CAUSES OF DELAY IN THE EXECUTION PHASE OF CONSTRUCTION PROJECTS IN KHYBER PUKHTOONKHWA PAKISTAN

Construction phase is the big problem in large construction business in the Islamic Republic of Pakistan. The construction of large industry plays important role for economy growth, development and evolution in the Islamic Republic of Pakistan. Delay causes a wide range of negative impact on construction projects. Current research focuses on the main flaws which impart delay in projects in sight of various industrial stakeholders which are clients, consultants and contractors. Current study is intended to identify and evaluate the factors causing delay and effects of delays in construction projects of Khyber Pukhtoonkhwa, Pakistan. The survey was conducted through validated questionnaire from structured interview and pilot survey to collect the responses on the causes of delay and delay effects. Client, consultants, and contractors were asked by questionnaire on the causes and effects of the delays. To analyze the data, statistical formula used to calculate the importance of the causes and effects of the delay through Relative important index (RII). After the outcome of the research fifteen (15) factors to cause delays and nine (9) factors of the effects of delays are examined. The top ranked of the reasons for the delays is the lack of Fund to finance the project to completion. While the top ranked of the effects of the delays is time overrun. By adding weight to these factors of trust in the people of the province will be restored to the correct way of mega-projects. Also provide these crucial attention factors, projects can be abstained from more than budgeting and will be useful to gain time and work area.Â

Laryngeal tuberculosis presenting as laryngeal carcinoma

Tuberculosis (TB) accounts for the highest number of mortalities among infectious diseases worldwide. Laryngeal TB is an extremely rare presentation of TB. It has many similarities to laryngeal carcinoma, one of the three most common cancers among males in the city, with an age standardized rate of 8.6. The associated risk factors of laryngeal carcinoma i.e. smoking, paan, betel nut usage and alcohol use also tend to be concentrated in the same demographic background as that of TB, creating a diagnostic dilemma. We present a case of granulomatous laryngeal TB, in a 40 year old male, with characteristic presenting features of laryngeal carcinoma i.e. persistent hoarseness and weight loss. He had no associated symptoms of fever, night sweats, cough or dysphagia, nor did he have any history of tobacco or irritant use. There was no history of tuberculosis (TB) contact. He was initially worked up for laryngeal carcinoma; however laryngoscopic biopsy revealed laryngeal TB. We present this case to emphasize the point that although primary laryngeal tuberculosis is a rarity, it must not be overlooked as a possibility when evaluating dysphonia and/or considering laryngeal carcinoma

Techno-economic and environmental analysis of renewable energy integration in irrigation systems: A comparative study of standalone and grid-connected PV/Diesel Generator systems in Khyber Pakhtunkhwa

Water is an essential requirement for agricultural productivity. In the agriculture sector, electricity generated by conventional sources contributes to a substantial amount of carbon footprints for pumping water through tube wells. Over the past few decades, a transitional shift towards renewable resources has increased leading to decarbonizing the environment and is considered as a viable solution for electricity production. To assist and provide a road map for this paradigm shift, the proposed study presents a techno-economic and environmental analysis of irrigation systems by carrying comparative analysis of both standalone and grid-connected systems based on four independent sites in a developing country. PV system integrated with grid enabling both energy purchase and sale (PV + G(P+S)), proved to be the most optimal configuration with cost of energy (COE) of $0.056/kWh,$0.059/kWh, $0.061/kWh, and$0.068/kWh while having net present cost (NPC) of $7,908,$20,186, $25,826, and$34,487 for Peshawar, Khyber Agency, Mardan, and Charsadda respectively, over a useful life span of 25 years. Furthermore, sensitivity analysis has been carried out based on uncertain variables such as Grid power purchase (GPP) and average solar radiation (GHI) to check the optimality behavior of the system. Results from environmental analysis revealed that (PV+ G(P+S)) system has a relatively low carbon impact as compared with conventional sources. This configuration also has the ability to prevent excess water extraction by selling any excessive solar PV energy to the grid. This study provides a policy framework insight for the entities for future optimization

CAUSES OF DELAY IN THE EXECUTION PHASE OF CONSTRUCTION PROJECTS IN KHYBER PUKHTOONKHWA PAKISTAN

Construction phase is the big problem in large construction business in the Islamic Republic of Pakistan. The construction of large industry plays important role for economy growth, development and evolution in the Islamic Republic of Pakistan. Delay causes a wide range of negative impact on construction projects. Current research focuses on the main flaws which impart delay in projects in sight of various industrial stakeholders which are clients, consultants and contractors. Current study is intended to identify and evaluate the factors causing delay and effects of delays in construction projects of Khyber Pukhtoonkhwa, Pakistan. The survey was conducted through validated questionnaire from structured interview and pilot survey to collect the responses on the causes of delay and delay effects. Client, consultants, and contractors were asked by questionnaire on the causes and effects of the delays. To analyze the data, statistical formula used to calculate the importance of the causes and effects of the delay through Relative important index (RII). After the outcome of the research fifteen (15) factors to cause delays and nine (9) factors of the effects of delays are examined. The top ranked of the reasons for the delays is the lack of Fund to finance the project to completion. While the top ranked of the effects of the delays is time overrun. By adding weight to these factors of trust in the people of the province will be restored to the correct way of mega-projects. Also provide these crucial attention factors, projects can be abstained from more than budgeting and will be useful to gain time and work area.

Development and Fidelity Assessment of Potential Flow based Framework for Aerodynamic Modeling of High Lift Devices

High lift devices play a vital role in dictating the accelerated performance of an aircraft for different flight phases such as takeoff, landing, and aerobatic maneuvers. The aerodynamic design of high lift devices for any particular aircraft is an iterative process and is achieved through extensive aerodynamic Analysis of the aircraft for various flap configurations. Computational Fluid Dynamics (CFD) and Wind tunnel testing are highly effective techniques for performing the required Analysis, yet they have high computational costs and time. To overcome this shortcoming, a robust framework based on potential flow solver (PFS) and geometry parameterization is required without compromising the fidelity of the Analysis. This research aims to develop a highly robust aerodynamic analysis framework based on the Vortex Lattice Method (VLM) coupled with Polhamus Suction Analogy and parametric modeling of high lift devices. The fidelity of the framework is validated through experimental testing and is quantified by developing a fidelity assessment matrix. It is established that the computational cost of CFD has been reduced three times with only a 10% to 20% loss in accuracy when the developed framework is used. The developed PFS framework gives results from 80% to 90%. The framework results for a reference aircraft are thoroughly compared with CFD analyses. The framework provides values that agree with corresponding CFD analyses in a fraction of the time

Accuracy of spontaneous breathing trial using ET-CPAP in predicting successful extubation of neonates

Objective: Extubation failure is common in mechanically ventilated neonates. Finding objective criteria for predicting successful extubation may help to reduce the incidence of failure and the length of mechanical ventilation (MV). We conducted this study to determine the accuracy of the spontaneous breathing trial (SBT) and lung function measurements in predicting successful extubation in neonates.Methodology: This cross-sectional validation study was conducted at a tertiary care neonatal intensive care unit (NICU) over 12 months from December 2019 to December 2020. Neonates intubated for \u3e24 hours and considered ready for extubation were enrolled in the study. Neonates who met defined eligibility criteria underwent a three minutes SBT using endotracheal continuous positive airway pressure (ET-CPAP) before extubation. The primary clinical team was blinded to the results, and all neonates were extubated after SBT. Extubation was considered successful if patients remained extubated for 48 hours.Results: Among the 107 infants, 77.5% (n=83) of infants passed the SBT. Of these, 78 were successfully extubated, giving the positive predictive value of 93.97%. The overall extubation success rate was 90% (n=96). The sensitivity and specificity of SBT were 81.2% and 54.5%, respectively. VE (ET-CPAP) and VE-ventilator at a cutoff of ≥238 ml and ≥143.7 ml have an area under the curve (AUC) of 0.77 and 0.75 respectively to predict successful extubation (p-value 0.003, 0.008 respectively).Conclusion: SBT predicts extubation success with pronounced accuracy. Therefore, we propose SBT as a valuable and crucial step that guides clinicians\u27 decision-making regarding extubation preparedness or impending failure in neonates

Protocol and statistical analysis plan for the mega randomised registry trial comparing conservative vs. liberal oxygenation targets in adults with sepsis in the intensive care unit (Mega-ROX Sepsis)

Background: The effect of conservative vs. liberal oxygen therapy on 90-day in-hospital mortality in adults with sepsis receiving unplanned invasive mechanical ventilation in the intensive care unit (ICU) is uncertain. Objective: The objective of this study was to summarise the protocol and statistical analysis plan for the Mega-ROX Sepsis trial. Design, setting, and participants: The Mega-ROX Sepsis trial is an international randomised clinical trial that will be conducted within an overarching 40,000-patient registry-embedded clinical trial comparing conservative and liberal ICU oxygen therapy regimens. We anticipate that between 10,000 and 13,000 patients with sepsis who are receiving unplanned invasive mechanical ventilation in the ICU will be enrolled in this trial. Main outcome measures: The primary outcome is in-hospital all-cause mortality up to 90 days from the date of randomisation. Secondary outcomes include duration of survival, duration of mechanical ventilation, ICU length of stay, hospital length of stay, and the proportion of patients discharged home. Results and conclusions: Mega-ROX Sepsis will compare the effect of conservative vs. liberal oxygen therapy on 90-day in-hospital mortality in adults with sepsis who are receiving unplanned invasive mechanical ventilation in the ICU. The protocol and a prespecified approach to analyses are reported here to mitigate analysis bias