Risk based, multi objective vehicle routing problem for hazardous materials: a test case in downstream fuel logistics

Abstract The paper analyses a practical case of study related to the distribution of fuels for the Total Erg Oil Company to the service stations located in the Province of Rome (Italy). The problem is formulated as a capacitated vehicle routing problem with time windows, where several heuristic procedures have been tested, considering both static and dynamic travel times. With respect to the standard operational costs used typically, a multivariable objective function has been proposed which takes into account also a new risk index. The risk index proposed is function of the population density of the zones covered by each path and of the estimated number of road accidents on each road link. In such a way, we take into account the population's exposure to the risk associated with an incidental event involving a fuel tank. The obtained output is the set of planned routes with minimum service cost and minimum risk. Results demonstrate how an accurate planning of the service saves up to 3 hours and 30 km on a daily basis compared to a benchmark. Moreover, the distribution company can parameterize the configuration of the service, by varying the weight adopted in order to include the risk index. Including the risk index may bring to a higher safety route planning, with an increase of the operating costs of only 2%

Advanced Model for Fast Assessment of Piezoelectric Micro Energy Harvesters

The purpose of this work is to present recent advances in modeling and design of piezoelectric energy harvesters, in the framework of micro-electro-mechanical systems (MEMS). More specifically, the case of inertial energy harvesting is considered, in the sense that the kinetic energy due to environmental vibration is transformed into electrical energy by means of piezoelectric transduction. The execution of numerical analyses is greatly important in order to predict the actual behavior of MEMS devices and to carry out the optimization process. In the common practice, the results are obtained by means of burdensome 3D finite element analyses (FEA). The case of beams could be treated by applying 1D models, which can enormously reduce the computational burden with obvious benefits in the case of repeated analyses. Unfortunately, the presence of piezoelectric coupling may entail some serious issues in view of its intrinsically three-dimensional behavior. In this paper, a refined, yet simple, model is proposed with the objective of retaining the Euler-Bernoulli beam model, with the inclusion of effects connected to the actual three-dimensional shape of the device. The proposed model is adopted to evaluate the performances of realistic harvesters, both in the case of harmonic excitation and for impulsive loads

Serum uric acid, creatinine, and the assessment of antioxidant capacity in critical illness

No Abstract - The letter addresses the issue of low plasma urate as a marker of impaired antioxidant capacity in critical illness

Parenteral Nutrition in Liver Resection

Albeit a very large number of experiments have assessed the impact of various substrates on liver regeneration after partial hepatectomy, a limited number of clinical studies have evaluated artificial nutrition in liver resection patients. This is a peculiar topic because many patients do not need artificial nutrition, while several patients need it because of malnutrition and/or prolonged inability to feeding caused by complications. The optimal nutritional regimen to support liver regeneration, within other postoperative problems or complications, is not yet exactly defined. This short review addresses relevant aspects and potential developments in the issue of postoperative parenteral nutrition after liver resection

Esiti di salute e performance del Servizio Sanitario Nazionale

Capitolo del Rapporto OASI incentrato sugli esiti di salute e performance del Servizio Sanitario Nazionale

Deep space orbit determination via Delta-DOR using VLBI antennas

The growing number of deep space exploration missions operating simultaneously in the solar system triggers an increasing demand for large ground antennas capable of tracking distant spacecraft. Several space agencies have their own deep space tracking networks, where each antenna belonging to a ground station complex is meant to be shared among different deep space missions in flight, significantly constraining the tracking schedule. A typical ranging and Doppler radio tracking session requires long tracking passes and a single ground antenna, while angular (Delta-DOR) observations require at least two antennas but usually for much shorter tracking sessions. However, during Delta-DOR observations, the baseline between the two receiving antennas should be kept as large as possible, thus reducing the time windows in which Delta-DOR observations are actually feasible. This leaves little room for adaptation of the tracking schedules of these antennas and calls for the need for possible alternatives for the receiving stations. The antennas belonging to the very long baseline interferometry (VLBI) network worldwide meet the requirements to carry out Delta-DOR tracking sessions. Here, we present an experimental activity carried out tracking ESA’s GAIA spacecraft using a mixed deep space antenna configuration involving an ESA ESTRACK antenna at New Norcia (Australia) and a VLBI antenna at Medicina (Italy). This baseline was used to form Delta-DOR observables with the aim of demonstrating that VLBI antennas offer the capability to track deep space missions, thus increasing the number of possible baselines and observation time windows

Liver-First Approach for Synchronous Colorectal Metastases : Analysis of 7360 Patients from the LiverMetSurvey Registry

Background The liver-first approach in patients with synchronous colorectal liver metastases (CRLM) has gained wide consensus but its role is still to be clarified. We aimed to elucidate the outcome of the liver-first approach and to identify patients who benefit at most from this approach. Methods Patients with synchronous CRLM included in the LiverMetSurvey registry between 2000 and 2017 were considered. Three strategies were analyzed, i.e. liver-first approach, colorectal resection followed by liver resection (primary-first), and simultaneous resection, and three groups of patients were analyzed, i.e. solitary metastasis, multiple unilobar CRLM, and multiple bilobar CRLM. In each group, patients from the three strategy groups were matched by propensity score analysis. Results Overall, 7360 patients were analyzed: 4415 primary-first, 552 liver-first, and 2393 simultaneous resections. Compared with the other groups, the liver-first group had more rectal tumors (58.0% vs. 31.2%) and higher hepatic tumor burden (more than three CRLMs: 34.8% vs. 24.0%; size > 50 mm: 35.6% vs. 22.8%; p < 0.001). In patients with solitary and multiple unilobar CRLM, survival was similar regardless of treatment strategy, whereas in patients with multiple bilobar metastases, the liver-first approach was an independent positive prognostic factor, both in unmatched patients (3-year survival 65.9% vs. primary-first 60.4%: hazard ratio [HR] 1.321, p = 0.031; vs. simultaneous resections 54.4%: HR 1.624, p < 0.001) and after propensity score matching (vs. primary-first: HR 1.667, p = 0.017; vs. simultaneous resections: HR 2.278, p = 0.003). Conclusion In patients with synchronous CRLM, the surgical strategy should be decided according to the hepatic tumor burden. In the presence of multiple bilobar CRLM, the liver-first approach is associated with longer survival than the alternative approaches and should be evaluated as standard.Peer reviewe