Search Results (4)

Background: Physiotherapy plays a key role in managing fibromyalgia, a multifaceted disorder, through a combination of active and passive treatments. The purpose of this review is to compare the efficacy of “hands-off” treatments alone versus the combination of “hands-off” and “hands-on” therapies. Methods: MEDLINE (PubMed), CENTRAL, and Embase were searched. English-language randomized controlled trials involving adults with fibromyalgia were included. The included studies were divided into subgroups to reduce the possible heterogeneity. We calculated the standardized mean difference or mean difference with 95% confidence intervals for the continuous data according to the outcome measures. We used the risk ratio for dichotomous data of the drop-out rate of the studies. Results: We included and analyzed seven RCTs. The meta-analysis showed no significant results in the outcomes, pain, QoL, health status, and drop-out rate. We found significant results (p < 0.001) in favor of combining “hands-off” and “hands-on” treatments for the rest quality (SMD 0.72, 95% CI 0.35 to 1.09). Conclusions: This review increases the treatment options available for clinicians. Up to now, the main guidelines on managing fibromyalgia suggest only approaches based on “hands-off” treatments. These findings suggest that other approaches based on mixed interventions combining “hands-off” and “hands-on” treatments did not reduce the patient outcomes. Moreover, the mixed intervention led to better results for the patients’ sleep quality than the “hands-off” treatments alone. Full article

In naval architecture, the standard way adopted to reduce the risk of potential loss of life for passenger ships after an accident is via regulations. In case of flooding, this explicitly implies the introduction of fixed watertight bulkheads, permanently modifying the internal ship’s layout. Damage stability regulations constantly aim at higher safety standards; therefore, the layout reconfiguration of an existing vessel may be essential to meet new requirements, leading to higher costs for retrofitting. Furthermore, increasing fragmentation of the internal layout has a physical limit, neglecting the possibility to elevate standards above a particular upper limit. In this view, innovative solutions give the chance to exceed such a limit. The present work describes the advantages of high-expansion foam application for passive and active protection from flooding events. The possibility to have a material granting sufficient water tightness allows installing fixed or deployable barriers that increase the safety level of the ship. Here, besides the description of the foam characteristics, the application on a reference passenger ship highlights the advantages of passive and active foam barriers to limit flooding and drastically reduce the risk of loss of lives. The changes in the limiting stability margins required by regulations and the analysis of dynamic flooding simulations for specific damage cases demonstrate the benefits of foam installation onboard passenger ships as a risk control option. Full article

Wind power is a substantial resource to assist global efforts on the decarbonization of energy. The drive to increase capacity has led to ever-increasing blade tip heights and lightweight, slender towers. These structures are subject to a variety of environmental loads that give rise to vibrations with potentially catastrophic consequences, making the mitigation of the tower’s structural vibrations an important factor for low maintenance requirements and reduced damage risk. Recent advances in the most important vibration control methods for wind turbine towers are presented in this paper, exploring the impact of the installation environment harshness on the performance of state-of-the-art devices. An overview of the typical structural characteristics of a modern wind turbine tower is followed by a discussion of typical damages and their link to known collapse cases. Furthermore, the vibration properties of towers in harsh multi-hazard environments are presented and the typical design options are discussed. A comprehensive review of the most promising passive, active, and semi-active vibration control methods is conducted, focusing on recent advances around novel concepts and analyses of their performance under multiple environmental loads, including wind, waves, currents, and seismic excitations. The review highlights the benefits of installing structural systems in reducing the vibrational load of towers and therefore increasing their structural reliability and resilience to extreme events. It is also found that the stochastic nature of the typical tower loads remains a key issue for the design and the performance of the state-of-the-art vibration control methods. Full article

The traditional risk control option adopted in naval architecture to meet safety-related objectives is by regulations, targeting damage limitation, nominally instigated in the wake of maritime accidents claiming heavy loss of life. These primarily concern the introduction of watertight bulkheads, i.e., permanent (passive) reconfiguration of the internal ship environment to enhance damage stability. This has been the most common measure, manifesting itself in the wake of every serious flooding accident since the beginning, back in the 19th century. However, traditional flooding protection through watertight subdivision, to an extent dictated by IMO regulations, has a physical limit which, if exceeded, a safety plateau is reached. This is currently the case and with damage stability standards progressively increasing, the safety gap between existing and new ships is dangerously widening and with design stability margins progressively eroding, stability management is unsustainable, leading to loss of earnings at best. The need for managing the residual risk through active intervention/protection over the life-cycle of the vessel drives industry to searching and adopting a new normal. This new normal is the innovation being explained in this paper by addressing safety enchantment through a systematic reconfiguration of the ship environment for passive and active protection in flooding accidents. In this respect, the “design-optimal” internal arrangement of a vessel, is adapted and reconfigured, using passive and active containment systems for flooding incidents, in the form of high-expansion foam products. The innovation is briefly explained, claiming transformational reduction in flooding risk in the most cost-effective way available. To support wider understanding and appreciation for the latter, the paper critically reviews the whole evolution of internal ship space reconfiguration, chronologically and systematically, concluding that new technological developments and breakthroughs will bring sustainable changes to the traditional evolutionary maritime safety enhancement. Full article