An unusual cause of respiratory distress

Background: Respiratory distress is a very common presenting complaint in children and neonates, and is one that will regularly face healthcare professionals. A thorough clinical assessment and sound appreciation of the broad range of differential diagnoses is key to enabling effective and subsequent targeted investigation and management of the condition. Bronchogenic cysts, while rare, are one of the most common mediastinal masses encountered in the neonate. The clinical presentation of bronchogenic cysts is variable, however in the neonate they often present with respiratory distress shortly after birth. Radiological appearances are rarely conclusive, with histology required for a definitive diagnosis. Case: Presented here is a case of a term infant who developed respiratory distress shortly after birth that required intubation and ventilation. Antenatal ultrasound demonstrated a persistent posterior mediastinal cystic structure. Investigations: Chest radiographs obtained shortly after birth revealed a smooth, well-defined homogenous mediastinal mass, with left lung hyperinflation. Subsequent computed tomography confirmed that the mass was closely related to the trachea anteriorly and oesophagus posteriorly, displacing both of these structures to the right. Differential diagnosis: Differential diagnosis was of an oesophageal duplication cyst or bronchogenic cyst. Treatment: After stabilisation on the neonatal intensive care unit, the infant was transferred to a tertiary centre for definitive management. Thoracotomy was performed, and histopathology of the mass confirmed the diagnosis of a bronchogenic cyst. Outcome and follow up: The infant made an uneventful recovery, and was discharged 17 days post-operatively. She has since been discharged from formal follow up and displays no respiratory complications. Discussion: This case serves as a reminder to the reader that, although uncommon, bronchogenic cysts should be considered in the differential diagnosis, particularly when assessing the newborn infant with respiratory distress. As such, it provides an important educative value. It also serves to highlight the importance of careful radiographic imaging and interpretation. While often not diagnostic, when used in conjunction with good clinical assessment, imaging can help to narrow the differential diagnosis and subsequently focus the investigation and management

Construction industry 4.0 and sustainability: an enabling framework

Governments worldwide are taking actions to address the construction sector's sustainability concerns, including high carbon emissions, health and safety risks, low productivity, and increasing costs. Applying Industry 4.0 technologies to construction (also referred to as Construction 4.0) could address some of these concerns. However, current understanding about this is quite limited, with previous work being largely fragmented and limited both in terms of technologies as well as their interrelationships with the triple bottom line of sustainability perspectives. The focus of this article is therefore on addressing these gaps by proposing a comprehensive multi-dimensional Construction 4.0 sustainability framework that identifies and categorizes the key Construction 4.0 technologies and their positive and negative impacts on environmental, economic, and social sustainability, and then establishing its applicability/usefulness through an empirical, multimethodology case study assessment of the UAE's construction sector. The findings indicate Construction 4.0’s positive impacts on environmental and economic sustainability that far outweigh its negative effects, although these impacts are comparable with regards to social sustainability. On Construction 4.0 technologies itself, their application was found to be nonuniform with greater application seen for building information modeling and automation vis-à-vis others such as cyber-physical systems and smart materials, with significant growth expected in the future for blockchain- and three-dimensional-printing-related technologies. The proposed novel framework could enable the development of policy interventions and support mechanisms to increase Construction 4.0 deployment while addressing its negative sustainability-related impacts. The framework also has the potential to be adapted and applied to other country and sectoral contexts

Multiagent Optimization Approach to Supply Network Configuration Problems With Varied Product-Market Profiles

IEEE This article demonstrates the application of a novel multiagent modeling approach to support supply network configuration (SNC) decisions toward addressing several challenges reported in the literature. These challenges include: enhancing supply network (SN)-level performance in alignment with the goals of individual SN entities; addressing the issue of limited information sharing between SN entities; and sustaining competitiveness of SNs in dynamic business environments. To this end, a multistage, multiechelon SN consisting of geographically dispersed SN entities catering to distinct product-market profiles was modeled. In modeling the SNC decision problem, two types of agents, each having distinct attributes and functions, were used. The modeling approach incorporated a reverse-auctioning process to simulate the behavior of SN entities with differing individual goals collectively contributing to enhance SN-level performance, by means of setting reserve values generated through the application of a genetic algorithm. A set of Pareto-optimal SNCs catering to distinct product-market profiles was generated using Nondominated Sorting Genetic Algorithm II. Further evaluation of these SNCs against additional criteria, using a rule-based approach, allowed the selection of the most appropriate SNC to meet a broader set of conditions. The model was tested using a refrigerator SN case study drawn from the literature. The results reveal that a number of SNC decisions can be supported by the proposed model, in particular, identifying and evaluating robust SNs to suit varied product-market profiles, enhancing SC capabilities to withstand disruptions and developing contingencies to recover from disruptions

Modelling sustainable supply networks with adaptive agents

© 2018 IEEE. This paper proposes a multi-agent modelling approach that supports supply network configuration decisions towards sustaining operations excellence in terms of economic, business continuity and environmental performance. Two types of agents are employed, namely, physical agents to represent supply entities and auxiliary agents to deal with supply network configuration decisions. While using the evolutionary algorithm, Non-dominated Sorting Genetic Algorithm-II to optimize both cost and lead time at the supply network level, agents are modelled with an architecture which consists of decision-making, learning and communication modules. The physical agents make decisions considering varying situations to suit specific product-market profiles thereby generating alternative supply network configurations. These supply network configurations are then evaluated against a set of performance metrics, including the energy consumption of the supply chain processes concerned and the transportation distances between supply entities. Simulation results generated through the application of this approach to a refrigerator production network show that the selected supply network configurations are capable of meeting intended sustainable goals while catering to the respective product-market profiles

Nonlinear dynamics of large amplitude dust acoustic shocks and solitary pulses in dusty plasmas

We present a fully nonlinear theory for dust acoustic (DA) shocks and DA solitary pulses in a strongly coupled dusty plasma, which have been recently observed experimentally by Heinrich et al. [Phys. Rev. Lett. 103, 115002 (2009)], Teng et al. [Phys. Rev. Lett. 103, 245005 (2009)], and Bandyopadhyay et al. [Phys. Rev. Lett. 101, 065006 (2008)]. For this purpose, we use a generalized hydrodynamic model for the strongly coupled dust grains, accounting for arbitrary large amplitude dust number density compressions and potential distributions associated with fully nonlinear nonstationary DA waves. Time-dependent numerical solutions of our nonlinear model compare favorably well with the recent experimental works (mentioned above) that have reported the formation of large amplitude non-stationary DA shocks and DA solitary pulses in low-temperature dusty plasma discharges.Comment: 9 pages, 4 figures. To be published in Physical Review

High iridium concentration of alkaline rocks of Deccan and implications to K/T boundary

We report here an unusually high concentration of iridium in some alkali basalts and alkaline rocks of Deccan region having an age of about 65Ma, similar to the age of the Cretaceous-Tertiary boundary. The alkali basalts of Anjar, in the western periphery of Deccan province, have iridium concentration as high as 178pg/g whereas the alkaline rocks and basalts associated with the Amba Dongar carbonatite complex have concentrations ranging between 8 and 80 pg/g. Some of these values are more than an order of magnitude higher than the concentration in the tholeiitic basalts of Deccan, indicating the significance of alkaline magmatism in the iridium inventory at the Cretaceous-Tertiary boundary. Despite higher concentration, their contribution to the global inventory of iridium in the Cretaceous-Tertiary boundary clays remains small. The concentration of iridium in fluorites from Amba Dongar was found to be <30 pg/g indicating that iridium is not incorporated during their formation in hydrothermal activity