20 research outputs found
Assessment of existing steel frames: Numerical study, pseudo-dynamic testing and influence of masonry infills
Most of existing steel multi-storey frames in Europe have been designed before the introduction of modern seismic design provisions, hence they often exhibit low performance under earthquake loads due to their low lateral resistance and energy dissipation capacity. In addition, such structures often include rigid and brittle masonry infill walls that highly influence their lateral response and distribution of damage pattern. However, current procedures for the assessment of existing steel buildings in Europe, included in the Eurocode 8 â Part 3 (EC8â3), do not provide adequate guidance for the assessment of âweakâ steel frame with masonry infill walls. Moreover, most of available modelling approaches of masonry infills formerly developed for reinforced concrete (RC) structures do not properly represent the behaviour of infill walls in steel frames. An improved numerical has to be provided to satisfactorily mimic infill walls' behaviour in steel moment frames. To this end, an experimental and theoretical study was carried out within the framework of HITFRAMES (i.e., HybrId Testing of an Existing Steel Frame with Infills under Multiple EarthquakeS) SERA project. This paper firstly presents the limitations of current EC8â3 by conducting a code-based assessment on a case study steel moment frame using pushover analysis. Three different single strut models, widely used for simulating the presence of masonry infills in RC structures, are considered for the numerical analyses. The paper also presents the results of pseudo-dynamic (PsD) tests performed on a large-scale 3D steel frame with masonry infills. The capability of the different masonry infill models is successively evaluated by comparisons between numerical and experimental results. On the basis of the obtained results, recommendations on how to potentially improve the single strut model for masonry infills surrounded by steel frames are also provided
The Hellenic emergency laparotomy study (HELAS): a prospective multicentre study on the outcomes of emergency laparotomy in Greece
Background
Emergency laparotomy (EL) is accompanied by high post-operative morbidity and mortality which varies significantly between countries and populations. The aim of this study is to report outcomes of emergency laparotomy in Greece and to compare them with the results of the National Emergency Laparotomy Audit (NELA).
Methods
This is a multicentre prospective cohort study undertaken between 01.2019 and 05.2020 including consecutive patients subjected to EL in 11 Greek hospitals. EL was defined according to NELA criteria. Demographics, clinical variables, and post-operative outcomes were prospectively registered in an online database. Multivariable logistic regression analysis was used to identify independent predictors of post-operative mortality.
Results
There were 633 patients, 53.9% males, ASA class III/IV 43.6%, older than 65 years 58.6%. The most common operations were small bowel resection (20.5%), peptic ulcer repair (12.0%), adhesiolysis (11.8%) and Hartmannâs procedure (11.5%). 30-day post-operative mortality reached 16.3% and serious complications occurred in 10.9%. Factors associated with post-operative mortality were increasing age and ASA class, dependent functional status, ascites, severe sepsis, septic shock, and diabetes. HELAS cohort showed similarities with NELA patients in terms of demographics and preoperative risk. Post-operative utilisation of ICU was significantly lower in the Greek cohort (25.8% vs 56.8%) whereas 30-day post-operative mortality was significantly higher (16.3% vs 8.7%).
Conclusion
In this study, Greek patients experienced markedly worse mortality after emergency laparotomy compared with their British counterparts. This can be at least partly explained by underutilisation of critical care by surgical patients who are at high risk for death
Development and internal validation of a clinical prediction model for serious complications after emergency laparotomy
Purpose
Emergency laparotomy (EL) is a common operation with high risk for postoperative complications, thereby requiring accurate risk stratification to manage vulnerable patients optimally. We developed and internally validated a predictive model of serious complications after EL.
Methods
Data for eleven carefully selected candidate predictors of 30-day postoperative complications (Clavien-Dindo gradeâ>ââ=â3) were extracted from the HELAS cohort of EL patients in 11 centres in Greece and Cyprus. Logistic regression with Least Absolute Shrinkage and Selection Operator (LASSO) was applied for model development. Discrimination and calibration measures were estimated and clinical utility was explored with decision curve analysis (DCA). Reproducibility and heterogeneity were examined with Bootstrap-based internal validation and InternalâExternal Cross-Validation. The American College of Surgeons National Surgical Quality Improvement Programâs (ACS-NSQIP) model was applied to the same cohort to establish a benchmark for the new model.
Results
From data on 633 eligible patients (175 complication events), the SErious complications After Laparotomy (SEAL) model was developed with 6 predictors (preoperative albumin, blood urea nitrogen, American Society of Anaesthesiology score, sepsis or septic shock, dependent functional status, and ascites). SEAL had good discriminative ability (optimism-corrected c-statistic: 0.80, 95% confidence interval [CI] 0.79â0.81), calibration (optimism-corrected calibration slope: 1.01, 95% CI 0.99â1.03) and overall fit (scaled Brier score: 25.1%, 95% CI 24.1â26.1%). SEAL compared favourably with ACS-NSQIP in all metrics, including DCA across multiple risk thresholds.
Conclusion
SEAL is a simple and promising model for individualized risk predictions of serious complications after EL. Future external validations should appraise SEALâs transportability across diverse settings
Usefulness of Cardiovascular Magnetic resonance imaging in supraventricular tachycardia ablation in a scleroderma patient
An intercontinental hybrid simulation experiment for the purposes of the seismic assessment of a three-span RC bridge
This paper presents the challenges encountered in preparing and conducting hybrid experiments between E.U., U.S. and Canada in the framework of an FP7-funded European project focusing on the study of seismic soil-structure interaction effects in bridge structures. The test involved partners located on both sides of the Atlantic; each one assigned a numerical or a physical module of the sub-structured bridge. More precisely, the seismic response of a recently built, 99m long, three-span, reinforced concrete bridge is assessed, after sub-structuring it into five structural components (modules); four of them being numerically analyzed in computers located in the cities of Thessaloniki (Greece), Patras (Greece), Urbana-Champaign. IL (U.S.) and Toronto (Canada) while an elastomeric bearing was physically tested in Patras (Greece). The results of the hybrid experiment, the challenges met during all stages of the campaign, as well as the feasibility, robustness and repetitiveness of the intercontinental hybrid simulation test are presented and critically discusse
An intercontinental hybrid simulation experiment for the purpose of seismic assessment of a three-span R/C bridge
Assessment of existing steel frames: Numerical study, pseudo-dynamic testing and influence of masonry infills
Most of existing steel multi-storey frames in Europe have been designed before the introduction of modern seismic design provisions, hence they often exhibit low performance under earthquake loads due to their low lateral resistance and energy dissipation capacity. In addition, such structures often include rigid and brittle masonry infill walls that highly influence their lateral response and distribution of damage pattern. However, current procedures for the assessment of existing steel buildings in Europe, included in the Eurocode 8 â Part 3 (EC8â3), do not provide adequate guidance for the assessment of âweakâ steel frame with masonry infill walls. Moreover, most of available modelling approaches of masonry infills formerly developed for reinforced concrete (RC) structures do not properly represent the behaviour of infill walls in steel frames. An improved numerical has to be provided to satisfactorily mimic infill walls' behaviour in steel moment frames. To this end, an experimental and theoretical study was carried out within the framework of HITFRAMES (i.e., HybrId Testing of an Existing Steel Frame with Infills under Multiple EarthquakeS) SERA project. This paper firstly presents the limitations of current EC8â3 by conducting a code-based assessment on a case study steel moment frame using pushover analysis. Three different single strut models, widely used for simulating the presence of masonry infills in RC structures, are considered for the numerical analyses. The paper also presents the results of pseudo-dynamic (PsD) tests performed on a large-scale 3D steel frame with masonry infills. The capability of the different masonry infill models is successively evaluated by comparisons between numerical and experimental results. On the basis of the obtained results, recommendations on how to potentially improve the single strut model for masonry infills surrounded by steel frames are also provided