Comparison of actions and resistances in different building design codes

AbstractStructural design codes of different countries provide engineers with data and procedures for design of the various structural components. Building design codes from USA, Europe, and Egypt are considered. Comparisons of the provisions for actions (loads), and for the resistance (strength) of sections in flexural and compressive axial loading are carried out. Several parameters are considered including variable actions for occupancy and different material strengths. The comparison is made considering both concrete and steel structures. Issues and consequences of mixing actions from one code and resistance from another code are also discussed

Biodegradable Scaffolds for Gastric Tissue Regeneration

Tissue engineering has been viewed as a valid approach toward the partial or total replacement of defective tissues and organs. Recent advances in nanotechnology have made it possible to develop biocompatible materials at the micro- and nano-scales to be used as scaffolds for cellular growth and regeneration of defective tissues. Gastric mucosal lining is an example of soft tissues that are highly susceptible to damage due to various reasons including cancer or ulcer development. Current therapeutic approaches to these diseases have some limitations. This chapter describes the basis for development of a novel modality combining nanotechnology, stem cells, and tissue engineering for the replacement of defective gastric tissues using synthetic biocompatible scaffolds. These microfibrous scaffolds are seeded with gastric stem cells, which are studied for their proliferation and differentiation into functional gastric mucous cells

Experimental investigation of long-term performance of fiber-reinforced epoxy and polyurethane polymer composites

The primary challenge encountered by polymers and their composites when exposed to saline water is their inadequate ability to withstand wear and tear over time. With a potential to replace conventional materials the long-term performance of FRP composites is still a novice area. This manuscript thus, reports an experimental investigation and prediction of the durability of fiber-reinforced polymer composites exposed to seawater at different temperatures. E-glass/epoxy and E-glass/polyurethane samples were exposed to 23 °C, 45 °C and 65 °C seawater for up to 2700 days (90 months). Tensile tests evaluated the mechanical performance of the composite as a function of exposure time, and strength-based technique was used to assess the durability. The experimental results revealed that the tensile strength of E-glass/epoxy composite decreased by 6.3% and 48.9% after 90 months in seawater at 23 and 65 °C, respectively, whereas it declined by 37.6% and 63.6% respectively for E-glass/Polyurethane composite. The prolonged immersion in seawater results in plasticization and swelling in the composite material, which accelerates the fiber/matrix debonding. SEM micrographs indicate fiber/matrix debonding, potholing, fiber pull-out, river line marks, and matrix cracking which showcases deterioration in the tensile properties of both composites

Vascular Endothelial Growth Factor gene polymorphism (rs2010963) in ST- Segment Elevation Myocardial Infarction: An Egyptian Pilot Study

ST- segment elevation myocardial infarction (STEMI) is the most severe form of coronary artery disease. Vascular endothelial growth factor (VEGF-A) is critical in post- Myocardial Infarction (MI) angiogenesis. VEGF-A (rs2010963) gene polymorphism hasn’t been explored in Egyptian ethnicity. This study aimed to explore the role of the VEGF-A gene (rs2010963) polymorphism in STEMI and its outcome. It was carried out on 50 STEMI patients and 50 controls who gave blood samples for VEGF-A level estimation by ELISA and VEGF-A gene(rs2010963) polymorphism by real-time PCR. We revealed that VEGF-A level was higher in STEMI cases vs. control at baseline and in STEMI cases at 2-weeks vs. baseline. At a cut off value > 20 pg/ml was a statistically significant discriminator of STEMI vs. control [AUC (95% CI) = 0.785 (0.692-0.861), sensitivity 82%, specificity 72%]. Participants with C/G-G/G genotypes of VEGF-A (rs2010963) had 2.8-times higher odds vs. those with C/C genotype to exhibit STEMI. C/G genotype was associated with highest VEGF-A level. STEMI participants with C/G genotype had 4.3-times higher odds vs. those with C/C-G/G genotype to exhibit poor outcome. In conclusions, VEGF-A level can discriminate STEMI cases from control. VEGF-A (rs2010963) gene polymorphism affects VEGF-A level, associated with risk of developing STEMI and affects clinical outcome

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

ICAR: endoscopic skull‐base surgery

n/