Base and surge strategies for controlling environmental and economic costs in logistics triads

The aim of this paper is to determine the extent to which it is possible to establish a ‘base’ and ‘surge’ strategy for logistics provision with a particular emphasis on minimising environmental and economic costs. Our method is the combination of empirical research outputs on the impact of uncertainty on economic and environmental costs, and a synthesis of the literature on resilience and the role of flexibility therein. We find that logistics planners either build contingents into their schedules (a priori) or that they respond with contingencies (a posteriori). The former is associated with a ‘base‘ approach; an example of which may be the incorporation of ‘slack time‘ into a schedule to accommodate expected delays due to road congestion. The latter is equivalent to a ‘surge‘ approach where as an example the logistics provider may have capacity flexibility, in the form of spare vehicles, to accommodate post-plan changes in shipper volume requirements. This paper explicitly rationalises the links between uncertainty, ‘base’ and ‘surge’ supply chain strategies, and the strategic use of logistics flexibility, in minimising environmental and economic costs in a logistics triad. The output is in the form of a conceptual managerial feedback control system

Biochemical and toxicological effects of organic (herbicide Primextra® Gold TZ) and inorganic (copper) compounds on zooplankton and phytoplankton species

In Europe, mainly in the Mediterranean region, an intensive usage of pesticides was recorded during the past 30 years. According to information from agricultural cooperatives of the Mondego valley (Figueira da Foz, Portugal), Primextra® Gold TZ is the most used herbicide in corn crop fields and one of the 20 best-selling herbicides in Portugal. Copper is mainly used in pesticide formulations. This study aims to determine the ecotoxicological and biochemical (namely fatty acid profiles) effects of the herbicide Primextra® Gold TZ and the metal copper on marine plankton. The organisms used in this study are three planktonic species: the marine diatom Thalassiosira weissflogii, the estuarine copepod Acartia tonsa and nauplii of the marine brine shrimp Artemia franciscana. Fatty acids (FAs) are one of the most important molecules transferred across the plant-animal interface in aquatic food webs and can be used as good indicators of stress. The conducted lab incubations show that T. weissflogii is the most sensitive species to the herbicide followed by A. tonsa (EC50 =0;0.0078 mg/L and EC50 =0;0.925 mg/L, respectively), whereas the copepod was the most sensitive species to the metal followed by T. weissflogii (EC50 =0.234 mg/L and EC50 =0.383 mg/L, respectively). A. franciscana was the most tolerant organism both to the herbicide and to the metal (EC50 =20.35 mg/L and EC50 = 18.93 mg/L, respectively). Changes in the FA profiles of primary producer and primary consumers were observed, with the increase of saturated FA and decrease of unsaturated FA contents, especially of highly unsaturated FAs that can be obtained mainly from food and therefore are referred to as ‘essential FA’. The study suggests that discharges of Primextra® Gold TZ or other pesticides mainly composed by copper may be a threat to plankton populations causing changes in the FA contents and thus in their nutritive value, with severe repercussions for higher trophic levels and thus the entire food web

Psoriasis

Pretende-se nestas Recomendações Terapêuticas dar uma visão global dos conhecimentos actuais sobre a patogenia, clínica e tratamento da psoríase. A educação dos doentes deve incidir na evicção dos factores desencadeantes (medicamentos, trauma, álcool, infecções, stress) e enfa tizar a acção benéfica da exposição solar controlada na psoríase. A terapêutica tópica emolientes, queratolíticos, derivados do alcatrão, antralina, corticosteróides tópicos, calcipotriol — é essencial no controlo da psoríase vulgar em placas e é importante como adjuvante nos casos mais graves; chama-se a atenção para os graus de potência e para os potenciais efeitos indesejáveis da corticoterapia tópica. A radiação UV isolada (fototerapia) ou em associação a fotos sensibilizantes (fotoquimioterapia) está indicada nalgumas formas de psoríase (gutata, em placas, palmo-plantar) refractárias aos tópicos. A terapêutica sistémica — retinóides, metotrexato, ciclosporina está reservada para as formas mais graves, extensas e refractárias de psoríase, sendo indispensável na psoríase eritrodérmica, pustulosa ou artropática. A estratégia actual visa obter o melhor índice terapêutico e dá particular importância às terapêuticas combinadas e/ou rotativas. Para finalizar, incluem-se alguns fluxogramas, com o objectivo de ordenar os passos a dar na abordagem do doente com psorfase e salientar a validade científica das diferentes terapêuticas disponíveis

Prevalence of personal weight control attempts in adults: a systematic review and meta-analysis

The purpose of this systematic review and meta-analysis was to estimate the prevalence of personal weight control attempts (weight loss and/or maintenance) worldwide and to identify correlates, personal strategies used and the underlying motives. We included epidemiological/observational studies of adults (≥18 years) reporting prevalence of weight control attempts in the past-year. Seventy-two studies (n = 1,184,942) met eligibility criteria. Results from high quality studies showed that 42% of adults from general populations and 44% of adults from ethnic-minority populations reported trying to lose weight, and 23% of adults from general populations reported trying to maintain weight annually. In general population studies, higher prevalence of weight loss attempts was observed in the decade of 2000–2009 (48.2%), in Europe/Central Asia (61.3%) and in overweight/obese individuals and in women (p < 0.01). Of the 37 strategies (grouped in 10 domains of the Oxford Food and Activity Behaviours Taxonomy) and 12 motives reported for trying to control weight, exercising and dieting (within the energy compensation and restraint domains, respectively) and wellbeing and long-term health were the most prevalent. To our knowledge, this is the first systematic review to investigate weight control attempts worldwide. Key strategies and motives were identified which have implications for future public health initiatives on weight control

Endobronchial Ultrasound under Moderate Sedation versus General Anesthesia

BACKGROUND: Different anesthetic protocols may influence endobronchial ultrasound-guided needle aspiration (EBUS-TBNA) outcomes, patient comfort, and even safety. In this study, two anesthesia techniques were assessed and compared for EBUS-TBNA. METHODS: A prospective, multicenter study was carried out. Patients were allocated to Group 1 (general anesthesia with neuromuscular blockade and controlled ventilation) and Group 2 (intravenous sedation). EBUS-TBNA accuracy was the primary outcome. Safety, patient comfort and satisfaction, and operators' difficulties were defined as secondary outcomes. RESULTS: Of the 115 patients enrolled (Group 1 = 59, Group 2 = 56), EBUS-TBNA was performed for hilar or mediastinal lesion diagnosis and lung cancer staging in, respectively, 77 (67%) and 38 (33%) patients. The numbers of lymph nodes stations (1.8 ± 1.0 vs. 1.7 ± 1.0, p = 0.472) and punctures per station (6.9 ± 3.1 vs. 6.0 ± 2.5, p = 0.084) were similar between groups. Adequate samples were obtained from 109 patients (97.3%) with similar diagnostic accuracy. Procedure duration was not significantly different (p = 0.348). Hemodynamic parameters and systolic and diastolic blood pressures were higher in Group 1 at the beginning and at the end of the procedure. Adverse events were equally distributed, and no significant differences were found regarding patient satisfaction and bronchoscopist/anesthesiologist difficulties. CONCLUSIONS: The type of anesthesia used did not influence EBUS-TBNA outcomes. EBUS-TBNA performed under sedation or general anesthesia did not affect the diagnostic yield, complication rate, and patients' comfort and satisfaction.info:eu-repo/semantics/publishedVersio

Optimal dimensioning model of water distribution systems

This study is aimed at developing a pipe-sizing model for a water distribution system. The optimal solution minimises the system&#8217;s total cost, which comprises the hydraulic network capital cost, plus the capitalised cost of pumping energy. The developed model, called Lenhsnet, may also be used for economical design when expanding existing hydraulic networks. The methodology developed includes an iterative dynamic calculation process as well as a hydraulic simulation model. The performance of the method is tested against 4 benchmark examples in the literature. The results obtained show the feasibility of this model, presenting it as a viable alternative for water distribution systems. The method is easily used, once it is performed under EPANET2 software interface

Nonalcoholic Steatohepatitis

Os autores apresentam um caso de esteatohepatite não alcoólica numa mulher obesa, não diabética, que evoluiu para cirrose hepática. A propósito desta entidade revêem a literatura discutindo a sua história natural e os principais processos patológicos a ela associados. Destacam a importância da obesidade no desenvolvimento da esteatohepatite e da vantagem, em casos seleccionados, da execução de biópsia hepática, como técnica de diagnóstico fundamental

Risk factors for falls in the community: based on self-report of elderly persons

Introduction: Several studies have shown independent risk factors for falling among community older people. However, there is few researches showing the importance of older person’s perception of their own fall risk. Aims: The study purpose was to identify independent risk factors for falls and to explore predictive factors related to the occurrence of falls in community-dwelling older people. Method: A cross-sectional study was conducted from January to April 2015. All data were based on self-report of older persons. An study-specific questionnaire was used. Univariate and logistic regression analyses were used. Results: The sample comprised 562 men and 760 women. Among the participants, 24.5% reported having had falls in the previous six months, scoring a total of 467 falling events. Of the individuals who had fallen, 36.8% had experienced recurrent falls. The risk of fall was nearly twice as high in women than in men (OR=1.85; 95% CI: 1.40-2.43). Being 75 years old or older was associated with an increased risk of falling compared with being 65-74 years old (OR=2.38; 95% CI:1.82-3.11). The elderly who had fallen reported injuries (48.3%) associated with falls, and 36% required health care. Conclusion: Six independent risk factors for falling into the community dwelling older people were identified, some of which are potentially modifiable.info:eu-repo/semantics/publishedVersio