The application of left ventricular (LV) global strain by speckle-tracking is becoming more widespread, with the potential for incorporation into routine clinical echocardiography in selected ...patients. There are no guidelines or recommendations for the training requirements to achieve competency. The aim of this study was to determine the learning curve for global strain analysis and determine the number of studies that are required for independent reporting.
Three groups of novice observers (cardiology fellows, cardiac sonographers, medical students) received the same standardized training module prior to undertaking retrospective global strain analysis on 100 patients over a period of 3 months. To assess the effect of learning, quartiles of 25 patients were read successively by each blinded observer, and the results were compared to expert for correlation.
Global longitudinal strain (GLS) had uniform learning curves and was the easiest to learn, requiring a minimum of 50 patients to achieve expert competency (intraclass correlation coefficient > 0.9) in all three groups over a period of 3 months. Prior background knowledge in echocardiography is an influential factor affecting the learning for interobserver reproducibility and time efficiency. Short-axis strain analysis using global circumferential stain and global radial strain did not yield a comprehensive learning curve, and expert level was not achieved by the end of the study.
There is a significant learning curve associated with LV strain analysis. We recommend a minimum of 50 studies for training to achieve competency in GLS analysis.
•Proposal of a structured MCDM-based approach to prioritize occupational risks.•Inclusion of human error probability as evaluation criterion.•Extension of HEART and SPAR-H in manufacturing SMEs, also ...including human performance factors dependencies.•Application to a real case.
Nowadays, the Occupational Health and Safety (OHS) is more and more recognized as a crucial process to be properly managed and continuously improved by every organization. Primarily addressed to prevent workers’ injuries and diseases, it positively impacts on productivity, competitiveness and reputation as well as it contributes to cost savings in general. OHS management is grounded upon the risk assessment results, on the basis of which defining corrective measures to be taken to reduce risks to acceptable values. In this regard, the paper proposes a Multi-Criteria Decision Making (MCDM) based methodology addressed to the occupational risks prioritization. In order to overcome the shortcomings of the traditional risk matrix, the new methodology considers three evaluation criteria differently weighted by the Analytic Hierarchy Process (AHP) method. Among criteria, one specifically refers to the contribution of human factors to the occurrence of accidents, and a combination of Human Error Assessment and Reduction Technique (HEART) and Standardized Plant Analysis Risk-Human (SPAR-H) techniques is used to this aim. Afterwards, the Vlse Kriterijumska Optimizacija Kompromisno Resenje (VIKOR) method is applied to rank risks. The proposed approach is implemented in a Sicilian manufacturing company that produces and commercializes wooden products, together with the sale of outdoor furniture. The comparison of the obtained results with the ones arising from previous risk analyses performed by the company highlights the higher ability of the proposed methodology to differentiate risks.
Adiponectin is an abundant plasma protein secreted from adipocytes that elicits protective effects in the vasculature and myocardium. In obesity and insulin-resistant states, adiponectin levels are ...reduced and loss of its protective effects might contribute to the excess cardiovascular risk observed in these conditions. Adiponectin ameliorates the progression of macrovascular disease in rodent models, consistent with its correlation with improved vascular outcomes in epidemiological studies. The mechanisms of adiponectin signaling are multiple and vary among its cellular sites of action. In endothelial cells, adiponectin enhances production of nitric oxide, suppresses production of reactive oxygen species, and protects cells from inflammation that results from exposure to high glucose levels or tumor necrosis factor, through activation of AMP-activated protein kinase and cyclic AMP-dependent protein kinase (also known as protein kinase A) signaling cascades. In the myocardium, adiponectin-mediated protection from ischemia-reperfusion injury is linked to cyclo-oxygenase-2-mediated suppression of tumor necrosis factor signaling, inhibition of apoptosis by AMP-activated protein kinase, and inhibition of excess peroxynitrite-induced oxidative and nitrative stress. In this Review, we provide an update of studies of the signaling effects of adiponectin in endothelial cells and cardiomyocytes.
•Design of a Multi-Criteria Decision Making approach to the Storage Location Assignment Problem in a 3D space.•Interval-based formulation of ELECTRE TRI and TOPSIS to deal with uncertain input ...data.•Design and implementation of a re-assignment procedure to ensure the occupation of the best storage locations.
Efficiency and effectiveness of logistic activities, in general, and of distribution networks, in particular, are largely influenced by the way warehouses operate as nodes of these networks. In recent years, warehouse management has undergone major changes due to the increase of e-commerce and competition in time-reduction. Despite that, logistic costs of warehouse processes (e.g. receiving, storage, order picking and shipping, etc.) are still often high. Referring to the order picking process, related activities may be optimized by a proper assignment of products to storage locations. In the literature, this problem is known as Storage Location Assignment Problem (SLAP). Due to the multi-criteria nature of SLAP, a combined ELECTRE TRI and TOPSIS based approach under an uncertain environment is designed in the present paper. Aiming at properly dealing with the uncertainty of the decision process, an interval extension of both ELECTRE TRI and TOPSIS is proposed. Therefore, ELECTRE TRI is firstly used to assign products to shelf levels whereas TOPSIS is afterwards applied to determine their storage locations within every level rather than using a random assignment policy. The whole methodology has been designed in cooperation with a Sicilian company that provides logistic services all over the Italian territory.
Exploiting the self‐assembling properties of liquid crystals, large‐scale spontaneous alignment of single‐ and multi‐walled carbon nanotubes induced by elastic interactions with the nematic LC matrix ...is demonstrated (see Figure). Collective reorientation processes of the liquid crystal are further used to reversibly manipulate the alignment direction of the dispersed nanotubes, as evidenced by conductivity measurements.
Two optical configurations are commonly used in single-molecule fluorescence microscopy: point-like excitation and detection to study freely diffusing molecules, and wide field illumination and ...detection to study surface immobilized or slowly diffusing molecules. Both approaches have common features, but also differ in significant aspects. In particular, they use different detectors, which share some requirements but also have major technical differences. Currently, two types of detectors best fulfil the needs of each approach: single-photon-counting avalanche diodes (SPADs) for point-like detection, and electron-multiplying charge-coupled devices (EMCCDs) for wide field detection. However, there is room for improvements in both cases. The first configuration suffers from low throughput owing to the analysis of data from a single location. The second, on the other hand, is limited to relatively low frame rates and loses the benefit of single-photon-counting approaches. During the past few years, new developments in point-like and wide field detectors have started addressing some of these issues. Here, we describe our recent progresses towards increasing the throughput of single-molecule fluorescence spectroscopy in solution using parallel arrays of SPADs. We also discuss our development of large area photon-counting cameras achieving subnanosecond resolution for fluorescence lifetime imaging applications at the single-molecule level.
Nowadays functional foods are becoming more popular due to their capacity to prevent and/or reduce the risk of certain diseases. Functional foods improve health and give physiological benefits ...providing nutrients beyond the simple nutritional value. The market for functional foods is growing rapidly and the consumers are willing to pay a premium price for these products. In this context, the production of pasta comprising Opuntia may represent an opportunity to combine the widespread consumption of pasta in the traditional Mediterranean Diet and the beneficial characteristics of the Opuntia, including anti-inflammatory, antioxidant, hypoglycemic, antimicrobial and neuroprotective properties. The aim of this paper is to evaluate the economic feasibility of the production of dried pasta functionalized with an extract of cladodes from Opuntia Ficus Indica in an existing medium-size pasta factory. For this purpose, an economic evaluation based on scenarios analysis was conducted. In particular, in each scenario different percentages of Opuntia solution were considered and two different economic aspects were varied: the price of the functionalized pasta and the cost of the Opuntia solution that satisfies a fixed price for the final product. The economic evaluation was carried out on the basis of the Net Present Value and of the Investment Payback Time.
•The production of pasta comprising Opuntia may represent an economic opportunity.•The purpose of this paper is to asses the feasibility of different economic scenarios.•Scenarios have been obtained by varying the main economic parameters involved in the production process.•The economic evaluation was carried out considering the NPV and the Payback Time.•Results show a framework to identify economic outcomes for the different scenarios.
The prevalence of obesity and associated cardiometabolic diseases continues to rise, despite efforts to improve global health. The adipose tissue is now regarded as an endocrine organ since its ...multitude of secretions, lipids chief among them, regulate systemic functions. The loss of normal adipose tissue phenotypic flexibility, especially related to lipid homeostasis, appears to trigger cardiometabolic pathogenesis. The goal of this manuscript is to review lipid balance maintenance by the lean adipose tissue's propensity for phenotype switching, obese adipose tissue's narrower range of phenotype flexibility, and what initial factors account for the waning lipid regulatory capacity. Metabolic, hypoxic, and inflammatory factors contribute to the adipose tissue phenotype being made rigid. A better grasp of normal adipose tissue function provides the necessary context for recognizing the extent of obese adipose tissue dysfunction and gaining insight into how pathogenesis evolves.
The dynamic production scheduling is a very complex process that may arise from the occurrence of unpredictable situations such as the arrival of new orders besides the ones already accepted. As a ...consequence, companies may often encounter several difficulties to make decisions about the new orders acceptance and sequencing along with the production of the existing ones. With this recognition, a mathematical programming model for the regenerative scheduling problem with deterministic processing times is formulated in the present paper to evaluate the economic advantage of accepting a new order in an engineer to order (ETO) manufacturing organization. The real case of an Italian ETO company which produces hydraulic marine and offshore cranes is afterwards presented.
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