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- 저자 : James O'Connor (검색결과 5 건)
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O'Connor, James T.,Torres, Neftali,Kralik, Nancy,Woo, Jeyoung Korea Institute of Construction Engineering and Ma 2018 Journal of construction engineering and project ma Vol.8 No.1
Achieving sustainability targets on construction projects has increasingly become one of the prime strategies for construction organizations. To provide more detailed guidance on sustainability implementation on projects, Construction Industry Institute (CII) Research Team (RT) 304 developed a catalog of the Construction Phase Sustainability Actions (CPSAs). The primary objective of this paper was the development of two support tools, the CPSA Screening Tool and the CPSA Implementation Index, that could be used to enable efficient application of CPSAs, support sustainability-related decisions, and measure CPSA implementation and performance. The authors developed the tools in four stages: conceptual, detailed planning, tool programming, and testing. The tools were then demonstrated on a capital project to confirm their efficacy and applicability. This paper presents the background, inputs and outputs, and the algorithms of each tool. The CPSA Screening Tool can prioritize the CPSAs most relevant to a project; the CPSA Implementation Index enables continuous monitoring of implementation levels.
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Lambrechts Mark James,Tran Khoa,Conaway William,Karamian Brian Abedi,Goswami Karan,Li Sandi,O'Connor Patrick,Brush Parker,Canseco Jose,Kaye Ian David,Woods Barrett,Hilibrand Alan,Schroeder Gregory,Vac 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.2
Study Design: A retrospective cohort study.Purpose: To determine whether the 11-item modified frailty index (mFI) is associated with readmission rates, complication rates, revision rates, or differences in patient-reported outcome measures (PROMs) for patients undergoing posterior cervical decompression and fusion (PCDF).Overview of Literature: mFI incorporates preexisting medical comorbidities and dependency status to determine physiological reserve. Based on previous literature, it may be used as a predictive tool for identifying postoperative clinical and surgical outcomes.Methods: Patients undergoing elective PCDF at our urban academic medical center from 2014 to 2020 were included. Patients were categorized by mFI scores (0–0.08, 0.09–0.17, 0.18–0.26, and ≥0.27). Univariate statistics compared demographics, comorbidities, and clinical/surgical outcomes. Multiple linear regression analysis evaluated the magnitude of improvement in PROMs at 1 year.Results: A total of 165 patients were included and grouped by mFI scores: 0 (n=36), 0.09 (n=62), 0.18 (n=42), and ≥0.27 (n=30). The severe frailty group (mFI ≥0.27) was significantly more likely to be diabetic (<i>p</i> <0.001) and have a greater Elixhauser comorbidity index (<i>p</i> =0.001). They also had worse baseline Physical Component Score-12 (PCS-12) (<i>p</i> =0.011) and modified Japanese Orthopaedic Association (mJOA) (<i>p</i> =0.012) scores and worse 1-year postoperative PCS-12 (<i>p</i> =0.008) and mJOA (<i>p</i> =0.001) scores. On regression analysis, an mFI score of 0.18 was an independent predictor of greater improvement in ΔVisual Analog Scale neck (<i>β</i> =−2.26, <i>p</i> =0.022) and ΔVAS arm (<i>β</i> =−1.76, <i>p</i> =0.042). Regardless of frailty status, patients had similar 90-day readmission rates (<i>p</i> =0.752), complication rates (<i>p</i> =0.223), and revision rates (<i>p</i> =0.814), but patients with severe frailty were more likely to have longer hospital length of stay (<i>p</i> =0.006) and require non-home discharge (<i>p</i> <0.001).Conclusions: Similar improvements across most PROMs can be expected irrespective of the frailty status of patients undergoing PCDF. Complication rates, 90-day readmission rates, and revision rates are not significantly different when stratified by frailty status. However, patients with severe frailty are more likely to have longer hospital stays and require non-home discharge.
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A Review of Finite Element Modeling for Anterior Cervical Discectomy and Fusion
Lin Maohua,Paul Rudy,Dhar Utpal Kanti,Doulgeris James,O’Connor Timothy E.,Tsai Chi-Tay,Vrionis Frank D. 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.5
The cervical spine poses many complex challenges that require complex solutions. Anterior cervical discectomy and fusion (ACDF) has been one such technique often employed to address such issues. In order to address the problems with ACDF and assess the modifications that have been made to the technique over time, finite element analyses (FEA) have proven to be an effective tool. The variations of cervical spine FEA models that have been produced over the past couple of decades, particularly more recent representations of more complex geometries, have not yet been identified and characterized in any literature. Our objective was to present material property models and cervical spine models for various simulation purposes. The outlining and refinement of the FEA process will yield more reliable outcomes and provide a stable basis for the modeling protocols of the cervical spine.
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Lin Maohua,Paul Rudy,Shapiro Stephen Z.,Doulgeris James,O’Connor Timothy E.,Tsai Chi-Tay,Vrionis Frank D. 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.5
Study Design: This study compares four cervical endplate removal procedures, validated by finite element models.Purpose: To characterize the effect of biomechanical strength and increased contact area on the maximum von Mises stress, migration, and subsidence between the cancellous bone, endplate, and implanted cage.Overview of Literature: Anterior cervical discectomy and fusion (ACDF) has been widely used for treating patients with degenerative spondylosis. However, no direct correlations have been drawn that incorporate the impact of the contact area between the cage and the vertebra/endplate.Methods: Model 1 (M1) was an intact C2C6 model with a 0.5 mm endplate. In model 2 (M2), a cage was implanted after removal of the C4–C5 and C5–C6 discs with preservation of the osseous endplate. In model 3 (M3), 1 mm of the osseous endplate was removed at the upper endplate. Model 4 (M4) resembles M3, except that 3 mm of the osseous endplate was removed.Results: The range of motion (ROM) at C2C6 in the M2–M4 models was reduced by at least 9º compared to the M1 model. The von Mises stress results in the C2C3 and C3C4 interbody discs were significantly smaller in the M1 model and slightly increased in the M2–M3 and M3–M4 models. Migration and subsidence decreased from the M2–M3 model, whereas further endplate removal increased the migration and subsidence as shown in the transition from M3 to M4.Conclusions: The M3 model had the least subsidence and migration. The ROM was higher in the M3 model than the M2 and M4 models. Endplate preparation created small stress differences in the healthy intervertebral discs above the ACDF site. A 1 mm embedding depth created the best balance of mechanical strength and contact area, resulting in the most favorable stability of the construct.
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