Critical Components Evaluation in Manufacturing-To-Order Processes

In this paper we address the evaluation of the criticality of important components in Manufacturing-To-Order and Assembly-To-Order processes, where the management of the inventory is a critical problem, especially very expensive ones. In these situations, if an item is purchased only when needed for a specific order, the delivery time could cause the delay of the entire production process. In addition, these manufacturing environments are often affected by uncertainty, caused by the execution of several activities by human operators, and by the intrinsic complexity of the process (especially in assembly processes). In this background, we provide a method to evaluate the criticality level of each important component in an assembly process exploiting the AoA project network formalization. In particular we put the focus on the coordination between the scheduled arrive of an element from the supplier, and the actual needed of the component in the assembly process. To this aim we develop a method taking into consideration two different criticality indexes. The approach is validate in a real manufacturing case

Call for Papers/Special Issue: 'Design contributions for the COVID-19 global emergency'

The 2019-20 coronavirus pandemic disease (COVID-19), appeared for the first time in Wuhan (Hubei Province, China) in late 2019 and rapidly spread in the rest of the world since the early months of 2020, has produced a significant and sadly dramatic impact in the life of all people. To date (April 22th, 2020), over 2.550.000 people have shown symptoms and over 175.000 died for health and respiratory problems. While the entire humanity feels dangerously powerless at the same time an unprecedented amount of initiatives across the world have shown human creativity and resilience. The entire scientific community is cohesive in facing this emergency and the severe health-related issues that have arisen in the last months. In this unparalleled scenario, the global Design community is called to act. And it is doing it! The new instances pointed out by the global emergencies allow reflecting to the ways the Design discipline can answer to unprecedented phenomena, with the will to foresee likely solutions in the long run from the lesson that we can learn in these months. At the same time, it is possible to immediately underline all bottom-up and top-down reactions that formally and informally are arising as conscious designed actions to solve the COVID-19 both at the small scales and at the large ones. There is a widespread perception that this worldwide crisis will change all aspects of our way of living and relating to each other. Governments, companies, NGOs, communities and individuals are already dedicating their time to reflect the future scenarios, devising solutions that can enable a transition to the new world that might come after the pandemic. Whilst contributing to the on-going challenges of the pandemic, the Design community can also contribute through its abductive reasoning, with propositions for new scenarios on the post-pandemic aftermath. The aim of this Special Issue of the Strategic Design Research Journal is to enrich the cultural and scientific debate by gathering and mapping all progresses produced in the COVID-19 emergency scenario and, then, to understand the role of the Design discipline in facing the complex global emergencies

Procalcitonin Reveals Early Dehiscence in Colorectal Surgery: The PREDICS Study

Objectives: We designed a multicentric, observational study to test if Procalcitonin (PCT) might be an early and reliable marker of anastomotic leak (AL) after colorectal surgery (ClinicalTrials.govIdentifier:NCT01817647). Background: Procalcitonin is a biomarker used to monitor bacterial infections and guide antibiotic therapy. Anastomotic leak after colorectal surgery is a severe complication associated with relevant short and long-term sequelae. Methods: Between January 2013 and September 2014, 504 patients underwent colorectal surgery, for malignant colorectal diseases, in elective setting. White blood count (WBC), C-reactive protein (CRP) and PCT levels were measured in 3rd and 5th postoperative day (POD). AL and all postoperative complications were recorded. Results: We registered 28 (5.6%) anastomotic leaks. Specificity and negative predictive value for AL with PCT less than 2.7 and 2.3 ng/mL were, respectively, 91.7% and 96.9% in 3rd POD and 93% and 98.3% in 5th POD. Receiver operating characteristic curve for biomarkers shows that in 3rd POD, PCTand CRP have similar area under the curve (AUC) (0.775 vs 0.772), both better than WBC (0.601); in 5th POD, PCT has a better AUC than CRP and WBC (0.862 vs 0.806 vs 0.611). Measuring together PCT and CRP significantly improves AL diagnosis in 5th POD (AUC: 0.901). Conclusions: PCTand CRP demonstrated to have a good negative predictive value for AL, both in 3rd and in 5th POD. Low levels of PCT, together with low CRP values, seem to be early and reliable markers of AL after colorectal surgery. These biomarkers might be safely added as additional criteria of discharge protocols after colorectal surgery

An integrated framework for design, management and operation of reconfigurable assembly systems

Abstract Manufacturing has to cope with the continuously increasing variety of products, change of volumes and shortening product life cycles. These trends also affect the automotive sector: the frequent introduction of new models, materials and assembly technologies put the suppliers of make-to-order parts under pressure. In this context, the design of assembly systems and their management are of paramount importance for the companies’ competitiveness. In this paper, we propose an approach for the design and reconfiguration of modular assembly systems through the integration of different computational tools addressing the design of the system, the optimization of the layout, the planning of reconfiguration actions as well as production planning. Integrating these computational tools and iterating through the resulting workflow and feedback allow to consider the outcomes and dependencies of alternative decision sequences holistically with the objective of an effective and efficient approach to production system design and management. The viability of the approach is demonstrated through the application to an automotive case study

Design Contributions for the COVID-19 Global Emergency (Part 2): Methodological Reflections and Future Visions

This is a landmark publication for the field of design. It was catalysed by unprecedented circumstances, as designers around the world had to rapidly deploy their competencies in strategic problem-solving to help humanity in the fight against an invisible enemy during a global pandemic. In alliance with other disciplines, from medicine to mechanical engineering, from computing to anthropology, designers everywhere have addressed the challenges and produced remarkable results through a diversity of initiatives. This Special Issue presents a peer-reviewed sample of these initiatives

Ischemic wound revascularization by the stromal vascular fraction relies on host-donor hybrid vessels

Nonhealing wounds place a significant burden on both quality of life of affected patients and health systems. Skin substitutes are applied to promote the closure of nonhealing wounds, although their efficacy is limited by inadequate vascularization. The stromal vascular fraction (SVF) from the adipose tissue is a promising therapy to overcome this limitation. Despite a few successful clinical trials, its incorporation in the clinical routine has been hampered by their inconsistent results. All these studies concluded by warranting pre-clinical work aimed at both characterizing the cell types composing the SVF and shedding light on their mechanism of action. Here, we established a model of nonhealing wound, in which we applied the SVF in combination with a clinical-grade skin substitute. We purified the SVF cells from transgenic animals to trace their fate after transplantation and observed that it gave rise to a mature vascular network composed of arteries, capillaries, veins, as well as lymphatics, structurally and functionally connected with the host circulation. Then we moved to a human-in-mouse model and confirmed that SVF-derived endothelial cells formed hybrid human-mouse vessels, that were stabilized by perivascular cells. Mechanistically, SVF-derived endothelial cells engrafted and expanded, directly contributing to the formation of new vessels, while a population of fibro-adipogenic progenitors stimulated the expansion of the host vasculature in a paracrine manner. These data have important clinical implications, as they provide a steppingstone toward the reproducible and effective adoption of the SVF as a standard care for nonhealing wounds

Colorectal surgery in Italy during the Covid19 outbreak: a survey from the iCral study group

Background The COVID19 pandemic had a deep impact on healthcare facilities in Italy, with profound reorganization of surgical activities. The Italian ColoRectal Anastomotic Leakage (iCral) study group collecting 43 Italian surgical centers experienced in colorectal surgery from multiple regions performed a quick survey to make a snapshot of the current situation. Methods A 25-items questionnaire was sent to the 43 principal investigators of the iCral study group, with questions regard- ing qualitative and quantitative aspects of the surgical activity before and after the COVID19 outbreak. Results Two-thirds of the centers were involved in the treatment of COVID19 cases. Intensive care units (ICU) beds were partially or totally reallocated for the treatment of COVID19 cases in 72% of the hospitals. Elective colorectal surgery for malignancy was stopped or delayed in nearly 30% of the centers, with less than 20% of them still scheduling elective colo- rectal resections for frail and comorbid patients needing postoperative ICU care. A significant reduction of the number of colorectal resections during the time span from January to March 2020 was recorded, with significant delay in treatment in more than 50% of the centers. Discussion Our survey confirms that COVID19 outbreak is severely affecting the activity of colorectal surgery centers partici- pating to iCral study group. This could impact the activity of surgical centers for many months after the end of the emergency

Hypoxia Modifies the Transcriptome of Human NK Cells, Modulates Their Immunoregulatory Profile, and Influences NK Cell Subset Migration

Hypoxia, which characterizes most tumor tissues, can alter the function of different immune cell types, favoring tumor escape mechanisms. In this study, we show that hypoxia profoundly acts on NK cells by influencing their transcriptome, affecting their immunoregulatory functions, and changing the chemotactic responses of different NK cell subsets. Exposure of human peripheral blood NK cells to hypoxia for 16 or 96 h caused significant changes in the expression of 729 or 1,100 genes, respectively. Gene Set Enrichment Analysis demonstrated that these changes followed a consensus hypoxia transcriptional profile. As assessed by Gene Ontology annotation, hypoxia-targeted genes were implicated in several biological processes: metabolism, cell cycle, differentiation, apoptosis, cell stress, and cytoskeleton organization. The hypoxic transcriptome also showed changes in genes with immunological relevance including those coding for proinflammatory cytokines, chemokines, and chemokine-receptors. Quantitative RT-PCR analysis confirmed the modulation of several immune-related genes, prompting further immunophenotypic and functional studies. Multiplex ELISA demonstrated that hypoxia could variably reduce NK cell ability to release IFNγ, TNFα, GM-CSF, CCL3, and CCL5 following PMA+Ionomycin or IL15+IL18 stimulation, while it poorly affected the response to IL12+IL18. Cytofluorimetric analysis showed that hypoxia could influence NK chemokine receptor pattern by sustaining the expression of CCR7 and CXCR4. Remarkably, this effect occurred selectively (CCR7) or preferentially (CXCR4) on CD56bright NK cells, which indeed showed higher chemotaxis to CCL19, CCL21, or CXCL12. Collectively, our data suggest that the hypoxic environment may profoundly influence the nature of the NK cell infiltrate and its effects on immune-mediated responses within tumor tissues