Introduction of an Assistance System to Support Domain Experts in Programming Low-code to Leverage Industry 5.0

The rapid technological leaps of Industry 4.0 increase the pressure and demands on humans working in automation, which is one of the main motivators of Industry 5.0. In particular, automation software development for mechatronic systems becomes increasingly challenging, as both domain knowledge and programming skills are required for high-quality, maintainable software. Especially for small companies from automation and robotics without dedicated software engineering departments, domain-specific low-code platforms become indispensable that enable domain experts to develop code intuitively using visual programming languages, e.g., for tasks such as retrofitting mobile machines. However, for extensive functionalities, visual programs may become overwhelming due to the scaling-up problem. In addition, the ever-shortening time-to-market increases the time pressure on programmers. Thus, an assistance system concept is introduced that can be implemented by low-code platform suppliers based on combining data mining and static code analysis. Domain experts are supported in developing low-code by targeted recommendations, metric-based complexity measurement, and reducing complexity by encapsulating functionalities. The concept is implemented for the industrial low-code platform HAWE eDesign to program hydraulic components in mobile machines, and its benefits are confirmed in a user study and an industrial expert workshop.Comment: 8 pages, https://ieeexplore.ieee.org/abstract/document/983945

The Effect of Vestibulo-Ocular Reflex Deficits and Covert Saccades on Dynamic Vision in Opioid-Induced Vestibular Dysfunction

Patients with bilateral vestibular dysfunction cannot fully compensate passive head rotations with eye movements, and experience disturbing oscillopsia. To compensate for the deficient vestibulo-ocular reflex (VOR), they have to rely on refixation saccades. Some can trigger "covert'' saccades while the head still moves; others only initiate saccades afterwards. Due to their shorter latency, it has been hypothesized that covert saccades are particularly beneficial to improve dynamic visual acuity, reducing oscillopsia. Here, we investigate the combined effect of covert saccades and the VOR on clear vision, using the Head Impulse Testing Device - Functional Test (HITD-FT), which quantifies reading ability during passive high-acceleration head movements. To reversibly decrease VOR function, fourteen healthy men (median age 26 years, range 2131) were continuously administrated the opioid remifentanil intravenously (0.15 mu g/kg/min). VOR gain was assessed with the video head-impulse test, functional performance (i.e. reading) with the HITD-FT. Before opioid application, VOR and dynamic reading were intact (head-impulse gain: 0.87 +/- 0.08, mean +/- SD;HITD-FT rate of correct answers: 90 +/- 9%). Remifentanil induced impairment in dynamic reading (HITD-FT 26 +/- 15%) in 12/14 subjects, with transient bilateral vestibular dysfunction (head-impulse gain 0.63 +/- 0.19). HITD-FT score correlated with head-impulse gain (R = 0.63, p = 0.03) and with gain difference (before/with remifentanil, R = -0.64, p = 0.02). One subject had a non-pathological head-impulse gain (0.82 +/- 0.03) and a high HITD-FT score (92%). One subject triggered covert saccades in 60% of the head movements and could read during passive head movements (HITD-FT 93%) despite a pathological head-impulse gain (0.59 +/- 0.03) whereas none of the 12 subjects without covert saccades reached such high performance. In summary, early catch-up saccades may improve dynamic visual function. HITD-FT is an appropriate method to assess the combined gaze stabilization effect of both VOR and covert saccades (overall dynamic vision), e.g., to document performance and progress during vestibular rehabilitation

Opioid-Induced Nausea Involves a Vestibular Problem Preventable by Head-Rest

Background and Aims Opioids are indispensable for pain treatment but may cause serious nausea and vomiting. The mechanism leading to these complications is not clear. We investigated whether an opioid effect on the vestibular system resulting in corrupt head motion sensation is causative and, consequently, whether head-rest prevents nausea. Methods Thirty-six healthy men (26.6 +/- 4.3 years) received an opioid remifentanil infusion (45 min, 0.15 mu g/kg/min). Outcome measures were the vestibulo-ocular reflex (VOR) gain determined by video-head-impulse-testing, and nausea. The first experiment (n = 10) assessed outcome measures at rest and after a series of five 1-Hz forward and backward head-trunk movements during one-time remifentanil administration. The second experiment (n = 10) determined outcome measures on two days in a controlled crossover design: (1) without movement and (2) with a series of five 1-Hz forward and backward head-trunk bends 30 min after remifentanil start. Nausea was psychophysically quantified (scale from 0 to 10). The third controlled crossover experiment (n = 16) assessed nausea (1) without movement and (2) with head movement;isolated head movements consisting of the three axes of rotation (pitch, roll, yaw) were imposed 20 times at a frequency of 1 Hz in a random, unpredictable order of each of the three axes. All movements were applied manually, passively with amplitudes of about +/- 45 degrees. Results The VOR gain decreased during remifentanil administration (p<0.001),averaging 0.92 +/- 0.05 (mean +/- standard deviation) before, 0.60 +/- 0.12 with, and 0.91 +/- 0.05 after infusion. The average half-life of VOR recovery was 5.3 +/- 2.4 min. 32/36 subjects had no nausea at rest (nausea scale 0.00/0.00 median/interquartile range). Head-trunk and isolated head movement triggered nausea in 64% (p<0.01) with no difference between head-trunk and isolated head movements (nausea scale 4.00/7.25 and 1.00/4.5, respectively). Conclusions Remifentanil reversibly decreases VOR gain at a half-life reflecting the drug's pharmacokinetics. We suggest that the decrease in VOR gain leads to a perceptual mismatch of multisensory input with the applied head movement, which results in nausea, and that, consequently, vigorous head movements should be avoided to prevent opioid-induced nausea

Preventing opioid-induced nausea and vomiting: Rest your head and close your eyes?

Although opioid-induced nausea and vomiting (OINV) is common and debilitating, its mechanism is still unclear. Recently, we suggested that opioids affect semicircular canal function and that this leads to a mismatch between canal input and other sensory information during head motion, which triggers OINV. Here, we assess if visual input is relevant for this mismatch. In a randomized-controlled crossover study 14 healthy men (26.9 +/- 3.4 years, mean +/- SD) were tested twice, once blindfolded and once with eyes open, with at least one-day washout. The opioid remifentanil was administered intravenously (0.15 mu g/kg/min) for 60 minutes. After a thirty-minutes resting period, subjects' head and trunk were passively moved. Nausea was rated before remifentanil start (T-0), before the movement intervention (T-30) and after 60 minutes (T-60) of administration. At rest (T-0, T-30), median nausea ratings were zero whether subjects were blindfolded or not. Movement triggered nausea independently of visual input (nausea rating 1.5/3.0 (median/interquartile range) in the blindfolded, 2.5/6 in the eyes-open condition, chi(2) (1) = 1.3, p = 0.25). As movement exacerbates OINV independently of visual input, a clash between visual and semicircular canal information is not the relevant trigger for OINV. To prevent OINV, emphasis should be put on head-rest, eye-closure is less important

Improvement of attention span and reaction time with hyperbaric oxygen treatment in patients with toxic injury due to mold exposure

It is, by now, well established that mold toxins (mycotoxins) can cause significant adverse health effects. In this study, 15 subjects who developed an attention deficit disorder (ADD) and slowing of reaction time at the time of exposure to mold toxins were identified. Deficits in attention span and reaction time were documented not only by taking a careful history, but also by performing a Test of Variables of Attention (TOVA). The TOVA test provides an objective measure of these two variables. It was found that mold-exposed subjects show statistically significant decreases in attention span and significant increases in reaction time to stimuli compared to controls. After ten sessions of hyperbaric oxygen treatment (HBOT), a statistically significant improvement was seen in both measures. This preliminary study suggests promising outcomes in treating mold-exposed patients with hyperbaric oxygen

Apolipoprotein E-dependent load of white matter hyperintensities in Alzheimer’s disease: a voxel-based lesion mapping study

Introduction: White matter (WM) magnetic resonance imaging (MRI) hyperintensities are common in Alzheimer’s disease (AD), but their pathophysiological relevance and relationship to genetic factors are unclear. In the present study, we investigated potential apolipoprotein E (APOE)-dependent effects on the extent and cognitive impact of WM hyperintensities in patients with AD. Methods: WM hyperintensity volume on fluid-attenuated inversion recovery images of 201 patients with AD (128 carriers and 73 non-carriers of the APOE ε4 risk allele) was determined globally as well as regionally with voxel-based lesion mapping. Clinical, neuropsychological and MRI data were collected from prospective multicenter trials conducted by the German Dementia Competence Network. Results: WM hyperintensity volume was significantly greater in non-carriers of the APOE ε4 allele. Lesion distribution was similar among ε4 carriers and non-carriers. Only ε4 non-carriers showed a correlation between lesion volume and cognitive performance. Conclusion: The current findings indicate an increased prevalence of WM hyperintensities in non-carriers compared with carriers of the APOE ε4 allele among patients with AD. This is consistent with a possibly more pronounced contribution of heterogeneous vascular risk factors to WM damage and cognitive impairment in patients with AD without APOE ε4-mediated risk

A period of immobility after remifentanil administration protects from nausea: an experimental randomized cross-over study

Background: The opioid remifentanil induces a decrease of vestibulo-ocular reflex function, which has been associated with nausea and vomiting when the subjects are moved. The study investigates in healthy female volunteers if immobility after remifentanil administration protects from nausea and vomiting. Methods: In volunteers, a standardized movement intervention (a manually applied head-trunk movement forward, backward and sideward) was started 5 min (session A), 35 min (session B) or 60 min (session C) after cessation of a remifentanil infusion (0.15 mu g.kg(-1).min(-1)). In a cross-over design, 16 participants were randomized to the early (sessions A and B) or the late intervention group (sessions A and C). Nausea was assessed using a 11-point numerical rating scale before and after each movement intervention. Differences within and between groups were assessed with non-parametric tests for paired and unpaired data. Results: Comparing sessions A, B and C, intensity of nausea was time-dependent after cessation of remifentanil administration (p = 0.015). In the early intervention group, nausea decreased from median 5.0 [IQR 1.5;6.0] in session A to 2.0 [1.0;3.0] in session B (p = 0.094);in the late intervention group nausea decreased from 3.5 [2.0;5.0] in session A to 0.5 [0.0;2.0] in session C (p = 0.031). Conclusions: In summary, in young healthy women, immobility after remifentanil administration protects from nausea and vomiting in a time-dependent manner. In analogy to motion sickness, opioid-induced nausea and vomiting in female volunteers can be triggered by movement