ABSTRACT
The frequent occurrences of bridge fires and the substantial disruptions and direct/indirect economic losses resulting from these events highlight the immediate need for effective fire-safety-oriented design of new bridges and retrofit approaches for vulnerable existing bridges. In this Perspective, we discuss why a holistic engineering approach integrating innovative fire analysis methods and structural design/retrofit strategies into multi-hazard and future-oriented risk modeling frameworks represents the way forward to more sustainable and resilient infrastructure in an uncertain and rapidly changing built environment.
ABSTRACT
Drawing on collective experience from ten collaborative research projects focused on the Global South, we identify three major challenges that impede the translation of research on sustainability and resilience into better-informed choices by individuals and policy-makers that in turn can support transformation to a sustainable future. The three challenges comprise: (i) converting knowledge produced during research projects into successful knowledge application; (ii) scaling up knowledge in time when research projects are short-term and potential impacts are long-term; and (iii) scaling up knowledge across space, from local research sites to larger-scale or even global impact. Some potential pathways for funding agencies to overcome these challenges include providing targeted prolonged funding for dissemination and outreach, and facilitating collaboration and coordination across different sites, research teams, and partner organizations. By systematically documenting these challenges, we hope to pave the way for further innovations in the research cycle.
Subject(s)
Resilience, Psychological , HumansABSTRACT
OBJECTIVE: Medication-related osteonecrosis of the jaw (MRONJ) is a pathologic process resulting in progressive destruction of the jaws. There are no established guidelines for the medical management of MRONJ. Interest in pentoxifylline and tocopherol is growing because these agents have been shown to be effective in treating osteoradionecrosis of the jaw. This review evaluates the clinical usefulness of pentoxifylline and tocopherol in treating MRONJ. STUDY DESIGN: Literature databases were searched for relevant reports of pentoxifylline and tocopherol in treating MRONJ. Only English-language reports and human studies were considered. RESULTS: There were 3 published observational studies and 2 abstracts relevant to this topic. The combination of pentoxifylline and tocopherol is associated with subjective and objective improvements and no major adverse outcomes. CONCLUSIONS: Pentoxifylline and tocopherol has been demonstrated to be effective for managing MRONJ nonsurgically, and, thus, this treatment modality holds promise. However, larger clinical studies are needed to optimize dose and duration.
Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw , Bone Density Conservation Agents , Osteoradionecrosis , Pentoxifylline , Tocopherols , Bisphosphonate-Associated Osteonecrosis of the Jaw/drug therapy , Bone Density Conservation Agents/adverse effects , Humans , Osteoradionecrosis/drug therapy , Pentoxifylline/therapeutic use , Phosphodiesterase Inhibitors/therapeutic use , Tocopherols/therapeutic useABSTRACT
Airway management in developmentally challenged, and often uncooperative, patients presents difficulty for the anesthesiologist and may be further complicated by severe trismus. We describe a case wherein the use of the Molt mouth gag significantly facilitated airway control using fiberoptic tracheal intubation.