Setup Duration Research Articles

Overcoming the Learning Curve in Robot-Assisted Spinal Surgery—How Does It Compare to O-Arm Navigation?

Background: Robotic systems have the potential to significantly enhance the accuracy and outcomes of spinal surgery. Adopting this new technology requires an examination of its learning curve and influencing factors. This study analyzes the learning curve associated with using the Mazor X Stealth Edition system for pedicle screw placement and performs a matched-pair analysis to compare operative durations between robot-assisted and navigation-based surgeries, evaluating the efficiency of the robotic system. Methods: We collected retrospective operative data from patients who underwent robot-assisted pedicle screw placements between December 2020 and June 2024 and conducted a cumulative sum (CuSUM) analysis to assess the learning curve, focusing on the robotic system’s setup duration. Additionally, we compared a group of patients who underwent robot-assisted pedicle screw placements with a pair-matched group who underwent O-arm-based navigation-assisted pedicle screw placements. Results: There was a notable decrease in the robotic setup duration, with a significant shift in trend observed after the first 20 cases. While the initial setup time was 24 minutes, it reduced to 17 minutes in later cases, reflecting a marked improvement in efficiency as the surgeon gained more experience with the robot. Conclusion: Our findings indicate there were no added difficulties using the robotic system compared to the navigation system. Moreover, the learning curve for the robotic system can be quickly surmounted, and it offers clear advantages over previous systems, making it a valuable tool for pedicle screw application.

Implementasi Metode Single Minute Exchange of Dies Untuk Optimasi Setting Time Mesin Flexo B1 Grup C Pada Carton Box Departement PT. A

PT. A is a company engaged in the production and sale of paper, cardboard boxes, and other similar products in Indonesia. The products it offers include paper, tissue, packaging, and other products. The Carton Box Department, from the results of observations made, the average actual setting time on the Flexo B1 Group C machine is 47 minutes/order, this is one of the weaknesses that causes a 32-minute gap from the target set by the company which is 15 minutes/order. The research objectives are to analyze, improve, and obtain improved setting time results on the Flexo B1 Group C machine and the production process time carried out. The SMED (Single Minute Exchange of Dies) method is one approach that can be pursued in improving setting time. The influence of the SMED (Single Minute Exchange of Dies) method in optimizing the setting time of the Flexo B1 Group C machine results in a decrease in setting time with a setup duration of 49.11 minutes, normal time of 59 minutes, and standard time 66 minutes to a setup duration 25.36 minutes, normal time 27 minutes and standard time 34 minutes and the percentage obtained is 51.8%. Keywords: Lean Manufacturing, Productivity, Single Minute Exchange of Dies

Reduction in setup time for the POLO part on the MAUSA B CNC machine

With the increasing demand for industries to enhance production at reduced costs while minimizing lead time, adopting efficient tools and techniques to optimize the manufacturing process has become crucial. The primary objective of this study was to boost productivity and simplify the entire setup process for the Polo component on a MAUSA B CNC machine by introducing the SMED (Single Minute Exchange of Die) approach, which aims to minimize machine and tool setup duration. The process in question has a lengthy manufacturing cycle, necessitating the implementation of sophisticated approaches to achieve substantial outcomes in reducing the cycle. Additionally, the process requires well-structured planning, which differs from serial processes where minor solutions can yield significant benefits in terms of cost and production cycle reduction. This article outlines the solutions and enhancements utilized in the process.

A Randomized, Single-Blind Clinical Trial Comparing Robotic-Assisted Fluoroscopic-Guided with Ultrasound-Guided Renal Access for Percutaneous Nephrolithotomy.

We conducted a randomized, single-blind clinical trial comparing the surgical outcomes of robotic-assisted fluoroscopic-guided (RAF group) and ultrasound-guided (US group) renal access in mini-percutaneous nephrolithotomy (PCNL). We recruited patients who underwent mini-PCNL with ureteroscopic assistance for large renal stones between January 2020 and May 2021. Block randomization was performed using online software. Automated needle target with x-ray was used for fluoroscopic-guided renal access in the RAF group. PCNL was performed by residents using a pneumatic lithotripsy system with 16.5Fr/17.5Fr tracts. The primary outcome was single puncture success, and the secondary outcomes were stone-free rate, complication rate, parameters measured during renal access and fluoroscopy time. In total, 71 patients (35 in US group, 36 in RAF group) were enrolled. No difference was seen in the single puncture success rate between the US and RAF groups (34.3% and 50.0%, p=0.2). In 14.3% cases in the US group vs no cases in the RAF group, the resident was unable to obtain access due to difficult targeting (p=0.025). The mean number of needle punctures was significantly fewer, and the median duration of needle puncture was shorter in the RAF group (1.83 vs 2.51 times, p=0.025; 5.5 vs 8.0 minutes, p=0.049, respectively). The stone-free rate at 3 months after surgery was 83.3% and 70.6% in the RAF and US groups, respectively (p=0.26). Multivariate analysis revealed that RAF guidance reduced the mean number of needle punctures by 0.73 times (p=0.021). RAF renal access in mini-PCNL may have further potential applications in this field.

Frameless Robot-Assisted vs Frame-Based Awake Deep Brain Stimulation Surgery: An Evaluation of Technique and New Challenges.

Methodological approaches to deep brain stimulation (DBS) continue to evolve from awake frame-based to asleep frameless procedures with robotic assistance, primarily directed to optimize operative efficiency, lead accuracy, and patient comfort. Comparison between the 2 is scarce. To analyze the impacts of methodological differences on operative efficiency and stereotactic accuracy using a frame compared with a frameless robotic platform while maintaining the awake state and use of multiple microelectrode recording (MER) trajectories. Thirty-four consecutive patients who underwent bilateral awake frameless robot-assisted DBS were compared with a previous cohort of 30 patients who underwent frame-based surgery. Patient demographics, operative times, and MER data were collected for both cohorts. Two-dimensional radial errors of lead placements were calculated. Preoperative setup, surgical, and total operating room times were all significantly greater for the robot-assisted cohort (P < .001). The need for computed tomography imaging when referencing the robotic fiducials led to increased setup duration because of patient transport, unnecessary for the frame-based cohort. Multiple simultaneous MER trajectories increased surgical time (mean 26 min) for the robot-assisted cohort only. The mean radial errors in the robot-assisted and frame cohorts were 0.98 ± 0.66 and 0.74 ± 0.49 mm (P = .03), respectively. The use of a truly frameless robotic platform such as the Mazor Renaissance (Mazor Robotics Ltd) presented challenges when implementing techniques used during awake frame-based surgery. Maintaining good accuracy, intraoperative reference imaging, and limited MER trajectories will help integrate frameless robot assistance into the awake DBS surgical workflow.

The Human-Centric SMED

The Human-Centric SMED (H-SMED) is an evolution of the classical methodology introduced by Shingo to manage the setup process, which is particularly suitable for companies where the setup involves activities with high human content, that can be hardly transformed into external operations to be performed during the machine uptime. The H-SMED integrates Industry 4.0 tools, as the MES Data Analysis, Lean Management and Ergonomics with a new attention to the centrality of workers, in order to guide the transition towards the next Industry 5.0. The H-SMED methodology is developed into four phases, devolved to: (1) understanding the changeover process; (2) identifying potential improvements; (3) moving from proposal to practice; (4) training and control, in a continuous improvement cycle. The case study of a world-wide known company in the fashion eyewear industry is proposed to validate the framework, reporting a 44% reduction of setup duration.

Brain-computer interface-triggered functional electrical stimulation therapy for rehabilitation of reaching and grasping after spinal cord injury: a feasibility study.

Feasibility and preliminary clinical efficacy analysis in a single-arm interventional study. We developed a brain-computer interface-triggered functional electrical stimulation therapy (BCI-FEST) system for clinical application and conducted an interventional study to (1) assess its feasibility and (2) understand its potential clinical efficacy for the rehabilitation of reaching and grasping in individuals with sub-acute spinal cord injury (SCI). Spinal cord injury rehabilitation hospital-Toronto Rehabilitation Institute-Lyndhurst Centre. Five participants with sub-acute SCI completed between 12 and 40 1-hour sessions using BCI-FEST, with up to 5 sessions a week. We assessed feasibility by measuring participants' compliance with treatment, the occurrence of adverse events, BCI sensitivity, and BCI setup duration. Clinical efficacy was assessed using Functional Independence Measure (FIM) and Spinal Cord Independence Measure (SCIM), as primary outcomes. In addition, we used two upper-limb function tests as secondary outcomes. On average, participants completed 29.8 sessions with no adverse events. Only one of the 149 sessions was affected by technical challenges. The BCI sensitivity ranged between 69.5 and 80.2%, and the mean BCI setup duration was ~11 min. In the primary outcomes, three out of five participants showed changes greater than the minimal clinically important differences (MCIDs). Additionally, the mean change in secondary outcome measures met the threshold for detecting MCID as well; four out of five participants achieved MCID. The new BCI-FEST intervention is safe, feasible, and promising for the rehabilitation of reaching and grasping after SCI.

AVAPS-AE versus ST mode: A randomized controlled trial in patients with obesity hypoventilation syndrome.

Average volume-assured pressure support-automated expiratory positive airway pressure (AVAPS-AE) combines an automated positive expiratory pressure to maintain upper airway patency to an automated pressure support with a targeted tidal volume. The aim of this study was to compare the effects of 2-month AVAPS-AE ventilation versus pressure support (ST) ventilation on objective sleep quality in stable patients with OHS. Secondary outcomes included arterial blood gases, health-related quality of life, daytime sleepiness, subjective sleep quality and compliance to NIV. This is a prospective multicentric randomized controlled trial. Consecutive OHS patients included had daytime Pa CO2 > 6 kPa, BMI ≥ 30 kg/m2 , clinical stability for more than 2 weeks and were naive from home NIV. PSG were analysed centrally by two independent experts. Primary endpoint was sleep quality improvement at 2 months. Among 69 trial patients, 60 patients had successful NIV setup. Baseline and follow-up PSG were available for 26 patients randomized in the ST group and 30 in the AVAPS-AE group. At baseline, Pa CO2 was 6.94 ± 0.71 kPa in the ST group and 6.61 ± 0.71 in the AVAPS-AE group (P = 0.032). No significant between-group difference was observed for objective sleep quality indices. Improvement in Pa CO2 was similar between groups with a mean reduction of -0.87 kPa (95% CI: -1.12 to -0.46) in the ST group versus -0.87 kPa (95% CI: -1.14 to -0.50) in the AVAPS-AE group (P = 0.984). Mean NIV use was 6.2 h per night in both groups (P = 0.93). NIV setup duration was shorter in the AVAPS-AE group (P = 0.012). AVAPS-AE and ST ventilation for 2 months had similar impact on sleep quality and gas exchange.

Optimization of Injection Timing and Injection Duration of a Diesel Engine Running on Pure Biodiesel SME (Soya Methyl Ester)

This study was carried out to predict the impact of injection timing and injection duration on engine brake power and Nitrogen Oxides emissions in a diesel engine using biofuel Soya Methyl Ester (SME). Predictions were accomplished at three different injection timings 10°, 5° Crank Angle (CA) before Top Dead Center (bTDC) and 0° CA at Top Dead Center (TDC) and four injection durations 20°, 25°, 30°, 35° CA. The study was conducted using a simulation software (Diesel-RK). The predicted results showed that the powers produced by all the setups of the different injection timings are almost equal, but they differ in injection durations, e.g. the power at setup (10° CA-bTDC) duration 20° CA and 2500 rpm equal to 52 kW, at setup (5° CA-bTDC) duration 25° CA and same engine speed the power is equal to 51 kW, and at setup (0° CA-TDC) durations 30° the power is equal to 51 kW. The power in all setups are decreased as the injection duration increased, e.g. at setup 0° CA TDC durations 25°, 35°, and 40° CA and at 4000 rpm, the brake powers are equal 71, 65, and 59 kW respectively, thus the reduction percentages are 9% and 17% when compared to the 25° injection duration. The nitrogen oxides emissions decreased as the injection duration is increased, e.g. the emissions at setup (10° CA-bTDC) durations 25°, 30°, and 40° CA and at 2500 rpm are equal 852, 589, 293 ppm respectively, the reduction percentages are 30% and 72%. The variations of injection timing and injection duration have taken a weighty influence on engine performance and emissions. The results are considered as a novelty in the field of using pure biofuel Soya Methyl Ester in diesel engine according to our information.

Evaluation Setup Process on Rotogravure Printing Machine in Oder to Reduce Setup Time

The company carries out various ways to be able to meet customer demand quickly, one of which is to speed up the production process. In the printing process, the company encountered a problem, one of which was the high downtime caused by the setup process. The standard setup time determined by the company is 150 minutes but in fact the time required is 211.33 minutes. This shows that there are inefficient methods applied by the company. In this study, we will evaluate the work method to get errors so that the setup duration becomes high. This study will draw on the Modified Cooper Harper Scale and Single Minute Exchange of Dies (MCH-SMED) method to balance the workload between operators so that the setup time can be reduced. The MCH method is used to analyze the mental and physical workload on an operator based on a tree decision scale so that it can balance the workload between operators. SMED is used to identify on-line and off-line operations in the setup process. This study aims to produce a comparison of the standard setup times that have been set by the company and after evaluating the integration process of printing machine setup (MCH-SMED). The results of this study are to obtain a new sequence of operations that can reduce the duration of setup time to 143.19 minutes or be able to reduce the setup time by 32%

High-Throughput Satellite Characterization: Spot beam payload characterization of high-throughput satellites in a compact antenna test facility

An innovative measurement methodology is developed and successfully implemented for a spot beam antenna and payload characterization of high-throughput satellites (HTSs) in a compact antenna test facility (CATF). With the developed measurement methodology, total measurement time and measurement setup duration are reduced by more than 70% with respect to conventional measurement techniques. The proposed methodology is successfully implemented in multiple spacecraft (SC) of the Indian Space Research Organisation (ISRO).

Weapon target assignment optimization for land based multi-air defense systems: A goal programming approach

This study addressed the issue of allocating the air defense missiles to incoming air targets to maximize the air defense effectiveness of land-based air defense systems. A constraint based nonlinear goal programming (multi-objective) model for weapon assignment problem to minimize survival probability was developed. The model not only gave optimum assignment but also resulted in engagement times and defense success for multi-defense sites. The model utilized parameters belonging to defense systems such as engagement duration, setup duration between engagements, command and control structures, fire doctrines, and defense strategies and parameters belonging to target such as probability of kill values, position, orientation, weapon load, target type, and course of actions inferred by current detection information. The simulation model has two-way usages. In the first usage, it obtains solution for the parameters given above under limited number of missiles. In the second usage, the model shows the amount of missile to be used to achieve the possible highest success with the parameters given above. To be able to use the optimization model in a simulation environment, a simulation model as an optimizer agent is developed and located in air defense simulation scenarios. The model collects input data, optimize assignments, calculates fire times, and schedules fire orders. This solution is exemplified by a land-based air defense example.

The impact of external disturbances on the performance of a cellular manufacturing system

In manufacturing systems, different types of disturbances influence system's performance, cellular manufacturing has been proposed as an approach to cope with the uncertainty characteristic of customer driven markets. However, even cellular manufacturing systems are prone to the effects of varying demand patterns. In this study, the effects of some aspects related to demand variation such as the arrival of material, the variety of products and the variation in product mix are investigated to identify those system characteristics that - within the context of cellular manufacturing systems - represent an advantage in the presence of such disturbances. To do so, discrete event simulation is used to conduct the experimentation by modelling a cellular manufacturing system. Additionally, statistical design of experiment is employed to identify the factors contributing to higher system performance. The results show that, in spite of the demand related disturbance, machines with low set-up duration and highly skilled operators constitute the most important characteristics of an efficient manufacturing cell.

A Novel Bearing Swivel Joint and a Universal Joint for Concrete Pull-Off Testing Using a Material Testing Machine

Abstract The overall goal of this short study was to integrate two pull-off coupling devices for concrete: a bearing swivel joint and a universal joint, into an existing material testing machine. Their performance was evaluated in terms of efficiency using setup duration and compared to that of a commercially available portable testing device. Fifty-three pull-off tests were conducted on concrete prisms in accordance with ASTM C1583-04. Our results indicate that the portable tester was most efficient (6 min/test), followed by the universal joint (16 min/test), and then the bearing swivel joint (22 min/test). An online movie, as referenced in the text, demonstrates the modified test procedure, and recommendations for improvements to the test method are briefly discussed. Future testing will evaluate the variability among test results from the three devices.

Improving Changeover Time: A Tailored SMED Approach for Welding Cells

Short changeover times have always been critical in manufacturing business. Set-up duration reduction initiatives have been associated with Shingós ‘Single Minute Exchange of Die’ (SMED) method. Although a great number of companies have initiated SMED, some failed on implementation. The main reason is that strict application of Shingós SMED methodology is not the most efficient way to reduce set-up times in all situations. In the present study a tailored methodology is presented that has been developed specifically for an automotive supplier. The validation of the proposed method was done through implementation on an industrial welding cell for a period of four months. The main finding is that in addition to SMED tailored methodology, appropriate strategy definition and preparatory activities are key enablers for success. That includes project targets and timescale definition, selection of the appropriate team and coordinator, allocation of specific roles and responsibilities to each team member, training of team and shop floor staff on the new methodology and changeover standards. By implementing the new tailored SMED improvement programme, the company achieved 33% reduction on changeover time.

The effect of setup time reduction on its variance

Earlier research has found that the variability in setup time can play a central role in which it produces paradoxes and can harm effective waiting time, WIP, and capacity as one reduces setup time. Specifically, if setup time is reduced without a reduction in its variance, the waiting time in the system can increase and so can WIP. Of course, the matter worsens if setup variance increases as one reduces its duration. Given such findings, it becomes critical to find out what happens to setup time variance when we cut setup time. It is unlikely that setup variability can increase as one reduces setup duration.