New Perspectives for Workflow Analysis in the Health Italian Sector through Discrete Event Simulation: The Case of a Department of Laboratory Medicine

The management systems currently used in the Italian healthcare sector provide fragmented and incomplete information on this system and are generally unlikely to give accurate information on the performances of the healthcare processes. The present paper introduces a combined discrete event simulation (DES)/business process management (BPM) approach as innovative means to study the workflow of the activities within the Department of Laboratory Medicine of the “San Paolo” Hospital in Naples (Italy). After a first “As-Is” analysis to identify the current workflows of the system and to gather information regarding its behaviour, a following DES-based “What-If” analysis is implemented to figure out alternative work hypotheses in order to highlight possible modifications to the system’s response under varying operating conditions and improve its overall performances. The structure of the simulation program is explained and the results of the scenario analysis are discussed. The paper starts with a brief exploration of the use of DES in healthcare and ends with general observations on the subject.

Characterization, conservation and sustainability of endangered animal breeds in Campania (Southern Italy)

Conservation of such animal genetic resources and sustainable development of their products seems to be one of the most important steps to be taken to save endangered animal breeds from the widespread use of cosmopolitan and more productive breeds. Indeed, the protection and conservation of biodiversity of animal breeds adapted to particular environmental conditions is essential to prevent irreversible erosion of genes and gene combinations. A special project to characterize and conserve eight endangered breeds of various animal species raised in Campania (southern-Italy) is reported in this paper along detailed descriptions of all breeds. Some strategies for their characterization and conservation are reported and discussed.

Conjunctival cytological examination,bacteriological culture,and antimicrobial resistance profiles of healthy Mediterranean buffaloes(Bubalus bubalis) from Southern Italy

Objective: To assess normal conjunctival cytological and bacteriological/fungal flora features in the Mediterranean buffalo(Bubalus bubalis).Methods: Swabs were taken from the inferior conjunctival sac of both eyes of 57 healthy female buffaloes aged 24–36 months, with no evidence of ocular disease, farmed in Campania region(Southern Italy), for microbiological analysis. Conjunctival eye specimens of both eyes were subsequently obtained by a cyto-brush, for cytological analysis.The antimicrobial susceptibility of bacterial isolates was also determined using the diskdiffusion method on Mueller Hinton agar plates.Results: Cytological examination of conjunctival swab specimens(114 eyes) revealed epithelial cells(basal, intermediate, columnar and super ficial) in all samples, whereas neutrophils, lymphocytes and plasma cells were present in 70%, 10% and 2% of samples,respectively. Microorganisms, for a total of 261 aerobic bacteria and 6 fungi, were isolated from 112/114 conjunctival samples [98.25%; 95% con fidence interval(CI): 93.18–99.70]. Only two conjunctival swabs did not yield bacteria and/or fungi(2/114, 1.75%;95% CI: 0.30–6.82). Gram-positive aerobes were most commonly cultured(181/261,69.35%; 95% CI: 63.31–74.81), with Enterococcus faecium and Staphylococcus lentus predominating. Escherichia coli was the most frequently isolated as Gram-negative bacteria(80/261, 30.65%; 95% CI: 25.19–36.69). The antimicrobial resistance patterns of the isolated bacteria showed amoxycillin/clavulanic acid and cephalothin as the least sensitive antibiotics for both Gram-positive and Gram-negative bacteria.Conclusions: These results provided first information on normal conjunctival ocular micro flora and cytological features in Mediterranean buffalo.

The Role of Ruminants on Environmental Pollution and Possible Solution to Reduce Global Warming

The aim of the work was to shed light on the responsibility of ruminants to inject methane(CH4)into the atmosphere and to highlight how about 70%of livestock and almost all small ruminants live in areas of the planet,usually the poorest,where it is not possible to produce food for the man.According to many authors,ruminant breeding is one of the main causes of deforestation and global warming observed in recent years and 11%-12% of world population’s malnutrition depends mainly on the increase in ruminant rearing that is also responsible for the poor efficiency in producing nutrients.A further objective is to highlight those factors that,for various reasons,are ignored.Ruminants have contributed both to the work,still used in many areas(just think of the hilly fields of rice in Asia),both with the supply of noble proteins to be one of the main factors that allowed the evolution of human species.Just think that where(Europe,Asia minor,Indian sub-continent)milk was used for feeding children,the numerical increase in human population was faster than the areas where its use was unknown(Americas and Australia).The most fertile soils,like the Great Plains of the United States,are those that in the past were populated by ruminants like the bison.Some scientists argue that humans are a species that is supposed to eat fruit physiologically.They ignore that Homo habilis has evolved since he became omnivorous.Many primates complement their diet with small mammals,crabs,crustaceans,molluscs,amphibians,worms and even fish trapped in some ponds during the low tide period.They ignore or want to ignore that primitive man chose the flesh driven by instinct because they needed vitamin B12.Regarding deforestation,many of the areas currently used as pastures have been obtained by burning forests,but it is not sufficiently stressed that all areas used today by man come from forest areas and that every year millions of hectares of forests are destroyed due to accidental fires or are caused by pyromaniacs.As for the production of CH4,although the ruminants produce physiologically CH4,it is also true that the increase in CH4 in the atmosphere is preceded by the increase in heat,the main cause of which is the increase in carbon dioxide(CO2).The presence of this gas in the atmosphere is due to the use of fossil fuels,namely oil,coal and natural gas,whose emissions are due to the multinational companies that manage the production of energy.It is likely that the demonization of ruminants serves to focus attention on a problem that is solvable by improving cattle rearing techniques and the rational use of manure.The purpose of this demonization is also to allocate the breeding areas to the seed multinationals.It is likely that the objective is to minimize the real problem of global warming,which derives from the misuse of the energy resources of the subsoil that derive from the accumulation over the millennia of different sources of carbon that are released daily in the atmosphere.

An update on microbiological causes of canine otitis externa in Campania Region,Italy

Objective: To update the recent knowledge of the microbiological causes of canine otitis externa in Campania Region(Italy) and the antibiotic susceptibility patterns of the isolated strains.Methods: A total of 122 dogs were examined by otoscopy, and auricular swab samples were collected from both ears in 74 dogs presenting clinical bilateral otitis and from single ears in 48 dogs displaying clinical unilateral otitis. Cytological examination,bacteriological analysis and antimicrobial susceptibility tests were performed.Results: Thirty-one out of 122 dogs were positive for yeast species(25.4%, 95% confidence interval(CI): 18.2%–34.2%) with a higher prevalence of Malassezia pachydermatis(21/31 isolates, 67.7%, CI: 48.5%–82.7%), and a total of 91 out of 122 dogs were positive for bacterial species(74.6%; CI: 65.8%–81.8%) with a higher prevalence of Staphylococcus pseudintermedius(45/143 isolates, 31.5%, CI: 24.1%–39.8%). These results are the first description of Streptococcus agalactiae-associated otitis. The yeasts isolated showed high levels of susceptibility to all antifungal agents tested; on the contrary all the isolated bacterial strains were highly resistant to at least four out of ten antimicrobial classes. Both Gram-positive and Gram-negative bacteria showed high resistance to amoxicillin/clavulanate and kanamycin hence they are not recommended as initial empirical therapy for the otitis treatment.Conclusions: This update illustrates an increase in antibiotic resistances providing an insight into the current knowledge of the therapeutic procedures followed on canine otitis externa in Italy. It also emphasizes the importance of considering the results of the microbiological and sensitivity tests to decide on an appropriate antibiotic therapy.

Application of ontologies to traceability in the dairy supply chain

Systems for tracking products through supply chains range from paper-based records maintained by producers, processors, and suppliers to sophisticated ICT-based solutions. In addition to supporting product traceability, ICTs may also support data capture, recording, storage, and sharing of traceability attributes on processing, genetics, inputs, disease/pest tracking and measurement of environmental variables. A key success factor for a traceability system is the capability to integrate and share information along the supply chain. ICT represents a tool to overcome integration problems, data fusion and information dissemination. In this paper we illustrate the application of ontology as a tool to model business processes and rules within an agri- food chain. The business case is represented by the Bovlac project: a scientific and technologic platform to trace fresh cheese production.

Endometritis associated with Enterococcus casseliflavus in a mare:A case report

Infectious endometritis is one of the main causes of subfertility/infertility in the mare. In this report, we present the first case of endometritis in mare associated with a strain of Enterococcus casseliflavus, an unusual gram-positive bacterium which can also be a zoonotic agent. Furthermore, the isolated strain showed a worrying multidrug-resistant profile. The accurate finding of a successful antimicrobial treatment and consequently,the pregnancy diagnosis indicate the importance to isolate, identify and define the antibiotic resistance profile of bacteria associated with endometritis.

Black soldier fly(Diptera:Stratiomyidae)larval heat generation and management

Mass production of black soldier fly,Hermetia illucens(L.)(Diptera:Stra-tiomyidae),larvae results in massive heat generation,which impacts facility management,waste conversion,and larval production.We tested daily substrate temperatures with dif-ferent population densities(i.e.,0,500,1000,5000,and 10000 larvae/pan),different pop-ulation sizes(i.e.,166,1000,and 10000 larvae at a fixed feed ratio)and air temperatures(i.e.,20 and 30℃)on various production parameters.Impacts of shifting larvae from 30 to 20℃on either day 9 or 11 were also determined.Larval activity increased substrate tem-peratures significantly(i.e.,at least 10℃above air temperatures).Low air temperature favored growth with the higher population sizes while high temperature favored growth with low population sizes.The greatest average individual larval weights(e.g.,0.126 and 0.124 g)and feed conversion ratios(e.g.,1.92 and 2.08 g/g)were recorded for either 10000 larvae reared at 20℃or 100 larvae reared at 30 C.Shifting temperatures from high(30℃)to low(20℃)in between(~10-d-old larvae)impacted larval production weights(16%increases)and feed conversion ratios(increased 14%).Facilities should consider the impact of larval density,population size,and air temperature during black soldier fly mass production as these factors impact overall larval production.

Influence of dietary hydrogenated palm oil supplementation on serum biochemistry and progesterone levels in dairy goats

The aim of this research was to investigate the influence of hydrogenated palm oil(HPO)added to a dairy goat diet on serum biochemistry and progesterone levels.Thirty pregnant Cilentana dairy goats were equally divided into 2 groups(control [CTR]and HPO groups).After kidding,concentrated feed for both groups was gradually increased up to 400 g/(animal d).and the HPO group received 50 g/(animal·d)of HPO.Supplementation with HPO significantly increased cholesterol levels(mg/dL, 63.80 vs.54.68 at 30 d.P<0.05;78.20 vs.58.00 at 60 d.P<0.05;83.80 vs.57.83 at 120 d.P<0.01)compared with the CTR group although no significant differences were detected for liver and kidney function indicators.Moreover,other biochemical parameters were not affected by HPO supplementation thus suggesting no change occurred in lipid and protein metabolism.Furthermore,a significant correlation was found between progesterone levels and serum cholesterol(r = 0.65,P≤0.01)although these were not significantly higher in HPO supplemented goats.The dose and time of HPO supplementation appears critical as regards assessing the limits between the risks and benefits of HPO supplementation in dairy goats.At the tested dose.HPO was well tolerated by the animals and may represent a useful tool to increase energy availability during highly demanding periods.

Enhancement of fruit byproducts through bioconversion by Hermetia llucens(Diptera:Stratiomyidae)

Bioconversion is a biological process by which organic materials are converted into products with higher biological and commercial value.During its larval stage the black soldier fly Hermetia illucens is extremely voracious and can feed on a wide vari-ety of organic materials.To study the impact of different fruit byproducts on the insect's growth,final larval biomass,substrate reduction,bioconversion parameters,and larval nu-tritional composition,10000 black soldier fly larvae(BSFL)were reared on 7.0 kg of one of three substrates(strawberry,tangerine,or orange)or on a standard diet as a control.The results highlight that BSFL can successfully feed and grow on each of these diets,though their development time,growth rate,and final biomass were differently impacted by the substrates,with strawberry being the most suitable.The lipid and protein contents of BSFL were similar among larvae fed on different substrates;however,major differences were detected in ash,micronutrient,fiber,fatty acid,and amino acid contents.Overall,the results indicate that fruit waste management through the BSFL bioconversion process rep-resents a commercially promising resource for regional and national agrifood companies.Our study offers new perspectives for sustainable and environmentally friendly industrial development by which fruit byproducts or waste might be disposed of or unconventionally enhanced to create secondary products of high biological and economic value,including BSFL biomass as animal feed or,in perspective,as alternative protein source for human nutrition.