composition in distributed systems and proposes a new solution to achieve real-time composition, further enhanced by [@mgvj27] laying down different alternatives for reconfiguration; and [@c29] describes two alternatives for application reconfiguration built inside the middleware one at task level and the other at service level. Other approaches describe garbage collection techniques inside the middleware such as [@j22] that support real-time execution even during system maintenance time.

Other works provide higher level designs of specific applications based on real-time middleware such as [@j16] that uses the Data Distribution Software for remote control.

As part as the new virtualization paradigms that provide new execution infrastructures where applications can coexist, we find [@ddscsi; @c35] that studies the performance and [@j26] that provides predictable cloud computing.

**Cyber-physical systems and IoT spheres**. Cyber-physical systems and IoT are highly related because both refer to the monitoring and actuation over physical objects. In the case of medical systems, the physical objects are the patients and the sensors and actuators that monitor them are medical devices (that are very close to IoT devices). Medical devices are part of a medical cyber-physical system (MCPS) that monitor the physical conditions of patients and actuates on them or help in deciding 