Building Information Modeling (BIM) Implementation for Sustainability Analysis: A Mega Airport Project Case Study

It has been generally perceived that decision-making processes for implementing sustainable solutions to building elements should be in design and pre-construction phases. This perception hinders the transformation of current non-sustainable buildings into sustainable ones. It has been realized that retrofitting existing buildings can be more beneficial in terms of time and cost compared to new construction. This study aims to show that implementation of Building Information Modeling (BIM) for energy analysis improves the retrofit planning process. This study explains that in practice, BIM tools provide significant opportunities for creation of Building Energy Modeling (BEM); and the outputs of BEM analysis can be readily used in selection of energy efficiency measures. The case study approach is used in this study. Accordingly, 3D energy models of the Istanbul Grand Airport Project have been created. A heuristic optimization depicts a clear picture of why it is necessary to incentivize transforming BIM to BEM for decision-making processes of retrofitting. Correspondingly, the study findings show that BIM implementations can provide cost and time savings for energy analysis practices

Accelerating construction of roadway bridges using alternative techniques and procurement methods

Approximately a quarter of the bridges in the United States are classified as either functionally obsolete or structurally deficient by the United States Department of Transportation (USDOT). As such, transportation agencies are challenged to handle the increasing need of upgrades with limited resources. Accelerated Bridge Construction (ABC) can reduce the construction duration and can decrease the environmental and socio-economic impacts of repair and upgrade activities by minimizing traffic disruptions. As several states are using accelerated construction techniques, a standard guideline would be highly beneficial for these agencies in developing or improving the ABC decision-making process. As problems are often project specific, a decision tool can assist in determining the viability of ABC over traditional construction methods and in selecting appropriate construction and contracting strategies on a case-by-case basis. This paper presents findings of a recent survey with regards to utilization of ABC strategies by state Departments of Transportation (DOTs), and a decision support framework which consists of three models: (1) Analytical Hierarchy Process (AHP) based ABC vs. traditional construction decision-making model; (2) ABC alternatives selection model; and (3) procurement method and contract selection model. The paper also discusses the use of ABC in New York State and describes a New York State bridge project to validate the AHP model. First published online 02 May 201

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Genome-wide identification and phenotypic characterization of seizure-associated copy number variations in 741,075 individuals

Copy number variants (CNV) are established risk factors for neurodevelopmental disorders with seizures or epilepsy. With the hypothesis that seizure disorders share genetic risk factors, we pooled CNV data from 10,590 individuals with seizure disorders, 16,109 individuals with clinically validated epilepsy, and 492,324 population controls and identified 25 genome-wide significant loci, 22 of which are novel for seizure disorders, such as deletions at 1p36.33, 1q44, 2p21-p16.3, 3q29, 8p23.3-p23.2, 9p24.3, 10q26.3, 15q11.2, 15q12-q13.1, 16p12.2, 17q21.31, duplications at 2q13, 9q34.3, 16p13.3, 17q12, 19p13.3, 20q13.33, and reciprocal CNVs at 16p11.2, and 22q11.21. Using genetic data from additional 248,751 individuals with 23 neuropsychiatric phenotypes, we explored the pleiotropy of these 25 loci. Finally, in a subset of individuals with epilepsy and detailed clinical data available, we performed phenome-wide association analyses between individual CNVs and clinical annotations categorized through the Human Phenotype Ontology (HPO). For six CNVs, we identified 19 significant associations with specific HPO terms and generated, for all CNVs, phenotype signatures across 17 clinical categories relevant for epileptologists. This is the most comprehensive investigation of CNVs in epilepsy and related seizure disorders, with potential implications for clinical practice

Cognitive behavioral therapy for tension-type headache: a case report

Tension-type headache has a very high socioeconomic impact, and its lifetime prevalence is reported to be between 30% and 78% in different studies. It is widely acknowledged that noninvasive management with a multidisciplinary approach should be considered for the treatment of tension-type headache. Cognitive behavioral therapy and relaxation exercises are efficient techniques. This article illustrates the application of a cognitive behavioral therapy protocol enhanced with progressive muscle stretching and relaxation exercises in the treatment of chronic tension-type headache via a case report. Our patient had an ongoing headache for 6 years when he was referred to us by the department of psychiatry. After 10 cognitive behavioral therapy sessions, the patient had learned to notice muscle tension and relax the muscles as well as to recognize and express his emotions in a better way. He became aware of automatic thoughts and learned to find alternative thoughts. Headache severity decreased, and he was able to increase participation in daily life activities

An asset management approach for drainage infrastructure and culverts

271 p.Drainage infrastructure systems (culvert, storm sewer, outfall and related drainage elements) are mostly buried underground and are in need of special attention in terms of proactive/preventive asset management strategy. Drainage infrastructure systems represent an integral portion of roadway assets that routinely require inspection, maintenance, repair and renewal. Further challenges are the wide geospatial distribution of these infrastructure assets and environmental exposure. There has been considerable research conducted on culverts, but this research mostly looked at the problem from a traditional structural/geotechnical perspective. Asset management procedures for culverts and drainage infrastructure systems are complex issues, and can benefit a great deal from an optimal asset management program that draws from programs pertaining to buried pipes. The first and most important step in an asset management initiative is the establishment of a mechanism for asset inventory and asset conditions in a format compatible with the routine procedures of field operators and inspectors. The first objective of this research project was to develop field protocols and operational business rules for inventory data collection and management and inspection of drainage infrastructure in terms of types of data to be collected, frequency of inspection, and analysis and reporting mechanisms. After review of these protocols by the project oversight committee, a pilot study was conducted to verify the efficiency of their implementation. The condition assessment protocol introduced is useful in evaluating the overall condition of culverts and can be used for decision making regarding the repair, renewal or replacement of culverts. For the second objective of this project, investigators examined the inventory and inspection protocols employed by the Ohio Department of Transportation and developed a decision support platform, which establishes a link between the inspection results and appropriate repair, renewal and replacement procedures. After applying the recommended procedures, the transportation agencies can better track the conditions of culverts thereby reducing the risk of culvert failures

Use of trenchless technologies for a comprehensive asset management of culverts and drainage structures

171 p.Due to an aging and rapidly deteriorating transportation infrastructure, agencies are facing the challenge of making quick and reliable decisions regarding the repair and renewal of their assets. While comprehensive asset management strategies have been developed for the visible components of the highway system, such as bridges and pavement, culverts and drainage structures are often neglected. The investigators recently completed an MRUTC project in which they have investigated the current culvert asset management practices of transportation agencies and also developed the inventory and inspection protocols necessary for establishing an effective culvert asset management program. This study builds upon the findings of the previous research project and focuses on the application of trenchless technologies for inspection, construction, repair and renewal of culverts. A literature search, a survey of departments of transportation and a survey of technology providers have been conducted to identify and characterize trenchless technology methods used for buried pipes. The limitations of trenchless technologies in terms of applicability to culverts are investigated. Steps of establishing a comprehensive culvert asset management strategy are identified. Based upon the findings a decision support system is developed which will help the decision makers identify the optimum repair/renewal procedures as a function of the condition of the culvert