Early ultrasound diagnosis of conjoined twins at eight weeks of pregnancy: A case report

BACKGROUND Conjoined twins are a rare occurrence,and the majority of these malformations are detected during second trimester screening.CASE SUMMARY Herein we report a case of conjoined twins,which was diagnosed by ultrasound at 8 wk gestation and was normal at 7 wk gestation.The two fetuses shared one heart and were diagnosed as thoracopagus twins.This is the first report of conjoined twins diagnosed at 8 wk gestation.The pregnancy was terminated electively at 9 wk gestation.Because some congenital malformations can be diagnosed earlier,a prenatal ultrasound examination at an early gestational stage cannot be dismissed.CONCLUSION This case demonstrates that a 7-8 wk gestation might be the earliest period when conjoined twins can be diagnosed by ultrasound.

Successful Separation of Conjoined Twins at the Conakry University Hospital Center

Introduction: The birth of conjoined twins is an event extremely rare that offers unique therapeutic challenges and circumstances. We must examine each situation with the many questions that arise and which sometimes require a long reflection. We report a case of separation of pygopages conjoined twins as well as a review of the literature. Patients and Observations: a pair of conjoined twins aged 11 days, weighing 3080 g between them, was referred to the neonatology department from the Faranah prefecture, 300 km from Conakry, for care. The mother, a 30-year-old housewife, multipara, eight gestures and nine parities, had not followed any prenatal consultation. The delivery took place at home in a village with the death of the mother immediately postpartum. The clinical and paraclinical investigation had concluded with the diagnosis of Siamese type pygopage. After multidisciplinary consultation, the surgical treatment by separation of the twins was carried out at the age of 50 days with success and preservation of the physiological functions. Conclusion: The birth of conjoined twins is extremely rare. Each pair of Siamese is different and the surgical strategy must be adapted according to the shared organs. The perfect multidisciplinary work of the medical staff has been the main contributor to our success.

Digital Twins for Wastewater Treatment:A Technical Review

The digital twins concept enhances modeling and simulation through the integration of real-time data and feedback.This review elucidates the foundational elements of digital twins,covering their concept,entities,domains,and key technologies.More specifically,we investigate the transformative potential of digital twins for the wastewater treatment engineering sector.Our discussion highlights the application of digital twins to wastewater treatment plants(WWTPs)and sewage networks,hardware(i.e.,facilities and pipes,sensors for water quality and activated sludge,hydrodynamics,and power consumption),and software(i.e.,knowledge-based and data-driven models,mechanistic models,hybrid twins,control methods,and the Internet of Things).Furthermore,two cases are provided,followed by an assessment of current challenges in and perspectives on the application of digital twins in WWTPs.This review serves as an essential primer for wastewater engineers navigating the digital paradigm shift.

DNA Methylation Variation Is Identified in Monozygotic Twins Discordant for Congenital Heart Diseases

Aims:Multiple genes and environmental factors are known to be involved in congenital heart disease(CHD),but epigenetic variation has received little attention.Monozygotic(MZ)twins with CHD provide a unique model for exploring this phenomenon.In order to investigate the potential role of Deoxyribonucleic Acid(DNA)methyla-tion in CHD pathogenesis,the present study examined DNA methylation variation in MZ twins discordant for CHD,especially ventricular septal defect(VSD).Methods and Results:Using genome-wide DNA methylation profiles,we identified 4004 differentially methylated regions(DMRs)in 18 MZ twin pairs discordant for CHD,and 2826 genes were identified.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis revealed a list of CHD-associated pathways.To further investigate the role of DNA methylation in VSD,data from 7 pairs of MZ twins with VSD were analyzed.We identified 1614 DMRs corresponding to 1443 genes associated with arrhythmogenic right ventricular cardiomyopathy,cyclic guanosine monopho-sphate-protein kinase G(cGMP-PKG)signaling pathway by KEGG analysis,and cell-cell adhesion,calcium ion transmembrane transport by GO analysis.A proportion of DMR-associated genes were involved in calcium signaling pathways.The methylation changes of calcium signaling genes might be related to VSD pathogenesis.Conclusion:CHD is associated with differential DNA methylation in MZ twins.CHD may be etiologically linked to DNA methylation,and methylation of calcium signaling genes may be involved in the development of VSD.

A digital twins enabled underwater intelligent internet vehicle path planning system via reinforcement learning and edge computing

The Autonomous Underwater Glider(AUG)is a kind of prevailing underwater intelligent internet vehicle and occupies a dominant position in industrial applications,in which path planning is an essential problem.Due to the complexity and variability of the ocean,accurate environment modeling and flexible path planning algorithms are pivotal challenges.The traditional models mainly utilize mathematical functions,which are not complete and reliable.Most existing path planning algorithms depend on the environment and lack flexibility.To overcome these challenges,we propose a path planning system for underwater intelligent internet vehicles.It applies digital twins and sensor data to map the real ocean environment to a virtual digital space,which provides a comprehensive and reliable environment for path simulation.We design a value-based reinforcement learning path planning algorithm and explore the optimal network structure parameters.The path simulation is controlled by a closed-loop model integrated into the terminal vehicle through edge computing.The integration of state input enriches the learning of neural networks and helps to improve generalization and flexibility.The task-related reward function promotes the rapid convergence of the training.The experimental results prove that our reinforcement learning based path planning algorithm has great flexibility and can effectively adapt to a variety of different ocean conditions.

Deformation Evolution and Perceptual Prediction for Additive Manufacturing of Lightweight Composite Driven by Hybrid Digital Twins

This paper proposes a deformation evolution and perceptual prediction methodology for additive manufacturing of lightweight composite driven by hybrid digital twins(HDT).In order to improve manufacturing quality of irregular lightweight composite through boosting conceptual design in aeronautic and aerospace engineering,the HDT meaning hybridization of physical and digital domains,including deformation and energy efficiency can be built,where the essential parameters can be perceptually predicted in advance,by virtue of the fusion of physical sensors and digital information.The long short term memory(LSTM)can be employed to void vanishing gradient problem and improve predicting precision via Recurrent Neural Networks,thereby laying a foundation for the HDT.The diverse manufacturing requirements of different regions are integrated into the parameters designing phase by attaching region weights confirmed via empiricism and in-service simulation.The effects of slicing strategy and external support structures on manufacturing quality are considered from the perspective of improving dimensional accuracy.The manufacturing efficiency and comprehensive costs are accounted as consideration factors,which are perceptually predicted via LSTM.The designed manufacturing parameters through HDT were virtually examined by evaluating the deformation and equivalent stress distributions of fabricated lightweight component with composite material through AM process simulation.The physical experiments were conducted to verify the HDT-based pre-designing and optimization method of manufacturing parameters via fused deposition modeling(FDM).The energy consumption of actual manufacturing process was measured via digital power meter and applied to evaluate accuracy of perceptual prediction outcomes.The dimensional accuracy and distortion distribution of the manufactured lightweight prototype made with composite material were measured through the coordinate measuring machine(CMM)and 3D optical scanner.The proposed method demonstrates effectiveness in improving manufacturing quality and accurately predicting energy consumption,which have been verified with a three-way solenoid valve element,in which the maximum deformation was reduced by 39.78%and the mean absolute percentage error for perceptual prediction was 3.76%.

Rendering Frankenstein's monsters?The emergence and impacts of human digital twins

Human digital twins(HDTs)are set to revolutionise human-system integration and improve human capacities,productivity,and well-being by including human character-istics in system design.Reflecting real-life behaviours and emotional reactions,HDTs render virtual data-driven models of people.Their presence in many fields-including office work,education,and healthcare-showcases their ability to advance diagnoses,workforce training,and individualised learning.However,the general HDTs acceptance hypothesis calls for a critical analysis of their ethical ramifications and social influence.Emphasising the need of social adaptations to maintain stability,structural functionalism provides a suited framework to examine the roles of HDTs inside social systems.Despite their obvious advantages,HDTs raise ethical questions.While addressing concerns about user acceptance and ethical norms,engineers,designers and the legal regulators,but also the users-by means of‘owners’-must consider the substantial consequences of HDTs and their customisation.HDTs'duality,like a double-edged sword,calls for deliberate usage and considerable thought to negotiate the changing terrain of human-machine interaction.

The status quo and future prospects of digital twins for healthcare

Digital twin technology plays a pivotal role in driving the digital transformation of healthcare services.This review provides a comprehensive overview of the applications of digital twins in the healthcare sector.We elucidate the concept and classification of digital twins for healthcare and provide a detailed account of their current applications in clinical diagnosis,treatment,and hospital operational management.Taking the cardiac digital twin as an example,this review showcases the typical use of digital twins in clinical practice and scientific research.Additionally,the challenges faced by digital twin technology in data collection,model construction,ethics,and regulations were analyzed.Finally,the broad prospects of digital twins in promoting precision and personalization in healthcare are envisioned.

Inaugural editorial-Digital Twins and Applications

Academician of the CAE member Youxian Sun from Zhejiang University initiated Digital Twins and Applications(ISSN 2995-2182).It is published by Zhejiang University Press and the Institution of Engineering and Technology and sponsored by Zhejiang Univer-sity.Digital Twins and Applications aim to provide a specialised platform for researchers,practitioners,and industry experts to publish high-quality,state-of-the-art research on digital twin technologies and their applications.

Origin of nucleation and growth of extension twins in grains unsuitably oriented for twinning during deformation of Mg-1%Al

A large number of anomalous extension twins,with low or even negative twinning Schmid factors,were found to nucleate and grow in a strongly textured Mg-1Al alloy during tensile deformation along the extruded direction.The deformation mechanisms responsible for this behaviour were investigated through in-situ electron back-scattered diffraction,grain reference orientation deviation,and slip trace-modified lattice rotation.It was found that anomalous extension twins nucleated mainly at the onset of plastic deformation at or near grain boundary triple junctions.They were associated with the severe strain incompatibility between neighbour grains as a result from the differentbasal slip-induced lattice rotations.Moreover,the anomalous twins were able to grow with the applied strain due to the continuous activation ofbasal slip in different neighbour grains,which enhanced the strain incompatibility.These results reveal the complexity of the deformation mechanisms in Mg alloys at the local level when deformed along hard orientations.

Bipolar hip arthroplasty using conjoined tendon preserving posterior lateral approach in treatment of displaced femoral neck fractures

BACKGROUND Hip fractures account for 23.8%of all fractures in patients over the age of 75 years.More than half of these patients are older than 80 years.Bipolar hemiarthroplasty(BHA)was established as an effective management option for these patients.Various approaches can be used for the BHA procedure.However,there is a high risk of postoperative dislocation.The conjoined tendon-preserving posterior(CPP)lateral approach was introduced to reduce postoperative dislocation rates.AIM To evaluate the effectiveness and safety of the CPP lateral approach for BHA in elderly patients.METHODS We retrospectively analyzed medical data from 80 patients with displaced femoral neck fractures who underwent BHA.The patients were followed up for at least 1 year.Among the 80 patients,57(71.3%)were female.The time to operation averaged 2.3 d(range:1-5 d).The mean age was 80.5 years(range:67-90 years),and the mean body mass index was 24.9 kg/m^(2)(range:17-36 kg/m^(2)).According to the Garden classification,42.5%of patients were typeⅢand 57.5%of patients were typeⅣ.Uncemented bipolar hip prostheses were used for all patients.Torn conjoined tendons,dislocations,and adverse complications during and after surgery were recorded.RESULTS The mean postoperative follow-up time was 15.3 months(range:12-18 months).The average surgery time was 52 min(range:40-70 min)with an average blood loss of 120 mL(range:80-320 mL).The transfusion rate was 10%(8 of 80 patients).The gemellus inferior was torn in 4 patients(5%),while it was difficult to identify in 2 patients(2.5%)during surgery.The posterior capsule was punctured by the fractured femoral neck in 3 patients,but the conjoined tendon and the piriformis tendon remained intact.No patients had stem varus greater than 3 degrees or femoral fracture.There were no patients with stem subsidence more than 5 mm at the last follow-up.No postoperative dislocations were observed throughout the follow-up period.No significance was found between preoperative and postoperative mean Health Service System scores(87.30±2.98 vs 86.10±6.10,t=1.89,P=0.063).CONCLUSION The CPP lateral approach can effectively reduce the incidence of postoperative dislocation without increasing perioperative complications.For surgeons familiar with the posterior lateral approach,there is no need for additional surgical instruments,and it does not increase surgical difficulty.

Survey on digital twins for Internet of Vehicles:Fundamentals,challenges,and opportunities

As autonomous vehicles and the other supporting infrastructures(e.g.,smart cities and intelligent transportation systems)become more commonplace,the Internet of Vehicles(IoV)is getting increasingly prevalent.There have been attempts to utilize Digital Twins(DTs)to facilitate the design,evaluation,and deployment of IoV-based systems,for example by supporting high-fidelity modeling,real-time monitoring,and advanced predictive capabilities.However,the literature review undertaken in this paper suggests that integrating DTs into IoV-based system design and deployment remains an understudied topic.In addition,this paper explains how DTs can benefit IoV system designers and implementers,as well as describes several challenges and opportunities for future researchers.

Digital Twins for Engineering Asset Management:Synthesis,Analytical Framework,and Future Directions

Effective engineering asset management(EAM)is critical to economic development and improving livability in society,but its complexity often impedes optimal asset functionalities.Digital twins(DTs)could revolutionize the EAM paradigm by bidirectionally linking the physical and digital worlds in real time.There is great industrial and academic interest in DTs for EAM.However,previous review studies have predominately focused on technical aspects using limited life-cycle perspectives,failing to holistically synthesize DTs for EAM from the managerial point of view.Based on a systematic literature review,we introduce an analytical framework for describing DTs for EAM,which encompasses three levels:DT 1.0 for technical EAM,DT 2.0 for technical-human EAM,and DT 3.0 for technical-environmental EAM.Using this framework,we identify what is known,what is unknown,and future directions at each level.DT 1.0 addresses issues of asset quality,progress,and cost management,generating technical value.It lacks multi-objective self-adaptive EAM,however,and suffers from high application cost.It is imperative to enable closed-loop EAM in order to provide various functional services with affordable DT 1.0.DT 2.0 accommodates issues of human-machine symbiosis,safety,and flexibility management,generating managerial value beyond the technical performance improvement of engineering assets.However,DT 2.0 currently lacks the automation and security of human-machine interactions and the managerial value related to humans is not prominent enough.Future research needs to align technical and managerial value with highly automated and secure DT 2.0.DT 3.0 covers issues of participatory governance,organization management,sustainable development,and resilience enhancement,generating macro social value.Yet it suffers from organizational fragmentation and can only address limited social governance issues.Numerous research opportunities exist to coordinate different stakeholders.Similarly,future research opportunities exist to develop DT 3.0 in a more open and complex system.

Exploring Alternatives to Create Digital Twins from and for Process Simulation

In this work,Digital Twins based on Neural Networks for the steady state production of styrene were generated.Thus,both the Aspen Technology AI Model Builder(alternative 1)and a homemade MS Excel VBA code connected to Aspen HYSYS and Aspen Plus(alternative 2)were used with this same aim.The raw data used for generating the Digital Twins were obtained from process simulations using Aspen HYSYS and/or Aspen Plus,which were connected through a recycle-like stream via automation for solving the entire simulation flowsheet.Aspen HYSYS was used for solving the pre-heating,reaction,and stabilization sections of the process whereas Aspen Plus ensured the computing of the separation and purification columns.Both alternatives led to an excellent prediction showing the capability of creating Digital Twins from and for process simulation.

Numerical simulation on size effect of copper with nano-scale twins

To understand the tensile deformation of electro-deposited Cu with nano-scale twins, a numerical study was carried out based on a conventional theory of mechanism-based strain gradient plasticity （CMSG）. The concept of twin lamella strengthening zone was used in terms of the cohesive interface model to simulate grain-boundary sliding and separation. The model included a number of material parameters, such as grain size, elastic modulus, plastic strain hardening exponent, initial yield stress, as well as twin lamellar distribution, which may contribute to size effects of twin layers in Cu polycrystalline. The results provide information to understand the mechanical behaviors of Cu with nano-scale growth twins.

Preoperative preparation and surgical separation of conjoined pygopagus twins

Conjoined twins are very rare with an estimated ,incidence of about 1 in 200 000 births with a male-female ratio of 1：3 The separation ot conjolned twins presents a challenge to surgeons and also a test for comprehensive efficiency of a hospital. Recently, a rare pair of pygopagus twins were admitted to our hospital and a successful surgical separation was carded out.

一次大磁暴主相期间ENA氧与氢的分离及分布特征——TWINS卫星观测

本文采用基于ENA(Energetic Neutral Atoms)次生电子起始脉冲高度分布,统计拟合分离中能段ENA两种主要成分氢和氧的方法,研发了实现ENA氢与氧分离的TWINS卫星原始数据处理软件;其中所需要的脉高分布模型,参照已有理论公式,利用TWINS(Two Wide-angle Imaging Neutral-atom Spectrometers)卫星标定数据进行拟合确定未知参数,再加以计算得到.将上述方法用于TWINS卫星实测数据,分离得到一次大磁暴主相期间ENA-H和ENA-O微分通量随观测视线的分布及其随主相增长的变化.分析发现:(1)ENA-H与ENA-O微分通量的强度和随观测视线的分布特征都有明显差别,从某种角度反映出ENA之源的O^+与H^+离子强度和分布之间的差异;(2)接近主相极大时,ENA-H有很强的低高度发射(LAE,Low Altitude Emission),出现在磁地方时午夜前极光和亚极光纬度区,意味着该区域较强的等离子片和环电流质子沉降,进入到外层基底以下较低高度大气层;而ENA-O则未有明显LAE产生;ENA-O强通量观测视线主要穿过广大环电流区,磁地方时主要在午夜之后以及黄昏前和黎明前后;(3)在磁暴主相快速增长期,ENA-O平均总通量持续增大,而ENA-H同步减小,ENA-O与ENA-H平均总通量的比率随环电流指数Dst绝对值的增大而大致成正比增长.

Evolution of twins and texture and its effects on mechanical properties of AZ31 magnesium alloy sheets under different rolling process parameters

In order to investigate the dependence of microstructure and mechanical properties on the rolling process parameters, AZ31 magnesium alloy sheets with different grain sizes, basal texture intensities and twinning types were obtained using hot rolling at various temperatures and reductions. The volume fractions of the extension, contraction and secondary twins in the as-rolled sheets depend on the grain size. The highest volume fractions of three types of twins are obtained at 523 K under the reduction of 10% when the average grain size value is the maximum. The critical reductions for complete dynamic recrystallization are 30% at 523 K and 40% at 473 K. The increase of yield strength is ascribed to both grain-refinement strengthening and basal texture strengthening at the first stage. When the grain size does not decrease with increasing the reduction, the yield strength is mainly influenced by the texture weakening.

Tensile Properties of Cu with Deformation Twins Induced by SMAT

High density nano-scale deformation twins were introduced in the surface layer of Cu sample by means of surface mechanical attrition treatment （SMAT） at room temperature. The Cu sample with deformation twins shows a yield strength of about 470 MPa in tension tests. The significant strengthening may be attributed to the effective inhibition of slip dislocations by abundant twin boundaries.

利用差分体像素CT由TWINS卫星ENA成像反演暴时环电流离子三维分布

本文将体像素CT方法应用于TWINS卫星高能中性原子立体成像数据,重建环电流离子通量强度三维分布.为了克服卫星ENA成像可能存在的仪器偏差造成反演误差增大甚至迭代发散无解的问题,发展了差分ENA体像素CT反演方法.采用环电流离子分布理论模型和实际卫星观测几何构形进行模拟检验,证明了该方法的可靠性和优越性.利用此方法分析2012年7月15日磁暴(min Dst=-133nT)主相期间TWINS两颗卫星的实测ENA数据(能量范围4keV^50keV),反演得到环电流离子微分通量随L值/纬度/地方时的三维分布与能谱.所得离子通量呈现显著不对称的部分环电流特征,主要分布在低纬-赤道区磁午夜前后至黎明前数小时,L值约为3.5~6.5的区域;将反演得到的磁午夜后赤道区环电流离子通量能谱,与THEMIS卫星当地测量得到的此区域同时的能谱作比较,两者符合得很好;证明本文发展的差分体像素CT是由多卫星ENA二维图像重建暴时环电流离子分布的有效方法.