Browsing by Issue Date, starting with "2023-10-05"
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- Assessment of the Impact of Lean Tools on the Safety of the Shoemaking IndustryPublication . Sá, José Carlos; Soares, Leonardo; Dinis-Carvalho, José; Silva, Francisco; Santos, GilbertoBoth the Lean philosophy and occupational safety and health have been widely studied, although this has usually been carried out independently. However, the correlation between Lean and occupational safety and health in the industrial context is still underexplored. Indeed, Lean tools can be applied to ensure the best safety environment for workers in each kind of manufacturing process, and this deserves to be studied. The study described here aims to understand the influence of each of a set of four Lean tools used in an industrial context with a strong manual labor component, seeking to determine the influence of each of these Lean tools on the increase in safety obtained through their application. For this purpose, four Lean tools that are quite commonly applied are selected, taking into account previously presented work that pointed to the positive influence of the application of each of these tools on worker safety: total productive maintenance system, Gemba walk, visual management and Yokoten. This study aims to apply these Lean tools and to analyze their impact on productivity, and then, on the safety of a company selected as a target in order to validate the concept. For this purpose, a new tool is created. In the first instance, the tool analyzes the current state of the productive process and the safety level through the study of the risk levels detected in the plant. In terms of productivity results, a reduction between 7% and 12% in cycle time is achieved in four areas of the plant. The feedback from employees showed increased satisfaction with the processes’ simplification. To conclude, a 50% reduction in the number of work accidents per month is observed as a result of the implementation of Lean tools. The influence of the selected Lean tools on increasing both productivity and safety is clear, and our results prove the selection of tools to be largely adequate.
- Retinal neurodegeneration in eyes with NPDR risk phenotypes: A two-year longitudinal studyPublication . Reste-Ferreira, Débora; Santos, Ana Rita; Marques, Inês Pereira; Santos, Torcato; Ribeiro, Maria Luísa; Mendes, Luís; Santos, Ana Rita; Lobo, Conceição; Cunha-Vaz, JoséDiabetic retinopathy (DR) is both a microangiopathy and a neurodegenerative disease. However, the connections between both changes are not well known. To characterise the longitudinal retinal ganglion cell layer + inner plexiform layer (GCL + IPL) changes and their association with microvascular changes in type-2 diabetes (T2D) patients with nonproliferative diabetic retinopathy (NPDR). This two-year prospective study (CORDIS, NCT03696810) included 122 T2D individuals with NPDR identified as risk phenotypes B and C, which present a more rapid progression. Phenotype C was identified by decreased VD ≥ 2SD in healthy controls, and phenotype B, identified by subclinical macular oedema with only minimal vascular closure. The GCL + IPL thickness, vessel density, perfusion density and area of intercapillary spaces (AIS) were assessed by optical coherence tomography (OCT) and OCT angiography (OCTA). Linear mixed effects models were employed to evaluate the retinal GCL + IPL progression and its associations. Regarding GCL + IPL thickness, T2D individuals presented on average 80.1 ± 7.49 μm, statistically significantly lower than the healthy control group, 82.5 ± 5.71 (p = 0.022), with only phenotype C differing significantly from controls (p = 0.006). GCL + IPL thickness steadily decreased during the two-year period in both risk phenotypes, with an annual decline rate of −0.372 μm/year (p < 0.001). Indeed, phenotype C showed a higher rate of progression (−0.459 μm/year, p < 0.001) when compared to phenotype B (−0.296 μm/year, p = 0.036). Eyes with ETDRS grade 20 showed GCL + IPL thickness values comparable to those of healthy control group (83.3 ± 5.80 and 82.7 ± 5.50 μm, respectively, p = 0.880), whereas there was a progressive decrease in GCL + IPL thickness in ETDRS grades 35 and 43–47 associated with the increase in severity of the retinopathy (−0.276 μm/year, p = 0.004; −0.585 μm/year, p = 0.013, respectively). Furthermore, the study showed statistically significant associations between the progressive thinning of GCL + IPL and the progressive increase in retinal capillary non-perfusion, with particular relevance for AIS (p < 0.001). Our findings showed that, in eyes with NPDR and at risk for progression, retinal neurodegeneration occurs at different rates in different risk phenotypes, and it is associated with retinal microvascular non-perfusion.