Overheating in vulnerable and non-vulnerable households

As the 2003 European heatwave demonstrated, overheating in homes can cause wide-scale fatalities. With temperatures and heatwave frequency predicted to increase due to climate change, such events can be expected to become more common. Thus, investigating the risk of overheating in buildings is key to understanding the scale of the problem and in designing solutions. Most work on this topic has been theoretical and based on lightweight dwellings that might be expected to overheat. By contrast, this study collects temperature and air quality data over two years for vulnerable and non-vulnerable UK homes where overheating would not be expected to be common. Overheating was found to occur, particularly and disproportionately in households with vulnerable occupants. As the summers in question were not extreme and contained no prolonged heatwaves, this is a significant and worrying finding. The vulnerable homes were also found to have worse indoor air quality. This suggests that some of the problem might be solved by enhancing indoor ventilation. The collected thermal comfort survey data were also validated against the European adaptive model. Results suggest that the model underestimates discomfort in warm conditions, having implications for both vulnerable and non-vulnerable homes

A Review of Current and Future Weather Data for Building Simulation

This article provides the first comprehensive assessment of methods for the creation of weather variables for use in building simulation. We undertake a critical analysis of the fundamental issues and limitations of each methodology and discusses new challenges, such as how to deal with uncertainty, the urban heat island, climate change and extreme events. Proposals for the next generation of weather files for building simulation are made based on this analysis. A seven-point list of requirements for weather files is introduced and the state-of-the-art compared to this via a mapping exercise. It is found that there are various issues with all current and suggested approaches, but the two areas most requiring attention are the production of weather files for the urban landscape and files specifically designed to test buildings against the criteria of morbidity, mortality and building services system failure

An artificial intelligence-based collaboration approach in industrial IoT manufacturing : key concepts, architectural extensions and potential applications

The digitization of manufacturing industry has led to leaner and more efficient production, under the Industry 4.0 concept. Nowadays, datasets collected from shop floor assets and information technology (IT) systems are used in data-driven analytics efforts to support more informed business intelligence decisions. However, these results are currently only used in isolated and dispersed parts of the production process. At the same time, full integration of artificial intelligence (AI) in all parts of manufacturing systems is currently lacking. In this context, the goal of this manuscript is to present a more holistic integration of AI by promoting collaboration. To this end, collaboration is understood as a multi-dimensional conceptual term that covers all important enablers for AI adoption in manufacturing contexts and is promoted in terms of business intelligence optimization, human-in-the-loop and secure federation across manufacturing sites. To address these challenges, the proposed architectural approach builds on three technical pillars: (1) components that extend the functionality of the existing layers in the Reference Architectural Model for Industry 4.0; (2) definition of new layers for collaboration by means of human-in-the-loop and federation; (3) security concerns with AI-powered mechanisms. In addition, system implementation aspects are discussed and potential applications in industrial environments, as well as business impacts, are presented

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Interoperable and Intelligent Architecture for Smart Buildings

Smart Building is essential to advance towards more comfortable and sustainable cities. However, existing Building Management Systems (BMS) are proprietary non-interoperable solutions based on automatic operations configured by the users. These BMS can not control intelligently current and future buildings with highly heterogeneous legacy appliances and equipment including renewable energy generation, storage, e-vehicles charging points among others. In order to achieve it, this paper proposes an interoperable and intelligent architecture based on recent ICT technologies such as Internet of Things, Artificial Intelligence and Cybersecurity Protocols. This architecture provides five main innovations such as adapt-&-play hardware integration, standardised multi-systems interoperability, building/human behaviours prediction, security/privacy protection and smart services provision for increasing building energy-efficiency, occupants’ well-being and grid flexibility. To evaluate the proposed architecture, five diverse European pilots have been proposed. Specifically, this paper presents the Spanish pilot with multiple heterogeneous equipment and systems that will be employed to demonstrate the impact of the proposed architecture

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care