The majority of houses in the Groningen gas field region, the largest in Europe, consist of unreinforced masonry material. Because of their particular characteristics (cavity walls of different material, large openings, limited bearing walls in one direction, etc.) these houses are exceptionally vulnerable to shallow induced earthquakes, frequently occurring in the region during the last decade. Raised by the damage incurred in the Groningen buildings due to induced earthquakes, the question whether the small and sometimes invisible plastic deformations prior to a major earthquake affect the overall final response becomes of high importance as its answer is associated with legal liability and consequences due to the damage-claim procedures employed in the region. This paper presents, for the first time, evidence of cumulative damage from available experimental and numerical data reported in the literature. Furthermore, the available modelling tools are scrutinized in terms of their pros and cons in modelling cumulative damage in masonry. Results of full-scale shake-table tests, cyclic wall tests, complex 3D nonlinear time-history analyses, single degree of freedom (SDOF) analyses and finally wall element analyses under periodic dynamic loading have been used for better explaining the phenomenon. It was concluded that a user intervention is needed for most of the SDOF modelling tools if cumulative damage is to be modelled. Furthermore, the results of the cumulative damage in SDOF models are sensitive to the degradation parameters, which require calibration against experimental data. The overall results of numerical models, such as SDOF residual displacement or floor lateral displacements, may be misleading in understanding the damage accumulation. On the other hand, detailed discrete-element modelling is found to be computationally expensive but more consistent in terms of providing insights in real damage accumulation.
BACKGROUND: Increasing evidence indicates the potential benefits of restricted fluid management in critically ill patients. Evidence lacks on the optimal fluid management strategy for invasively ventilated COVID-19 patients. We hypothesized that the cumulative fluid balance would affect the successful liberation of invasive ventilation in COVID-19 patients with acute respiratory distress syndrome (ARDS).METHODS: We analyzed data from the multicenter observational 'PRactice of VENTilation in COVID-19 patients' study. Patients with confirmed COVID-19 and ARDS who required invasive ventilation during the first 3 months of the international outbreak (March 1, 2020, to June 2020) across 22 hospitals in the Netherlands were included. The primary outcome was successful liberation of invasive ventilation, modeled as a function of day 3 cumulative fluid balance using Cox proportional hazards models, using the crude and the adjusted association. Sensitivity analyses without missing data and modeling ARDS severity were performed.RESULTS: Among 650 patients, three groups were identified. Patients in the higher, intermediate, and lower groups had a median cumulative fluid balance of 1.98 L (1.27-7.72 L), 0.78 L (0.26-1.27 L), and - 0.35 L (- 6.52-0.26 L), respectively. Higher day 3 cumulative fluid balance was significantly associated with a lower probability of successful ventilation liberation (adjusted hazard ratio 0.86, 95% CI 0.77-0.95, P = 0.0047). Sensitivity analyses showed similar results.CONCLUSIONS: In a cohort of invasively ventilated patients with COVID-19 and ARDS, a higher cumulative fluid balance was associated with a longer ventilation duration, indicating that restricted fluid management in these patients may be beneficial. Trial registration Clinicaltrials.gov ( NCT04346342 ); Date of registration: April 15, 2020.
SIA developed alongside EIA in the early 1970s as a mechanism to consider the social impacts of planned interventions. The early understanding tended to limit the practical application of SIA to the project level, usually within the context of regulatory frameworks, and primarily considered only the direct negative impacts. However, like other types of impact assessment, SIA has evolved over time and has diverged considerably from EIA.
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