The Role of Digital Technologies in Improving Energy Efficiency at Logistics Facilities: A State-of-the-Art

The logistics industry is facing increasing challenges that have been further amplified by recent disruptions. In this context, warehouses have been playing an ever-crucial role. They have been transitioning from simple storage centres into high-functional facilities where several and heterogeneous processes are performed to guarantee efficiency and service level fulfilment. These dramatic changes have often made them highly energy intensive. To cope with these changes, a wide array of digital technologies is now available and has started to be gradually introduced by companies at their logistics facilities to reduce energy consumption and improve the environmental sustainability of warehousing operations. Nevertheless, on the academic side, although a mounting number of papers have been found addressing the adoption of digital technologies at logistics facilities with an energy efficiency perspective, a clear overview of the solutions in place and their impact on warehousing processes has been largely neglected so far. This contribution aims at addressing this research gap by offering a state-of-the-art of the role of digital technologies in improving energy efficiency at logistics facilities. The study is based on a systematic review approach performed by means of the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) protocol. The research is part of a broader Italian funded PNRR Research project “Centro Nazionale per la Mobilità Sostenibile” (MOST) – Spoke 10 “Sustainable Logistics”. Results indicate that the impact of digital technologies on warehouse processes is still underexamined, and research has mainly focused on specific technical issues or single warehousing processes rather than providing a holistic approach. The study provides a comprehensive framework offering guidance for technology implementation. Implications are discussed and streams for future investigation are identified

International longitudinal registry of patients with atrial fibrillation and treated with rivaroxaban: RIVaroxaban Evaluation in Real life setting (RIVER)

Background Real-world data on non-vitamin K oral anticoagulants (NOACs) are essential in determining whether evidence from randomised controlled clinical trials translate into meaningful clinical benefits for patients in everyday practice. RIVER (RIVaroxaban Evaluation in Real life setting) is an ongoing international, prospective registry of patients with newly diagnosed non-valvular atrial fibrillation (NVAF) and at least one investigator-determined risk factor for stroke who received rivaroxaban as an initial treatment for the prevention of thromboembolic stroke. The aim of this paper is to describe the design of the RIVER registry and baseline characteristics of patients with newly diagnosed NVAF who received rivaroxaban as an initial treatment. Methods and results Between January 2014 and June 2017, RIVER investigators recruited 5072 patients at 309 centres in 17 countries. The aim was to enroll consecutive patients at sites where rivaroxaban was already routinely prescribed for stroke prevention. Each patient is being followed up prospectively for a minimum of 2-years. The registry will capture data on the rate and nature of all thromboembolic events (stroke / systemic embolism), bleeding complications, all-cause mortality and other major cardiovascular events as they occur. Data quality is assured through a combination of remote electronic monitoring and onsite monitoring (including source data verification in 10% of cases). Patients were mostly enrolled by cardiologists (n = 3776, 74.6%), by internal medicine specialists 14.2% (n = 718) and by primary care/general practice physicians 8.2% (n = 417). The mean (SD) age of the population was 69.5 (11.0) years, 44.3% were women. Mean (SD) CHADS2 score was 1.9 (1.2) and CHA2DS2-VASc scores was 3.2 (1.6). Almost all patients (98.5%) were prescribed with once daily dose of rivaroxaban, most commonly 20 mg (76.5%) and 15 mg (20.0%) as their initial treatment; 17.9% of patients received concomitant antiplatelet therapy. Most patients enrolled in RIVER met the recommended threshold for AC therapy (86.6% for 2012 ESC Guidelines, and 79.8% of patients according to 2016 ESC Guidelines). Conclusions The RIVER prospective registry will expand our knowledge of how rivaroxaban is prescribed in everyday practice and whether evidence from clinical trials can be translated to the broader cross-section of patients in the real world

Sustainable logistics facilities: a simulation-based approach towards warehouse decarbonization within the food and beverage industry

Logistics research has recently shifted the attention to the environmental impact of logistics facilities as a response to their increasing contribution to energy consumption and greenhouse gas emissions, as such, warehousing now plays a crucial role in the decarbonization journey. Focusing on the food and beverage industry, well-known for its high energy-intensity related to both industrial and warehousing processes, many companies are leveraging 4.0 technologies to support the transition to green warehousing measures to enhance the energy efficiency and reduce the carbon footprint of their production and logistics processes. Nevertheless, literature still lacks guidance on implementing green warehousing measures and offers limited insights into real-world applications. This paper aims to address these gaps by proposing a simulation-based framework and its application on a real industrial business case. This framework supports companies in their journey to reduce carbon emissions at their logistics facilities and helps practitioners in their decision-making processes to identify the most suitable green warehousing measures based on the specific needs and features of their warehouses. The developed framework is applied in a real-world business case to enhance reliability and evaluate the benefits in terms of environmental and economic sustainability. The simulation results indicate that renewable energy sources have significant potential to reduce environmental impact while maintaining high economic performance, and the implementation of a battery energy storage system improves energy consumption performance at the expense of economic performance

Relationship of HLA-DQAI alleles and humoral antibody following measles vaccination

AbstractBackground: The human leukocyte antigen (HLA)-DQA1 locus is only moderately polymorphic compared to other HLA class II loci; however, we hypothesized that these polymorphisms could be important in determining the humoral antibody response to measles vaccine virus.Methods: The seroprevalence of measles antibody was determined in 881 school children who had been immunized with MMR-II at age approximately 15 months. All subjects resided in a geographic area with no circulating measles virus. The IgG antibody levels were determined by a measles-specific whole virus enzyme immunoassay (EIA) (BioWhittaker, Walkersville, MD). Subjects who were nonresponders (IgG seronegative or equivocal) (n = 46) and hyperresponders (upper 10th percentile of IgG levels of all subjects) (n = 64) were HLA-DQA1 typed using polymerase chain reaction with sequence-specific primers (PCR-SSP). The HLA-DQA1 allele frequencies, as well as homozygosity rates, were compared between the nonresponders and hyperresponders.Results: The overall allele frequency distribution of alleles between the nonresponders and hyperresponders was significantly different (P = 0.05), with nonresponders having an excess of HLA-DQA∗05 alleles (P = 0.017) and hyperresponders having an excess of HLA-DQA1∗01 alleles (P = 0.013). The homozygosity rate among nonresponders was significantly higher than among hyperresponders (23.9% vs. 9.4%, P = 0.037).Conclusion: HLA-DQA1 alleles have important associations with the antibody response to measles vaccine. Specifically, the carriage of the HLA-DQA1∗05 alleles is associated with nonresponse and that of HLA-DQA1∗01 alleles with hyperresponse. In addition, HLA-DQA1 homozygosity is significantly associated with poor antibody response to measles vaccine

Gender differences in genital lichen sclerosus: Data from a multicenter Italian study on 729 consecutive cases

BACKGROUND: Studies specifically conducted to assess gender differences in genital lichen sclerosus (GLS) are not available. This multiÂcenter study aimed to identify possible gender-related differences on GLS clinical features, history and course, through collecting data from a large mixed-sex sample of patients. METHODS: This was a cross-sectional study on 729 subjects (53.8% females, 46.2% males) affected with GLS, consecutively observed within a network of 15 Italian dermatology units. The following information was specifically collected: Clinical features and severity of symptoms reÂlated to GLS, extragenital involvement, previous therapies, diagnostic suspicion at referral, type of referring physicians, development of genital squamous-cell carcinoma (SCC).RESULTS: Females complained of symptoms more frequent and severe than men; pallor and scarring-sclerosis-atrophy were the most frequent features without gender differences; itching-related signs were more frequent in females than in males as well as extragenital involvement; prior to receiving a definitive diagnosis, females received treatment more frequently than males; 40% of patients were referred with a misdiagnosis; the highest rate of correct suspected diagnosis at referral came from dermatologists than from other physicians; duration of the disease was found to predispose to SCC development. CONCLUSIONS: Our findings highlighted several gender differences on clinical presentation and symptom profile of GLS. In spite of some characteristic features, misdiagnosis at referrals was frequent