Growth And The Growth Hormone-Insulin Like Growth Factor 1 Axis In Children With Chronic Inflammation:Current Evidence, Gaps In Knowledge And Future Directions

Growth failure is frequently encountered in children with chronic inflammatory conditions like juvenile idiopathic arthritis, inflammatory bowel disease and cystic fibrosis. Delayed puberty and attenuated pubertal growth spurt is often seen during adolescence. The underlying inflammatory state mediated by pro-inflammatory cytokines, prolonged use of glucocorticoid and suboptimal nutrition contribute to growth failure and pubertal abnormalities. These factors can impair growth by their effects on the growth hormone-insulin like growth factor axis and also directly at the level of the growth plate via alterations in chondrogenesis and local growth factor signaling. Recent studies on the impact of cytokines and glucocorticoid on the growth plate studies further advanced our understanding of growth failure in chronic disease and provided a biological rationale of growth promotion. Targeting cytokines using biologic therapy may lead to improvement of growth in some of these children but approximately one third continue to grow slowly. There is increasing evidence that the use of relatively high dose recombinant human growth hormone may lead to partial catch up growth in chronic inflammatory conditions, although long term follow-up data is currently limited. In this review, we comprehensively review the growth abnormalities in children with juvenile idiopathic arthritis, inflammatory bowel disease and cystic fibrosis, systemic abnormalities of the growth hormone-insulin like growth factor axis and growth plate perturbations. We also systematically reviewed all the current published studies of recombinant human growth hormone in these conditions and discuss the role of recombinant human insulin like growth factor-1

HMS-utfordringer i anleggsbransjen

Masteroppgave. NTNU - Norges teknisk-naturvitenskapelige universitet. Institutt for Bygg- og miljøteknikk.Bygge- og anleggsbransjen er en av de næringene med høyest antall rapporterte arbeidsulykker og dødsfall. Ulike krav knyttet til fremdrift, økonomi og sikkerhet byr på store utfordringer. En av de mest sentrale temaene ligger i sikkerhetsutfordringer knyttet til overgangen mellom prosjekteringsfasen og produksjonsfasen. I 2014 signerte aktører på et felles bransjesamarbeid med et mål om å redusere antall ulykker i hele bygg- og anleggsbransjen. Til tross for at HMS-charteret nå har innført tiltak som er med på å redusere risikobildet, er det mye som gjenstår for å oppnå målet om en skadefri bransje. Hensikten med oppgaven er å undersøke hvilke utfordringer som finnes, hvorfor utfordringene oppstår og hvordan de kan håndteres for å ivareta arbeidernes sikkerhet. Arbeidet har bestått av litteraturstudie og semi-strukturerte intervju. Til sammen har ti informanter vært delaktig i prosessen og bidratt med deres tanker og erfaringer om HMS i anleggsbransjen. Resultatet viser til manglende ivaretakelse av sikkerhet i prosjektutvikling og prosjektering, utfordringer som oppstår i samhandling før byggestart og manglende sikkerhetskompetanse blant planleggende og utførende aktører. I sammenheng med menneskelige faktorer oppstår ulykkene på grunn av manglende risikovurderinger, manglende praktisk erfaring i prosjekteringsfasen, mangel på opplæring og kompetanse i utførelsesfasen, svikt i arbeidsledelsen og fysiske barrierer som enten svikter eller ikke er til stede. Byggherren og prosjektledelsen sitter med et overordnet ansvar for å ivareta arbeidsmiljøet på arbeidsplassen gjennom systematisk planlegging, gjennomføring, rapportering og oppfølging av HMS-arbeidet. For å oppnå god samhandling er prosjektet avhengig av det menneskelige individet og deres evne til å samarbeide og skape tillit til hverandre for å nå felles mål. For at samarbeidet skal være mulig må prosjektet først og fremst styres av god generell ledelse. Med god generell ledelse følger ofte god sikkerhetsledelse. En god sikkerhetsledelse fungerer best når sikkerhetsarbeidet er integrert med et godt fungerende tverrfaglig samarbeid.Statens vegvesen Vegdirektorate

HMS-utfordringer i anleggsbransjen

Bygge- og anleggsbransjen er en av de næringene med høyest antall rapporterte arbeidsulykker og dødsfall. Ulike krav knyttet til fremdrift, økonomi og sikkerhet byr på store utfordringer. En av de mest sentrale temaene ligger i sikkerhetsutfordringer knyttet til overgangen mellom prosjekteringsfasen og produksjonsfasen. I 2014 signerte aktører på et felles bransjesamarbeid med et mål om å redusere antall ulykker i hele bygg- og anleggsbransjen. Til tross for at HMS-charteret nå har innført tiltak som er med på å redusere risikobildet, er det mye som gjenstår for å oppnå målet om en skadefri bransje. Hensikten med oppgaven er å undersøke hvilke utfordringer som finnes, hvorfor utfordringene oppstår og hvordan de kan håndteres for å ivareta arbeidernes sikkerhet. Arbeidet har bestått av litteraturstudie og semi-strukturerte intervju. Til sammen har ti informanter vært delaktig i prosessen og bidratt med deres tanker og erfaringer om HMS i anleggsbransjen. Resultatet viser til manglende ivaretakelse av sikkerhet i prosjektutvikling og prosjektering, utfordringer som oppstår i samhandling før byggestart og manglende sikkerhetskompetanse blant planleggende og utførende aktører. I sammenheng med menneskelige faktorer oppstår ulykkene på grunn av manglende risikovurderinger, manglende praktisk erfaring i prosjekteringsfasen, mangel på opplæring og kompetanse i utførelsesfasen, svikt i arbeidsledelsen og fysiske barrierer som enten svikter eller ikke er til stede. Byggherren og prosjektledelsen sitter med et overordnet ansvar for å ivareta arbeidsmiljøet på arbeidsplassen gjennom systematisk planlegging, gjennomføring, rapportering og oppfølging av HMS-arbeidet. For å oppnå god samhandling er prosjektet avhengig av det menneskelige individet og deres evne til å samarbeide og skape tillit til hverandre for å nå felles mål. For at samarbeidet skal være mulig må prosjektet først og fremst styres av god generell ledelse. Med god generell ledelse følger ofte god sikkerhetsledelse. En god sikkerhetsledelse fungerer best når sikkerhetsarbeidet er integrert med et godt fungerende tverrfaglig samarbeid

On the Effects of Self-supervision and Contrastive Alignment in Deep Multi-view Clustering

Self-supervised learning is a central component in recent approaches to deep multi-view clustering (MVC). However, we find large variations in the development of self-supervision-based methods for deep MVC, potentially slowing the progress of the field. To address this, we present Deep-MVC, a unified framework for deep MVC that includes many recent methods as instances. We leverage our framework to make key observations about the effect of self-supervision, and in particular, drawbacks of aligning representations with contrastive learning. Further, we prove that contrastive alignment can negatively influence cluster separability, and that this effect becomes worse when the number of views increases. Motivated by our findings, we develop several new DeepMVC instances with new forms of self-supervision. We conduct extensive experiments and find that (i) in line with our theoretical findings, contrastive alignments decreases performance on datasets with many views; (ii) all methods benefit from some form of self-supervision; and (iii) our new instances outperform previous methods on several datasets. Based on our results, we suggest several promising directions for future research. To enhance the openness of the field, we provide an open-source implementation of DeepMVC, including recent models and our new instances. Our implementation includes a consistent evaluation protocol, facilitating fair and accurate evaluation of methods and components11Code: https://github.com/DanielTrosten/DeepMVC

Hubs and Hyperspheres: Reducing Hubness and Improving Transductive Few-shot Learning with Hyperspherical Embeddings

Distance-based classification is frequently used in transductive few-shot learning (FSL). However, due to the high-dimensionality of image representations, FSL classifiers are prone to suffer from the hubness problem, where a few points (hubs) occur frequently in multiple nearest neighbour lists of other points. Hubness negatively impacts distance-based classification when hubs from one class appear often among the nearest neighbors of points from another class, degrading the classifier's performance. To address the hubness problem in FSL, we first prove that hubness can be eliminated by distributing representations uniformly on the hypersphere. We then propose two new approaches to embed representations on the hypersphere, which we prove optimize a tradeoff between uniformity and local similarity preservation - reducing hubness while retaining class structure. Our experiments show that the proposed methods reduce hubness, and significantly improves transductive FSL accuracy for a wide range of classifiers 11Code available at https://github.com/uitml/noHub.

RELAX: Representation Learning Explainability

Despite the significant improvements that self-supervised representation learning has led to when learning from unlabeled data, no methods have been developed that explain what influences the learned representation. We address this need through our proposed approach, RELAX, which is the first approach for attribution-based explanations of representations. Our approach can also model the uncertainty in its explanations, which is essential to produce trustworthy explanations. RELAX explains representations by measuring similarities in the representation space between an input and masked out versions of itself, providing intuitive explanations that significantly outperform the gradient-based baselines. We provide theoretical interpretations of RELAX and conduct a novel analysis of feature extractors trained using supervised and unsupervised learning, providing insights into different learning strategies. Moreover, we conduct a user study to assess how well the proposed approach aligns with human intuition and show that the proposed method outperforms the baselines in both the quantitative and human evaluation studies. Finally, we illustrate the usability of RELAX in several use cases and highlight that incorporating uncertainty can be essential for providing faithful explanations, taking a crucial step towards explaining representations

Inefficiencies in Norwegian small-scale construction, or the problem of too long trucks?

“When the truck arrived at the construction site it could not unload the material because it [the truck] was too long, we had to send it away […], this happens all the time in Oslo where we have to build on very small plots.” (Carpenter, Oslo). As the quote illustrates, inefficiencies and resulting low productivity remain a challenge for today’s small construction businesses. While the reasons for inefficiencies are not completely understood, various techniques for project planning and control have proven their practical value in mitigating them. Lean construction has been articulated as one of the concepts that can solve inefficiency problems. The national initiative “Lean construction Norway” initiated by government, academia, and industry, seeks to diffuse lean production principles in the construction industry. However, small to medium sized contractors remain largely excluded from the innovative practices. This article sets out to study what a small Norwegian contractor enforcing lean concepts in addressing construction inefficienciesmay gain. Ingrained in the concept of muda we exemplify waste related to waiting, overproduction, defects, inventory, motion, over processing, and transporting. We ran a case study in a small industry standard type of residential project executed by a small contractor. Data were collected based on a series of qualitative interviews conducted with the on-site personnel. The findings illustrate a variety of inefficiencies resulting in low productivity. We expect that management inspired by lean principles in conjunction with modern planning methods such as building information modelling may improve project delivery in Norwegian small-scale construction

Inefficiencies in Norwegian Small-scale Construction, or the Problem of too Long Trucks?

“When the truck arrived at the construction site it could not unload the material because it [the truck] was too long, we had to send it away […], this happens all the time in Oslo where we have to build on very small plots.” (Carpenter, Oslo). As the quote illustrates, inefficiencies and resulting low productivity remain a challenge for today's small construction businesses. While the reasons for inefficiencies are not completely understood, various techniques for project planning and control have proven their practical value in mitigating them. Lean construction has been articulated as one of the concepts that can solve inefficiency problems. The national initiative “Lean construction Norway” initiated by government, academia, and industry, seeks to diffuse lean production principles in the construction industry. However, small to medium sized contractors remain largely excluded from the innovative practices. This article sets out to study what a small Norwegian contractor enforcing lean concepts in addressing construction inefficiencies may gain. Ingrained in the concept of muda we exemplify waste related to waiting, overproduction, defects, inventory, motion, over processing, and transporting. We ran a case study in a small industry standard type of residential project executed by a small contractor. Data were collected based on a series of qualitative interviews conducted with the on-site personnel. The findings illustrate a variety of inefficiencies resulting in low productivity. We expect that management inspired by lean principles in conjunction with modern planning methods such as building information modelling may improve project delivery in Norwegian small-scale construction