Interoperabilidad de sensores de bajo coste con modelos BIM mediante programación visual paramétrica

The current advances in Smart Cities technology trend towards the creation of complex and interconnected systems, through the application of new software tools and devices based on the Internet of Things, Big Data and so on. However, the cost of certain elements and devices (such as monitoring of environmental and confort parameters) is oftenly very high, leading to exclusive procedures and being used only in relatively singular works or in those in which they have been found, or is foreseeable, to find pathologies. From this point emerges the need for proposing the development of versatile and reliable monitoring protocols from open source digital prototyping platforms and the use of low-cost sensors, in order to lay aside that exclusivity. Thus, it could be possible to contribute to the expansion of the field of application to get greater efficiency and sustainability together. This paper demosnstrates and shows the most effective options of interoperability of low-cost sensors with BIM models to make possible the development of BIM 7D stage, by monitoring thermal data and synchronizing and live updating in a virtual model. This will make possible more accurate simulations, as well as the improving decision-making process over the entire lifecycle of the infrastructure.La coyuntura tecnológica actual de las ciudades Inteligentes se orienta hacia la creación de sistemas complejos e interconectados, con aplicación de nuevas herramientas y dispositivos basados en Internet de las Cosas (IoT), Big Data, etc. Sin embargo, el coste de determinados elementos (como los de monitorización de parámetros de confort ambiental en edificios) suele ser elevado, lo que conlleva a su exclusividad y a utilizarse únicamente en obras relativamente singulares o en aquellas en las que se han encontrado, o es previsible, encontrar patologías. De ello surge la necesidad de plantear el desarrollo de protocolos de monitorización versátiles y económicos a partir de plataformas de prototipado digital de código abierto y la utilización de sensores de bajo coste, a fin de dejar a un lado la antedicha exclusividad y poder, así, contribuir a la ampliación de su campo de aplicación en pos de una lograr una mayor eficiencia y sostenibilidad en conjunto. Este trabajo estudia y muestra las alternativas más viables de interoperabilidad de sensores de bajo coste con modelos BIM para posibilitar el desarrollo de la fase BIM 7D, mediante la monitorización de datos térmicos y sincronización en tiempo real para su visualización en un modelo virtual. Esto permitirá la calibración de simulaciones más precisas, así como la mejora del proceso de toma de decisiones durante el ciclo de vida de la infraestructur

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective

Safety of hospital discharge before return of bowel function after elective colorectal surgery

© 2020 BJS Society Ltd Published by John Wiley & Sons LtdBackground: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients