Digital Twins and Enabling Technologies in Museums and Cultural Heritage: An Overview.

This paper presents an overview of various types of virtual museums (ViM) as native artifacts or as digital twins (DT) of physical museums (PM). Depending on their mission and features, we discuss various enabling technologies and sensor equipment with their specific requirements and complexities, advantages and drawbacks in relation to each other at all stages of a DT's life cycle. A DT is a virtual construct and embodies innovative concepts based on emerging technologies (ET) using adequate sensor configurations for (meta-)data import and exchange. Our keyword-based search for articles, conference papers, (chapters from) books and reviews yielded 43 contributions and 43 further important references from Industry 4.0, Tourism and Heritage 4.0. After closer examination, a reference corpus of 40 contributions was evaluated in detail and classified along with their variants of DT-content-, communication-, and collaboration-centric and risk-informed ViMs. Their system features correlate with different application areas (AA), new or improved technologies-mostly still under development-and sensors used. Our proposal suggests a template-based, generative approach to DTs using standardized metadata formats, expert/curator software and customers'/visitors' engagement. It advocates for stakeholders' collaboration as part of a comprehensive validation and verification assessment (V&VA) throughout the DT's entire life cycle.

Etoposide as Salvage Therapy for Cytokine Storm Due to Coronavirus Disease 2019.

Coronavirus disease 2019 (COVID-19) has resulted in significant morbidity and mortality because of a lack of effective therapies. Therapeutic strategies under investigation target the overactive cytokine response with anti-cytokine or immunomodulators therapies. We present a unique case of severe cytokine storm resistant to multiple anti-cytokine therapies, but eventually responsive to etoposide. Thus, etoposide may have a role as salvage therapy in treatment of cytokine storm in COVID-19. To our knowledge, this is the first reported case of use of etoposide in COVID-19.

Interhospital Transfer of Patients With Acute Pulmonary Embolism: Challenges and Opportunities.

Acute pulmonary embolism (PE) is associated with significant morbidity and mortality. The management paradigm for acute PE has evolved in recent years with wider availability of advanced treatment modalities ranging from catheter-directed reperfusion therapies to mechanical circulatory support. This evolution has coincided with the development and implementation of institutional pulmonary embolism response teams (PERT) nationwide and internationally. Because most institutions are not equipped or staffed for advanced PE care, patients often require transfer to centers with more comprehensive resources, including PERT expertise. One of the unmet needs in current PE care is an organized approach to the process of interhospital transfer (IHT) of critically ill PE patients. In this review, we discuss medical optimization and support of patients before and during transfer, transfer checklists, defined roles of emergency medical services, and the roles and responsibilities of referring and receiving centers involved in the IHT of acute PE patients.

Recurrent Acute Neurogenic Pulmonary Edema after Uncontrolled Seizures.

Acute pulmonary edema following significant injury to the central nervous system is known as neurogenic pulmonary edema (NPE). Commonly seen after significant neurological trauma, NPE has also been described after seizure. While many pathogenic theories have been proposed, the exact mechanism remains unclear. We present a 31-year-old man who developed recurrent acute NPE on two consecutive admissions after experiencing witnessed generalized tonic-clonic (GTC) seizures. Chest radiographs obtained after seizure during both admissions showed bilateral infiltrates which rapidly resolved within 24 hours. He required intubation on each occasion, was placed on lung protective ventilation, and was successfully extubated within 72 hours. There was no identified source of infection, and no cardiac pathology was thought to be contributory.