Due to space constraints in urban areas,metro tunnels are typically constructed in pairs,with a small clearance.The interaction between twin tunnels leads to a significantly more complex ground deformation and stress ...Due to space constraints in urban areas,metro tunnels are typically constructed in pairs,with a small clearance.The interaction between twin tunnels leads to a significantly more complex ground deformation and stress distribution than that observed in a single tunnel scenario,particularly if the tunnels are excavated in sequence.A series of physical model tests were conducted to investigate soil deformation and stress disturbances caused by the excavation of twin tunnels.The test results indicate that the interaction between the twin tunnels was observed.Due to the soil arching effect,the excavation of Tunnel 2 increases the soil stress acting on Tunnel 1.An analytical method was proposed to determine soil stress considering the soil arching effect and the interaction between twin tunnels.The method categorized the relative locations between twin tunnels into non-influenced,partially influenced,and fully influenced scenarios.For non-influenced and fully influenced scenarios,the soil stresses above twin tunnels were calculated based on a symmetric major principal stress trace.For the partially influenced scenario,however,the soil arch above Tunnel 2 was asymmetric due to the interaction,and the stress distribution was obtained based on a new asymmetric major principal stress trace.The soil stress on Tunnel 1 was influenced by the load transferred from Tunnel 2 and calculated based on the force equilibrium.A comparison of the analytical and test results indicates that the proposed method effectively predicts the soil stress in the cover layer above twin tunnels excavated sequentially,considering the interaction and soil arching effects.展开更多
The soil arching effect is an important factor affecting the internal load transfer of excavation-induced slopes.Physical model tests are usually used for studying the soil arching effect.Although physical model tests...The soil arching effect is an important factor affecting the internal load transfer of excavation-induced slopes.Physical model tests are usually used for studying the soil arching effect.Although physical model tests can monitor local point loads to demonstrate changes in local stresses,changes in force chains inside slopes are rarely demonstrated by physical modelling,which restricts the understanding of load transfer.To explore overall changes in stresses in slopes from a more microscopic perspective,a numerical simulation of the slope under excavation was carried out.Using built-in code and fish function programming in PFC^(3D),the slope model was developed.Monitoring areas were set up to monitor the changes in stresses and force chains during excavation.The simulation results show that excavation width affects the size of deformation area,and the deformation area expands as excavation width increases.Excavation causes load transfer and the formation of soil arching in the slope.A mechanism is proposed to explain the effect of excavation on soil arching formation and load transfer.The numerical simulation is important for revealing the load transfer of slopes during excavation,and the research results have practical value for the prevention and mitigation of landslides caused by excavation.展开更多
Narrow backfill earth pressure estimation is applied to study the stability of supporting structures in the vicinity of existing buildings.Previous narrow backfill earth pressure studies have neglected seismic-unsatur...Narrow backfill earth pressure estimation is applied to study the stability of supporting structures in the vicinity of existing buildings.Previous narrow backfill earth pressure studies have neglected seismic-unsaturated seepage multi-field coupling,resulting in inaccurate estimates.To address these deficiencies,this paper proposed a calculation method for seismic passive earth pressure in unsaturated narrow backfill,based on inclined thin-layer units.It considers the interlayer shear stress,arching effect,and the multi-field coupling of seismic-unsaturated seepage.Additionally,this paper includes a parametric sensitivity analysis.The outcomes indicate that the earthquake passive ground pressure of unsaturated narrow backfill can be reduced by increasing the aspect ratio,seismic acceleration coefficient,and unsaturation parameterα.It can also be reduced by decreasing the effective interior friction angle,soil cohesion,wallearth friction angle,and vertical discharge.Furthermore,for any width soil,lowering the elevation of the action point of passive thrust can be attained by raising the effective interior friction angle,wall-earth friction angle,and unsaturation parameterα.Reducing soil cohesion,seismic acceleration coefficient,and vertical discharge can also lower the height of the application point of passive thrust.展开更多
Based on the characteristics of the top coal thickness of the fully mechanized caving in special thick coal seam,the long distance of coal gangue caving,as well as the different sizes of the coal gangue broken fragmen...Based on the characteristics of the top coal thickness of the fully mechanized caving in special thick coal seam,the long distance of coal gangue caving,as well as the different sizes of the coal gangue broken fragment dimension and spatial variation of drop flow,this paper uses laboratory dispersion simulation experiment and theoretical analysis to study the arch structure effect and its influence rule on the top coal loss in the process of coal gangue flow.Research shows that in the process of coal gangue flow,arch structure can be formed in three types:the lower arch structure,middle arch structure,and upper arch structure.Moreover,the arch structure has the characteristics of dynamic random arch,the formation probability of dynamic random arch with different layers is not the same,dynamic random arch caused the reduction of the top coal fluency;analyzing the dynamic random arch formation mechanism,influencing factors,and the conditions of instability;the formation probability of the lower arch structure is the highest,the whole coal arch and the coal gangue arch structure has the greatest impact on top coal loss.Therefore,to prevent or reduce the formation of lower whole coal arch structure,the lower coal gangue arch structure and the middle whole coal arch structure is the key to reduce the top coal loss.The research conclusion provides theoretical basis for the further improvement of the top coal recovery rate of the fully mechanized caving in extra thick coal seam.展开更多
To determine the distribution of active earth pressure on retaining walls, a series of model tests with the horizontally translating rigid walls are designed. Particle image velocimetry is used to study the movement a...To determine the distribution of active earth pressure on retaining walls, a series of model tests with the horizontally translating rigid walls are designed. Particle image velocimetry is used to study the movement and shear strain during the active failure of soil with height H and friction angle φ. The test results show that there are 3 stages of soil deformation under retaining wall translation: the initial stage, the expansion stage and the stability stage. The stable sliding surface in the model tests can be considered to be composed of two parts. Within the height range of 0.82 H-1.0 H, it is a plane at an angle of π/4+φ/2 to the horizontal plane. In the height range of 0-0.82 H, it is a curve between a logarithmic spiral and a plane at an angle of π/4+φ/2 to the horizontal. A new method applicable to any sliding surface is proposed for active earth pressure with the consideration of arching effect. The active earth pressure is computed with the actual shape of the slip surface and compared with model test data and with predictions obtained by existing methods. The comparison shows that predictions from the newly proposed method are more consistent with the measured data than the predictions from the other methods.展开更多
To discuss the soil arching effect on the load transferring model and sharing ratios by the piles and inter-pile subsoil in the bidirectionally reinforced composite ground, the forming mechanism, mechanical behavior a...To discuss the soil arching effect on the load transferring model and sharing ratios by the piles and inter-pile subsoil in the bidirectionally reinforced composite ground, the forming mechanism, mechanical behavior and its effect factors were discussed in detail. Then, the unified strength theory was introduced to set up the elastoplastic equilibrium differential equation of the subsoil under the limit equilibrium state. And from the equation, the solutions were derived with the corresponding formulas presented to calculate the earth pressure over and beneath the horizontal reinforced cushion or pillow, the stress of inter-pile subsoil and the pile-soil stress ratio. Based on the obtained solutions and measured data from an engineering project, the influence rules by the soil property parameters (i.e., the cohesion c and internal friction angle φ) and pile spacing on the pile-soil stress ratio n were discussed respectively. The results show that to improve the load sharing ratio by the piles, the more effective means for filling materials with a larger value of φ is to increase the ratio of pile cap size to spacing, while to reduce the pile spacing properly and increase the value of cohesion c is advisable for those filling materials with a smaller value of φ.展开更多
In the 1990s, several major earthquakes occurred throughout the world, with a common observation that near fault ground motion （NFGM） characteristics had a distinct impact on causing damage to civil engineering stru...In the 1990s, several major earthquakes occurred throughout the world, with a common observation that near fault ground motion （NFGM） characteristics had a distinct impact on causing damage to civil engineering structures that could not be predicted by using far field ground motions. Since then, seismic responses of structures under NFGMs have been extensively examined, with most of the studies focusing on structures with relatively short fundamental periods, where the traveling wave effect does not need to be considered. However, for long span bridges, especially arch bridges, the traveling wave （only time delay considered） effect may be very distinct and is therefore important. In this paper, the results from a case study on the seismic response of a steel arch bridge under selected NFGMs is presented by considering the traveling wave effect with variable apparent velocities. The effects of fling step and long period pulses of NFGMs on the seismic responses of the arch bridge are also discussed.展开更多
In piled and geosynthetic-reinforced(PGR) embankment, the arching behavior determines the overburden load on piles and subsoils. Placement of geosynthetic is effective in reducing the relative displacement between pil...In piled and geosynthetic-reinforced(PGR) embankment, the arching behavior determines the overburden load on piles and subsoils. Placement of geosynthetic is effective in reducing the relative displacement between pile and subsoil. When the mobilized shear stress is less than the shear strength, partially developed arching will occur. Consequently, existing analytical methods, adopting the ultimate shear strength failure criterion, need to be improved. This study developed a simplified 2 D analytical method, which is based on the developing arching effect, to evaluate the load redistribution of the PGR embankment. Then, the influences of embankment height and internal friction angle, subsoil depth, ratio of pile cap width to pile clear spacing(RPC) and geosynthetic tensile stiffness on the critical height ratio, stress concentration ratio, soil arching ratio, geosynthetic tension and axial strain were investigated. This study suggests that a RPC of 1:1.0 and a one-way of single-layer geosynthetic tensile stiffness of 2000 kN/m should be considered as the sensitivity thresholds for the PGR embankment.展开更多
Combined with practical engineering, based on the introduction of soil arching theory, we explore the impact of barrier piles in blind sheet-pile bank connecting structure. Besides, we build a plane strain model by AB...Combined with practical engineering, based on the introduction of soil arching theory, we explore the impact of barrier piles in blind sheet-pile bank connecting structure. Besides, we build a plane strain model by ABAQUS sot＇cware to study the impact of cross section type, the pile spacing and soil properties on soil arching effect. We find that cross section type of the pile has a certain influence on soil stress distribution in front of the barrier piles by comparing circular cross section and rectangular cross section. We also find that clear distance between the barrier piles and cohesive force of the soil have a great influence on that impact. We can increase clear distance between the barrier piles appropriately to improve the efficiency of construction and reduce the proiect cost.展开更多
Background Aortic dissection（AD） is a life-threatening surgical emergency. Total arch replacement combined with stent trunk has gradually become the standard procedure for De Bakey type Ⅰ AD in China, but the compl...Background Aortic dissection（AD） is a life-threatening surgical emergency. Total arch replacement combined with stent trunk has gradually become the standard procedure for De Bakey type Ⅰ AD in China, but the complication and mortality rates are still relatively high due to surgical technical difficulties and complexity. In principle, AD should be treated with emergency surgery once the diagnosis is confirmed, but the operation time varies greatly in China due to the restriction of medical conditions. Therefore, analyzing and comparing the surgical mortality and complications rate between acute and chronic phase may facilitate the clinicians to comprehensively evaluate the patient＇s condition, and thus select an appropriate operation timing. Methods A total of330 De Bakey type Ⅰ AD patients admitted and treated with total arch replacement combined with stent trunk procedure in Guangdong Cardiovascular Institute from Jan 2010 to Jan 2014 were retrospectively analyzed. According to whether the onset was longer than 2 w, patients were divided into acute phase group and chronic phase group. There were 231 cases in acute phase group（≤ 2 w）, and the average length from onset to operation was 5.6± 3.8 d; while 99 cases in chronic phase group（〉 2 w）, and the average length from onset to operation was 20.6 ±14.7 d. Results The total mortality rate was 13%. Acute renal failure, neurological dysfunction, and wound healing were the major complications after operation. The in-hospital morality rate was 16.0%（37/231） in the acute group, while 6.1 %（6/99） in the chronic group. The surgical data of the ratio of CABG, cardiopulmonary bypass（CPB） time, aortic cross clamp time, intra-operative RBC infusion were significant higher in the acute phase group（P 〈 0.05）. The postoperative data of ICU stay, mechanical ventilation time, the incidences of neurological dysfunction, CRRT-dependent acute renal failure, hepatic insufficiency, and poor wound healing were significant higher in the acute phase group（P 〈 0.05）. Conclusions The total arch replacement combined with stent trunk for De Bakey type Ⅰ aortic dissection is safe and effective. Patients in the acute phase show higher postoperative mortality and complications. The acute phase is associated with relatively higher risk of surgical treatment.展开更多
基金supported by the National Natural Science Foundation of China(Grant No.52308463)the Shanghai Rising-Star Program(Grant No.23YF1449100)the Fundamental Research Funds for the Central Universities(Grant No.2023-2-ZD08).
文摘Due to space constraints in urban areas,metro tunnels are typically constructed in pairs,with a small clearance.The interaction between twin tunnels leads to a significantly more complex ground deformation and stress distribution than that observed in a single tunnel scenario,particularly if the tunnels are excavated in sequence.A series of physical model tests were conducted to investigate soil deformation and stress disturbances caused by the excavation of twin tunnels.The test results indicate that the interaction between the twin tunnels was observed.Due to the soil arching effect,the excavation of Tunnel 2 increases the soil stress acting on Tunnel 1.An analytical method was proposed to determine soil stress considering the soil arching effect and the interaction between twin tunnels.The method categorized the relative locations between twin tunnels into non-influenced,partially influenced,and fully influenced scenarios.For non-influenced and fully influenced scenarios,the soil stresses above twin tunnels were calculated based on a symmetric major principal stress trace.For the partially influenced scenario,however,the soil arch above Tunnel 2 was asymmetric due to the interaction,and the stress distribution was obtained based on a new asymmetric major principal stress trace.The soil stress on Tunnel 1 was influenced by the load transferred from Tunnel 2 and calculated based on the force equilibrium.A comparison of the analytical and test results indicates that the proposed method effectively predicts the soil stress in the cover layer above twin tunnels excavated sequentially,considering the interaction and soil arching effects.
基金supported by the National Key Scientific Instrument and Equipment Development Projects of China(No.41827808)the Major Program of National Natural Science Foundation of China(No.42090055)+2 种基金the National Natural Science Foundation of China(Nos.42077268)the National Natural Science Foundation of China(No.42107194)the Fundamental Research Funds for the Central Universities(No.CUGL190810)。
文摘The soil arching effect is an important factor affecting the internal load transfer of excavation-induced slopes.Physical model tests are usually used for studying the soil arching effect.Although physical model tests can monitor local point loads to demonstrate changes in local stresses,changes in force chains inside slopes are rarely demonstrated by physical modelling,which restricts the understanding of load transfer.To explore overall changes in stresses in slopes from a more microscopic perspective,a numerical simulation of the slope under excavation was carried out.Using built-in code and fish function programming in PFC^(3D),the slope model was developed.Monitoring areas were set up to monitor the changes in stresses and force chains during excavation.The simulation results show that excavation width affects the size of deformation area,and the deformation area expands as excavation width increases.Excavation causes load transfer and the formation of soil arching in the slope.A mechanism is proposed to explain the effect of excavation on soil arching formation and load transfer.The numerical simulation is important for revealing the load transfer of slopes during excavation,and the research results have practical value for the prevention and mitigation of landslides caused by excavation.
基金Project(42277175)supported by the National Natural Science Foundation of ChinaProject(NRMSSHR-2022-Z08)supported by the Key Laboratory of Natural Resources Monitoring and Supervision in Southern Hilly Region,Ministry of Natural Resources,China。
文摘Narrow backfill earth pressure estimation is applied to study the stability of supporting structures in the vicinity of existing buildings.Previous narrow backfill earth pressure studies have neglected seismic-unsaturated seepage multi-field coupling,resulting in inaccurate estimates.To address these deficiencies,this paper proposed a calculation method for seismic passive earth pressure in unsaturated narrow backfill,based on inclined thin-layer units.It considers the interlayer shear stress,arching effect,and the multi-field coupling of seismic-unsaturated seepage.Additionally,this paper includes a parametric sensitivity analysis.The outcomes indicate that the earthquake passive ground pressure of unsaturated narrow backfill can be reduced by increasing the aspect ratio,seismic acceleration coefficient,and unsaturation parameterα.It can also be reduced by decreasing the effective interior friction angle,soil cohesion,wallearth friction angle,and vertical discharge.Furthermore,for any width soil,lowering the elevation of the action point of passive thrust can be attained by raising the effective interior friction angle,wall-earth friction angle,and unsaturation parameterα.Reducing soil cohesion,seismic acceleration coefficient,and vertical discharge can also lower the height of the application point of passive thrust.
基金the Independent Research Subject of State Key Laboratory of Coal Resources and Mine Safety of China University of Mining and Technology (No.SKLCRSM12X03)the Scientific Research and Innovation Project for College Graduates in Jiangsu (No.CXZZ13_0947)+1 种基金Top-Notch Academic Programs of Jiangsu Higher Education Institutionsthe Priority Academic Development Program of Jiangsu Higher Education Institutions
文摘Based on the characteristics of the top coal thickness of the fully mechanized caving in special thick coal seam,the long distance of coal gangue caving,as well as the different sizes of the coal gangue broken fragment dimension and spatial variation of drop flow,this paper uses laboratory dispersion simulation experiment and theoretical analysis to study the arch structure effect and its influence rule on the top coal loss in the process of coal gangue flow.Research shows that in the process of coal gangue flow,arch structure can be formed in three types:the lower arch structure,middle arch structure,and upper arch structure.Moreover,the arch structure has the characteristics of dynamic random arch,the formation probability of dynamic random arch with different layers is not the same,dynamic random arch caused the reduction of the top coal fluency;analyzing the dynamic random arch formation mechanism,influencing factors,and the conditions of instability;the formation probability of the lower arch structure is the highest,the whole coal arch and the coal gangue arch structure has the greatest impact on top coal loss.Therefore,to prevent or reduce the formation of lower whole coal arch structure,the lower coal gangue arch structure and the middle whole coal arch structure is the key to reduce the top coal loss.The research conclusion provides theoretical basis for the further improvement of the top coal recovery rate of the fully mechanized caving in extra thick coal seam.
基金Projects(51978084, 51678073) supported by the National Natural Science Foundation of ChinaProject(2020JJ4605) supported by the Natural Science Foundation of Hunan Province, ChinaProject(2019IC13) supported by the International Cooperation and Development Project of Double First-Class Scientific Research in Changsha University of Science & Technology, China。
文摘To determine the distribution of active earth pressure on retaining walls, a series of model tests with the horizontally translating rigid walls are designed. Particle image velocimetry is used to study the movement and shear strain during the active failure of soil with height H and friction angle φ. The test results show that there are 3 stages of soil deformation under retaining wall translation: the initial stage, the expansion stage and the stability stage. The stable sliding surface in the model tests can be considered to be composed of two parts. Within the height range of 0.82 H-1.0 H, it is a plane at an angle of π/4+φ/2 to the horizontal plane. In the height range of 0-0.82 H, it is a curve between a logarithmic spiral and a plane at an angle of π/4+φ/2 to the horizontal. A new method applicable to any sliding surface is proposed for active earth pressure with the consideration of arching effect. The active earth pressure is computed with the actual shape of the slip surface and compared with model test data and with predictions obtained by existing methods. The comparison shows that predictions from the newly proposed method are more consistent with the measured data than the predictions from the other methods.
基金Project (07JJ4015) supported by the Natural Science Foundation of Hunan Province, China
文摘To discuss the soil arching effect on the load transferring model and sharing ratios by the piles and inter-pile subsoil in the bidirectionally reinforced composite ground, the forming mechanism, mechanical behavior and its effect factors were discussed in detail. Then, the unified strength theory was introduced to set up the elastoplastic equilibrium differential equation of the subsoil under the limit equilibrium state. And from the equation, the solutions were derived with the corresponding formulas presented to calculate the earth pressure over and beneath the horizontal reinforced cushion or pillow, the stress of inter-pile subsoil and the pile-soil stress ratio. Based on the obtained solutions and measured data from an engineering project, the influence rules by the soil property parameters (i.e., the cohesion c and internal friction angle φ) and pile spacing on the pile-soil stress ratio n were discussed respectively. The results show that to improve the load sharing ratio by the piles, the more effective means for filling materials with a larger value of φ is to increase the ratio of pile cap size to spacing, while to reduce the pile spacing properly and increase the value of cohesion c is advisable for those filling materials with a smaller value of φ.
基金Federal Highway Administration(FHWA) Under Grant No.DTFH41-98900094
文摘In the 1990s, several major earthquakes occurred throughout the world, with a common observation that near fault ground motion （NFGM） characteristics had a distinct impact on causing damage to civil engineering structures that could not be predicted by using far field ground motions. Since then, seismic responses of structures under NFGMs have been extensively examined, with most of the studies focusing on structures with relatively short fundamental periods, where the traveling wave effect does not need to be considered. However, for long span bridges, especially arch bridges, the traveling wave （only time delay considered） effect may be very distinct and is therefore important. In this paper, the results from a case study on the seismic response of a steel arch bridge under selected NFGMs is presented by considering the traveling wave effect with variable apparent velocities. The effects of fling step and long period pulses of NFGMs on the seismic responses of the arch bridge are also discussed.
基金Project(51508279) supported by the National Natural Science Foundation of ChinaProject(KFJ170104) supported by the Open Fund of National Engineering Laboratory of Highway Maintenance Technology of Changsha University of Science & Technology, China+1 种基金Project(BK20150885) supported by the Jiangsu Provincial Natural Science Fund, ChinaProject(2019003) supported by the Key Laboratory of Ministry of Education for Geomechanics and Embankment Engineering of Hohai University, China。
文摘In piled and geosynthetic-reinforced(PGR) embankment, the arching behavior determines the overburden load on piles and subsoils. Placement of geosynthetic is effective in reducing the relative displacement between pile and subsoil. When the mobilized shear stress is less than the shear strength, partially developed arching will occur. Consequently, existing analytical methods, adopting the ultimate shear strength failure criterion, need to be improved. This study developed a simplified 2 D analytical method, which is based on the developing arching effect, to evaluate the load redistribution of the PGR embankment. Then, the influences of embankment height and internal friction angle, subsoil depth, ratio of pile cap width to pile clear spacing(RPC) and geosynthetic tensile stiffness on the critical height ratio, stress concentration ratio, soil arching ratio, geosynthetic tension and axial strain were investigated. This study suggests that a RPC of 1:1.0 and a one-way of single-layer geosynthetic tensile stiffness of 2000 kN/m should be considered as the sensitivity thresholds for the PGR embankment.
文摘Combined with practical engineering, based on the introduction of soil arching theory, we explore the impact of barrier piles in blind sheet-pile bank connecting structure. Besides, we build a plane strain model by ABAQUS sot＇cware to study the impact of cross section type, the pile spacing and soil properties on soil arching effect. We find that cross section type of the pile has a certain influence on soil stress distribution in front of the barrier piles by comparing circular cross section and rectangular cross section. We also find that clear distance between the barrier piles and cohesive force of the soil have a great influence on that impact. We can increase clear distance between the barrier piles appropriately to improve the efficiency of construction and reduce the proiect cost.
基金supported by The Medical Scientific Research Foundation of Guangdong Province(No.A2016028/No.A2015458)
文摘Background Aortic dissection（AD） is a life-threatening surgical emergency. Total arch replacement combined with stent trunk has gradually become the standard procedure for De Bakey type Ⅰ AD in China, but the complication and mortality rates are still relatively high due to surgical technical difficulties and complexity. In principle, AD should be treated with emergency surgery once the diagnosis is confirmed, but the operation time varies greatly in China due to the restriction of medical conditions. Therefore, analyzing and comparing the surgical mortality and complications rate between acute and chronic phase may facilitate the clinicians to comprehensively evaluate the patient＇s condition, and thus select an appropriate operation timing. Methods A total of330 De Bakey type Ⅰ AD patients admitted and treated with total arch replacement combined with stent trunk procedure in Guangdong Cardiovascular Institute from Jan 2010 to Jan 2014 were retrospectively analyzed. According to whether the onset was longer than 2 w, patients were divided into acute phase group and chronic phase group. There were 231 cases in acute phase group（≤ 2 w）, and the average length from onset to operation was 5.6± 3.8 d; while 99 cases in chronic phase group（〉 2 w）, and the average length from onset to operation was 20.6 ±14.7 d. Results The total mortality rate was 13%. Acute renal failure, neurological dysfunction, and wound healing were the major complications after operation. The in-hospital morality rate was 16.0%（37/231） in the acute group, while 6.1 %（6/99） in the chronic group. The surgical data of the ratio of CABG, cardiopulmonary bypass（CPB） time, aortic cross clamp time, intra-operative RBC infusion were significant higher in the acute phase group（P 〈 0.05）. The postoperative data of ICU stay, mechanical ventilation time, the incidences of neurological dysfunction, CRRT-dependent acute renal failure, hepatic insufficiency, and poor wound healing were significant higher in the acute phase group（P 〈 0.05）. Conclusions The total arch replacement combined with stent trunk for De Bakey type Ⅰ aortic dissection is safe and effective. Patients in the acute phase show higher postoperative mortality and complications. The acute phase is associated with relatively higher risk of surgical treatment.
