Operations management techniques for resource optimization in health care structures

This paper focuses on the identification of improvement opportunities through process analysis inside sanitary services, and the case of the radiology department of a primary public hospital in Rome is reported. At first, an exhaustive study of the internal processes in the analysed department was performed in order to identify bottlenecks and service level loss causes. Secondly, in order to gain a better resource exploitation and to increase the department productivity, a method for optimizing resource management through patient scheduling and shift management was identified: patients have been divided among inpatients (already hospitalized) and outpatients (who are admitted to the hospital just for the exam and do not require an overnight stay) and a higher resource utilization has been reached leveraging on a flexible management of the formers preparation. Moreover, service lead times have been analysed with reference to patient characteristics and exam typology and, basing on the classification of exams, the patient scheduling is solved with a linear programming approach. The methodology does not include the application of state-of-art Operations Management techniques and, for an industrial context, it may appear extremely simple; however, as far as the optimization of sanitary services is concerned, the adoption of the described criteria has demonstrated that increases in service capacity and reductions of the overtime for physicians and nurses are easily reachable. This analysis has anyway required an appropriate statistical investigation on time variability per each exam typology in the radiology department on top of a deep understanding of the several complex processes inside the hospital system. The criteria can be straightforward extended to different departments, or applied in the radiology departments of other hospitals for a comparative analysis, as is already planned for the next step of the research

Next generation sequencing for gut microbiome characterization in rainbow trout (Oncorhynchus mykiss) fed animal by-product meals as an alternative to fishmeal protein sources

Animal by-product meals from the rendering industry could provide a sustainable and commercially viable alternative to fishmeal (FM) in aquaculture, as they are rich in most essential amino acids and contain important amounts of water-soluble proteins that improve feed digestibility and palatability. Among them, poultry by-product meal (PBM) have given encouraging results in rainbow trout (Oncorhynchus mykiss). However, the introduction of new ingredients in the diet needs to be carefully evaluated since diet is one of the main factors affecting the gut microbiota, which is a complex community that contributes to host metabolism, nutrition, growth, and disease resistance. Accordingly, we investigated the effects of partial replacement of dietary FM with a mix of animal by-product meals and plant proteins on intestinal microbiota composition of rainbow trout in relation to growth and feeding efficiency parameters. We used 1540 trout with an initial mean body weight of 94.6 +/- 14.2 g. Fish were fed for 12 weeks with 7 different feed formulations. The growth data showed that trout fed on diets rich in animal by-product meals grew as well as fish fed on control diet, which was rich in FM (37.3%) and PBM-free. High-throughput 16S rRNA gene amplicon sequencing (MiSeq platform, Illumina) was utilised to study the gut microbial community profile. After discarding Cyanobacteria (class Chloroplast) and mitochondria reads a total of 2,701,274 of reads taxonomically classified, corresponding to a mean of 96,474 +/- 68,056 reads per sample, were obtained. Five thousand three hundred ninety-nine operational taxonomic units (OTUs) were identified, which predominantly mapped to the phyla of Firmicutes, Proteobacteria, Bacteroidetes and Actinobacteria. The ratio between vegetable and animal proteins proved to play a central role in determining microbiome profiles and Firmicutes and Proteobacteria phyla were particularly discriminatory for diet type in trout. Plant ingredients favoured a higher Firmicutes: Proteobacteria ratio than animal proteins. Acceptable abundance of Firmicutes was guaranteed by including at least 25% of vegetable proteins in the diet regardless of animal protein source and percentage. In summary animal by-product meals, as replacements to FM, gave good results in terms of growth performances and did not induce significant changes in gut microbial richness, thus proving to be a suitable protein source for use in rainbow trout aqua feed

The genomic organisation of the tra/trd locus validates the peculiar characteristics of dromedary δ-chain expression

The role of γδ T cells in vertebrate immunity is still an unsolved puzzle. Species such as humans and mice display a low percentage of these T lymphocytes (i.e., “γδ low species”) with a restricted diversity of γδ T cell receptors (TR). Conversely, artiodactyl species (i.e., “γδ high species”) account for a high proportion of γδ T cells with large γ and δ chain repertoires. The genomic organisation of the TR γ (TRG) and δ (TRD) loci has been determined in sheep and cattle, noting that a wide number of germline genes that encode for γ and δ chains characterise their genomes. Taking advantage of the current improved version of the genome assembly, we have investigated the genomic structure and gene content of the dromedary TRD locus, which, as in the other mammalian species, is nested within the TR α (TRA) genes. The most remarkable finding was the identification of a very limited number of variable germline genes (TRDV) compared to sheep and cattle, which supports our previous expression analyses for which the somatic hypermutation mechanism is able to enlarge and diversify the primary repertoire of dromedary δ chains. Furthermore, the comparison between genomic and expressed sequences reveals that D genes, up to four incorporated in a transcript, greatly contribute to the increased diversity of the dromedary δ chain antigen binding-site

Meat quality and lipid fatty acid profile from wild thrush (Turdus philomelos), woodcock (Scolopax rusticola) and starling (Sturnus vulgaris): A preliminary comparative study

Background: The present study aimed to evaluate the nutritional proximate composition, some qualitative traits and fatty acid profile of meat from wild thrush, woodcock and starling hunted in Southern Italy in 2017 and 2018. Methods: Nutritive composition and physical traits of meat and lipid fatty acid profile were evaluated in breast muscle (Pectoralis major) of gamebirds. Results: From findings, the meat pH was significantly (P < 0.001) higher in starling when compared to the other two species. Thrush meat was significantly (P = 0.002) darker and had higher redness (P < 0.001) and yellowness (P = 0.004) in comparison to starling and woodcock. Thrush breast muscle showed the highest (P < 0.001) level of lipids and lowest (P < 0.001) protein content. Meat from thrush showed the best lipid fatty acid profile based on the higher (P < 0.001) monounsaturated fatty acids (MUFA) and lower (P < 0.001) saturated fatty acids (SFA) concentrations. Starling breast muscle reported the highest (P = 0.002) polyunsaturated fatty acids (PUFA) level compared to both thrush and woodcock, whereas no differences were detected on total n-3. The ratio n-6/n-3 was higher (P = 0.001) in starling muscle. Thrush breast muscle had the lowest (P < 0.001) atherogenic and thrombogenic indices compared to the other gamebirds. Conclusions: The findings indicated that meat from the three investigated gamebirds species may represent a healthily lipid food source for human consumption in relation to the prevention of cardiovascular diseases

Effect of an extruded linseed diet on meat quality traits in Nero Lucano pigs

The study aimed to evaluate the effect of a diet containing extruded linseed (Linum usitatissimum L.) on growth performances, carcass traits and meat quality in Nero Lucano pigs. Sixteen male piglets were weaned at about 50 days of age and divided into two homogeneous groups fed a control diet (C) or a diet containing 3% extruded linseed (EL). The trial lasted 32 weeks and pigs were slaughtered at 9 months of age. Samples from the Longissimus dorsi (Ld) muscle were analysed to assess physical and chemical parameters and intramuscular fatty acid composition. Average daily gain, feed intake and feed conversion ratio were not affected by the diet. Pigs fed the C diet showed a significantly greater slaughter weight in comparison to the EL group (116.50 vs 108.25 kg) Meat pH and chemical composition were not influenced by the diet. No differences were found for shear force (WBS) in raw meat, while cooked meat of the EL group showed a lower WBS value. The EL diet significantly lowered total SFA and increased total PUFA, of both n-6 and n-3 series. Among the n-6, significant differences between dietary treatments were found for linoleic acid. As for the n-3 series, EL feeding significantly enhanced linolenic acid, EPA, DPA and DHA. Feeding EL also significantly lowered the PUFA/SFA and n-6/n-3 ratios and the AI and TI, with benefits for human health. In conclusion, dietary supplementation with 3% EL didn't affect growth performance while it improved the fatty acid profile of meat. Keywords: fatty acid profile, feeding, flaxseed, por

Evolution of the T-cell receptor (TR) Loci in the adaptive immune response: The tale of the TRG locus in mammals

T lymphocytes are the principal actors of vertebrates’ cell-mediated immunity. Like B cells, they can recognize an unlimited number of foreign molecules through their antigen-specific heterodimer receptors (TRs), which consist of αβ or γδ chains. The diversity of the TRs is mainly due to the unique organization of the genes encoding the α, β, γ, and δ chains. For each chain, multi-gene families are arranged in a TR locus, and their expression is guaranteed by the somatic recombination process. A great plasticity of the gene organization within the TR loci exists among species. Marked structural differences affect the TR γ (TRG) locus. The recent sequencing of multiple whole genome provides an opportunity to examine the TR gene repertoire in a systematic and consistent fashion. In this review, we report the most recent findings on the genomic organization of TRG loci in mammalian species in order to show differences and similarities. The comparison revealed remarkable diversification of both the genomic organization and gene repertoire across species, but also unexpected evolutionary conservation, which highlights the important role of the T cells in the immune response

Effect of an extruded linseed diet on meat quality traits in Nero Lucano pigs

The study aimed to evaluate the effect of a diet containing extruded linseed (Linum usitatissimum L.) on growth performances, carcass traits and meat quality in Nero Lucano pigs. Sixteen male piglets were weaned at about 50 days of age and divided into two homogeneous groups fed a control diet (C) or a diet containing 3% extruded linseed (EL). The trial lasted 32 weeks and pigs were slaughtered at 9 months of age. Samples from the Longissimus dorsi (Ld) muscle were analysed to assess physical and chemical parameters and intramuscular fatty acid composition. Average daily gain, feed intake and feed conversion ratio were not affected by the diet. Pigs fed the C diet showed a significantly greater slaughter weight in comparison to the EL group (116.50 vs 108.25 kg) Meat pH and chemical composition were not influenced by the diet. No differences were found for shear force (WBS) in raw meat, while cooked meat of the EL group showed a lower WBS value. The EL diet significantly lowered total SFA and increased total PUFA, of both n-6 and n-3 series. Among the n-6, significant differences between dietary treatments were found for linoleic acid. As for the n-3 series, EL feeding significantly enhanced linolenic acid, EPA, DPA and DHA. Feeding EL also significantly lowered the PUFA/SFA and n-6/n-3 ratios and the AI and TI, with benefits for human health. In conclusion, dietary supplementation with 3% EL didn't affect growth performance while it improved the fatty acid profile of meat

The Organization of the Pig T-Cell Receptor γ (TRG) Locus Provides Insights into the Evolutionary Patterns of the TRG Genes across Cetartiodactyla

The domestic pig (Sus scrofa) is a species representative of the Suina, one of the four suborders within Cetartiodactyla. In this paper, we reported our analysis of the pig TRG locus in comparison with the loci of species representative of the Ruminantia, Tylopoda, and Cetacea suborders. The pig TRG genomic structure reiterates the peculiarity of the organization of Cetartiodactyla loci in TRGC "cassettes", each containing the basic V-J-J-C unit. Eighteen genes arranged in four TRGC cassettes, form the pig TRG locus. All the functional TRG genes were expressed, and the TRGV genes preferentially rearrange with the TRGJ genes within their own cassette, which correlates the diversity of the γ-chain repertoire with the number of cassettes. Among them, the TRGC5, located at the 5' end of the locus, is the only cassette that retains a marked homology with the corresponding TRGC cassettes of all the analyzed species. The preservation of the TRGC5 cassette for such a long evolutionary time presumes a highly specialized function of its genes, which could be essential for the survival of species. Therefore, the maintenance of this cassette in pigs confirms that it is the most evolutionarily ancient within Cetartiodactyla, and it has undergone a process of duplication to give rise to the other TRGC cassettes in the different artiodactyl species in a lineage-specific manner

Effects of Dietary Extruded Linseed (Linum usitatissimum) and Oregano (Origanum vulgare) on Growth Traits, Carcass Composition and Meat Quality of Grigia di Potenza Suckling Kids

The aim of this trial was to compare the influence of supplementing diets with extruded linseed and oregano on growth parameters and meat qualitative traits in Grigia di Potenza breed suckling kids. Twenty-four male kids, exclusively fed milk from their dams, were assigned to the following diets: C) group control fed without any supplement; L) group fed control feed containing 3% extruded linseed (Linum usitatissimum L.); and LO) group fed control diet with 0.6% dried oregano (Origanum vulgare) and 3% extruded linseed. Growth performance as well as slaughtering traits and meat cuts of kids were not significantly influenced (P > 0.05) by dietary treatments. Conversely, kids in linseed group reported the lower (P < 0.05) percentage of dissectible fat in leg and loin. The meat from Longissimus lumborum and Semimembranosus muscles of kids in linseed diet had the lowest (P < 0.05) cooking loss percentage, whereas the proximate chemical composition of both meat muscles did not vary among treatments (P > 0.05). The experimental diets partially modulated the kid meat fatty acid composition in both muscles, where feeding linseed and oregano improved (P < 0.05) the content of DPA and reduced MUFA. Based on the current findings, it can be concluded that linseed and oregano supplementation can be used in goat diet as no significant detrimental effects on productive performance and meat quality of suckling kids were observed

Effects of protein sources on performance, carcass composition, blood parameters and meat quality in Charolais heifers

The aim of the present study was to evaluate the effects of feeding faba bean and sweet lupin as alternative protein sources to soybean on productive performance, blood parameters, carcass composition, and chemical-physical characteristics of meat and its fatty acid (FA) profile in Charolais heifers. Twenty-four heifers were divided into three homogenous groups and fed with durum wheat straw and three iso-energetic and isonitrogenous pelleted complete diets containing 14% (on as-fed basis) soybean meal; 28% faba bean; and 20% sweet lupin seed. The animals were slaughtered after a 168 day feeding period, and the Longissimus lumborum muscle was sampled for meat quality measurements. The feed conversion index was better in the heifers fed faba bean compared with the soybean treatment group (6.71 versus 7.17). No differences were found among treatment groups in productive performance, slaughtering data and physical features. The concentration of linoleic acid in the meat of the soybean group differed significantly from that in the lupin group (2.38 versus 2.11%). Feeding lupin seed increased the concentrations of C20:3 n-6 (0.09%) and C20:4 n-6 (0.20%) in meat significantly, compared with the soya- and faba bean treatments (0.06–0.07% and 0.12–0.13%, respectively). No differences were found among groups for blood parameters, except for urea concentration, which was lower in the lupin group compared with the concentrations in the serum of heifers receiving the soya bean treatment (31.29 as opposed to 37.56 mg/dL). In conclusion, since faba bean and lupin seed did not affect any of the parameters negatively, these legume grains can be included successfully as alternative protein sources in beef cattle diet.Keywords: Faba bean, lupin seed, soybean, beef cattle, feedin