Role of Phosphoinositide 3-Kinase and Extracellular Signal-Regulated Kinase Pathways in Granulocyte Macrophage-Colony-Stimulating Factor Failure to Delay Fas-Induced Neutrophil Apoptosis in Elderly Humans

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Exploring industry 4.0 technologies to enable circular economy practices in a manufacturing context: a business model proposal.

Purpose - The purpose of this study was to explore how rising technologies from Industry 4.0 can be integrated with circular economy (CE) practices to establish a business model that reuses and recycles wasted material such as scrap metal or e-waste Design/methodology/approach – The qualitative research method was deployed in three stages. Stage one was a literature review of concepts, successful factors, and barriers related to the transition towards a CE along with sustainable supply chain management, smart production systems, and additive manufacturing. Stage two comprised a conceptual framework to integrate and evaluate the synergistic potential among these concepts. Finally, stage three validated the proposed model by collecting rich qualitative data based on semi-structured interviews with managers, researchers, and professors of operations management to gather insightful and relevant information. Findings – The outcome of the study is the recommendation of a circular model to reuse scrap electronic devices, integrating web technologies, reverse logistics, and additive manufacturing to support CE practices. Results suggest a positive influence from improving business sustainability by reinserting waste into the supply chain to manufacture products on demand. Research implications/originality – The impact of reusing wasted materials to manufacture new products is relevant to minimizing resource consumption and negative environmental impacts. Furthermore, it avoids hazardous materials ending up in landfills or in the oceans, seriously threatening life in ecosystems. In addition, reuse of wasted material enables the development of local business networks that generate jobs and improve economic performance.N/

A Systematic Review of Lean Implementation Frameworks and Roadmaps: Lessons Learned the Way Forward

Purpose: The purpose of this study is to carry out a comprehensive systematic review of Lean implementation frameworks and roadmaps developed over the past decade and report the key findings along with the limitations and the way forward. Methodology: A systematic review methodology proposed by Tranfield (2003) was followed to identify the relevant works on the research topic. Articles were searched using a set of inclusion criteria in various databases including Google Scholar, Web of Science and Science Direct over a period of thirty years. Findings: The high failure rate of Lean system implementation, reaching a range between 70-90% in almost all industries, is a matter of concern. This failure rate is still high even though numerous frameworks and roadmap models exist to streamline Lean implementation. There is no standard framework or roadmap identified in the literature and many organisations are implementing lean in their unique ways. However it would be desirable to develop a practical and systematic roadmap on Lean looking into the cultural and leadership dimensions rather than focusing on a set of tools. Moreover, most frameworks and roadmaps lack the sustianance aspects of Lean implementation. Limitation: This research only identifies the fundamental gaps with the existing frameworks and roadmaps on lean implementation. The next phase of the research is to develop a roadmap and validate it with a number of organisations in different cultural contexts and leadership styles. Originality: The authors argue that this is one of the most comprehensive systematic review on lean frameworks and roadmaps ever produced in the literature to date

Interleukin-6, interleukin-1β, and tumor necrosis factor α in menstrual effluents as biomarkers of chronic endometritis.

Objective: To assess the relationship between chronic endometritis (CE) and proin␣ammatory cytokine levels in menstrual ef␣uents and to develop a simple noninvasive test for screening CE. Design: Case-control study. Setting: Academic center. Patient(s): Sixty-four women referred to our center for infertility. Intervention(s): Of␣ce hysteroscopy; endometrial biopsy; collection of menstrual blood at subsequent cycle. Main Outcome Measure(s): Interleukin (IL) 6, IL-1b, and tumor necrosis factor (TNF) a concentrations in menstrual ef␣uents. Result(s): Thirty-sixoutof64infertilewomenhadhistologicallyprovenCE.Theremaining28womenwereincludedascontrols.IL-6, IL-1b, and TNF-a levels were markedly higher in menstrual ef␣uents of women with CE compared with control subjects. Receiver operating characteristic curve analysis revealed a good CE screening capacity for all of the cytokines. The combined evaluation of either IL-6/TNF-a or IL-6/IL-1b increased the diagnostic capacity of the test, which reached a 100% sensitivity and a negative predictive value of 100 when at least one cytokine was found to exceed its cutoff value; it also reached a 100% speci␣city and a positive predictive value of 100 in cases of positivity of both cytokines. Logistic regression analysis con␣rmed the IL-6/TNF-a– based model as a signi␣cant predictor of CE. Conclusion(s): Proin␣ammatorycytokinelevelsareincreasedinmenstrualef␣uentsofwomen with CE. A test dosing IL-6 and TNF-a seems to have a high screening capacity for CE. (Fertil Steril! 2014;101:242–7. !2014 by American Society for Reproductive Medicine.

Global Perspectives on Operational Excellence: Unveiling Critical Failure Factors and Sustainable Pathways

Purpose: The purpose of this global study is to investigate the critical failure factors (CFFs) in the deployment of Operational Excellence (OPEX) programs as well as the key performance indicators (KPIs) that can be used to measure OPEX failures. The study also empirically analyses various OPEX methodologies adopted by various organizations at a global level. Methodology: This global study utilized an online survey to collect data. The questionnaire was sent to 800 senior managers resulting ultimately in 249 useful responses. Findings: The study results suggest that Six Sigma is the most widely utilized across the OPEX methodologies, followed by Lean Six Sigma and Lean. Agile manufacturing is the least utilized OPEX methodology. The top four critical failure factors (CFFs) were poor project selection and prioritization, poor leadership, lack of proper communication and resistance to change issues. Implications: This study extends the current body of knowledge on OPEX by first delineating the CFFs for OPEX and identifying the differing effects of these CFFs across various organizational settings. Senior managers and OPEX professionals can use the findings to take remedial actions and to improve the sustainability of OPEX initiatives in their respective organizations. Originality: This study uniquely identifies critical factors leading to OPEX initiative failures, providing practical insights for industry professionals and academia, fostering a deeper understanding of potential pitfalls. The research highlights a distinctive focus on social and environmental performance metrics, urging a paradigm shift for sustained OPEX success, differentiating itself in addressing broader sustainability concerns by recognising the interconnectedness of 12 critical failure factors, the study offers a pioneering foundation for future research and the development of a comprehensive management theory on OPEX failures

Substantial lymph-vascular space invasion (Lvsi) as predictor of distant relapse and poor prognosis in low-risk early-stage endometrial cancer

Objective: The aim of this study is to analyze the prognostic role of lymph-vascular space invasion (LVSI), evaluated in a semi-quantitative fashion on prognosis of early stage, low risk endometrial cancer (EC). Methods: We enrolled patients who underwent surgery for endometrial cancer between 2003 and 2018 in two referral cancer center. All patients had endometrioid EC, G1–G2, with myometrial invasion <50%, and no lymph-node involvement. LVSI was analyzed in a semi-quantitative way, according to a 3-tiered scoring system in absent, focal and substantial. Results: Among 524 patients, any positive LVSI was found in 57 patients (10.9%) with focal LVSI (n=35, 6.7%) and substantial LVSI (n=22, 4.2%). Substantial LVSI was associated to higher rate of G2 (p<0.001), myometrial infiltration (p=0.002) and greater tumor dimensions (p=0.014). Patients with substantial LVSI were more likely to receive adjuvant treatment (6.6% vs. 52.6%, p<0.001). The 5-year OS was 99.5% in patients with absent LVSI and 70.6% in those with substantial LVSI (p<0.001). The 5-year disease free survival (DFS) was 93.6% in patients with absent LVSI and 56.5% in those with substantial LVSI (p<0.001). The rate of distant failures increased from 1.8% for absent LVSI to 22.7% for substantial LVSI (p=0.002). In univariate analysis substantial LVSI was the strongest predictor of poor overall survival (hazard ratio [HR]=11.9, p=0.001). Multivariate analysis showed that substantial LVSI was an independent predictive factor of both recurrence (HR=5.88, p=0.001) and distant failure (HR=10.6, p=0.006). Conclusions: Substantial LVSI represents the strongest independent risk factor for decreased survival and distant relapse, indicating a role for potential hematogenous dissemination

The Impact of Quarantine and Physical Distancing Following COVID-19 on Mental Health : Study Protocol of a Multicentric Italian Population Trial

The COVID-19 pandemic and its related containment measures-mainly physical distancing and isolation-are having detrimental consequences on the mental health of the general population worldwide. In particular, frustration, loneliness, and worries about the future are common reactions and represent well-known risk factors for several mental disorders, including anxiety, affective, and post-traumatic stress disorders. The vast majority of available studies have been conducted in China, where the pandemic started. Italy has been severely hit by the pandemic, and the socio-cultural context is completely different from Eastern countries. Therefore, there is the need for methodologically rigorous studies aiming to evaluate the impact of COVID-19 and quarantine measures on the mental health of the Italian population. In fact, our results will help us to develop appropriate interventions for managing the psychosocial consequences of pandemic. The "COVID-IT-mental health trial" is a no-profit, not-funded, national, multicentric, cross-sectional population-based trial which has the following aims: a) to evaluate the impact of COVID-19 pandemic and its containment measures on mental health of the Italian population; b) to identify the main areas to be targeted by supportive long-term interventions for the different categories of people exposed to the pandemic. Data will be collected through a web-platform using validated assessment tools. Participants will be subdivided into four groups: a) Group 1-COVID-19 quarantine group. This group includes the general population which are quarantined but not isolated, i.e., those not directly exposed to contagion nor in contact with COVID-19+ individuals; b) Group 2-COVID-19+ group, which includes isolated people directly/indirectly exposed to the virus; c) Group 3-COVID-19 healthcare staff group, which includes first- and second-line healthcare professionals; d) Group 4-COVID-19 mental health, which includes users of mental health services and all those who had already been diagnosed with a mental disorder. Mental health services worldwide are not prepared yet to manage the short- and long-term consequences of the pandemic. It is necessary to have a clear picture of the impact that this new stressor will have on mental health and well-being in order to develop and disseminate appropriate interventions for the general population and for the other at-risk groups

Air pollutants and daily number of admissions to psychiatric emergency services: evidence for detrimental mental health effects of ozone

Abstract Aims Aim of the current study is to investigate the associations between daily levels of air pollutants (particulate matter, ozone, carbon monoxide, nitrogen dioxide) and daily admissions for mental disorders to the emergency department of two general hospitals in Umbria region (Italy). Methods We collected data about daily admissions to psychiatric emergency services of two general hospitals, air pollutants' levels and meteorological data for the time period 1 January 2015 until 31 December 2016. We assessed the impact of an increase in air pollutants on the number of daily admissions using a time-series econometric framework. Results A total of 1860 emergency department admissions for mental disorders were identified. We observed a statistically significant impact of ozone levels on daily admissions. The estimated coefficient of O3 is statistically significant at the 1% level. All other pollutants were not significantly associated with the number of daily admissions. Conclusions Short-term exposure to ozone may be associated with increased psychiatric emergency services admissions. Findings add to previous literature on existing evidence for air pollution to have an impact on mental health. Ozone may be considered a potential environmental risk factor for impaired mental health

A lean six sigma framework for continuous and incremental improvement in the oil and gas sector

This article aims to explore synergies between Lean Production (LP) and Six Sigma principles in order to propose a Lean Six Sigma (LSS) framework for continuous and incremental improvement in the oil and gas sector. The Three-Dimensional LSS Framework seeks to provide various combinations about the integration between LP principles, DMAIC cycle and PDCA cycle to support operations management needs. Design/methodology/approach - The research method is composed of two main steps: (i) diagnostic of current problems and proposition of a conceptual framework that qualitatively integrates synergistic aspects of LP and Six Sigma; and (ii) analysis of the application of the construct through semi-structured interviews with leaders from oil and gas companies to assess and validate the proposed framework. Findings - As a result, a conceptual framework of LSS is developed contemplating the integration of LP and Six Sigma and providing a systemic and holistic approach to problemsolving through continuous and incremental improvement in the oil and gas sector. Originality/value - This research is different from previous studies because it integrates LP principles, DMAIC and PDCA cycles into a unique framework that fulfils a specific need of oil and gas sector. It presents a customized LSS framework that guides wastes and costs reduction, while enhances quality and reduces process variability to elevate efficiency in operations management of this sector. The paper type is an original research that present new and original scientific findings.N/