Repair of major road embankment failure using reinforced earth (re) wall

A case history of repair works of major road embankment failure along Genting Highlands to Bukit Cincin, Pahang is presented. Failures at 10 locations along Genting Highlands to Bukit Cincin road occurred on 30th October 1997 during the monsoon seasons. The repair works at Location 1 using reinforced earth wall was considered since there was enough space available at the downslope section and also the soil at the downslope section of the failed embankment was strong enough to construct the wall safely. This paper fully explained the details remedial works using reinforced earth wall at Location 1

Pull out characteristics of soil nails in Pahang / Damanhuri Jamalludin ...[et al.]

A total of 45 locations of slope failures occurred along Jalan Baru Gap to Fraser Hill, Pahang. Of the 45 locations of slope failures, only 31 locations were repaired using soil nails. At each location, only one pull out test was carried out. This study involved the results of the pull out tests at all the 31 locations and the results were obtained from Public Works Department, K.L. The maximum pull out load during the test was 90 kN and the displacement at 90 kN load must be less than 10mm for the test to be considered satisfy the specifications. The main purpose of this study is to determine the characteristics of the pull out test on soil nail and the interaction between the soil nail and the soil

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Using the Arau Model to locate groundwater potential zones in the northern regions of Malaysia / Ahmad Kamal Mad Issa et al.

A major portion of water demand in most states in Malaysia is being supplied from surface water sources. These sources are deemed inadequate to fulfil the water demand for the future. Water supply for Perlis which is situated in northern Malaysia is mainly supplied from surface waters with groundwater supplementing this supply for localised use. In this study using an integration of remote sensing and Geographic Information System (GIS) techniques, groundwater potential zones were positively identified resulting in significant savings of resources. The Weighted Linear Combination (WLC) Method in GIS was used to predict potential groundwater zones in the study area based on a new mathematical model. This model called the Arau Equation for Groundwater Potential was applied where six parameters were identified based on Civil Engineering principles. This study investigated the analysis using GIS of landuse produced from a SPOT remote sensing image of Perlis, together with secondary data which consisted of geology, topography elevation, slope distribution, drainage distribution and rainfall distribution data. These data were analyzed to produce thematic maps. In the final analysis specific areas were identified as zones of very high, high, moderate or low in terms of groundwater yield. A reliability of 79% was achieved using the Reliability Analysis when compared to historical data on groundwater boreholes and tubewells in the study area