104 research outputs found
Building Information Modelling (BIM) value realisation framework for asset owners
The paper is presenting a value realisation framework for asset owners based on an exploratory study. The study is descriptive in nature and adopting a qualitative approach towards data collection. The paper adopts the viewpoint of BIM business value measurement considering that; (i) if the process is better as a result of BIM-based processes, then it is different in some relevant way; (ii) if it is different in some relevant way as a result of certain BIM properties or characteristics, then the change is observable; (iii) if the change is observ-able because of certain direct BIM benefits, then it is countable; (iv) if it is countable using defined measurement metrics, then it is measurable; (v) if it is measurable using established measurement techniques, an organisation can value each unit and therefore, realise the benefits of BIM. The specific contribution of paper is to improve asset owners’ understanding of BIM-business value measurement techniques and approaches
Artificial pancreas systems for people with type 2 diabetes: Conception and design of the european CLOSE project
In the last 10 years tremendous progress has been made in the development of artificial pancreas (AP) systems for people
with type 1 diabetes (T1D). The pan-European consortium CLOSE (Automated Glucose Control at Home for People with
Chronic Disease) is aiming to develop integrated AP solutions (APplus) tailored to the needs of people with type 2 diabetes
(T2D). APplus comprises a product and service package complementing the AP system by obligatory training as well as home
visits and telemedical consultations on demand. Outcome predictors and performance indicators shall help to identify people
who could benefit most from AP usage and facilitate the measurement of AP impact in diabetes care. In a first step CLOSE
will establish a scalable APplus model case working at the interface between patients, homecare service providers, and payers
in France. CLOSE will then scale up APplus by pursuing geographic distribution, targeting additional audiences, and enhancing
AP functionalities and interconnectedness. By being part of the European Institute of Innovation and Technology (EIT)
Health public-private partnership, CLOSE is committed to the EIT “knowledge triangle” pursuing the integrated advancement
of technology, education, and business creation. Putting stakeholders, education, and impact into the center of APplus
advancement is considered key for achieving wide AP use in T2D care
Short- and mid-term effects on performance, health and qualitative behavioural assessment of Romane lambs in different milk feeding conditions
The common practice of artificially rearing lambs from prolific meat breeds of sheep constitutes a welfare issue due to increased mortality rates and negative health issues. In this multidisciplinary study, we investigated the possible short- and mid-term advantages of artificially feeding fresh ewe's milk instead of commercial milk replacer on lambs' growth, health and welfare. Romane lambs were either separated from their mothers on D3 and fed with Lacaune ewes' milk (LAC, n?=?13) or milk replacer (REP, n?=?15), or they were reared by their mothers (MOT, n =?15). On D45, they were weaned, gathered in single-sex groups until the end of the study on D150. Lamb performance and biomarkers of overall health were assessed by measuring: growth, dirtiness of the perianal area, enteric pathogens in the faeces, total antioxidant status and redox status assessed by plasma reduced glutathione/oxidised glutathione ratio, and immune response after vaccination against chlamydiosis. As an exploratory approach, blood cell transcriptomic profiles were also investigated. Last, qualitative behaviour assessment (QBA) was performed as an integrated welfare criterion. Lacaune ewes' milk and REP never differed in their average daily gain but grew less than MOT lambs in the early suckling period and just after weaning. No effect was detected afterwards. On D30, LAC and REP lambs had lower total antioxidant and higher redox status than MOT lambs but did not differ among themselves. Lacaune ewes' milk and MOT had a cleaner perianal area than REP lambs on D21, while faecal pathogen infection did not vary between the treatment groups. After vaccination, LAC also had a stronger immune response on D90 compared to REP lambs. Transcriptome analysis performed on D150 showed differential gene expression, mainly in relation to inflammatory, immune and cell cycle response, between male lambs of the LAC group and those of the MOT and REP groups. Based on QBA, LAC lambs never differed from MOT lambs in their general activity and varied from REP only on D21; REP lambs were always more agitated than MOT lambs. In conclusion, artificial milk feeding impaired early growth rate, health and emotional state mainly during the milk feeding period and at weaning. Feeding artificially reared lambs with fresh ewe's milk partly mitigated some of the negative effects induced by milk replacer but without achieving the full benefit of being reared by the mother
Bridging the Pressure Gap in Water and Hydroxyl Chemistry on Metal Surfaces: The Cu(110) Case
Pathogenesis, diagnosis and management of pneumorrhachis
Pneumorrhachis (PR), the presence of intraspinal air, is an exceptional but eminent radiographic finding, accompanied by different aetiologies and possible pathways of air entry into the spinal canal. By reviewing the literature and analysing a personal case of traumatic cervical PR after head injury, we present current data regarding the pathoanatomy, clinical and radiological presentation, diagnosis and differential diagnosis and treatment modalities of patients with PR and associated pathologies to highlight this uncommon phenomenon and outline aetiology-based guidelines for the practical management of PR. Air within the spinal canal can be divided into primary and secondary PR, descriptively classified into extra- or intradural PR and aetiologically subsumed into iatrogenic, traumatic and nontraumatic PR. Intraspinal air is usually found isolated not only in the cervical, thoracic and, less frequently, the lumbosacral regions but can also be located in the entire spinal canal. PR is almost exceptional associated with further air distributions in the body. The pathogenesis and aetiologies of PR are multifold and can be a diagnostic challenge. The diagnostic procedure should include spinal CT, the imaging tool of choice. PR has to be differentiated from free intraspinal gas collections and the coexistence of air and gas within the spinal canal has to be considered differential diagnostically. PR usually represents an asymptomatic epiphenomenon but can also be symptomatic by itself as well as by its underlying pathology. The latter, although often severe, might be concealed and has to be examined carefully to enable adequate patient treatment. The management of PR has to be individualized and frequently requires a multidisciplinary regime
The V471A polymorphism in autophagy-related gene ATG7 modifies age at onset specifically in Italian Huntington disease patients
The cause of Huntington disease (HD) is a polyglutamine repeat expansion of more than 36 units in the huntingtin protein, which is inversely correlated with the age at onset of the disease. However, additional genetic factors are believed to modify the course and the age at onset of HD. Recently, we identified the V471A polymorphism in the autophagy-related gene ATG7, a key component of the autophagy pathway that plays an important role in HD pathogenesis, to be associated with the age at onset in a large group of European Huntington disease patients. To confirm this association in a second independent patient cohort, we analysed the ATG7 V471A polymorphism in additional 1,464 European HD patients of the “REGISTRY” cohort from the European Huntington Disease Network (EHDN). In the entire REGISTRY cohort we could not confirm a modifying effect of the ATG7 V471A polymorphism. However, analysing a modifying effect of ATG7 in these REGISTRY patients and in patients of our previous HD cohort according to their ethnic origin, we identified a significant effect of the ATG7 V471A polymorphism on the HD age at onset only in the Italian population (327 patients). In these Italian patients, the polymorphism is associated with a 6-years earlier disease onset and thus seems to have an aggravating effect. We could specify the role of ATG7 as a genetic modifier for HD particularly in the Italian population. This result affirms the modifying influence of the autophagic pathway on the course of HD, but also suggests population-specific modifying mechanisms in HD pathogenesis
Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study
Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation
Parkinson's Disease-Related Impairments in Body Movement, Coordination and Postural Control Mechanisms When Performing 80° Lateral Gaze Shifts.
We investigated early signs of Parkinson's disease-related impairment in mediolateral postural control. Thirty-six participants (18 Hoehn & Yahr stage 2 patients in the off-drug condition and 18 healthy controls) were studied in a stationary gaze condition and when performing 80° lateral gaze shifts at 0.125 and 0.25 Hz. Body sway, coordination and postural control mechanisms were analyzed. All participants performed the visual tasks adequately. The patients were not unstable in the stationary gaze condition. In both groups, mediolateral ankle- and hip-based postural control mechanisms were significantly more active under gaze shift conditions than under the stationary gaze condition. As expected, the patients exhibited significantly greater angular movements of the lower back and significantly lower angular movements of the head (relative to controls) when performing gaze shifts. When considering linear displacements (rather than angular movements), the patients exhibited significantly greater displacements of the lower back and lower, slower displacements of the head than controls under gaze shift conditions. Relative to controls, the patients performed "en block" body movements. Overall, our results show that the patients' ankle- and hip-based mediolateral postural control mechanisms did not adapt to the difficulty of the visual task being performed
- …