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Purpose A subset of patients with common variable immunodeficiency (CVID) develops granulomatous and lymphocytic interstitial lung disease (GLILD), a restrictive lung disease associated with early mortality. The optimal therapy for GLILD is unknown. This study was undertaken to see if rituximab and azathioprine (combination chemotherapy) would improve pulmonary function and/or radiographic abnormalities in patients with CVID and GLILD. Methods A retrospective chart review of patients with CVID and GLILD who were treated with combination chemotherapy was performed. Complete pulmonary function tests (PFTs) and high-resolution computed tomography (HRCT) scans of the chest were done prior to therapy and >6 months later. HRCT scans of the chest were blinded, randomized, and scored independently (in pairs) by two radiologists. The differences between pre- and post-treatment HRCT scores and PFT parameters were analyzed. Results Seven patients with CVID and GLILD met inclusion criteria. Post-treatment increases were noted in both FEV1 (p=0.034) and FVC (p=0.043). HRCT scans of the chest demonstrated improvement in total score (p=0.018), pulmonary consolidations (p=0.041), ground-glass opacities (p=0.020) nodular opacities (p=0.024), and both the presence and extent of bronchial wall thickening (p=0.014, 0.026 respectively). No significant chemotherapy-related complications occurred. Conclusions Combination chemotherapy improved pulmonary function and decreased radiographic abnormalities in patients with CVID and GLILD.

Testing and implementation of Human-Robot Collaboration (HRC) could be dangerous due to the high-speed movements and massive forces generated by industrial robots. Wherever humans and industrial robots share a common workplace, accidents are likely to happen and always unpredictable. This has hindered the development of human robot collaborative strategies as well as the ability of authorities to pass regulations on how humans and robots should work together in close proximities. This paper presents the use of a Virtual Reality digital twin of a physical layout as a mechanism to understand human reactions to both predictable and unpredictable robot motions. A set of established metrics as well as a newly developed Kinetic Energy Ratio metric are used to analyse human reactions and validate the effectiveness of the Virtual Reality environment. It is the aim that Virtual Reality digital twins could inform the safe implementation of Human-Robot Collaborative strategies in factories of the future.

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