Screening for familial hypercholesterolaemia in primary care: Time for general practice to play its part

Fifty per cent of first-degree relatives of index cases with familial hypercholesterolemia (FH) inherit the disorder. Despite cascade screening being the most cost-effective method for detecting new cases, only a minority of individuals with FH are currently identified. Primary care is a key target area to increase identification of new index cases and initiate cascade screening, thereby finding close relatives of all probands. Increasing public and health professional awareness about FH is essential. In the United Kingdom and in Australia, most of the population are reviewed by a General Practitioner (GP) at least once over a three-year period, offering opportunities to check for FH as part of routine clinical consultations. Such opportunistic approaches can be supplemented by systematically searching electronic health records with information technology tools that identify high risk patients. GPs can help investigate and implement results of this data retrieval. Current evidence suggests that early detection of FH and cascade testing meet most of the criteria for a worthwhile screening program. Among heterozygous patients the long latent period before the expected onset of coronary artery disease provides an opportunity for initiating effective drug and lifestyle changes. The greatest challenge for primary care is to implement an efficacious model of care that incorporates sustainable identification and management pathways

Sustainable car life cycle design, taking inspiration from natural systems and thermodynamics

This paper exposes the search for a tool and method, which from a systems approach, adopts the rules and logic that govern our physical context (biosphere) in order to provide guidelines that the car industry could use to achieve an ideal state for ecological, economical and social sustainability

Digitally fabricated low cost housing: material, joint and prototype

Motivated by the global housing deficit and limited natural resources, this study aims to utilize digital fabrication technologies coupled with local sustainable materials in the quest for alternative, adequate low-cost housing solutions for the less fortunate population, mainly in developing countries. The thesis is structured into two main parts: a theoretical and an empirical study. The theoretical part identifies the research problem and lays the foundation of knowledge, as well as defines the motivating questions, aim, objectives, scope, methodology and tools used throughout the thesis. An overview of fundamental concepts of mechanisation, standardisation, prefabrication, mass housing, and mass customisation is provided. Different types of prefabricated housing are presented followed by a discussion of select architect-led and industry-led early precedents in prefabrication. The theoretical part also includes an analysis of state-of-the-art built projects or prototypes of digitally fabricated houses. Through this analysis, how these prototypes respond to housing problems is addressed and an observation is made of how these built projects can be categorised into main streams or different trends. After defining the potentials and limitations of these precedents, a number of design criteria or design guidelines are proposed forming the basis for the proposition of a housing system that addresses these drawbacks under the name “Housing System 01”. The second part of the thesis is a Design-Build-Evaluate empirical study in which the proposed housing system combining concepts of complete off-site prefabrication with modular parametric localised digital fabrication is outlined. Given the necessity of cost reductions, an integral joining system (snap-fit) using an agricultural residue panel material is tested as the principal method for the construction of wall assemblies. The study proves that by using integral joints, it is possible to involve the end-user of the housing unit in the construction activities promoting the concept of “Self-Build”, as the simplicity of the system allows for the participation of end-users with no previous construction expertise thereby decreasing cost. A set of mechanical tests are performed to characterise wheat straw panels and then snap-fit joints are dimensioned within the elastic limits of this specific material. Three partial wall assembly prototypes are built. One axial compression test is performed on one of the prototypes. The tests show that the material and the joint system promise to provide a viable construction system as an alternative low-cost housing solution. Further optimisation and more physical structural testing are needed to address more complex forces and loading scenarios

A survey on personal computer applications in industrial design process

Thesis (Master)--Izmir Institute of Technology, Industrial Design, Izmir, 1999Includes bibliographical references (leaves: 157-162)Text in English, Abstract: Turkish and Englishxii, 194 leavesIn this thesis, computer aided design systems are studied from the industrial designer's point of view. The study includes industrial design processes, computer aided design systems and the integration aspects.The technical issues are priorly studied, including current hardware and software technologies. The pure technical concepts are tried to be supported with real-world examples and graphics. Several important design software are examined, whether by personal practice or by literature research, depending on the availability of the software.Finally, the thesis include a case study, a 17" LCD computer monitor designed with a set of graphic programs including two-dimensional and three-dimensional packages.Keywords: Computers, industrial design methods, design software, computer aided design

A design methodology for the user interface of an electromechanical parts database

Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering; and, (M.B.A.)--Massachusetts Institute of Technology, Sloan School of Management; in conjunction with the Leaders for Global Operations Program at MIT, 2013.Cataloged from PDF version of thesis.Includes bibliographical references (p. 44).In an increasingly complex supply chain, the use of a structured methodology for locating applicable existing parts during the design process can help a large-volume manufacturer to encourage the reuse of components already in inventory, rather than source new ones. This reuse can dramatically reduce the speed at which the database grows in complexity and can prevent unnecessary escalation of inventory levels. It can also serve to increase the order volume of a smaller number of electromechanical components and reduce the cost and delivery time of new products in development. The use of an internal search tool to facilitate the design process will also encourage engineers to make design decisions that benefit the larger organization. This thesis proposes a design methodology for a web-based search tool aimed at reducing unnecessary new part creation in a component database. Included is a proposed set of features to be implemented in the software tool to assist engineers in locating, reviewing and utilizing relevant existing parts quickly, as well as suggestions for integrating this tool into the standard engineering workflow. The goal will be to encourage the reuse of parts in inventory and prevent unjustified proliferation in the database.by Toni J. Ferreira.M.B.A.S.M

Working Notes from the 1992 AAAI Workshop on Automating Software Design. Theme: Domain Specific Software Design

The goal of this workshop is to identify different architectural approaches to building domain-specific software design systems and to explore issues unique to domain-specific (vs. general-purpose) software design. Some general issues that cut across the particular software design domain include: (1) knowledge representation, acquisition, and maintenance; (2) specialized software design techniques; and (3) user interaction and user interface

Performance assessment of urban precinct design: a scoping study

Executive Summary: Significant advances have been made over the past decade in the development of scientifically and industry accepted tools for the performance assessment of buildings in terms of energy, carbon, water, indoor environment quality etc. For resilient, sustainable low carbon urban development to be realised in the 21st century, however, will require several radical transitions in design performance beyond the scale of individual buildings. One of these involves the creation and application of leading edge tools (not widely available to built environment professions and practitioners) capable of being applied to an assessment of performance across all stages of development at a precinct scale (neighbourhood, community and district) in either greenfield, brownfield or greyfield settings. A core aspect here is the development of a new way of modelling precincts, referred to as Precinct Information Modelling (PIM) that provides for transparent sharing and linking of precinct object information across the development life cycle together with consistent, accurate and reliable access to reference data, including that associated with the urban context of the precinct. Neighbourhoods are the ‘building blocks’ of our cities and represent the scale at which urban design needs to make its contribution to city performance: as productive, liveable, environmentally sustainable and socially inclusive places (COAG 2009). Neighbourhood design constitutes a major area for innovation as part of an urban design protocol established by the federal government (Department of Infrastructure and Transport 2011, see Figure 1). The ability to efficiently and effectively assess urban design performance at a neighbourhood level is in its infancy. This study was undertaken by Swinburne University of Technology, University of New South Wales, CSIRO and buildingSMART Australasia on behalf of the CRC for Low Carbon Living

New perspectives in percutaneous coronary intervention based on an integrated approach of imaging and physiology

In this thesis we investigated: a) the prognostic role of FFR in functional evaluation of epicardial stenosis in different anatomical and clinical settings of patients with stable CAD, heart valve disease and LVD; b) the role of IMR, CFR and absolute coronary flow and microvascular resistances assessment with a new dedicated thermodilution catheter; c) the diagnostic performance of two new angiography-derived FFR technologies for a quantitative and functional assessment of CAD; d) the impact of antiplatelet agents and BVS Absorb™ implantantion on procedure-related microvascular impairment, platelet activation and the related myonecrosis; e) the safety and feasibility of new 2-stent bifurcation techniques and the clinical outcome of known bifurcations techniques. We believe that many answers have been provided by our extensive translational research. FFR remains the milestone in functional assessment of the ischemic burden related to coronary stenoses. Our findings corroborate the strong clinical outcome background of FFR, supporting FFR-guided revascularization strategies above angio-based decision making, and therefore strongly discouraging any purely anatomy guided revascularization attempts in different clinical and anatomical settings. Absolute coronary blood flow (Q) and microvascular resistance (R) can be safely and reproducibly measured with continuous thermodilution, opening new opportunities for the study of the coronary microcirculation. FFRangio and QFR provide both a comprehensive physiological assessment of the entire coronary tree within few minutes, enabling online FFR measurement during the angiographic procedure. This, in turn, may facilitate the adoption of FFR-based clinical decision making regarding coronary revascularization. Both prasugrel and BVS Abosrb™ have proven a beneficial acute effect on peri-procedural coronary microvascular function and platelet activation. Although BVS Absorb™ did not live up to its promise because of the higher events in the mid-term due to greater scaffold thrombosis, our findings are at least reassuring on the acute impact of these devices on the microcirculation. Lastly in PCI of bifurcation lesions, our feasibility results of in vitro tests, offer new solutions for both complex anatomy requiring 2-stent-technique and bailout technique in case of failure of the most consolidated provisional T-stenting

NASA Tech Briefs, May 1993

Topics include: Advanced Composites and Plastics; Electronic Components and Circuits; Electronic Systems; Physical Sciences; Materials; Computer Programs; Mechanics; Machinery; Fabrication Technology; Mathematics and Information Sciences; Life Sciences