Enhancing Guideline-based decision support with distributed computation through local mobile application

We introduce the need for a distributed guideline-based decision sup-port (DSS) process, describe its characteristics, and explain how we implement-ed this process within the European Union?s MobiGuide project. In particular, we have developed a mechanism of sequential, piecemeal projection, i.e., 'downloading' small portions of the guideline from the central DSS server, to the local DSS in the patient's mobile device, which then applies that portion, us-ing the mobile device's local resources. The mobile device sends a callback to the central DSS when it encounters a triggering pattern predefined in the pro-jected module, which leads to an appropriate predefined action by the central DSS, including sending a new projected module, or directly controlling the rest of the workflow. We suggest that such a distributed architecture that explicitly defines a dialog between a central DSS server and a local DSS module, better balances the computational load and exploits the relative advantages of the cen-tral server and of the local mobile device.

Sustainable Living. Environmental integration in 15 vernacular Spanish houses

This research was published online by the Spanish Ministry of Public Works in 2012. It collects 20 years of work that contributes to recognizing and enhancing the vernacular architecture in Spain, which has no known author, but has significant values and shows a wide variety of adaptation examples to climatic and environmental conditions. The research analyzes in detail and from different scales 15 houses in different climatic conditions and geographic regions in order to go deeper into the specific characteristics of each one of them from the perspective of sustainability. These houses are located in Tenerife, Salamanca, Huelva, Granada, Toledo, Madrid, Menorca, Alicante, Mallorca, Almería, La Coruña, Cantabria, Huesca and Lugo. The article analyzes the traditional dwelling, the natural environment and conditions that surround it and intends to discover the formal dialogue among them, as well as the origin of the design strategies

Calidad ambiental electromagnética : atenuación de las radiaciones electromagnéticas en los espacios habitados

La perspectiva del arquitecto en calidad ambiental, y salud en un contexto sostenible, se amplía al considerar las radiaciones electromagnéticas no ionizantes en el diseño arquitectónico. En ese sentido, además del confort higrotérmico, acústico, lumínico y de la calidad del aire, se podría considerar el confort electromagnético de un lugar. Dado que existe gran controversia en cuales han de ser los límites de exposición a radiaciones electromagnéticas no ionizantes, establezco como punto de referencia los valores límite más restrictivos, que son los recomendados por la norma SBM-2008, desarrollada por el Institut für Baubiologie & Oekologie Neubeuern (IBN)1. Se plantean como hipótesis que podemos modificar el entorno electromagnético con materiales de construcción y geometría; y que determinados trazados geométricos tienen la capacidad de reducir el impacto de los campos electromagnéticos sobre los organismos vivos. El objetivo consiste en demostrar experimentalmente que podemos trabajar sobre la calidad ambiental electromagnética de un espacio, a través de la elección de materiales de construcción y trazados geométricos, intentando demostrar que existe una relación causa - efecto entre ambos. La metodología plantea tres aproximaciones experimentales, cada una con un tipo de radiación electromagnética, pues se pretende abarcar las situaciones que comúnmente se pueden presentar en un entorno habitado, ya sea urbano o rural. La primera aproximación trata sobre las alteraciones del campo geomagnético natural (nT / m) provocadas por los materiales de construcción. Utilizo el geomagnetómetro BPM 2010, para realizar un ensayo con cuatro tipos de materiales de distinta procedencia: origen vegetal muy poco procesado (corcho aglomerado negro) y más procesado (OSB), origen derivado del petróleo (tablero rígido de poliuretano) y de origen mineral metálico (chapa minionda). De la lectura de los datos se observa relación causa-efecto entre los materiales de construcción estudiados y las modificaciones que pueden ejercer sobre el campo magnético de un lugar. A continuación se estudia el entorno de radiación electromagnética artificial a baja frecuencia (3 Hz a 3 kHz) y a alta frecuencia, (800 MHz a 10 GHz) en vivienda y en oficina utilizando unas geometrías concretas: las tarjetas de corrección de radiaciones. Estas tarjetas se ubican en paramentos verticales y horizontales de un espacio sometido a radiación propia de un entorno urbano. Se concluye que en una habitación inciden múltiples variables simultáneas muy difíciles de trabajar por separado y que aparentemente no se pueden identificar cambios significativos en las mediciones con y sin las tarjetas de corrección de radiaciones. A continuación estudio el entorno de radiación electromagnética artificial a baja frecuencia asociada a la red de distribución eléctrica. Para poder ver cómo este entorno electromagnético lo podemos modificar, utilizo las tarjetas de corrección de radiaciones ubicadas en relación directa con organismos vivos, por un lado germinados de semillas de haba mungo sometidas a campos electromagnéticos complejos a alta y baja frecuencia, propios de una oficina; y por otro lado germinados de semillas de haba mungo, sometidas a campos electromagnéticos puros a 50 Hz, sin influencias de radiación a alta frecuencia. Se concluye que se observa relación causa - efecto entre los trazados geométricos estudiados y su capacidad para reducir el impacto de los campos electromagnéticos a altas y bajas frecuencias sobre las semillas de haba mungo. También utilizo las tarjetas de corrección de radiaciones en un ensayo normalizado en el laboratorio de bioelectromagnetismo del Hospital Universitario Ramón y Cajal, con células de neuroblastoma humano. Se concluye que se observa relación causa - efecto entre los trazados geométricos estudiados y su capacidad para reducir el impacto de los campos electromagnéticos de 50 Hz Y 100 μT sobre células de neuroblastoma humano y además disminuyen la velocidad de proliferación celular respecto del grupo de células de control. Finalmente se estudia el entorno de radiación electromagnética artificial a alta frecuencia, asociado a comunicaciones inalámbricas. Para ello realizo simulaciones con el software CST Studio, sobre las tarjetas de corrección de radiaciones a alta frecuencia. A la luz de los datos se observa relación causa - efecto entre el trazado geométrico estudiado y su capacidad para reducir radiaciones electromagnéticas de alta frecuencia. Se comprueba además que, las tarjetas de corrección de radiaciones disminuyen la intensidad de la radiación acercándose a los límites de exposición establecidos por el instituto de la biología de la construcción alemán, que podrían estar señalando los estándares de biocompatibilidad. ABSTRACT The perspective of the architect in environmental quality, and health in a sustainable context is extended to consider non-ionizing electromagnetic radiation in architectural design. In that sense, besides the hygrothermal, acoustic, lighting and air quality comfort, the electromagnetic comfort of an indoor space could be considered. There is still great controversy about which should be the limits of exposure to nonionizing electromagnetic radiation, as a benchmark, the more restrictive limits are considered, by the SBM- 2008 standard, developed by the Institut für Baubiologie & Oekologie Neubeuern (IBN). The hypotheses that arise are the following: the electromagnetic environment can be modified by using certain construction materials and geometry; and certain geometric design have the ability to reduce the impact of electromagnetic fields on living organisms. The aim is to demonstrate experimentally that we can work on electromagnetic environmental quality of a indoor space, by using certain construction materials and geometric design, trying to demonstrate a cause - effect relationship between them. The methodology raises three experimental approaches, each with a type of radiation, it is intend to cover situations commonly may occur in an inhabited environment, whether urban or rural. The first approach discusses the alteration of the natural magnetic field (nT / m) caused by the building materials. Geomagnetometre BPM 2010 is used for conducting a test with four types of materials from different sources: vegetable origin less processing (black agglomerate cork) and vegetable origin more processed (OSB), petroleum origin (rigid polyurethane board) and metallic origin (miniwave plate). It is observed across the data information that exist cause-effect relationship between the construction materials studied and the modifications that they can exercise on the magnetic field of a place. Then I study the environment of artificial electromagnetic radiation at low frequency (3 Hz to 3 kHz) and high frequency (800 MHz to 10 GHz) in housing and office, using some specific geometries: correcting radiation cards. These cards are placed in vertical and horizontal surfaces of an indoor space concerned by radiation. I conclude that an indoor space is affected by multiple simultaneous variables difficult to work separately and apparently it is not possible identify significant changes in measurements with and without correcting radiation cards. Then the artificial electromagnetic environment of low-frequency radiation associated with the electricity distribution network is studied. To see how the electromagnetic environment can be changed, correcting radiation cards are placed directly related to living organisms. On one hand, mung bean seeds subject to complex electromagnetic fields at low and high frequency, typical of an office; and on the other hand mung bean seeds, subjected to pure electromagnetic fields at 50 Hz, no influenced by high frequency radiation. It is observed that exist cause-effect relationship between the geometric design and their ability to reduce the impact of electromagnetic fields at high and low frequencies that arrives on on mung bean seeds. The correcting radiation cards were also used in a standard test in the bioelectromagnetics laboratory of Ramón y Cajal University Hospital, on human neuroblastoma cells. It is observed that exist cause-effect relationship between the geometric design and their ability to reduce the impact of electromagnetic fields at 50 Hz and 100 μT on human neuroblastoma cells and also decrease the rate of cell proliferation compared to the group of cells control. Finally the artificial electromagnetic radiation environment at high frequency associated with wireless communications was studied. Simulations with CST Study software were made to determine the behavior of correcting radiation cards in high-frequency. It is observed across the data information that exist causeeffect relationship between the geometric design and the ability to reduce the levels of high-frequency electromagnetic radiation. It also checks that radiation correcting cards decrease the intensity of radiation approaching exposure limits established by Institut für Baubiologie & Oekologie Neubeuern (IBN), which could be signaling biocompatibility standards.

Myocardial signaling defects and impaired cardiac function of a human beta 2-adrenergic receptor polymorphism expressed in transgenic mice.

A threonine to isoleucine polymorphism at amino acid 164 in the fourth transmembrane spanning domain of the beta 2-adrenergic receptor (beta 2AR) is known to occur in the human population. The functional consequences of this polymorphism to catecholamine signaling in relevant cells or to end-organ responsiveness, however, are not known. To explore potential differences between the two receptors, site-directed mutagenesis was carried out to mimic the polymorphism. Transgenic FVB/N mice were then created overexpressing wild-type (wt) beta 2AR or the mutant Ile-164 receptor in a targeted manner in the heart using a murine alpha myosin heavy chain promoter. The functional properties of the two receptors were then assessed at the level of in vitro cardiac myocyte signaling and in vivo cardiac responses in intact animals. The expression levels of these receptors in the two lines chosen for study were approximately 1200 fmol/mg protein in cardiac membranes, which represents a approximately 45-fold increase in expression over endogenous beta AR. Myocyte membrane adenylyl cyclase activity in the basal state was significantly lower in the Ile-164 mice (19.5 +/- 2.7 pmol/min/mg) compared with wt beta 2AR mice (35.0 +/- 4.1 pmol/min/mg), as was the maximal isoproterenol-stimulated activity (49.8 +/- 7.8 versus 77.1 +/ 7.3 pmol/min/mg). In intact animals, resting heart rate (441 +/- 21 versus 534 +/- 17 bpm) and dP/dtmax (10,923 +/- 730 versus 15,308 +/- 471 mmHg/sec) were less in the Ile-164 mice as compared with wt beta 2AR mice. Similarly, the physiologic responses to infused isoproterenol were notably less in the mutant expressing mice. Indeed, these values, as well as other contractile parameters, were indistinguishable between Ile-164 mice and nontransgenic littermates. Taken together, these results demonstrate that the Ile-164 polymorphism is substantially dysfunctional in a relevant target tissue, as indicated by depressed receptor coupling to adenylyl cyclase in myocardial membranes and impaired receptor mediated cardiac function in vivo. Under normal homeostatic conditions or in circumstances where sympathetic responses are compromised due to diseased states, such as heart failure, this impairment may have important pathophysiologic consequences.

Método da propagação de feixe de ângulo largo para análise de guias de ondas ópticos não-lineares

Este trabalho propõe uma extensão do método de propagação de feixe (BPM - Beam Propagation Method) para a análise de guias de ondas ópticos e acopladores baseados em materiais não-lineares do tipo Kerr. Este método se destina à investigação de estruturas onde a utilização da equação escalar de Helmholtz (EEH) em seu limite paraxial não mais se aplica. Os métodos desenvolvidos para este fim são denominados na literatura como métodos de propagação de feixe de ângulo largo. O formalismo aqui desenvolvido é baseado na técnica das diferenças finitas e nos esquemas de Crank-Nicholson (CN) e Douglas generalizado (GD). Estes esquemas apresentam como característica o fato de apresentarem um erro de truncamento em relação ao passo de discretização transversal, Δx, proporcional a O(Δx2) para o primeiro e O(Δx4). A convergência do método em ambos esquemas é otimizada pela utilização de um algoritmo interativo para a correção do campo no meio não-linear. O formalismo de ângulo largo é obtido pela expansão da EEH para os esquemas CN e GD em termos de polinômios aproximantes de Padé de ordem (1,0) e (1,1) para CN e GD, e (2,2) e (3,3) para CN. Os aproximantes de ordem superior a (1,1) apresentam sérios problemas de estabilidade. Este problema é eliminado pela rotação dos aproximantes no plano complexo. Duas condições de contorno nos extremos da janela computacional são também investigadas: 1) (TBC - Transparent Boundary Condition) e 2) condição de contorno absorvente (TAB - Transparent Absorbing Boundary). Estas condições de contorno possuem a facilidade de evitar que reflexões indesejáveis sejam transmitidas para dentro da janela computacional. Um estudo comparativo da influência destas condições de contorno na solução de guias de ondas ópticos não-lineares é também abordada neste trabalho.

Filtro respiratório reduz efeitos cardiovasculares associados à poluição: estudo randomizado, duplo-cego, controlado e cruzado em pacientes com insuficiência cardíaca (FILTER-HF trial)

Introdução A poluição do ar é um fator de risco associado com descompensação e mortalidade em pacientes com insuficiência cardíaca (IC). Objetivo Avaliar o impacto de um filtro de polipropileno sobre desfechos cardiovasculares em pacientes com IC e voluntários saudáveis durante exposição controlada à poluição. Métodos Ensaio clínico duplocego, controlado e cruzado, incluindo 26 pacientes com IC e 15 voluntários saudáveis, expostos a três protocolos diferentes de inalação randomizados por ordem: Ar Limpo; Exposição à Partículas de Exaustão do Diesel (ED); e ED filtrada. Os desfechos estudados foram função endotelial por índice de hiperemia reativa (RHi) e índice de aumento (Aix), biomarcadores séricos, variáveis de teste cardiopulmonar submáximo (caminhada de seis-minutos [tc6m]; consumo de oxigênio [VO2]; equivalente ventilatório de gás carbônico [VE/VCO2 slope]; consumo de O2 por batida [PulsoO2]) e variabilidade da frequência cardíaca (VFC). Resultados No grupo IC, a ED piorou o RHi [de 2,17 (IQR: 1,8-2,5) para 1,72 (IQR: 1,5-2,2); p=0,002], reduziu o VO2 [de 11.0 ± 3.9 para 8.4±2.8ml/Kg/min; p < 0.001], o tc6m [de 243,3±13 para 220,8 ± 14m; p=0,030] e o PulsoO2 [de 8.9 ± 1.0 para 7.8±0.7ml/bpm; p < 0.001]; e aumentou o BNP [de 47,0pg/ml (IQR: 17,3-118,0) para 66,5pg/ml (IQR: 26,5-155,5); p=0,004]. O filtro foi capaz de reduzir a concentração de poluição de 325±31 para 25±6?g/m3 (p < 0,001 vs. ED). No grupo IC, o filtro foi associado com melhora no RHi [2,06 (IQR: 1,5-2,6); p=0,019 vs. ED); aumento no VO2 (10.4 ± 3.8ml/Kg/min; p < 0.001 vs. ED) e PulsoO2 (9.7±1.1ml/bpm; p < 0.001 vs. ED); e redução no BNP [44,0pg/ml (IQR: 20,0-110,0); p=0,015 vs. ED]. Em ambos os grupos, a ED reduziu o Aix, sem efeito do filtro. O uso do filtro foi associado com maior ventilação e reinalação de CO2. Outras variáveis pesquisadas como VE/VCO2 slope e VFC não sofreram influências entre os protocolos. Conclusão A poluição do ar afetou adversamente o desempenho cardiovascular de pacientes com IC. Este é o primeiro ensaio clínico demonstrando que um simples filtrorespiratório pode prevenir a disfunção endotelial, a intolerância ao exercício e o aumento do BNP associados à poluição em pacientes com IC. O uso de máscaras com filtro tem o potencial de reduzir a morbidade associada à IC. Identificador ClinicalTrials.gov: NCT01960920

A new paradigm: cloud agile manufacturing

Cloud Agile Manufacturing is a new paradigm proposed in this article. The main objective of Cloud Agile Manufacturing is to offer industrial production systems as a service. Thus users can access any functionality available in the cloud of manufacturing (process design, production, management, business integration, factories virtualization, etc.) without knowledge — or at least without having to be experts — in managing the required resources. The proposal takes advantage of many of the benefits that can offer technologies and models like: Business Process Management (BPM), Cloud Computing, Service Oriented Architectures (SOA) and Ontologies. To develop the proposal has been taken as a starting point the Semantic Industrial Machinery as a Service (SIMaaS) proposed in previous work. This proposal facilitates the effective integration of industrial machinery in a computing environment, offering it as a network service. The work also includes an analysis of the benefits and disadvantages of the proposal.

Cloud agile manufacturing

This paper proposes a new manufacturing paradigm, we call Cloud Agile Manufacturing, and whose principal objective is to offer industrial production systems as a service. Thus users can access any functionality available in the cloud of manufacturing (process design, production, management, business integration, factories virtualization, etc.) without knowledge — or at least without having to be experts — in managing the required resources. The proposal takes advantage of many of the benefits that can offer technologies and models like: Business Process Management (BPM), Cloud Computing, Service Oriented Architectures (SOA) and Ontologies. To develop the proposal has been taken as a starting point the Semantic Industrial Machinery as a Service (SIMaaS) proposed in previous work. This proposal facilitates the effective integration of industrial machinery in a computing environment, offering it as a network service. The work also includes an analysis of the benefits and disadvantages of the proposal.

A Construction Management Framework for Mass Customisation in Traditional Construction

A Mass Customisation model is discussed as a competitive positioning strategy in the marketplace adding value to the customer’s end-use. It includes the user as part of the construction process responding to the customer’s demands and wishes. To the present day, almost all proposals for Mass Customisation have been focused on the design phase and single family houses. The reality is that the processes carried out in the work execution are so inefficient that the costs of the Mass Customisation models are assumed by the customer and they do not offer solutions that support the change management. Furthermore, this inefficiency often makes Mass Customisation unfeasible in terms of deadlines and site management. Therefore, the present proposal focuses on achieving the paradigm of Mass Customisation in the traditional residential construction complementary to the existing proposals in the design phase. All this through the proposal of a framework for the integral management in the work execution, which will address change management introduced by the users offering an efficient and productive model that reduces costs in the process. This model will focus on the synergy between different strategies, techniques and technologies currently used in the construction management (such as Lean Construction or Six Sigma), together with, other strategies and technologies that have proven to be valid solutions in other fields (such as Business Process Management, Service Oriented Architecture, etc.).

Gestão de processos de negócio em organizações desportivas: um estudo de caso no Comitée Européen de Rink-Hockey

A Gestão de Processos de Negócio (BPM – Business Process Management) é uma abordagem que tem como objetivo melhorar a eficiência nas organizações, através da gestão dos processos, em que se realiza a sua modelação, organização e otimização de uma forma iterativa e contínua. O BPM permite suportar os processos de negócio, através da utilização de métodos, técnicas e software para projetar, representar e analisar processos organizacionais que envolvem, pessoas, organizações, aplicações, documentos e outras fontes de informação (Aalst, Hofstede, & Weske, 2003). Neste estudo é utilizado um Business Process Management System (BPMS) para realizar a modelação dos processos do Comité Européen de Rink-Hockey (CERH), para a inscrição de equipas e atletas, nos eventos realizados sob a responsabilidade deste comité. A modelação é realizada através da utilização do Business Process Model and Notation (BPMN). A utilização do BPMS foi realizada considerando as seguintes etapas: (1) desenho do processo; (2) definição do processo; (3) desenvolvimento do processo e (4) administração e utilização de processos. Pretendeu-se, demonstrar a viabilidade e operacionalidade na utilização de uma ferramenta BPMS open-source, numa abordagem BPM, na modelação e implementação de processos, em detrimento de soluções proprietárias de custo elevado. O critério adotado para a seleção da ferramenta baseia-se na análise de relatórios sobre BPMS, que nos permitiu identificar e sustentar a solução adotada (Hill, Cantara, & Kerremans, 2009; Ovum, 2010; Richardson, Moore, Clair, & Vitti, 2010; Sinur & Hill, 2010). O resultado foi o desenvolvimento dos processos na organização, com a sua modelação em BPMN e implementação num BPMS, onde podemos comprovar a abordagem BPM numa organização desportiva.

Time-Resolved Micro PIV in the Pivoting Area of the Triflo Mechanical Heart Valve

The Lapeyre-Triflo FURTIVA valve aims at combining the favorable hemodynamics of bioprosthetic heart valves with the durability of mechanical heart valves (MHVs). The pivoting region of MHVs is hemodynamically of special interest as it may be a region of high shear stresses, combined with areas of flow stagnation. Here, platelets can be activated and may form a thrombus which in the most severe case can compromise leaflet mobility. In this study we set up an experiment to replicate the pulsatile flow in the aortic root and to study the flow in the pivoting region under physiological hemodynamic conditions (CO = 4.5 L/min / CO = 3.0 L/min, f = 60 BPM). It was found that the flow velocity in the pivoting region could reach values close to that of the bulk flow during systole. At the onset of diastole the three valve leaflets closed in a very synchronous manner within an average closing time of 55 ms which is much slower than what has been measured for traditional bileaflet MHVs. Hot spots for elevated viscous shear stresses were found at the flanges of the housing and the tips of the leaflet ears. Systolic VSS was maximal during mid-systole and reached levels of up to 40 Pa.

Recipes : First M.E. Church, W.H.M. Society.

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Bruce proper motion survey; the general catalogue.

[Part] B issued in 3 sections; [pt.] C, in 2 sections.

Ventilation rate and behavioural responses of two species of intertidal goby (Pisces : Gobiidae) at extremes of environmental temperature

We investigated the behavioural responses of two gobiid fish species to temperature to determine if differences in behaviour and ventilation rate might explain any apparent vertical zonation. A survey of the shore at Manly, Moreton Bay revealed Favonigobius exquisitus to dominate the lower shore and Pseudogobius sp. 4 the upper shore. These species were exposed to a range of temperatures (15-40 degreesC) in aquaria for up to 6 h. At 20 degreesC F. exquisitus exhibited a mean gill ventilation rate of 26 +/- 1.4 bpm (beats per minute) differing significantly from Pseudogobius, which ventilated at a fivefold greater rate of 143 +/- 6 bpm. The ventilation rate in F. exquisitus underwent a fivefold increase from normal local water temperature (20 degreesC) to high temperature (35 degreesC) conditions, whereas that of Pseudogobius did not even double, suggesting that Pseudogobius sp. is a better thermal regulator than F. exquisitus. While both species emerged from the water at high temperatures (>30 degreesC) the behaviours they exhibited while immersed at high temperature were quite different. F. exquisitus undertook vertical displacement movements we interpret as an avoidance response, whereas Pseudogobius sp. appeared to use a coping strategy involving movements that might renew the water mass adjacent to its body. The thermal tolerances and behaviours of F. exquisitus and Pseudogobius sp. are in broad agreement with their vertical distribution on the shore.