Digitization for Integration:Fragmented realities in the utility sector

The construction industry and its reform agendas commonly assume that digitization of a construction asset's life cycle also integrates its stakeholders. Behind this lies the premise that stakeholders reduce ambiguity and create consistency by using software that operates on the basis of shared and uniform knowledge. To explore this premise, this study identified the knowledge bases - data standards and modelling protocols for engineering software - that distinctive underground infrastructure owner’s use. To this end, we analysed a utility engineering consultancy that registers and processes asset data of twelve major utility owners. We observed their utility information managers and studied their asset management guidelines. We used two utility taxonomies from literature to compare identified digital modelling standards. Subsequently, we used literature about modelling standards in digital practices to argue how selected examples of divergent digital models hamper uniformity. We conclude that digital reality models may also differ and thus confuse, fragment, and ultimately delimit collaborative digital practices. This insight stresses the relevance of defining shared domain understanding to facilitate the uptake of software for collaborative engineering practices. It stimulates construction improvement agents to consider this important notion of shared digital realities in their debates about achieving integration by ‘going digital'

Visceral obesity measured using computed tomography scans:No significant association with mortality in critically ill patients

Introduction: The association between obesity and outcome in critical illness is unclear. Since the amount of visceral adipose tissue(VAT) rather than BMI mediates the health effects of obesity we aimed to investigate the association between visceral obesity, BMI and 90-day mortality in critically ill patients. Method: In 555 critically ill patients (68% male), the VAT Index(VATI) was measured using Computed Tomography scans on the level of vertebra L3. The association between visceral obesity, BMI and 90-day mortality was investigated using univariable and multivariable analyses, correcting for age, sex, APACHE II score, sarcopenia and muscle quality. Results: Visceral obesity was present in 48.1% of the patients and its prevalence was similar in males and females. Mortality was similar amongst patients with and without visceral obesity (27.7% vs 24.0%, p = 0.31). The corrected odds ratio of 90-day mortality for visceral obesity was 0.667 (95%CI 0.424–1.049, p = 0.080). Using normal BMI as reference, the corrected odds ratio for overweight was 0.721 (95%CI 0.447–1.164 p = 0.181) and for obesity 0.462 (95%CI 0.208–1.027, p = 0.058). Conclusion: No significant association of visceral obesity and BMI with 90-day mortality was observed in critically ill patients, although obesity and visceral obesity tended to be associated with improved 90-day mortality.</p

Visceral obesity measured using computed tomography scans:No significant association with mortality in critically ill patients

Introduction: The association between obesity and outcome in critical illness is unclear. Since the amount of visceral adipose tissue(VAT) rather than BMI mediates the health effects of obesity we aimed to investigate the association between visceral obesity, BMI and 90-day mortality in critically ill patients. Method: In 555 critically ill patients (68% male), the VAT Index(VATI) was measured using Computed Tomography scans on the level of vertebra L3. The association between visceral obesity, BMI and 90-day mortality was investigated using univariable and multivariable analyses, correcting for age, sex, APACHE II score, sarcopenia and muscle quality. Results: Visceral obesity was present in 48.1% of the patients and its prevalence was similar in males and females. Mortality was similar amongst patients with and without visceral obesity (27.7% vs 24.0%, p = 0.31). The corrected odds ratio of 90-day mortality for visceral obesity was 0.667 (95%CI 0.424–1.049, p = 0.080). Using normal BMI as reference, the corrected odds ratio for overweight was 0.721 (95%CI 0.447–1.164 p = 0.181) and for obesity 0.462 (95%CI 0.208–1.027, p = 0.058). Conclusion: No significant association of visceral obesity and BMI with 90-day mortality was observed in critically ill patients, although obesity and visceral obesity tended to be associated with improved 90-day mortality.</p

G protein-coupled Receptor 30 (GPR30) PDZ-dependently and Constitutively Increases ERK1/2 Signaling Through Calcineurin and Kinase Suppressor of Ras 2 (KSR2)

The objective of the present study was to map the mechanism whereby G protein-coupled receptor 30 (GPR30), also called G protein-coupled estrogen receptor (GPER), stimulates extracellular signal-regulated kinase (ERK)1/2 signaling. GPR30 plays important roles in cancer and cardiometabolic regulation. We showed recently that GPR30 forms a plasma membrane complex through its C-terminal type I PSD-95/Discs-large/ZO-1 homology (PDZ) motif with a membrane-associated guanylate kinase (MAGUK) and protein kinase A (PKA)-anchoring protein 5 (AKAP5), and AKAP5-anchored PKA regulatory subunit RII suppresses receptor endocytosis and enables the receptor to constitutively inhibit cAMP production. Here, we investigated if this PDZ-dependent GPR30 complex also regulates ERK1/2 signaling. To do so, human and mouse GPR30 were ectopically expressed in HEK293 cells and MDCK cells, and receptors and effectors were monitored by immunoblotting, immunoprecipitation, confocal immunofluorescence microscopy, split luciferase reporter techniques, and reporter gene assays. We found that GPR30 constitutively increased extracellular signal-regulated kinase (ERK) 1/2 activity in several cell systems. The response was dependent on an intact receptor PDZ motif. Furthermore, knocking down AKAP5 or inhibiting calcineurin with FK506 inhibited the receptor response. GPR30 PDZ-dependently inhibited basal NFAT signaling, consistent with the receptor favoring AKAP5-anchoring of calcineurin. The calcineurin substrate kinase suppressor of Ras 2 (KSR2), a mitogen-activated protein kinase (MAPK) scaffold, enhanced the GPR30-promoted response, also dependently on the receptor PDZ motif. GPR30 also PDZ-dependently favored a membrane KSR2 complex at the expense of the monomeric form. On the other hand, disrupting AKAP5-PKA RII interaction with St-Ht31, or inhibiting protein kinase C (PKC) with GF109203X or epidermal growth factor receptor (EGFR) tyrosine kinase with AG1478 had no effect on the GPR30-stimulated response. FK506 also increased the amount of GPR30 in the plasma membrane, thus acting opposite to St-Ht31, which increased receptor endocytosis. We conclude that the PDZ-dependent GPR30 complex with AKAP5 includes calcineurin, which favors GPR30 endocytosis and enables the receptor to constitutively increase ERK1/2 signaling through KSR2. Support or Funding Information Swedish Cancer Foundatio

Visceral obesity measured using computed tomography scans: No significant association with mortality in critically ill patients

Introduction: The association between obesity and outcome in critical illness is unclear. Since the amount of visceral adipose tissue(VAT) rather than BMI mediates the health effects of obesity we aimed to investigate the association between visceral obesity, BMI and 90-day mortality in critically ill patients. Method: In 555 critically ill patients (68% male), the VAT Index(VATI) was measured using Computed Tomography scans on the level of vertebra L3. The association between visceral obesity, BMI and 90-day mortality was investigated using univariable and multivariable analyses, correcting for age, sex, APACHE II score, sarcopenia and muscle quality. Results: Visceral obesity was present in 48.1% of the patients and its prevalence was similar in males and females. Mortality was similar amongst patients with and without visceral obesity (27.7% vs 24.0%, p = 0.31). The corrected odds ratio of 90-day mortality for visceral obesity was 0.667 (95%CI 0.424–1.049, p = 0.080). Using normal BMI as reference, the corrected odds ratio for overweight was 0.721 (95%CI 0.447–1.164 p = 0.181) and for obesity 0.462 (95%CI 0.208–1.027, p = 0.058). Conclusion: No significant association of visceral obesity and BMI with 90-day mortality was observed in critically ill patients, although obesity and visceral obesity tended to be associated with improved 90-day mortality