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Low-tech passive solar design concepts and bio-based material solutions for reducing life cycle GHG emissions of buildings-Life cycle assessment of regenerative design strategies (2/2)
No full textIn order to achieve the necessary reduction of greenhouse gas (GHG) emissions and decarbonization of building construction and operation, both high-and low-tech building design strategies are promoted. Amongst particularly promising strategies are the deployment of energy efficiency measures, for reducing operational energy use and related impacts, as well as the application of low-carbon, bio-based construction materials, for reducing embodied impacts. In part two of our study on the life cycle assessment (LCA) of regenerative design strategies, LCA is applied to investigate the environmental impacts and reduction potentials of strategies at building level by analyzing two low-tech, passive building concepts-the be2226 building and the N11 SolarHouse-in both their original designs as well as optimized alternatives applying bio-based material solutions. The analysis includes three steps. In a first step the life cycle GHG emissions of the original buildings are assessed, revealing strengths and weaknesses on both operational and embodied GHG emissions. Environmental hotspots are identified across environmental indicators, life cycle stages and building elements. In a second step the case studies are remodeled with bio-based building element alternatives showing substantial embodied GHG emissions reduction potential compared to the original case studies. Finally, the results of all building variants are compared with climate targets for buildings revealing that the N11 building meets established climate targets already in its original version, and that a straw-based material optimization can even enable meeting more ambitious climate targets.We thank the architects of the case study buildings for providing the necessary information on their respective projects, namely Sascha Schär of N11 architects (N11 SolarHouse), and Dietmar Eberle and team (be2226). Martin Röck received funding through a DOC Fellowship of the Austrian Academy of Sciences (OeAW) [2019/1]
Evaluation of a novel anthropomorphic thorax phantom with a dynamic lung using 4DCT
No full textPurpose/Objective: Four-dimensional computed tomography (4DCT) has revolutionized the radiation therapy field by allowing visualization and tracking of movements in the target volume and organs at risk, leading to more accurate treatment procedures. However, the image quality and accuracy of quantitative information could be affected by severe artifacts arising from regular or irregular breathing and motion artifacts. These image quality measurements are mostly performed using phantoms, which do not represent entirely the complexities and motion of patients. Recently, the 3D-printing technology has been introduced into radiotherapy that allows for increased customization and generating anthropomorphic dynamic/deformable phantoms. This study aims to evaluate the 4DCT image quality and proof-of-concept of an in-house developed realistic dynamic/deformable phantom in terms of tumor trajectory and motion artifacts, which allows for more realistic motion evaluation than with more commonly used simplistic phantoms. Material/Methods: A novel anthropomorphic thorax phantom (Figure 1A) was manufactured with fused deposition modeling (FDM) printing by using tissue-equivalent materials that represented soft tissue, lung tissue and bone. These materials were selected based on the effective atomic number and relative electron density. The soft tissue structure was based on CT images of a real patient with, in addition, tissue-equivalent bone such as spine and ribs and a deformable and compressible lung, including bronchi and tumors with accurate mechanical properties for realistic compression. The compression was performed by a developed electronic lung compression system (LCS), that simulated realistic respiration induced breathing motion. This system was connected to a static chest movement system (CMS; Figure 1B). The latter system was used to connect the ANZAI belt and allowed to track the breathing phases by the 4DCT system. A snippet of the respiratory curve is shown in Figure 2A. Images were acquired in static 3DCT (reference volume) and 4DCT. The image acquisition was performed on a SOMATOM Definition Drive CT scanner (Siemens Healthineers) with a tube voltage of 120 kVp (Qr40). This scanner used a phase-based sorting algorithm to reconstruct at specific breathing phases (0% inhale, 25% inhale, 50% inhale, 75% inhale, 100% inhale, 75% exhale, 50% exhale, 25% exhale). The scan parameters for the 4DCT were chosen based on clinical practice and included a pitch of 0.14 s, a field-of-view of 500 mm and a CTDIvol of 22 mGy. In addition, reconstruction was performed with 3 mm slice thickness. In evaluation, two tumors that had different volumes(tumor 1 and 2; Figure 1A) were assessed by quantifying the center of mass and volume between the respiratory phases. In addition, the amplitude between the different tumors was evaluated to demonstrated the realistic motion induced by the LCS
Micro-Level Bicycle Infrastructure Design Elements: A Framework for Developing a Bikeability Index for Urban Areas
No full textModern and smart cities prioritize providing sufficient facilities for inclusive and bicycle-friendly streets. Several methods have been developed to assess city bicycle environments at street, neighborhood, and city levels. However, the importance of micro-level indicators and bicyclists’ perceptions cannot be neglected when developing a bikeability index (BI). Therefore, this paper proposes a new BI method for evaluating and providing suggestions for improving city streets, focusing on bicycle infrastructure facilities. The proposed BI is an analytical system aggregating multiple bikeability indicators into a structured index using weighed coefficients and scores. In addition, the study introduces bicycle infrastructure indicators using five bicycle design principles acknowledged in the literature, experts, and city authorities worldwide. A questionnaire was used to collect data from cyclists to find the weights and scores of the indicators. The survey of 383 participants showed a balanced gender distribution and a predominantly younger population, with most respondents holding bachelor’s or master’s degrees and 57.4% being students. Most participants travel 2–5 km per day and cycle 3 to 5 days per week. Among the criteria, respondents graded safety as the most important, followed by comfort on bicycle paths. Confirmatory factor analysis (CFA) is used to estimate weights of the bikeability indicators, with the values of the resultant factor loadings used as their weights. The highest-weight indicator was the presence of bicycle infrastructure (0.753), while the lowest-weight indicator was slope (0.302). The proposed BI was applied to various bike lanes and streets in Hasselt, Belgium. The developed BI is a useful tool for urban planners to identify existing problems in bicycle streets and provide potential improvements.Funding: This research received no external funding.
Acknowledgments: We acknowledge the Higher Education Commission (HEC) Pakistan for funding
Tufail Ahmed’s Ph.D. research
One-year real-world benefits of Tandem Control-IQ technology on glucose management and person-reported outcomes in adults with type 1 diabetes: a prospective observational cohort study
No full textAims/hypothesis This multicentre prospective observational cohort study aimed to evaluate real-world changes in glycaemic and person-reported outcomes after 1 year's use of Control-IQ technology in adults with type 1 diabetes. Methods Adults who started with Control-IQ between December 2021 and December 2022 were consecutively recruited in 13 Belgian diabetes centres. Data were collected at start and after 4, 8 and 12 months. The primary endpoint was the evolution of time in range (TIR; glucose levels of 3.9-10.0 mmol/l). Data are reported as mean +/- SD or least-squares mean (95% CI). Results A total of 473 adults were included, with a mean age of 38.5 +/- 13.1 years and of whom 57.3% were female. TIR increased from 58.8% (95% CI 56.7, 60.9) at start to 70.9% (69.1, 72.8) at 12 months (p<0.001). HbA(1c) decreased from 57.3 mmol/mol (56.1, 58.5) (7.4% [7.3, 7.5]) to 49.5 mmol/mol (48.5, 50.6) (6.7% [6.6, 6.8]) and time <3.9 mmol/l from 4.2% (3.9, 4.6) to 1.9% (1.8, 2.1) (all p<0.001). Participants scored better on the Hypoglycaemia Fear Survey version 2 worry (22.5 [21.3, 23.7] vs 18.1 points [17.0, 19.3]), the Problem Areas in Diabetes - Short Form (7.2 [6.7, 7.8] vs 6.1 points [5.5, 6.7]), and the Diabetes Treatment Satisfaction Questionnaire status (25.5 [24.8, 26.2] vs 31.0 points [30.4, 31.6]) (all p<0.001). The number of self-reported severe hypoglycaemia events (37.5 [21.3, 65.9] vs 15.7 [9.7, 25.3] events per 100 person-years, p=0.002) and work absenteeism days (116.3 [42.8, 315.5] vs 69.3 [25.4, 189.2] days per 100 person-years, p=0.034) decreased. Conclusions/interpretation One-year use of Control-IQ was associated with better glucose management, improved diabetes-related quality of life, more treatment satisfaction, less severe hypoglycaemia and less work absenteeism in adults with type 1 diabetes.Tandem Diabetes Care; Dexco
It’s (not) all about the money: financial decisions at the intersection of business and family
No full textPurpose
We develop a conceptual framework that combines the established concept of money scripts from financial psychology with the family-practice-fit framework. Through this integration, we analyze how family identity, values and maturity levels interact with financial decision-making. We examine four key financial decisions and their alignment with family characteristics through the lens of different money scripts.
Design/methodology/approach
This conceptual paper explores how business families’ collective attitudes toward money and wealth (money scripts) influence their financial business decisions. We examine the relationship between money scripts and four key financial decisions: ROE expectations, profit growth targets, capital structure and dividend policies. By integrating money scripts with the family-practice-fit framework, we investigate how family characteristics shape financial decision-making in family businesses.
Findings
Our analysis reveals that family businesses’ financial decisions often reflect their collective money scripts rather than purely rational economic considerations. These shared attitudes toward money can lead to financial choices that prioritize family values over conventional business logic. The framework demonstrates how misalignment between money scripts, family characteristics and financial decisions can create tensions affecting both family unity and business performance.
Originality/value
This paper pioneers the application of money scripts to family business research, offering a novel framework for understanding seemingly irrational financial decisions. It contributes to family business theory by expanding the family-practice-fit framework and provides practical guidance for business families and advisors in making financial decisions that align with family values while supporting business objectives
Development and validation of artificial intelligence models for early detection of postoperative infections (PERISCOPE): a multicentre study using electronic health record data
No full textBackground Postoperative infections significantly impact patient outcomes and costs, exacerbated by late diagnoses, yet early reliable predictors are scarce. Existing artificial intelligence (AI) models for postoperative infection prediction often lack external validation or perform poorly in local settings when validated. We aimed to develop locally valid models as part of the PERISCOPE AI system to enable early detection, safer discharge, and more timely treatment of patients. Methods We developed and validated XGBoost models to predict postoperative infections within 7 and 30 days of surgery. Using retrospective pre-operative and intra-operative electronic health record data from 2014 to 2023 across various surgical specialities, the models were developed at Hospital A and validated and updated at Hospitals B and C in the Netherlands and Belgium. Model performance was evaluated before and after updating using the two most recent years of data as temporal validation datasets. Main outcome measures were model discrimination (area under the receiver operating characteristic curve (AUROC)), calibration (slope, intercept, and plots), and clinical utility (decision curve analysis with net benefit). Findings The study included 253,010 surgical procedures with 23,903 infections within 30-days. Discriminative performance, calibration properties, and clinical utility significantly improved after updating. Final AUROCs after updating for Hospitals A, B, and C were 0.82 (95% confidence interval (CI) 0.81-0.83), 0.82 (95% CI 0.81-0.83), and 0.91 (95% CI 0.90-0.91) respectively for 30-day predictions on the temporal validation datasets (2022-2023). Calibration plots demonstrated adequate correspondence between observed outcomes and predicted risk. All local models were deemed clinically useful as the net benefit was higher than default strategies (treat all and treat none) over a wide range of clinically relevant decision thresholds. Interpretation PERISCOPE can accurately predict overall postoperative infections within 7- and 30-days post-surgery. The robust performance implies potential for improving clinical care in diverse clinical target populations. This study supports the need for approaches to local updating of AI models to account for domain shifts in patient populations and data distributions across different clinical settings. Copyright (c) 2024 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).This study was funded by a “REACT EU” grant from “European Regional Development Fund (ERDF)” and “Kansen voor West” with grant number KVW-00351. The funders had no role in study design, data collection, data analysis, interpretation, or manuscript writing. The PERISCOPE group was not funded. The authors would like to thank Kathryn Lake for proofreading the manuscript
De extase van de jagers. Verbeeldingen van de mystieke ervaring
No full textWanneer je religie opvat als een specifieke verbeeldingsvorm, vergelijkbaar met bijvoorbeeld kunst, literatuur of filosofie, kan je op een onbevangen manier de religieuze erfenis in onze cultuur verkennen. In De extase van de jagers leidt cultuurfilosoof Kris Pint je langs een reeks excentrieke figuren: een vogelsjamaan en een vliegende heilige, een cynische Messias en een onverschrokken mystica, een mysterieus veenlijk en een melancholische filosoof, een afvallige Romeinse keizer en een rebelse psychotherapeut. Hun lotgevallen en mystieke ervaringen nodigen uit om een andere blik te werpen op jezelf en de wereld, en om je te verzetten tegen de verschraling van onze innerlijke wildernis
Immersive Virtual Reality in Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Its Efficacy in Upper Limb Recovery
No full textBackground: Immersive virtual reality (imVR) has shown promise for upper limb stroke rehabilitation (ULSR). However, optimal implementation and treatment modalities remain unclear. This systematic review and meta-analysis aimed to evaluate imVR's efficacy in ULSR and determine optimal treatment parameters. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs), comparing imVR to conventional rehabilitation (CR) in adult stroke patients, was conducted. Databases including, the Web of Science, Scopus, and PubMed, were searched. Meta-regression further explored the relationship between intervention duration, frequency, and outcomes. Results: Twenty-three studies were included in the systematic review, representing 395 patients, with thirteen incorporated into the meta-analysis. imVR showed statistically significant improvements in the Fugl-Meyer Assessment Upper Extremity (FMA-UE) Scale (mean difference (MD) = 3.04, 95% CI [1.46; 4.62], p < 0.001) and the Box and Block Test (BBT) (MD = 2.85, 95% CI [0.70; 4.99], p = 0.009) compared to CR, but not in the Action Research Arm Test (ARAT) (MD = 3.47, 95% CI [-0.22; 7.15], p = 0.06). However, these improvements did not reach clinically significant thresholds (7 points for FMA-UE and 6 points for BBT). Clinical subgroup analysis showed significant improvements for both subacute (standardized mean difference (SMD) = 0.92, 95% CI [0.48; 1.36], p = 0.002) and chronic (SMD = 0.69, 95% CI [0.03; 1.35], p = 0.03) stroke stages. Meta-regression indicated that there was a significant positive relationship between the intervention duration and upper limb improvement. Conclusions: imVR demonstrates potential for improving upper limb motor function following stroke, particularly with longer intervention durations and individual session lengths for chronic stroke. However, the improvements observed were not clinically significant, highlighting the need for further research with larger sample sizes and standardized outcome measures to determine optimal treatment protocols.This research was funded by the NASCERE project, a joint PhD program between Jimma University and Hasselt University supported by the VLIR-UOS
The multi-omics signatures of telomere length in childhood
No full textBackground Telomere length is an important indicator of biological age and a complex multi-factor trait. To date, the telomere interactome for comprehending the high-dimensional biological aspects linked to telomere regulation during childhood remains unexplored. Here we describe the multi-omics signatures associated with childhood telomere length. Methods This study included 1001 children aged 6 to 11 years from the Human Early-life Exposome (HELIX) project. Telomere length was quantified via qPCR in peripheral blood of the children. Blood DNA methylation, gene expression, miRNA expression, plasma proteins and serum and urinary metabolites were measured through microarrays or (semi-) targeted assays. The association between each individual omics feature and telomere length was assessed in omics-wide association analyses. In addition, a literature-guided, sparse supervised integration method was applied to multiple omics, and latent components were extracted as predictors of child telomere length. The association of these latent components with early-life aging risk factors (child lifestyle, body mass index (BMI), exposure to smoking, etc.), were interrogated. Results After multiple-testing correction, only two CpGs (cg23686403 and cg16238918 at PARD6G gene) out of all the omics features were significantly associated with child telomere length. The supervised multi-omics integration approach revealed robust associations between latent components and child BMI, with metabolites and proteins emerging as the primary contributing features. In these latent components, the contributing molecular features were known as involved in metabolism and immune regulation-related pathways. Conclusions Findings of this multi-omics study suggested an intricate interplay between telomere length, metabolism and immune responses, providing valuable insights into the molecular underpinnings of the early-life biological aging