Effect of construction joints on the splitting tensile strength of concrete

AbstractThe purpose of this study is to experimentally correlate the compressive strength (f′c) of concrete to the splitting tensile strength (T) for plain concrete in the existence of a construction joint, and formulate an empirical equation relating T to f′c. Both the American Concrete Institute code (ACI 318-08 (ACI Committee 318, 2008)) and the American Society for Testing and Materials (ASTM (ASTM Standard C496, 2002; ASTM Standard C192/C192M, 2002; ASTM Standard C39/C39M, 2005; ASTM Standard C617, 2002)) provide the testing methods and standards, as well as the applicable theoretical and experimental formulas for the correlation between T to f′c for concrete specimens, which are monolithic, indicating that the specimens lack any construction joints. Providing a useful reduction factor in the splitting tensile strength of concrete due the existence of a construction joint is essential. It is a well known fact that construction joints are used in every concrete structure, which indicates that engineers would definitely benefit from an equation that could relate the splitting tensile strength of concrete in function of its compressive strength.The results suggest that the reduction in the splitting tensile strength in the presence of a construction joint is not as much as most engineers tend to believe. Due to that belief, most engineers tend to overdesign for steel reinforcement at those joints to compensate for this reduction. The objective of the study is to better the understanding of the effects of a construction joint on the splitting tensile strength. Thus provide an empirical equation to assist engineers in their design calculations, therefore reducing the amount of steel reinforcement at the construction joints. Thus also leading to cost saving on projects

Influence of Aging Time on Asphalt Pavement Performance

Aging of asphalt pavements typically occurs through oxidation of the asphalt and evaporation of the lighter maltenes from the binder. The main objective of this study is to evaluate influence of aging on performance of asphalt paving materials.nAsphalt concrete mixtures, were prepared, and subjected to short term aging (STA) procedure which involved heating the loose mixtures in an oven for two aging period of (4 and 8) hours at a temperature of 135 o C. Then it was subject to Long term aging (LTA) procedure using (2 and 5) days aging periods at 85 o C for Marshall compacted specimens. The effect of aging periods on properties of asphalt concrete at optimum asphalt content such as Marshall Properties, indirect tensile strength at 25 o C, Resilient Modulus and resistance to permanent deformation were evaluated. The impact of Short-term and long-term aging on asphalt concrete properties was evaluated. The stiffness of the mixture increases by increasing aging period that lead to increase of Marshall Stability, indirect tensile strength, and the resilient modulus, which leads to increases the resistance of mixtures against permanent deformation. The 8 hr. short term aging causes the Marshall stability, indirect tensile strength at 25 o C and resilient modulus to be increased by 52%, 34 % , 20% respectively as compared with control mixture while, the permanent deformation decreased by (33 %) as compared with control mixture

Surveys of potato-growing areas and surface water in Lebanon for potato brown and ring rot pathogens.

Field surveys were carried out over three growing seasons (2013\u20132015), in the main potato growing areas of Lebanon, to assess the occurrence of potato brown rot caused by Ralstonia solanacearum and potato ring rot caused by Clavibacter michiganensis subsp. sepedonicus. A total of 232 potato samples were collected from Bekaa valley and 145 samples from Akkar plain, which are the largest Lebanese areas cropped with potatoes. Composite samples of 200 potato tubers were randomly collected from each field, following procedures laid down in EU legislation. Twelve potato demonstration fields were established in Akkar plain and designed for potato export to European markets: these were also surveyed using the same strategy. Furthermore, a network of 40 sampling sites in Bekaa and 19 sites in Akkar was established to collect surface water. GPS coordinates of potato fields and water sampling sites were recorded to map specific sampling points using Geographic Information System. All samples gave negative results for R. solanacearum and C. michiganensis subsp. sepedonicus in potatoes and R. solanacearum in water, as indicated using the official EU methods for detection and diagnosis for these pathogens. A monitoring system for R. solanacearum and C. michiganensis subsp. michiganensis has been set up in Lebanon. This will increase the phytosanitary quality of potatoes and provide access to broader international markets

FACTORS INFLUENCING THE DECISION OF TOURIST BUSINESSES TO ADOPT DIGITAL MARKETING

The purpose of the current study is to investigate how the views of domestic tourists affect their propensity to adopt platforms and tools for digital marketing. On the basis of the perceived organisational E-readiness and the revised information systems success model, regression analyses were employed to evaluate the assumptions based on 375 selfadministered questionnaire surveys done with tourist businesses. The selection of questionnaires was based on a convenience strategy and a stratified proportional sampling method. The results of the research indicate that user satisfaction, system quality, IT infrastructure, information quality, service quality, and top-level management support are substantially associated with the use of digital marketing platforms and tools. The results of this study have practical and policy implications for legislators, marketers, and managers as they design successful and efficient digital marketing strategies to satisfy the requirements and expectations of tourist businesses

Myeloablative Fractionated Busulfan for Allogeneic Stem Cell Transplant in Older Patients or Patients With Comorbidities

Traditional conditioning regimens for patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) provide suboptimal outcomes, especially for older patients and those with comorbidities. We hypothesized that a fractionated myeloablative busulfan dose delivered over an extended period would reduce nonrelapse mortality (NRM) while retaining antileukemic effects. Here, we performed a phase 2 trial for adults with hematological malignancies receiving matched related or unrelated allo-HCT. Participants received busulfan 80 mg/m2 as outpatients on days -20 and -13 before transplant. Fludarabine 40 mg/m2 was administered on days -6 to -3, followed by busulfan dosed to achieve a target area under the curve of 20 000 mol/min for the whole course. The primary end point was day-100 NRM. Seventy-eight patients were included, with a median age of 61 years (range, 39-70 years), who received transplantation for acute leukemia (24%), myelodysplastic syndrome (27%), or myeloproliferative disease/chronic myeloid leukemia (44%). HCT-specific comorbidity index (HCT-CI) was ≥3 in 34 (44%). With a median follow-up of 36.4 months (range, 2.9-51.5), the 100-day, 1-year, and 3-year NRM rates were 3.8%, 8%, and 9.3%, respectively, without a significant difference in age or HCT-CI score. The 1-year and 3-year relapse incidence was 10% and 18%, respectively. The 3-year overall survival was 80%, without a significant difference in age or HCT-CI score and was similar for patients aged \u3e60 years and those aged \u3c60 years as well as for those with HCT-CI ≥3 and HCT-CI \u3c3. Overall, a myeloablative fractionated busulfan regimen has low NRM without an increase in relapse rate, resulting in promising survival, even in older patients or in patients with comorbidities. This trial was registered at www.clinicaltrials.gov as #NCT02861417

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

EAP Tutor's approaches to giving written feedback on academic writing in British and Syrian ELT centres

EThOS - Electronic Theses Online ServiceGBUnited Kingdo