Indications and Recommendations for Tracheostomy in Trauma Population With COVID-19 Infection: A Review of the Literature

This review explores the current body of evidence pertaining to tracheostomy placement in COVID-19 seropositive patients and summarizes the research by tracheostomy indications, timing, and procedure. Literature review was performed in accordance with the 2020 PRISMA guidelines and includes 12 papers discussing protocols for adult patients seropositive for COVID-19. The studies demonstrated high mortality rates after tracheostomy, especially in geriatric patients, and suggested a multifactorial determination of whether to perform a tracheostomy. There was inconclusive data regarding wait time between testing seropositive, tracheostomy, and weaning off of ventilation. COVID-19 generally reaches highest infectivity between days 9 and 10; furthermore, high early mortality rates seen in COVID-19 may confound mortality implicated by tracheostomy placement. Due to the aerosol-generating nature of tracheostomy placement, management and maintenance, techniques, equipment, and personnel should be carefully considered and altered for COVID-19 patients. With surgical tracheostomy, literature suggested decreased usage of electrocautery; with percutaneous tracheostomy, single-use bronchoscope should be used. The nonemergent exchange of tracheostomy should be done only after the patient tested negative for COVID-19. Placement of tracheostomy should only be considered in COVID-19 patients who are no longer transmissible, with rigorous attention to safety precautions. Understanding procedures for airway maintenance in a respiratory disease like COVID-19 is imperative, especially due to current shortages in ventilators and PPE. However, because of a lack of available data and its likelihood of change as more data emerges, we lack complete guidelines for tracheostomy placement in COVID-19 seropositive patients, and those existing will likely evolve with the disease.

Maintenance Techniques for Cracks in Asphalt Layers

Treating cracks in asphalt pavements is a major stage of each maintenance work for engineers. The goal of any crack cure is to limit the water intrusion into underlying pavement structure layers. Such water infiltrates in to base layers of the pavement and may cause damage to the pavement structure. The previous studies focused on crack repairing materials and methods but not the bonding at the interface joint. In this study, the influence of the repairing materials and depth on the bonding at the interface joint using two repairing materials. Slabs were cast to simulate surface of road. Unlikely, slabs contain cracks in the middle of slab with different depths (35 mm, 50 mm, 70 mm). Consequently, these cracks were repaired with two methods; firstly, repairing them with RC+Sand and secondly, with Sika flex®-1a. The slabs were tested after being repaired to know the best method and depth. It has been concluded that slabs having cracks that have been repaired with RC+Sand increase failure load compared with empty cracks and cracks that have been repaired with Sika flex®-1a. Also, cracks with small depth that have been repaired with Sika flex®-1a increase failure load compared with empty cracks.

Cluster Formation and Maintenance Techniques for Mobile Adhoc Networks with Improved Quality of Service

— In an Adhoc Network, every node is mobile and self-contained. As these networks lack infrastructure, highly adaptive algorithms are required to deal with frequent mobility changes by member nodes as well as Cluster Head (CH) nodes. The weighted clustering algorithms contribute significantly to cluster-based routing. In these algorithms, the selection of cluster heads is the most important task. In weighted clustering methods, the selected CH did their best to serve the network. However, the CH may become overloaded due to the arrival of nodes greater than their desired threshold value. In this case, the CH can become a bottleneck as it is unable to cope with rapidly increasing loads which ultimately degrade the network performance. In this paper, we address three network issues (i) Member Node movement (ii) Cluster head Node movement, and (iii) Overload at the Cluster head node caused due to mobility of nodes. Our proposed method Cluster Formation and Maintenance Techniques for Mobile Adhoc Networks with Improved Quality of Service (CFMIQS) include various adaptive algorithms to provide solutions to deal with these network issues and improve network Quality of Service (QoS). The Simulated Results are compared with the K-means AODV algorithm, the results showed better Packet Delivery Fraction (PDF) and Throughput values. Keywords— Cluster partition, MANET, Primary Cluster head, QoS, Secondary Cluster head

Pendampingan Pembuatan Kompor Energi Alternatif Berbahan Bakar Limbah Serbuk Kayu dan Sekam Padi di Kelurahan TPU Keramat Cereme Taba Lubuklinggau

Based on the observations we made in the TPU Keramat Cereme Taba Village, which is part of the area in Lubuklinggau City, most of the people make a living as wood craftsmen and farmers often cause problems, namely the increasing number of piles of sawdust and rice husks that have not been handled, then the high gas elpigi because it is difficult to find and the community. The goal is to manufacture energy-efficient stoves fueled by sawdust and rice husk waste as a solution to overcome waste. The method of implementing the activities is in the form of lectures, demonstrations and direct practicums. The implementation time is March to June 2021. The target of this activity is youth and women in the village. Evaluation of the increase in participants' knowledge was carried out by pre- and post-test after socialization. The evaluation of participants' skills was carried out during a direct demonstration of stove making. The results of the PKM implementation showed success because there was an increase in knowledge of around 87.5 percent, namely (a) an increase in participants' knowledge about the usefulness of sawdust and rice husk waste by 89 percent. (b) Increased knowledge during media demonstrations about the efficiency of sawdust and rice husk stoves (KOKADI) compared to Elpigi Gas Stoves by 87 percent. (c) Increased knowledge of KOKADI stove maintenance techniques by 88 percent. And (d) Improving community skills regarding the manufacture of KOKADI stoves by 86 percent. This service activity is classified as successful, with an average increase of more than 70 percent, which is an increase of around 87.5 percent. All participants attended PKM activities starting from the opening, the benefits of sawdust and rice husk waste, simulating the manufacture of KOKADI stoves, and observing directly the process of comparing the efficiency of KOKADI with Elpigi gas stoves (KGE).

Advances in Maintenance of Ports and Waterways: Water Injection Dredging

The main objective of this chapter is to demonstrate developments in port maintenance techniques that have been intensively tested in major European ports. As regular port maintenance is highly expensive, port authorities are considering alternative strategies. Water Injection Dredging (WID) can be one of the most efficient alternatives. Using this dredging method, density currents near the bed are created by fluidizing fine-grained sediments. The fluidized sediment can leave the port channels and be transported away from the waterways via the natural force of gravity. WID actions can be successfully coupled with the tidal cycle for extra effectiveness. In addition, WID is combined with another strategy to reduce maintenance dredging: the nautical bottom approach, which enables the vessel to navigate through the WID-induced fluid mud layer. The nautical bottom approach uses the density or the yield stress of sediment to indicate the navigability after WID rather than the absolute depth to the sediment bed. Testing WID-based port maintenance requires thorough preparation. Over the years modeling and monitoring tools have been developed in order to test and optimize WID operations. In this chapter, the application of the recently developed tools is discussed.

Review Paper on Defects in Rigid Pavement

In this project Pavement failure is defined in terms of decreasing serviceability caused by the development of cracks and ruts. Before going into the maintenance strategies, we must look into the causes of failure of rigid pavements. Failures of rigid pavements are caused due to many reasons or combination of reasons. Application of correction in the existing surface will enhance the life of maintenance works as well as that of strengthening layers. It has been seen that only three parameters i.e., unevenness index, pavement cracking and rutting are considered while other distresses have been omitted while going for maintenance operations. Along with the maintenance techniques there are various methods for pavement preservation which will help in enhancing the life of pavement and delaying its failure. The purpose of this study was to evaluate the possible causes of pavement distresses, and to recommend remedies to minimize distress of the pavement. The project describes lessons learnt from pavement failures and problems experienced during the last few years on a number of projects in India. Based on the past experiences’ various pavement preservation techniques and measures are also discussed which will be helpful in increasing the serviceable life of pavement

Comprehensive Life Cycle Environmental Assessment of Preventive Maintenance Techniques for Asphalt Pavement

Preventive maintenance (PM) is regarded as the most economical maintenance strategy for asphalt pavement, but the life cycle environmental impacts (LCEI) of different PM techniques have not yet been comprehensively assessed and compared, thus hindering sustainable PM planning. This study aims to comprehensively estimate and compared the LCEI of five PM techniques then propose measures to reduce environmental impacts in PM design by using life cycle assessment (LCA), including fog seal with sand, micro-surfacing, composite seal, ultra-thin asphalt overlay, and thin asphalt overlay. Afterwards, ten kinds of LCEI categories and energy consumption of PM techniques were compared from the LCA phases, and inventory inputs perspectives, respectively. Results show that fog seal with sand and micro-surfacing can lower all LCEI scores by more than 50%. The environmental performance of five PM techniques provided by sensitivity analysis indicated that service life may not create significant impact on LCA results to some extent. Moreover, four PM combination plans were developed and compared for environmental performance, and results show that the PM plan only includes seal coat techniques that can reduce the total LCEI by 7–29% in pavement life. Increasing the frequency of seal coat techniques can make the PM plans more sustainable.

Maintenance Costs and Advanced Maintenance Techniques: Survey and Analysis

The costs/benefits associated with investing in advanced maintenance techniques is not well understood. Using data collected from manufacturers, we estimate the national losses due to inadequate maintenance and make comparisons between those that rely on reactive maintenance, preventive maintenance, and predictive maintenance. The total annual costs/losses associated with maintenance is estimated to be on average $222.0 billion, as estimated using Monte Carlo analysis. Respondents were categorized into three groups and compared. The first group is the top 50 % of respondents that rely on reactive maintenance, measured in expenditures. The remaining respondents were split in half based on their reliance on predictive maintenance. The top 50 % of respondents in using reactive maintenance, measured in expenditures, compared to the other respondents suggests that there are substantial benefits of moving away from reactive maintenance toward preventive and/or predictive maintenance. The bottom 50 %, which relies more heavily on predictive and preventive maintenance, had 52.7 % less unplanned downtime and 78.5 % less defects. The comparison between the smaller two groups, which rely more heavily on preventive and predictive maintenance, shows that there is 18.5 % less unplanned downtime and 87.3 % less defects for those that rely more on predictive than preventive.