Abstract
Background
There has been a shift in recent years to using ultrasound (US) and magnetic resonance imaging (MRI) as first-line investigations for suspected cranial large vessel vasculitis ...(LVV) and is a new recommendation by the EULAR 2018 guidelines for imaging in LVV. This cross-sectional study compares the performance of US and MRI and contrast-enhanced magnetic resonance angiography (MRA) for detecting vasculitis in patients with giant cell arteritis (GCA).
Methods
Patients with new-onset or already diagnosed GCA were recruited. The common temporal arteries and supra-aortic large vessels were evaluated by US and MRI/MRA. Blinded experts read the images and applied a dichotomous score (vasculitis: yes/no) in each vessel.
Results
Thirty-seven patients with giant cell arteritis (GCA) were recruited. Two patients were excluded. Of the remaining patients, nine had new-onset disease and 26 had established disease. Mean age was 71 years, and median C-reactive protein (CRP) was 7.5 mg/L. The median time between US and MRI was 1 day. Overall, US revealed vasculitic changes more frequently than MRI (
p
< 0.001). US detected vascular changes in 37% of vessels compared to 21% with MRI. Among patients with chronic disease, US detected vascular changes in 23% of vessels compared to 7% with MRI in (
p
< 0.001). The same was true for patients with new-onset disease. US detected vasculitic changes in 22% of vessels and MRI detected disease in 6% (
p
= 0.0004). Compared to contrast-enhanced MRA, US was more sensitive in detecting vasculitic changes in the large arteries, including the axillary, carotid, and subclavian arteries.
Conclusion
US more frequently detects vasculitic changes in the large arteries compared to contrast-enhanced MRA. When evaluating the cranial vessels, US performs similarly to MRI. This data supports the recommendation that US be considered as a first-line evaluation in patients suspected to have GCA.
Research Question: In the context of Lean Construction, how can the concepts of ‘value’ and ‘values’ be distinctly defined and differentiated? Purpose: The concept of value is a cornerstone in Lean ...Construction, yet its understanding is often muddled among scholars and practitioners, partially due to the conflation of ‘value’ (singular) with ‘values’ (plural). These two terms, while interconnected, represent distinct concepts. This paper seeks to demystify and differentiate between ‘value’ and ‘values,’ clarifying their individual meanings and interrelationship. The paper aims to establish a clear, shared understanding of these fundamental concepts within the Lean Construction community through detailed explanations and practical illustrations. Research Design: Conceptual research Findings: The research clearly distinguishes between ‘values’ and ‘value’. Values encompass beliefs about what is important in life and how one should behave, while value is the outcome of an evaluative judgment of an object’s worth. How someone judges the value of an object is dependent on their values, knowledge, and the context they find themselves in. Limitations While pertinent to the realm of projects and corporate contexts, the paper does not deeply explore values and values within these settings. Rather, it chooses to elucidate these concepts at the personal level to make them more understandable. Implications: This paper highlights the need for precise use of ‘value’ and ‘values’ in research and practice. Clear differentiation of these terms is key to avoiding confusion and ensuring effective decision-making and communication in construction projects. The paper advocates for careful terminology use to improve project outcomes and academic clarity. Value for practitioners: The introduced and explained terminology in this paper will aid in articulating the desired value in projects. Paper type: Full paper
Question: What is value? Purpose: The purpose of the paper is to explore the concept of value on a fundamental level to arrive at a definition that is usable within the context of Lean Construction ...Research Method: Literature study and abductive reasoning Findings: Value is the result of an evaluative judgment. This judgment is guided by values and based on the evaluator's knowledge at hand. It is always based on comparing two or more alternatives in a given context. This context envelops all get and give consequences for a particular party from a decision made on the basis of the value judgment. The get and give consequences are always in the form of gained or lost experiences, or expressed in monetary terms as a placeholder for experiences. The consequences are not summative; the value judgment is done by considering them all at once. Limitations: This is a conceptual paper; the practical applicability of the findings is not explored. Implications: Value should be considered as something that fathoms more than the very narrow needs based view that is common in much of the LC literature. Value for authors: Better understanding of the concept of value
Lean construction has inspired the AEC industry globally over the last decades, and this manifests within a wide array of contexts. The purpose of this paper is to provide a narrative-based ...qualitative analysis of the emergence and impact of Lean construction on a national level, notably in the Norwegian AEC industry. The analysis is based on the concept of paradigm shift and on empirical knowledge in the form of narratives. The narratives of practitioners and researchers provide deep insights into how Lean Construction has inspired the Norwegian AEC industry and academia, respectively. The reflections indicate that the introduction of the Lean construction principles and tools in the Norwegian AEC industry has depended on promoters who have been convinced about its advantages. The role of active promoters - in particular Dr. Glenn Ballard - is underlined as key to successful introduction of Lean Construction. Key cultural features of the Norwegian AEC industry are emphasized as important success factors. Lean Construction in Norway needs to be understood as a phenomenon occurring within a setting that is generally advantageous but also following an effort carried out on several levels. Key elements that can be used within other contexts are (1) the existence of promoters, (2) cooperation between industry and academic circles, (3) a high degree of trust and (4) a predominance of bottom-up organizations within the industry with few levels of hierarchy.
Ethical behaviour in the design phase of AEC projects Lohne, Jardar; Svalestuen, Fredrik; Knotten, Vegard ...
International journal of managing projects in business,
01/2017, Letnik:
10, Številka:
2
Journal Article
Recenzirano
Purpose
The purpose of this paper is to report on studies on the ethics in the design phase in Norwegian construction projects. The ambition is to establish a descriptive picture of ethical ...challenges practitioners meet in the design phase in order to raise awareness among them.
Design/methodology/approach
In addition to a literature review and a document study of ethical frameworks within the industry, interviews with key participants were carried out according to a qualitative approach. The study was undertaken in order to address framework conditions for handling ethically challenging situations, challenges of an ethical nature practitioners commonly encounter in the design phase and finally the structural (systemic) reasons for such challenges.
Findings
This research finds indications of actors manoeuvring in the design phase for own benefit at the expense of other actors. The findings equally indicate that the design phase poses significant challenges in light of tender documents pricing and exploiting cost reimbursement contracts. In some of the projects examined, participants shifted loyalty after novation contracting and they actively tried to steer the decision processes in their own favour.
Originality/value
There does in fact seem to be perceptions of a room of manoeuvre between what is unlawful and what is ethically sound in this phase.
The building design phase requires intense collaboration between the participants. However, achieving this can prove difficult. The project often has a short time span, at the same time as the ...participants have limited experience from working together. This paper reports on the experience with teambuilding and collaboration from several Norwegian building design participants. The ambition has been to find out what characterizes a highly efficient building design team. In addition to a literature review and interviews with five key participants, a survey in a large Norwegian contractor firm was carried out. The findings identify twelve key elements that influence the performance of a building design team. The three most important elements are good collaboration between all project leaders, identifying the design team members’ role and trust between the team members, respectively. Having a highly efficient team is important for the collaboration between participants in the building design phase, and knowing what elements that influence the performance can help the industry to develop design teams on their projects.
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