A platform for change: How identifying and aligning technology building blocks provides a digital platform of change in the construction industry

The construction industry is currently in turmoil, searching in every direction for that ‘silver bullet’ or digital solution, to bring efficiency, productivity and in some ways stability to the sector. It was the World Economic Forum report of 2016, that drew major attention to the industry, mainly because it highlighted some of the inadequacies of the sector and its inability to transform as so many other industries have. It also referenced so many megatrends that would ultimately impact over the coming years. Ironically construction is rated at 21 of 22 industries with respect to digitization deployment according to McKinsey Global. Coinciding with this desire to better itself, it is also trying to eliminate data silos, incorrect information and integrate new technology, systems, as well as materials and products. It is, however, struggling to achieve results in order to cope with new pressures from Global trends, like urban migration, population increase and an emerging digital landscape. The existing stakeholders are struggling with low margins, poor interoperability and the adoption of sporadic technology within industry silos to resolve the issues within their boundaries. Under these conditions, it is highly unlikely that a ‘silver bullet’ will appear: therefore the industry should do what it does best on sites around the world and this is to problem solve. There are enough singular solutions in place and lead users to prove their capabilities, so rather than inventing a new digital solution, the industry must build it from existing pieces. This report aims to capture the pressures the industries forces, to identify significant problems and address these with a collection of solutions, which, when combined have the potential to be transformational platform for the industry. Having spent 13 years in construction, reinvention requires a review of global construction practices; highlighting the collaborations that exist in the field and office to identify technological tools required for transformation. The project will look at the factors impacting the sector, the changing environment of the industry, its lead users and changemakers in order to demonstrate that the solution to help the industry overcome its problems already exists and is just a matter of building it. However, before we build up the solution, one must first dig down to for a solid foundation, which can only be built of data

Addition of hyaluronic acid to the FIB-4 liver fibrosis score improves prediction of incident cirrhosis and hepatocellular carcinoma in Type 2 diabetes: The Edinburgh Type 2 Diabetes Study

Background: Type 2 diabetes is associated with increased risk of progression to cirrhosis and hepatocellular carcinoma (HCC) in people with chronic liver diseases, particularly non-alcoholic fatty liver disease (NAFLD). However, the absolute risk of progression is low so it is crucial to accurately identify patients who would benefit most from hepatology referral and intensified management. Current risk-stratification tools are sub-optimal and perform worse in people with diabetes.Aims: To determine whether the addition of complementary biomarker(s) to current NAFLD risk-stratification tools in people with Type 2 diabetes could improve the identification of people who are at increased risk of developing incident cirrhosis or HCC.Methods: The Edinburgh Type 2 diabetes Study (ET2DS) is a cohort study of men and women with Type 2 diabetes (n=1066, age 60-75 at baseline). Cases of cirrhosis and HCC were identified over 11-years of follow-up. Biomarkers were measured at baseline and year one and association with incident disease assessed using logistic regression.Results: Of existing risk-stratification scores tested, the Fibrosis-4 (FIB-4) index and the AST:platelet ratio index (APRI) performed best in this cohort. Addition of hyaluronic acid (cut-point ≥50μg/L) to FIB-4 (cut-point ≥1.3) maintained a false negative rate ≤25% and reduced the number of people incorrectly identified as ‘high-risk’ for incident disease by ~50%.Conclusions: The addition of hyaluronic acid to FIB-4 reduced the proportion of people inappropriately identified as ‘high-risk’ for development of cirrhosis/HCC in a community population of otherwise asymptomatic people with Type 2 diabetes. These findings require validation in independent cohorts

Protein composition and function of red and white skeletal muscle mitochondria

Red and white muscles are faced with very different energetic demands. However, it is unclear whether relative mitochondrial protein expression is different between muscle types. Mitochondria from red and white porcine skeletal muscle were isolated with a Percoll gradient. Differences in protein composition were determined using blue native (BN)-PAGE, two-dimensional differential in gel electrophoresis (2D DIGE), optical spectroscopy, and isobaric tag for relative and absolute quantitation (iTRAQ). Complex IV and V activities were compared using BN-PAGE in-gel activity assays, and maximal mitochondrial respiration rates were assessed using pyruvate (P) + malate (M), glutamate (G) + M, and palmitoyl-carnitine (PC) + M. Without the Percoll step, major cytosolic protein contamination was noted for white mitochondria. Upon removal of contamination, very few protein differences were observed between red and white mitochondria. BN-PAGE showed no differences in the subunit composition of Complexes I–V or the activities of Complexes IV and V. iTRAQ analysis detected 358 mitochondrial proteins, 69 statistically different. Physiological significance may be lower: at a 25% difference, 48 proteins were detected; at 50%, 14 proteins were detected; and 3 proteins were detected at a 100%. Thus any changes could be argued to be physiologically modest. One area of difference was fat metabolism where four β-oxidation enzymes were ∼25% higher in red mitochondria. This was correlated with a 40% higher rate of PC+M oxidation in red mitochondria compared with white mitochondria with no differences in P+M and G+M oxidation. These data suggest that metabolic demand differences between red and white muscle fibers are primarily matched by the number of mitochondria and not by significant alterations in the mitochondria themselves