Splenomegaly impacts prognosis in essential thrombocythemia and polycythemia vera: A single center study

Splenomegaly is one of the major clinical manifestations of primary myelofibrosis and is common also in other chronic Philadelphia-negative myeloproliferative neoplasms, causing symptoms and signs and affecting quality of life of patients diagnosed with these diseases. We aimed to study the impact that such alteration has on thrombotic risk and on the survival of patients with essential thrombocythemia and patients with Polycythemia Vera (PV). We studied the relationship between splenomegaly (and its grade), thrombosis and survival in 238 patients with et and 165 patients with PV followed at our center between January 1997 and May 2019

Parcel lockers vs. home delivery: a model to compare last-mile delivery cost in urban and rural areas

Purpose This paper investigates the economic performances of two business-to-consumer (B2C) e-commerce last-mile delivery options -parcel lockers (PLs) and traditional home delivery (HD) in contexts where e-commerce is still at its early stages. It analyses and compares two different implementation contexts, urban and rural areas. Design/methodology/approach This study develops an analytical model that estimates delivery costs for both the PL and HD options. The model is applied to two base cases (representative of urban and rural areas in Italy), and sensitivity analyses are subsequently performed on a set of key variables/parameters (i.e. PL density, PL fill rate and PL annual costs). To support the model development and application, interviews with practitioners (Edwards et al., 2011) were performed. Findings PLs imply lower delivery cost than HD, independently from the implementation area (urban or rural): advantages mainly derive from the higher delivery density and the drastic reduction of failed deliveries. Benefits entailed by PLs are more significant in rural areas due to lower PL investments and annual costs, as well as higher HD costs. Originality/value This paper offers insights to both academics and practitioners. On the academic side, it develops a model to compare the delivery cost of PL and HD, which includes the analysis of urban and rural contexts. This could serve as a platform for developing/informing future analytical/optimisation contributions. On the managerial side, it may support practitioners in making decisions about the implementation of PLs and HD, to benchmark their costs and to identify the main variables and parameters at play

Enhancing in-store picking for e-grocery: an empirical-based model

Purpose: This paper identifies, configures and analyses a solution aimed at increasing the efficiency of in-store picking for e-grocers and combining the traditional store-based option with a warehouse-based logic (creating a back area dedicated to the most required online items). Design/methodology/approach: The adopted methodology is a multi-method approach combining analytical modelling and interviews with practitioners. Interviews were performed with managers, whose collaboration allowed the development and application of an empirically-grounded model, aimed to estimate the performances of the proposed picking solution in its different configurations. Various scenarios are modelled and different policies are evaluated. Findings: The proposed solution entails time benefits compared to traditional store-based picking for three main reasons: lower travel time (due to the absence of offline customers), lower retrieval time (tied to the more efficient product allocation in the back) and lower time to manage stock-outs (since there are no missing items in the back). Considering the batching policies, order picking is always outperformed by batch and zone picking, as they allow for the reduction of the average travelled distance per order. Conversely, zone picking is more efficient than batch picking when demand volumes are high. Originality/value: From an academic perspective, this work proposes a picking solution that combines the store-based and warehouse-based logics (traditionally seen as opposite/alternative choices). From a managerial perspective, it may support the definition of the picking process for traditional grocers that are offering – or aim to offer – e-commerce services to their customers

Combining crowdsourcing and mapping customer behaviour in last-mile deliveries

In the light of the dramatic rise of online sales, last-mile deliveries (i.e., the delivery of products ordered online to the final customer) have been increasingly gaining the attention of both managers and academics. As a matter of fact, they are very critical in terms of effectiveness (as customers demand fast and accurate deliveries), and efficiency (since they imply very high costs). Henceforth, logistics players operating in the B2C e-commerce environment are striving to find and implement innovative solutions, different from the costly traditional by-van home deliveries. Among the options analysed by scholars so far, two promising ones are crowdsourcing logistics (i.e., outsourcing delivery activities to “common” people) and mapping the behaviour of customers (i.e., analysing the probability distribution of the customer presence at home and accordingly scheduling deliveries to minimise the probability of failed deliveries). In this paper, we introduce and study a combination between the two solutions, proposing a variant of the Vehicle Routing Problem, which considers both the Availability Profiles and Occasional Drivers (VRPAPOD). We model the delivery problem as a mixed-integer program and solve it with a branch-and-price algorithm. To analyse the benefit of the combined use of crowdshipping and customers availability profiles (APs), we conduct several experiments in a real context in the city of Milan, randomly extracting 100 customers in a 16 km2 area. The combined solution is compared with two benchmarking models, namely the traditional home delivery (traditional VRP) and the crowdsourcing logistics option (Vehicle Routing Problem with Occasional Drivers (VRPOD)). Results prove that logistics players can achieve important benefits by relying on the crowd and scheduling deliveries according to clients' APs, which become more significant in case of high drivers availability

Truck-based drone delivery system: An economic and environmental assessment

Innovative solutions for last-mile delivery have sparked great interest among consumers and logistics operators. The combination of new technologies with existing ones can lead to new possible last-mile delivery configurations, among which truck-drone joint delivery is one of the most promising. This paper evaluates the environmental and economic sustainability of a last-mile delivery solution involving electric trucks equipped with drones, and it provides a comparison with traditional logistics systems. The comparative life cycle assessment methodology is used to quantify the greenhouse gas emissions per parcel delivered. The total cost of ownership methodology is adopted for the economic analysis. Results suggest that the truck-drone alternative leads to significant emissions reductions, while its cost performance is primarily affected by the drone automation level

Using pharmacokinetics for tailoring prophylaxis in people with hemophilia switching between clotting factor products: A scoping review

The objective of this scoping review is to summarize the current use of pharmacokinetics for tailoring prophylaxis in hemophilia patients switching between clotting factor products. Patients with hemophilia may require switching of clotting factor concentrates due to a variety of factors, but there have been perceived risks associated with switching, such as inhibitor development or suboptimal protection due to inadequate dosing while titrating treatment. Studies that look at patients switching from one clotting factor concentrate to another are categorized in terms of their primary and/or secondary objectives, notably biosimilarity and comparative pharmacokinetic studies and inhibitor development studies. Research on how best to switch concentrates with respect to dosing regimen are lacking, and currently a trial-and-error approach is used for dosing the new factor concentrate. In the future, studies looking at the predictability of pharmacokinetics (PK) of a new factor concentrate based on individual PK knowledge of the original factor concentrate may offer clinical benefit by providing a safer switching approach and protocol

Smart Retailing: a model to assess the economic sustainability of smart shelf-enabled dynamic pricing

Smart Retailing, a new approach to retail management that leverages digital technologies, is gaining much attention, as it enables innovation and improvements in consumers’ quality of life. However, the potentialities stemming from the application of such technologies are still not fully explored. Investment analyses addressing specific technologies could be useful to fill the academic gaps and guide retailers in their digital transition. This paper aims thus at evaluating the economic sustainability of investment in smart shelves, which are employed to perform dynamic pricing in presence of perishable goods. A model simulating the pricing variation in different scenarios was built and economic and financial analyses were performed to evaluate the sustainability of the investment. Data to feed the model were collected through semi-structured interviews with a smart shelf technology provider and three grocery retailers. The results show that the employment of smart shelves allows retailers to increase their profits. First, they are always able to assign to the product the price which most accurately reflects the customers’ willingness to pay. Second, the costs related to misplacement issues are reduced. This study contributes to the knowledge in this unexplored field by providing a model that simulates the dynamic pricing policy after the introduction of smart shelf technology and evaluates its economical sustainability. It also provides retailers who want to join the digital transformation of the stores with a useful tool to guide their investments

Extracellular vesicle microRNAs contribute to the osteogenic inhibition of mesenchymal stem cells in multiple myeloma

Osteolytic bone disease is the major complication associated with the progression of multiple myeloma (MM). Recently, extracellular vesicles (EVs) have emerged as mediators of MM-associated bone disease by inhibiting the osteogenic differentiation of human mesenchymal stem cells (hMSCs). Here, we investigated a correlation between the EV-mediated osteogenic inhibition and MM vesicle content, focusing on miRNAs. By the use of a MicroRNA Card, we identified a pool of miRNAs, highly expressed in EVs, from MM cell line (MM1.S EVs), expression of which was confirmed in EVs from bone marrow (BM) plasma of patients affected by smoldering myeloma (SMM) and MM. Notably,we found that miR-129-5p, which targets different osteoblast (OBs) differentiation markers, is enriched in MM-EVs compared to SMM-EVs, thus suggesting a selective packaging correlated with pathological grade. We found that miR-129-5p can be transported to hMSCs by MM-EVs and, by the use of miRNA mimics, we investigated its role in recipient cells. Our data demonstrated that the increase of miR-129-5p levels in hMSCs under osteoblastic differentiation stimuli inhibited the expression of the transcription factor Sp1, previously described as a positive modulator of osteoblastic differentiation, and of its target the Alkaline phosphatase (ALPL), thus identifying miR-129-5p among the players of vesicle-mediated bone disease