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Justification for Research: the construction companies are facing barriers and challenges in BIM adoption as there is no clear guidance or best practice studies from which they can learn and build up their capacity for BIM use in order to increase productivity, efficiency, quality, and to attain competitive advantages in the global market and to achieve the targets in environmental sustainability. Purpose: this paper aims to explain a comprehensive and systemic evaluation and assessment of the relevant BIM technologies as part of the BIM adoption and implementation to demonstrate how efficiency gains have been achieved towards a lean architectural practice. Design/Methodology/Approach: The research is undertaken through a KTP (Knowledge transfer Partnership) project between the University of Salford and the John McCall Architects based in Liverpool, which is an SME (Small Medium Enterprise). The overall aim of KTP is to develop Lean Design Practice through the BIM adoption and implementation. The overall BIM implementation approach uses a socio-technical view in which it does not only consider the implementation of technology but also considers the socio-cultural environment that provides the context for its implementation. The technology adoption methodology within the BIM implementation approach is the action research oriented qualitative and quantitative research for discovery, comparison, and experimentation as the KTP project with JMA provides an environment for "learning by doing" Findings: research has proved that BIM technology adoption should be undertaken with a bottom-up approach rather than top-down approach for successful change management and dealing with the resistance to change. As a result of the BIM technology adoption, efficiency gains are achieved through the piloting projects and the design process is improved through the elimination of wastes and value generation. Originality/Value: successful BIM adoption needs an implementation strategy. However, at operational level, it is imperative that professional guidelines are required as part of the implementation strategy. This paper introduces a systematic approach for BIM technology adoption based on a case study implementation and it demonstrates a guideline at operational level for other SME companies of architectural practices.

Many of the scientific and regulatory challenges that exist in research on the safety, quality and efficacy of dietary supplements are common to all countries as the marketplace for them becomes increasingly global. This article summarizes some of the challenges in supplement science and provides a case study of research at the Office of Dietary Supplements at the National Institutes of Health, USA, along with some resources it has developed that are available to all scientists. It includes examples of some of the regulatory challenges faced and some resources for those who wish to learn more about them.

A roundtable to discuss the measurement of vitamin B-12 (cobalamin) status biomarkers in NHANES took place in July 2010. NHANES stopped measuring vitamin B-12–related biomarkers after 2006. The roundtable reviewed 3 biomarkers of vitamin B-12 status used in past NHANES—serum vitamin B-12, methylmalonic acid (MMA), and total homocysteine (tHcy)—and discussed the potential utility of measuring holotranscobalamin (holoTC) for future NHANES. The roundtable focused on public health considerations and the quality of the measurement procedures and reference methods and materials that past NHANES used or that are available for future NHANES. Roundtable members supported reinstating vitamin B-12 status measures in NHANES. They noted evolving concerns and uncertainties regarding whether subclinical (mild, asymptomatic) vitamin B-12 deficiency is a public health concern. They identified the need for evidence from clinical trials to address causal relations between subclinical vitamin B-12 deficiency and adverse health outcomes as well as appropriate cutoffs for interpreting vitamin B-12–related biomarkers. They agreed that problems with sensitivity and specificity of individual biomarkers underscore the need for including at least one biomarker of circulating vitamin B-12 (serum vitamin B-12 or holoTC) and one functional biomarker (MMA or tHcy) in NHANES. The inclusion of both serum vitamin B-12 and plasma MMA, which have been associated with cognitive dysfunction and anemia in NHANES and in other population-based studies, was preferable to provide continuity with past NHANES. Reliable measurement procedures are available, and National Institute of Standards and Technology reference materials are available or in development for serum vitamin B-12 and MMA.

New developments in the treatment and management of phenylketonuria (PKU) as well as advances in molecular testing have emerged since the National Institutes of Health 2000 PKU Consensus Statement was released. An NIH State-of-the-Science Conference was convened in 2012 to address new findings, particularly the use of the medication sapropterin to treat some individuals with PKU, and to develop a research agenda. Prior to the 2012 conference, five working groups of experts and public members met over a 1-year period. The working groups addressed the following: long-term outcomes and management across the lifespan; PKU and pregnancy; diet control and management; pharmacologic interventions; and molecular testing, new technologies, and epidemiologic considerations. In a parallel and independent activity, an Evidence-based Practice Center supported by the Agency for Healthcare Research and Quality conducted a systematic review of adjuvant treatments for PKU; its conclusions were presented at the conference. The conference included the findings of the working groups, panel discussions from industry and international perspectives, and presentations on topics such as emerging treatments for PKU, transitioning to adult care, and the U.S. Food and Drug Administration regulatory perspective. Over 85 experts participated in the conference through information gathering and/or as presenters during the conference, and they reached several important conclusions. The most serious neurological impairments in PKU are preventable with current dietary treatment approaches. However, a variety of more subtle physical, cognitive, and behavioral consequences of even well-controlled PKU are now recognized. The best outcomes in maternal PKU occur when blood phenylalanine (Phe) concentrations are maintained between 120 and 360 μmol/L before and during pregnancy. The dietary management treatment goal for individuals with PKU is a blood Phe concentration between 120 and 360 μmol/L. The use of genotype information in the newborn period may yield valuable insights about the severity of the condition for infants diagnosed before maximal Phe levels are achieved. While emerging and established genotype-phenotype correlations may transform our understanding of PKU, establishing correlations with intellectual outcomes is more challenging. Regarding the use of sapropterin in PKU, there are significant gaps in predicting response to treatment; at least half of those with PKU will have either minimal or no response. A coordinated approach to PKU treatment improves long-term outcomes for those with PKU and facilitates the conduct of research to improve diagnosis and treatment. New drugs that are safe, efficacious, and impact a larger proportion of individuals with PKU are needed. However, it is imperative that treatment guidelines and the decision processes for determining access to treatments be tied to a solid evidence base with rigorous standards for robust and consistent data collection. The process that preceded the PKU State-of-the-Science Confe...

Skin colonization with antibiotic-resistant propionibacteria is much more common now than a decade ago. Resistant propionibacteria are widely distributed on acne-prone skin and in the nares. This suggests that they will be very difficult to eradicate using existing therapeutic regimens, especially from the nasal reservoir.

ABSTRACT:Severe issues about data acquisition and management arise during the design creation and development due to complexity, uncertainty and ambiguity. BIM (Building Information Modelling) is a tool for a team based lean design approach towards improved architectural practice across the supply chain. However, moving from a CAD (Computer Aided Design) approach to BIM (Building Information Modelling) represents a fundamental change for individual disciplines and the construction industry as a whole. Although BIM has been implemented by large practices, it is not widely used by SMEs (Small and Medium Sized Enterprises). Purpose: This paper aims to present a systematic approach for BIM implementation for Architectural SMEs at the organizational level Design/Methodology/Approach: The research is undertaken through a KTP (Knowledge transfer Partnership) project between the University of Salford and John McCall Architects (JMA) a SME based in Liverpool. The overall aim of the KTP is to develop lean design practice through BIM adoption. The BIM implementation approach uses a socio-technical view which does not only consider the implementation of technology but also considers the socio-cultural environment that provides the context for its implementation. The action research oriented qualitative and quantitative research is used for discovery, comparison, and experimentation as it provides "learning by doing". Findings: The strategic approach to BIM adoption incorporated people, process and technology equally and led to capacity building through the improvements in process, technological infrastructure and upskilling of JMA staff to attain efficiency gains and competitive advantages. Originality/Value : This paper introduces a systematic approach for BIM adoption based on the action research philosophy and demonstrates a roadmap for BIM adoption at the operational level for SME companies.

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