A Study on the Bending Stiffness of Reinforced Concrete Tunnel Segments with Added Steel Fibers.

In recent years, steel-fiber-reinforced concrete (SFRC) has been increasingly applied in shield tunnel engineering. However, most research on SFRC segments focuses on the load-bearing capacity, while the tunnel deformation is an equally critical indicator that decides if the tunnel can operate safely during service conditions. Therefore, it is essential to also study the stiffness variations in SFRC segments, which is closely connected to the serviceability limit state (SLS).

An Enhanced Progressive Damage Model for Laminated Fiber-Reinforced Composites Using the 3D Hashin Failure Criterion: A Multi-Level Analysis and Validation.

This paper presents a progressive damage model (PDM) based on the 3D Hashin failure criterion within the ABAQUS/Explicit 2021 framework via a VUMAT subroutine, enhancing the characterization of the mechanical performance and damage evolution in the elastic and softening stages of composite materials via the accurate calculation of damage variables and accommodation of non-monotonic loading conditions. In the subsequent multi-level verification, it is found that the model accurately simulates the primary failure modes at the element level and diminishes the influence of element size, ensuring a reliable behavior representation under non-monotonic loading. At the laminate level, it also accurately forecasts the elastic behavior and damage evolution in open-hole lamina and laminates, demonstrating the final crack band at ultimate failure.

Predicting time-to-intubation after critical care admission using machine learning and cured fraction information.

Intubation for mechanical ventilation (MV) is one of the most common high-risk procedures performed in Intensive Care Units (ICUs). Early prediction of intubation may have a positive impact by providing timely alerts to clinicians and consequently avoiding high-risk late intubations. In this work, we propose a new machine learning method to predict the time to intubation during the first five days of ICU admission, based on the concept of cure survival models.

Designing pareto-optimal selection systems for multiple minority subgroups and multiple criteria.

Currently used Pareto-optimal (PO) approaches for balancing diversity and validity goals in selection can deal only with one minority group and one criterion. These are key limitations because the workplace and society at large are getting increasingly diverse and because selection system designers often have interest in multiple criteria. Therefore, the article extends existing methods for designing PO selection systems to situations involving multiple criteria and multiple minority groups (i.

Validated risk prediction models for outcomes of acute kidney injury: a systematic review.

Background: Acute Kidney Injury (AKI) is frequently seen in hospitalized and critically ill patients. Studies have shown that AKI is a risk factor for the development of acute kidney disease (AKD), chronic kidney disease (CKD), and mortality.

Methods: A systematic review is performed on validated risk prediction models for developing poor renal outcomes after AKI scenarios.

Weighting admission scores to balance predictiveness-diversity: The Pareto-optimization approach.

Context: Although many medical schools seek to improve diversity, they grapple with the challenge of how to weight the scores of different admission methods to achieve a balance between obtaining high predictiveness and ensuring diversity in the selected student pool. Yet, in large-scale employment settings, substantial progress has been made on this front: Pareto-optimization has been introduced as an elegant statistical tool to assist decision makers in determining the weights assigned to selection methods in advance (before the selection has taken place) so that a selection system is designed to achieve an optimal balance as reflected by the trade-off that one outcome (e.g.

A comprehensive examination of the cross-validity of pareto-optimal versus fixed-weight selection systems in the biobjective selection context.

The article presents evidence for the cross-validity potential of fixed-weight (FW) versus Pareto-Optimal (PO) selection systems in biobjective selection situations where both the goals of diversity and quality are valued and the importance of the goals is undecided a priori. The article extends previous research by also studying the cross-validity potential of selection systems in the practically most important sample-to-sample cross-validity scenario. We address three research questions: (a) Do different PO systems show comparable levels of relative (i.

Long-term outcome in ICU patients with acute kidney injury treated with renal replacement therapy: a prospective cohort study.

Background: In intensive care unit (ICU) patients, acute kidney injury treated with renal replacement therapy (AKI-RRT) is associated with adverse outcomes. The aim of this study was to evaluate variables associated with long-term survival and kidney outcome and to assess the composite endpoint major adverse kidney events (MAKE; defined as death, incomplete kidney recovery, or development of end-stage renal disease treated with RRT) in a cohort of ICU patients with AKI-RRT.

Methods: We conducted a single-center, prospective observational study in a 50-bed ICU tertiary care hospital.

The influence of propofol and sevoflurane on intestinal motility during laparoscopic surgery.

Background: Volatile anaesthetics have an influence on small bowel peristalsis during laparoscopic surgery. A recent study concluded that desflurane increased intestinal motility compared to sevoflurane. Hence, a desflurane-based anaesthesia protocol may reduce surgical exposure during intestinal suturing or stapling due to small bowel hyperperistalsis.

Long-term quality of life in critically ill patients with acute kidney injury treated with renal replacement therapy: a matched cohort study.

Introduction: Acute kidney injury (AKI) is a common complication in intensive care unit (ICU) patients and is associated with increased morbidity and mortality. We compared long-term outcome and quality of life (QOL) in ICU patients with AKI treated with renal replacement therapy (RRT) with matched non-AKI-RRT patients.

Methods: Over 1 year, consecutive adult ICU patients were included in a prospective cohort study.

SILS sigmoidectomy versus multiport laparoscopic sigmoidectomy for diverticulitis.

Background And Objectives: In this single-institution study, we aimed to compare the safety, feasibility, and outcomes of single-incision laparoscopic sigmoidectomy (SILSS) with multiport laparoscopic sigmoidectomy (MLS) for recurrent diverticulitis.

Methods: Between October 2011 and February 2013, 60 sigmoidectomies were performed by the same surgeon. Forty patients had a MLS and 20 patients had a SILSS.

Contrast-associated AKI in the critically ill: relevant or irrelevant?

Purpose Of Review: Iodinated contrast media are frequently administered in ICU patients. Recent studies challenge the relevance of contrast media toxicity in ICU patients and relate occurrence of acute kidney injury to baseline characteristics and severity of illness.

Recent Findings: Various findings in studies with kidney biomarkers indicate the causal relationship between contrast media exposure and kidney damage.

Severe lactic acidosis in critically ill patients with acute kidney injury treated with renal replacement therapy.

Purpose: Severe lactic acidosis (SLA) is frequent in intensive care unit (ICU) patients with acute kidney injury (AKI) treated with renal replacement therapy (RRT). The aim of the study is to describe the epidemiology of SLA in this setting.

Materials And Methods: An observational single-center cohort analysis was performed on AKI patients treated with RRT.

Implementing the Kidney Disease: Improving Global Outcomes/acute kidney injury guidelines in ICU patients.

Purpose Of Review: Acute kidney injury (AKI) is a frequent finding in critically ill patients and is associated with adverse outcomes. With the purpose of improving outcome of AKI, the Kidney Disease: Improving Global Outcomes (KDIGO) group, a group of experts in critical care nephrology, has presented a set of guidelines in 2012, based on the evidence gathered until mid 2011. This review will update these guidelines with recent evidence.

Randomized clinical trial on the influence of anaesthesia protocol on intestinal motility during laparoscopic surgery requiring small bowel anastomosis.

Background: Hyperperistalsis of the small bowel during laparoscopic surgery may cause mucosal prolapse and reduce exposure, making laparoscopic suturing or stapling more demanding for the surgeon. Although it is commonly accepted that both opioids and volatile anaesthetics induce intestinal paralysis, intestinal hyperactivity during anaesthesia is not uncommon. This randomized trial investigated the effect of different volatile anaesthetics on intestinal motility and the impact on surgeon satisfaction.

AKI patients have worse long-term outcomes, especially in the immediate post-ICU period.

Acute kidney injury (AKI) is associated with worse outcome in the acute phase of acute illness but also in the chronic phase. In a large Danish study in this issue of Critical Care, 1-year mortality was higher in patients with AKI than in patients without AKI. Mortality was most important during the first 50 days after admission to the intensive care unit (ICU), whereas after 2 months the survival curves of patients with AKI and those of patients without AKI were similar.

Clinical consequences of acute kidney injury.

Acute kidney injury (AKI) can no longer be considered a surrogate marker for severity of illness. Recent epidemiologic data demonstrate the association of AKI and mortality. Even small decreases of kidney function are associated with increased mortality.

Designing Pareto-optimal selection systems: formalizing the decisions required for selection system development.

The article presents an analytic method for designing Pareto-optimal selection systems where the applicants belong to a mixture of candidate populations. The method is useful in both applied and research settings. In an applied context, the present method is the first to assist the selection practitioner when deciding on 6 major selection design issues: (1) the predictor subset, (2) the selection rule, (3) the selection staging, (4) the predictor sequencing, (5) the predictor weighting, and (6) the stage retention decision issue.

Serum urea concentration is probably not related to outcome in ICU patients with AKI and renal replacement therapy.

Background: Acute kidney injury (AKI) is a common complication in patients admitted to the intensive care unit (ICU). Among other variables, serum urea concentrations are recommended for timing of initiation of renal replacement therapy (RRT). The aim of this study was to evaluate whether serum urea concentration or different serum urea concentration cutoffs as recommended in the literature were associated with in-hospital mortality at time of initiation of RRT for AKI.

A closer look at the frame-of-reference effect in personality scale scores and validity.

This article contributes to the understanding of why the use of a frame-of-reference leads to increased criterion-related validity of personality inventories. Two competing explanations are described and tested. A between-subjects (N = 337) and a within-subject (N = 105) study are conducted to test the hypothesized effects of use of a frame of reference on reliability and validity.

Epidemiology of AKI in the ICU.

Up to a little while ago there was no uniform definition for acute kidney injury (AKI). Recently, the Acute Dialysis Quality Initiative proposed the RIFLE consensus classification for AKI. This classification was adapted and modified by the Acute Kidney Injury Network into the AKI staging system.

Combining predictors to achieve optimal trade-offs between selection quality and adverse impact.

The authors propose a procedure to determine (a) predictor composites that result in a Pareto-optimal trade-off between the often competing goals in personnel selection of quality and adverse impact and (b) the relative importance of the quality and impact objectives that correspond to each of these trade-offs. They also investigated whether the obtained Pareto-optimal composites continue to perform well under variability of the selection parameters that characterize the intended selection decision. The results of this investigation indicate that this is indeed the case.