ABSTRACT
Sustainable production aims at creating products from processes that minimize environmental impact, energy consumption and natural resources. Customers and markets are ever more leaning towards digital, custom, and flexible solutions with lower environmental impact. Hence, Industry 4.0 (I4.0) solutions are increasingly including social and environmental sustainability aspects. We focus on the realization of an infrastructure integrating industrially relevant application modules by combining system reconfigurability and artificial intelligence, towards sustainable production. To meet the final goal of sustainable production, we address four challenges considering flexibility and sustainability in production in a holistic way: (1) developing infrastructural and methodological tools to support companies to explore the potential of I4.0 towards sustainable production; (2) managing the configurability and customization possibilities of products; (3) effectively handling the flexibility provided by a production system with rapid reconfiguration capabilities; (4) integrating hardware and software flexibility by using reconfigurable robotics and machine learning methods. By developing and connecting different application modules, we obtain a physical demonstrator which represents on the one hand an exemplary scenario of reconfigurable and flexible production system; on the other, it enables new research activities and insights with a see, touch & feel approach for industrial and research realities.
ABSTRACT
PURPOSE: The aim of this study was to investigate changes in exercise capacity (EC) and quality of life (QoL) of patients with ventricular assist devices (VADs) during cardiac rehabilitation (CR). METHODS: Data from patients with VAD implantation and subsequent CR between 2007 and 2017 were analyzed retrospectively. Measures of the 6-min walk test [6MWT] distance, Functional Independence Measure [FIM], ergometry, MacNew Heart Disease Questionnaire [MNH], and Hospital Anxiety and Depression Scale [HADS] at entry and discharge were examined. RESULTS: Data from 110 patients (age 53 ± 12 yr; male 82%) were analyzed. Patients improved during CR significantly in the 6MWT (114 ± 85 m, P < .001), ergometry (20 ± 17 W, P = .002), FIM (8 ± 7 points, P < .001), and MNH (0.8 ± 0.7 points, P < .001). Initial HADS levels were high with a mean value of 9 and did not improve during CR (-0.4 ± 5 points, P = .637). Significant differences of improvements in the 6MWT were observed between left and biventricular VAD (129 ± 90 m vs 85 ± 67 m, P = .043) as well as destination therapy and bridge-to-transplant (184 ± 88 m vs 102 ± 82 m, P = .005). CONCLUSIONS: Patients with VAD implantation had statistically and clinically significant improvements in EC and QoL as assessed with the MNH during CR. Patients on destination therapy showed a larger benefit from CR than bridge-to-transplant patients and patients with left VAD improved more than biventricular VAD patients.
