Analisis Kapasitas Balok Beton Bertulang Dengan Lubang Pada Badan Balok

Konstruksi gedung bertingkat biasanya membutuhkan jaringan utilitas seperti saluran kabel listrik, perpipaan, kabel telepon, pendingin ruangan dan lain-lain. Biasanya jaringan ini ditempatkan pada ruang diatas plafon atau dipasang menempel pada balok. Penempatan ini dapat mengurangi tinggi ruangan pada bangunan, sehingga diperlukan alternatif desain yang diantaranya dengan memanfaatkan ruang-ruang pada balok struktur. Balok beton bertulang dengan lubang pada badan balok berfungsi sebagai struktur yang menahan dan menyalurkan beban-beban yang bekerja di atasnya,tetapi juga berfungsi sebagai pendukung utilitas. Selain itu, web openings pada balok dapat meminimalisasi tinggi atau space dari ruang, juga akan mereduksi volume beton yang digunakan serta lebih rapi. Pada penelitian ini akan dikaji balok beton dengan tumpuan jepit-jepit dengan lubang pada badan balok yang ditempatkan pada daerah seperempat bentang, dengan variasi panjang lubang, tinggi lubang serta luas lubang.Capaian dari penelitian ini adalah melihat fenomena balok beton bertulang akibat pembuatan lubang pada badan balok dengan mengkaji nilai tegangan normal, nilai tegangan geser, nilai momen lentur, nilai gaya geser dan nilai lendutan akibat balok berlubang yang dibandingkan dengan balok tidak berlubang. Dari hasil pengujian yang dilakukan, diperoleh terjadi kenaikan nilai tegangan, nilai momen, nilai geser di sekitar daerah perlubangan. Seiring bertambah besar panjang dan tinggi lubang, maka nilai tegangannya pun semakin besar. Lendutan semakin bertambah seiring dengan bertambah besarnya variasi lubang ataupun penambahan beban. Hasil menunjukkan ukuran lubang 10cm x 10 cm dan 15 cm x 15 cm nilai lendutannya lebih kecil daripada lendutan balok utuh. Mengingat kenaikan nilai kapasitas pada daerah perlubangan, diperlukan perkuatan struktur berupa pemasangan tulangan disekitar lubang

Postoperative outcomes in oesophagectomy with trainee involvement

BACKGROUND: The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. METHODS: Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. RESULTS: Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases in 130, and all phases in 315 procedures. For procedures with a chest anastomosis, those with trainee involvement had similar 90-day mortality, complication and reoperation rates to consultant-performed oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P = 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P = 0.150, P = 0.430, and P = 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P = 0.005). CONCLUSION: Trainee involvement was not found to be associated with significantly inferior postoperative outcomes for selected patients undergoing oesophagectomy. The results support continued supervised trainee involvement in oesophageal cancer surgery

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Coolwater culmination: Sensitive high-resolution ion microprobe (SHRIMP) U-Pb and isotopic evidence for continental delamination in the Syringa Embayment, Salmon River suture, Idaho

During dextral oblique translation along Laurentia in western Idaho, the Blue Mountains superterrane underwent clockwise rotation and impinged into the Syringa embayment at the northern end of the Salmon River suture. Along the suture, the superterrane is juxtaposed directly against western Laurentia, making this central Cordilleran accretionary-margin segment unusually attenuated. In the embayment, limited orthogonal contraction produced a crustal wedge of oceanic rocks that delaminated Laurentian crust. The wedge is exposed through Laurentian crust in the Coolwater culmination as documented by mapping and by sensitive high-resolution ion microprobe U-Pb, Sri, and εNd data for gneisses that lie inboard of the suture. The predominant country rock is Mesoproterozoic paragneiss overlying Laurentian basement. An overlying Neoproterozoic (or younger) paragneiss belt in the Syringa embayment establishes the form of the Cordilleran miogeocline and that the embayment is a relict of Rodinia rifting. An underlying Cretaceous paragneiss was derived from arc terranes and suture-zone orogenic welt but also from Laurentia. The Cretaceous paragneiss and an 86-Ma orthogneiss that intruded it formed the wedge of oceanic rocks that were inserted into the Laurentian margin between 98 and 73 Ma, splitting supracrustal Laurentian rocks from their basement. Crustal thickening, melting and intrusion within the wedge, and folding to form the Coolwater culmination continued until 61 Ma. The embayment formed a restraining bend at the end of the dextral transpressional suture. Clockwise rotation of the impinging superterrane and overthrusting of Laurentia that produced the crustal wedge in the Coolwater culmination are predicted by oblique collision into the Syringa embayment