bluuebunny/crossref_metadata_2025 huggingface dataset:
The Green Building Approach: Recent Initiatives in the Evolving Italian Scenario
Authors: Tucci Fabrizio
Published: June 2021

Several analyses and reports on sustainable design are pointing worldwide in the direction of what is known as the ‘Green Building’ approach: an integrated, multi-sectoral approach to the implementation of improvements that aim to increase levels of well-being, social inclusion and long-lasting development in cities, on the basis of most urgent aspects of environmental quality, efficiency and circularity of resources, in a climate change scenario. In Italy, in 2017, the ‘Future City Manifesto’ was launched as part of the initiatives of the Italian General States of the Green Economy in Architecture, aiming at mainstreaming the Green Building approach within the international Green City Network. The objective of this chapter is to present and discuss recent initiatives in the field of sustainable architecture and green economy in Italy, pointing at innovative processes, strategies, methods and tools in a Green Building approach, suitable to activate policy actions and foster significant results as regards future green growth and urban development.
Water Runoff and Catchment Improvement by Nature-Based Solution (NBS) Promotion in Private Household Gardens: An Agent-Based Model
Authors: Koppelaar Rembrandt , Marvuglia Antonino , Rugani Benedetto
Published: June 2021

Nature-based solutions (NBS) such as rainwater gardens and permeable paving can be deployed as an alternative to conventional urban gardens to improve cities’ resilience against increasing rainfall. This study describes the application of an agent-based model (ABM) to assess the role of private gardens toward the enhancement of water management by households. The ABM simulates the process of switching from “gray” (i.e., paved) to green gardens, taking into account the effect of “soft” (garden networks and gardening workshops) and “hard” (monetary) incentives. The ABM is supported by a water balance model to consider the effect of rainfall on soil water retention. Four different cities in Europe were analyzed: Szeged (Hungary), Alcalá de Henares (Spain), Metropolitan city of Milan (Italy), and Çankaya Municipality (Turkey). The results demonstrate that greening private gardens can generate impact on water run-off and catchment in cities in the order of 5–10%, reaching picks up to 20% in certain cases. While the proposed model is not devoid of limitations, the results provide useful insights in the ways different instruments (e.g., municipal subsidies and knowledge support) could assist with the greening of private gardens for NBS promotion to respond to cities’ water management challenges.
Carbon Accounting for Regenerative Cities
Authors: Heinonen Jukka , Ottelin Juudit
Published: June 2021

The carbon budget for limiting global warming to the targeted 1.5 ° is running out. Cities have a central role in climate change mitigation, as the vast majority of all greenhouse gas emissions occur to satisfy the energy and material needs of cities and their residents. However, cities typically only account for their direct local emissions from transportation, industry, and energy production. This may lead to the so-called low-carbon illusion of cities following from producing little and reporting low emissions, while extensively relying on imported material and energy flows. Consumption-based accounting, or carbon footprinting, enables overcoming this problem by assigning the emissions to the end user regardless of the place of production. However, currently the carbon footprinting methods only capture the harm side, and not the potential positive effects, the restorative or regenerative impacts, caused by green infrastructure, reforestation, and carbon capture and storage, for example. These positive impacts are sometimes called “carbon handprint”. In this chapter, we create a handprint-extended carbon footprinting method to illustrate how restorative and regenerative impacts can be incorporated consistently in the carbon accounting of cities and carbon footprints of consumers. We also link the discussion on regenerative cities with the remaining carbon budgets.
How Rating Systems Support Regenerative Change in the Built Environment
Authors: Orova Melinda , Reith András
Published: June 2021

Urban development principles have evolved from sustainability, where the focus was on limiting the negative impact of urban environment, to restorative and regenerative sustainability, where positive impact is needed on global social and ecological systems. This recent paradigm shift requires the development of new tools for practitioners, like design methodologies, new technologies, and assessment methods.

To measure the impact of sustainability on the built environment, several building-scale assessment tools exist. The question is how these widespread rating systems support restorative change in the built environment.

The main question of the research is answered in three methodological steps. First, the goals of restorative sustainability are summarized from the available extensive literature, including the topics of Place, Energy, Water, Well-being, Carbon, Resources, Equity, Education, and Economics. Then different rating tools (Living Building Challenge, WELL, LEED, BREEAM, DGNB) are analysed how the considered issues and indicators in these rating tools are connected to restorative goals. Then these indicators are assessed how they serve that goal.

The result of this study shows the main strengths and gaps in current wide-spread international rating tools regarding their support of restorative sustainability.
Covering the Gap for an Effective Energy and Environmental Design of Green Roofs: Contributions from Experimental and Modelling Researches
Authors: Cirrincione Laura , Peri Giorgia
Published: June 2021

Green roofs are components of the building envelope that have become increasingly popular in urban contexts because other than providing numerous environmental benefits they are also capable of reducing building energy consumption, especially in summer. However, despite all these advantages, green roofs are still affected by some limitations. Specifically, there are some gaps affecting the energy modelling consisting in the absence of a proper database, information (growth stage, leaf area index, and coverage ratio) relative to the different green roof plant species, which technicians could use in case of lack of actual field data to perform energy analysis of buildings equipped with green roofs. These gaps concern also environmental and economic assessments of such technology. In fact, the currently available green roof LCA and LCC studies seem to underestimate the role of the substrate on the overall environmental impact and the role of the disposal phase on the life cycle cost of the green roof. In this chapter, all these aspects are addressed, and contributions to their solution, which arose from both experimental and modelling research, carried out by the authors are presented.
Gender Matters! Thermal Comfort and Individual Perception of Indoor Environmental Quality: A Literature Review
Authors: Haselsteiner Edeltraud
Published: June 2021

The use of technology in construction has allowed a significant increase in comfort and the construction of energy-efficient buildings. However, for indoor environmental comfort, there is no universal standard that fits all. The indoor climate is perceived individually and the requirements are subjectively shaped. In this paper, a literature review is carried out to describe particular aspects relevant to gender. The aim is to raise awareness of these aspects in order to advance equality orientation as an integral part of planning and energy-efficient building concepts. The findings show that thermal comfort is an essential parameter, and up to 3 °C of differences between women and men were found. This difference is most evident in offices where women show a better cognitive performance in a warmer environment, while men do better in colder temperatures. Gender was also found to be an influencing factor of satisfaction with humidity, acoustic conditions, visual comfort, privacy, air quality, health aspects, light preferences, and brightness perception. Moreover, sick-building syndrome is more common among women. In conclusion, the literature confirms that essential indoor environmental quality (IEQ) parameters vary significantly across men and women and should be taken more into account in the practice of building technology.
Rethinking Infrastructure as the Fabric of a Changing Society
Authors: Weijnen Margot , Correljé Aad
Published: June 2021

In this chapter, we explore the nature of infrastructure, how it is appreciated by society, how this appreciation has changed over the lifetime of the infrastructure, and how infrastructure development and performance are influenced by the governance structures in place. While the focus in this chapter is on energy infrastructure, ample illustrative material is also provided from other infrastructure sectors. We examine the trends towards technological and administrative decentralisation and towards digitalisation of infrastructure (service) provision. These trends enable formerly passive consumers to adopt new roles as providers of energy, data and transport services, and result in strongly increasing cross-sector interdependencies, especially between energy, transport and digital infrastructure. These interdependencies, however, are not reflected in the siloed governance structure of these domains, which hinders the energy transition. Furthermore, we diagnose a mismatch between, on the one hand, the focus of energy infrastructure governance on cost-effectiveness—with a view to low-cost service provision—and, on the other hand, the role of infrastructure in upholding and creating social value in terms of equity, fairness and social justice. Since the energy market liberalisation, the fundamental role of infrastructure as the fabric of society appears to be a blind spot in reflections on infrastructure and largely unexplored territory in current infrastructure policy and governance. If not remedied, this blind spot may exacerbate existing inequalities between energy consumers and create new divides in society, as is illustrated by current developments in the Netherlands with respect to sustainable heat provision. We advocate a richer value orientation in energy infrastructure governance and infrastructure governance at large, which goes beyond the current focus on efficiency and economic value, in recognition of changing societal values and priorities and, most of all, to fulfil the potential of infrastructure in creating an inclusive society.
Perspectives on Justice in the Future Energy System: A Dutch Treat
Authors: Correljé Aad
Published: June 2021

The (un)affordability, the (un)reliability and the (un)sustainability of our energy supply are increasingly associated with the phenomenon of energy justice. This concerns the way in which different groups of citizens and businesses experience the benefits and burdens of the energy transition. We explore how the concept of energy justice may support a just transition. Firstly, we address the socio-political embedding of the energy sector and policy-making. Then we explain how the concept of energy justice is defined and operationalized, in respect of policy making and implementation. Thereupon we apply the concept of energy justice to the current Dutch energy debate, addressing the reduction of natural gas production to diminish the number and strength of earthquakes in Groningen, and the longer-term policy objectives of the energy transition. It addresses the radical changes in energy use and supply and the consequent wide variety in direct and indirect consequences for citizens and businesses, depending on their specific circumstances. The notion of energy justice is discussed as a feature in local, national and EU policy making and implementation, and as a claim of social actors, communities and individuals. The suggestion that justice issues can be identified and solved at these levels, is too simple. It is important to consider the layout and nature of the socio-technical energy system and its functioning. It is concluded that the concept of justice may help researchers to identify the relevant values and value conflicts in the energy transition. This can help policymakers to make informed choices.
Hydrogen–The Bridge Between Africa and Europe
Authors: van Wijk Ad , Wouters Frank
Published: June 2021

This chapter describes a European energy system based on 50% renewable electricity and 50% green hydrogen, which can be achieved by 2050. The green hydrogen shall consist of hydrogen produced in Europe, complemented by hydrogen imports, especially from North Africa. Hydrogen import from North Africa will be beneficial for both Europe and North Africa. A bold energy sector strategy with an important infrastructure component is suggested, which differs from more traditional bottom-up sectoral strategies. This approach guarantees optimized use of (existing) infrastructure, has low risk and cost, improves Europe’s energy security and supports European technology leadership. In North Africa it would foster economic development, boost export, create future-oriented jobs in a high-tech sector and support social stability.
Decentralised Control and Peer-To-Peer Cooperation in Smart Energy Systems
Authors: Deconinck Geert
Published: June 2021

In order to achieve a decarbonised energy system, change has to happen from electricity generation to the transmission grid over the distribution level all the way down to the industrial loads and the local households. To get involvement of communities in this energy transition, local participation is needed, so that the citizens can be aware of the impact of their energy-related actions on environment and climate. However, the energy system has typically been organised in a top-down fashion, with centralised approaches and little active control, resulting in passive grid and ditto customers. Smart grids have put active customers and consumer engagement as one of the cornerstones of a more intelligent energy infrastructure, which can be organised differently. Indeed, in different niches decentralised approaches have been used successfully (decoupled microgrids, peer-to-peer networks, etc.). This chapter explores how decentralised approaches can fit the future energy system and how it can empower people for engaging in the energy transition.
EU Energy Policy: A Socio-Energy Perspective for an Inclusive Energy Transition
Authors: Mengolini Anna , Masera Marcelo
Published: June 2021

This chapter presents the evolution of EU energy policy, examining how concepts of inclusiveness and justice in energy have been progressively included in relevant energy policy documents. It discusses how EU energy policy has evolved to acknowledge the importance of the individual as well as the collective dimension of energy for an inclusive green transition. Recognizing the challenges linked to the translation of these concepts into concrete actions, the chapter elaborates a socio-energy system approach that can help in making visible important aspects of the energy transition that would go unrecognized in other analytical approaches that focus mainly on the technological side. There is an increasing awareness that the European Green Deal and other political initiatives for a sustainable future require not only technological change but also careful attention to the social implications of the transition. The chapter applies the proposed approach to smart metering technologies, discussing how the technology-centric view of the energy system is framed around the average consumer or early-adopter, leaving vulnerable groups and those living in energy poverty underrepresented. A socio-energy approach also challenges the predominant use of purely quantitative results such as energy or cost savings to evaluate the successfulness of initiatives tackling inclusiveness and fairness (e.g. energy poverty). Social outcomes of energy policy choices and technology arrangements need to be better investigated and accompanied by innovative ways to measure their success. The proposed socio-energy approach offers a way of including wider societal implications of the energy transition in the design of energy policies and in their implementation.
On a general bilinear functional equation
Authors: Bahyrycz Anna , Sikorska Justyna
Published: June 2021

Let X, Y be linear spaces over a field $${\mathbb {K}}$$
K
. Assume that $$f :X^2\rightarrow Y$$

f
:

X
2

→
Y

satisfies the general linear equation with respect to the first and with respect to the second variables, that is, for all $$x,x_i,y,y_i \in X$$

x
,

x
i

,
y
,

y
i

∈
X

and with $$a_i,\,b_i \in {\mathbb {K}}{\setminus } \{0\}$$

a
i

,

b
i

∈
K
\

{
0
}

, $$A_i,\,B_i \in {\mathbb {K}}$$

A
i

,

B
i

∈
K

($$i \in \{1,2\}$$

i
∈
{
1
,
2
}

). It is easy to see that such a function satisfies the functional equation for all $$x_i,y_i \in X$$

x
i

,

y
i

∈
X

($$i \in \{1,2\}$$

i
∈
{
1
,
2
}

), where $$C_1:=A_1B_1$$

C
1

:
=

A
1

B
1

, $$C_2:=A_1B_2$$

C
2

:
=

A
1

B
2

, $$C_3:=A_2B_1$$

C
3

:
=

A
2

B
1

, $$C_4:=A_2B_2$$

C
4

:
=

A
2

B
2

. We describe the form of solutions and study relations between $$(*)$$

(

∗
)

and $$(**)$$

(

∗

∗
)

.
Integrated prognostication of intrahepatic cholangiocarcinoma by contrast-enhanced computed tomography: the adjunct yield of radiomics
Authors: Silva Mario , Maddalo Michele , Leoni Eleonora , Giuliotti Sara , Milanese Gianluca , Ghetti Caterina , Biasini Elisabetta , De Filippo Massimo , Missale Gabriele , Sverzellati Nicola
Published: June 2021

Purpose

To test radiomics for prognostication of intrahepatic mass-forming cholangiocarcinoma (IMCC) and to develop a comprehensive risk model.

Methods

Histologically proven IMCC (representing the full range of stages) were retrospectively analyzed by volume segmentation on baseline hepatic venous phase computed tomography (CT), by two readers with different experience (R1 and R2). Morphological CT features included: tumor size, hepatic satellite lesions, lymph node and distant metastases. Radiomic features (RF) were compared across CT protocols and readers. Univariate analysis against overall survival (OS) warranted ranking and selection of RF into radiomic signature (RSign), which was dichotomized into high and low-risk strata (RSign*). Models without and with RSign* (Model 1 and 2, respectively) were compared.

Results

Among 78 patients (median follow-up 262 days, IQR 73–957), 62/78 (79%) died during the study period, 46/78 (59%) died within 1 year. Up to 10% RF showed variability across CT protocols; 37/108 (34%) RF showed variability due to manual segmentation. RSign stratified OS (univariate: HR 1.37 for R1, HR 1.28 for R2), RSign* was different between readers (R1 0.39; R2 0.57). Model 1 showed AUC 0.71, which increased in Model 2: AUC 0.81 (p < 0.001) and AIC 89 for R1, AUC 0.81 (p = 0.001) and AIC 90.2 for R2.

Conclusion

The use of RF into a unified RSign score stratified OS in patients with IMCC. Dichotomized RSign* classified survival strata, its inclusion in risk models showed adjunct yield. The cut-off value of RSign* was different between readers, suggesting that the use of reference values is hampered by interobserver variability.
ECOG and BMI as preoperative risk factors for severe postoperative complications in ovarian cancer patients: results of a prospective study (RISC-GYN—trial)
Authors: Inci Melisa Guelhan , Rasch Julia , Woopen Hannah , Mueller Kristina , Richter Rolf , Sehouli Jalid
Published: June 2021

Background

Accompanying co-morbidities in patients with ovarian cancer are of major relevance for scheduling debulking surgery, especially in the anesthesiological consultations. Aim of this study was to evaluate the impact of co-morbidities and patient characteristics on postoperative complications.

Methods

Patients undergoing maximal cytoreductive surgery were prospectively enrolled from October 2015 to January 2017. Various variables were recorded, such as the Charlson comorbidity index, Eastern cooperative oncology group scale of performance status (ECOG PS) and the American society of anesthesiologists physical status classification system (ASA PS). Surgical complications were graded using the Clavien–Dindo criteria. Logistic regression models were used to analyze risk factors for severe postoperative complications.

Results

Of 106 enrolled patients, 19 (17.9%) developed severe postoperative complications grade ≥ IIIb according to Clavien–Dindo criteria. In the multivariable regression analysis impaired (ECOG PS) > 1 (odds ratio OR) 13.34, 95% confidence interval (CI) 1.74–102.30, p = 0.01), body mass index (BMI) > 25 kg/m2 (OR 10.48, 95% CI 2.38–46.02, p = 0.002) along with the use of intraoperative norepinephrine > 0.11 µg/kg/min (OR 4.69, 95% CI 1.13–19.46, p = 0.03) and intraoperative fresh frozen plasma (FFP) > 17 units (OR 4.11, 95% CI 1.12–15.14, p = 0.03) appeared as significant predictors of severe postoperative complications.

Conclusion

We demonstrated that neither the presence of a certain comorbidity nor the summation of the co-morbidities were associated with adverse outcome. Patient characteristics, such as ECOG PS > 1 and obesity (BMI > 25 kg/m2), are highly predictive factors for severe postoperative complications. The analysis of intraoperative data showed that the need for more than > 0.11 µg/kg/min of norepinephrine and transfusions of FFPs more than 17 units were strongly associated with severe postoperative complications.
H3K27me3 immunostaining is diagnostic and prognostic in diffuse gliomas with oligodendroglial or mixed oligoastrocytic morphology
Authors: Ammendola Serena , Caldonazzi Nicolò , Simbolo Michele , Piredda Maria Liliana , Brunelli Matteo , Poliani Pietro Luigi , Pinna Giampietro , Sala Francesco , Ghimenton Claudio , Scarpa Aldo , Barresi Valeria
Published: June 2021

Oligodendroglioma is defined by IDH mutation and 1p/19q codeletion. The latter is mutually exclusive to ATRX immunohistochemical loss and has been recently associated with the loss of H3K27me3 immunostaining. We aimed to assess the diagnostic and prognostic value of H3K27me3 immuno-expression in diffuse gliomas with oligodendroglial or mixed oligoastrocytic morphology. H3K27me3 immunostaining was performed in 69 diffuse gliomas with oligodendroglial (n = 62) or oligoastrocytic (n = 7) morphology. The integration with routinely assessed IDH mutations, ATRX immunostaining, and 1p/19q codeletion classified these cases as 60 oligodendroglial and 9 astrocytic. H3K27me3 was lost in 58/60 oligodendrogliomas with retained (n = 47) or non-conclusive (n = 11) ATRX staining, 3/6 IDH-mutant astrocytomas with ATRX loss, and 3/3 IDH-wt astrocytomas. H3K27me3 was retained in 2/60 oligodendrogliomas with retained ATRX, and in 3/6 IDH-mutant astrocytomas, two of which had lost and one retained ATRX. The combination of H3K27me3 and ATRX immunostainings with IDH mutational status correctly classified 55/69 (80%) cases. In IDH-mutant gliomas, ATRX loss indicates astrocytic phenotype, while ATRX retention and H3K27me3 loss identify oligodendroglial phenotype. Only 14 (20%) IDH-mutant cases with retained ATRX and H3K27me3 or inconclusive ATRX immunostaining would have requested 1p/19q codeletion testing to be classified. Furthermore, H3K27me3 retention was associated with significantly shorter relapse-free survival (P < 0.0001), independently from IDH mutation or 1p/19q codeletion (P < 0.005). Our data suggest that adding H3K27me3 immunostaining to the diagnostic workflow of diffuse gliomas with oligodendroglial or mixed morphology is useful for drastically reducing the number of cases requiring 1p/19q codeletion testing and providing relevant prognostic information.
Personality matters: relationship between personality characteristics, spirituality, demoralization, and perceived quality of life in a sample of end-of-life cancer patients
Authors: Ghiggia Ada , Pierotti Vanni , Tesio Valentina , Bovero Andrea
Published: June 2021

Purpose

Personality could be an interesting dimension to explore in end-of-life cancer patients, in order to investigate how personality affects quality of life. Thus, this study aimed to investigate the relationship among personality through the Big Five Inventory (BFI), spirituality, and demoralization and to explore their impact on their quality of life.

Methods

A sample of 210 end-of-life Italian cancer patients were assessed with the BFI, the Demoralization Scale (DS), the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-SP-12), the Functional Assessment of Cancer Therapy Scale–General Measure (FACT-G), and the Karnofsky performance status.

Results

Correlational analysis highlighted a significantly negative relationship between extraversion and agreeableness traits and all the demoralization dimensions. On the other side, neuroticism trait was significantly and positively correlated with the Demoralization Scale (p < 0.01). To understand the impact of these variables on quality of life (FACT-G), we performed a hierarchical multiple regression: in the final model, demoralization remained the strongest contributing factor (β =  − 0.509,p < 0.001), followed by neuroticism (β =  − 0.175,p < 0.001), spirituality (β = 0.163,p = 0.015), and Karnofsky index (β = 0.115,p = 0.012).

Conclusion

Our data underlined how both the neuroticism trait and demoralization are correlated with a worst health status in terminal cancer patients, whereas spirituality is a protective factor. The study of personality may allow to better understand the inner patient’s experience and improve communication between patient and healthcare staff in order to build and apply better-tailored psychological treatment.
How I do it: parietal trans-sulcal para-fascicular approach to lateral thalamic/internal capsule cavernous malformation
Authors: Amoo Michael , Sweeney Kieron J. , Kilbride Ronan , Javadpour Mohsen
Published: June 2021

Background

The surgical management of deep brain lesions is challenging, with significant morbidity. Advances in surgical technology have presented the opportunity to tackle these lesions.

Methods

We performed a complete resection of a thalamic/internal capsule CM using a tubular retractor system via a parietal trans-sulcal para-fascicular (PTPF) approach without collateral injury to the nearby white matter tracts.

Conclusion

PTPF approach to lateral thalamic/internal capsule lesions can be safely performed without injury to eloquent white matter fibres. The paucity of major vessels along this trajectory and the preservation of lateral ventricle integrity make this approach a feasible alternative to traditional approaches.
Erfahrungen von Wiener Psychotherapeut_innen mit der Antragstellung und Bewilligungspraxis der Krankenkassen
Authors: Schigl Brigitte , Lerch Leonore , Rohner Julia
Published: June 2021

In dem Online-Survey wurden die Erfahrungen von Wiener Psychotherapeut_innen (n = 380) mit dem Procedere der Antragstellung bzgl. Kostenzuschuss für Psychotherapie sowie der Bewilligungspraxis der Krankenkassen erhoben. Ziel war es, Veränderungen und aktuellen Stand des Umgangs mit Bewilligungen im Vergleich der Krankenkassen aus Sicht der Wiener Psychotherapeut_innen aufzuzeigen, da vermehrt Probleme berichtet wurden. Die deskriptiv dargestellten qualitativen und quantitativen Ergebnisse beziehen sich auf strukturelle/operationale Aspekte und patient_innenbezogene Dynamiken. In den Ergebnissen zeigen sich v. a. berichtete Schwierigkeiten mit zwei Krankenkassen, die auf eine Ungleichbehandlung der Patient_innen durch die einzelnen Versicherungsträger schließen lassen.
The RERS challenge: towards controllable and scalable benchmark synthesis
Authors: Howar Falk , Jasper Marc , Mues Malte , Schmidt David , Steffen Bernhard
Published: June 2021

This paper (1) summarizes the history of the RERS challenge for the analysis and verification of reactive systems, its profile and intentions, its relation to other competitions, and, in particular, its evolution due to the feedback of participants, and (2) presents the most recent development concerning the synthesis of hard benchmark problems. In particular, the second part proposes a way to tailor benchmarks according to the depths to which programs have to be investigated in order to find all errors. This gives benchmark designers a method to challenge contributors that try to perform well by excessive guessing.
Rethinking construction in preschool: discerning didactic strategies in Swedish preschool activities
Authors: Boström Johan , Hultén Magnus , Gyberg Per
Published: June 2021

Even though construction tasks have a long history as an activity in the Swedish preschool, technology as a content matter (e.g., construction) is relatively new. Hence, preschool teachers are generally unsure of the content of technology and how to handle it from a teaching perspective. Thus, there is need for deeper understanding of how construction tasks in preschool can be enacted and what kind of premises are offered to the children. To investigate this, we took our stance in activity theory and the concepts of mediating artifacts, rules and division of labour. This helped us discern what type of instructional practices that were enacted by preschool teachers when working with construction tasks. Activity theory in combination with thematic analysis helped us distinguish four general didactic actions that the teachers used to bring about the construction task—to engage, to guide, to coordinate, to show. These four strategies were then formulated into specific technology didactic actions through the perspectives of technology as product, process and concepts.
Reducing fire risk in buildings: the role of fire safety expertise and governance in building and planning approval
Authors: Benson C. M. , Elsmore S.
Published: June 2021

Following the Grenfell tower incident, fire safety is being re-examined around the world. One key area is planning and building approval. It has been suggested that expert fire authority advice is being ignored in building and planning control. In this paper, freedom of information requests were submitted to fifty local government authorities (covering approx. one quarter of the England and Wales population), and three fire authorities, to examine their consultation process. No prior study has examined this relationship in detail. This work attempts to identify who is assessing fire safety, what expertise exists in the system, and what guidance is available from central government. The impact of austerity on the ability to effectively manage fire safety is also discussed. Results show local government authorities have a large degree of discretion with no guidance from central government on fire safety expertise needed to assess non-prescriptive building standards, and only limited guidance on how fire authority advice should be used by local government. The result is a dramatically different level of engagement of fire authorities, and implementation of fire safety advice. There does not appear to be any guarantee that fire expertise is being employed for the purpose of fire safety in building/planning processes. This means the building regulatory regime may be one of the many issues contributing to fire safety issues. Stronger legislation is required to prevent a post-code lottery of fire safety implementation.
Defining clinical pharmacy and support activities indicators for hospital practice using a combined nominal and focus group technique
Authors: Lopes Hugo , Lopes Andrea Rodrigues , Farinha Helena , Martins Ana Paula
Published: June 2021

Background Although clinical pharmacy is a crucial part of hospital pharmacist’s day-to-day activity, its performance is not usually subject to a holistic assessment. Objective To define a set of relevant and measurable clinical pharmacy and support activities key performance indicators (cpKPI and saKPI, respectively). Setting Portuguese Hospital Pharmacies. Method After a comprehensive literature review focusing on the metrics already in use in other countries, several meetings with directors of hospital pharmacies were conducted to obtain their perspectives on hospital pharmacy practices and existing metrics. Finally, five rounds with a panel of 8 experts were performed to define the final set of KPIs, where experts were asked to score each indicator’ relevance and measurability, and encouraged to suggest new metrics. Main outcome measure The first Portuguese list of KPIs to assess pharmacists’ clinical and support activities performance and quality in hospital pharmacies. Results A total of 136 KPIs were assessed during this study, of which 57 were included in the original list and 79 were later added by the expert panel. By the end of the study, a total of 85 indicators were included in the final list, of which 40 are considered to be saKPI, 39 cpKPI and 6 neither. Conclusion A set of measurable KPIs was established to allow for benchmarking within and between Portuguese hospital Pharmacies and to elevate professional accountability and transparency. Future perspectives include the use of both cpKPIs and saKPIs on a national scale to identify the most efficient performances and areas of possible improvement.
Time to Intervene: A Continuous-Time Approach to Network Analysis and Centrality
Authors: Ryan Oisín , Hamaker Ellen L.
Published: June 2021

Network analysis of ESM data has become popular in clinical psychology. In this approach, discrete-time (DT) vector auto-regressive (VAR) models define the network structure with centrality measures used to identify intervention targets. However, VAR models suffer from time-interval dependency. Continuous-time (CT) models have been suggested as an alternative but require a conceptual shift, implying that DT-VAR parameters reflect total rather than direct effects. In this paper, we propose and illustrate a CT network approach using CT-VAR models. We define a new network representation and develop centrality measures which inform intervention targeting. This methodology is illustrated with an ESM dataset.
Development of Microstructure and Properties of Multicomponent MoS2/HA/PEEK Coatings on a Titanium Alloy Via Electrophoretic Deposition and Heat Treatment
Authors: Kuśmierczyk Filip , Zimowski Sławomir , Łukaszczyk Alicja , Kopia Agnieszka , Cieniek Łukasz , Moskalewicz Tomasz
Published: June 2021

In this study, molybdenum disulfide nanosheets, bioactive hydroxyapatite particles of two types in various amounts, and PEEK 704 microparticles were electrophoretically co-deposited to fabricate multicomponent coatings on Ti-13Nb-13Zr alloy substrates. A mixture of pure ethanol and cationic chitosan polyelectrolyte was used as a dispersion medium. The kinetics and mechanism of deposition were investigated. The kinetics depended significantly on the suspension’s chemical composition and the voltage used during EPD. Cationic chitosan provided the steric stabilization of the suspension and enabled cathodic co-deposition of all coating components. Green macroscopically homogeneous coatings were subsequently heat treated. The treatment densified the coatings and caused the formation of a stable semi-crystalline PEEK matrix consisting of spherulites. The MoS2 nanosheet packages, separate HA particles and their agglomerates were embedded in the coating matrix. After heat treatment, both types of coatings, differing in HA type, were characterized by excellent adhesion to the substrate and moderate scratch resistance. During surface topography investigation, it was found that coatings containing smaller HA nanoparticles had a slightly lower surface roughness. The coatings raised the corrosion resistance of the titanium alloy substrate in Ringer’s solution. The possibility of the electrophoretic co-deposition of various ceramic and PEEK particles to develop multicomponent coatings, as well as their contribution to enhancing titanium alloy surface properties, represents an important input in further developing superior bioactive titanium implants.
Biology of primary breast cancer in older women beyond routine biomarkers
Authors: Parks R. M. , Alfarsi L. H. , Green A. R. , Cheung K. L.
Published: June 2021

Purpose

There are numerous biomarkers which may have potential predictive and prognostic significance in breast cancer. This is extremely important in older adults, who may opt for less aggressive therapy. This work outlines the literature on biological assessment outside of standard biomarkers (defined as ER, PgR, HER2, Ki67) in women ≥ 65 years with primary operable invasive breast cancer, to determine which additional biomarkers are relevant to outcome in older women.

Methods

Medline and Embase databases were searched. Studies were eligible if included ≥ 50 patients aged ≥ 65 years; stratified results by age; measured a biomarker outside of standard assay and reported patient data.

Results

A total of 12 studies were appraised involving 5000 patients, measuring 28 biomarkers. The studies were extremely varied in methodology and outcome but three themes emerged: 1. Differences in biomarker expression between younger and older women, indicating that breast cancer in older women is generally less aggressive compared to younger women; 2. Relationship of biomarker expression with survival, suggesting biomarkers which may exclusively predict response to primary treatment in older women; 3. Association of biomarker with chemotherapy, suggesting that older patients should not be declined chemotherapy based on age alone.

Conclusion

There is evidence to support further investigation of B-cell lymphoma (BCL2), liver kinase (LK)B1, epidermal growth factor receptor (EGFR), cytoplasmic cyclin-E, mucin (MUC)1 and cytokeratins (CKs) as potential predictive or prognostic markers in older women with breast cancer undergoing surgery. Studies exploring these biomarkers in larger cohorts and in women undergoing non-operative therapies are required.
Structural Behaviour and Fire Design of Duplex and Ferritic Stainless Steel CHS Stub Columns
Authors: Mohammed Asif , Cashell Katherine A.
Published: June 2021

This paper investigates the structural behaviour and design of duplex and ferritic stainless steel stub columns with a circular hollow cross-section (CHS) at elevated temperature. A numerical model is developed to supplement the limited test results on stainless steel CHS stub columns in the literature. Following validation, the numerical approach is employed to gain an understanding of the critical behavioural characteristics which have not previously been studied. In addition, the paper considers and extends the continuous strength method (CSM) to include duplex and ferritic stainless steel for CHS stub columns in fire. The CSM employs a base curve linking the cross-section resistance to its deformation capacity and implements an elastic, linear hardening material model. The cross-sectional resistances obtained from the proposed CSM are compared with those from the numerical analysis, as well as with the standardised procedures in the European, American and Australia/New Zealand design standards. It is demonstrated that CSM can lead to more accurate and less scattered strength predictions than current design codes.
Supporting autism spectrum disorder screening and intervention with machine learning and wearables: a systematic literature review
Authors: Francese Rita , Yang Xiaomin
Published: June 2021

The number of autism spectrum disorder individuals is dramatically increasing. For them, it is difficult to get an early diagnosis or to intervene for preventing challenging behaviors, which may be the cause of social isolation and economic loss for all their family. This SLR aims at understanding and summarizing the current research work on this topic and analyze the limitations and open challenges to address future work. We consider papers published between 2015 and the beginning of 2021. The initial selection included about 2140 papers. 11 of them respected our selection criteria. The papers have been analyzed by mainly considering: (1) the kind of action taken on the autistic individual, (2) the considered wearables, (3) the machine learning approaches, and (4) the evaluation strategies. Results revealed that the topic is very relevant, but there are many limitations in the considered studies, such as reduced number of participants, absence of datasets and experimentation in real contexts, need for considering privacy issues, and the adoption of appropriate validation approaches. The issues highlighted in this analysis may be useful for improving machine learning techniques and highlighting areas of interest in which experimenting with the use of different noninvasive sensors.
Analysing Media Reactions to Male/Male Dance Partnerships On British Reality TV Shows: Inclusive Masculinity in Strictly Come Dancing and Dancing On Ice
Authors: Wong Yen Nee , Harman Vicki , Owen Craig
Published: June 2021

Strictly Come DancingandDancing on Iceare primetime reality television shows that promote partner dancing as a form of leisure in the UK. Both shows have consistently represented partner dancing as a partnership between a man and a woman. However, in 2019 and 2020male/male partnerships were introduced into both shows for the first time. Drawing on media reports that discuss these male/male partnerships, this paper explores how the partnerships were represented and made sense of by mainstream and LGBT + media. Employing thematic discourse analysis, we demonstrate how the male/male dance partnerships were framed by a complex and contradictory inclusive masculinity discourse. On the one hand, this discourse celebrated the male/male couples as evidence that Britain is a progressive society in which homophobia is in decline. At the same time, the representations largely centred on the male dance couples’ bromances while ignoring or silencing discourses of gay love or sex. We show that although the representations can be viewed as a positive step forward, there were also some limitations to the representations which necessitate more critical examination in future research
Low-Dose Cyproterone Acetate Treatment for Transgender Women
Authors: Even Zohar Naomi , Sofer Yael , Yaish Iris , Serebro Merav , Tordjman Karen , Greenman Yona
Published: June 2021

Background

Transgender women with intact gonads receive lifelong hormonal treatment to suppress physiologic androgen production, the optimal efficacious and safe cyproterone acetate (CPA) dose has not been established.

Aim

To assess the effectiveness and safety of low-dose (10–20 mg/day) compared with high-dose (50–100 mg/day) CPA treatment.

Methods

We conducted a historical cohort study of transgender women treated at a tertiary center for transgender health.

Outcome Measures

Serum levels of testosterone, estradiol, prolactin, gonadotrophins, liver enzymes, and lipids.

RESULTS

There were 38 transgender women in the low-dose group and 26 in the high-dose group. Age (median 24.9 years, interquartile range [IQR] 21–30 vs 25 years, IQR 19–35) and follow-up time (median 12 months, IQR 6–23 vs 15 months, IQR 12–36) were similar in the low- and high-dose groups, respectively. Serum gonadotropins and testosterone were suppressed to a similar level at all time points in both groups. Prolactin levels increased significantly in both groups, however, with a more substantial increase in the high- vs the low-dose group (804 ± 121 vs 398 ± 69 mIU/ml at 12 months, respectively, P = .004). Total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglyceride levels were not significantly affected by the dose.

Clinical Implications

We suggest an adjustment of current clinical practice guidelines to recommend lower doses of CPA for the treatment of transgender women.

Strengths & Limitations

This is the first demonstration that low-dose CPA treatment of transgender women is effective. Limitations include a relatively small sample and retrospective study design.

CONCLUSION

Low-dose CPA treatment of transgender women is as effective as high-dose treatment and possibly safer.
Whole-genome sequencing for neonatal intensive care unit outbreak investigations: Insights and lessons learned
Authors: Sansom Sarah E. , Logan Latania K. , Green Stefan J. , Moore Nicholas M. , Hayden Mary K.
Published: June 2021

Infectious diseases outbreaks are a cause of significant morbidity and mortality among hospitalized patients. Infants admitted to the neonatal intensive care unit (NICU) are particularly vulnerable to infectious complications during hospitalization. Thus, rapid recognition of and response to outbreaks in the NICU is essential. At Rush University Medical Center, whole-genome sequencing (WGS) has been utilized since early 2016 as an adjunctive method for outbreak investigations. The use of WGS and potential lessons learned are illustrated for 3 different NICU outbreak investigations involving methicillin-resistant Staphylococcus aureus (MRSA), group B Streptococcus (GBS), and Serratia marcescens. WGS has contributed to the understanding of the epidemiology of outbreaks in our NICU, and it has also provided further insight in settings of unusual diseases or when lower-resolution typing methods have been inadequate. WGS has emerged as the new gold standard for evaluating strain relatedness. As barriers to implementation are overcome, WGS has the potential to transform outbreak investigation in healthcare settings.
Third Nerve Palsy Due to Intracranial Aneurysms and Recovery after Endovascular Coiling
Authors: Kameda-Smith Michelle , Pai Akshat , Jung Youngkyung , Khan Dure , Adile Ashley A. , Hui Katrina , Martyniuk Amanda , Larrazabal Ramiro , Algird Almunder , Klurfan Paula , Gunnarsson Thorsteinn , Farrokhyar Forough , van Adel Brian
Published: June 2021

Introduction:

The modality of treatment of third nerve palsy (TNP) associated with intracranial aneurysms remains controversial. While treatment varies with the location of the aneurysm, microsurgical clipping of PComm aneurysms has generally been the traditional choice, with endovascular coiling emerging as a reasonable alternative.

Methods:

Patients with TNP due to an intracranial aneurysm who subsequently underwent treatment at a mid-sized Canadian neurosurgical center over a 15-year period (2003–2018) were examined.

Results:

A total of 616 intracranial aneurysms in 538 patients were treated; the majority underwent endovascular coiling with only 24 patients treated with surgical clipping. Only 37 patients (6.9%) presented with either a partial or complete TNP and underwent endovascular embolization; of these, 17 presented with a SAH secondary to intracranial aneurysm rupture. Aneurysms associated with TNP included PComm (64.9%), terminal ICA (29.7%), proximal MCA (2.7%), and basilar tip (2.7%) aneurysms. In general, smaller aneurysms and earlier treatment were provided for patients for ruptured aneurysms with a shorter mean interval to TNP recovery. In the endovascularly treated cohort initially presenting with TNP, seven presented with a complete TNP and the remaining were partial TNPs. TNP resolved completely in 20 patients (55.1%) and partially in 10 patients (27.0%). Neither time to coiling nor SAH at presentation were significantly associated with the recovery status of TNP.

Conclusion:

Endovascular coil embolization is a viable treatment modality for patients presenting with an associated cranial nerve palsy.