Fostering the Reuse of Manufacturing Resources for Resilient and Sustainable Supply Chains

In the current context characterized by turbulent market conditions and the increasing relevance of sustainability requirements, reconfigurable manufacturing systems (RMSs) offer great potentialities for supply chains and networks. While plenty of contributions have addressed RMSs from a technological and system-specific perspective since the mid-1990s, the research interest for the strategic potentialities of RMSs at the supply chain level is recent and mainly related to building supply chains’ resilience and sustainability. Despite the interest, methods to support supply chains to strategically exploit RMSs are still missing, while being highly needed. In this paper, a method—consisting of an index to assess machines reusability and a mixed integer programming (MIP) algorithm—is provided to support the identification of reusable and reconfigurable machine candidates at the early stage of the strategic network design. The overall method allows machines to be compared based on their reusability and geographical locations. The application of the method, as well as an example referring to the production of emergency devices during the COVID-19 pandemic are reported. The theoretical and practical implications of the study are also discussed, and, among others, strategic parameters related to machines have been identified and elaborated as enablers of supply chain reconfigurability; the proposed method supports practitioners in improving supply chain resilience and sustainability. The method also encourages practitioners towards the development and adoption of reconfigurable machines. Finally, this study also has social impacts for local communities and stimulates customer-centric collaboration among companies belonging to similar industries and sectors

Ross-Kabbani Operation in an Infant with Mitral Valve Dysplasia

Background. Mitral valve replacement can be very difficult to obtain in infants because the valve annulus diameter can be smaller than the available prosthesis. Case Report. We describe the case of a 2-month-old female weighing 3.5 kg affected by mitral valve dysplasia leading to severe valve stenosis. Despite full medication, the clinical conditions were critical and surgery was undertaken. The mitral valve was unsuitable for repair and the orifice of mitral anulus was 12 mm, too small for a mechanical prosthesis. Therefore, a Ross-Kabbani operation was undertaken, replacing the mitral valve with the pulmonary autograft and reconstructing the right ventricular outflow tract with an etherograft. Results. The postoperative course was uneventful and the clinical conditions are good at 4-month follow-up. Conclusion. The Ross-Kabbani operation can be an interesting alternative to mitral valve replacement in infants when valve repair is not achievable and there is little space for an intra-annular mechanical prosthesis implant

Core Characteristics of Reconfigurability and their Influencing Elements

The unpredictability of market requirements is more and more pushing manufacturing firms to be responsive. To this end, reconfigurability is needed. Reconfigurability is composed of six core characteristics: modularity, integrability, diagnosability, scalability, convertibility and customization. These characteristics are related with each other. This paper - exploiting the available literature - aims at identifying and analyzing elements influencing the core characteristics. As a result, characteristics, influencing elements and relationships have been located in a comprehensive framework. The novelty of this research is that the relationships between characteristics have been taken into account. For this reason, this research is considered a first step to understand how manufacturing firms can achieve reconfigurability, by fully exploiting the core characteristic

A Literature-Based Analysis of the Cyber-Physical Systems Under the Lens of Reconfigurability

Cyber-physical systems (CPSs) are an increasingly known set of technologies and applications promising to enable manufacturing firms improving their responsiveness to deal with the unpredictability of market requirements. Indeed, from an operational perspective, responsiveness can be achieved because CPSs are an enabler of the reconfigurability of factories. Reconfigurability is a capability that has been theorized since almost two decades. Therefore, today we can consider such grounded theory as a lens to frame emerging CPS-related knowledge. This paper is an effort to give a contribution in this direction. In particular, starting from the acknowledgement that a relevant characteristic of reconfigurability is modularity, this research proposes a literature-based analysis of the Cyber-Physical Systems of the future smart factory

A framework to manage reconfigurability in manufacturing

Nowadays, manufacturing firms are dealing with the unpredictability of market requirements and the frequent changes induced by technological innovation. For this reason, firms are more and more addressing the need to be responsive at an affordable cost. To do so, they are required to develop a capability called reconfigurability. This paper is a review of the existing literature because the current need makes interesting to reflect on the state of the art of reconfigurability as a concept. This reflection has led to focus on reconfigurability characteristics for both their relevance and their relationships with managerial decisions in manufacturing. To this end, a framework has been proposed. It is based on system lifecycle and production levels. These two elements have been deduced from literature and identified as relevant dimensions for decision-making

Ross-kabbani operation in an infant with mitral valve dysplasia.

Background. Mitral valve replacement can be very difficult to obtain in infants because the valve annulus diameter can be smaller than the available prosthesis. Case Report. We describe the case of a 2-month-old female weighing 3.5 kg affected by mitral valve dysplasia leading to severe valve stenosis. Despite full medication, the clinical conditions were critical and surgery was undertaken. The mitral valve was unsuitable for repair and the orifice of mitral anulus was 12 mm, too small for a mechanical prosthesis. Therefore, a Ross-Kabbani operation was undertaken, replacing the mitral valve with the pulmonary autograft and reconstructing the right ventricular outflow tract with an etherograft. Results. The postoperative course was uneventful and the clinical conditions are good at 4-month follow-up. Conclusion. The Ross-Kabbani operation can be an interesting alternative to mitral valve replacement in infants when valve repair is not achievable and there is little space for an intra-annular mechanical prosthesis implant

Adherence to antithrombotic therapy guidelines improves mortality among elderly patients with atrial fibrillation: insights from the REPOSI study

Atrial fibrillation (AF) is associated with a substantial risk of thromboembolism and mortality, significantly reduced by oral anticoagulation. Adherence to guidelines may lower the risks for both all cause and cardiovascular (CV) deaths. Methods: Our objective was to evaluate if antithrombotic prophylaxis according to the 2012 European Society of Cardiology (ESC) guidelines is associated to a lower rate of adverse outcomes. Data were obtained from REPOSI; a prospective observational study enrolling inpatients aged ≥65 years. Patients enrolled in 2012 and 2014 discharged with an AF diagnosis were analysed. Results: Among 2535 patients, 558 (22.0 %) were discharged with a diagnosis of AF. Based on ESC guidelines, 40.9 % of patients were on guideline-adherent thromboprophylaxis, 6.8 % were overtreated, and 52.3 % were undertreated. Logistic analysis showed that increasing age (p = 0.01), heart failure (p = 0.04), coronary artery disease (p = 0.013), peripheral arterial disease (p = 0.03) and concomitant cancer (p = 0.003) were associated with non-adherence to guidelines. Specifically, undertreatment was significantly associated with increasing age (p = 0.001) and cancer (p < 0.001), and inversely associated with HF (p = 0.023). AF patients who were guideline adherent had a lower rate of both all-cause death (p = 0.007) and CV death (p = 0.024) compared to those non-adherent. Kaplan–Meier analysis showed that guideline-adherent patients had a lower cumulative risk for both all-cause (p = 0.002) and CV deaths (p = 0.011). On Cox regression analysis, guideline adherence was independently associated with a lower risk of all-cause and CV deaths (p = 0.019 and p = 0.006). Conclusions: Non-adherence to guidelines is highly prevalent among elderly AF patients, despite guideline-adherent treatment being independently associated with lower risk of all-cause and CV deaths. Efforts to improve guideline adherence would lead to better outcomes for elderly AF patient

Leptin induces the generation of procoagulant, tissue factor bearing microparticles by human peripheral blood mononuclear cells

Obesity is linked to increased thrombotic risk. Circulating leptin concentration correlates with body mass index. Microparticles are small (.05-1μm) vesicles shed by activated and apoptotic cells, involved in numerous pathophysiologically relevant phenomena including blood coagulation and thrombosis. We tested the hypothesis that leptin induces the shedding of procoagulant, tissue factor bearing microparticles by human peripheral blood mononuclear cells, and investigated the intracellular mechanisms leading to microparticle release upon incubation with leptin

Shedding light on typical species : implications for habitat monitoring

Habitat monitoring in Europe is regulated by Article 17 of the Habitats Directive, which suggests the use of typical species to assess habitat conservation status. Yet, the Directive uses the term “typical” species but does not provide a definition, either for its use in reporting or for its use in impact assessments. To address the issue, an online workshop was organized by the Italian Society for Vegetation Science (SISV) to shed light on the diversity of perspectives regarding the different concepts of typical species, and to discuss the possible implications for habitat monitoring. To this aim, we inquired 73 people with a very different degree of expertise in the field of vegetation science by means of a tailored survey composed of six questions. We analysed the data using Pearson's Chi-squared test to verify that the answers diverged from a random distribution and checked the effect of the degree of experience of the surveyees on the results. We found that most of the surveyees agreed on the use of the phytosociological method for habitat monitoring and of the diagnostic and characteristic species to evaluate the structural and functional conservation status of habitats. With this contribution, we shed light on the meaning of “typical” species in the context of habitat monitoring