Designing sustainable cold chains for long-range food distribution: Energy-effective corridors on the Silk Road Belt

Modern food production-distribution processes represent a critical stressor for the environment and for natural ecosystems. The rising flows of food across growing and consumption areas couple with the higher expectations of consumers for the quality of products and compel the intensive use of refrigerated rooms and transport means throughout the food supply chain. In order to aid the design of sustainable cold chains that incorporate such aspects, this paper proposes a mixed integer linear programming model to minimize the total energy consumption associated with the cold operations experienced by perishable products. This model is intended for food traders, logistics practitioners, retail managers, and importers collaboratively called to design and plan a cost and environmentally effective supply strategy, physical channels, and infrastructures for cold chains. The proposed model is validated with a case study inspired by the distribution of two example food products, namely fresh apples and ice cream, along the New Silk Road connecting Europe and China. The illustrated analysis investigates the effect of alternative routes and transport modes on the sustainability of the cold chain. It is found that the most energy-efficient route for ice cream is via rail over a northern route and, for apples, is via a southern maritime route, and, for these two routes, the ratios of the total energy consumed to the energy content of the food are 760 and 913, respectively. By incorporating the energy lost due to the food quality decay, the model identifies the optimal route to adopt in accordance with the shelf life and the conservation temperature of each product

A influência da anatomia patológica na construção do conhecimento alienista na Corte Imperial – o caso da paralisia geral progressiva (1868-1882)

This research note discusses the impact of anatomopathology on the development of psychiatric knowledge in Rio de Janeiro between 1868 and 1882. Through the analysis of medical dissertations and scientific articles about general paralysis of the insane (GPI) I argue that the acceptance of this disease category, considered nowadays a type of neurosyphilis, played an important role in the process through which alienist expertise became psychiatric knowledge. Since it had been significantly oriented by concepts inherited from the terrain of anatomopathology, the GPI framing process allowed the alienist cohort to incorporate concepts and paradigms which were considered ‘morescientific’ by general medicine during this period. Thus, the way GPI was described and developed as a disease entity doubtless favoured the process through which alienists professionalized and gained prestige in Rio de Janeiro.A presente nota de pesquisa discute as influências do campo da anatomia patológica na produção do conhecimento alienista no Rio de Janeiro, entre 1868 e 1882, através da análise do processo de enquadramento da paralisia geral progressiva (PGP), doença hoje considerada um tipo de sífilis do sistema nervoso. Baseada em teses de doutoramento e artigos publicados em periódicos médicos do período, evidencio que os referenciais da anatomia patológica estiveram diretamente imbricados no reconhecimento dos aspectos orgânicos desta doença mental e, consequentemente, da conquista de seu status enquanto entidade nosológica independente. Tal processo também permitiu que o alienismo se apropriasse de paradigmas considerados “mais científicos” pela medicina geral do período, quando buscava emergir enquanto campo psiquiátrico na Corte Imperial

Phenotype and genotype of 87 patients with Mowat-Wilson syndrome and recommendations for care

Mowat-Wilson syndrome (MWS) is a rare intellectual disability/multiple congenital anomalies syndrome caused by heterozygous mutation of the ZEB2 gene. It is generally underestimated because its rarity and phenotypic variability sometimes make it difficult to recognize. Here, we aimed to better delineate the phenotype, natural history, and genotype-phenotype correlations of MWS.MethodsIn a collaborative study, we analyzed clinical data for 87 patients with molecularly confirmed diagnosis. We described the prevalence of all clinical aspects, including attainment of neurodevelopmental milestones, and compared the data with the various types of underlying ZEB2 pathogenic variations.ResultsAll anthropometric, somatic, and behavioral features reported here outline a variable but highly consistent phenotype. By presenting the most comprehensive evaluation of MWS to date, we define its clinical evolution occurring with age and derive suggestions for patient management. Furthermore, we observe that its severity correlates with the kind of ZEB2 variation involved, ranging from ZEB2 locus deletions, associated with severe phenotypes, to rare nonmissense intragenic mutations predicted to preserve some ZEB2 protein functionality, accompanying milder clinical presentations.ConclusionKnowledge of the phenotypic spectrum of MWS and its correlation with the genotype will improve its detection rate and the prediction of its features, thus improving patient care.GENETICS in MEDICINE advance online publication, 4 January 2018; doi:10.1038/gim.2017.221

Phenotype and genotype of 87 patients with Mowat–Wilson syndrome and recommendations for care

Purpose: Mowat–Wilson syndrome (MWS) is a rare intellectual disability/multiple congenital anomalies syndrome caused by heterozygous mutation of the ZEB2 gene. It is generally underestimated because its rarity and phenotypic variability sometimes make it difficult to recognize. Here, we aimed to better delineate the phenotype, natural history, and genotype–phenotype correlations of MWS. Methods: In a collaborative study, we analyzed clinical data for 87 patients with molecularly confirmed diagnosis. We described the prevalence of all clinical aspects, including attainment of neurodevelopmental milestones, and compared the data with the various types of underlying ZEB2 pathogenic variations. Results: All anthropometric, somatic, and behavioral features reported here outline a variable but highly consistent phenotype. By presenting the most comprehensive evaluati

Between the disease and the cure: the experience of malariotherapy by psychiatrists of Rio de Janeiro (1924-1956)

Submitted by Gilvan Almeida ([email protected]) on 2016-09-26T14:04:41Z No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 155.pdf: 1742847 bytes, checksum: 75fda382b96935a21cc02d6dcce99ccb (MD5)Approved for entry into archive by Marcus Vinícius Silva ([email protected]) on 2017-07-31T17:12:07Z (GMT) No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 155.pdf: 1742847 bytes, checksum: 75fda382b96935a21cc02d6dcce99ccb (MD5)Made available in DSpace on 2017-07-31T17:12:07Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 155.pdf: 1742847 bytes, checksum: 75fda382b96935a21cc02d6dcce99ccb (MD5) Previous issue date: 2015Fundação Oswaldo Cruz. Casa de Oswaldo Cruz. Programa de Pós-Graduação em História das Ciências e da Saúde. Rio de Janeiro, RJ, BrasilDurante a virada do século XIX para o XX a comunidade médica tentava lidar com o crescente número de pacientes acometidos pela sífilis. Os esculápios classificavam a doença em diferentes fases, sendo a última e mais grave a paralisia geral progressiva ou PGP. Quando o doente chegava a este estágio suas faculdades psicomotoras começavam a ser progressivamente prejudicadas, o que resultava, em grande parte dos casos, em óbito. O percentual de cura dos doentes paralíticos gerais era muito pequeno e as técnicas até então disponíveis para o tratamento pouquíssimo promissoras. Ao longo da história, a febre se mostrou benéfica no tratamento de diversas doenças mentais e seu uso para estes fins remonta a Hipócrates (século IV a.C.). A utilização dos acessos febris provocados pela malária no tratamento da paralisia geral progressiva foi proposta, em 1917, pelo médico austríaco Julius Wagner-Jauregg. A técnica, batizada de malarioterapia, consistia na inoculação de sangue contendo um dos agentes etiológicos da malária, o protozoário da espécie Plasmodium vivax em doentes portadores desta forma de sífilis nervosa. Através das trocas científicas internacionais que ocorriam em diversas áreas do conhecimento e, especialmente, no campo da medicina experimental, ao longo da primeira metade do século XX, a técnica passou a ser conhecida, utilizada e estudada em diferentes países do mundo, inclusive no Brasil. Assim, o presente trabalho tem como objetivo analisar o processo de incorporação da malarioterapia no quadro terapêutico de instituições hospitalares cariocas ligadas à Assistência a Psicopatas do Distrito Federal e no Serviço de Neurossífilis do Hospital da Fundação Gaffrée e Guinle. Procuramos, desta forma, compreender como e em que medida a terapia palúdica contribuiu para a consolidação do campo da psiquiatria no Rio de Janeiro e para a modificação da visão dos médicos, especialmente de psiquiatras, sobre a paralisia geral progressiva.Between the turn of the 19th and 20th century the medical community tried to handle with the increasing number of patients suffering from syphilis. The doctors classified this disease in different levels and general paralysis of the insane was its last and most serious phase. When the patient reached this level his psychomotor faculties were progressively damaged, driving the paretic to death. The amount of cured patients was very small and the available therapeutics were little promising. Along history, fever showed its wholesome effects in the treatment of many mental ills and this kind of feverish accesses use goes back to Hipocrates (IV b.C.). The employment of fever accesses produced by malaria infection in the treatment of general paresis of the insane was proposed by the Austrian psychiatrist Julius Wagner-Jauregg, in 1917. The method, called malaria fever therapy or simply malariatherapy, consisted in the inoculation of blood with one of the aetiological agents of malaria, the protozoan Plasmodium vivax, in sick people who had this form of neurosyphilitic infection. Through international scientific exchanges which occurred especially in the experimental medical field in the first half of the twentieth century, the malaria fever therapy was practiced, disseminated, and studied in different countries around the world, including Brazil. The objective of the present work is to analyse the incorporation process of this method at the therapeutic board of healthcare institutions localized in the city of Rio de Janeiro. These were the asylums linked to the Psychopaths Healthcare of the Capital and the Neurosyphilis Service belonged to the Hospital of the Gaffrée e Guinle Foundation. In this way, we seek to comprehend in which level and how the malariatherapy contributed to the establishment of the psychiatric field in Rio, and to the changes in the way the doctors, especially psychiatrists, saw general paralysis and its prognosis

Warehouse management system customization and information availability in 3pl companies: A decision-support tool

Purpose This paper illustrates an original decision-support tool that aids 3PL managers to decide on the proper Warehouse Management System (WMS) customization. Aim of this tool is to address to the three main issues affecting such decision: the cost of the information sharing, the scarce visibility of the client\u2019s data, and the uncertainty of quantifying the return from investing into a WMS feature. Methodology The tool behaves as a digital twin of a WMS. In addition, it incorporates a set of WMS\u2019s features based both on heuristics and optimization techniques and uses simulation to perform what-if multi-scenario analyses of alternative management scenarios. In order to validate the effectiveness of the tool, its application to a real-world 3PL warehouse operating in the sector of biomedical products is illustrated. Findings The results of a simulation campaign along an observation horizon of ten months demonstrate how the tool supports the comparison of alternative scenarios with the as-is, thereby suggesting the most suitable WMS customization to adopt. Practical implications The tool supports 3PL managers in enhancing the efficiency of the operations and the fulfilling of the required service level, which is increasingly challenging given the large inventory mix and the variable clients portfolio that 3PLs have to manage. Particularly, the choice of the WMS customization that better perform with each business can be problematic, given the scarce information visibility of the provider on the client\u2019s processes. Value To the author\u2019s knowledge, this paper is among the first to address a still uncovered gap of the warehousing literature by illustrating a decision-support tool that exploits optimization and simulation techniques to quantify the impacts of the information availability on the warehousing operations performance. As a second novel contribution, this tool enables to create a digital twin of a WMS and foresee the evolution of the warehouse\u2019s performance over time