Comparison of the clinical outcomes of skin bridge loop ileostomy and traditional loop ileostomy in patients with low rectal cancer

To compare the clinical results of patients with low rectal cancer who underwent skin bridge loop ileostomy and traditional loop ileostomy, and provide clinical evidence for choosing a better ostomy method. We retrospectively collected data of 118 patients with rectal cancer who underwent low anterior resection and loop ileostomy. To investigate the patients characteristics, postoperative stoma-related complications and the frequency of exchanged ostomy bags. The differences of these indicators between the two groups of patients who underwent skin bridge loop ileostomy and traditional loop ileostomy were compared. The Visual Analog Scale (VAS) score of the skin bridge loop ileostomy group was lower than that of the traditional ileostomy loop group (P < 0.05). The skin bridge group had a lower Discoloration, Erosion, Tissue overgrowth (DET) score and incidence of mucocutaneous separation than the traditional group at the 1st and 2nd weeks after operation (P < 0.05). The average number of weekly exchanged ostomy bags was significantly less in the skin bridge group than in the traditional group within 4 weeks after surgery (P < 0.05). Our experience demonstrates that the skin bridge loop ileostomy may significantly reduce early postoperative stoma-related complications, the frequency of exchanged ostomy bags and patients’ medical costs after discharge.

Analysis of Performance Evaluation Index for bridge group networking monitoring and collaborative supervision

<p>With the number of bridges increases, the bridge health monitoring (BHM) technique is developing from single bridge monitoring to collaborative supervision of bridge group. Therefore, there are many technical problems need to be solved especially the performance evaluation index for bridge group network. This paper analyses the performance evaluation index of the bridges and bridge group network, establishes the performance evaluation index for bridge group based on rating factor (RF) and technical condition evaluation index. Based on bridge field testing and monitoring data, bridge technical condition evaluation index and performance evaluation method for bridge group are proposed. A case study demonstrates that the research results provide support for bridge group networking monitoring and collaborative supervision.</p>

Seismic Fragility Analysis of Bridge Group Pile Foundations considering Fluid-Pile-Soil Interaction

The cross-sea bridges play an important role to promote the development of regional economy. These bridges located in earthquake-prone areas may be subjected to severe earthquakes during their lifetime. Group pile foundations have been widely used in cross-sea bridges due to their structural efficiency, ease of construction, and low cost. This paper investigates the seismic performance of bridge pile foundation based on the seismic fragility analysis. Based on the analysis platform OpenSees, the three-dimensional finite model of the bridge pile foundation is developed, where the pile-water interaction is replaced by the added mass method, nonlinear p-y, t-z, and q-z elements are used to simulate pile-soil interaction, and the displacement of the surface ground motion due to seismic excitations is applied on all spring supports. The seismic fragility curves of the bridge pile foundation are generated by using the earthquake records recommended by FEMA P695 as input motions. The curvature ductility based fragility curves are obtained using seismic responses for different peak ground accelerations. The effects of pile-water interaction, soil conditions, and different types of ground motions on the bridge pier fragilities are studied and discussed. Seismic fragility of the pier-group pile system shows that Sec C (the bottom section of the pier) is the most vulnerable section in the example fluid-structure-soil interaction (FSSI) system for all four damage LSs. The seismic responses of Sec E (a pile section located at the interface of the soil layer and water layer) are much lower than other sections. The parameter analysis shows that pile-water interaction has slight influence (less than 5%) on the fragility curves of the bridge pier. For the bridge group pile foundations considering the fluid-pile-soil interaction, PNF may induce larger seismic response than far-field (FF) and no-pulse near field (NNF). The bridge pile foundation in stiff soil is most vulnerable to seismic damage than soft condition.

Co-Active Prioritization by Means of Contingency Tables for Analyzing Element-level Bridge Inspection Results and Optimizing Returns

An efficient prioritization of bridge actions such as preventive maintenance, rehabilitation, or replacement (MRR) that accounts for inter-element interactions will optimize a long-term return on investments (ROI) in terms of service life extension. What enables this return is the assignment of “Co-Active” elements. This study develops a methodology based on the concept of “Co-Active elements”. The word, “Co-Active”, is used to represent a small group of elements that act together to improve the Bridge Health Index (BHI). The Co-Active parameters for three major bridge groups in Georgia are presented. To illustrate how the Co-Active model works, 1439 in-service bridges’ Element-Level Bridge Inspection results from the state of Georgia in U.S.A., representing a concrete bridge group with six Co-Active elements, are studied. The analysis results indicate that the overall BHI improves by 20% over the subsequent 20 years when expansion joints are replaced. The effects of Co-Active elements on the BHI predictions are quantifiable and depend on factors such as the timing of MRR, the condition of bridge elements as well as the type of MRR. Furthermore, it is concluded that inter-dependent relationships among Co-Active elements are highly affected by Co-Active coefficients. They increase when the degree of dependency among elements increases. Finally, the proposed bridge Co-Active prioritization analysis accounts for a performance target and associated gaps and thus is able to identify critical elements that affect bridge service life the most.

Biomechanical Analysis of the Zirconia and Graphene-based CAD-CAM Dental Bridges at Different Pontic Length: A Finite Element Analysis

Introduction: During masticatory loading, dental bridges are subjected to various forces that might generate deflections in the bridge framework. For this reason, designing long-span bridges require great care about flexions that happen during the function. This can be compensated by increasing occluso-gingival height, using rigid materials and enhancing resistance to deflection by modifying the abutments’ preparations. The current study hypothesied that the stress, deflection, strain and deformation of the fixed partial dentures are guided by the three-dimensional configurations of the pontic areas, and all other parameters could be mutually changed with different influence on the overall outcome. Aim: The study aimed to evaluate the difference in the amount of stress, deflection, strain and deformation on using different materials and configurations in the pontic and connector area of the dental bridge using the 3D Finite Element Analysis (FEA). Materials and Methods: An invitro virtual biomechanical analysis using 3D FEA method was conducted. 3D models were created from the Cone Beam Computed Tomography (CBCT) of a dentulous patient and two materials were selected for this study, Zirconia and enhanced graphene-based polymer. The study models were assembled into four groups as the following: Group I: 3-unit Zirconia fixed-fixed bridge; Group II: 3-unit Graphene fixed-fixed bridge; Group III: 4-unit Zirconia fixed-fixed bridge; Group IV: 4-unit Graphene fixed-fixed bridge. Using FEA software a 600 N load was applied and the resultant normal stress, deflection, maximum equivalent strain and total deformation data were monitored, collected and interpreted. Results: The findings of the current study showed higher values of normal stress, deflection, equivalent elastic strain and total deformation in Graphene-based bridges (group II and IV) than the Zirconia-based bridges (group I and III). It should also be mentioned that normal stress, deflection, equivalent elastic strain, and total deformation showed higher values in the three-unit bridge (group I and II) than their corresponding 4-unit bridge groups (group III and IV). Conclusion: This biomechanical analysis confirmed that the stress concentration and deflection of the fixed bridge are influenced by material characteristics. However, configuration of the pontic area could influence the studied mechanical parameters regardless the length of the dental bridge.