Environmental Impact Assessment of the Life Cycle of a Timber Building

Timber construction offers a number of advantages in terms of sustainability in comparison with other construction technologies. This can partly be attributed to the fact that structural timber products often require less processing for their manufacturing compared to other construction products and their sustainability is therefore relatively increased. As a result, structures such as timber buildings are associated with increased sustainability potential and are therefore selected as sustainable solutions for the construction of housing, commercial or other types of building projects. The current research, described in this paper, is aimed at the quantification of the environmental impact caused by the construction of timber buildings. A case study is used as the basis for the calculations which take into account the whole life cycle of the timber building examined. A life cycle assessment is conducted and the environmental impact assessment results are calculated according to the Eco-Indicator 99 methodology. The interpretation of the results leads to conclusions regarding the level and type of environmental impact caused by the life cycle of timber building projects

Wireless communication with chaos

Peer reviewedPublisher PD

Dynamic Morphing of Smart Trusses and Mechanisms Using Fuzzy and Neuro-Fuzzy Techniques

In the present investigation, the principles of dynamic morphing of smart truss structures and mechanisms are discussed. A possible way in order to find the optimal geometry of the structure for the enhancement of structural performance in terms of vibration control is sought. The vibrations of the host dynamic structures are monitored by controllers which are based on the principles of Mamdani-type fuzzy inference and Sugeno-type adaptive neuro-fuzzy inference. More specifically, the objective of the present study is a design, tuning, and an application of robust intelligent control mechanisms by means of the suppression of structural vibrations for several types of excitation forces. The proposed models are discretized by using a finite element method. For the time integration of the equations of motion, the Newmark-β method is used. The calculations and the analysis are conducted within the Matlab environment by using the Adaptive Neuro-Fuzzy Inference System (ANFIS) tool, which is included in the fuzzy toolbox. The controllers are tested with different excitation forces applied on a truss-shaped structure. The control outputs are applied on each time of the simulation in order to achieve the lowest possible deformation and to prevent potential damage or corruption of the structure. The same principles are used for the dynamic morphing of structures and mechanisms. The proposed formulation can be applied, among many others, on smart irrigation systems such as spray booms, on radio-telescope bases, on the spars of smart wings, on aircraft wings etc

Valvulotomy of the great saphenous vein in ex situ non-reversed and in situ setting: a multicenter post-market study to assess the safety and efficacy of the AndraValvulotome™”

Purpose To evaluate the safety and technical success of the AndraValvulotome™ device (Andramed GmbH, Reutlingen, Germany) in patients with peripheral arterial disease (PAD) requiring bypass surgery using the great saphenous vein (GSV) as graft. Methods This was a multicenter, post-market observational study conducted in 2021 in 11 German centers. Safety and efficacy data were prospectively collected and analyzed. Primary endpoints were the absence of device-related serious adverse events until 30 ± 7 days follow-up, the clinical efficacy of valvulotomy, which was defined as pulsatile blood flow in the bypass and the number of insufficiently destroyed vein valves. Secondary endpoints were the number of valvulotomy passages, the primary patency rate of the venous bypass (determined by a color-duplex sonography showing a normal blood flow through the bypass and absence of stenosis or occlusion), and the primary technical success defined as the absence of product-specific (serious) adverse events and clinical efficacy. Results Fifty-nine patients were enrolled. The mean age of the patients was 71 years (46–91), and 74.6% were males. The vein material used for bypass grafting had a median length of 47.5 cm (range 20–70 cm) with a median diameter of 5.0 mm (range 3–6 mm) and 4.0 mm (range 2–6 mm) in the proximal and distal segments, respectively. The technical success rate was 96.6%. The primary patency rate was 89.9% at 30 days follow-up. The clinical efficacy was rated as very good in 81% of patients, fair in 17%, and poor in 2%. Between 1 and 5 (average 2.9) valvulotome passages were performed. One product-related serious adverse event was recorded (bypass vein dissection). Conclusion The AndraValvulotome™ can be considered a safe and effective device to disrupt venous valves during in situ non-reversed bypass surgeries using GSV grafts in patients with PAD

Delivery of non-invasive ventilation to people living with motor neuron disease in the UK

Objective Non-invasive ventilation (NIV) improves survival and quality of life in motor neuron disease (MND), but many patients fail to receive effective ventilation. This study aimed to map the respiratory clinical care for MND patients at a service and individual healthcare professional (HCP) level to understand where attention may be needed to ensure all patients receive optimal care. Methods Two online surveys of HCPs working with MND patients in the UK were conducted. Survey 1 targeted HCPs providing specialist MND care. Survey 2 targeted HCPs working in respiratory/ventilation services and community teams. Data were analysed using descriptive and inferential statistics. Results Responses from 55 HCPs providing specialist MND care who worked at 21 MND care centres and networks and 13 Scotland Health Boards were analysed from Survey 1. Responses from 85 HCPs from respiratory/ventilation services and 73 HCPs from community teams, representing 97 services were analysed from Survey 2. Significant differences in practice were identified at each stage of the respiratory care pathway as well as evidence of the need for improvement. This included when patients were referred to respiratory services, the time taken waiting to commence NIV, the availability of sufficient NIV equipment and provision of services, particularly out of hours. Conclusion We have highlighted significant disparity in MND respiratory care practices. Increased awareness of the factors that influence NIV success and the performance of individuals and services is important for optimal practice

Interventions to promote oral nutritional behaviours in people living with neurodegenerative disorders of the motor system : a systematic review

Background & Aims: Weight loss is common in people with neurodegenerative diseases of the motor system (NDMS), such as Parkinson’s disease and Amyotrophic Lateral Sclerosis, and is associated with reduced quality of life, functional ability and survival. This systematic review aims to identify interventions and intervention components (i.e. behaviour change techniques [BCTs] and modes of delivery [MoDs]) that are associated with increased effectiveness in promoting oral nutritional behaviours that help people with NDMS to achieve a high-calorie diet. Methods: Eight electronic databases including MEDLINE and CINAHL were searched from inception to May 2018. All interventions from included studies were coded for relevant BCTs and MoDs. Methodological quality of studies was assessed using the Cochrane risk of bias tool. Results: Fourteen studies were included. Of these, eight studies reported interventions to assist with swallowing difficulties and six studies reported interventions targeting dietary content. Beneficial effects in managing swallowing difficulties were observed with video assisted swallowing therapy, lung volume recruitment and swallowing management clinics with outpatient support. In contrast, studies reporting effectiveness of chin down posture, use of thickened liquids and respiratory muscle training were inconclusive. Positive effects in interventions targeting dietary content included the use of food pyramid tools, individualised nutritional advice with nutritional interventions, electronic health applications, face-to-face dietary counselling and high fat, high carbohydrate and milk whey protein supplements. Individualised nutritional advice with weekly phone contact did not appear to be effective. Most frequently coded BCTs were ‘instructions on how to perform the behaviour’, ‘self-monitoring’ and ‘behavioural practice/rehearsal’. Most commonly identified MoDs were ‘human’, ‘face-to-face’ and ‘somatic therapy’. However, the robustness of these findings are low due to small number of studies, small sample sizes and large between-study variability. Conclusions: Despite the limited evidence, these findings may help inform the development of more effective interventions to promote oral nutritional behaviours in people with NDMS. However, further research is needed to demonstrate which interventions, or intervention components, yield most benefit

The optimisation of non-invasive ventilation in amyotrophic lateral sclerosis : a systematic review

Background Non-invasive ventilation (NIV) prolongs survival and quality of life in amyotrophic lateral sclerosis (ALS); however, its benefits depend upon the optimisation of both ventilation and adherence. We aimed to identify factors associated with effective initiation and ongoing use of NIV in ALS to develop evidence-based guidance and identify areas for further research. Methods We searched eleven electronic databases (Jan 1998 – May 2018) for all types of quantitative and qualitative studies. Supplementary grey literature searches were conducted. Records were screened against eligibility criteria, data were extracted from included studies and risk of bias was assessed. We present findings using a narrative synthesis. Results We screened 2430 unique records and included 52 quantitative and 6 qualitative papers. Factors reported to be associated with NIV optimisation included: co-ordinated multidisciplinary care, place of initiation, selection of interfaces, ventilator modes and settings appropriate for the individual patient, and adequate secretion management. The literature indicated that patients with significant bulbar dysfunction can still derive considerable benefit from NIV if their needs are met. Research emphasises that obstructive airway events, mask leak and uncontrolled secretions should be addressed by adjustments to the interface and machine settings, and the concomitant use of cough augmentation. Conclusion This review highlights that NIV optimisation requires an individualised approach to respiratory management tailored to the differing needs of each patient. Ultimately this should lead to improved survival and quality of life. This review expands on recommendations in current international guidelines for NIV use in ALS and identifies areas for future research

Gastrostomy in patients with amyotrophic lateral sclerosis (ProGas): a prospective cohort study

Background Gastrostomy feeding is commonly used to support patients with amyotrophic lateral sclerosis who develop severe dysphagia. Although recommended by both the American Academy of Neurology and the European Federation of Neurological Societies, currently little evidence indicates the optimum method and timing for gastrostomy insertion. We aimed to compare gastrostomy insertion approaches in terms of safety and clinical outcomes. Methods In this large, longitudinal, prospective cohort study (ProGas), we enrolled patients with a diagnosis of definite, probable, laboratory supported, or possible amyotrophic lateral sclerosis who had agreed with their treating clinicians to undergo gastrostomy at 24 motor neuron disease care centres or clinics in the UK. The primary outcome was 30-day mortality after gastrostomy. This study was registered on the UK Clinical Research Network database, identification number 9923. Findings Between Nov 2, 2010, and Jan 31, 2014, 345 patients were recruited of whom 330 had gastrostomy. 163 (49%) patients underwent percutaneous endoscopic gastrostomy, 121 (37%) underwent radiologically inserted gastrostomy, 43 (13%) underwent per-oral image-guided gastrostomy, and three (1%) underwent surgical gastrostomy. 12 patients (4%, 95% CI 2·1–6·2) died within the first 30 days after gastrostomy: five (3%) of 163 after percutaneous endoscopic gastrostomy, four (3%) of 121 after radiologically inserted gastrostomy, and three (7%) of 43 after per-oral image-guided gastrostomy (p=0·46). Including repeat attempts in 14 patients, 21 (6%) of 344 gastrostomy procedures could not be completed: 11 (6%) of 171 percutaneous endoscopic gastrostomies, seven (6%) of 121 radiologically inserted gastrostomies, and three (6%) of 45 per-oral image-guided gastrostomies (p=0·947). Interpretation The three methods of gastrostomy seemed to be as safe as each other in relation to survival and procedural complications. In the absence of data from randomised trials, our findings could inform clinicians and patients in reaching decisions about gastrostomy and will stimulate further research into the nutritional management in patients with amyotrophic lateral sclerosis

First measurement of R(Xτ/ℓ)R(X_{\tau/\ell}) as an inclusive test of the b→cτνb \to c \tau \nu anomaly

We measure the tau-to-light-lepton ratio of inclusive $B$-meson branching fractions $R(X_{\tau/\ell}) \equiv \mathcal{B}(B\to X \tau \nu)/\mathcal{B}(B \to X \ell \nu)$, where $\ell$ indicates an electron or muon, and thereby test the universality of charged-current weak interactions. We select events that have one fully reconstructed $B$ meson and a charged lepton candidate from $189~\mathrm{fb}^{-1}$ of electron-positron collision data collected with the Belle II detector. We find $R(X_{\tau/\ell}) = 0.228 \pm 0.016~(\mathrm{stat}) \pm 0.036~(\mathrm{syst})$, in agreement with standard-model expectations. This is the first direct measurement of $R(X_{\tau/\ell})$