FM-BIM Mobilisation Framework : critical success factors to help deliver successful BIM projects

The ‘FM-BIM Mobilisation Framework’ is based on my PhD work (https://doi.org/10.24377/LJMU.t.00014250) and associated research papers.The aim of this guide is to provide a series of Critical Success Factors (CSF), which can be used by Facility Management (FM) professionals and other stakeholders to help them better engage in Building Information Modelling (BIM) projects. By doing so we will all help deliver better project outcomes and the full benefits of BIM, enabling us to optimise built assets in operation for users, organisations and wider society. BIM has become the chosen route for procuring and delivering new built assets. In addition, the BIM process is increasingly being applied to existing built assets. Laser scanning and other data capture techniques are being used in the digitalisation of organisations’ real estate portfolios. The collection of information/data may also be used ‘where appropriate’ to set up retrospective BIM models. If well implemented, the BIM process has the potential to deliver significant benefits not only during the design and construction phases but also during the much longer operational phase. However, the benefits need to be clearly transparent, realistic and achievable. Working with the BIM process also presents its own challenges and concerns. If we are to deliver the full benefits of BIM across all the built asset’s life cycle phases these barriers need to be addressed and overcome. This ‘FM-BIM Mobilisation Framework’ presents ten CSF Main Themes (MT) with associated Sub-Themes (ST). These can be seen as a mobilisation checklist of actions with supporting explanations, examples and useful links to resources for support. If acted upon, they will help people engage more successfully with BIM projects to achieve their desired outcomes. The CSF and associated guidance are not intended to be a complete guide to BIM as there are many other resources already available which fulfil this requirement

Qualitative study of primary care clinicians\u27 views on point-of-care testing for C-reactive protein for acute respiratory tract infections in family medicine.

OBJECTIVE: To explore clinicians views of the barriers and facilitators to use of C-reactive protein (CRP) point-of-care tests (POCT) in US family medicine clinics for the management of acute respiratory tract infections (ARTIs) in adults. SETTING: Five family medicine clinics across two US states. PARTICIPANTS: 30 clinicians including 18 physicians, 9 physician residents, 2 physician assistants and 1 nurse practitioner, took part in the study. DESIGN: A qualitative study using a grounded theory approach to thematically analyse focus group interviews. RESULTS: These clinicians had limited access to diagnostic tests for patients with ARTI, and very little knowledge of CRP POCT. Three major themes were identified and included the potential clinical role of CRP POCT, concerns related to implementing CRP POCT and evidence needed prior to wider adoption in family medicine. Clinicians believed CRP POCT could support decision-making for some presentations of ARTIs and patient populations when used in conjunction with clinical criteria. Clinicians had concerns about possible overuse and inaccuracy of CRP POCT which they believed might increase antibiotic prescribing rates. Other concerns identified included integration of the test with clinic workflows and cost-effectiveness. CONCLUSIONS: Clinicians stand at the forefront of antibiotic stewardship efforts, but have few diagnostic tests to help them confidently manage ARTIs. CRP POCT may facilitate some aspects of clinical practice. Incorporating CRP POCT with clinical guidelines may strengthen utility of this test, when there is diagnostic uncertainty

ARCHITECTURE FOR A CBM+ AND PHM CENTRIC DIGITAL TWIN FOR WARFARE SYSTEMS

The Department of the Navy’s continued progression from time-based maintenance into condition-based maintenance plus (CBM+) shows the importance of increasing operational availability (Ao) across fleet weapon systems. This capstone uses the concept of digital efficiency from a digital twin (DT) combined with a three-dimensional (3D) direct metal laser melting printer as the physical host on board a surface vessel. The DT provides an agnostic conduit for combining model-based systems engineering with a digital analysis for real-time prognostic health monitoring while improving predictive maintenance. With the DT at the forefront of prioritized research and development, the 3D printer combines the value of additive manufacturing with complex systems in dynamic shipboard environments. To demonstrate that the DT possesses parallel abilities for improving both the physical host’s Ao and end-goal mission, this capstone develops a DT architecture and a high-level model. The model focuses on specific printer components (deionized [DI] water level, DI water conductivity, air filters, and laser motor drive system) to demonstrate the DT’s inherent effectiveness towards CBM+. To embody the system of systems analysis for printer suitability and performance, more components should be evaluated and combined with the ship’s environment data. Additionally, this capstone recommends the use of DTs as a nexus into more complex weapon systems while using a deeper level of design of experiment.Outstanding ThesisCivilian, Department of the NavyCommander, United States NavyCivilian, Department of the NavyCivilian, Department of the NavyCivilian, Department of the NavyCivilian, Department of the NavyCivilian, Department of the NavyCivilian, Department of the NavyApproved for public release. Distribution is unlimited

Patient Willingness to Have Tests to Guide Antibiotic Use for Respiratory Tract Infections: From the WWAMI Region Practice and Research Network (WPRN).

INTRODUCTION: The majority of consultations for acute respiratory tract infections (RTIs) lead to prescriptions for antibiotics, which have limited clinical benefit. We explored patients' willingness to have blood tests as part of the diagnostic work-up for RTIs, and patient knowledge about antibiotics. METHODS: Patients at 6 family medicine clinics were surveyed. Regression modeling was used to determine independent predictors of willingness to have venous and point-of-care (POC) blood tests, and knowledge of the value of antibiotics for RTIs. RESULTS: Data were collected from 737 respondents (response rate 83.8%), of whom 65.7% were women, 60.1% were white, and 25.1% were current smokers; patients' mean age was 46.9 years. Sex (female), race (white), and a preference to avoid antibiotics were independent predictors of greater level of antibiotic knowledge. A total of 63.1% were willing to have a venous draw and 79% a POC blood test, to help guide antibiotic decision-making. Non-American Indian/Alaskan Native race, current smoking, and greater knowledge of antibiotics were independent predictors of willingness to have a POC test. CONCLUSION: A large majority of patients seemed willing to have POC tests to facilitate antibiotic prescribing decisions for RTIs. Poor knowledge about antibiotics suggests better education regarding antibiotic use might influence patient attitudes towards use of antibiotics for RTIs

Persistent physical symptoms reduction intervention: a system change and evaluation (PRINCE) - integrated GP care for persistent physical symptoms: protocol for a feasibility and cluster randomised waiting list, controlled trial

Introduction Persistent physical symptoms (PPS), also known as medically unexplained symptoms are associated with profound physical disability, psychological distress and high healthcare costs. England's annual National Health Service costs of attempting to diagnose and treat PPS amounts to approximately £3 billion. Current treatment relies on a positive diagnosis, life-style advice and drug therapy. However, many patients continue to suffer from ongoing symptoms and general practitioners (GPs) are challenged to find effective treatments. Training GPs in basic cognitive behavioural skills and providing self-help materials to patients could be useful, but availability in primary care settings is limited. Methods and analysis A cluster randomised waiting list, controlled trial will be conducted to assess the feasibility of an integrated approach to care in general practice. Approximately 240 patients with PPS will be recruited from 8 to 12 GP practices in London. GP practices will be randomised to 'integrated GP care plus treatment as usual' or waiting list control. Integrated GP care plus treatment as usual will include GP training in cognitive behavioural skills, GP supervision and written and audio visual materials for both GPs and participants. The primary objectives will be assessment of trial and intervention feasibility. Secondary objectives will include estimating the intracluster correlation coefficient for potential outcome measures for cluster effects in a sample size calculation. Feasibility parameters and identification of suitable primary and secondary outcomes for future trial evaluations will be assessed prerandomisation and at 12 and 24 weeks' postrandomisation, using a mixed-methods approach. Ethics and dissemination Ethical approval was granted by the Camberwell St Giles Ethics Committee. Results will be disseminated via peer-reviewed publications and conference presentations. This trial will inform researchers, clinicians, patients and healthcare providers about the feasibility and potential cost-effectiveness of an integrated approach to managing PPS in primary care. Trial registration number NCT02444520; Pre-results

Regulator of G-protein signalling 2 mRNA is differentially expressed in mammary epithelial subpopulations and over-expressed in the majority of breast cancers

To understand which signalling pathways become deregulated in breast cancer, it is necessary to identify functionally significant gene expression patterns in the stem, progenitor, transit amplifying and differentiated cells of the mammary epithelium. We have previously used the markers 33A10, CD24 and Sca-1 to identify mouse mammary epithelial cell subpopulations. We now investigate the relationship between cells expressing these markers and use gene expression microarray analysis to identify genes differentially expressed in the cell populations. METHODS: Freshly isolated primary mouse mammary epithelial cells were separated on the basis of staining with the 33A10 antibody and an alpha-Sca-1 antibody. The populations identified were profiled using gene expression microarray analysis. Gene expression patterns were confirmed on normal mouse and human mammary epithelial subpopulations and were examined in a panel of breast cancer samples and cell lines. RESULTS: Analysis of the separated populations demonstrated that Sca-1- 33A10High stained cells were estrogen receptor alpha (Esr1)- luminal epithelial cells, whereas Sca-1+ 33A10Low/- stained cells were a mix of nonepithelial cells and Esr1+ epithelial cells. Analysis of the gene expression data identified the gene Rgs2 (regulator of G-protein signalling 2) as being highly expressed in the Sca-1- 33A10Low/- population, which included myoepithelial/basal cells. RGS2 has previously been described as a regulator of angiotensin II receptor signalling. Gene expression analysis by quantitative real-time RT-PCR of cells separated on the basis of CD24 and Sca-1 expression confirmed that Rgs2 was more highly expressed in mouse myoepithelial/basal mammary cells than luminal cells. This expression pattern was conserved in normal human breast cells. Functional analysis demonstrated RGS2 to be a modulator of oxytocin receptor signalling. The potential significance of RGS2 expression in breast cancer was demonstrated by semi-quantitative RT-PCR analysis, data mining and quantitative real-time RT-PCR approaches, which showed that RGS2 was expressed in the majority of solid breast cancers at much higher levels than in normal human mammary cells. CONCLUSION: Molecular analysis of prospectively isolated mammary epithelial cells identified RGS2 as a modulator of oxytocin receptor signalling, which is highly expressed in the myoepithelial cells. The RGS2 gene, but not the oxytocin receptor, was also shown to be over-expressed in the majority of breast cancers, identifying the product of this gene, or the pathway(s) it regulates, as potentially significant therapeutic targets

Concert recording 2013-03-31b

[Track 01]. Sweet Georgie fame / Blossom Dearie -- [Track 02]. Joy spring / Clifford Brown -- [Track 03]. Summer samba / Marcos Valle -- [Track 04]. Rhythm\u27ning / Thelonious Monk -- [Track 05]. One note samba / Antonio Carlos Jobim -- [Track 06]. In a sentimental mood / Duke Ellington -- [Track 07]. Recordame / Joe Henderson -- [Track 08]. Full house / Wes Montgomery -- [Track 09]. Cats and kittens / Peter Erskine -- [Track 10]. Primal prayer / Dan Haerle -- [Track 11]. Cookin\u27 Boox / Detroit Jackson

‘Like being on death row’: Britain and the end of coal, c. 1970 to the present

ABSTRACT The introduction draws on the work of Raymond Williams to identify the ‘structures of feeling’ that surround the figure of the coal miner in contemporary British culture. As an analysis of the media coverage of the closure of the UK’s last deep-coal mine in December 2015 demonstrates, mine workers were cast as ‘residual proletarians’ whose modes of being and consciousness were portrayed as both admirable and pitifully out of date. The introduction goes on to demonstrate the dominance that selective memories of the miners’ strike of 1984/1985 exert over contemporary understandings of coal mining. Drawing on the work of Williams again, the introduction reflects on how certain images and tropes have reached hegemonic status while others have been marginalised. The introduction concludes by arguing that historical scholarship must extricate itself from the stranglehold of ‘1984/85’ and contends that the true significance of coal for contemporary British history lies in the extraordinary range of emotions, meanings and significations with which both the industry and the miners were invested by the contemporaries themselves

CD24 staining of mouse mammary gland cells defines luminal epithelial, myoepithelial/basal and non-epithelial cells

INTRODUCTION: Breast cancer is thought to arise in mammary epithelial stem cells. There is, therefore, a large amount of interest in identifying these cells. The breast is a complex tissue consisting of two epithelial layers (an outer myoepithelial/basal layer and an inner luminal epithelial layer) as well as a large non-epithelial component (fibroblasts, endothelial cells, lymphocytes, adipocytes, neurons and myocytes). The definitive identification of a mammary epithelial stem cell population is critically dependent on its purity. To date, this has been hampered by the lack of suitable markers to separate out the two epithelial layers, and to remove contaminating non-epithelial cells. METHODS: Mouse mammary glands were dissociated and stained with CD24. Cells were sorted into separate populations based on CD24 expression and assessed for luminal epithelial and myoepithelial/basal markers by direct fluorescent microscopy and real time PCR. The stem/progenitor potential of these cell populations was assessed in vivo by cleared mammary fat pad transplantation. RESULTS: Three populations of CD24 expressing cells were identified: CD24(Negative), CD24(Low )and CD24(High). Staining of these cells with cytokeratin markers revealed that these populations correspond to non-epithelial, myoepithelial/basal and luminal epithelial cells, respectively. Cell identities were confirmed by quantitative PCR. Cleared mammary fat pad transplantation of these cell populations revealed that extensive mammary fat pad repopulation capacity segregates with the CD24(Low )cells, whilst CD24(High )cells have limited repopulation capacity. CONCLUSION: Differential staining of mammary epithelial cells for CD24 can be used to simultaneously isolate pure populations of non-epithelial, myoepithelial/basal and luminal epithelial cells. Furthermore, mammary fat pad repopulation capacity is enriched in the CD24(Low )population. As separation is achieved using a single marker, it will be possible to incorporate additional markers to further subdivide these populations. This will considerably facilitate the further analysis of mammary epithelial subpopulations, whilst ensuring high purity, which is key for understanding mammary epithelial stem cells in normal tissue biology and carcinogenesis

Estrogen promotes cutaneous wound healing via estrogen receptor β independent of its antiinflammatory activities

Post-menopausal women have an increased risk of developing a number of degenerative pathological conditions, linked by the common theme of excessive inflammation. Systemic estrogen replacement (in the form of hormone replacement therapy) is able to accelerate healing of acute cutaneous wounds in elderly females, linked to its potent antiinflammatory activity. However, in contrast to many other age-associated pathologies, the detailed mechanisms through which estrogen modulates skin repair, particularly the cell type–specific role of the two estrogen receptors, ERα and ERβ, has yet to be determined. Here, we use pharmacological activation and genetic deletion to investigate the role of both ERα and ERβ in cutaneous tissue repair. Unexpectedly, we report that exogenous estrogen replacement to ovariectomised mice in the absence of ERβ actually delayed wound healing. Moreover, healing in epidermal-specific ERβ null mice (K14-cre/ERβL2/L2) largely resembled that in global ERβ null mice. Thus, the beneficial effects of estrogen on skin wound healing are mediated by epidermal ERβ, in marked contrast to most other tissues in the body where ERα is predominant. Surprisingly, agonists to both ERα and ERβ are potently antiinflammatory during skin repair, indicating clear uncoupling of inflammation and overall efficiency of repair. Thus, estrogen-mediated antiinflammatory activity is not the principal factor in accelerated wound healing