Structure analysis and enhancement of creep resistance and thermal properties of eutectic Sn-Ag lead free solder alloy by Ti and Cd - addition

Eutectic (Sn-3.5wt.%Ag) solder alloy is used in electronic circuits in which the creep property of the solder joints is essential for their applications. The study of creep, structure and thermal properties of three solder alloys (Sn-3.5wt.%Ag,Sn-3.5wt.%Ag-0.27wt.%Ti and Sn-3.5wt.Ag-0.27wt.%Cd) is characterized by the presence of (Ag3Sn-IMC) beside the phase (β-Sn). The microstructure parameters obtained from the X-ray analysis represented by, lattice parameters (a, c), the axial ratio (c/a), the residual strains (Δa/a0, Δc/c0) and peak height intensities (hkl) of some crystallographic planes are given. All parameters were found to be sensitive to the additions of (Ti or Cd), applied stresses and working temperatures in the range (298-373K).The crystallite size of the (211) reflection was found to increase from (61-132nm) with the additions and to decrease from (115-79nm) with the working temperatures. The morphological studies show a remarkable decrease in the size of (β-Sn) grains with the addition of (Cd) content which confirms the X-ray data. The obtained results show a decrease in melting temperature with the additions. The creep properties are notably improved by the addition of either (Ti) or (Cd). In order to reveal the creep characteristics such as stress exponent (n) and activation energy (Q), the tensile creep tests were performed within the temperature range (298-373K) at constant applied stress (17.27MPa). Based on the obtained stress exponents and activation energies, it is explained that the dominant deformation mechanism is dislocation climb over all temperature range. &nbsp

Transformer Faults Classification Based on Convolution Neural Network

This paper studies the latest advances made in Deep Learning (DL) methods utilized for transformer inrush and fault currents classification. Inrush and fault currents at different operating conditions, initial flux and fault type are simulated. This paper presents a technique for the classification of power transformer faults which is based on a DL method called convolutional neural network (CNN) and compares it with traditional artificial neural network (ANN) and other techniques. The inrush and fault current signals of the transformer are simulated within MATLAB by using Fourier analyzers that provides the 2nd harmonic signal. The 2nd harmonic peak and variance statistic values of input signals of the three phases of transformer are used at different operating conditions. The resulted values are aggregated into a dataset to be used as an input for the CNN model, then training and testing the CNN model is performed. Consequently, it is obvious that the CNN algorithm achieves a better performance compared to other algorithms. This study helps with easy discrimination between normal signals and faulty signals and to determine the type of the fault to clear it easily

Phéochromocytome et grossesse - Gestion péri opératoire et conduite à tenir obstétricale: a propos d’un cas clinique et revue de littérature

L’association phéochromocytome et grossesse est rare pouvant mettre en jeu le pronostic vital maternel et fœtal. Le diagnostic est aisé à condition d’y penser systématiquement face à une hypertension artérielle gravidique atypique, accompagnée de signes cliniques évocateurs, ou résistante au traitement. La certitude diagnostique est donnée par des tests biologiques simples et fiables. Nous rapportons le cas d’un phéochromocytome survenu au 1er trimestre, révélé par des épisodes d’hypertension artérielle. Le traitement avait consisté en une préparation médicale préopératoire suivie d’une surrénalectomie. L’évolution materno-fœtale était favorable. La survenue d’un phéochromocytome au cours de la grossesse pose un problème de diagnostic et de contrôle tensionnel. La stratégie thérapeutique dépend du terme, du retentissement materno-fœtal et de la réponse au traitement médical

In-vitro responses of peritoneal macrophages of marine red hybrid tilapia (Oreochromis spp.) model to vibriosis: A comparative study between vaccinated and non-vaccinated fish

Vibriosis, an infection caused by Gram-negative bacteria of the genus Vibrio is a major disease in global aquaculture. Vaccination is an effective preventive measure against vibriosis. Phagocytosis, the fundamental cellular mechanism that eliminates invading pathogens is governed by phagocytic cells like macrophages and neutrophils. To gain insight into the mechanism of vaccination and its role in influencing macrophage activity in reducing the number of live Vibrio species prior to the establishment of infection in the host, in vitro responses of peritoneal macrophages of vaccinated and unvaccinated marine red hybrid tilapia were compared in terms of phagocytosis, intracellular killing, and macrophage death rates. A total of 90 healthy marine red hybrid tilapia were divided into three equal groups. Group 1 and 2 were vaccinated using feed-based oil-adjuvanted and non-adjuvanted killed whole cell V. harveyi vaccine, respectively. Group 3 was not vaccinated. Vaccine feed was given on weeks 0, 2 and 6. Peritoneal macrophages were collected at week 0 and 10. Macrophages were exposed to V. harveyi or V. alginolyticus and harvested at 0-, 30-, 60- and 120-minutes post-infection. The rate of phagocytosis, intracellular killing rate of bacteria and rate of macrophage cell death were calculated. In general, post-vaccinated macrophages of all treatment groups showed a significant (p<0.05) increase in phagocytosis than pre-vaccinated macrophages following V. harveyi and V. alginolyticus challenge. Macrophages of post-vaccine oil-adjuvanted group showed significant (p<0.05) increase in intracellular killing of V. harveyi and V. alginolyticus. Macrophages of post- vaccinated Group 2 fish showed a higher cell death rate following V. harveyi and V. alginolyticus infection than that of post-vaccinated Group 1 fish. This study proved that the macrophages of tilapia immunized with an oil-adjuvanted vaccine were more efficient in phagocytosis, intracellular killing, and more resistance compared to non-adjuvanted vaccinated and unvaccinated tilapia in the presence of V. harveyi or V. alginolyticus

A Case Series of Severe Hospitalized COVID-19 Patients Treated with Tocilizumab and Glucocorticoids: A Report from Saudi Arabian Hospital

Background: The clinical spectrum of COVID-19 is variable and ranges from asymptomatic, mildly symptomatic, moderately severe and severe disease. A small proportion might develop severe disease and may have cytokine storm. One of the therapeutic options to treat such cases is Tocilizumab (TCZ). In this study, we present cases of severe COVID-19 treated with TCZ and glucocorticoids and discuss the treatment responses. Methods: This is a retrospective observational study of severe COVID-19 cases treated with TCZ and glucocorticoids. The case series examined the characteristics and outcome of those patients. Results: This study included 40 Severe Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) confirmed patients who received TCZ and glucocorticoids. The mean age of the included patients was 57.55 (±Standard deviation 12.86) years. There were 34 (85%) males, 19 (47.5%) were obese (BMI >30), 13 (32.5%) over weight, and five (12.5%) normal weight. The mean days from positive SARS-CoV-2 polymerase chain reaction (PCR) test to admission was 1.641 (±3.2) days. Of the patients, 18 (45%) had diabetes mellitus, 14 (35%) had hypertension. The mean days from hospital admission to ICU was 1.8 (±2.6), 20 (50%) required mechanical ventilation, 39 (97.5%) had received prone position, seven (17.5%) had renal replacement therapy, 13 (32.5%) required inotropes, four (10%) had plasmapheresis, one (2.5%) had intravenous immunoglobulin, all patients received steroid therapy, and the majority 31 (77.5%) did not receive any anti-viral therapy. Of all the patients, six (15%) died, 28 (70%) were discharged and six (15%) were still in hospital. Conclusion: The overall mortality rate was lower than those cited in meta-analysis. As our understanding of the COVID-19 continues, the approach and therapeutics are also evolving

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&nbsp;years; 78.2% included were male with a median age of 37&nbsp;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

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

The Comprehensive Quality in Health Services by Using Six Sigma

The study aimed to know the overall quality of the concept and its importance in providing high-quality health services and the availability of the key factors in the application and services and to take administrative factors, technical and human and financial, which may contribute to the raise if directed properly and have an adult in improving the quality of health services impact. Based on the nature of the study and the objectives it seeks, the analytical descriptive approach was used. It was based on the study of the phenomenon as it exists in reality and it is treated as a precise description and expressed in qualitative and quantitative terms. To analyze the analytical aspects of the research subject and then collect the initial data through the questionnaire as a main tool for research, designed specifically for this purpose, and distributed to government hospitals in Khartoum State, and included the study community department managers and patients in government hospitals in Khartoum state. A random sample was collected (300) department managers and patients from the Khartoum government hospitals. Each individual has the opportunity to be a member of the study sample during the year 2016. The study concluded with a number of results, the most important of which is that the hospital management has the material potential (furniture, equipment, ...) to use the Six Sigma curriculum with an intermediate degree. The hospital management is ready to use the Six Sigma curriculum to a high degree. Six Sigma In the middle level, the hospital management is keen to train the heads of departments to form teams for the process of continuous improvement to a high degree, the hospital administration is continuously improving the purpose of reducing the deviations and errors that occur, the hospital management is ready to provide an information system Its data continuously At, there is the management of the hospital readiness to provide direct contact with an intermediate degree of quality coaches tuning software system. The study presented a number of recommendations, the most important of which is linking the promotion system in the public hospitals in Khartoum state with the quality control program, paying attention to the overall quality and stressing the possibility of using it in hospitals in Khartoum State because of its scientific and practical importance and improving the quality of the services and the operations provided

Creep microstructure relationships in Sn-Sb and Sn-Sb-Cu alloys

SIGLEAvailable from British Library Document Supply Centre-DSC:DXN028530 / BLDSC - British Library Document Supply CentreGBUnited Kingdo