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With the increasing expectations of clients and the growing complexity of the built environment, property management teams are facing constant pressure to effectively manage and rectify defects for improved building operational efficiency and performance. This study aims to develop and validate a defect correlation evaluation model for project and property management professionals by specifically (i) examining the defect detection and management mechanisms of residential buildings and (ii) quantifying the mechanical characteristics of defects by using association rules mining (ARM) techniques. In addressing the limitations of current evaluation approaches, this study proposed an ARM evaluation model that integrated, contextualized, and operationalized building defects into work type, location, elements, and defect type. The association between these classifications was explored and mapped. Among the resulting 123 meaningful rules, rules occurred at a rate of about 62% of the same work type in the linked work type, nearly 193% of the same element in another element, and about 23% of the close location in the far location. In conclusion, this study informs project and property management professionals of the key and complex associations between defects of different characteristics and highlights the most common occurrence defects in residential apartment buildings. Thus, this helps reduce the ambiguity and subjectivity of prioritization in defect management and facilitates maintenance and repair planning.Graphical Abstract

The current total cavopulmonary connection Fontan has competing inflows and outflows, creating hemodynamic inefficiencies that contribute to Fontan failure and complicate placement and efficiency of mechanical circulatory support. We propose a novel convergent cavopulmonary connection (CCPC) Fontan design to create a single, converged venous outflow to the pulmonary arteries, thus increasing efficiency and mechanical circulatory support access. We then evaluate the feasibility and hemodynamic performance of the CCPC in various patient sizes using computational fluid dynamic assessments of computer-aided designs.

Inspired by the melanogenesis occurring in nature, we report tyrosinase-mediated antifouling surface coating by synthesizing a tyrosine-conjugated sulfobetaine derivative (Tyr-SB). Synthetic Tyr-SB contains zwitterionic sulfobetaine and tyrosine, whose phenolic amine group acts as a dormant coating precursor. In contrast to catecholamine derivatives, tyrosine derivatives are stable against auto-oxidation and are enzymatically oxidized only in the presence of tyrosinase to initiate melanin-like oxidation. When the surface of interest was applied during the course of Tyr-SB oxidation, a superhydrophilic poly(Tyr-SB) film was coated on the surfaces, thereby showing antifouling performance against proteins or adherent cells. Because the oxidation of Tyr-SB occurred under mild aqueous conditions (pH 6–7) without the use of any chemical oxidants, such as sodium periodate or ammonium persulfate, we anticipate that the coating method described herein will serve as a biocompatible tool in the field of biosensors, cell surface engineering, and medical devices, whose interfaces differ in chemistry.

Background:Postoperative outcomes of the Fontan operation have been linked to geometry of the cavopulmonary pathway, including graft shape after implantation. Computational fluid dynamics (CFD) simulations are used to explore different surgical options. The objective of this study is to perform a systematic in vitrovalidation for investigating the accuracy and efficiency of CFD simulation to predict Fontan hemodynamics. Methods:CFD simulations were performed to measure indexed power loss (iPL) and hepatic flow distribution (HFD) in 10 patient-specific Fontan models, with varying mesh and numerical solvers. The results were compared with a novel in vitroflow loop setup with 3D printed Fontan models. A high-resolution differential pressure sensor was used to measure the pressure drop for validating iPL predictions. Microparticles with particle filtering system were used to measure HFD. The computational time was measured for a representative Fontan model with different mesh sizes and numerical solvers. Results:When compared to in vitrosetup, variations in CFD mesh sizes had significant effect on HFD (P=  .0002) but no significant impact on iPL (P=  .069). Numerical solvers had no significant impact in both iPL (P=  .50) and HFD (P=  .55). A transient solver with 0.5 mm mesh size requires computational time 100 times more than a steady solver with 2.5 mm mesh size to generate similar results. Conclusions:The predictive value of CFD for Fontan planning can be validated against an in vitroflow loop. The prediction accuracy can be affected by the mesh size, model shape complexity, and flow competition.

Mental health and substance abuse patients face many challenges in receiving effective long-term outpatient behavioral therapies, including issues related to accessibility and personalized care. Mobile health technologies, particularly those integrating virtual reality (VR), are increasingly becoming more accessible and affordable, thus providing a potential avenue to deploy outpatient behavioral therapy. This paper proposes a method to address the aforementioned challenges by personalizing and validating VR simulation content for behavioral therapy. An initial demonstration will be performed for tobacco cessation, which is a critical public health treatment area for mental illness and substance abuse. The method empirically builds smoker personas from theoretically grounded survey content. The personas are then used to design and pilot VR simulation modules tailored to behavioral interventions, which will be tested in the patient population. The VR simulation will record a subject’s emotions and brain activities in real-time through subjective (surveys) and objective (neurophysiology) measures of emotional response. The overall goal of the study is to validate the VR content by demonstrating that significant differences are seen in emotional response when presenting content personalized for the patient.

Patient telemetry monitoring stations in hospitals have received considerable attention due to the widely reported incidents of patient deaths linked to operator error. Monitoring stations are one of the most critical environments in a healthcare setting, where telemetry technician delayed response or failure to respond may contribute to adverse patient events. The technician’s task is to monitor patient vital signs and respond to irregular patient vitals by communicating this event to the patient care team. Poorly designed monitoring stations can potentially increase technician cognitive workload and stress, and decrease performance (time to respond, accuracy of response). This paper introduces a novel approach to evaluate the impact of monitoring station design on telemetry technician performance through the use of neurophysiological measurement (heart rate, heart rate variability, blood pressure, electroencephalography, core temperature, eye tracking) in a virtual reality (VR) environment. VR provides several benefits over conventional 2D simulations and physical mock-ups by providing an immersive environment where design alternatives can be generated with greater flexibility and speed and also without interfering with daily operations in a safety-critical environment. A replicate model of a telemetry monitoring station at MedStar Washington Hospital Center was simulated in VR. Features such as monitor layout, the number of patients simultaneously monitored, and the graphical user interface design, will be modified to evaluate technician performance for each design alternative. The outcomes of this research can be used to inform telemetry room design across several hospital settings and ultimately reduce adverse patient events due to poor telemetry technician performance.

Introduction:Tissue-engineered vascular grafts guided by computer-aided designs (CAD) using computational fluid dynamic (CFD) simulation can create novel Fontan conduits unconstrained by available materials and optimized for patient-specific anatomy. However, the relative contributions of both surgical expertise and CAD to Fontan designs have not been assessed. In this study, we used CFD to study the hemodynamic performance of ten Fontan conduits, as well as redesigns performed with by CAD and a novel, clay sculpturing method (Surgeon?s Unconstrained Modelling - SUM).Methods:Ten cardiac MRI datasets were used to create three-dimensional (3D) models of original Fontans. Baseline CFD simulations assessed hepatic flow distribution (HFD), indexed power loss (iPL) and risk for venous thrombosis. Thrombosis risk was defined by % of conduit with wall shear stress <1 dyne/cm2 (%WSS). Eight Fontans did not meet parameter thresholds, and were redesigned using both CAD and SUM. For CAD, a 3D-digital version of the heart and superior cavopulmonary connection was sent to the engineering team for redesign, iteratively guided by CFD. For SUM, the surgeon (blinded to CAD redesign) was provided a 3D-print of the same anatomy and sculpted a clay Fontan, that was 3D-scanned. Final CFD analyses of both models, including iPL, HFD and WSS, were compared.Results:Eight pairs of Fontan conduits were created by CAD and SUM. When compared to original Fontan, both CAD and SUM redesigns had significantly improved iPL (Figure 1A). %WSS is noted to balance designs that decrease iPL but increase thrombosis risk; an inverse relationship is noted between iPL and %WSS (Figure 1B). Fontan conduits by CAD also demonstrated improved balance in HFD and lower %WSS (Figure 1A).Conclusions:Surgeons design patient-specific Fontan conduits with low iPL. CAD further improves the HFD and %WSS results. Future design studies could incorporate %WSS, as well as workflows that combine CAD and SUM design methods.