work sequence analysis and computer simulations of value flow and workers relocations a case study

Abstract Several solutions have been proposed for the workload balancing in manual assembly lines with workers' task assignment. Facing the case study of a sheet metal assembly line of transport pallets, the paper addresses the problem of the dynamic task assignment. The walking path minimization is considered in the problem, together with task sequence constraints. A real-time simulation allows to test the solution variations before their implementation

Therapists' clinical work between sessions: A preliminary study of the Post Session Therapist Questionnaire

Objective: In this paper, we present the development of a new self-report questionnaire to assess a characteristic of clinical work that has not been considered in the literature: the mental (affective and rational) work that therapists do between clinical sessions. The resulting instrument is the Post Session Therapist Questionnaire. Method: After consulting the literature and conducting in-depth discussions of the dimensions to be investigated, we generated 40 items through brainstorming. We had 16 experts carefully examine the questionnaire\u2019s content validity at various stages and thus obtained 38 pertinent, clear, and unambiguous items. The experts also provided positive evaluations of the questionnaire\u2019s instructions and response mode. We then carried out a pilot study with 27 clinicians, who filled out the questionnaire twice, referring to 100 patients in each case. To assess the structural validity of the new instrument, we conducted an exploratory factor analysis using the session (N = 200) as the unit of analysis. Result: Three factors substantially supported the theoretical dimensions that we conceptualized in the first stage of the research: We called the factors Positive Regard, Comprehension, and Diagnostic Effort. These dimensions have good internal consistency. Conclusion: The study\u2019s results suggest that these clinical dimensions are meaningful in the development of clinical processes, which encourages further study of the psychometric properties of the questionnaire, with larger samples, so as to consider these results in relationship to the outcomes of the following sessions

imaging the kidney from light to super resolution microscopy

Abstract The important achievements in kidney physiological and pathophysiological mechanisms can largely be ascribed to progress in the technology of microscopy. Much of what we know about the architecture of the kidney is based on the fundamental descriptions of anatomic microscopists using light microscopy and later by ultrastructural analysis provided by electron microscopy. These two techniques were used for the first classification systems of kidney diseases and for their constant updates. More recently, a series of novel imaging techniques added the analysis in further dimensions of time and space. Confocal microscopy allowed us to sequentially visualize optical sections along the z-axis and the availability of specific analysis software provided a three-dimensional rendering of thicker tissue specimens. Multiphoton microscopy permitted us to simultaneously investigate kidney function and structure in real time. Fluorescence-lifetime imaging microscopy allowed to study the spatial distribution of metabolites. Super-resolution microscopy increased sensitivity and resolution up to nanoscale levels. With cryo-electron microscopy, researchers could visualize the individual biomolecules at atomic levels directly in the tissues and understand their interaction at subcellular levels. Finally, matrix-assisted laser desorption/ionization imaging mass spectrometry permitted the measuring of hundreds of different molecules at the same time on tissue sections at high resolution. This review provides an overview of available kidney imaging strategies, with a focus on the possible impact of the most recent technical improvements

AUTOMATED ANOMALY MONITORING AND DETECTION SYSTEM FOR FCU SYSTEM

Implementing and integrating new technologies such as the Internet of Things (IoT), smart sensors, and information and communication technology (ICT) into building facilities generates a large amount of data that will be utilized to better manage building facilities specifically FCU. Automated fault detection and diagnostics(AFDD) systems assist facility managers in informing operators to perform scheduled maintenance and visualizing facility anomalies on building information models (BIM). This study proposes a AFDD system for FCU system using an IoT sensors and by visualizing faults in a BIM model. The proposed system shows the data management and anomaly detection and monitoring technique on the BIM. The experiment results demonstrated the framework's competence to detect anomalies in the FCU system. Furthermore, data collected from various simulated conditions of the building facilities was utilized to monitor and detect anomalies in the 3D model of the fan coil. The automated detection FCU anomalies on the BIM model and preliminary results of the system are demonstrated

Gastrointestinal Malabsorption of Thyroxine

Levothyroxine, a largely prescribed drug with a narrow therapeutic index, is often a lifelong treatment. The therapeutic efficacy of thyroxine may be marred by behavioral, pharmacologic and pathologic issues acting as interfering factors. Despite a continuous search for an optimal thyroxine treatment, a significant number of patients fail to show a complete chemical and/or clinical response to this reference dose of thyroxine. Gastrointestinal malabsorption of oral thyroxine represents an emerging cause of refractory hypothyroidism and may be more frequent than previously reputed.In this review article we aimed at examining the pharmacologic features of thyroxine preparations and their linkage with the intestinal absorption of the hormone. We have stressed the major biochemical and pharmacologic characteristics of thyroxine and its interaction with the putative transporter at the intestinal level. We have examined the interfering role of nutrients, foods, and drugs on thyroxine absorption at gastric and intestinal level. The impact of gastrointestinal disorders on thyroxine treatment efficacy has been also analyzed, in keeping with the site of action and the interfering mechanisms. Based on the evidence obtained from the literature, we also propose a schematic diagnostic workup for the most frequent and, often hidden, gastrointestinal diseases impairing thyroxine absorption

Iot open-source architecture for the maintenance of building facilities

none6noThe introduction of the Internet of Things (IoT) in the construction industry is evolving facility maintenance (FM) towards predictive maintenance development. Predictive maintenance of building facilities requires continuously updated data on construction components to be acquired through integrated sensors. The main challenges in developing predictive maintenance tools for building facilities is IoT integration, IoT data visualization on the building 3D model and implementation of maintenance management system on the IoT and building information modeling (BIM). The current 3D building models do not fully interact with IoT building facilities data. Data integration in BIM is challenging. The research aims to integrate IoT alert systems with BIM models to moni-tor building facilities during the operational phase and to visualize building facilities’ conditions virtually. To provide efficient maintenance services for building facilities this research proposes an integration of a digital framework based on IoT and BIM platforms. Sensors applied in the building systems and IoT technology on a cloud platform with opensource tools and standards enable monitoring of real-time operation and detecting of different kinds of faults in case of malfunction or failure, therefore sending alerts to facility managers and operators. Proposed preventive maintenance methodology applied on a proof-of-concept heating, ventilation and air conditioning (HVAC) plant adopts open source IoT sensor networks. The results show that the integrated IoT and BIM dashboard framework and implemented building structures preventive maintenance methodology are applicable and promising. The automated system architecture of building facilities is intended to provide a reliable and practical tool for real-time data acquisition. Analysis and 3D visualization to support intelligent monitoring of the indoor condition in buildings will enable the facility managers to make faster and better decisions and to improve building facilities’ real time monitoring with fallouts on the maintenance timeliness.openVilla V.; Naticchia B.; Bruno G.; Aliev K.; Piantanida P.; Antonelli D.Villa, V.; Naticchia, B.; Bruno, G.; Aliev, K.; Piantanida, P.; Antonelli, D

Bronchiolitis. Analysis of 10 consecutive epidemic seasons

Bronchiolitis is the leading cause of hospitalization in infants under 12 months. Our aims were to analyze epidemiological characteristics of infants with bronchiolitis over 10 consecutive seasons and to evaluate whether there are any clinical differences between infants hospitalized for bronchiolitis during epidemic peak months and infants in non-peak months. We enrolled consecutive enrolled 723 previously healthy term infants hospitalized at the Paediatric Emergency Department, "Sapienza" University of Rome over the period 2004-2014. Fourteen respiratory viruses were detected from nasopharyngeal aspirates by molecular methods. Clinical and demographic data were extracted from clinical charts. Viruses were detected in 351 infants (48.5%): RSV in 234 (32.4%), RV in 44 (6.1%), hBoV in 11 (1.5%), hMPV in 12 (1.6%), co-infections in 39 (5.4%), and other viruses in 11 (1.5%). Analyzing the 10 epidemic seasons, we found higher incidence for bronchiolitis every 4 years with a peak during the months December-January. Infants hospitalized during peak months had lower family history for asthma (P = 0.003), more smoking mothers during pregnancy (P = 0.036), were slightly higher breastfed (0.056), had lower number of blood eosinophils (P = 0.015) and had a higher clinical severity score (P = 0.017). RSV was detected mostly during peak months, while RV was equally distributed during the seasons. We found some variations in bronchiolitis incidence during epidemics, and discriminative characteristics in infants hospitalized for bronchiolitis during peak months and in non-peak months, that might reflect two different populations of children. Pediatr Pulmonol. 2016; 9999:XX-XX. © 2016 Wiley Periodicals, Inc

IL-17 Inhibition: A Valid Therapeutic Strategy in the Management of Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with a significant negative impact on the quality of life of patients. To date, the therapeutic landscape for the management of the disease has been extremely limited, resulting in a profound unmet need. Indeed, adalimumab, an anti-tumor necrosis factor (TNF)-α monoclonal antibody, is the only approved biologic agent for HS, obtaining a therapeutic response in only 50% of HS patients. Numerous clinical trials are currently ongoing to test novel therapeutic targets in HS. The IL-17-mediated cascade is the target of several biologic agents that have shown efficacy and safety in treating moderate-to-severe HS. Both bimekizumab and secukinumab, targeting IL-17 in different manners, have successfully completed phase III trials with promising results; the latter has recently been approved by EMA for the treatment of HS. The aim of this review is to summarize the current state of knowledge concerning the relevant role of IL-17 in HS pathogenesis, highlighting the key clinical evidence of anti-IL-17 agents in the treatment of this disease

Levothyroxine therapy: Changes of TSH levels by switching patients from tablet to liquid formulation. A systematic review and meta-analysis

Background: In the last years, levothyroxine (LT4) has been commercialized also in liquid formulation, which is less sensitive to the factors known to reduce the absorption of tablet LT4. To date, there is no robust information that liquid LT4 can improve pharmacologic thyroid homeostasis of patients with reduced efficacy of tablet LT4. This analysis aimed at achieving solid evidence that switching thyroxine treatment from tablet to liquid preparation improves patients' TSH levels. Methods: The search was performed in PubMed/MEDLINE and Scopus database based on the terms "thyroid," "levothyroxine," and "liquid," and updated until September 25, 2017. Studies were included only if they described patients with suboptimal TSH on tablet LT4, subsequently switched to liquid LT4. Results: The literature search retrieved 462 articles and six were finally included. The pooled mean difference of TSH value between tablet and liquid LT4 was 4.23 mIU/L (95% CI from 3.69 to 4.77). Mild heterogeneity was found (I260%). Overall mean difference of TSH was significant (p < 0.0001). Conclusion: The present meta-analysis showed that patients with suboptimal TSH on tablet LT4 can have a significantly improved TSH by switching to liquid LT4 formulation at unchanged dose

Circulating CXCL10 is increased in non-segmental vitiligo, in presence or absence of autoimmune thyroiditis

Recently the importance of CXCL10 in the pathogenesis of non-segmental vitiligo (NSV) and autoimmune thyroid disorders (AITD) has been shown. No data are present about chemokines CXCL10 (Th1 prototype) and CCL2 (Th2 prototype) circulating levels in NSV patients with/without thyroiditis (AT). Serum CXCL10 and CCL2 have been measured in 50 consecutive NSV patients, in 40 consecutive patients with NSV and AT (NSV+AT), in 50 sex- and age-matched controls without AT (control 1) and in 40 sex- and age-matched patients with AT without NSV (control 2). Serum CXCL10 levels were significantly higher in control 2, than in control 1 (P=0.001; ANOVA). NSV patients have serum CXCL10 levels significantly higher than control 1, or control 2 (P=0.001). NSV+AT patients have serum CXCL10 levels higher than control 1, or 2 (P<0.001), and than NSV (P=0.01). In conclusion, we first demonstrate high serum CXCL10 in NSV patients, overall in presence of AT and hypothyroidism, suggesting the importance of a common Th1 immune response in their immune-pathogenesis. To evaluate if serum CXCL10 might be used as a clinical marker of NSV and/or AT further studies are needed