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Electromagnetic interference in pacemakers has almost always been reported in association with the cutting mode of monopolar electrocautery and rarely in association with the coagulation mode. We report a case of electrocautery-induced electromagnetic interference with a DDDR pacemaker (dual-chamber paced, dual-chamber sensed, dual response to sensing, and rate modulated) in the coagulating and not cutting mode during a spine procedure. We also discuss the factors affecting intraoperative electromagnetic interference. A 74-year-old man experienced intraoperative electromagnetic interference that resulted in asystole caused by surgical electrocautery in the coagulation mode while the electrodispersive pad was placed at different locations and distances from the operating site (This electromagnetic interference did not occur during the use of the cutting mode). However, because of careful management, the outcome was favorable. Clinicians should be aware that the coagulation mode of electrocautery can cause electromagnetic interference and hemodynamic instability. Heightened vigilance and preparedness can ensure a favorable outcome.

Construction law is a vital component of the body of knowledge that is needed by construction professionals in order to successfully operate in the commercial world of construction. Construction law plays an important role in shaping building projects. Construction projects are complex because they involve many human and non-human factors and variables. Teaching construction law is therefore a complex issue with several dimensions. In recent years, Information Technology (IT) has become strongly established as a supporting tool for many professions, including teachers. If faculty members have a knowledge base established on similar past projects, it would assist the faculty members to present case studies and contractually based scenarios to students. This paper proposes potential utilisation of a Knowledge-based System (KBS) for teaching construction law to built environment students. The KBS is primarily designed for building professionals to learn from similar past projects. The KBS is able to assist professionals by providing accurate and timelyinformation for decision making and a user-friendly tool for analysing and selecting the suggested controls for variations in educational buildings. It is recommended that the wealth of knowledge available in the KBS can be very helpful in teaching construction law to built environment students. The system presents real case studies and scenarios to students to allow them to analyse and learn construction law. The KBS could be useful to students as a general research tool because the students could populate it with their own data and use it with the reported educational projects. With further generic modifications, the KBS will also be useful for built environment students to learn about project management of building projects; thus, it will raise the overall level of professional understanding, and eventually productivity, in the construction industry.

Purpose - To provide an in-depth analysis of the potential effects of variations in institutional building projects, which would be helpful for building professionals in assessing and taking proactive measures for reducing the adverse impact of variations. Design/methodology/approach - To achieve the study objectives, a questionnaire survey was carried out to collect information on potential effects of variations. Responses from 28 professionals working for a developer organization (a government agency) were analyzed. Furthermore, 26 face-to-face interviews using the questionnaires were also analyzed. Findings - The results suggest that the most frequent effects of variations were increase in project costs, additional payments for contractor, progress affected but without any delay, completion schedule delay, increase in overhead expenses and rework and demolition. Recommendations were suggested based on the findings of the research and literature review. Research limitations/implications - This paper presented only the developers' view of the effects of variation orders on institutional building projects in Singapore. Further works can be extended to survey the consultants and the contractors who have carried out these projects. Practical implications - The study will benefit the professionals involved with institutional building projects. The professionals would learn about the downstream effects that may assist in the valuable evaluation of variation orders. Originality/value - This is a timely study as the program of rebuilding and improving existing institutional buildings is currently underway in Singapore. A clearer view of the effects of variations on the projects will enable the project team to take advantage of beneficial variations. Furthermore, the findings can be used by future researchers to carry out studies on the management of variation orders in various other types of projects. [ABSTRACT FROM AUTHOR]