Elastic buildings: Calibrated district-scale simulation of occupant-flexible campus operation for hybrid work optimization

Before 2020, the way occupants utilized the built environment had been changing slowly towards scenarios in which occupants have more choice and flexibility in where and how they work. The global COVID-19 pandemic accelerated this phenomenon rapidly through lockdowns and hybrid work arrangements. Many occupants and employers are considering keeping some of these flexibility-based strategies due to their benefits and cost impacts. This paper explores how demand-driven control strategies in the built environment might support the transition to increased workplace flexibility by simulating various scenarios related to the operational technologies and policies of a real-world campus using a district-scale City Energy Analyst (CEA) model that is calibrated with measured energy demand data and occupancy profiles extracted from WiFi data. These scenarios demonstrate the energy impact of ramping building operations up and down more rapidly and effectively to the flex-based work strategies that may solidify. The scenarios show a 5–15% decrease in space cooling demand due to occupant absenteeism of 25–75% if centralized building system operation is in place, but as high as 17–63% if occupancy-driven building controls are implemented. The paper discusses technologies and strategies that are important in this paradigm shift of operations. © 2023 The Author(s)

Data-driven predictive control for smart HVAC system in IoT-integrated buildings with time-series forecasting and reinforcement learning

Optimising HVAC operations towards human wellness and energy efficiency is a major challenge for smart facilities management, especially amid COVID situations. Although IoT sensors and deep learning were applied to support HVAC operations, the loss of forecasting accuracy in recursive prediction largely hinders their applications. This study presents a data-driven predictive control method with time-series forecasting (TSF) and reinforcement learning (RL), to examine various sensor metadata for HVAC system optimisation. This involves the development and validation of 16 Long Short-Term Memory (LSTM) based architectures with bi-directional processing, convolution, and attention mechanisms. The TSF models are comprehensively evaluated under independent, short-term recursive, and long-term recursive prediction scenarios. The optimal TSF models are integrated with a Soft Actor-Critic RL agent to analyse sensor metadata and optimise HVAC operations, achieving 17.4% energy savings and 16.9% thermal comfort improvement in the surrogate environment. The results show that recursive prediction leads to a significant reduction in model accuracy, and the effect is more pronounced in the temperature-humidity prediction model. The attention mechanism significantly improves prediction performance in both recursive and independent prediction scenarios. This study contributes new data-driven methods for smart HVAC operations in IoT-enabled intelligent buildings towards a human-centric built environment. © 2023 The Authors

Design and validation of a low-cost emergency mechanical ventilator in response to the pandemic caused by COVID-19

In this paper, the redesign and construction of a low- cost, open-source, emergency mechanical ventilator prototype is presented, in response to the shortage of mechanical ventilators caused by the COVID-19 pandemic in low- and middle-income countries. This redesign took as its starting point an open-source mechanical ventilator already validated through preclinical testing in a porcine animal model. The objective ofthis work was to improve the previous device, with changes in hardware and software, which resulted in a lower-cost device with greater replicability, maintaining the functional characteristics previously obtained with the base ventilator, verified by means of a mechanical ventilator calibrator. Results show a stable and precise behavior, and with an adequate operating range in accordance with the WHO and MHRA requirements, with a maximum error of 4.97% for pressure and 8.23% for tidal volume measurements. © 2022 Latin American and Caribbean Consortium of Engineering Institutions. All rights reserved.

Real-Time Estimation of Alternative Stress Index for Low-Cost, Mechanical Ventilators for Emergency Use

Stress index is a useful indicator in mechanical ventilation to assess improper ventilation settings. It can indicate tidal overdistension or tidal recruitment, which are two major mechanisms of ventilator-induced lung injury. However, it's implementation require dedicated hardware and software and is not a widespread parameter used in commercial ventilators. In this work, an alternative, simple way to visually inspect the concavity of the pressure-time curve during mechanical ventilation is presented, by calculating the pressure difference of the pressure-time curve. This proves useful when implemented in low-cost emergency devices, such as those designed to cope with the COVID-19 pandemic, because of the reduced computational load required to perform its calculation. The method was implemented in a low-cost emergency mechanical ventilator and tested with an artificial lung for a proof-of-concept. Results show that this alternative method can be effectively used to qualitatively assess the concavity of the pressure-time curve.

The rise and rise of FOAMeD in dermatology education-A review

Aims: Australian medical students have historically had limited dedicated clinical education in dermatology. Recently, the COVID-19 pandemic has resulted in additional barriers to face-to-face clinical education. With the increasing usage of social media and web-based resources, Free Online Open Access Medical Education (FOAMeD) has emerged as a popular educational paradigm. The FOAMed movement promotes accessible, collaborative and contemporaneous clinical education, knowledge-sharing and communication in medicine. In this review, we explore the platforms, content and delivery modalities available in dermatology FOAMed for medical students. Methods: MEDLINE, Cochrane Library, Scopus and Social media platforms were searched with the following search terms: ?FOAMed?, ?FOAM? AND/OR ?Dermatology?, ?Skin disease?, ?Dermatological?, ?Dermatology education? AND/OR ?medical education?, ?medical student? to identify potential dermatology FOAMed resources for medical students. Additional FOAMed resources were identified through university and institution student resource lists, word of mouth and ancestry searching of identified FOAMed resources. Dermatology FOAMed resources were categorised according to platform, content media and delivery. Specific examples of dermatology FOAMed are discussed. Results: Dermatology FOAMed platforms identified could be grouped into six categories: social networking, media sharing networks, digital libraries, community blogs, blog comments and forums, and microblogging. Content media could be broadly classified into textual, visual, audio and combination delivery. Delivery of dermatology FOAMed encompassed (use a list/bullet point here): podcasts, videos, vodcasts, digital libraries, educational images, blog articles, memes, infographics, livestreams, host discussions, webinars, reels and games. Specific examples of dermatology FOAMed are discussed including (use another list here) the SpotDiagnosis (podcast), UE Open.Ed (video sharing network), @DocScribbles (Twitter), Sydney University Dermatology Society-SUDS (Facebook community group) and DontForgetTheBubbles (community blog). Conclusions: Dermatology FOAMed for medical students are widely available through multiple modalities. Learner satisfaction and clinical education outcomes are subject to further research.

Spot diagnosis: anatomy of a dermatology podcast

Background: The teaching of dermatology in medical schools is variable, and in many cases, minimal1. Postgraduate teaching of dermatology is similar, despite skin diseases comprising 15% of the work of GPs in Australia2. Aim and method: At the Skin Health Institute, we created a free, open-access podcast series on skin disease and dermatology, called Spot Diagnosis, aimed at educating medical students and GPs/GP trainees. Results: Spot Diagnosis was launched in March 2020, just as the COVID-19 pandemic hit Australia. Despite this, Spot Diagnosis has been very successful. To date, Spot Diagnosis: 1. Has had more than 10000 downloads in 64 different countries 2. Has made it onto the resource lists of multiple medical schools 3. Has been approved for RACGP and ACRRM CPD points 4. Has been profiled in the mainstream and medical media 5. Is still going strong after two seasons and twenty episodes. Discussion: I would like to explore the rationale behind creating the podcast, especially looking at how we decided on the format, topics, and guests. I would like to discuss the practical aspects of recording and editing a podcast, particularly during the pandemic and how we marketed Spot Diagnosis using social media. Finally, I would like to highlight how we, as dermatology educators, engaged successfully with the brave new world of FOAMed (Free-online medical education).

Molecular pathogenesis of cardiac microthrombi in fatal covid-19: Insights from clinicohistopathologic and single nuclei rna sequencing analyses

Cardiac microthrombi are postulated to underlie cardiac injury in critical COVID-19. To determine pathogenic mechanism(s) of cardiac injury in fatal COVID-19, we conducted a single-center prospective cohort study of 69 consecutive COVID-19 decedents. Microthrombi was the most commonly detected acute cardiac histopathologic feature (n=48, 70%). We tested associations of cardiac microthrombi with biomarkers of inflammation, cardiac injury, and fibrinolysis and with inhospital antiplatelet therapy, therapeutic anticoagulation, and corticosteroid treatment, while adjusting for multiple clinical factors, including COVID-19 therapies. Higher peak ESR and CRP during hospitalization were independently associated with higher odds of microthrombi (ESR, Pnonlinearity 0.015, Passociation=0.008;CRP per 20mg/L increase, OR 1.17, 95%CI 1.00-1.36). Using single nuclei RNA-sequence analysis, we discovered an enrichment of prothrombotic, anti-fibrinolytic, and extracellular matrix signaling amongst cardiac fibroblasts in microthrombi-positive COVID-19 hearts, compared with microthrombi-negative COVID-19 hearts and non-COVID-19 donor hearts. Our cumulative findings identify these specific transcriptomic changes in cardiac fibroblasts as salient features of COVID-19-associated cardiac microthrombi.

Adaptations of Breast Imaging Centers to the COVID-19 Pandemic: A Survey of California and Texas

Objective: To determine the early impact of the COVID-19 pandemic on breast imaging centers in California and Texas and compare regional differences. Methods: An 11-item survey was emailed to American College of Radiology accredited breast imaging facilities in California and Texas in August 2020. A question subset addressed March-April government restrictions on elective services ("during the shutdown" and "after reopening"). Comparisons were made between states with chi-square and Fisher's tests, and timeframes with McNemar's and paired t-tests. Results: There were 54 respondents (54/240, 23%, 26 California, 28 Texas). Imaging volumes fell during the shutdown and remained below pre-pandemic levels after reopening, with reduction in screening greatest (ultrasound 12% of baseline, mammography 13%, MRI 23%), followed by diagnostic MRI (43%), procedures (44%), and diagnostics (45%). California reported higher volumes during the shutdown (procedures, MRI) and after reopening (diagnostics, procedures, MRI) versus Texas (P=0.001-0.02). Most screened patients (52/54, 96% symptoms and 42/54, 78% temperatures), and 100% (53/53) modified check-in and check-out. Reading rooms or physician work were altered for social distancing (31/54, 57%). Physician mask (45/48, 94%), gown (15/48, 31%), eyewear (22/48, 46%), and face shield (22/48, 46%) use during procedures increased after reopening versus pre-pandemic (P<0.001-0.03). Physician (47/54, 87%) and staff (45/53, 85%) financial impacts were common, but none reported terminations. Conclusion: Breast imaging volumes during the early pandemic fell more severely in Texas than in California. Safety measures and financial impacts on physicians and staff were similar in both states.