-limiting toxicity and neuropathy in patients with colon cancer treated with FOLFOX regimens

International Nuclear Information System (INIS)

Ali, Raafi; Sawyer, Michael B.; Bianchi, Laurent; Roberts, Sarah; Mollevi, Caroline; Senesse, Pierre; Baracos, Vickie E.; Assenat, Eric

2016-01-01

Evidence suggests that lean body mass (LBM) may be useful to normalize chemotherapy doses. Data from one prospective and one retrospective study were used to determine if the highest doses of oxaliplatin/kg LBM within FOLFOX regimens would be associated with dose-limiting toxicity (DLT) in colon cancer patients. Toxicity over four cycles was graded according to NCI Common Toxicity Criteria V2 or V3 (Common Terminology Criteria for Adverse Events, National Cancer Institute, Bethesda, MD). Muscle tissue was measured by computerized tomography (CT) and used to evaluate the LBM compartment of the whole body. In prospective randomized clinical trials conducted in France (n = 58), for patients given FOLFOX-based regimens according to body surface area, values of oxaliplatin/kg LBM were highly variable, ranging from 2.55 to 6.6 mg/kg LBM. A cut point of 3.09 mg oxaliplatin/kg LBM for developing toxicity was determined by Receiver Operating Characteristic (ROC) analysis, below this value 0/17 (0.0%) of patients experienced DLT; in contrast above this value 18/41 (44.0%) of patients were dose reduced or had treatment terminated owing to toxicity (≥Grade 3 or neuropathy ≥Grade 2); for 9/41 the DLT was sensory neuropathy. These findings were validated in an independent cohort of colon cancer patients (n = 80) receiving FOLFOX regimens as part of standard care, in Canada. Low LBM is a significant predictor of toxicity and neuropathy in patients administered FOLFOX-based regimens using conventional body surface area (BSA) dosing

De praktijk van Lean Six Sigma

NARCIS (Netherlands)

Does, R.J.M.M.; de Koning, H.

2008-01-01

Zowel Lean als Six Sigma zijn benaderingen van kwaliteits- en efficiëntieverbetering die op dit moment sterk in de belangstelling staan van zowel de industrie als de dienstverlening. Lean Six Sigma integreert beide benaderingen. Ze wordt door sommigen gezien als panacee voor alle mogelijke

Just-in-Time og Lean Manufacturing

DEFF Research Database (Denmark)

Michelsen, Aage U.

2004-01-01

Filosofi, principper og teknikker i JIT. Princip i Kanban-styring og dimensionering af et Kanban-system. Lean Thinking og Value Stream Mapping.......Filosofi, principper og teknikker i JIT. Princip i Kanban-styring og dimensionering af et Kanban-system. Lean Thinking og Value Stream Mapping....

Lean Six Sigma in a hospital

NARCIS (Netherlands)

van den Heuvel, J.; Does, R.J.M.M.; de Koning, H.

2006-01-01

Abstract Hospitals today face major challenges. Patients demand quality of care to be improved continuously. Health insurance companies demand the lowest possible prices. Lean Six Sigma is a program that can help healthcare providers to achieve these (seemingly) conflicting goals. Lean Six Sigma is

Dual energy X-Ray absorptiometry body composition reference values from NHANES.

Directory of Open Access Journals (Sweden)

Thomas L Kelly

Full Text Available In 2008 the National Center for Health Statistics released a dual energy x-ray absorptiometry (DXA whole body dataset from the NHANES population-based sample acquired with modern fan beam scanners in 15 counties across the United States from 1999 through 2004. The NHANES dataset was partitioned by gender and ethnicity and DXA whole body measures of %fat, fat mass/height(2, lean mass/height(2, appendicular lean mass/height(2, %fat trunk/%fat legs ratio, trunk/limb fat mass ratio of fat, bone mineral content (BMC and bone mineral density (BMD were analyzed to provide reference values for subjects 8 to 85 years old. DXA reference values for adults were normalized to age; reference values for children included total and sub-total whole body results and were normalized to age, height, or lean mass. We developed an obesity classification scheme by using estabbody mass index (BMI classification thresholds and prevalences in young adults to generate matching classification thresholds for Fat Mass Index (FMI; fat mass/height(2. These reference values should be helpful in the evaluation of a variety of adult and childhood abnormalities involving fat, lean, and bone, for establishing entry criteria into clinical trials, and for other medical, research, and epidemiological uses.

Using lean methodologies for economically and environmentally sustainable foundries

Directory of Open Access Journals (Sweden)

R. M. Torielli

2011-02-01

Full Text Available Lean manufacturing is often seen as a set of tools that reduce the total cost and improve the quality of manufactured products. The lean management philosophy is one which targets waste reduction in every facet of the manufacturing business; however, only recently have studies linked lean management philosophies with improving environmental sustainability. These studies suggest that lean manufacturing is more than a set of lean tools that can optimize manufacturing efficiencies; it is a process and mindset that needs to be integrated into daily manufacturing systems to achieve sustainability. The foundry industry, as well as manufacturing in general, has significant challenges in the current regulatory and political climate with developing an economically and environmentally sustainable business model. Lean manufacturing has proven itself as a model for both economic sustainability and environmental stewardship. Several recent studies have shown that both lean and green techniques and “zero-waste” policies also lead to reductions in overall cost. While these strategies have been examined for general manufacturing, they have not been investigated in detail for the foundry industry. This paper will review the current literature and describe how lean and green can provide a relevant framework for environmentally and economically sustainable foundries. Examples of lean and green technologies and techniques which can be applied to foundries in a global context will be described.

[Body composition and metabolic risk in small for gestational age children treated with growth hormone].

Science.gov (United States)

Aurensanz Clemente, Esther; Samper Villagrasa, Pilar; Ayerza Casas, Ariadna; Ruiz Frontera, Pablo; Moreno Aznar, Luis Alberto; Bueno Lozano, Gloria

2016-09-16

Small for gestational age (SGA) children are at increased risk of metabolic syndrome. Our objective is to evaluate changes in body composition produced by growth hormone (GH) treatment. A group of 28 SGA children without catch-up growth and undergoing treatment with GH was selected for evaluation. Over the course of 3 years from the beginning of the treatment with GH, the children's body composition variables (bone mineral density [BMD], fat and lean body mass proportion) were evaluated annually with dual-energy X-ray absorptiometry. A study of correlation between metabolic and body composition variables was also made. Treatment with GH produces a reduction in fat mass proportion in relation to lean body mass, decreasing from 25.94±6.09 to 22.88±5.38% (P=.034). In the abdominal regions we observe an increase in lean mass, from 1,356,91±426,71 to 2,570,96±814,36g (P=.000) and a tendency for visceral fat deposits to decrease. BMD in lumbar vertebrae improved from -1.55±0.68 to -0.90±0.79Z (P=.019). Treatment with GH produces changes in body composition, improving BMD and increasing the proportion of lean body mass with a reduction in fat mass. If these changes persisted into adulthood, they may cause a reduction in the metabolic and cardiovascular risk in this group of patients. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Teaching Special Decisions in a Lean Accounting Environment

Science.gov (United States)

Haskin, Daniel

2010-01-01

Lean accounting has become increasingly important as more and more companies adopt the lean enterprise model or some variation of it. Cost and managerial accounting textbooks continue to use, almost exclusively, models based on standard overhead absorption, which if used in a lean environment will not accurately reflect the benefits from the…

Expression of 11beta-hydroxysteroid dehydrogenase 1 and 2 in subcutaneous adipose tissue of lean and obese women with and without polycystic ovary syndrome.

Science.gov (United States)

Svendsen, P F; Madsbad, S; Nilas, L; Paulsen, S K; Pedersen, S B

2009-11-01

To investigate the expression of 11beta-hydroxysteroid dehydrogenase (11beta-HSD) type 1 and 2 and hexose-6-phosphate dehydrogenase (H6PDH) mRNA in subcutaneous abdominal tissue from lean and obese women with and without polycystic ovary syndrome (PCOS), and to investigate the association between these enzymes and different measures of insulin sensitivity. Cross-sectional study. A total of 60 women, 36 women with PCOS, 17 lean (lean PCOS, LP) and 19 obese (obese PCOS, OP) and 24 age- and weight-matched control women, 8 lean (lean controls, LC) and 16 obese (obese controls, OC). Subcutaneous adipose tissue was collected from the abdomen. Peripheral insulin sensitivity was assessed by the euglycemic hyperinsulinemic clamp and determined as glucose disposal rate and insulin sensitivity index. Whole-body insulin sensitivity was calculated using homeostasis model assessment insulin resistance index. Body composition was evaluated by dual X-ray absorptiometry. Adipose mRNA expression of leptin and adiponectin were determined by real-time PCR. Polycystic ovary syndrome (PPCOS or obesity on11beta-HSD2 or H6PDH mRNA expression. Decreased peripheral insulin sensitivity (P<0.001) and increased upper body fat distribution (P<0.01) were associated with increased expression of 11beta-HSD1, but neither 11beta-HSD2 nor H6PDH. Polycystic ovary syndrome and obesity are independently associated with increased expression of 11beta-HSD1. This may lead to increased conversion of cortisone to cortisol in the peripheral adipose tissue and subsequently increased glucocorticoid activity. Decreased peripheral insulin sensitivity and central obesity was associated with increased expression of 11beta-HSD1.

Body image of Greek breast cancer patients treated with mastectomy or breast conserving surgery.

Science.gov (United States)

Anagnostopoulos, Fotios; Myrgianni, Spyridoula

2009-12-01

The aim of this study was to assess and compare the body image of breast cancer patients (n = 70) whom underwent breast conserving surgery or mastectomy, as well as to compare patients' scores with that of a sample of healthy control women (n = 70). A secondary objective of this study was to examine the reliability and validity of the 10-item Greek version of the Body Image Scale, a multidimensional measure of body image changes and concerns. Exploratory and confirmatory factor analyses on the items of this scale resulted in a two factor solution, indicating perceived attractiveness, and body and appearance satisfaction. Comparison of the two surgical groups revealed that women treated with mastectomy felt less attractive and more self-conscious, did not like their overall appearance, were dissatisfied with their scar, and avoided contact with people. Hierarchical regression analysis showed that more general body image concerns were associated with belonging to the mastectomy group, compared to the cancer-free group of women. Implications for clinical practice and recommendations for future investigations are discussed.

Development of framework for sustainable Lean implementation: an ISM approach

Science.gov (United States)

Jadhav, Jagdish Rajaram; Mantha, S. S.; Rane, Santosh B.

2014-07-01

The survival of any organization depends upon its competitive edge. Even though Lean is one of the most powerful quality improvement methodologies, nearly two-thirds of the Lean implementations results in failures and less than one-fifth of those implemented have sustained results. One of the most significant tasks of top management is to identify, understand and deploy the significant Lean practices like quality circle, Kanban, Just-in-time purchasing, etc. The term `bundle' is used to make groups of inter-related and internally consistent Lean practices. Eight significant Lean practice bundles have been identified based on literature reviewed and opinion of the experts. The order of execution of Lean practice bundles is very important. Lean practitioners must be able to understand the interrelationship between these practice bundles. The objective of this paper is to develop framework for sustainable Lean implementation using interpretive structural modelling approach.

Body Composition in Adult Patients with Thalassemia Major

Directory of Open Access Journals (Sweden)

Marianna Vlychou

2016-01-01

Full Text Available Objective. To assess body composition in adult male and female patients with thalassemia major by dual-energy X-ray absorptiometry (DXA and to compare the findings with a group of healthy age-matched controls. Methods. Our study group included sixty-two patients (27 males, mean age 36 years, and 35 females, mean age 36.4 years and fifteen age-matched healthy controls. All patients had an established diagnosis of thalassemia major and followed a regular blood transfusion scheme since childhood and chelation treatment. Fat, lean, and bone mineral density (BMD were assessed with dual-energy X-ray absorptiometry. Ferritin levels and body mass index of all patients and controls were also recorded. Student t-test and Wilcoxon test were performed and statistical significance was set at p<0.05. Results. BMD and whole body lean mass are lower in both male and female adult patients compared with controls (p<0.01 in both groups, whereas whole body fat mass was found to have no statistically significant difference compared to controls. Regional trunk fat around the abdomen was found to be lower in male patients compared to controls (p=0.02. Conclusion. Severe bone loss and diminished lean mass are expected in adult male and female patients with thalassemia major. Fat changes seem to affect mainly male patients.

Application of lean thinking to health care: issues and observations

Science.gov (United States)

Joosten, Tom; Bongers, Inge; Janssen, Richard

2009-01-01

Background Incidents and quality problems are a prime cause why health care leaders are calling to redesign health care delivery. One of the concepts used is lean thinking. Yet, lean often leads to resistance. Also, there is a lack of high quality evidence supporting lean premises. In this paper, we present an overview of lean thinking and its application to health care. Development, theory and application of lean thinking to health care Lean thinking evolved from a tool designed to improve operational shop-floor performance at an automotive manufacturer to a management approach with both operational and sociotechnical aspects. Sociotechnical dynamics have until recently not received much attention. At the same time a balanced approach might lead to a situation where operational and sociotechnial improvements are mutually reinforcing. Application to health care has been limited and focussed mainly on operational aspects using original lean tools. A more integrative approach would be to pay more attention to sociotechnical dynamics of lean implementation efforts. Also, the need to use the original lean tools may be limited, because health care may have different instruments and tools already in use that are in line with lean thinking principles. Discussion We believe lean thinking has the potential to improve health care delivery. At the same time, there are methodological and practical considerations that need to be taken into account. Otherwise, lean implementation will be superficial and fail, adding to existing resistance and making it more difficult to improve health care in the long term. PMID:19696048

Implementation of Lean Manufacturing in Romanian Organisations

Directory of Open Access Journals (Sweden)

Ucenic Camelia Ioana

2017-01-01

Full Text Available The implementation of lean manufacturing is one of the main tools for attaining a higher performance level in the Romanian organisations. The study uses data collected at middle management level from organisations located in Transylvania. The organisations come from different fields of activity and are in different stages of lean implementation. The article makes use of quantitative and qualitative instruments for the evaluation of lean in the above mentioned companies. Characteristics as waste reduction, cost, quality, product design have different approaches in the companies. Their way of approach gives useful information regarding the type of company from the point of view of lean manufacturing implementation. This knowledge provides a useful support at different managerial levels in the process of decision making.

A case study of lean, sustainable manufacturing

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Geoff Miller

2010-06-01

Full Text Available A small furniture production company has integrated lean tools and sustainability concepts with discrete event simulation modeling and analysis as well as mathematical optimization to make a positive impact on the environment, society and its own financial success. The principles of lean manufacturing that aid in the elimination of waste have helped the company meet ever increasing customer demands while preserving valuable resources for future generations. The implementation of lean and sustainable manufacturing was aided by the use of discrete event simulation and optimization to overcome deficits in lean’s traditional implementation strategies. Lean and green manufacturing can have a more significant, positive impact on multiple measures of operational performance when implemented concurrently rather than separately. These ideas are demonstrated by three applications.

Using Simulation to Explore Lean Manufacturing Implementation Strategies

Science.gov (United States)

Shannon, Patrick W.; Krumwiede, Kip R.; Street, Jeffrey N.

2010-01-01

Lean manufacturing, an outgrowth of the Toyota Production System, has spread far beyond the automobile industry and is seen by many leaders as a key management philosophy in the battle to compete on an international scale. Successful implementation of lean requires that managers and employees be educated in the proper application of lean tools and…

Learning Lean: A Survey of Industry Lean Needs

Science.gov (United States)

Fliedner, Gene; Mathieson, Kieran

2009-01-01

The authors examined business practitioners' preferences for higher education curricula design in general and for what graduates should know about Lean, or waste-reduction efforts. The authors conducted a Web-based survey and found that practitioners are not as concerned about graduates' possessing specific technical skills as they are about them…

"The largest Lean transformation in the world": the implementation and evaluation of lean in Saskatchewan healthcare.

Science.gov (United States)

Kinsman, Leigh; Rotter, Thomas; Stevenson, Katherine; Bath, Brenna; Goodridge, Donna; Harrison, Liz; Dobson, Roy; Sari, Nazmi; Jeffery, Cathy; Bourassa, Carrie; Westhorp, Gill

2014-01-01

The Saskatchewan Ministry of Health has committed to a multi-million dollar investment toward the implementation of Lean methodology across the province's healthcare system. Originating as a production line discipline (the Toyota Production System), Lean has evolved to encompass process improvements including inventory management, waste reduction and quality improvement techniques. With an initial focus on leadership, strategic alignment, training and the creation of a supportive infrastructure (Lean promotion offices), the goal in Saskatchewan is a whole health system transformation that produces "better health, better value, better care, and better teams." Given the scope and scale of the initiative and the commitment of resources, it is vital that a comprehensive, longitudinal evaluation plan be implemented to support ongoing decision-making and program design. The nature of the initiative also offers a unique opportunity to contribute to health quality improvement science by advancing our understanding of the implementation and evaluation of complex, large-scale healthcare interventions. The purpose of this article is to summarize the background to Lean in Saskatchewan and the proposed evaluation methods. Copyright © 2014 Longwoods Publishing.

Principles of lean planning and control

NARCIS (Netherlands)

Riezebos, J.

2015-01-01

Lean production systems use teams instead of functional departments as well as simple shop floor control methods to manage the flow of orders at the shop floor. Lean shop floor control focuses on robust and visual methods that are able to cope with variation in processing times, routing sequences,

Lean oncology: a new model for oncologists

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Montesarchio Vincenzo

2012-04-01

Full Text Available Abstract The history of the term Lean is relatively recent and originates from the Toyota Production System (TPS. The term "Lean" means "thin", which refers to a mental process, operational, productive, no-frills, quick but not hasty, consequential to the previous event. The Lean process flows seamlessly into the result, eliminates unnecessary complications to the effect, prevents unnecessary equipment processes. The idea is to 'do more with less', like using the (few available resources in the most productive way possible, through the elimination of all types of waste that inevitably accompanies every stage of a production process. Lean management is primarily a management philosophy, a system of values and behaviors that goes beyond the mere application of the instrument and that, once internalized, will form the nucleus of the corporate culture. "Lean Oncology" is a term coined to identify a methodology of care and treatment to cancer patients, consisting on process simplification, streamlining of the organizational and routes of drug treatment, detection and elimination of waste. Its main objective is the centrality of the patient.

Lean oncology: a new model for oncologists.

Science.gov (United States)

Montesarchio, Vincenzo; Grimaldi, Antonio Maria; Fox, Bernard A; Rea, Antonio; Marincola, Francesco M; Ascierto, Paolo A

2012-04-25

The history of the term Lean is relatively recent and originates from the Toyota Production System (TPS). The term "Lean" means "thin", which refers to a mental process, operational, productive, no-frills, quick but not hasty, consequential to the previous event. The Lean process flows seamlessly into the result, eliminates unnecessary complications to the effect, prevents unnecessary equipment processes. The idea is to 'do more with less', like using the (few) available resources in the most productive way possible, through the elimination of all types of waste that inevitably accompanies every stage of a production process. Lean management is primarily a management philosophy, a system of values and behaviors that goes beyond the mere application of the instrument and that, once internalized, will form the nucleus of the corporate culture. "Lean Oncology" is a term coined to identify a methodology of care and treatment to cancer patients, consisting on process simplification, streamlining of the organizational and routes of drug treatment, detection and elimination of waste. Its main objective is the centrality of the patient.

Lean IT partnering : How partners create value by developing a lean culture for IT supply and management

NARCIS (Netherlands)

Zee, van der J.T.M.; Blijleven, V.B; Gong, Y.

2015-01-01

Lean, as a philosophy, has been around for quite some time, predominantly in the manufacturing domain. Since the 1990s Lean management provides organizations with a way to achieve superior performance by focusing on customer value, innovation and productivity. In 2011 Steven Bell and Michael Orzen

Implementation of lean thinking: one health system's journey.

Science.gov (United States)

Kim, Christopher S; Spahlinger, David A; Kin, Jeanne M; Coffey, Richard J; Billi, John E

2009-08-01

Lean Thinking is a management philosophy derived from the manufacturing industry, where Toyota has long been the gold standard. Health care organizations have started to apply this approach to patient care. After initial experimentation, the University of Michigan Health System (UMHS) has adopted Lean Thinking as its uniform approach to quality improvement and is striving to become a complete Lean organization. In 2005, the senior leadership selected an initial set of projects in areas that traced the patient's journey across different care settings within our health system. Four of the projects were as follows: orthopedic surgery clinic scheduling, radiation oncology therapy, peripherally inserted central catheter (PICC) services, and coordination of care to the outpatient setting. Lean Thinking encourages service providers to focus on value as defined by the customer and the relentless elimination of waste that impedes the flow of value. A series of learning projects were conducted to test whether Lean methods would work at UMHS. The following factors were found to be key to LEAN PROJECT SUCCESS: expert guidance for initial efforts, leadership in the form of clinical champions and senior management support of the improvement work, frontline worker engagement in mapping out "current state" processes, identifying waste and designing an improved "future state," using metrics to develop and track interventions, and defining realistic project scope. As UMHS's experience applying Lean Thinking to our patient care processes has grown, so have support, enthusiasm, and expertise within the organization. UMHS's Lean Thinking system, now known as the Michigan Quality System, has emerged as the core improvement strategy.

β-endorphins Plasma Level is Higher in Lean Polycystic Ovary Syndrome (PCOS) Women.

Science.gov (United States)

Kiałka, M; Milewicz, T; Spałkowska, M; Krzyczkowska-Sendrakowska, M; Wasyl, B; Pełka, A; Krzysiek, J

2016-01-01

The evaluation the β-endorphin plasma levels in lean women with polycystic ovary syndrome as well as in women without this disorder. The associations between β-endorphins and other laboratory parameters were also investigated. 31 women lean, defined as women with normal range body mass index, 15 with polycystic ovary syndrome and 16 without this disorder were included to the study. In all the patients the level of β-endorphins was measured. Also the diagnostic laboratory profile including hormone assessment was made in all patients. There were significant differences in β-endorphin levels between the 2 groups. The β-endorphin level was higher in the polycystic ovary syndrome group compared to the healthy controls (15.5±4.37 pg/ml vs. 6.9±2.47 pg/ml, ppolycystic ovary syndrome group. Increase in β-endorphin level of 1 pg/ml was associated with an increase of cortisol at 8 am level of 1.134 µg/dl and decrease of sex hormone binding globuline of 0.948 nmol/l in polycystic ovary syndrome group. Our study showed that the levels of β-endorphins were significantly higher in lean patients with polycystic ovary syndrome than in lean controls. Moreover, β-endorphins levels were found to be correlated with other hormonal parameters. In this respect, β-endorphins may play a role in polycystic ovary syndrome pathophysiology. © Georg Thieme Verlag KG Stuttgart · New York.

Acute regulation of plasma leptin by isoprenaline in lean and obese fasted subjects.

Science.gov (United States)

Baynes, K C R; Nicholas, M D; Shojaee-Moradie, F; Umpleby, A M; Giannoulis, M G

2006-07-01

In human obesity, there is some evidence for impaired adrenergic sensitivity with respect to catecholamine-induced lipolysis. The beta-adrenoceptor agonist isoprenaline has been shown to suppress plasma leptin levels in lean humans in vivo. We hypothesized that a reduced adrenergic sensitivity in obese humans would result in impaired suppression of leptin secretion. Eight obese [Ob, body mass index (BMI) = 33.3 kg/m2] and seven lean (Ln, BMI = 21.8 kg/m2) men were studied after an overnight fast. Intravenous isoprenaline infusion was initiated at a rate of 8 ng/kg/min, titrated up to 24 ng/kg/min over 30 min and continued at this rate for a further 120 min with continuous electrocardiogram monitoring. Baseline fasting plasma leptin was higher in obese compared with lean subjects (Ob 12.2 +/- 1.8, Ln 2.6 +/- 0.6 ng/ml, p fasting glycerol as a measure of lipolysis was similar in both groups (Ob 62.9 +/- 7.6, Ln 42.4 +/- 8.9 micromol/l) and increased from baseline to 150 min by equivalent amounts (Ob +66.9%, Ln +81.2%, p = NS). Plasma leptin decreased from baseline to 150 min with similar relative changes in both groups (Ob -29.2%, Ln -27.8%). Obese subjects show a similar lipolytic and leptin response to acute isoprenaline infusion compared with lean subjects. Impaired beta-adrenergic-induced inhibition of leptin secretion does not appear to contribute to hyperleptinaemia in obese human subjects.

Lean Transformation of Multinational Concerns

DEFF Research Database (Denmark)

Matthiesen, Rikke Vestergaard; Johansen, John

2008-01-01

triggered. This paper reports on exploratory studies from a multinational company adopting centrally managed pilot projects as a transformation mechanism for continuous change towards a lean business system and an organizational culture of continuous improvements (CI). Competitive pressure demands...... from a multinational company adopting centrally managed pilot projects as a transformation mechanism for continuous change towards a lean business system and an organizational culture of continuous improvements (CI)....

Lean healthcare from a change management perspective.

Science.gov (United States)

van Rossum, Lisa; Aij, Kjeld Harald; Simons, Frederique Elisabeth; van der Eng, Niels; Ten Have, Wouter Dirk

2016-05-16

Purpose - Lean healthcare is used in a growing number of hospitals to increase efficiency and quality of care. However, healthcare organizations encounter problems with the implementation of change initiatives due to an implementation gap: the gap between strategy and execution. From a change management perspective, the purpose of this paper is to increase scientific knowledge regarding factors that diminish the implementation gap and make the transition from the "toolbox lean" toward an actual transformation to lean healthcare. Design/methodology/approach - A cross-sectional study was executed in an operating theatre of a Dutch University Medical Centre. Transformational leadership was expected to ensure the required top-down commitment, whereas team leadership creates the required active, bottom-up behavior of employees. Furthermore, professional and functional silos and a hierarchical structure were expected to impede the workforce flexibility in adapting organizational elements and optimize the entire process flow. Findings - The correlation and regression analyses showed positive relations between the transformational leadership and team leadership styles and lean healthcare implementation. The results also indicated a strong relation between workforce flexibility and the implementation of lean healthcare. Originality/value - With the use of a recently developed change management model, the Change Competence Model, the authors suggest leadership and workforce flexibility to be part of an organization's change capacity as crucial success factor for a sustainable transformation to lean healthcare.

Injury frequency and body composition of elite Romanian rugby players

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Bogdan ALMĂJAN-GUȚĂ

2017-03-01

Full Text Available Background: The physical exertion in the game of rugby is intense and depends on the playing position. This study hypothesized that peculiarities of body composition are important and should be properly interpreted in order to improve fitness and particularly in order to reduce the risk of injuries. Purpose: The aim of the present paper is to highlight the importance of body composition evaluation and to underline the usefulness of the data thus obtained for both training individualization and sports injuries risk reduction. Material and Methods: Thirty seven senior male rugby players from the former Romanian national team were assessed on body composition using a segmental multi-frequency bio-impedance analyzer InBody 720 (The Body Composition Analyzer – South Korea. We compared the results from both the preseason and the regular season 2012 with the international norms for elite players and we categorized the data by playing positions. Results: We have analyzed the amount of lean mass on each limb (kg, body water content (l, percentage of body fat, bone mineral and protein content (kg. We observed that the number of injuries is directly correlated to high levels of body fat percentage, low lean mass, and edema scores. Conclusions: The risk of injury can be identified among elite rugby players not only by using fitness tests, but also by using a simple and objective test of body composition. These results show how important it is to monitor the level of body fat, lean muscle mass and muscular development in order to modify nutrition and food habits, individualize trainings and thus reduce the number of injuries.

Lean Manufacturing e Lean Accounting Cost: um enfoque no real desempenho em empresas de capital aberto na BOVESPA

OpenAIRE

Teixeira, Hipólito Francisco

2016-01-01

Esta pesquisa teve por alvo o campo de estudo denominado Lean Accounting (LA) aplicado as empresas que adotam os procedimentos de Produção Enxuta (PE). As empresas neste ambiente competitivo e muito imprevisivel têm procuradoadotar decisões e procedimentos voltadosa valorizar sua própria continuidade e diferencial para se expor perante ao mercado. Neste sentido novas tecnologias de produção e controles contábeis são necessários. Lean Accounting (LA) ou Contabilidade Lean ou “enxuta” pode s...

Cardiovascular and metabolic responses to fasting and thermoneutrality are conserved in obese Zucker rats.

Science.gov (United States)

Overton, J M; Williams, T D; Chambers, J B; Rashotte, M E

2001-04-01

The primary purpose of the study was to test the hypothesis that reduced leptin signaling is necessary to elicit the cardiovascular and metabolic responses to fasting. Lean (Fa/?; normal leptin receptor; n = 7) and obese (fa/fa; mutated leptin receptor; n = 8) Zucker rats were instrumented with telemetry transmitters and housed in metabolic chambers at 23 degrees C (12:12-h light-dark cycle) for continuous (24 h) measurement of metabolic and cardiovascular variables. Before fasting, mean arterial pressure (MAP) was higher (MAP: obese = 103 +/- 3; lean = 94 +/- 1 mmHg), whereas oxygen consumption (VO(2): obese = 16.5 +/- 0.3; lean = 18.6 +/- 0.2 ml. min(-1). kg(-0.75)) was lower in obese Zucker rats compared with their lean controls. Two days of fasting had no effect on MAP in either lean or obese Zucker rats, whereas VO(2) (obese = -3.1 +/- 0.3; lean = -2.9 +/- 0.1 ml. min(-1). kg(-0.75)) and heart rate (HR: obese = -56 +/- 4; lean = -42 +/- 4 beats/min) were decreased markedly in both groups. Fasting increased HR variability both in lean (+1.8 +/- 0.4 ms) and obese (+2.6 +/- 0.3 ms) Zucker rats. After a 6-day period of ad libitum refeeding, when all parameters had returned to near baseline levels, the cardiovascular and metabolic responses to 2 days of thermoneutrality (ambient temperature 29 degrees C) were determined. Thermoneutrality reduced VO(2) (obese = -2.4 +/- 0.2; lean = -3.3 +/- 0.2 ml. min(-1). kg(-0.75)), HR (obese = -46 +/- 5; lean = -55 +/- 4 beats/min), and MAP (obese = -13 +/- 6; lean = -10 +/- 1 mmHg) similarly in lean and obese Zucker rats. The results indicate that the cardiovascular and metabolic responses to fasting and thermoneutrality are conserved in Zucker rats and suggest that intact leptin signaling may not be requisite for the metabolic and cardiovascular responses to reduced energy intake.

Lean Construction Supply Chain : A Literature Review

OpenAIRE

Ren, Jiamei

2012-01-01

The aim of this thesis is to enhance the management of supply systems in construction industry using lean principles. This study is an attempt to identify what kind of activities causes’ construction process delay and how to perform lean concept into supply chain in practice. The objective is to assure on-time delivery of information and materials to construction sites at lowest cost and maximum value for the customer. These study problems have been analysed from a lean construction supply ch...

Optimization of large scale food production using Lean Manufacturing principles

DEFF Research Database (Denmark)

Engelund, Eva Høy; Friis, Alan; Breum, Gitte

2009-01-01

This paper discusses how the production principles of Lean Manufacturing (Lean) can be applied in a large-scale meal production. Lean principles are briefly presented, followed by a field study of how a kitchen at a Danish hospital has implemented Lean in the daily production. In the kitchen...... not be negatively affected by the rationalisation of production procedures. The field study shows that Lean principles can be applied in meal production and can result in increased production efficiency and systematic improvement of product quality without negative effects on the working environment. The results...... show that Lean can be applied and used to manage the production of meals in the kitchen....

Induction of IL-6 by Cytotoxic Chemotherapy Is Associated With Loss of Lean Body and Fat Mass in Tumor-free Female Mice.

Science.gov (United States)

Elsea, Collin R; Kneiss, Janet A; Wood, Lisa J

2015-10-01

Cancer patients treated with cytotoxic chemotherapy experience fatigue and changes in body composition that can impact physical functioning and quality of life during and after treatment. Interleukin-6 (IL-6) is associated with fatigue in cancer survivors and plays an important role in the regulation of body composition. The purpose of the present study was to determine the specific role of IL-6 in cyclophosphamide-doxorubicin-5-fluorouracil (CAF)-induced changes in fatigue, food intake, and body composition using mice lacking IL-6. Female wild-type (WT) and IL-6 (-/-) mice were injected with four cycles of CAF or normal saline (NS) administered at 21-day intervals. Daily voluntary wheel-running activity (VWRA), used as a proxy for fatigue, and food intake were monitored daily up to 21 days after the fourth dose. Dual-energy X-ray absorptiometry (DEXA) was used to assess treatment-related changes in lean body mass (LBM), fat mass (FM), and bone mineral content (BMC). Patterns of change in fatigue and food intake did not differ between CAF-treated WT and IL-6 (-/-) mice. However, a Genotype × Drug interaction was observed for LBM (p = 0.047) and FM (p = 0.035) but not BMC (p = .569). Whereas WT mice lost LBM and FM during CAF treatment, IL-6-deficient mice did not. Treatment-related decreases in levels of the anabolic hormone insulin-like growth factor-1 (IGF-1) may contribute to LBM and FM loss since CAF decreased IGF-1 levels in an IL-6-dependent manner. These findings implicate IL-6 and possibly IGF-1 in the regulation of body composition in breast cancer patients exposed to cytotoxic chemotherapy. © The Author(s) 2014.

Lean computing for the cloud

CERN Document Server

Bauer, Eric

2016-01-01

Applies lean manufacturing principles across the cloud service delivery chain to enable application and infrastructure service providers to sustainably achieve the shortest lead time, best quality, and value This book focuses on lean in the context of cloud computing capacity management of applications and the physical and virtual cloud resources that support them. Lean Computing for the Cloud considers business, architectural and operational aspects of efficiently delivering valuable services to end users via cloud-based applications hosted on shared cloud infrastructure. The work also focuses on overall optimization of the service delivery chain to enable both application service and infrastructure service providers to adopt leaner, demand driven operations to serve end users more efficiently. The book’s early chapters analyze how capacity management morphs with cloud computing into interlocked physical infrastructure capacity management, virtual resou ce capacity management, and application capacity ma...

A conserved plan for wiring up the fan-shaped body in the grasshopper and Drosophila.

Science.gov (United States)

Boyan, George; Liu, Yu; Khalsa, Sat Kartar; Hartenstein, Volker

2017-07-01

The central complex comprises an elaborate system of modular neuropils which mediate spatial orientation and sensory-motor integration in insects such as the grasshopper and Drosophila. The neuroarchitecture of the largest of these modules, the fan-shaped body, is characterized by its stereotypic set of decussating fiber bundles. These are generated during development by axons from four homologous protocerebral lineages which enter the commissural system and subsequently decussate at stereotypic locations across the brain midline. Since the commissural organization prior to fan-shaped body formation has not been previously analyzed in either species, it was not clear how the decussating bundles relate to individual lineages, or if the projection pattern is conserved across species. In this study, we trace the axonal projections from the homologous central complex lineages into the commissural system of the embryonic and larval brains of both the grasshopper and Drosophila. Projections into the primordial commissures of both species are found to be lineage-specific and allow putatively equivalent fascicles to be identified. Comparison of the projection pattern before and after the commencement of axon decussation in both species reveals that equivalent commissural fascicles are involved in generating the columnar neuroarchitecture of the fan-shaped body. Further, the tract-specific columns in both the grasshopper and Drosophila can be shown to contain axons from identical combinations of central complex lineages, suggesting that this columnar neuroarchitecture is also conserved.

Conservation and non-conservation in general relativity

International Nuclear Information System (INIS)

Bondi, H.

1990-01-01

The difficulties of conservation laws in general relativity are discussed, with special reference to the non-tangible nature of gravitational energy and its transformation into tangible forms of energy. Inductive transfer of energy is marked out as wholly distinct from wave transfer. Slow (adiabatic) changes are utilized to make clear, in the axi-symmetric case, that the mass of an isolated body is conserved irrespective of any local changes (e.g. of shape) and that in inductive transfer the movement of energy between two bodies can readily be traced by the changes in their masses. (author)

The effect of ghrelin upon the early immune response in lean and obese mice during sepsis.

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Daniel Siegl

Full Text Available It is well established that obesity-related hormones can have modulatory effects associated with the immune response. Ghrelin, a hormone mainly derived from endocrine cells of the gastric mucosa, regulates appetite, energy expenditure and body weight counteracting leptin, a hormone mainly derived from adipocytes. Additionally, receptors of both have been detected on immune cells and demonstrated an immune regulatory function during sepsis.In the present study, the effect of peripheral ghrelin administration on early immune response and survival was investigated with lean mice and mice with diet-induced obesity using cecal ligation and puncture to induce sepsis.In the obese group, we found that ghrelin treatment improved survival, ameliorated hypothermia, and increased hyperleptinemia as compared to the lean controls. We also observed that ghrelin treatment divergently regulated serum IL-1ß and TNF-α concentrations in both lean and obese septic mice. Ghrelin treatment initially decreased but later resulted in increased bacteriaemia in lean mice while having no impact upon obese mice. Similarly, ghrelin treatment increased early neutrophil oxidative burst while causing a decrease 48 hours after sepsis inducement.In conclusion, as the immune response to sepsis temporally changes, ghrelin treatment differentially mediates this response. Specifically, we observed that ghrelin conferred protective effects during the early phase of sepsis, but during the later phase deteriorated immune response and outcome. These adverse effects were more pronounced upon lean mice as compared to obese mice.

Manipulation of Muscle Creatine and Glycogen Changes Dual X-ray Absorptiometry Estimates of Body Composition.

Science.gov (United States)

Bone, Julia L; Ross, Megan L; Tomcik, Kristyen A; Jeacocke, Nikki A; Hopkins, Will G; Burke, Louise M

2017-05-01

Standardizing a dual x-ray absorptiometry (DXA) protocol is thought to provide a reliable measurement of body composition. We investigated the effects of manipulating muscle glycogen and creatine content independently and additively on DXA estimates of lean mass. Eighteen well-trained male cyclists undertook a parallel group application of creatine loading (n = 9) (20 g·d for 5 d loading; 3 g·d maintenance) or placebo (n = 9) with crossover application of glycogen loading (12 v 6 g·kg BM per day for 48 h) as part of a larger study involving a glycogen-depleting exercise protocol. Body composition, total body water, muscle glycogen and creatine content were assessed via DXA, bioelectrical impedance spectroscopy and standard biopsy techniques. Changes in the mean were assessed using the following effect-size scale: >0.2 small, >0.6, moderate, >1.2 large and compared with the threshold for the smallest worthwhile effect of the treatment. Glycogen loading, both with and without creatine loading, resulted in substantial increases in estimates of lean body mass (mean ± SD; 3.0% ± 0.7% and 2.0% ± 0.9%) and leg lean mass (3.1% ± 1.8% and 2.6% ± 1.0%) respectively. A substantial decrease in leg lean mass was observed after the glycogen depleting condition (-1.4% ± 1.6%). Total body water showed substantial increases after glycogen loading (2.3% ± 2.3%), creatine loading (1.4% ± 1.9%) and the combined treatment (2.3% ± 1.1%). Changes in muscle metabolites and water content alter DXA estimates of lean mass during periods in which minimal change in muscle protein mass is likely. This information needs to be considered in interpreting the results of DXA-derived estimates of body composition in athletes.

Investigating employee resistance to Lean transformation: UK case study.

OpenAIRE

Bruce, J.; Scott, Philip; Roberts, Martyn

2011-01-01

Lean is a business process transformation approach that eliminates ‘wastes’ – activities that generate no value for the customer. Lean originated from the production line but is widely implemented in the service sector. This study investigates human and social factors in a Lean transformation in a ‘knowledge worker’ environment. We identify a paradox: a successful Lean programme in the service sector develops staff who are educated and empowered and thus potential opponents to future business...

The evolution of Lean organizations

OpenAIRE

Serafinas, Dalius; Ruželė, Darius

2014-01-01

Remiantis evoliucijos tyrimų modeliais bei autorių sudarytu evoliucionuojančios organizacijos modeliu,straipsnyje analizuojama Lean vadybos metodologija ir tiriama, kaip evoliucionuoja ją įgyvendinančios Lietuvosgamybinės organizacijos. The purpose of this paper is to examine the evolution of Lean organizations.Design/methodology/approach: a conceptual literature on the evolution of species, organisms and organizations was reviewed and an original model (framework) of the evolution of orga...

Limb/trunk lean mass ratio as a risk factor for mortality in peritoneal dialysis patients

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Seok Hui Kang

2012-06-01

Full Text Available Protein energy wasting (PEW is a common problem in dialysis patients. There have been few reports on the effects of regional lean mass distribution for peritoneal dialysis (PD patients. We reviewed the medical records and identified all adults who received PD between May 2001 and May 2011. Five hundred thirty four patients were enrolled. The clinical and laboratory data were collected at 1 and 12 months. Regional lean masses were measured by dual-energy X-ray absorptiometry. The limb/trunk lean mass ratio (LTLM was defined as a value on dividing the sum of four limbs by the trunk lean mass. The mean age at the start of PD was 53.2±14.1 years. Diabetes mellitus (DM was most common underlying disease of end-stage renal disease (49.6%. In males, the low LTLM tertile was associated with low body mass index, creatinine, arm muscle circumference, and high C-reactive protein. In females, the low LTLM tertile was associated with low creatinine and normalized protein equivalent of nitrogen appearance. On both univariate and multivariate analysis adjusted for age, Davies risk index, and residual renal function, initial low LTLM tertile and maintenance of low LTLM were associated with mortality in PD patients. Distribution or change of regional lean mass may be more useful for predicting nutritional status. Initial low LTLM and maintenance of low LTLM were associated with mortality in PD patients. LTLM as a new marker would be useful for predicting the nutritional status and the mortality in patients on PD.

LEAN THINKING IN HEALTHCARE: REVIEW OF IMPLEMENTATION RESULTS

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Marija Kovacevic

2016-03-01

Full Text Available For over decade, automotive industry originated lean concept has been successfully implemented in healthcare systems as a management method and philosophy with main focus on elimination of all types of wastes and looses in all tasks and processes so that time, materials, resources and medical procedures could be realized as effectively as it is possible. As main result lean concept implementation ensured to healthcare organizations to focus on their main core function and dedicate more time and efforts to patients without additional costs for them or healthcare system. However, lean implementation in healthcare could be much more difficult than in standard industrial environment and there are significant number of examples of lean in healthcare projects that failed to gain any measurable results and sustainable benefits from it. This paper presents review of some of the most successful implementations of lean tools and principles in healthcare organizations.

The application of lean principles in product development

DEFF Research Database (Denmark)

Bjarnø, Ole-Christian

2007-01-01

Although Lean Manufacturing has been a megatrend for several years, its principles have not been broadly applied in product development processes. We have therefore found it useful to look into the theories of lean manufacturing and to discuss how and to what extent they could be applied in the p......Although Lean Manufacturing has been a megatrend for several years, its principles have not been broadly applied in product development processes. We have therefore found it useful to look into the theories of lean manufacturing and to discuss how and to what extent they could be applied...... in the product development processes, and this study is compared with industrial practices in several front running companies in Denmark. From this research a suggestion for a framework and a tool-box for lean product development is created and discussed from a HR management, an implementation, an operational...

Lean healthcare.

Science.gov (United States)

Weinstock, Donna

2008-01-01

As healthcare organizations look for new and improved ways to reduce costs and still offer quality healthcare, many are turning to the Toyota Production System of doing business. Rather than focusing on cutting personnel and assets, "lean healthcare" looks to improve patient satisfaction through improved actions and processes.

Adipokines, Oxidized Low-Density Lipoprotein, and C-Reactive Protein Levels in Lean, Overweight, and Obese Portuguese Patients with Type 2 Diabetes

Science.gov (United States)

Neuparth, Maria João; Proença, Jorge Brandão; Santos-Silva, Alice; Coimbra, Susana

2013-01-01

Aim. Our aim was to study how different BMI scores may influence the levels of inflammation, oxidative stress, adipogenesis, glucose, and lipid metabolism, in lean, overweight, and obese Portuguese patients with type 2 diabetes mellitus (T2DM). Methods. We studied 28 lean, 38 overweight, and 17 obese patients with T2DM and 20 controls (gender and age matched). The circulating levels of oxLDL, CRP, and some adipokines—adiponectin, leptin, and chemerin—and the lipid profile were evaluated. Results. Obese patients presented significantly lower levels of adiponectin and higher leptin, oxLDL, and chemerin levels, as compared to the overweight, lean, and control groups. Overweight, compared to lean and control, subjects showed significantly lower adiponectin and higher leptin and chemerin levels; oxLDL values were significantly higher in overweight than in lean patients. Lean patients presented significantly higher chemerin values than the control. Obese patients presented significantly higher CRP values, as compared to lean patients and the control group. Obese and overweight patients presented significantly higher triglycerides values than lean patients. Except for CRP, all the observed significant changes between control and patients remained significant after statistical adjustment for the body mass index (BMI). Conclusion. The levels of leptin, adiponectin, oxLDL, CRP, and triglycerides in patients with T2DM seem to be more associated with obesity and less with diabetes. Chemerin levels were raised in lean, overweight, and obese patients, suggesting that, independently of BMI, an adipocyte dysfunction occurs. Moreover, chemerin may provide an important early biomarker of adipocyte dysfunction and a link between obesity and type 2 diabetes mellitus. PMID:24634792

Experienced Barriers to Lean in Swedish Manufacturing and Health Care

Directory of Open Access Journals (Sweden)

Bengt Halling

2013-12-01

Full Text Available The purpose is to compare similarities and divergences in how the concepts of Lean and barriers to Lean are described by key informants at a production unit in a large manufacturing company and two emergency health care units in Sweden. Data was collected via semi-structured interviews and analyzed with the constant comparative method (CCM and Porras and Robertson’s (1992 change model. : In both organizations, the view of Lean changed from a toolbox to a human behavior view. Eight barriers were experienced in both organizations. Three barriers were unique to manufacturing or to health care, respectively. Nine barriers were elements of social factors; five were elements of organizing arrangements. Only people practically involved and responsible for the implementation at the two organizations participated in the study. Persons responsible for implementing Lean should consider organizational arrangements and social factors in order to limit barriers to successful implementation. Most research on Lean has been about successful Lean implementations. This study focuses on how Lean is viewed and what barriers personnel in manufacturing and health care have experienced. In comparing the barriers to Lean experienced in the two groups, common, archetypical, and unique barriers for manufacturing and health care can be identified, thus contributing to knowledge about barriers to Lean implementation.

How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children's hospital, Stockholm, Sweden.

Science.gov (United States)

Mazzocato, Pamela; Holden, Richard J; Brommels, Mats; Aronsson, Håkan; Bäckman, Ulrika; Elg, Mattias; Thor, Johan

2012-02-01

There is growing interest in applying lean thinking in healthcare, yet, there is still limited knowledge of how and why lean interventions succeed (or fail). To address this gap, this in-depth case study examines a lean-inspired intervention in a Swedish pediatric Accident and Emergency department. We used a mixed methods explanatory single case study design. Hospital performance data were analyzed using analysis of variance (ANOVA) and statistical process control techniques to assess changes in performance one year before and two years after the intervention. We collected qualitative data through non-participant observations, semi-structured interviews, and internal documents to describe the process and content of the lean intervention. We then analyzed empirical findings using four theoretical lean principles (Spear and Bowen 1999) to understand how and why the intervention worked in its local context as well as to identify its strengths and weaknesses. Improvements in waiting and lead times (19-24%) were achieved and sustained in the two years following lean-inspired changes to employee roles, staffing and scheduling, communication and coordination, expertise, workspace layout, and problem solving. These changes resulted in improvement because they: (a) standardized work and reduced ambiguity, (b) connected people who were dependent on one another, (c) enhanced seamless, uninterrupted flow through the process, and (d) empowered staff to investigate problems and to develop countermeasures using a "scientific method". Contextual factors that may explain why not even greater improvement was achieved included: a mismatch between job tasks, licensing constraints, and competence; a perception of being monitored, and discomfort with inter-professional collaboration. Drawing on Spear and Bowen's theoretical propositions, this study explains how a package of lean-like changes translated into better care process management. It adds new knowledge regarding how lean

Six sigma and lean production adoption in a manufacturing company

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Alisson Christian Scheller

2014-11-01

Full Text Available The connection among Lean Production with Six Sigma originated the Lean Six Sigma methodology, focused on processes variation and waste reduction. This methodology was developed on different ways in the companies and there is no consensus over its structure and its implementation. In this context, this paper aims to identify and analyze the main characteristics on the adoption and integration of Lean Six Sigma methodology through a case study conducted in a manufacturing company that adopts lean production and six sigma. The results show two important aspects of the Lean Six Sigma methodology. One of them is the adoption of the value stream mapping as a central tool on Lean Six Sigma. The other is the use of DMAIC for improvements actions. The study indicates that despite the difficulties on Lean Six Sigma implementation, the methodology offers benefits to the company that adopts it in the suitable way.

Product innovation and commercialization in lean global start-ups

DEFF Research Database (Denmark)

Tanev, Stoyan; Rasmussen, Erik Stavnsager; Zijdemans, Erik

2015-01-01

The paper examines the distinctive characteristics of product innovation and commercialization in Lean Global Start-up (LGS) – new technology firms which have adopted a lean and global path from or near to their inception. It suggests an uncertainty vs risk framework which allows integrating two...... research streams – Born Global (BG) firms and lean start-ups. In addition to its integrative theoretical value, the paper offers insights for lean start-up managers dealing with the challenges of a global start....

Using Lean to Advance Quality Improvement Research.

Science.gov (United States)

Blackmore, Christopher Craig; Williams, Barbara L; Ching, Joan M; Chafetz, Lynne A; Kaplan, Gary S

2016-01-01

Quality improvement research skills are not commonplace among quality improvement practitioners, and research on the effectiveness of quality improvement has not always kept pace with improvement innovation. However, the Lean tools applied to quality improvement should be equally relevant to the advancement of quality improvement research. We applied the Lean methods to develop a simplified quality improvement publication pathway enabling a small research methodology group to increase quality improvement research throughout the institution. The key innovations of the pathway are horizontal integration of the quality improvement research methods group across the institution, implementation of a Lean quality improvement research pathway, and application of a just-in-time quality improvement research toolkit. This work provides a road map and tools for the acceleration of quality improvement research. At our institution, the Lean quality improvement research approach was associated with statistically significant increases in the number (annual mean increase from 3.0 to 8.5, p = .03) and breadth of published quality improvement research articles, and in the number of quality improvement research projects currently in process. Application of Lean methods to the quality improvement research process can aid in increasing publication of quality improvement articles from across the institution.

Sex impacts the relation between body composition and physical function in older adults.

Science.gov (United States)

Valentine, Rudy J; Misic, Mark M; Rosengren, Karl S; Woods, Jeffrey A; Evans, Ellen M

2009-01-01

To determine the sex-specific relationships between physical activity, aerobic fitness, adiposity (%Fat), mineral-free lean mass (MFLM), and balance and gait performance in older adults. Eighty-five female and 49 male sedentary, healthy, community-dwelling older adults (mean [SD] age, 69.6 [5.4] and 70.3 [4.7] years, respectively) were evaluated on habitual physical activity via questionnaire, aerobic fitness by a maximal oxygen consumption treadmill test, whole and regional body composition by dual-energy x-ray absorptiometry, and lower extremity physical function using gait tasks and computerized dynamic posturography. As expected, men had less body fat, more lean mass, and higher aerobic fitness than did women and tended to perform better on all lower extremity physical function tasks (all P 0.50, all P women (r = -0.38, P men. Neither fitness nor body composition was related to balance in men, whereas in women, leg MFLM was positively associated (r = 0.27, P Women, but not men, with a greater ratio of body weight to leg MFLM performed worse on gait tasks (P women are more strongly affected by alterations in body composition. Lower %Fat and preservation of lower body lean mass have important implications for reducing the risk of physical disability, especially in older women.

Monte Carlo efficiency calibration of a neutron generator-based total-body irradiator

International Nuclear Information System (INIS)

Shypailo, R.J.; Ellis, K.J.

2009-01-01

Many body composition measurement systems are calibrated against a single-sized reference phantom. Prompt-gamma neutron activation (PGNA) provides the only direct measure of total body nitrogen (TBN), an index of the body's lean tissue mass. In PGNA systems, body size influences neutron flux attenuation, induced gamma signal distribution, and counting efficiency. Thus, calibration based on a single-sized phantom could result in inaccurate TBN values. We used Monte Carlo simulations (MCNP-5; Los Alamos National Laboratory) in order to map a system's response to the range of body weights (65-160 kg) and body fat distributions (25-60%) in obese humans. Calibration curves were constructed to derive body-size correction factors relative to a standard reference phantom, providing customized adjustments to account for differences in body habitus of obese adults. The use of MCNP-generated calibration curves should allow for a better estimate of the true changes in lean tissue mass that many occur during intervention programs focused only on weight loss. (author)

Is there a lean future for global startups?

DEFF Research Database (Denmark)

Tanev, Stoyan

2017-01-01

This article integrates insights from the latest research on the lean startup entrepreneurial method, born-global firms, and global startups. It contributes to the clarification of terminology referring to the global aspects of startups, summarizes insights from previous literature focusing on gl......-based global startup research and practice. The analysis should benefit both researchers and practitioners in technology entrepreneurship, international entrepreneurship, and global innovation management.......This article integrates insights from the latest research on the lean startup entrepreneurial method, born-global firms, and global startups. It contributes to the clarification of terminology referring to the global aspects of startups, summarizes insights from previous literature focusing...... on global startups, and further substantiates the articulation of the need for considering the lean global startup as a new type of firm. The main message is that the lessons learned from the emergence of lean startup entrepreneurship offer a basis for promoting a similar lean phase in technology...

Lean-team effectiveness through leader values and members’ informing

NARCIS (Netherlands)

van Dun, Desirée Hermina; Wilderom, Celeste P.M.

2016-01-01

Purpose Although empirical tests of effective lean-team leadership are scarce, leaders are often blamed when lean work-floor initiatives fail. In the present study, a lean-team leader’s work values are assumed to affect his or her team members’ behaviors and, through them, to attain team

Higher levels of circulating chemerin in both lean and obese patients with polycystic ovary syndrome.

Science.gov (United States)

Ademoglu, E; Berberoglu, Z; Carlioglu, A; Dellal, F; Gorar, S; Alphan, Z; Uysal, S; Karakurt, F

2014-12-01

The aim of this paper was to compare serum chemerin levels in nonobese and overweight/obese patients with polycystic ovary syndrome (PCOS) with lean controls. Seventy women with newly diagnosed or untreated PCOS and 38 age-matched nonobese healthy controls were enrolled in the present study. Participants with PCOS were categorized as nonobese (Body Mass Index [BMI] PCOS group than in nonobese PCOS women but did not reach statistical significance. Nonobese healthy controls had significantly lower chemerin levels than two PCOS groups (Pwomen with PCOS than in other two groups. Also, these two parameters were higher in lean patients with PCOS than in healthy controls (PPCOS women but also in nonobese PCOS women. The physiological significance of elevated serum chemerin in PCOS remains unclear.

Lean Manufacturing Auto Cluster at Chennai

Science.gov (United States)

Bhaskaran, E.

2012-10-01

Due the presence of lot of automotive Industry, Chennai is known as Detroit of India, that producing over 40 % of the Indian vehicle and components. Lean manufacturing concepts have been widely recognized as an important tool in improving the competitiveness of industries. This is a continuous process involving everyone, starting from management to the shop floor. Automotive Component Industries (ACIs) in Ambattur Industrial Estate, Chennai has formed special purpose vehicle (SPV) society namely Ambattur Industrial Estate Manufacturers Association (AIEMA) Technology Centre (ATC) lean manufacturing cluster (ATC-LMC) during July 2010 under lean manufacturing competitiveness scheme, that comes under National Manufacturing Competitiveness Programme of Government of India. The Tripartite Agreement is taken place between National Productivity Council, consultants and cluster (ATC-LMC). The objective is to conduct diagnostic study, study on training and application of various lean manufacturing techniques and auditing in ten ACIs. The methodology adopted is collection of primary data/details from ten ACIs. In the first phase, diagnostic study is done and the areas for improvement in each of the cluster member companies are identified. In the second phase, training programs and implementation is done on 5S and other areas. In the third phase auditing is done and found that the lean manufacturing techniques implementation in ATC-LMC is sustainable and successful in every cluster companies, which will not only enhance competitiveness but also decrease cost, time and increase productivity. The technical efficiency of LMC companies also increases significantly.

Identification of Lean Implementation Hurdles in Indian Industries

OpenAIRE

Bhim Singh

2016-01-01

Due to increased pressure from global competitors, manufacturing organizations are switching over to lean philosophies from traditional mass production. Lean manufacturing is a manufacturing philosophy which focuses on elimination of various types of wastes and creates maximum value for the end customers. Lean thinking aims to produce high quality products and services at the lowest possible cost with maximum customer responsiveness. Indian Industry is facing lot of problems in this transform...

Lean process management implementation through enhanced problem solving capabilities

Directory of Open Access Journals (Sweden)

Perumal Puvanasvaran

2010-12-01

Full Text Available All Original Equipment Manufacturers (OEM organizations in Aerospace, Automotive and Electronics industries had to upgrade their functions. These organizations including suppliers and solutions providers are duty bound to improve their functions through strategic initiatives. One such initiative is Lean Process Management. Lean Process Management has proven to aid organizations in developing manufacturing and administrative management solutions and make the organization a leaner at the same time a ‘fitter’ one, achieving World Class standards in terms of production, quality, marketing, etc, etc. The issue or problem is, although a number of authors, experts, researchers have discussed the lean process management as part organization centric issues, they failed to provide an effective lean process management system. Besides the need to formulate an effective lean process as suggested by some authors, another important reason suggested is the employee’s development aspect regarding how to unlock the infinite potential of their workforce. This employee’s development is basically the problem solving capabilities of the employees while implementing the Lean through clear cutting protocols or processes of Lean Process Management. The employees need to be developed and equipped to contribute optimally to the process. Because of this scenario, the main objective of this study is to develop an employees development system which the author has acronym or trademark it as People Development System (PDS to enhance problem solving capability among its employees while implementing the lean process management there. Although, the PDS can be implemented throughout the organization, if it is implemented in a particular department in an organization, it will be feasible to study and analyze its effectiveness in-depth. So, this study documents and analyzes the implementation of Lean process in the Kitting Department of the aerospace company, ABC Company

Efficacy and efficiency of a lean cataract pathway: a comparative study.

Science.gov (United States)

van Vliet, Ellen Joan; Sermeus, Walter; van Gaalen, Claudia M; Sol, Johannes C A; Vissers, Jan M H

2010-12-01

The demand for cataract surgery is rising, calling for pathways that have good access and are cost-effective. Lean thinking is a management strategy, aimed at improving quality while reducing costs. Lean production processes are designed to identify gaps between expected and actual performance. To analyse the efficacy and efficiency of a lean cataract pathway. Lean care delivered to a prospective cohort (616 cataract patients) was compared (1) with traditional care delivered to a historical cohort (591 cataract patients) and (2) with expected lean care in the prospective cohort. To evaluate efficacy, the authors analysed how many patients received care that adhered to the lean pathway's specifications. To evaluate efficiency, the authors analysed how often patients visited the hospital and how many additional patients could access the pathway. In the lean pathway, patient visits decreased by 23%, and access to the cataract pathway increased with 42%. A 40% decrease in patient visits and a 76% increase in access could have been realised if healthcare staff would have adhered to the lean pathway's specifications. Lean pathways can realise large improvements, and still have a significant gap between expected and actual care delivery. The challenge for healthcare teams is not to improve care delivery by using lean pathways as opposed to using traditional pathways, but to strive for optimal performance by consistently adhering to the specifications of the lean pathway.

Is There a Lean Future for Global Startups?

Directory of Open Access Journals (Sweden)

Stoyan Tanev

2017-05-01

Full Text Available This article integrates insights from the latest research on the lean startup entrepreneurial method, born-global firms, and global startups. It contributes to the clarification of terminology referring to the global aspects of startups, summarizes insights from previous literature focusing on global startups, and further substantiates the articulation of the need for considering the lean global startup as a new type of firm. The main message is that the lessons learned from the emergence of lean startup entrepreneurship offer a basis for promoting a similar lean phase in technology-based global startup research and practice. The analysis should benefit both researchers and practitioners in technology entrepreneurship, international entrepreneurship, and global innovation management.

Lean principles adoption in environmental management system (EMS - ISO 14001

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Perumal Puvanasvaran

2012-12-01

Full Text Available Purpose: The purpose of this study is to examine the characteristic of the lean principles into ISO 14001 and to propose linkage of the lean principles and ISO 14001.Design/methodology/approach: To achieve the objective of the study, literature survey and quantitative research method using questionnaires survey are used.Findings and Originality/value: The findings of this study confirm that ISO 14001 certified company adopted lean production practices.  The study also proves that lean principles have positive and significant relationship with ISO 14001 EMS and the linkage can be made between lean principles and ISO 14001 to achieve Continual Improvement.Research limitations/implications: The small sizes of the sample of the participating companies are the main limitations of this study and this research mainly focuses on the manufacturing environment and services industry.Practical implications: This research show that all ISO 14001 companies do adopt at least one lean production practices and the main findings are lean principles has positive and highly significant relationship with ISO 14001 requirements.  This is because the integration of lean principles into ISO 14001 will serve practical methods for ISO14001 EMS to achieve the continual improvement.Originality/value: This research is amongst the first to study the combined lean principles with ISO 1400.  Based on the current situation, there is no integration within this two management system. 

Improving Healthcare through Lean Management: Experiences from the Danish healthcare system

DEFF Research Database (Denmark)

Edwards, Kasper; Nielsen, Anders Paarup

still is in its infancy and it is just a matter of letting sufficient time pass in order have a successful implementation of lean in all areas of healthcare. The second hypothesis states that a major barrier to lean management in healthcare simply is lacking understanding of the lean concepts leading......The ideas and principles from lean management are now widely being adopted within the healthcare sector. The analysis in this paper shows that organizations within healthcare most often only implement a limited set of tools and methods from the lean tool-box. Departing from a theoretical analysis...... of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare...

Lean Supply Chain Planning: A Performance Evaluation through Simulation

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Rossini Matteo

2016-01-01

Full Text Available Nowadays companies look more and more for improving their efficiency to excel in the market. At the same time, the competition has moved from firm level to whole supply chain level. Supply chain are very complex systems and lacks of coordination among their members leads to inefficiency. Supply chain planning task is to improve coordination among supply chain members. Which is the best planning solution to improve efficiency is an open issue. On the other hand, Lean approach is becoming more and more popular among managers. Lean approach is recognize as efficiency engine for production systems, but effects of Lean implementation out of single firm boundaries is not clear. This paper aims at providing a theoretical and practical starting point for Lean implementation in supply chain planning issue. To reach it, a DES simulation model of a three-echelon and multi-product supply chain has been set. Lean management is a very broad topic and this paper focuses on two principles of “pull” and “create the flow”. Kanban system and setup-time and batch-size reductions are implemented in the lean-configured supply chain to apply “pull” and “create the flow” respectively. Lean principles implementations have been analyzed and compared with other supply chain planning policies: EOQ and information sharing (Visibility. Supported by the simulation study, this paper points Lean supply chain planning is a competitive planning policies to increase efficiency.

The roles of communication process for an effective lean manufacturing implementation

OpenAIRE

Puvanasvaran, Perumal; Megat, Hamdan; Hong, Tang Sai; Razali, Muhamad Mohd.

2009-01-01

Many companies are implementing lean manufacturing concept in order to remain competitive and sustainable, however, not many of them are successful in the process due to various reasons. Communication is an important aspect of lean process in order to successfully implement lean manufacturing. This paper determines the roles of communication process in ensuring a successful implementation of leanness in manufacturing companies. All the information of lean manufacturing practice...

Lean production and business performance: influences of ...

African Journals Online (AJOL)

Hence, this study aims to examine the influence of leadership style in the implementation of lean production. Data were gathered from randomly selected Malaysian manufacturing firms. Findings reveal a positive relationship between lean production and business performance. Specifically, democratic leadership style was ...

Existing equations to estimate lean body mass are not accurate in the critically ill: Results of a multicenter observational study.

Science.gov (United States)

Moisey, Lesley L; Mourtzakis, Marina; Kozar, Rosemary A; Compher, Charlene; Heyland, Daren K

2017-12-01

Lean body mass (LBM), quantified using computed tomography (CT), is a significant predictor of clinical outcomes in the critically ill. While CT analysis is precise and accurate in measuring body composition, it may not be practical or readily accessible to all patients in the intensive care unit (ICU). Here, we assessed the agreement between LBM measured by CT and four previously developed equations that predict LBM using variables (i.e. age, sex, weight, height) commonly recorded in the ICU. LBM was calculated in 327 critically ill adults using CT scans, taken at ICU admission, and 4 predictive equations (E1-4) that were derived from non-critically adults since there are no ICU-specific equations. Agreement was assessed using paired t-tests, Pearson's correlation coefficients and Bland-Altman plots. Median LBM calculated by CT was 45 kg (IQR 37-53 kg) and was significantly different (p LBM (error ranged from 7.5 to 9.9 kg), compared with LBM calculated by CT, suggesting insufficient agreement. Our data indicates a large bias is present between the calculation of LBM by CT imaging and the predictive equations that have been compared here. This underscores the need for future research toward the development of ICU-specific equations that reliably estimate LBM in a practical and cost-effective manner. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

ROLE OF LEPTIN ON CYTOCHROME P-450 AND SOME LIVER MICROSOMAL ENZYMES ACTIVITIES IN THE OBESE AND LEAN MICE

International Nuclear Information System (INIS)

HEBEISHY, M.I.A.; MAZEN, G.M.A.; SHAHIN, M.I

2008-01-01

Leptin is a hormone that is secreted by adipocytes and regulates body weight through its effect on satiety and energy metabolism. The obese mouse is deficient in this protein and is characterized by obesity and other metabolic disorders. This study investigated the alterations of several hepatic cytochrome P 4 -5 0 (CYP), conjugation and antioxidant enzymes in lean and obese mice and the role of leptin in the modulation of these enzymes. Lean and obese male mice were injected with leptin (100 μg / rat) for 15 days. The obtained results revealed that administration of leptin to lean mice caused a significant elevation in the level of blood glucose, serum insulin, 6α, 6β, 16α- hydroxylation of testosterone, the activity of CYP 1 A 1 , CYP 4 A and GSH reductase in liver microsomes while serum corticosterone and the activity of total GSH were significantly decreased when compared to lean control mice. Moreover, obese mice treated with leptin recorded significant reduction in body weight, blood glucose concentration, serum levels of insulin and corticosterone, 7α and 16α- hydroxylation of testosterone, the activity of CYP 1A 1, CYP 2 B 1 and CYP 4 A and GST in liver microsomes. On the other hand, 6α, 6β-hydroxylation of testosterone, the activity of CYP 2 E 1 and GSH reductase in liver microsome were significantly increased when compared to obese control mice. The mechanism for the observed alterations may be due to direct leptin effects or via indirect alterations in insulin, corticosterone and/or growth hormone

LEAN SIX SIGMA – MULTIPLE CASE STUDY

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Delvio Venanzi

2017-12-01

Full Text Available Lean Six Sigma é uma gestão focada na qualidade e desempenho produtivo em sistemas operacionais. Este artigo discute os fundamentos desta metodologia através de duas diferentes concepções de gestão, Lean Manufacturing e Six Sigma. Primeiro, o artigo explica o DMAIC (definir, medir, analisar, melhorar e controlar e suas respectivas fases, após a filosofia Lean com o sipoc e técnicas de mapeamento de fluxo de valor. O artigo pretende mostrar a integração destes dois conceitos e seus resultados. A metodologia consistiu em uma teoria baseada em uma pesquisa bibliográfica de pesquisa exploratória que consistiu de três estudos de caso em empresas de diferenças localizadas em Sorocaba, São Paulo. Neste artigo estuda a aplicação de Lean Seis Sigma e seus resultados.

Lean six sigma application to transportation logistics