Teaching Construction in the Virtual University: the WINDS project

This paper introduces some of the Information Technology solutions adopted in Web based INtelligent Design Support (WINDS) to support education in A/E/C design. The WINDS project WINDS is an EC-funded project in the 5th Framework, Information Society Technologies programme, Flexible University key action. WINDS is divided into two actions: ·The research technology action is going to implement a learning environment integrating an intelligent tutoring system, a computer instruction management system and a set of co-operative supporting tools. ·The development action is going to build a large knowledge base supporting Architecture and Civil Engineering Design Courses and to experiment a comprehensive Virtual School of Architecture and Engineering Design. During the third year of the project, more than 400 students all over Europe will attend the Virtual School. During the next three years the WINDS project will span a total effort of about 150 man-years from 28 partners of 10 European countries. The missions of the WINDS project are: Advanced Methodologies in Design Education. WINDS drives a breakdown with conventional models in design education, i.e. classroom or distance education. WINDS implements a problem oriented knowledge transfer methodology following Roger Schank's Goal Based Scenario (GBS) pedagogical methodology. GBS encourages the learning of both skills and cases, and fosters creative problem solving. Multidisciplinary Design Education. Design requires creative synthesis and open-end problem definition at the intersection of several disciplines. WINDS experiments a valuable integration of multidisciplinary design knowledge and expertise to produce a high level standard of education. Innovative Representation, Delivery and Access to Construction Education. WINDS delivers individual education customisation by allowing the learner access through the Internet to a wide range of on-line courses and structured learning objects by means of personally tailored learning strategies. WINDS promotes the 3W paradigm: learn What you need, Where you want, When you require. Construction Practice. Construction industry is a repository of ""best practices"" and knowledge that the WINDS will profit. WINDS system benefits the ISO10303 and IFC standards to acquire knowledge of the construction process directly in digital format. On the other hand, WINDS reengineers the knowledge in up-to-date courses, educational services, which the industries can use to provide just-in-time rather than in-advance learning. WINDS IT Solutions The missions of the WINDS project state many challenging requirements both in knowledge and system architecture. Many of the solutions adopted in these fields are innovative; others are evolution of existing technologies. This paper focuses on the integration of this set of state-of-the-art technologies in an advanced and functionally sound Computer Aided Instruction system for A/E/C Design. In particular the paper deals with the following aspects: Standard Learning Technology Architecture The WINDS system relies on the in progress IEEE 1484.1 Learning Technology Standard Architecture. According to this standard the system consists of two data stores, the Knowledge Library and the Record Database, and four process: System Coach, Delivery, Evaluation and the Learner. WINDS implements the Knowledge Library into a three-tier architecture: 1.Learning Objects: ·Learning Units are collections of text and multimedia data. ·Models are represented in either IFC or STEP formats. ·Cases are sets of Learning Units and Models. Cases are noteworthy stories, which describes solutions, integrate technical detail, contain relevant design failures etc. 2.Indexes refer to the process in which the identification of relevant topics in design cases and learning units takes place. Indexing process creates structures of Learning Objects for course management, profile planning procedures and reasoning processes. 3.Courses are taxonomies of either Learning Units or a design task and Course Units. Knowledge Representation WINDS demonstrates that it is possible and valuable to integrate a widespread design expertise so that it can be effectively used to produce a high level standard of education. To this aim WINDS gathers area knowledge, design skills and expertise under the umbrellas of common knowledge representation structures and unambiguous semantics. Cases are one of the most valuable means for the representation of design expertise. A Case is a set of Learning Units and Product Models. Cases are noteworthy stories, which describe solutions, integrate technical details, contain relevant design failures, etc. Knowledge Integration Indexes are a medium among different kind of knowledge: they implement networks for navigation and access to disparate documents: HTML, video, images, CAD and product models (STEP or IFC). Concept indexes link learning topics to learning objects and group them into competencies. Index relationships are the base of the WINDS reasoning processes, and provide the foundation for system coaching functions, which proactively suggest strategies, solutions, examples and avoids students' design deadlock. Knowledge Distribution To support the data stores and the process among the partners in 10 countries efficiently, WINDS implements an object oriented client/server as COM objects. Behind the DCOM components there is the Dynamic Kernel, which dynamically embodies and maintains data stores and process. Components of the Knowledge Library can reside on several servers across the Internet. This provides for distributed transactions, e.g. a change in one Learning Object affects the Knowledge Library spread across several servers in different countries. Learning objects implemented as COM objects can wrap ownership data. Clear and univocal definition of ownerships rights enables Universities, in collaboration with telecommunication and publisher companies, to act as "education brokers". Brokerage in education and training is an innovative paradigm to provide just-in-time and personally customised value added learning knowledg

Esterified Hyaluronic Acid and Autologous Bone in the Surgical Correction of the Infra-Bone Defects

We study the osteoinductive effect of the hyaluronic acid (HA) by using an esterified low-molecular HA preparation (EHA) as a coadjuvant in the grafting processes to produce bone-like tissue in the presence of employing autologous bone obtained from intra-oral sites, to treat infra-bone defects without covering membrane

Fieldable genotyping of Bacillus anthracis and Yersinia pestis based on 25-loci Multi Locus VNTR Analysis

<p>Abstract</p> <p>Background</p> <p>Anthrax and plague are diseases caused by <it>Bacillus anthracis </it>and <it>Yersinia pestis </it>respectively. These bacteria are etiological agents for worldwide zoonotic diseases and are considered among the most feared potential bioterror agents. Strain differentiation is difficult for these microorganisms because of their high intraspecies genome homogeneity. Moreover, fast strain identification and comparison with known genotypes may be crucial for naturally occurring outbreaks versus bioterrorist events discrimination.</p> <p>Results</p> <p>Thirty-nine <it>B. anthracis </it>and ten <it>Y. pestis </it>strains, representative of the species genetic diversity, were genotyped by Agilent 2100 Bioanalyzer using previously described Multiple Locus VNTR Analysis assays (MLVA). Results were compared to previous data obtained by standard genotyping system (capillary electrophoresis on automatic sequencer) and, when necessary, direct amplicon sequencing. A reference comparison table containing actual fragment sizes, sequencer sizes and Agilent sizes was produced.</p> <p>Conclusion</p> <p>In this report an automated DNA electrophoresis apparatus which provides a cheaper alternative compared to capillary electrophoresis approaches was applied for genotyping of <it>B. anthracis </it>and <it>Y. pesti</it>s. This equipment, uses pre-cast gels and provides easy transportation, low maintenance and overall general logistic requirements and costs, is easy to set up and provides rapid analysis. This platform is a candidate for on-site MLVA genotyping of biothreat agents as well as other bacterial pathogens. It is an alternative to the more expensive and demanding capillary electrophoresis methods, and to the less expensive but more time-consuming classical gel electrophoresis approach.</p

Long‐term persistence of neutralizing SARS‐CoV‐2 antibodies in pets

We monitored the severe acute respiratory syndrome coronavirus 2 antibody response in seven dogs and two cats by using two multispecies ELISA tests, plaque reduction neutralisation test and virus neutralization. SARS-CoV-2 neutralizing antibodies in pets persisted up to 10 months since the first positive testing, thus replicating observations in COVID-19 human patients

Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO) : 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group

Background: Adhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups. Methods: The guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group. A systematic literature search was performed prior to the update of the guidelines to identify relevant new papers on epidemiology, diagnosis, and treatment of ASBO. Literature was critically appraised according to an evidence-based guideline development method. Final recommendations were approved by the workgroup, taking into account the level of evidence of the conclusion. Recommendations: Adhesion formation might be reduced by minimally invasive surgical techniques and the use of adhesion barriers. Non-operative treatment is effective in most patients with ASBO. Contraindications for non-operative treatment include peritonitis, strangulation, and ischemia. When the adhesive etiology of obstruction is unsure, or when contraindications for non-operative management might be present, CT is the diagnostic technique of choice. The principles of non-operative treatment are nil per os, naso-gastric, or long-tube decompression, and intravenous supplementation with fluids and electrolytes. When operative treatment is required, a laparoscopic approach may be beneficial for selected cases of simple ASBO. Younger patients have a higher lifetime risk for recurrent ASBO and might therefore benefit from application of adhesion barriers as both primary and secondary prevention. Discussion: This guideline presents recommendations that can be used by surgeons who treat patients with ASBO. Scientific evidence for some aspects of ASBO management is scarce, in particular aspects relating to special patient groups. Results of a randomized trial of laparoscopic versus open surgery for ASBO are awaited.Peer reviewe

Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic

Objective: Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients. Methods: This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak. Results: Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p&lt;0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p&lt;0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p&lt;0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p&lt;0.001). Conclusion: Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic

An explainable model of host genetic interactions linked to COVID-19 severity

We employed a multifaceted computational strategy to identify the genetic factors contributing to increased risk of severe COVID-19 infection from a Whole Exome Sequencing (WES) dataset of a cohort of 2000 Italian patients. We coupled a stratified k-fold screening, to rank variants more associated with severity, with the training of multiple supervised classifiers, to predict severity based on screened features. Feature importance analysis from tree-based models allowed us to identify 16 variants with the highest support which, together with age and gender covariates, were found to be most predictive of COVID-19 severity. When tested on a follow-up cohort, our ensemble of models predicted severity with high accuracy (ACC = 81.88%; AUCROC = 96%; MCC = 61.55%). Our model recapitulated a vast literature of emerging molecular mechanisms and genetic factors linked to COVID-19 response and extends previous landmark Genome-Wide Association Studies (GWAS). It revealed a network of interplaying genetic signatures converging on established immune system and inflammatory processes linked to viral infection response. It also identified additional processes cross-talking with immune pathways, such as GPCR signaling, which might offer additional opportunities for therapeutic intervention and patient stratification. Publicly available PheWAS datasets revealed that several variants were significantly associated with phenotypic traits such as "Respiratory or thoracic disease", supporting their link with COVID-19 severity outcome.A multifaceted computational strategy identifies 16 genetic variants contributing to increased risk of severe COVID-19 infection from a Whole Exome Sequencing dataset of a cohort of Italian patients

Carriers of ADAMTS13 Rare Variants Are at High Risk of Life-Threatening COVID-19

Thrombosis of small and large vessels is reported as a key player in COVID-19 severity. However, host genetic determinants of this susceptibility are still unclear. Congenital Thrombotic Thrombocytopenic Purpura is a severe autosomal recessive disorder characterized by uncleaved ultra-large vWF and thrombotic microangiopathy, frequently triggered by infections. Carriers are reported to be asymptomatic. Exome analysis of about 3000 SARS-CoV-2 infected subjects of different severities, belonging to the GEN-COVID cohort, revealed the specific role of vWF cleaving enzyme ADAMTS13 (A disintegrin-like and metalloprotease with thrombospondin type 1 motif, 13). We report here that ultra-rare variants in a heterozygous state lead to a rare form of COVID-19 characterized by hyper-inflammation signs, which segregates in families as an autosomal dominant disorder conditioned by SARS-CoV-2 infection, sex, and age. This has clinical relevance due to the availability of drugs such as Caplacizumab, which inhibits vWF-platelet interaction, and Crizanlizumab, which, by inhibiting P-selectin binding to its ligands, prevents leukocyte recruitment and platelet aggregation at the site of vascular damage

Gain- and Loss-of-Function CFTR Alleles Are Associated with COVID-19 Clinical Outcomes

Carriers of single pathogenic variants of the CFTR (cystic fibrosis transmembrane conductance regulator) gene have a higher risk of severe COVID-19 and 14-day death. The machine learning post-Mendelian model pinpointed CFTR as a bidirectional modulator of COVID-19 outcomes. Here, we demonstrate that the rare complex allele [G576V;R668C] is associated with a milder disease via a gain-of-function mechanism. Conversely, CFTR ultra-rare alleles with reduced function are associated with disease severity either alone (dominant disorder) or with another hypomorphic allele in the second chromosome (recessive disorder) with a global residual CFTR activity between 50 to 91%. Furthermore, we characterized novel CFTR complex alleles, including [A238V;F508del], [R74W;D1270N;V201M], [I1027T;F508del], [I506V;D1168G], and simple alleles, including R347C, F1052V, Y625N, I328V, K68E, A309D, A252T, G542*, V562I, R1066H, I506V, I807M, which lead to a reduced CFTR function and thus, to more severe COVID-19. In conclusion, CFTR genetic analysis is an important tool in identifying patients at risk of severe COVID-19