1,549 research outputs found

    A Time-Saving Technique for Specimen Extraction in Sleeve Gastrectomy

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    Economic and environmental sustainability dimensions of a fashion supply chain: A quantitative model

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    Paper aim: The paper presents a model to assess the economic and the environmental sustainability dimensions of a fashion supply chain and tests it on a company. Originality: The gap intended to fill is the lack of models in this context having this purpose, and, in general, the necessity to develop models and metrics allowing to quantitatively assess the economic and environmental dimensions of supply chains. Research method: The fashion supply chain has been divided into five processes. Hence, an analytic model was developed by considering the total costs incurring in each process (economic evaluation), and the annual kilograms of CO2 emitted (environmental perspective). The model was then applied to a case study. Data was obtained from interviews with the management. Main findings: Results show that from the economic perspective supply impacts the most, while from the environmental one the most polluting activity is production. Implications for theory and practice: The model is easy to apply and to understand and allows to identify the activities in the supply chain where the majority of costs/emissions are generated. It is therefore expected to be useful for undertaking operational decisions aimed at decreasing the economic or environmental impact of a fashion supply chain

    A model for assessing economic and environmental sustainability dimensions of a fashion supply chain and a case study

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    Due to the recent attention gained by sustainability issues in the context of supply chains, the aim of this study is to present a model developed under Microsoft Excel™ for the assessment of the economic and environmental dimensions of a fashion supply chain, sector that deserves particular attention being one of the most polluting in the world. The assessment of the economic dimension is made through the evaluation of the total cost incurred in each process of the supply chain, while the environmental aspect is evaluated in terms of the carbon dioxide emissions generated. Specifically, in this paper the modelling of the warehouse function is detailed. To test the effectiveness of the model a case study is carried out on a fashion company based in the North of Italy; the key results are reported in the manuscript, showing where the majority of costs and emissions are generated. Information obtained from this tool can support the company's management in their operational decisions and show where to focus their attention to enhance the economic and environmental sustainability

    A transient high-coherence oscillation in 4U 1820-30

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    We re-analyzed two Rossi X-Ray Timing Explorer archival observations of the atoll source 4U 1820-30 in order to investigate the detailed time-frequency properties of the source during the intervals when a ~7 Hz QPO was detected by Wijnands et al. (1999, ApJ, 512, L39). We find that in both observations, in addition to a QPO signal lasting a couple of minutes as previously reported, there is a much narrower transient oscillation with a life time of only a few seconds. Within this time, the oscillation is consistent with being coherent. Its integrated fractional rms is around 10% and its frequency 7.3 Hz and 5.7 Hz in the two observations. We discuss the possible association of this QPO with other oscillations known both in Neutron-Star and Black-Hole systems, concentrating on the similarities with the narrow 5-7 Hz oscillations observed at high flux in Black-Hole Candidates.Comment: 5 pages, 3 figures, accepted for publication in A&A. FIgure 1 is reduced in resolution, full-resolution version of this text available at http://www.merate.mi.astro.it/~belloni/ms0335.ps.g

    INTEGRAL/RossiXTE high-energy observation of a state transition of GX 339-4

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    On 2004 August 15, we observed a fast (shorter than 10 hours) state transition in the bright black-hole transient GX 339-4 simultaneously with RossiXTE and INTEGRAL. This transition was evident both in timing and spectral properties. Combining the data from PCA, HEXTE and IBIS, we obtained good quality broad-band (3-200 keV) energy spectra before and after the transition. These spectra indicate that the hard component steepened. Also, the high-energy cutoff that was present at ~70 keV before the transition was not detected after the transition. This is the first time that an accurate determination of the broad-band spectrum across such a transition has been measured on a short time scale. It shows that, although some spectral parameters do not change abruptly through the transition, the high-energy cutoff increases/disappears rather fast. These results constitute a benchmark on which to test theoretical models for the production of the hard component in these systems.Comment: Accepted for publication in MNRAS (9 pages, 6 figures

    Oral liquid L-thyroxine (L-t4) may be better absorbed compared to L-T4 tablets following bariatric surgery.

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    Drug malabsorption is a potential concern after bariatric surgery. We present four case reports of hypothyroid patients who were well replaced with thyroxine tablets to euthyroid thyrotropin (TSH) levels prior to Roux-en-Y gastric bypass surgery. These patients developed elevated TSH levels after the surgery, the TSH responded reversibly to switching from treatment with oral tablets to a liquid formulation

    Oncological safety of stromal vascular fraction enriched fat grafting in two-stage breast reconstruction after nipple sparing mastectomy: long-term results of a prospective study

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    OBJECTIVE: Autologous fat transfer (AFT) is commonly used to treat implant palpability and prevent fibrosis and thinning in mastectomy skin flaps. A major limit to this procedure is volume retention over time, leading to the introduction of fat enrichment with stromal vascular fraction (SVF+AFT). Oncological concerns have been raised over the injection of an increased concentration of progenitors cells (ASCs) in the SVF. The aim of the study is to evaluate the long-term cancer recurrence risk of SVF+AFT cases compared to AFT, in patients undergoing Nipple Sparing Mastectomy (NSM). PATIENTS AND METHODS: A prospective study was designed to compare three groups of patients undergoing NSM followed by SVF+AFT, AFT or none (control group), after a two-stage breast reconstruction. Patients were strictly followed-up for at least 5-years from the second stage reconstructive procedure. Loco-regional and systemic recurrence rate were evaluated over time as the primary outcome. Logistic regression was used to investigate which factors were associated with recurrence events and independent variables of interest were: surgical technique, age above 50 years old, lympho-vascular invasion, oncological stage, adjuvant or neoadjuvant chemotherapy, adjuvant radiotherapy and adjuvant hormone therapy. RESULTS: 41 women were included in G1 (SVF+AFT), 64 in G2 (AFT), and 64 in G3 (control group). Loco-regional recurrence rate was 2.4% for G1, 4.7% for G2, and 1.6% for G3. Systemic recurrence was 7.3%, 3.1%, and 3.1%, respectively. Among the variables included, there were no significant risk factors influencing a recurrence event, either loco-regional or systemic. In particular, SVF+AFT (G1) did not increase the oncological recurrence. CONCLUSIONS: Our data suggest that both centrifuged and SVF-enhanced fat transfer have a similar safety level in comparison to patients who did not undergo fat grafting in breast reconstruction after NSM

    Synthetic Crysotile Nano-Crystals as a Reference Standard to Investigate Surface-Induce Serum Albumin Structural Modifications

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    Geoinspired synthetic chrysotile, which represents an ideal asbestos reference standard, has been utilized to investigate homomolecular exchange of bovine serum albumin (BSA), the major plasma protein, between the adsorbed and dissolved state at the interface between asbestos fibers and biological medium. FTIR spectroscopy has been used to quantify BSA structural modifications due to surface adhesion on chrysotile fibers as a function of the surface coating extent. Circular dichroism spectroscopy has been used to investigate the adsorption/desorption equilibrium through analysis of the BSA structural perturbations after protein desorption from chrysotile surface. Data results show clearly that in the solid state BSA modifications are driven by surface interaction with the substrate, following a bimodal adsorption evidenced by two different binding constants. On the other hand, BSA desorbed in solution is able to rearrange, in the lack of substrate, although keeping irreversible modifications with respect to the native species. The lack of regaining its native structure certainly affects albumin interaction with biological environment. The present investigation on the stoichiometric synthetic geoinspired chrysotile nanocrystals is the first approach toward a deeper attempt to use standard synthetic chrysotile reference samples in mimicking the behavior of asbestos fibers and allows to better understand their interaction with a biological environment

    Contact force sensing in ablation of ventricular arrhythmias using a 56-hole open-irrigation catheter: a propensity-matched analysis.

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    PURPOSE: The effect of adding contact force (CF) sensing to 56-hole tip irrigation in ventricular arrhythmia (VA) ablation has not been previously studied. We aimed to compare outcomes with and without CF sensing in VA ablation using a 56-hole radiofrequency (RF) catheter. METHODS: A total of 164 patients who underwent first-time VA ablation using Thermocool SmartTouch Surround Flow (TC-STSF) catheter (Biosense-Webster, Diamond Bar, CA, USA) were propensity-matched in a 1:1 fashion to 164 patients who had first-time ablation using Thermocool Surround Flow (TC-SF) catheter. Patients were matched for age, gender, cardiac aetiology, ejection fraction and approach. Acute success, complications and long-term follow-up were compared. RESULTS: There was no difference between procedures utilising either TC-SF or TC-STSF in acute success (TC-SF: 134/164 (82%), TC-STSF: 141/164 (86%), p = 0.3), complications (TC-SF: 11/164 (6.7%), TC-STSF: 11/164 (6.7%), p = 1.0) or VA-free survival (TC-SF: mean arrhythmia-free survival time = 5.9 years, 95% CI = 5.4-6.4, TC-STSF: mean = 3.2 years, 95% CI = 3-3.5, log-rank p = 0.74). Fluoroscopy time was longer in normal hearts with TC-SF (19 min, IQR: 14-30) than TC-STSF (14 min, IQR: 8-25; p = 0.04). CONCLUSION: Both TC-SF and TC-STSF catheters are safe and effective in treating VAs. The use of CF sensing catheters did not improve safety or acute and long-term outcomes, but reduced fluoroscopy time in normal heart VA
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