USE OF THE OBSERVATIONAL APPROACH FOR EMBANKMENT CONSTRUCTION ON ORGANIC SOIL DEPOSITS IN SRI LANKA

Abstract Road embankments on organic soil deposits cause stability issues during the construction stage and consolidation settlement problems during the post construction stage. As the conservative approach, which designs road embankments using unfavourable or prismatic ground conditions, becomes uneconomical or not feasible for construction of road embankments on organic soil deposits observational approach is very often used for such design and construction. In the observational approach, the most probable or more optimistic ground conditions are considered in the initial design. The risks associated with using most probable soil properties are managed by reviewing the initial design through the analysis of the observational data obtained during the construction stage. In this regards, analysis tools to assess the stability of the embankment during construction stage and the estimation of the degree of consolidation during ground improvement phase are extremely important. Even though there is large number of analytical methods available to use for the data analysis, not much research is done to identify the tools relevant to the organic soft soils found in Sri Lanka. This research is aimed at investigation of the analytical tools that can be used to analysis of settlement monitoring data obtained during the implementation of the observational approach for construction of the road embankments over the soft soil deposits in Sri Lanka

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42\ub74% vs 44\ub72%; absolute difference \u20131\ub769 [\u20139\ub758 to 6\ub711] p=0\ub767; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5\u20138] vs 6 [5\u20138] cm H2O; p=0\ub70011). ICU mortality was higher in MICs than in HICs (30\ub75% vs 19\ub79%; p=0\ub70004; adjusted effect 16\ub741% [95% CI 9\ub752\u201323\ub752]; p<0\ub70001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0\ub780 [95% CI 0\ub775\u20130\ub786]; p<0\ub70001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status. Funding: No funding

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Earthquake induced kinematic forces on pile foundations in fayered medium

The kinematic forces induced on piles in two-layered soil medium are investigated using finite element method. Typical layered subsurface condition with the soil properties relevant to Sri Lanka are considered in the present study. Hyperbolic nonlinear constitutive model is used for the soil medium and the soil medium is modelled as a fully coupled system. The effect of the earthquake was simulated by lateral ground cceleration applied to the bedrock. The validity of the results of the proposed model was established by comparing with the trends observed in similar studies reported in the literature. The effects of the stiffness of the soil layers, pile diameter, fixity at the pile head, and a defect present at the layer interface on the kinematic forces are investigated in the present study. Finally, the use of the results of the present study in the design and construction of bored and cast insitu concrete in Sri Lanka are highlighted

Integrating Environmental Management Accounting (EMA) Practices with Waste Management - A Case of an Electrical Item Manufacturer in Sri Lanka

Purpose – The purpose of the paper is to examine how an electrical item manufacturer in Sri Lanka uses EMA and other practices to manage waste.Design/methodology/approach – The study followed the case study approach. In-depth interviews, and observations were used as primary sources of data and documentary evidences such as quality manuals, records prepared by the Finance Division, brochures and internal documents along with online resources were used as secondary sources of data. In collecting data, measures were taken to improve trustworthiness. Collected data were analyzed using explanatory building approach. Findings – Despite the conventional absorption method to absorb waste related costs, the organization currently follows several practices such as cleaner production, Kanban and Kaizen to manage waste.  The manufacturer has some physical and monetary accounting practices relevant to recording, measurement and analysis of waste. The study further reveals that the intensity of accounting and environmental management strategies depends on the significance of a particular cost element to the organization.Research limitations/implications – Since the study covers only a particular electronic item manufacturer, generalizing the findings is somewhat difficult. This is mainly due to the context specific characteristics of the manufacturer. Therefore, the findings will be better suited for organizations in the electronic industry with similar characteristics.Originality/value – This study aims to contribute to the dearth of research on the application of EMA practices towards waste management in the manufacturing sector of a developing country. The findings will be useful for manufacturing sector organizations to enhance focus on physical and monetary accounting practices towards improving efficiency in waste management.Keywords- Electronic industry, manufacturing organizations, environmental management accounting practices, Sri Lanka, waste management.Paper type- Case Study

Traumatic brain injury (TBI) outcomes in an LMIC tertiary care centre and performance of trauma scores.

Background This study evaluates post-ICU outcoes of patients admitted with moderate and severe Traumatic Brain Injury (TBI) in a tertiary neurocritical care unit in an low middle income country and the performance of trauma scores: A Severity Characterization of Trauma, Trauma and Injury Severity Score, Injury Severity Score and Revised Trauma Score in this setting. Methods Adult patients directly admitted to the neurosurgical intensive care units of the National Hospital of Sri Lanka between 21st July 2014 and 1st October 2014 with moderate or severe TBI were recruited. A telephone administered questionnaire based on the Glasgow Outcome Scale Extended (GOSE) was used to assess functional outcome of patients at 3 and 6 months after injury. The economic impact of the injury was assessed before injury, and at 3 and 6 months after injury. Results One hundred and one patients were included in the study. Survival at ICU discharge, 3 and 6 months after injury was 68.3%, 49.5% and 45.5% respectively. Of the survivors at 3 months after injury, 43 (86%) were living at home. Only 19 (38%) patients had a good recovery (as defined by GOSE 7 and 8). Three months and six months after injury, respectively 25 (50%) and 14 (30.4%) patients had become “economically dependent”. Selected trauma scores had poor discriminatory ability in predicting mortality. Conclusions This observational study of patients sustaining moderate or severe TBI in Sri Lanka (a LMIC) reveals only 46% of patients were alive at 6 months after ICU discharge and only 20% overall attained a good (GOSE 7 or 8) recovery. The social and economic consequences of TBI were long lasting in this setting. Injury Severity Score, Revised Trauma Score, A Severity Characterization of Trauma and Trauma and Injury Severity Score, all performed poorly in predicting mortality in this setting and illustrate the need for setting adapted tools.</p