1,505 research outputs found

    A Cloud-based Collaborative Ecosystem for the Automation of BIM Execution Plan (BEP)

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    Master Information Delivery Plan (MIDP) is a key requirement for BIM Execution Plan (BEP) that enlists all information deliverables in BIM-based project, containing information about what would be prepared, when, by who, as well as the procedures and protocols to be used. In a well-conceived BEP, the MIDP facilitates collaboration among stakeholders. However, current approaches to generating MIDP are manual, making it tedious, error-prone, and inconsistent, thereby limiting some expected benefits of BIM implementation. The purpose of the present research is to automate the MIDP and demonstrate a collaborative BIM system that overcomes the problems associated with the traditional approach. A BIM cloud-based system (named Auto-BIMApp) involving naming that automated MIDP generation is presented. A participatory action research methodology involving academia and industry stakeholders is followed to design and validate the Auto-BIMApp. A mixed-method experiment is conducted to compare the proposed automated generation of MIDP using Auto-BIMApp with the traditional practice of using spreadsheets. The quantitative results show over 500% increased work efficiency, with improved and error-free collaboration among team members through Auto-BIMApp. Moreover, the responses from the participants using Auto-BIMApp during the experiment shows positive feedback in term of ease of use and automated functionalities of the Auto-BIMApp. The replacement of traditional practices to a complete automated collaborative system for the generation of MIDP, with substantial productivity improvement, brings novelty to the present research. The Auto-BIMApp involve multidimensional information, multiple platforms, multiple types, and levels of users, and generates three different representations of MIDP

    Endovascular treatment of visceral artery aneurysms and pseudoaneurysms with stent-graft: Analysis of immediate and long-term results

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    The aim of this study is to analyze the safety and efficacy of stent-graft endovascular treatment for visceral artery aneurysms and pseudoaneurysms. METHODS: Multicentric retrospective series of patients with visceral aneurysms and pseudoaneurysms treated by means of stent graft. The following variables were analyzed: Age, sex, type of lesion (aneurysms/pseudoaneurysms), localization, rate of success, intraprocedural and long term complication rate (SIR classification). Follow-up was performed under clinical and radiological assessment. RESULTS: Twenty-five patients (16 men), with a mean age of 59 (range 27-79), were treated. The indication was aneurysm in 19 patients and pseudoaneurysms in 6. The localizations were: splenic artery (12), hepatic artery (5), renal artery (4), celiac trunk (3) and gastroduodenal artery (1). Successful treatment rate was 96% (24/25 patients). Intraprocedural complication rate was 12% (4% major; 8% minor). Complete occlusion was demonstrated during follow up (mean 33 months, range 6-72) in the 24 patients with technical success. Two stent migrations (2/24; 8%) and 4stent thrombosis (4/24; 16%) were detected. Mortality rate was 0%. CONCLUSION: In our study, stent-graft endovascular treatment of visceral aneurysmns and pseudoaneurysms has demonstrated to be safe and is effective in the long-term in both elective and emergent cases, with a high rate of successful treatment and a low complication rate

    Assessment of pulmonary artery pressure by echocardiography—A comprehensive review

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    Pulmonary hypertension is a pathological haemodynamic condition defined as an increase in mean pulmonary arterial pressure ≥ 25mmHg at rest, assessed using gold standard investigation by right heart catheterisation. Pulmonary hypertension could be a complication of cardiac or pulmonary disease or a primary disorder of small pulmonary arteries. Elevated pulmonary pressure (PAP) is associated with increased mortality, irrespective of the aetiology. The gold standard for diagnosis is invasive right heart catheterisation, but this has its own inherent risks. In the past 30 years, immense technological improvements in echocardiography have increased its sensitivity for quantifying pulmonary artery pressure (PAP) and it is now recognised as a safe and readily available alternative to right heart catheterisation. In future, scores combining various echo techniques can approach the gold standard in terms of sensitivity and accuracy, thereby reducing the need for repeated invasive assessments in these patients

    Properties of Modified Warm-Mix Asphalt Mixtures Containing Different Percentages of Reclaimed Asphalt Pavement

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    The Rapid reduction of energy resources and the escalated effects of global warming have created a strong motivation to find some new techniques in the field of paving construction. Adopting new technologies, such as warm-mix asphalt (WMA) or the recycling process of asphalt can be very helpful for the economy and have a significant impact on the environmental footprint. Thus, this research aimed to study the mechanical and durable characteristics of modified WMA mixtures using (1.0%, 1.5%, and 2.0%) Sasobit REDUX®, (0.3%, 0.4%, and 0.5%) Aspha-Min®, and (0.07%, 0.1%, and 0.125) ZycoTherm® additives corresponding to three percentages of reclaimed asphalt pavement (RAP) (20%, 40%, and 60%). Three mixing temperatures have been conducted in this study to generate WMA mixtures at (135 °C, 125 °C, and 115 °C) corresponding to three compacting temperatures (125 °C, 115 °C, and 105 °C). The mechanical properties of the developed WMA mixtures have been evaluated using the Superpave volumetric properties (air voids, voids filled with asphalt, and voids in mineral aggregate), while the durable properties have been investigated using the resilient modulus test (MR) at 25 °C, resilient modulus ratio (RMR), and Hamburg wheel-track test in terms of permanent deformation, moisture susceptibility, and rutting resistance. To make the WMA mixtures accept high quantities of RAP (>25%), an insignificant increase in the amounts of WMA additives was needed to produce mixtures carrying sustainability labels. Results indicated that all the used additives had pushed the WMA mixtures to achieve considerable mechanical properties, whereas the best properties for the WMA mixtures containing 0%, 20%, 40%, and 60% of RAP have been achieved by mixing with (1.0% Sasobit REDUX® @ 125 °C), (1.0% Sasobit REDUX® or 0.3% Aspha-Min® @ 135 °C), (1.5% Sasobit REDUX® @ 125 °C), and (2.0% Sasobit REDUX® or 0.5% Aspha-Min® @ 135 °C), respectively. On another hand, the best durable properties have been achieved by mixing the mentioned WMA mixtures containing 0%, 20%, 40%, and 60% of RAP with 0.07%, 0.07%, 0.1%, and 0.125% of ZycoTherm® at 153 °C, respectively. Using such additives in the recycled WMA mixtures made it possible to activate waste recycling in the paving industry

    Dimensions of corporate governance and organizational learning: an empirical study

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    This paper aims to investigate the impact of corporate governance on organizational learning dimensions. To achieve the study's objectives, a form of questionnaire was used to collect data, the sample of the study included 229 respondents, the Statistical Package for Social Sciences (SPSS) was used to analyze questionnaire data, and the study found a set of results, most of which were positive. Managers' impressions of community governance in private Jordanian universities are leveled medially, and their observations of organizational learning elements are at a high level. The presence of a statistically significant important impact of corporate governance variable scopes on organizational learning in Jordanian private universities. However, Corporate governance (participation, equality, efficiency, accountability) have a significant effect on Organizational Learning Dimensions. While strategic vision and transparency have no significant effect on Organizational Learning

    Granular Cell Tumor of the Urinary Bladder

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    A 67-year-old Korean man presented with gross, painless hematuria that had lasted for the previous 2 months. Cystoscopy showed a semispherical tumor approximately 1 cm in diameter that was covered with normal bladder mucosa and extended from the bladder neck to the posterior wall of the bladder. The patient underwent transurethral resection of the tumor. Histological examination and immunohistochemical staining showed a granular cell tumor (GCT). There were no features suggesting a malignant phenotype. On follow-up, the patient has remained free of bladder recurrence. We herein report this case of a GCT of the urinary bladder and review the literature

    Schools of Public Health in Low and Middle-Income Countries: An Imperative Investment for Improving the Health of Populations?

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    BACKGROUND: Public health has multicultural origins. By the close of the nineteenth century, Schools of Public Health (SPHs) began to emerge in western countries in response to major contemporary public health challenges. The Flexner Report (1910) emphasized the centrality of preventive medicine, sanitation, and public health measures in health professional education. The Alma Ata Declaration on Primary Health Care (PHC) in 1978 was a critical milestone, especially for low and middle-income countries (LMICs), conceptualizing a close working relationship between PHC and public health measures. The Commission on Social Determinants of Health (2005-2008) strengthened the case for SPHs in LMICs as key stakeholders in efforts to reduce global health inequities. This scoping review groups text into public health challenges faced by LMICs and the role of SPHs in addressing these challenges. MAIN TEXT: The challenges faced by LMICs include rapid urbanization, environmental degradation, unfair terms of global trade, limited capacity for equitable growth, mass displacements associated with conflicts and natural disasters, and universal health coverage. Poor governance and externally imposed donor policies and agendas, further strain the fragile health systems of LMICs faced with epidemiological transition. Moreover barriers to education and research imposed by limited resources, political and economic instability, and unbalanced partnerships additionally aggravate the crisis. To address these contextual challenges effectively, SPHs are offering broad based health professional education, conducting multidisciplinary population based research and fostering collaborative partnerships. SPHs are also looked upon as the key drivers to achieve sustainable development goals (SDGs). CONCLUSION: SPHs in LMICs can contribute to overcoming several public health challenges being faced by LMICs, including achieving SDGs. Most importantly they can develop cadres of competent and well-motivated public health professionals: educators, practitioners and researchers who ask questions that address fundamental health determinants, seek solutions as agents of change within their mandates, provide specific services and serve as advocates for multilevel partnerships. Funding support, human resources, and agency are unfortunately often limited or curtailed in LMICs, and this requires constructive collaboration between LMICs and counterpart institutions from high income countries

    Schools of public health in low and middle-income countries: an imperative investment for improving the health of populations?

    Get PDF
    BACKGROUND: Public health has multicultural origins. By the close of the nineteenth century, Schools of Public Health (SPHs) began to emerge in western countries in response to major contemporary public health challenges. The Flexner Report (1910) emphasized the centrality of preventive medicine, sanitation, and public health measures in health professional education. The Alma Ata Declaration on Primary Health Care (PHC) in 1978 was a critical milestone, especially for low and middle-income countries (LMICs), conceptualizing a close working relationship between PHC and public health measures. The Commission on Social Determinants of Health (2005-2008) strengthened the case for SPHs in LMICs as key stakeholders in efforts to reduce global health inequities. This scoping review groups text into public health challenges faced by LMICs and the role of SPHs in addressing these challenges. MAIN TEXT: The challenges faced by LMICs include rapid urbanization, environmental degradation, unfair terms of global trade, limited capacity for equitable growth, mass displacements associated with conflicts and natural disasters, and universal health coverage. Poor governance and externally imposed donor policies and agendas, further strain the fragile health systems of LMICs faced with epidemiological transition. Moreover barriers to education and research imposed by limited resources, political and economic instability, and unbalanced partnerships additionally aggravate the crisis. To address these contextual challenges effectively, SPHs are offering broad based health professional education, conducting multidisciplinary population based research and fostering collaborative partnerships. SPHs are also looked upon as the key drivers to achieve sustainable development goals (SDGs). CONCLUSION: SPHs in LMICs can contribute to overcoming several public health challenges being faced by LMICs, including achieving SDGs. Most importantly they can develop cadres of competent and well-motivated public health professionals: educators, practitioners and researchers who ask questions that address fundamental health determinants, seek solutions as agents of change within their mandates, provide specific services and serve as advocates for multilevel partnerships. Funding support, human resources, and agency are unfortunately often limited or curtailed in LMICs, and this requires constructive collaboration between LMICs and counterpart institutions from high income countries

    Prospective randomized comparison of open versus laparoscopic management of splenic artery aneurysms: a 10-year study

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    Abstract BACKGROUND: The literature does not support the choice between open and laparoscopic management of splenic artery aneurysms (SAA). METHODS: We designed a prospective, randomized comparison between open and laparoscopic surgery for SAA. Primary end points were types of surgical procedures performed and clinical outcomes. Analysis was developed on an intention-to-treat basis. RESULTS: Fourteen patients were allocated to laparotomy (group A) and 15 to laparoscopy (group B). Groups displayed similar patient- and aneurysm-related characteristics. The conversion rate to open surgery was 13.3 %. The type of surgical procedure performed on the splenic artery was similar in the two groups: aneurysmectomy with splenic artery ligature or direct anastomosis was performed in 51 % and 21 % of patients in group A and in 60 % and 20 % in group B, respectively. The splenectomy rate was similar (14 % vs. 20 %). Postoperative splenic infarction was observed in one case in each group. Laparoscopy was associated with shorter procedures (p = 0.0003) and lower morbidity (25 % vs. 64 %, p = 0.045). Major morbidity requiring interventional procedures and blood transfusion was observed only in group A. Laparoscopy was associated with quicker resumption of oral diet (p < 0.001), earlier drain removal (p = 0.046), and shorter hospital stay (p < 0.01). During a mean follow-up of 50 months, two patients in group A required hospital readmission. In group B, two patients developed a late thrombosis of arterial anastomoses. CONCLUSIONS: Our study demonstrates that laparoscopy permits multiple technical options, does not increase the splenectomy rate, and reduces postoperative complications. It confirms the supposed clinical benefits of laparoscopy when ablative procedures are required but laparoscopic anastomoses show poor long-term results

    Treatment of acute diverticulitis laparoscopic lavage vs. resection (DILALA): study protocol for a randomised controlled trial

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    <p>Abstract</p> <p>Background</p> <p>Perforated diverticulitis is a condition associated with substantial morbidity. Recently published reports suggest that laparoscopic lavage has fewer complications and shorter hospital stay. So far no randomised study has published any results.</p> <p>Methods</p> <p>DILALA is a Scandinavian, randomised trial, comparing laparoscopic lavage (LL) to the traditional Hartmann's Procedure (HP). Primary endpoint is the number of re-operations within 12 months. Secondary endpoints consist of mortality, quality of life (QoL), re-admission, health economy assessment and permanent stoma. Patients are included when surgery is required. A laparoscopy is performed and if Hinchey grade III is diagnosed the patient is included and randomised 1:1, to either LL or HP. Patients undergoing LL receive > 3L of saline intraperitoneally, placement of pelvic drain and continued antibiotics. Follow-up is scheduled 6-12 weeks, 6 months and 12 months. A QoL-form is filled out on discharge, 6- and 12 months. Inclusion is set to 80 patients (40+40).</p> <p>Discussion</p> <p>HP is associated with a high rate of complication. Not only does the primary operation entail complications, but also subsequent surgery is associated with a high morbidity. Thus the combined risk of treatment for the patient is high. The aim of the DILALA trial is to evaluate if laparoscopic lavage is a safe, minimally invasive method for patients with perforated diverticulitis Hinchey grade III, resulting in fewer re-operations, decreased morbidity, mortality, costs and increased quality of life.</p> <p>Trial registration</p> <p>British registry (ISRCTN) for clinical trials <a href="http://www.controlled-trials.com/ISRCTN82208287">ISRCTN82208287</a><url>http://www.controlled-trials.com/ISRCTN82208287</url></p
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