14 research outputs found
Collaborative Use of DEM and FEM for Brick Joint Splitting in Strong Earthquake Ground Motion
Masonry structures constructed about one hundred and fifty years ago, in the era
of the opening of Japan, have been recognized as industrial heritages. Many of them are
masonry warehouses made of brick or stone walls framed by wood members. In this research,
a two-story warehouse in Tomioka city, a mortar jointed brick masonry with wooden frame
reinforcements, was studied for strong earthquake ground motion. Several vibration modes
were identified by micro-tremor observations and excitation tests. The three-dimensional FE
overall model was constructed and tuned for the distinctive vibration modes. Two DEM local
models, one for bending at the center bottom of the wall treated by plane strain, and the other
for shear at the upper corner of the wall by plane stress, were constructed to evaluate brick
joint splitting. For both models, dynamic displacement response obtained by the three-
dimensional FEM were specified at their peripheries via periphery blocks. At the center bottom
of the wall, horizontally developing joint splitting in the section was evaluated. At the upper
corners, obliquely proceeding joint splitting on the wall was evaluated. In these analyses, the
specified displacements were calculated by the FE model for intact brick walls, regardless of
the degrading status of the walls. Although this assumption will have to be justified, the results
of DEM were consistent with the reported summary of past earthquake damages
Bilateral infraorbital nerve blocks decrease postoperative pain but do not reduce time to discharge following outpatient nasal surgery
While infraorbital nerve blocks have demonstrated analgesic benefits for pediatric nasal and facial plastic surgery, no studies to date have explored the effect of this regional anesthetic technique on adult postoperative recovery. We designed this study to test the hypothesis that infraorbital nerve blocks combined with a standardized general anesthetic decrease the duration of recovery following outpatient nasal surgery.
At a tertiary care university hospital, healthy adult subjects scheduled for outpatient nasal surgery were randomly assigned to receive bilateral infraorbital injections with either 0.5% bupivacaine (Group IOB) or normal saline (Group NS) using an intraoral technique immediately following induction of general anesthesia. All subjects underwent a standardized general anesthetic regimen and were transported to the recovery room following tracheal extubation. The primary outcome was the duration of recovery (minutes) from recovery room admission until actual discharge to home. Secondary outcomes included average and worst pain scores, nausea and vomiting, and supplemental opioid requirements.
Forty patients were enrolled. A statistically significant difference in mean [SD] recovery room duration was not observed between Groups IOB and NS (131 [61] min vs 133 [58] min, respectively; PÂ =Â 0.77). Subjects in Group IOB did experience a reduction in average pain on a 0â100Â mm scale (mean [95% confidence interval]) compared to Group NS (â11 [â21 to 0], PÂ =Â 0.047), but no other comparison of secondary outcomes was statistically significant.
When added to a standardized general anesthetic, bilateral IOB do not decrease actual time to discharge following outpatient nasal surgery despite a beneficial effect on postoperative pain
Transpapillary biliary biopsy for malignant biliary strictures: comparison between cholangiocarcinoma and pancreatic cancer
International Consensus Statement on Rhinology and Allergy: Rhinosinusitis
Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICARâRS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICARâRSâ2021 as well as updates to the original 140 topics. This executive summary consolidates the evidenceâbased findings of the document. Methods: ICARâRS presents over 180 topics in the forms of evidenceâbased reviews with recommendations (EBRRs), evidenceâbased reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICARâRSâ2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidenceâbased management algorithm is provided. Conclusion: This ICARâRSâ2021 executive summary provides a compilation of the evidenceâbased recommendations for medical and surgical treatment of the most common forms of RS