When cyber-physical systems (CPS) are connected to perform smart manufacturing, we have a cyber-physical production system (CPPS). In such systems, CPS collaborate in an intelligent way to obtain and ...maintain the optimum of the manufacturing process, handle disturbances and adapt to changing conditions. This work, based on a systematic literature review, shows current trends in cyber-physical production systems with a special focus on the role of connectivity and control systems in production. We are looking for the enablers of CPPS focusing on the current evolution of control systems in the smart factory of the future. As a result, a conceptual framework as well as a CPPS control system architecture for the introduction and organisation of enablers for CPPS is presented to support practitioners in the realisation of smart manufacturing control concepts.
MR-guided focused ultrasound (MRgFUS), in combination with intravenous microbubble administration, has been applied for focal temporary BBB opening in patients with neurodegenerative disorders and ...brain tumors. MRgFUS could become a therapeutic tool for drug delivery of putative neurorestorative therapies. Treatment for Parkinson's disease with dementia (PDD) is an important unmet need. We initiated a prospective, single-arm, non-randomized, proof-of-concept, safety and feasibility phase I clinical trial (NCT03608553), which is still in progress. The primary outcomes of the study were to demonstrate the safety, feasibility and reversibility of BBB disruption in PDD, targeting the right parieto-occipito-temporal cortex where cortical pathology is foremost in this clinical state. Changes in β-amyloid burden, brain metabolism after treatments and neuropsychological assessments, were analyzed as exploratory measurements. Five patients were recruited from October 2018 until May 2019, and received two treatment sessions separated by 2-3 weeks. The results are set out in a descriptive manner. Overall, this procedure was feasible and reversible with no serious clinical or radiological side effects. We report BBB opening in the parieto-occipito-temporal junction in 8/10 treatments in 5 patients as demonstrated by gadolinium enhancement. In all cases the procedures were uneventful and no side effects were encountered associated with BBB opening. From pre- to post-treatment, mild cognitive improvement was observed, and no major changes were detected in amyloid or fluorodeoxyglucose PET. MRgFUS-BBB opening in PDD is thus safe, reversible, and can be performed repeatedly. This study provides encouragement for the concept of BBB opening for drug delivery to treat dementia in PD and other neurodegenerative disorders.
•Weak synchronization of construction suppliers causes high buffer levels and lead times.•An approach for production planning and control in real-time is proposed.•Real-time scheduling and monitoring ...allows to reduce buffer contents and lead-times.•Industry 4.0 makes real-time data available.•The approach is validated in a case study with a discrete-event simulation model.
A special characteristic of Engineer-to-Order (ETO) construction supplier companies is that they are composed of an off-site and on-site production part. Often, their synchronization is difficult by using traditional scheduling and monitoring methodologies resulting in excessive lead times, buffer levels and, as a result, additional costs. Real-time data, made available by Industry 4.0 technologies, represent a high potential to sense and react to plan deviations as soon as they appear. The paper presents a decentralized and agile approach for scheduling and control in ETO construction supply chains. The approach was modelled and validated based on a case study of an ETO façade supplier company and a discrete event simulation. It emerged that the agile approach has its main benefits in the reduction of buffer sizes and construction lead-times. The original aspect of the article is the investigation of effects of agile scheduling and control in ETO construction supply chains.
Industry 4.0 has attracted the attention of manufacturing companies over the past ten years. Despite efforts in research and knowledge transfer from research to practice, the introduction of Industry ...4.0 concepts and technologies is still a major challenge for many companies, especially small and medium-sized enterprises (SMEs). Many of these SMEs have no overview of existing Industry 4.0 concepts and technologies, how they are implemented in their own companies, and which concepts and technologies should primarily be focused on future Industry 4.0 implementation measures. The aim of this research was to develop an assessment model for SMEs that is easy to apply, provides a clear overview of existing Industry 4.0 concepts, and supports SMEs in defining their individual strategy to introduce Industry 4.0 in their firm. The maturity level-based assessment tool presented in this work includes a catalog of 42 Industry 4.0 concepts and a norm strategy based on the results of the assessment to support SMEs in introducing the most promising concepts. For testing and validation purposes, the assessment model has been applied in a field study with 17 industrial companies.
Ablative neurosurgery has been used to treat Parkinson's disease for many decades. MRI-guided focused ultrasound allows focal lesions to be made in deep brain structures without skull incision. We ...investigated the safety and preliminary efficacy of unilateral subthalamotomy by focused ultrasound in Parkinson's disease.
This prospective, open-label pilot study was done at CINAC (Centro Integral de Neurociencias), University Hospital HM Puerta del Sur in Madrid, Spain. Eligible participants had Parkinson's disease with markedly asymmetric parkinsonism. Patients with severe dyskinesia, history of stereotactic surgery or brain haemorrhage, a diagnosis of an unstable cardiac or psychiatric disease, or a skull density ratio of 0·3 or less were excluded. Enrolled patients underwent focused ultrasound unilateral subthalamotomy. The subthalamic nucleus was targeted by means of brain images acquired with a 3-Tesla MRI apparatus. Several sonications above the definitive ablation temperature of 55°C were delivered and adjusted according to clinical response. The primary outcomes were safety and a change in the motor status of the treated hemibody as assessed with part III of the Movement Disorders Society–Unified Parkinson's Disease Rating Scale (MDS–UPDRS III) in both off-medication and on-medication states at 6 months. Adverse events were monitored up to 48 h after treatment and at scheduled clinic visits at 1, 3, and 6 months after treatment. The study is registered with ClinicalTrials.gov, number NCT02912871.
Between April 26 and June 14, 2016, ten patients with markedly asymmetric parkinsonism that was poorly controlled pharmacologically were enrolled for focused ultrasound unilateral subthalamotomy. By 6 months follow-up, 38 incidents of adverse events had been recorded, none of which were serious or severe. Seven adverse events were present at 6 months. Three of these adverse events were directly related to subthalamotomy: off-medication dyskinesia in the treated arm (one patient, almost resolved by 6 months); on-medication dyskinesia in the treated arm (one patient, resolved after levodopa dose reduction); and subjective speech disturbance (one patient). Four of the adverse events present at 6 months were related to medical management (anxiety and fatigue one patient each and weight gain two patients). The most frequent adverse events were transient gait ataxia (related to subthalamotomy, six patients), transient pin-site head pain (related to the head frame, six patients), and transient high blood pressure (during the procedure, five patients). Transient facial asymmetry (one patient) and moderate impulsivity (two patients) were also recorded. The mean MDS–UPDRS III score in the treated hemibody improved by 53% from baseline to 6 months in the off-medication state (16·6 SD 2·9 vs 7·5 3·9) and by 47% in the on-medication state (11·9 3·1 vs 5·8 3·5).
MRI-guided focused ultrasound unilateral subthalamotomy was well tolerated and seemed to improve motor features of Parkinson's disease in patients with noticeably asymmetric parkinsonism. Large randomised controlled trials are necessary to corroborate these preliminary findings and to assess the potential of such an approach to treat Parkinson's disease.
Fundación de investigación HM Hospitales and Insightec.
Summary
The environments of children influence their risk for childhood obesity through, among other factors, a child's weight‐related behaviors (i.e., diet and physical activity). In this article, ...we present evidence on social environmental factors associated with a child's diet and physical activity, and more generally, the prevention and control of childhood obesity among Hispanic/Latinx children in the United States and children from countries in Latin America. Using a socio‐ecologic lens, we present evidence from cross‐sectional and longitudinal studies conducted in the United States involving Hispanic/Latinx children, and evidence from studies involving children in Latin America. Studies examining parenting factors in the home environment (e.g., parenting strategies) are especially emphasized, with more limited evidence on social environmental factors in other lived contexts (e.g., school). The influence of acculturation on social relationships cuts across levels of the socio‐ecological framework. Intervention research identified strategies and research gaps for intervening on social factors to promote healthy behaviors and reduce risk for childhood obesity. Community health workers and others forms of peer support were identified as relevant approaches at multiple levels of the socio‐ecological framework. This article concludes with directions for future research to further understand the environment using newer information and communication technologies.
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