Through Engineering 4.0 the Safe Operating Block for Patients and Medical Staff

The Paper deals with the management of the operating block in its many activities. By a new approach and with innovative machinery specific several problems were thus studied and overcome, such as the control of hospital infections, the operations of washing and sterilization of surgical instruments, the planning of interventions, the tracking of drugs and medical devices entering the operating block, the management of stocks, the bed management, the monitoring of environmental parameters for patient comfort and safety, the monitoring of machines and the interlocking of doors, etc. Furthermore, it is proposed a wide use of the analytical tools to support decision making, extended to the most modern Cyber-Physical Systems and Digital Twin, alongside Machine Learning and Artificial Intelligence algorithms. Concluding with the new services that can be offered following the digital transformation 4.0 process of the operating block. Using the tools made available by the most advanced Engineering, an operating block was redesigned, safer for patients and medical staff and more efficient from a conduction point of view. This is done using an administration model that was first conceptualized, designed and then implemented adopting what is made available by Industry 4.0, as well as a series of Management Engineering methodologies aimed at an optimized government of complex systems. Through the data collected by appropriate sensors and translated by the software into usable information, there is an optimal use of the available resources, furthermore, the activities for which improvements can be made with the benefit of patients and structures are identified

Engineering Solutions 4.0 in the fight against the spread of Covid 19 A new Methodology including processes, procedures and devices

Thanks to the principles and technologies made available by Industry 4.0, the authors conceptualized and modeled a new strategy, capable of making an effective contribution to the problem of limiting contagion from Covid19 today, and tomorrow from any possible other type virus, bacteria or pathogen agent introduced by subjects who, although unaware of being vectors, develop the infection only after their access to the places of stay (Hotel, office, Infrastructure, etc.) where they go to reside. The key point of the strategy is a 4.0 thermoscanner, created by the authors, which is positioned in appropriately chosen locations of the settlement and an innovative method of disinfection of the same implemented by means of UV-C rays and Ozone in the gaseous state, produced by a machine, also conceptualized and developed by the authors, capable of reproducing the Chapman Cycle with the associated advantages. Therefore, it is operated an absolute disinfection based on a reversible cycle Oxygen-Ozone-Oxygen, with a prompt re-habitability of the treated rooms, with minimal treatment costs and without the use of expensive and unhealthy chemicals or wet water vapor (incompatible with paper and electronics). This technology was described in the paper “Sanitizing of Confined Spaces Using Gaseous Ozone Produced by 4.0 Machines” presented by the authors to the WCE 2021 IAENG Congress and awarded with the “Best Paper Award of the 2021 International Conference of Systems Biology and Bioengineering”. In the presence of a Person with a fever, the thermoscanner automatically launches an alert to the site Safety officers, who confine him to an isolated place and make the Health Institutions intervene and take it over

An Application of Engineering 4.0 to Hospitalized Patients

In this paper the authors address the problem of surveillance of bedridden patients in hospitals and residences for elderly. Unfortunately, patients cannot be supervised by operators 24 h a day, given the associated costs. An attempt to solve this problem is already provided by wearable devices. This paper describes a 4.0 system implemented to overcome the limits (identified by interviewing a sample of nurses belonging to different facilities) of the wearable devices available on the market. The system proposed consists in monitoring the bed, instead of the patient, through applied sensors. By centralizing and analyzing the data collected it is possible to promptly inform the operative center of the occurrence of risky events to which bedridden patients are normally subjected. The scope of the system is preventing such risks, where possible, or mitigating their effects with a real time intervention. A case study on an active facility, conducted as a pilot project, confirms the humanitarian and economic benefits for patients and facility

Smart Inventory 4.0: Advanced version

The Authors of this paper had first conceptualized and then developed the automated picking plant described in the paper “A 4.0 Automated Warehouse Storage and Picking System for Order Fulfillment”, presented by the Authors to the WCE 2021 IAENG Congress and awarded with the “Best Paper Award of the 2021 International Conference of Manufacturing Engineering and Engineering Management”. In the perspective of the continuous improvement of Industry 4.0 they have brought to this first system the significant functional improvements object of this paper. In particular, having found that the loading of the goods in the individual boxes was carried out by the Operators in this factory by using ladders on which they climbed, without the necessary PPE and carrying the load manually, with the consequent risk of falling from such heights (3-6m) to cause even serious physical damage, the Authors first studied and then implemented an automatic loading system. A second problem was then highlighted for the storage of special products such as Food and Pharma, that, unlike what happens in the Beauty Sector (for which the plant was designed), need to remain in specific conditions of temperature and relative humidity. The paper describes how, in this new version, the two parameters are monitored in each single box by means of appropriate sensors that send alerts to the centralized control system when these parameters are outside the preset threshold. In this way, prompt remedial intervention is possible, avoiding the deterioration of the contents of the boxes and the consequent economic damage deriving from their alienation. All this is made possible at acceptable costs thanks to the technologies offered by Industry 4.0 such as modern robotics and Data Centralization via IIoT for monitoring and control

Dystroglycan mediates clustering of essential GABAergic components in cerebellar Purkinje cells

Muscle dystrophin–glycoprotein complex (DGC) links the intracellular cytoskeleton to the extracellular matrix. In neurons, dystroglycan and dystrophin, two major components of the DGC, localize in a subset of GABAergic synapses, where their function is unclear. Here we used mouse models to analyze the specific role of the DGC in the organization and function of inhibitory synapses. Loss of full-length dystrophin in mdx mice resulted in a selective depletion of the transmembrane β-dystroglycan isoform from inhibitory post-synaptic sites in cerebellar Purkinje cells. Remarkably, there were no differences in the synaptic distribution of the extracellular α-dystroglycan subunit, of GABAA receptors and neuroligin 2. In contrast, conditional deletion of the dystroglycan gene from Purkinje cells caused a disruption of the DGC and severely impaired post-synaptic clustering of neuroligin 2, GABAA receptors and scaffolding proteins. Accordingly, whole-cell patch-clamp analysis revealed a significant reduction in the frequency and amplitude of spontaneous IPSCs recorded from Purkinje cells. In the long-term, deletion of dystroglycan resulted in a significant decrease of GABAergic innervation of Purkinje cells and caused an impairment of motor learning functions. These results show that dystroglycan is an essential synaptic organizer at GABAergic synapses in Purkinje cells

Restoration of acute insulin response in T2DM subjects 1 month after biliopancreatic diversion

objective: Biliopancreatic diversion (BPD) restores normal glucose tolerance in a few weeks in morbid obese subjects with type 2 diabetes, improving insulin sensitivity. However, there is less known about the effects of BPD on insulin secretion. We tested the early effects of BPD on insulin secretion in obese subjects with and without type 2 diabetes. Methods and Procedures: Twenty-one consecutive morbid obese subjects, 9 with type 2 diabetes (T2DM) and 12 with normal fasting glucose (NFG) were evaluated, just before and 1 month after BPD, by measuring body weight (BW), glucose, adipocitokines, homeostasis model assessment of insulin resistance (HOMA-IR), acute insulin response (AIR) to e.v. glucose and the insulinogenic index adjusted for insulin resistance ([∆I5/∆G5]/HOMA-IR). Results: Preoperatively, those with T2DM differed from those with NFG in showing higher levels of fasting glucose, reduced AIR (57.9 ± 29.5 vs. 644.9 ± 143.1 pmol/l, P < 0.01) and reduced adjusted insulinogenic index (1.0 ± 0.5 vs. 17.6 ± 3.9 1/mmol 2 , P < 0.001). One month following BPD, in both groups BW was reduced (by ~11%), but all subjects were still severely obese; HOMA-IR and leptin decreased significanlty, while high-molecular weight (HMW) adiponectin and adjusted insulinogenic index increased. In the T2DM group, fasting glucose returned to non-diabetic values. AIR did not change in the NFG group, while in the T2DM group it showed a significant increase (from 58.0 ± 29.5 to 273.8 ± 47.2 pmol/l, P < 0.01). In the T2DM group, the AIR percentage variation from baseline was significantly related to changes in fasting glucose (r = 0.70, P = 0.02), suggesting an important relationship exists between impaired AIR and hyperglycaemia. Discussion: BPD is able to restore AIR in T2DM even just 1 month after surgery. AIR restoration is associated with normalization of fasting glucose concentrations

Contribution of ultrarare variants in mTOR pathway genes to sporadic focal epilepsies

Objective: We investigated the contribution to sporadic focal epilepsies (FE) of ultrarare variants in genes coding for the components of complexes regulating mechanistic Target Of Rapamycin (mTOR)complex 1 (mTORC1). Methods: We collected genetic data of 121 Italian isolated FE cases and 512 controls by Whole Exome Sequencing (WES) and single-molecule Molecular Inversion Probes (smMIPs) targeting 10 genes of the GATOR1, GATOR2, and TSC complexes. We collapsed \u201cqualifying\u201d variants (ultrarare and predicted to be deleterious or loss of function) across the examined genes and sought to identify their enrichment in cases compared to controls. Results: We found eight qualifying variants in cases and nine in controls, demonstrating enrichment in FE patients (P = 0.006; exact unconditional test, one-tailed). Pathogenic variants were identified in DEPDC5 and TSC2, both major genes for Mendelian FE syndromes. Interpretation: Our findings support the contribution of ultrarare variants in genes in the mTOR pathway complexes GATOR and TSC to the risk of sporadic FE and a shared genetic basis between rare and common epilepsies. The identification of a monogenic etiology in isolated cases, most typically encountered in clinical practice, may offer to a broader community of patients the perspective of precision therapies directed by the underlying genetic cause

Temperature variations in the low stratosphere (50–200 hPa) monitored by means of the atmospheric muon flux

The dependence of the muon flux on the atmospheric parameters (pressure and temperature) is a well-known effect since long time ago. We have correlated the muon flux recorded by the electromagnetic detector of EAS-TOP with the atmospheric temperature (up to few hPa level) monitored by the radio-soundings of the ITAV—Aeronautica Militare at Pratica di Mare (Rome). A significant effect has been observed when the muon flux is correlated with the atmospheric temperature in the region 50–200 hPa, as expected, since this is the region where the mesons of first generation are produced. The technique has been applied to two short periods of strong temperature variations in the low stratosphere, showing that the temporal pattern of the temperature is fairly well reproduced by the variations of the muon flux. The main results of this analysis are presented