ANALYSIS OF POSSIBLE GEODETIC APPROACHES FOR 3D MODEL CREATION IN BIM

The topic of this paper is the description and analysis of technologies for generating a geometric basis for BIM. The main element is an analysis of the capabilities of mobile laser scanning and the outputs of this method compared to other methods. The selected interior space was measured by different technologies, laser scanning, classical geodetic using total station, and manual measurement. The main device tested was the ZEB-REVO. It is a handheld mobile laser scanner, carried by an operator. It has a range of 40 m, with the accuracy in measured lengths is 1–3cm per 10 m depending on the type of surface. The scanning speed is 43,000 points per second. The device is equipped with an inertial measurement unit (IMU) and uses SLAM technology for trajectory definition. The device does not have a camera in the simplest configuration and the operator cannot monitor the scanning status. Nevertheless, measurement with this scanner is very simple. The instrument is mainly used for surveying construction objects, but it can be advantageously used for documentation of underground spaces or in e.g., forestry for defining DBH or volume of stockpiles. This device is not equipped with a GNSS unit, and the typical scanning time is 20–30 min without model deformation. Accuracy and output analysis was performed for all technologies used. The results are presented in tables and show the suitability of PLS (personal laser scanner) in general

Toxic Shock-like Syndrome Associated with Necrotizing Streptococcus Pyogenes Infection

Two patients with toxic shock-like syndrome are presented. Both patients had necrotizing cellulitis due to Streptococcus pyogenes, and both patients required extensive surgical debridement. The association of Streptococcus pyogenes infection and toxic shock-like syndrome is discussed

A Multidisciplinary Intubation Algorithm for Suspected COVID-19 Patients in the Emergency Department

Introduction: Intubation of patients suspected of having coronavirus disease 2019 (COVID-19) is considered to be a high-risk procedure due to the aerosolization of viral particles. In an effort to minimize the risk of exposure and optimize patient care, we sought to develop, test, provide training, and implement a standardized algorithm for intubating these high-risk patients at our institution.Methods: We developed an initial intubation algorithm, incorporating strategic use of equipment and incorporating emerging best practices. By combining simulation-based training sessions and rapid-cycle improvement methodology with physicians, nurses, and respiratory therapists, and incorporating their feedback into the development, we were able to optimize the process prior to implementation. Training sessions also enabled the participants to practice the algorithm as a team. Upon completion of each training session, participants were invited to complete a brief online survey about their overall experience.Results: An algorithm and training system vetted by simulation and actual practice were developed. A training video and dissemination package were made available for other emergency departments to adopt. Survey results were overall positive, with 97.92% of participants feeling confident in their role in the intubation process, and many participants citing the usefulness of the multidisciplinary approach to the training.Conclusion: A multidisciplinary, team-based approach to the development and training of a standardized intubation algorithm combining simulation and rapid-cycle improvement methodology is a useful, effective process to respond to rapidly evolving clinical information and experiences during a global pandemic

Metastasis-inducing S100A4 protein is associated with the disease activity of rheumatoid arthritis

Objectives. To evaluate the association between metastasis-inducing protein S100A4 and disease activity in patients with RA, and to demonstrate the effect of TNF-alpha blocking therapy on plasma levels of S100A4 in these patients. Methods. Plasma levels of the S100A4 protein were analysed in 40 anti-TNF-alpha naive patients with active RA. Of the 40 patients, 25 were treated with adalimumab and monitored over time. The conformational form of S100A4 was analysed using size-exclusion gel chromatography. TNF-alpha mRNA expression and protein synthesis were analysed by RT-PCR and ELISA, respectively. Results. Baseline levels of S100A4 were significantly correlated with disease activity in RA patients (r = 0.41; P < 0.01). After 12 weeks of treatment with adalimumab, there was an obvious shift in the conformations of S100A4 from the multimeric to the dimeric forms, whereas the total levels of the S100A4 protein remained unchanged. This suggests that the bioactive (multimer) S100A4 may decline in response to successful treatment with adalimumab. In addition, we showed significant up-regulation of TNF-alpha mRNA (P < 0.01), and protein release to the cell culture medium of monocytes stimulated with the S100A4 multimer compared with those treated with the dimer and to the unstimulated monocytes (P < 0.001). Conclusions. This is the first study to show that the levels of the S100A4 protein are correlated with RA disease activity. Furthermore, only the bioactive form, but not the total amount of S100A4, decreases after successful TNF-alpha blocking therapy in patients with RA. These data support an important role for the S100A4 multimer in the pathogenesis of R

Elevated Atmospheric CO2 Affects Ectomycorrhizal Species Abundance and Increases Sporocarp Production under Field Conditions

Anthropogenic activities during the last century have increased levels of atmospheric CO2. Forest net primary productivity increases in response to elevated CO2, altering the quantity and quality of carbon supplied to the rhizosphere. Ectomycorrhizal fungi form obligate symbiotic associations with the fine roots of trees that mediate improved scavenging for nutrients in exchange for a carbohydrate supply. Understanding how the community structure of ectomycorrhizal fungi is altered by climate change is important to further our understanding of ecosystem function. Betula pendula and Fagus sylvatica were grown in an elevated CO2 atmosphere delivered using free air carbon dioxide enrichment (FACE) under field conditions in the U.K., and Picea abies was grown under elevated CO2 in glass domes in the Czech Republic. We used morphotyping and sequencing of the internal transcribed spacer region of the fungal ribosomal operon to study ectomycorrhizal community structure. Under FACE, un-colonised roots tips increased in abundance for Fagus sylvatica, and during 2006, sporocarp biomass of Peziza badia significantly increased. In domes, ectomycorrhizal community composition shifted from short-distance and smooth medium-distance to contact exploration types. Supply and competition for carbon belowground can influence ectomycorrhizal community structure with the potential to alter ecosystem function

Serum hyaluronic acid as a potential marker with a predictive value for further radiographic progression of hand osteoarthritis

SummaryObjectiveTo compare serum levels of hyaluronic acid (HA) between patients with erosive and non-erosive hand osteoarthritis (HOA), and investigate its association with morphological changes and radiographic progression over 2 years.MethodsFifty-five women with erosive and 33 women with non-erosive HOA were included in this study. All underwent clinical examination, which included assessment of pain, swelling, deformity and deviation of small hand joints and completed health assessment questionnaires. Serum levels of HA were measured by ELISA. Three-phase bone scintigraphy was performed at baseline. Radiographs of both hands were performed at baseline and after 2 years and scored according Kallman grading scale.ResultsSerum levels of HA were significantly higher in patients with erosive than with non-erosive HOA (P<0.01). It correlated significantly with the number of hand joints with deviations and deformities. HA adjusted for age and disease duration significantly correlated with radiographs at baseline and after 2 years in all patients with HOA (r=0.560 and r=0.542, P<0.01 for both correlations). Although there was an association between HA and radiographic score in erosive disease, after adjustment for confounders it remained no longer significant. HA adjusted for confounders correlated significantly with the late phase in all patients with HOA (r=0.412, P<0.01) and in patients with erosive disease (r=0.320, P<0.05).ConclusionHA is increased in patients with erosive HOA and could be proposed as a surrogate marker with a predictive value for further radiographic progression of HOA in general. Further investigation is necessary to confirm these results

Single, intra-articular treatment with 6 ml hylan G-F 20 in patients with symptomatic primary osteoarthritis of the knee: a randomised, multicentre, double-blind, placebo controlled trial

International audienceObjectives: The primary objective was to compare a single, 6 ml, intra-articular injection of hylan G-F 20 with placebo in patients with symptomatic knee osteoarthritis. The safety of a repeat injection of hylan G-F 20 was also assessed. Methods: Patients with primary osteoarthritis knee pain were randomly assigned to arthrocentesis plus a 6 ml intra-articular injection of either hylan G-F 20 or placebo in a prospective, double-blind (one injector/one blinded observer) study. Results were evaluated at 4, 8, 12, 18 and 26 weeks post-injection. The primary outcome criterion was change from baseline over 26 weeks in Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index A pain. Secondary outcome measures included WOMAC A1 and C, patient global assessment (PGA) and clinical observer global assessment (COGA) and Outcome Measures in Rheumatology, Osteoarthritis Research Society International responder rates. A 4-week, open, repeat treatment phase evaluated safety only. Results: A total of 253 patients (Kellgren-Lawrence grade II or III) was randomly assigned. Patients receiving hylan G-F 20 experienced statistically significantly greater improvements in WOMAC A pain scores (-0.15, SE 0.076, p=0.047), and several of the secondary outcome measures (WOMAC A1, PGA and COGA), than patients receiving placebo. There was no difference between the safety results of the two groups. No increased risk of local adverse events was observed in the open, repeat treatment phase. Conclusions: This placebo-controlled study demonstrated that, in patients with knee osteoarthritis, a single 6 ml intra-articular injection of hylan G-F 20 is safe and effective in providing statistically significant, clinically relevant pain relief over 26 weeks, with a modest difference versus placebo

Assessing the ability of MODIS EVI to estimate terrestrial ecosystem gross primary production of multiple land cover types

© 2016 Elsevier Ltd Terrestrial ecosystem gross primary production (GPP) is the largest component in the global carbon cycle. The enhanced vegetation index (EVI) has been proven to be strongly correlated with annual GPP within several biomes. However, the annual GPP-EVI relationship and associated environmental regulations have not yet been comprehensively investigated across biomes at the global scale. Here we explored relationships between annual integrated EVI (iEVI) and annual GPP observed at 155 flux sites, where GPP was predicted with a log-log model: ln(GPP)=a×ln(iEVI)+b. iEVI was computed from MODIS monthly EVI products following removal of values affected by snow or cold temperature and without calculating growing season duration. Through categorisation of flux sites into 12 land cover types, the ability of iEVI to estimate GPP was considerably improved (R2 from 0.62 to 0.74, RMSE from 454.7 to 368.2 g C m−2 yr−1). The biome-specific GPP-iEVI formulae generally showed a consistent performance in comparison to a global benchmarking dataset (R2 = 0.79, RMSE = 387.8 g C m−2 yr−1). Specifically, iEVI performed better in cropland regions with high productivity but poorer in forests. The ability of iEVI in estimating GPP was better in deciduous biomes (except deciduous broadleaf forest) than in evergreen due to the large seasonal signal in iEVI in deciduous biomes. Likewise, GPP estimated from iEVI was in a closer agreement to global benchmarks at mid and high-latitudes, where deciduous biomes are more common and cloud cover has a smaller effect on remote sensing retrievals. Across biomes, a significant and negative correlation (R2 = 0.37, p < 0.05) was observed between the strength (R2) of GPP-iEVI relationships and mean annual maximum leaf area index (LAImax), and the relationship between the strength and mean annual precipitation followed a similar trend. LAImax also revealed a scaling effect on GPP-iEVI relationships. Our results suggest that iEVI provides a very simple but robust approach to estimate spatial patterns of global annual GPP whereas its effect is comparable to various light-use-efficiency and data-driven models. The impact of vegetation structure on accuracy and sensitivity of EVI in estimating spatial GPP provides valuable clues to improve EVI-based models

Education as Risk Factor of Mild Cognitive Impairment:The Link to the Gut Microbiome

Background: With differences apparent in the gut microbiome in mild cognitive impairment (MCI) and dementia, and risk factors of dementia linked to alterations of the gut microbiome, the question remains if gut microbiome characteristics may mediate associations of education with MCI. Objectives: We sought to examine potential mediation of the association of education and MCI by gut microbiome diversity or composition. Design: Cross-sectional study. Setting: Luxembourg, the Greater Region (surrounding areas in Belgium, France, Germany). Participants: Control participants of the Luxembourg Parkinson’s Study. Measurements: Gut microbiome composition, ascertained with 16S rRNA gene amplicon sequencing. Differential abundance, assessed across education groups (0–10, 11–16, 16+ years of education). Alpha diversity (Chao1, Shannon and inverse Simpson indices). Mediation analysis with effect decomposition was conducted with education as exposure, MCI as outcome and gut microbiome metrics as mediators. Results: After exclusion of participants below 50, or with missing data, n=258 participants (n=58 MCI) were included (M [SD] Age=64.6 [8.3] years). Higher education (16+ years) was associated with MCI (Odds ratio natural direct effect=0.35 [95% CI 0.15–0.81]. Streptococcus and Lachnospiraceae-UCG-001 genera were more abundant in higher education. Conclusions: Education is associated with gut microbiome composition and MCI risk without clear evidence for mediation. However, our results suggest signatures of the gut microbiome that have been identified previously in AD and MCI to be reflected in lower education and suggest education as important covariate in microbiome studies