Networking historic environmental standards to address modern challenges for sustainable conservation in HBIM

Awareness of the logic and context of original (and subsequent) design priorities is critical to informing decisions relating to valorisation, repair, refurbishment, energy retrofit or re-use of built heritage. A key benefit of collating data through Historic Building Information Modelling (HBIM) should be to assist others facing similar challenges. Here, examples for sharing understanding of how components belong to a system are outlined in the context of a newly completed dataset of public library buildings in the UK funded by Andrew Carnegie, predominantly built between 1900 and 1914. Demands for the functionality and economy of public library buildings, coupled with the emergent standardisation of building components at the time, provide a specific condition with potential for further iteration to other buildings of the period or related typologies. The work highlights the urgency of providing cost-efficient knowledge sharing structures in an era of altered priorities with respect to energy use for modern heritage. We propose the means for mapping common features to network knowledge amongst stakeholders through relevant open source pathways. The results demonstrate that integrating geographic approaches to knowledge sharing in HBIM with environmental considerations also supports wider questions of risk management related to the stewardship of historic buildings in the context of climate change

The safety of digital mental health interventions: Systematic review and recommendations

Background: Evidence suggests that digital mental health interventions (DMHIs) for common mental health conditions are effective. However, digital interventions, such as face-to-face therapies, pose risks to patients. A safe intervention is considered one in which the measured benefits outweigh the identified and mitigated risks. Objective: This study aims to review the literature to assess how DMHIs assess safety, what risks are reported, and how they are mitigated in both the research and postmarket phases and building on existing recommendations for assessing, reporting, and mitigating safety in the DMHI and standardizing practice. Methods: PsycINFO, Embase, and MEDLINE databases were searched for studies that addressed the safety of DMHIs. The inclusion criteria were any study that addressed the safety of a clinical DMHI, even if not as a main outcome, in an adult population, and in English. As the outcome data were mainly qualitative in nature, a meta-analysis was not possible, and qualitative analysis was used to collate the results. Quantitative results were synthesized in the form of tables and percentages. To illustrate the use of a single common safety metric across studies, we calculated odds ratios and CIs, wherever possible. Results: Overall, 23 studies were included in this review. Although many of the included studies assessed safety by actively collecting adverse event (AE) data, over one-third (8/23, 35%) did not assess or collect any safety data. The methods and frequency of safety data collection varied widely, and very few studies have performed formal statistical analyses. The main treatment-related reported AE was symptom deterioration. The main method used to mitigate risk was exclusion of high-risk groups. A secondary web-based search found that 6 DMHIs were available for users or patients to use (postmarket phase), all of which used indications and contraindications to mitigate risk, although there was no evidence of ongoing safety review. Conclusions: The findings of this review show the need for a standardized classification of AEs, a standardized method for assessing AEs to statically analyze AE data, and evidence-based practices for mitigating risk in DMHIs, both in the research and postmarket phases. This review produced 7 specific, measurable, and achievable recommendations with the potential to have an immediate impact on the field, which were implemented across ongoing and future research. Improving the quality of DMHI safety data will allow meaningful assessment of the safety of DMHIs and confidence in whether the benefits of a new DMHI outweigh its risks

Pengaruh Pelatihan Dan Promosi Terhadap Motivasi Dan Kinerja Karyawan (Studi Pada Karyawan Pt.pln (Persero) Area Kendari)

Tujuan penelitian ini adalah untuk mengetahui dan menjelaskan pengaruh pelatihan terhadap motivasi, pengaruh pelatihan terhadap kinerja karyawan, pengaruh promosi terhadap motivasi, pengaruh promosi terhadap kinerja karyawan dan pengaruh motivasi terhadap kinerja karyawan. Penelitian ini menggunakan pendekatan kuantitatif dengan menggunakan metode survei (explanatory research) dan menggunakan analisis path. Hasil penelitian ini menyatakan pelatihan berpengaruh signifikan dan positif terhadap motivasi, promosi berpengaruh signifikan dan positif terhadap motivasi, promosi berpengaruh signifikan dan positif terhadap kinerja karyawan, motivasi berpengaruh signifikan dan positif terhadap kinerja karyawan. Namun, pelatihan berpengaruh tidak signifikan dan positif terhadap kinerja karyawan

Oesophageal pressure-flow metrics in relation to bolus volume, bolus consistency and bolus perception

Author version made available in accordance with the publisher's policy.The utility of combined oesophageal pressure–impedance recording has been enhanced by automation of data analysis. To understand how oesophageal function as measured by automated impedance manometry (AIM) pressure-flow analysis varies with bolus characteristics and subjective perception of bolus passage. Oesophageal pressure–impedance recordings of 5 and 10 ml liquid or viscous swallows and 2 and 4 cm solid swallows from 20 healthy control subjects (five male; 25–73 years) were analysed. Metrics indicative of bolus pressurization (intrabolus pressure and intrabolus pressure slope) were derived. Bolus flow resistance, the relationship between bolus pressurization and flow timing, was assessed using a pressure-flow index. Bolus retention was assessed using the ratio of nadir impedance to peak pressure impedance (impedance ratio). Subjective perception of bolus passage was assessed swallow by swallow. Viscosity increased the bolus flow resistance and reduced bolus clearance. Responses to boluses of larger volume and more viscous consistency revealed a positive correlation between bolus pressurization and oesophageal peak pressure. Flow resistance was higher in subjects who perceived bolus hold up of solids. Bolus volume and bolus type alter oesophageal function and impact AIM analysis metrics descriptive of oesophageal function. Perception of bolus transit was associated with heightened bolus pressurization relative to bolus flow

Whey- vs Casein-Based Enteral Formula and Gastrointestinal Function in Children With Cerebral Palsy.

Objectives: Children with severe cerebral palsy (CP) commonly have gastrointestinal (GI) dysfunction. Whey-based enteral formulas have been postulated to reduce gastroesophageal reflux (GOR) and accelerate gastric emptying (GE). The authors investigated whether whey-based (vs casein-based) enteral formulas reduce GOR and accelerate GE in children who have severe CP with a gastrostomy and fundoplication. Methods: Thirteen children received a casein-based formula for 1 week and either a 50% whey whole protein (50% WWP) or a 100% whey partially hydrolyzed protein (100% WPHP) formula for 1 week. Reflux episodes, gastric half-emptying time (GE t1/2), and reported pain and GI symptoms were measured. Results: Whey formulas emptied significantly faster than casein (median [interquartile range (IQR)] GE t1/2, 33.9 [25.3-166.2] min vs 56.6 [46-191] min; P = .033). Reflux parameters were unchanged. GI symptoms were lower in children who received 50% WWP (visual analog symptom score, median [IQR], 0[0-11.8]) vs 100% WPHP (13.0 [2.5-24.8]) (P = .035). Conclusion: This pilot study shows that in children who have severe CP with a gastrostomy and fundoplication, GE of the whey-based enteral formula is significantly faster than casein. The acceleration in GE does not alter GOR frequency, and there appears to be no effect of whey vs casein in reducing acid, nonacid, and total reflux episodes. The results indicate that enteral formula selection may be particularly important for children with severe CP and delayed GE. (JPEN J Parenter Enteral Nutr. 2012;36:118S-123S

POD‐identification reduced order model of linear transport equations for control purposes

Intrusive reduced order modeling techniques require access to the solver's discretization and solution algorithm, which are not available for most computational fluid dynamics codes. Therefore, a nonintrusive reduction method that identifies the system matrix of linear fluid dynamical problems with a least-squares technique is presented. The methodology is applied to the linear scalar transport convection-diffusion equation for a 2D square cavity problem with a heated lid. The (time-dependent) boundary conditions are enforced in the obtained reduced order model (ROM) with a penalty method. The results are compared and the accuracy of the ROMs is assessed against the full order solutions and it is shown that the ROM can be used for sensitivity analysis by controlling the nonhomogeneous Dirichlet boundary conditions