25 research outputs found
Development, Implementation, and Tracking of Preventative Safety Metrics
What gets measured, gets improved. With respect to the safety and health of Kentucky Transportation Cabinet (KYTC) employees, the primary metric used has been the OSHA recordable incident rate. This incident rate measures how often a Cabinet employee sustains an injury that demands more than basic first aid. This metric is important for understanding injury frequencies, but it does not assist with management of the safety, health, and overall well-being of KYTC personnel. Based on a review of leading safety indicators adopted by various industries, this study devised a comprehensive list of safety metrics the Cabinet will benefit from tracking. Metrics were evaluated, organized, weighted, and compiled into a three-tier scorecard that is used to assess performance at KYTC’s district, area, and executive levels. Five major dimensions of an effective safety program were identified: (1) management leadership and commitment, (2) employee engagement, (3) training and competence, (4) hazard identification and control, and (5) evaluation and improvement. Surveys of KYTC districts found that all metrics performed robustly, while stakeholders at executive levels usually assigned lower scores to the five dimensions. Employee engagement had the lowest score. The Cabinet will benefit from seeking out more opportunities to involve employees in the agency’s safety program. Equally, the study reiterates the value of gaining management buy-in, support, and leadership when working to eliminate incidents and injuries
Construction-Ready Digital Terrain Models
Since 2009, Kentucky has made its 3D design data available as a supplemental reference to bidders through the project delivery process. This research discusses methods for ensuring electronic engineering data (EED) — and specifically the proposed digital terrain model (DTM) — support modern construction management methods at the Kentucky Transportation Cabinet (KYTC). Researchers performed a literature review, surveyed KYTC construction and design staff, engaged with Cabinet staff and industry members to understand the current state of practice, and evaluated quality- related attributes of the EED through case studies. The report presents a set of targeted recommendations for improving KYTC processes of highway design review, training and guidance for Cabinet staff, data sharing and management, professional service contract negotiations, and facilitated communication between KYTC and its industry partners
Evaluating the Safety Cultures of Kentucky Transportation Cabinet Maintenance Crews
Highway work zones can be dangerous and unpredictable. Between 2003 and 2017, over 1,800 workers died on road construction sites. Eliminating injuries and deaths requires state transportation agencies to adopt robust safety cultures as there is a clear relationship between these cultures and worker behaviors. The Kentucky Transportation Cabinet (KYTC) is committed to improving safety performance by nurturing a positive safety climate among highway maintenance crews. To understand the safety cultures of KYTC maintenance crews, researchers administered a survey based on the Safety Climate Assessment Tool (S-CAT) developed by the Center for Construction Research and Training (CPWR). This is the first tool developed for the construction industry. The survey was used to quantified the existing safety climate and evaluate how effective safety programs and controls are at reducing workplace hazards. Survey respondents answered questions on 37 indicators across eight safety climate categories: employee risk perception, management commitment, aligning and integrating safety as a value, ensuring accountability at all levels, improving supervisory leadership, empowering and involving employees, improving communication, and safety training. For each indicator respondents assigned a rating on a five-point Likert scale — Inattentive (1), Reactive (2), Compliant (3), Proactive (4), Exemplary (5). Analysis of survey responses at the statewide and district levels found that KYTC’s safety culture can be characterized as between compliant and proactive. Focus groups with maintenance superintendents generated recommendations to improve safety cultures and install multiple layers of preventive measures to further reduce the number and threat of jobsite hazards
Impact of technology use on workforce performance and information access in the construction industry
For decades, labor shortage has been a consistent struggle in the construction industry. At the same time, technological innovations have played a central role in the growth and development of an increasingly diverse construction industry. Existing research indicates that technological adoption is crucial for enhancing project productivity. Despite the importance and potential benefits of technology use, no research has yet studied how technology use on-site impact the worker’s performance and the difficulty of the process to access needed information. The objective of this paper is to analyze and understand the impact of on-site technology use on 1) the self-evaluated performance record (including safety, attendance, quality, productivity, and initiative), and 2) the difficulty of the process to access information, of construction workers and frontline supervisors in the construction industry. To achieve the research objective, 2,780 construction craft workers and frontline supervisors were surveyed using an online questionnaire. The survey participants were asked to self-evaluate 1) their work personal performance record (including safety, attendance, quality, productivity, and initiative), and 2) the difficulty of the process to receive or get access to information. The participants were additionally asked to specify whether different listed information technologies, material technologies, and equipment technologies are used on site. The collected data was then analyzed. Key findings indicate that the on-site use of several technologies had statistically significant impact in increased worker performance and information access. This study contributes to the body of knowledge by empirically quantifying the impact of on-site technology use on worker performance and information access in the construction industry
Assessing Technology Implementation Success for Highway Construction and Asset Management
The increasing demand for safe, reliable, and higher-quality infrastructure systems has led to more complex transportation construction and maintenance projects. This, coupled with the declining staff levels at many transportation agencies, requires a more comprehensive evaluation of technology implementation to compensate for these challenges. With a focus on effective technology implementation, this research goes beyond simply evaluating technologies to investigate technology implementation with personnel and policies at departments of transportation (DOTs). The study methodology involved a comprehensive literature review, a survey of all 50 state DOTs, and an in-person workshop of 18 DOT experts to validate the survey results and preliminary research findings. The findings support the need for those implementing technologies to understand people, processes, and technology maturity for their improved chances of implementation success. Using the approach presented, the DOTs can assess themselves and identify pathways to higher maturity levels in the areas of their people, processes, and technologies. This study also highlighted six factors that are important considerations for technology implementation and thus determined the relative importance of people, processes, and technology for these factors. The objective of this study was to assess the importance of people, processes, and technology that DOTs should prioritize to enhance the likelihood of successfully implementing technologies. The framework presented herein can be extended to any new or existing technology implementation initiatives at a DOT, including automatic identification and data capture (AIDC), emerging sensing and wireless technologies, safety technologies, and others.This article is published as Tripathi, Amit, Gabriel B. Dadi, Hala Nassereddine, Roy E. Sturgill, and Alexa Mitchell. "Assessing Technology Implementation Success for Highway Construction and Asset Management." Sensors 23, no. 7 (2023): 3671. doi: https://doi.org/10.3390/s23073671. Copyright: © 2023 by the authors. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/)
Assessing Technology Implementation Success for Highway Construction and Asset Management
The increasing demand for safe, reliable, and higher-quality infrastructure systems has led to more complex transportation construction and maintenance projects. This, coupled with the declining staff levels at many transportation agencies, requires a more comprehensive evaluation of technology implementation to compensate for these challenges. With a focus on effective technology implementation, this research goes beyond simply evaluating technologies to investigate technology implementation with personnel and policies at departments of transportation (DOTs). The study methodology involved a comprehensive literature review, a survey of all 50 state DOTs, and an in-person workshop of 18 DOT experts to validate the survey results and preliminary research findings. The findings support the need for those implementing technologies to understand people, processes, and technology maturity for their improved chances of implementation success. Using the approach presented, the DOTs can assess themselves and identify pathways to higher maturity levels in the areas of their people, processes, and technologies. This study also highlighted six factors that are important considerations for technology implementation and thus determined the relative importance of people, processes, and technology for these factors. The objective of this study was to assess the importance of people, processes, and technology that DOTs should prioritize to enhance the likelihood of successfully implementing technologies. The framework presented herein can be extended to any new or existing technology implementation initiatives at a DOT, including automatic identification and data capture (AIDC), emerging sensing and wireless technologies, safety technologies, and others
Numerical study of melting/solidification by an hybrid lattice method
International audienceIn this paper, we propose a hybrid method coupling a Lattice Boltzmann Method (LBM) and a Finites Volumes Method (FVM), to study melting and solidification problems. The LBM is used to determine the dynamics field while the FVM is applied to discretize the energy equation. This model is validated by comparison to available literature results concerning a square cavity heated without phase change then for the melting of Gallium in an enclosure commonly used as benchmark test case
Acute coronary syndrome prediction in emergency care: A machine learning approach
BACKGROUND AND OBJECTIVE: Clinical concern for acute coronary syndrome (ACS) is one of emergency medicine\u27s most common patient encounters. This study aims to develop an ensemble learning-driven framework as a diagnostic support tool to prevent misdiagnosis.
METHODS: We obtained extensive clinical electronic health data on patient encounters with clinical concerns for ACS from a large urban emergency department (ED) between January 2017 and August 2020. We applied an analytical framework equipped with many well-developed algorithms to improve the data quality by addressing missing values, dimensionality reduction, and data imbalance. We trained ensemble learning algorithms to classify patients with ACS or non-ACS etiologies of their symptoms. We used performance evaluation metrics such as accuracy, sensitivity, precision, F1-score, and the area under the receiver operating characteristic (AUROC) to measure the model\u27s performance.
RESULTS: The analysis included 31,228 patients, of whom 563 (1.8%) had ACS and 30,665 (98.2%) had alternative diagnoses. Eleven features, including systolic blood pressure, brain natriuretic peptide, chronic heart disease, coronary artery disease, creatinine, glucose, heart attack, heart rate, nephrotic syndrome, red cell distribution width, and troponin level, are reported as significantly contributing risk factors. The proposed framework successfully classifies these cohorts with sensitivity and AUROC as high as 86.3% and 93.3%. Our proposed model\u27s accuracy, precision, specificity, Matthew\u27s correlation coefficient, and F1-score were 85.7%, 86.3%, 93%, 80%, and 86.3%, respectively.
CONCLUSION: Our proposed framework can identify early patients with ACS through further refinement and validation
Diffusion locale de polyacrylamide avec réaction granulomateuse après greffe de cheveux artificiels
49 Comparing the Safety and Efficacy of a Rapid High-Sensitivity Cardiac Troponin I Protocol Between Hospital-Based and Free-Standing Emergency Department
Study Objectives: Significant variability exists in patient population and diagnostic capabilities of large academic tertiary, community-based hospital, and free-standing emergency departments (ED). Current high sensitivity cardiac troponin I (hs-cTnI) research has been conducted almost exclusively in hospital-based ED (HBED) settings and the translation of these protocols into the free-standing EDs (FSED) has yet to be explored. This study compared the safety, efficacy, and ED throughput of applying a 0/1-hour, rapid-rule out protocol using hs-cTnI for exclusion of acute myocardial infarction (AMI) in HBEDs and FSEDs.
Methods: This was a pre-planned, secondary analysis of a stepped wedge cluster randomized trial of patients evaluated for possible AMI in 9 EDs in an integrated health system from July 2020 through March of 2021. Five of the EDs were HBEDs and four were FSEDs. The trial arms included a new 0/1-hour rapid protocol using hs-cTnI versus standard care, which used a 0/3-hour protocol without reporting hs-cTnI values below the 99th percentile. All adult ED patients were eligible if the treating clinician ordered an ECG and cardiac troponin. We excluded patients with STEMI, a hs-cTnI \u3e18 ng/L in the ED, or a traumatic cause of symptoms. The primary outcome was safe ED discharge, defined as discharge with no death or AMI within 30-days. Analysis included a mixed effect model adjusting for ED site, time, sex, age, and race. We report adjusted odds ratios (aOR).
Results: The trial included 32,609 patients, of whom 26,957 were seen in HBEDs and 5,652 were seen in FSEDs. Safe discharge from HBED occurred 53% (5947/11,062) of the time in the standard care arm and 50.4% (8,005/15894) under the rapid rule-out protocol (aOR 1.04, 95% CI 0.94 – 1.15, p = 0.5). Safe discharge from a FSED occurred 86.2% (2106/2443) of the time in the standard care arm and increased to 95.1% (3052/3209) under the rapid protocol (aOr 1.48, 95% CI 1.03 – 2.13, p=.033). Initiation of a rapid rule-out protocol had no significant impact on overall ED length of stay (aOR 1.00, 95% CI 0.98-1.03, p = 0.8). There was a statistically significant reduction in FSED length of stay with application of a rapid rule-out protocol (3.43 hours (2.55, 4.58) vs. 3.97 hours (2.88, 4.77) using standard care, aOR 0.91, 95% CI 0.87- 0.95, p \u3c0.001). The percentage of patients who rule-out with their initial hs-cTnI (\u3c4 ng/L) at FSEDs (74%) was significantly larger when compared to hospital based EDs (54%), p\u3c.001. Safe discharge data for all 9 ED sites is detailed in table 1.
Conclusion: Implementation of a hs-cTnI rapid 0/1-hour protocol to evaluate for AMI in FSEDs is feasible and had greater impact on safe ED discharge and length of stay compared to HBEDs