State-of-the-art on product-service systems and digital technologies

Digitalization has undoubtedly revolutionized the way businesses think, plan and operate. This transition finds origin in the dramatic increase in demand of digital solutions, from those that target every day activities to highly-specific manufacturing processes. The last decades have been characterized for having both researchers and practitioners join efforts to innovate through solutions that are smarter, more productive and more efficient. This constant effort has accompanied the appearance of other impactful phenomena, often considered as a new industrial revolution. In a historically parallel line, companies made leaps towards exploring alternative ways to organize their business structure and relate to their customers. So is the case of Product-Service Systems (PSS), which have called for increased attention in the last years due to the extensive opportunities they offer. Recent literature raises the question of which and how sustainability advantages can be derived from PSS implementation. This study aims to understand the interactions of digital technologies and PSS through a state-of-the-art review. The authors have identified that academic literature encounters the challenge of finding digital technologies under a large cloud of different terminologies, which complicates systematization. Therefore, increased efforts will be applied to clarify the area of study and provide novel insights and results. This process will include the dissemination of enablers, constrains and possible effects of integrating digital technologies with PSS. The authors aim to contribute to the on-going discussion regarding the relationship between PSS and sustainability, specifically in applications that have high impacts, such as digital technologies

Glutamic acid decarboxylase antibody-associated neurological syndromes: Clinical and antibody characteristics and therapy response

Background: Antibodies against glutamic acid decarboxylase (GAD-abs) at high serum levels are associated with diverse autoimmune neurological syndromes (AINS), including cerebellar ataxia, epilepsy, limbic encephalitis and stiff-person syndrome. The impact of low serum GAD-ab levels in patients with suspected AINS remains controversial. Specific intrathecal GAD-ab synthesis may serve as a marker for GAD-ab-associated nervous system autoimmunity. We present characteristics of a multicentric patient cohort with suspected AINS associated with GAD antibodies (SAINS-GAD+) and explore the relevance of serum GAD-ab levels and intrathecal GAD-ab synthesis. Methods: All patients with SAINS-GAD+ included in the registry of the German Network for Research on Autoimmune Encephalitis (GENERATE) from 2011 to 2019 were analyzed. High serum GAD-ab levels were defined as RIA>2000 U/mL, ELISA>1000 U/mL, or as a positive staining pattern on cell-based assays. Results: One-hundred-one patients were analyzed. In descending order they presented with epilepsy/limbic encephalitis (39%), cerebellar ataxia (28%), stiff person syndrome (22%), and overlap syndrome (12%). Immunotherapy was administered in 89% of cases with improvements in 46%. 35% of SAINS-GAD+ patients had low GAD-ab serum levels. Notably, unmatched oligoclonal bands in CSF but not in serum were more frequent in patients with low GAD-ab serum levels. GAD-ab-levels (high/low) and intrathecal GAD-ab synthesis (present or not) did not impact clinical characteristics and outcome. Conclusions: Overall, immunotherapy in SAINS-GAD+ was moderately effective. Serum GAD-ab levels and the absence or presence of intrathecal GAD-ab synthesis did not predict clinical characteristics or outcomes in SAINS-GAD+. The detection of unmatched oligoclonal bands might outweigh low GAD-ab serum levels