Business Model and Non-Financial Key Performance Indicator Disclosure

Business model disclosure is proposed as a communication tool for companies to increase the effectiveness of non-financial key performance indicator (NFKPI) disclosure. First, business model enables the identification of indicators that are aligned with strategic objectives. Moreover, it acts as an integrated framework, showing how different capitals are combined to create value

Xenon Anesthesia Improves Respiratory Gas Exchanges in Morbidly Obese Patients

Background. Xenon-in-oxygen is a high density gas mixture and may improve PaO2/FiO2 ratio in morbidly obese patients uniforming distribution of ventilation during anesthesia. Methods. We compared xenon versus sevoflurane anesthesia in twenty adult morbidly obese patients (BMI > 35) candidate for roux-en-Y laparoscopic gastric bypass and assessed PaO2/FiO2 ratio at baseline, at 15 min from induction of anaesthesia and every 60 min during surgery. Differences in intraoperative and postoperative data including heart rate, systolic and diastolic pressure, oxygen saturation, plateau pressure, eyes opening and extubation time, Aldrete score on arrival to the PACU were compared by the Mann-Whitney test and were considered as secondary aims. Moreover the occurrence of side effects and postoperative analgesic demand were assessed. Results. In xenon group PaO2-FiO2 ratio was significantly higher after 60 min and 120 min from induction of anesthesia; heart rate and overall remifentanil consumption were lower; the eyes opening time and the extubation time were shorter; morphine consumption at 72 hours was lower; postoperative nausea was more common. Conclusions. Xenon anesthesia improved PaO2/FiO2 ratio and maintained its distinctive rapid recovery times and cardiovascular stability. A reduction of opioid consumption during and after surgery and an increased incidence of PONV were also observed in xenon group

Acute inflammatory demyelinating polyneuropathy and a unilateral babinski/plantar reflex

Acquired acute demyelinating peripheral polyneuropathy (AADP) is a general classification of pathologies that could affect secondary the peripheral nervous system. They are characterized by an autoimmune process directed towards myelin. Clinically they are characterized by progressive weakness and mild sensory changes. Acute inflammatory demyelinating polyneuropathy often is referred to as Guillain-Barré syndrome (GBS). GBS is the major cause of acute nontraumatic paralysis in healthy people and it is caused by autoimmune response to viral agents (influenza, coxsackie, Epstein-Barr virus, or cytomegalovirus) or bacterial infective organisms (Campylobacter jejuni, Mycoplasma pneumoniae). A detailed history, with symptoms of progressive usually bilateral weakness, hyporeflexia, with a typical demyelinating EMG pattern supports the diagnosis. Progressive affection of respiratory muscles and autonomic instability coupled with a protracted and unpredictable recovery normally results in the need for ICU management. We present a case report of a patient with a typical GBS presentation but with a unilateral upgoing plantar reflex (Babinski sign). A unifying diagnosis was made and based on a literature search in Pubmed appears to be the first described case of its kind

Business Model Reporting: Why the Perception of Preparers and Users Matters

The aim of this work is to investigate the alignment of preparers’ and users’ perceptions of the BM and its constitutive elements. Results show that, while both categories assign great importance to this concept, different conceptions of the purpose and the components of a BM emerge

Effects of triticale cultivars grown in a Mediterranean environment on biomass yield and quality

Triticale is a valuable crop in Mediterranean environments because its growth capacity at low temperatures and its precocity make it possible to obtain high biomass yields in early spring. Precocity of triticale is particularly appreciated in Mediterranean environment, where irrigation allows the sowing of a spring–summer corn crop after a winter cereal crop has been harvested for silage. In these conditions, early planted corn can take advantage of both longer-cycle cultivars and of the lower incidence of the European corn borer Ostrinia nubilalis attacks. Nutritional quality of triticale as forage is related to the phenological stage at harvest, cultivar choice, seeding rate and environmental conditions. The work reported in this paper was aimed at verifying if the hypothesized effects of the different habitus (cold requirement) of triticale cultivar grown at different seeding rates affect biomass quantity and quality at the stages of flowering and milk-waxy-maturity, which are the most relevant for triticale silage production

Rhabdomyolysis Following Bariatric Surgery: a Retrospective Analysis

Background: Rhabdomyolysis (RML) indicates a skeletal muscle necrosis which results in an emission of intracellular contents from myocytes into the circulatory system. It has been recognized to be a complication of bariatric surgery. A high BMI and a prolonged operative time are the main risk factors associated to the development of RML. The aim of this study is to define the incidence and the main features of RML in a cohort of obese patients undergoing bariatric surgery. Materials and Methods: a retrospective observational analysis was carried out on 100 patients undergone bariatric surgery. The bariatric operations were open or laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (SG); they were performed at the university hospital Nuovo S. Chiara in 2011. Results: 6 of 100 patients enrolled developed RML. Three of these also showed acute kidney injury due to RML (50%). A significant correlation between post-operative increased creatine phosphokinase (CPK) levels and BMI was found (r=0.369; r2=0,137; p=0.005) as well as a significant correlation between the increased levels of creatine phosphokinase, myoglobin and operative time (increased operative time - highest CPK: r=0.550; r2=0.302; p<0.0001; increased operative time - highest myoglobin: r=0.553; r2=0.305; p<0.0001). Moreover, hypertension and prolonged operative time were found to be variables associated with RML in bivariate analysis. Conclusions: The incidence of RML following bariatric surgery was 6%. Since rhabdomyolysis is the most important complication of bariatric surgery, appropriate precautions should be taken during surgery. Post-operative monitoring of CPK and myoglobin levels is essential for an early diagnosis of RML

3-S BOM. Pioneering sustainability-scoring-system for multi-functional product configurations based on ESG and circularity

The Bill of Materials (BOM) is the primary place where product configurations are formulated and designed. Despite its critical role, the BOM falls short in addressing sustainability concerns. The current state of the art does not capture data on the sustainability performance of suppliers of listed components. Furthermore, the BOM neglects synthetic information on reusability and circularity of components. To overcome these limitations, this study proposes the introduction of a Sustainability-Scoring-System (3-S BOM). The aim is to upscale the traditional BOM to the new sustainability market demand. The 3-S BOM has two purposes: to integrate synthetic data on sustainability and to allow further configurations of products based on diversified sustainability profiles. Specifically, each component, sub-assembly and assembly within the BOM is assigned an Overall Sustainability Score (OSS), which covers three key sustainability areas On the supplier side, an ESG score will be representative of the supplier’s level of sustainability, while on the component side, a Hazardous Substances and Virgin Materials (HV) indicator and a Hazardous Substances and Virgin Materials Circularity (HVci) indicator will assess the sustainability of the components, taking into account their composition and circularity. The customer is actively involved in defining the sustainability profile of the purchased product by defining how the ESG, HV and HVci must influence the final assembly of the purchased product, choosing between different levels of specificity