Effect of mixture proportions on the drying shrinkage and permeation properties of high strength concrete containing class F fly ash

Sustainability of concrete can be improved by using large volume of fly ash as a replacement of cement and by ensuring improved durability of concrete. Durability of concrete containing large volume of class F fly ash is dependent on the design of mixture proportions. This paper presents an experimental study on the effect of mixture proportions on the drying shrinkage and permeation properties of high strength concrete containing large volume local class F fly ash. Concrete mixtures were designed with and without adjustments in the water to binder ratio (w/b) and the total binder content to take into account the incorporation of fly ash up to 40% of total binder. Concretes, in which the mixture proportions were adjusted for fly ash inclusion achieved equivalent strength of the control concrete and showed enhanced properties of drying shrinkage, sorptivity, water permeability and chloride penetration as compared to the control concrete. The improvement of durability properties was less significant when no adjustments were made to the w/b ratio and total binder content. The results show the necessity of the adjustments in mixture proportions of concrete to achieve improved durability properties when using class F fly ash as a cement replacement

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Apgar scores in assessing morbidity of the second neonate of cephalic/non-cephalic twins in different delivery modes

Our study was undertaken to determine whether caesarean section for the second of cephalic/non-cephalic presenting twins may prevent or diminish neonatal morbidity. For this study, 482 cephalic/non-cephalic presenting twins admitted to our hospital were retrospectively evaluated. They were separated into two groups according to their delivery mode: vaginal or caesarean delivery. Records of Apgar score (<7) at 5 min, seizure occurrence, neonatal intensive care unit (NICU) admission and duration, need for mechanical ventilation and perinatal mortality of second twins were compared. Second fetuses' mortality rates of the two groups were similar. NICU admission rate and duration, seizure and mechanical ventilation necessity rates of second fetuses were similar for both groups. Only 5 min Apgar score rates of the vaginal group were lower than the caesarean group. Caesarean section for cephalic/non-cephalic presenting twins does not decrease morbidity scores but provides effective improvement on morbidity of second fetus, according to Apgar scores

Prevalence of human papilloma virus infection in pregnant Turkish women compared with non-pregnant women

Purpose of Investigation: We aimed to find a prevalence of human papilloma virus (HPV) in order to define the 100 genotypes and subset of 14 oncogenic genotypes in pregnant Turkish women and to compare these with non-pregnant women. Methods: Cervical thin-prep specimens were obtained from 164 women in the first trimester pregnancy and 153 non pregnant women. Results: 29.2% of pregnant versus 19.6% of non-pregnant Turkish women had at least one of the 100 types of HPV infection - a statistically significant difference. The rate of 14 high-risk HPV genotype infections was significantly higher in pregnant (14.6) compared to non-pregnant Turkish women (9.6%). Conclusions: Pregnant Turkish women are at higher risk for all HPV infections including high-risk cervical cancer genotypes

Association of cervical infection of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis with peritoneum colonisation in pregnancy

This study investigated the prevalence of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis infections in the cervices and peritoneum of pregnant women and compared them with non-pregnant controls. A total of 96 pregnant women who planned to deliver by caesarean section, and 124 non-pregnant women were screened for cervical Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis infections by polymerase chain reaction analysis. If cervical infection was present, peritoneal infection was searched from the Pouch of Douglas during caesarean section in the pregnant group and was searched by culdocentesis in the control group. Chlamydia trachomatis infection was present in 7.3% of pregnant women and 2.4% of the non-pregnant controls. Ureaplasma urealyticum infection was present in 26% of pregnant women and 15.3% of the non-pregnant controls. The incidence of Chlamydia trachomatis and Ureaplasma urealyticum infection was significantly higher in pregnancy. Mycoplasma hominis infection was present less frequently compared with Chlamydia trachomatis and Ureaplasma urealyticum in both groups. Intraperitoneal colonisation by Chlamydia trachomatis was present in only one pregnant woman and in one non-pregnant control. No intraperitoneal infection was detected for Ureaplasma urealyticum and Mycoplasma hominis. Cervical Ureaplasma urealyticum and Chlamydia trachomatis infections were more frequently seen in pregnant Turkish women