Choosing the most sustainable deconstruction strategy requires assessment of the effects of various contributing factors including prices and energy embodiment of the materials and components, the ...travelling distances, energy use and cost associated with the recycling processes, inflation rate, costs of designing the components for reuse-ability, costs of disassembly and re-assembly. Furthermore, a typical building comprises thousands of different components with various characteristics which may affect their reusability and recyclability. These lead to an enormous amount of information that needs to be stored and made available for analysis prior to and during the deconstruction stage. The present study proposes a framework for evaluating and comparing the effects of various alternative deconstruction strategies on cost, energy use and carbon footprint of construction using the information provided by a typical building information model. The results of a case study are presented to illustrate the potential applications of the proposed method.
•Planning for deconstruction should start from the very first stages of design.•Building information models can be used to evaluate deconstruction strategies.•We developed a framework for evaluating the environmental impact of deconstruction.•We developed a framework for evaluating the economic impact of deconstruction.•Carbon footprint of construction can be reduced via reuse of structural components.
Transparent thin films comprised of highly ordered titania nanotube-arrays were grown from titanium thin films using an anodization technique, from which highly sensitive and selective hydrogen ...sensors that can operate at room temperature were fabricated. Titanium films sputter deposited on glass at 500 °C were anodized in a fluorine-containing electrolyte to obtain nanotube-array films. Precise monitoring of current during the anodization enabled removal of the samples from the anodization bath at a point where the remaining metal layer became discontinuous, without destroying the nanotube architecture. The samples were then annealed in oxygen at 420 °C to crystallize the nanotube-arrays as well as oxidize any un-anodized metallic regions, yielding transparent films comprised of titanium oxide nanotube-arrays. Herein, we discuss the morphology, structure and optical characterization of these films. When coated with a 10-nm discontinuous palladium layer, the optically transparent nanotube-array films serve as excellent hydrogen sensors, exhibiting a four-order magnitude drop in resistance with exposure to 1000 ppm hydrogen at room temperature.
Purpose
This systematic review and meta-analysis aimed to evaluate the association between intraoperative oliguria and the risk of postoperative acute kidney injury (AKI) in patients undergoing ...non-cardiac surgery.
Methods
The MEDLINE and EMBASE databases were searched up to August 2022 for studies in adult patients undergoing non-cardiac surgery, where the association between intraoperative urine output and the risk of postoperative AKI was assessed. Both randomised and non-randomised studies were eligible for inclusion. Study selection and risk of bias assessment were independently performed by two investigators. The risk of bias was evaluated using the Newcastle–Ottawa scale. We performed meta-analysis of the reported multivariate adjusted odds ratios for the association between intraoperative oliguria (defined as urine output < 0.5 mL/kg/hr) and the risk of postoperative AKI using the inverse-variance method with random effects models. We conducted sensitivity analyses using varying definitions of oliguria as well as by pooling unadjusted odds ratios to establish the robustness of the primary meta-analysis. We also conducted subgroup analyses according to surgery type and definition of AKI to explore potential sources of clinical or methodological heterogeneity.
Results
Eleven studies (total 49,252 patients from 11 observational studies including a post hoc analysis of a randomised controlled trial) met the selection criteria. Seven of these studies contributed data from a total 17,148 patients to the primary meta-analysis. Intraoperative oliguria was associated with a significantly elevated risk of postoperative AKI (pooled adjusted odds ratio OR 1.74; 95% confidence interval CI 1.36–2.23,
p
< 0.0001, 8 studies). Sensitivity analyses supported the robustness of the primary meta-analysis. There was no evidence of any significant subgroup differences according to surgery type or definition of AKI.
Conclusions
This study demonstrated a significant association between intraoperative oliguria and the risk of postoperative AKI, regardless of the definitions of oliguria or AKI used. Further prospective and multi-centre studies using standardised definitions of intraoperative oliguria are required to define the thresholds of oliguria and establish strategies to minimise the risk of AKI.
AbstractFine tuning of concrete recycling processes requires a comprehensive understanding of the overlapping interactions and effects of the various influencing parameters. The most important ...parameters associated with recycled concrete aggregate (RCA) production that may affect quality and yield include such properties of the parent concrete as the composition, strength and aggregate grading, type of crushers used, number of crushing stages, the size of the RCA particles, and the size reduction sequence. The effects of such parameters overlap and interact with one another and render it impossible for firm conclusions to be drawn on the effects of one parameter in isolation as evidenced by results reported in available literature. The present paper reports on the findings of an experimental study on the concomitant effects of the strength of the parent concrete, size of the natural aggregates used in the parent concrete, and the number of crushing stages on the properties of coarse recycled concrete aggregates, including mortar content, water absorption, bulk density, Los Angeles abrasion loss, and compressive strength of the recycled aggregate concrete. The study is confined only to granitic coarse aggregates, as this is the only type used in Singapore for ordinary concrete.
Standards for clinical trials for treating TB du Cros, P; Greig, J; Alffenaar, J-W C ...
The international journal of tuberculosis and lung disease,
12/2023, Volume:
27, Issue:
12
Journal Article
Peer reviewed
Open access
The value, speed of completion and robustness of the evidence generated by TB treatment trials could be improved by implementing standards for best practice.
A global panel of experts participated in ...a Delphi process, using a 7-point Likert scale to score and revise draft standards until consensus was reached.
Eleven standards were defined: Standard 1, high quality data on TB regimens are essential to inform clinical and programmatic management; Standard 2, the research questions addressed by TB trials should be relevant to affected communities, who should be included in all trial stages; Standard 3, trials should make every effort to be as inclusive as possible; Standard 4, the most efficient trial designs should be considered to improve the evidence base as quickly and cost effectively as possible, without compromising quality; Standard 5, trial governance should be in line with accepted good clinical practice; Standard 6, trials should investigate and report strategies that promote optimal engagement in care; Standard 7, where possible, TB trials should include pharmacokinetic and pharmacodynamic components; Standard 8, outcomes should include frequency of disease recurrence and post-treatment sequelae; Standard 9, TB trials should aim to harmonise key outcomes and data structures across studies; Standard 10, TB trials should include biobanking; Standard 11, treatment trials should invest in capacity strengthening of local trial and TB programme staff.
These standards should improve the efficiency and effectiveness of evidence generation, as well as the translation of research into policy and practice.
Abstract Purpose In previous studies of fungal keratitis (FK) from temperate countries, yeasts were the predominant isolates with ocular surface disease (OSD) being the leading risk factor. Since the ...2005-6 outbreak of contact lens (CL) associated Fusarium keratitis, there may have been a rise in CL associated filamentary FK in the United Kingdom. This retrospective case series investigated the patterns of FK from 2007 to 2014. We compared these to 1994-2006 data from the same hospital. Design Retrospective observational study Methods All cases of FK presenting to Moorfields Eye Hospital between 2007 and 2014 were identified. The definition of FK was either a fungal organism isolated by culture or fungal structures identified by light microscopy (LM) of scrape material, histopathology, or in-vivo corneal confocal microscopy (IVCM). Main outcome measure was the cases of FK per year. Results 112 patients had confirmed FK. Median age was 47.2 years. Between 2007 and 2014, there was an increase in annual numbers of FK (Poisson regression, p=0.0001). FK was confirmed using various modalities: 79 (70.5%) had positive cultures, 16 (14.3%) by LM, and 61 (54.5%) by IVCM. 78 (69.6%) were diagnosed with filamentary fungus alone, 28 (25%) with yeast alone and 6 (5.4%) with mixed filamentary and yeast infections. This represents an increase in the proportion of filamentary fungal infections from the pre-2007 data. Filamentary fungal and yeast infections were associated CL use and OSD respectively. Conclusions The number of FK has increased. This increase is due to CL associated filamentary FK. Clinicians should be aware of these changes, which warrant epidemiological investigations to identify modifiable risk factors.
Ferric carboxymaltose (FCM) administration helps reduce transfusion requirements in the perioperative situation, which improves patient outcomes and reduces healthcare costs. However, there is ...increasing evidence of hypophosphataemia after FCM use. We aim to determine the incidence of hypophosphataemia after FCM administration and elucidate potential biochemical factors associated with the development of subsequent hypophosphataemia. A retrospective review of anonymised data of all FCM administrations in a single institution was conducted from August 2018 to August 2021. Each unique FCM dose administered was examined to assess its effect on Hb and serum phosphate levels within the subsequent 28 days from each FCM administration. Phosphate levels were repeatedly measured within the 28-day interval and the lowest phosphate level within that period was determined. Patients' serum phosphate levels within 28 days of FCM administration were compared against normal serum phosphate levels within 2 weeks before FCM administration. The odds ratios of various pre-FCM serum markers were calculated to elucidate potential biochemical predictors of post-FCM hypophosphataemia. In 3 years, a total of 1296 doses of FCM were administered to 1069 patients. The mean improvement in Hb was 2.45 g/dL (SD = 1.94) within 28 days of FCM administration, with the mean time taken to peak Hb levels being 6.3 days (SD = 8.63), which is earlier than expected, but was observed in this study and hence reported. The incidence of hypophosphataemia <0.8 mmol/L was 22.7% (n = 186), and <0.4 mmol/L was 1.6% (n = 9). This figure is lower than the numbers reported in previously published meta-analyses given that routine checks of serum phosphate levels were not conducted initially and hence could possibly be higher. The odds of developing hypophosphataemia (<0.8 mmol/L) were 27.7 (CI: 17.3-44.2, p < 0.0001) if baseline serum phosphate was less than 1 mmol/L. The odds of developing hypophosphataemia (<0.8 mmol/L) were 1.3 (CI: 1.08-1.59, p < 0.01) if the change in Hb levels observed after FCM administration were more than 4 g/dL. Hypophosphataemia after FCM administration is significant and FCM should be used by clinicians with caution.
Extremely sensitive, drift‐free, and robust hydrogen sensors based on titania nanotube arrays (see Figure) are reported. Very large changes in the electrical conductivity of the nanotubes upon ...exposure to hydrogen gas have been measured, over one order of magnitude greater than the previous record. Dependence of the electrical conductivity on both temperature and nanotube pore size is found.
PDF
