Digital twins in the construction industry: a comprehensive review of current implementations, enabling technologies, and future directions

This paper presents a comprehensive understanding of current digital twin (DT) implementations in the construction industry, along with providing an overview of technologies enabling the operation of DTs in the industry. To this end, 145 publications were identified using a systematic literature review. The results revealed eight key areas of DT implementation including (i) virtual design, (ii) project planning and management, (iii) asset management and maintenance, (iv) safety management, (v) energy efficiency and sustainability, (vi) quality control and management, (vii) supply chain management and logistics, and (viii) structural health monitoring. The findings demonstrate that DT technology has the capacity to revolutionise the construction industry across these areas, enabling optimised designs, improved collaboration, real-time monitoring, predictive maintenance, enhanced safety practices, energy performance optimisation, quality inspections, efficient supply chain management, and proactive maintenance. This study also identified several challenges that hinder the widespread implementation of DT in construction, including (i) data integration and interoperability, (ii) data accuracy and completeness, (iii) scalability and complexity, (iv) privacy and security, and (v) standards and governance. To address these challenges, this paper recommends prioritising standardised data formats, protocols, and APIs for seamless collaboration, exploring semantic data modelling and ontologies for data integration, implementing validation processes and robust data governance for accuracy and completeness, harnessing high-performance computing and advanced modelling techniques for scalability and complexity, establishing comprehensive data protection and access controls for privacy and security, and developing widely accepted standards and governance frameworks with industry-wide collaboration. By addressing these challenges, the construction industry can unlock the full potential of DT technology, thus enhancing safety, reliability, and efficiency in construction projects

Out-of-Hospital Cardiac Arrest during the COVID-19 Pandemic: A Systematic Review

Objective: Out-of-hospital cardiac arrest (OHCA) is a prominent cause of death worldwide. As indicated by the high proportion of COVID-19 suspicion or diagnosis among patients who had OHCA, this issue could have resulted in multiple fatalities from coronavirus disease 2019 (COVID-19) occurring at home and being counted as OHCA. Methods: We used the MeSH term “heart arrest” as well as non-MeSH terms “out-of-hospital cardiac arrest, sudden cardiac death, OHCA, cardiac arrest, coronavirus pandemic, COVID-19, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).” We conducted a literature search using these search keywords in the Science Direct and PubMed databases and Google Scholar until 25 April 2022. Results: A systematic review of observational studies revealed OHCA and mortality rates increased considerably during the COVID-19 pandemic compared to the same period of the previous year. A temporary two-fold rise in OHCA incidence was detected along with a drop in survival. During the pandemic, the community’s response to OHCA changed, with fewer bystander cardiopulmonary resuscitations (CPRs), longer emergency medical service (EMS) response times, and worse OHCA survival rates. Conclusions: This study’s limitations include a lack of a centralised data-gathering method and OHCA registry system. If the chain of survival is maintained and effective emergency ambulance services with a qualified emergency medical team are given, the outcome for OHCA survivors can be improved even more

Prognostic factors responsible for survival in sex cord stromal tumors of the ovary - a multivariate analysis

Abstract Objective. To evaluate prognostic factors that impact on the survival of women with ovarian sex cord stromal tumors (SCST). Methods. Data including age at diagnosis, stage, histology, grade, treatment, and survival were extracted from the 1988-2001 Surveillance, Epidemiology, and End Results Program. Kaplan-Meier and Cox proportional hazards analyses were used to determine the predictors for survival. Results. 376 women (median age: 51) with ovarian sex cord stromal cell tumors were identified, including 339 with granulosa cell and 37 with Sertoli-Leydig cell tumors. 265 (71%) patients had stage I, 39 (10%) stage II, 40 (11%) stage III, and 32 (8%) had stage IV disease. Women with stage I-II disease had a 5-year disease-specific survival of 95% compared to 59% in those with stage III-IV cancers (p < 0.001). Patients ≤50 years had a survival advantage over those>50 years (93% vs. 84%, p < 0.001). This age-associated survival advantage was observed for early (97% vs. 92%, p = 0.003), but not for advanced-staged (68% vs. 53%, p = 0.09) patients. 110 patients with stage I-II disease underwent conservative surgery without hysterectomy. The survival for this group was similar to patients who underwent a standard surgery including a hysterectomy (94.8% and 94.9%, p = 0.38). On multivariate analysis, age ≤50 (p = 0.001) and early-stage disease (p < 0.001) remained significant prognostic factor for improved survival. Conclusions. Younger age and early-stage disease are important predictors for improved survival in patients with ovarian sex cord stromal tumors. Conservative surgical treatment for early-staged patients wishing to retain fertility appears to be a safe alternative

Atezolizumab and nab-Paclitaxel in Advanced Triple-Negative Breast Cancer: Biomarker Evaluation of the IMpassion130 Study

BackgroundUnderstanding the impact of the tumor immune microenvironment and BRCA1/2-related DNA repair deficiencies on the clinical activity of immune checkpoint inhibitors may help optimize both patient and treatment selection in metastatic triple-negative breast cancer. In this substudy from the phase 3 IMpassion130 trial, immune biomarkers and BRCA1/2 alterations were evaluated for association with clinical benefit with atezolizumab and nab-paclitaxel (A+nP) vs placebo and nP in unresectable (P+nP) locally advanced or metastatic triple-negative breast cancer.MethodsPatients were randomly assigned 1:1 to nab-paclitaxel 100 mg/m2 (days 1, 8, and 15 of a 28-day cycle) and atezolizumab 840 mg every 2 weeks or placebo until progression or toxicity. Progression-free survival and overall survival were evaluated based on programmed death-ligand 1 (PD-L1) expression on immune cells (IC) and tumor cells, intratumoral CD8, stromal tumor-infiltrating lymphocytes, and BRCA1/2 mutations.ResultsPD-L1 IC+ in either primary or metastatic tumor tissue was linked to progression-free survival and overall survival benefit with A+nP. PD-L1 IC+ low (26.9%; 243 of 902 patients) and high (13.9%; 125 of 902 patients) populations had improved outcomes that were comparable. Intratumoral CD8 and stromal tumor-infiltrating lymphocytes positivity (sTIL+) were associated with PD-L1 IC+ status; improved outcomes were observed with A+nP vs P+nP only in CD8+ and sTIL+ patients who were also PD-L1 IC+. BRCA1/2 mutations (occurring in 14.5% [89 of 612 patients]) were not associated with PD-L1 IC status, and PD-L1 IC+ patients benefited from A+nP regardless of BRCA1/2 mutation status.ConclusionsAlthough A+nP was more efficacious in patients with richer tumor immune microenvironment, clinical benefit was only observed in patients whose tumors were PD-L1 IC+