Background: The reported associations between time to first antibiotic dose after hospital arrival and short-term mortality have varied in prior studies of CAP. It is unclear the benefit of early antibiotics in all patients given the risks of antibiotic overuse and misdiagnosis; Methods: A PubMed and Google Scholar search was performed to identify articles detailing the epidemiology, prognosis, diagnosis, and preliminary management of CAP; Results: In sepsis, antibiotics should not be delayed, and should be administered as soon as possible after recognition. For moderate or severe CAP patients without sepsis, antibiotics should be administered as soon as the diagnosis of CAP is highly likely. For stable, non–critically ill patients with CAP, the timing of antibiotics is not as clear and available evidence does not recommend strict requirements. Antibiotic timing – both rapid and delayed could be used as indicators of quality care in differing clinical scenarios; Results: The dogma of starting antibiotics quickly, within a rigid timeframe of expectations and guidelines has not improved outcomes in pneumonia patients, and has led to an increase in antibiotic treatment in uninfected patients. Severity of illness is the key factor associated with poor outcomes and should more significantly guide the timing of antibiotic initiation.

Structural design optimization (SDO) plays a pivotal role in enhancing various aspects of construction projects, including design quality, cost-efficiency, safety, and structural reliability. Recent endeavors in academia and industry have sought to harness the potential of Building Information Modeling (BIM) and optimization algorithms to optimize SDO and improve design outcomes. This review paper aims to synthesize these efforts, shedding light on how SDO contributes to project coordination. Furthermore, the integration of sustainability considerations and the application of innovative technologies and optimization algorithms in SDO necessitate more interactive early-stage collaboration among project stakeholders. This study offers a comprehensive exploration of contemporary research in integrated SDO employing BIM and optimization algorithms. It commences with an exploratory investigation, employing both qualitative and quantitative analysis techniques following the PRISMA systematic review methodology. Subsequently, an open-ended opinion survey was conducted among construction industry professionals in Europe. This survey yields valuable insights into the coordination challenges and potential solutions arising from technological shifts and interoperability concerns associated with widespread SDO implementation. These preliminary steps of systematic review and industry survey furnish a robust knowledge foundation, enabling the proposal of an intelligent framework for automating early-stage sustainable structural design optimization (ESSDO) within the construction sector. The framework ESSDO addresses the challenges of fragmented collaboration between architects and structural engineers. This proposed framework seamlessly integrates with the BIM platform, i.e., Autodesk Revit for architects. It extracts crucial architectural data and transfers it to the structural design and analysis platform, i.e., Autodesk Robot Structural Analysis (RSA), for structural engineers via the visual programming tool Dynamo. Once the optimization occurs, optimal outcomes are visualized within BIM environments. This visualization elevates interactive collaborations between architects and engineers, facilitating automation throughout the workflow and smoother information exchange.

Construction 4.0 is witnessing exponential growth in Digital Twin (DT) technology developments and applications, revolutionizing the adoption of Building Information Modelling (BIM) and other emerging technologies used throughout the lifecycle of the built environment. BIM provides technologies, procedures, and data schemas representing building components and systems. At the same time, DT enhances this with real-time data for cyber-physical integration, enabling live asset monitoring and better decision-making. Despite being in the early stages of development, DT applications have rapidly progressed in the AEC sector, resulting in a diverse literature landscape due to the various technologies and parameters involved in fully developing the DT technology. The intricate complexities inherent in digital twin advancements have confused professionals and researchers. This confusion arises from the nuanced distinctions between the two technologies, i.e., BIM and DT, causing a convergence that hinders realizing their potential. To address this confusion and lead to a swift development of DT technology, this study presents a holistic review of the existing research focusing on the critical components responsible for developing DT applications in the construction industry. The study identifies five crucial elements: technologies, maturity levels, data layers, enablers, and functionalities. Additionally, it identifies research gaps and proposes future avenues for streamlined DT developments and applications in the AEC sector. Future researchers and practitioners can target data integrity, integration and transmission, bi-directional interoperability, nontechnical factors, and data security to achieve mature digital twin applications for AEC practices. This study highlights the growing significance of DTs in construction and provides a foundation for further advancements in this field to harness its potential to transform built environment practices.