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Academic literature on the topic 'CLTI'

Author: Grafiati
Published: 10 December 2022
Last updated: 28 January 2023

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Journal articles on the topic "CLTI"

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Khattri, Ram B., Kyoungrae Kim, Trace Thome, Zachary R. Salyers, Kerri A. O’Malley, Scott A. Berceli, Salvatore T. Scali, and Terence E. Ryan. "Unique Metabolomic Profile of Skeletal Muscle in Chronic Limb Threatening Ischemia." Journal of Clinical Medicine 10, no. 3 (February 2, 2021): 548. http://dx.doi.org/10.3390/jcm10030548.

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Chronic limb threatening ischemia (CLTI) is the most severe manifestation of peripheral atherosclerosis. Patients with CLTI have poor muscle quality and function and are at high risk for limb amputation and death. The objective of this study was to interrogate the metabolome of limb muscle from CLTI patients. To accomplish this, a prospective cohort of CLTI patients undergoing either a surgical intervention (CLTI Pre-surgery) or limb amputation (CLTI Amputation), as well as non-peripheral arterial disease (non-PAD) controls were enrolled. Gastrocnemius muscle biopsy specimens were obtained and processed for nuclear magnetic resonance (NMR)-based metabolomics analyses using solution state NMR on extracted aqueous and organic phases and 1H high-resolution magic angle spinning (HR-MAS) on intact muscle specimens. CLTI Amputation specimens displayed classical features of ischemic/hypoxic metabolism including accumulation of succinate, fumarate, lactate, alanine, and a significant decrease in the pyruvate/lactate ratio. CLTI Amputation muscle also featured aberrant amino acid metabolism marked by elevated branched chain amino acids. Finally, both Pre-surgery and Amputation CLTI muscles exhibited pronounced accumulation of lipids, suggesting the presence of myosteatosis, including cholesterol, triglycerides, and saturated fatty acids. Taken together, these metabolite differences add to a growing body of literature that have characterized profound metabolic disturbance’s in the failing ischemic limb of CLTI patients.
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Frese, Jan Paul, Larissa Schawe, Jan Carstens, Karlis Milbergs, Fiona Speichinger, Alexandra Gratl, Andreas Greiner, and Ben Raude. "A Modified Run-Off Resistance Score from Cross-Sectional Imaging Discriminates Chronic Critical Limb Ischemia from Intermittent Claudication in Peripheral Arterial Disease." Diagnostics 12, no. 12 (December 14, 2022): 3155. http://dx.doi.org/10.3390/diagnostics12123155.

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Atherosclerotic peripheral arterial disease (PAD) leads to intermittent claudication (IC) and may progress into chronic limb-threatening ischemia (CLTI). Scoring systems to determine the atherosclerotic burden of a diseased extremity have been developed. This study aimed to evaluate a modification of the run-off resistance (mROR) score for its usability in cross-sectional imaging. The mROR was determined from preoperative imaging of patients undergoing revascularization for PAD. A total of 20 patients with IC and 20 patients with CLTI were consecutively included. A subgroup analysis for diabetic patients was conducted. The mROR was evaluated for its correlation with disease severity and clinical covariates. Patients with CLTI were older; cardiovascular risk factors, diabetes, and ASA 4 were more frequent. The mROR scores were higher in CLTI than in IC. In diabetic patients, no difference was detected between CLTI and IC. In CLTI, non-diabetic patients had a higher mROR. The mROR score is positively correlated with the severity of PAD and can discriminate CLTI from IC. In diabetic patients with CLTI, the mROR is lower than in non-diabetic patients. The mROR score can be determined from cross-sectional imaging angiographies. It may be useful for clinicians helping with vascular case planning, as well as for scientific purposes.
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De Stefano, Frank, Luis H. Paz Rios, Brian Fiani, Jawed Fareed, and Alfonso Tafur. "National Trends for Peripheral Artery Disease and End Stage Renal Disease From the National Inpatient Sample Database." Clinical and Applied Thrombosis/Hemostasis 27 (January 1, 2021): 107602962110256. http://dx.doi.org/10.1177/10760296211025625.

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Peripheral artery disease (PAD), and subsequent chronic limb-threatening ischemia (CLTI), are frequently encountered among patients with end-stage renal disease (ESRD). Their coexistence is less favorable in comparison to patients with ESRD alone. We sought to investigate trends, comorbidities, determinants for cost, and prognostic outcomes in patients with concomitant ESRD and PAD. A retrospective analysis was performed using data from the National Inpatient Sample database from the years 2005-2014. ICD-9 codes were used to identify patients with diagnoses of PAD, CLTI, and ESRD. Pearson’s Chi-square, T-test, ANOVA, and multivariate binary logistic regression were used in this analysis. 7,214,843 patients with ESRD were identified. Of these, 123,499 patients were diagnosed with PAD and 102,447 with CLTI. Compared to ESRD alone, mortality rates increased with PAD and CLTI (5.7% vs. 13.9% vs. 15.9%, P < 0.001). Length of stay in days (7.3 vs. 10.2 vs. 11.1, P < 0.001) and in-hospital costs (59,872 vs. 85,866 vs. 89,016, P < 0.001) were higher with PAD and CLTI, respectively. CLTI demonstrated the highest independent predictor of mortality [OR = 6.93 (6.43-7.46), P < 0.001]. A decreasing trend in the rate of PAD (2005: 1.9% vs. 2014: 1.4%, P < 0.001) and CLTI (2005: 1.6% vs. 2014: 1.1%, P < 0.001) was noted. The presence of coexisting PAD, and furthermore CLTI, in patients with ESRD significantly raised in-hospital mortality, cost, and length of stay. A negative trend in rates of PAD and CLTI were observed. Proactive identification of this high-risk population may lead to accurate diagnosis and tailored therapeutic strategies.
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Syed, Muzammil H., Abdelrahman Zamzam, Jason Valencia, Hamzah Khan, Shubha Jain, Krishna K. Singh, Rawand Abdin, and Mohammad Qadura. "MicroRNA Profile of Patients with Chronic Limb-Threatening Ischemia." Diagnostics 10, no. 4 (April 17, 2020): 230. http://dx.doi.org/10.3390/diagnostics10040230.

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Chronic limb-threatening ischemia (CLTI) results in devastating complications such as lower-limb amputations. In this study, a genome-wide plasma microRNAs (miRNA) sequencing was performed to identify miRNA(s) associated with CLTI. Blood samples were collected from early stage CLTI patients (ABI < 0.9) and non-PAD controls (ABI ≥ 0.9) for 3 experiments: discovery phase (n = 23), confirmatory phase (n = 52) and validation phase (n = 20). In the discovery phase, next generation sequencing (NGS) was used to identify miRNA circulating in the plasma CLTI (n = 13) patients, compared to non-PAD controls (n = 10). Two down-regulated miRNAs (miRNA-6843-3p and miRNA-6766-5p) and three upregulated miRNAs (miRNA-1827, miRNA-320 and miRNA-98-3p) were identified (≥2-fold change). In the confirmatory phase, these 5 deregulated miRNAs were further investigated in non-PAD (n = 21) and CTLI (n = 31) patients using qRT-PCR. Only miRNA-1827 was found to be significantly upregulated (≥3-fold, p-value < 0. 001) in the CLTI group. Lastly, to minimize the influence of confounding factors, miRNA-1827 plasma levels were validated in a third cohort of CLTI patients (n = 10) matched to non-PAD controls (n = 10). Our analysis demonstrated that miRNA-1827 expression was increased in the CLTI cohort (≥2-folds, p-value < 0.001). In summary, circulating miRNA-1827 is significantly elevated in patients with CLTI.
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Hurst, Joanne E., Peta Ellen Tehan, Keith Hussey, and James Woodburn. "Association of peripheral artery disease and chronic limb-threatening ischemia with socioeconomic deprivation in people with diabetes: A population data-linkage and geospatial analysis." Vascular Medicine 26, no. 2 (January 25, 2021): 147–54. http://dx.doi.org/10.1177/1358863x20981132.

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The association between the prevalence and geographical distribution of peripheral artery disease (PAD) and chronic limb-threatening ischemia (CLTI) in patients with diabetes in the context of socioeconomic deprivation is not well understood. We undertook a retrospective cohort study of 76,307 people with diabetes admitted as a hospital inpatient in a large Scottish health administrative area. Utilising linked health records, we identified diagnoses of PAD and/or CLTI and their distribution using small area cartography techniques according to multiple deprivation maps. Spatial autocorrelation techniques were applied to examine PAD and CLTI patterning. Association between crude inpatient prevalence-adjusted outcome rates and exposure to social deprivation were determined. We found crude prevalence-adjusted rates of 8.05% for PAD and 1.10% for CLTI with a five- to sevenfold difference from the least to most deprived regions. Statistically significant hot spots were found for PAD ( p < 0.001) and CLTI ( p < 0.001) in the most deprived areas, and cold spots for PAD ( p < 0.001) but not CLTI ( p = 0.72) in the least deprived areas. Major health disparities in PAD/CLTI diagnoses in people with diabetes is driven by socioeconomic deprivation.
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Kim, Tanner I., Carlos Mena, and Bauer E. Sumpio. "The Role of Lower Extremity Amputation in Chronic Limb-Threatening Ischemia." International Journal of Angiology 29, no. 03 (May 14, 2020): 149–55. http://dx.doi.org/10.1055/s-0040-1710075.

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AbstractChronic limb-threatening ischemia (CLTI) is a severe form of peripheral artery disease associated with high rates of limb loss. The primary goal of treatment in CLTI is limb salvage via revascularization. Multidisciplinary teams provide improved care for those with CLTI and lead to improved limb salvage rates. Not all patients are candidates for revascularization, and a subset will require major amputation. This article highlights the role of amputations in the management of CLTI, and describes the patients who should be offered primary amputation.
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Van Den Hoven, Pim, Lauren N. Goncalves, Paulus H. A. Quax, Catharina S. P. Van Rijswijk, Jan Van Schaik, Abbey Schepers, Alexander L. Vahrmeijer, Jaap F. Hamming, and Joost R. Van Der Vorst. "Perfusion Patterns in Patients with Chronic Limb-Threatening Ischemia versus Control Patients Using Near-Infrared Fluorescence Imaging with Indocyanine Green." Biomedicines 9, no. 10 (October 9, 2021): 1417. http://dx.doi.org/10.3390/biomedicines9101417.

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In assessing the severity of lower extremity arterial disease (LEAD), physicians rely on clinical judgements supported by conventional measurements of macrovascular blood flow. However, current diagnostic techniques provide no information about regional tissue perfusion and are of limited value in patients with chronic limb-threatening ischemia (CLTI). Near-infrared (NIR) fluorescence imaging using indocyanine green (ICG) has been used extensively in perfusion studies and is a possible modality for tissue perfusion measurement in patients with CLTI. In this prospective cohort study, ICG NIR fluorescence imaging was performed in patients with CLTI and control patients using the Quest Spectrum Platform® (Middenmeer, The Netherlands). The time–intensity curves were analyzed using the Quest Research Framework. Fourteen parameters were extracted. Successful ICG NIR fluorescence imaging was performed in 19 patients with CLTI and in 16 control patients. The time to maximum intensity (seconds) was lower for CLTI patients (90.5 vs. 143.3, p = 0.002). For the inflow parameters, the maximum slope, the normalized maximum slope and the ingress rate were all significantly higher in the CLTI group. The inflow parameters observed in patients with CLTI were superior to the control group. Possible explanations for the increased inflow include damage to the regulatory mechanisms of the microcirculation, arterial stiffness, and transcapillary leakage.
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Woronowicz-Kmiec, Sandra, Thomas Betz, Ingolf Töpel, Stefan Bröckner, Markus Steinbauer, and Christian Uhl. "Short and long-term outcome after common femoral artery hybrid procedure in patients with intermittent claudication and chronic limb threatening ischemia." Vasa 50, no. 5 (September 2021): 363–71. http://dx.doi.org/10.1024/0301-1526/a000954.

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Summary: Background: This study aimed to evaluate the differences between the outcomes of patients with intermittent claudication (IC) and chronic limb threatening ischemia (CLTI) who underwent a hybrid procedure comprising common femoral artery endarterectomy and endovascular therapy. Patients and methods: This was a retrospective single-center study of all patients with peripheral arterial occlusive disease (PAD) who underwent the hybrid procedure between March 2007 and August 2018. The primary endpoint was primary patency after 7 years. The secondary endpoints were primary-assisted patency, secondary patency, limb salvage, and survival. Results: During the follow-up period, 427 limbs in 409 patients were treated. A total of 267 and 160 patients presented with clinical signs of IC and CLTI, respectively. The 30-day mortality was 1.4% (IC: 0% vs. CLTI: 3.8%, p=0.001). The overall 30-day major amputation rate was 1.6% (IC: 0% vs. CLTI: 4.4, p=0.001). The rates of primary and secondary patency after 7 years were 63% and 94%, respectively, in the IC group and 57% and 88%, respectively, in the CLTI group; the difference was not significant. Limb salvage (94% vs. 82%, p=0.000) and survival (58% vs. 29%, p=0.000) were significantly higher in the IC group. In a multivariate analysis, CLTI was the only risk factor for major amputation. CLTI and single vessel run-off were risk factors for death. Statin therapy was a protective factor. Conclusions: The hybrid procedure provides excellent results as a treatment option for multilevel lesions in patients with PAD. However, patients with CLTI had a shorter long-term survival and lower limb salvage rate.
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Hart, Odette, Nicole Xue, Brittany Davis-Havill, Mark Pottier, Minesh Prakash, Sascha-Akito Reimann, Jasmin King, William Xu, and Manar Khashram. "The Incidence of Chronic Limb-Threatening Ischemia in the Midland Region of New Zealand over a 12-Year Period." Journal of Clinical Medicine 11, no. 12 (June 9, 2022): 3303. http://dx.doi.org/10.3390/jcm11123303.

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The epidemiology of severe PAD, as characterized by short-distance intermittent claudication (IC) and chronic limb-threatening ischemia (CLTI), remains undefined in New Zealand (NZ). This was a retrospective observational cohort study of the Midland region in NZ, including all lower limb PAD-related surgical and percutaneous interventions between the 1st of January 2010 and the 31st of December 2021. Overall, 2541 patients were included. The mean annual incidence of short-distance IC was 15.8 per 100,000, and of CLTI was 36.2 per 100,000 population. The annual incidence of both conditions was greater in men. Women presented 3 years older with PAD (p < 0.001). Patients with short-distance IC had lower ipsilateral major limb amputation at 30 days compared to CLTI (IC 2, 0.3% vs. CLTI 298, 16.7%, p < 0.001). The 30-day mortality was greater in elderly patients (<65 years 2.7% vs. ≥65 years 4.4%, p = 0.049), but did not differ depending on sex (females 36, 3.7% vs. males 64, 4.1%, p = 0.787). Elderly age was associated with a worse survival for both short-distance IC and CLTI. There was a worse survival for females with CLTI. In conclusion, PAD imposes a significant burden in NZ, and further research is required in order to reduce this disparity.
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Kim, Tanner I., and Peter A. Schneider. "New Innovations and Devices in the Management of Chronic Limb-Threatening Ischemia." Journal of Endovascular Therapy 27, no. 4 (May 18, 2020): 524–39. http://dx.doi.org/10.1177/1526602820921555.

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As the number of patients afflicted by chronic limb-threatening ischemia (CLTI) continues to grow, new solutions are necessary to provide effective, durable treatment options that will lead to improved outcomes. The diagnosis of CLTI remains mostly clinical, and endovascular revascularization remains mostly balloon-based. Multiple innovative techniques and technologies are in development or in early usage that may provide new solutions. This review categorizes areas of advancement, highlights recent developments in the management of CLTI and looks forward to novel devices that are currently under investigation.
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Dissertations / Theses on the topic "CLTI"

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Livas, Charalampos. "Building extension through additional CLT storeys." Thesis, Luleå tekniska universitet, Institutionen för teknikvetenskap och matematik, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-82227.

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In the last decade, the use of cross-laminated timber (CLT) panels as load bearing elements have become a usual solution for buildings and structures with an upward trend internationally. This is because CLT has brilliant physical and mechanical properties and it is also an eco-friendly and renewable material. In addition, the prefabricated nature of the CLT panels in a controlled environment increases the overall building speed, reduces dramatically the erection time, and makes it an even more competitive structural material compared to more traditional ones like concrete and steel. Up until now, timber as a building material has mainly been used for roofs and pergolas in Greece. Concrete and steel have traditionally been the dominant building materials over the years. Timber is not such competitive mainly because there is not enough knowledge of abouttimber buildings. The fact that Greece is not a sawn timber producer affects this trend. Nowadays, the simple and cheap import of sawn timber, as well as the sensitiveness about the environment, are strong factors for introducing timber buildings to Greece. There is already a great demand for timber buildings, and an increase in the requests is expected.CLT panels are used in a wide spectrum of structural applications. They are used as structural components for houses, offices, multi-story buildings, schools, industrial halls, sports halls, and special structures [4]. Another innovative application of CLT is the renovation through vertical expansion with additional floors to existing buildings. This new and promising trend is becoming more and more frequent, especially in developing cities where there is a need for new houses in limited space. The low density of CLT and so the low overall weight of the additional structure, makes the CLT components a robust building solution for vertical renovation since there is usually no need for reinforcement of the foundations of the current building [15]. The aim of this study is to provide the author with the opportunity to deepen his knowledge regarding the special characteristics of CLT as a building material as well as to understand its mechanical properties and the theories which describe them. In addition, this study constitutes the first attempt at modeling and designing a timber structure made with CLT panels. Therefore, the knowledge gained about the special features in CLT modeling is a fundamental task. Finally, since the design of the CLT structure is based on the European design rules for buildings, the engagement with the appropriate Eurocodes, i.e. Eurocode 0, 1 & 5, is another critical task in this study. The structure under consideration is a two-story CLT structure which is a vertical expansion of a current composite (concrete-steel) building. The first additional floor will be used as an office area and the second one as a typical family house. Both additional floors are made of CLT elements and, where is necessary, glulam beams and columns are considered as reinforcement of the CLT panels and as supports, respectively. The design method includes finite element analysis (FEA) which is performed by the commercial structural softwareDLUBAL – RFEM [8]. In this study, the latter software is chosen for the design and the analysis of the structure since it is specialized software for timber structures made of CLT elements.
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Pancetti, Alessandra Roque. "Caracterização parcial da toxina citoletal distensora (CLTD) de escherichia coli." [s.n.], 1997. http://repositorio.unicamp.br/jspui/handle/REPOSIP/316684.

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orientador: Domingos da Silva Leite
Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia
Made available in DSpace on 2018-07-22T16:22:18Z (GMT). No. of bitstreams: 1 Pancetti_AlessandraRoque_M.pdf: 4244205 bytes, checksum: 53fdcd93d28647a26b93f7db9190a2f2 (MD5) Previous issue date: 1997
Resumo: Neste trabalho foram pesquisadas as melhores condições de cultivo e estocagem da amostra de Escherichia coli 86-6136 para a produção da Toxina Citoletal Distensora (CLDT), assim como o melhor método de extração e purificação para a caracterização parcial da toxina. Após o que, foi realizada a produção de anticorpos neutralizantes policlonais em coelhos albinos e a análise dos efeitos citopáticos e citotóxicos da CLDT em cultura de células. O melhor meio para cultivo da amostra 86-6136 encontrado foi o "Evans Toxin Medium", pois com este meio foi verificada a produção de CLDT em ensaios de atividade citotóxica em cultura de células, com efeito semelhante ao descrito em literatura. Os estudos de obtenção da toxina demonstraram que o método mais vantajoso para a extração era a ultrasonicação do sedimento bacteriano, pois dispendia menos tempo e havia boa recuperação da atividade citotóxica, quando comparado com os outros métodos empregados, além de existir ganho no rendimento de mais de 4 vezes em atividade específica e 2 vezes em citotoxicidade, quando comparado ao sobrenadante inicial. Após a extração, o material foi submetido a diversos processos cromatográficos (Deae-Sepharose Fast-Flow; CM-Sepharose Fast-Flow; Phenil Sepharose; Sepharose CL6B; Sepharose CL4B; Superdex 200). A cromatografia que teve mais relevância para melhorar o grau de pureza da amostra foi em Sepharose CL6B. A amostra, quando submetida a cromatografia nesta resina, mostrou padrão de eluição com 3 picos, sendo que a atividade biológica estava concentrada no primeiro pico. Em eletroforese com SDS-P AGE, o material contendo atividade biológica apresentou 3 bandas, com os pesos moleculares estimados em 38,8; 37,3 e 22,4 kDa. Não foram obtidos resultados em ensaios eletroforéticos em P AGE convencional. Os ensaios cromatográficos em Sepharose CL6B resultaram em aumento de 100 vezes na citotoxicidade da amostra, e 237 vezes em atividade relativa. Os ensaios em cromatografia líquida de alta performance (HPLC) em coluna Mono-Q não permitiram a recuperação da atividade citotóxica da toxina CLDT, e por isso foram abandonados. A atividade da toxina CLDT pôde ser observada em cultura de células Vero, HeLa e CHO. Apenas nas células CHO tanto o efeito citopático quanto o citotóxico foram observados. Em ensaios em células Vero e HeLa, o efeito de distensão celular não é evidente, e em células Vero, a viabilidade celular, ao final das 120 hrs de ensaio, é bem maior em relação às outras duas linhagens. A produção de anticorpo policlonal em coelhos albinos pôde ser verificada em teste de imunodifusão radial dupla, e sua capacidade neutralizante foi observada em ensaios de soroneutralização em cultura de células CHO. Os antissoros obtidos apresentaram atividade neutralizante do efeito citotóxico da toxina CLDT no título até 1/1024
Abstract: In this work, the best conditions of culture and stock methods of EscherichiQ coli 86-6136 strain for the production of citolethal distending toxin (CLDT), as well as its partial characterization, were studied. The production of polyclonal antibodies in rabbits and the study of citophatic and citotoxic effects of CLDT in culture cells was determined. The best growth medium found for CLDT production was Casaminoacid- Yeast Extract CA YE), as determined by biological activity assays in culture cells. The best method for CLDT extraction was sonic disruption of the bacterial cells. Higher yield of citotoxic activity was reached when compared to other methods, in addition to 4-fold increased specific activity and 2-fold citotoxicity, compared to the initial culture supernatant. After bacterial cells disruption, the supernatant was cromatographed on several columns (Deae-Sepharose Fast-Flow; CM-Sepharose Fast-Flow; Phenil-Sepharose; Sepharose CL6B; Sepharose CL4B; Superdex 200). The best method for increasingpurity was Sepharose CL6B. The material was separated in three peaks spectrophotometrically detected (absorbance 280 nm) among these the first one displayed biological activity. On SDS-PAGE, this material exhibited three bands whose M.W. were 38.8, 37.3 and 22.4 kDa. After cromatography on Sepharose CL6B, the material displayed increased citotoxicity and relative activity of 100 and 237-fold, respectively. High-performance liquid chromatography (HPLC) on Mono-Q column resulted in unrecoverable biological activity. The CLDT biological activity could be observed in Vero, ReLa and CRO cultured cells. Only in CRO, both citophatic and citotoxic effects could be observed. In Vero and HeLa cells the cellular progressive distention could not be observed and in Vero cells cellular viability was higher than in the other cells after 120 hr. Production of polyclonal antibodies was verified in Ouchterlony test and its neutralization capability was determined in seraneutralization tests in CHO cells. The sera obtained was shown to neutralize citotoxic activity of CLDT up to the 1/1024 dilution
Mestrado
Microbiologia
Mestre em Ciências Biológicas
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Namroud, Larsana, and Ellen Hansson. "Projektering av KL-träbjälklag i bostäder med hänsyn till spännvidd och ljudkrav." Thesis, Tekniska Högskolan, Jönköping University, JTH, Byggnadsteknik och belysningsvetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-50168.

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Wood construction has increased in the recent years for apartment buildings consisting of four to five floors. Compared to other building materials, wood has great environmental benefits. For a building in a larger scale constructed in wood, cross-laminated timber, also known as CLT is an option. The technology for CLT originated in Sweden during the 1990s and since then the development has increased. CLT has excellent stiffness and strength properties. The design of a floor in CLT is important for how the building and the environment are perceived indoors. The wooden floor is about five times lighter than concrete, which means that measures are required to meet the sound requirements set by Boverkets building regulations in Sweden. This will affect the span. The aim of the project is to present a knowledge overview of CLT and for floor in CLT up to 9 meters in span, to compete with concrete floor in steel and prefabricated concrete frames. The study includes a quantitative methodology using three different data collection methods. These are literature study, document analysis and calculations. The literature study and the document analysis are based on scientific-and research articles, together with manuals. The calculations are carried out in Stora Enso's calculation program Calculatis by Stora Enso. The program follows Eurocode's design principles. The result of the study shows that a CLT-board with laminated beams gives greater span than just a CLT-board does. The calculation means that the plate must meet the deflection requirement L / 300. Research shows that construction with CLT is increasing and there is great potential to obtain a cost-effective reduction of the carbon footprint and at the same time improve the utilization of natural resources by replacing non-renewable building materials such as concrete and steel with CLT. In order to achieve the sound requirements that are established, the CLT floor must be dimensioned thicker and measures such as additional insulation. By looking at the results, the conclusion is drawn that CLT-floor may grow further to compete with concrete floor in the future. Currently the material is considered useful and environmental for smaller constructions for such as smaller houses, due to the sound insulation problem. For larger constructions with the similar problem can timber-concrete composite be an alternative. CLT-floor reinforced with glulam beams may be considered as a choice for larger and bigger constructions because the span widths increase, and the construction can withstand maximum deflection. The study is limited to mainly considering CLT but also a small amount of concrete and glulam. Vibrations and environmental risks such as moisture, sunlight and fire, are not considered. The calculations the work uses are based on Eurocode 5, dimensioning of wooden structures. Other types of design principles have been excluded.
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Harmachova, Karolina. "Vibration performance of hybrid steel-CLT floors." Thesis, KTH, Byggnadsmaterial, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-192475.

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In the light of today’s effort to achieve sustainable future of the planet, timber as building material makes a comeback on the construction market. Since the requirements on the buildings and the internal comfort increase, there is a need for finding new solutions and products; one of them is cross-laminated timber (CLT), which has the potential to be used for high-rise buildings due to its mechanical properties. The aim of this work was to study the vibration performance of CLT floors as it is often the governing factor in design of CLT structures unlike for other common building materials. The orthotropic mechanical properties of CLT were determined by the shear analogy method and verified with a finite element (FE) model of a simply supported beam compared to hand calculations of shear forces, bending moments and deflections. The properties based on Timoshenko’s approach were evaluated as less precise regarding the deflection. The non-composite structural behaviour of a steel-CLT hybrid floor structure was predicted for FE dynamic analysis based on a comparison between modelling exercise and hand calculations. Two different methods, the Concrete Society (SC) and Steel Construction Institution (SCI) methods, both seemed to be applicable for determination of the response factor first since the mechanical properties are not used as input in the calculations. These two methods differ in certain aspects, and based on FE analysis of simply supported slab even the resulting response factor for the CLT differs significantly. Moreover, the hand calculation results were similar to those of the FE analysis for the CS method, but in less agreement for the SCI method. Nevertheless, it is not recommended to reject the latter method based on this study and further studies should be performed on real structures with response factor known from on-site measurements. A part of the first floor of Canary Wharf College was modelled and analysed, and previous measurements of the frequency and response factors enabled a validation of some assumptions. The SCI approach showed to be inadequate for this type of structure and therefore only the CS method was applied further. Analysis of the floor structures supported by walls demonstrated similar results from both the measurements and the dynamic analysis. However, if the floor slab was supported by beams, the response factor was significantly overestimated although on the conservative side. This difference suggests that the modelling of such conditions are not satisfactory. The CS method appears to assess correctly the magnitude of the response factor for CLT floors supported by walls but overestimates it in case of beam supports. The first finding shall be confirmed through analysis of other structures and a more extensive research should focus on the latter one to determine more exact behaviour of the model under different conditions.
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Eriksson, Richard, and Maria Karlsson. "Effect of birch in CLT elements : An investigation of how introducing birch effects the strength properties of CLT elements." Thesis, KTH, Bro- och stålbyggnad, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-280361.

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In this thesis, material properties for a CLT element have been examined with regard to the structure of theelement and its content of different types of wood. The focus has been on how Birch affects the properties,since its properties in shear are much better compared to the commonly used pine and spruce.Calculations have been made in python script within the Rhino 6 software and its Grasshopper plugin.Grasshopper basically works with coding but with a visual interface that is very user friendly. This programhas been used because of its parametric structure which makes changes in the structure very simple andthe whole model changes with the changes in parameters.The basis for the survey has been the following parameters:• Number of layers within the KL element• Widths of lamellae• Thicknesses of lamellae• Material properties of Birch, Pine and Spruce• Quotas between Birch, Pine and SpruceThe results show that the shear stiffness of the CLT-element increases with the amount of birch. The value ofthe G-moduli, however, does not only depend on the amount but the positioning as well. The shear stiffnessis the greatest when the birch is placed closest to the middle of the element.The conclusion made is that further investigation of the practical and economical aspects are required to makean informed decision about whether the use of birch or increased board width is the most efficient method ofimproving the shear stiffness of CLT.
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Yeager, Mary Elizabeth Bratton. "A cross-validation study of the college learning effectiveness inventory (CLEI)." Diss., Manhattan, Kan. : Kansas State University, 2009. http://hdl.handle.net/2097/1647.

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Pai, Sai Ganesh Sarvotham. "Force transfer around openings in CLT shear walls." Thesis, University of British Columbia, 2014. http://hdl.handle.net/2429/51632.

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During an earthquake, shear walls can experience damage around corners of doors and windows due to development of stress concentration. Reinforcements provided to minimize this damage are designed for forces that develop at these corners known as transfer forces. In this thesis, the focus is on understanding the forces that develop around opening corners in cross laminated timber (CLT) shear walls and reinforcement requirements for the same. In the literature, four different analytical models are commonly considered to determine the transfer force for design of wood-frame shear walls. These models have been reviewed in this thesis. The Diekmann model is found to be the most suitable analytical model to determine the transfer force around a window-type opening. Numerical models are developed in ANSYS to analyse the forces around opening corners in CLT shear walls. CLT shear walls with cut-out openings are analysed using a three-dimensional brick element model and a frame model. These models highlight the increase in shear and torsion around opening corners due to stress concentration. The coupled-panel construction practice for CLT shear walls with openings is analysed using a continuum model calibrated to experimental data. The analysis shows the increase in strength and stiffness of walls, when tie-rods are used as reinforcement. Analysis results also indicate that the tie-rods should be designed to behave linearly for optimum performance of the wall. Finally, a linear regression model is developed to determine the stiffness of a simply-supported CLT shear wall with a window-type opening. This model provides insight into the effect of various geometrical and material parameters on the stiffness of the wall. The process of model development has been explained, which can be improved further to include the behaviour of anchors.
Applied Science, Faculty of
Civil Engineering, Department of
Graduate
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Mancha, André Luiz Pereira. "Wage differential between statutory and CLT public employees." reponame:Repositório Institucional do FGV, 2018. http://hdl.handle.net/10438/24643.

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Since 1998 in the Public Administration there are statutory workers ('estatutários') and others hired by the CLT labor regime ('celetistas'). Thisfact occurs due the Constitutional Amendment number 19 , formulated that year, which has changed the article 39 of Brazilian Constitution. It allowed public entities to hire employees under CLT legislation. This situation lasted until 2007 when the Supreme Court of Brazil suspended such modification and so the original understanding of the Constitution was reestablished. This work intends to evaluate the wage differential between statutory and CLT employees by means of an econometric approach. Using a fixed effectsregression we have analyzed the impact of the labor regime upon public workers wages and using the Oaxaca-Blinder decomposition we quantified how much of such differential is due the labor regime and how much is due to the individual characteristics (education, tenure and others). There are evidences that CLT workers have in average wages R$ 310.00 lower than statutory. Controlling by occupation we also see a negative prize to CLT worker to all groups except by the High Skilled Workers that have a salary R$ 95.98 higher than the Statutory. Low Skilled Workers show the smallest differential (R$ 12.20) followed by Teachers and Researchers (R$ 85.27) and Technicians (R$ 97.11). The Oaxaca-Blinder decomposition shows that the largest part is not explained by endowments differences. The spending with wages and benefits to public employees is one of the main debates in the current scenario of fiscal adjustment facing the relevant increase of Public Debt in the last years. The Brazilian society has a perception that the Government has an excessive amount of workers and furthermore these onesreceive higher wages without a reasonable explanation when compared to similar occupations in private companies. At the end of 2017 the Brazilian Government presented an action plan to reduce the spending with wages and benefits of public employees. Among the proposals there were a decrease in the initial salary of public service and an increase in the public pension plan contribution.
Desde o ano de 1998 coexistem na Administração Direta, Autarquias e Fundações Públicas, funcionários públicos estatutários e 'celetistas'. Esta situação decorre da Emenda 19, a qual alterou o artigo 39 da Constituição e permitiu que estas entidades contratassem funcionários pela CLT. Essa situação perdurou até o ano de 2007, quando o Supremo Tribunal Federal (STF)suspendeu liminarmente (ADI 2135) a nova redação e dessa forma restaurou a situação original, válida atualmente. Este trabalho se propõe a medir a diferença no salário entre servidores públicos estatutários e celetistas por meio de uma abordagem econométrica. Utilizando uma regressão de efeitos fixos foi analisado o impacto do regime de trabalho sobre o salário dos servidores e por meio da decomposição de Oaxaca-Blinder estimou-se quanto desta diferença decorre do regime de trabalho e quanto se deve às características dos indivíduos de cada grupo (escolaridade, experiência e outros). Há indícios de que os celetistas recebem um salário R$ 310.00 menor do que seus pares estatutários. Controlando os efeitos de cada profissão há um diferencial negativo para todas os celetistas exceto para os profissionais de alta qualificação os quais possuem um salário R$ 95.98 maior do que os estatutários. Com relação aos outros grupos, os profissionais de baixa qualificação apresentam o menor diferencial de salários (R$ 12.20) seguido por professores e pesquisadores (R$ 85.27) e técnicos (R$ 97.11). Na decomposição do diferencial a maior parte não decorre de diferenças nas características dos indivíduos de cada grupo. O impacto dos salários e benefícios de funcionários públicos sobre as contas públicas é um dos principais pontos debatidos dentre as propostas que englobam o plano de ajuste fiscal do Governo Brasileiro. A percepção atual da sociedade é que além do governo contar com um contingente significativo de servidores públicos, estes recebem maiores salários quando comparados a trabalhadores em atividades semelhantes na iniciativa privada. Nesse contexto o governo federal apresentou no final de 2017 uma série de medidas para adequação dos gastos com folha de pagamento de servidores públicos, dentre elas a redução do salário inicial e elevação da contribuição previdenciária destes trabalhadores.
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Williams, A. Lynn, Sharynne McLeod, Rebecca J. McCauley, Steven F. Warren, and Marc E. Fey. "Interventions for Speech Sound Disorders in Children (CLI)." Digital Commons @ East Tennessee State University, 2010. https://www.amzn.com/1598570188.

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With detailed discussion and invaluable video footage of 23 treatment interventions for speech sound disorders (SSDs) in children, this textbook and DVD set should be part of every speech-language pathologist's professional preparation. Focusing on children with functional or motor-based speech disorders from early childhood through the early elementary period, this textbook gives preservice SLPs critical analyses of a complete spectrum of evidence-based phonological and articulatory interventions. This textbook fully prepares SLPs for practice with a vivid inside look at intervention techniques in action through high-quality DVD clips large and varied collection of intervention approaches with widespread use across ages, severity levels, and populations proven interventions in three categories: direct speech production, broader contexts such as perceptual intervention, and speech movements clear explanations of the evidence behind the approaches so SLPs can evaluate them accurately contributions by well-known experts in SSDs from across the US, Canada, Australia, and the UK An essential core text for pre-service SLPs—and an important professional resource for practicing SLPs, early interventionists, and special educators—this book will help readers make the best intervention decisions for children with speech sound disorders. Evidence-based intervention approaches—demonstrated in DVD clips—such as: minimal pairs perceptual intervention core vocabulary stimulability treatment intervention for developmental dysarthria the psycholinguistic approach
https://dc.etsu.edu/etsu_books/1180/thumbnail.jpg
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Rasheed, Mollah Mohammed Haroon Ar. "Communicative Language Teaching (CLT) in Bangladesh: Effectiveness and Enhancements." Thesis, University of Canterbury. School of Teacher Education, 2011. http://hdl.handle.net/10092/9450.

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This investigation reports on a study that explores the views of students, teachers and parents about the Communicative Language Teaching (CLT) approach in learning English as a second language in Bangladesh. This study focuses on the improvement of English language outcomes in Bangladesh. Though compulsory for fifteen years of schooling, public examination results indicate that students perform poorly in English. This research is conducted at the secondary schools in Bangladesh where English is compulsory because of its global nature as the second or foreign language. Mainstream students learning English using the Communicative Language Teaching (CLT) approach are facing many challenges. The study employs a mixed methods approach which includes qualitative interviews, semi-structured focus group interviews and observations; and quantitative data involved achievement tests to find gaps between oral and written attainment, in order to determine the effectiveness of CLT developing language skills to communicate in and outside the classrooms. ESL learners in Bangladesh have been using CLT for nearly two decades, but the attainments are not satisfactory particularly in oral language (listening and speaking) compared to written language (reading and writing). Four schools (two high and two low achievement) were selected from two divisional cities according to the public examination results. Five students, all English subject teachers and five parents from each school were invited randomly to participate. Findings indicated a confirmation of the gap between oral and written language achievements and highlighted that CLT is not working effectively to develop communicative competence to the learners. The participants identified several factors causing this. Among these were large class sizes (number of students), an extensive curriculum, insufficient class time (duration), an inappropriate examination system, excessive teacher workload, lack of parent awareness of CLT, and negative relationships between home and school. All of these factors impact on the effectiveness of CLT in Bangladesh. All participants agreed that CLT as an approach is better than other approaches used in Bangladesh to develop English language learning, but the varied interpretation and implementation (practice) makes it less effective. Therefore, they suggested some issues for local and national level policy makers that could enhance the CLT practice in Bangladesh.
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Books on the topic "CLTI"

1

Hull, Jeannie. Clai. Caerdydd: Dref Wen, 1989.

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Aley, Rob. PHP CLI. Berkeley, CA: Apress, 2016. http://dx.doi.org/10.1007/978-1-4842-2238-6.

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Martins, Sérgio Pinto. Comentários à CLT. São Paulo: Editora Atlas, 1998.

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Whipple, A. B. C. Los cli pers. Barcelona: Folio, 1995.

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Ragunathan, Vivek. C++/CLI Primer. Berkeley, CA: Apress, 2016. http://dx.doi.org/10.1007/978-1-4842-2367-3.

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Kowalski, Robert. The CLI Book. Berkeley, CA: Apress, 2017. http://dx.doi.org/10.1007/978-1-4842-3177-7.

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Hughes, Holly. Clit notes: A Sapphic sampler. New York: Grove Press, 1996.

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Synesius. Synésios de Cyréne.: Lettres LXIII-CLVI. Paris: Les Belles Lettres, 2000.

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Brazil. CLT e legislação correlata. Edited by Editora Revista dos Tribunais. São Paulo: Editora Revista dos Tribunais, 2005.

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Atkin, Denny. Sony CLI For Dummies. New York: John Wiley & Sons, Ltd., 2004.

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Book chapters on the topic "CLTI"

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Forsyth, James Michael. "Chronic Limb-Threatening Ischaemia (CLTI)." In How to Be a Safe Consultant Vascular Surgeon from Day One, 68–76. Boca Raton: CRC Press, 2022. http://dx.doi.org/10.1201/b23010-8.

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Hüttner, W. "195 ClTi X 4Φi Titanium chloride." In Diamagnetic Diatomic Molecules. Part 1, 271. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-540-69954-5_197.

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Hüttner, W. "196 ClTi+ X 3Φr Chlorotitanium(1+) ion." In Diamagnetic Diatomic Molecules. Part 1, 272. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-540-69954-5_198.

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Christen, Dines. "Molecular Constants of ClTi X 4Φ Titanium Monochloride." In Molecular Constants Mostly from Microwave, Molecular Beam, and Sub-Doppler Laser Spectroscopy, 473–87. Berlin, Heidelberg: Springer Berlin Heidelberg, 2017. http://dx.doi.org/10.1007/978-3-662-49199-7_139.

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Christen, Dines. "Molecular Constants of ClTi+ X 3Φ Titanium Monochloride (1+) Ion." In Molecular Constants Mostly from Microwave, Molecular Beam, and Sub-Doppler Laser Spectroscopy, 488–500. Berlin, Heidelberg: Springer Berlin Heidelberg, 2017. http://dx.doi.org/10.1007/978-3-662-49199-7_140.

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Späth, Peter. "CLI." In Pro Android with Kotlin, 469–77. Berkeley, CA: Apress, 2018. http://dx.doi.org/10.1007/978-1-4842-3820-2_18.

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Späth, Peter. "CLI." In Pro Android with Kotlin, 615–24. Berkeley, CA: Apress, 2022. http://dx.doi.org/10.1007/978-1-4842-8745-3_19.

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Kaiser, Richard. "C++/CLI." In Xpert.press, 937–1097. Berlin, Heidelberg: Springer Berlin Heidelberg, 2009. http://dx.doi.org/10.1007/978-3-540-68844-0_9.

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Gladwin, Derek. "Cli-fi." In Ecological Exile, 167–85. Abingdon, Oxon ; New York, NY : Routledge is an imprint of the Taylor & Francis Group, an Informa Business, [2018] | Series: Routledge environmental humanities: Routledge, 2017. http://dx.doi.org/10.9774/gleaf.9781315641478_10.

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Harris, Ivan. "Salesforce CLI." In Beginning Salesforce DX, 35–68. Berkeley, CA: Apress, 2022. http://dx.doi.org/10.1007/978-1-4842-8114-7_4.

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Conference papers on the topic "CLTI"

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Yang, Zixuan, Lin Wang, and Xiaofan Wang. "Controllability of Multilayer Drive-response Networked CLTI Systems." In 2022 13th Asian Control Conference (ASCC). IEEE, 2022. http://dx.doi.org/10.23919/ascc56756.2022.9828173.

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van den Heuvel, Robert. "Surgery with adequate saphenous vein partly better than endovascular treatment in CLTI." In AHA Scientific Sessions 2022, edited by Marc Bonaca. Baarn, the Netherlands: Medicom Medical Publishers, 2023. http://dx.doi.org/10.55788/777a1ff6.

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Alsumait, Asmaa, and Maha Fasial. "CLTD." In iiWAS2018: 20th International Conference on Information Integration and Web-based Applications & Services. New York, NY, USA: ACM, 2018. http://dx.doi.org/10.1145/3282373.3282846.

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Pham, Hubert, Justin Mazzola Paluska, Rob Miller, and Steve Ward. "Clui." In the 25th annual ACM symposium. New York, New York, USA: ACM Press, 2012. http://dx.doi.org/10.1145/2380116.2380141.

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"CLEI 2019 Preface." In 2019 XLV Latin American Computing Conference (CLEI). IEEE, 2019. http://dx.doi.org/10.1109/clei47609.2019.9073969.

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"CLEI 2019 Sponsors." In 2019 XLV Latin American Computing Conference (CLEI). IEEE, 2019. http://dx.doi.org/10.1109/clei47609.2019.9073974.

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"CLEI 2019 Organizing Committee." In 2019 XLV Latin American Computing Conference (CLEI). IEEE, 2019. http://dx.doi.org/10.1109/clei47609.2019.9073824.

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"CLEI 2019 Program Committee." In 2019 XLV Latin American Computing Conference (CLEI). IEEE, 2019. http://dx.doi.org/10.1109/clei47609.2019.9073955.

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"CLEI 2022 Cover Page." In 2022 XVLIII Latin American Computer Conference (CLEI). IEEE, 2022. http://dx.doi.org/10.1109/clei56649.2022.9959923.

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"CLEI 2022 Cover Page." In 2022 XVLIII Latin American Computer Conference (CLEI). IEEE, 2022. http://dx.doi.org/10.1109/clei56649.2022.9959921.

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Reports on the topic "CLTI"

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Augsburg, Britta, Laura Abramovsky, Erin Flynn, and Francisco Oteiza. Improving CLTS targeting: evidence from Nigeria. IFS, June 2016. http://dx.doi.org/10.1920/bn.ifs.2016.0183.

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Augsburg, Britta, Laura Abramovsky, and Francisco Oteiza. Sustainable Total Sanitation – Nigeria: second CLTS impact evaluation report. The IFS, October 2017. http://dx.doi.org/10.1920/re.ifs.2017.0134.

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Tesink, K., and R. Fox. A Uniform Resource Name (URN) Namespace for the Common Language Equipment Identifier (CLEI) Code. RFC Editor, August 2005. http://dx.doi.org/10.17487/rfc4152.

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Rachev, S. T., and J. E. Yukich. Convolution Metrics and Rates of Convergence in the CLT (Central Limit Theorem). Fort Belvoir, VA: Defense Technical Information Center, October 1987. http://dx.doi.org/10.21236/ada189341.

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Kohlitz, Jeremy, Naomi Carrard, and Juliet Willett. Support Mechanisms to Strengthen Equality and Non-Discrimination (EQND) in Rural Sanitation (Part 2 of 2). Institute of Development Studies (IDS), July 2019. http://dx.doi.org/10.19088/slh.2020.003.

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A renewed focus on equity is being driven by the Human Rights to Water and Sanitation framework and Sustainable Development Goal 6.2, which emphasise the importance of adequate and equitable sanitation for all. However, as raised in Part 1 of this issue on equality and non-discrimination (EQND), there is evidence that CLTS processes for achieving community-wide outcomes are not always systematic, adequate, sustained, or sufficient to meet the needs of disadvantaged groups. A compilation of 50 CLTS and rural sanitation programmes around the world that significantly used support mechanisms was gathered to inform this issue. Our rapid review of the programmes found that although numerous trials existed, few had been taken to scale, few were located outside of Asia, and many did not have disaggregated monitoring and evaluation information that is publicly shared or collected at all. This issue therefore emphasises the importance of monitoring, evaluating and knowledge sharing processes in building an evidence base for facilitating equitable rural sanitation outcomes.
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Smith, Aaron. Test Setup Design and Cyclic Evaluation of Rocking CLT Wall and Floor Restoring Force Lateral System. Portland State University, June 2019. http://dx.doi.org/10.15760/ccemp.46.

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Falk, Robert H., James J. Bridwell, Tom Williamson, and Todd Black. Development of a ready-to-assemble tornado shelter from cross-laminated timber (CLT): impact and wind pressure testing. Madison, WI: U.S. Department of Agriculture, Forest Service, Forest Products Laboratory, 2019. http://dx.doi.org/10.2737/fpl-gtr-266.

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Hickling, Sophie. Tackling Slippage. Institute of Development Studies (IDS), September 2019. http://dx.doi.org/10.19088/slh.2020.004.

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This issue of Frontiers of CLTS explores current thinking and practice on the topic of tackling slippage of open defecation free (ODF) status. It looks at how slippage is defined and identified, and at different patterns of slippage that are seen after ODF is declared. Although a considerable amount has been written on how to establish strong Community-Led Total sanitation (CLTS) programmes that prevent slippage from happening, this issue looks at how to reverse slippage that has already taken place. Note however, that at a certain level, strategies used to reverse slippage and those used in advance to set a programme up for success to prevent slippage occurring overlap. From the literature, there is little documented evidence on how slippage can be reversed; evidence and guidance tend to focus on prevention. This review begins to address this gap. Implementers are encouraged to use the proposed patterns of slippage framework and slippage factors section to understand the type and extent of slippage experienced, then use the examples in the section on tackling slippage to identify potential slippage responses. In addition to a review of current literature,1 in depth interviews were carried out with key informants at global, regional and country level. Key informants were selected purposively to identify experiences and innovations in tackling slippage from across the sector.
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Cavill, Sue, Joanna Mott, Paul Tyndale-Biscoe, Matthew Bond, Chelsea Huggett, and Elizabeth Wamera. Engaging Men and Boys in Sanitation and Hygiene Programmes. Institute of Development Studies (IDS), August 2018. http://dx.doi.org/10.19088/slh.2020.002.

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This issue of Frontiers of CLTS shares and builds on the learning from a desk study that explores examples of men’s and boys’ behaviours and gender roles in sanitation and hygiene (S&H). Of particular interest is the extent to which the engagement of men and boys in S&H processes is leading to sustainable and transformative change in households and communities and reducing gendered inequality. The review focuses on men and boys: how to engage them (or not), how to mobilise them as allies in the transformation of S&H outcomes and the problems they contribute to and experience.
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Kumar, Avni, Jeremy Kohlitz, and Juliet Willetts. Mainstreaming Climate Risks into Rural Sanitation Programming in Lao PDR. Institute of Development Studies, November 2022. http://dx.doi.org/10.19088/slh.2022.022.

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Despite climate change being a major concern for the sanitation sector, rural sanitation remains neglected in the wider discussions of climate impacts on WASH services. Also, the voices of vulnerable individuals, households, and communities who are experiencing the effects of climate change in relation to sanitation issues are missing. This learning brief presents learnings from a practitioner’s experience of integrating climate risk considerations into a Community-Led Total Sanitation (CLTS) programme. The interventions were piloted across three districts of Savannakhet province with a focus on villages that have frequently experienced heavy rainfall and flooding in the past. The learning brief is intended to provide inspiration and ideas to WASH experts and practitioners with interest in integrating considerations of climate change into rural sanitation programming.
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