67 research outputs found
Shaking table tests of unreinforced and retrofitted rectangular three-leaf masonry walls under triaxial seismic excitation
No full textThe paper reports on the findings of the EU/H2020-funded project REBOND/SERA and investigates, by means of shaking table tests, two key questions on the seismic behaviour of multi-leaf masonry walls. The first one concerns the potential detrimental effects of the vertical component of ground motion on the strength degradation of the wall. The second relates to the effectiveness of a retrofitting scheme based on galvanized steel glass fibres inserted through the wall thickness. Investigating these two issues helps identify cases where the vertical ground motion component should be used in the seismic assessment of both as built and retrofitted masonry structures. It can also indicate cases. The ground motion is incrementally applied with scale factors ranging from 10 % to 120 %, unless collapse is reached at a lower intensity level. These results are compared with those previously published on an identically designed wall tested neglecting the vertical component of the ground motion. The dynamic tests of the retrofitted wall are also comparatively discussed. It is shown that the vertical ground motion component significantly affects the response of the three leaf wall, with more severe cracks and damage levels being observed at lower seismic intensities. With the 100 % scaled record, the consideration of the vertical component caused residual drifts of 0.25 %, corresponding to damage that was not observed under horizontal excitation only. Notably, the first residual vertical displacements were recorded at 75 % of the input earthquake and increased to 2.5 mm at 100 % of the input earthquake. On the other hand, the proposed retrofitting scheme, as anticipated, increased the wall strength and delayed crack formation. The first residual displacements in the retrofitted wall were recorded at 120 % of the earthquake input, which is strong evidence of the effectiveness of the proposed retrofitting scheme
Η επίπτωση της πανδημίας του COVID-19 στην χειρουργική δραστηριότητα: ανασκόπηση της βιβλιογραφίας και η περίτπωση του ΓΝΑ "ΛΑΙΚΟ"
No full textΣκοπός Σκοπός αυτού του άρθρου είναι να αξιολογήσει τον αντίκτυπο της πανδημίας COVID-19 στη χειρουργική δραστηριότητα καθώς και να αναλύσει τις αλλαγές που επέφερε στις επείγουσες επεμβάσεις και στη χειρουργική ογκολογία. Επιπλέον, αναφέρουμε την εμπειρία του Χειρουργικού Τμήματός μας στην Αθήνα, Ελλάδα. Υλικό και μέθοδος Πραγματοποιήθηκε ανασκόπηση της βιβλιογραφίας αξιολογώντας άρθρα σχετικά με τη χειρουργική δραστηριότητα και τον ιό COVID-19 που δημοσιεύτηκαν από την αρχή της πανδημίας έως τον Ιανουάριο του 2022 στη βάση δεδομένων PubMed. Όσον αφορά στην πρακτική του κέντρου μας, συλλέξαμε δεδομένα για χειρουργικές επεμβάσεις που πραγματοποιήθηκαν σε ασθενείς σε αντίστοιχες χρονικές περιόδους πριν και μετά την πανδημία COVID-19. Αποτελέσματα Από τις 16.957 μελέτες, οι 51 επιλέχθηκαν για επανεξέταση. Σύμφωνα με αυτές, η κύρια επίδραση της πανδημίας στον Χειρουργικό Τομέα αποτυπώθηκε στη μείωση του συνόλου των χειρουργικών επεμβάσεων, κυρίως λόγω της αναβολής των εκλεκτικών χειρουργικών επεμβάσεων, οι οποίες παρουσίασαν μέση μείωση 54% σε σχέση με την προ-COVID-19 περίοδο. . Μικρότερη μείωση παρατηρήθηκε στον αριθμό των επειγόντων και ογκολογικών χειρουργείων. Στο κέντρο μας αναφέραμε μέση μείωση κατά 20,5% στο συνολικό χειρουργικό όγκο, με μικρότερη πτώση των επειγόντων χειρουργείων, ενώ μικρή άνοδο εμφανίστηκε στις ογκολογικές χειρουργικές επεμβάσεις. Συμπεράσματα Η μειωμένη χειρουργική δραστηριότητα κατά την πανδημία, λόγω των υγειονομικών μέτρων που επιβλήθηκαν, απαιτεί γενναίες διορθωτικές παρεμβάσεις για την αποφυγή των δυσμενών συνεπειών της, όπως εξέλιξη της νόσου, αυξημένο κόστος θεραπείας, μειωμένη ποιότητα ζωής και τελικά επιβίωση των ασθενών.Background/ Aim The aim of this article is to evaluate the impact of the COVID-19 pandemic on the surgical activity as well as to analyze the changes on the surgical emergency and surgical oncology. Additionally, we report the experience of our surgical department in Athens, Greece. Material and Methods We performed a literature review evaluating articles on surgical activity and COVID-19 published from the beginning of the pandemic up until the January of 2022 on PubMed. Concerning the practice in our center, we collected data on surgical procedures performed on patients in corresponding time periods before and after the COVID-19 pandemic outbreak. Results Of the 16,957 studies, 51 were selected for review. According to them, the main effect of the pandemic on the Surgical Sector was reflected in the reduction of total surgeries, mainly due to the postponement of elective surgical procedures, which showed a median reduction of 54% compared to the pre-COVID-19 period. A smaller decrease was observed in the number of emergency and oncological surgeries, whose continuous operation has been set as a priority by the guidelines. In our center we reported an average reduction of 20.5% in total surgical volume, with a smaller drop in emergency surgeries, whereas a small increase was observed in oncology surgeries. Conclusions Reduced surgical activity during the pandemic, due to the health measures imposed, requires courageous corrective interventions to avoid its adverse effects, such as disease progression, increased treatment costs, reduced quality of life and ultimately decreased survival of the patients
Το στάδιο των χειρουργικών ασθενών με κολοορθικό καρκίνο στην Ελλάδα
No full textΓενικές πληροφορίες Ο κολοορθικός καρκίνος είναι από τις συχνότερες και σοβαρότερες κακοήθειες παγκοσμίως, με 746.000 νέες περιπτώσεις και 614.000 θανάτους το 2012. Παρότι στις περισσότερες ανεπτυγμένες χώρες λειτουργούν προγράμματα προσυμπτωματικού ελέγχου και οι νέες περιπτώσεις καταχωρούνται σε εθνικές βάσεις δεδομένων, ελάχιστες πληροφορίες είναι διαθέσιμες για την αντιμετώπιση της νόσου στον ελλαδικό χώρο. Στόχος της παρούσας έρευνας είναι να μελετήσει τη συμπτωματολογία και το στάδιο της νόσου των ασθενών κατά τη διάγνωση καθώς και να περιγράψει το είδος της χειρουργικής θεραπείας τους. Μέθοδος Εξετάστηκαν αναδρομικά οι φάκελοι 249 ασθενών με καρκίνο παχέος εντέρου και ορθού οι οποίοι χειρουργήθηκαν με σκοπό την ίαση στη Δ΄ Χειρουργική Κλινική ΓΠΝ «Γ. Παπανικολάου» Θεσσαλονίκης και Α’ Χειρουργική Κλινική 401ΓΣΝ Αθηνών κατά το διάστημα 2010-2016. Αποτέλεσματα Η συχνότερη κλινική εικόνα των ασθενών ήταν το κοιλιακό άλγος (29,1% των περιπτώσεων) για νόσο του δεξιού κόλου και οι διαταραχές των κενώσεων για νόσο του αριστερού κόλου. Το 27,7% των κακοηθειών εμφανίστηκε με εικόνα οξέος χειρουργικού προβλήματος, ενώ μόνο το 4,8% των περιπτώσεων διαγιγνώσθηκε σε προσυμπτωματικό έλεγχο. Η χειρουργική θεραπεία εξατομικεύτηκε με βάση την εντόπιση και το στάδιο του όγκου. Όπως προέκυψε από την παθολογοανατομική εξέταση των χειρουργικών παρασκευασμάτων, το στάδιο κατά ΤΝΜ της νόσου των ασθενών της σειράς ήταν: Στάδιο 0: 5(2%), Στάδιο Ι: 45(18,1%), Στάδιο ΙΙ: 83(33,3%), Στάδιο ΙΙΙ: 95(38,2%), Στάδιο IV: 21(8,4%). Συμπεράσματα Τα δημογραφικά και κλινικά χαρακτηριστικά των ασθενών της μελέτης συμφωνούν σε μεγάλο βαθμο με τη διεθνή βιβλιογραφία. Η βαθύτερη ανάλυση των δεδομένων αναδεικνύει την αναγκαιότητα αυξημένης συμμετοχής του γενικού πληθυσμού σε προγράμματα προσυμπτωματικού ελέγχου, λειτουργίας κέντρων αναφοράς και θέσπισης εθνικής βάσης δεδομένων με σκοπό την αποτελεσματικότερη αντιμετώπιση του καρκίνου του παχέος εντέρου.Background Colorectal cancer (CRC) is one of the most common and most serious malignancies worldwide, accounting for 746,000 new cases and 614,000 deaths in 2012 alone. Although screening programs are offered in most developed countries and the new cases are recorded in national cancer databases, little is known about the treatment of CRC in Greece. The aim of this study is to examine the symptomatology and the status of CRC patients at the time of diagnosis as well as the type of their surgical treatment. Methods The hospital records of 249 patients with CRC who had undergone a procedure with curative intent, in Fourth Surgical Department, G. Papanikolaou Hospital Thessaloniki and in First Department of Surgery, 401 Army General Hospital Athens, were retrospectively studied. Patients were divided in two groups according to the location of their tumor (colon and rectum) and the results were compared to databases of developed countries. Results Abdominal pain was the most common presenting symptom (29,1% of cases) for right-sided CRC and a change in bowel habits for the left-sided CRC. In our study, 27.7% of the patients were admitted as surgical emergencies, while only 4.8% of the malignancies were detected by screening. Surgical treatment varied according to the location and the stage of the tumour. Histopathological study of the resection specimens allowed us to note that 5 patients (2%) have been diagnosed in stage 0, 45 (18,1%) in stage I, 83 (33,3%) in stage II, 95 (38,2%) in stage III and 21 (8,4%) in stage IV. Conclusions The demographic and clinical characteristics of these patients are in agreement with the existing bibliography. Further interpretation of the results highlights the need of increased participation in screening programs, creation of specialized cancer centers of excellence and establishment of a national cancer database, for a more effective treatment of colorectal cancer
Η ποιητική του νεοελληνικού λαϊκού παραμυθιού. Παραμυθιακοί τύποι και μοτίβα σε κείμενα νεοελληνικής λογοτεχνίας
No full textΗ παρούσα εργασία επιχειρεί να πραγματευθεί την ποιητική του νεοελληνικού λαϊκού παραμυθιού ως είδους της λαϊκής λογοτεχνικής δημιουργίας, καθώς συνιστά αντικείμενο μελέτης λαογραφικών, φιλολογικών ανθρωπολογικών αλλά και ψυχολογικών και παιδαγωγικών ερευνών. Εκκινώντας από την προέλευση της παραμυθιακής αφήγησης και της σχέσης της με τον μύθο γίνεται αντιληπτή η παράλληλη πορεία τους μέχρι και σήμερα, καθώς μύθος και παραμύθι εξακολουθούν να αναπαράγονται ακολουθώντας τις εκάστοτε κοινωνικές μεταβολές. Μέσα σε αυτά τα πλαίσια, εξετάζεται η εξελικτική πορεία του στο χρόνο, οι ποιητολογικές αλλά και οι ειδολογικές συμβάσεις που το καθιστούν λογοτέχνημα. Γίνεται επίσης προσπάθεια να διερευνηθεί το ζήτημα της προφορικότητας και της εγγραμματοσύνης, της λογοτεχνικότητας και της αισθητικής του λαϊκού παραμυθιού, χωρίς να παραλείπουμε να αναφερθούμε τόσο σε θέματα που αφορούν στα δομικά στοιχεία του παραμυθιού όπως είναι το «θέμα» και το «μοτίβο», τα μορφολογικά του στοιχεία, η λειτουργία των δρώντων προσώπων, όσο και σε θέματα που αφορούν στα είδη και την ταξινόμηση του λαϊκού παραμυθιού. Η σχέση της λογοτεχνίας με τη λαογραφία, τον μύθο και την παράδοση προσεγγίζονται μέσα από τις διακειμενικές σχέσεις της προφορικότητας του λαϊκού παραμυθιού με συγγραφείς και κείμενα της νεοελληνικής λογοτεχνίας, όπου εγγράφονται τύποι και μοτίβα της παραμυθιακής αφήγησης. Σε αυτό το σημείο οφείλουμε να σημειώσουμε ότι η αναφορά σε συγκεκριμένους λογοτέχνες και είδη είναι ενδεικτικά και περιλαμβάνει διαφορετικές λογοτεχνικές γενιές και λογοτεχνικά είδη και δεν αποτελεί συστηματική διερεύνηση, μιας συγκεκριμένης περιόδου ή ενός λογοτέχνη, κάτι που θα μπορούσε να αποτελέσει πεδίο μελλοντικής έρευνας.The present dissertation attempts to deal with the poetics of the modern Greek folk tale as a kind of popular literary creation, since it constitutes the subject of study of folklore, philological, anthropological but also psychological and pedagogical research. Taking as starting point the origin of the fairy tale narration and its relationship with the myth, it is clearly understood that they have a parallel course until today, as myth and fairy tale continue to be reproduced following the respective social changes. In this context, its evolutionary course over time is examined, as well as the poetic and ideological conventions that make it a literary work. Efforts are also being made to explore the issue of orality and literacy of the literature and aesthetics of the folk tale, without failing to refer to issues related to the structural elements of the fairy tale such as the "theme" and the "motif", its morphological elements, the function of the characters, as well as to issues concerning the species and the classification of the folk tale. The relation of literature with folklore, myth and tradition is approached through the intertextual relations of the orality of the folk tale with authors and texts of modern Greek literature, where types and motifs of the fairy tale narration are recorded. At this point we should note that the reference to specific writers and genres is indicative and includes different literary generations and literary genres and is not a systematic investigation of a particular period or author, which could be a field of future research
Towards very large scale laboratory simulation of structure-foundation-soil interaction (SFSI) problems
No full textWe are at the maturity convergence point of a set of actuation, control, instrumentation and data analysis technologies that make it feasible to construct laboratory experimental rigs that will allow us to address key controlling uncertainties in SFS I assessment and design, which can only be addressed by testing at, or near to, prototype scale. This paper will explore the process of innovation that must be established in order to integrate these enabling technologies and thereby create novel test facilities that offer new, high value, capabilities.</p
Experimental identification of stiffness and ultimate resistance of buried soil-pipe systems
No full textIn context of pipeline design, the soil’s stiffness and ultimate lateral resistance are critical values. Existing approximations for ultimate lateral resistance vary significantly and there are few expressions for the soil stiffness parameters. These parameters are implemented in soil constitutive models for pipeline design under different displacement induced conditions. This research focusses on the experimental investigation of the response of the soil-pipe system to enforced horizontal loading for application to natural gas pipelines. The study examines shallow burial depths (<5.5D), using a section of solid acrylic pipe in dry Leighton Buzzard grade B sand. Plane-strain conditions have been replicated and experiments run to evaluate quantities for soil stiffness, through lab experiments and validated finite element analyses (FEA). Monotonic loading was applied onto the pipe within varied conditions, changing both burial depth and soil density to establish the relationship with soil stiffness. The FEA results were used to ratify such behaviors, establishing an analysis for displacement response and corresponding stiffness parameters. Absolute and relative stiffness values from both analyses were then compared with existing literature and the results reflect the importance of relative soil properties and expected displacements. Results find that horizontal loading within shallow burial depths induce 2D displacements, which could be modelled as vectors rather than horizontal displacements
Towards very large scale laboratory simulation of structure-foundation-soil interaction (SFSI) problems
No full textWe are at the maturity convergence point of a set of actuation, control, instrumentation and data analysis technologies that make it feasible to construct laboratory experimental rigs that will allow us to address key controlling uncertainties in SFS I assessment and design, which can only be addressed by testing at, or near to, prototype scale. This paper will explore the process of innovation that must be established in order to integrate these enabling technologies and thereby create novel test facilities that offer new, high value, capabilities.</p
Optimization of fecal cytology in the dog: comparison of three sampling methods
No full textDry-mount fecal cytology (FC) is a component of the diagnostic evaluation of gastrointestinal diseases. There is limited information on the possible effect of the sampling method on the cytologic findings of healthy dogs or dogs admitted with diarrhea. We aimed to: (1) establish sampling method–specific expected values of selected cytologic parameters (isolated or clustered epithelial cells, neutrophils, lymphocytes, macrophages, spore-forming rods) in clinically healthy dogs; (2) investigate if the detection of cytologic abnormalities differs among methods in dogs admitted with diarrhea; and (3) investigate if there is any association between FC abnormalities and the anatomic origin (small- or large-bowel diarrhea) or the chronicity of diarrhea. Sampling with digital examination (DE), rectal scraping (RS), and rectal lavage (RL) was prospectively assessed in 37 healthy and 34 diarrheic dogs. The median numbers of isolated (p = 0.000) or clustered (p = 0.002) epithelial cells, and of lymphocytes (p = 0.000), differed among the 3 methods in healthy dogs. In the diarrheic dogs, the RL method was the least sensitive in detecting neutrophils, and isolated or clustered epithelial cells. Cytologic abnormalities were not associated with the origin or the chronicity of diarrhea. Sampling methods differed in their sensitivity to detect abnormalities in FC; DE or RS may be of higher sensitivity compared to RL. Anatomic origin or chronicity of diarrhea do not seem to affect the detection of cytologic abnormalities. © 2017, © 2017 The Author(s)
Medicare part D prescribing for direct oral anticoagulants in the United States: Cost, use and the “Rubber Effect”
No full textIntroduction Direct oral anticoagulants (DOAC) have gained an increased share over warfarin for prevention and treatment of thromboembolic disease. We studied DOAC adoption across providers and medical specialties. Methods Retrospective, cross-sectional analysis of Medicare Part D public use files (PUF), 2013 to 2015. We summarized prescription data for claims and drug payment, stratified by drug class, specialty and calendar year. We treated DOAC claims as a count outcome and explored patterns of expansion across prescribers via a truncated negative binomial regression. We described dispersion and spread in DOAC prescribing, across hospital referral regions (HRRs), including the p90/p10 ratios, and the median absolute deviation from the median. Results In 2015 part D PUF, oral anticoagulant claims have climbed to approximately 24.4 million with a payment cost of approximately 367.4 (interquartile range 323.9 to 445.9), as opposed to 317.0 (interquartile range 303.8 to 324.3) and $8.0 (6.7 to 9.8) for DOACs and warfarin, respectively. DOAC adoption differs by specialty. Cardiologists, cardiac electrophysiologists and orthopedics had the highest predicted DOAC share per 100 claims (53.8, 72.9 and 71.5, respectively in 2015); nephrologists, family practitioners and geriatricians the lowest (22.3, 21.5 and 20.7, respectively in 2015). The p90/p10 ratio and the median absolute deviation from the median varied across HRRs and correlated positively with the prevalence of stroke and atrial fibrillation in the Medicare population. Conclusions DOACs have been increasing their share year-over-year, but adoption varies across specialties. In prevalent areas for stroke and atrial fibrillation, prescription dispersion magnifies, and this may signify a rapid adoption by top providers. © 2018 Ziakas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
- …
