Integrated Analysis of Energy, Material and Time Flows in Manufacturing Systems

AbstractEnvironmental objectives (e.g. energy and resource demand, emissions, waste) become increasingly relevant for manufacturing companies in addition to traditional economic objectives (e.g. throughput time, output). Currently, different methods and tools are available to address those objectives individually, such as value stream mapping (economic), material and energy flow analysis/MEFA as well as Life Cycle Assessment/LCA (environmental). However, there is a lack on approaches that bring together benefits of those tools and allow simultaneous consideration of all objectives. Against this background, a methodology is developed to analyses the energy, material and time flows of manufacturing systems in an integrated manner. The proposed method is exemplary applied to the case of an Australian manufacturing company

Clinical Challenges and Consequences of Measurable Residual Disease in Non-APL Acute Myeloid Leukemia

The ability to detect residual levels of leukemic blasts (measurable residual disease, MRD) has already been integrated in the daily routine for treatment of patients with chronic myeloid and acute lymphoblastic leukemia. In acute myeloid leukemia (AML), a variety of mostly retrospective studies have shown that individuals in AML remission who tested positive for MRD at specific time-points or had increasing MRD levels are at significantly higher risk of relapse and death compared to MRD-negative patients. However, these studies differ with respect to the “MRD-target”, time-point of MRD determination, material analyzed, and method applied. How this probably very valuable MRD information in individual patients may be adapted in the daily clinical routine, e.g., to separate patients who need more aggressive therapies from those who may be spared additional—potentially toxic—therapies is still a work-in-progress. With the exception of MRD assessment in acute promyelocytic leukemia (APL), the lack of randomized, prospective trials renders MRD-based decisions and clinical implications in AML a difficult task. As of today, we still do not have proof that early intervention in MRD-positive AML patients would improve outcomes, although this is very likely. In this article, we review the current knowledge on non-APL AML MRD assessment and possible clinical consequences