Structural behaviour of square RC columns confined with CFRP wraps

Loading capacity and strains of square reinforced concrete (RC) columns, strengthened with external carbon fiber reinforced polymer (CFRP) sheets, were tested and evaluated. The experimental parameters include: number of wrap layers, concrete strength and the slenderness of the columns (L/a). All test specimens were loaded to failure in axial compression. Compressive stress, axial and hoop strains have been recorded to evaluate the stress-strain relationship, ultimate strength, stiffness, and ductility of the specimens.Results clearly demonstrate that composite wrapping can enhance the structural performance of RC columns in terms of both maximum strength and ductility. The effects of test parameters are evidenced and compared

Structural behaviour of square RC columns confined with CFRP wraps

Loading capacity and strains of square reinforced concrete (RC) columns, strengthened with external carbon fiber reinforced polymer (CFRP) sheets, were tested and evaluated. The experimental parameters include: number of wrap layers, concrete strength and the slenderness of the columns (L/a). All test specimens were loaded to failure in axial compression. Compressive stress, axial and hoop strains have been recorded to evaluate the stress-strain relationship, ultimate strength, stiffness, and ductility of the specimens.Results clearly demonstrate that composite wrapping can enhance the structural performance of RC columns in terms of both maximum strength and ductility. The effects of test parameters are evidenced and compared

Influence du type d’addition minérale sur les propriétés de transfert des Bétons AutoPlaçants Influence of the type of mineral admixtures on the transport properties of self compacting concrete

La formulation des bétons autoplaçants (BAP) présente certaines spécificités dont un volume élevé de pâte et une quantité importante d’ajouts minéraux. Ces deux paramètres influencent sensiblement les propriétés de transfert de ces bétons. Dans ce travail, nous avons étudié l’influence de la nature et du pourcentage de plusieurs additions minérales sur certaines propriétés de transfert (la diffusion des ions chlore et la perméabilité au gaz) des BAP. Trois différentes additions minérales ont été testées : des fillers calcaires, de la pouzzolane naturelle et des cendres volantes. Ensuite, nous avons cherché une probable relation analytique entre ces propriétés et la résistance à la compression de ces bétons. Au total, douze formulations ont été étudiées, elles couvrent trois différentes classes de résistances (30 MPa, 50 MPa et 70 MPa) et quatre types de bétons: un béton ordinaire vibré, un BAP à base de pouzzolanes naturelles, un BAP à base de fillers calcaires et un BAP à base de cendres volantes. Les résultats montrent que la nature de l’addition minérale dans les BAP influe considérablement sur les propriétés de transferts de ces bétons. Après 28, 90 et 360 jours de cure, les BAP contenant de la pouzzolane naturelle représentent des performances très comparables à celles obtenues sur des BAP à base de cendres volantes et bien meilleures que celles obtenues sur des BAP formulés avec du filler calcaire. Indépendamment du type d’addition minérale, les résultats confirment l’existence d’une forte corrélation entre le développement de la résistance à la compression et les propriétés de transferts des BAP. Formulation of self compacting concrete (SCC) has some specific characteristics including a high volume of paste and a large amount of mineral admixtures. These two parameters influence significantly the transport properties of SCC. In this work, we studied the influence of nature and the percentage of several mineral admixtures on some transport properties (the ions diffusion and chloride gas permeability) of the SCC. Three different mineral additives were tested: the limestone fillers, the natural pozzolan and the fly ash. Then we looked for the analytical relationship between these properties and the compressive strength of concrete. A total of twelve formulations were studied, they cover three different compressive strength classes (30 MPa, 50 MPa and 70 MPa) and four types of concrete: ordinary vibrated concrete, a SCC containing natural pozzolan, a SCC based with limestone fillers and SCC containing fly ash. The results show that the nature of the mineral admixtures in SCC influence on the transport properties of these concretes. After 28, 90 and 360 days of curing, the SCC containing natural pozzolan represent very similar performance to those obtained on SCC containing fly ash and much better than those obtained on SCC formulated with limestone filler. Regardless of the type of mineral admixtures, the results confirm the existence of a strong correlation between development of compressive strength and transport properties of SCC

Influence du type d’addition minérale sur les propriétés de transfert des Bétons AutoPlaçants

La formulation des bétons autoplaçants (BAP) présente certaines spécificités dont un volume élevé de pâte et une quantité importante d’ajouts minéraux. Ces deux paramètres influencent sensiblement les propriétés de transfert de ces bétons. Dans ce travail, nous avons étudié l’influence de la nature et du pourcentage de plusieurs additions minérales sur certaines propriétés de transfert (la diffusion des ions chlore et la perméabilité au gaz) des BAP. Trois différentes additions minérales ont été testées : des fillers calcaires, de la pouzzolane naturelle et des cendres volantes. Ensuite, nous avons cherché une probable relation analytique entre ces propriétés et la résistance à la compression de ces bétons. Au total, douze formulations ont été étudiées, elles couvrent trois différentes classes de résistances (30 MPa, 50 MPa et 70 MPa) et quatre types de bétons: un béton ordinaire vibré, un BAP à base de pouzzolanes naturelles, un BAP à base de fillers calcaires et un BAP à base de cendres volantes. Les résultats montrent que la nature de l’addition minérale dans les BAP influe considérablement sur les propriétés de transferts de ces bétons. Après 28, 90 et 360 jours de cure, les BAP contenant de la pouzzolane naturelle représentent des performances très comparables à celles obtenues sur des BAP à base de cendres volantes et bien meilleures que celles obtenues sur des BAP formulés avec du filler calcaire. Indépendamment du type d’addition minérale, les résultats confirment l’existence d’une forte corrélation entre le développement de la résistance à la compression et les propriétés de transferts des BAP

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background: The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods: In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results: Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89·6 per cent) compared with that in countries with a middle (753 of 1242, 60·6 per cent; odds ratio (OR) 0·17, 95 per cent c.i. 0·14 to 0·21, P < 0·001) or low (363 of 860, 42·2 per cent; OR 0·08, 0·07 to 0·10, P < 0·001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -9·4 (95 per cent c.i. -11·9 to -6·9) per cent; P < 0·001), but the relationship was reversed in low-HDI countries (+12·1 (+7·0 to +17·3) per cent; P < 0·001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0·60, 0·50 to 0·73; P < 0·001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion: Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results: In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion: Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Surgical site infection after gastrointestinal surgery in children: An international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda