Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Contribution à l'étude du comportement mécanique des structures bois-béton avec joints collés

This thesis explores the mechanical behaviour of adhesively bonded TCC joints and beams Through experimental and numerical investigations.The mechanical behaviour of the adhesive bonded joints between timber (GL24h) and self-compacting concrete (SCC) set by the dry or wet bonding process is investigated. For this purpose, double push-out shear tests on TCC joints bonded by epoxy resin of adhesives were performed. The role of several variables was considered for both fabrication processes. These parameters were: variation of moisture content (m.c.) of timber, adhesive type, adhesive thickness, sand addition, concrete surface treatment, and scale of bonding length. The results showed that glueing seems to be a feasible alternative instead of mechanical means for producing dry and wet TCC joints. Under dry conditions of timber elements, the shear strength can be considered highly satisfactory, with a mean value range of 6-8MPa. The failure mode is primarily affected by concrete and timber failure. However, the findings confirm the hypothesis that increasing the moisture content of the timber before the glueing process significantly reduces the shear strength of adhesively bonded TCC joints by approximately 30% in certain instances.An experimental investigation of the failure characteristics, interface slip, strain distribution, and load-deflection response of adhesively bonded timber-concrete composite (TCC) beams fabricated using wet or dry processes was conducted. A total of six full-scale adhesively bonded TCC beams were produced with a span of 3.2 m and subjected to four-point bending tests. Wet and dry fabricated TCC beams revealed distinct failure modes. The results emphasized the critical role of bonding integrity in ensuring effective composite action and shared contribution mechanism. Wet-fabricated TCC beams exhibited a rigid bonding characterized by a consistent neutral axis alignment and load distribution along the beam span, while dry-fabricated beams experienced interface separation and compromised load-shared contribution, resulting in a significant reduction of the ultimate bending capacity of TCC beams. The outcomes showed that wet and dry TCC beams exhibited comparable load-to-mid-span deflection responses before failure, highlighting uniform behaviour and alignment with fully composite characteristics under the imposed loads.Furthermore, an analytical model for calculating TCC beams is presented and validated. The foundation of the analytical model is established upon the γ-method derived from Eurocode 5. The analytical model is compared with experimental results, highlighting its reliability and precision. Load-deflection responses, bending strain distributions, and ultimate failure loads are accurately captured, affirming the model's capability to anticipate the TCC beam behaviour.Additionally, a 3D non-linear Finite Element (FE) model for adhesively bonded Timber-Concrete Composite (TCC) beams is presented. The model analyzes the deformation behaviour, bending stress distribution, ultimate capacity, and failure characteristics of TCC beams. Despite the challenges that arose in cases of bonding failure, leading to exceptional deviations in behaviour, the results revealed a remarkable agreement between the predictions of the FE model and the outcomes of experimental tests. The FE model accurately predicted the degree of composite action. Notably, the FE model and analytical model based on the γ-method exhibit comparable predictive performance in terms of deformation. Bending stress distribution findings highlighted a strong correspondence between FE simulations and experimental data. Furthermore, the FE model demonstrated efficacy in predicting the ultimate capacity of TCC beams and consistently captured failure modes, indicating its reliability in simulating the complex behaviour of TCC beams.Cette thèse explore le comportement mécanique des joints et des poutres en composite bois-béton (TCC) collés par adhésif à travers des investigations expérimentales et numériques.Le comportement mécanique des joints collés par adhésif entre le bois (GL24h) et le béton auto-plaçant (SCC) formés par un processus de collage à sec ou humide est étudié. À cette fin, des essais de cisaillement double push-out ont été réalisés sur des joints TCC collés par de la résine époxy. Les résultats ont montré que le collage semble être une alternative réalisable aux moyens mécaniques pour produire des joints TCC secs et humides. Dans des conditions de bois sec, la résistance au cisaillement peut être considérée comme très satisfaisante, avec une plage de valeurs moyennes de 6 à 8 MPa. Le mode de rupture est principalement influencé par la rupture du béton et du bois.Une investigation expérimentale des caractéristiques de rupture, du glissement de l'interface, de la distribution des contraintes et de la réponse charge-déformation des poutres en composite bois-béton collées par adhésif, fabriquées selon des procédés humides ou secs, a été menée. Six poutres en composite bois-béton collées par adhésif à échelle réelle ont été produites avec une portée de 3,2 mètres et soumises à des essais de flexion à quatre points. Les poutres en composite bois-béton fabriquées par voie humide ou sèche ont révélé des modes de rupture distincts. Les résultats ont souligné le rôle critique de l'intégrité du collage pour garantir une action composite efficace et un mécanisme de contribution partagée. Les poutres en composite bois-béton fabriquées par voie humide ont présenté un collage rigide caractérisé par un alignement neutre et une distribution de charge uniformes le long de la portée de la poutre, tandis que les poutres fabriquées par voie sèche ont connu une séparation d'interface et une contribution de charge compromise, entraînant une réduction significative de la capacité de flexion ultime des poutres en composite bois-béton. Les résultats ont montré que les poutres en composite bois-béton fabriquées par voie humide et sèche présentaient des réponses de déflexion charge-mi-portée comparables avant la rupture, mettant en évidence un comportement uniforme et un alignement avec des caractéristiques totalement composites sous les charges imposées.De plus, un modèle analytique pour le calcul des poutres en composite bois-béton est présenté et validé. La base du modèle analytique est établie sur la méthode γ dérivée de l'Eurocode 5. Le modèle analytique est comparé aux résultats expérimentaux, mettant en évidence sa fiabilité et sa précision. Les réponses charge-déflexion, les distributions des contraintes de flexion et les charges de rupture ultimes sont capturées avec précision, affirmant la capacité du modèle à anticiper le comportement des poutres en composite bois-béton.En outre, un modèle d'éléments finis non linéaire tridimensionnel (FE) pour les poutres en composite bois-béton collées par adhésif est présenté. Le modèle analyse le comportement de déformation, la distribution des contraintes de flexion, la capacité ultime et les caractéristiques de rupture des poutres en composite bois-béton. Le modèle FE a prédit avec précision le degré d'action composite. Notamment, le modèle FE et le modèle analytique basé sur la méthode γ présentent une performance prédictive comparable en termes de déformation. Les résultats de la distribution des contraintes de flexion ont mis en évidence une correspondance étroite entre les simulations FE et les données expérimentales. De plus, le modèle FE a démontré son efficacité dans la prédiction de la capacité ultime des poutres en composite bois-béton et a capturé de manière cohérente les modes de rupture, indiquant sa fiabilité dans la simulation du comportement complexe des poutres en composite bois-béton

Contribution to the study of mechanical behaviour and the durability of multi-material wood-concrete structures with glued joints

Cette thèse explore le comportement mécanique des joints et des poutres en composite bois-béton (TCC) collés par adhésif à travers des investigations expérimentales et numériques.Le comportement mécanique des joints collés par adhésif entre le bois (GL24h) et le béton auto-plaçant (SCC) formés par un processus de collage à sec ou humide est étudié. À cette fin, des essais de cisaillement double push-out ont été réalisés sur des joints TCC collés par de la résine époxy. Les résultats ont montré que le collage semble être une alternative réalisable aux moyens mécaniques pour produire des joints TCC secs et humides. Dans des conditions de bois sec, la résistance au cisaillement peut être considérée comme très satisfaisante, avec une plage de valeurs moyennes de 6 à 8 MPa. Le mode de rupture est principalement influencé par la rupture du béton et du bois.Une investigation expérimentale des caractéristiques de rupture, du glissement de l'interface, de la distribution des contraintes et de la réponse charge-déformation des poutres en composite bois-béton collées par adhésif, fabriquées selon des procédés humides ou secs, a été menée. Six poutres en composite bois-béton collées par adhésif à échelle réelle ont été produites avec une portée de 3,2 mètres et soumises à des essais de flexion à quatre points. Les poutres en composite bois-béton fabriquées par voie humide ou sèche ont révélé des modes de rupture distincts. Les résultats ont souligné le rôle critique de l'intégrité du collage pour garantir une action composite efficace et un mécanisme de contribution partagée. Les poutres en composite bois-béton fabriquées par voie humide ont présenté un collage rigide caractérisé par un alignement neutre et une distribution de charge uniformes le long de la portée de la poutre, tandis que les poutres fabriquées par voie sèche ont connu une séparation d'interface et une contribution de charge compromise, entraînant une réduction significative de la capacité de flexion ultime des poutres en composite bois-béton. Les résultats ont montré que les poutres en composite bois-béton fabriquées par voie humide et sèche présentaient des réponses de déflexion charge-mi-portée comparables avant la rupture, mettant en évidence un comportement uniforme et un alignement avec des caractéristiques totalement composites sous les charges imposées.De plus, un modèle analytique pour le calcul des poutres en composite bois-béton est présenté et validé. La base du modèle analytique est établie sur la méthode γ dérivée de l'Eurocode 5. Le modèle analytique est comparé aux résultats expérimentaux, mettant en évidence sa fiabilité et sa précision. Les réponses charge-déflexion, les distributions des contraintes de flexion et les charges de rupture ultimes sont capturées avec précision, affirmant la capacité du modèle à anticiper le comportement des poutres en composite bois-béton.En outre, un modèle d'éléments finis non linéaire tridimensionnel (FE) pour les poutres en composite bois-béton collées par adhésif est présenté. Le modèle analyse le comportement de déformation, la distribution des contraintes de flexion, la capacité ultime et les caractéristiques de rupture des poutres en composite bois-béton. Le modèle FE a prédit avec précision le degré d'action composite. Notamment, le modèle FE et le modèle analytique basé sur la méthode γ présentent une performance prédictive comparable en termes de déformation. Les résultats de la distribution des contraintes de flexion ont mis en évidence une correspondance étroite entre les simulations FE et les données expérimentales. De plus, le modèle FE a démontré son efficacité dans la prédiction de la capacité ultime des poutres en composite bois-béton et a capturé de manière cohérente les modes de rupture, indiquant sa fiabilité dans la simulation du comportement complexe des poutres en composite bois-béton.This thesis explores the mechanical behaviour of adhesively bonded TCC joints and beams Through experimental and numerical investigations.The mechanical behaviour of the adhesive bonded joints between timber (GL24h) and self-compacting concrete (SCC) set by the dry or wet bonding process is investigated. For this purpose, double push-out shear tests on TCC joints bonded by epoxy resin of adhesives were performed. The role of several variables was considered for both fabrication processes. These parameters were: variation of moisture content (m.c.) of timber, adhesive type, adhesive thickness, sand addition, concrete surface treatment, and scale of bonding length. The results showed that glueing seems to be a feasible alternative instead of mechanical means for producing dry and wet TCC joints. Under dry conditions of timber elements, the shear strength can be considered highly satisfactory, with a mean value range of 6-8MPa. The failure mode is primarily affected by concrete and timber failure. However, the findings confirm the hypothesis that increasing the moisture content of the timber before the glueing process significantly reduces the shear strength of adhesively bonded TCC joints by approximately 30% in certain instances.An experimental investigation of the failure characteristics, interface slip, strain distribution, and load-deflection response of adhesively bonded timber-concrete composite (TCC) beams fabricated using wet or dry processes was conducted. A total of six full-scale adhesively bonded TCC beams were produced with a span of 3.2 m and subjected to four-point bending tests. Wet and dry fabricated TCC beams revealed distinct failure modes. The results emphasized the critical role of bonding integrity in ensuring effective composite action and shared contribution mechanism. Wet-fabricated TCC beams exhibited a rigid bonding characterized by a consistent neutral axis alignment and load distribution along the beam span, while dry-fabricated beams experienced interface separation and compromised load-shared contribution, resulting in a significant reduction of the ultimate bending capacity of TCC beams. The outcomes showed that wet and dry TCC beams exhibited comparable load-to-mid-span deflection responses before failure, highlighting uniform behaviour and alignment with fully composite characteristics under the imposed loads.Furthermore, an analytical model for calculating TCC beams is presented and validated. The foundation of the analytical model is established upon the γ-method derived from Eurocode 5. The analytical model is compared with experimental results, highlighting its reliability and precision. Load-deflection responses, bending strain distributions, and ultimate failure loads are accurately captured, affirming the model's capability to anticipate the TCC beam behaviour.Additionally, a 3D non-linear Finite Element (FE) model for adhesively bonded Timber-Concrete Composite (TCC) beams is presented. The model analyzes the deformation behaviour, bending stress distribution, ultimate capacity, and failure characteristics of TCC beams. Despite the challenges that arose in cases of bonding failure, leading to exceptional deviations in behaviour, the results revealed a remarkable agreement between the predictions of the FE model and the outcomes of experimental tests. The FE model accurately predicted the degree of composite action. Notably, the FE model and analytical model based on the γ-method exhibit comparable predictive performance in terms of deformation. Bending stress distribution findings highlighted a strong correspondence between FE simulations and experimental data. Furthermore, the FE model demonstrated efficacy in predicting the ultimate capacity of TCC beams and consistently captured failure modes, indicating its reliability in simulating the complex behaviour of TCC beams

Contribution à l'étude du comportement mécanique des structures bois-béton avec joints collés

This thesis explores the mechanical behaviour of adhesively bonded TCC joints and beams Through experimental and numerical investigations.The mechanical behaviour of the adhesive bonded joints between timber (GL24h) and self-compacting concrete (SCC) set by the dry or wet bonding process is investigated. For this purpose, double push-out shear tests on TCC joints bonded by epoxy resin of adhesives were performed. The role of several variables was considered for both fabrication processes. These parameters were: variation of moisture content (m.c.) of timber, adhesive type, adhesive thickness, sand addition, concrete surface treatment, and scale of bonding length. The results showed that glueing seems to be a feasible alternative instead of mechanical means for producing dry and wet TCC joints. Under dry conditions of timber elements, the shear strength can be considered highly satisfactory, with a mean value range of 6-8MPa. The failure mode is primarily affected by concrete and timber failure. However, the findings confirm the hypothesis that increasing the moisture content of the timber before the glueing process significantly reduces the shear strength of adhesively bonded TCC joints by approximately 30% in certain instances.An experimental investigation of the failure characteristics, interface slip, strain distribution, and load-deflection response of adhesively bonded timber-concrete composite (TCC) beams fabricated using wet or dry processes was conducted. A total of six full-scale adhesively bonded TCC beams were produced with a span of 3.2 m and subjected to four-point bending tests. Wet and dry fabricated TCC beams revealed distinct failure modes. The results emphasized the critical role of bonding integrity in ensuring effective composite action and shared contribution mechanism. Wet-fabricated TCC beams exhibited a rigid bonding characterized by a consistent neutral axis alignment and load distribution along the beam span, while dry-fabricated beams experienced interface separation and compromised load-shared contribution, resulting in a significant reduction of the ultimate bending capacity of TCC beams. The outcomes showed that wet and dry TCC beams exhibited comparable load-to-mid-span deflection responses before failure, highlighting uniform behaviour and alignment with fully composite characteristics under the imposed loads.Furthermore, an analytical model for calculating TCC beams is presented and validated. The foundation of the analytical model is established upon the γ-method derived from Eurocode 5. The analytical model is compared with experimental results, highlighting its reliability and precision. Load-deflection responses, bending strain distributions, and ultimate failure loads are accurately captured, affirming the model's capability to anticipate the TCC beam behaviour.Additionally, a 3D non-linear Finite Element (FE) model for adhesively bonded Timber-Concrete Composite (TCC) beams is presented. The model analyzes the deformation behaviour, bending stress distribution, ultimate capacity, and failure characteristics of TCC beams. Despite the challenges that arose in cases of bonding failure, leading to exceptional deviations in behaviour, the results revealed a remarkable agreement between the predictions of the FE model and the outcomes of experimental tests. The FE model accurately predicted the degree of composite action. Notably, the FE model and analytical model based on the γ-method exhibit comparable predictive performance in terms of deformation. Bending stress distribution findings highlighted a strong correspondence between FE simulations and experimental data. Furthermore, the FE model demonstrated efficacy in predicting the ultimate capacity of TCC beams and consistently captured failure modes, indicating its reliability in simulating the complex behaviour of TCC beams.Cette thèse explore le comportement mécanique des joints et des poutres en composite bois-béton (TCC) collés par adhésif à travers des investigations expérimentales et numériques.Le comportement mécanique des joints collés par adhésif entre le bois (GL24h) et le béton auto-plaçant (SCC) formés par un processus de collage à sec ou humide est étudié. À cette fin, des essais de cisaillement double push-out ont été réalisés sur des joints TCC collés par de la résine époxy. Les résultats ont montré que le collage semble être une alternative réalisable aux moyens mécaniques pour produire des joints TCC secs et humides. Dans des conditions de bois sec, la résistance au cisaillement peut être considérée comme très satisfaisante, avec une plage de valeurs moyennes de 6 à 8 MPa. Le mode de rupture est principalement influencé par la rupture du béton et du bois.Une investigation expérimentale des caractéristiques de rupture, du glissement de l'interface, de la distribution des contraintes et de la réponse charge-déformation des poutres en composite bois-béton collées par adhésif, fabriquées selon des procédés humides ou secs, a été menée. Six poutres en composite bois-béton collées par adhésif à échelle réelle ont été produites avec une portée de 3,2 mètres et soumises à des essais de flexion à quatre points. Les poutres en composite bois-béton fabriquées par voie humide ou sèche ont révélé des modes de rupture distincts. Les résultats ont souligné le rôle critique de l'intégrité du collage pour garantir une action composite efficace et un mécanisme de contribution partagée. Les poutres en composite bois-béton fabriquées par voie humide ont présenté un collage rigide caractérisé par un alignement neutre et une distribution de charge uniformes le long de la portée de la poutre, tandis que les poutres fabriquées par voie sèche ont connu une séparation d'interface et une contribution de charge compromise, entraînant une réduction significative de la capacité de flexion ultime des poutres en composite bois-béton. Les résultats ont montré que les poutres en composite bois-béton fabriquées par voie humide et sèche présentaient des réponses de déflexion charge-mi-portée comparables avant la rupture, mettant en évidence un comportement uniforme et un alignement avec des caractéristiques totalement composites sous les charges imposées.De plus, un modèle analytique pour le calcul des poutres en composite bois-béton est présenté et validé. La base du modèle analytique est établie sur la méthode γ dérivée de l'Eurocode 5. Le modèle analytique est comparé aux résultats expérimentaux, mettant en évidence sa fiabilité et sa précision. Les réponses charge-déflexion, les distributions des contraintes de flexion et les charges de rupture ultimes sont capturées avec précision, affirmant la capacité du modèle à anticiper le comportement des poutres en composite bois-béton.En outre, un modèle d'éléments finis non linéaire tridimensionnel (FE) pour les poutres en composite bois-béton collées par adhésif est présenté. Le modèle analyse le comportement de déformation, la distribution des contraintes de flexion, la capacité ultime et les caractéristiques de rupture des poutres en composite bois-béton. Le modèle FE a prédit avec précision le degré d'action composite. Notamment, le modèle FE et le modèle analytique basé sur la méthode γ présentent une performance prédictive comparable en termes de déformation. Les résultats de la distribution des contraintes de flexion ont mis en évidence une correspondance étroite entre les simulations FE et les données expérimentales. De plus, le modèle FE a démontré son efficacité dans la prédiction de la capacité ultime des poutres en composite bois-béton et a capturé de manière cohérente les modes de rupture, indiquant sa fiabilité dans la simulation du comportement complexe des poutres en composite bois-béton

التصرف الانشائي للكمرات الخرسانية المعالجة من الصدا

This research presents the results of a laboratory investigation of the flexural capacity such as strength, deflection and steel mechanical properties for both corroded and repaired corroded beams. Examination of the behavior of crack development was also examined. Fourteen small scaled reinforced concrete beams were used in the testing program. Ten out of them were tested as simply supported beams subjected to two concentrated point loads. Two out of the ten as control beams two others as corroded beams and six of them as repaired beams. The other four were used to investigate the corrosion rate and the mechanicals properties for corroded steel bars. An electrochemical system was used to achieve the corrosion level. The specimens were immersed in a 5 percent of sodium chloride solution for a period of 11 weeks. The beams were connected in parallel to +5 Volts with a capacity of 25 Amperes electric DC current generated by power supply which impressed an equal voltage on each beam to accelerate the corrosion process. Steel bars were immersed in the solution to act as a cathode and to force the steel reinforced concrete beam to act as an anode. Six corroded beams out of the fourteen were structurally repaired after been corroded. Additional longitudinal steel reinforcement bars fixed with shear connectors were added to the flexural corroded reinforcement. Three types of cementitious and resin repairing materials were used to apply a new layer instead of the crashed deteriorated beams bottom concrete cover. It was concluded that the flexural capacity of the corroded beams reduced by about 28 % compared with the control beams and showed a noted reduction in its ductility behavior during the flexural test. The flexural capacity of the repaired beams increased by about 47 % compared with the control beams. They showed good ductility behavior during the flexural test and performed as sound constructed beams regarding their flexural capacity, crack development and deflection. It also concluded that types of repairing materials used for applying a new layer to corroded beams did not affect the flexural performance of repaired beams, in spite of that it may be important to inhabit the corrosion process in the future