The impact of digital twins on the evolution of intelligent manufacturing and Industry 4.0.

As the adoption of Industry 4.0 advances and the manufacturing process becomes increasingly digital, the Digital Twin (DT) will prove invaluable for testing and simulating new parameters and design variants. DT solutions build a 3D digital replica of the physical object allowing the managers to develop better products, detect physical issues sooner, and predict outcomes more accurately. In the past few years, Digital Twins (DTs) dramatically reduced the cost of developing new manufacturing approaches, improved efficiency, reduced waste, and minimized batch-to-batch variability. This paper aims to highlight the evolution of DTs, review its enabling technologies, identify challenges and opportunities for implementing DT in Industry 4.0, and examine its range of applications in manufacturing, including smart logistics and supply chain management. The paper also highlights some real examples of the application of DT in manufacturing.

Adaptation Strategies for Automated Machine Learning on Evolving Data.

Automated Machine Learning (AutoML) systems have been shown to efficiently build good models for new datasets. However, it is often not clear how well they can adapt when the data evolves over time. The main goal of this study is to understand the effect of concept drift on the performance of AutoML methods, and which adaptation strategies can be employed to make them more robust to changes in the underlying data. To that end, we propose 6 concept drift adaptation strategies and evaluate their effectiveness on a variety of AutoML approaches for building machine learning pipelines, including Bayesian optimization, genetic programming, and random search with automated stacking. These are evaluated empirically on real-world and synthetic data streams with different types of concept drift. Based on this analysis, we propose ways to develop more sophisticated and robust AutoML techniques.

No age thresholds in the emergency department: A retrospective cohort study on age differences.

Emergency care in elderly patients has gained attention by researchers due to high utilization rate and the importance of emergency services in elderly care. We examine if there is a clear age threshold between young and old patients at which there is a need for extra care and facilities in the emergency department. This retrospective cohort study uses emergency department (ED) data collected over the course of a year, containing information about 31,491 patient visits. The measured variables are treatment time, waiting time, number of tests, number of medical procedures, number of specialties involved and the patient's length of stay on the ED. To examine the multivariate differences between different patient groups, the data set is split into eighteen age groups and a MANOVA analysis is conducted to compare group means. The results show that older patients tend to have a longer stay on the ED. They also require more medical tests, have higher resource utilization and admission rates to the hospital. When the patients are grouped according to life stages (<18, 18-39, 40-64 and ≥65), each life stage shows significantly different characteristics across all variables. To understand where these differences start, age bins of five years are analyzed and almost none of the consecutive groups are significantly different in any variable. A significant difference between all groups is observed when age interval of the bins is increased to 10 years. This indicates that although age has an effect on the patient's treatment, a clear age threshold that identifies the group of elderly patients is not observable from emergency room variables. The results of this study show no clear age boundary between young and old patients. In other words, we could not find support for favoring the often-used age boundary of 65 over other boundaries (e.g. 60 or 70) to distinguish the group of elderly patients on the ED.

Accessory nerve function after level 2b-preserving selective neck dissection.

BACKGROUND: The aim of this prospective study was to evaluate the relationship between accessory nerve functions and level 2b-preserving selective neck dissection. METHODS: Forty-one necks of 30 patients with laryngeal cancer who underwent unilateral or bilateral level 2b-preserving neck dissections, between February 2003 and July 2005, were evaluated. Neck and shoulder movements and muscle strengths were examined and electroneuromyography (ENMG) was performed preoperatively at the postoperative 21st day and 6th month. Pathological anatomical findings at the postoperative 6th month were also evaluated. RESULTS: All shoulder movements and muscle strengths were preserved. Neck extension, rotation movements, and flexion strengths were restricted. ENMG values were affected moderately in the early postoperative period and improved slightly in the late postoperative period. None of the patients developed shoulder syndrome or adhesive capsulitis. CONCLUSION: Preserving level 2b during selective neck dissection decreases trauma to the accessory nerve and improves functional results.

Atypical angiofibromas: a report of four cases.

In this study, our four patients with angiofibroma with various atypical features are presented. Related literature is reviewed and criteria for atypicality are proposed. 14 patients, diagnosed and treated for angiofibroma in the Otorhinolaryngology Department of Faculty of Medicine in Uludag University between January 1992 and December 2003, have been evaluated. The files of the patients were examined and four patients with atypical characteristics have been included in the study. Angiofibromas presenting with at least one of the following criteria such as origin or location other than nasopharynx, presenting complaints other than nasal obstruction or epistaxis, aged younger than seven or older than 25, female sex, atypical histopathology and multifocalitiy were considered as "atypical". Four of 14 angiofibromas (28.5%), which were diagnosed and treated in our clinic, had atypical features. The reasons for atypicality were unusual localization in three patients and uncommon initial symptom in one case. In the atypical localization group, neoplasm was located in tonsil in one case, and in inferior turbinate in two patients. The only patient with atypical initial symptom presented with a bulging in the cheek. The patients, who have different characteristics other than classical angiofibromas, may be called "Atypical Angiofibroma (AAF)", under the scope of the related literature and our experience. These patients should be included in atypical group according to the characteristics such as, localization, symptom, age, sex, histopathology and multifocality.