Meta models for real-time design assessment within an integrated information and numerical modelling framework

In situations where rapid decisions are required or a large number of design alternatives is to be explored, numerical predictions of construction pro-cesses have to be performed in near real-time. For the design assessment of com-plex engineering problems such as mechanised tunnelling, simple numerical and analytical models are not able to reproduce all complex 3D interactions. To over-come this problem, in this paper a novel concept for on-demand design assess-ment for mechanized tunnelling using simulation-based meta models is proposed. This concept includes: i) the generation of enhanced simulation-based meta mod-els; ii) real-time meta model-based design assessment in the design tool, and; iii) the implementation within a unified numerical and information modelling plat-form called SATBIM. The capabilities of this concept are demonstrated through an example for the evaluation of tunnel alignment design and the assessment of the impact of tunnelling on existing infrastructure. Moreover, meta models are used for fast forward calculation in sensitivity analyses for the evaluation of the importance of model parameters. The concept proved its efficiency by assessing the design alternatives in real-time with the prediction error of less than 3% com-pared to complex numerical simulation in presented example

Toxoplasma gondii seropositivity is negatively associated with multiple sclerosis

BACKGROUND: Toxoplasma (T.) gondii is a ubiquitous intracellular parasitic protozoan that was recently associated with various autoimmune diseases. OBJECTIVES: We aimed to investigate the prevalence of T. gondii IgG and IgM antibodies between MS patients and healthy controls. METHODS: Sera from 163 MS, 91 clinically isolated syndrome cases and 178 age and gender matched controls were evaluated for the prevalence of T. gondii IgG antibodies utilizing chemiluminescent immunoassay (ARCHITECT). RESULTS: MS-patients showed a significantly lower prevalence for T. gondii IgG antibodies compared to controls (33.3% vs. 47.9%; p=0.011, OR=1.8 (95% CI 1.2-3.2)). CONCLUSION: The results demonstrate a negative association between an infection with the parasite T. gondii and the presence of MS

Concordance between patient- and physician-reported Myasthenia Gravis Activities of Daily Living (MG-ADL) scores

Introduction/Aims: Myasthenia gravis (MG) is a neuromuscular disease characterized by abnormal skeletal muscle fatiguability. The MG Activities of Daily Living (MG-ADL) scale assesses eight symptoms and is often used as primary endpoint in MG clinical trials where it is completed by neurologists. However, in observational studies, patients frequently complete the MG-ADL scale independently of their neurologist. In this study we aimed to assess the concordance between self- and physician-reported MG-ADL scores. Methods: An international observational study was conducted among adult patients with MG scheduled for a routine visit or who entered the hospital via emergency services. Consenting patients and physicians completed the MG-ADL. Concordance between assessments was calculated using Gwet's agreement coefficient (Gwet's AC) for the MG-ADL individual items and the intraclass correlation coefficient (ICC) for the MG-ADL total score. Results: Data were collected from 137 patients (63% female; mean age, 57.7 years). Physicians assessed the patient's symptoms as slightly more severe (8.1 vs 7.5 MG-ADL total score, respectively), corresponding to a difference of 0.6 on a range from 0 to 24. The ICC for the MG-ADL total score between the patient and the physician assessment was 0.94 (95% confidence interval, 0.89 to 0.95), showing excellent concordance. Gwet's AC showed substantial to almost perfect agreement for all items, except eyelid droop, for which the agreement was moderate. Discussion: Our results demonstrate that patients and neurologists have a concordant assessment of the patient's MG symptoms when using the MG-ADL scale. This evidence supports patient self-administration of the MG-ADL in clinical practice and research