ABSTRACT
Nowadays, new challenges around increasing production quality and productivity, and decreasing energy consumption, are growing in the manufacturing industry. In order to tackle these challenges, it is of vital importance to monitor the health of critical components. In the machine tool sector, one of the main aspects is to monitor the wear of the cutting tools, as it affects directly to the fulfillment of tolerances, production of scrap, energy consumption, etc. Besides, the prediction of the remaining useful life (RUL) of the cutting tools, which is related to their wear level, is gaining more importance in the field of predictive maintenance, being that prediction is a crucial point for an improvement of the quality of the cutting process. Unlike monitoring the current health of the cutting tools in real time, as tool wear diagnosis does, RUL prediction allows to know when the tool will end its useful life. This is a key factor since it allows optimizing the planning of maintenance strategies. Moreover, a substantial number of signals can be captured from machine tools, but not all of them perform as optimum predictors for tool RUL. Thus, this paper focuses on RUL and has two main objectives. First, to evaluate the optimum signals for RUL prediction, a substantial number of them were captured in a turning process and investigated by using recursive feature elimination (RFE). Second, the use of bidirectional recurrent neural networks (BRNN) as regressive models to predict the RUL of cutting tools in machining operations using the investigated optimum signals is investigated. The results are compared to traditional machine learning (ML) models and convolutional neural networks (CNN). The results show that among all the signals captured, the root mean squared (RMS) parameter of the forward force ( F-y ) is the optimum for RUL prediction. As well, the bidirectional long-short term memory (BiLSTM) and bidirectional gated recurrent units (BiGRU), which are two types of BRNN, along with the RMS of F-y signal, achieved the lowest root mean squared error (RMSE) for tool RUL, being also computationally the most demanding ones.
ABSTRACT
Objective: COVID-19 has left no healthcare system untouched. Adjustments to accommodate COVID-19 pandemic needs resulted in widespread deferment of non-COVID19 scheduled healthcare activities, added to a general patient's reluctance to visit healthcare settings. This study is aimed to analyse retrospectively demographic and clinical characteristics of patients with acute poisoning attended at the Emergency Department (ED) in three different pandemic periods of time. Material and/or methods: We carried out an observational and retrospective study in which we included all the patients who visited the Emergency Department at Hospital Son Espases due to acute poisoning during three different periods of time from June to July in 2019 (pre pandemic), same period in 2020 (right after the strict confinement in Spain) and in 2021 (post-pandemic). This study was approved by the Research Ethics Committee of the Balearic Islands. Results: All cases of acute poisoning were included (n = 1182). Patients with acute poisoning presenting to the ED decreased significantly during the pandemic (2019: 1.9%, 2020: 1.5%;p < 0.01). The ratio male/female and the mean age of the patients increased during the pandemic (2 vs. 1.4, p = 0.02, and 31.4 vs. 41.3 years, p < 0.001, respectively). The roll of poisoning in suicide attempts increased substantially during the pandemic (2019: 8.71%, 2020: 21%;p < 0.01), mostly driven by the increase in poisoning due to commercially available drugs (2019: 14.20%;2020: 28.76%, p < 0.01), while recreational drug poisoning decreased (2019: 76.1%, 2020: 62%;p < 0.01), while in 2021, figures tended to return to prior patterns. Conclusions: This study found significant changes in some clinical patterns in patients attending the ED due to acute poisoning in the context of COVID19, in line with the already described impact of the pandemic in other areas of the healthcare system.
ABSTRACT
Objective: The COVID-19 pandemic has affected daily life in unprecedented ways. Many studies have found dramatic changes in individuals' physical activity, sleep and mental health [1]. This study aimed to analyze retrospectively demographic and clinical characteristics of patients with acute poisoning presenting to the Emergency Department (ED) [2] in three different periods of time (June-July): pre-pandemic (2019), after strict confinement of the Spanish population (2020) and post-pandemic (2021) [3]. Methods: All cases of poisoning in the study periods were reviewed. Demographic variables and the type of intoxication were studied. A comparison was made between the three periods. Results: All cases of acute poisoning were included (n=1182, 528 in June-July 2019;299 in June-July 2020, 355 in June-July 2021). Patients with acute poisoning presenting to the ED decreased during the pandemic (2019: 1.9%, 2020: 1.5%;p<0.01). The ratio male/female increased during the pandemic (2 versus 1.4, p=0,02). The mean age of the patients increased during the pandemic (2019: 31.4, 2020: 41.3, p<0,001), this tendency was maintained in 2021 (38.3). Poisoning in suicide attempts increased during the pandemic (2019: 8.71%, 2020: 21%;p<0.01), as well as poisoning due to commercialized drugs (2019: 14.20%;2020: 28.76%, p<0.01), while recreational drug poisoning decreased (2019: 76.1%, 2020: 62%;p<0.01), in 2021 these increased again (69%, p 0.07). Conclusion: This study has found significant changes in some clinical patterns in patients attending the ED due to acute poisoning in the context of COVID-19, in line with the already described psychological impact of the pandemic.
ABSTRACT
Objective: The COVID-19 pandemic has generated an increase in anxiety-depressive disorders throughout society, with an evident impact on children and adolescents, further precipitated by limitations in social activities during confinement. The increase in home isolation with abuse of new technologies, often far from parental control, involves risky situations such as the case we present. Case report: A 19-year-old man diagnosed with major depressive disorder, with psychiatric admissions since July 2019 for overdose with suicidal intent was home treated with methylphenidate 40mg, mirtazapine 15mg and vortioxetine 10mg. In August, the patient was searching for information on the Internet about euthanasia and suicide without pain in different pages and Internet forums. He bought two products online (by Amazon) that seemed effective for this purpose: a kilogram packet of sodium nitrate and a bottle of antifreeze. Finally, he decided on the first option due to the risk of suffering after ingesting antifreeze. On August 26 (4:00 pm), he ate a tablespoon (80 mg) of sodium nitrate. He developed dyspnea and feeling overwhelmed so he decided to informed his family of what he had done and an ambulance was called. He was transferred to hospital and given oxygen. At 7:00 pm in the emergency department he was noted to have a greyish coloration (“hot dead” appearance) with poor respiratory mechanics, tachycardic, tachypneic, with signs of peri-arrest: blood pressure 96/50mmHg, heart rate 145 bpm, respiratory rate 30/min, oxygen saturations 70%. He also had uncoordinated movements, and could not obey orders. The patient was sedated for intubation and mechanical ventilation. An arterial blood gas analysis performed after intubation showed: pH 7.35, pO2 165mmHg, pCO2 24mmHg, base excess -10.4, bicarbonate 14.5 mEq/L, potassium 3.1 mmol/L, methemoglobin 83%, carboxyhemoglobin 1.4%, lactate 13.3mmol/L. Methylene blue 1% (75mg intravenously) and activated charcoal by nasogastric tube were administered (after intubation). Later, he was admitted to the intensive care unit (9:20 pm). Physicians from this unit decided to administrate hydroxocobalamin (5 g intravenously at 00.39 am). The patient was extubated and discharged from the intensive care unit 36 hours after his admission to the department of Internal Medicine, without clinical complications;later he was transferred to Psychiatry Department. Conclusion: The toxic mechanism of sodium nitrate is related to the generation of methemoglobin. This patient survived a potentially lethal methemoglobin level following intentional ingestion of sodium nitrate with prompt administration of an antidote.
ABSTRACT
Background: The COVID-19 pandemic has caused global changes that affect the daily life of the world's population, with a direct impact on individuals' physical and mental health as well as on their social and recreational habits. Methods: This study aimed to retrospectively analyze the demographic and clinical characteristics of patients attended to for acute poisoning in a hospital emergency department (ED) at three different periods of time: pre-pandemic (2019), after strict lockdown of the population in Spain (2020), and post-pandemic (2021). We analyzed 2 months (June and July) in each period. Results: A total of 1,182 cases of acute poisoning were included. Compared to the pre-pandemic period, during lockdown, the number of patients with acute poisoning decreased (2019: 1.9% vs. 2020: 1.5%; p<.01); the ratio of men to women increased (2.0 vs. 1.4; p=.02); and the mean age of patients increased (2019: 31.4 vs. 2020: 41.3; p<.001), a trend which continued in 2021 (38.3). Poisoning with suicidal intention also increased during the pandemic (2019: 8.71% vs. 2020: 21.0%; p<.01) whereas poisonings with a recreational intention declined (2019: 76.1% vs. 2020: 62.0%; p<.01) with a non-significant increase in 2021 (69.0%, p=.07). Conclusion: The COVID-19 pandemic generated clinical and epidemiological changes in the acute poisonings attended to in a hospital emergency department during the various phases of the pandemic.
ABSTRACT
The current COVID-19 pandemic is caused by the SARS-CoV-2 coronavirus. The initial recognized symptoms were respiratory, sometimes culminating in severe respiratory distress requiring ventilation, and causing death in a percentage of those infected. As time has passed, other symptoms have been recognized. The initial reports of cutaneous manifestations were from Italian dermatologists, probably because Italy was the first European country to be heavily affected by the pandemic. The overall clinical presentation, course and outcome of SARS-CoV-2 infection in children differ from those in adults as do the cutaneous manifestations of childhood. In this review, we summarize the current knowledge on the cutaneous manifestations of COVID-19 in children after thorough and critical review of articles published in the literature and from the personal experience of a large panel of paediatric dermatologists in Europe. In Part 1, we discuss one of the first and most widespread cutaneous manifestation of COVID-19, chilblain-like lesions. In Part 2, we review other manifestations, including erythema multiforme, urticaria and Kawasaki disease-like inflammatory multisystemic syndrome, while in Part 3, we discuss the histological findings of COVID-19 manifestations, and the testing and management of infected children, for both COVID-19 and any other pre-existing conditions.