Post-splenectomy infections in chronic schistosomiasis as a consequence of bacterial translocation

INTRODUCTION : Bacterial translocation is the invasion of indigenous intestinal bacteria through the gut mucosa to normally sterile tissues and internal organs. Schistosomiasis may cause alterations in the immune system and damage to the intestines, portal system and mesenteric lymph nodes. This study investigated bacterial translocation and alterations in the intestinal microbiota and mucosa in schistosomiasis and splenectomized mice. METHODS : Forty female 35-day-old Swiss Webster mice were divided into the following four groups with 10 animals each: schistosomotic (ESF), splenectomized schistosomotic (ESEF), splenectomized (EF) and control (CF). Infection was achieved by introduction of 50 Schistosoma mansoni (SLM) cercariae through the skin. At 125 days after birth, half of the parasitized and unparasitized mice were subjected to splenectomy. Body weights were recorded for one week after splenectomy; then, the mice were euthanized to study bacterial translocation, microbiota composition and intestinal morphometry. RESULTS : We observed significant reductions in the weight increases in the EF, ESF and ESEF groups. There were increases of at least 1,000 CFU of intestinal microbiota bacteria in these groups compared with the CF. The EF, ESF and ESEF mice showed decreases in the heights and areas of villi and the total villus areas (perimeter). We observed frequent co-infections with various bacterial genera. CONCLUSIONS : The ESEF mice showed a higher degree of sepsis. This finding may be associated with a reduction in the immune response associated with the absence of the spleen and a reduction in nutritional absorption strengthened by both of these factors (Schistosoma infection and splenectomy).

Reinvigorating and redesigning early intervention in psychosis services for young people in Auckland

RESUMO: Auckland tem sido pioneira na implementação de modelos de Intervenção Precoce em Psicose. No entanto, esta organização do serviço não mudou nos últimos 19 anos. Segundo os dados obtidos da utilização do serviço, no período de 1996 -2012 foram atendidos 997 doentes, que tinham um número médio de 89 contactos (IQR: 36-184), com uma duração média de 62 horas de contactos (IQR: 24-136). Estes doentes passaram um número médio de 338 dias (IQR: 93-757) em contacto com o programa. 517 doentes (52%) não necessitaram de internamento no hospital, e os que foram internados, ficaram uma mediana de 124 dias no hospital (IQR: 40-380). Os doentes asiáticos tiveram um aumento de 50% de probabilidade de serem internados no hospital. Este relatório inclui 15 recomendações para orientar as reformas para o serviço e, nomeadamente, delinear a importância de uma visão organizacional e dos seus componentes-chave. As recomendações incluem o reforço da gestão e da liderança numa estrutura de equipe mais integrada, com recursos dedicados a melhorar a consciencialização da comunidade, a educação e deteção precoce, bem como a capacidade de receber referenciações diretas. Os Indicadores Chave de Desempenho devem ser estabelecidos, mas os Exames de Estado Mental em risco, devem ser removidos. Auckland deve manter a faixa etária alvo atual. A duração do serviço deve ser aumentada para um mínimo de três anos, com a opção de aumentá-la para cinco anos. A proporção de gestor de cuidados para os doentes deve ser preconizada em 1:15, enquanto o pessoal de apoio não-clínico deve ser aumentado. Os psiquiatras devem ter uma carga de trabalho de cerca de 80 doentes por equivalente de tempo completo. Um serviço local de prestação de cuidados deve ser desenvolvido com, nomeadamente, intervenções culturais para responder às necessidades da população multicultural de Auckland. A capacidade de investigação deve ser incorporada no Serviço de Intervenção Precoce em Psicoses. Qualquer alteração deverá envolver contacto com todas as partes interessadas, e a Administração Regional de Saúde deve comprometer-se em tempo, recursos humanos e políticos para apoiar e facilitar a mudança do sistema, investindo de forma significativa para melhor servir a comunidade Auckland.----------------------------------- ABSTRACT: Auckland has been pioneering in the adoption of Early Intervention in Psychosis models but the design of the service has not changed in 19 years. In service utilisation data from 997 patients seen from 1996 -2012, patients had a median number of 89 contacts (IQR: 36-184), with a median duration of 62 hours of contact (IQR: 24-136). Patients spent a median number of 338 days (IQR: 93-757) in contact with the program. 517 patients (52%) did not require admission to hospital, and those who did spent a median of 124 days in hospital (IQR: 40-380). Asian patients had a 50% increased chance of being admitted to hospital. This report includes 15 recommendations to guide reforms to the service, including outlining the importance of vision and key components. It recommends strengthened managerial leadership and a more integrated team structure with dedicated resources for improved community awareness, education and early detection as well as the capacity to take direct referrals. Key Performance Indicators (KPIs) should be established but At Risk Mental States should be excluded. Auckland should maintain the current target age range. The duration of service should be increased to a minimum of three years, with the option to extend this to five years. The ratio of care co-ordinator to patients should be capped at 1:15 whilst non-clinical supporting staff should be increased. Psychiatrists should have a caseload of about 80 per FTE. A local Service Delivery framework should be developed, as should cultural interventions to meet the needs of the multicultural population of Auckland. Research capacity should be incorporated into the fabric of Early Intervention in Psychosis Services. Any changes should involve consultation with all stakeholders, and the DHB should commit to investing time, human and political resources to support and facilitate meaningful system change to best serve the Auckland community.

Assessment of overlay masonry strengthening system under in-plane monotonic and cyclic loading using the diagonal tensile test

The development of novel strengthening techniques to address the seismic vulnerability of masonry elements is gradually leading to simpler, faster and more effective strengthening strategies. In particular, the use of fabric reinforced cementitious matrix systems is considered of great potential, given the increase of ductility achieved with simple and economic strengthening procedures. To assess the effectiveness of these strengthening systems, and considering that the seismic action is involved, one important component of the structural behaviour is the in-plane cyclic response. In this work is discussed the applicability of the diagonal tensile test for the assessment of the cyclic response of strengthened masonry. The results obtained allowed to assess the contribution of the strengthening system to the increase of the load carrying capacity of masonry elements, as well as to evaluate the damage evolution and the stiffness degradation mechanisms developing under cyclic loading.

Design formula for the flexural strengthening of RC beams using prestressed CFRP reinforcement

Applying a certain prestress level to the carbon fiber reinforced polymer (CFRP) reinforcement according to either externally bonded reinforcing (EBR) or near surface mounted (NSM) techniques can mobilize the strengthening potentialities of this high tensile strength composite material. For the prediction of the flexural behavior of reinforced concrete (RC) structures strengthened with prestressed EBR or NSM CFRPs, however, simplified analytical and design formulations still need to be developed as a guidance for engineers to design this type of strengthened structures by hand calculation without any programming help. Hence, the current work aims to briefly explain a developed simplified analytical approach, with a design framework, to predict the flexural behavior of RC beams flexurally strengthened with either prestressed EBR or NSM CFRP reinforcements. Moreover, an upper limit for the prestress level is proposed in order to optimize the ductility performance of the NSM prestressing technique. The good predictive performance of the analytical approaches was appraised by simulating the results of experimental programs composed of RC beams strengthened with prestressed NSM CFRP reinforcements.

Embedded Through-Section shear strengthening technique using steel and CFRP bars in RC beams of different percentage of existing stirrups

The Embedded Through-Section (ETS) technique is a promising technique for the shear strengthening of existing (RC) elements. According to this technique, holes are drilled through the beam section, and bars of steel or FRP material are introduced into these holes and bonded to the concrete with adhesive materials. An experimental program was carried out with RC T-cross section beams strengthened in shear using the ETS steel bars and ETS CFRP rods. The research is focused on the evaluation of the ETS efficiency on beams with different percentage of existing internal transverse reinforcement (ρsw=0.0%, ρsw=0.1% and ρsw=0.17%). The effectiveness of different ETS strengthening configurations was also investigated. The good bond between the strengthening ETS bars and the surrounding concrete allowed the yield initiation of the ETS steel bars and the attainment of high tensile strains in the ETS CFPR rods, leading to significant increase of shear capacity, whose level was strongly influenced by the inclination of the ETS bars and the percentage of internal transverse reinforcement.

Flexural strengthening of RC beams using hybrid composite plate (HCP): experimental and analytical study

Hybrid Composite Plate (HCP) is a reliable recently proposed retrofitting solution for concrete structures, which is composed of a strain hardening cementitious composite (SHCC) plate reinforced with Carbon Fibre Reinforced Polymer (CFRP). This system benefits from the synergetic advantages of these two composites, namely the high ductility of SHCC and the high tensile strength of CFRPs. In the materialstructural of HCP, the ultra-ductile SHCC plate acts as a suitable medium for stress transfer between CFRP laminates (bonded into the pre-sawn grooves executed on the SHCC plate) and the concrete substrate by means of a connection system made by either chemical anchors, adhesive, or a combination thereof. In comparison with traditional applications of FRP systems, HCP is a retrofitting solution that (i) is less susceptible to the detrimental effect of the lack of strength and soundness of the concrete cover in the strengthening effectiveness; (ii) assures higher durability for the strengthened elements and higher protection to the FRP component in terms of high temperatures and vandalism; and (iii) delays, or even, prevents detachment of concrete substrate. This paper describes the experimental program carried out, and presents and discusses the relevant results obtained on the assessment of the performance of HCP strengthened reinforced concrete (RC) beams subjected to flexural loading. Moreover, an analytical approach to estimate the ultimate flexural capacity of these beams is presented, which was complemented with a numerical strategy for predicting their load-deflection behaviour. By attaching HCP to the beams’ soffit, a significant increase in the flexural capacity at service, at yield initiation of the tension steel bars and at failure of the beams can be achieved, while satisfactory deflection ductility is assured and a high tensile capacity of the CFRP laminates is mobilized. Both analytical and numerical approaches have predicted with satisfactory agreement, the load-deflection response of the reference beam and the strengthened ones tested experimentally.

Transfer zone of prestressed CFRP reinforcement applied according to NSM technique for strengthening of RC structures

This study presents an experimental program to assess the tensile strain distribution along prestressed carbon fiber reinforced polymer (CFRP) reinforcement flexurally applied on the tensile surface of RC beams according to near surface mounted (NSM) technique. Moreover, the current study aims to propose an analytical formulation, with a design framework, for the prediction of distribution of CFRP tensile strain and bond shear stress and, additionally, the prestress transfer length. After demonstration the good predictive performance of the proposed analytical approach, parametric studies were carried out to analytically evaluate the influence of the main material properties, and CFRP and groove cross section on the distribution of the CFRP tensile strain and bond shear stress, and on the prestress transfer length. The proposed analytical approach can also predict the evolution of the prestress transfer length during the curing time of the adhesive by considering the variation of its elasticity modulus during this period.

Shear strengthening of damaged reinforced concrete beams with hybrid composite plates

This paper aims to evaluate experimentally the potentialities of Hybrid Composite Plates (HCPs) technique for the shear strengthening of reinforced concrete (RC) beams that were previously subjected to intense damage in shear. HCP is a thin plate of Strain Hardening Cementitious Composite (SHCC) reinforced with Carbon Fiber Reinforced Polymer (CFRP) laminates. For this purpose, an experimental program composed of two series of beams (rectangular and T cross section) was executed to assess the strengthening efficiency of this technique. In the first step of this experimental program, the control beams, without steel stirrups, were loaded up to their shear failure, and fully unloaded. Then, these pre-damaged beams were shear strengthened by applying HCPs to their lateral faces by using a combination of epoxy adhesive and mechanical anchors. The bolts were applied with a certain torque in order to increase the concrete confinement. The obtained results showed that the increase of load carrying capacity of the damaged strengthened beams when HCPs were applied with epoxy adhesive and mechanical anchors was 2 and 2.5 times of the load carrying capacity of the corresponding reference beams (without HCPs) for the rectangular and T cross section beam series, respectively. To further explore the potentialities of the HCPs technique for the shear strengthening, the experimental tests were simulated using an advanced numerical model by a FEM-based computer program. After demonstration the good predictive performance of the numerical model, a parametric study was executed to highlight the influence of SHCC as an alternative for mortar, as well as the influence of torque level applied to the mechanical anchors, on the load carrying capacity of beams strengthened with the proposed technique.

Evaluation of the bond performance in FRP-brick components re-bonded after initial delamination

The bond behavior between Fiber Reinforced Polymers (FRPs) and masonry substrates has been the subject of many studies during the last years. Recent accelerated aging tests have shown that bond degradation and FRP delamination are likely to occur in FRP-strengthened masonry components under hygrothermal conditions. While an investigation on the possible methods to improve the durability of these systems is necessary, the applicability of different bond repair methods should also be studied. This paper aims at investigating the debonding mechanisms after repairing delaminated FRP-strengthened masonry components. FRP-strengthened brick specimens, after being delaminated, are repaired with two different adhesives: a conventional epoxy resin and a highly flexible polymer. The latter is used as an innovative adhesive in structural applications. The bond behavior in the repaired specimens is investigated by performing single-lap shear bond tests. Digital image correlation (DIC) is used for deeper investigation of the surface deformation and strains development. The effectiveness of the repair methods is discussed and compared with the strengthened specimens.

Application of acoustic emission technique for bond characterization in FRP-masonry systems

The acoustic emission (AE) technique is used for investigating the interfacial fracture and damage propagation in GFRP-and SRG-strengthened bricks during debonding tests. The bond behavior is investigated through single-lap shear bond tests and the fracture progress during the tests is recorded by means of AE sensors. The fracture progress and active debonding mechanisms are characterized in both specimen types with the aim of AE outputs. Moreover, a clear distinction between the AE outputs of specimens with different failure modes, in both SRG-and GFRP-strengthened specimens, is found which allows characterizing the debonding failure mode based on acoustic emission data.

Tensile creep of a structural epoxy adhesive: experimental and analytical characterization

Epoxy adhesives are nowadays being extensively used in Civil Engineering applications, mostly in the scope of the rehabilitation of reinforced concrete (RC) structures. In this context, epoxy adhesives are used to provide adequate stress transference from fibre reinforced polymers (FRP) to the surrounding concrete substrate. Most recently, the possibility of using prestressed FRPs bonded with these epoxy adhesives is also being explored in order to maximize the potentialities of this strengthening approach. In this context, the understanding of the long term behaviour of the involved materials becomes essential. Even when non-prestressed FRPs are used a certain amount of stress is permanently applied on the adhesive interface during the serviceability conditions of the strengthened structure, and the creep of the adhesive may cause a continuous variation in the deformational response of the element. In this context, this paper presents a study aiming to experimentally characterize the tensile creep behaviour of an epoxy-based adhesive currently used in the strengthening of concrete structures with carbon FRP (CFRP) systems. To analytically describe the tensile creep behaviour, the modified Burgers model was fitted to the experimental creep curves, and the obtained results revealed that this model is capable of predicting with very good accuracy the long term behaviour of this material up to a sustained stress level of 60% of the adhesive’s tensile strength.

Investigating the durability of FRP-masonry elements immersed in water

Nowadays, there is an increasing interest in using fiber reinforced polymers (FRP) for strengthening masonry elements. It has been observed that these materials, when used for externally bonded reinforcement (EBR), improve the performance of masonry components. However, issues such as durability and long-term performance of strengthened elements are still open. The bond between composite material and masonry substrate is a critical mechanism in EBR strengthening techniques, and therefore its durability and long-term performance should be deeply investigated and characterized. In the present study, the influence of water immersion on the bond performance is investigated by performing single-lap shear bond tests on two sets of GFRP-strengthened specimens immersed in water for six months. Different surface preparation techniques are used for each set of specimens to study their effect on the bond degradation. The specimens are prepared following the wet lay-up procedure. The observations and the obtained results are presented and discussed.

Shear strengthening of reinforced concrete beams with SHCC-FRP panels

Tese de Doutoramento em Engenharia Civil

Innovative methodologies for the enhancement of the flexural strengthening performance of NSM CFRP technique for RC beams

Tese de Doutoramento em Engenharia Civil

Assessment of the properties to characterize the interface between clay brick substrate and strengthening mortar

The behaviour of masonry elements under in-plane and out-of-plane loads can be improved through the application of strengthening systems based on reinforcing overlays. After strengthening, the transition region between the original substrate and the strengthening layer is especially stressed, and premature failure of the strengthened masonry is reached if insufficient interfacial capacity is assured. Therefore, the assessment of the mechanical behaviour of the interface is critical to the development of the masonry strengthening system based on the application of strengthening overlays. In this research a method for the characterization of the interface behaviour between two different materials, a polypropylene fibre reinforced mortar (PFRM) and a ceramic brick used for masonry construction is presented. Direct shear tests were carried out in couplet specimens. Due to the orthotropic nature of the bricks surface, the shear load was applied along three different directions in order to perform an overall estimation of the interface behaviour. The peak and residual shear stresses, as well as the failure modes, were obtained at different levels of the normal stress. Based on these experimental results constitutive laws were assessed for the simulation of the interface mechanical behaviour based on the Mohr and Mohr-Coulomb failure criteria.