A remanufacturing process library for environmental impact simulations

International audience'Closed loop' end-of-life strategies such as remanufacturing must be applied to create eco-efficient products. Remanufacturing may be a key element in reducing the environmental impact of products but this remains to be proved. The aim of this study is to help designers evaluate the environmental impacts of their remanufacturing process during the design phase. The first task is to identify, list and classify the various remanufacturing processes (disassembly, cleaning, sorting and controlling, reconditioning, reassembly) by type of process and then estimate the environmental impact for each process. These processes are then formalized by characterization and organised in a database. Using a simulator, the different processes can be aggregated to assess the environmental impacts of a remanufacturing line. An example is presented in the last part of this paper to illustrate the proposal

2-DFR : un cadre conceptuel destiné aux concepteurs pour un remanufacturing durable

Remanufacturing is believed to be among the key strategies for sustainable development of industrial products. The aim of remanufacturing is to retrieve the product’s inherent value when it no longer fulfils the user’s needs. However, it is a non-linear process that poses many uncertainties. Therefore, integrating remanufacturing concerns during the early design phase is necessary to adapt products to the future remanufacturing processes and to the future remanufacturing system.Another crucial aspect in achievingsustainable remanufacturing activity is to plan and coordinate remanufacturing system in a sustainable way. The presence of various academic tools and methods to facilitate remanufacturing activities might overcome the challenges observed and enhance both the quality and quantity. Unfortunately, these tools/methods are rarely used by remanufacturing stakeholders, probably due to the lack of platform for them to facilitate the usage.The objective of this dissertation is to help the designers and remanufacturers to:•Characterize remanufactured products and processes in relation to sustainable development,•Classify and choose remanufacturing tools ormethods to improve sustainable remanufacturing.To achieve these objectives, a Two Dimensional Framework for Remanufacturing (2DFR) is proposed. It combines the sustainable development and remanufacturing system perspectives. A list of remanufacturing constraints from both perspectives is proposed in the first part of this dissertation. It was validated as a design for remanufacturing guideline during a remanufacturing workshop event in the framework of the European project ERN (H2020). The 2DFR is used again in the second part of this dissertation to develop a method to classify remanufacturing tools/methods. A method to guide and facilitate user in choosing remanufacturing tools/methods is proposed using the list of remanufacturing characteristics listed in the first proposition and the previous classification method. A configurator that functions as an interface for both the classification method and the choosing method is developed. Illustrated case studies are presented to validate its usage.The characteristics of sustainable remanufacturing products and processes defined in the first proposition offer to the users a comprehensive checklist when designing and making decisions. Meanwhile the second proposition encourages the usage by the industry of the existing academics tools/methods related to remanufacturing.Le remanufacturing est considéré comme une des stratégies clés pour le développement durable des produits industriels. Le but du remanufacturing est de récupérer la valeur du produit lorsque celui-ci ne répond plus aux besoins des utilisateurs. Ce processus complexe, qui comporte de nombreuses incertitudes, nécessite d’être pris en compte au tout début de la phase de conception pour que le produit remanufacturé soit adapté aux processus et aux futurs systèmes de remanufacturing.Un autre aspect essentiel pour aboutir à un remanufacturing durable est de bien planifier et coordonner sur le long terme, le système global de remanufacturing. La présence de nombreux outils et de méthodes académiques pour faciliter les processus de remanufacturing pourrait permettre de surmonter les défis posés et d’améliorer les qualités et quantités des produits intégrant le processus de remanufacturing. Malheureusement, ces outils et méthodes sont rarement utilisés par les acteurs du domaine de remanufacturing, probablement à cause du manque de plateformes pour faciliter leurs usages.L'objectif de cette thèse est donc d’aider les concepteurs et les fabricants à:1.Caractériser les produits et les processus remanufacturés, en lien avec le développement durable2.Classifier et aider au choix des outils ou des méthodes de remanufacturing pour améliorer le remanufacturing durablePour atteindre ces objectifs, un cadre à deux Dimensions (a Two Dimensional Framework for Remanufacturing - 2DFR), est proposé. Il combine les perspectives liées au développement durable et celles liées au système de remanufacturing. Une liste des contraintes liées au remanufacturing est ainsi proposée dans la première partie de la thèse selon ces deux perspectives. Elle a été validée comme un guide de conception pour le remanufacturing lors d’un atelier dans le cadre du projet européen ERN (H2020). Le 2DFR est ensuite utilisé dans la deuxième partie de la thèse pour développer la classification des outils et des méthodes de remanufacturing. Enfin, une méthode pour guider l’utilisateur dans le choix des outils et méthodes de remanufacturing est proposée. Elle est créée à partir de la liste des caractéristiques du remanufacturing apparues dans la première proposition et de la méthode de classification mentionnée précédemment. Un démonstrateur qui fonctionne comme une interface pour les deux méthodes de classification et de choix des outils est développée. Des études de cas permettent d’illustrer son utilisation.Les caractéristiques pour des produits et processus de remanufacturing durables définies dans la première proposition offrent ainsi aux utilisateurs un guide complet lors de la conception et de la prise de décisions. La deuxième proposition, quant à elle, encourage l'utilisation par l'industrie des outils et méthodes académiques existants liés au remanufacturing

2-DFR : a framework to guide designers toward sustainable remanufacturing

Le remanufacturing est considéré comme une des stratégies clés pour le développement durable des produits industriels. Le but du remanufacturing est de récupérer la valeur du produit lorsque celui-ci ne répond plus aux besoins des utilisateurs. Ce processus complexe, qui comporte de nombreuses incertitudes, nécessite d’être pris en compte au tout début de la phase de conception pour que le produit remanufacturé soit adapté aux processus et aux futurs systèmes de remanufacturing.Un autre aspect essentiel pour aboutir à un remanufacturing durable est de bien planifier et coordonner sur le long terme, le système global de remanufacturing. La présence de nombreux outils et de méthodes académiques pour faciliter les processus de remanufacturing pourrait permettre de surmonter les défis posés et d’améliorer les qualités et quantités des produits intégrant le processus de remanufacturing. Malheureusement, ces outils et méthodes sont rarement utilisés par les acteurs du domaine de remanufacturing, probablement à cause du manque de plateformes pour faciliter leurs usages.L'objectif de cette thèse est donc d’aider les concepteurs et les fabricants à:1. Caractériser les produits et les processus remanufacturés, en lien avec le développement durable2. Classifier et aider au choix des outils ou des méthodes de remanufacturing pour améliorer le remanufacturing durablePour atteindre ces objectifs, un cadre à deux Dimensions (a Two Dimensional Framework for Remanufacturing - 2DFR), est proposé. Il combine les perspectives liées au développement durable et celles liées au système de remanufacturing. Une liste des contraintes liées au remanufacturing est ainsi proposée dans la première partie de la thèse selon ces deux perspectives. Elle a été validée comme un guide de conception pour le remanufacturing lors d’un atelier dans le cadre du projet européen ERN (H2020). Le 2DFR est ensuite utilisé dans la deuxième partie de la thèse pour développer la classification des outils et des méthodes de remanufacturing. Enfin, une méthode pour guider l’utilisateur dans le choix des outils et méthodes de remanufacturing est proposée. Elle est créée à partir de la liste des caractéristiques du remanufacturing apparues dans la première proposition et de la méthode de classification mentionnée précédemment. Un démonstrateur qui fonctionne comme une interface pour les deux méthodes de classification et de choix des outils est développée. Des études de cas permettent d’illustrer son utilisation.Les caractéristiques pour des produits et processus de remanufacturing durables définies dans la première proposition offrent ainsi aux utilisateurs un guide complet lors de la conception et de la prise de décisions. La deuxième proposition, quant à elle, encourage l'utilisation par l'industrie des outils et méthodes académiques existants liés au remanufacturing.Remanufacturing is believed to be among the key strategies for sustainable development of industrial products. The aim of remanufacturing is to retrieve the product’s inherent value when it no longer fulfils the user’s needs. However, it is a non-linear process that poses many uncertainties. Therefore, integrating remanufacturing concerns during the early design phase is necessary to adapt products to the future remanufacturing processes and to the future remanufacturing system.Another crucial aspect in achievingsustainable remanufacturing activity is to plan and coordinate remanufacturing system in a sustainable way. The presence of various academic tools and methods to facilitate remanufacturing activities might overcome the challenges observed and enhance both the quality and quantity. Unfortunately, these tools/methods are rarely used by remanufacturing stakeholders, probably due to the lack of platform for them to facilitate the usage.The objective of this dissertation is to help the designers and remanufacturers to:• Characterize remanufactured products and processes in relation to sustainable development,• Classify and choose remanufacturing tools ormethods to improve sustainable remanufacturing.To achieve these objectives, a Two Dimensional Framework for Remanufacturing (2DFR) is proposed. It combines the sustainable development and remanufacturing system perspectives. A list of remanufacturing constraints from both perspectives is proposed in the first part of this dissertation. It was validated as a design for remanufacturing guideline during a remanufacturing workshop event in the framework of the European project ERN (H2020). The 2DFR is used again in the second part of this dissertation to develop a method to classify remanufacturing tools/methods. A method to guide and facilitate user in choosing remanufacturing tools/methods is proposed using the list of remanufacturing characteristics listed in the first proposition and the previous classification method. A configurator that functions as an interface for both the classification method and the choosing method is developed. Illustrated case studies are presented to validate its usage.The characteristics of sustainable remanufacturing products and processes defined in the first proposition offer to the users a comprehensive checklist when designing and making decisions. Meanwhile the second proposition encourages the usage by the industry of the existing academics tools/methods related to remanufacturing

PENGUKURAN JANGKAUAN GERAK PADA LUTUT ORANG INDONESIA SEBAGAI DATA AWAL PERANCANGAN KAKI TIRUAN ATAS LUTUT

Penyandang disabilitas kaki akibat proses amputasi atau disabilitas bawaan sejak lahir di Indonesia memiliki pilihan untuk menggunakan kaki tiruan dengan sendi konvensional dan kaki tiruan dengan sendi mekanik. Sayangnya produk kaki tiruan dengan sendi mekanik masih didominasi oleh produk impor. Langkah awal dari upaya menggantikan kaki tiruan atas lutut (above knee prostheses) produk impor dengan produk dalam negeri adalah dengan melakukan penelitian mengenai jangkauan gerak (range of motion) pada sendi lutut. Range of motion (RoM) pada orang Indonesia, yang memiliki ras Mongoloid, dapat memiliki perbedaan dengan rancangan jangkauan gerak pada kaki tiruan produk impor yang telah dijual di Indonesia. Perbedaan dapat dijumpai akibat adanya perbedaan antropometri postur orang Indonesia yang diklasifikasikan sebagai ras Mongoloid dengan penduduk Eropa/Amerika yang tergolong ras Kaukasoid. Begitu juga dengan beberapa aktifitas yang dominan dilakukan oleh orang Indonesia. Tujuan dari penelitian ini adalah mendapatkan data pengukuran RoM bagi orang Indonesia saat melakukan gerakan sehari-hari untuk diolah menjadi data ilmiah yang penting untuk digunakan dalam proses desain dan perancangan kaki tiruan. Metode penelitian ini bersifat eksperimental dengan mengambil data jangkauan gerak (RoM) orang Indonesia dengan variasi: jenis kelamin, berat badan dan dua jenis gerakan. Gerakan utama yang akan diambil adalah gerakan sujud dan gerakan duduk pertama pada shalat. Hasil pengukuran jangkauan gerak lutut saat responden melakukan gerakan duduk pertama dalam salat berkisar antara 145°-160°. Rata-rata jangkauan gerak lutut saat responden adalah 152°. Hasil ini menunjukkan kebutuhan jangkauan gerak yang sangat besar pada aktifitas duduk tersebut. Data gerakan sendi lutut yang telah didapatkan akan digunakan untuk mendesain karakteristik lutut pada kaki tiruan buatan produk domestik dengan karakter gerakan orang Indonesia. Kata kunci: jangkauan gerak, kaki tiruan, orang Indonesia, sendi lutu

Analysis of the existing design for remanufacturing tools: A first step toward an integrated design platform for remanufacturing

International audienceMany researches have been done to facilitate remanufacturing process and optimize its benefits, and, as a result, several tools and methodologies have been developed. This research aims to integrate these methodologies and tools into a more practical and useful integrated design framework.Since existing tools and methodologies have a wide range of applications and objectives, their interconnection is not a trivial task. The contribution of this paper is to provide an analysis grid for analyzing and classifying these existing tools (or methods) into a two-dimensional framework. The first dimension contains the four pillars of sustainable development “extended” framework (economic, social, environmental and technical aspects) identified by Fatimah [Fatimah 2013]. The second dimension is based on the six elements of a remanufacturing system (product design, reverse supply chain, information flow, employee knowledge and skill, remanufacturing operation and product marketing) proposed by Barquet [Barquet 2013]. The grid is presented and the input and output parameters of 7 existing tools (or methods) are analyzed using our grid. As a conclusion, this analysis indicates that none of the tool (or method) has a significant overlap and some interesting synergies are identified

Decision Making System for Designing Products and Production Systems for Remanufacturing Activities

International audienc

Paediatric COVID-19 mortality: a database analysis of the impact of health resource disparity

Background The impact of the COVID-19 pandemic on paediatric populations varied between high-income countries (HICs) versus low-income to middle-income countries (LMICs). We sought to investigate differences in paediatric clinical outcomes and identify factors contributing to disparity between countries.Methods The International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC) COVID-19 database was queried to include children under 19 years of age admitted to hospital from January 2020 to April 2021 with suspected or confirmed COVID-19 diagnosis. Univariate and multivariable analysis of contributing factors for mortality were assessed by country group (HICs vs LMICs) as defined by the World Bank criteria.Results A total of 12 860 children (3819 from 21 HICs and 9041 from 15 LMICs) participated in this study. Of these, 8961 were laboratory-confirmed and 3899 suspected COVID-19 cases. About 52% of LMICs children were black, and more than 40% were infants and adolescent. Overall in-hospital mortality rate (95% CI) was 3.3% [=(3.0% to 3.6%), higher in LMICs than HICs (4.0% (3.6% to 4.4%) and 1.7% (1.3% to 2.1%), respectively). There were significant differences between country income groups in intervention profile, with higher use of antibiotics, antivirals, corticosteroids, prone positioning, high flow nasal cannula, non-invasive and invasive mechanical ventilation in HICs. Out of the 439 mechanically ventilated children, mortality occurred in 106 (24.1%) subjects, which was higher in LMICs than HICs (89 (43.6%) vs 17 (7.2%) respectively). Pre-existing infectious comorbidities (tuberculosis and HIV) and some complications (bacterial pneumonia, acute respiratory distress syndrome and myocarditis) were significantly higher in LMICs compared with HICs. On multivariable analysis, LMIC as country income group was associated with increased risk of mortality (adjusted HR 4.73 (3.16 to 7.10)).Conclusion Mortality and morbidities were higher in LMICs than HICs, and it may be attributable to differences in patient demographics, complications and access to supportive and treatment modalities

Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19

Background: We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world's largest international, standardized data sets concerning hospitalized patients. Methods: The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admission to an intensive care unit (ICU) and invasive mechanical ventilation (IMV). Results: Data were available for 689 572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10 years 1.49 (95% CI 1.48, 1.49)] and male sex [1.23 (1.21, 1.24)] were associated with a higher risk of death. Rates of admission to an ICU and use of IMV increased with age up to age 60 years then dropped. Symptoms, co-morbidities and treatments varied by age and had varied associations with clinical outcomes. The case-fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients and was on average 21.5%. Conclusions: Age was the strongest determinant of risk of death, with a ∼30-fold difference between the oldest and youngest groups; each of the co-morbidities included was associated with up to an almost 2-fold increase in risk. Smoking and obesity were also associated with a higher risk of death. The size of our international database and the standardized data collection method make this study a comprehensive international description of COVID-19 clinical features. Our findings may inform strategies that involve prioritization of patients hospitalized with COVID-19 who have a higher risk of death

Thrombotic and hemorrhagic complications of COVID-19 in adults hospitalized in high-income countries compared with those in adults hospitalized in low- and middle-income countries in an international registry

Background: COVID-19 has been associated with a broad range of thromboembolic, ischemic, and hemorrhagic complications (coagulopathy complications). Most studies have focused on patients with severe disease from high-income countries (HICs). Objectives: The main aims were to compare the frequency of coagulopathy complications in developing countries (low- and middle-income countries [LMICs]) with those in HICs, delineate the frequency across a range of treatment levels, and determine associations with in-hospital mortality. Methods: Adult patients enrolled in an observational, multinational registry, the International Severe Acute Respiratory and Emerging Infections COVID-19 study, between January 1, 2020, and September 15, 2021, met inclusion criteria, including admission to a hospital for laboratory-confirmed, acute COVID-19 and data on complications and survival. The advanced-treatment cohort received care, such as admission to the intensive care unit, mechanical ventilation, or inotropes or vasopressors; the basic-treatment cohort did not receive any of these interventions. Results: The study population included 495,682 patients from 52 countries, with 63% from LMICs and 85% in the basic treatment cohort. The frequency of coagulopathy complications was higher in HICs (0.76%-3.4%) than in LMICs (0.09%-1.22%). Complications were more frequent in the advanced-treatment cohort than in the basic-treatment cohort. Coagulopathy complications were associated with increased in-hospital mortality (odds ratio, 1.58; 95% CI, 1.52-1.64). The increased mortality associated with these complications was higher in LMICs (58.5%) than in HICs (35.4%). After controlling for coagulopathy complications, treatment intensity, and multiple other factors, the mortality was higher among patients in LMICs than among patients in HICs (odds ratio, 1.45; 95% CI, 1.39-1.51). Conclusion: In a large, international registry of patients hospitalized for COVID-19, coagulopathy complications were more frequent in HICs than in LMICs (developing countries). Increased mortality associated with coagulopathy complications was of a greater magnitude among patients in LMICs. Additional research is needed regarding timely diagnosis of and intervention for coagulation derangements associated with COVID-19, particularly for limited-resource settings

At-admission prediction of mortality and pulmonary embolism in an international cohort of hospitalised patients with COVID-19 using statistical and machine learning methods

By September 2022, more than 600 million cases of SARS-CoV-2 infection have been reported globally, resulting in over 6.5 million deaths. COVID-19 mortality risk estimators are often, however, developed with small unrepresentative samples and with methodological limitations. It is highly important to develop predictive tools for pulmonary embolism (PE) in COVID-19 patients as one of the most severe preventable complications of COVID-19. Early recognition can help provide life-saving targeted anti-coagulation therapy right at admission. Using a dataset of more than 800,000 COVID-19 patients from an international cohort, we propose a cost-sensitive gradient-boosted machine learning model that predicts occurrence of PE and death at admission. Logistic regression, Cox proportional hazards models, and Shapley values were used to identify key predictors for PE and death. Our prediction model had a test AUROC of 75.9% and 74.2%, and sensitivities of 67.5% and 72.7% for PE and all-cause mortality respectively on a highly diverse and held-out test set. The PE prediction model was also evaluated on patients in UK and Spain separately with test results of 74.5% AUROC, 63.5% sensitivity and 78.9% AUROC, 95.7% sensitivity. Age, sex, region of admission, comorbidities (chronic cardiac and pulmonary disease, dementia, diabetes, hypertension, cancer, obesity, smoking), and symptoms (any, confusion, chest pain, fatigue, headache, fever, muscle or joint pain, shortness of breath) were the most important clinical predictors at admission. Age, overall presence of symptoms, shortness of breath, and hypertension were found to be key predictors for PE using our extreme gradient boosted model. This analysis based on the, until now, largest global dataset for this set of problems can inform hospital prioritisation policy and guide long term clinical research and decision-making for COVID-19 patients globally. Our machine learning model developed from an international cohort can serve to better regulate hospital risk prioritisation of at-risk patients