Pull-out and push-in tests of bonded steel strands

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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

Measuring specific parameters in pretensioned concrete members using a single testing technique

Pretensioned concrete members are designed and manufactured by using at least two materials: concrete and prestressing reinforcement. Also, two main stages must be considered: prestress transfer and member loading. Hence, the behavior of these members depends strongly on the reinforcement-to-concrete bond performance and prestress losses. In this paper, a testing technique to measure the specific parameters related with the involved phenomena is presented. The testing technique is based on the analysis of series of specimens varying in embedment length to simulate several cross sections at only one end of a pretensioned concrete member. Each specimen is characterized by means of the sequential release of the prestress transfer (detensioning) and the pull-out (loading) operation. The test provides data on prestressing force, transmission length (initial and long-term), anchorage length (without and with slip), reinforcement slips, bond stresses, longitudinal concrete strains, concrete modulus of elasticity, and prestress losses (instantaneous and time-dependent)

Splitting of concrete cover in steel fiber reinforced concrete: Semi-empirical modeling and minimum confinement requirements

The use of steel fiber reinforced concrete (SFRC) is becoming more and more common. Concerning bond of rebars to concrete, fibers provide passive confinement and not only improve bond performance but also affect the mode of bond failure. To analyze these aspects, a series of prismatic specimens have been subjected to the Pull Out Test, and an accurate model for predicting the mode of bond failure has been developed. The following factors have been considered: concrete compressive strength (30–50 MPa), rebar diameter (8–20 mm), concrete cover (between 30 mm and 5 times rebar diameter), fiber content (up to 70 kg/m3), and fiber slenderness and length. This model relates splitting probability to the factors considered. It has been proved that increasing fiber content restrains the risk of splitting failure. The favorable effect of fibers when preventing splitting failures has been revealed to be more important for higher concrete compressive strength values, which require higher concrete cover/diameter ratios for splitting failure to be prevented. Fiber slenderness and fiber length modify the effect of fiber content on splitting probability and therefore on minimum cover/diameter ratios required to prevent splitting failures

Lagesicherheit lose verlegter Waermedaemmplatten auf Flachdaechern gegen Abheben durch Windeinwirkung

TIB Hannover: RN 5973(2121) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman