Comparison of wear performance of thermal sprayed cermet (WC-Co) coatings from suspension and feedstock powders.

WC-Co coatings were deposited using conventional High Velocity Oxy-Fuel Jet-Kote (HVOF-JK) and Suspension HVOF (S-HVOF) methods. Microstructural and mechanical properties along with the wear resistance of coatings were investigated. Reciprocating sliding wear tests were conducted against sintered Si3N4 counter-body with a normal load of 25N and total sliding distance of 500m following ASTM G133-2 standard. Coatings were characterised by Scanning Electron Microscope (SEM), X-Ray Diffraction (XRD) and nano-Indentation techniques. HVOF-JK coating showed good retention of WC whereas S-HVOF coating showed the presence of W, W2C and amorphous/nanocrystalline phases. Nano-indentation of HVOF-JK and S-HVOF showed that the relative hardness of the HVOF-JK coating was higher but their elastic modulus was lower. The lower total wear rate was exhibited by the HVOF-JK coating. This difference in wear performance is attributed to the difference in hardness of the coatings and decarburisation of WC particles

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

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Green Synthesis and Scale-Up of MOFs for Water Harvesting from Air

The synthetic scalability of water harvesting metal–organic frameworks (MOFs) is crucial for making these promising materials accessible and widely available for use in household devices. Herein, we present a facile, sustainable, and high-yield synthesis method to produce a series of water-harvesting MOFs, including MOF-303, CAU-23, MIL-160, MOF-313, CAU-10, and Al-fumarate. Using readily available reactants and water as the only solvent, we were able to synthesize these materials at the kilogram scale in a 200 L batch reactor with yields of 84–96% and space-time yields of 238–305 kg/day/m3 under optimized reaction conditions. We also show that our procedure preserves framework crystallinity, porosity, and water-harvesting performance of the MOFs synthesized at scale

Design and Optimization of a Centrifugal Pump for Slurry Transport Using the Response Surface Method

Since centrifugal pumps consume a mammoth amount of energy in various industrial applications, their design and optimization are highly relevant to saving maximum energy and increasing the system’s efficiency. In the current investigation, a centrifugal pump has been designed and optimized. The study has been carried out for the specific application of transportation of slurry at a flow rate of 120 m3/hr to a head of 20 m. For the optimization process, a multi-objective genetic algorithm (MOGA) and response surface methodology (RSM) have been employed. The process is based on the mean line design of the pump. It utilizes six geometric parameters as design variables, i.e., number of vanes, inlet beta shroud, exit beta shroud, hub inlet blade draft, Rake angle, and the impeller’s rotational speed. The objective functions employed are pump power, hydraulic efficiency, volumetric efficiency, and pump efficiency. In this reference, five different software packages, i.e., ANSYS Vista, ANSYS DesignModeler, response surface optimization software, and ANSYS CFX, were coupled to achieve the optimized design of the pump geometry. Characteristic maps were generated using simulations conducted for 45 points. Additionally, erosion rate was predicted using 3-D numerical simulations under various conditions. Finally, the transient behavior of the pump, being the highlight of the study, was evaluated. Results suggest that the maximum fluctuation in the local pressure and stresses on the cases correspond to a phase angle of 0°–30° of the casing that in turn corresponds to the maximum erosion rates in the region

Harvesting Water from Air with High-Capacity, Stable Furan-Based Metal–Organic Frameworks

We synthesized two isoreticular furan-based metal–organic frameworks (MOFs), MOF-LA2-1(furan) and MOF-LA2-2(furan) with rod-like secondary building units (SBUs) featuring 1D channels, as sorbents for atmospheric water harvesting (LA = long arm). These aluminum-based MOFs demonstrated a combination of high water uptake and stability, exhibiting working capacities of 0.41 and 0.48 g of water per g of MOF (under isobaric conditions of 1.70 kPa), respectively. Remarkably, both MOFs showed negligible loss in water uptake after 165 adsorption-desorption cycles. These working capacities rival those of MOF-LA2-1(pyrazole), which has a working capacity of 0.55 g of water per g of MOF. The current MOFs stand out for their high water stability as evidenced by 165 cycles of water uptake and release. MOF-LA2-2(furan) is the first aluminum MOF to employ a double \u27long arm\u27 extension strategy, confirmed through single-crystal X-ray diffraction (SCXRD). The MOFs were synthesized using a straightforward synthesis route. This study offers valuable insights into designing durable, water-stable MOFs and underscores their potential for efficient water harvesting

Kuwait Recommendations on Vaccine Use in People with Inflammatory Rheumatic Diseases

People with IRD are at increased risk of infection, and in 2011 EULAR made general recommendations for vaccination in these patients. Global and European perspectives are important, but they cannot accurately reflect the individual situations of patients in different countries and regions. Based on our clinical experience and opinions, we have sought to tailor the original EULAR recommendations to include advice for vaccination with new agents approved in the intervening years—including the new class of targeted synthetic disease-modifying antirheumatic drugs. We have also considered the specific demographic needs of patients in local populations in the Gulf region. The resulting 16 recommendations are grouped into four main categories covering general vaccination guidelines and best-practice for all patients with IRD, followed by a set of recommended vaccines against specific pathogens. The last two categories include recommendations for certain patient subgroups with defined risks and for patients who wish to travel

Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study

Background: The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate viral hepatitis by 2030. Although no virological cure exists for hepatitis B virus (HBV) infection, existing therapies to control viral replication and prophylaxis to minimise mother-to-child transmission make elimination of HBV feasible. We aimed to estimate the national, regional, and global prevalence of HBsAg in the general population and in the population aged 5 years in 2016, as well as coverage of prophylaxis, diagnosis, and treatment. Methods: In this modelling study, we used a Delphi process that included a literature review in PubMed and Embase, followed by interviews with experts, to quantify the historical epidemiology of HBV infection. We then used a dynamic HBV transmission and progression model to estimate the country-level and regional-level prevalence of HBsAg in 2016 and the effect of prophylaxis and treatment on disease burden. Findings: We developed models for 120 countries, 78 of which were populated with data approved by experts. Using these models, we estimated that the global prevalence of HBsAg in 2016 was 3·9% (95% uncertainty interval [UI] 3·4–4·6), corresponding to 291 992 000 (251 513 000–341 114 000) infections. Of these infections, around 29 million (10%) were diagnosed, and only 4·8 million (5%) of 94 million individuals eligible for treatment actually received antiviral therapy. Around 1·8 (1·6–2·2) million infections were in children aged 5 years, with a prevalence of 1·4% (1·2–1·6). We estimated that 87% of infants had received the three-dose HBV vaccination in the first year of life, 46% had received timely birth-dose vaccination, and 13% had received hepatitis B immunoglobulin along with the full vaccination regimen. Less than 1% of mothers with a high viral load had received antiviral therapy to reduce mother-to-child transmission. Interpretation: Our estimate of HBV prevalence in 2016 differs from previous studies, potentially because we took into account the effect of infant prophylaxis and early childhood vaccination, as well as changing prevalence over time. Although some regions are well on their way to meeting prophylaxis and prevalence targets, all regions must substantially scale-up access to diagnosis and treatment to meet the global targets. Funding: John C Martin Foundation. © 2018 Elsevier Lt