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Efficacy and Safety of Radioligand Therapy with Actinium-225 DOTATATE in Patients with Advanced, Metastatic or Inoperable Neuroendocrine Neoplasms: A Systematic Review and Meta-Analysis
No full textForced convection in two-phase core-annular flows
Get PDFPredicting the temperature distribution in laminar two-phase flows is essential in a wide range of engineering applications, like heat dissipation of electronic equipment and thermal design of biological reactors. Motivated by this, we extend the classical Graetz problem, studying the heat transfer between two flowing phases in a core-annular flow configuration. Using a rigorous two-scale asymptotic analysis, we derived two coupled one-dimensional advection–diffusion heat-transfer equations (one for each phase) embedding the effects of advection, diffusion (both axial and transverse) and viscous dissipation. Specifically, the heat-transfer mechanisms are described through effective velocity and effective diffusion coefficients, while the interaction between the phases is accounted for via ad hoc coupling and source terms, respectively. The dynamics of the problem is controlled by seven dimensionless groups: the Péclet and Brinkman numbers, the heat flux, the viscosity, thermal diffusivity and thermal conductivity ratios, and the volume fraction. Our analysis reveals the existence of two main regimes, depending on the disparity in thermal conductivity between the phases. When the conductivity ratio is of order one, the problem is strongly coupled; otherwise, the phases are thermally decoupled. Interestingly, we investigate the evolution of the heat-transfer coefficient in the thin-film limit, shedding light on the most common assumptions underlying extensively used models in the context of film flows. Finally, we derived closed-form scaling laws for the Nusselt number clarifying the impact of the phases topology on heat-transfer dynamics. Since our model has been derived by first principles, we hope that it will improve the understanding of two-phase forced convection
Upgrading the waste Acrylonitrile-Butadiene-Styrene into crude oil and highly efficient electrocatalysts for oxygen reduction reaction
No full textAcrylonitrile butadiene styrene (ABS) is a thermoplastic copolymer that is used in a variety of applications due to its unique physicochemical properties, however, there is not yet an established recycling scheme for this material. This work presents the transformation of waste ABS into efficient platinum group metal-free electrocatalysts for the oxygen reduction reaction (ORR) in alkaline media and crude oil. Waste ABS was pyrolyzed at three different temperatures and subsequently functionalized with iron phthalocyanine (FePc). Separately, the char obtained at a higher temperature during the first pyrolysis was additionally mixed with a commercial conductive carbon black and functionalized to obtain electrocatalysts with excellent performance towards ORR in an alkaline environment. The most promising electrocatalyst showed onset potential (Eon) of 0.94 V vs. RHE and half-wave potential (E1/2) of 0.86 V vs. RHE with peroxide production of less than 5 % over the entire potential window. The liquid oil produced during pyrolysis was recovered and underwent a complete chemical characterization
La pianificazione condivisa delle cure per i minori in cure palliative pediatriche. Considerazioni cliniche ed etico-giuridiche a partire da alcune storie significative.
Full text linkStarting from the analysis of some emblematic stories, the Authors make
clinical, ethical and legal considerations about the relationship of care and trust, especially regarding an appropriate shared care planning. The focus is on the communication and decision-making difficulties faced by healthcare professionals in dealing with the patient’s parents for the purpose of implementing the patient’s best interest. Prominent among the critical profiles highlighted are the role of the adolescent patient’s wishes, the definition of the quality-of-life standard pursued and the limits of appropriateness and usefulness of care, beyond which medical intervention is configured in the terms of futile medical care
INDUSTRY 4.0 AND ENVIRONMENTAL SUSTAINABILITY: THE ROLE OF DIGITAL TECHNOLOGIES FOR THE CIRCULAR ECONOMY IN MANUFACTURING
Full text linkQuesta tesi di dottorato, intitolata “Industria 4.0 e Sostenibilità Ambientale: Il Ruolo delle Tecnologie Digitali per l’Economia Circolare nel Settore Manifatturiero”, analizza l’integrazione tra tecnologie digitali dell’Industria 4.0 (I4.0) e pratiche di Economia Circolare (EC) per promuovere la sostenibilità ambientale nel settore manifatturiero. Condotta presso il Dipartimento di Ingegneria Meccanica e Industriale dell’Università degli Studi di Brescia, nell’ambito di un progetto europeo PON Ricerca e Innovazione, la ricerca affronta le sfide del modello economico lineare, proponendo sistemi rigenerativi abilitati da strumenti come IoT, intelligenza artificiale e produzione additiva. Nonostante il potenziale sinergico tra I4.0 ed EC, permangono lacune nella comprensione della loro evoluzione congiunta e nell’applicazione pratica, specialmente in contesti emergenti come l’India, dove l’adozione di principi circolari potrebbe ottimizzare l’uso delle risorse e mitigare gli impatti ambientali.
La tesi si articola attorno a tre domande di ricerca:
RQ1: Come si è evoluta la ricerca accademica su EC, sostenibilità ambientale e I4.0, e quali insight possono emergere da un’analisi bibliometrica per orientare le ricerche future?
RQ2: In che modo le tecnologie digitali influenzano i processi di gestione delle operations per supportare sostenibilità ambientale e circolarità?
RQ3: Quale livello di adozione di pratiche circolari è osservabile tra le aziende manifatturiere indiane?
La metodologia combina un approccio teorico, basato su analisi bibliometrica, revisione sistematica della letteratura e contingency analysis, con un’indagine empirica tramite survey e modellazione statistica. L’analisi bibliometrica rivela una letteratura frammentata ma in crescita, con cluster tematici che evidenziano la necessità di framework olistici per integrare tecnologie digitali, sostenibilità e gestione operativa. Il framework teorico sviluppato dimostra come IoT e produzione additiva possano ottimizzare i processi di Operations Management (OM), a patto di un impiego contestualizzato. Dal lato empirico, lo studio sulle aziende indiane evidenzia una moderata adozione di pratiche circolari: le grandi imprese mostrano maggiore preparazione, mentre le PMI affrontano barriere strutturali, come limitate competenze tecnologiche e finanziarie. Emerge inoltre il ruolo cruciale della collaborazione nella supply chain e di modelli di business servitizzati per accelerare la transizione circolare.
I contributi teorici includono una mappatura completa dell’evoluzione della ricerca e un’integrazione critica tra I4.0, EC e OM, identificando tendenze e lacune per futuri studi. Sul piano manageriale, la tesi offre linee guida per investire in tecnologie digitali in ambiti strategici (approvvigionamenti, produzione, logistica inversa) e promuovere collaborazioni intersettoriali. Le raccomandazioni pratiche sostengono le aziende, specialmente in economie emergenti, nel superare ostacoli sistemici attraverso formazione, politiche incentivanti e piattaforme condivise.
In conclusione, la ricerca fornisce una roadmap per bilanciare innovazione tecnologica e sostenibilità, dimostrando che l’interazione sinergica tra I4.0 ed EC, unita a strategie collaborative, può trasformare il settore manifatturiero verso modelli rigenerativi. Integrando rigore accademico e analisi empirica, la tesi sottolinea l’urgenza di approcci multidisciplinari per affrontare le sfide ambientali globali, offrendo strumenti teorici e pratici per accelerare la transizione circolare.This doctoral thesis, titled "Industry 4.0 and Environmental Sustainability: The Role of Digital Technologies for the Circular Economy in Manufacturing", presents the research conducted over three years at the Department of Mechanical and Industrial Engineering, University of Brescia, under a project co-financed by the European Union through the PON R&I 2014–2020 Programme. The study investigates the intersection of Industry 4.0 (I4.0) technologies and Circular Economy (CE) practices in addressing environmental sustainability challenges within the manufacturing sector.
Amid global concerns over resource depletion, waste generation, and unsustainable linear economic models, CE has emerged as a viable solution promoting resource efficiency and waste minimization through restorative and regenerative systems. At the same time, I4.0 technologies—including the Internet of Things (IoT), artificial intelligence, big data, and additive manufacturing—offer powerful tools to enable these circular practices. The thesis explores the synergy between I4.0 and CE as a pathway to sustainable growth and improved operations management in manufacturing.
Despite growing interest in this field, existing research remains fragmented, lacking in confirmatory and prescriptive frameworks that could better guide implementation. To bridge this gap, the thesis emphasizes both theoretical analysis and empirical investigation, particularly focusing on the Indian manufacturing context—a region with high industrial growth potential but facing critical environmental challenges.
To address this, the thesis is structured around three core research questions:
RQ1: How has academic research evolved regarding CE, environmental sustainability, and I4.0, and what insights can be gained from bibliometric analysis to inform future research?
RQ2: In what ways do digital technologies influence operations management processes to support environmental sustainability and circularity?
RQ3: What level of adoption of circular practices is observed among Indian manufacturing companies?
An interdisciplinary methodology is employed, combining both literature-oriented and practice-oriented approaches. The literature-oriented approach uses bibliometric, content, and contingency analyses to map intellectual developments, identify thematic clusters, and build a theoretical framework linking I4.0 technologies to sustainability and circularity in operations management. The practice-oriented approach applies survey research, including descriptive statistics and structural equation modelling, to assess the current state of CE adoption among Indian manufacturers.
Findings reveal that although literature in this area is expanding rapidly, it remains fragmented, underscoring the need for integrated strategies. Theoretical analysis shows that digital technologies can significantly enhance OM processes, though their sustainability impact depends on strategic implementation. Empirical data suggest that large firms show greater readiness for CE, while SMEs face systemic barriers. Moreover, collaboration across supply chains and the adoption of servitized business models are found to be crucial enablers of circular practices.
Overall, the thesis contributes theoretical insights and practical strategies for leveraging digital technologies to support CE and environmental sustainability in manufacturing
Predicting Length of Stay in Geriatric Patients Using an Ensemble Learning Method
Full text linkProlonged hospital stays that exceed the expected duration pose a challenge to patient care and utilization of hospital resources. Leveraging routine clinical data and knowledge about the intensity of medical care, a comprehensive predictive model was developed and validated to assess the risk of prolonged hospitalization. The model, adjusted for patients aged 50 years and older, integrates classification and regression models, applied from the fourth to the fourteenth day of hospitalization to account for updated patient data. Separate predictive models were trained for homogeneous subgroups of patients based on emergency department diagnosis. Moreover, a dashboard was developed to support physicians in clinical practice, facilitating the prompt identification of patients at high risk of delayed discharge. This approach addresses the pressing need to optimize resource allocation and mitigate the risks associated with prolonged hospitalization, particularly among elderly patients
The European heart failure management resources, treatment reimbursement and activities of professional and patient organizations
No full textAims: The European Heart Failure (HF) Survey was developed by the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) to map HF management resources, reimbursement of drugs/devices for HF treatment, and structure and activities of HF professional and patient organizations. Methods and results: The survey encompassed 43 ESC member countries. The median number of hospitals with dedicated HF centres was 2.6 (interquartile range [IQR] 0.9–4.7) per million people. Natriuretic peptide assessment was available at a median of 6.1 (IQR 1.8–10.6) emergency departments and 8.2 (IQR 1.3–14.7) hospitals per million people, respectively, whilst cardiac magnetic resonance was available at a median of 2.0 (IQR 0.9–3.8) hospitals per million people. Short-term and long-term mechanical circulatory support and heart transplantation were available at a median of 1.1 (IQR 0.5–2.4), 0.4 (IQR 0.0–0.5) and 0.3 (0.2–0.5) hospitals per million people, respectively. Whilst essential HF medications were mostly available and reimbursed, gaps were observed in availability and funding of newer and advanced therapies. Density of all diagnostic and therapeutic capabilities was greater in countries with more favourable socioeconomic status. National HF societies were reported in 98% of countries, whilst HF patient organizations in 45% of countries.anaemia. Conclusions: The European HF Survey is the result of long-standing HFA/ESC efforts to monitor HF epidemiology, management resources, educational and awareness activities. It offers a valuable assessment of current management capabilities, highlighting challenges in providing contemporary standards of care. It also provides insights into future directions needed to address these gaps
Digital servitization of the machinery sector: A comparison between Italy-Based and Foreign companies
No full textThe machinery industry sector is among the most important due to its production of equipment utilized by other industries in manufacturing processes. Traditionally characterized by transactional sales, this sector is currently shifting towards servitized business models, wherein products such as machines and industrial equipment are bundled with services or offered purely as services. Implementing servitized business models is non-trivial as it necessitates thorough investigation. Additionally, machinery is undergoing a digital transformation that, in combination with servitization, has led to the concept of digital servitization. Since the Italian market is among the most important at European level, it is critical for Italian companies to understand their positioning against competition. This paper delves into the digital servitization evolution of machinery companies, comparing those based in Italy with their foreign counterparts. The findings highlight that, despite facing similar challenges, foreign companies are more advanced in this transition than their Italian counterparts
Associations between multimorbidity and kidney function decline in old age: A population-based cohort study
No full textBackground: Individual chronic conditions have been linked to kidney function decline; however, the role of multimorbidity (the presence of ≥2 conditions) and multimorbidity patterns remains unclear. Methods: A total of 3094 individuals from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) were followed for 15 years. Multimorbidity was operationalized as the number of chronic conditions and multimorbidity patterns identified using latent class analysis (LCA). Joint models and Cox regression models were used to explore the associations between multimorbidity, and subsequent absolute and relative (≥25% decline from baseline) changes, respectively, in the estimated glomerular filtration rate (eGFR) calculated using the creatinine-based Berlin Initiative Study equation. Results: Mean age of the sample was 73.9, and 87% had multimorbidity. There was an independent dose–response relationship between the number of chronic conditions, and absolute (β [95% confidence interval, CI] = −0.05 [−0.07; −0.03]) and relative (hazard ratio, HR [95% CI] = 1.23 [1.17; 1.29]) declines in eGFR. Five patterns of multimorbidity were identified. The Unspecific, low burden pattern had the lowest morbidity burden and was used as the reference category. The Unspecific, high burden, and Cardiometabolic patterns showed accelerated absolute (β [95% CI] = −0.15 [−0.26; −0.05] and −0.77 [−0.98; −0.55], respectively) and relative (HR [95% CI] = 1.45 [1.09; 1.92] and 3.45 [2.27; 5.23], respectively) declines. Additionally, the Cognitive and Sensory pattern showed accelerated relative decline (HR [95% CI] = 1.53 [1.02; 2.31]). No associations were found for the Psychiatric and Respiratory pattern. Conclusion: Multimorbidity is strongly associated with accelerated kidney function decline in older age. Individuals with cardiometabolic multimorbidity exhibit a particularly increased risk. Increased monitoring and timely interventions may preserve kidney function and reduce cardiovascular risks in individuals presenting with conditions that are characteristic of high-risk multimorbidity patterns
