Integrated sensors for robotic laser welding

A welding head is under development with integrated sensory systems for robotic laser welding applications. Robotic laser welding requires sensory systems that are capable to accurately guide the welding head over a seam in three-dimensional space and provide information about the welding process as well as the quality of the welding result. In this paper the focus is on seam tracking. It is difficult to measure three-dimensional parameters of a ream during a robotic laser welding task, especially when sharp corners are present. The proposed sensory system is capable to provide the three dimensional parameters of a seam in one measurement and guide robots over sharp corners

The impact of slow steaming on the carriers’ and shippers’ costs: The case of a global logistics network

We propose an analytical modeling methodology for quantifying the impact of slow steaming on the carrier's voyage cost and on the shipper's total landed logistics costs. The developed methodology can be employed by a carrier and a shipper in their contract negotiations, in order for the two parties to determine how they could divide between them the savings resulted from slow steaming. We demonstrate that the impact of slow steaming and speed adjustment policies on the shippers’ total landed logistics costs tend to increase as the vessel travels towards the end of its voyage

Sustainable supply chain management in the digitalisation era: The impact of Automated Guided Vehicles

Internationalization of markets and climate change introduce multifaceted challenges for modern supply chain (SC) management in the today's digitalisation era. On the other hand, Automated Guided Vehicle (AGV) systems have reached an age of maturity that allows for their utilization towards tackling dynamic market conditions and aligning SC management focus with sustainability considerations. However, extant research only myopically tackles the sustainability potential of AGVs, focusing more on addressing network optimization problems and less on developing integrated and systematic methodological approaches for promoting economic, environmental and social sustainability. To that end, the present study provides a critical taxonomy of key decisions for facilitating the adoption of AGV systems into SC design and planning, as these are mapped on the relevant strategic, tactical and operational levels of the natural hierarchy. We then propose the Sustainable Supply Chain Cube (S2C2), a conceptual tool that integrates sustainable SC management with the proposed hierarchical decision-making framework for AGVs. Market opportunities and the potential of integrating AGVs into a SC context with the use of the S2C2 tool are further discussed

Design of sustainable supply chains for the agrifood sector: a holistic research framework

Agrifood sector is one of the most important economic and political areas within the European Union, with key implications for sustainability such as the fulfillment of human needs, the support of employment and economic growth, and its impact on the natural environment.  Growing environmental, social and ethical concerns and increased awareness of the impacts of the agrifood sector have led to increased pressure by all involved supply chain stakeholders, while at the same time the European Union has undertaken a number of relevant regulatory interventions.  This paper aims to present a methodological framework for the design of green supply chains for the agrifood sector.  The framework aims towards the optimization of the agrifood supply chain design, planning and operations through the implementation of appropriate green supply chain management and logistics principles.  More specifically, focus is put on the minimization of the environmental burden and the maximization of supply chain sustainability of the agrifood supply chain.  The application of such a framework could result into substantial reduction of CO2 emissions both by the additional production of other biofuels from waste, as well as the introduction of a novel intelligent logistics network, in order to reduce the harvest and transportation energy input.  Moreover, the expansion of the biomass feedstock available for biofuel production can provide adequate support towards avoidance of food/fuel competition for land use.   Keywords: supply chain management, green supply chains, sustainable development, agrifood secto

The emerging role of water footprint in supply chain management: A critical literature synthesis and a hierarchical decision-making framework

Freshwater overexploitation and scarcity have led to extensive shifts in demand patterns for water-friendly products. As several agricultural and industrial activities are closely intertwined with water consumption, the availability of sufficient freshwater resources constitutes a significant precondition for covering global consumer needs. In this context, the design and management of sustainable supply chains in terms of freshwater resources' preservation have emerged as major challenges in the corporate agenda. As such, the concept of water footprint as a key performance indicator of freshwater utilization has been introduced at national, corporate and product levels. In this manuscript, we first provide a critical literature synthesis concerning product water footprint assessment in order to map the state-of-the-art research related to freshwater consumption and pollution in the agricultural and industrial sectors. Our analysis demonstrates that although water footprint assessment is a rapidly evolving research field, scientific publications focusing on a holistic approach concerning freshwater exploitation at a supply chain extent are rather limited. The findings further verify that the agrifood sector dominates global water use. In this respect, we analyse both corporate and academic literature in order to identify emerging issues on freshwater resources' management for agrifood products. Finally, we propose a first-effort hierarchical decision-making framework that includes water footprint mitigation policies for agrifood supply chains in order to support all stakeholders in developing a comprehensive water stewardship strategy.Public Benefit Foundation Alexander S. Onassis, European Community 7th Framework Programme (FP7-REGPOT- 2012-2013-1) GREEN-AgriChains project (Grant ID: 316167

Causes, Timing, and Impact of Dual Antiplatelet Therapy Interruption for Surgery (from the Patterns of Non-adherence to Anti-platelet Regimens In Stented Patients Registry).

Temporary interruption of dual antiplatelet therapy (DAPT) is not infrequently required in patients undergoing percutaneous coronary intervention (PCI). We sought to describe the procedures and outcomes associated with DAPT interruption in patients treated with DAPT following successful PCI from the Patterns of non-adherence to anti-platelet regimens in stented patients registry (n = 5018). DAPT interruption was prespecified as physician recommended cessation for <14 days. Of the study cohort, 490 patients (9.8%) experienced 594 DAPT interruptions over 2 years following PCI. Only 1 antiplatelet agent was interrupted in 57.2% cases and interruption was frequently recommended by noncardiologists (51.3%). Where type of surgery was reported, majority of DAPT interruptions occurred for minor surgery (68.4% vs 31.6%) and a similar cessation pattern of single versus dual antiplatelet cessation was observed regardless of minor or major surgery. Subsequent to DAPT interruption, 12 patients (2.4%) experienced 1 thrombotic event each, of which 5 (1.0%) occurred during the interruption period. All events occurred in patients who either stopped both agents (8 of 12) or clopidogrel-only (4 of 12), with no events occurring due to aspirin cessation alone. In conclusion, in the Patterns of Non-adherence to Anti-platelet Regiments in Stented Patients registry, 1 in 10 patients were recommended DAPT interruption for surgery within 2 years of PCI. Interruption was more common for a single agent rather than both antiplatelet agents regardless of severity of surgery, and was frequently recommended by noncardiologists. Only 1% of patients with DAPT interruption experienced a subsequent thrombotic event during the interruption period, which mainly occurred in patients stopping both antiplatelet agents

Revascularization for coronary artery disease in diabetes mellitus: Angioplasty, stents and coronary artery bypass grafting

Author Manuscript: 2011 April 14Patients with diabetes mellitus (DM) are prone to a diffuse and rapidly progressive form of atherosclerosis, which increases their likelihood of requiring revascularization. However, the unique pathophysiology of atherosclerosis in patients with DM modifies the response to arterial injury, with profound clinical consequences for patients undergoing percutaneous coronary intervention (PCI). Multiple studies have shown that DM is a strong risk factor for restenosis following successful balloon angioplasty or coronary stenting, with greater need for repeat revascularization and inferior clinical outcomes. Early data suggest that drug eluting stents reduce restenosis rates and the need for repeat revascularization irrespective of the diabetic state and with no significant reduction in hard clinical endpoints such as myocardial infarction and mortality. For many patients with 1- or 2-vessel coronary artery disease, there is little prognostic benefit from any intervention over optimal medical therapy. PCI with drug-eluting or bare metal stents is appropriate for patients who remain symptomatic with medical therapy. However, selection of the optimal myocardial revascularization strategy for patients with DM and multivessel coronary artery disease is crucial. Randomized trials comparing multivessel PCI with balloon angioplasty or bare metal stents to coronary artery bypass grafting (CABG) consistently demonstrated the superiority of CABG in patients with treated DM. In the setting of diabetes CABG had greater survival, fewer recurrent infarctions or need for re-intervention. Limited data suggests that CABG is superior to multivessel PCI even when drug-eluting stents are used. Several ongoing randomized trials are evaluating the long-term comparative efficacy of PCI with drug-eluting stents and CABG in patients with DM. Only further study will continue to unravel the mechanisms at play and optimal therapy in the face of the profoundly virulent atherosclerotic potential that accompanies diabetes mellitus.National Institutes of Health (U.S.) (GM 49039

Fetal loss and long-term maternal morbidity and mortality: A systematic review and meta-analysis.

BACKGROUND: Evidence suggests common pathways between pregnancy losses and subsequent long-term maternal morbidity, rendering pregnancy complications an early chronic disease marker. There is a plethora of studies exploring associations between miscarriage and stillbirth with long-term adverse maternal health; however, these data are inconclusive. METHODS AND FINDINGS: We systematically searched MEDLINE, EMBASE, AMED, BNI, CINAHL, and the Cochrane Library with relevant keywords and MeSH terms from inception to June 2023 (no language restrictions). We included studies exploring associations between stillbirth or miscarriage and incidence of cardiovascular, malignancy, mental health, other morbidities, and all-cause mortality in women without previous pregnancy loss. Studies reporting short-term morbidity (within a year of loss), case reports, letters, and animal studies were excluded. Study selection and data extraction were performed by 2 independent reviewers. Risk of bias was assessed using the Newcastle Ottawa Scale (NOS) and publication bias with funnel plots. Subgroup analysis explored the effect of recurrent losses on adverse outcomes. Statistical analysis was performed using an inverse variance random effects model and results are reported as risk ratios (RRs) with 95% confidence intervals (CIs) and prediction intervals (PIs) by combining the most adjusted RR, odds ratios (ORs) and hazard ratios (HRs) under the rare outcome assumption. We included 56 observational studies, including 45 in meta-analysis. There were 1,119,815 women who experienced pregnancy loss of whom 951,258 had a miscarriage and 168,557 stillbirth, compared with 11,965,574 women without previous loss. Women with a history of stillbirth had a greater risk of ischaemic heart disease (IHD) RR 1.56, 95% CI [1.30, 1.88]; p < 0.001, 95% PI [0.49 to 5.15]), cerebrovascular (RR 1.71, 95% CI [1.44, 2.03], p < 0.001, 95% PI [1.92, 2.42]), and any circulatory/cardiovascular disease (RR 1.86, 95% CI [1.01, 3.45], p = 0.05, 95% PI [0.74, 4.10]) compared with women without pregnancy loss. There was no evidence of increased risk of cardiovascular disease (IHD: RR 1.11, 95% CI [0.98, 1.27], 95% PI [0.46, 2.76] or cerebrovascular: RR 1.01, 95% CI [0.85, 1.21]) in women experiencing a miscarriage. Only women with a previous stillbirth were more likely to develop type 2 diabetes mellitus (T2DM) (RR: 1.16, 95% CI [1.07 to 2.26]; p < 0.001, 95% PI [1.05, 1.35]). Women with a stillbirth history had an increased risk of developing renal morbidities (RR 1.97, 95% CI [1.51, 2.57], p < 0.001, 95% [1.06, 4.72]) compared with controls. Women with a history of stillbirth had lower risk of breast cancer (RR: 0.80, 95% CI [0.67, 0.96], p-0.02, 95% PI [0.72, 0.93]). There was no evidence of altered risk of other malignancies in women experiencing pregnancy loss compared to controls. There was no evidence of long-term mental illness risk in women with previous pregnancy losses (stillbirth: RR 1.90, 95% CI [0.93, 3.88], 95% PI [0.34, 9.51], miscarriage: RR 1.78, 95% CI [0.88, 3.63], 95% PI [1.13, 4.16]). The main limitations include the potential for confounding due to use of aggregated data with variable degrees of adjustment. CONCLUSIONS: Our results suggest that women with a history of stillbirth have a greater risk of future cardiovascular disease, T2DM, and renal morbidities. Women experiencing miscarriages, single or multiple, do not seem to have an altered risk

Pneumothorax in COVID-19 Acute Respiratory Distress Syndrome: Case Series.

Objective The study aims to describe the clinical characteristics and outcomes of patients with COVID-19 related acute respiratory distress syndrome (ARDS) who developed pneumothorax. Design and setting A retrospective chart review was performed of the electronic medical record. Patients were included if they were identified as having confirmed COVID-19 as well as pneumothorax from March 16, 2020 to May 31, 2020. Patients\u27 demographic and clinical characteristics, mechanical ventilator parameters, lung compliance measurements and outcomes during hospitalization were collected. This case series was conducted in intensive care units at two large tertiary care centers within the Northwell Health System, located in New York State. Patients A total of 75 patients were identified who were predominantly male (73.3%) with an average age of 62.8 years. Thirty (40%) were Hispanic, 20 (26.7%) were White, 16 (21.3%) were Asian, and nine (12%) were Black. Common comorbid conditions were hypertension (52%), diabetes mellitus (26.7%), hyperlipidemia (32.0%), and chronic pulmonary disease (8, 10.7%). Measurements and main results Most of the patients were diagnosed with pneumothorax while on mechanical ventilation (92%) despite overall adherence with lung-protective ventilation strategies. Average tidal volume was 6.66 mL/kg) of ideal body weight. The average positive end-expiratory pressure (PEEP) was 10.83 (cm) H2O. Lung compliance was poor, with average peak and plateau pressures of 41.9 cm H2O and 35.2 cm H2O, respectively. Inpatient mortality was high in these patients (76%). Conservative management with initial observation had a success rate (73.3%) with similar mortality and shorter length of stay (LOS) on average. Significant factors in the conservatively managed group included lack of tension physiology, the smaller size of pneumothorax, lack of underlying diabetes, presence of pneumomediastinum, and not being on mechanical ventilation during diagnosis. Conclusion Despite overall adherence to best practice ventilator management in ARDS, we observed a large number of pneumothoraces during the COVID-19 pandemic. Conservative management may be appropriate if there are no clinical signs or symptoms of tension physiology and pneumothorax size is small