Experimental Findings and Validation on Torsional Behaviour of Fibre-Reinforced Concrete Beams: A Review

Fibres have long been utilized in the construction sector to improve the mechanical qualities of structural elements such as beams, columns, and slabs. This study aims to review the torsional behaviour of various forms of fibre reinforced concrete to identify possible enhancements and the practicability of concrete structural beams. Concrete reinforced steel fibre, synthetic fibre, and hybrid fibre are examples of fibre reinforced concrete. The review found that the mixing, orientation, and volume of fibres, the size of coarse particles, the aspect ratio of fibres, and the stiffness of fibres all affect the torsional strength of fibre reinforced concrete. Nevertheless, the application of fibres to recycled self-consolidating concrete of various forms needs to be explored and studied to ascertain its feasibility to facilitate greener concrete. Thus, with the results compiled in this review paper, it was possible to delimit advances and gaps on the effect of editing reinforcement fibres in relation to the torsion of structural element

Assessment of the proliferative, apoptotic and cellular renovation indices of the human mammary epithelium during the follicular and luteal phases of the menstrual cycle

Introduction During the menstrual cycle, the mammary gland goes through sequential waves of proliferation and apoptosis. in mammary epithelial cells, hormonal and non-hormonal factors regulate apoptosis. To determine the cyclical effects of gonadal steroids on breast homeostasis, we evaluated the apoptotic index ( AI) determined by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling ( TUNEL) staining in human mammary epithelial cells during the spontaneous menstrual cycle and correlated it with cellular proliferation as determined by the expression of Ki-67 during the same period.Methods Normal breast tissue samples were obtained from 42 randomly selected patients in the proliferative ( n = 21) and luteal ( n = 21) phases. Menstrual cycle phase characterization was based on the date of the last and subsequent menses, and on progesterone serum levels obtained at the time of biopsy.Results the proliferation index ( PI), defined as the number of Ki-67-positive nuclei per 1,000 epithelial cells, was significantly larger in the luteal phase (30.46) than in the follicular phase (13.45; P = 0.0033). the AI was defined as the number of TUNEL-positive cells per 1,000 epithelial cells. the average AI values in both phases of the menstrual cycle were not statistically significant ( P = 0.21). However, the cell renewal index ( CRI = PI/AI) was significantly higher in the luteal phase ( P = 0.033). A significant cyclical variation of PI, AI and CRI was observed. PI and AI peaks occurred on about the 24th day of the menstrual cycle, whereas the CRI reached higher values on the 28th day.Conclusions We conclude that proliferative activity is dependent mainly on hormonal fluctuations, whereas apoptotic activity is probably regulated by hormonal and non-hormonal factors.Universidade Federal de São Paulo, Dept Gyneol, Mastol Div, São Paulo, BrazilStanford Univ, Sch Med, Dept Neurosurg, Stanford, CA 94305 USAAPC Pathol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Gyneol, Mastol Div, São Paulo, BrazilWeb of Scienc

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

A compreensão médica portuguesa sobre a concepção da criança no século XVIII

A partir do século XVII, novos conhecimentos anatómicos vão possibilitar aos médicos uma compreensão da concepção humana que desagua na autoconfiança que exibe hoje a medicina. Portugal vai integrando esse novo saber médico e, ao longo de Setecentos, vê cada vez mais generalizar-se a ideia de que o homem participava na concepção por meio do sémen que fecundava o ovo existente na mulher, rompendo com as concepções vindas da Antiguidade. Apesar de alguma novidade no conhecimento anatómico e de um raciocínio médico mais fundado na observação sistemática, a ideia que sobressai é a da impotência para responder aos normais anseios das pessoas e a pouca capacidade para desfazer mitos há muito enraizados, como a possibilidade da influência da imaginação na concepção. Um dos contributos de maior alcance desta racionalidade parece ter sido o despertar para uma consciência desenvolvimentista que acentuava a necessidade de se actuar preventivamente na promoção da saúde. Daí a importância de se olhar para os cuidados a ter para com a criança e desde o início, ou seja, desde a concepção

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<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<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

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac