Virtual reality training for occupational risk prevention: application case in geotechnical drilling works

The construction industry is considered one of the most dangerous industries globally. The construction site is a complex environment where diverse teams of people interact with large machinery. In addition, the lack of safety culture on the job site and deficiencies in safety training increase these problems. Within the construction works, geotechnical drilling worksites involve high-powered machinery, and workers are exposed to different risks when using them. Despite these risks, safety training courses on these topics are not specialized. Most of the training courses are generic in occupational hazards, failing to address in detail the work dynamics and risks associated with geotechnical work, where heavy machinery is a fundamental factor. There is a lack of adequate learning content specific to drilling works, meaning the heavy machinery, how to use it and how to prevent accidents due to these drilling tasks are poorly understood. This research investigates the risks associated with geotechnical drilling work and explores the potential of virtual reality (VR) to simulate immersive work environments, focusing on interaction with drilling machinery. A geotechnical drilling machine modelled 3D and integrated into a realistic VR environment. The machinery motions and the different tasks of the work team were modelled. The simulation allows a worker to interact in a working environment, identify risks and prevent accidents, and, moreover, be trained in best practices for machinery usage, according to previous real-world experiences from senior workers.This research has been supported by the CONICYT through its economic support of Felipe Muñoz, beneficiary of a predoctoral grant (CONICYT-PCHA/International Doctorate/2019-72200306), ‘DI emergente PUCV 2022’project ofthe Vicerrectoría de Investigación y estudios avanzados-Pontificia Universidad Católica de Valparaíso (039.350/2022) and by the Ministry of Science, Innovation and Universities of Spain (MICIU) through the BIMI- oTICa project (RTC-2017-6454-7). The authors also acknowledge financial support from the Spanish Ministry of Economy and Competitiveness, through the ‘Severo Ochoa Programme for Centres of Excellence in R&D (CEX2018-000797-S)’. The authors declare their compliance with all provisions of the Authors’ Duties according to the WIT Press Publication Ethics and Malpractice Statement.Peer ReviewedPostprint (published version

Prevention of occupational risks in geotechnical drilling works through virtual reality training

The architecture, engineering, construction and operations industry has high accident rates as a result of characteristics of the construction site and work activities, the heavy machinery used and a lack of safety culture. In particular, geotechnical drilling worksites involve the use of high-powered machinery and workers are exposed to different risks when using them. However, risk prevention training courses are not well-specialised for this type of work. There is a lack of adequate learning content specific to drilling works, meaning the heavy machinery, how to use it and how to prevent accidents due to these drilling tasks are poorly understood. Therefore, this research explores the potential of virtual reality technology as a tool for analysing the risks associated with geotechnical drilling works and as complementary training content to traditional courses. A specific use case, a geotechnical drilling machine is modelled in 3D and integrated into a realistic virtual reality environment where the movements of the machine are recreated, in addition to interactions so that workers can simulate the geotechnical drilling process, identify risks and prevent accidents, and, moreover, be trained in best practices for machinery usage, according to previous real-world experiences from senior workers. © 2021 WIT PressThis work has been supported by the CONICYT through its economic support of Felipe Muñoz, beneficiary of a pre-doctoral grant (CONICYT – PCHA/International Doctorate/2019-72200306) and by the Ministry of Science, Innovation and Universities of Spain (MICIU) through the BIMIoTICa project (RTC-2017-6454-7). The authors also acknowledge financial support from the Spanish Ministry of Economy and Competitiveness, through the “Severo Ochoa Programme for Centres of Excellence in R&D (CEX2018-000797-S)”.Postprint (published version

Factors influencing Safety on Construction Projects (fSCPs): types and categories

Due to the fact of activity, environment and work dynamics, the construction industry is characterised by high accident rates. Different initiatives have emerged to reduce these figures, which focus on using new methodologies and technologies for safety management. Therefore, it is essential to know the key factors and their influence on safety in construction projects (fSCPs) to focus efforts on these elements. Through a systematic literature review, based on PRISMA methodology, this article identifies, describes and categorises 100 factors that affect construction safety. It thus contributes by providing a comprehensive general framework, unifying previous studies focused on specific geographic areas or case studies with factors not considered or insufficiently disaggregated, along with an absence of classifications focused on understanding where and how factors affect the different dimensions of construction projects. The 100 factors identified are described and categorised according to the dimensions and aspects of the project in which these have an impact, along with identifying whether they are shaping or immediate factors or originating influences for the generation of accidents. These factors, their description and classification are a key contribution to improving the systematic creation of safety and generating training and awareness materials to fully develop a safety culture in organisations.This research was funded by Proyecto VRIEA-PUCV (grant number 039.429/2021). This work was supported by the CONICYT to F.M., who was the beneficiary of a pre-doctoral grant (CONICYT—PCHA/International Doctorate/2019-72200306) and by the Ministry of Science, Innovation and Universities of Spain (MICIU) through the BIMIoTICa project (RTC-2017-6454-7). The authors also acknowledge the financial support from the Spanish Ministry of Economy and Competitiveness, through the “Severo Ochoa Programme for Centres of Excellence in R&D (CEX2018-000797-S)”. Institution: Vicerrectoría de Investigación y Estudios avanzados - Pontificia Universidad Católica de Valparaíso (VRIEA-PUCV) Code Project: 039.429/2021.Peer ReviewedPostprint (published version

Towards the integration and automation of the design process for domestic drinking-water and sewerage systems with BIM

The use of building information modelling (BIM) in construction projects is expanding, and its usability throughout building lifecycles, from planning and construction to operation and maintenance, is gaining increasing proof. In the design of domestic drinking-water and sewerage systems (DDWSSs), BIM focuses on coordinating disciplines and their design. Despite studies promoting BIM environments for DDWSSs that take into account the regulatory frameworks of corresponding countries, these efforts do not include the use of parametric tools that enhance the efficiency of the design process. Therefore, engineers still use conventional 2D design, which requires many rounds of iteration, and manual work is also generally still used. In this research, we developed and validated an intuitive methodology for solving a specific DDWSS problem, using a design science research method (DSRM) as an applied science approach. This was addressed by developing an artefact and validating it through two case studies. The obtained solution combines BIM models and parametric tools to automate the manual activities of the traditional design method. This article aims to bring abstract BIM concepts into practice and encourage researchers and engineers to adopt BIM for DDWSSs.This research was funded by Proyecto VRIEA-PUCV, grant number 039.427/2021, and the Grants for the Promotion of Research in the Department of Civil and Building Engineering, UCLM. This research was also funded by Spanish Ministry of Economy and Competitiveness provided through the research project BIA2013-47290-R, BIA2017-86811-C2-1-R and BIA2017-86811-C2-2-R. All these projects were funded with FEDER funds.Peer ReviewedPostprint (published version

Proposal for the deployment of an augmented reality tool for construction safety inspection

The construction site is a hazardous place. The dynamic, complex interaction between workers, machinery, and the environment leads to dangerous risks. In response to such risks, the goal is to fulfill the zero accidents philosophy, which requires the development of safety skills among workers and the provision of tools for risk prevention. In pursuit of that vision, this work studies collective protective equipment (CPE). Traditional methodologies propose visual inspections using checklists, the effectiveness of which depends on the quality of the inspection by the safety advisor (SA). This paper analyses the traditional process of safety inspections in building projects: the traditional methods, main pain points, and bottlenecks are identified, along with the key performance indicators (KPIs) needed to complete these processes correctly. Because of this, a methodology that digitises the CPE inspection process is proposed. Augmented reality (AR) is used as a 3D viewer with an intuitive interface for the SA, and, accordingly, functional requirements are detailed and different information layers and user interfaces for AR applications are proposed. In addition, the workflow and KPIs are shown. To demonstrate the feasibility of the proposal, a proof of concept is developed and evaluated. The relevance of this work lies in providing background for the use of AR in safety inspection processes on construction sites and in offering methodological recommendations for the development and evaluation of these applications.This work has been supported by the Ministry of Science, Innovation and Universities of Spain (MICIU) through the BIMIoTICa project (RTC-2017-6454-7) and by the CONICYT for its economic support to Felipe Muñoz, beneficiary of a pre-doctoral grant (CONICYT—PCHA/International Doctorate/2019-72200306). The authors also acknowledge the financial support from the Spanish Ministry of Economy and Competitiveness, through the “Severo Ochoa Centre of Excellence (2019–2023) under the grant CEX2018-000797-S funded by MCIN/AEI/10.13039/501100011033”.Peer ReviewedPostprint (published version

La narrativa en experiencias de realidad mixta para desarrollar cultura de prevención de riesgos laborales en construcción

La creciente digitalización en la construcción, especialmente impulsada a través del Modelado de información de construcción (Building Information Modeling, BIM) pero que también incluye monitorización, visión por computador y virtualización, entre otras, conduce a la reflexión y renovación de los procesos para la prevención de riesgos laborales (PRL). La tríada Tecnología-Procesos-Personas permite anticipar y diseñar de forma holística esta transformación digital que se viene produciendo en la industria. Como ejemplo, se está intensificando la trazabilidad de las actividades cotidianas para el estudio de nuevos procedimientos encaminados a erradicar los accidentes. Se busca optimizar procesos, como las trayectorias de vehículos y personas, el horario previsto para ciertas tareas simultáneas, con el fin de evitar la probabilidad de colisión entre maquinaria y trabajadores. A pesar de ello, en los últimos años el índice de incidencia de siniestros no solo no experimenta mejora, sino que muestra un cierto repunte, ya sea porque estas innovaciones no se están desplegando debidamente, porque se requiera de mayor madurez tecnológica o por no atender debidamente el comportamiento humano, clave en los índices de accidentabilidad. Así, más allá de la tecnología, es crucial el desarrollo de una cultura de prevención. En particular, el uso de la realidad mixta se plantea como un canal que permite al trabajador interiorizar la prevención como pilar fundamental no solo para su supervivencia, sino también para su calidad de vida sin secuelas debidas a accidentes o a malos hábitos laborales. La realidad virtual y aumentada permite situar al usuario en una gran variedad de escenarios y circunstancias peligrosas, prácticamente ilimitada, tales como laderas deslizantes, maquinaria descontrolada o clima adverso, de acuerdo con el tipo de obra y criterio del experto prevencionista. Existe aún un paso más allá del realismo de los escenarios virtuales: el mensaje a transmitir. Con estas experiencias se puede facilitar la transferencia de conocimiento entre trabajadores, por ejemplo, entre un minero a punto de jubilarse que relata su angustia ante una caída desde una gran altura y un joven que termina de incorporarse y que solo conoce peligros desde la teoría. Este enfoque permite estudiar el rol de las emociones y factores culturales como determinantes del comportamiento de las personas. El uso de la narrativa (storytelling) como medio bien conocido del cine y teatro para transmitir sentimientos a las audiencias, puede ayudar a profundizar en la concienciación de los usuarios que están experimentando los contenidos en primera persona (storyliving) y que tengan un significado emocional más allá del contenido teórico sobre los protocolos PRL. Disminuir el índice de accidentabilidad implica aprender a identificar los riesgos, saber valorarlos en su gravedad y estar capacitados para reaccionar ante ellos para erradicarlos o, cuando menos, para minimizar su probabilidad de ocurrencia. El objetivo es pasar de un sistema preventivo que descansa sobre todo en la legislación y supervisión a otro basado en la cultura, evolucionar de sistemas de vigilancia al desarrollo de narrativas convincentes, donde el factor humano ocupa un lugar central

Effect of viral storm in patients admitted to intensive care units with severe COVID-19 in Spain: a multicentre, prospective, cohort study

Background: The contribution of the virus to the pathogenesis of severe COVID-19 is still unclear. We aimed to evaluate associations between viral RNA load in plasma and host response, complications, and deaths in critically ill patients with COVID-19. Methods: We did a prospective cohort study across 23 hospitals in Spain. We included patients aged 18 years or older with laboratory-confirmed SARS-CoV-2 infection who were admitted to an intensive care unit between March 16, 2020, and Feb 27, 2021. RNA of the SARS-CoV-2 nucleocapsid region 1 (N1) was quantified in plasma samples collected from patients in the first 48 h following admission, using digital PCR. Patients were grouped on the basis of N1 quantity: VIR-N1-Zero ([removed]2747 N1 copies per mL). The primary outcome was all-cause death within 90 days after admission. We evaluated odds ratios (ORs) for the primary outcome between groups using a logistic regression analysis. Findings: 1068 patients met the inclusion criteria, of whom 117 had insufficient plasma samples and 115 had key information missing. 836 patients were included in the analysis, of whom 403 (48%) were in the VIR-N1-Low group, 283 (34%) were in the VIR-N1-Storm group, and 150 (18%) were in the VIR-N1-Zero group. Overall, patients in the VIR-N1-Storm group had the most severe disease: 266 (94%) of 283 patients received invasive mechanical ventilation (IMV), 116 (41%) developed acute kidney injury, 180 (65%) had secondary infections, and 148 (52%) died within 90 days. Patients in the VIR-N1-Zero group had the least severe disease: 81 (54%) of 150 received IMV, 34 (23%) developed acute kidney injury, 47 (32%) had secondary infections, and 26 (17%) died within 90 days (OR for death 0·30, 95% CI 0·16–0·55; p<0·0001, compared with the VIR-N1-Storm group). 106 (26%) of 403 patients in the VIR-N1-Low group died within 90 days (OR for death 0·39, 95% CI 0·26–0·57; p[removed]11 página

Viral RNA load in plasma is associated with critical illness and a dysregulated host response in COVID‑19

Background. COVID-19 can course with respiratory and extrapulmonary disease. SARS-CoV-2 RNA is detected in respiratory samples but also in blood, stool and urine. Severe COVID-19 is characterized by a dysregulated host response to this virus. We studied whether viral RNAemia or viral RNA load in plasma is associated with severe COVID-19 and also to this dysregulated response. Methods. A total of 250 patients with COVID-19 were recruited (50 outpatients, 100 hospitalized ward patients and 100 critically ill). Viral RNA detection and quantification in plasma was performed using droplet digital PCR, targeting the N1 and N2 regions of the SARS-CoV-2 nucleoprotein gene. The association between SARS-CoV-2 RNAemia and viral RNA load in plasma with severity was evaluated by multivariate logistic regression. Correlations between viral RNA load and biomarkers evidencing dysregulation of host response were evaluated by calculating the Spearman correlation coefficients. Results. The frequency of viral RNAemia was higher in the critically ill patients (78%) compared to ward patients (27%) and outpatients (2%) (p < 0.001). Critical patients had higher viral RNA loads in plasma than non-critically ill patients, with non-survivors showing the highest values. When outpatients and ward patients were compared, viral RNAemia did not show significant associations in the multivariate analysis. In contrast, when ward patients were compared with ICU patients, both viral RNAemia and viral RNA load in plasma were associated with critical illness (OR [CI 95%], p): RNAemia (3.92 [1.183–12.968], 0.025), viral RNA load (N1) (1.962 [1.244–3.096], 0.004); viral RNA load (N2) (2.229 [1.382–3.595], 0.001). Viral RNA load in plasma correlated with higher levels of chemokines (CXCL10, CCL2), biomarkers indicative of a systemic inflammatory response (IL-6, CRP, ferritin), activation of NK cells (IL-15), endothelial dysfunction (VCAM-1, angiopoietin-2, ICAM-1), coagulation activation (D-Dimer and INR), tissue damage (LDH, GPT), neutrophil response (neutrophils counts, myeloperoxidase, GM-CSF) and immunodepression (PD-L1, IL-10, lymphopenia and monocytopenia). Conclusions. SARS-CoV-2 RNAemia and viral RNA load in plasma are associated with critical illness in COVID-19. Viral RNA load in plasma correlates with key signatures of dysregulated host responses, suggesting a major role of uncontrolled viral replication in the pathogenesis of this disease.This work was supported by awards from the Canadian Institutes of Health Research, the Canadian 2019 Novel Coronavirus (COVID-19) Rapid Research Funding initiative (CIHR OV2 – 170357), Research Nova Scotia (DJK), Atlantic Genome/Genome Canada (DJK), Li-Ka Shing Foundation (DJK), Dalhousie Medical Research Foundation (DJK), the “Subvenciones de concesión directa para proyectos y programas de investigación del virus SARS‐CoV2, causante del COVID‐19”, FONDO–COVID19, Instituto de Salud Carlos III (COV20/00110, CIBERES, 06/06/0028), (AT) and fnally by the “Convocatoria extraordinaria y urgente de la Gerencia Regional de Salud de Castilla y León, para la fnanciación de proyectos de investigación en enfermedad COVID-19” (GRS COVID 53/A/20) (CA). DJK is a recipient of the Canada Research Chair in Translational Vaccinology and Infammation. APT was funded by the Sara Borrell Research Grant CD018/0123 funded by Instituto de Salud Carlos III and co-fnanced by the European Development Regional Fund (A Way to Achieve Europe programme). The funding sources did not play any role neither in the design of the study and collection, not in the analysis, in the interpretation of data or in writing the manuscript

Envejecimiento de la población

&bull;Actividades b&aacute;sicas de la vida diaria en personas mayores y factores asociados &bull;Asociaci&oacute;n entre depresi&oacute;n y posesi&oacute;n de mascotas en personas mayores &bull;Calidad de vida en adultos mayores de Santiago aplicando el instrumento WHOQOL-BREF &bull;Calidad de vida en usuarios con enfermedad de Parkinson, demencia y sus cuidadores, comuna de Vitacura &bull;Caracterizaci&oacute;n de egresos hospitalarios de adultos mayores en Puerto Natales (2007-2009) &bull;Comportamiento de las patolog&iacute;as incluidas como GES para el adulto mayor atendido en un Cesfam &bull;Contribuci&oacute;n de vitaminas y minerales a las ingestas recomendadas diarias en ancianos institucionalizados de Madrid &bull;Estado de salud oral del paciente inscrito en el Programa de Visita Domiciliaria &bull;Evaluaci&oacute;n del programa de discapacidad severa en Casablanca con la matriz de marco l&oacute;gico &bull;Factores asociados a satisfacci&oacute;n vital en una cohorte de adultos mayores de Santiago, Chile &bull;Pauta instrumental para la identificaci&oacute;n de riesgos para el adulto mayor autovalente, en su vivienda &bull;Perfil farmacol&oacute;gico del paciente geri&aacute;trico institucionalizado y posibles consecuencias en el deterioro cognitivo &bull;Programa de cuidados paliativos y alivio del dolor en Puerto Natales &bull;Rehabilitaci&oacute;n mandibular implantoprot&eacute;sica: efecto en calidad de vida relacionada con salud bucal en adultos mayores &bull;Salud bucodental en adultos mayores autovalentes de la Regi&oacute;n de Valpara&iacute;so &bull;Transici&oacute;n epidemiol&oacute;gica y el estudio de carga de enfermedad en Brasi

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe