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Given the urgent need for decarbonization of the construction industry due to its pivotal role in global greenhouse gas emissions, industrialized construction (IC) has emerged as a promising technique to change the productivity, quality, and sustainability of construction. Although some evidence and case studies reveal that IC has distinct decarbonization advantages compared with traditional construction, there still is a need to analyze best practices, opportunities, and challenges in order to guide industry practitioners and to define key knowledge gaps. A systematic review was conducted following the three core steps: database search; research gap identification, analysis according to key lifecycle stages, and decarbonization themes. This synthesized existing academic works at the intersection of industrialized construction and decarbonization to provide a comprehensive understanding of decarbonization in IC. The findings show that although a significant amount of research focused on emissions during project stages A1–A3, there is a noticeable research gap in evaluating the carbon emissions associated with transportation, operations, and end-of-life attributes of IC. Moreover, the absence of real-time assessments during the B6–B7 operational stages impedes optimal carbon emission assessment. The verbosity of carbon estimation and tracking methodologies also adds challenges to ensuring that additional carbon impacts of IC are adequately offset by improved efficiency and lower onsite emissions. The potential of decarbonization of IC can be explored further by future research on the standardization of life-cycle assessments, development of continuous carbon-tracking methodologies, and application of alternative materials and new technologies. Practical Applications: The effectiveness of IC practices in reducing carbon emissions may vary, as deduced from the reviewed literature. However, the conscientious selection of materials characterized by low embodied emissions can contribute to a reduction in carbon emissions, applicable to both IC and non-IC projects. IC projects are uniquely positioned to achieve an even greater reduction in carbon emissions because of a unique process that innately offers waste reduction and product quality improvements. Although a considerable volume of research has focused on estimating carbon emissions, there appears to be a gap in tracking the precise quantity of emissions across various life-cycle phases within IC. Although there is considerable research on decarbonization in prefabricated components, research on specific life-cycle phases still is lagging. Furthermore, future research should prioritize investigating similar opportunities for three-dimensional (3D) volumetric systems. [ABSTRACT FROM AUTHOR]

Background: The objective was to describe the design of a population-level electronic health record (EHR) and insurance claims-based surveillance system of adolescents and adults with congenital heart defects (CHDs) in Colorado and to evaluate the bias introduced by duplicate cases across data sources.Methods: The Colorado CHD Surveillance System ascertained individuals aged 11-64 years with a CHD based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic coding between 2011 and 2013 from a diverse network of health care systems and an All Payer Claims Database (APCD). A probability-based identity reconciliation algorithm identified duplicate cases. Logistic regression was conducted to investigate bias introduced by duplicate cases on the relationship between CHD severity (severe compared to moderate/mild) and adverse outcomes including all-cause mortality, inpatient hospitalization, and major adverse cardiac events (myocardial infarction, congestive heart failure, or cerebrovascular event). Sensitivity analyses were conducted to investigate bias introduced by the sole use or exclusion of APCD data.Results: A total of 12,293 unique cases were identified, of which 3,476 had a within or between data source duplicate. Duplicate cases were more likely to be in the youngest age group and have private health insurance, a severe heart defect, a CHD comorbidity, and higher health care utilization. We found that failure to resolve duplicate cases between data sources would inflate the relationship between CHD severity and both morbidity and mortality outcomes by ~15%. Sensitivity analyses indicate that scenarios in which APCD was excluded from case finding or relied upon as the sole source of case finding would also result in an overestimation of the relationship between a CHD severity and major adverse outcomes.Discussion: Aggregated EHR- and claims-based surveillance systems of adolescents and adults with CHD that fail to account for duplicate records will introduce considerable bias into research findings.Conclusion: Population-level surveillance systems for rare chronic conditions, such as congenital heart disease, based on aggregation of EHR and claims data require sophisticated identity reconciliation methods to prevent bias introduced by duplicate cases. [ABSTRACT FROM AUTHOR]

Geometric variability often creates challenges for component aggregation in the assembly of interchangeable components in modular construction. Despite complete interchangeability-based design, geometric variability resulting from production processes creates variances between the as-built states of identical components. This inevitable occurrence of discrepancies between design and fabrication creates challenges for component aggregation on site and causes rework during assembly and erection. This paper presents a framework for optimally planning the order and arrangement of components such that the impacts of geometric variability, and the rework it can cause are minimized. The proposed framework compares the critical interface points of components in order to optimize the assembly plan in two distinct approaches: (1) minimization of the overall assembly geometric deviation, and (2) avoidance of rework caused by component aggregation. The proposed framework can be carried out for serial-parallel assemblies and for volumetric assemblies utilizing the as-built state in the form of three-dimensional (3D) point cloud data. The results of the two case studies in this paper demonstrate that not only can the assembly plan of interchangeable components be optimized to reduce the impacts of geometric variability, but geometric deviations can also be quantified, which is of vital importance for proper construction planning. [ABSTRACT FROM AUTHOR]

The article discusses the effective ways to determine the fitness of older adults to drive. The elderly population in the US is growing and therefore it is extremely important to determine when to ask the older people to stop driving. Public policy on restricted licensing and stringent renewal procedures reduce the number of older drivers; physicians must also inform the department of motor vehicles if they find an individual has a condition that makes him/her unfit for driving.

We present a mechanism for spin-wave excitation using a pinned domain wall, which is forced to oscillate at its eigenfrequency and radiates spin waves. The domain wall acts as a frequency doubler as the excited spin waves have twice the frequency of the domain wall oscillation. The investigations have been carried out using micromagnetic simulations and enable the determination of the main characteristics of the excited spin waves such as frequency, wavelength, and velocity. This behavior is understood by the oscillation in the perpendicular magnetization, which shows two antinodes oscillating out of phase with respect to each other. [ABSTRACT FROM AUTHOR]

Elevated systemic afterload in patients with Fontan circulation may lead to impaired single ventricular function. Wave intensity analysis (WIA) enables evaluation of compression and expansion waves traveling through vasculature. We aimed to investigate the unfavorable wave propagation causing excessive afterload may be an important contributor to the overall single ventricle function and to the limited functional capacity in this patient population. Patients with hypoplastic left heart syndrome (HLHS) (n = 25), single left ventricle (SLV) (n = 24), and normal controls (n = 10) underwent phase-contrast MRI based WIA analysis evaluated in the ascending aorta. Forward compression wave (FCW) representing dP/dt, backward compression wave (BCW) reflecting vascular stiffness, and forward decompression wave (FDW) representing LV relaxation were recorded and indexed to each other. FCW was lowest in HLHS patients (1098 mm5/s), and higher in the SLV group (1457 mm5/s), and controls (6457 mm5/s) (P < 0.001). BCW/FCW was increased in HLHS (0.22) and SLV (0.14) groups compared to controls (0.08) (P = 0.003). Peak VO2 correlated with FCW (R = 0.50, P = 0.015), stroke volume (R = 0.72, P < 0.001), and cardiac output (R = 0.44, P = 0.034). Patients with HLHS and SLV have unfavorable aortic WIA patterns with increased BCW/FCW ratio indicating increased systemic afterload due to retrograde compression waves. Reduced FCW and systolic MRI indices correlated with peak VO2 suggesting that abnormal systolic wave propagation may play a role in exercise intolerance for Fontan patients. • Patients with Fontan circulation have abnormal wave propagation through systemic circulation • Abnormal wave propagation further elevates the single ventricle afterload • Standard MRI and wave intensity indices are associated with the exercise capacity [ABSTRACT FROM AUTHOR]

Pulse oximetry screening for critical congenital heart disease (CCHD) has been recommended by the American Academy of Pediatrics (AAP). The objectives of this study are to describe saturation data, and to evaluate the effectiveness of AAP-recommended pulse oximetry screening guidelines applied retrospectively to a cohort of newborns with known CCHD at moderate altitude (5557 feet, Aurora, Colorado). Data related to seven critical congenital heart disease diagnoses were extracted from electronic health records (pulse oximetry, prostaglandin administration, and oxygen supplementation). Descriptive epidemiologic data were calculated. 158 subjects were included in this analysis; the AAP pulse oximetry screening protocol was applied to 149 subjects. Mean pre-ductal and post-ductal pulse oximetry values of the infants known to have CCHD at 24 h of life were 87.1% ± 7.2 and 87.8% ± 6.3, respectively. Infants treated with prostaglandins and oxygen had lower oximetry readings. The screening algorithm would have identified 80.5% of infants with known CCHDs (120/149 subjects). Additionally, sequential pulse oximetry screening based on the AAP-recommended protocol was able to identify a true positive screen capture rate of 80.5% at moderate altitude., Competing Interests: Conflicts of InterestSontag has received grants from the National Institutes of Heart Lung and Blood Disorders, the Health Services and Resources Administration, and the Cystic Fibrosis Foundation. Kim, Ariefdjohan, and Rausch declare that they have no conflicts of interest., (© 2018 by the authors.)

Background and Objective: Consensus guidelines have recommended newborn pulse oximetry screening for critical congenital heart disease (CCHD). Given that newborn oxygen saturations are generally lower at higher altitudes, the American Academy of Pediatrics and others recommend additional evaluation of the screening algorithm at altitude. Our objective was to evaluate the feasibility of newborn pulse-oximetry CCHD screening at moderate altitude (Aurora, CO; 1694 m). We hypothesized the overall failure rate would be significantly higher compared with published controls., Methods: We enrolled 1003 consecutive infants at ≥35 weeks' gestation in a prospective observational study. The nationally recommended protocol for CCHD screening was adhered to with the exceptions of no reflex echocardiograms being performed and providers being informed of results only if saturations were less than predefined critical values., Results: There were 1003 infants enrolled, and 988 completed the screen. The overall failure rate for completed screenings was 1.1% (95% confidence interval: 0.6%-2.0%). The first 500 infants had 1.6% fail, and the last 503 infants had 0.6% fail. Among infants who failed screening, 73% failed secondary to saturations <90%, whereas saturations between 90% and 94%, persistently >3% difference, and multiple criteria were each responsible for 9% of failures. Overall, 1.6% of all infants had incomplete screening and had not passed at the time the test was stopped., Conclusions: Pulse oximetry screening failure rates at moderate altitude are significantly higher than at sea level. Larger studies with alternative algorithms are warranted at moderate altitudes.