Implementazione di tecniche di Total Productive Maintenance all'interno di un sistema produttivo. Il caso Bonfiglioli riduttori Spa

Nell'elaborato viene trattato il processo di implementazione di tecniche di Total Productive Maintenance (TPM) su di un impianto pilota all'interno dell'azienda Bonfiglioli Riduttori S.p.A. Dall'analisi dei dati dello storico degli interventi a guasto, effettuati sull'impianto, si sono ottenuti i parametri manutentivi di interesse per avere un quadro generale della situazione di partenza e sono state identificate due tipologie di manutenzione, come previsto dal TPM: l'automanutenzione affidata agli operatori e una serie di interventi programmati di preventiva a carico dell'ente manutenzione. Sono stati effettuati anche una serie di interventi migliorativi per incrementare l'efficienza dell'impianto. In conclusione sono stati confrontati i parametri di partenza con quelli di fine progetto per valutare i miglioramenti conseguiti valutando anche l'aspetto economico degli investimenti fatti. Dai dati ottenuti alla fine del percorso, sono state fatte le dovute considerazioni e sono stati proposti degli elementi di riflessione.

Drug-induced torsades de pointes in an underserved urban population. Methadone: is there therapeutic equipoise?

BACKGROUND Although it has been well established that methadone use can result in prolonged QTc/torsades de pointes (TdP) and has been labeled as one of the main drugs that cause TdP, it is still prescribed indiscriminately, and several cases of methadone-associated TdP have been seen in our community. METHODS Our objective was to determine the associated factors for prolonged QTc and the development of torsades de pointes (TdP) in our underserved patient population. We found 12,550 ECGs with prolonged QTc between 2002 and 2013. Medical records were reviewed in order to identify precipitating factors for prolonged QTc and to detect incidence of TdP. RESULTS We identified 2735 patients with prolonged QTc who met the inclusion criteria. Of these, 89 (3%) experienced TdP. There was a greater prevalence of HIV infection in the TdP group (11.2 vs. 3.7%, p < 0.001). Furosemide, hydrochlorothiazide, selective serotonin reuptake inhibitors (SSRIs), amiodarone, ciprofloxacin, methadone, haloperidol, and azithromycin were the drugs most often associated with prolonged QTc (31, 8.2, 7.6, 7.1, 3.9, 3.4 and 3.3%, respectively). However, the agents most commonly associated with TdP were furosemide (39.3%), methadone (27%), SSRIs (19.1%), amiodarone (18%), and dofetilide (9%). The medications with statistical significance in the multivariate analysis for TdP development in descending order were as follows: ranolazine (odds ratios [OR] = 53.61, 95% confidence interval [CI] 5.4-524, p < 0.001), dofetilide (OR = 25, CI 6.47-103.16, p < 0.001), voriconazole (OR = 21.40, CI 3.24-124.25, p < 0.001), verapamil (OR = 10.98, CI 2.62-44.96, p < 0.001), sotalol (OR = 12.72, 1.95-82.81, p = 0.008), methadone (OR = 9.89, CI 4.05-24.15, p < 0.001), and SSRI (OR = 2.26, CI 1.10-5.96, p < 0.001). This multivariate analysis revealed that amiodarone and HIV infection were not implicated in TdP. CONCLUSION Methadone was by far the leading medication implicated in the development of TdP and an independent predictor in both univariate and multivariate analyses despite the fact that it was not the most common QT-prolonging medication in our population.

Maintenance of coelomic fluid pH in sea urchins exposed to elevated CO2: the role of body cavity epithelia and stereom dissolution

Experimental ocean acidification leads to a shift in resource allocation and to an increased [HCO3-] within the perivisceral coelomic fluid (PCF) in the Baltic green sea urchin Strongylocentrotus droebachiensis. We investigated putative mechanisms of this pH compensation reaction by evaluating epithelial barrier function and the magnitude of skeleton (stereom) dissolution. In addition, we measured ossicle growth and skeletal stability. Ussing chamber measurements revealed that the intestine formed a barrier for HCO3- and was selective for cation diffusion. In contrast, the peritoneal epithelium was leaky and only formed a barrier for macromolecules. The ossicles of 6 week high CO2-acclimatised sea urchins revealed minor carbonate dissolution, reduced growth but unchanged stability. On the other hand, spines dissolved more severely and were more fragile following acclimatisation to high CO2. Our results indicate that epithelia lining the PCF space contribute to its acid-base regulation. The intestine prevents HCO3- diffusion and thus buffer leakage. In contrast, the leaky peritoneal epithelium allows buffer generation via carbonate dissolution from the surrounding skeletal ossicles. Long-term extracellular acid-base balance must be mediated by active processes, as sea urchins can maintain relatively high extracellular [HCO3-]. The intestinal epithelia are good candidate tissues for this active net import of HCO3- into the PCF. Spines appear to be more vulnerable to ocean acidification which might significantly impact resistance to predation pressure and thus influence fitness of this keystone species.

Frankfort Harbor maintenance dredging, revision of disposal plan to incorporate changes in the nearshore and slternative deepwater placement of dredged materials, evaluation and EA B1; FONSI : environmental impact statement.

Mode of access: Internet.

James River maintenance dredging : environmental impact statement.

F only available in microfiche.

Evaluation of traffic control devices for rural high-speed maintenance work zones.

Texas Department of Transportation, Research and Technology Transfer Office, Austin

Protection of personnel in maintenance and construction zones. Interim report.

Texas State Department of Highways and Public Transportation, Transportation Planning Division, Austin

Feasibility of changeable message signs and highway advisory radio for freeway maintenance. Final report.

Texas State Department of Highways and Public Transportation, Transportation Planning Division, Austin

Effectiveness of flashing arrow boards during moving maintenance operations. Final report.

Federal Highway Administration, Washington, D.C.

Highway maintenance simulation model. Final report.

Louisiana Department of Transportation and Development, Research and Development Section, Baton Rouge