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PurposeA smart city is a city that functions in a sustainable and intelligent way, by integrating all of its infrastructures and services in a cohesive way using intelligent devices for monitoring and control, to ensure efficiency and better quality of life for its citizens. As other countries globally, the UK is keen on economic development and investment in smart-city missions to create interest in monetary environment and inward investment. This paper aims to explore the driving forces of smart road transport transformation and implementation in the UK.Design/methodology/approachThe study involved interviews with 16 professionals from the UK road transport sector. A semi-structured interview technique was used to collect experts' perception, which was then examined using content analysis.FindingsThe results of the study revealed that the technological advancement is a key driver. The main challenges faced during the implementation of smart-city elements in the UK road network are lack of investment, maintenance, state of readiness and the awareness of the smart road transport concept. The study concludes that an understanding of the concept of smart cities from a road transport perspective is very important to create awareness of the benefits and the way it works. A wider collaboration between every sector is crucial to create a successful smart city.Originality/valueThe study contributes to the field of digitalisation of road transport sector. This paper reveals the key driving forces of smart road transport transformation, the current status of smart road transport implementation in the UK and challenges of the smart road transport development in the UK.

PurposeThe UK water industry is a private sector that has no government mandate to implement building information modelling (BIM) but would benefit from its use. Research has identified that fragmentation and inefficiency still existed in the water industry project delivery processes. These issues can be addressed by harnessing the collaboration that BIM brings by using emerging information technology. The UK water industry has had little research in the use of BIM in the project delivery processes over the years.Design/methodology/approachThe aim of the research is to explore and examine BIM elements currently used in the water industry, as well as understand the organisational cultural support for BIM. It also investigated the adoption of BIM which will enable to improve water industry project delivery processes. An empirical study was performed in the UK given the relatively new and unexplored nature of the research problem, a qualitative research methodology was adopted. In total, 14 semi-structured interviews from six water sector organisations were conducted to collect data, which was then analysed using thematic analysis for inference and conclusion.FindingsThe study identified that BIM has already changed how projects are delivered by the water companies and their supply chain. Use of emerging technology such as Autodesk Revit, Civil 3D and virtual reality has gained traction and is leading organisations to continue investing in these areas to remain relevant. Although staff training was offered by all organisations within the study cohort, some interviews still thought that more can be done by their organisations as BIM is still maturing. Those interviewed regarded BIM models as data and information rich with the ability to enable the supply chain to obtain quicker approvals.Originality/valueThe paper provides a richer insight into the understanding and awareness of BIM elements used in the water industry to improve project delivery processes. This study suggests that the water industry supply chain has taken positive steps and started to benefit from BIM use. It also recommends that there is a need for cross-sector collaboration to capture and share best and worst practices relating to BIM adoption in the water sector.

In the global context, Building Information Modeling (BIM) is a catalytic agent for innovation, productivity, and efficiency in the construction industry. BIM adoption in Kenya is rare, whereas the volume of construction is poised to increase and the gains that can be achieved via its use could be enormous. In the UK, all projects are to use a minimum of level two BIM to enhance collaboration and coordination with visual aids and a common data environment that enhances communication with the project proponents and all the other stakeholders. The main aim of this study was to determine the BIM gaps in terms of awareness and use in order to form a basis for the development of future adoption strategies in infrastructure projects in Kenya. The research was carried out in Nairobi and London. The study was designed as a survey that started with a desk study followed by semi-structured interviews. Analysis of the data was done using content analysis. The findings identify significant differences in BIM awareness and use, the influence of which could provide insight for the developed and developing countries. The state of research, training, and practice pertaining to BIM in Kenya remains largely undocumented, whereas in the UK, there are national-level initiatives driving its adoption. This paper concludes that BIM success is dependent on close collaboration between the client, consultants, contractors, and suppliers along with the establishment of a well-developed BIM protocol and the lessons learnt from the UK can easily be used by Kenya as it embarks on its BIM journey for an efficient and harmonious working environment in this era of globalization.

The Building Information Model concepts include a range of IT tools supporting the collaborative processes in an organisation. This approach allows all stakeholders to have an integrated system in which editing and retrieving up to date information on shared models will become easier changing the businesses processes. This paper will be presenting a review of research on the Building Information Model in practice. The Building Information Model has been around for some time and is becoming more popular as of its mandate in the UK back in April 2016. This research is based on case studies on BIM in practice in the transport infrastructure sector. The methodology for this research is a case study on a Tier 1 contractor in the UK who are using BIM as one of their processes. A brief overview of BIM will be explained and the key findings in the research will be highlighted identifying the business value of BIM, the results will demonstrate how BIM is being practised within the organisation and to improve design management, the challenges with the implementation of the new processes will be outlined, this paper will also show how the construction company have utilised the adoption of BIM to mitigate and manage communication issues within their projects. Research has shown that the key communication and management problems such as loss of documentation, poor communication and quality can be mitigated with the use of BIM. Finding out these challenges will allow the issues found along with the potential of BIM to be outlined and allows the conclusion that BIM is the future of construction.

By 2050, Two thirds of the world's population are soon to be residing in cities, this means a rise in the number of people and cars on roads, currently 55% of the world's population currently live in urban areas and this percentage is estimated to rise to 68% over the next 30 years. Smart motorways are one of the implemented strategies to accommodate for the population growth, smart motorways were introduced in 2006 and was first implemented on the M42 in the West Midlands in UK. Smart motorways are well known in the UK as there are many schemes constructing them at this time, the popular question which is asked by the public is what is a smart motorway and why is it smart? This paper is aimed to evaluate smart motorways, how they operate and what makes them smart. This paper will be beneficial to any researchers on technology in smart cities and widen knowledge on smart motorways. This paper also explores issued faced with contractors when constructing these smart motorways, the technologies used within the smart motorways will be discussed and technologies used within the construction stage will also be analysed. This paper will conclude on smart cities, are they worth it?

The UK government has defined BIM level 2 as a set of processes and standards that validate and control collaborative practices for the production, sharing and exchange of information during all stages of construction. All public-sector projects in the UK are mandated to be BIM level 2 compliant as of April 2016, and with this being a mandate, companies in the UK must understand the knowledge exchange partnership framework which will enable the organizations to successfully achieve the requirements in terms of the collaborative practices. This paper is based on a case study which focuses on the implementation of BIM Level 2 collaborative practices for a major infrastructure construction company in the UK who are Tier 1 contractors. The main aim for this paper is to investigate how the organizations are implementing collaborative practices which follow level 2 requirement. The key findings of this research suggest that with the use of BIM, organizations can improve collaboration with the right workflow implemented correctly. Implementing a BIM collaborative workflow would be enhanced by having a lot of training and raising awareness within the organization. Benefits from this research paper include making people aware of processes that need to be changed within a business to implement BIM correctly and enable the knowledge management process to become useful and provide benefits towards an organization. Results from this research will be documented in this paper and key highlight such as what challenges are being faced and how they are being overcome, these obstacles will be explored which will provide potential improvements for the future.

Adults with beta thalassemia major frequently have low BMD, fractures, and bone pain. The purpose of this study was to determine the prevalence of low BMD, fractures, and bone pain in all thalassemia syndromes in childhood, adolescence, and adulthood, associations of BMD with fractures and bone pain, and etiology of bone disease in thalassemia. Patients of all thalassemia syndromes in the Thalassemia Clinical Research Network, > or =6 yr of age, with no preexisting medical condition affecting bone mass or requiring steroids, participated. We measured spine and femur BMD and whole body BMC by DXA and assessed vertebral abnormalities by morphometric X-ray absorptiometry (MXA). Medical history by interview and review of medical records, physical examinations, and blood and urine collections were performed. Three hundred sixty-one subjects, 49% male, with a mean age of 23.2 yr (range, 6.1-75 yr), were studied. Spine and femur BMD Z-scores < -2 occurred in 46% and 25% of participants, respectively. Greater age, lower weight, hypogonadism, and increased bone turnover were strong independent predictors of low bone mass regardless of thalassemia syndrome. Peak bone mass was suboptimal. Thirty-six percent of patients had a history of fractures, and 34% reported bone pain. BMD was negatively associated with fractures but not with bone pain. Nine percent of participants had uniformly decreased height of several vertebrae by MXA, which was associated with the use of iron chelator deferoxamine before 6 yr of age. In patients with thalassemia, low BMD and fractures occur frequently and independently of the particular syndrome. Peak bone mass is suboptimal. Low BMD is associated with hypogonadism, increased bone turnover, and an increased risk for fractures.

External beam radiation therapy (XRT) is frequently used to treat refractory disease sites or consolidate remission in patients with relapsed non-Hodgkin's lymphoma (NHL) prior to autologous bone marrow transplantation (ABMT). We report the long-term outcome and toxicities associated with this therapy. We uniformly treated 552 patients with NHL with total body irradiation, high-dose chemotherapy, and anti-B-cell monoclonal antibody-purged ABMT. Of these patients, 152 received XRT to the mediastinum, abdomen, or pelvis (n = 102) or other sites (n = 50) prior to ABMT. In this nonrandomized series, there was no difference in progression-free survival between patients treated with XRT and those not treated with XRT. For patients with indolent histology, there was no difference in overall survival between patients treated with XRT and those not treated with XRT. For patients with aggressive histology, the median overall survival time was 64 months in the XRT patients and 79 months in the patients not treated with XRT (P= .09). The risk of acute transplantation-related deaths was not influenced by prior XRT (P = .68). Of patients who received XRT, 12.5% developed secondary myelodysplasia compared with 5.8% of patients not receiving XRT (P = .01). Patients receiving XRT to the mediastinum or axilla had a significantly higher risk of late respiratory death (P = .002). In conclusion, XRT allows refractory patients to become eligible for transplantation and experience a disease-free survival interval equivalent to that of patients who do not receive XRT. However, a higher incidence of non-relapse-associated deaths was observed in patients who received XRT. Future work should explore alternative conditioning strategies and altered timing of XRT, in an attempt to limit these late toxicities.

We report the results of high-dose chemoradiotherapy and anti–B-cell monoclonal antibody-purged autologous bone marrow transplantation (ABMT) in patients with relapsed indolent follicular lymphoma. Between March 1985 and May 1995, 153 patients underwent ABMT using a uniform ablative regimen with cyclophosphamide and total body irradiation and bone marrow (BM) purging. All patients received multiple chemotherapy regimens before ABMT. At BM harvest, only 30% of patients were in complete remission, and overt BM infiltration was present in 47%. The disease-free survival (DFS) and overall survival (OS) are estimated to be 42% and 66% at 8 years, respectively. Patients whose BM was negative by polymerase chain reaction (PCR) for bcl2/IgH rearrangement after purging experienced longer freedom from recurrence than those whose BM remained PCR positive (P < .0001). Continued PCR negativity in follow-up BM samples was also strongly predictive of continued complete remission (CR). The 12-year survival from diagnosis for these 153 patients is 69%. Considering that the median survival from diagnosis and first recurrence of patients with advanced follicular lymphoma are 8 and 5 years, respectively, our results provide evidence that myeloablative therapy and ABMT may prolong overall survival.

PURPOSE: The absolute risk of myelodysplastic syndrome (MDS) after autologous bone marrow transplant (ABMT) for non–Hodgkin's lymphoma (NHL) exceeds 5% in several reported series. We report the outcome of a large cohort of patients who developed MDS after ABMT for NHL. PATIENTS AND METHODS: Between December 1982 and December 1997, 552 patients underwent ABMT for NHL, with a uniform ablative regimen of cyclophosphamide and total body irradiation followed by reinfusion of obtained marrow purged with monoclonal antibodies. MDS was strictly defined, using the French-American-British classification system, as requiring bone marrow dysplasia in at least two cell lines, with associated unexplained persistent cytopenias. RESULTS: Forty-one patients developed MDS at a median of 47 months after ABMT. The incidence of MDS was 7.4%, and actuarial incidence at 10 years is 19.8%, without evidence of a plateau. Patients who developed MDS received significantly fewer numbers of cells reinfused per kilogram at ABMT (P = .0003). Karyotypes were performed on bone marrow samples of 33 patients, and 29 patients had either del(7) or complex abnormalities. The median survival from diagnosis of MDS was 9.4 months. The International Prognostic Scoring System for MDS failed to predict outcome in these patients. Thirteen patients underwent allogeneic BMT as treatment for MDS, and all have died of BMT-related complications (11 patients) or relapse (two patients), with a median survival of only 1.8 months. CONCLUSION: Long-term follow-up demonstrates a high incidence of MDS after ABMT for NHL. The prognosis for these patients is uniformly poor, and novel treatment strategies are needed for this fatal disorder.

Contamination of hematopoietic stem cells (HSCs) with tumor cells has been associated with increased incidence of relapse in patients with non-Hodgkin's lymphoma following autologous HSC transplantation. Effective purging of tumor cells may improve the results of HSC transplantation, but current methods of purging are technically difficult to perform with large numbers of cells and do not consistently remove all detectable cells. We report a pilot clinical trial in which 10 patients with relapsed B-cell non-Hodgkin's lymphoma received high-dose chemotherapy followed by infusion of autologous HSCs depleted of B-cells by high-density microparticles (HDM) coated with anti-CD19 and anti-CD20 monoclonal antibodies (BCell-HDM). HSCs were mobilized with cyclophosphamide and granulocyte colony-stimulating factor. In 6 of the 10 patients, B-cells were detectable by immunocytochemical analysis of the apheresis products prior to treatment. Following treatment with the BCell-HDM, no B-cells were detected in the products from 5 of these patients, a result representing a median depletion of >2.2 logs (range, >0.4 to >5.1 logs). The median recovery of nontarget cells postdepletion was 73% for CD34 cells and 78% for CD3+ cells. All patients received high-dose cyclophosphamide, BCNU (carmustine), and etoposide prior to reinfusion of their B-cell-depleted autologous HSCs. The median number of CD34+ cells cryopreserved was 3.6 x 10(6) cells/kg (range, 2.2-10.1 x 10(6) cells/kg). Engraftment was rapid in all cases, with a median time to achieve an absolute neutrophil count of 0.5 x 10(9)/L of 10 days (range, 8-11 days). The median time to achieve a platelet count of 20 x 10(9)/L unsupported by platelet transfusion was 11.5 days (range, 8-17 days). This nonmagnetic negative-depletion technology is simple, rapid, and effective in depleting target cells to undetectable levels, with excellent recovery of nontarget cells.Biol Blood Marrow Transplant 2002;8(8):429-34.