Atomic Species Associated with the Portevin–Le Chatelier Effect in Superalloy 718 Studied by Mechanical Spectroscopy

In many Ni-based superalloys, dynamic strain aging (DSA) generates an inhomogeneous plastic deformation resulting in jerky flow known as the Portevin--Le Chatelier (PLC) effect. This phenomenon has a deleterious effect on the mechanical properties and, at high temperature, is related to the diffusion of substitutional solute atoms toward the core of dislocations. However, the question about the nature of the atomic species responsible for the PLC effect at high temperature still remains open. The goal of the present work is to answer this important question; to this purpose, three different 718-type and a 625 superalloy were studied through a nonconventional approach by mechanical spectroscopy. The internal friction (IF) spectra of all the studied alloys show a relaxation peak P718 (at 885 K for 0.1 Hz) in the same temperature range, 700 K to 950 K, as the observed PLC effect. The activation parameters of this relaxation peak have been measured, Ea(P718){\thinspace}={\thinspace}2.68{\thinspace}{\textpm}{\thinspace}0.05 eV, $\tau$0{\thinspace}={\thinspace}2{\textperiodcentered}10-15 {\textpm} 1 s as well as its broadening factor $\beta${\thinspace}={\thinspace}1.1. Experiments on different alloys and the dependence of the relaxation strength on the amount of Mo attribute this relaxation to the stress-induced reorientation of Mo-Mo dipoles due to the short distance diffusion of one Mo atom by exchange with a vacancy. Then, it is concluded that Mo is the atomic species responsible for the high-temperature PLC effect in 718 superallo

High Temperature Mechanical Spectroscopy in Ordered Ni3(Al, Ta)

Mechanical loss measurements were performed on polycrystalline and single crystalline samples (of three different orientations) of a Ni3(Al, 1%Ta) alloy with the L12 ordered structure. Measurements were conducted in torsion pendula, on as-cast samples and samples predeformed either at 300 K or at 1300 K, and revealed the occurrence of two main phenomena : (a) The presence of a well-defined internal friction peak at a temperature of about 950 K for a frequency of 1 Hz. This relaxation peak has an activation energy of about 3 eV and its amplitude is strongly dependent on sample orientation and predeformation conditions. (b) An internal friction background, which amplitude at high temperatures (above 1100 K) mainly depends on strain amplitude and predeformation conditions. Both phenomena appear closely related to the presence of point defects, to the complex dissociation mode of superdislocations and to the change in dislocation mechanisms occurring at the peak temperature in flow stress (about 800 K) in relationship with a change in active slip systems

Red Blood Cell Transfusion in the Intensive Care Unit

IMPORTANCE: Red blood cell (RBC) transfusion is common among patients admitted to the intensive care unit (ICU). Despite multiple randomized clinical trials of hemoglobin (Hb) thresholds for transfusion, little is known about how these thresholds are incorporated into current practice.OBJECTIVE: To evaluate and describe ICU RBC transfusion practices worldwide.DESIGN, SETTING, AND PARTICIPANTS: International, prospective, cohort study that involved 3643 adult patients from 233 ICUs in 30 countries on 6 continents from March 2019 to October 2022 with data collection in prespecified weeks.EXPOSURE: ICU stay.MAIN OUTCOMES AND MEASURES: The primary outcome was the occurrence of RBC transfusion during ICU stay. Additional outcomes included the indication(s) for RBC transfusion (consisting of clinical reasons and physiological triggers), the stated Hb threshold and actual measured Hb values before and after an RBC transfusion, and the number of units transfused.RESULTS: Among 3908 potentially eligible patients, 3643 were included across 233 ICUs (median of 11 patients per ICU [IQR, 5-20]) in 30 countries on 6 continents. Among the participants, the mean (SD) age was 61 (16) years, 62% were male (2267/3643), and the median Sequential Organ Failure Assessment score was 3.2 (IQR, 1.5-6.0). A total of 894 patients (25%) received 1 or more RBC transfusions during their ICU stay, with a median total of 2 units per patient (IQR, 1-4). The proportion of patients who received a transfusion ranged from 0% to 100% across centers, from 0% to 80% across countries, and from 19% to 45% across continents. Among the patients who received a transfusion, a total of 1727 RBC transfusions were administered, wherein the most common clinical indications were low Hb value (n = 1412 [81.8%]; mean [SD] lowest Hb before transfusion, 7.4 [1.2] g/dL), active bleeding (n = 479; 27.7%), and hemodynamic instability (n = 406 [23.5%]). Among the events with a stated physiological trigger, the most frequently stated triggers were hypotension (n = 728 [42.2%]), tachycardia (n = 474 [27.4%]), and increased lactate levels (n = 308 [17.8%]). The median lowest Hb level on days with an RBC transfusion ranged from 5.2 g/dL to 13.1 g/dL across centers, from 5.3 g/dL to 9.1 g/dL across countries, and from 7.2 g/dL to 8.7 g/dL across continents. Approximately 84% of ICUs administered transfusions to patients at a median Hb level greater than 7 g/dL.CONCLUSIONS AND RELEVANCE: RBC transfusion was common in patients admitted to ICUs worldwide between 2019 and 2022, with high variability across centers in transfusion practices.</p

Red Blood Cell Transfusion in the Intensive Care Unit

Importance: Red blood cell (RBC) transfusion is common among patients admitted to the intensive care unit (ICU). Despite multiple randomized clinical trials of hemoglobin (Hb) thresholds for transfusion, little is known about how these thresholds are incorporated into current practice. Objective: To evaluate and describe ICU RBC transfusion practices worldwide. Design, setting, and participants: International, prospective, cohort study that involved 3643 adult patients from 233 ICUs in 30 countries on 6 continents from March 2019 to October 2022 with data collection in prespecified weeks. Exposure: ICU stay. Main outcomes and measures: The primary outcome was the occurrence of RBC transfusion during ICU stay. Additional outcomes included the indication(s) for RBC transfusion (consisting of clinical reasons and physiological triggers), the stated Hb threshold and actual measured Hb values before and after an RBC transfusion, and the number of units transfused. Results: Among 3908 potentially eligible patients, 3643 were included across 233 ICUs (median of 11 patients per ICU [IQR, 5-20]) in 30 countries on 6 continents. Among the participants, the mean (SD) age was 61 (16) years, 62% were male (2267/3643), and the median Sequential Organ Failure Assessment score was 3.2 (IQR, 1.5-6.0). A total of 894 patients (25%) received 1 or more RBC transfusions during their ICU stay, with a median total of 2 units per patient (IQR, 1-4). The proportion of patients who received a transfusion ranged from 0% to 100% across centers, from 0% to 80% across countries, and from 19% to 45% across continents. Among the patients who received a transfusion, a total of 1727 RBC transfusions were administered, wherein the most common clinical indications were low Hb value (n = 1412 [81.8%]; mean [SD] lowest Hb before transfusion, 7.4 [1.2] g/dL), active bleeding (n = 479; 27.7%), and hemodynamic instability (n = 406 [23.5%]). Among the events with a stated physiological trigger, the most frequently stated triggers were hypotension (n = 728 [42.2%]), tachycardia (n = 474 [27.4%]), and increased lactate levels (n = 308 [17.8%]). The median lowest Hb level on days with an RBC transfusion ranged from 5.2 g/dL to 13.1 g/dL across centers, from 5.3 g/dL to 9.1 g/dL across countries, and from 7.2 g/dL to 8.7 g/dL across continents. Approximately 84% of ICUs administered transfusions to patients at a median Hb level greater than 7 g/dL. Conclusions and relevance: RBC transfusion was common in patients admitted to ICUs worldwide between 2019 and 2022, with high variability across centers in transfusion practices