An Approach to Develop Digital Twins in Industry.

The industry is currently undergoing a digital revolution driven by the integration of several enabling technologies. These include automation, robotics, cloud computing, industrial cybersecurity, systems integration, digital twins, etc. Of particular note is the increasing use of digital twins, which offer significant added value by providing realistic and fully functional process simulations. This paper proposes an approach for developing digital twins in industrial environments. The novelty lies in not only focusing on obtaining the model of the industrial system and integrating virtual reality and/or augmented reality but also in emphasizing the importance of incorporating other enabled technologies of Industry 4.0, such as system integration, connectivity with standard and specific industrial protocols, cloud services, or new industrial automation systems, to enhance the capabilities of the digital twin. Furthermore, a proposal of the software tools that can be used to achieve this incorporation is made. Unity is chosen as the real-time 3D development tool for its cross-platform capability and streamlined industrial system modeling. The integration of augmented reality is facilitated by the Vuforia SDK. Node-RED is selected as the system integration option, and communications are carried out with MQTT protocol. Finally, cloud-based services are recommended for effective data storage and processing. Furthermore, this approach has been used to develop a digital twin of a robotic electro-pneumatic cell.

Experimental Measurement of the Thermal Conductivity of Fused Deposition Modeling Materials with a DTC-25 Conductivity Meter.

The expansion and low cost of additive manufacturing technologies have led to a revolution in the development of materials used by these technologies. There are several varieties of materials that can be used in additive manufacturing by fused deposition modeling (FDM). However, some of the properties of these materials are unknown or confusing. This article addresses the need to know the thermal conductivity in different filaments that this FDM technology uses, because there are multiple applications for these additive manufacturing products in the field of thermal insulation. For the study of thermal conductivity, the DTC-25 commercial conductivity measurement bench was used, where the tests were carried out on a set of seven different materials with 100% fabrication density-from base materials such as acrylonitrile butadiene styrene (ABS) or polylactic acid (PLA), to materials with high mechanical and thermal resistance such as thermoplastic polyurethane (TPU), polyether ether ketone (PEEK), and high-performance polyetherimide thermoplastic (ULTEM), to materials with metal inclusions (aluminum 6061) that would later be subjected to thermal after-treatments. This study shows how the parts manufactured with aluminum inclusions have a higher thermal conductivity, at 0.40 ± 0.05 W/m·K, compared to other materials with high mechanical and thermal resistance, such as TPU, with a conductivity of 0.26 ± 0.05 W/m·K.

Modeling Experimental Parameters for the Fabrication of Multifunctional Surfaces Composed of Electrospun PCL/ZnO-NPs Nanofibers.

In this work, a one-step electrospinning technique has been implemented for the design and development of functional surfaces with a desired morphology in terms of wettability and corrosion resistance by using polycaprolactone (PCL) and zinc oxide nanoparticles (ZnO NPs). The surface morphology has been characterized by confocal microscopy, scanning electron microscopy (SEM), atomic force microscopy (AFM) and water contact angle (WCA), whereas the corrosion resistance has been evaluated by Tafel polarization curves. Strict control over the input operational parameters (applied voltage, feeding rate, distance tip to collector), PCL solution concentration and amount of ZnO NPs have been analyzed in depth by showing their key role in the final surface properties. With this goal in mind, a design of experiment (DoE) has been performed in order to evaluate the optimal coating morphology in terms of fiber diameter, surface roughness (Ra), water contact angle (WCA) and corrosion rate. It has been demonstrated that the solution concentration has a significant effect on the resultant electrospun structure obtained on the collector with the formation of beaded fibers with a higher WCA value in comparison with uniform bead-free fibers (dry polymer deposition or fiber-merging aspect). In addition, the presence of ZnO NPs distributed within the electrospun fibers also plays a key role in corrosion resistance, although it also leads to a decrease in the WCA. Finally, this is the first time that an exhaustive analysis by using DoE has been evaluated for PCL/ZnO electrospun fibers with the aim to optimize the surface morphology with the better performance in terms of corrosion resistance and wettability.

Building a bridge between patients and transplant healthcare professionals - a descriptive study.

This article describes a pathway for collaboration between transplant healthcare professionals and organ recipients. Under the umbrella of the European Society for Organ Transplantation (ESOT) a joint initiative started from three Sections and Committees of ESOT: EDTCO (European Donation and Transplant Coordination Organisation), ETHAP (European Transplant Allied Healthcare Professionals) and ELPAT (Ethical, Legal and Psycho-social Aspects of Transplantation). The formal 'kick-off' of the Advisory Board Meeting of the European Transplant Patient Organisation (ETPO) was during the ESOT congress in 2019. The aim was to produce a series of statements to serve as a path to dialogue between patients and transplant professionals and to define the next steps towards giving a voice to the patient network. To include the patients' perspectives, two surveys have been performed. The results identified the unmet needs and lead to a proposal for future plans. Educational activities have since started leading to a patient learning workstream. All initiatives taken have one purpose: to include patients, give them a voice and build a foundation for collaboration between patients and transplant professionals. ESOT has created a platform for mutual understanding, learning and a collaborative partnership between ETPO and European donation and transplant professionals.

Designing Multifunctional Protective PVC Electrospun Fibers with Tunable Properties.

In this work, the electrospinning technique is used for the fabrication of electrospun functional fibers with desired properties in order to show a superhydrophobic behavior. With the aim to obtain a coating with the best properties, a design of experiments (DoE) has been performed by controlling several inputs operating parameters, such as applied voltage, flow rate, and precursor polymeric concentration. In this work, the reference substrate to be coated is the aluminum alloy (60661T6), whereas the polymeric precursor is the polyvinyl chloride (PVC) which presents an intrinsic hydrophobic nature. Finally, in order to evaluate the coating morphology for the better performance, the following parameters-such as fiber diameter, surface roughness (Ra, Rq), optical properties, corrosion behavior, and wettability-have been deeply analyzed. To sum up, this is the first time that DoE has been used for the optimization of superhydrophobic or anticorrosive surfaces by using PVC precursor for the prediction of an adequate surface morphology as a function of the input operational parameters derived from electrospinning process with the aim to validate better performance.

Feature Extraction from Building Submetering Networks Using Deep Learning.

The understanding of the nature and structure of energy use in large buildings is vital for defining novel energy and climate change strategies. The advances on metering technology and low-cost devices make it possible to form a submetering network, which measures the main supply and other intermediate points providing information of the behavior of different areas. However, an analysis by means of classical techniques can lead to wrong conclusions if the load is not balanced. This paper proposes the use of a deep convolutional autoencoder to reconstruct the whole consumption measured by the submeters using the learnt features in order to analyze the behavior of different building areas. The display of weights and information of the latent space provided by the autoencoder allows us to obtain precise details of the influence of each area in the whole building consumption and its dependence on external factors such as temperature. A submetering network is deployed in the León University Hospital building in order to test the proposed methodology. The results show different correlations between environmental variables and building areas and indicate that areas can be grouped depending on their function in the building performance. Furthermore, this approach is able to provide discernible results in the presence of large differences with respect to the consumption ranges of the different areas, unlike conventional approaches where the influence of smaller areas is usually hidden.

A Deep Learning Approach for Fusing Sensor Data from Screw Compressors.

Chillers are commonly used for thermal regulation to maintain indoor comfort in medium and large buildings. However, inefficiencies in this process produce significant losses, and optimization tasks are limited because of accessibility to the system. Data analysis techniques transform measurements coming from several sensors into useful information. Recent deep learning approaches have achieved excellent results in many applications. These techniques can be used for computing new data representations that provide comprehensive information from the device. This allows real-time monitoring, where information can be checked with current working operation to detect any type of anomaly in the process. In this work, a model based on a 1D convolutional neural network is proposed for fusing data in order to predict four different control stages of a screw compressor in a chiller. The evaluation of the method was performed using real data from a chiller in a hospital building. Results show a satisfactory performance and acceptable training time in comparison with other recent methods. In addition, the model is capable of predicting control states of other screw compressors different than the one used in the training. Furthermore, two failure cases are simulated, providing an early alarm detection when a continuous wrong classification is performed by the model.

What do patients know? Education from the European Lung Foundation perspective.

The European Lung Foundation (ELF) is an organisation whose mission is to bring together the public and patients with respiratory professionals to improve lung health. A core part of all its activities focus on education: the education of patients on their condition, including how to prevent, treat and manage it; the education of healthcare professionals on how to improve work with patients and awareness about the issues that are important to patients; and education of the public and policy makers of the importance of lung health at a European level. ELF was founded and works in a unique partnership with the European Respiratory Society (ERS). This article has been written by the recent past Chairs and the new Chairs of three ELF committees (Council (D. Smyth and I. Saraiva), Professional Advisory Committee (K. Lisspers and G. Hardavella) and Patient Advisory Committee (J. Fuertes and K. Hill)) in order to reflect on ELF's journey in this regard over recent years. In particular, it seems a good moment to assess the success and impact of the first patient Chair of ELF, Dan Smyth, and reflect on what this has meant for ELF's educational activities, and what the future now looks like. EDUCATIONAL AIMS: To understand the importance of educated patients (patients that are knowledgeable on their condition and how healthcare processes work).To understand the importance of guiding patients to quality reliable sources of information and education.To establish ways to ensure that healthcare professionals are prepared to work with educated patients.To outline the initiatives that ELF has driven forward in the field of education.To see the value in patients advocating at the European level for raising standards of education for patients and physicians.

Miocarditis aguda secundaria a clozapina / Clozapine-associated myocarditis

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Treatment of Knee Osteoarthritis With Allogeneic Bone Marrow Mesenchymal Stem Cells: A Randomized Controlled Trial.

BACKGROUND: Osteoarthritis is the most prevalent joint disease and a common cause of joint pain, functional loss, and disability. Conventional treatments demonstrate only modest clinical benefits without lesion reversal. Autologous mesenchymal stromal cell (MSC) treatments have shown feasibility, safety, and strong indications for clinical efficacy. We performed a randomized, active control trial to assess the feasibility and safety of treating osteoarthritis with allogeneic MSCs, and we obtain information regarding the efficacy of this treatment. METHODS: We randomized 30 patients with chronic knee pain unresponsive to conservative treatments and showing radiological evidence of osteoarthritis into 2 groups of 15 patients. The test group was treated with allogeneic bone marrow MSCs by intra-articular injection of 40 × 10(6) cells. The control group received intra-articular hyaluronic acid (60 mg, single dose). Clinical outcomes were followed for 1 year and included evaluations of pain, disability, and quality of life. Articular cartilage quality was assessed by quantitative magnetic resonance imaging T2 mapping. RESULTS: Feasibility and safety were confirmed and indications of clinical efficacy were identified. The MSC-treated patients displayed significant improvement in algofunctional indices versus the active controls treated with hyaluronic acid. Quantification of cartilage quality by T2 relaxation measurements showed a significant decrease in poor cartilage areas, with cartilage quality improvements in MSC-treated patients. CONCLUSIONS: Allogeneic MSC therapy may be a valid alternative for the treatment of chronic knee osteoarthritis that is more logistically convenient than autologous MSC treatment. The intervention is simple, does not require surgery, provides pain relief, and significantly improves cartilage quality.

Long-term benefit of early pre-reperfusion metoprolol administration in patients with acute myocardial infarction: results from the METOCARD-CNIC trial (Effect of Metoprolol in Cardioprotection During an Acute Myocardial Infarction).

OBJECTIVES: The goal of this trial was to study the long-term effects of intravenous (IV) metoprolol administration before reperfusion on left ventricular (LV) function and clinical events. BACKGROUND: Early IV metoprolol during ST-segment elevation myocardial infarction (STEMI) has been shown to reduce infarct size when used in conjunction with primary percutaneous coronary intervention (pPCI). METHODS: The METOCARD-CNIC (Effect of Metoprolol in Cardioprotection During an Acute Myocardial Infarction) trial recruited 270 patients with Killip class ≤II anterior STEMI presenting early after symptom onset (<6 h) and randomized them to pre-reperfusion IV metoprolol or control group. Long-term magnetic resonance imaging (MRI) was performed on 202 patients (101 per group) 6 months after STEMI. Patients had a minimal 12-month clinical follow-up. RESULTS: Left ventricular ejection fraction (LVEF) at the 6 months MRI was higher after IV metoprolol (48.7 ± 9.9% vs. 45.0 ± 11.7% in control subjects; adjusted treatment effect 3.49%; 95% confidence interval [CI]: 0.44% to 6.55%; p = 0.025). The occurrence of severely depressed LVEF (≤35%) at 6 months was significantly lower in patients treated with IV metoprolol (11% vs. 27%, p = 0.006). The proportion of patients fulfilling Class I indications for an implantable cardioverter-defibrillator (ICD) was significantly lower in the IV metoprolol group (7% vs. 20%, p = 0.012). At a median follow-up of 2 years, occurrence of the pre-specified composite of death, heart failure admission, reinfarction, and malignant arrhythmias was 10.8% in the IV metoprolol group versus 18.3% in the control group, adjusted hazard ratio (HR): 0.55; 95% CI: 0.26 to 1.04; p = 0.065. Heart failure admission was significantly lower in the IV metoprolol group (HR: 0.32; 95% CI: 0.015 to 0.95; p = 0.046). CONCLUSIONS: In patients with anterior Killip class ≤II STEMI undergoing pPCI, early IV metoprolol before reperfusion resulted in higher long-term LVEF, reduced incidence of severe LV systolic dysfunction and ICD indications, and fewer heart failure admissions. (Effect of METOprolol in CARDioproteCtioN During an Acute Myocardial InfarCtion. The METOCARD-CNIC Trial; NCT01311700).

Massive coronary subclavian steal syndrome.

Coronary subclavian steal syndrome is an unusual cause of angina, secondary to decreased or reversed flow in patients with patent "in situ" internal mammary-to-coronary artery graft. The most frequent cause of coronary subclavian steal syndrome is ipsilateral subclavian artery stenosis. We present a 60-year-old man with cerebrovascular and peripheral artery disease and a documented massive coronary subclavian steal syndrome, which impaired cardiopulmonary bypass weaning after multiple coronary artery bypass with double T-mammary artery graft.

Espasmo coronario secuencial en angina variante de Prinzmetal con presentación sincopal / Sequential coronary spasm in prinzmetal ¿s Angina Presenting as Syncope

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