Following the Structural Changes of Iron Oxides during Reduction under Transient Conditions.

Iron is considered as attractive energy carrier in a carbon-free circular energy economy. The reduction of iron oxide is crucial for its applica-tion as a metal fuel as it determines the efficiency of the cycle. Temperature programmed reduction of α-Fe2O3 was monitored by complementary X-ray absorption spectroscopy (XAS) and diffraction (XRD) to obtain the phase composition with high time resolution. Synchrotron Mössbauer spectroscopy (SMS) was additionally employed due to its high sensitivity to the different iron species. Theoretical calculations of surface and bulk adsorption processes were performed to establish the potential reaction pathways and the corresponding energy barriers. A kinetic particle model was then developed to bridge the experimental data and theoretical calculations, which reproduced the reduction onset and behavior. The reduction process was found to be strongly dependent on the heating rate in terms of the reduction window and the observed intermediate species. We propose that a core-shell mechanism determines the reaction by forming an iron layer which subsequently hinders diffusion of water out of the porous particles leading to some unreduced FeO at high temperature. This study demonstrates the need for complementary methods for describing complex heterogeneous systems and overcoming the chemical sensitivity limitations of any single method.

[Terminology of quantitative optical coherence tomography angiography metrics]. / Osobennosti terminologii kolichestvennykh pokazatelei opticheskoi kogerentnoi tomografii-angiografii.

This review is devoted to the English- and Russian-language terminology of quantitative metrics that are used in the evaluation of images obtained by optical coherence tomography angiography (OCT-A). The paper presents an analysis of the use of terms characterizing intraretinal blood flow (vascular density, perfusion density, skeletonized density, etc.), area and shape of the foveal avascular zone, and choriocapillaris blood flow. The factors causing the heterogeneity of OCT-A terminology are described, including the lack of a unified international nomenclature for OCT-A, features of their Russian translation, inconsistency of the parameters in optical coherence tomography systems of different manufacturers. The article also considers ways to standardize the terminology.

Benchmarking circularity in supply chains: A systematic literature review.

The challenges posed by unsustainable practices in today's economy underscore the urgent need for a transition toward a circular economy (CE) and a holistic supply chain (SC) perspective. Benchmarking plays a pivotal role in managing circular SCs, offering a metric to gauge progress. However, the lack of consensus on the optimal benchmarking approach hampers effective implementation of circular business practices. To address this gap, we conducted a systematic review of the literature, identifying 29 pertinent publications. The analysis revealed 30 unique attributes and sub-attributes for benchmarking circularity, which were clustered into five main attributes. The main attributes are goals, subjects, key performance indicators (KPIs), data sources, and evaluation methods, while the sub-attributes are organised as features of the main attributes and depicted as a feature model. Drawing from selected publications, we illustrated each feature with examples. Our model offers a comprehensive benchmarking reference for circularity and will be a valuable tool for managers in the transition toward circularity. Supply chains seeking to benchmark their transition to circularity can apply the reference model to ensure that their benchmarking strategy is consistent with state-of-the-art knowledge. By providing a generic circularity benchmarking approach that is valid for diverse economic sectors, our findings contribute to theoretical efforts to address the lack of generic frameworks for CE.

Effect of different diet composition on the fat profile of two different black soldier fly larvae populations.

Black soldier fly larvae (Hermetia illucens; BSFL) can transform organic wastes into nutritional biomass useful in animal feeding. The aim of this work was to study the effect of five diets (meat, fruit, vegetable substrates, a mix of them and control) on the profile of fatty acids (FAs) and sterols of BSFL. For a more exhaustive characterization of the nutritional properties, the profile of esterified FAs in the sn-2 position of the triglycerides, the most absorbed lipid component during animal digestion was evaluated. The dietary effect was estimated on two different Hermetia illucens populations (Greek - UTH and Italian - UNIPI). The diet affected all the lipid fractions examined. Regardless of diet, the fat was characterized mainly of lauric acid and other saturated FAs, which were found to be synthesized by the larvae, as it was not present in any of the five substrates. In general, UTH larvae contained a higher level of lipids (7.38 vs 2.48 g/100 g of larvae; P < 0.001) and saturated FAs (49.71 vs 36.10 g/100 g of Total Lipids; P < 0.001) and a lower percentage of monounsaturated FAs (14.74 vs 26.70 g/100 g of Total Lipids), C18:3n-3 (0.67 vs 1.13 g/100 g of Total Lipids; P < 0.001), and C18:2c9t11 (2.02 vs 2.80 g/100 g of Total Lipids; P < 0.001). Irrespective of the populations, BSFL reared on control and fruit substrates showed higher level of lipids (8.06 and 5.61 g/100 g of larvae, respectively), and saturated FA (38.99 and 71.19 g/100 g of Total Lipids, respectively), while the presence of meat increased the level of C20:4n-6, C20:5n-3 and C22:5n-3 (0.70, 0.13 and 0.45 g/100 g of Total Lipids, respectively). The results confirmed that BSFL accumulate phytosterols in their lipid fraction. The sterol profile was strongly influenced by the substrate on which the larvae were reared, with higher levels of cholesterol in the larvae of the meat group (38.55 mg/100 g of Total Lipids) and of stigmasterol and campesterol (9.04 and 15.23 mg/100 g of Total Lipids, respectively) in those of the vegetable group. The sterol content between the two populations was significantly different, with a higher percentage in UTH larvae (113.28 vs 34.03 mg/100 g of Total Lipids; P < 0.001). Finally, BSFLs showed a high plasticity of the lipid profile depending on both the substrate and the metabolism linked to the different populations. This variability allows the nutritional characteristics of the BSFL to be shaped by modifying the substrate, to adapt it to the technological and feeding needs to which the larvae are destined.

Mitigation Strategies against Food Safety Contaminant Transmission from Black Soldier Fly Larva Bioconversion.

The black soldier fly larva, Hermetia illucens, can efficiently convert organic waste into biomatter for use in animal feed. This circularity comes with a risk of contaminating downstream consumers of the larval products with microbes, heavy metals, and other hazards potentially present in the initial substrate. This review examines research on mitigation techniques to manage these contaminants, from pretreatment of the substrate to post-treatment of the larvae. While much research has been done on such techniques, little of it focused on their effects on food safety contaminants. Cheap and low-technology heat treatment can reduce substrate and larval microbial load. Emptying the larval gut through starvation is understudied but promising. Black soldier fly larvae accumulate certain heavy metals like cadmium, and their ability to process certain hazards is unknown, which is why some government authorities are erring on the side of caution regarding how larval bioconversion can be used within feed production. Different substrates have different risks and some mitigation strategies may affect larval rearing performance and the final products negatively, so different producers will need to choose the right strategy for their system to balance cost-effectiveness with sustainability and safety.

Atmosphere-dependent combustion of Ganoderma lucidum biomass toward its enhanced transformability into green energy.

Globally, the circular efficiency of biomass resources has become a priority due to the depletion and negative environmental impacts of fossil fuels. This study aimed to quantify the atmosphere-dependent combustion of Ganoderma lucidum (GL) biomass and its thermodynamic and kinetic parameters toward enhancing its circularity and transformability characteristics. The GL combustion occurred in the three stages of moisture removal, volatile release, and coke combustion. Combustion performance characteristics were more favorable in the N2/O2 atmosphere than in the CO2/O2 atmosphere under the same heating rates. The rising heating rate facilitated the release of volatiles. According to the model-free methods of Ozawa-Flynn-Wall and Kissinger-Akahira-Sunose, the activation energies essential for the primary reaction were 283.09 kJ/mol and 288.28 kJ/mol in the N2/O2 atmosphere and 233.09 kJ/mol and 235.64 kJ/mol in the CO2/O2 atmosphere. The gaseous products of the GL combustion included CH4, H2O, C = O, CO, CO2, NH3, C = C, and C-O(H). Ash prepared in both atmospheres exhibited a tendency for slag formation, with oxy-fuel combustion lowering its risk. This study thus provides a theoretical and practical basis for transforming GL residues into a sustainable energy source.

Egestabase - An online evidence platform to discover and explore options to recover plant nutrients from human excreta and domestic wastewater for reuse in agriculture.

Restoring nutrient circularity across scales is important for ecosystem integrity as well as nutrient and food security. As such, research and development of technologies to recover plant nutrients from various organic residues has intensified. Yet, this emerging field is diverse and difficult to navigate, especially for newcomers. As an increasing number of actors search for circular solutions to nutrient management, there is a need to simplify access to the latest knowledge. Since the majority of nutrients entering urban areas end up in human excreta, we have chosen to focus on human excreta and domestic wastewater. Through systematic mapping with stakeholder engagement, we compiled and consolidated available evidence from research and practice. In this paper, we present 'Egestabase' - a carefully curated open-access online evidence platform that presents this evidence base in a systematic and accessible manner. We hope that this online evidence platform helps a variety of actors to navigate evidence on circular nutrient solutions for human excreta and domestic wastewater with ease and keep track of new findings.

New circularity indicator for decision making in the stockpile management of construction and demolition waste: Perspectives of Australian practitioners.

Despite the increasing popularity of the circular economy, there remains a lack of consensus on how to quantify circularity, a critical aspect of the practical implementation of this model. To address this gap, this article examines the industry's perspective and efforts toward implementing the circular economy in real-world scenarios. We conducted 40 interviews with engineers, project leaders, and top-level managers in the Australian construction sector. Using Saldaña's coding approach, we analysed their views on circular economy practices and efforts within their organisations. Our findings reveal while waste minimisation, reduction of greenhouse gas emissions, and cost considerations are widely regarded as essential indicators of a successful circular economy model, the significance of waste storage and long-term stockpiling while awaiting treatment has been overlooked or under-emphasised in industry practices and academic literature. Stockpiling of waste has often been seen as a staging process in waste treatment. However, based on industry insights, it accumulates to the point of mismanagement when it becomes a safety and environmental concern. Addressing this oversight, we propose a storage circularity indicator that allows incorporating waste storage and stockpiling in circular economy models. Our research contributes to various environmental and waste management aspects, supporting policies and strategies for solid waste management and excessive stockpile prevention. By emphasising the significance of storage circularity, we clarify waste prevention techniques and address socio-economic issues such as the urgent need to reduce long-term stockpiling of solid waste. This work highlights the importance of decision-support tools in waste management to facilitate the implementation of circular economy principles. Our proposed storage circularity indicator promotes industrial collaboration, aligning with the concept of industrial symbiosis to optimise resource use and minimise waste generation. By discussing these topics, we aim to contribute to the advancement of more robust waste management strategies and policies that promote sustainable production and consumption practices.

Performance of Hermetia illucens (Diptera: Stratiomyidae) larvae reared on organic waste diets and pupal chitin and chitosan yield.

Recently, much research has been oriented towards the influence of different food wastes and agricultural by-products on the final larval biomass and chemical composition of the insect species Hermetia illucens L. (Diptera: Stratiomyidae). However, there is a gap in the literature regarding the possible relationship between the feeding substrate of H. illucens larvae and chitin. In this context, in the present study, larvae of H. illucens derived from two populations (i.e., UNIPI and UTH), were reared on different diets composed of fruits, vegetables, and meat. Based on the results, the larval survival was high for all diets tested. Larval growth in terms of weight gain, larval length, and feed conversion ratio (FCR) depended on the composition of each diet. The chitin and chitosan composition of larvae, reared on different substrates, did not reveal significant differences. Given the fact that the feeding substrate represent a significant cost in the industrial production of insects, its correlation with a high value product (i.e. chitosan) is important. On the other hand, as the prepupal stage of H. illucens is currently used as animal feed, the metabolization of chitin by farmed animals when the larvae or prepupae were offered as feed could have adverse effects. Thus, depending on the final product that is to be produced, industries could benefit from the establishment of a suitable diet.

Waste to resource recovery at a marina: Empirical evidence of upstream and downstream innovation for circularity.

In 2021, an Australian research centre partnered with a regional marina and shipyard where 90 businesses build, refit, and maintain boats in premium condition. Tenants and owners grapple with environmental waste management issues. Since there is a gap in applying action research but numerous calls to co-produce solutions and participate in translating ideas into practice, action research was used in this case study involving upstream and downstream innovation for circularity. Mixed methods data was collected through interviews, stakeholder workshops, and waste audits. A strategic action plan was created for closing the loop on waste. Interventions included tackling toxic, degradable products with natural alternatives, trading and remanufacturing materials to extend product life cycles, testing problematic materials, and pursuing product stewardship. This study is novel because it extends diffusion of innovation theory to real-world impact through a co-innovation process. Results underscore that ongoing achievements depend on properly sorting waste, accessing reprocessing facilities, and maintaining dedicated staff and partnerships, especially legislative support for making continuous improvement.

Nano cells from fruit bunch residue: Nestling nanotechnology within the circular oil palm milling residue management.

Nano-structured materials gain a vast market acceptance mainly due to their overarching endurance. Nanofibrillar cellulose (NFC) is one example of an augmenting agent unviable for production by small and medium enterprises (SMEs) due to the underlying process complexity. This study aims to characterise the NFC-alternative cells denoted as TRX-cellsⓇ, which is a mix of cellulose and non-cellulose components, ruling out its status as 'cellulose nanofibers, CNF'. The aim to test-fit the TRX-cells® production process into the circularity model was executed by deliberating on the usability of the byproduct. In doing so, fibrous oil palm empty fruit bunch (EFB) was treated with dioxydanyl radicals (DIOR) and homogenised. The rapid EFB-DIOR reaction at 70°C targeting dearomatisation reaction in a 10%-solid open system was performed before refining the DIOR-treated EFB to micro-scale fibres. Subjecting the micro-fibres to 17 kWh/mt PFI-milling yielded 85-95% of nano-scale fibrous mass. Relative to the stiff micro-fibres, the nano-scale cells web exhibit 34-41% softness enhancement judged from the web tear resistance profile associated with inter-fibre space reduction. Advanced chromatographic evidence for 27% xylan amongst TRX-cells®' total aldo-sugars was one form of the non-cellulose nano-component. High-resolution Transmission Electron Microscopy hyphenated to Energy Dispersive Analysis of X-ray (HRTEM-EDX) elemental mapping showed a 0.4 atomic percentage of nano-biominerals, confirming the presence of the redistributed dearomatised cells adjacent to cellulose held in the web of the hemicellulose. Shearing at the dearomatised inter-cell wall layers by PFI mill peeled 5 nm-100 nm thickness laminae. The smorgasbord of cellulose and non-celluloses resulted in crystallinity comparable to softwood NFC of approximately 60%, with unique preservation and precision-printing enabling properties. Given the non-recyclability of the DIOR-treated EFB microfibres, nestling the rapid waste transformation process into the circularity model shed light on circular bio-nanotechnology to the spectrum of opportunity for zero-waste, reduced emission and net zero carbon practices on top of an added value from waste transformation to a product.

A breakthrough in macro-scale circularity and eco-efficiency assessment: A case study of OECD countries.

Countries' circularity performance and CO2 emissions should be addressed as a part of the UN net-zero Sustainable Development Goals (SDGs) 2030. Macro-scale circularity assessment is regarded as a helpful tool for tracking and adjusting nations' progress toward the sustainable Circular Economy (CE) and SDGs. However, practical frameworks are required to address the shortage of real-world circularity assessments at the macro level. The establishment of CE benchmarks is also essential to enhance circularity in less sustainable nations. Further, monitoring the extent to which nations' circularity activities are sustainable and in line with the SDGs is an area that lacks sufficient practical research. The current research aims to develop a macro-level framework and benchmarks for national sustainable circularity assessments. Methodologically, we develop a dynamic network data envelopment analysis (DN-DEA) framework for multi-period circularity and eco-efficiency assessment of OECD countries. To do so, we incorporate dual-role and bidirectional carryovers in our macro-scale framework. From a managerial perspective, we conduct a novel comparative analysis of the circularity and eco-efficiency of the nations to monitor macro-scale sustainable CE trends. Research results reveal a significant performance disparity in circularity, eco-efficiency, and benchmarking patterns. Accordingly, circularly efficient nations cannot necessarily be considered eco-friendly and sustainable. Although Germany (as a superior circular nation) can be regarded as a circularity benchmark, it cannot serve as an eco-efficiency benchmark for less eco-efficient nations. Hence, the new method allows decision-makers not only to identify the nations' circularity outcome but also to distinguish sustainable nations from less sustainable ones. This, on the one hand, provides policymakers with a multi-faceted sustainability analysis, beyond the previous unidimensional analysis. On the other, it proposes improvement benchmarks for planning and regulating nations' future circularity in line with real sustainability goals. The capabilities of our innovative approach are demonstrated in the case study.

Impairment Arguments, Interests, and Circularity.

A common justification for abortion rights is that the death of the fetus does not violate any of the fetus's time-relative interests. The time-relative interest account (TRIA) of harm and wrongdoing tells us that a necessary condition for harming someone is that his or her time-relative interests are frustrated. Regarding the justification for abortion, this account falls prey to impairment arguments. Impairment arguments entertain cases of prenatal injury, such as the mother using illicit drugs that disable the child. The intuition is that the child who is born with such disabilities is harmed by the mother's drug use. But it is unclear what time-relative interest is violated in cases of prenatal harm. Typical responses to impairment arguments point out that the abortion case is different because the child does not exist to experience such harms; but in prenatal injury + survival cases, the child does live to experience those harms. Thus, the TRIA justification for abortion is not impugned by impairment counter-examples. This article argues that this response to impairment arguments is viciously circular. The response must say that so long as you kill the child, no harm is done. But this assumes that killing itself is morally inconsequential and is not itself a case of harm. The response to impairment arguments, then, assumes the permissibility of abortion.

Mechanical recycling of printed flexible plastic packaging: The role of binders and pigments.

Low-density polyethylene (LDPE), extensively employed in flexible plastic packaging, often undergoes printing with inks. However, during the mechanical recycling of post-consumer waste, these inks act as contaminants, subsequently compromising the quality and usability of recycled material. To understand better exactly which ink components cause which effects, this study comprehensively assesses the thermal behavior of three organic pigments and two commonly utilised binders, correlated with the impact on the mechanical recycling of LDPE-based flexible plastic packaging. In this regard, the study focuses on four pivotal factors: processability, mechanical properties, aesthetic attributes, and volatile organic compound profiles. The results indicate that nitrocellulose, used as a binder, degrades during reprocessing, resulting in film discoloration and the emission of potentially odorous compounds. Conversely, pigments are found to be dispersed within droplets of polyurethane binder in LDPE recyclates, whilst reprocessing printed samples detrimentally affects film properties, notably dart drop impact resistance, strain at break, and the number of inclusions. Additionally, it is shown that both inks comprise components that emit volatile compounds during reprocessing: non-thermally stable components, nitrocellulose and pigment yellow PY13, as well as low-molecular weight molecules from polyurethane and by-products from wax, plasticisers, and additives.

Measuring circular economy in olive oil mills: A review of circularity indicators and tools.

Circularity assessment and monitoring have become a core research topic in academic societies, as well as a basis for developing economic development measures. Despite the circular economy (CE) being a game-changer for the agro-food sector, little effort has been made to identify its level of circularity. In order to achieve the transition to a CE, stakeholders and industry professionals must be provided with appropriate indicators, tools and methods. Due to the complexity of CE measurement, it is necessary to devise indicators, methods and tools that are tailored to each industry. The objective of this review article is to identify the indicators and tools required for assessing the level of circularity in olive oil mills. This research collected data regarding available CE indicators at the company and product levels, as well as those applicable to the agro-food industry. As a result, a list of indicators appropriate to the needs of olive mills has been developed that could be used to measure the level of implementation of circular practices in this industry. The main conclusion reached is that once indicators are defined, they should be compared or combined with life cycle assessment methodologies to determine their applicability and effectiveness. There is no doubt that olive oil plays a significant economic, environmental and social role throughout the Mediterranean region. Hence, evaluating the CE is essential to demonstrate the effectiveness of current policies.

On the performance of Sargassum-derived calcium alginate ion exchange resins for Pb2+ adsorption: batch and packed bed applications.

Driven by climate change and human activity, Sargassum blooming rates have intensified, producing copious amount of the invasive, pelagic seaweed across the Caribbean and Latin America. Battery recycling and lead-smelter wastes have heavily polluted the environment and resulted in acute lead poisoning in children through widespread heavy metal contamination particular in East Trinidad. Our study details a comprehensive investigation into the use of Sargassum (S. natans), as a potential resource-circular feedstock for the synthesis of calcium alginate beads utilized in heavy metal adsorption, both in batch and column experiments. Here, ionic cross-linking of extracted sodium alginate with calcium chloride was utilized to create functional ion-exchange beads. Given the low quality of alginates extracted from Sargassum which produce poor morphological beads, composite beads in conjunction with graphene oxide and acrylamide were used to improve fabrication. Stand-alone calcium alginate beads exhibited superior Pb2+ adsorption, with a capacity of 213 mg g-1 at 20 °C and pH 3.5, surpassing composite and commercial resins. Additives like acrylamide and graphene oxide in composite alginate resins led to a 21-40% decrease in Pb2+ adsorption due to reduced active sites. Column operations confirmed Alginate systems' practicality, with 20-24% longer operating times, 15 times lower adsorbent mass on scale-up and 206% smaller column diameters compared to commercial counterparts. Ultimately, this study advocates for Sargassum-based Alginate ion-exchange beads as a bio-based alternative in Trinidad and developing nations for dealing with heavy metal ion waste, offering superior heavy metal adsorption performance and supporting resource circularity.

Formation Pattern Analysis of Spheroids Formed by a Droplet-Based Microfluidic System for Predicting the Aggressiveness of Tumor Cells.

Examining tumor heterogeneity is essential for selecting an appropriate anticancer treatment for an individual. This study aimed to distinguish low- and high-aggressive tumor cells by analyzing the formation patterns of spheroids. The droplet-based microfluidic system was employed for the formation of each spheroid from four different subtypes of breast tumor cells. Additionally, heterotypic spheroids with T lymphocytes and cancer-associated fibroblasts (CAFs) were produced, and distinctions between low- and high-aggressive tumor cells were explored through the analysis of formation patterns using circularity, convexity, and cell distributions. In both homotypic spheroids and heterotypic spheroids with T lymphocytes, spheroids formed from low-aggressive tumor cells exhibited high circularity and convexity. On the other hand, spheroids formed from high-aggressive tumor cells had relatively low circularity and convexity. In the case of heterotypic spheroids with CAFs, circularity and convexity did not exhibit clear differences between low- and high-aggressive tumor cells, but distinct variations were observed in cell distributions. CAFs and low-aggressive tumor cells were evenly distributed, whereas the CAFs were predominantly located in the inner layer, and high-aggressive tumor cells were primarily located in the outer layer. This finding can offer valuable insights into predicting the aggressiveness of unknown tumor cells.

Minimal logical teleology in artifacts and biology connects the two domains and frames mechanisms via epistemic circularity.

The understanding of artifacts and biological phenomena has often influenced each other. This work argues that at the core of these epistemic bridges there are shared teleological notions and explanations manifested in analogies between artifacts and biological phenomena. To this end, I first propose a focus on the logical structure of minimal teleological explanations, which renders said epistemic bridges more evident than an ontological or metaphysical approach to teleology, and which can be used to describe scientific practices in different areas by virtue of formal generality and minimalism (section 2). Second, I show how this approach highlights some epistemic features shared by the understanding of artifacts and biological phenomena, like a specific kind of epistemic circularity, and how functional analogies between artifacts and biological phenomena translate such epistemic circularity from one domain to the other (section 3). Third, I conduct a case study on the scientific practice around the brain's "compass", showing how the understanding of artifacts influences purpose ascription and measurement, and frames mechanisms in biology, especially in areas where purpose ascription is most difficult, like cognitive neuroscience (sections 4 and 5).

Comparative assessment of two circularity indicators for the case of reusable versus single-use secondary packages for fresh foods in Spain.

Sustainable packaging is a crucial focus in the context of circular economy efforts. This study evaluates the circularity of two secondary packaging systems used in Spanish fresh food produces: Reusable Plastic Crates and Single-use Cardboard Boxes. A Mass Flow Analysis was performed to assess the material flows in the production and use phases of both systems and two circular indicators were applied: the Material Circularity Indicator and Product Circular Indicator. While most previous studies for single-use packaging use these indicators at the product level, this study applies a system approach since the Reusable Plastic Crates can be reused 100 times. The functional unit was defined as the distribution of 1000 tonnes of fresh products, resulting in the distribution of 6,666,700 packages with 15 kg of products. The Material Circularity Indicator and Product Circular Indicator results show that Reusable Plastic Crates are more circular than Single-use Cardboard Boxes. The Product Circular Indicator provides a more comprehensive assessment of circularity by considering multiple life cycle stages, efficiency, and unrecoverable waste, resulting in a difference in circularity evaluations. The indicators used have limitations as they do not consider the resource stock. Further research is needed to explore this aspect.

Digital technologies to unlock safe and sustainable opportunities for medical device and healthcare sectors with a focus on the combined use of digital twin and extended reality applications: A review.

Medical devices have increased in complexity where there is a pressing need to consider design thinking and specialist training for manufacturers, healthcare and sterilization providers, and regulators. Appropriately addressing this consideration will positively inform end-to-end supply chain and logistics, production, processing, sterilization, safety, regulation, education, sustainability and circularity. There are significant opportunities to innovate and to develop appropriate digital tools to help unlock efficiencies in these important areas. This constitutes the first paper to create an awareness of and to define different digital technologies for informing and enabling medical device production from a holistic end-to-end life cycle perspective. It describes the added-value of using digital innovations to meet emerging opportunities for many disposable and reusable medical devices. It addresses the value of accessing and using integrated multi-actor HUBs that combine academia, industry, healthcare, regulators and society to help meet these opportunities. Such as cost-effective access to specialist pilot facilities and expertise that converges digital innovation, material science, biocompatibility, sterility assurance, business model and sustainability. It highlights the marked gap in academic R&D activities (PRISMA review of best publications conducted between January 2010 and January 2024) and the actual list of U.S. FDA's approved and marketed artificial intelligence/machine learning (AI/ML), and augmented reality/virtual reality (AR/VR) enabled-medical devices for different healthcare applications. Bespoke examples of benefits underlying future use of digital tools includes potential implementation of machine learning for supporting and enabling parametric release of sterilized products through efficient monitoring of critical process data (complying with ISO 11135:2014) that would benefit stakeholders. This paper also focuses on the transformative potential of combining digital twin with extended reality innovations to inform efficiencies in medical device design thinking, supply chain and training to inform patient safety, circularity and sustainability.