Mechanical ventilation for the treatment of severe excessive dynamic airway collapse

[Excerpt] We read with interest the case report by Ismael et al1 describing a patient with Sjo¨gren’s syndrome and cystic lung disease who could not be weaned from a ventilator due to severe central excessive dynamic airway collapse (EDAC) of the lower part of the trachea and proximal bronchi. EDAC corresponds to the expiratory bulging of the tracheobronchial wall without known airway structural abnormalities, leading to a decrease of at least 50% in internal diameter.2 It is a rare and underdiagnosed entity, commonly confused with other respiratory diseases such as asthma and COPD. Although noninvasive procedures such as cervicothoracic computed tomography scan on inspiration and expiration may suggest the disorder, the accepted standard method for diagnosis is bronchoscopy.3-7 (...).

Predicting plateau pressure in intensive medicine for ventilated patients

Barotrauma is identified as one of the leading diseases in Ventilated Patients. This type of problem is most common in the Intensive Care Units. In order to prevent this problem the use of Data Mining (DM) can be useful for predicting their occurrence. The main goal is to predict the occurence of Barotrauma in order to support the health professionals taking necessary precautions. In a first step intensivists identified the Plateau Pressure values as a possible cause of Barotrauma. Through this study DM models (classification) where induced for predicting the Plateau Pressure class (>=30 cm

Intelligent decision support to predict patient barotrauma risk in intensive care units

The occurrence of Barotrauma is identified as a major concern for health professionals, since it can be fatal for patients. In order to support the decision process and to predict the risk of occurring barotrauma Data Mining models were induced. Based on this principle, the present study addresses the Data Mining process aiming to provide hourly probability of a patient has Barotrauma. The process of discovering implicit knowledge in data collected from Intensive Care Units patientswas achieved through the standard process Cross Industry Standard Process for Data Mining. With the goal of making predictions according to the classification approach they several DM techniques were selected: Decision Trees, Naive Bayes and Support Vector Machine. The study was focused on identifying the validity and viability to predict a composite variable. To predict the Barotrauma two classes were created: “risk” and “no risk”. Such target come from combining two variables: Plateau Pressure and PCO2. The best models presented a sensitivity between 96.19% and 100%. In terms of accuracy the values varied between 87.5% and 100%. This study and the achieved results demonstrated the feasibility of predicting the risk of a patient having Barotrauma by presenting the probability associated.

Critical events in mechanically ventilated patients

Mechanical Ventilation is an artificial way to help a Patient to breathe. This procedure is used to support patients with respiratory diseases however in many cases it can provoke lung damages, Acute Respiratory Diseases or organ failure. With the goal to early detect possible patient breath problems a set of limit values was defined to some variables monitored by the ventilator (Average Ventilation Pressure, Compliance Dynamic, Flow, Peak, Plateau and Support Pressure, Positive end-expiratory pressure, Respiratory Rate) in order to create critical events. A critical event is verified when a patient has a value higher or lower than the normal range defined for a certain period of time. The values were defined after elaborate a literature review and meeting with physicians specialized in the area. This work uses data streaming and intelligent agents to process the values collected in real-time and classify them as critical or not. Real data provided by an Intensive Care Unit were used to design and test the solution. In this study it was possible to understand the importance of introduce critical events for Mechanically Ventilated Patients. In some cases a value is considered critical (can trigger an alarm) however it is a single event (instantaneous) and it has not a clinical significance for the patient. The introduction of critical events which crosses a range of values and a pre-defined duration contributes to improve the decision-making process by decreasing the number of false positives and having a better comprehension of the patient condition.

Different module placements in a modular façade system for natural ventilation

Nowadays natural ventilation has gained prominence because its correct use can reduce energy consumption for cooling systems and improve thermal comfort among users. In this paper, we report on the modelling initiative, based on the wind tunnel tests that were carried out for the determination of the influence of natural ventilation in buildings. Indeed, the renewal of air in a closed environment without using an air conditioning system with mechanical elements can lead to energy savings and, in addition, provide air quality.The wind tunnel tests were carried out by varying the positioning of six ventilation modules in the façade system configuration. The modules were positioned below the window-sill (ventilated window-sill) as well as separately above and below the façade. The wind speed measurements were taken inside and outside the model for the different façades configurations to evaluate the best performance in relation to natural ventilation. The results supported the positioning of the six ventilation modules below the window-sill, forming a â ventilated window-sillâ as the most effective natural ventilation solution.

Continuous monitoring of concrete mechanical properties since an early age to support construction phasing

The assessment of concrete mechanical properties during construction of concrete structures is of paramount importance for many intrinsic operations. However many of the available non-destructive methods for mechanical properties have limitations for use in construction sites. One of such methodologies is EMM-ARM, which is a variant of classic resonant frequency methods. This paper aims to demonstrate the efforts towards in-situ applicability of EMMARM, as to provide real-time information about concrete mechanical properties such as E-modulus and compressive strength. To achieve the aforementioned objective, a set of adaptations to the method have been successfully implemented and tested: (i) the reduction of the beam span; (ii) the use of a different mould material and (iii) a new support system for the beams. Based on these adaptations, a reusable mould was designed to enable easier systematic use of EMMARM. A pilot test was successfully performed under in-situ conditions during a bridge construction.

Mortars with incorporation of PCM based in different binders: mechanical and thermal behavior

Currently we are witnessing a huge concern of society with the parameters of comfort of the buildings and the energetic consumptions. It is known that there is a huge consumption of non-renewable sources of energy. Thus, it is urgent to develop and explore ways to take advantage of renewable sources of energy by improving the energy efficiency of buildings. The mortars with incorporation of phase change materials (PCM) have the ability to regulate the temperature inside buildings, contributing to the thermal comfort and reduction of the use of heating and cooling equipment, using only the energy supplied by the sun. However, the incorporation of phase change materials in mortars modifies its characteristics. The main purpose of this study was mechanical and thermal characterization of mortars with incorporation of PCM in mortars based in different binders. The binders studied were aerial lime, hydraulic lime, gypsum and cement. For each type of binder a reference composition (0% PCM) and a composition with incorporation of 40% of PCM were developed. It was possible to observe that the incorporation of PCM in mortars caused differences in properties such as workability, compressive strength, flexural strength and adhesion, however leads to an improvement of thermal behavior.

Mechanical characterization of old chestnut beams

The main objective of this work is to evaluate, by non-destructive techniques, seven old Chestnut beams. For that, after the geometric assessment and the detailed visual inspection that allowed to strength grade the beams, a series of non-destructive tests was setup. In a first step, non-destructive bending tests, under the elastic limit, were performed to quantify the modulus of elasticity in bending (MoE) of the seven beams. Then, Resistograph® and Pilodyn® tests were done to assess the superficial decay and to have aclearer idea of the voids dimensions. Then, two beams were tested in bending until failure to evaluate the bending strength. In a second step, end parts were cut from the beams, one per end of the beams, to perform Resistograph®, Pilodyn® and ultrasound tests, to quantify the density of the beams and to extract meso-specimens to be used in tension parallel to the grain tests

Influence of the wood mechanical properties in the dovetail joint behavior

The force distribution inside a dovetail joint is complex. Wood is simultaneously loaded in different directions in the several connected surfaces. The analytical solutions available for the analysis of the behavior of those carpentry joints rely on the mechanical properties of wood. In particular, the stiffness properties of wood under compression are crucial for the forces equilibrium. Simulations showed that the stiffness values considered in each of the springs normally assumed in the analytical models, have great influence in the bearing capacity and stiffness of the dovetail joints, with important consequence on the stress distribution over the overall structure. In a wide experimental campaign, the properties under compression of the most common wood species of existing timber structures have been determined. Then, a solved example of a dovetail joint is presented assuming different wood species and the corresponding strength and stiffness properties values obtained in the tests.

Evaluation of the performance of recycled textile fibres in the mechanical behaviour of a gypsum and cork composite material

Given the need for using more sustainable constructive solutions, an innovative composite material based on a combination of distinct industrial by-products is proposed aiming to reduce waste and energy consumption in the production of construction materials. The raw materials are thermal activated flue-gas desulphurization (FGD) gypsum, which acts as a binder, granulated cork as the aggregate and recycled textile fibres from used tyres intended to reinforce the material. This paper presents the results of the design of the composite mortar mixes, the characterization of the key physical properties (density, porosity and ultrasonic pulse velocity) and the mechanical validation based on uniaxial compressive tests and fracture energy tests. In the experimental campaign, the influence of the percentage of the raw materials in terms of gypsum mass, on the mechanical properties of the composite material was assessed. It was observed that the percentage of granulated cork decreases the compressive strength of the composite material but contributes to the increase in the compressive fracture energy. Besides, the recycled textile fibres play an important role in the mode I fracture process and in the fracture energy of the composite material, resulting in a considerable increase in the mode I fracture energy.

Mechanical analysis of asphalt mixtures produced with waste plastic modified binders

This work compares the viscoelastic properties of an asphalt binder (70/100 pen) modified with different waste plastics and the mechanical properties of the resultant asphalt mixtures. Two different plastic wastes were used, namely recycled HDPE and EVA. Three different polymer modified binders were produced with these plastic wastes: i) 5% HDPE modified binder (P5); ii) 5% EVA modified binder (E5) and; iii) a modified binder with 4% of EVA and 2% HDPE (E4P2). Asphalt mixtures were produced with these modified binders, and their mechanical properties were analysed and compared with a conventional mixture produced with a 30/50 pen bitumen. It was possible to conclude that these recycled polymers are able to improve the mechanical performance of the asphalt mixtures used in road paving.

A mechanical analysis of asphalt recycled mixtures produced with high recycling rates

In this work four asphalt mixtures were compared in terms of mechanical characteristics. One of the mixtures (control mixture) was used as a reference to the study of three mixtures produced with reclaimed asphalt pavement (RAP). One of the recycled mixtures incorporated 30% of RAP and the other two were produced with 50% of RAP. The effect of using a rejuvenator additive (3% rejuvenator) was also evaluated in one of the mixtures with 50% of RAP.

Traditional timber frame walls: mechanical behavior analysis and retrofitting

Timber frame construction is characteristic of several historic city centres as well as of vernacular architecture in several countries around the world, either motivated by the availability of materials and construction traditions or by the need of reducing the seismic vulnerability of buildings, namely in south European countries, where this construction technique was adopted for seismic-resistance purposes. From past earthquakes, it has been seen that timber frame construction can be viewed as an interesting technology as it has exhibited a very reasonable behaviour when compared to other traditional construction techniques such as masonry walls. This chapter provides an overview of the main insights on the seismic performance of timber frame buildings from the evidences of past earthquakes and provides the main results of recent research focused on the in-plane cyclic behavior of timber frame walls with distinct geometrical configurations. Additionally, the main seismic performance indexes of timber frame walls, both unreinforced and retrofitted, are presented and discussed in detail.

Assessing the production of jet mix columns using alkali activated waste based on mechanical and financial performance and CO2 (eq) emissions

Recent research has proved the potential of alkaline activated fly-ash for soil stabilisation. However, such studies have not focused on the link between financial, mechanical and environmental aspects of this solution, but only on their absolute mechanical properties. The present paper characterises the mechanical behaviour of a large spectrum of activator-ash-soil combinations used to build jet mixing columns, analysing also the cost and CO2 (eq) emissions. The concern with these two vectors forced a decrease in the quantity of stabilising agent added to the soil, relatively to previous research, and the effects of such low quantities have not yet been published. However, the results clearly showed a significant improve in strength, still well above the average values expected when improving the stressstrain behaviour of a weak soil. Uniaxial compressive strength tests were used to assess the effects of the fly-ash percentage, the alkalieash ratio and the water content. The carbon calculator recently developed by the European Federation of Foundation Contractors and the Deep Foundations Institute was used to quantify the CO2 (eq) emissions associated with this technique. The financial cost was estimated based on the experience of a major Portuguese contractor. For comparison purposes, soil cement mixtures were also analysed, using similar conditions and tools used for the soil-ash analysis. Results showed that the cement and ash solutions are very similar in terms of overall performance, with some advantage of the former regarding financial cost, and a significant advantage of the latter regarding the CO2 (eq) emissions. This new grout, although it is in an embryonic stage, it has the potential for broader developments in the field.