Stepwise Design Research Articles

Development, content validation and standardization of an adult patient prioritization tool for hospital clinical pharmacy services

BackgroundPatient prioritization is a effective strategy to identify high risk patients for targeted Clinical Pharmacy Service (CPS) in hospital pharmacy. However, there is a paucity of patient prioritization tool to use in clinical practice. ObjectivesDescribe the development, content validation and standardization of an adult patient prioritization tool for hospital CPS named, PrioFarClinH. MethodsThe tool was developed using a stepwise design multi: Scoping Review to identify prioritization criteria/sub-criteria; Delphi technique to obtain consensus under the identified criteria/sub-criteria; Survey with pharmacists evaluating applicability of the criteria/sub-criteria obtained from Delphi; Definition of criteria/sub-criteria to be included in PrioFarClinH attribution of scores. Content validation was performed by a panel of experts evaluating relevance, feasibility, clarity and adequacy of the score. Content Validity Index (CVI) was calculated. Standardization occurred through a retrospective observational study carried out at 24 and 72 h and median of the patient's hospital stay. An intragroup norm was performed, determining percentile ranks of the instrument's total scores. Patients with a P90 score were classified with a high level of prioritization for CPS. ResultsPrioFarClinH is divided into three sections, with prioritization criteria for health issues; therapeutic classes; laboratory parameters. It comprises 51 criteria with specific scores with simple total calculation. None of the criteria presented CVI <0.78, maintaining the items from the initial version of PrioFarClinH. The scores were adjusted per suggestions from the panel of judges. Data were collected from 393 patients. The P90 percentile in the three hospitalization stages (24 h, 72 h, and median) was found, respectively, in the following scores: 18.0, 20.0, and 22.6. ConclusionsPrioFarClinH is a comprehensive tool to target and to prioritize adults patients most likely to benefit from CPS. Evidence for adequate content validity was provided. However, further validation of this tool is necessary to establish tool performance.

The protocol of enhanced recovery after cardiac surgery in adult patients: A stepped wedge cluster randomized trial

BackgroundThe Enhanced Recovery After Cardiac Surgery is a bundle of measurements from preoperative to postoperative phases to improve patients’ recovery. MethodsThis study is a multicenter, stepwise design, cluster randomized controlled trial. 3600 patients presenting during control and intervention periods are eligible if they are aged from 18 to 80 years old awaiting elective cardiac surgery with cardiopulmonary bypass (CPB). 5 centers are randomly assigned to staggered start dates for one-way crossover from the control phase to the intervention phase. In the intervention periods, patients will receive ERAS strategy including preoperative, intraoperative and postoperative approaches. During the control phase, patients receive usual care. The primary outcome consists of major adverse cardiac and cerebrovascular events (MACCEs), postoperative pulmonary complications (PPCs), and acute kidney injury (AKI). DiscussionThis study aims to compare the application of ERAS management protocol and traditional management protocol in adult cardiac surgery under extracorporeal circulation.

A Comprehensive Strategy for Stepwise Design of a Lab PROTOTYPE for the Removal of Emerging Contaminants in Water Using Cyclodextrin Polymers as Adsorbent Material.

The significant environmental issue of water pollution caused by emerging contaminants underscores the imperative for developing novel cleanup methods that are efficient, economically viable, and that are intended to operate at high capacity and under continuous flows at the industrial scale. This study shows the results of the operational design to build a prototype for the retention at lab scale of pollutant residues in water by using as adsorbent material, insoluble polymers prepared by β-cyclodextrin and epichlorohydrin as a cross-linking agent. Laboratory in-batch tests were run to find out the adsorbent performances against furosemide and hydrochlorothiazide as pollutant models. The initial evaluation concerning the dosage of adsorbent, pH levels, agitation, and concentration of pharmaceutical pollutants enabled us to identify the optimal conditions for conducting the subsequent experiments. The adsorption kinetic and the mechanisms involved were evaluated revealing that the experimental data perfectly fit the pseudo second-order model, with the adsorption process being mainly governed by chemisorption. With KF constant values of 0.044 (L/g) and 0.029 (L/g) for furosemide and hydrochlorothiazide, respectively, and the determination coefficient (R2) being higher than 0.9 for both compounds, Freundlich yielded the most favorable outcomes, suggesting that the adsorption process occurs on heterogeneous surfaces involving both chemisorption and physisorption processes. The maximum monolayer adsorption capacity (qmax) obtained by the Langmuir isotherm revealed a saturation of the β-CDs-EPI polymer surface 1.45 times higher for furosemide (qmax = 1.282 mg/g) than hydrochlorothiazide (qmax = 0.844 mg/g). Based on these results, the sizing design and building of a lab-scale model were carried out, which in turn will be used later to evaluate its performance working in continuous flow in a real scenario.

The protocol of Enhanced Recovery After Cardiac Surgery (ERACS) in congenital heart disease: a stepped wedge cluster randomized trial

BackgroundThe Enhanced Recovery After Cardiac Surgery (ERACS) programs are comprehensive multidisciplinary interventions to improve patients’ recovery. The application of the ERAS principle in pediatric patients has not been identified completely.MethodsThis study is a multicenter, stepwise design, cluster randomized controlled trial. 3030 patients presenting during control and intervention periods are eligible if they are aged from 28 days to 6 years old and awaiting elective correction surgery of congenital heart disease with cardiopulmonary bypass. 5 centers are randomly assigned to staggered start dates for one-way crossover from the control phase to the intervention phase. In the intervention periods, patients will receive a bundle strategy including preoperative, intraoperative, and postoperative approaches. During the control phase, patients receive the usual care. The primary outcome consists of major adverse cardiac and cerebrovascular events (MACCEs), postoperative pulmonary complications (PPCs), and acute kidney injury (AKI).DiscussionThis study aims to explore whether the bundle of ERAS measurements could improve patients’ recovery in congenital heart surgery.Trial registrationhttp://www.clinicaltrials.gov. (NCT05914103).

Energy absorption properties of a 3D-printed lattice-core foam composite under compressive and low-velocity impact loading

This experimental work aims to investigate the compression and low-velocity impact characteristics of different lattice structures made via Fused Deposition Modeling (FDM) technology to be used as a skeleton of a lightweight polyurethane foam (PUF) composite. Three frame-unit geometries, namely one cubic cell and two pyramidal cell variants, were firstly considered as reinforcement. A stepwise design rationale was adopted to identify better lattice configurations progressively, focusing on manufacturing aspects such as cell geometry and structural density, as well as efficiency requirements. A square-based pyramid geometry was identified as the most efficient in energy dissipation and, therefore, was selected for further investigations, varying bulk density, to identify the lattice reinforcement to be embedded in the polyurethane foam matrix and generate the PUF composite. The experimental outcomes showed enhanced dissipative capacity of the composite structure under static and dynamic loading conditions, suggesting promising applications to preserve the integrity of objects in accidental collisions.

Versatile computer-aided design of free-form DNA nanostructures and assemblies.

Recent advances in structural DNA nanotechnology have been facilitated by design tools that continue to push the limits of structural complexity while simplifying an often-tedious design process. We recently introduced the software MagicDNA, which enables design of complex 3D DNA assemblies with many components; however, the design of structures with free-form features like vertices or curvature still required iterative design guided by simulation feedback and user intuition. Here, we present an updated design tool, MagicDNA 2.0, that automates the design of free-form 3D geometries, leveraging design models informed by coarse-grained molecular dynamics simulations. Our GUI-based, stepwise design approach integrates a high level of automation with versatile control over assembly and subcomponent design parameters. We experimentally validated this approach by fabricating a range of DNA origami assemblies with complex free-form geometries, including a 3D Nozzle, G-clef, and Hilbert and Trifolium curves, confirming excellent agreement between design input, simulation, and structure formation.

Thermoelectric converter with stepwise legs for high energy conversion efficiency

Due to industrial activity, an enormous amount of heat is wasted on the environment enabling energy loss and global warming. Thermoelectric (TE) technologies make possible the direct conversion of waste heat into electrical energy. The main bottlenecks of energy conversion by TE devices are low efficiency as well as the expensive and complex fabrication procedure of industrial converters. In this work, we fabricated a Bi2Te3-based TE converter with stepwise legs for highly efficient energy conversion using a single-step sintering method. Before the fabrication of the converter, we employed the numerical simulation and found that Co is the best choice among the other well-established metallic layers, that can be used for the highly conductive covering of the n- and p-type TE legs. The employment of this metal produces the lowest thermal stress that occurs in the stepwise converter at the cooling stage of a sintering process. The energy conversion efficiency of the designed converter estimated using the finite element method reaches 10.1% at a temperature difference of 375 K (Tc = 300 K). Moreover, the measured value of efficiency achieves 8.5%, which is 1.4 times higher than the commercial Bi2Te3-based converters and 9–14% higher than the other reported stepwise converters. The enhanced efficiency mainly originates from the effective stepwise design of the n- and p-type TE legs. This work offers a new path for the simple single-step fabrication of the Bi2Te3-based TE converters that should have great potential for energy harvesting.

Game-based assessment framework for virtual reality, augmented reality and digital game-based learning

Immersive learning technologies such as virtual reality (VR), augmented reality (AR) and educational digital games offer many benefits to teaching and learning. With their potential to immerse learners in realistic environments and facilitate higher-order cognitive learning, these technologies could be used to complement current classroom pedagogical practices. However, given that these learning environments differ from conventional classroom learning activities, current assessment practices may be insufficient for assessing learning in immersive environments. This paper develops the concept of a game-based assessment framework (GBAF) for educators interested in the assessment of learning in digital games, VR or AR. Importantly, this paper also presents the application of the framework to the design and implementation of assessments for a VR game during the game design phase. Grounded in the principles of Constructive Alignment and the Evidence-Centred Design (ECD) framework, this assessment framework describes the steps to consider for assessments and outlines the components that must be aligned for the design of assessments. To illustrate the application of the GBAF to the design of assessments for immersive learning environments, a stepwise design of assessments for a VR game is presented. The results of the outcome of the assessment of laboratory health and safety competencies of six engineering students is also presented. The GBAF offers simple and useful guidelines for the design of assessments around game tasks. It could serve as a structured basis for educators and researchers to design assessments to measure lower and higher-order cognitive learning in complex immersive environments.

Stress Alleviation Methods for community-Based Health ActiVists (SAMBHAV): Development of a digital program for stress reduction for community health workers in rural India

BackgroundCommunity health workers (CHWs) face high levels of stress (both professional and personal) and risk of burnout, highlighting the need for efforts to promote their mental health and well-being. This study seeks to develop a digital stress reduction program for CHWs in rural India. MethodsA stepwise design process was employed to adapt and digitize the evidence-based World Health Organization's Self-Help Plus (SH+) intervention for addressing psychological distress among CHWs in Madhya Pradesh, India. This involved participatory design workshops with CHWs to ensure that the digital stress reduction intervention would be relevant for their needs and the local culture and context. Small groups of CHWs reviewed the adapted program content, allowing the research team to make refinements such as simplifying language, tailoring content to the local setting, and ensuring that program materials are both interesting and relevant. Simultaneously, the research team digitized the content, leveraging a combination of video and graphical content, and uploaded it to the Sangath Learning Management System, a digital platform accessible on a smartphone app. ResultsIn total, 18 CHWs contributed to the adaptation of the SH+ content and digital intervention development. Participants commented on finding some terms difficult to follow and recommended simplifying the language and providing detailed explanations. Participants offered positive feedback on the adapted content, expressing that they found the examples covered in the material both relatable and relevant to their own personal experiences at home and in the workplace. By combining participants’ insights and comments with feedback from content experts, it was possible to finalize a digital Hindi version of the SH+ intervention for CHWs in rural India. ConclusionsThis study is timely given the continued detrimental impacts of the COVID-19 pandemic, and offers a promising and potentially scalable digital program to alleviate psychological distress among frontline health workers.

Short-course, high-dose primaquine regimens for the treatment of liver-stage vivax malaria in children

ObjectivesTo assess the pharmacokinetics, safety, and tolerability of two high-dose, short-course primaquine (PQ) regimens compared with standard care in children with Plasmodium vivax infections. MethodsWe performed an open-label pediatric dose-escalation study in Madang, Papua New Guinea (Clinicaltrials.gov NCT02364583). Children aged 5-10 years with confirmed blood-stage vivax malaria and normal glucose-6-phosphate dehydrogenase activity were allocated to one of three PQ treatment regimens in a stepwise design (group A: 0.5 mg/kg once daily for 14 days, group B: 1 mg/kg once daily for 7 days, and group C: 1 mg/kg twice daily for 3.5-days). The study assessments were completed at each treatment time point and fortnightly for 2 months after PQ administration. ResultsBetween August 2013 and May 2018, 707 children were screened and 73 met the eligibility criteria (15, 40, and 16 allocated to groups A, B, and C, respectively). All children completed the study procedures. The three regimens were safe and generally well tolerated. The pharmacokinetic analysis indicated that an additional weight adjustment of the conventionally recommended milligram per kilogram PQ doses is not necessary to ensure the therapeutic plasma concentrations in pediatric patients. ConclusionsA novel, ultra-short 3.5-day PQ regimen has potential benefits for improving the treatment outcomes in children with vivax malaria that warrants further investigation in a large-scale clinical trial.

Study on Maneuvering Target Trajectory Simulation and Tracking Based on IMM algorithm

On the background of air defense missile which use radar command guidance, this article focuses on the maneuvering target trajectory simulation and tracking problem by considering possible maneuvering modes and target overload. Taking Serpentine maneuvering (S maneuvering) as an example, the target trajectory is simulated based on overload using stepwise design method, and data are measured through sensor models. Since single model cannot model the maneuvering target motion exactly, the estimation is addressed by combining the interacting multiple model algorithm and unscented Kalman filter algorithm, so as to study the applications of maneuvering target trajectory simulation and tracking in air defense missile systems. The effectiveness of the algorithm is demonstrated with simulated data.

A novel high-entropy alloy with multi-strengthening mechanisms: Activation of TRIP effect in C-doped high-entropy alloy

Efforts have been made to intentionally activate multiple strengthening mechanisms in a single alloy because individual strengthening effects have not been sufficiently exhibited in previous alloys with multi-strengthening mechanisms. Here, we design a novel high-entropy alloy with multi-strengthening mechanisms through a stepwise design approach utilizing CALPHAD type thermodynamic calculation. The target strengthening mechanisms are introduced step by step, from solid solution strengthening, the addition of precipitation hardening and transformation-induced plasticity, based on the calculation. The finally designed Co21Cr11Fe49Mn4Ni4V2C1Mo3Si5 alloy simultaneously benefits from solid solution strengthening due to Mo and V addition, precipitation hardening from nanoscale precipitates, grain boundary strengthening by grain refinement, and transformation-induced plasticity by BCC deformation-induced martensite transformation. Individual strengthening effects is sufficiently exhibited in the designed alloy, which leads to an excellent combination of yield strength (732 MPa), ultimate tensile strength (1100 MPa), and ductility (47.5%).

ABCL-052 MINDway: A Phase Ib/II Dose Optimization Study to Assess Safety and Pharmacokinetics of Tafasitamab + Lenalidomide in Patients With Relapsed/Refractory Diffuse Large B-Cell Lymphoma

The chemo-free immunotherapy tafasitamab + lenalidomide has been granted FDA accelerated approval and EU conditional marketing authorization for relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) treatment in autologous stem cell transplant-ineligible adults. Treatment schedule optimization aims to reduce the frequency of hospital visits and decrease treatment burden and healthcare utilization. MINDway (NCT05222555) will investigate if tafasitamab administration at levels higher than the approved 12 mg/kg dose at a reduced dosing frequency maintains the benefit-risk relationship of tafasitamab + lenalidomide for patients with R/R DLBCL. To assess an optimized tafasitamab treatment schedule in patients with R/R DLBCL. Open-label, multicenter, Phase Ib/II study. Currently enrolling; the planned sample size is 51 patients. Eligible patients are aged 18-80 years with histologically confirmed R/R DLBCL and 1-3 prior systemic regimens, including CD20-targeted therapy. Patients previously treated with CD19-targeted therapy or immunomodulatory imide drugs, such as lenalidomide, are excluded. The modified dosing regimen will be investigated in a stepwise design: two sequential dose-finding cohorts (planned n=6 each) followed by an expansion cohort (planned n=39). Lenalidomide 25 mg will be administered in all cohorts on Days 1-21 of each 28-day cycle for up to 12 cycles. After Cycle 12, patients will continue tafasitamab monotherapy at the assigned dosing regimen until progression. After reviewing safety and pharmacokinetic data from Cohorts 1 and 2, patients will be enrolled in an expansion cohort to receive tafasitamab + lenalidomide (tafasitamab dose: 24 or 30 mg/kg) for further evaluation. No intra-patient dose escalation from 24 to 30 mg/kg is permitted. The primary endpoints are the incidence and severity of treatment-emergent adverse events. Key secondary endpoints are tafasitamab serum concentration after 3 and 12 cycles, best objective response rate, duration of response, and progression-free survival. Not yet available. MINDway will evaluate an optimized tafasitamab dosing regimen to reduce the frequency of hospital/clinic visits for tafasitamab-treated patients with R/R DLBCL. Reducing the frequency of visits by half is expected to reduce patient burden and support long-term treatment compliance. Fewer visits may result in less exposure to hospital infections in this already susceptible population. MorphoSys AG.

Self-Assembly of Lanthanide Crescent-Like and Macrocyclic Clusters from Versatile o-Vanillin-Based Ligands.

The construction of metallosupramolecules is an interesting but challenging topic for chemists. Dedicated design of multidentate ligands is an effective approach for the construction of novel lanthanide supramolecules. Herein, we report on the stepwise design and syntheses of two flexible and multidentate ligands H2 L1 and H4 L2 based on the o-vanillin. By regulating the coordination sites and mode of the ligands, two novel DyIII -based supramolecules, [Dy4 Na(μ2 -OH)2 L1 4 (H2 O)5 (CH3 OH)](CF3 SO3 )3 ⋅ 3H2 O ⋅ CH3 OH (Dy4 ) and [Dy8 L2 4 (H2 L2 )4 (H2 O)4 ] ⋅ 4CH3 OH ⋅ 12H2 O (Dy8 ), have been obtained. Structural studies reveal that Dy4 and Dy8 show different nuclearity and topology: Dy4 shows a crescent-like structure coordinated by the ligands in different coordination fashions in which two ligands chelate DyIII forming {Dy2 } units and linked by the other two ligands; Dy8 is obtained from the supramolecular assembly, in which four completely deprotonated ligands construct the {Dy2 } units and the units are linked by four di-deprotonated ligands, forming a macrocycle topology. Additionally, magnetic measurements reveal that the two complexes exhibit slow magnetic relaxation behavior.

High strength steel frames with curved knee braces: Performance-based damage-control design framework

High strength steel frames with curved knee braces (HSSFs-CKBs) are typical seismic resilient structural systems. Previous experimental research showed that an HSSF-CKBs specimen could be readily repaired after an earthquake by replacing damaged curved knee braces (CKBs) which serve as energy dissipating devices, as long as high strength steel components stay essentially elastic to shake down post-earthquake residual deformations. To provide a practical tool for engineers in seismic resilience design, this paper developed a performance-based damage-control design framework for low-to-medium rise HSSFs-CKBs. A multi-storey HSSF-CKBs was first interlinked with an equivalent bilinear single-degree-of-freedom (SDOF) system. Then, the seismic input energy demand of the HSSF-CKBs was determined based on the seismic energy balance of the equivalent SDOF system, which was further distributed to different storeys to design structural components. To facilitate the design, a stepwise design procedure was proposed. A three-storey low-rise HSSF-CKBs and a six-storey medium-rise HSSF-CKBs were designed following the procedure. The seismic response of the designed structures was examined by pushover analyses and nonlinear time-history analyses using numerical models verified by shaking table test data. The analysis results showed that the designed structures exhibited the expected behaviour, and the maximum interstorey drifts were controlled below the design target, which verified the effectiveness of the proposed design framework.

PB2112: MINDWAY: A PHASE IB/II DOSE OPTIMIZATION STUDY TO ASSESS SAFETY AND PHARMACOKINETICS OF TAFASITAMAB + LENALIDOMIDE IN PATIENTS WITH RELAPSED/REFRACTORY DIFFUSE LARGE B-CELL LYMPHOMA

Background: Tafasitamab is an Fc-enhanced, humanized, anti-CD19 monoclonal antibody which, in combination with the immunomodulatory drug lenalidomide, has been granted accelerated FDA approval and EU conditional marketing authorization based on results from L-MIND (NCT02399085) for the treatment of relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) in adult patients ineligible for autologous stem cell transplant. Treatment schedule optimization aims to reduce the frequency of hospital visits and decrease treatment burden and healthcare utilization while maintaining clinical benefits. Aims: MINDway (NCT05222555) will investigate if administration of tafasitamab at levels higher than the approved 12 mg/kg dose at a reduced dosing frequency can maintain the benefit-risk relationship of tafasitamab + lenalidomide treatment for patients with R/R DLBCL. Methods: MINDway is an open-label, multicenter, Phase Ib/II study in patients aged 18‒80 years with histologically confirmed DLBCL and R/R status after at least one, but no more than three, prior systemic regimens, including CD20-targeted therapy. Patients previously treated with CD19-targeted therapy or with immunomodulatory imide drugs such as lenalidomide are excluded. The modified tafasitamab dosing regimen will be investigated in a stepwise design with two sequential dose-finding cohorts (planned n=6 each) followed by an expansion cohort (planned n=39; Figure). Lenalidomide 25 mg will be administered in all cohorts on Day (D) 1‒21 of each 28-D cycle for up to 12 cycles. After Cycle 12, patients will continue tafasitamab monotherapy at the assigned dosing regimen until progression. Following a review of the safety and pharmacokinetic data from Cohorts 1 and 2, patients will be enrolled in an expansion cohort to receive tafasitamab + lenalidomide at the tafasitamab dose of 24 mg/kg or 30 mg/kg for further evaluation. No intra-patient dose escalation from 24 mg/kg to 30 mg/kg is permitted. The primary endpoint is the incidence and severity of treatment-emergent adverse events; key secondary endpoints include tafasitamab serum concentrations after 3 and 12 treatment cycles and best objective response rate, duration of response, and progression-free survival by investigator assessment. All endpoints will be analyzed using descriptive statistics; no formal statistical tests will be performed. MINDway is currently enrolling, with a planned sample size of 51 patients. Results: Results for this study are not yet available: outcome data as described above will be presented in due course. Image:Summary/Conclusion: MINDway will optimize the tafasitamab dosing regimen to reduce the frequency of hospital/clinic visits for tafasitamab treated R/R DLBCL patients. Reducing the overall frequency of clinic visits by half is expected to reduce the patient burden and support long-term treatment compliance. Furthermore, given the severity of the disease, reduced hospital visits may result in less exposure to hospital infections in this already susceptible population.

Steel moment resisting frames with energy-dissipation rocking columns under near-fault earthquakes: Probabilistic performance-based-plastic-design for the ultimate stage

In this paper, a probabilistic performance-based-plastic-design methodology for steel moment resisting frames with energy-dissipation rocking columns (MRF-EDRCs) was developed, and the emphasis was given to the ultimate stage of the structure subjected to near-fault earthquakes. Firstly, based on the energy balance notion and an equivalent nonlinear single-degree-of-freedom (SDOF) system representing a low-to-medium steel MRF-EDRC, nonlinear spectral analyses were carried out considering various combinations of hysteretic parameters and a wide range of structural periods. More than 55 million energy modification factors quantifying the seismic demand of the system subjected to near-fault earthquake motions were obtained. Then, a probabilistic spectral model of the energy modification factor was established, which can be utilised as the basis of the design methodology. To promote engineering applications, a stepwise design framework for the steel MRF-EDRC with target drift and a prescribed probabilistic performance target was proposed. To verify the effectiveness of the proposition, a prototype structure with two target drifts was designed and modelled by finite element approach. The rationale of the modelling strategies was confirmed by previous test data. Subsequently, the seismic performance of the designed structure was evaluated by nonlinear pushover and dynamic analyses. The results showed that the designed structure conforming to the proposed method can limit the maximum inter-storey drift to a preselected threshold with a prescribed probabilistic performance target.

Crown Macromolecular Derivatives: Stepwise Design of New Types of Polyfunctionalized Phosphorus Dendrimers.

Phosphorus dendrimers are used for many applications in different domains including nanomedicine as cargo of drugs or as species active per se but also in a variety of other fields ranging from nanoscience to catalysis. Their properties depend on the nature of their internal structure and mainly of the diversity and versatility of the functional groups located on their outer shell. Therefore, there is a need to diversify their structure in order to use them for new applications and to propose alternative synthetic pathways to be built easily, at each step and in high yield a family of original stable phosphorus dendrimers of different generations. Such a goal is illustrated in this report with the original synthesis of 14 new phosphorus dendrimers of generation 0 to 2 and the possibility to modify at will their internal structure and the nature of their functional end groups.

Stepwise slime mould growth as a template for urban design

The true slime mould, Physarum polycephalum, develops as a vascular network of protoplasm, connecting node-like sources of food in an effort to solve multi-objective transport problems. The organism first establishes a dense and continuous mesh, reinforcing optimal pathways over time through constructive feedbacks of protoplasmic streaming. Resolved vascular morphologies are the result of an evolutionarily-refined mechanism of computation, which can serve as a versatile biological model for network design at the urban scale. Existing digital Physarum models typically use positive reinforcement mechanisms to capture meshing and refinement behaviours simultaneously. While these automations generate accurate descriptions of sensory and constructive feedback, they limit stepwise design control, reducing flexibility and applicability. A model that decouples the two “phases” of Physarum behaviour would enable multistage control over network growth. Here we introduce such a system, first by producing a site-responsive mesh from a population of nutrient-attracted agents, and then by independently calculating from it a flexible, proximity-defined shortest-walk to produce a final network. We develop and map networks within existing urban environments that perform similarly to those biologically grown, establishing a versatile tool for bio-inspired urban network design.

Stepwise Design and Evaluation of a Values-Oriented Ambient Intelligence Healthcare Monitoring Platform

ObjectivesThe majority of all developed digital health technologies do not reach successful implementation. A discrepancy among technology design, the context of use, and user needs and values is identified as the main reason for this failure. Value-sensitive design (VSD) is a design method enabling to align design with user values by embedding values in technology, yet the method is lacking clear heuristics for practical application. To improve the successful design and implementation of digital health, we propose and evaluate a stepwise approach to VSD. MethodsThe approach consists of the phases: experiment, demonstrate, and validate. Experiment takes place in an office to create makeshift solutions. Demonstrate takes place in a mock-up environment and aims to optimize design requirements through user feedback. The validate phase takes place in an authentic care situation and studies how the novel technology affects current workflows. ResultsWe applied the stepwise VSD approach to the design of a hospital-based ambient intelligence solution for remotely and continuously monitoring quality and safety of patient care. We particularly focused on embodiment of the values of safety, privacy, and inclusiveness in the design. Design activities of the experiment and demonstrate phase are discussed. ConclusionsA stepwise approach to VSD enables a design to optimally meet the values of all users involved, while aligning the design process with the practical limitations of healthcare institutions. We discuss some benefits and challenges related to VSD and the potential for transfer of this approach to other digital health solutions.