Building information modelling (BIM): now and beyond

Building Information Modeling (BIM), also called n-D Modeling or Virtual Prototyping Technology, is a revolutionary development that is quickly reshaping the Architecture-Engineering-Construction (AEC) industry. BIM is both a technology and a process. The technology component of BIM helps project stakeholders to visualize what is to be built in a simulated environment to identify any potential design, construction or operational issues. The process component enables close collaboration and encourages integration of the roles of all stakeholders on a project. The paper presents an overview of BIM with focus on its core concepts, applications in the project life cycle and benefits for project stakeholders with the help of case studies. The paper also elaborates risks and barriers to BIM implementation and future trends

Editorial

The Architecture, Engineering and Construction (AEC) industries have long sought techniques to decrease project cost, increase productivity and quality, enhance safety, and reduce project delivery time. Building Information Modeling (BIM) offers the potential to achieve these goals. BIM simulates the construction project in a virtual environment. With BIM technology, an accurate virtual model of a facility is digitally constructed. When completed, the computer-generated model contains precise geometry and relevant data needed to support the programming, fabrication, procurement, construction, and post-construction activities. It can be used by project stakeholders for planning and decision making throughout the project life cycle. BIM represents a new paradigm within AEC, one that encourages integration of the roles of all stakeholders on a project. It has the potential to promote greater efficiency and harmony among players who, in the past, saw themselves as adversaries

Comparison of palatal rotational flap with buccal advancement flap for the treatment of oroantral fistula

Objective: To compared outcome of palatal rotational flap with buccal advancement flap for the treatment of oroantral fistula. Methodology: This Randomized controlled clinical trial was performed in outpatient Department of Oral and Maxillofacial Surgery Unit, Punjab dental hospital, Lahore from June 2013 to December 2013. One hundred and twenty patients were included which were divided into two groups; Group A (buccal advancement flap) and Group B (palatal rotational flap). Both procedures were performed under local anesthesia. Oral penicillin and nasal decongestant were prescribed after the procedure. Results: The mean±SD ages were 35.10±8.56 years of group A and 35.73±9.40 years in group B. There were 40 males and 20 females in group A, while in group B there were 42 males and 18 females. Male to female ratios were 2:1 and 2.4:1. Fifty two patients (86.6%) have success and 8 patients (13.4%) have no success in group A while in group B, 56 patients (93.3%) have success rate and 4 patients (6.7%) have no success rate. Statistically, there was no significant difference (P>0.05). There is no statistical difference in the outcome of oroantral fistula for both local and distant flaps. Conclusion: Treatment options for OAC/OAF include various soft tissue flaps with or without bone grafting and the best method should be emphasized upon to achieve proper closure. Buccal advancement flaps are best suited for small fistulas while palatal rotational flap or a combination of the two gives best results for large oroantral fistulas

The role of education in the circular built environment: Analysis of Australian educational programs impact on construction and demolition waste management

Resource circularity has become a necessity in the built environment sector. A significant amount of construction and demolition (C&D) waste is generated worldwide. This waste results from poor resource efficiency in the sector. Australia is among the lowest-ranked countries in the Organisation for Economic Co-operation and Development (OECD) regarding the sector's resource efficiency. A circular economy and resource efficiency can be achieved primarily through education, enforcement, and encouragement in the sector. Of these three elements, education is the focus of this paper. Education can generate attitudinal and behavioural change among stakeholders to move towards effective waste management (WM). This study aims to determine whether current Australian educational programs have successfully achieved circular economy objectives and improved resource efficiency. This paper provides an insightful overview of the programs and proposes a framework to evaluate the effectiveness of educational programs in a circular built environment. Lastly, it recommends a few practical suggestions to improve their effectiveness in the built environment sector

Creation and Stimulation of End-markets for Construction and Demolition Waste in Australia

The generation of construction and demolition (C&D) waste from infrastructure, and building and housing activity across Australia is increasing, leading to C&D waste management becoming a high priority for federal, state, territory and local governments, private industry and the general public. In response to industry and public concerns related to unsustainable C&D waste management, this project aimed to enhance understanding of the operation and capacity of end-markets for C&D waste recyclables in Australian jurisdictions. This understanding involves the integration of circular economy principles and a cradle-to-cradle approach into C&D waste management systems in the Australian context

Awareness with Recall During General Anesthesia: A Cross-Sectional Study

Background: Accidental awareness and recall a well-known complication of anesthesia and sedation despite advancements in monitoring, drugs, and techniques. This study aimed to determine the prevalence and factors of awareness with recall (AWR) during general anesthesia in a tertiary care hospital. Methods: A cross-sectional study was conducted at Maqsood Medical Center Peshawar from April to October 2022, with a total of 383 patients ≥18 years, in good neurological health, and having ASA Physical Status I, II, III, IV undergoing elective general anesthesia-based procedures were included through a convenience sampling technique. Data was collected by administering the Brice questionnaire for structured interviews one hour after admission in PACU after assessing responsiveness. Data was analyzed using SPSS 26 with p<0.05 considered significant. Results: The mean age of the study participants was 40.93+05.2 years. The Incidence of awareness was found 7(1.8%) out of which 8(2.1%) experienced pain, 7(1.8%), being touched, 7(1.8%), hearing sounds, 8(2.1%), unable to speak 8(2.1%), feeling of paralysis, 6(1.6%) experienced tube being inside the throat, 17(4.4%) experienced an abrupt increase in blood pressure, 7(1.8%) experienced sweating, and tear production and 5(1.3%) observed movement and grimacing. No specific association was found between awareness of gender and surgery type. There was a significant association between awareness and ASA classification(p=0.000) and with intraoperative pain(p=0.00), and hemodynamic changes (p=0.04). Conclusion: In conclusion, there was an unexpectedly high prevalence of anesthetic awareness with recall. During surgery, patients typically experience pain, difficulty in communication, and paralysis. Keywords: Analgesia, Anesthesia, Operative Surgical Procedure, Metacognition

Comparative efficacy of non-electric cooling techniques to reduce nutrient solution temperature for the sustainable cultivation of summer vegetables in open-air hydroponics

The cultivation of summer vegetables in open-air nutrient film technique (NFT) hydroponics is limited due to the elevated nutrient solution temperature (NST). In this regard, non-electric evaporative-cooling techniques were explored to maintain NST in open-air NFT hydroponics. Four cooling setups were employed by wrapping polyvinyl chloride (PVC) grow pipes with one and two layers of either wet or dry jute fabrics and attaching them with coiled aluminum pipe buried inside a) wet sand-filled brick tunnels (Cooling Setup I), b) two inverted and vertically stacked earthen pots (Cooling Setup II), c) two inverted and vertically stacked earthen pots externally wrapped with wet jute fabric (Wrapped Cooling Setup II), and d) an earthen pitcher wrapped with wet jute fabric (Cooling Setup III). Wrapping grow pipes with two layers of wet jute fabric reduced NST by 5°C as compared to exposed (naked) grow pipes. The double-layer jute fabric-wrapped grow pipes produced 182% more reduction in NST in comparison to single layer-wrapped grow pipes. Additionally, the installation of Wrapped Cooling Setup II and Cooling Setup III outperformed Cooling Setup I and Cooling Setup II through NST reduction of approximately 4°C in comparison to control. Interestingly, Cooling Setup III showed its effectiveness through NST reductions of 193%, 88%, and 23% during 11 a.m.–12 p.m. as compared to Cooling Setup I, Cooling Setup II, and Wrapped Cooling Setup II, respectively. In contrast, Wrapped Cooling Setup II caused NST reductions of 168%, 191%, and 18% during 2–3 p.m. in comparison to Cooling Setup I, Cooling Setup II, and Cooling Setup III, respectively. Thus, the double-layer jute fabric-wrapped grow pipes linked with Wrapped Cooling Setup II can ensure summer vegetable cultivation in open-air NFT hydroponics as indicated by the survival of five out of 12 vegetable plants till harvest by maintaining NST between 26°C and 28°C

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Central retinal artery occlusion as a result of symptomatic patent foramen ovale

Objective: The objective of this case report is to highlight the importance of patent foramen ovale (PFO) as a potential cause of central retinal artery occlusion (CRAO). Methods: A teenage girl presented with a sudden painless onset of vision loss in the right eye, which was accompanied by frontal headaches and vertigo. The patient was referred to the Ophthalmology Department, where subsequent examination revealed a best corrected visual acuity of 20/ 400 and a positive relative afferent pupillary defect (RAPD) in the right eye. Fundoscopy and optical coherence tomography confirmed the diagnosis of central retinal artery occlusion following which investigations to rule out hematologic, vascular, and cardiac causes were performed. Results: Transoesophageal echocardiography revealed PFO as the cause of this cryptogenic stroke. All the necessary blood testing work was performed (complete blood counts, erythrocyte sedimentation rate, C-reactive protein, lipid profile, homocysteine levels, prothrombin time, activated partial thromboplastin time, international normalized ratio, liver, renal and thyroid function tests, antinuclear antibodies, anti-smooth muscle antibodies, anti-mitochondrial antibodies, p-ANCA, c-ANCA, anti-cardiolipin antibodies, protein C, Protein S, activated protein C resistance, anti-thrombin III, VDRL, antibodies for viral retinitis, angiotensin converting enzyme, Mantoux test, detailed urine and electrolyte reports). Transoesophageal echocardiography revealed right to left shunt.Conclusions: This case along with other reported evidence in literature support the strong connection between PFO and CRAO. Closure of symptomatic PFO may result in prevention of severe visual loss.Abbreviations: CRAO = central retinal artery occlusion, PFO = patent foramen ovale, RAPD = relative afferent pupillary defect, BCVA = best corrected visual acuity, OCT = Optical coherence tomography, IOP = Intraocular pressures, TTE = transthoracic echocardiography, HM = hand motion, TEE = transesophageal echocardiogram