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O cenário dos negócios mudou de forma significativa nos últimos anos e, diante da competitividade global, a tecnologia da informação (TI) e a manufatura enxuta (Lean Manufacturing) são recursos que permitem contribuições para o desempenho da empresa. Os princípios e as práticas da manufatura enxuta são reconhecidos no mundo inteiro como a maneira mais eficaz de construir e sustentar a melhoria contínua das empresas. Melhorar a produtividade, reduzir custos e oferecer produtos de qualidade são fatores vitais para as empresas em qualquer parte do mundo. Com a evolução da informática através dos equipamentos e programas tornou-se possível a existência de uma tecnologia de informação (TI), sendo desenvolvidas muitas funcionalidades, ao longo do tempo, para auxiliar na organização dos processos produtivos das empresas e atender às necessidades de informação de vários departamentos de forma integrada. Embora seja reconhecida a importância destes recursos, a aplicação da TI bem como os princípios da manufatura enxuta têm sido vistos por alguns autores como mutuamente exclusivos, mas ambas as abordagens são cada vez mais interdependentes, pois as informações de produção em tempo real são fundamentais para o processo decisório nas organizações. Tomando, então, como base esta discussão sobre a TI e a manufatura enxuta, o objetivo deste estudo consiste em analisar como as empresas estão aplicando as práticas da manufatura enxuta aliadas aos recursos da tecnologia da informação, discutir o seu relacionamento nas organizações e comparar os resultados em termos de desempenho. Para o desenvolvimento da pesquisa, foi aplicada a abordagem qualitativa por meio do método estudo de caso. The business scenario has changed significantly in recent years and, in the face of global competitiveness, information technology (IT) and lean manufacturing (Lean Manufacturing) are resources that enable contributions to the company's performance. The principles and practices of lean manufacturing are recognized worldwide as the most effective way to build and sustain continuous business improvement. Improving productivity, reducing costs and providing quality products are vital factors for businesses any part of the world. With the evolution of informatics through the equipments and programs it became possible the existence of an information technology (IT), being developed many functionalities over time to assist in the organization of the productive processes of the companies and to meet the information needs of several departments in an integrated way. Even though the importance of these features is recognized, the application of IT as well as the principles of lean manufacturing have been viewed by some authors as mutually exclusive, but both approaches are increasingly interdependent by the fact that production information in real time is fundamental for the decision-making process in organizations. By taking the discussion above based on IT and lean manufacturing, the objective of this study is to analyze how companies are applying lean manufacturing practices combined with information technology resources, discuss their relationships in organizations and compare results in terms of operational performance. For the development of the research, the qualitative approach was applied through the case study method.

It was decided at the EURAMET TC-M meeting in Torino in 2006 to realize a comparison in gauge and absolute pressure up to 200 kPa as it would allow a link to the CCM.P-K6 and CCM.P-K2 comparisons to be established. This project interested a lot of laboratories from the beginning with 23 participants, 22 of which have submitted results. The circulation of the transfer standard began in July 2009 and lasted until January 2012. No major problems occurred during the transport. The measurand of the comparison is the effective area of a piston-cylinder determined in gauge and absolute pressure from 25 kPa to 200 kPa with pressure steps of 25 kPa. The transfer standard is a gas lubricated tungsten carbide piston-cylinder with an effective area of ~9.8 cm2, fabricated by DH Instruments and compatible with a PG-7601 pressure balance. Some participants used their own pressure balance while a pressure balance with a reference vacuum sensor has been circulated for the participants not equipped with this system. One participant (SMU, Slovakia) has never provided the measurement results and another participant (FORCE Technology, Denmark) submitted a revised set of measurement results after the pilot laboratory mentioned that the equivalence was not met. After the determination of the reference value, all the 22 participants who delivered the results in gauge pressure demonstrated equivalence respective to the reference value on most of the range. In absolute pressure the equivalence is demonstrated, for all nominal pressures, by all 17 participants who submitted results. The comparison is linked to the CCM.P-K6 for gauge pressure and to CCM.P-K2 for absolute pressure. The link does not strongly affect the equivalence of the results and an excellent degree of equivalence is achieved in gauge and absolute pressure. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

European national metrology institutes use calibration systems of various types for calibrating thermometers in air. These were compared to each other for the first time in a project organized by the European Association of National Metrology Institutes (EURAMET). This EURAMET P1061 comparison project had two main objectives: (1) to study the equivalence of calibrations performed by different laboratories and (2) to investigate correlations between calibration methods and achievable uncertainties. The comparison was realized using a pair of 100 $$\Omega $$ platinum resistance thermometer probes connected to a digital thermometer bridge as the transfer standard. The probes had different dimensions and surface properties. The measurements covered the temperature range between $$-40\,^{\circ }\mathrm{{C}}$$ and $$+150\,^{\circ }\mathrm{{C}}$$ , but each laboratory chose a subrange most relevant to its scope and performed measurements at five nominal temperature points covering the subrange. To enable comparison between the laboratories, comparison reference functions were determined using weighted least-squares fitting. Various effects related to variations in heat transfer conditions were demonstrated but clear correlations to specific characteristics of calibration system were not identified. Calibrations in air and liquid agreed typically within $$\pm 0.05\,^{\circ }\mathrm{{C}}$$ at $$+10\,^{\circ }\mathrm{{C}}$$ and $$+80\,^{\circ }\mathrm{{C}}$$ . Expanded uncertainties determined by the participants ranged from $$0.02\,^{\circ }\mathrm{{C}}$$ to $$0.4\,^{\circ }\mathrm{{C}}$$ and they were shown to be realistic in most cases.

A 49-year-old operated for aortic coartaction patient presented with thoracic and ascending aortic aneurysm. He was asymptomatic. Angio-magnetic resonance nuclear scan and angiography revealed an ascending aortic aneurysm (5.2 cm), bicuspid aortic valve, 6-cm proximal descending aortic pseudoaneurysm at the site of the previous operation with involvement of the left subclavian artery. Restenosis at the original site of coarctation and aortic arch hypoplasia distally to the brachiocefalic trunk was also found. The operation performed was a "modified Bentall - De Bono". The pseudoaneurysm was not accessible through median sternotomy due to the massive lung adhesions following the previous surgery. The left common carotid artery was explanted from the aortic arch and connected with a graft to the ascending aortic conduit. A proximal neck suitable for landing zone of the endovascular stent-graft was then established. The postoperative course was uneventful. After two weeks, the patient was readmitted. The exclusion of the thoracic descending aortic pseudoaneurysm by endovascular implantation of the stent-graft prosthesis was performed. The left subclavian artery was excluded because left vertebral artery was closed. The patient did not develop hand claudicatio. The procedure was successful.

The wafer handling is a complex operation that requires wafer positioning, accuracy and repeatability needed for reliable results. Every action taken with a wafer must be exactly what the operator wants, no more and no less. In semiconductor environment the motor control is fundamental, because the trajectory on the work-piece must be compensated in real-time. The authors would present a demo capable to demonstrate that all command tasks for the movement of a manipulator robot could be generalized to any other robot.

The participation of growth factors (GFs) in the regulation of luteinizing hormone releasing hormone (LHRH) neuronal function has recently been proposed, but little is known about the role played by GFs during early LHRH neurone differentiation. In the present study, we have used combined biochemical and morphological approaches to study the ability of a number of GFs normally expressed during brain development, including basic fibroblast growth factor (bFGF), epidermal growth factor (EGF), insulin and insulin-like growth factor I (IGF-I) to induce survival, differentiation, proliferation, and phenotypic expression of immortalized (GT1-1) LHRH neurones in vitro, at early (3-days in vitro, 3-DIV) and late (8-DIV) stages of neuronal differentiation. Comparison of GF-treated vs untreated neurones grown in serum-deprived (SD) medium demonstrated bFGF to be the most potent, and insulin the least active in promoting neuronal differentiation. Thus, at both 3-DIV and 8-DIV, but especially at 8-DIV, bFGF induced the greatest increase in the total length and number of LHRH processes/cell and in growth cone surface area. bFGF was also the most active at 3-DIV, and IGF-I at 8-DIV, in counteracting SD-induced cell death, whereas EGF was the most potent in increasing [3H]thymidine incorporation. All GFs studied decreased the spontaneous release of LHRH from GT1-1 cells when applied at 3-DIV or 8-DIV, except for insulin which was inactive at both time-points and bFGF which was inactive at 8-DIV. Pre-treatment of GT1-1 cells with a suboptimal ('priming') dose of bFGF for 12 h followed by application of the different GFs induced a sharp potentiation of the neurotrophic and proliferative effects of the latter and particularly of those of IGF-I. Moreover, bFGF priming counteracted EGF-induced decrease in LHRH release and significantly stimulated LHRH secretion following IGF-I or insulin application, suggesting that bFGF may sensitize LHRH neurones to differentiating effects of specific GFs during development.

Macrophage inflammatory protein 1alpha (MIP-1alpha) is a chemokine that may act principally by preventing hemopoietic cells from entering G1, thereby attenuating the cytotoxic effects of cell cycle-specific chemotherapeutic agents. Here we examine the effect of MIP-1alpha on the sensitivity of human granulocyte-macrophage hemopoietic progenitor cells (granulocyte-macrophage colony-forming cells; GM-CFCs) with the cytotoxic effects of antitumor agents that act mainly via alkylation at the O6 position of guanine in DNA. Mononuclear cell preparations from human bone marrow were used in an in vitro GM-CFC colony-forming assay. The GM-CFC survival from individual patients displayed a range of sensitivities to the methylating agent temozolomide [(Tz) 20-55% survival at 10 microg/ml Tz]. However, in all 16 cases, MIP-1alpha (50 ng/ml) protected against GM-CFC killing: survival in the presence of MIP-1alpha ranged from 65-97% at 10 microg/ml Tz, with GM-CFCs being 1.5-4.5-fold more resistant than control cells from the same patient. The highest levels of protection were seen in the GM-CFCs with the highest sensitivity in the absence of MIP-1alpha. Similar degrees of protection were seen for the methylating agent streptozotocin, but no protection was detected for the chloroethylating agents carmustine or mitozolomide in the samples for which there was protection against the toxic effects of Tz. Whereas the mechanism of this effect remains to be established, the results may have potential immediate clinical application in the attenuation of hematological toxicity after administration of methylating antitumor agents.

Editor,—We were interested to read Kirwan et al ’s report of acute angle closure glaucoma (AACG) associated with the antidepressant paroxetine (Seroxat),1 as we have reported a similar case.2 In Kirwan’s report, AACG occurred within 24 hours of the first dose, suggesting an anticholinergic mechanism. Our case became symptomatic some 2 weeks after daily dosage was commenced, leading us to postulate that the effect could have been mediated by serotoninergic pathways. This raises the possibility of other important ocular side effects with drugs of this class. Paroxetine is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. SSRIs act by inducing a gradual rise in postsynaptic levels of serotonin (5-hydroxytryptamine, 5-HT) via desensitisation of the feedback systems which control the rate limiting enzyme in 5-HT synthesis.3 The 5-HT receptors involved have not yet been fully elucidated, and their role in ocular physiology is a subject of ongoing research. In animal studies, serotoninergic stimulation may cause mydriasis, and can have an independent effect in raising the intraocular pressure (IOP).4 Receptors for 5-HT have been demonstrated in the human eye.5 It is therefore possible that SSRIs could have an effect on IOP in humans. Consequently, we should look for raised IOP and open angle glaucoma as a side effect of SSRIs. A recent study has shown a significant short term rise in IOP after a single oral dose of the SSRI fluoxetine (Prozac). Twenty depressed patients were given either fluoxetine 20 mg or placebo in a randomised crossover blinded study, and fluoxetine was associated with a mean IOP elevation of over 4 mm Hg, lasting 6–8 hours.6 We have been unable to find any publication regarding the effect on IOP in the longer term, but we have recently become aware of previously unpublished …

The hypothesis that alpha-adrenergic receptor blockade accounts for the ability of ergotamine to stop migraine attacks was tested, in migraine patients, in an experimental migraine model based on nitroderivative- induced attacks. In a preliminary single blind, placebo controlled study, thymoxamine, a prevalently post-synaptic alpha adrenergic receptor antagonist, was able to abort migraine attack in 9 out of 10 patients, as opposed to 2 out of 10 by placebo (p0.005 Fisher's exact test). In a subsequent randomized, crossover, placebo controlled double blind study, the ability of a selective alpha-1 adrenergic receptor agonist, methoxamine, to block ergotamine antimigraine effect was studied. In 26 patients migraine was induced in two separate tests and then ergotamine was administered once after methoxamine pretreatment and once after placebo; methoxamine was significantly more effective than placebo in blocking antimigraine effect of ergotamine (p = 0.0055 Fisher's exact test). These results support the hypothesis that ergotamine alpha-1 adrenolytic properties may account for its antimigraine effect suggesting that this action takes place outside the blood-brain barrier, since methoxamine can cross it very poorly. Ergotamine target structure could be the trigeminal innervation of the extracranial and/or dural vessels.

Fungal infections have only rarely been reported to occur in patients having undergone total knee arthroplasty. This case report documents the first known case of Aspergillus fumigatus as the offending organism. Its initial presentation as a popliteal cyst further reinforces the known association of popliteal cysts and intra-articular knee pathology.

Twenty-eight benzene derivatives spanning a broad range of lipophilicities were used as model compounds to examine the optimum stationary phase and eluent conditions for the determination of lipophilic indices by reversed-phase high-performance liquid chromatography. This was assessed by linear regressions comparing published octanol-water partition coefficients with isocratic capacity factors and capacity factors extrapolated to 100% water in the eluent. Methanol-water eluents are always to be preferred to acetonitrile-water and tetrahydrofuran-water eluents. The octadecylsilane (ODS) phase yielded good correlations especially when a masking agent was added to the eluent, but this introduced an additional experimental variable. The octadecyl-polyvinyl copolymer (ODP) phase was just as satisfactory as the ODS phase without the need for a masking agent, and thus appears to be a valuable alternative.

Stimulation of red cell production by erythropoietin and of granulocyte production by granulocyte colony-stimulating factor (G-CSF) and granulocyte macrophage-CSF (GM-CSF) has been demonstrated in several clinical studies. The first study to show that a human CSF could be used to shorten the period of neutropenia and reduce the risk of serious infection following intensive combination chemotherapy was carried out in Manchester using G-CSF. The period of neutropenia was significantly shortenened (by a median of 80%) and the neutrophil count levels were restored and above normal by 14 days after chemotherapy. In view of these results a further study was undertaken to examine the possibility of using intensive two weekly chemotherapy under cover of G-CSF. Treatment with Doxorubicin at doses of 75, 100, 125 and 150 mg/m2 was followed by infusion of G-CSF for 11 days. The neutrophil counts returned to normal within 12-14 days, allowing the delivery of up to three cycles of high dose chemotherapy at 14 day intervals. These studies demonstrated that intensive chemotherapy with dose-limiting myelodepression can be given with increased frequency under cover of G-CSF. Our studies using GM-CSF have also shown that administration by continuous i.v. infusion can reduce the period of life-threatening neutropenia following high dose Melphalan (120 mg/m2) without resort to autologous bone marrow transplantation (ABMT). In this study the period of granulocytopenia following Melphalan (less than 500 g x 10(9)/m2) was less than 15 days. This compares favourably with other series using high dose Melphalan followed by ABMT without CSF, where the duration of severe neutropenia was prolonged beyond three weeks. Although it appears that G-CSF and GM-CSF should be given either by continuous i.v. infusion or s.c. injection at doses between 3-10 micrograms/kg/day to obtain maximum biological effect, a great deal more work is required to determine optimum schedules and investigate the possibility of using more than one bioregulator.

Report of a workshop on standardization of selective cultures for normal and leukaemic cells

Feline leukaemia virus (FeLV) is the aetiological agent of a wide range of neoplastic and degenerative conditions [1]. The predominant, naturally occurring, FeLV-induced tumours are T-cell lymphomas, and recently some of the viral events in their pathogenesis have been elucidated. Both transduction and insertional mutagenesis of the myc gene are frequent concomitants of T-cell transformation by FeLV. In addition, a possible role for the T-cell antigen receptor gene in leukaemogenesis has been revealed with the discovery of an FeLV-mediated transduction of the β-chain of the T-cell antigen receptor [2, 3].

Intra-articular tumors of the knee joint causing intermittent locking are extremely rare. A 39-year-old woman with the complaint of joint locking had a pedunculated intra-articular mass and nodular synovitis.

Mice irradiated with 4 doses of 4.5 Gy X-rays at 3-week intervals, demonstrated long-term proliferative defects in B lymphocytes. There was a reduced mitogenic response to bacterial polysaccharide (30%), a lower concentration (35%) of B-lymphocyte colony-forming cells (BL-CFC) in agar with an increased proportion of clusters (X 2), and a reduced concentration (30%) of plaque-forming cells. Grafts of thymocytes were able to restore the levels of BL-CFC in the short term, but in the long term large grafts of femoral marrow cells were much better in restoring the numbers of BL-CFC. The reduced mitogenesis (25%) of splenocytes by concanavalin A and the diminished number of plaque-forming cells, may suggest persistent injury in T-B cell cooperation.

The incidence of heterotopic ossification after total hip replacement using the direct lateral approach is compared to the incidence using the transtrochanteric approach. All the initial ectopic ossification occurred by six months following the implant with noncemented fixation. The direct lateral approach adds slightly to the incidence of ectopic ossification as compared to the transtrochanteric approach. Heterotopic ossification of minimal grade did not interfere with any of the planar motions of the hip, whereas severe ectopic ossification disabled the hip in several planes of motion and restricted it significantly in the others. The more severe form of ectopic bone was more common after the transtrochanteric approach to the hip, while the lighter form developed more often following the direct lateral approach.

Background While laparoscopic approach for right hemicolectomy (LRH) is considered appropriate for the surgical treatment of both malignant and benign diseases of right colon, there is still debate about how to perform the ileo-colic anastomosis. The ColonDxItalianGroup (CoDIG) was designed as a cohort, observational, prospective, multi-center national study with the aims of evaluating the surgeons’ attitude regarding the intracorporeal (ICA) or extra-corporeal (ECA) anastomotic technique and the related surgical outcomes. Methods One hundred and twenty-five Surgical Units experienced in colorectal and advanced laparoscopic surgery were invited and 85 of them joined the study. Each center was asked not to change its surgical habits. Data about demographic characteristics, surgical technique and postoperative outcomes were collected through the official SICE website database. One thousand two hundred and twenty-five patients were enrolled between March 2018 and September 2018. Results ICA was performed in 70.4% of cases, ECA in 29.6%. Isoperistaltic anastomosis was completed in 85.6%, stapled in 87.9%. Hand-sewn enterotomy closure was adopted in 86%. Postoperative complications were reported in 35.4% for ICA and 50.7% for ECA; no significant difference was found according to patients’ characteristics and technologies used. Median hospital stay was significantly shorter for ICA (7.3 vs. 9 POD). Postoperative pain in patients not prescribed opioids was significantly lower in ICA group. Conclusions In our survey, a side-to-side isoperistaltic stapled ICA with hand-sewn enterotomy closure is the most frequently adopted technique to perform ileo-colic anastomosis after any indications for elective LRH. According to literature, our study confirmed better short-term outcomes for ICA, with reduction of hospital stay and postoperative pain. Trial registration Clinical trial (Identifier: NCT03934151).

Chromatin in cancer undergoes chemical and structural changes that alter gene expression patterns. One of the chemical modifications that impacts gene regulation is 5-hydroxymethylcytosine (5hmC), also called DNA hydroxymethylation. 5hmC is a stable mark that is commonly associated with transcriptional activation. In cancer, the global loss of 5hmC is a hallmark. In addition, the deregulation of 5hmC in specific regions of the genome, such as enhancers, promoters, and body of the gene, alters the expression of genes in cancer. These alterations have been detected by the improvement in the mapping of 5hmC at genomic scale, which has allowed us to evaluate the sites where 5hmC alterations occur and the genes that are affected. In this chapter, the recent knowledge about the status of 5hmC in genome specific sites of human solid cancers, the relationship with enzymes ten-eleven translocation (TET) and isocitrate dehydrogenase (IDH) involved in the dynamic regulation of 5hmC levels, and the impact of the 5hmC aberrant changes on the genic expression in these malignances is reviewed.

Fabric-Reinforced Cementitious Matrix (FRCM) systems, also known as Textile Reinforced Concrete (TRC) are nowadays widely used as confining material to enhance both strength and deformation capacity of columns of seismic resistant r.c. frames. In the past, when carbon fiber was used in the textile, experimental results showed that the efficiency of the wrapping is limited by the connection between substrate and fiber, which is not as effective as when epoxy resins are used. To improve the strength of the connection between fibres and mortar binder in FRCM system, the use of p-Phenylene BenzobisOxazole (PBO), having a molecular structure capable of establishing chemical bonds with hydrated compounds in a special inorganic binder, was recently suggested. The efficiency of this new confining system was demonstrated by a large number of compression test on concrete specimens with different cross section shapes e dimensions, confinement amount, concrete strength, and cross section corner radius. By contrast, few experimental researches report the behaviour of large scale specimens under external action able to resemble the actual behaviour of columns of moment resistant frames. In this context, results of experimental tests on ten reinforced concrete columns with square or rectangular cross section, two different concrete strength, unconfined or wrapped with two or four layer of textile, subject to axial load and bending moments are here presented and discussed