Development of A User-Centered Design Framework for Palliative and Hospice Care Patients for a Better Quality of Life Experience

Goal Three of the Sustainable Development Goals emphasizes the concept of “leaving no one behind”; a model for inclusivity and coherence. Amongst those that are often “left behind” are patients at the end stage of their life due to a terminal illness or a medical diagnosis. These are often left to die without thought to the quality of life that they receive before their demise, and many experience this stage at home due to fear of expenses, or in a best-case scenario at a hospital to help alleviate or manage pain. In many places worldwide, this is where palliative and hospice care come in and focus on the End-of-Life care provided to patients who fit the criteria.The number of architecture and design related studies in this field are not numerous, and those that are there do not focus on the patient as a user with rights, but merely as a patient that is there. The concept of a user-centered design is forgotten in midst of all the pain and suffering of all concerned, namely, the patient, his beloved, and his caregivers. However, focusing on this nexus at the core of the design project may help promote this painful and stressful time in life and induce serenity and acceptance in a time that is often dark and ominous. This research aims to develop a design framework for places that deal with End-of-Life care and how to provide a better quality of End-of-Life experience for terminally ill patients

Rural Regeneration in Egypt: A Review of Existing Typologies in Borderline Areas

Tracking rural areas and studying them may not be an easy task. The concept of whether the area at hand is urban or rural could be simple, but lately rural areas could carry many features that may deviate the definition into one which is unclear. In urbanized rural development, reversing the urbanization spotted may not be the ideal way to go, urban developers often suggest that to go back to the roots is to regenerate the area back into rural, however, regenerating rural areas using rural parameters and definitions may not be what the urban area in hand needs and the changes and challenges that are facing rural communities in Egypt need to be understood before any plan can be deemed as effective or even worthwhile The rapid increase in urbanization and how it affects agriculture land, shorelines, and rural land, has affected badly the rural capacity, and led to a constant threat of overhaul in place of towns, cities, and other urban activities. However, rural areas are the lungs of the planet alongside forests and other green areas and having them diminish substantially will lead to an inevitable catastrophe. Regenerating rural areas should focus on revitalizing and embedding them into the social, cultural, and economic structure of the region, however, it may not always involve turning them back to what is commonly termed as rural.This research attempts to review and discuss the meaning and definitions of rural regeneration with a view to propose a strategic plan to regenerate borderline areas in Egypt

Development of A User-Centered Design Framework for Palliative and Hospice Care Patients for a Better Quality of Life Experience

Goal Three of the Sustainable Development Goals emphasizes the concept of “leaving no one behind”; a model for inclusivity and coherence. Amongst those that are often “left behind” are patients at the end stage of their life due to a terminal illness or a medical diagnosis. These are often left to die without thought to the quality of life that they receive before their demise, and many experience this stage at home due to fear of expenses, or in a best-case scenario at a hospital to help alleviate or manage pain. In many places worldwide, this is where palliative and hospice care come in and focus on the End-of-Life care provided to patients who fit the criteria.The number of architecture and design related studies in this field are not numerous, and those that are there do not focus on the patient as a user with rights, but merely as a patient that is there. The concept of a user-centered design is forgotten in midst of all the pain and suffering of all concerned, namely, the patient, his beloved, and his caregivers. However, focusing on this nexus at the core of the design project may help promote this painful and stressful time in life and induce serenity and acceptance in a time that is often dark and ominous. This research aims to develop a design framework for places that deal with End-of-Life care and how to provide a better quality of End-of-Life experience for terminally ill patients

Rural Regeneration in Egypt: A Review of Existing Typologies in Borderline Areas

Tracking rural areas and studying them may not be an easy task. The concept of whether the area at hand is urban or rural could be simple, but lately rural areas could carry many features that may deviate the definition into one which is unclear. In urbanized rural development, reversing the urbanization spotted may not be the ideal way to go, urban developers often suggest that to go back to the roots is to regenerate the area back into rural, however, regenerating rural areas using rural parameters and definitions may not be what the urban area in hand needs and the changes and challenges that are facing rural communities in Egypt need to be understood before any plan can be deemed as effective or even worthwhile The rapid increase in urbanization and how it affects agriculture land, shorelines, and rural land, has affected badly the rural capacity, and led to a constant threat of overhaul in place of towns, cities, and other urban activities. However, rural areas are the lungs of the planet alongside forests and other green areas and having them diminish substantially will lead to an inevitable catastrophe. Regenerating rural areas should focus on revitalizing and embedding them into the social, cultural, and economic structure of the region, however, it may not always involve turning them back to what is commonly termed as rural.This research attempts to review and discuss the meaning and definitions of rural regeneration with a view to propose a strategic plan to regenerate borderline areas in Egypt

Conceptualizing Walking and Walkability in the Smart City through a Model Composite <i>w</i>² Smart City Utility Index

This paper explores walking and walkability in the smart city and makes a case for their centrality in the debate on the resilience and sustainability of smart cities, as outlined in the United Nations’ (UN) Sustainable Development Goals (SDGs). It is argued that, while the human/inhabitant-centric paradigm of urban development consolidates, and research on walking, walkability, and pedestrian satisfaction flourishes, the inroads of ICT render it necessary to reflect on these issues in the conceptually- and geographically-delimited space of the smart city. More importantly, it becomes imperative to make respective findings useful and usable for policymakers. To this end, by approaching walking and walkability through the lens of utility, the objective of this paper is to develop a conceptual framework in which the relevance of walking and walkability, hereafter referred to as w2, as a distinct subject of research in the smart cities debate is validated. This framework is then employed to construct a model of a composite w2 smart city utility index. With the focus on the development of the conceptual framework, in which the w2 utility index is embedded, this paper constitutes the first conceptual step of the composite index development process. The value added of this paper is three-fold: First, the relevance of walking and walkability as a distinct subject of research in the realm of smart cities research is established. Second, a mismatch between end-users’ satisfaction derived from walking and their perception of walkability and the objective factors influencing walking and walkability is identified and conceptualized by referencing the concept of utility. Third, a model smart city w2 utility index is proposed as a diagnostic and prognostic tool that, in the subsequent stages of research and implementation, will prove useful for decisionmakers and other stakeholders involved in the process of managing smart cities

Energy Efficiency through the Implementation of an AI Model to Predict Room Occupancy Based on Thermal Comfort Parameters

Room occupancy prediction based on indoor environmental quality may be the breakthrough to ensure energy efficiency and establish an interior ambience tailored to each user. Identifying whether temperature, humidity, lighting, and CO2 levels may be used as efficient predictors of room occupancy accuracy is needed to help designers better utilize the readings and data collected in order to improve interior design, in an effort to better suit users. It also aims to help in energy efficiency and saving in an ever-increasing energy crisis and dangerous levels of climate change. This paper evaluated the accuracy of room occupancy recognition using a dataset with diverse amounts of light, CO2, and humidity. As classification algorithms, K-nearest neighbors (KNN), hybrid Adam optimizer&ndash;artificial neural network&ndash;back-propagation network (AO&ndash;ANN (BP)), and decision trees (DT) were used. Furthermore, this research is based on machine learning interpretability methodologies. Shapley additive explanations (SHAP) improve interpretability by estimating the significance values for each feature for classifiers applied. The results indicate that the KNN performs better than the DT and AO-ANN (BP) classification models have 99.5%. Though the two classifiers are designed to evaluate variations in interpretations, we must ensure that they have accurate detection. The results show that SHAP provides successful implementation following these metrics, with differences detected amongst classifier models that support the assumption that model complexity plays a significant role when predictability is taken into account

Energy Efficiency through the Implementation of an AI Model to Predict Room Occupancy Based on Thermal Comfort Parameters

Room occupancy prediction based on indoor environmental quality may be the breakthrough to ensure energy efficiency and establish an interior ambience tailored to each user. Identifying whether temperature, humidity, lighting, and CO2 levels may be used as efficient predictors of room occupancy accuracy is needed to help designers better utilize the readings and data collected in order to improve interior design, in an effort to better suit users. It also aims to help in energy efficiency and saving in an ever-increasing energy crisis and dangerous levels of climate change. This paper evaluated the accuracy of room occupancy recognition using a dataset with diverse amounts of light, CO2, and humidity. As classification algorithms, K-nearest neighbors (KNN), hybrid Adam optimizer–artificial neural network–back-propagation network (AO–ANN (BP)), and decision trees (DT) were used. Furthermore, this research is based on machine learning interpretability methodologies. Shapley additive explanations (SHAP) improve interpretability by estimating the significance values for each feature for classifiers applied. The results indicate that the KNN performs better than the DT and AO-ANN (BP) classification models have 99.5%. Though the two classifiers are designed to evaluate variations in interpretations, we must ensure that they have accurate detection. The results show that SHAP provides successful implementation following these metrics, with differences detected amongst classifier models that support the assumption that model complexity plays a significant role when predictability is taken into account

Evaluation of Serum Cystatin C as a Marker of Early Renal Impairment in Patients with Liver Cirrhosis

Background. Serum cystatin C (CysC) was proposed as an effective reflection of the glomerular filtration rate (GFR). However, its role in patients with liver cirrhosis has not been extensively verified especially in the detection of early RI. Patients and Methods. Seventy consecutive potential candidates for living donor liver transplantation with serum creatinine (Cr) <1.5 mg/dL were included. CysC, Cr, and estimated GFR [creatinine clearance (CCr), Cockcroft-Gault formula (C-G), MDRD equations with 4 and 6 variables, CKD-EPI-Cr, CKD-EPI-CysC, and CKD-EPI-Cr-CysC] were all correlated to isotopic GFR. Early RI was defined as GFR of 60–89 mL/min/1.73 m2. Results. Patients were 25.7% and 74.3% Child-Pugh classes B and C, respectively. GFR was ≥90, 60–89, and 30–59 mL/min/1.73 m2 in 31.4%, 64.3%, and 4.3% of the patients, respectively. All markers and equations, except C-G, were significantly correlated to GFR with CKD-EPI-Cr-CysC formula having the highest correlation (r = 0.474) and the largest area under the ROC curve (0.808) for discriminating early RI. At a cutoff value of 1.2 mg/L, CysC was 89.6% sensitive and 63.6% specific in detecting early RI. Conclusion. In patients with liver cirrhosis, CysC and CysC-based equations showed the highest significant correlation to GFR and were measures that best discriminated early RI

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates