A vacuum-air permeability test for in-situ assessment of cover concrete

The transport properties of fluids in the cover layer are the main indicator of the durability of reinforced concrete structures. Many laboratory tests exist for measuring these properties. However, there are relatively few tests that can be used on site. In this paper, the development of a new nondestructive rapid test capable of measuring the air permeability of in situ concrete is described. The new method measures the movement of gas between different holes drilled into the concrete and gives results for the permeability of the concrete and for the volume of concrete that has been tested. A pressure measuring method was developed to measure the pressure inside the concrete by using a piezoresistive pressure transducer and a data logger. Four different techniques were investigated and one preparation technique is recommended for in situ use

Profile of Nasopharyngeal Carcinoma in Dr. Cipto Mangunkusumo National Hospital, 2010

Nasopharyngeal carcinoma (NPC) is the most common head and neck Malignancy in Indonesia. NPCpresents numerous challenges from non-specific signs and symptoms until lack of awareness from generalpractitioners (GP), which lead to late or missed diagnosis. Early diagnosis and prevention are proposedas the best solutions for this problem. In order to do that, we need a complete and well-managed patients’data. This study aims to reveal the demographic, clinical and histopathologic characteristics of NPC inIndonesia. A cross-sectional study was conducted by collecting medical records of all NPC patients in 2010from Otorhinolaryngology Department of Dr. Cipto Mangunkusumo National Hospital. The extracted datawere then analyzed to describe the problem of NPC in Indonesia. Out of 167 patients, 68.3% of the patientsare male and most of them are Sundanese and Javanese. Palpable lump in the neck is the most commoncomplaint in presentation (58.1%), followed by nasal congestion (49.1%). Salted fish consumption was themost prevalent risk factor (29.9%). Based on the histopathologic findings, 75.4% of the cases were classifiedas WHO-3 and around half of the patients (51%) were in stage IV upon diagnosis. Studying demographic andclinical characteristics of NPC patients is the first step to overcome problems caused by NPC in Indonesia

Prospective randomized comparison of open versus laparoscopic management of splenic artery aneurysms: a 10-year study

Abstract BACKGROUND: The literature does not support the choice between open and laparoscopic management of splenic artery aneurysms (SAA). METHODS: We designed a prospective, randomized comparison between open and laparoscopic surgery for SAA. Primary end points were types of surgical procedures performed and clinical outcomes. Analysis was developed on an intention-to-treat basis. RESULTS: Fourteen patients were allocated to laparotomy (group A) and 15 to laparoscopy (group B). Groups displayed similar patient- and aneurysm-related characteristics. The conversion rate to open surgery was 13.3 %. The type of surgical procedure performed on the splenic artery was similar in the two groups: aneurysmectomy with splenic artery ligature or direct anastomosis was performed in 51 % and 21 % of patients in group A and in 60 % and 20 % in group B, respectively. The splenectomy rate was similar (14 % vs. 20 %). Postoperative splenic infarction was observed in one case in each group. Laparoscopy was associated with shorter procedures (p = 0.0003) and lower morbidity (25 % vs. 64 %, p = 0.045). Major morbidity requiring interventional procedures and blood transfusion was observed only in group A. Laparoscopy was associated with quicker resumption of oral diet (p < 0.001), earlier drain removal (p = 0.046), and shorter hospital stay (p < 0.01). During a mean follow-up of 50 months, two patients in group A required hospital readmission. In group B, two patients developed a late thrombosis of arterial anastomoses. CONCLUSIONS: Our study demonstrates that laparoscopy permits multiple technical options, does not increase the splenectomy rate, and reduces postoperative complications. It confirms the supposed clinical benefits of laparoscopy when ablative procedures are required but laparoscopic anastomoses show poor long-term results

Investigation and Statistical Analysis for Optimizing Surface Roughness, Cutting Forces, Temperature, and Productivity in Turning Grey Cast Iron

This paper investigated the influence of cutting parameters, including feed rate, cutting speed, tool nose radius, and wet or dry cutting conditions, on the resultant force, cutting edge/workpiece temperature, and surface roughness when turning grey cast iron. Results showed that increasing the feed rate increased the resultant force, cutting temperature, and surface roughness. At the same time, increasing the cutting speed and nose radius increased the cutting temperature, which in turn reduced the resultant force. For practical applications, basic mathematical calculations based on the sole effect of each parameter on the output of the experiments were used to estimate the extent of percentage increase in cutting temperature due to increasing feed rate, cutting speed, and nose radius. Similarly, the same approach was used to estimate the effect of increasing feed rate, cutting speed, and nose radius on average surface roughness. Results showed that increasing the feed rate increases the cutting temperature by 5 to 11% depending on the nose radius and cutting speed. On the other hand, increasing the cutting speed was found to have limited effect on cutting temperature with small nose radius whereas this effect increases with increasing the nose radius reaching about 11%. Increasing the nose radius also increases the cutting temperature, depending mainly on cutting speed, reaching a maximum of 21% at higher cutting speeds. Results also showed that increasing the feed rate increased the average surface roughness considerably to about 120% at high cutting speeds and a large nose radius. On the other hand, increasing the cutting speed and nose radius reduced the surface roughness (i.e., improved surface quality) by a maximum of 29 and 23%, respectively. In order to study the combined effects of the cutting parameters on the three responses, namely, the resultant cutting force, cutting temperature, and surface roughness, full factorial design and ANOVA were used, where it was found to be in good agreement with mathematical calculations. Additionally, the desirability function optimization tool was used to minimize the measured responses whilst maximizing the material removal rate

Phytochemical analysis and evaluation of antibacterial activity of Moringa oleifera extracts against gram-negative bacteria: an in vitro and molecular docking studies

Moringa oleifera seed and leaf are used traditionally for the treatment of various healthproblems (among others, hypertension, scrapes, skin infection, diabetes, genitourinaryillnesses), and to boost the immune system, as well as to act as a contraceptive. Inthis study, the antibacterial activity of seed and leaf M. oleifera extracts on three-gramnegative bacteria was investigated, and phytochemical analysis for the association ofantibacterial activity with the active constituents in the plant was determined. Moreover,understanding of the mechanism of action was achieved by applying the Auto DockVina technique. The phytochemical screening of M. oleifera seed and leaf extractsexhibited the presence of alkaloids, carbohydrates, cardioactive glycosides, flavonoids,tannins, phenols, steroids and terpenoids. In silico results revealed that compounds(4-O-caffeoyl quinic acid, 4-(α-L-rhamnopyranosyloxyl)-benzylisothiocyanate);(Isoquercitrin, 4-(α-L-rhamnopyranosyloxy) benzyl glucosinolate); and (Astragalin,4-(α-L-rhamnopyranosyloxy) benzyl glucosinolate) from leaf and seed have the highestbinding affinity and very good interactions with Transcriptional Activator Protein (LasR),Klebsiella pneumoniae carbapenemase (KPC), and Malonyl-CoA-acyl carrier proteintransacylase (FabD), respectively

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Genome-wide analysis identifies 12 loci influencing human reproductive behavior.

The genetic architecture of human reproductive behavior-age at first birth (AFB) and number of children ever born (NEB)-has a strong relationship with fitness, human development, infertility and risk of neuropsychiatric disorders. However, very few genetic loci have been identified, and the underlying mechanisms of AFB and NEB are poorly understood. We report a large genome-wide association study of both sexes including 251,151 individuals for AFB and 343,072 individuals for NEB. We identified 12 independent loci that are significantly associated with AFB and/or NEB in a SNP-based genome-wide association study and 4 additional loci associated in a gene-based effort. These loci harbor genes that are likely to have a role, either directly or by affecting non-local gene expression, in human reproduction and infertility, thereby increasing understanding of these complex traits