Aplicabilidade da Filosofia Lean na Indústria 4.0 / Applicability of Lean Philosophy in Industry 4.0

A Indústria 4.0 representa uma nova Revolução Industrial que está em andamento. Nesse cenário, as tecnologias habilitadoras estão mudando fundamentalmente os processos industriais e a forma como os produtos são produzidos, colaborando para a criação de uma nova cadeia de valor. Já a Filosofia Lean atua na redução de custos e no aumento da qualidade nos processos, sendo muito empregada na indústria desde a metade do século passado. Assim, este artigo tem por objetivo verificar a aplicabilidade da Filosofia Lean nas tecnologias habilitadoras da Indústria 4.0. Para isso, foi realizada uma pesquisa na literatura disponível sobre o assunto e, a partir dos estudos encontrados, pôde-se concluir que a Filosofia Lean tem aplicabilidade em todas as tecnologias habilitadoras da Indústria 4.0, por meio da utilização de um ou mais de seus princípios.

11C-choline vs. 18F-FDG PET/CT in assessing bone involvement in patients with multiple myeloma

<p>Abstract</p> <p>Background</p> <p>Multiple Myeloma (MM) is a B cell neoplasm causing lytic or osteopenic bone abnormalities. Whole body skeletal survey (WBSS), Magnetic resonance (MR) and ¹⁸F-FDG PET/CT are imaging techniques routinely used for the evaluation of bone involvement in MM patients.</p> <p>Aim</p> <p>As MM bone lesions may present low ¹⁸F-FDG uptake; the aim of this study was to assess the possible added value and limitations of ¹¹C-Choline to that of ¹⁸F-FDG PET/CT in patients affected with MM.</p> <p>Methods</p> <p>Ten patients affected with MM underwent a standard ¹¹C-Choline PET/CT and an ¹⁸F-FDG PET/CT within one week. The results of the two scans were compared in terms of number, sites and SUV_maxof lesions.</p> <p>Results</p> <p>Four patients (40%) had a negative concordant ¹¹C-Choline and ¹⁸F-FDG PET/CT scans. Two patients (20%) had a positive ¹¹C-Choline and ¹⁸F-FDG PET/CT scans that identified the same number and sites of bone lesions. The remaining four patients (40%) had a positive ¹¹C-Choline and ¹⁸F-FDG PET/CT scan, but the two exams identified different number of lesions. Choline showed a mean SUV_maxof 5 while FDG showed a mean SUV_maxof 3.8 (P = 0.042). Overall, ¹¹C-Choline PET/CT scans detected 37 bone lesions and ¹⁸F-FDG PET/CT scans detected 22 bone lesions but the difference was not significant (P = 0.8).</p> <p>Conclusion</p> <p>According to these preliminary data, ¹¹C-Choline PET/CT appears to be more sensitive than ¹⁸F-FDG PET/CT for the detection of bony myelomatous lesions. If these data are confirmed in larger series of patients, ¹¹C-Choline may be considered a more appropriate functional imaging in association with MRI for MM bone staging.</p

L'emocromo: così convenzionale, così richiesto, ma così sconosciuto

Complete blood count (CBC) is one of the mostly performed diagnostic exam. It can give a variety of informations about a child's health status. The article has the aim of guiding the pediatrician into reading the the different values of the CBC, in order to properly recognize and interpret the alterations and underlying the red flags which must be identified in order to proceed into further investigations or to request a specialist consultation (pediatric hematologist)

Aligned ovine diaphragmatic myoblasts overexpressing human connexin-43 seeded on poly (L-lactic acid) scaffolds for potential use in cardiac regeneration

Diaphragmatic myoblasts (DMs) are precursors of type-1 muscle cells displaying high exhaustion threshold on account that they contract and relax 20 times/min over a lifespan, making them potentially useful in cardiac regeneration strategies. Besides, it has been shown that biomaterials for stem cell delivery improve cell retention and viability in the target organ. In the present study, we aimed at developing a novel approach based on the use of poly (L-lactic acid) (PLLA) scaffolds seeded with DMs overexpressing connexin-43 (cx43), a gap junction protein that promotes inter-cell connectivity. DMs isolated from ovine diaphragm biopsies were characterized by immunohistochemistry and ability to differentiate into myotubes (MTs) and transduced with a lentiviral vector encoding cx43. After confirming cx43 expression (RT-qPCR and Western blot) and its effect on inter-cell connectivity (fluorescence recovery after photobleaching), DMs were grown on fiberaligned or random PLLA scaffolds. DMs were successfully isolated and characterized. Cx43 mRNA and protein were overexpressed and favored inter-cell connectivity. Alignment of the scaffold fibers not only aligned but also elongated the cells, increasing the contact surface between them. This novel approach is feasible and combines the advantages of bioresorbable scaffolds as delivery method and a cell type that on account of its features may be suitable for cardiac regeneration. Future studies on animal models of myocardial infarction are needed to establish its usefulness on scar reduction and cardiac function.Centro de Investigaciones Cardiovasculare

Acromegaly is associated with increased cancer risk: A survey in Italy

It is debated if acromegalic patients have an increased risk to develop malignancies. The aim of the present study was to assess the standardized incidence ratios (SIRs) of different types of cancer in acromegaly on a large series of acromegalic patients managed in the somatostatin analogs era. It was evaluated the incidence of cancer in an Italian nationwide multicenter cohort study of 1512 acromegalic patients, 624 men and 888 women, mean age at diagnosis 45 \uc2\ub1 13 years, followed up for a mean of 10 years (12573 person-years) in respect to the general Italian population. Cancer was diagnosed in 124 patients, 72 women and 52 men. The SIRs for all cancers was significantly increased compared to the general Italian population (expected: 88, SIR 1.41; 95% CI, 1.18-1.68, P &lt; 0.001). In the whole series, we found a significantly increased incidence of colorectal cancer (SIR 1.67; 95% CI, 1.07-2.58, P = 0.022), kidney cancer (SIR 2.87; 95% CI, 1.55-5.34, P &lt; 0.001) and thyroid cancer (SIR 3.99; 95% CI, 2.32-6.87, P &lt; 0.001). The exclusion of 11 cancers occurring before diagnosis of acromegaly (all in women) did not change remarkably the study outcome. In multivariate analysis, the factors significantly associated with an increased risk of malignancy were age and family history of cancer, with a non-significant trend for the estimated duration of acromegaly before diagnosis. In conclusion, we found evidence that acromegaly in Italy is associated with a moderate increase in cancer risk

POTENCIAL TERAPÊUTICO DE CÉLULAS-TRONCO NA REGENERAÇÃO DE TECIDOS OCULARES

Degenerative eye diseases represent a significant challenge to global visual health, impacting on the quality of life of those affected. This summary reviews scientific evidence exploring the therapeutic potential of stem cells in the regeneration of ocular tissues. To carry out the integrative review on the therapeutic potential of stem cells in the regeneration of ocular tissues, a systematic search was conducted in scientific databases, including PubMed, Scopus and Scielo. The inclusion criteria were studies published between 2014 and 2024, addressing relevant advances in the field. The descriptors used included induced pluripotent stem cells, stem cell transplantation, cell differentiation, visual acuity, regenerative medicine. The initial selection resulted in a list of potential articles, which were assessed for their relevance to the proposed topic. In this way, we sought to cover a wide range of therapeutic approaches, from bioengineering to the clinical application of stem cells in ophthalmology. The studies addressed various therapeutic fronts, from the creation of bioengineered retinal pigment epithelium monolayers for dry macular degeneration to the characterization and transplantation of photoreceptors isolated from retinal organoids. Mandai et al. (2017) brought promising prospects by using autologous induced stem cells for macular degeneration, while Garber (2015) highlighted ethical challenges in conducting clinical trials. Ben M'Barek et al. (2016) proposed a stem cell-based therapy for retinal diseases, and Gagliardi et al. (2018) presented the characterization of CD73-positive photoreceptors. Safety was addressed by Satarian et al. (2017) in a study of intravitreal injection of bone marrow mesenchymal stem cells. Song et al. (2015) provided preliminary results on the treatment of macular degeneration with retinal pigment epithelium cells derived from embryonic stem cells. The results highlight promising advances in ocular stem cell therapy, indicating potential for ocular tissue regeneration. However, ethical and practical challenges must be considered during the clinical translation of these innovative therapies. This summary provides a comprehensive overview of the current state of research in this dynamic field, emphasizing the continued importance of these studies for advancing therapeutic options in ophthalmology.Doenças oculares degenerativas representam um desafio significativo para a saúde visual global, impactando a qualidade de vida dos afetados. Este resumo revisita evidências científicas que exploram o potencial terapêutico das células-tronco na regeneração de tecidos oculares. Para realizar a revisão integrativa sobre o potencial terapêutico de células-tronco na regeneração de tecidos oculares, foi conduzida uma busca sistemática em bases de dados científicas, incluindo PubMed, Scopus e Scielo. Os critérios de inclusão foram estudos publicados entre 2014 e 2024, abordando avanços relevantes no campo. Os descritores utilizados incluíram células-tronco pluripotentes induzidas, transplante de células-tronco, diferenciação celular, acuidade visual, medicina regenerativa. A seleção inicial resultou em uma lista de potenciais artigos, que foram avaliados quanto à relevância para o tema proposto. Dessa forma, buscou-se abranger uma ampla gama de abordagens terapêuticas, desde bioengenharia até a aplicação clínica de células-tronco na oftalmologia. Os estudos abordaram diversas frentes terapêuticas, desde a criação de monocamadas de epitélio pigmentar da retina bioengenheiradas para a degeneração macular seca até a caracterização e transplante de fotorreceptores isolados de organoides de retina. Mandai et al. (2017) trouxe perspectivas promissoras ao utilizar células-tronco induzidas autólogas para degeneração macular, enquanto Garber (2015) destacou desafios éticos na condução de ensaios clínicos. Ben M'Barek et al. (2016) propôs uma terapia baseada em células-tronco para doenças retinianas, e Gagliardi et al. (2018) apresentou a caracterização de fotorreceptores positivos para CD73. A segurança foi abordada por Satarian et al. (2017) em um estudo de injeção intravítrea de células-tronco mesenquimais da medula óssea. Song et al. (2015) forneceu resultados preliminares sobre o tratamento da degeneração macular com células de epitélio pigmentar da retina derivadas de células-tronco embrionárias. Os resultados destacam avanços promissores na terapia com células-tronco ocular, indicando potencial para a regeneração de tecidos oculares. Contudo, desafios éticos e práticos devem ser considerados durante a tradução clínica dessas terapias inovadoras. Este resumo oferece uma visão abrangente do estado atual da pesquisa nesse campo dinâmico, enfatizando a importância contínua desses estudos para o avanço das opções terapêuticas em oftalmologia. &nbsp; &nbsp

COVID-19 Severity in Multiple Sclerosis: Putting Data Into Context

Background and objectives: It is unclear how multiple sclerosis (MS) affects the severity of COVID-19. The aim of this study is to compare COVID-19-related outcomes collected in an Italian cohort of patients with MS with the outcomes expected in the age- and sex-matched Italian population. Methods: Hospitalization, intensive care unit (ICU) admission, and death after COVID-19 diagnosis of 1,362 patients with MS were compared with the age- and sex-matched Italian population in a retrospective observational case-cohort study with population-based control. The observed vs the expected events were compared in the whole MS cohort and in different subgroups (higher risk: Expanded Disability Status Scale [EDSS] score &gt; 3 or at least 1 comorbidity, lower risk: EDSS score ≤ 3 and no comorbidities) by the χ2 test, and the risk excess was quantified by risk ratios (RRs). Results: The risk of severe events was about twice the risk in the age- and sex-matched Italian population: RR = 2.12 for hospitalization (p &lt; 0.001), RR = 2.19 for ICU admission (p &lt; 0.001), and RR = 2.43 for death (p &lt; 0.001). The excess of risk was confined to the higher-risk group (n = 553). In lower-risk patients (n = 809), the rate of events was close to that of the Italian age- and sex-matched population (RR = 1.12 for hospitalization, RR = 1.52 for ICU admission, and RR = 1.19 for death). In the lower-risk group, an increased hospitalization risk was detected in patients on anti-CD20 (RR = 3.03, p = 0.005), whereas a decrease was detected in patients on interferon (0 observed vs 4 expected events, p = 0.04). Discussion: Overall, the MS cohort had a risk of severe events that is twice the risk than the age- and sex-matched Italian population. This excess of risk is mainly explained by the EDSS score and comorbidities, whereas a residual increase of hospitalization risk was observed in patients on anti-CD20 therapies and a decrease in people on interferon

DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France

We evaluated the effect of DMTs on Covid-19 severity in patients with MS, with a pooled-analysis of two large cohorts from Italy and France. The association of baseline characteristics and DMTs with Covid-19 severity was assessed by multivariate ordinal-logistic models and pooled by a fixed-effect meta-analysis. 1066 patients with MS from Italy and 721 from France were included. In the multivariate model, anti-CD20 therapies were significantly associated (OR&nbsp;=&nbsp;2.05, 95%CI&nbsp;=&nbsp;1.39–3.02, p&nbsp;&lt;&nbsp;0.001) with Covid-19 severity, whereas interferon indicated a decreased risk (OR&nbsp;=&nbsp;0.42, 95%CI&nbsp;=&nbsp;0.18–0.99, p&nbsp;=&nbsp;0.047). This pooled-analysis confirms an increased risk of severe Covid-19 in patients on anti-CD20 therapies and supports the protective role of interferon