Environmental sustainability in manufacturing is nowadays an urgent and remarkable issue and the main concerns are related to more efficient use of materials and energy.
In sheet metal forming ...processes there is still a lack of knowledge in this field mainly due to the need of a proper modelling of sustainability issues and factors to be taken into account. The aim of this paper is mainly to underline the state of the art from a forming point of view about the sustainability contributions offered in any phase of a product life cycle. Actually, a lack in terms of comprehensive contributions is present in the technical literature, thus, the authors try to give a sort of holistic vision aimed to provide basic guidelines in order to help in identifying the possible solutions with regard to all the phases of a forming product life cycle. The main attention was paid to sheet metal forming technologies. The paper gives an overview of the main topics concerning sheet metal forming problems related to energy and resource efficiency with the aim to stress the principal contributions which may derive from such processes to environmental performances of manufacturing.
Health-related quality of life (HRQOL) is an important goal of therapy for chronic myeloid leukemia (CML) patients treated with current molecular-targeted therapies. The main objective of this study ...was to investigate factors associated with long-term HRQOL outcomes of CML patients receiving imatinib. Analysis was performed on 422 CML patients recruited in an observational multicenter study. HRQOL was assessed with the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Key socio-demographic and clinical data were investigated for their association with HRQOL outcomes. Chronic fatigue and social support were also investigated. Univariate and multivariate linear regression analyses were used to identify independent factors associated with HRQOL outcomes. Fatigue was the only variable showing an independent and consistent association across all physical and mental HRQOL outcomes (P<0.01). Differences between patients reporting low versus high fatigue levels were more than eight and seven times the magnitude of a clinically meaningful difference, respectively, for the role physical (Δ=70 points) and emotional scale (Δ=63 points) of the SF-36. Fatigue did not occur as an isolated symptom and was most highly correlated with musculoskeletal pain (r=0.511; P≤0.001) and muscular cramps (r=0.448; P≤0.001). Chronic fatigue is the major factor limiting HRQOL of CML patients receiving imatinib.
•Row orientation and microclimate affected berry pulp temperature.•Berries gained heat energy from ambient temperature and direct irradiance.•Pulp temperature responded to skin colour ...development.•Berry temperature and ripeness level affected primary and secondary composition.•Phenols and individual anthocyanins reacted to radiation and temperature changes.
Ambient radiation and temperature are global drivers of grapevine growth, grape yield and composition, and wine quality. Knowledge of the implications of vineyard row orientation/microclimate is required for decision-making in current and future macro- and mesoclimates. Temporal and cumulative microclimatic changes, induced by vine row orientation (NS; EW; NE-SW; NW-SE) of vertically trellised Shiraz grapevines, on berry pulp temperature and composition at different ripeness levels were investigated. Berries dynamically gained heat energy relative to: ambient climate/weather; direct canopy wall/bunch irradiance; and berry skin colour development. Berries exposed to direct solar radiation during the morning, leading to higher pulp temperatures than ambient, but having a cooling profile after that, resulted in slightly advanced sugar ripening and generally higher skin total anthocyanins and phenols, without significant effects on pH and titratable acidity, at the respective ripeness levels. In contrast, excessive exposure of bunches and those that built up heat, reaching highest temperatures during late afternoon, seemed not conducive to grape composition associated with higher quality. The S, SE, E and NE canopy sides showed consistently higher skin total anthocyanin and phenol contents than their counter sides. Except for acylated forms of peonidin-glucoside, anthocyanin (mono-, acetyl- and coumaroyl-glucosides) accumulation was mostly favoured in berries exposed to exterior canopy sides, but differences in acylated anthocyanins between exterior-facing and interior-facing berries were less than for mono-glucoside anthocyanins. Over-exposure and heat peaking during late afternoon seemed detrimental. Novel information on berry pulp temperature variation in a developing composite grape bunch, exposed to weather and microclimate fluctuation, is provided. An ostensibly homogeneous bunch in reality represents a dynamic berry pulp thermal range at any point in time. Cumulative thermal and radiation impact was evident. This is the first comprehensive attestation on the role of grapevine row orientation (or any viticulture practice) in the management of seasonal nocturnal- and diurnal berry temperature and concomitant composition.
The industrial interest on light weight components has contributed in the last years to a significant research effort on new materials able to guarantee high mechanical properties, good formability ...and reasonable costs together with reduced weights when compared to traditional mild steels. Among such materials advanced high strength steels (AHSS) such as transformations induced plasticity (TRIP) and dual phase (DP), and light weight alloys proved their usefulness in stamping of automotive components. As AHSS are concerned, one of the main drawbacks is related to springback occurrence. Many aspects have to be taken into account when springback reduction is investigated: material behavior issues, process conditions, numerical simulations parameters calibration, geometrical aspects and so on. Moreover, springback minimization problems are typically multi-objective ones because springback reduction may conflict with other goals in stamping design such as thinning reduction. In this paper, such problem was investigated through integration between numerical simulations, Response Surface Methodology and Pareto optimal solutions search techniques. The design of a U-channel stamping operation was investigated utilizing two different dual phase steel grades: DP 1000 and DP 600. An explicit/forming-implicit/springback approach was utilized for the numerical simulations. Friction conditions and blank holder force were optimized as design variables in order to accomplish two different objectives: reduce excessive thinning and avoid excessive geometrical distortions due to springback occurrence.
The regional stress field in volcanic areas may be overprinted by that produced by magmatic activity, promoting volcanism and faulting. In particular, in strike‐slip settings, the definition of the ...relationships between the regional stress field and magmatic activity remains elusive. To better understand these relationships, we collected stratigraphic, volcanic, and structural field data along the strike‐slip central Aeolian arc (Italy): here the islands of Lipari and Vulcano separate the extensional portion of the arc (to the east) from the contractional one (to the west). We collected >500 measurements of faults, extension fractures, and dikes at 40 sites. Most structures are NNE‐SSW to NNW‐SSE oriented, eastward dipping, and show almost pure dip‐slip motion, consistent with an E‐W extension direction, with minor dextral and sinistral shear. Our data highlight six eruptive periods during the last 55 ka, which allow considering both islands as a single magmatic system, in which tectonic and magmatic activities steadily migrated eastward and currently focus on a 10 km long × 2 km wide active segment. Faulting appears to mostly occur in temporal and spatial relation with magmatic events, supporting that most of the observable deformation derives from transient magmatic activity (shorter term, days to months), rather than from steady longer‐term regional tectonics (102–104 years). More in general, the central Aeolian case shows how magmatic activity may affect the structure and evolution of volcanic arcs, overprinting any strike‐slip motion with magma‐induced extension at the surface.
Key Points
Relation between strike‐slip kinematics and magmatism at volcanic arcs
Two neighbor volcanic islands share a single magmatic system
Magmatic stress is dominant and generates transient faulting
•Ten-minute separation of amino sugars, muramic acid, and N-acetyl glucosamine.•Separation optimized for mobile phase, pH, buffer strength, and temperature.•Accuracy (< 25%) and precision (< 15%) at ...environmental levels and ratios.•Detection limits of 20 µg L−1 for galactosamine and 5 µg L−1 for other analytes.•Amino sugar soil hydrolysates quantified by external calibration and standard addition.
A rapid separation and quantitation of the stereoisomer amino sugars glucosamine, galactosamine, and mannosamine, along with muramic acid, is needed. These compounds, when their quantities are accurate, can be used to understand the origin and fate of natural organic matter (NOM) in the environment. These target molecules are biomarkers of fungi and bacteria and allow the deconvolution of microbial transformations and degradation of NOM in a wide variety of environmental matrices. Analytical methods applied to this suite of biomarkers are needed to understand carbon and nitrogen biogeochemistry with a changing global climate. Traditional separations of these analytes by gas chromatography require sample derivatization, as does reverse phase liquid chromatography. In contrast, ion chromatography can separate the analytes directly, but requires a separate analytical method to quantify muramic acid. In this work we present a direct analysis of all these molecules using hydrophilic liquid interaction chromatography. Solvent composition, buffer strength, pH, flow rate, and column temperature were optimized. The method can separate these four compounds and the biopolymeric precursor molecule N-acetylglucosamine in a single run in under 8 min with equivalent resolution to the best previously reported separations that did not require derivatization prior to analysis. Detection of the analytes was performed by both tandem and time-of-flight mass spectrometry. The method was assessed for its quantitative capabilities through i) peak area assignment, ii) check standards with ratios of the target analytes likely to be present in real samples, iii) an injection internal standard, and iv) quantitative analysis of real soil hydrolysates by external calibration and standard addition approaches. Across their expected analytical ranges the response for each analyte was highly linear with good accuracy (<25%) and precision (<15%) over three orders of magnitude. Detection limits of 20 µg L−1 were found for galactosamine and 5 µg L−1 for the remainder of the analytes, comparable to the majority of other methods reported in the literature. Overall, this new approach can directly and rapidly quantify amino sugars recovered in environmental hydrolysates.
Purpose: Acute pain is a prevalent symptomatology in prehospital emergency care. Although inadequate assessment and treatment of acute pain are associated with various complications, about 43% of ...adults suffering from pain are undertreated. This phenomenon is poorly studied, and limited data are available in the literature. The objective was to investigate the pain management in a prehospital emergency health-care setting, verifying pain assessment, pharmacological treatment adherence and the effectiveness of pain relief therapy. Patients and Methods: A retrospective observational study was conducted in a sample including all adults treated by the professionals of nurse-staffed ambulances and medical cars in an Italian Emergency Medical Services (EMS) from 1 January 2019 to 31 May 2019. We collected both demographic information and Numeric Rating Scale scores, which evaluated presence and intensity of pain, from the EMS paper forms. All analyses were performed using SPSS, version 27. Results: The study sample was composed of 629 people: 310 males (49%) and 319 females (51%), with an average age of 64.2+ or -22 years (range 18-108). Pain information was collected in 75.5% (n = 475) of our sample; among them 222 patients (46.7%) suffered from pain. We recorded that 79.7% (n = 177) of the subjects with pain received no pharmacological treatment, and in almost all of the treated cases they did not adhere to the analgesia algorithm in use. Among those who were pharmacologically treated, pain statistically significantly decreased in intensity, from before to after, in both emergency vehicles (nurse-staffed ambulances pre m = 8.36+ or -0.9 vs post m = 4.18+ or -2.2, p<0.001; medical cars pre m = 7.25+ or -1.7 vs post m = 3.50+ or -2.6, p<0.001). Subsequently, pain was only re-ascertained in 24.3% of subjects. Conclusion: Our findings confirm that pain is a prevalent symptom in prehospital patients, especially in the younger age range, but that it remains an underrecognized, underestimated, and undertreated symptom with the risk of causing worse health outcomes. Keywords: pain assessment, pain management, prehospital emergency care, emergency medical services, undertreatment of pain
The aim of this study was to evaluate the impact of early treatment with corticosteroids on SARS-CoV-2 clearance in hospitalized COVID-19 patients. Retrospective analysis on patients admitted to the ...San Raffaele Hospital (Milan, Italy) with moderate/severe COVID-19 and availability of at least two nasopharyngeal swabs. The primary outcome was the time to nasopharyngeal swab negativization. A multivariable Cox model was fitted to determine factors associated with nasopharyngeal swab negativization. Of 280 patients included, 59 (21.1%) patients were treated with steroids. Differences observed between steroid users and non-users included the proportion of patients with a baseline PaO
/FiO
≤ 200 mmHg (45.8% vs 34.4% in steroids and non-steroids users, respectively; p = 0.023) or ≤ 100 mmHg (16.9% vs 12.7%; p = 0.027), and length of hospitalization (20 vs 14 days; p < 0.001). Time to negativization of nasopharyngeal swabs was similar in steroid and non-steroid users (p = 0.985). According to multivariate analysis, SARS-CoV-2 clearance was associated with age ≤ 70 years, a shorter duration of symptoms at admission, a baseline PaO
/FiO
> 200 mmHg, and a lymphocyte count at admission > 1.0 × 10
/L. SARS-CoV-2 clearance was not associated with corticosteroid use. Our study shows that delayed SARS-CoV-2 clearance in moderate/severe COVID-19 is associated with older age and a more severe disease, but not with an early use of corticosteroids.
The largest study, by Atanasoff et al, incorporated 13 cases in which patients received a vaccination against influenza, Td, Tdap, or human papillomavirus and developed prolonged shoulder pain with ...associated bursitis, tendonitis, and/or rotator cuff tears as seen on MRI.1 Cases of SIRVA have also been reported following other vaccines including pneumococcal and hepatitis.3,4 Nearly all the reported cases demonstrate similar radiographic findings related to SIRVA, including subacrominal and subdeltoid bursitis, tendonitis, supraspinatus and infraspinatus rotator cuff tears, and bone marrow edema. According to the Centers for Disease Prevention and Control (CDC), for men and women<130 lbs (<60 kg), a 5/8-1 inch needle is sufficient to ensure intramuscular injection into the deltoid muscle. ...it is very plausible that there was over-penetration of the vaccine through the deltoid into the teres minor tendon at its insertion onto the posterior aspect of the greater tuberosity of the humerus with resultant partial tear of the teres minor tendon. ...SIRVA should be considered as a plausible cause when faced with isolated teres minor tendon pathology in the appropriate clinical setting.
Background
Intermittent fasting (IF) is an increasingly popular approach to dietary control that focuses on the timing of eating rather than the quantity and content of caloric intake. IF ...practitioners typically seek to improve their weight and other health factors. Millions of practitioners have turned to purpose-built mobile apps to help them track and adhere to their fasts and monitor changes in their weight and other biometrics.
Objective
This study aimed to quantify user retention, fasting patterns, and weight loss by users of 2 IF mobile apps. We also sought to describe and model starting BMI, amount of fasting, frequency of weight tracking, and other demographics as correlates of retention and weight change.
Methods
We assembled height, weight, fasting, and demographic data of adult users (ages 18-100 years) of the LIFE Fasting Tracker and LIFE Extend apps from 2018 to 2020. Retention for up to 52 weeks was quantified based on recorded fasts and correlated with user demographics. Users who provided height and at least 2 readings of weight and whose first fast and weight records were contemporaneous were included in the weight loss analysis. Fasting was quantified as extended fasting hours (EFH; hours beyond 12 in a fast) averaged per day (EFH per day). Retention was modeled using a Cox proportional hazards regression. Weight loss was analyzed using linear regression.
Results
A total of 792,692 users were followed for retention based on 26 million recorded fasts. Of these, 132,775 (16.7%) users were retained at 13 weeks, 54,881 (6.9%) at 26 weeks, and 16,478 (2.1%) at 52 weeks, allowing 4 consecutive weeks of inactivity. The survival analysis using Cox regression indicated that retention was positively associated with age and exercise and negatively associated with stress and smoking. Weight loss in the qualifying cohort (n=161,346) was strongly correlated with starting BMI and EFH per day, which displayed a positive interaction. Users with a BMI ≥40 kg/m2 lost 13.9% of their starting weight by 52 weeks versus a slight weight gain on average for users with starting BMI <23 kg/m2. EFH per day was an approximately linear predictor of weight loss. By week 26, users lost over 1% of their starting weight per EFH per day on average. The regression analysis using all variables was highly predictive of weight change at 26 weeks (R2=0.334) with starting BMI and EFH per day as the most significant predictors.
Conclusions
IF with LIFE mobile apps appears to be a sustainable approach to weight reduction in the overweight and obese population. Healthy weight and underweight individuals do not lose much weight on average, even with extensive fasting. Users who are obese lose substantial weight over time, with more weight loss in those who fast more.
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