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Search Results: 1 - 10 of 379047 matches for " Bruno G. Rüttimann "
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World Trade Logics and Measure of Global Inequality: Regional Pattern and Globalization Evolution between 2003-2012  [PDF]
Bruno G. Rüttimann
Open Journal of Applied Sciences (OJAppS) , 2014, DOI: 10.4236/ojapps.2014.44019
Abstract: The economy is globalizing. But how are the different economic world regions performing regarding globalization of trade flows? Why are they performing differently? Globalization is not only the increase of international trade between certain preferential geographic areas of economy, but also the resulting increase of interweavement of trade flows between different geographical areas, independent of the amount of trade. This paper is a revised and expanded version of the paper entitled “World Trade and Associated Systems Risk of Global Inequality: Empiric Study of Globalization Evolution between 2003-2011 and Regional Pattern Analysis” presented at International Conference on Applied Economics (ICOAE2013), Istanbul, 27-29 June, 2013. This paper analyzes the evolution of world trade flows between 2003-2012 and performs a cross-section analysis of the year 2012. The economic interweavement will be measured by an inequality risk metric applied to the supply-demand matrix. This risk indicator is based on the concept of statistical entropy resulting in an inequality risk measure, giving an indication for the degree of economic globalization and the evolution of globalization in different geographical regions. In addition, it analyses the governing rational of globalization evolution. The result of this research shows that economic trade flows are globalizing, but with clear different regional patterns, not only between globalizing and de-globalizing regions, but also within the globalizing and de-globalizing regions itself. The emerging economies such as China or the Middle East are globalizing whereas mature economies such as North America and Europe are de-globalizing, confirming for globalization of the inverse Kuznets evolution. The different patterns between the different economic world regions can be explained by using the Globalization Type’s Model as well as the Central Theorem of Globalization.
Discourse about Linear Programming and Lean Manufacturing: Two Different Approaches with a Similar, Converging Rational  [PDF]
Bruno G. Rüttimann
Journal of Service Science and Management (JSSM) , 2015, DOI: 10.4236/jssm.2015.81010
Abstract: In recent years, the Toyota Production System has also assumed in western manufacturing plants a predominant position. Lean Manufacturing, as it is usually called in the occidental world, aims at a “Single-piece-flow” job handling and has its advantages compared to the classic “Batch and Queue” job handling. On the other hand, mathematical Linear Programming optimization techniques have passed into oblivion, having obtained the feel to be inappropriate for production planning. Although the two approaches have different aims and application, they give particular attention to scarce resources. The concepts of “bottleneck” in Lean Manufacturing and “shadow price” in Linear Programming are complementary. The paper shows the different focus of the two approaches and crystallizes their synergic values.
The Power of DOE: How to Increase Experimental Design Success and Avoid Pitfalls  [PDF]
Bruno G. Rüttimann, Konrad Wegener
Journal of Service Science and Management (JSSM) , 2015, DOI: 10.4236/jssm.2015.82028
Abstract: Personal empirical experience when lecturing and consulting shows that not only students, but also experienced engineers familiar with DOE, show much more interest in the modeling of a process than to statistical inference, neglecting attention to “boundary conditions” of the process. But exactly the observation of ancillary boundary conditions of experiments, such as minimizing Beta-risk and noise, is determinant for the efficient execution of an experimental design and the effective application of DOE derived models. This essay focuses attention to the must-dos in the DOE statistics approach in order to avoid research pitfalls by presenting a fail-proof 14-step approach when applying DOE modeling.
Reasons for Operational Excellence Deployment Failures and How to Avoid Them  [PDF]
Bruno G. Rüttimann, Martin T. St?ckli
Journal of Service Science and Management (JSSM) , 2015, DOI: 10.4236/jssm.2015.84061
Abstract: Globalization of business accompanied with increased margin squeeze has been leading many companies in western Europe during the last decade to deploy substantial Operational Excellence (OPEX) programs to remain competitive. Mainly proven Six Sigma and Lean techniques for quality and process improvement have been adopted however with variable lasting success. What are the reasons for success or failure? Which are the applied approaches? What are the circumstances leading to the outcome? This paper shows that management competence as well as the selected approach is decisive for success or failure. In addition, an optimized deployment approach to achieve a sustainable implementation of the OPEX program is presented.
Going beyond Triviality: The Toyota Production System—Lean Manufacturing beyond Muda and Kaizen  [PDF]
Bruno G. Rüttimann, Martin T. St?ckli
Journal of Service Science and Management (JSSM) , 2016, DOI: 10.4236/jssm.2016.92018
Abstract: Personal consulting experience has been showing that even many proven managers responsible for Lean Six Sigma Operational Excellence (OPEX) techniques have not fully understood the profound and comprehensive significance of Lean. Apart from the idealized interpretation of Lean boiled down to the limited concepts of Muda and Kaizen, the classical “temple” representation of the Toyota Production System (TPS) often leads to the interpretation that Lean is a toolbox from which one can select supposedly independent tools. By picking just some tools, however, the full potential of the TPS certainly cannot be exploited and—in the worst case—it may even cause production disruption. This essay criticizes the wide-spread ultra-simplification of concepts and, as a consequence, the distorted interpretation leads to an inappropriate use of the Lean tools. It presents two additional representations of the classical TPS temple model stressing the intrinsic systemic effects as well as the underlying theory concepts of the TPS to allow a flawless Just-in-Time (JIT) production. In fact, the original TPS is not a toolbox, but a comprehensive synergic tool system.
Lean and Industry 4.0—Twins, Partners, or Contenders? A Due Clarification Regarding the Supposed Clash of Two Production Systems  [PDF]
Bruno G. Rüttimann, Martin T. St?ckli
Journal of Service Science and Management (JSSM) , 2016, DOI: 10.4236/jssm.2016.96051
Although Lean manufacturing techniques are not yet in place in every shop floor production, the so-called Smart Factory with the very promising German-coined label “Industry 4.0” is already making its tour. While the Toyota Production System (TPS) has shown to be the most performant manufacturing system, the Industry 4.0 initiative is still in the scoping phase with the demanding goal to become a highly integrated cyber production system. The partial and often limited knowledge about Lean production leads to distorted ideas that the two approaches are incompatible. In order to eradicate wrong statements, this paper tries to explain what Lean really is and how it has to be considered in the context of the Industry 4.0 initiative. Further, it discusses the existing contradiction within the Industry 4.0 goals regarding manufacturing performance and break-even point.
Leveraging Lean in the Office: Lean Office Needs a Novel and Differentiated Approach  [PDF]
Bruno G. Rüttimann, Urs P. Fischer, Martin T. St?ckli
Journal of Service Science and Management (JSSM) , 2014, DOI: 10.4236/jssm.2014.75032
Abstract: 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 both, procedural and relational processes. The office environment, therefore, cannot be described by a purely transactional shop floor model—it necessitates a separate model, with a differenciated approach, which covers the procedural as well as the relational aspects of office tasks. Also the different characteristics of the transaction object as well as the operation transformation and process governance do not allow an un-adapted application of Toyota’s comprehensive Lean toolset. The approach of Lean for the office environment needs a reinterpretation of the Lean logic and TPS Lean tools for the procedural part as well. Therefore, different and adapted approaches and tools are clearly necessary. The paper shows the objectives and principles of Lean and why Lean manufacturing is also interesting to be applied in the office environment. The differences between office and production jobs are detailed and introduce the problem of lean application in the office. The particular characteristics of the office environment are discussed and enable to enter into the Relational Office Model. Furthermore, we explain the paradigm shift which is necessary to take full benefit of the Lean approach in the office environment, however without presenting the reinterpreted office Lean toolset due to space reasons. This will be the topic of a next paper.
Cognitive decline in Parkinson’s disease: from “The Shaking Palsy” to a more complex paradigm
Letteri F,Reniè R,Bruno G
Prevention and Research : International Open Access Journal of Prevention and Research in Medicine , 2013, DOI: 10.7362/2240-2594.127.2013
Abstract: Parkinson’s disease (PD) was originally considered a pure motor disorder according to the first description by James Parkinson in “The Shaking Palsy”. Nowadays, an increasing awareness of the complexity underlying PD has been acquired among clinicians: dementia is one of the most investigated PD’s non-motor features because of its individual and social burden. Recent evidences report dementia affects up to 80% of PD patients in later stages and it represents a relevant risk for nursing home-admissions and duration of hospitalization. Clinical diagnostic criteria for dementia associated with Parkinson’s disease (PDD) have been suggested to develop common lines of diagnosis. Frequently, PD patients present a state of cognitive impairment since the time of diagnosis, defined as Parkinson’s disease mild cognitive impairment (PD-MCI). In non-demented PD population, MCI is the major predictor for conversion to dementia and new diagnostic criteria and guidelines for diagnostic procedures in PD-MCI have been proposed by Movement Disorder Society to better identified it. The involvement of different circuits including dopamine, norepinephrine and acetylcholine neurotransmission give reason of the multifaceted cognitive profile described in PD patients with mild cognitive impairment and dementia. Main clinical features include attention deficits, executive dysfunction, as well as visuospatial and memory impairments. Neuroimaging and the assessment of genetics, central and peripheral biochemistry and neuropsychology seem to be useful in detecting an early cognitive decline. In particular, the combination of these single biomarkers might make more sensible and specific the early diagnosis of PD-MCI and PDD. In 2012, Cochrane analysis has outlined the therapeutic efficacy of acetylcholinesterase inhibitors (AChEI) in patients with PDD. Among AChEI, rivastigmine is the most recognized treatment that appears to provide a real benefit in cognitive functions, neuropsychiatric disturbances and activities of daily living in patients with PD-MCI and PDD. Some findings suggest possible therapeutic effects in improving cognition of memantine, which is already used in the treatment of Alzheimer’s disease. Also atomoxetine, a selective norepinephrine reuptake inhibitor, showed beneficial for PD’s non-motor symptoms linked to the loss of norepinephrine neurons such as global cognition (i.e. attentional modulation) and daytime sleepiness. Finally, the treatment of motor-symptoms with levodopa has demonstrated a positive impact on some cognitive impairments such as working memory
Estudo de paralisias faciais traumáticas: análise de casos clínicos e cirúrgicos
Pinna, Bruno R.;Testa, José R.G.;Fukuda, Yotaka;
Revista Brasileira de Otorrinolaringologia , 2004, DOI: 10.1590/S0034-72992004000400007
Abstract: traumatic facial paralysis is the second more common cause of facial impairment. study design: chart review. material and method: a retrospective review of 82 patients with facial paralysis was conducted from january 1990 to january 1999. results: from this group 54 were males (65.8%) and 28 females (34.2%), patients' age ranged from 2 to 75 years (mean age 30.9 y). the kind of trauma was iatrogenic in 15 (18.22%); penetrating injuries into the face in 2 (2.44%); temporal bone fractures in 50 (60.97%); gunshot injuries in 14 (17.07%) and birth injury in 1 (1.22%). there were 71 sudden paralysis (86.5%), 10 progressive paralysis (12.3%) and 1 at birth (1.22%). the beginning electrical tests were symmetrical in 32 (43.84%) and with markedly decreased response in 41 (56.16%). the symmetrical ones had complete recovery in 24, 80% of recovery in 6 and 60% of recovery in 2; the asymmetrical ones with decreased response, only 5 recoveries completely. conclusion: 1. there was greater male incidence; 2. there were more sudden paralysis and they recovered better than the progressives; 3. there were more patients with temporal trauma with fractures and they recovery better than the others; 4. the electrical tests could give the prognoses to the facial paralysis patient; 5. the worst cases of facial paralysis received more aggressive treatment, with good results.
Cost-effectiveness of childhood hepatitis A vaccination in Argentina: a second dose is warranted
Ellis,Alejandro; Rüttimann,Ricardo W.; Jacobs,R. Jake; Meyerhoff,Allen S.; Innis,Bruce L.;
Revista Panamericana de Salud Pública , 2007, DOI: 10.1590/S1020-49892007000500002
Abstract: objectives: to investigate the cost-effectiveness of childhood vaccination against hepatitis a in the five geographic regions of argentina, and to determine whether adding a second dose to the current one-dose schedule would provide health gains justifying its added cost. methods: a markov model was used to consider four immunization options for the 2005 birth cohort: (1) no vaccination; (2) vaccination at 12 months of age, (3) vaccinations at 12 and 72 months of age; or (4) vaccinations at 12 and 18 months of age. hepatitis a costs and consequences were predicted over 50 years. the cost-effectiveness of first and second vaccine doses was assessed through a range of vaccine prices and assumptions regarding the duration of vaccine protection. costs and health gains (measured in quality-adjusted life years) were adjusted to present values using a 3% annual discount rate. results: the one-dose vaccination policy is predicted to reduce each birth cohort member's 50-year probability of overt hepatitis a from 7.2% to 4.1%. a second dose would reduce the probability to between 2.0% and 2.2%. vaccination at 12 months of age, at 12 and 72 months, or at 12 and 18 months would reduce cases among personal contacts by 82%, 87%, and 92%, respectively. the first vaccine dose would meet accepted standards of cost-effectiveness in each region, and reduce costs in the northeast, central, and south regions. adding a second dose at age 18 months would be cost-effective in each region, and further reduce costs in the cuyo region. if the duration of protection with one dose is less than anticipated, the second dose would be more cost-effective. conclusions: greater health gains are derived from the first than second hepatitis a vaccine dose. however, this analysis supports the cost-effectiveness of providing both first and second doses to argentina's children.
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