Examination of the relationship between organisational and facility management strategy and value added

Facility Management (FM) is a profession in which facility managers are employed to manage a diverse set of services, personnel, and built environmentsto accomplish organisational goals. The findings of this study showed that many organisations are focusing on achieving strategic goals and objectives withoutconsidering FM as a supportive function of the whole strategic plan. It is generally recognised that the stakeholders who are involved with the organisation shouldexamine that there is a misalignment between FM and strategic management, and the associate need to minimise this misalignment with the contribution of facility management and strategy professionals.The aim of this research was to develop an alignment model in order to examine how value was added by FM services and how they can enable organisationaleffectiveness through perceiving business needs. Four objectives were set for the study: to examine the phenomenon of Facility Management in relation toalignment as a contributor to the organisations’ aim and objectives. This was to assess the role and position of FM and explore some of the challenges and dilemmas occurring within their organisational environment, to explore and analyse the complexities of FM processes and assets in various types of organisations, and finally to develop and validate an alignment model for evaluating the value added through the alignment between FM and theorganisation.The methodology adopted for this research included a combination of literature review, three case studies (with semi-structured interviews) and a web-based questionnaire (WBS), This was in order to identify the alignment between FM and organisation. More specifically, the FM literature review evaluated some classification frameworks of various organisational models presenting an in-depth analysis. The associated web-based questionnaire was designed and circulated among facility managers from different organisations. The total numbers of respondents of the WBS was 60. In addition, data was collected from three semistructured interviews with associated decision makers. Three case studies were selected from different types of organisations based in the Middle East. The findings of the research revealed that there is a misalignment that exists in the organisation with the lack of acceptance of the facility management role in the strategic level of the organisation.This research has contributed to the existing body of knowledge on FM by identifying the misalignment between FM and organisation and the FM added value into the organisation. This thesis has contributed to knowledge in this field through its explanation of the background of the alignment models in relation with the organisational models. It has also contributed to synthesis of the organisation models with the FM alignment variables. A synthesis of the organisation models and the alignment variables revealed that most organisation models utilised the variable supply and demand, the management by agent utilised the organisation variable, and the FM-in house utilised the FM resource alignment variable.The findings of this research helped to develop a value added alignment model (VAAM) for the achievement of alignment in the organisation. This was done through the facility manager’s role which supported the development of the strategic plan in the organisation. Moreover, the alignment model also revealed outcomes that can enable the FM’s role in the strategic management, and thisincluded awareness of the FM’s role in the organisation among executive management. Finally, this study draws the conclusion, that in order for the developed alignment model to work facility managers need to be involved in allthe strategy phases of the organisation

Personalized e-Learning Implementation - The GIS Case

Personalized e-learning implementation is recognized as among one of the most interesting research areas in the distance learning Web-based education. In particular, the GIS e-learning initiatives that incorporate —by default— a number of sequencing spatial techniques (i.e. spatial objects selection and sequencing), will well benefit from a welldefined personalized e-learning implementation with embedded spatial functionality. This is the case addressed in this paper. The GIS e-learning implementation introduced in the current paper is based on a set of teaching (lecturing) rules according to the cognitive style of learning preferences of both the learners and the lecturers as well. It is important to note that, in spite of the fact that most of these teaching rules are generic (i.e. domain, view and user independent), there are no so far well-defined and commonly accepted rules on how the learning spatial GIS objects and techniques should be selected and how they should be sequenced to make “instructional sense" in a Web-based GIS course

Feasibility and safety of high-dose adenosine perfusion cardiovascular magnetic resonance

<p>Abstract</p> <p>Introduction</p> <p>Adenosine is the most widely used vasodilator stress agent for Cardiovascular Magnetic Resonance (CMR) perfusion studies. With the standard dose of 140 mcg/kg/min some patients fail to demonstrate characteristic haemodynamic changes: a significant increase in heart rate (HR) and mild decrease in systolic blood pressure (SBP). Whether an increase in the rate of adenosine infusion would improve peripheral and, likely, coronary vasodilatation in those patients is unknown. The aim of the present study was to assess the tolerance and safety of a high-dose adenosine protocol in patients with inadequate haemodynamic response to the standard adenosine protocol when undergoing CMR perfusion imaging.</p> <p>Methods</p> <p>98 consecutive patients with known or suspected coronary artery disease (CAD) underwent CMR perfusion imaging at 1.5 Tesla. Subjects were screened for contraindications to adenosine, and an electrocardiogram was performed prior to the scan. All patients initially received the standard adenosine protocol (140 mcg/kg/min for at least 3 minutes). If the haemodynamic response was inadequate (HR increase < 10 bpm or SBP decrease < 10 mmHg) then the infusion rate was increased up to a maximum of 210 mcg/kg/min (maximal infusion duration 7 minutes).</p> <p>Results</p> <p>All patients successfully completed the CMR scan. Of a total of 98 patients, 18 (18%) did not demonstrate evidence of a significant increase in HR or decrease in SBP under the standard adenosine infusion rate. Following the increase in the rate of infusion, 16 out of those 18 patients showed an adequate haemodynamic response. One patient of the standard infusion group and two patients of the high-dose group developed transient advanced AV block. Significantly more patients complained of chest pain in the high-dose group (61% vs. 29%, p = 0.009). On multivariate analysis, age > 65 years and ejection fraction < 57% were the only independent predictors of blunted haemodynamic responsiveness to adenosine.</p> <p>Conclusions</p> <p>A substantial number of patients do not show adequate peripheral haemodynamic response to standard-dose adenosine stress during perfusion CMR imaging. Age and reduced ejection fraction are predictors of inadequate response to standard dose adenosine. A high-dose adenosine protocol (up to 210 mcg/kg/min) is well tolerated and results in adequate haemodynamic response in nearly all patients.</p

The AIQ Meta-Testbed: Pragmatically Bridging Academic AI Testing and Industrial Q Needs

AI solutions seem to appear in any and all application domains. As AI becomes more pervasive, the importance of quality assurance increases. Unfortunately, there is no consensus on what artificial intelligence means and interpretations range from simple statistical analysis to sentient humanoid robots. On top of that, quality is a notoriously hard concept to pinpoint. What does this mean for AI quality? In this paper, we share our working definition and a pragmatic approach to address the corresponding quality assurance with a focus on testing. Finally, we present our ongoing work on establishing the AIQ Meta-Testbed.Comment: Accepted for publication in the Proc. of the Software Quality Days 2021, Vienna, Austri

Magnetic resonance imaging phantoms for quality-control of myocardial T1 and ECV mapping: specific formulation, long-term stability and variation with heart rate and temperature

Background: Magnetic resonance imaging (MRI) phantoms are routinely used for quality assurance in MRI centres; however their long term stability for verification of myocardial T1/ extracellular volume fraction (ECV) mapping has never been investigated. Methods: Nickel-chloride agarose gel phantoms were formulated in a reproducible laboratory procedure to mimic blood and myocardial T1 and T2 values, native and late after Gadolinium administration as used in T1/ECV mapping. The phantoms were imaged weekly with an 11 heart beat MOLLI sequence for T1 and long TR spin-echo sequences for T2, in a carefully controlled reproducible manner for 12 months. Results: There were only small relative changes seen in all the native and post gadolinium T1 values (up to 9.0 % maximal relative change in T1 values) or phantom ECV (up to 8.3 % maximal relative change of ECV, up to 2.2 % maximal absolute change in ECV) during this period. All native and post gadolinium T2 values remained stable over time with <2 % change. Temperature sensitivity testing showed MOLLI T1 values in the long T1 phantoms increasing by 23.9 ms per degree increase and short T1 phantoms increasing by 0.3 ms per degree increase. There was a small absolute increase in ECV of 0.069 % (~0.22 % relative increase in ECV) per degree increase. Variation in heart rate testing showed a 0.13 % absolute increase in ECV (~0.45 % relative increase in ECV) per 10 heart rate increase. Conclusions: These are the first phantoms reported in the literature modeling T1 and T2 values for blood and myocardium specifically for the T1mapping/ECV mapping application, with stability tested rigorously over a 12 month period. This work has significant implications for the utility of such phantoms in improving the accuracy of serial scans for myocardial tissue characterisation by T1 mapping methods and in multicentre work

Cardiosphere-Derived Cells Improve Function in the Infarcted Rat Heart for at Least 16 Weeks – an MRI Study

Aims Endogenous cardiac progenitor cells, expanded from explants via cardiosphere formation, present a promising cell source to prevent heart failure following myocardial infarction. Here we used cine-magnetic resonance imaging (MRI) to track administered cardiosphere-derived cells (CDCs) and to measure changes in cardiac function over four months in the infarcted rat heart. Methods and Results CDCs, cultured from neonatal rat heart, comprised a heterogeneous population including cells expressing the mesenchymal markers CD90 and CD105, the stem cell marker c-kit and the pluripotency markers Sox2, Oct3/4 and Klf-4. CDCs (2×106) expressing green fluorescent protein (GFP+) were labelled with fluorescent micron-sized particles of iron oxide (MPIO). Labelled cells were administered to the infarcted rat hearts (n = 7) by intramyocardial injection immediately following reperfusion, then by systemic infusion (4×106) 2 days later. A control group (n = 7) was administered cell medium. MR hypointensities caused by the MPIOs were detected at all times and GFP+ cells containing MPIO particles were identified in tissue slices at 16 weeks. At two days after infarction, cardiac function was similar between groups. By 6 weeks, ejection fractions in control hearts had significantly decreased (47±2%), but this was not evident in CDC-treated hearts (56±3%). The significantly higher ejection fractions in the CDC-treated group were maintained for a further 10 weeks. In addition, CDC-treated rat hearts had significantly increased capillary density in the peri-infarct region and lower infarct sizes. MPIO-labelled cells also expressed cardiac troponin I, von Willebrand factor and smooth muscle actin, suggesting their differentiation along the cardiomyocyte lineage and the formation of new blood vessels. Conclusions CDCs were retained in the infarcted rat heart for 16 weeks and improved cardiac function

Cell tracking in cardiac repair: what to image and how to image

Stem cell therapies hold the great promise and interest for cardiac regeneration among scientists, clinicians and patients. However, advancement and distillation of a standard treatment regimen are not yet finalised. Into this breach step recent developments in the imaging biosciences. Thus far, these technical and protocol refinements have played a critical role not only in the evaluation of the recovery of cardiac function but also in providing important insights into the mechanism of action of stem cells. Molecular imaging, in its many forms, has rapidly become a necessary tool for the validation and optimisation of stem cell engrafting strategies in preclinical studies. These include a suite of radionuclide, magnetic resonance and optical imaging strategies to evaluate non-invasively the fate of transplanted cells. In this review, we highlight the state-of-the-art of the various imaging techniques for cardiac stem cell presenting the strengths and limitations of each approach, with a particular focus on clinical applicability