M.C. Townsend Associates (United States)

The Greater Toronto Airports Authority is undertaking a major capital development initiative at Toronto Pearson International Airport known as Pearson Long-term Investment in Facilities and Terminals (Pearson LIFT). Pearson LIFT is designed to transform the airport into the world-class, sustainable and passenger-centric hub which will be needed in the coming decades. This paper examines the mechanisms established to manage the complexity of this transformation, focusing on two interrelated new initiatives that have been implemented by the airport company: the Single Point of Contact (SPOC) Cabinet governance model and the Interface Coordination Group (ICG). Drawing on programme management principles, systems theory, organisational design and infrastructure governance, this paper analyses how these bodies function to mediate interdepartmental coordination, mitigate operational risk and ensure strategic alignment across multiple aviation capital programmes, some of which are executed simultaneously in a live airport environment. The SPOC Cabinet operates as a senior-level forum, facilitating cross-functional collaboration, critical decision endorsements and escalation pathways to the Executive Capital Committee. In contrast, the ICG serves as a tactical coordination mechanism, using a centralised airport activity calendar and structured conflict resolution guidelines to manage programme and airport operational activities. Through an analysis of both initiatives, their methodologies and governance structures, this paper argues that the SPOC–ICG model represents a new way of managing complex aviation infrastructure delivery in operationally constrained airport environments. The findings contribute to the literature on aviation megaproject delivery and offer a replicable framework for other complex, multi-stakeholder aviation programmes seeking to balance strategic oversight with operational agility. This article is also included in The Business & Management Collection which can be accessed at https://hstalks.com/business/.

A construction schedule review is an essential aspect of schedule management for U.S. state departments of transportation (DOTs) to deliver transportation construction projects on time. Despite their importance, current literature pays limited attention to addressing schedule quality problems for highway construction projects. This research aims to assess schedule quality problems from DOTs’ perspective and suggests recommendations to improve DOTs’ schedule review practices. To achieve this, two questions were formulated: 1) What schedule problems do DOT schedule reviewers perceive as vital to schedule quality? and 2) What schedule problems do DOT schedule reviewers find repeatedly? This research first reviewed relevant literature and identified 44 schedule quality problems noted about highway construction. Based on these 44 problems, a survey was developed to assess the level of impact and the likelihood of occurrence of each problem. The survey was deployed to Texas Department of Transportation practitioners with schedule review experience. The analysis prioritized the problems by the relative impact and frequency, and DOTs can utilize this analysis to improve their schedule review process and practices. This paper contributes to the academic body of knowledge by investigating the schedule quality problems in highway construction and DOT practitioners’ perceptions of the schedule quality problems. Its industry contribution includes providing the methodology for DOTs to assess their schedule quality problems.

"Spirometry in 2022: Is a Single Set of Prediction Equations for All the Best Path Forward?." American Journal of Respiratory and Critical Care Medicine, 0(ja), pp. –

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The outcomes of operational shutdowns and maintenance events, ‘Shuts and Turns’, can significantly affect a company’s performance and reputation. These are typically highly complex operations that demand significant resources and must deliver results. Shuts and Turns are expensive activities, not only in terms of the direct cost of labour plant and materials but also the production deferral. Leading operators recognise that they also pose significant risk to future production which is why significant time and effort goes into robust management framework. Safety performance is paramount, with schedule adherence also key. Operators spend considerable time planning to ensure successful Shuts and Turns have: an established management framework; effective scope management; thorough front-end loading; robust controls and change management; an assessment of the risks of emerging work; efficient resource planning; and rigorous safety and QA/QC processes. This paper provides: an overview of the different types of Shuts and Turns used by Australian operators; the benefits of a robust shutdown governance approach; an overview of key success areas; importance of lessons learned; and a detailed case study based on our work with a major downstream facility. The paper will appeal to oil and gas operators, major contractors and service providers.

To review the pharmacology of buprenorphine, the evolution of buprenorphine dosing recommendations, and the current literature regarding its recommendations for the perioperative period. There is a consensus that for all surgeries, buprenorphine should be continued throughout the perioperative period. If the surgery is a minimal to mild pain surgery, no dose adjustment is needed. There is no clear consensus regarding moderate to severe pain. With all surgeries, multimodal analgesia should be utilized, with regional anesthesia when possible. Patients taking buprenorphine should continue their buprenorphine perioperatively; whether to decrease or maintain dosing is up for debate. Multimodal analgesia should also be used throughout the perioperative period, and communication between the patient and all provider teams is of the utmost importance to provide adequate analgesia during the perioperative period, as well as to arrange safe analgesia upon discharge.

Existing laws have a generality that permits them to be applied to nanotechnology, but eventually it will be necessary to generate legislation targeted to issues specific to nanotechnology. As nanotechnology continues to develop into commercially viable products, legal doctrines are increasingly likely to play an important role in protecting intellectual property, facilitating financial transactions, and handling health, safety, and environmental issues. Nanotechnology: Legal Aspects provides thorough, yet comprehensible overview of different legal doctrines that are relevant to nanotechnology and explains how they may apply in the development, commercialization, and use of nano-products. The book is divided into three parts that correspond to the different phases in the lifecycle of nano-products: Protection, Regulation, and Liability. The in-depth coverage of these topics in a single source sets this work apart from others at the interface of law and nanoscience. Accessible to those without specific training in either nanotechnology or law... Nanotechnology: Legal Aspects offers a reader-friendly and affordable alternative that appeals to nano-aware audiences as well as legal professionals, students, and scientists who wish to build a greater understanding of the legal aspects of nanotechnology.

Introduction: Insufficient sleep is associated incident hypertension. Because blood pressure (BP) varies across 24h, shorter sleep may be associated with increased BP across all 24h. Additionally, we evaluated whether BP variability was also associated with shorter sleep. Methods: Participants were adults with untreated prehypertension or stage-1 hypertension assessed at baseline as part of a clinical trial. Recordings took place during overnight visits in a Clinical Research Center. Sleep was reported by nurses continuously monitoring patients. Those with <7h sleep were classified “shorter” (N=13) and the rest “longer” (N=30). BP was assessed with a Spacelabs ambulatory monitor. Linear regression models evaluated effect of group on day, night, and 24h systolic and diastolic BP and heart rate (HR). Results: The “shorter” group slept for M=370 (SD=87) minutes and the “longer” group slept for M=521 (SD=51) mins. Results for day, night, and 24h systolic and diastolic blood pressure and heart rate are reported in the Table. Also, higher 24h variability in systolic BP (B=1.2, p=0.03), diastolic BP (B=1.4, p=0.002), and HR (B=1.3, p=0.03) were demonstrated. This was reflected in higher variability during daytime for systolic BP (B=1.1, p=0.04), diastolic BP (B=1.5, p=0.001), and HR (B=1.2, p=0.05); no differences in variability were seen during the night. Conclusions: Shorter sleep duration is associated with higher systolic BP and HR across 24h (day and night), as well as increased variability in systolic and diastolic BP and HR across 24h (during the day in particular). This could provide additional insight in to how sleep duration is associated with hypertension incidence.

Arterial stiffness and enhanced wave reflections independently predict cardiovascular risk. Wave reflections augment central (aortic) pulse pressure (PP), an index of arterial stiffness, and systolic pressure. Increased wave reflections and PP have previously been associated with endothelial dysfunction in hypertensive and healthy middle-aged adults. The study objective was to determine whether endothelial dysfunction is associated with PP and other measures of vascular stiffness in young normotensive and prehypertensive subjects. We measured office, central, and 24-hour measurements in 102 (64 female, 38 male) non-hypertensive, non-diabetic participants. Endothelial function was assessed non-invasively using post-ischemic reactive hyperemia with strain-gauge plethysmography. The racially diverse subject pool was comprised of 60% Caucasians, 18% African Americans, and 24% Asians, with mean age 30, mean BMI 25.6, mean office SBP/DBP = 110 ± 13 mm Hg/70 ± 9 mm Hg. Endothelial function was highly associated with office (β= - 4.2 mm Hg, p<0.001) and 24-hour PP (β= - 1.4 mm Hg, p=0.008), along with central measures of wave reflection: ((augmentation pressure (β= - 2.1 mm Hg), augmentation index (β= - 3.7): both p<0.001). Beta values correspond to the change noted for one standard deviation in endothelial function. In conclusion, endothelial dysfunction is significantly and consistently associated with arterial stiffness and increased wave reflections in young non-hypertensive adults. Identification of endothelial dysfunction in otherwise healthy young individuals may provide an opportunity to reduce vascular stiffness and associated cardiovascular risk.