465 research outputs found
INFLUENCE OF BOND-SLIP ON NUMERICAL FRAGILITY CURVES AND STRUCTURAL RELIABILITY OF RC STRUCTURAL INTERNAL BEAM-COLUMN SUB-ASSEMBLY
In this paper results obtained from monotonic nonlinear static analyses performed on Re-inforced Concrete (RC) internal beam-column sub-assembly are shown. Bond-slip phenome-non between steel longitudinal bars and surrounding concrete is also taken into account in order to predict the numerical response under lateral actions of the RC internal beam-column sub-assembly investigated.
The study is addressed, through parametric models and Monte Carlo simulations, to pro-pose preliminary fragility curves for different damage states of the RC internal beam-column sub-assembly, including materials inherent uncertainties
Typological seismic losses assessment by damaged masonry buildings after LâAquila 2009 and Emilia 2012 earthquakes
In this paper a seismic risk analysis of masonry buildings based on damage data from the 2009 L'Aquila and 2012 Emilia earthquakes. The seismic vulnerability is described by fragility curves from which economic loss curves are derived for each representative typological class of masonry buildings. The information on the buildings was collected by the Italian Civil Protection Department with the AeDES form and available in the Observed Damage Database (D.a.D.O.). The reliability of the database considered, however, was improved by carrying out a process of estimating undamaged buildings from data from the 15th ISTAT census. Finally, for each damage level, according to EMS-98 scale, a procedure to derive the Expected Annual Loss is presented, so as to express its percentage contribution in the seismic risk assessment
Seismic risk analysis on masonry buildings damaged by LâAquila 2009 and Emilia 2012 earthquakes
Earthquakes in the recent past continue to provide more and more information on the seismic behavior of existing buildings and on the related economic losses. For the reason it is interesting to compare the damage of buildings stocks archived after earthquakes survey activities. In this paper a study of the damage occurred on masonry buildings after LâAquila 2009 and Emilia 2012 earthquakes is carried out, by considering the data available in the web-gis Da.D.O platform. Firstly, fragility curves are illustrated and compared by considering the vulnerability classes of Da.D.O. (Class A, Class B and Class C1). Then, an approach is proposed in order to evaluate the total Expected Annual Loss (EALtot) and its contributions due to the several damage level (D1, âŠ, D5). The preliminary obtained results show that, with reference to the two masonry buildings stocks considered, the higher contribution to the (EALtot) is given by the damage level D3, that may be considered as the life safety limit state. In the case analyzed, the corresponding EALD3 results almost equal to 1/3 of EALtot
Epuraea imperialis (Reitter, 1877). New invasive species of Nitidulidae (Coleoptera) in Europe, with a checklist of sap beetles introduced to Europe and Mediterranean areas
Australian species Epuraea imperialis (Reitter, 1877), previously introduced to New Zealand, is recorded as a new invasive species from the Canary Islands, Continental Spain, Portugal, France, Belgium, and Italy. It is redescribed and figured, and its taxonomic position in the genus Epuraea Erichson, 1843 is discussed. A tentative checklist of sap beetles introduced to Europe and the Mediterranean areas is finally included
Elective surgery for colorectal cancer in the aged: a clinical-economical evaluation.
A series of 56 consecutive patients, referred for surgery to a specialized institute, had elective laparotomies with various surgical procedures aimed at curing locoregional colorectal cancer. Data defining patient and tumour-related preoperative, operative and postoperative variables, including costs, were collected. The study group was divided into two age groups (< 65 vs > or = 65 years), which were similar in terms of patient- and tumour-related variables. Differences were not statistically significant (Pounds 440; 95% exact CI; Pounds -50; 1800). There is no evidence to suggest that there are any total charge differences in treating the two age groups, as confirmed by the cost analysis
Healthcare professionals' preferences for surgery or primary endocrine therapy to treat older women with operable breast cancer
Introduction : Primary endocrine therapy (PET) is an alternative treatment to surgery for oestrogen receptor (ER) positive operable breast cancer in older women. However, there is variable use of PET in the UK, with up to 40% of patients aged over 70 receiving PET instead of surgery in some regions. Treatment options offered to patients rely heavily on healthcare professional (HCP) assessment and opinion on which treatments are appropriate.
Materials and methods : This was a mixed methods study combining semi-structured interviews with HCPs working in high and low PET regions in the UK, followed by a postal questionnaire survey distributed via the Association of Breast Surgery (ABS).
Results : Thirty-four HCPs (20 breast surgeons; 13 nurse specialists; 1 geriatrician) were interviewed from 14 sites across the UK and 252/641 questionnaires returned (39%). There was an overriding view that PET is not suitable for patients under the age of 80 unless there are significant comorbidities. Opinion was split regarding the best way to treat patients with dementia. Patient preference was generally stated to be the most important factor when considering treatment, however only around a quarter 65/244 (26.6%) felt that all patients over the age of 70 should be offered PET as an alternative treatment option.
Conclusions : Opinions differ on the best way to treat women over 70 with operable breast cancer, especially if they have co-existing dementia, as well as whether they should be offered PET as a treatment option. This may be a significant cause of treatment variation in the UK.
Keywords : Breast cancer;
Primary endocrine therapy;
Surgery;
Elderly;
Older;
Mixed methods.</p
What influences healthcare professionals' treatment preferences for older women with operable breast cancer?: an application of the discrete choice experiment
Introduction
Primary endocrine therapy (PET) is used variably in the UK as an alternative to surgery for older women with operable breast cancer. Guidelines state that only patients with âsignificant comorbidityâ or âreduced life expectancyâ should be treated this way and age should not be a factor.
Methods
A Discrete Choice Experiment (DCE) was used to determine the impact of key variables (patient age, comorbidity, cognition, functional status, cancer stage, cancer biology) on healthcare professionals' (HCP) treatment preferences for operable breast cancer among older women. Multinomial logistic regression was used to identify associations.
Results
40% (258/641) of questionnaires were returned. Five variables (age, co-morbidity, cognition, functional status and cancer size) independently demonstrated a significant association with treatment preference (p < 0.05). Functional status was omitted from the multivariable model due to collinearity, with all other variables correlating with a preference for operative treatment over no preference (p < 0.05). Only co-morbidity, cognition and cancer size correlated with a preference for PET over no preference (p < 0.05).
Conclusion
The majority of respondents selected treatment in accordance with current guidelines, however in some scenarios, opinion was divided, and age did appear to be an independent factor that HCPs considered when making a treatment decision in this population
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