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BackgroundAutomated Internet intervention studies have generally had large dropout rates for follow-up assessments. Live phone follow-ups have been often used to increase follow-up completion rates.ObjectiveTo compare, via a randomized study, whether receiving phone calls improves follow-up rates beyond email reminders and financial incentives in a depression prevention study.MethodA sample of 95 participants (63 English-speakers and 32 Spanish-speakers) was recruited online to participate in a "Healthy Mood" study. Consented participants were randomized to either a Call or a No Call condition. All participants were sent up to three email reminders in one week at 1, 3, and 6 months after consent, and all participants received monetary incentives to complete the surveys. Those in the Call condition received up to ten follow-up phone calls if they did not complete the surveys in response to email reminders.ResultsThe follow-up rates for Call vs. No Call conditions at 1, 3, and 6 months, respectively, were as follows: English speakers, 58.6% vs. 52.9%, 62.1% vs. 52.9%, and 68.9% vs. 47.1%; Spanish speakers, 50.0% vs. 35.7%, 33.3% vs. 21.4%, and 33.3% vs. 7.1%. The number of participants who completed follow-up assessments only after being called at 1-, 3- and 6 months was 2 (14.3%), 0 (0%), and 3 (25.0%) for English speakers, and 2 (18.9%), 0 (0%), and 1 (7.7%) for Spanish speakers. The number of phone calls made to achieve one completed follow-up was 58.8 in the English sample and 57.7 and Spanish-speaking sample.ConclusionsAdding phone call contacts to email reminders and monetary incentives did increase follow-up rates. However, the rate of response to follow-up was low and the number of phone calls required to achieve one completed follow-up raises concerns about the utility of adding phone calls. We also discuss difficulties with using financial incentives and their implications.

Abstract Human papillomavirus (HPV)‐related cervical and nasopharyngeal cancers differ in molecular mechanisms underlying the oncogenic processes. The disparity may be attributed to differential expression of oncoproteins. The current study investigated the host oncogenes expression pattern in HPV‐associated cervical and nasopharyngeal cancer. Formalin‐fixed paraffin‐embedded tissues originating from the nasopharyngeal and cervical regions were screened using Hematoxylin and Eosin staining. Genomic DNA and total RNA were extracted from confirmed cancer biopsies and non‐cancer tissues (NC). HPV was detected by PCR using MY09/GP5+/6+ primers. Protein expression levels of AKT, IQGAP1, and MMP16 in HPV‐infected cancers and controls were determined by immunohistochemistry. RT‐qPCR was used to profile mRNAs of the oncogenes. AKT and IQGAP1 proteins were highly expressed in the epithelial cancers compared with the non‐cancer tissues (p 0.05). The oncoproteins expression level between the HPV‐positive and HPV‐negative cancer biopsies showed no significant difference (p

Abstract Background Despite tremendous progress in antiretroviral therapy (ART) and access to ART, many patients have advanced human immunodeficiency virus (HIV) disease (AHD). Patients on AHD, whether initiating ART or providing care after disengagement, have an increased risk of morbidity and mortality. The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) launched an enhanced care package using a hub-and-spoke model to optimize AHD care in Malawi. This model improves supply availability and appropriate linkage to care. We utilized a hub-and-spoke model to share health facility challenges and recommendations on the AHD package for screening and diagnosis, prophylaxis, treatment, and adherence support. Methods This qualitative study assessed the facility-level experiences of healthcare workers (HCWs) and lay cadres (LCs) providing AHD services to patients through an intervention package. The study population included HCWs and LCs supporting HIV care at four intervention sites. Eligible study participants were recruited by trained Research Assistants with support from the health facility nurse to identify those most involved in supporting patients with AHD. A total of 32 in-depth interviews were conducted. Thematic content analysis identified recurrent themes and patterns across participants’ responses. Results While HCWs and LCs stated that most medications are often available at both hub and spoke sites, they reported that there are sometimes limited supplies and equipment to run samples and tests necessary to provide AHD care. More than half of the HCWs stated that AHD training sufficiently prepared them to handle AHD patients at both the hub and spoke levels. HCWs and LCs reported weaknesses in the patient referral system within the hub-and-spoke model in providing a linkage of care to facilities, specifically improper referral documentation, incorrect labeling of samples, and inconsistent availability of transportation. While HCWs felt that AHD registers were time-consuming, they remained motivated as they thought they provided better patient services. Conclusions These findings highlight the importance of offering comprehensive AHD services. The enhanced AHD program addressed weaknesses in service delivery through decentralization and provided services through a hub-and-spoke model, improved supply availability, and strengthened linkage to care. Additionally, addressing the recommendations of service providers and patients is essential to improve the health and survival of patients with AHD.

[This corrects the article DOI: 10.1371/journal.pone.0248410.].

Neural Networks (NN) are often trained offline on large datasets and deployed on specialised hardware for inference, with a strict separation between training and inference. However, in many realistic applications the training environment differs from the real world, or data arrives in a streaming fashion and is continuously changing. In these scenarios, the ability to continuously train and update NN models is desirable. Continual learning (CL) algorithms allow training of models on a stream of data. CL algorithms are often designed to work in constrained settings, such as limited memory and computational power, or limitations on the ability to store past data (e.g, due to privacy concerns or memory requirements). High-energy physics experiments are developing intelligent detectors, with algorithms running on computer systems located close to the detector to meet the challenges of increased data rates and occupancies. The use of NN algorithms in this context is limited by changing detector conditions, such as degradation over time or failure of an input signal which might cause the NNs to lose accuracy leading, in the worst case to the loss of interesting events. CL has the potential to solve this issue, using large amounts of continuously streaming data to allow the network to recognise changes, and to learn and adapt to detector conditions. It has the potential to outperform traditional NN training techniques as not all possible scenarios can be predicted and modelled in static training data samples. However, NN training is computationally expensive and when combined with the strict timing requirements of embedded processors deployed close to the detector, current state-of-the-art offline approaches cannot be directly applied to the real-time systems. Alternatives to typical backpropagation-based training that can be deployed on FPGAs for real-time data processing are presented, and their computational and accuracy characteristics are discussed in the context of High-Luminosity LHC.

The High-Luminosity LHC upgrade of the CMS experiment will utilise a large number of Machine Learning (ML) based algorithms in its hardware-based trigger. These ML algorithms will facilitate the selection of potentially interesting events for storage and offline analysis. Strict latency and resource requirements limit the size and complexity of these models due to their use in a high-speed trigger setting and deployment on FPGA hardware. It is envisaged that these ML models will be trained on large, carefully tuned, Monte Carlo datasets and subsequently deployed in a real-world detector environment. Not only is there a potentially large difference between the MC training data and real-world conditions but these detector conditions could change over time leading to a shift in model output which could degrade trigger performance. The studies presented explore different techniques to reduce the impact of this effect, using the CMS track finding and vertex trigger algorithms as a test case. The studies compare a baseline retraining and redeployment of the model and episodic training of a model as new data arrives in a continual learning context. The results show that a continually learning algorithm outperforms a simple retrained model when degradation in detector performance is applied to the training data and is a viable option for maintaining performance in an evolving environment such as the High-Luminosity LHC.

IntroductionThe Malawi Ministry of Health (MoH) has been in collaboration with Médecins sans Frontières (MSF) to increase access to quality HIV care through decentralization of antiretroviral therapy (ART) diagnosis and treatment from hospital to clinics in Nsanje District since 2011. A population-based household survey was implemented to provide information on HIV prevalence and cascade of care to inform and prioritize community-based HIV interventions in the district.MethodsA cross-sectional survey was conducted between September 2016 and January 2017. Using two-stage cluster sampling, eligible adult individuals aged ≥15 years living in the selected households were asked to participate. Participants were interviewed and tested for HIV at home. Those tested HIV-positive had their HIV-RNA viral load (VL) measured, regardless of their ART status. All participants tested HIV-positive at the time of the survey were advised to report their HIV test result to the health facility of their choice that MSF was supported in the district. HIV-RNA VL results were made available in this health facility.ResultsAmong 5,315 eligible individuals, 91.1% were included in the survey and accepted an HIV test. The overall prevalence was 12.1% (95% Confidence Interval (CI): 11.2-13.0) and was higher in women than in men: 14.0% versus 9.5%, PConclusionsDespite encouraging results in HIV testing coverage, cascade of care, and UNAIDS targets in Nsanje District, some gap remains in the first 90, specifically among men and young adults. Enhanced community engagement and new strategies of testing, such as index testing, could be implemented to identify those who are still undiagnosed, particularly men and young adults.

Although studies suggest that patients with diabetes with a serious mental illness (SMI) have poor diabetes outcomes, reports conflict regarding the quality of their diabetes care and level of glucose control. In an observational follow-up to our initial cross-sectional study, we compared glucose control (glycosylated hemoglobin [HbA1c]) between patients with diabetes with SMI versus those without SMI at two postbaseline assessments during an approximately 5-year period. Both groups continued to have glucose levels higher than what is considered good control and neither group demonstrated a significant change in mean HbA1c at the two follow-up time points. Those with SMI continued to have lower HbA1c levels than those without SMI even after adjusting for potential confounders. More effective strategies are needed to assist patients with diabetes to improve the management of their glucose levels. [ABSTRACT FROM AUTHOR]

OBJECTIVES: We examined the effectiveness of the Sources of Strength suicide prevention program in enhancing protective factors among peer leaders trained to conduct schoolwide messaging and among the full population of high school students. METHODS: Eighteen high schools-6 metropolitan and 12 rural-were randomly assigned to immediate intervention or the wait-list control. Surveys were administered at baseline and 4 months after program implementation to 453 peer leaders in all schools and to 2675 students selected as representative of the 12 rural schools. RESULTS: Training improved the peer leaders' adaptive norms regarding suicide, their connectedness to adults, and their school engagement, with the largest gains for those entering with the least adaptive norms. Trained peer leaders in larger schools were 4 times as likely as were untrained peer leaders to refer a suicidal friend to an adult. Among students, the intervention increased perceptions of adult support for suicidal youths and the acceptability of seeking help. Perception of adult support increased most in students with a history of suicidal ideation. CONCLUSIONS: Sources of Strength is the first suicide prevention program involving peer leaders to enhance protective factors associated with reducing suicide at the school population level. [ABSTRACT FROM AUTHOR]

Following the drug-approval process, concerns remain regarding the safety of new drugs that are introduced into the marketplace. In the case of rare adverse events, the number of subjects that are treated in randomized controlled trials is invariably inadequate to determine the safety of the new pharmaceutical. Identifying safety signals for new and/or existing drugs is a major priority in the protection of public health. Unfortunately, design, analysis, and available data are often quite limited for detecting in a timely fashion any potentially harmful effects of drugs. In this review, we examine a variety of approaches for determining the possibility of adverse drug reactions. Our review includes spontaneous reports, meta-analysis of randomized controlled clinical trials, ecological studies, and analysis of medical claims data. We consider both experimental design and analytic problems as well as potential solutions. Many of these methodologies are then illustrated through application to data on the possible relationship between taking antidepressants and increased risk of suicidality. [ABSTRACT FROM AUTHOR]

In this article, we present a discussion of two general ways in which the traditional randomized trial can be modified or adapted in response to the data being collected. We use the term adaptive design to refer to a trial in which characteristics of the study itself, such as the proportion assigned to active intervention versus control, change during the trial in response to data being collected. The term adaptive sequence of trials refers to a decision-making process that fundamentally informs the conceptualization and conduct of each new trial with the results of previous trials. Our discussion below investigates the utility of these two types of adaptations for public health evaluations. Examples are provided to illustrate how adaptation can be used in practice. From these case studies, we discuss whether such evaluations can or should be analyzed as if they were formal randomized trials, and we discuss practical as well as ethical issues arising in the conduct of these new-generation trials. [ABSTRACT FROM AUTHOR]

Objective: This study identified factors associated with use of the emergency department for medical reasons among individuals with serious mental illness.Methods: A total of 200 randomly selected outpatients who were receiving community-based psychiatric care were recruited for the study and interviewed with items from the National Health Interview Survey and other national health surveys.Results: Emergency department use (37 percent of the sample) was negatively associated with older age and positively associated with the number of co-occurring medical conditions, smoking, recent injury, and recent change in health care provider.Conclusions: The relatively high rate of emergency department use may be suggestive of inappropriate use or may reflect perceived barriers to care. Future work should identify specific reasons for seeking care in the emergency department and develop interventions to optimize appropriate emergency department use. [ABSTRACT FROM AUTHOR]

The overall purpose of this study was to explore the alcohol consumption patterns of adolescents by beverage type. Atotal of 705 primarily 9th grade students were recruited to participate in this study in the spring of 2002. Alcoholic beverage use differed significantly across gender and ethnicity on a number of beverage-specific drinking measures, including initiation, quantity and frequency, binge drinking, chugging, and alcohol problems (p's<.05). Stepwise discriminant analyses indicated that drug use and social beliefs were notably important in discriminating adolescent drinkers from non-drinkers of specific alcoholic beverages. This study's results indicate the need for testing interventions tailored to alcohol consumption patterns including beverage type. [ABSTRACT FROM AUTHOR]

BACKGROUND/OBJECTIVE: Somatic health care utilization was studied among individuals with serious mental illness who were receiving community-based psychiatric services. RESEARCH DESIGN: Cross-sectional study. SUBJECTS: A total of 200 outpatients, 100 with schizophrenia and 100 with affective disorder, were recruited from randomly selected samples receiving care at two psychiatric centers. MEASURES: Patients were interviewed using questions from national health surveys. Multiple logistic regression analyses were used to compare responses from each sample to those of matched subsets of individuals from the general population. RESULTS: The psychiatric samples were more likely to report receiving some medical care services in the past year than were individuals in the general population including having visited a general medical doctor (Odds ratio, schizophrenia sample = 2.04; Odds ratio, affective disorder sample = 2.37) and having a complete physical examination (Odds ratio, schizophrenia sample = 2.69; Odds ratio, affective disorder sample = 1.74). However, our samples were less likely to receive routine dental care (Odds ratio, schizophrenia sample = 0.46; Odds ratio, affective disorder sample = 0.60). Perceived barriers to receiving medical care were reported significantly more often by the patient groups than the comparison groups (Odds ratios > 3). CONCLUSIONS: General health services are widely utilized by individuals with serious mental illness who are in outpatient psychiatric care. Dental services remain underutilized, however, and there is a high rate of perceived barriers to receiving medical care in this population. [ABSTRACT FROM AUTHOR]

Cruciate ligament reconstruction has progressed dramatically in the last 20 years. Anatomic placement of ligament substitutes has fostered rehabilitation efforts that stress immediate and full range of motion, immediate weightbearing, neuromuscular strength and coordination, and early return to athletic competition (3 months). This has placed extreme importance on secure graft fixation at the time of ligament reconstruction. Current ligament substitutes require a bony or soft tissue component to be fixed within a bone tunnel or on the periosteum at a distance from the normal ligament attachment site. Fixation devices have progressed from metal to biodegradable and from far to near-normal native ligament attachment sites. Ideally, the biomechanical properties of the entire graft construct would approach those of the native ligament and facilitate biologic incorporation of the graft. Fixation should be done at the normal anatomic attachment site of the native ligament (aperture fixation) and, over time, allow the biologic return of the histologic transition zone from ligament to fibrocartilage, to calcified fibrocartilage, to bone. The purpose of this article is to review current fixation devices and techniques in cruciate ligament surgery. [ABSTRACT FROM AUTHOR]

The UK’s Defence Science and Technology Laboratory (Dstl) is partnering with the US Naval Research Laboratory (NRL) on a joint mission to launch miniature sensors that will advance space weather measurement and modelling capabilities. The Coordinated Ionospheric Reconstruction Cubesat Experiment (CIRCE) comprises two 6U cube-satellites that will be launched into a near-polar low earth orbit (LEO), targeting 500 km altitude, in 2021. The UK contribution to CIRCE is the In situ and Remote Ionospheric Sensing (IRIS) suite, complementary to NRL sensors, and comprising three highly miniaturised payloads provided to Dstl by University College London (UCL), University of Bath, and University of Surrey/Surrey Satellite Technology Ltd (SSTL). One IRIS suite will be flown on each satellite, and incorporates an ion/neutral mass spectrometer, a tri-band global positioning system (GPS) receiver for ionospheric remote sensing, and a radiation environment monitor. From the US, NRL have provided two 1U Triple Tiny Ionospheric Photometers (Tri-TIPs) on each satellite (Nicholas et al., 2019), observing the ultraviolet 135.6 nm emission of atomic oxygen at night-time to characterize the two-dimensional distribution of electrons.

Tofu is a common food in Indonesia, made from soybean, and needs gigantic water for the process. The liquid waste of the tofu industry is usually directly discharged into the river without being processed. Liquid wastes of tofu have high organic content and become a problem in water pollution. Rotating Biological Contactor (RBC) is efficient method to treat waste with a high organic matter load by utilizing microorganisms to consume organic matter through biofilms. Biofilm will degrade organic matter aerobically. The purpose of the study is to determine the capability of RBC to reduce the organic content of tofu wastewater with different rotations of the disk. Rotation was experimentally varied from 30, 40, 50, 60 RPM and control. Results were considered in percentage decrease from the untreated waste: TSS of 87.56 ± 6.48%, BOD of 99.13 ± 0.21 %, and COD of 98.53 ± 0.08%. To conclude, the optimum rotation is 50 RPM for decreasing BOD and COD, otherwise 40 RPM for reducing TSS. The results effluent RBC on three parameters passed the quality standards legally for the soybean processing company or activity.

A light environment in aquatic habitat is one of the essential physical parameters affecting the growth and physiology of fish. To investigate the effects of light on the growth of zebrafish embryos and larvae (Danio rerio), fishes were reared under the illumination of Light Emitting Diodes (LEDs) of different wavelengths, including green, red, blue, and white. Morphometric, neuromast staining with 2-[4-(Dimethylamino)styryl]-1-ethylpyridinium iodide (DASPEI) and Polymerase Chain Reaction (PCR) analyses were used to examine the initial development of sensory capacity in this study. On days 5, 6, and 7, the green light produced the most favorable result. Blue light consistently impacted early parameters such as eye development, egg yolk absorption, and total length. These impacts were synchronous with the initiation of feeding. Exposure to specific wavelengths of light can induce the appearance of gene expression, opn1lw1 detected opsin and (mtnr1ba and aanat2) were active under all four experimental lighting conditions. This retinal gene appears to be sensitive to ambient wavelength, but apparently, genes in the melatonin pathway are not.

Microbial diversity within an aquatic community can be used to increase the growth and development of organisms. In this study, Zebrafish larvae were reared in three treatments 1) a probiotic containing 17 strains of Lactobacillus spp., 2) an amoxicillin solution, 3) water from the broodstock culture tank as the control. Survival of the larvae throughout 10 dpf was recorded. To determine the development of the gastrointestinal tract DASPEI stain was used for larvae at the age of 3 dpf to 6dpf. The intensity of the fluorescence in each larva was observed through the automated digital microscope. According to the experiment results, a significant difference (P

Twenty-seven paired human cadaveric knee specimens were used to determine the effect of surgical technique and various interference screw parameters on the pullout strength of patellar tendon femoral bone blocks. The study compared the fixation strength of endoscopically inserted and conventional 'rear-entry' screws of different mode of failure was bone block pullout from the interference screw. There was no significant difference in fixation strength between 9-mm diameter screws inserted through a conventional rear-entry technique and 7-mm diameter screws inserted through an endoscopic technique. There was no significant effect of screw length on fixation strength. The pullout force for 20-mm long screws were compared with 5.5-mm diameter screws. There was no significant effect of increased screw core diameter on fixation strength. There was a weak positive correlation (r squared = 0.45) between screw insertion torque and pullout force. Our measured mean pullout force for the 7-mm endoscopically inserted screws of 362 + or - 198 N represents 20.1% of the failure load of the normal young adult anterior cruciate ligament. Our data indicate that properly inserted 7-mm diameter endoscopic interference screws can provide fixation strengths of patellar tendon anterior cruciate ligament grafts equivalent to those of conventional 9-mm diameter rear-entry, outside-in screws. [ABSTRACT FROM AUTHOR]

Eighty-seven patients had anterior cruciate ligament reconstruction using one-limbed gracilis and semitendinosus tendon graft. No extraarticular or associated ligamentous procedures were performed. A 44-patient subgroup was alternated on an every-other-case basis between 2 graft placements, either over the top or through the femoral condyle; 64 patients (32 of each type) returned for complete evaluations. Average followup was 2.9 years. Groups were similar in age, gender, injury chronicity, number of meniscectomies, and preoperative activity levels. No statistical differences between groups were seen in overall knee rating, range of motion, KT-1000 arthrometer measurements, isokinetic muscle testing, or one-legged hop test. Injured minus normal anterior laxity at 89N was 2.1 + or - 2.0 mm. Isokinetic testing demonstrated an average 95% normal knee extension strength and 106% normal flexion strength, measured at 60 deg/sec. Average hop index was 95%. Eight of 64 patients evaluated demonstrated injured minus normal differences of 4.5 mm or greater. Three of 8 had frankly positive 2+ and 5 had 1+ pivot shifts; however, 4 of these returned fully to sports, and 4 returned with modifications. Overall, 55 of 64 patients returned to preinjury sports. [ABSTRACT FROM AUTHOR]

This paper discusses how to foster creativity and sustainability during Axiomatic Design processes, including Industry 4.0 as an example application. Creativity is generating valuable, new ideas. Innovation is making new ideas viable. This paper explains how AD theory and methods can improve the selection process in evolution-inspired creativity for formulating functional requirements and generating and selecting design parameters. FR formulation is a key to creating value in design solutions. No design solution can be better than its FRs. The FRs must capture the true, underlying essence of customer needs. In addition, an FR must define the solution space appropriately, so that all the best DP candidates are included. Suh’s axioms are used to select the single best DPs from the candidates. In AD, viabilityis established systematically during the axiomatic decomposition and the physical integration processes. Methods for detecting poor design thinking are presented. Metrics and tests for evaluating FRs’ facility for creativity and innovation are proposed. Techniques for improving FRs are proposed, decomposed, and reviewed for their compliance with the axioms.

Industry 4.0 and digitization are currently changing shop floor management in production. Especially in the production of highly customized and individual products, digitization offers many opportunities for more efficient processes. Providing the right information in the right time at the right place can help to reduce lead time as well as production costs. This paper shows the use of Axiomatic Design to develop a conceptual design for an innovative and digital shop floor information system for supporting assembly operators in machine industry in their daily work. The research is based on a real industrial case study with a medium sized manufacturer of customized machines. Needs from practice were collected through workshops with the industry partner and were translated into functional requirements. These functional requirements were derived with an Axiomatic Design decomposition to design solutions. The results of the AD analysis were used as a basis for the concept design of an operator information system in the company.

The objective of this paper is to go a step further introducing the concept of Industry 4.0 (I4.0) using Axiomatic Design as a research methodology. The rationale for this work is to increase the performance of SMEs allowing a better utilization of resources, using tools coming to the foreground of industry enabled by the Fourth Industrial Revolution (also known as Industry 4.0). This would improve the competitive position of SMEs on the global market. The state-of-the-art shows that only few companies andespecially few small and medium sized enterprises (SMEs) are using data analytics to take advantage of new technological achievements to compete with one another. The method used in this paper for deriving aconceptual framework how SMEs can exploit the advantages of smart data analytics in manufacturing is axiomatic design, using inputs collected from a field study at SMEs. The results show that SMEs are challenged in implementing advanced data analytics instruments and need to define strategies for collecting, analysing and interpreting data for improving their performance and provide framework which should help SMEs to implement data analytics on the shop floor.

Although a large number of crystal structures of heterocyclic thiosemicarbazones have recently appeared in the literature, few structures of heterocyclic bis(thiosemicarbazones) or their metal complexes have been reported. Complexes of iron(II), indium(III), tin(IV), bismuth(III) involve bis(thiosemicarbazones) coordinating as N3S2 pentadentate ligands, often resulting in 7-coordinate complexes. In contrast, complexes with zinc(II) are often binuclear with thiosemicarbazone moieties of a bis(thiosemicarbazone) coordinating to two different zinc centers. Also included in this study is the structure of the first complex with a 2,6-diformylpyridine bis(thiosemicarbazone) ligand, a 4-coordinate nickel(II) complex with unusual coordination.

Cyber-physical production systems (CPPS) enable completely new possibilities in the factory of the future through the connectivity between the digital world and the physical production system. It has so far been difficult to transfer these advantages and concepts to students as well as professionals in a clear and practical oriented manner. The Fraunhofer Italia team has built a demonstration model for a flexible and decentralized CPPS system for showcase purposes. As part of an improvement of the existing system, Axiomatic Design (AD) was applied as the scientific design theory. Starting from the identification of the Customer Attributes, Functional Requirements were derived and the Design Parameters for the new design were defined by means of the AD decomposition and mapping process. In this paper, the application of AD for product improvement is described step-by-step based on the example of the redesign of the CPPS demonstration model.