How can BIM support construction safety management? Development of SIM

BIM is continuously changing the way construction can be approached, from design, scheduling, costing to facilities management. However, even though construction safety is a worldwide issue, and though previous, yet limited, studies have proven its great potential, BIM has not been extended to include automated construction safety management functions, i.e., hazard identification, assessment and control for construction works. In fact, as many as 71% of safety incidents can be prevented by safety considerations at design stage. Automation via BIM is the key to enhance effectiveness and efficiency of safety management, but development of Safety Information Modelling (SIM) is the key pre-requisite. This paper aims to outline a research project for developing both information and technical requirements for SIM via questionnaire survey, focus group, and real case studies. The project results, to be validated by real projects, will act as solid platform for developing:- i) Practical guidance to construction and safety professionals on the types of safety management a SIM can conduct, and the ways of utilizing the safety information in a SIM model [based on the systematic SIM information requirements (e.g., object identification, geometry attributes, safety rules)]; and ii) Overall guidance to software developers to develop appropriate SIM tools for different scenarios [based on the systematic SIM technical requirements (e.g., model information exchange, visualization, conflict analysis process for risk assessment, reliability)].published_or_final_versio

Clinical use of gadobutrol for contrast-enhanced magnetic resonance imaging of neurological diseases

Kenneth T Cheng1, Hannah Y Cheng2, Kam Leung31Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA; 2Freelance Technical Writer, New Orleans, LA, USA; 3National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD, USAAbstract: Contrast-enhanced magnetic resonance imaging (CE-MRI) is an important clinical tool for diagnosing neurological diseases. The appropriate use of a suitable MRI contrast agent or contrast pharmaceutical is essential for CE-MRI to produce desirable diagnostic images. Currently, there are seven contrast agents (CAs) or pharmaceuticals approved for clinical imaging of the central nervous system (CNS) in the US, Europe, or Japan. All of the clinically approved CAs are water-soluble gadolinium-based contrast agents (GBCAs) which do not penetrate the CNS blood–brain barrier (BBB). These agents are used for imaging CNS areas without a BBB, or various pathologies, such as tumors and infection that break down the BBB and allow CAs to enter into the surrounding parenchyma. Clinically, GBCAs are most useful for detecting primary and secondary cerebral neoplastic lesions. Among these CNS GBCAs, gadobutrol (Gd-BT-DO3A, Gadovist™) is a neutral, nonionic, macrocyclic compound that showed promising results from clinical trials of CNS imaging. In comparison with other GBCAs, Gd-BT-DO3A has relatively high in vitro kinetic stability and r1 relaxivity. Gd-BT-DO3A has been recently approved by the US Food and Drug Administration (FDA) in 2011 for CNS imaging. A review of available literature shows that Gd-BT-DO3A exhibits similar safety and clinical efficacy profiles to other GBCAs. Gd-BT-DO3A has the distinguishing feature that it is the only clinical agent commercially available in a formulation of 1.0 M concentration with a relatively higher in vitro T1 shortening per unit volume than other clinical GBCAs which are only available in 0.5 M concentration. This double concentration of Gd-BT-DO3A may allow a relatively higher concentration of the agent to localize in the CNS and produce a better contrast enhancement at the same clinical dose as other GBCAs. Several recent published multicenter clinical trials appeared to support this potential advantage of Gd-BT-DO3A.Keywords: Gadovist, Gd-BT-DO3A, CE-MRI, CNS imaging, MRI contrast agent, gadoliniu

Three-dimensional ultrasonography of conjoined twins

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Limited open reduction and Ilizarov external fixation in the treatment of distal tibial fractures

The authors reviewed 31 distal tibial fractures (16 involving the tibial plafond) treated with Ilizarov external fixation. The study population was composed of 19 males and 12 females, with an average age of 54. The fractures were classified according to the AO classification: A1 (3), A2 (6), A3 (6), C1 (2), C2 (8), C3 (6). There were six open injuries. In 14 pilon cases, open reduction of the intra-articular fragments and bone grafting via a limited incision was performed. Clinical follow-up averaged 28 months (range 18-42). All but one fracture united with an average healing time of 13.9 weeks. Nearly all patients with AO type A fracture had excellent or good functional scores. The 14 cases of AO C2 and C3 group had five (38%) good results, five (38%) fair results and three (24%) poor results. This method yielded results comparable with previous studies using open reduction and internal fixation. Twenty-nine percent of the patients had pin track infection, which remained the most important complication of this method. © 2003 Elsevier Ltd. All rights reserved.postprin

Combined simultaneous transcranial and transsphenoidal resection of large-to-giant pituitary adenomas

Background: While large-to-giant pituitary adenomas (PAs) may be safely removed by experienced surgeons through a single route, the procedure is technically challenging. We present the outcome of a simultaneous combined transcranial and transsphenoidal approach and discuss its applications. Methods: A retrospective review was conducted on 12 consecutive patients. Surgical complications, visual and endocrinological functions, and tumour control were reviewed. Results: There were four men and eight women, with a mean age of 47.6 years. All but one patient had non-functioning PAs. The mean tumour height was 4.1 cm (range: 2.3-5.5). The predominant presenting symptoms were visual field loss in eight patients, headache in three patients and mental confusion in one patient. There was no operative mortality. Post-operative cerebrospinal fluid leakage occurred in one patient. Five of the eight patients who presented with visual field loss achieved full recovery, and three had partial improvement. Two patients developed permanent diabetes insipidus after surgery. Panhypopituitarism occurred in one patient. Gross total removal (GTR) was achieved in five, and subtotal removal (STR) in seven patients. Seven patients received post-operative external irradiation. All patients who had GTR remained tumour-free and all those with STR had stable diseases after a mean follow-up period of 53.1 months (range: 14.1-92.1). Conclusion: The simultaneous 'above and below' approach is a safe and effective surgical strategy for large-to-giant PAs, particularly when expertise in endoscopic transsphenoidal surgery is unavailable. Its use, however, should be limited to a carefully selected group of patients, and tailored to individual user's expertise and experience. © 2011 The Author(s).published_or_final_versio

Health literacy issues in the care of Chinese American immigrants with diabetes: a qualitative study

Objectives. To investigate why first-generation Chinese immigrants with diabetes have difficulty obtaining, processing and understanding diabetes related information despite the existence of translated materials and translators. Design This qualitative study employed purposive sampling. Six focus groups and two individual interviews were conducted. Each group discussion lasted approximately 90 min and was guided by semistructured and open-ended questions. Setting. Data were collected in two community health centres and one elderly retirement village in Los Angeles, California. Participants 29 Chinese immigrants aged ≥45 years and diagnosed with type 2 diabetes for at least 1 year. Results. Eight key themes were found to potentially affect Chinese immigrants' capacity to obtain, communicate, process and understand diabetes related health information and consequently alter their decision making in self-care. Among the themes, three major categories emerged: cultural factors, structural barriers, and personal barriers. Conclusions. Findings highlight the importance of cultural sensitivity when working with first-generation Chinese immigrants with diabetes. Implications for health professionals, local community centres and other potential service providers are discussed.published_or_final_versio

A new multiple regression approach for the construction of genetic regulatory networks

Objective: Re-construction of a genetic regulatory network from a given time-series gene expression data is an important research topic in systems biology. One of the main difficulties in building a genetic regulatory network lies in the fact that practical data set has a huge number of genes vs. a small number of sampling time points. In this paper, we propose a new linear regression model that may overcome this difficulty for uncovering the regulatory relationship in a genetic network. Methods: The proposed multiple regression model makes use of the scale-free property of a real biological network. In particular, a filter is constructed by using this scale-free property and some appropriate statistical tests to remove redundant interactions among the genes. A model is then constructed by minimizing the gap between the observed and the predicted data. Results: Numerical examples based on yeast gene expression data are given to demonstrate that the proposed model fits the practical data very well. Some interesting properties of the genes and the underlying network are also observed. Conclusions: In conclusion, we propose a new multiple regression model based on the scale-free property of real biological network for genetic regulatory network inference. Numerical results using yeast cell cycle gene expression dataset show the effectiveness of our method. We expect that the proposed method can be widely used for genetic network inference using high-throughput gene expression data from various species for systems biology discovery. © 2009 Elsevier B.V.postprin

Social contact patterns relevant to the spread of respiratory infectious diseases in Hong Kong.

The spread of many respiratory infections is determined by contact patterns between infectious and susceptible individuals in the population. There are no published data for quantifying social contact patterns relevant to the spread of respiratory infectious diseases in Hong Kong which is a hotspot for emerging infectious diseases due to its high population density and connectivity in the air transportation network. We adopted a commonly used diary-based design to conduct a social contact survey in Hong Kong in 2015/16 using both paper and online questionnaires. Participants using paper questionnaires reported more contacts and longer contact duration than those using online questionnaires. Participants reported 13 person-hours of contact and 8 contacts per day on average, which decreased over age but increased with household size, years of education and income level. Prolonged and frequent contacts, and contacts at home, school and work were more likely to involve physical contacts. Strong age-assortativity was observed in all age groups. We evaluated the characteristics of social contact patterns relevant to the spread of respiratory infectious diseases in Hong Kong. Our findings could help to improve the design of future social contact surveys, parameterize transmission models of respiratory infectious diseases, and inform intervention strategies based on model outputs