AbstractThe construction industry is fraught with waste and inefficiencies resulting in projects often failing to meet owners’ expectations. Integrated project delivery (IPD) is the newest project ...delivery system (PDS) and changes the traditional roles and relationships of key project stakeholders. Through increased early collaboration, IPD attempts to eliminate waste and deliver the highest-value projects to owners. It is seen as a potential solution to many of the challenges impeding successful project performance. However, a transformational move toward IPD has yet to reach a tipping point, and its use is not prevalent throughout the construction industry. Little research has been done to quantitatively analyze IPD compared with the more commonly used delivery methods. Through substantial collection of quantitative project performance data and univariate statistical analysis, this study fills the gap in PDS research by evaluating the effects of IPD on building construction projects across a wide range of performance metrics from the perspective of general contractors and construction managers. This research demonstrates that IPD/near-IPD outperformed non-IPD projects with respect to performance in communication, change management, and business performance areas. Communication was found superior in terms of the number of requests for information (RFIs) per million dollars; change management in terms of change-order processing time; and business performance in terms of a project’s impact on company image and the potential for return business. A new term called project quarterback rating (PQR), which combines key performance metrics, was used to quantitatively evaluate overall performance. Statistically significant evidence of the overall superior performance of IPD/near-IPD compared with non-IPD projects was found. These results should encourage owners to consider the use of IPD, or IPD principles in conjunction with other delivery methods, in future capital facilities endeavors.
Diabetic kidney disease is the leading cause of kidney failure worldwide; in the USA, it accounts for over 50% of individuals entering dialysis or transplant programmes. Unlike other complications of ...diabetes, the prevalence of diabetic kidney disease has failed to decline over the past 30 years. Hyperglycaemia is the primary aetiological factor responsible for the development of diabetic kidney disease. Once hyperglycaemia becomes established, multiple pathophysiological disturbances, including hypertension, altered tubuloglomerular feedback, renal hypoxia, lipotoxicity, podocyte injury, inflammation, mitochondrial dysfunction, impaired autophagy and increased activity of the sodium-hydrogen exchanger, contribute to progressive glomerular sclerosis and the decline in glomerular filtration rate. The quantitative contribution of each of these abnormalities to the progression of diabetic kidney disease, as well as their role in type 1 and type 2 diabetes mellitus, remains to be determined. Sodium-glucose co-transporter 2 (SGLT2) inhibitors have a beneficial impact on many of these pathophysiological abnormalities; however, as several pathophysiological disturbances contribute to the onset and progression of diabetic kidney disease, multiple agents used in combination will likely be required to slow the progression of disease effectively.
Background
During the last two decades, an increasing number of bariatric surgical procedures have been performed worldwide. There is no consensus regarding optimal perioperative care in bariatric ...surgery. This review aims to present such a consensus and to provide graded recommendations for elements in an evidence-based “enhanced” perioperative protocol.
Methods
The English-language literature between January 1966 and January 2015 was searched, with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohort studies. Selected studies were examined, reviewed and graded. After critical appraisal of these studies, the group of authors reached a consensus recommendation.
Results
Although for some elements, recommendations are extrapolated from non-bariatric settings (mainly colorectal), most recommendations are based on good-quality trials or meta-analyses of good-quality trials.
Conclusions
A comprehensive evidence-based consensus was reached and is presented in this review by the enhanced recovery after surgery (ERAS) Society. The guidelines were endorsed by the International Association for Surgical Metabolism and Nutrition (IASMEN) and based on the evidence available in the literature for each of the elements of the multimodal perioperative care pathway for patients undergoing bariatric surgery.
AbstractIntegrated project delivery (IPD) is an emerging construction project delivery system that collaboratively involves key participants very early in the project timeline, often before the ...design is started. It is distinguished by a multiparty contractual agreement that typically allows risks and rewards to be shared among project stakeholders. Because IPD is becoming increasingly popular, various organizations are expressing interest in its benefits to the architecture/engineering/construction (AEC) industry. However, no research studies have shown statistically significant performance differences between IPD and more established delivery systems. This study fills that missing gap by evaluating the performance of IPD projects compared to projects delivered using the more traditional design-bid-build, design-build, and construction management at-risk systems, and showing statistically significant improvements for IPD. Relevant literature was analyzed, and a data collection instrument was developed and utilized in detailed interviews to gather quantitative performance data from 35 recently completed projects. Univariate data analyses, such as t-tests and Mann-Whitney-Wilcoxon tests, were performed to evaluate IPD performance. The results indicate that IPD achieves statistically significant improvements in 14 metrics across six performance areas: quality, schedule, project changes, communication among stakeholders, environmental, and financial performance. The major contribution of this paper is demonstrating that IPD provides higher quality facilities faster and at no significant cost premium. These results would be extremely valuable in the hands of decision makers to enable them to choose the appropriate delivery system for their projects.
Ultrasound is composed of sound waves with frequency beyond the limit of human hearing. By tuning frequency, ultrasound can be utilized in many industrial applications including food. Ultrasound ...techniques are relatively cheap, simple and energy saving, and thus became an emerging technology for probing and modifying food products. Low power (high frequency) ultrasound is used for monitoring the composition and physicochemical properties of food components and products during processing and storage, which is crucial for controlling the food properties and improving its quality. High power (low frequency) ultrasound, on the other hand, induces mechanical, physical and chemical/biochemical changes through cavitation, which supports many food processing operations such as extraction, freezing, drying, emulsification and inactivation of pathogenic bacteria on food contact surfaces. This review summarizes the major applications of low and high power ultrasound in food science and technology. The basic principles of low and high power ultrasound will be highlighted, and their methods and applications including important research results will be presented. These applications include meat products, vegetables and fruits, cereal products, aerated foods, honey, food gels, food proteins, food enzymes, microbial inactivation, freezing, drying and extraction.
► Classification, principles and types of ultrasound. ► Low power ultrasound based techniques. ► Applications of low power ultrasound in food science and technology. ► Applications of high power ultrasound in food science and technology.
Cancer causes a major health concern worldwide due to high incidence and mortality rates. To accomplish this purpose, the Scopus, PubMed, and Web of Science databases were searched using the keywords ...bacteria and cancer. Most of published research addressed several different factors that induced cancer, such as toxins, medications, smoking, and obesity. Nonetheless, few studies are dealing with cancer induction via bacterial infection. In addition, mechanisms of cancer induction via bacterial infections are not well understood. Therefore, in this review, we will shed light on different bacteria that induced cancer via different molecular mechanisms. Among the bacterial infection that induced cancer, Helicobacter pylori was the first recognized bacteria which caused gastric cancer and might be also linked to extragastric cancer in humans. H. pylori has been associated with adenocarcinoma in the distal stomach by its ability to cause severe inflammations. It has been found that inflammations induced cancer via different mechanisms including induction of cell proliferation and production of high levels of free radicals. Recently, free radicals were found to induce and cause various types of cancer. Salmonella typhi has been found to be associated with gallbladder carcinoma (GBC). Also, intercellular infection of lungs with Chlamydia pneumoniae was found to contribute as one of the ethological factors of lung cancer. Moreover, infection of the urinary tract with Staphylococcus aureus, Klebsiella spp., and Proteus mirabilis has been found to cause bladder cancer. These microorganisms produce a high level of N-nitrosamines which are metabolically activated leading to the generation of alkylating agents that damage DNA and other macromolecules. It is concluded that a certain bacterium is linked with induction of a specific type of cancer via different molecular and biochemical mechanisms as discussed in the text in details. This infection could potentially affect human health in different ways. In addition, it is important to know the possible factors involved in cancer induction for better treatment of cancer patients.
AbstractDespite the high spending and high employment, the construction industry struggles to agree how to go about project performance assessment and what constitutes a successful project. This does ...not allow stakeholders to address the issues in and drawbacks of their respective projects. Hence, this research outlines performance metrics upper limits, which can be used in defining a successful project. Data were collected from Construction Industry Institute (CII) members and multiple construction firms through University of Wisconsin–Madison active research projects. Two classification and regression tree (CART) models were developed using 4-fold randomized cross-validation to provide the metrics thresholds of success with a classification accuracy of 81% and 85%, respectively. CART models revealed that a successful project can be defined as having construction schedule growth less than 10.4%, construction cost growth less than 9.8%, requests for information (RFIs) per $million less than or equal to 8.6, and RFI processing time less than or equal to 7 days. Additional thresholds showed that a high-performing successful project would have a change orders per $million of less than 0.39 and rework of less than 1.5%. These thresholds can serve as a step toward a quantitative definition of success by translating qualitative success status into quantitative success status. Additionally, the established thresholds can be used as benchmarks for acceptable construction performance, which can then be adopted as risk thresholds or tolerances during project planning.
Purpose The exact process of construction projects performance assessment and benchmarking still remains subjective relying on qualitative techniques, which does not allow stakeholders to address the ...issues and the drawbacks of their respective projects as effectively as possible for performance improvement purposes. Hence, this research aims to establish a unified project performance score (PPS) for assessing and comparing projects performance. Design/methodology/approach Data were collected from Construction Industry Institute (CII) members and through University of Wisconsin active research projects. Exploratory data analysis was done to investigate the calculated performance metrics and the collected data characteristics. Data were converted into six performance metrics which were used as the independent variables in creating the PPS model. Logistic regression model was developed to generate the unified PPS equation in order to explain the variables that significantly affect construction projects successful post-completion performance. The PPS model was then applied on the collected dataset to benchmark projects in terms of project delivery systems, compensation types and project types in order to showcase the PPS capabilities and possible applications. Findings The model revealed that construction cost and schedule growth are the most important metrics in assessing projects performance, while RFIs’ processing time and change orders per million dollars were the features with the least effect on the PPS value. The authors found that integrated project delivery (IPD) and target value (TV) projects outperformed all other project delivery and compensation types. While, industrial projects showed the worst performance, as compared to commercial or institutional projects. Originality/value The PPS model can be used to assess the performance of any pool of executed projects, and introducing a novel addition to the field of construction business analytics which is a supplementary tool to successful decision making and performance improvement. Additionally, the bidding selection system can be revolutionized from a cost-based to a performance based one using the PPS model to improve the outcomes of the buyout process.
A number of promising nano-sized particles (nanoparticles) have been developed to conquer the limitations of conventional chemotherapy. One of the most promising methods is stimuli-responsive ...nanoparticles because they enable the safe delivery of the drugs while controlling their release at the tumor sites. Different intrinsic and extrinsic stimuli can be used to trigger drug release such as temperature, redox, ultrasound, magnetic field, and pH. The intracellular pH of solid tumors is maintained below the extracellular pH. Thus, pH-sensitive nanoparticles are highly efficient in delivering drugs to tumors compared to conventional nanoparticles. This review provides a survey of the different strategies used to develop pH-sensitive nanoparticles used in cancer therapy.
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