Design of LiteSteel Beam floor joists with web opening using an equivalent web thickness method

The LiteSteel Beam (LSB) is an innovative cold-formed steel hollow flange section. When used as floor joists, the LSB sections require holes in the web to provide access for various services. In this study a detailed investigation was undertaken into the elastic lateral distortional buckling behaviour of LSBs with circular web openings subjected to a uniform moment using finite element analysis. Validated ideal finite element models were used first to study the effect of web holes on their elastic lateral distortional buckling behaviour. An equivalent web thickness method was then proposed using four different equations for the elastic buckling analyses of LSBs with web holes. It was found that two of them could be successfully used with approximate numerical models based on solid web elements with an equivalent reduced thickness to predict the elastic lateral distortional buckling moments.

Improved Equivalent Frame Analysis Method for Flat Plate Structures in Vicinity of Edge Columns

This paper proposes a modification to the ACI 318-02 equivalent frame method of analysis of reinforced concrete flat plate exterior panels. Two existing code methods were examined: ACI 318 and BS 8110. The derivation of the torsional stiffness of the edge strip as proposed by ACI 318 is examined and a more accurate estimate of this value is proposed, based on both theoretical analysis and experimental results. A series of 1/3-scale models of flat plate exterior panels have been tested. Unique experimental results were obtained by measuring strains in reinforcing bars at approximately 200 selected locations in the plate panel throughout the entire loading history. The measured strains were used to calculate curvature and, hence, bending moments; these were used along with moments in the columns to assess the accuracy of the equivalent frame methods. The proposed method leads to a more accurate prediction of the moments in the plate at the column front face, at the panel midspan, and in the edge column. Registered Subscribers: View the full article. This document is available as a free download to qualified members. An electronic (PDF) version is available for purchase and download. Click on the Order Now button to continue with the download.

Application of the Equivalent Static Analysis method to the design of a steel frame structure with added viscous dampers

All the structures designed by engineers are vulnerable to natural disasters including floods and earthquakes. The energy released during strong ground motions should be dissipated by structural elements. Before 1990’s, this energy was expected to be dissipated through the beams and columns which at the same time were a part of gravity-load-resisting system. However, the main disadvantage of this idea was that gravity-resisting-frame was not repairable. Hence, during 1990’s, the idea of designing passive energy dissipation systems, including dampers, emerged. At the beginning, main problem was lack of guidelines for passive energy dissipation systems. Although till 2000 many guidelines and procedures where published, yet most of them were based on complicated analysis which was not so convenient for engineers and practitioners. In order to solve this problem recently some alternative design methods are proposed including 1. Lopez Garcia (2001) simple procedure for optimal damper configuration in MDOF structures 2. Christopoulos and Filiatrault (2006) trial and error procedure 3. Silvestri et al. (2010) Five-Step Method. 4. Palermo et al. (2015) Direct Five-Step Method. 5. Palermo et al. (2016) Simplified Equivalent Static Analysis (ESA). In this study, effectiveness and differences between last three alternative methods have been evaluated.

Numerical method for predicting the elastic lateral distortional buckling moment of a mono-symmetric beam with web openings

When used as floor joists, the new mono-symmetric LiteSteel beam (LSB) sections require web openings to provide access for inspections and various services. The LSBs consist of two rectangular hollow flanges connected by a slender web, and are subjected to lateral distortional buckling effects in the intermediate span range. Their member capacity design formulae developed to date are based on their elastic lateral buckling moments, and only limited research has been undertaken to predict the elastic lateral buckling moments of LSBs with web openings. This paper addresses this research gap by reporting the development of web opening modelling techniques based on an equivalent reduced web thickness concept and a numerical method for predicting the elastic buckling moments of LSBs with circular web openings. The proposed numerical method was based on a formulation of the total potential energy of LSBs with circular web openings. The accuracy of the proposed method’s use with the aforementioned modelling techniques was verified through comparison of its results with those of finite strip and finite element analyses of various LSBs.

New design rules for the shear strength of LiteSteel Beams with web openings

Abstract: LiteSteel beam (LSB) is a new cold-formed steel hollow flange channel section produced using a patented manufacturing process involving simultaneous cold-forming and dual electric resistance welding. The LSBs are commonly used as floor joists and bearers with web openings in residential, industrial and commercial buildings. Their shear strengths are considerably reduced when web openings are included for the purpose of locating building services. However, no research has been undertaken on the shear behaviour and strength of LSBs with web openings. Therefore experimental and numerical studies were undertaken to investigate the shear behaviour and strength of LSBs with web openings. In this research, finite element models of LSBs with web openings in shear were developed to simulate the shear behaviour and strength of LSBs including their buckling characteristics. They were then validated by comparing their results with available experimental test results and used in a detailed parametric study. The results showed that the current design rules in cold-formed steel structures design codes are very conservative for the shear design of LSBs with web openings. Improved design equations have been proposed for the shear capacity of LSBs with web openings based on both experimental and parametric study results. An alternative shear design method based on an equivalent reduced web thickness was also proposed. It was found that the same shear strength design rules developed for LSBs without web openings can be used for LSBs with web openings provided the equivalent reduced web thickness equation developed in this paper is used. This is a significant advancement as it simplifies the shear design methods of LSBs with web openings considerably.

High-kappa TiO2 Thin Film Prepared by Sol-Gel Spin-Coating Method

High-k TiO2 thin film on p-type silicon substrate was fabricated by a combined sol-gel and spin coating method. Thus deposited titania film had anatase phase with a small grain size of 16 nm and surface roughness of congruent to 0.6 nm. The oxide capacitance (C-ox), flat band capacitance (C-FB), flat band voltage (V-FB), oxide trapped charge (Q(ot)), calculated from the high frequency (1 MHz) C-V curve were 0.47 nF, 0.16 nF, -0.91 V, 4.7x10(-12) C, respectively. As compared to the previous reports, a high dielectric constant of 94 at 1 MHz frequency was observed in the devices investigated here and an equivalent oxide thickness (EOT) was 4.1 nm. Dispersion in accumulation capacitance shows a linear relationship with AC frequencies. Leakage current density was found in acceptable limits (2.1e-5 A/cm(2) for -1 V and 5.7e-7 A/cm(2) for +1 V) for CMOS applications.

High-kappa TiO2 Thin Film Prepared by Sol-Gel Spin-Coating Method

High-k TiO2 thin film on p-type silicon substrate was fabricated by a combined sol-gel and spin coating method. Thus deposited titania film had anatase phase with a small grain size of 16 nm and surface roughness of congruent to 0.6 nm. The oxide capacitance (C-ox), flat band capacitance (C-FB), flat band voltage (V-FB), oxide trapped charge (Q(ot)), calculated from the high frequency (1 MHz) C-V curve were 0.47 nF, 0.16 nF, -0.91 V, 4.7x10(-12) C, respectively. As compared to the previous reports, a high dielectric constant of 94 at 1 MHz frequency was observed in the devices investigated here and an equivalent oxide thickness (EOT) was 4.1 nm. Dispersion in accumulation capacitance shows a linear relationship with AC frequencies. Leakage current density was found in acceptable limits (2.1e-5 A/cm(2) for -1 V and 5.7e-7 A/cm(2) for +1 V) for CMOS applications.

Flexural behaviour and design of cold-formed steel beams with rectangular hollow flanges

Until recently, the hot-rolled steel members have been recognized as the most popular and widely used steel group, but in recent times, the use of cold-formed high strength steel members has rapidly increased. However, the structural behavior of light gauge high strength cold-formed steel members characterized by various buckling modes is not yet fully understood. The current cold-formed steel sections such as C- and Z-sections are commonly used because of their simple forming procedures and easy connections, but they suffer from certain buckling modes. It is therefore important that these buckling modes are either delayed or eliminated to increase the ultimate capacity of these members. This research is therefore aimed at developing a new cold-formed steel beam with two torsionally rigid rectangular hollow flanges and a slender web formed using intermittent screw fastening to enhance the flexural capacity while maintaining a minimum fabrication cost. This thesis describes a detailed investigation into the structural behavior of this new Rectangular Hollow Flange Beam (RHFB), subjected to flexural action The first phase of this research included experimental investigations using thirty full scale lateral buckling tests and twenty two section moment capacity tests using specially designed test rigs to simulate the required loading and support conditions. A detailed description of the experimental methods, RHFB failure modes including local, lateral distortional and lateral torsional buckling modes, and moment capacity results is presented. A comparison of experimental results with the predictions from the current design rules and other design methods is also given. The second phase of this research involved a methodical and comprehensive investigation aimed at widening the scope of finite element analysis to investigate the buckling and ultimate failure behaviours of RHFBs subjected to flexural actions. Accurate finite element models simulating the physical conditions of both lateral buckling and section moment capacity tests were developed. Comparison of experimental and finite element analysis results showed that the buckling and ultimate failure behaviour of RHFBs can be simulated well using appropriate finite element models. Finite element models simulating ideal simply supported boundary conditions and a uniform moment loading were also developed in order to use in a detailed parametric study. The parametric study results were used to review the current design rules and to develop new design formulae for RHFBs subjected to local, lateral distortional and lateral torsional buckling effects. Finite element analysis results indicate that the discontinuity due to screw fastening has a noticeable influence only for members in the intermediate slenderness region. Investigations into different combinations of thicknesses in the flange and web indicate that increasing the flange thickness is more effective than web thickness in enhancing the flexural capacity of RHFBs. The current steel design standards, AS 4100 (1998) and AS/NZS 4600 (1996) are found sufficient to predict the section moment capacity of RHFBs. However, the results indicate that the AS/NZS 4600 is more accurate for slender sections whereas AS 4100 is more accurate for compact sections. The finite element analysis results further indicate that the current design rules given in AS/NZS 4600 is adequate in predicting the member moment capacity of RHFBs subject to lateral torsional buckling effects. However, they were inadequate in predicting the capacities of RHFBs subject to lateral distortional buckling effects. This thesis has therefore developed a new design formula to predict the lateral distortional buckling strength of RHFBs. Overall, this thesis has demonstrated that the innovative RHFB sections can perform well as economically and structurally efficient flexural members. Structural engineers and designers should make use of the new design rules and the validated existing design rules to design the most optimum RHFB sections depending on the type of applications. Intermittent screw fastening method has also been shown to be structurally adequate that also minimises the fabrication cost. Product manufacturers and builders should be able to make use of this in their applications.

Verificação à fadiga de pontes rodoviárias mistas (aço-concreto)

As pontes rodoviárias mistas (aço-concreto) estão sujeitadas às ações dinâmicas variáveis, por exemplo, devido ao tráfego de veículos sobre a superfície irregular do pavimento. Estas ações dinâmicas podem gerar a nucleação de fraturas ou mesmo a sua propagação sobre a estrutura. A correta consideração desses aspectos objetivou o desenvolvimento de uma metodologia de análise, com a finalidade de avaliar os níveis dos esforços e tensões oriundos do tráfego dos veículos sobre a superfície irregular do pavimento e, bem como, proceder uma verificação à fadiga de obras de arte rodoviárias em aço e mistas (aço-concreto). Para tal, as técnicas para a contagem de ciclos de tensão e a aplicação das regras de dano acumulado foram analisadas através de curvas do tipo S-N, associadas a diversas normas de projeto. A ponte rodoviária mista (aço-concreto) investigada neste estudo é constituída por quatro vigas de aço longitudinais e por um tabuleiro de concreto armado. O modelo numérico-computacional, desenvolvido para a análise dinâmica da ponte, foi concebido com base em técnicas usuais de discretização através do método dos elementos finitos. Simulam-se as almas das vigas de aço e as lajes de concreto do tabuleiro através de elementos finitos de casca. As mesas dessas vigas, transversinas e os enrijecedores são modelados por elementos de viga tridimensionais. Os veículos são representados a partir de sistemas "massa-mola-amortecedor". O tráfego dessas viaturas é considerado mediante a simulação de comboios semi-infinitos, deslocando-se com velocidade constante sobre a ponte. As conclusões da presente investigação versam acerca da vida útil de serviço dos elementos estruturais de pontes mistas (aço-concreto).

Influencia de la configuración geométrica de placas prefabricadas para forjados en las tensiones originadas por la transferencia del pretensado en elementos realizados con armaduras pretesas ancladas por adherencia

Las piezas pretensadas de hormigón presentan zonas muy solicitadas correspondientes a la zona de transferencia. En muchos casos se ha detectado figuración en tales zonas cuyo origen está ligado a la transferencia de la fuerza de pretensado, pudiendo llegar a causar el rechazo de la pieza. En el caso de las piezas prefabricadas con armaduras pretesas adherentes, no siempre es posible disponer armado transversal para controlar esta fisuración, ya sea por el proceso constructivo, ya sea por disponer en general de secciones transversales muy optimizadas. Recientemente se desarrolló una nueva tipología de piezas de hormigón prefabricado para forjados unidireccionales pretensadas con armadura activa pretesa y sin armadura transversal. La tipología se asimila a una sección en PI invertida, con alas de gran envergadura en comparación con el ancho de nervio, y armadura activa distribuida en las alas. Este diseño parece propenso a la aparición de fisuración en el momento de la transferencia del pretensado. Así, se han producido fallos de carácter frágil: colapso de piezas ya colocadas en obra, separándose la losa inferior de los nervios y cayendo sobre el piso. Las herramientas de análisis usuales han resultado inútiles al aplicarse a la investigación de esta patología. Para afrontar el estudio de los problemas detectados en la tipología, se ha analizado el fenómeno de las tensiones de tracción en la zona de transferencia, usualmente denominadas exfoliación y estallido, así como los métodos de análisis aplicables a elementos pretesos sin armadura transversal. En algunas ocasiones se trata del resultado de trabajos desarrollados para piezas postesadas, o para calcular cuantías de armadura transversal, adaptados a posteriori. También existen métodos desarrollados específicamente para piezas pretesas sin armadura transversal. Junto a los factores considerados en los métodos existentes se han localizado otros, no tenidos en cuenta habitualmente, pero que pueden ser determinantes en piezas no convencionales, como son: la existencia de pretensado superior e inferior, la falta de simetría de la sección transversal, el ancho variable de las piezas, una relación entre el ancho del ala y el espesor de los nervios elevada, la distribución transversal del pretensado en relación al ancho variable. Además, la mayoría de los métodos se han basado en simplificaciones bidimensionales. Para tener en cuenta la influencia de estos factores, se han modelizado piezas en las que varían tanto la geometría de la sección transversal y la cuantía de pretensado, como la ley de adherencia o la distribución de armadura activa en la sección. Estos modelos se han analizado mediante el método de elementos finitos, efectuándose u análisis elástico lineal tridimensional. En general, los métodos existentes no han predicho adecuadamente las tensiones obtenidas mediante elementos finitos. Sobre los resultados obtenidos por elementos finitos se ha desarrollado un ajuste experimental, que presentan un alto grado de correlación y de significación, así como una reducida dispersión y error relativo. En consecuencia, se propone un método de obtención de la tensión máxima de exfoliación, consistente en varias ecuaciones, que tienen en cuenta las peculiaridades de la configuración de las piezas citadas y permiten considerar cualquier ley de adherencia, manteniendo la coherencia con la longitud de transmisión. Las ecuaciones se emplean para la obtención de la tensión máxima de exfoliación en piezas de la tipología estudiada cuya armadura activa se sitúe fuera del núcleo central de la sección transversal. Respecto al estallido, se propone una modificación de los métodos existentes que, comparado con los resultados del análisis por elementos finitos, mejora el valor medio y la dispersión a valores admisibles y del lado de la seguridad. El método considera la geometría de la sección y la distribución del pretensado en la losa inferior. Finalmente, se ofrecen estrategias de diseño para piezas de la tipología o semejantes. End zones of prestressed concrete members are highly stressed. Cracking have often appeared at end zone, and its beginning is related to prestress release. Some members become rejected because of these cracks. Sometimes it is not possible having transverse reinforcement in order to control cracking, when referring to pretensioned precast members. The reason may be the construction process or highly optimized crosssections. A new typology of precast concrete members designed for one-way composite floors was recently developed. The members, without transverse reinforcement, are prestressed with pretensioned wires or strands. This typology is similar to an inverted TT slab, with a large flange related to the web thickness and prestressing reinforcement spread across the flange. This design is highly susceptible to appear cracking at prestress release. Therefore, brittle failures have been reported: fail of slabs laid in place on a construction site, resulting in the separation of the flange from the webs,, and the subsequent fall on the lower floor. Usual analytical methods have been useless to study the failure. End zone tensile stresses have been analysed to study the detected typology problems. These tensile stresses are usually called spalling and bursting (also called splitting in the U.S.). Analysis methods applicable to pretensioned members without transverse reinforcement have been analysed too. Some methods were originally developed for postensioned concrete or for obtaining the amount of transverse reinforcement. In addition, there are methods developed specifically for pretensioned members without transverse reinforcement. Some factors, frequently ignored, have been found, such as lower and upper prestress, lack of symmetry in the cross section, variable width, a high ratio between flange width and web thickness or prestressing reinforcement location related to variable width. They can play a decisive role in non-conventional members. In addition, most methods are based on 2D simplifications. Finite Element modelling has been conducted in order to consider the influence of these factors. A linear 3D approach has been used. The modelled members vary according to cross section geometry, bond behaviour, or prestressing reinforcement location. In general, the obtained tensile stresses don’t agree with existing methods. An experimental adjustment has been conducted on the obtained results, with a high correlation ratio and significance level as well as a low dispersion and relative error. Therefore, a method to obtain the maximum spalling stress is proposed. The proposal consists on some equations that consider the special features of the typology and bond behaviour. Consistency between transmission length and bond behaviour is considered too. The equations are used to calculate maximum spalling stress for the studied typology members whose prestressing reinforcement is located out of the core of the cross section. In relation to bursting, a modification of existing methods is proposed. Compared to finite element results, the proposal improves mean value and dispersion, whose ranges are considered acceptable and secure. The method takes into account cross section geometry and location of prestressing reinforcement across the lower flange. Finally, strategies to design members of this typology or similar are proposed.

Effects of alternating current voltage amplitude and oxide capacitance on mid-gap interface state defect density extractions in In0.53Ga 0.47As capacitors

This work looks at the effect on mid-gap interface state defect density estimates for In0.53Ga0.47As semiconductor capacitors when different AC voltage amplitudes are selected for a fixed voltage bias step size (100 mV) during room temperature only electrical characterization. Results are presented for Au/Ni/Al2O3/In0.53Ga0.47As/InP metal–oxide–semiconductor capacitors with (1) n-type and p-type semiconductors, (2) different Al2O3 thicknesses, (3) different In0.53Ga0.47As surface passivation concentrations of ammonium sulphide, and (4) different transfer times to the atomic layer deposition chamber after passivation treatment on the semiconductor surface—thereby demonstrating a cross-section of device characteristics. The authors set out to determine the importance of the AC voltage amplitude selection on the interface state defect density extractions and whether this selection has a combined effect with the oxide capacitance. These capacitors are prototypical of the type of gate oxide material stacks that could form equivalent metal–oxide–semiconductor field-effect transistors beyond the 32 nm technology node. The authors do not attempt to achieve the best scaled equivalent oxide thickness in this work, as our focus is on accurately extracting device properties that will allow the investigation and reduction of interface state defect densities at the high-k/III–V semiconductor interface. The operating voltage for future devices will be reduced, potentially leading to an associated reduction in the AC voltage amplitude, which will force a decrease in the signal-to-noise ratio of electrical responses and could therefore result in less accurate impedance measurements. A concern thus arises regarding the accuracy of the electrical property extractions using such impedance measurements for future devices, particularly in relation to the mid-gap interface state defect density estimated from the conductance method and from the combined high–low frequency capacitance–voltage method. The authors apply a fixed voltage step of 100 mV for all voltage sweep measurements at each AC frequency. Each of these measurements is repeated 15 times for the equidistant AC voltage amplitudes between 10 mV and 150 mV. This provides the desired AC voltage amplitude to step size ratios from 1:10 to 3:2. Our results indicate that, although the selection of the oxide capacitance is important both to the success and accuracy of the extraction method, the mid-gap interface state defect density extractions are not overly sensitive to the AC voltage amplitude employed regardless of what oxide capacitance is used in the extractions, particularly in the range from 50% below the voltage sweep step size to 50% above it. Therefore, the use of larger AC voltage amplitudes in this range to achieve a better signal-to-noise ratio during impedance measurements for future low operating voltage devices will not distort the extracted interface state defect density.

Strength of the Iberian intraplate lithosphere: Cenozoic deformations and seismicity

Previous studies about the strength of the lithosphere in the Iberia centre fail to resolve the depth of earthquakes because of the rheological uncertainties. Therefore, new contributions are considered (the crustal structure from a density model) and several parameters (tectonic regime, mantle rheology, strain rate) are checked in this paper to properly examine the role of lithospheric strength in the intraplate seismicity and the Cenozoic evolution. The strength distribution with depth, the integrated strength, the effective elastic thickness and the seismogenic thickness have been calculated by a finite element modelling of the lithosphere across the Central System mountain range and the bordering Duero and Madrid sedimentary basins. Only a dry mantle under strike-slip/extension and a strain rate of 10-15 s-1, or under extension and 10-16 s-1, causes a strong lithosphere. The integrated strength and the elastic thickness are lower in the mountain chain than in the basins. These anisotropies have been maintained since the Cenozoic and determine the mountain uplift and the biharmonic folding of the Iberian lithosphere during the Alpine deformations. The seismogenic thickness bounds the seismic activity in the upper–middle crust, and the decreasing crustal strength from the Duero Basin towards the Madrid Basin is related to a parallel increase in Plio–Quaternary deformations and seismicity. However, elasto–plastic modelling shows that current African–Eurasian convergence is resolved elastically or ductilely, which accounts for the low seismicity recorded in this region.

The Antibiotic Resistance and Prescribing in European Children Project: A Neonatal and Pediatric Antimicrobial Web-based Point Prevalence Survey in 73 Hospitals Worldwide

BACKGROUND: The neonatal and pediatric antimicrobial point prevalence survey (PPS) of the Antibiotic Resistance and Prescribing in European Children project (http://www.arpecproject.eu/) aims to standardize a method for surveillance of antimicrobial use in children and neonates admitted to the hospital within Europe. This article describes the audit criteria used and reports overall country-specific proportions of antimicrobial use. An analytical review presents methodologies on antimicrobial use.

METHODS: A 1-day PPS on antimicrobial use in hospitalized children was organized in September 2011, using a previously validated and standardized method. The survey included all inpatient pediatric and neonatal beds and identified all children receiving an antimicrobial treatment on the day of survey. Mandatory data were age, gender, (birth) weight, underlying diagnosis, antimicrobial agent, dose and indication for treatment. Data were entered through a web-based system for data-entry and reporting, based on the WebPPS program developed for the European Surveillance of Antimicrobial Consumption project.

RESULTS: There were 2760 and 1565 pediatric versus 1154 and 589 neonatal inpatients reported among 50 European (n = 14 countries) and 23 non-European hospitals (n = 9 countries), respectively. Overall, antibiotic pediatric and neonatal use was significantly higher in non-European (43.8%; 95% confidence interval [CI]: 41.3-46.3% and 39.4%; 95% CI: 35.5-43.4%) compared with that in European hospitals (35.4; 95% CI: 33.6-37.2% and 21.8%; 95% CI: 19.4-24.2%). Proportions of antibiotic use were highest in hematology/oncology wards (61.3%; 95% CI: 56.2-66.4%) and pediatric intensive care units (55.8%; 95% CI: 50.3-61.3%).

CONCLUSIONS: An Antibiotic Resistance and Prescribing in European Children standardized web-based method for a 1-day PPS was successfully developed and conducted in 73 hospitals worldwide. It offers a simple, feasible and sustainable way of data collection that can be used globally.

'Online' geriatric assessment procedure for older adults referred for geriatric assessment during an acute care episode for consideration of reliability of triage decisions

Background Comprehensive geriatric assessment has been shown to improve patient outcomes, but the geriatricians who deliver it are in short-supply. A web-based method of comprehensive geriatric assessment has been developed with the potential to improve access to specialist geriatric expertise. The current study aims to test the reliability and safety of comprehensive geriatric assessment performed “online” in making geriatric triage decisions. It will also explore the accuracy of the procedure in identifying common geriatric syndromes, and its cost relative to conventional “live” consultations. Methods/Design The study population will consist of 270 acutely hospitalized patients referred for geriatric consultation at three sites. Paired assessments (live and online) will be conducted by independent, blinded geriatricians and the level of agreement examined. This will be compared with the level of agreement between two independent, blinded geriatricians each consulting with the patient in person (i.e. “live”). Agreement between the triage decision from live-live assessments and between the triage decision from live-online assessments will be calculated using kappa statistics. Agreement between the online and live detection of common geriatric syndromes will also be assessed using kappa statistics. Resource use data will be collected for online and live-live assessments to allow comparison between the two procedures. Discussion If the online approach is found to be less precise than live assessment, further analysis will seek to identify patient subgroups where disagreement is more likely. This may enable a protocol to be developed that avoids unsafe clinical decisions at a distance. Trial registration Trial registration number: ACTRN12611000936921