A revival in façades: Textile reinforced concrete panels are light, safe and aesthetically pleasing

Textile reinforced concrete was developed in recent years into a construction technique that has its benefits and advantages in applications where conventional types of reinforcement have their limits. The current, minimum slab thickness for steel-reinforced concrete façade slabs is 7.0 cm; this is due to the minimum, required concrete cover to ensure adequate corrosion protection. Façade slab anchors for these slab thicknesses are building authority approved. As corrosion protection is not an issue for textile reinforced concrete, the minimum thickness for the concrete cover can be significantly reduced. The requirement for component thickness is now determined by the load-bearing capacity and by production-related boundary conditions. For practical building reasons, panel thicknesses of 3.0 cm have proven to be the best choice. Compared to steel-reinforced façade panels, this is a weight and thickness reduction of almost 60%. Thin concrete elements are of great interest in cases when the thickness or the weight of the panels is largely limited e.g. because of adjoining concrete elements in renovation or upgrade projects, retrofitting or improvements. Compared to other building materials, concrete has characteristic advantages in building physics and fire protection properties, irrespective of the thickness. Obviously, minimal thicknesses place extra demands on planning and construction. Especially effects on concrete, punching, splitting and concrete breakout must be examined in experiments. This is an overview of calculation and test methods. Results are provided to show the bearing behaviour of fixings in thin, textile reinforced concrete slabs. The design rules are explained and the results are illustrated

Extended experience in parieto-occipital expansion surgery by meander technique—clinical and radiological evaluation

Introduction: Brachycephaly and anterior and posterior plagiocephaly appear as an isolated entity or manifest in syndromic conditions. In severe cases, possible treatment options currently comprise either cranioplasty or osteogenetic distraction. The aim of this paper is to retrospectively review the perioperative course of a series of children treated by posterior meander expansion technique at our institution with focus on the course of postoperative intracranial volume and eventual tonsillar descent evolution. Methods: Forty-two children received a posterior cranial vault remodeling by means of a posterior meander technique during a 7-year period. Hospital records were reviewed, and pre- and postoperative MRIs were analyzed for intracranial volume, cephalic and asymmetry index, and tonsillar position over time. Results: Median age at surgery was 11.5 months (range 17 days-10 years). Nineteen children had a symmetrical cranial deformity, twenty-three an asymmetrical synostosis. Half of the cohort showed a syndromic condition. Transfusions were administered in the majority (92.2%) of the cases. A significant postoperative increase of intracranial volume was present from 1188.9 ± 370.4 cm(3) to 1324.8 ± 352.9 cm(3) (p < 0.001). The asymmetry index showed a significant improvement postoperatively: 0.86 ± 0.06 versus 0.91 ± 0.05 (p < 0.001), while the cephalic index showed a non-statistical change (0.91 ± 0.11 versus 0.88 ± 0.08). Tonsillar herniation, bilateral or homolateral, showed no significant changes at early control, while a nonsignificant amelioration of tonsillar descent was seen among children older than 12 months at late imaging follow-up. Conclusion: Among the osteoplastic techniques, the posterior meander technique offers several advantages, such as early mobilization of the child, less bony defects, absence of implants, and a small complication rate. However, further comparative studies among different surgical techniques are needed

Management of pineal region tumors in a pediatric case series

Pineal region tumors commonly present with non-communicating hydrocephalus. These heterogeneous histological entities require different therapeutic regimens. We evaluated our surgical experience concerning procurance of a histological diagnosis, management of hydrocephalus, and choice of antitumoral treatment. We analyzed the efficacy of neuroendoscopic biopsy and endoscopic third ventriculocisternostomy (ETV) in patients with pineal region tumors between 2006 and 2019 in a single-center retrospective cross-sectional study with regard to diagnostic yield, hydrocephalus treatment, as well as impact on further antitumoral management. Out of 28 identified patients, 23 patients presented with untreated hydrocephalus and 25 without histological diagnosis. One patient underwent open biopsy, and 24 received a neuroendoscopic biopsy with concomitant hydrocephalus treatment if necessary. Eighteen primary ETVs, 2 secondary ETVs, and 2 ventriculoperitoneal shunts (VPSs) were performed. Endoscopic biopsy had a diagnostic yield of 95.8% (23/24) and complication rates of 12.5% (transient) and 4.2% (permanent), respectively. ETV for hydrocephalus management was successful in 89.5% (17/19) with a median follow-up of more than 3 years. Following histological diagnosis, 8 patients (28.6%) underwent primary resection of their tumor. Another 9 patients underwent later-stage resection after either adjuvant treatment (n = 5) or for progressive disease during observation (n = 4). Eventually, 20 patients received adjuvant treatment and 7 were observed after primary management. One patient was lost to follow-up. Heterogeneity of pineal region tumor requires histological confirmation. Primary biopsy of pineal lesions should precede surgical resection since less than a third of patients needed primary surgical resection according to the German pediatric brain tumor protocols. Interdisciplinary decision making upfront any treatment is warranted in order to adequately guide treatment

Apparent Alkyl Transfer and Phenazine Formation via an Aryne Intermediate

Treatment of chlorotriaryl derivatives 3a and 3d or fluorotriaryl derivatives 3b and 3e with potassium diisopropylamide afforded alkyl-shifted phenazine derivatives 5a/5b, rather than the expected 9-membered triazaorthocyclophane 2a. The phenazine derivatives were isolated in 78–98% yield depending on the halogen and alkyl group present. In the absence of the halogen (chloro or fluoro), the apparent alkyl shift proceeds more slowly and cannot proceed via the intermediacy of the aryne intermediate. Mechanistic possibilities include intramolecular nucleophilic attack on an aryne intermediate leading to a zwitterionic intermediate and alkyl transfer via a 5-endo-tet process, or via a Smiles rearrangement

Glutathione Deficiency in Cardiac Patients Is Related to the Functional Status and Structural Cardiac Abnormalities

International audienceBACKGROUND: The tripeptide glutathione (L-gamma-glutamyl-cysteinyl-glycine) is essential to cell survival, and deficiency in cardiac and systemic glutathione relates to heart failure progression and cardiac remodelling in animal models. Accordingly, we investigated cardiac and blood glutathione levels in patients of different functional classes and with different structural heart diseases. METHODS: Glutathione was measured using standard enzymatic recycling method in venous blood samples obtained from 91 individuals, including 15 healthy volunteers and 76 patients of New York Heart Association (NYHA) functional class I to IV, undergoing cardiac surgery for coronary artery disease, aortic stenosis or terminal cardiomyopathy. Glutathione was also quantified in right atrial appendages obtained at the time of surgery. RESULTS: In atrial tissue, glutathione was severely depleted (-58%) in NYHA class IV patients compared to NYHA class I patients (P = 0.002). In patients with coronary artery disease, this depletion was related to the severity of left ventricular dysfunction (P = 0.006). Compared to healthy controls, blood glutathione was decreased by 21% in NYHA class I patients with structural cardiac disease (P<0.01), and by 40% in symptomatic patients of NYHA class II to IV (P<0.0001). According to the functional NYHA class, significant depletion in blood glutathione occurred before detectable elevation in blood sTNFR1, a marker of symptomatic heart failure severity, as shown by the exponential relationship between these two parameters in the whole cohort of patients (r = 0.88). CONCLUSIONS: This study provides evidence that cardiac and systemic glutathione deficiency is related to the functional status and structural cardiac abnormalities of patients with cardiac diseases. These data also suggest that blood glutathione test may be an interesting new biomarker to detect asymptomatic patients with structural cardiac abnormalities

The ecological and economic advantages of carbon reinforced concrete—Using the C³ result house CUBE especially the BOX value chain as an example

Against the background of global warming and the associated need to drastically reduce energy and resource consumption, action must also be taken in the building sector. Resource-efficient construction methods must be used that nevertheless allow the increasing construction tasks in areas such as infrastructure and housing to continue to be fulfilled. In order to successfully introduce a new construction method to the market, the aspects of recyclability and economic efficiency are essential, in addition to important government requirements for climate neutrality and technical performance. Above all, the economic viability, that is, the economic advantageousness, as well as its simple applicability compared to competing systems, decides on the success and widespread use of a new technology. Carbon reinforced concrete, with its outstanding technical properties and simultaneous material efficiency, is an important building block toward climate neutrality in the construction industry. It is a promising technology that still has to prove its economic advantages and robust applicability under market conditions. In addition to the infrastructure sector, there is great potential in the area of housing creation, which needs to be tapped for carbon reinforced concrete. For this challenge, it is necessary to design a competitive value chain that allows the realization of marketable products in mass production on existing plant technology. The article gives a short overview of the economic and ecological status quo in the field of prefabricated construction with carbon concrete, using the example of the C3-result building CUBE. In particular, the CUBE-BOX, which is made of prefabricated and semi-prefabricated parts, is examined in more detail and the carbon reinforced concrete components used are compared with classic reinforced concrete constructions in terms of sustainability. In this context, the conceivable global climate protection contribution of the carbon reinforced concrete construction method is forecast based on potential market segments