Since the Internet-of-Things (IoT) has been introduced, it is considered as one of the emerging technologies providing great opportunities to many vertical industries. One of the major IoT application areas that gets significant attention is smart city. Since it is unrealistic to expect full convergence toward a single IoT platform in the near future, it is mandatory to enable interworking between different platforms based on multiple standards, coexisting in the emerging smart cities. In this paper, we take the example of two global IoT standards, FIWARE and oneM2M, which are actively used in many smart city projects, and analyze them to show the feasibility of IoT platforms interworking. Based on the analysis, we design and implement a novel IoT interworking architecture providing a semantic driven integration framework suitable for smart city. The core idea behind our approach is to introduce interworking proxies that: 1) conduct a static mapping of sensor information between IoT platforms and 2) perform semantic interoperability using semantically annotated resources via a semantic interworking proxy that dynamically discovers new kinds of information and adapts itself to enable automatic translation of semantic data between given source and target IoT platforms while it is running. We present the system based on these proxies and evaluate it in Santander smart city. The results demonstrate that it is able to discover and manage IoT sensors connected to both oneM2M and FIWARE. It appears that the semantic approach provides the flexibility and dynamic adaptivity needed for fast growing and rapidly changing urban environments.

For the last decade the Smart City concept has been under development, fostered by the growing urbanization of the world’s population and the need to handle the challenges that such a scenario raises. During this time many Smart City projects have been executed–some as proof-of-concept, but a growing number resulting in permanent, production-level deployments, improving the operation of the city and the quality of life of its citizens. Thus, Smart Cities are still a highly relevant paradigm which needs further development before it reaches its full potential and provides robust and resilient solutions. In this paper, the focus is set on the Internet of Things (IoT) as an enabling technology for the Smart City. In this sense, the paper reviews the current landscape of IoT-enabled Smart Cities, surveying relevant experiences and city initiatives that have embedded IoT within their city services and how they have generated an impact. The paper discusses the key technologies that have been developed and how they are contributing to the realization of the Smart City. Moreover, it presents some challenges that remain open ahead of us and which are the initiatives and technologies that are under development to tackle them.

Introduction: Pronounced extracellular acidosis reduces both cardiac contractility and the β-adrenergic response. In the past, this was shown in some studies using animal models. However, few data exist regarding how the human end-stage failing myocardium, in which compensatory mechanisms are exhausted, reacts to acute mild metabolic acidosis. The aim of this study was to investigate the effect of mild metabolic acidosis on contractility and the β-adrenergic response of isolated trabeculae from human end-stage failing hearts. Methods: Intact isometrically twitching trabeculae isolated from patients with end-stage heart failure were exposed to mild metabolic acidosis (pH 7.20). Trabeculae were stimulated at increasing frequencies and finally exposed to increasing concentrations of isoproterenol (0 to 1 × 10^-6M). Results: A mild metabolic acidosis caused a depression in twitch-force amplitude of 26% (12.1 ± 1.9 to 9.0 ± 1.5 mN/mm²; n = 12; P < 0.01) as compared with pH 7.40. Force-frequency relation measurements yielded no further significant differences of twitch force. At the maximal isoproterenol concentration, the force amplitude was comparable in each of the two groups (pH 7.40 versus pH 7.20). However, the half-maximal effective concentration (EC₅₀) was significantly increased in the acidosis group, with an EC₅₀ of 5.834 × 10^-8M (confidence interval (CI), 3.48 × 10^-8 to 9.779 × 10^-8; n = 9), compared with the control group, which had an EC₅₀ of 1.056 × 10^-8M (CI, 2.626 × 10^-9 to 4.243 × 10^-8; n = 10; P < 0.05), indicating an impaired β-adrenergic force response. Conclusions: Our data show that mild metabolic acidosis reduces cardiac contractility and significantly impairs the β-adrenergic force response in human failing myocardium. Thus, our results could contribute to the still-controversial discussion about the therapy regimen of acidosis in patients with critical heart failure.

The first major contribution of the IoT Architectural Reference Model (IoT ARM) is the IoT Reference Model itself. Besides models, the IoT Reference Model provides the concepts and definitions on which IoT architectures can be built. This Chapter introduces the IoT Reference Model as a precondition for working with the Reference Architecture that is introduced in Chap. 8 .

Previous investigations have presumed a potential therapeutic effect of statin therapy in patients with acute respiratory distress syndrome (ARDS). Statins are expected to attenuate inflammation in the lungs of patients with ARDS due to their anti-inflammatory effects. Clinical investigations of the role of statin therapy have revealed contradictory results. This study aimed to investigate whether pretreatment and continuous therapy with statins in patients with sepsis-associated ARDS are associated with 28-day survival according to disease severity (mild, moderate, or severe). Patients with sepsis-associated ARDS from the surgical intensive care were enrolled in this prospective observational investigation. ARDS was classified into three groups (mild, moderate, and severe); 28-day mortality was recorded as the primary outcome variable and organ failure was recorded as secondary outcome variable. Sequential Organ Failure Assessment scores and the requirements for organ support were evaluated throughout the observational period to assess organ failure. 404 patients with sepsis-associated ARDS were enrolled in this investigation. The distribution of the ARDS subgroups was 13 %, 59 %, and 28 % for mild, moderate, and severe disease, respectively. Statin therapy improved 28-day survival exclusively in the patients with severe ARDS compared with patients without statin therapy (88.5 % and 62.5 %, respectively; P = 0.0193). To exclude the effects of several confounders, we performed multivariate Cox regression analysis, which showed that statin therapy remained a significant covariate for mortality (hazard ratio, 5.46; 95 % CI, 1.38–21.70; P = 0.0156). Moreover, after carrying a propensity score-matching in the severe ARDS cohort, Kaplan-Meier survival analysis confirmed the improved 28-day survival among patients with statin therapy (P = 0.0205). Patients with severe ARDS who received statin therapy had significantly more vasopressor-free days compared with those without statin therapy (13 ± 7 and 9 ± 7, respectively; P = 0.0034), and they also required less extracorporeal membrane oxygenation (ECMO) therapy and had more ECMO-free days (18 ± 9 and 15 ± 9, respectively; P = 0.0873). This investigation suggests a beneficial effect of continuous statin therapy in patients with severe sepsis-associated ARDS and a history of prior statin therapy. Further study is warranted to elucidate this potential effect.

The i-gel™, LMA-Supreme (LMA-S) and Laryngeal Tube Suction-D (LTS-D) are single-use supraglottic airway devices with an inbuilt drainage channel. We compared them with regard to their position in situ as well as to clinical performance data during elective surgery.