In this work, the recent advances for rapid prototyping in the orthoprosthetic industry are presented. Specifically, the manufacturing process of orthoprosthetic aids are analysed, as thier use is ...widely extended in orthopedic surgery. These devices are devoted to either correct posture or movement (orthosis) or to substitute a body segment (prosthesis) while maintaining functionality. The manufacturing process is traditionally mainly hand-crafted: The subject's morphology is taken by means of plaster molds, and the manufacture is performed individually, by adjusting the prototype over the subject. This industry has incorporated computer aided design (CAD), computed aided engineering (CAE) and computed aided manufacturing (CAM) tools; however, the true revolution is the result of the application of rapid prototyping technologies (RPT). Techniques such as fused deposition modelling (FDM), selective laser sintering (SLS), laminated object manufacturing (LOM), and 3D printing (3DP) are some examples of the available methodologies in the manufacturing industry that, step by step, are being included in the rehabilitation engineering market-an engineering field with growth and prospects in the coming years. In this work we analyse different methodologies for additive manufacturing along with the principal methods for collecting 3D body shapes and their application in the manufacturing of functional devices for rehabilitation purposes such as splints, ankle-foot orthoses, or arm prostheses.
The use of benchmarking in the management of healthcare facilities enables immediate comparison between hospitals. Benchmarking allows ascertaining their expected energy consumption and estimating ...the possible savings margin. In the 2005–2015 period, 90 EU Eco-Audits of 23 public hospitals in Germany were studied to analyze the energy consumption related with weather conditions, built surface area, gross domestic product (GDP), geographic location (GL), bed numbers, and employee numbers. The results reveal that the average annual energy consumption of a hospital under normal conditions, both climatic and operational, is 0.27 MWh/m2, 14.37 MWh/worker, and 23.41 MWh/bed. The indicator dependent on the number of beds proved to be the most suitable as a reference to quantify the energy consumption of a hospital.
The study of reliability, availability and control of industrial manufacturing machines is a constant challenge in the industrial environment. This paper compares the results offered by several ...maintenance strategies for multi-stage industrial manufacturing machines by analysing a real case of a multi-stage thermoforming machine. Specifically, two strategies based on preventive maintenance, Preventive Programming Maintenance (PPM) and Improve Preventive Programming Maintenance (IPPM) are compared with two new strategies based on predictive maintenance, namely Algorithm Life Optimisation Programming (ALOP) and Digital Behaviour Twin (DBT). The condition of machine components can be assessed with the latter two proposals (ALOP and DBT) using sensors and algorithms, thus providing a warning value for early decision-making before unexpected faults occur. The study shows that the ALOP and DBT models detect unexpected failures early enough, while the PPM and IPPM strategies warn of scheduled component replacement at the end of their life cycle. The ALOP and DBT strategies algorithms can also be valid for managing the maintenance of other multi-stage industrial manufacturing machines. The authors consider that the combination of preventive and predictive maintenance strategies may be an ideal approach because operating conditions affect the mechanical, electrical, electronic and pneumatic components of multi-stage industrial manufacturing machines differently.
Fusion of nascent myoblasts to pre-existing myofibres is critical for skeletal muscle growth and repair. The vast majority of molecules known to regulate myoblast fusion are necessary in this ...process. Here, we uncover, through high-throughput in vitro assays and in vivo studies in the chicken embryo, that TGFβ (SMAD2/3-dependent) signalling acts specifically and uniquely as a molecular brake on muscle fusion. While constitutive activation of the pathway arrests fusion, its inhibition leads to a striking over-fusion phenotype. This dynamic control of TGFβ signalling in the embryonic muscle relies on a receptor complementation mechanism, prompted by the merging of myoblasts with myofibres, each carrying one component of the heterodimer receptor complex. The competence of myofibres to fuse is likely restored through endocytic degradation of activated receptors. Altogether, this study shows that muscle fusion relies on TGFβ signalling to regulate its pace.
Human genomics is undergoing a step change from being a predominantly research-driven activity to one driven through health care as many countries in Europe now have nascent precision medicine ...programmes. To maximize the value of the genomic data generated, these data will need to be shared between institutions and across countries. In recognition of this challenge, 21 European countries recently signed a declaration to transnationally share data on at least 1 million human genomes by 2022. In this Roadmap, we identify the challenges of data sharing across borders and demonstrate that European research infrastructures are well-positioned to support the rapid implementation of widespread genomic data access.
The design of walking-assistance exosuits is becoming increasingly popular among those who aim at developing a light, affordable and wearable system. They are indeed an alternative to traditional ...exoskeletons, which tend to be bulkier and more expensive. The main advantages of exosuits, as opposed to exoskeletons, are their lower weight and price, as well as their increased wearability and kinematic compatibility with the user. Thus, it is key to optimize their design and, particularly, the number of actuators and the actuation scheme. One of the current, common ways to achieve better designs, is to conduct a Principal Component Analysis (PCA) on some of the involved variables to reduce their dimensionality and thus, simplify the actuation system. The goal of this paper is to analyze the different variables upon which PCA can be conducted and propose the resulting actuation schemes, comparing the results and determining the best design approach for the design of a synergy-based, gait-assistance exosuit. The study focuses on both postural and dynamic synergies to optimize their design. Here, both synergy types are reviewed from a design perspective, yielding different design criteria following a PCA-based study, each with their own set of advantages and disadvantages. Thus, the design of cable-driven exosuits is optimized via analysis of gait parameters related with its actuation, such as joint torque or cable extensions. Kinematics or postural synergies lead to a higher cumulative variance of the first principal component and the transmission system is simpler than the ones obtained through dynamic synergies.
A hospital’s water installations are critical for its function, but the environmental cost is high. This study quantifies the mean potable cold water consumption (PCWC) in 19 hospitals belonging to ...the German Public Health System. The hospital floor area ranges from 3000 to 151,000 m2 and the number of beds from 45 to 1003 beds. To this end, 60 Eco-Management and Audit Scheme statements were analyzed corresponding to the period 2005-2015 in accordance with their geographic location, heating-degree-days per year, cold-degree-days per year, hospital category depending on the number of beds, floor area, and number of workers. It was found that PCWC is greater in hospitals located in areas with greater heating-degree-days per year. The potential mean annual savings estimated were 8,600,000 m3 of water equivalent to 15,000,000 euros, 4000 MWh energy, and 30,000 tons of CO2 emissions. It was concluded that, to determine the mean annual water consumption, it is preferable to use the number of beds as reference indicator, and the value of the consumption as reference indicator was proposed as 103 m3 per bed per year.
The accurate identification of the final energy consumption in hospitals is a key task to determine potential savings and therefore to set appropriate design criteria. However, correlations between ...consumption and functional indicators for Spanish hospitals have not been yet accounted for in detail. A total of 80 Eco-Management and Audit Schemes (EMAS) from 20 hospitals were analysed in the period 2005–2014 in order to seek correlations between energy consumption and climate conditions, gross domestic product (GDP), built surface area, number of available beds and number of staff.
The results set the average annual energy consumption in a Spanish hospital for standard operating conditions as 0.27MWh/m2, 9.99 MWh/worker and 34.61MWh/bed (standard deviations 0.07MWh/m2, 3.96MWh/worker and 12.49 MWh/bed, respectively). The geographic location was seen to show a direct influence on those values, as opposed to the specific type of management (TM), the number of available beds, the GDP or the particular climate conditions.
Deficiency in dihydropyrimidine dehydrogenase (DPD) enzyme is the main cause of severe and lethal fluoropyrimidine-related toxicity. Various approaches have been developed for DPD-deficiency ...screening, including DPYD genotyping and phenotyping. The goal of this prospective observational study was to perform exhaustive exome DPYD sequencing and to examine relationships between DPYD variants and toxicity in advanced breast cancer patients receiving capecitabine.
Two-hundred forty-three patients were analysed (88.5% capecitabine monotherapy). Grade 3 and grade 4 capecitabine-related digestive and/or neurologic and/or hemato-toxicities were observed in 10.3% and 2.1% of patients, respectively. DPYD exome, along with flanking intronic regions 3'UTR and 5'UTR, were sequenced on MiSeq Illumina. DPD phenotype was assessed by pre-treatment plasma uracil (U) and dihydrouracil (UH2) measurement.
Among the 48 SNPs identified, 19 were located in coding regions, including 3 novel variations, each observed in a single patient (among which, F100L and A26T, both pathogenic in silico). Combined analysis of deleterious variants *2A, I560S (*13) and D949V showed significant association with grade 3-4 toxicity (sensitivity 16.7%, positive predictive value (PPV) 71.4%, relative risk (RR) 6.7, p<0.001) but not with grade 4 toxicity. Considering additional deleterious coding variants D342G, S492L, R592W and F100L increased the sensitivity to 26.7% for grade 3-4 toxicity (PPV 72.7%, RR 7.6, p<0.001), and was significantly associated with grade 4 toxicity (sensitivity 60%, PPV 27.3%, RR 31.4, p = 0.001), suggesting the clinical relevance of extended targeted DPYD genotyping. As compared to extended genotype, combining genotyping (7 variants) and phenotyping (U>16 ng/ml) did not substantially increase the sensitivity, while impairing PPV and RR.
Exploring an extended set of deleterious DPYD variants improves the performance of DPYD genotyping for predicting both grade 3-4 and grade 4 toxicities (digestive and/or neurologic and/or hematotoxicities) related to capecitabine, as compared to conventional genotyping restricted to consensual variants *2A, *13 and D949V.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Making the correct maintenance strategy decision for industrial multistage machines (MSTM) is a constant challenge for industrial manufacturers. Preventive maintenance strategies are the most popular ...and provide interesting results but cannot prevent unexpected failures and consequences, such as time lost production (TLP). In these cases, a predictive maintenance strategy should be used to maintain the appropriate level of operation time. This research aims to present a model to identify the component that failed before its mean time to failure (MTTF) and, depending on whether the cause of the failure is known, propose the use of a predictive maintenance strategy and further decision-making to ensure the highest possible value from operating time. Also, it is necessary to check the reliable value of MTTF before taking certain decisions. For this research, a real case study of a MSTM was characterized component by component, setting the individual maintenance times. The initial maintenance strategy used for all the components is the preventive programming maintenance (PPM). If a component presents an unexpected failure, a method is proposed to decide whether the maintenance strategy should be changed, adding a predictive maintenance strategy to monitor said component. The research also provides a trust level to evaluate the reliable value of MTTF of each component. The authors consider this approach very useful for machine manufacturers and end users.
PDF
