The Rheumatology drugs for COVID-19 management: Which and when?

Introduction: While waiting for the development of specific antiviral therapies and vaccines to effectively neutralize the SARS-CoV2, a relevant therapeutic strategy is to counteract the hyperinflammatory status, characterized by an increase mainly of interleukin (IL)-1β, IL-2, IL-6, IL-7, IL-8, and tumor necrosis factor (TNF)-α, which hallmarks the most severe clinical cases. 'Repurposing' immunomodulatory drugs and applying clinical management approved for rheumatic diseases represents a game-changer option. In this article, we will review the drugs that have indication in patients with COVID-19, including corticosteroids, antimalarials, anti-TNF, anti-IL-1, anti-IL-6, baricitinib, intravenous immunoglobulins, and colchicine. The PubMed, Medline, and Cochrane Library databases were searched for English-language papers concerning COVID-19 treatment published between January 2020 and October 2020. Results were summarized as a narrative review due to large heterogeneity among studies. In the absence of specific treatments, the use of immunomodulatory drugs could be advisable in severe COVID-19 patients, but clinical outcomes are still suboptimal. An early detection and treatment of the complications combined with a multidisciplinary approach could allow a better recovery of these patient

Ranking of occupational health and safety risks by a multi-criteria perspective: Inclusion of human factors and application of VIKOR

Nowadays, the Occupational Health and Safety (OHS) is more and more recognized as a crucial process to be properly managed and continuously improved by every organization. Primarily addressed to prevent workers’ injuries and diseases, it positively impacts on productivity, competitiveness and reputation as well as it con-tributes to cost savings in general. OHS management is grounded upon the risk assessment results, on the basis of which defining corrective measures to be taken to reduce risks to acceptable values. In this regard, the paper proposes a Multi-Criteria Decision Making (MCDM) based methodology addressed to the occupational risks prioritization. In order to overcome the shortcomings of the traditional risk matrix, the new methodology considers three evaluation criteria differently weighted by the Analytic Hierarchy Process (AHP) method. Among criteria, one specifically refers to the contribution of human factors to the occurrence of accidents, and a com-bination of Human Error Assessment and Reduction Technique (HEART) and Standardized Plant Analysis Risk- Human (SPAR-H) techniques is used to this aim. Afterwards, the Vlse Kriterijumska Optimizacija Kompromisno Resenje (VIKOR) method is applied to rank risks. The proposed approach is implemented in a Sicilian manufacturing company that produces and commercializes wooden products, together with the sale of outdoor furniture. The comparison of the obtained results with the ones arising from previous risk analyses performed by the company highlights the higher ability of the proposed methodology to differentiate risks

Human Factor Interrelationships to Improve Worker Reliability: Implementation of MCDM in the Agri-Food Sector

Performance Shaping Factors (PSFs) are contextual, individual, and cognitive factors used in Human Reliability Analysis (HRA) to quantify the worker contribution to errors when performing a generic task. Although the empirical evidence demonstrates the existence of PSF interrelationships, the majority of HRA methods assume their independence. As a consequence, the resulting Human Error Probability (HEP) might be over- or underestimated. To deal with this issue, only a few qualitative guidelines or statistical-based approaches have been proposed so far. While the former are not well structured, the latter require a high computational effort and a proper number of input data. Therefore, the present paper provides an alternative approach to deal with the PSFs interaction issue to facilitate the identification of the most influential human factors on which to take corrective actions. To this purpose, Multi Criteria Decision Making (MCDM) methods may represent a structured, effortless, and easily replicable framework. Owing to their ability to deal with the interdependence of decision factors, DEMATEL and ANP are hence considered and afterwards compared, highlighting their strengths and weaknesses. Both methods are implemented in an agri-food company which produces pistachios in Southern Italy

Life cycle assessment of a new industrial process for sustainable construction materials

One of the key sectors for the green transition of European countries is construction, that is more and more asked to evolve towards innovative ecological binders and green cost-effective processes. The construction sector is highly energy intensive, and the cement production is one of the main sources of environmental pollution in the world. In this regard, GeoPolymers (GP) seem to be promising for a sustainable replacement of cementitious materials. Therefore, the Life Cycle Assessment (LCA) of the industrial production of different formulations of Geopolymer Concrete (GC) was performed in this study after scaling up the Life Cycle Inventory (LCI) from a laboratory scale to an industrial one. Based on LCA results, the Global Warming Potential (GWP) indicator demonstrated a lower greenhouse gas emission of the proposed GC production in respect to the CC manufacturing process, while no significant difference was observed in the GWP scores of the considered GC formulations when referring to the functional unit. Nevertheless, the usage of the innovative GC formulations, on an industrial scale, would avoid a significant reduction of sand and kaolin extracted, with a consequent decrease on the environmental impact. Finally, the economic assessment showed that the combined production of thermal and electrical energy by a cogeneration system could provide a significant cost reduction when the percentage of electricity fed into the public network is higher than 39%

The Rheumatology Drugs for COVID-19 Management: Which and When?

Introduction: While waiting for the development of specific antiviral therapies and vaccines to effectively neutralize the SARS-CoV2, a relevant therapeutic strategy is to counteract the hyperinflammatory status, characterized by an increase mainly of interleukin (IL)-1β, IL-2, IL-6, IL-7, IL-8, and tumor necrosis factor (TNF)-α, which hallmarks the most severe clinical cases. ‘Repurposing’ immunomodulatory drugs and applying clinical management approved for rheumatic diseases represents a game-changer option. In this article, we will review the drugs that have indication in patients with COVID-19, including corticosteroids, antimalarials, anti-TNF, anti-IL-1, anti-IL-6, baricitinib, intravenous immunoglobulins, and colchicine. The PubMed, Medline, and Cochrane Library databases were searched for English-language papers concerning COVID-19 treatment published between January 2020 and October 2020. Results were summarized as a narrative review due to large heterogeneity among studies. In the absence of specific treatments, the use of immunomodulatory drugs could be advisable in severe COVID-19 patients, but clinical outcomes are still suboptimal. An early detection and treatment of the complications combined with a multidisciplinary approach could allow a better recovery of these patients