Irradiation embrittlement of pressure vessel steels : analysis of IAEA coordinated programme results

The results of the IAEA "Coordinated Research Programme on Irradiation Embrittlement of Pressure Vessel Steels" were examined again to analyse the reasons behind the reported large scattering and discrepancies in the effect of irradiation on the ductile-brittle transition temperature (DBTT). It is concluded that using specimens from different locations throughout the HSST steel plate thickness was the main reason behind the scattering in these results. Specimens from different locations bad different microstructures and different initial mechanical properties which led to different irradiation sensitivities. The analysis showed that the specimens used can be considered to consist of two sets different in microstructure, mechanical properties and irradiation sensitivity. Set 1 composed of specimens taken from positions between $\frac{T}{4}$ and $\frac{T}{2}$throughout the plate thickness while set 2 composed ofspecimens taken from positions between the surface and $\frac{T}{4}$.In this way the scattering became very small and evennegligable and the discrepancies were explained

Knowledge and Perception of Diabetes and Available Services among Diabetic Patients in the State of Qatar

Introduction: Diabetes is a major public health concern in Qatar. This study examined diabetes knowledge and perception of available services for diabetes control among diabetic patients in Qatar.Methods: Data from 300 diabetic patients were collected through face-to-face interviews using a semi-structured questionnaire between February and May 2015 at Hamad Medical Corporation healthcare facilities in Qatar. Survey responses were represented as frequencies, and Chi-square tests were used to compare proportions across gender. A p-value of 0.05 was considered statistically significant.Results: 31% of patients had Type 1 Diabetes (T1D) (females 36.6%, males 26.5%) and 54% had Type 2 Diabetes (T2D) (males 56.6%, females 50%). Knowledge about diabetes types did not differ by sex (P=0.16). 32.3% of patients were treated for diabetes-related complications including: high cholesterol (39.2%), vision problems (33.1%), hypertension (30.0%), and foot problems (25.1 %). Most patients were diagnosed at primary care clinics (41.7%). During visits, 78.3% of patients reported that they were fully advised about different diabetes tests. 57.0% of patients had ?4 visits for diabetes checkups in the past 12 months. 66.7% of patients reported that they were confident or very confident in managing their diabetes as a result of their healthcare visits in the past year. The majority of patients reported receiving diabetes-related guidance from physicians (89.7%).Conclusions: Study participants had variable knowledge of diabetes, its complications and risk factors, and services available to diabetics. More comprehensive education and awareness about diabetes is recommended for both patients and family members. At the provider level, further improvement in patient counseling and promotion of available services can be beneficial

Knowledge and Perception of Diabetes and Available Services among Diabetic Patients in the State of Qatar

Introduction: Diabetes is a major public health concern in Qatar. This study examined diabetes knowledge and perception of available services for diabetes control among diabetic patients in Qatar. Methods: Data from 300 diabetic patients were collected through face-to-face interviews using a semi-structured questionnaire between February and May 2015 at Hamad Medical Corporation healthcare facilities in Qatar. Survey responses were represented as frequencies, and Chi-square tests were used to compare proportions across gender. A p-value of 0.05 was considered statistically significant. Results: 31% of patients had Type 1 Diabetes (T1D) (females 36.6%, males 26.5%) and 54% had Type 2 Diabetes (T2D) (males 56.6%, females 50%). Knowledge about diabetes types did not differ by sex (P=0.16). 32.3% of patients were treated for diabetes-related complications including: high cholesterol (39.2%), vision problems (33.1%), hypertension (30.0%), and foot problems (25.1 %). Most patients were diagnosed at primary care clinics (41.7%). During visits, 78.3% of patients reported that they were fully advised about different diabetes tests. 57.0% of patients had ≥4 visits for diabetes checkups in the past 12 months. 66.7% of patients reported that they were confident or very confident in managing their diabetes as a result of their healthcare visits in the past year. The majority of patients reported receiving diabetes-related guidance from physicians (89.7%). Conclusions: Study participants had variable knowledge of diabetes, its complications and risk factors, and services available to diabetics. More comprehensive education and awareness about diabetes is recommended for both patients and family members. At the provider level, further improvement in patient counseling and promotion of available services can be beneficial

Survey of Leafhopper Species in Almond Orchards Infected with Almond Witches'-Broom Phytoplasma in Lebanon

Leafhoppers (Hemiptera: Auchenorrhyncha: Cicadellidae) account for more than 80% of all “Auchenorrhynchous” vectors that transmit phytoplasmas. The leafhopper populations in two almond witches'-broom phytoplasma (AlmWB) infected sites: Tanboureet (south of Lebanon) and Bourj El Yahoudieh (north of Lebanon) were surveyed using yellow sticky traps. The survey revealed that the most abundant species was Asymmetrasca decedens, which represented 82.4% of all the leafhoppers sampled. Potential phytoplasma vectors in members of the subfamilies Aphrodinae, Deltocephalinae, and Megophthalminae were present in very low numbers including: Aphrodes makarovi, Cicadulina bipunctella, Euscelidius mundus, Fieberiella macchiae, Allygus theryi, Circulifer haematoceps, Neoaliturus transversalis, and Megophthalmus scabripennis. Allygus theryi (Horváth) (Deltocephalinae) was reported for the first time in Lebanon. Nested PCR analysis and sequencing showed that Asymmetrasca decedens, Empoasca decipiens, Fieberiella macchiae, Euscelidius mundus, Thamnottetix seclusis, Balclutha sp., Lylatina inexpectata, Allygus sp., and Annoplotettix danutae were nine potential carriers of AlmWB phytoplasma. Although the detection of phytoplasmas in an insect does not prove a definite vector relationship, the technique is useful in narrowing the search for potential vectors. The importance of this information for management of AlmWB is discussed

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Role of microRNA-208a as a diagnostic and prognostic marker in patients with ST-elevation myocardial infarction

Acute Myocardial infarction (AMI) is the leading cause of death worldwide. Diagnosis of AMI depends on presenting symptoms, electrocardiogram (ECG), and cardiac troponins (cTns). Troponins are not good markers for patients presenting at the first hour of chest pain, so there is still a need for a marker that can be detected within the first hour of presentation, with high specificity and sensitivity, guide the medical decisions and give good insight on the expected prognosis. Previous studies reported miR-208a as a cardiac specific microRNA that can be detected in the plasma as early as 15 min of cardiac insult and is stable in plasma for hours. But no study has investigated its role as a predictor of primary percutaneuos coronary angiography (PCI) outcome. The study objective was to investigate the diagnostic role of miR-208a in AMI and its ability to predict the outcome of primary PCI and in-hospital major adverse events (MACE). In the present study, 75 patients presented by chest pain to Zagazig University hospitals were enrolled into 2 groups. Group 1 included 40 patients diagnosed with ST-elevation myocardial infarction and underwent primary PCI, of them 21 had sufficient reperfusion and 19 had no-reflow. Group 2 had negative cTns. Institutional review board approval and consents according to the Helsinki declaration were obtained. Plasma expression of miR-208a was assessed in both groups and patients were followed along their hospital stay (range =6-96 hours). MicroRNA-208a was found to be a good marker for diagnosis of MI (AUC= 0.926) which was not inferior to cTns. There was no value of adding miR208a to the classic clinical model. miR-208a can predict in-hospital MACE (AUC=0.871) and no reflow (AUC=0.875) after primary PCI and is significantly superior to cTns in these outcomes. We conclude that miR-208a is a good diagnostic and prognostic marker of myocardial infarction and can predict no reflow after primary PCI

FTIR Study of Nanostructure Perovskite BaTiO 3

Pure barium titanate $BaTiO_3 (BT)$ and BT doped with two different transition elements $Fe^{3+}$ and $Ni^{2+}$ at 5 mol.% (BT5Fe and BT5Ni, respectively) as constant concentration in powder form have been prepared by sol-gel method using barium acetate, titanium(IV) n-butoxide, iron and nickel nitrates as precursor materials. The microstructure of BT and the influence of Fe and Ni dopants on it were investigated by X-ray diffraction and Fourier transform infrared spectroscopy. X-ray diffraction shows that tetragonal phase is dominant for pure BT sintered for 4 h at 800°C. Scanning electron microscopy and transmission electron microscopy were used to study surface morphology and particle size distribution for BT5Fe and BT5Ni, respectively. The presence of hydroxyl defects were verified by Fourier transform infrared spectroscopy for $(BaTi_{1-x}Fe_{x}O_{3-x/2}) (BT_xFe)$, where x=0.005, 0.01, 0.05, and 0.07 and $(BaTi_{1-x}Ni_{x}O_{3-x/2}) (BT_xNi)$, where x=0.005, 0.01, 0.03, 0.05, and 0.07