Exploring the integration of the human as a flexibility factor in CPS enabled manufacturing environments: methodology and results

Cyber Physical Systems (CPS) are expected to shape the evolution of production towards the fourth industrial revolution named Industry 4.0. The increasing integration of manufacturing processes and the strengthening of the autonomous capabilities of manufacturing systems make investigating the role of humans a primary research objective in view of emerging social and demographic megatrends. Understanding how the employees can be better integrated to enable increased flexibility in manufacturing systems is a prerequisite to allow technological solutions, as well as humans, to harness their full potential. Humans can supervise and adjust the settings, be a source of knowledge and competences, can diagnose situations, take decisions and several other activities influencing manufacturing performances, overall providing additional degrees of freedom to the systems. This paper, studies two different integration models: Human-in-the-Loop and Human-in-the-Mesh. They are both analysed in the context of four industrial cases of deployment of cyber physical systems in production

From key business factors to KPIs within a reconfigurable and flexible cyber-physical system

In a global market characterized by strong competition and quickly changing boundary conditions, flexible and reconfigurable production systems can rapidly react to both endogenous and exogenous drivers. To this extent, it is necessary to define a new production system model, which can combine the most significant key business factors (KBFs), in order to meet the specified objectives and the relevant KPIs and to control the system. The model can be used within a cyber-physical system, to properly support the different functions and take the right decisions through simulation ICT tools. This research task is part of PERFoRM (Production harmonizEd Reconfiguration of Flexible Robots and Machinery), a European funded project, which aims at developing an innovative manufacturing system based on a new agile concept introducing the implementation of methods, methodologies and strategies for transforming existing production systems into plug-and-produce production ones based on Cyber-Physical Systems technologies. In particular, this paper aims at describing the relationships among the KBFs (Key Business Factors), namely the drivers of the production system, and the relevant KPIs. The model has been validated through an industrial use case, in order to gain important information about constraints and opportunities for improvement in other contexts.This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 680435.This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 680435.info:eu-repo/semantics/publishedVersio

Psychological treatments and psychotherapies in the neurorehabilitation of pain. Evidences and recommendations from the italian consensus conference on pain in neurorehabilitation

BACKGROUND: It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams. OBJECTIVES: To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases. METHODS: A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions. RESULTS: The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive-Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post-Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache. CONCLUSIONS: Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the pape

Communication and visiting policies in Italian intensive care units during the first COVID-19 pandemic wave and lockdown: a nationwide survey

Background: During the first coronavirus disease 2019 (COVID-19) pandemic wave, an unprecedented number of patients with respiratory failure due to a new, highly contagious virus needed hospitalization and intensive care unit (ICU) admission. The aim of the present study was to describe the communication and visiting policies of Italian intensive care units (ICUs) during the first COVID-19 pandemic wave and national lockdown and compare these data with prepandemic conditions. Methods: A national web-based survey was conducted among 290 Italian hospitals. Each ICU (active between February 24 and May 31, 2020) was encouraged to complete an individual questionnaire inquiring the hospital/ICU structure/organization, communication/visiting habits and the role of clinical psychology prior to, and during the first COVID-19 pandemic wave. Results: Two hundred and nine ICUs from 154 hospitals (53% of the contacted hospitals) completed the survey (202 adult and 7 pediatric ICUs). Among adult ICUs, 60% were dedicated to COVID-19 patients, 21% were dedicated to patients without COVID-19 and 19% were dedicated to both categories (Mixed). A total of 11,102 adult patients were admitted to the participating ICUs during the study period and only approximately 6% of patients received at least one visit. Communication with family members was guaranteed daily through an increased use of electronic devices and was preferentially addressed to the same family member. Compared to the prepandemic period, clinical psychologists supported physicians more often regarding communication with family members. Fewer patients received at least one visit from family members in COVID and mixed-ICUs than in non-COVID ICUs, l (0 [0–6]%, 0 [0–4]% and 11 [2–25]%, respectively, p < 0.001). Habits of pediatric ICUs were less affected by the pandemic. Conclusions: Visiting policies of Italian ICUs dedicated to adult patients were markedly altered during the first COVID-19 wave. Remote communication was widely adopted as a surrogate for family meetings. New strategies to favor a family-centered approach during the current and future pandemics are warranted

Psychological Treatments and Psychotherapies in the Neurorehabilitation of Pain: Evidences and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation

Background: It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams.Objectives: To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases.Methods: A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions.Results: The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive\u2014Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post\u2014Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache.Conclusions: Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the paper

What is the role of the placebo effect for pain relief in neurorehabilitation? Clinical implications from the Italian Consensus Conference on Pain in Neurorehabilitation

Background: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use. Methods: A review of the existing reviews and meta-analyses was performed to assess the magnitude of the placebo effect in disorders that may undergo neurorehabilitation treatment. The search was performed on Pubmed using placebo, pain, and the names of neurological disorders as keywords. Methodological quality was assessed using a pre-existing checklist. Data about the magnitude of the placebo effect were extracted from the included reviews and were commented in a narrative form. Results: 11 articles were included in this review. Placebo treatments showed weak effects in central neuropathic pain (pain reduction from 0.44 to 0.66 on a 0-10 scale) and moderate effects in postherpetic neuralgia (1.16), in diabetic peripheral neuropathy (1.45), and in pain associated to HIV (1.82). Moderate effects were also found on pain due to fibromyalgia and migraine; only weak short-term effects were found in complex regional pain syndrome. Confounding variables might have influenced these results. Clinical implications: These estimates should be interpreted with caution, but underscore that the placebo effect can be exploited in neurorehabilitation programs. It is not necessary to conceal its use from the patient. Knowledge of placebo mechanisms can be used to shape the doctor-patient relationship, to reduce the use of analgesic drugs and to train the patient to become an active agent of the therapy

World Society of Emergency Surgery (WSES) guidelines for management of skin and soft tissue infections

Peer reviewe

Resilient manufacturing systems enabled by AI support to AR equipped operator

Supply chains and manufacturing systems robustness and resilience are, for many years, but especially nowadays, key features requested to ensure reliable and efficient production processes. Two domains are crucial to achieve such purpose: the former is fast and comprehensive monitoring, efficient and reliable condition detection and effective and explicable support for decision making. The latter refers to the intervention by operators, able to better identify problems and to put in place effective operations aimed at fixing it or, better, to prevent such circumstances. This paper presents an integrated approach encompassing a sophisticated IoT and AI-based approach to monitor and detect critical situations, fully integrated with an AR (Augmented Reality) system supporting operators in the field to take informed actions in bi-directional continuous connection. Activities in the context of EC funded project Qu4lity developed in Politecnico di Milano Industry 4.0 Lab, a test environment implementing the proposed approach and demonstrating in an automated production line the effectiveness of the approach, significantly improving performances. Analysis of performance indicators demonstrates the soundness of the proposed solution and implementation methodology to make the overall production process more resilient, efficient and with product defects reduction

ICT in Manufacturing: Trends and Challenges for 2020 – an European View

Agitated by the financial crisis in 2008 and occupied by the national debt debate since 2010, European companies need to take actions to recover from lost opportunities during the last years. The manufacturing sector still plays a major role in the European economy and is seen as a vital sector for the successful future of a common Europe. Acclaiming success in the private sector on a regularly basis, ICT has been identified as a key driver with a high potential to enhance European manufacturing industry in a sustainable way. The paper presents an approach of deriving new research priorities in Europe for the Horizon 2020 agenda. Based on agile roadmapping methodology, six ICT core areas for investments in research projects have been identified