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Yang, Heyoung, Su Youn Kim, and Seongmin Yim. "A Case Study of the Korean Government’s Preparation for the Fourth Industrial Revolution: Public Program to Support Business Model Innovation." Journal of Open Innovation: Technology, Market, and Complexity 5, no. 2 (June 21, 2019): 35. http://dx.doi.org/10.3390/joitmc5020035.
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The Fourth Industrial Revolution caused by innovative technologies is an irresistible megatrend, and many companies, institutions, and major countries are making efforts to participate. The World Economic Forum took the lead in discussing the Fourth Industrial Revolution, adding the issue to its 2016 agenda, and found that many governments, including that of Korea, were concerned about how to support their nation’s participation in the Fourth Industrial Revolution and were pursuing programs to support such efforts. In this study, we describe one of those programs, the Korean government’s Flagship Project Support Program (FPSP), which supports latecomers in creating open platforms and creating new business ideas in innovative technological industries. The program helps businesses overcome entry barriers to existing business ecosystems established by big technological players in growing fields such as smart cars, the Internet of Things (IoT), virtual reality (VR), etc. The purpose of this study is to determine whether latecomers and small- and medium-sized companies that are experiencing difficulties in their own innovation can succeed in innovation through the Korean government’s FPSP. This study performed a comprehensive and qualitative analysis based on the Logic Model Framework consisting of an investigation of business ecosystems before and after the FPSP, assessment of outcomes, and evaluation of the effectiveness of the FPSP. This study shows that open platforms resulting from the FPSP successfully innovated business models in Korea. Our study, therefore, has implications for other governments seeking to play a role in supporting the Fourth Industrial Revolution.
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Mamali, Cătălin. "Character self-construction and moral principles – general theoretical framework." Filozofia Publiczna i Edukacja Demokratyczna 4, no. 2 (December 15, 2015): 6. http://dx.doi.org/10.14746/fped.2015.4.2.13.
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Cholamjiak, Prasit, and Pongsakorn Sunthrayuth. "A halpern-type iteration for solving the split feasibility problem and the fixed point problem of Bregman relatively nonexpansive semigroup in Banach spaces." Filomat 32, no. 9 (2018): 3211–27. http://dx.doi.org/10.2298/fil1809211c.
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We study the split feasibility problem (SFP) involving the fixed point problems (FPP) in the framework of p-uniformly convex and uniformly smooth Banach spaces. We propose a Halpern-type iterative scheme for solving the solution of SFP and FPP of Bregman relatively nonexpansive semigroup. Then we prove its strong convergence theorem of the sequences generated by our iterative scheme under implemented conditions. We finally provide some numerical examples and demonstrate the efficiency of the proposed algorithm. The obtained result of this paper complements many recent results in this direction.
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Cheng, Xu, Xingjian Liu, Zhongwei Li, Kai Zhong, Liya Han, Wantao He, Wanbing Gan, Guoqing Xi, Congjun Wang, and Yusheng Shi. "High-Accuracy Globally Consistent Surface Reconstruction Using Fringe Projection Profilometry." Sensors 19, no. 3 (February 6, 2019): 668. http://dx.doi.org/10.3390/s19030668.
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This paper presents a high-accuracy method for globally consistent surface reconstruction using a single fringe projection profilometry (FPP) sensor. To solve the accumulated sensor pose estimation error problem encountered in a long scanning trajectory, we first present a novel 3D registration method which fuses both dense geometric and curvature consistency constraints to improve the accuracy of relative sensor pose estimation. Then we perform global sensor pose optimization by modeling the surface consistency information as a pre-computed covariance matrix and formulating the multi-view point cloud registration problem in a pose graph optimization framework. Experiments on reconstructing a 1300 mm × 400 mm workpiece with a FPP sensor is performed, verifying that our method can substantially reduce the accumulated error and achieve industrial-level surface model reconstruction without any external positional assistance but only using a single FPP sensor.
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Rodrigues, Paulo Henrique, and Márcia Cristina de Costa Trindade Cyrino. "Aspectos da prática pedagógica considerados na elaboração de um caso multimídia para formação de professores que ensinam Matemática." Ciência & Educação (Bauru) 23, no. 3 (July 2017): 577–95. http://dx.doi.org/10.1590/1516-731320170030003.
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Resumo: Este artigo tem como objetivo discutir aspectos da prática pedagógica, considerados por um grupo de estudos e pesquisa na elaboração de um caso multimídia a ser utilizado na formação de professores que ensinam Matemática (FPEM). Foi realizada uma pesquisa qualitativa de cunho interpretativo, cuja análise das informações incidiu sobre as negociações de significados e reflexões compartilhadas pelos membros desse grupo, na elaboração de um caso multimídia, em três empreendimentos: discussão de artigo e elaboração de um framework, discussão de casos multimídia portugueses e estruturação do caso multimídia "Os colares". Para apresentação dos resultados, foi associado o conjunto de aspectos da prática pedagógica, mobilizados por tal grupo, no planejamento e na prática da professora protagonista do caso multimídia "Os colares". Esses aspectos revelam as expectativas do grupo de a exploração de casos multimídia, na FPEM, ser uma oportunidade de construção e desenvolvimento da identidade profissional de (futuros) professores que ensinam Matemática.
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Alsetoohy, Omar, and Baker Ayoun. "Intelligent agent technology." Journal of Hospitality and Tourism Technology 9, no. 1 (March 12, 2018): 109–24. http://dx.doi.org/10.1108/jhtt-04-2017-0028.
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Purpose This paper aims to empirically investigate the influence of the intelligent agent technology (IAT) on hotels’ food procurement practices (FPPRs) and food procurement performance (FPP). The study also explores the influence of FPPR on FPP in hotels. Design/methodology/approach Data from a survey of managers at luxury hotels in Florida, which yielded an effective sample of 78, were subjected to partial least squares structural equation modeling analysis. Findings IAT usage has statistically significant positive effect on both FPPR and FPP. Additionally, the results indicated that PPR has a positive influence on FPP. Research limitations/implications The study provided academia with a comprehensive review of the prior research on IAT benefits in food supply chain management (FSCM) and a comprehensive explanation of how the hotel FPPR are being performed by IAT. It also offers industry and technology specific insights. Practical implications Hotel managers should pay more attention to IAT application regarding the FPPR, specifically gathering information, supplier contract, contacting, requisitioning and intelligence and analysis. Moreover, hotel managers should enhance their employees’ abilities to be technology-oriented to maximize IAT benefits in FPP. Originality/value The results represent an extension to the technological innovation literature of the hospitality industry to bridge the gap of IAT in hotel FP. The framework used in the study serves as a foundation for future research studies in the hospitality industry, in FSCM in particular.
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Demyanov, G. V. "The Results Of Work At Creating the State Geocentric Coordinate System WithIn the FPP GLONASS Framework." Geodesy and Cartography 870, no. 13 (December 31, 2012): 22–24. http://dx.doi.org/10.22389/0016-7126-2012-22-24.
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Nowak, Ewa. "Can human and artificial agents share an autonomy, categorical imperative-based ethics and “moral” selfhood?" Filozofia Publiczna i Edukacja Demokratyczna 6, no. 2 (June 28, 2018): 169–208. http://dx.doi.org/10.14746/fped.2017.6.2.20.
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AI designers endeavour to improve ‘autonomy’ in artificial intelligent devices, as recent developments show. This chapter firstly argues against attributing metaphysical attitudes to AI and, simultaneously, in favor of improving autonomous AI which has been enabled to respect autonomy in human agents. This seems to be the only responsible way of making further advances in the field of autonomous social AI. Let us examine what is meant by claims such as designing our artificial alter egos and sharing moral selves with artificial humanoid devices as well as providing autonomous AI with an ethical framework modelled upon the core aspects of moral selfhood, e.g., making decisions which are based on autonomous law-giving, in Kantian terms.
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Fallahpour, Alireza, Kuan Yew Wong, Srithar Rajoo, Ezutah Udoncy Olugu, Mehrbakhsh Nilashi, and Zenonas Turskis. "A FUZZY DECISION SUPPORT SYSTEM FOR SUSTAINABLE CONSTRUCTION PROJECT SELECTION: AN INTEGRATED FPP-FIS MODEL." JOURNAL OF CIVIL ENGINEERING AND MANAGEMENT 26, no. 3 (March 20, 2020): 247–58. http://dx.doi.org/10.3846/jcem.2020.12183.
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Sustainability has become a key concern for project selection in construction industries. Determining the best sustainable project based on various sustainability attributes is a very complicated decision. Accordingly, developing a suitable decision support framework can be very helpful for decision makers to attain planned business goals and complete projects at the right time with good quality. This research develops a decision support model which helps managers to understand the concept of sustainability in construction project selection and choose the best project using a new integrated Multi-Criteria Decision Making (MCDM) approach under uncertainty by integrating Fuzzy Preference Programming (FPP) as a modification of Fuzzy Analytical Hierarchy Process (FAHP), with Fuzzy Inference System (FIS) as a fuzzy rulebased expert system. In the first phase of the research, fifteen sustainability attributes were selected. In the second phase, the final weight of each attribute was computed by using FPP. In the last phase, the most appropriate project was selected by running the weighted FIS. The results showed that Project 3 (P3) is the best project. Finally, two different evaluative tests were also applied to verify the validity and robustness of the developed model.
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Bekrycht, Tomasz. "Republikanizm i liberalizm w świetle idei konstytucjonalizmu. Uwagi o legitymizacji prawa." Filozofia Publiczna i Edukacja Demokratyczna 7, no. 1 (September 10, 2018): 26–39. http://dx.doi.org/10.14746/fped.2018.7.1.2.
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This paper addresses two key issues. The first involves an analysis of the connections between the ideas of republicanism, liberalism and constitutionalism. The second concerns the republican idea of self-determination and, consequently, the issue of the legitimation of law. The first section of the paper puts forward the thesis that constitutionalism can nowadays be understood as the idea of the legitimization of positive law, involving the synthesis of the two key values proclaimed by republicanism and liberalism, namely self-determination and negative freedom. The issue here is that the ideas of self-determination and negative freedom are both counterfactual, and the only area in which they can be synthesized is within the conceptual framework of positive law. The second section of the paper constitutes the justification of this thesis.
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Riera, Pedro. "Voting after the change: A natural experiment on the effect of electoral reform on party system fragmentation." International Political Science Review 41, no. 2 (March 27, 2019): 271–86. http://dx.doi.org/10.1177/0192512118822891.
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This article analyses the causal effect of the 1993 electoral reform in New Zealand on party system fragmentation using the ‘synthetic’ control method. Previous studies using cross-national evidence suggest that electoral reforms change the number of parties. However, they do not take into account possible endogeneity problems and usually focus on their short-term effects. Since the electoral system in use in this country before the change was first past the post (FPTP), I can create a ‘synthetic’ control democracy that had the same institutional framework but did not modify the rules of the game. The results indicate that the electoral reform produced the expected effects on party system size at the electoral level, but that these effects tended to disappear in the long run. In contrast, electoral system effects at the legislative level were larger and stickier over time.
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Boluda, Alvaro, Carmen Casado, Beatriz Alonso, and M. García Armada. "Efficient Oxidase Biosensors Based on Bioelectrocatalytic Surfaces of Electrodeposited Ferrocenyl Polycyclosiloxanes—Pt Nanoparticles." Chemosensors 9, no. 4 (April 15, 2021): 81. http://dx.doi.org/10.3390/chemosensors9040081.
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The in-situ synthesis of catalytic surfaces with metallic nanoparticles must overcome the issues related to particle aggregation and polydispersity in the particle size. This work achieves it by using two electrodeposited ferrocenyl polycyclosiloxane polymers (MFPP and FPP) as templates for electro-synthesize Pt nanoparticles (PtNPS). In addition, this new electrode surface combines two efficient electrocatalysts: Ferrocene and Pt nanoparticles, with synergistic biocatalytic properties that constitute an electrocatalytic framework for the covalent immobilization of xanthine oxidase. In this work, we present the results of the kinetic, electrochemical and analytical studies of the prepared electrodes. These results showed that the PtNPs/FPP system is the best bioelectrocatalytic surface and improves other more complex xanthine oxidase devices based on the hydrogen peroxide oxidation, allowing the use of lower measuring potential with good sensitivity, wider linear ranges and low detection limits. In addition, this electrode provides the novelty of allowing the measurement of xanthine through the enzymatic consumption of oxygen at potential −0.1 V with a sensitivity of 1.10 A M−1 cm−2, linear ranges of 0.01–0.1 and 0.1–1.4 mM, low detection limit (48 nM) and long-term stability. The new device has been successfully applied to the determination of xanthine in fish meat.
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Zalewska, Monika. "Znaczenie metafor pojęciowych na przykładzie prawa autorskiego." Filozofia Publiczna i Edukacja Demokratyczna 5, no. 1 (June 4, 2018): 111–28. http://dx.doi.org/10.14746/fped.2016.5.1.6.
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The problematic gap between legal and social norms exists in copyright law. The consequences of this gap are severe and include: not following copyright rules, and a big conflict between artists and recipients of a culture. In this context, copyright piracy is prevalent in Poland and legal tools aimed to protect interests of artists have failed. Copyright law might have been in sync with analogue era, but not to digital world. Identification of roots of the discrepancy between social expectations and legally binding rules might be the first step toward rectifying of situation. This article demonstrates the conceptual metaphors as a possible reason for malfunctioning the copyright law. Some metaphors treat intangible objects as tangible ones (intellectual or artistic work) and might pose difficulties mentioned above. Additionally, Larsson defined a group of metaphors in legal system. Bound with them are metaphors outside of law. For example, if law treats intellectual property as tangible property, than metaphors outside the copyright legal system, such as piracy apply. Polish copyright law in the context of Lakoff – Johnson theory of metaphors is a framework of the study.
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Bitner-Wróblewska, Anna. "W poszukiwaniu wspólnego czasu. Ziemie bałtyjskie a Skandynawia we wczesnym okresie wędrówek ludów." Folia Praehistorica Posnaniensia 10 (November 1, 2018): 177–241. http://dx.doi.org/10.14746/fpp.2003.10.08.
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Investigations concerning the mutual contacts between Scandinavia and the south-eastern Baltic zone in the Early Migration Period should be combined with careful chronological studies, otherwise it is not possible to point out the source of inspiration and the direction of contacts. A barrier limited such studies still remains the differences in chronological systems used by the researchers from both sides of the Baltic Sea. The author has proposed the synchronisation of Balt-Scandinavian chronology based on the most common phenomenon in Europe in the Early Migration Period, namely the stamp ornamentation. But instead of rather amorphous styles the horizons of certain artefacts decorated in these styles, Samland and Sosdala horizons, have been distinguished and analysed. The author established the relative chronological sequence of individual artefacts within the Sosdala and Samland horizons. There are three phases of each horizon. In absolute dating the beginning of horizons in question could be placed in the 2nd half of the 4lh c., while their ending in mid 5lh c. Basing on such a framework it was possible to establish the sequences of both Scandinavian and Balt artefacts correlated to each other. It was possible to distinguish six phases: phase 0 preceding the appearance of the Samland and Sosdala horizons, phases 1-3 synchronic with these horizons and phases 4—5 succeeding the horizons in question. The above sequence of phases may be fitted within the interregional chronological framework.
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Kaleta, Krzysztof. "Władza konstytuująca jako przedmiot badań nauk prawnych." Filozofia Publiczna i Edukacja Demokratyczna 7, no. 1 (September 10, 2018): 40–64. http://dx.doi.org/10.14746/fped.2018.7.1.3.
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The article discusses the nature and role of constituent power in contemporary constitutional democracies. It presents the genesis of the concept of constituent power (phrased by Joseph Emmanuel Sieyès within the distinction between «pouvoir constituant» and «pouvoir constitué»), different approaches to this concept framed in the XXth century legal science by such thinkers as H. Kelsen and C. Schmitt, and finally the contemporary interpretations of this concept. The author indicates and analyses two major issues relevant to the nature and role of constituent power in the contemporary constitutional democracy. Firstly, he examines the thesis that the democratic constituent power’s activity remains normatively undetermined. The search for internal normativity that might characterise constituent power in democracy determines such practical constitutional issues as discretion of the legislator within the process of making or amending the constitution. Secondly, the author points out that analysis of the role of pouvoir constituant» in contemporary constitutionalism should not be limited to analysis of the „constitutional moment” only; the significance of constituent power should not be seen just in the framework of the one-off act of making the constitution. Constituent power should remain an active participant of constitutional discourse which induces a search for new principles ensuring balance between constituent and constituted power in constitutional democracies.
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Stobiecka, Monika. "Perspektywy i wyzwania badań na styku archeologii i sztuki." Folia Praehistorica Posnaniensia 24 (December 15, 2019): 263–88. http://dx.doi.org/10.14746/fpp.2019.24.16.
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The main goal of this paper is to reflect on the perspectives and challenges of art and archaeology research. The paper investigates main objectives through the lens of the art historian and archaeologist. Even though, the study on relations between art and archaeology has a long tradition in archaeology and the most famous researchers reflected on those tensions (Colin Renfrew, Michael Shanks, Andrew Jones, Ian Russell, Paul Reilly, Paul Bonaventura), art and archaeology approach is still not a coherent and systematic methodological framework. To deal with this notable lack, the author revises previous studies and points at the possible advantages of the development of studies at the border of art, archaeology and aesthetics. The main problems are illustrated and discussed in reference to archaeological museums and the Polish contemporary art represented by Hubert Czerepok, Agata Ingarden, Agnieszka Kalinowska, Agnieszka Kurant, Robert Kuśmirowski and Joanna Rajkowska.
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Dec, Olga. "Potrzeba rekonceptualizacji wczesnośredniowiecznych pochówków „wampirów” z ziem polskich." Folia Praehistorica Posnaniensia 25 (December 15, 2020): 63–70. http://dx.doi.org/10.14746/fpp.2020.25.03.
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The aim of the article is to outline the need to reconceptualized the early medieval burials of “vampires” from Poland. These burials are understood as the remains of the so-called “anti- vampire” practices resulting from the social perception of bad death. These, in turn, are recognized as a socio-religious phenomenon, the assumption of which was to postpone the evil actions of the ‘vampire’ by means of certain measures. Due to doubts about the term “vampire”, concerning both the linguistic sphere and the cultural and historical realities, it is suggested not to use it. The proposed alternative, more precise terms would therefore be the terms “returning dead” or “(un)dead”. Another issue raised is the setting of ‘anti-vampire’ burials in an atypical framework. “Anti-vampirical” burials meet the criteria of atypicality on a macro scale, however, it is possible to consider them typical, assuming that they functioned in the culture of Western Slavs in the early Middle Ages as belonging to a specific social group.
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Lusk, Edward J., and Michael Halperin. "An Associational Examination of the CaptialCube Effect Context for the MPV over the Linguistic Partitions: Testing Sensitivity & Specificity." Accounting and Finance Research 6, no. 2 (February 27, 2017): 1. http://dx.doi.org/10.5430/afr.v6n2p1.
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In this third examination of the CapitalCubeÔ Market Navigation Platform [CCMNP] we have selected the previously vetted set of embedded variables: Market Performance Variables [MPV] for their Linguistic Qualifiers [LQ] considering their directional market effects or MPV[LQ[{Neutral: Unfavorable: Favorable}]]. In the testing, we are interested in the Sensitivity and the Specificity of these vetted variables over the annual S&P500 Panel from 2005 to 2013. The inference framework employed a Median Split: High or Low for each of the 13 MPV tested and a random selection to avoid the FPE-jeopardy that is part of the Chi2 testing model. We used the Tamhane & Dunlop cut-off to identify Chi2 cells effects of interest and used these to develop the Sensitivity and the Specificity tests. Results: We were able to reject the a priori Nulls proffered for the testing protocols indicating that one may reject the supposition that the labeling of the LQ is formed by random processes in the CCMNP.
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Klar, Philipp, and Georg Northoff. "When the World Breaks Down: A 3-Stage Existential Model of Nihilism in Schizophrenia." Psychopathology 54, no. 4 (2021): 169–92. http://dx.doi.org/10.1159/000516814.
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The existential crisis of nihilism in schizophrenia has been reported since the early days of psychiatry. Taking first-person accounts concerning nihilistic experiences of both the self and the world as vantage point, we aim to develop a dynamic existential model of the pathological development of existential nihilism. Since the phenomenology of such a crisis is intrinsically subjective, we especially take the immediate and pre-reflective first-person perspective’s (FPP) experience (instead of objectified symptoms and diagnoses) of schizophrenia into consideration. The hereby developed existential model consists of 3 conceptualized stages that are nested into each other, which defines what we mean by existential. At the same time, the model intrinsically converges with the phenomenological concept of the self-world structure notable inside our existential framework. Regarding the 3 individual stages, we suggest that the onset or first stage of nihilistic pathogenesis is reflected by phenomenological solipsism, that is, a general disruption of the FPP experience. Paradigmatically, this initial disruption contains the well-known crisis of common sense in schizophrenia. The following second stage of epistemological solipsism negatively affects all possible perspectives of experience, that is, the first-, second-, and third-person perspectives of subjectivity. Therefore, within the second stage, solipsism expands from a disruption of immediate and pre-reflective experience (first stage) to a disruption of reflective experience and principal knowledge (second stage), as mirrored in abnormal epistemological limitations of principal knowledge. Finally, the experience of the annihilation of healthy self-consciousness into the ultimate collapse of the individual’s existence defines the third stage. The schizophrenic individual consequently loses her/his vital experience since the intentional structure of consciousness including any sense of reality breaks down. Such a descriptive-interpretative existential model of nihilism in schizophrenia may ultimately serve as input for future psychopathological investigations of nihilism in general, including, for instance, its manifestation in depression.
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Koliński, Rafał. "Badania Instytutu Prahistorii UAM w Poznaniu na Tell Arbid (północno-wschodnia Syria) w latach 2008-2009." Folia Praehistorica Posnaniensia 16 (November 1, 2018): 219–54. http://dx.doi.org/10.14746/fpp.2011.16.08.
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In 2008 a new research project has been launched by the Institute of Prehistory, Adam Mickiewicz University of Poznań in the framework of Polish-Syrian Archaeological Mission to Tell Arbid. The objective of the project is to make extensive clearance of the remains identified previously in Sector SR at Tell Arbid as belonging to the post-Akkadian period (ca. 2150-2000 BC), a period of alleged abandonment and cultural collapse in the north-eastern part of Syria. Two seasons of fieldwork resulted in extensive exposure of the post-Akkadian structures, including several buildings, household and industrial installations (pottery kiln) as well as some graves. Among the findings, a considerable number of copper/bronze tools, implements and jewelry pieces are worth mentioning; the presence of numerous artifacts of copper/bronze and of a sandstone casting mould is suggestive of presence of a foundry at the site. Beside the post-Akkadian remains, an overlying level belonging to Habur Ware period (ca 1800-1700 BC) was explored. It featured mainly foundations of houses as well as a considerable number of graves dug into the surface of the tell. Among the graves, three family chamber graves stand out, because of their well-preserved construction, including a vaulted chamber, and an entrance shaft protected by a retention wall. One of these graves yielded a rich set of burial gifts, including weapons and other implements of copper/bronze, more than dozen pottery vessels and over 200 beads, as well as some semi-precious stones. Work at the site will be continued in 2010.
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Andra, Doni, Muhammad Farchani Rosyid, and Arief Hermanto. "Theoretical study of interaction between matter and curvature fluid in the theory of f(R)-gravity: Diffusion and friction." International Journal of Geometric Methods in Modern Physics 16, no. 03 (March 2019): 1950045. http://dx.doi.org/10.1142/s0219887819500452.
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The relativistic diffusion process and friction have been studied, especially in the framework of [Formula: see text]-gravity theory. The study of relativistic diffusion and friction processes based on [Formula: see text]-gravity is an alternative solution to solve the incompatibility problem emerging in the attempt to couple between the Fokker–Planck equation [FPE] to the Einstein field equation [EFE] encountered by Calogero. The energy–momentum tensor of the cosmological scalar field as proposed by Calogero is replaced by the presence of additional terms in the field equation of [Formula: see text]-gravity. The additional energy–momentum tensor in the field equation of [Formula: see text]-gravity in this context is regarded to compensate for the presence of the diffusion and another process like friction. The additional energy–momentum tensor is also regarded as due to the so-called curvature fluid or background fluid. Here we assume the presence of interaction between matter and the background fluid in the form of physical processes like diffusion, friction, etc. We also assume that there is ‘interplay’ between diffusion process and friction. In other words, the diffusion process and friction are not independent. As examples, we consider some viable models of [Formula: see text] that satisfy both cosmological and local gravity constraints, i.e. [Formula: see text], and [Formula: see text]. Furthermore, we apply it to explain the diffusion and friction processes in the expanding universe by considering the Friedmann–Lemaitre–Robertson–Walker (FLRW) model.
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Jansen, Marleen E., Anne W. Klein, Erika C. Buitenhuis, Wendy Rodenburg, and Martina C. Cornel. "Expanded Neonatal Bloodspot Screening Programmes: An Evaluation Framework to Discuss New Conditions With Stakeholders." Frontiers in Pediatrics 9 (February 22, 2021). http://dx.doi.org/10.3389/fped.2021.635353.
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Neonatal bloodspot screening (NBS) programmes that screen for rare but serious conditions are expanding worldwide. Fast developments for testing and treatment put pressure on implementation processes. In 2015 the Netherlands embarked on an NBS expansion from 17 to 31 conditions. An evaluation framework was developed based on international NBS frameworks to gain insight in test properties, clinical findings, follow-up and implementation. A stakeholder process took place with implications for the planning of the expanded NBS panel. The evaluation framework progressed into a go/no go framework to start national screening, and is currently explored as basis for continuous evaluation of the NBS panel. The framework and stakeholder process may serve as an example for other programmes.
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Tripathi, Abhinav, and Zongxuan Sun. "Investigating Trajectory-Based Combustion Control Using a Controlled Trajectory Rapid Compression and Expansion Machine." ASME Letters in Dynamic Systems and Control 1, no. 3 (January 27, 2021). http://dx.doi.org/10.1115/1.4049526.
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Abstract This study presents a systematic framework for the real-time implementation of a new combustion control strategy—trajectory-based combustion control—for the operation of free piston engines (FPEs). The free piston engine is an alternative architecture of internal combustion (IC) engines, which does not have a mechanical crankshaft and hence allows extreme operational flexibility in terms of piston trajectory. The key idea of trajectory-based combustion control is to modulate the autoignition dynamics by tailoring the pressure and temperature history of the fuel–air mixture inside the combustion chamber, using the piston trajectory as the control input, for the optimal operation of the free piston engine. Here, we present the experimental investigation of trajectory-based combustion control using a novel instrument called controlled trajectory rapid compression and expansion machine (CT-RCEM) that can be used for studying a single combustion cycle of an internal combustion engine with precisely controlled initial and boundary conditions. The effect of the shape of the piston trajectory on the combustion phasing, combustion efficiency, and the indicated thermal efficiency has been found to be significant. The experimental results indicate that the trajectory-based combustion control is an effective strategy for combustion phasing control for FPE operation.
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Anjum, Raheel, Ahmed Yar, Ghulam Murtaza, Qadeer Ahmed, and A. I. Bhatti. "Model-Based Unified Framework for Detection and Mitigation of Cyclic Torque Imbalance in a Gasoline Engine." Journal of Engineering for Gas Turbines and Power 143, no. 7 (March 31, 2021). http://dx.doi.org/10.1115/1.4049620.
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Abstract Torque produced by the internal combustion (IC) engine is desired to be of similar value for consecutive combustion cycles; nevertheless, difference occurs in the cyclic torque due to uncertainties in its generation. Variations between output work of successive combustion cycles are considered as the main cause of imbalance in the cyclic torque. Such variations are displayed in engine output torque and affect the engine performance. In this paper, a novel model-based unified framework is proposed for the detection and mitigation of cyclic torque imbalance in a gasoline engine by employing the first principle-based engine model (FPEM). Engine speed dynamics in the model are transformed to develop the direct relationship between engine speed dynamics and fuel input. Fault in fuel injection subsystem is induced to generate imbalance in the cyclic torque. FPEM-based uniform second-order sliding mode (USOSM) observer is applied for estimation of the unknown input, i.e., net piston force (fn) from engine speed dynamics to detect imbalance in the cyclic torque. Estimated net piston force (f⁁n) is utilized to design the control law for certainty equivalence super twisting algorithm (CESTA) based fault tolerant control (FTC) technique to mitigate the torque imbalance. The results of numerical simulation demonstrated that the desired objective is achieved by the proposed unified framework.
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Mastorci, Francesca, Luca Bastiani, Cristina Doveri, Gabriele Trivellini, Anselmo Casu, Cristina Vassalle, and Alessandro Pingitore. "Adolescent Health: A Framework for Developing an Innovative Personalized Well-Being Index." Frontiers in Pediatrics 8 (May 7, 2020). http://dx.doi.org/10.3389/fped.2020.00181.
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Liu, Hui, Zi-Hua Mo, Hang Yang, Zheng-Fu Zhang, Dian Hong, Long Wen, Min-Yin Lin, et al. "Automatic Facial Recognition of Williams-Beuren Syndrome Based on Deep Convolutional Neural Networks." Frontiers in Pediatrics 9 (May 19, 2021). http://dx.doi.org/10.3389/fped.2021.648255.
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Background: Williams-Beuren syndrome (WBS) is a rare genetic syndrome with a characteristic “elfin” facial gestalt. The “elfin” facial characteristics include a broad forehead, periorbital puffiness, flat nasal bridge, short upturned nose, wide mouth, thick lips, and pointed chin. Recently, deep convolutional neural networks (CNNs) have been successfully applied to facial recognition for diagnosing genetic syndromes. However, there is little research on WBS facial recognition using deep CNNs.Objective: The purpose of this study was to construct an automatic facial recognition model for WBS diagnosis based on deep CNNs.Methods: The study enrolled 104 WBS children, 91 cases with other genetic syndromes, and 145 healthy children. The photo dataset used only one frontal facial photo from each participant. Five face recognition frameworks for WBS were constructed by adopting the VGG-16, VGG-19, ResNet-18, ResNet-34, and MobileNet-V2 architectures, respectively. ImageNet transfer learning was used to avoid over-fitting. The classification performance of the facial recognition models was assessed by five-fold cross validation, and comparison with human experts was performed.Results: The five face recognition frameworks for WBS were constructed. The VGG-19 model achieved the best performance. The accuracy, precision, recall, F1 score, and area under curve (AUC) of the VGG-19 model were 92.7 ± 1.3%, 94.0 ± 5.6%, 81.7 ± 3.6%, 87.2 ± 2.0%, and 89.6 ± 1.3%, respectively. The highest accuracy, precision, recall, F1 score, and AUC of human experts were 82.1, 65.9, 85.6, 74.5, and 83.0%, respectively. The AUCs of each human expert were inferior to the AUCs of the VGG-16 (88.6 ± 3.5%), VGG-19 (89.6 ± 1.3%), ResNet-18 (83.6 ± 8.2%), and ResNet-34 (86.3 ± 4.9%) models.Conclusions: This study highlighted the possibility of using deep CNNs for diagnosing WBS in clinical practice. The facial recognition framework based on VGG-19 could play a prominent role in WBS diagnosis. Transfer learning technology can help to construct facial recognition models of genetic syndromes with small-scale datasets.
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Sala, Arianna, Aldana Lizarraga, Isabelle Ripp, Paul Cumming, and Igor Yakushev. "Static versus Functional PET: Making Sense of Metabolic Connectivity." Cerebral Cortex, August 19, 2021. http://dx.doi.org/10.1093/cercor/bhab271.
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Abstract Recently, Jamadar et al. (2021, Metabolic and hemodynamic resting-state connectivity of the human brain: a high-temporal resolution simultaneous BOLD-fMRI and FDG-fPET multimodality study. Cereb Cortex. 31(6), 2855–2867) compared the patterns of brain connectivity or covariance as obtained from 3 neuroimaging measures: 1) functional connectivity estimated from temporal correlations in the functional magnetic resonance imaging blood oxygen level-dependent signal, metabolic connectivity estimated, 2) from temporal correlations in 16-s frames of dynamic [18F]-fluorodeoxyglucose-positron emission tomography (FDG-PET), which they designate as functional FDG-PET (fPET), and 3) from intersubject correlations in static FDG-PET images (sPET). Here, we discuss a number of fundamental issues raised by the Jamadar study. These include the choice of terminology, the interpretation of cross-modal findings, the issue of group- to single-subject level inferences, and the meaning of metabolic connectivity as a biomarker. We applaud the methodological approach taken by the authors, but wish to present an alternative perspective on their findings. In particular, we argue that sPET and fPET can both provide valuable information about brain connectivity. Certainly, resolving this conundrum calls for further experimental and theoretical efforts to advance the developing framework of PET-based brain connectivity indices.
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Kimura, Dai, Jordy Saravia, Cynthia R. Rovnaghi, Gianfranco Umberto Meduri, Andreas Schwingshackl, Stephania A. Cormier, and Kanwaljeet J. Anand. "Plasma Biomarker Analysis in Pediatric ARDS: Generating Future Framework from a Pilot Randomized Control Trial of Methylprednisolone: A Framework for Identifying Plasma Biomarkers Related to Clinical Outcomes in Pediatric ARDS." Frontiers in Pediatrics 4 (March 31, 2016). http://dx.doi.org/10.3389/fped.2016.00031.
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Nijman, Ruud G., Rianne Oostenbrink, Henriette A. Moll, Climent Casals-Pascual, Ulrich von Both, Aubrey Cunnington, Tisham De, et al. "A Novel Framework for Phenotyping Children With Suspected or Confirmed Infection for Future Biomarker Studies." Frontiers in Pediatrics 9 (July 28, 2021). http://dx.doi.org/10.3389/fped.2021.688272.
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Background: The limited diagnostic accuracy of biomarkers in children at risk of a serious bacterial infection (SBI) might be due to the imperfect reference standard of SBI. We aimed to evaluate the diagnostic performance of a new classification algorithm for biomarker discovery in children at risk of SBI.Methods: We used data from five previously published, prospective observational biomarker discovery studies, which included patients aged 0– <16 years: the Alder Hey emergency department (n = 1,120), Alder Hey pediatric intensive care unit (n = 355), Erasmus emergency department (n = 1,993), Maasstad emergency department (n = 714) and St. Mary's hospital (n = 200) cohorts. Biomarkers including procalcitonin (PCT) (4 cohorts), neutrophil gelatinase-associated lipocalin-2 (NGAL) (3 cohorts) and resistin (2 cohorts) were compared for their ability to classify patients according to current standards (dichotomous classification of SBI vs. non-SBI), vs. a proposed PERFORM classification algorithm that assign patients to one of eleven categories. These categories were based on clinical phenotype, test outcomes and C-reactive protein level and accounted for the uncertainty of final diagnosis in many febrile children. The success of the biomarkers was measured by the Area under the receiver operating Curves (AUCs) when they were used individually or in combination.Results: Using the new PERFORM classification system, patients with clinically confident bacterial diagnosis (“definite bacterial” category) had significantly higher levels of PCT, NGAL and resistin compared with those with a clinically confident viral diagnosis (“definite viral” category). Patients with diagnostic uncertainty had biomarker concentrations that varied across the spectrum. AUCs were higher for classification of “definite bacterial” vs. “definite viral” following the PERFORM algorithm than using the “SBI” vs. “non-SBI” classification; summary AUC for PCT was 0.77 (95% CI 0.72–0.82) vs. 0.70 (95% CI 0.65–0.75); for NGAL this was 0.80 (95% CI 0.69–0.91) vs. 0.70 (95% CI 0.58–0.81); for resistin this was 0.68 (95% CI 0.61–0.75) vs. 0.64 (0.58–0.69) The three biomarkers combined had summary AUC of 0.83 (0.77–0.89) for “definite bacterial” vs. “definite viral” infections and 0.71 (0.67–0.74) for “SBI” vs. “non-SBI.”Conclusion: Biomarkers of bacterial infection were strongly associated with the diagnostic categories using the PERFORM classification system in five independent cohorts. Our proposed algorithm provides a novel framework for phenotyping children with suspected or confirmed infection for future biomarker studies.
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Kigezi, T. N., and J. F. Dunne. "A Model-Based Control Design Approach for Linear Free-Piston Engines." Journal of Dynamic Systems, Measurement, and Control 139, no. 11 (August 8, 2017). http://dx.doi.org/10.1115/1.4036886.
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A general design approach is presented for model-based control of piston position in a free-piston engine (FPE). The proposed approach controls either “bottom-dead-center” (BDC) or “top-dead-center” (TDC) position. The key advantage of the approach is that it facilitates controller parameter selection, by the way of deriving parameter combinations that yield both stable BDC and stable TDC. Driving the piston motion toward a target compression ratio is, therefore, achieved with sound engineering insight, consequently allowing repeatable engine cycles for steady power output. The adopted control design approach is based on linear control-oriented models derived from exploitation of energy conservation principles in a two-stroke engine cycle. Two controllers are developed: A proportional integral (PI) controller with an associated stability condition expressed in terms of controller parameters, and a linear quadratic regulator (LQR) to demonstrate a framework for advanced control design where needed. A detailed analysis is undertaken on two FPE case studies differing only by rebound device type, reporting simulation results for both PI and LQR control. The applicability of the proposed methodology to other common FPE configurations is examined to demonstrate its generality.
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Perramon, Aida, Antoni Soriano-Arandes, David Pino, Uxue Lazcano, Cristina Andrés, Martí Català, Anna Gatell, et al. "Schools as a Framework for COVID-19 Epidemiological Surveillance of Children in Catalonia, Spain: A Population-Based Study." Frontiers in Pediatrics 9 (September 8, 2021). http://dx.doi.org/10.3389/fped.2021.754744.
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Objective: We describe and analyze the childhood (<18 years) COVID-19 incidence in Catalonia, Spain, during the first 36 weeks of the 2020-2021 school-year and to compare it with the incidence in adults.Methods: Data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests were obtained from the Catalan Agency for Quality and Health Assessment. Overall, 7,203,663 SARS-CoV-2 tests were performed, of which 491,819 were positive (6.8%). We collected epidemiological data including age-group incidence, diagnostic effort, and positivity rate per 100,000 population to analyze the relative results for these epidemiological characteristics.Results: Despite a great diagnostic effort among children, with a difference of 1,154 tests per 100,000 population in relation to adults, the relative incidence of SARS-CoV-2 for <18 years was slightly lower than for the general population, and it increased with the age of the children. Additionally, positivity of SARS-CoV-2 in children (5.7%) was lower than in adults (7.2%), especially outside vacation periods, when children were attending school (4.9%).Conclusions: A great diagnostic effort, including mass screening and systematic whole-group contact tracing when a positive was detected in the class group, was associated with childhood SARS-CoV-2 incidence and lower positivity rate in the 2020-2021 school year. Schools have been a key tool in epidemiological surveillance rather than being drivers of SARS-CoV-2 incidence in Catalonia, Spain.
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Arthurs, Christopher J., Pradyumn Agarwal, Anna V. John, Adam L. Dorfman, Ronald G. Grifka, and C. Alberto Figueroa. "Reproducing Patient-Specific Hemodynamics in the Blalock–Taussig Circulation Using a Flexible Multi-Domain Simulation Framework: Applications for Optimal Shunt Design." Frontiers in Pediatrics 5 (April 26, 2017). http://dx.doi.org/10.3389/fped.2017.00078.
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Atun-Einy, Osnat, Meir Lotan, Yael Harel, Efrat Shavit, Shimshon Burstein, and Gali Kempner. "Physical Therapy for Young Children Diagnosed with Autism Spectrum Disorders–Clinical Frameworks Model in an Israeli Setting." Frontiers in Pediatrics 1 (2013). http://dx.doi.org/10.3389/fped.2013.00019.
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Hirschfeld, Steven, Elizabeth Goodman, Shari Barkin, Elaine Faustman, Neal Halfon, and Anne W. Riley. "Health Measurement Model—Bringing a Life Course Perspective to Health Measurement: The PRISM Model." Frontiers in Pediatrics 9 (June 10, 2021). http://dx.doi.org/10.3389/fped.2021.605932.
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Health is a multidimensional concept that is challenging to measure, and in the rapidly evolving developmental changes that occur during the first 21 years of human life, requires a dynamic approach to accurately capture the transitions, and overall arc of a complex process of internal and external interactions. We propose an approach that integrates a lifecourse framework with a layered series of assessments, each layer using a many to many mapping, to converge on four fundamental dimensions of health measurement-Potential, Adaptability, Performance, and Experience. The four dimensions can conceptually be mapped onto a plane with each edge of the resulting quadrilateral corresponding to one dimension and each dimensions assessment calibrated against a theoretical ideal. As the plane evolves over time, the sequential measurements will form a volume. We term such a model the Prism Model, and describe conceptually how single domain assessments can be built up to generate the holistic description through the vehicle of a layer of Exemplar Cases. The model is theoretical but future work can use the framework and principles to generate scalable and adaptable applications that can unify and improve the precision of serial measurements that integrate environmental and physiologic influences to improve the science of child health measurement.
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Orzan, Eva, Giulia Pizzamiglio, Raffaella Marchi, Enrico Muzzi, Lorenzo Monasta, Lucio Torelli, and Agnese Feresin. "Modeling Postnatal Hearing Case Finding Within the Italian National Health System." Frontiers in Pediatrics 9 (March 12, 2021). http://dx.doi.org/10.3389/fped.2021.564662.
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Objective: Despite the successful implementation of newborn hearing screening (NHS), a debate is emerging as to what should be the best means of enabling timely diagnosis and intervention for preschoolers with educationally significant sensorineural or conductive hearing impairment (HI) missed at the time of NHS or occurred after birth. Our study aims to document the proportion and characteristics of HIs diagnosed in children in need of audiologic assessment, in order to outline the optimization areas of an operational framework for auditory surveillance during preschool age.Method: The referral routes and outcomes of 730 audiological assessments performed in 3 years within the framework of the early hearing identification program in Trieste (Italy) were retrospectively analyzed.Results: Among 570/595 completed evaluations, an HI was diagnosed in 114 children, 73.7% of which presenting an exclusively conductive HI due to middle ear effusion. HIs were found in 36/141 who failed NHS, and 60/385 preschoolers who were referred by the primary care pediatrician's surveillance activity during well-child visits, with diagnostic yield of 25.5 and 15.5%, respectively.Conclusion: Ongoing preschool surveillance in primary care setting integrated into a NHS program is feasible to conduct and may effectively identify HIs that missed NHS or were related with a risk factor. New triage instruments and protocols for immediate audiology referral could allow to obtain the diagnosis of educationally significant conductive and sensorineural HIs ahead of the development concern and in the same way reduce patient mobility, thus optimizing timing efficiency and economic impact of the program.
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Parkerson, Sarah, Ranjit Philip, Ajay Talati, and Shyam Sathanandam. "Management of Patent Ductus Arteriosus in Premature Infants in 2020." Frontiers in Pediatrics 8 (February 11, 2021). http://dx.doi.org/10.3389/fped.2020.590578.
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The patent ductus arteriosus (PDA) is the most commonly found cardiac condition in neonates. While there have been several studies and thousands of publications on the topic, the decision to treat the PDA is still strongly debated among cardiologists, surgeons, and neonatologists. This is in part due to the shortage of long-term benefits with the interventions studied. Practice variations still exist within sub-specialties and centers. This article briefly summarizes the history, embryology and histology of the PDA. It also succinctly discusses the hemodynamic significance of a PDA which builds the framework to review all the available literature on PDA closure in premature infants, though not a paradigm shift just yet; it introduces transcatheter PDA closure (TCPC) as a possible armament to the clinician for this age-old problem.
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Hessey, Erin, Nabil Melhem, Rashid Alobaidi, Emma Ulrich, Catherine Morgan, Sean M. Bagshaw, and Manish D. Sinha. "Acute Kidney Injury in Critically Ill Children Is Not all Acute: Lessons Over the Last 5 Years." Frontiers in Pediatrics 9 (March 15, 2021). http://dx.doi.org/10.3389/fped.2021.648587.
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Acute kidney injury (AKI) in the pediatric intensive care unit (PICU) is an important risk factor for increased morbidity and mortality during hospitalization. Over the past decade, accumulated data on children and young people indicates that acute episodes of kidney dysfunction can have lasting consequences on multiple organ systems and health outcomes. To date, there are no guidelines for follow-up of surviving children that may be at risk of long-term sequelae following AKI in the PICU. This narrative review aims to describe literature from the last 5 years on the risk of medium and long-term kidney and non-kidney outcomes after AKI in the PICU. More specifically, we will focus on outcomes in children and young people following AKI in the general PICU population and children undergoing cardiac surgery. These outcomes include mortality, hypertension, proteinuria, chronic kidney disease, and healthcare utilization. We also aim to highlight current gaps in knowledge in medium and long-term outcomes in this pediatric population. We suggest a framework for future research to develop evidence-based guidelines for follow-up of children surviving an episode of critical illness and AKI.
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Greco, Céline. "From Victim to Minister's Advisor: A Personnal View of Child Protection in France." Frontiers in Pediatrics 9 (March 12, 2021). http://dx.doi.org/10.3389/fped.2021.587806.
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In France, maltreatment of children, that mean “physical, sexual or emotional maltreatment, or neglect of a child” is a very underestimated phenomenon, yet it is running rampant. The various causes of child abuse are subject to denial, and the ensuing delay of identification of victims is profoundly damaging. As a medical doctor and survivor of child abuse, I have a clear vision of the shortcomings of our child protection system. Non-recognition or late recognition of cases of child abuse is directly related to a lack of knowledge and training on this subject, which leads to weaknesses both in terms of detection and reporting of potential cases. Once the children are identified, they need to receive proper care that should not be limited to the social aspects. Indeed, the victims of abuse suffer from important repercussions on their physical and mental health. Without proper care, their health as adults will be severely impacted. These children require specific care and an adapted health care pack, as well as inclusion in the child protection framework. The task force “Child health in child protection” that I manage has suggested the creation of a standardized healthcare protocol for child victims of abuse, with psychological and medical costs fully covered by the Government, especially regarding clinical psychologists and psycho-motor therapists.
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Ferreira, Alexie, Emanuela Ferretti, Krista Curtis, Cynthia Joly, Myuri Sivanthan, Nathalie Major, and Thierry Daboval. "Parents' Views to Strengthen Partnerships in Newborn Intensive Care." Frontiers in Pediatrics 9 (September 27, 2021). http://dx.doi.org/10.3389/fped.2021.721835.
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Background: Parental involvement in their newborn's neonatal intensive care reduces stress and helps with the parent-child attachment, transition to home, and future development. However, parents' perspectives are not often sought or considered when adapting family-centered care in neonatal intensive care units (NICUs).Aim: To identify what parents believe helps or hinders their involvement in their newborn's care when admitted to our Level 3B NICU.Methods: Between August and October 2018, nine mothers and one father were interviewed during three 60- to 90-min audiotaped focus groups using a semi-structured interview tool. From the content analysis of the verbatims, three reviewers identified key themes that affected how involved parents could be in their newborn's care.Results: Parents provided examples of factors that facilitated or restricted their involvement. The analysis identified themes: (1) parent-staff interactions, (2) supportive/trustworthy healthcare professionals, (3) consistency in care and caring staff, (4) family, couple, and peer support, (5) newborn status, (6) resources and education for parents, (7) the NICU environment, and (8) academic and research participation.Conclusion: We identified a conceptual framework to allow our NICU team to prioritize working strategies to strengthen parental involvement in newborn care. In addition to implementing ways to involve parents, we need to address parents' satisfaction with their participation. These findings may help other investigators explore parents' expectations toward their NICU experience.
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Odum, James D., Hector R. Wong, and Natalja L. Stanski. "A Precision Medicine Approach to Biomarker Utilization in Pediatric Sepsis-Associated Acute Kidney Injury." Frontiers in Pediatrics 9 (April 14, 2021). http://dx.doi.org/10.3389/fped.2021.632248.
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Sepsis is a leading cause of morbidity and mortality in critically ill children, and acute kidney injury (AKI) is a frequent complication that confers an increased risk for poor outcomes. Despite the documented consequences of sepsis-associated AKI (SA-AKI), no effective disease-modifying therapies have been identified to date. As such, the only treatment options for these patients remain prevention and supportive care, both of which rely on the ability to promptly and accurately identify at risk and affected individuals. To achieve these goals, a variety of biomarkers have been investigated to help augment our currently limited predictive and diagnostic strategies for SA-AKI, however, these have had variable success in pediatric sepsis. In this mini-review, we will briefly outline the current use of biomarkers for SA-AKI, and propose a new framework for biomarker discovery and utilization that considers the individual patient's sepsis inflammatory response. Now recognized to be a key driver in the complex pathophysiology of SA-AKI, understanding the dysregulated host immune response to sepsis is a growing area of research that can and should be leveraged to improve the prediction and diagnosis of SA-AKI, while also potentially identifying novel therapeutic targets. Reframing SA-AKI in this manner – as a direct consequence of the individual patient's sepsis inflammatory response – will facilitate a precision medicine approach to its management, something that is required to move the care of this consequential disorder forward.
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Scarponi, Dorella, Viviana Cammaroto, Andrea Pasini, Claudio La Scola, Francesca Mencarelli, Cristina Bertulli, Marco Busutti, Gaetano La Manna, and Andrea Pession. "Multidisciplinarity in Transition Pathways for Patients With Kidney Disease: The Current State of Play." Frontiers in Pediatrics 9 (September 20, 2021). http://dx.doi.org/10.3389/fped.2021.689758.
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In the field of medical care, successful transition from pediatric-centered to adult-oriented healthcare can provide a sense of continuity in the development of youth, and prepare them to accept responsibility for and manage their own chronic kidney condition in complete autonomy. The so-called transition process requires the presence of some basic aspects: a multidisciplinary team, which acts as a bridge between child and adult services; a comprehensive clinical, cognitive, psychological, and social change for the young people; the involvement of family and caregivers. Within the framework of transition and chronicity during the developmental age, we selected international papers explaining models which agreed on some important steps in the transition process, although many differences can be observed between different countries. In fact, in Europe, the situation appears to be heterogeneous as regards certain aspects: the written transition plan, the educational programmes, the timing of transfer to adult services, the presence of a transition coordinator, a dedicated off-site transition clinic. We then analyzed some studies focusing on patients with renal diseases, including the first to contain a standardized protocol for transition which was launched recently in the USA, and which seems to have already achieved important positive, although limited, results. In Italy, the issue of transition is still in its infancy, however important efforts in the management of chronic kidney disease have already been initiated in some regions, including Emila Romagna, which gives us hope for the future of many young people.
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De Sutter, Evelien, Birte Coopmans, Femke Vanendert, Marc Dooms, Karel Allegaert, Pascal Borry, and Isabelle Huys. "Clinical Research in Neonates: Redesigning the Informed Consent Process in the Digital Era." Frontiers in Pediatrics 9 (September 1, 2021). http://dx.doi.org/10.3389/fped.2021.724431.
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Background: Currently, many initiatives are devoted to optimizing informed consent for participation in clinical research. Due to the digital transformation in health care, a shift toward electronic informed consent (eIC) has been fostered. However, empirical evidence on how to implement eIC in clinical research involving neonates is lacking.Methods: Semi-structured interviews were conducted with 31 health care professionals active in Belgium or the Netherlands. All health care professionals had experience in conducting clinical research involving neonates. Interviews were audio-recorded, transcribed and analyzed using the framework method.Results: Interviewees generally supported the use of eIC in clinical research involving neonates. For example, eIC could enable parents to receive study feedback via the eIC system. Requirements were expressed for parental involvement to decide on which feedback would be appropriate to return. Moreover, experts specialized in presenting information and designing electronic systems should be involved. Broad consensus among health care professionals indicates that the face-to-face-interaction between parents and the research team is vital to establish a relationship of trust. Therefore, it is necessary that the use of eIC runs alongside personal interactions with the parents. Concerns were raised about the accessibility of eIC to parents. For this reason, it was suggested that parents should always be given the possibility to read and sign a paper-based informed consent form or to use eIC.Conclusions: Health care professionals' views indicate that the use of eIC in clinical research with neonates may offer various opportunities. Further development and implementation will require a multi-stakeholder approach.
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Green, Dionna J., Kyunghun Park, Varsha Bhatt-Mehta, Donna Snyder, and Gilbert J. Burckart. "Regulatory Considerations for the Mother, Fetus and Neonate in Fetal Pharmacology Modeling." Frontiers in Pediatrics 9 (July 26, 2021). http://dx.doi.org/10.3389/fped.2021.698611.
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The regulatory framework for considering the fetal effects of new drugs is limited. This is partially due to the fact that pediatric regulations (21 CFR subpart D) do not apply to the fetus, and only US Health and Human Service (HHS) regulations apply to the fetus. The HHS regulation 45 CFR Part 46 Subpart B limits research approvable by an institutional review board to research where the risk to the fetus is minimal unless the research holds out the prospect of a direct benefit to the fetus or the pregnant woman (45 CFR 46.204). Research that does not meet these requirements, but presents an opportunity to understand, prevent, or alleviate a serious problem affecting the health of pregnant women, fetuses, or neonates, may be permitted by the Secretary of the HHS after expert panel consultation and opportunity for public review and comment (45 CFR 46.407). If the product is regulated by the US Food and Drug Administration (FDA), FDA may get involved in the review process. The FDA does however have a Reviewer Guidance on Evaluating the Risks of Drug Exposure in Human Pregnancies from 2005 and this guidance does discuss the intensity of drug exposure. Estimation of that exposure using physiologically based pharmacokinetic (PBPK) modeling has been suggested by some investigators. Given that drug exposure during pregnancy will impact the fetus, a number of new guidances in the last 2 years also address inclusion of pregnant women in clinical drug trials. Therefore, the drug-specific information on fetal pharmacology will increase dramatically in the next decade due to interest in drugs administered in pregnancy and with the assistance of model-informed drug development.
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Personne, Stéphane, Céline Brochot, Paulo Marcelo, Aurélie Corona, Sophie Desmots, Franck Robidel, Anthony Lecomte, Véronique Bach, and Florence Zeman. "Evaluation of Placental Transfer and Tissue Distribution of cis- and Trans-Permethrin in Pregnant Rats and Fetuses Using a Physiological-Based Pharmacokinetic Model." Frontiers in Pediatrics 9 (September 23, 2021). http://dx.doi.org/10.3389/fped.2021.730383.
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Biomonitoring studies have highlighted the exposure of pregnant women to pyrethroids based on the measurement of their metabolites in urine. Pyrethroids can cross the placental barrier and be distributed in the fetus as some pyrethroids were also measured in the meconium of newborns. Prenatal exposure to pyrethroids is suspected to alter the neurodevelopment of children, and animal studies have shown that early life exposure to permethrin, one of the most commonly used pyrethroid in household applications, can alter the brain development. This study aimed to characterize the fetal permethrin exposure throughout gestation in rats. We developed a pregnancy physiologically based pharmacokinetic (pPBPK) model that describes the maternal and fetal kinetics of the cis- and trans- isomers of permethrin during the whole gestation period. Pregnant Sprague–Dawley rats were exposed daily to permethrin (50 mg/kg) by oral route from the start of gestation to day 20. Permethrin isomers were quantified in the feces, kidney, mammary gland, fat, and placenta in dams and in both maternal and fetal blood, brain, and liver. Cis- and trans-permethrin were quantified in fetal blood and tissues, with higher concentrations for the cis-isomer. The pPBPK model was fitted to the toxicokinetic maternal and fetal data in a Bayesian framework. Several parameters were adjusted, such as hepatic clearances, partition coefficients, and intestinal absorption. Our work allowed to estimate the prenatal exposure to permethrin in rats, especially in the fetal brain, and to quantitatively estimate the placental transfer. These transfers could be extrapolated to humans and be incorporated in a human pPBPK model to estimate the fetal exposure to permethrin from biomonitoring data.
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Fang, Lingyu, Lianqiang Wu, Shuping Han, Xiaohui Chen, and Zhangbin Yu. "Quality Improvement to Increase Breastfeeding in Preterm Infants: Systematic Review and Meta-Analysis." Frontiers in Pediatrics 9 (June 10, 2021). http://dx.doi.org/10.3389/fped.2021.681341.
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Background and Objective: Due to its numerous health benefits, breast milk (BM) is recommended for preterm infants. Despite such recommendations, the rates of breastfeeding in preterm infants are lower than that in term infants. Quality improvement (QI) bundles increase breastfeeding in preterm infants, but their replication in neonatal intensive care units has had inconsistent outcomes.Methods: We used the Population or Problem, Intervention, Comparison, and Outcomes (PICO) framework to develop our search strategy, and searched MEDLINE, Embase, and the Cochrane Library from inception through January 15, 2021. Studies describing any active QI intervention to increase BM use in preterm infants were included. The primary outcome measure was the rate of any breastfeeding or exclusive mother's own milk (MOM) at discharge or during hospitalization.Results: Sixteen studies were eligible for inclusion and showed an acceptable risk of bias, and included 1 interrupted time series, study 3 controlled before-and-after studies, and 12 uncontrolled before-and-after studies; of these, 3 studies were excluded due to insufficient dichotomous data, 13 were included in the meta-analysis. In the meta-analysis, the rate of any breastfeeding was significantly improved at discharge and during hospitalization after QI [risk ratio (RR) = 1.23, 95% confidence interval (CI): 1.14–1.32, P < 0.00001 and RR = 1.89, 95% CI: 1.09–3.29, P = 0.02, respectively]. The rate of exclusive MOM after QI was also significantly increased at discharge (RR = 1.51, 95% CI: 1.04–2.18, P = 0.03), but not during hospitalization (RR = 1.53, 95% CI: 0.78–2.98, P = 0.22). However, after sensitivity analysis, the comprehensive results still suggested that QI could significantly improve the rate of exclusive MOM during hospitalization (RR = 1.21, 95% CI: 1.08–1.35, P = 0.001). Funnel plots and Egger's test indicated publication bias in the rate of any BF at discharge. We corrected publication bias by trim and fill analysis, and corrected RR to 1.272, 95% CI: (1.175, 1.369), which was consistent with the results of the initial model.Conclusions: A QI bundle appears to be effective for promoting BM use in preterm infants at discharge or during hospitalization.
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Mâsse, Louise C., Teresia M. O’Connor, Yingyi Lin, Sheryl O. Hughes, Claire N. Tugault-Lafleur, Tom Baranowski, and Mark R. Beauchamp. "Calibration of the food parenting practice (FPP) item bank: tools for improving the measurement of food parenting practices of parents of 5–12-year-old children." International Journal of Behavioral Nutrition and Physical Activity 17, no. 1 (November 16, 2020). http://dx.doi.org/10.1186/s12966-020-01049-9.
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Abstract Purpose There has been a call to improve measurement rigour and standardization of food parenting practices measures, as well as aligning the measurement of food parenting practices with the parenting literature. Drawing from an expert-informed conceptual framework assessing three key domains of food parenting practices (autonomy promotion, control, and structure), this study combined factor analytic methods with Item Response Modeling (IRM) methodology to psychometrically validate responses to the Food Parenting Practice item bank. Methods A sample of 799 Canadian parents of 5–12-year-old children completed the Food Parenting Practice item bank (129 items measuring 17 constructs). The factorial structure of the responses to the item bank was assessed with confirmatory factor analysis (CFA), confirmatory bi-factor item analysis, and IRM. Following these analyses, differential Item Functioning (DIF) and Differential Response Functioning (DRF) analyses were then used to test invariance properties by parents’ sex, income and ethnicity. Finally, the efficiency of the item bank was examined using computerized adaptive testing simulations to identify the items to include in a short form. Results Overall, the expert-informed conceptual framework was predominantly supported by the CFA as it retained the same 17 constructs included in the conceptual framework with the exception of the access/availability and permissive constructs which were respectively renamed covert control and accommodating the child to better reflect the content of the final solution. The bi-factor item analyses and IRM analyses revealed that the solution could be simplified to 11 unidimensional constructs and the full item bank included 86-items (empirical reliability from 0.78 to 0.96, except for 1 construct) and the short form had 48 items. Conclusion Overall the food parenting practice item bank has excellent psychometric properties. The item bank includes an expanded version and short version to meet various study needs. This study provides more efficient tools for assessing how food parenting practices influence child dietary behaviours. Next steps are to use the IRM calibrated item bank and draw on computerized adaptive testing methodology to administer the item bank and provide flexibility in item selection.
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Tully, Louise, Lucinda Case, Niamh Arthurs, Jan Sorensen, James P. Marcin, and Grace O'Malley. "Barriers and Facilitators for Implementing Paediatric Telemedicine: Rapid Review of User Perspectives." Frontiers in Pediatrics 9 (March 17, 2021). http://dx.doi.org/10.3389/fped.2021.630365.
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Background: COVID-19 has brought to the fore an urgent need for secure information and communication technology (ICT) supported healthcare delivery, as the pertinence of infection control and social distancing continues. Telemedicine for paediatric care warrants special consideration around logistics, consent and assent, child welfare and communication that may differ to adult services. There is no systematic evidence synthesis available that outlines the implementation issues for incorporating telemedicine to paediatric services generally, or how users perceive these issues.Methods: We conducted a rapid mixed-methods evidence synthesis to identify barriers, facilitators, and documented stakeholder experiences of implementing paediatric telemedicine, to inform the pandemic response. A systematic search was undertaken by a research librarian in MEDLINE for relevant studies. All identified records were blind double-screened by two reviewers. Implementation-related data were extracted, and studies quality appraised using the Mixed-Methods Appraisal Tool. Qualitative findings were analysed thematically and then mapped to the Consolidated Framework for Implementation Research. Quantitative findings about barriers and facilitators for implementation were narratively synthesised.Results: We identified 27 eligible studies (19 quantitative; 5 mixed-methods, 3 qualitative). Important challenges highlighted from the perspective of the healthcare providers included issues with ICT proficiency, lack of confidence in the quality/reliability of the technology, connectivity issues, concerns around legal issues, increased administrative burden and/or fear of inability to conduct thorough examinations with reliance on subjective descriptions. Facilitators included clear dissemination of the aims of ICT services, involvement of staff throughout planning and implementation, sufficient training, and cultivation of telemedicine champions. Families often expressed preference for in-person visits but those who had tried tele-consultations, lived far from clinics, or perceived increased convenience with technology considered telemedicine more favourably. Concerns from parents included the responsibility of describing their child's condition in the absence of an in-person examination.Discussion: Healthcare providers and families who have experienced tele-consultations generally report high satisfaction and usability for such services. The use of ICT to facilitate paediatric healthcare consultations is feasible for certain clinical encounters and can work well with appropriate planning and quality facilities in place.
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Viet, Susan Marie, Michael Dellarco, Edith Chen, Thomas McDade, Elaine Faustman, Sean Brachvogel, Marissa Smith, and Rosalind Wright. "Recommendations for Assessment of Environmental Exposures in Longitudinal Life Course Studies Such as the National Children's Study." Frontiers in Pediatrics 9 (April 29, 2021). http://dx.doi.org/10.3389/fped.2021.629487.
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An important step toward understanding the relationship between the environment and child health and development is the comprehensive cataloging of external environmental factors that may modify health and development over the life course. Our understanding of the environmental influences on health is growing increasingly complex. Significant key questions exist as to what genes, environment, and life stage mean to defining normal variations and altered developmental trajectories throughout the life course and also across generations. With the rapid advances in genetic technology came large-scale genomic studies to search for the genetic etiology of complex diseases. While genome-wide association studies (GWAS) have revealed genetic factors and networks that advance our understanding to some extent, it is increasingly recognized that disease causation is largely non-genetic and reflects interactions between an individual's genetic susceptibility and his or her environment. Thus, the full promise of the human genome project to prevent or treat disease and promote good health arguably depends on a commitment to understanding the interactions between our environment and our genetic makeup and requires a design with prospective environmental data collection that considers critical windows of susceptibility that likely correspond to the expression of specific genes and gene pathways. Unlike the genome, which is static, relevant exposures as well as our response to exposures, change over time. This has fostered the complementary concept of the exposome ideally defined as the measure of all exposures of an individual over a lifetime and how those exposures relate to health. The exposome framework considers multiple external exposures (e.g., chemical, social) and behaviors that may modify exposures (e.g., diet), as well as consequences of environmental exposures indexed via biomarkers of physiological response or measures of behavioral response throughout the lifespan. The exposome concept can be applied in prospective developmental studies such as the National Children's Study (NCS) with the practical understanding that even a partial characterization will bring major advances to health. Lessons learned from the NCS provide an important opportunity to inform future studies that can leverage these evolving paradigms in elucidating the role of environment on health across the life course.
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Tripathi, Abhinav, and Zongxuan Sun. "Investigating Trajectory Based Combustion Control Using a Controlled Trajectory Rapid Compression and Expansion Machine (CT-RCEM)." ASME Letters in Dynamic Systems and Control, January 6, 2021, 1–23. http://dx.doi.org/10.1115/1.4049526.
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Abstract This work presents a systematic framework for the real time implementation of a new combustion control strategy – trajectory-based combustion control – for the operation of free piston engines. The free piston engine is an alternative architecture of IC engines which does not have a mechanical crankshaft and hence allows extreme operational flexibility in terms of piston trajectory. The key idea of trajectory-based combustion control is to modulate the autoignition dynamics by tailoring the pressure and temperature history of the fuel-air mixture inside the combustion chamber, using the piston trajectory as the control input, for the optimal operation of the free piston engine. Here, we present the experimental investigation of trajectory-based combustion control using a novel instrument called controlled trajectory rapid compression and expansion machine (CT-RCEM) that can be used for studying a single combustion cycle of an internal combustion engine with precisely controlled initial and boundary conditions. The effect of the shape of the piston trajectory on the combustion phasing, combustion efficiency and the indicated thermal efficiency has been found to be significant. The experimental results indicate that the trajectory-based combustion control is an effective strategy for combustion phasing control for FPE operation.
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Panasenko, Nikolay Nikitovich, and Alexey Vladimirovich Sinelshchikov. "MATHEMATICAL MODEL OF BASIC FINITE ELEMENTS IN THE FINITE-ELEMENTARY THEORY OF PORT LIFTING STRUCTURES." Vestnik of Astrakhan State Technical University. Series: Marine engineering and technologies, February 25, 2018, 109–28. http://dx.doi.org/10.24143/2073-1574-2018-1-109-128.
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The problem of computational analysis of the seismic safety of lifting cranes specified by the regulatory systems (FPP "Safety Rules for dangerous production facilities using Lifting mechanisms" for standard industrial application cranes; Regulation 31.1.02-2004 "Technical operation rules for carrying and lifting equipment in the sea merchant harbors" for harbor cranes; Code of Design-031-01 "Codes of Design of antiseismic atomic power stations" and Code of Design-043-11 "Rules of Design and safe operating hoisting cranes for objects of use of atomic energy" for cranes used at the nuclear facilities) is currently under discussion, despite the emphasis on the part of scientific community. All this has led to carrying out the research which presented a vision of the problems of designing cranes in earthquake-proof design as a finite element theory of structures, and on the basis of methods of the theory of seismic stability of structures - the linear spectral method, according to the Code 14.13330.2014 "Building in earthquake areas" and the method of dynamic analysis, according to Guidelines 1.5.2.05.999.0025-2011 "Calculation and design of earthquake resistant nuclear power plants". The article highlights the trend of recent years of the increasing complexity of calculated finite element models of structures, often combining both finite element models of buildings and supporting structures, and cranes. A computational analysis of such constructions leads to a combination in the design model of finite elements of different dimensions. The article points out that both the choice of the type of finite elements and the way they are connected together within the framework of one calculation model directly affect the reliability of the results obtained. Based on the practical experience of computational analysis of complex spatial engineering structures, the article proposes stiffness and mass matrices for one-, two- and three-dimensional basic finite elements for calculating port lifting structures.