Synergistic Sintering of Lignite Fly Ash and Steelmaking Residues towards Sustainable Compacted Ceramics

The development of value-added ceramic materials deriving only from industrial by-products is particularly interesting from technological, economic, and environmental point of views. In this work, the synergistic sintering of ternary and binary mixtures of fly ash, steelmaking electric arc furnace dust, and ladle furnace slag for the synthesis of compacted ceramics is reported. The sintered specimens’ microstructure and mineralogical composition were characterized by SEM-EDS and XRD, respectively. Moreover, the shrinkage, apparent density, water absorption, and Vickers microhardness (HV) were investigated at different sintering temperatures and raw material compositions. The characterization of the sintered compacts revealed the successful consolidation of the ceramic microstructures. According to the experimental findings, the ceramics obtained from fly ash/steel dust mixtures exhibited enhanced properties compared to the other mixtures tested. Moreover, the processing temperature affected the final properties of the produced ceramics. Specifically, a 407% HV increase for EAFD and a 2221% increase for the FA-EAFD mixture were recorded, by increasing the sintering temperature from 1050 to 1150°C. Likewise, a 972% shrinkage increase for EAFD and a 577% shrinkage increase for the FA-EAFD mixture were recorded, by increasing the sintering temperature from 1050 to 1150°C. The research results aim at shedding more light on the development of sustainable sintered ceramics from secondary industrial resources towards circular economy

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

The effect of sintering processes of lignite calcareous ashes on the production of ceramics

Abstract Two-step sintering (TSS) and microwave (MW) heating process are two new techniques, promising approaches to obtain effectively densified ceramics. TSS is characterized by the absence of the final stage of grain growth occurring upon the conventional sintering and by the development of nanograin microstructure. MW energy offers many advantages for effective and rapid, thus eco-friendlier and economic sintering of materials over conventional processing. This process, by its selective and volumetric heating, can reduce the sintering time considerably, enhance the solidification efficiency and improve physical and mechanical properties. In the present research, compacts prepared from lignite combustion Class-C ashes originated from West Macedonia -Greece were sintered employing the aforementioned alternative sintering procedures and compared to similar specimens that were conventionally sintered. The ceramic microstructures obtained were characterized by means of XRD and SEM-EDX analysis, as well as by density measurements conducted using the Archimedes method. The effectiveness of the solidification process was thoroughly studied and is discussed here, and the specific microstructural features attained are compared between each other and evaluated in relation to the sintering method applied. The results show that the valorization of lignite calcareous ashes into ceramic materials is feasible through different sintering techniques

A beamline for fundamental neutron physics at TRIUMF

This article describes the new primary proton beamline 1U at TRIUMF. The purpose of this beamline is to produce ultracold neutrons (UCN) for fundamental-physics experiments. It delivers up to 40 µA of 480 MeV protons from the TRIUMF cyclotron to a tungsten spallation target and uses a fast kicker to share the beam between the Center for Molecular and Materials Science and UCN. The beamline has been successfully commissioned and operated with a beam current up to 10 µA, facilitating first large-scale UCN production in Canada.This article describes the new primary proton beamline 1U at TRIUMF. The purpose of this beamline is to produce ultracold neutrons (UCN) for fundamental-physics experiments. It delivers up to 40 microA of 480 MeV protons from the TRIUMF cyclotron to a tungsten spallation target and uses a fast kicker to share the beam between the Center for Molecular and Materials Science and UCN. The beamline has been successfully commissioned and operated with a beam current up to 10 microA, facilitating first large-scale UCN production in Canada

Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study

Background: Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods: We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients' preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings: Between June 16, 2014, and April 29, 2015, data from 22 803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21 694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj −4·4%, 95% CI −5·5 to −3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj −2·6%, 95% CI −3·9 to −1·4) and the administration of reversal agents (1·23, 1·07–1·41; −1·9%, −3·2 to −0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj −0·3%, 95% CI −2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; −0·4%, −3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation: We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications. Funding: European Society of Anaesthesiology

Use of failure-to-rescue to identify international variation in postoperative care in low-, middle- and high-income countries: A 7-day cohort study of elective surgery

The incidence and impact of postoperative complications are poorly described. Failure-to-rescue, the rate of death following complications, is an important quality measure for perioperative care but has not been investigated across multiple health care systems. Methods. We analysed data collected during the International Surgical Outcomes Study, an international 7-day cohort study of adults undergoing elective inpatient surgery. Hospitals were ranked by quintiles according to surgical procedural volume (Q1 lowest to Q5 highest). For each quintile we assessed in-hospital complications rates, mortality, and failure-to-rescue. We repeated this analysis ranking hospitals by risk-adjusted complication rates (Q1 lowest to Q5 highest). Results. A total of 44 814 patients from 474 hospitals in 27 low-, middle-, and high-income countries were available for analysis. Of these, 7508 (17%) developed one or more postoperative complication, with 207 deaths in hospital (0.5%), giving an overall failure-to-rescue rate of 2.8%. When hospitals were ranked in quintiles by procedural volume, we identified a threefold variation in mortality (Q1: 0.6% vs Q5: 0.2%) and a two-fold variation in failure-to-rescue (Q1: 3.6% vs Q5: 1.7%). Ranking hospitals in quintiles by risk-adjusted complication rate further confirmed the presence of important variations in failureto- rescue, indicating differences between hospitals in the risk of death among patients after they develop complications. Conclusions. Comparison of failure-to-rescue rates across health care systems suggests the presence of preventable postoperative deaths. Using such metrics, developing nations could benefit from a data-driven approach to quality improvement, which has proved effective in high-income countries