59 research outputs found
Effect of anisotropy and destructuration on behavior of Haarajoki test embankment
This paper investigates the influence of anisotropy and destructuration on the behavior of Haarajoki test embankment, which was built by the Finnish National Road Administration as a noise barrier in 1997 on a soft clay deposit. Half of the embankment is constructed on an area improved with prefabricated vertical drains, while the other half is constructed on the natural deposit without any ground improvement. The construction and consolidation of the embankment is analyzed with the finite-element method using three different constitutive models to represent the soft clay. Two recently proposed constitutive models, namely S-CLAY1 which accounts for initial and plastic strain induced anisotropy, and its extension, called S-CLAY1S which accounts, additionally, for interparticle bonding and degradation of bonds, were used in the analysis. For comparison, the problem is also analyzed with the isotropic modified cam clay model. The results of the numerical analyses are compared with the field measurements. The simulations reveal the influence that anisotropy and destructuration have on the behavior of an embankment on soft clay
The unruptured intracranial aneurysm treatment score A multidisciplinary consensus
Objective: We endeavored to develop an unruptured intracranial aneurysm (UIA) treatment score (UIATS) model that includes and quantifies key factors involved in clinical decision-making in the management of UIAs and to assess agreement for this model among specialists in UIA management and research. Methods: An international multidisciplinary (neurosurgery, neuroradiology, neurology, clinical epidemiology) group of 69 specialists was convened to develop and validate the UIATS model using a Delphi consensus. For internal (39 panel members involved in identification of relevant features) and external validation (30 independent external reviewers), 30 selected UIA cases were used to analyze agreement with UIATS management recommendations based on a 5-point Likert scale (5 indicating strong agreement). Interrater agreement (IRA) was assessed with standardized coefficients of dispersion (v(r)*) (v(r)* 5 0 indicating excellent agreement and v(r)* = 1 indicating poor agreement). Results: The UIATS accounts for 29 key factors in UIA management. Agreement with UIATS (mean Likert scores) was 4.2 (95% confidence interval [CI] 4.1-4.3) per reviewer for both reviewer cohorts; agreement per case was 4.3 (95% CI 4.1-4.4) for panel members and 4.5 (95% CI 4.3-4.6) for external reviewers (p = 0.017). Mean Likert scores were 4.2 (95% CI 4.1-4.3) for interventional reviewers (n = 56) and 4.1 (95% CI 3.9-4.4) for noninterventional reviewers (n = 12) (p = 0.290). Overall IRA (v(r)*) for both cohorts was 0.026 (95% CI 0.019-0.033). Conclusions: This novel UIA decision guidance study captures an excellent consensus among highly informed individuals on UIA management, irrespective of their underlying specialty. Clinicians can use the UIATS as a comprehensive mechanism for indicating how a large group of specialists might manage an individual patient with a UIA.Peer reviewe
The impact of FLOW 800-specific hemodynamic parameters and visualization on surgery of arteriovenous malformations
Development and validation of the unruptured intracranial aneurysm treatment score (UIATS) dervied from multidisciplinary consensus
The value of FLOW 800 analyses for intraoperative real-time hemodynamic assessment after extracranial-intracranial bypass surgery
Einfluss der Behandlungsmodalität intrakranieller Aneurysmen auf das Risiko von verzögerter zerebraler Ischämie nach aneurysmatischer Subarachnoidalblutung
Primäre dekompressive Kraniektomie bei Patienten mit raumforderndem sylvischem Hämatom aufgrund einer aneurysmatischen Subarachnoidalblutung
Determinants for the size of ruptured intracranial aneurysms - A retrospective cohort analysis
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