Investigation of material removal rate and surface roughness during electrical discharge machining on Al (6061)-5%SiC-10%B4C hybrid composite

Electrode Discharge Mechanism (EDM) is a manufacturing process using controlled sparks that occur between an electrically conductive workpiece and an electrode in the presence of an insulating liquid. The EDM process is commonly used to manufacture metallic matrix compounds that have wide applications in the railway sectors and the aircraft industry. Aluminum metal matrix composites (AMMCs) are one of the important kinds of metallic matrix compounds due to their advanced characteristics, such as lightweight and high strength. This lightweight material was developed and used in various manufacturing processes, like the automobile industry to reduce vehicle weight and thus reduce fuel consumption. This paper discussed the experiments of the EDM that were conducted to examine the effect of machining parameters, including peak current (10, 20, and 30 A), pulse on different times (50, 100, and 200 µsec), duty factors (4, 6, and 8) on the material removal rate, and surface roughness of the Al (6061)-5%SiC-10%B4C hybrid composite as workpiece using copper electrode tool by Box-Behnken design. The analysis data for the dependent and independent variables manifested that the influence of machine parameters whenever Ip and Pon increase, the MRR and Ra increase.

Knowledge and Attitude of Mothers about Children Immunization and Barriers to Adherence the Program, in Erbil City

Background and objective: Immunization programs are one of the most important methods to prevent infections and sickness among children. We can overcome many obstacles if mothers have the necessary knowledge and attitude regarding vaccines. The study aims to assess mothers’ knowledge, attitudes, and barriers related to immunization programs and associations related to socio-demographic characteristics. Methods: A cross-sectional study design was carried out in Erbil city across six primary health care centers (Hawkari, Azadi, Runaki, Shadi, Mala Afandi, and Nazdar Bamarni) during the period of January 5, 2021, to April 8, 2021. Non-probability convenience sampling methods were used. The sample consisted of 410 mothers ages 18 and older. A questionnaire with four parts (socio-demographic characteristics, knowledge, attitude, and barriers to adherence immunization programs) was used to collect data. Statistical package for Social Science (version 23) was used for data analysis. Chi-square and Fisher exact tests were used to determine the association between socio-demographic characteristics and knowledge and attitudes. Frequency and percentage were used to identify barriers. Results: The study findings showed a statistically significant association between the knowledge of mothers and their age, educational level, occupation, and socioeconomic status. Mothers have a high attitude regarding immunizations. The majority (69.3%) of mothers have not had any missed opportunities for not given immunizations. The most common reasons for not giving immunizations were mothers being busy and child sickness at the time of immunizations. Conclusions: There was statistically significant association between mother’s knowledge and age, education, occupations, and socioeconomic status. A high level of attitude was recorded among mothers regarding immunizations. Mothers reported being busy on the day of the immunizations and child sickness as the most common barriers to receiving immunizations

Polytrauma Patients and the Significant Role of the Radiologist Diagnosis Through the Imaging Management

This study aimed at recognizing that images have become important not only for diagnosis but also for treatment, and also lies in the analyzing processes of the imaging diagnosis of multiple trauma patients and the significant role of the radiologist diagnosis through the imaging management. The researchers adopted the survey methodology for gathering data upon the recent worldwide studies concerning the polytrauma patients and the significant role of the radiologist diagnosis through the imaging management. The study concluded that the decision to manage the patient surgically or by percutaneous intervention depends upon the clinical severity and secondarily on the findings of whole body MDCT; which identifies blunt polytrauma related injuries which require intervention. Keywords: Polytrauma, Radiologist, Imaging Management and Diagnosis

Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease

Introduction: Chronic kidney disease (CKD) is associated with multimorbidity and high treatment burden. Pill-burden is one component of the overall treatment burden. However, little is known about its magnitude and contribution to the overall treatment burden among patients with advanced stages of CKD. This study aimed to quantify the magnitude of pill-burden in dialysis-dependent vs. non-dialysis-dependent advanced-stage CKD patients and its association with treatment burden. Methods: This was a cross-sectional study for the assessment of pill-burden and treatment burden among non-dialysis and hemodialysis (HD)-dependent CKD patients. Pill-burden was quantified as "number of pills/patient/week" through electronic medical record, while treatment burden was assessed using the "Treatment Burden Questionnaire (TBQ)". Furthermore, oral and parenteral medication burden was also quantified. Data were analyzed using both descriptive and inferential analysis, including Mann - Whitney U test and two-way between groups analysis of variance (ANOVA). Results: Among the 280 patients included in the analysis, the median (IQR) number of prescribed chronic medications was 12 (5.7) oral and 3 (2) parenteral medications. The median (IQR) pill-burden was 112 (55) pills/week. HD patients experienced higher pill-burden than non-dialysis patients [122 (61) vs. 109 (33) pills/week]; however, this difference did not reach statistical significance (p = 0.81). The most commonly prescribed oral medications were vitamin D (90.4%), sevelamer carbonate (65%), cinacalcet (67.5%), and statins (67.1%). Overall, patients who had high pill-burden (≥112 pills/week) had significantly higher perceived treatment burden compared to low pill-burden patients (<112 pills/week) [47(36.2) vs. 38.5(36.7); p = 0.0085]. However, two-way ANOVA showed that dialysis status is the significant contributor to the treatment-burden in the high overall pill-burden group (p < 0.01), the high oral-medication-burden group (p < 0.01), and the high parenteral-medication-burden group (p = 0.004). Conclusions: Patients with advanced CKD experienced a high pill-burden, which increases the treatment burden; however, the dialysis status of the patient is the main factor affecting the overall treatment burden. Future intervention studies should target this population with an aim to reduce polypharmacy, pill-burden, and treatment burden, which may ultimately improve CKD patients' quality of life.The authors would like to acknowledge Qatar University for the funding provided for the study. This manuscript is part of an MSc dissertation submitted to Qatar University and related abstracts were presented and published as part of the 56th European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) Congress, Budapest, Hungary, 13-16 June 2019. The study received funding from Qatar University (grant number: QUCG- CPH-22/23-592 and QUST-CPH-SPR/2017-19). The content of this paper is the sole responsibility of the authors.Scopu

Highly efficient GaN Doherty power amplifier for N78 sub-6 GHz band 5G applications

In this paper, a high-efficiency GaN Doherty power amplifier (DPA) for 5G applications in the N78 sub-6 GHz band is introduced. The theoretical analysis of the matching networks for the peak and carrier transistors is presented, with a focus on the impact of unequal power splitting for both transistors and the recommendation of a post-harmonic suppression network. The proposed design features an unequal Wilkinson power divider at the input and a post-harmonic suppression network at the output, both of which are crucial for achieving high efficiency. The Doherty power amplifier comprises two GaN 10 W HEMTs, measured across the 3.3 GHz to 3.8 GHz band (the N78 band), and the results reveal significant improvements in gain, output power, drain efficiency, and power-added efficiency. Specifically, the proposed design achieved a power gain of over 12 dB and 42 dBm saturated output power. It also achieved a drain efficiency of 80% at saturation and a power-added efficiency of 75.2%. Furthermore, the proposed harmonic suppression network effectively attenuated the harmonics at the output of the amplifier from the second to the fourth order to more than −50 dB, thus enhancing the device’s linearity

Burden of musculoskeletal disorders in the Eastern Mediterranean Region, 1990–2013: findings from the Global Burden of Disease Study 2013

Moradi-Lakeh M, Forouzanfar MH, Vollset SE, et al. Burden of musculoskeletal disorders in the Eastern Mediterranean Region, 1990–2013: findings from the Global Burden of Disease Study 2013. Annals of the Rheumatic Diseases. 2017;76(8):annrheumdis-2016-210146

The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013

Charara R, Forouzanfar M, Naghavi M, et al. The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013. PLOS ONE. 2017;12(1): e0169575.The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the Global Burden of Disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost-YLLs) and nonfatal outcomes (years lived with disability-YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of the total disease burden in the EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders than did males of equivalent ages, except for those under 15 years of age. The highest proportion of DALYs occurred in the 25-49 age group, with a peak in the 35-39 years age group (5344 DALYs/100,000). The burden of mental disorders in EMR increased from 1726 DALYs/100,000 in 1990 to 1912 DALYs/100,000 in 2013 (10.8% increase). Within the mental disorders group in EMR, depressive disorders accounted for most DALYs, followed by anxiety disorders. Among EMR countries, Palestine had the largest burden of mental disorders. Nearly all EMR countries had a higher mental disorder burden compared to the global level. Our findings call for EMR ministries of health to increase provision of mental health services and to address the stigma of mental illness. Moreover, our results showing the accelerating burden of mental health are alarming as the region is seeing an increased level of instability. Indeed, mental health problems, if not properly addressed, will lead to an increased burden of diseases in the region

Global prevalence and genotype distribution of hepatitis C virus infection in 2015 : A modelling study

Publisher Copyright: © 2017 Elsevier LtdBackground The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate hepatitis C virus (HCV) infection by 2030, which can become a reality with the recent launch of direct acting antiviral therapies. Reliable disease burden estimates are required for national strategies. This analysis estimates the global prevalence of viraemic HCV at the end of 2015, an update of—and expansion on—the 2014 analysis, which reported 80 million (95% CI 64–103) viraemic infections in 2013. Methods We developed country-level disease burden models following a systematic review of HCV prevalence (number of studies, n=6754) and genotype (n=11 342) studies published after 2013. A Delphi process was used to gain country expert consensus and validate inputs. Published estimates alone were used for countries where expert panel meetings could not be scheduled. Global prevalence was estimated using regional averages for countries without data. Findings Models were built for 100 countries, 59 of which were approved by country experts, with the remaining 41 estimated using published data alone. The remaining countries had insufficient data to create a model. The global prevalence of viraemic HCV is estimated to be 1·0% (95% uncertainty interval 0·8–1·1) in 2015, corresponding to 71·1 million (62·5–79·4) viraemic infections. Genotypes 1 and 3 were the most common cause of infections (44% and 25%, respectively). Interpretation The global estimate of viraemic infections is lower than previous estimates, largely due to more recent (lower) prevalence estimates in Africa. Additionally, increased mortality due to liver-related causes and an ageing population may have contributed to a reduction in infections. Funding John C Martin Foundation.publishersversionPeer reviewe

Children’s and adolescents’ rising animal-source food intakes in 1990–2018 were impacted by age, region, parental education and urbanicity

Animal-source foods (ASF) provide nutrition for children and adolescents’ physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world’s child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 15–19 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes.publishedVersio

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8–14.4 million) incident T2D cases, representing 70.3% (68.8–71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0–27.1%)), excess refined rice and wheat intake (24.6% (22.3–27.2%)) and excess processed meat intake (20.3% (18.3–23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4–87.7%)) and Latin America and the Caribbean (81.8% (80.1–83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1–60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally.publishedVersio