17 research outputs found

    Flow behavior and mechanical properties of multi-pass thermomechanically processed 7075 Al-alloy

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    Research on multi-pass hot processing of 7075 Al-alloy was rarely discussed. This study aims to design and evaluate different thermomechanical processing strategies (TMPS) to produce 3 mm-thick sheets of 7075 Al-alloy. A physical simulation was performed using the hot compression test of a Gleeble 3500 to study flow mechanisms and microstructural evolution, while an experimental investigation was carried out using a rolling mill to examine the effect of TMPS on the mechanical properties. Four hot forming strategies were designed and tested at a constant strain rate of 0.1 s−1 over a temperature range of 200–450 °C. These strategies involved applying a constant amount of deformation of 65–70% in single (SP), double (DP), triple (TP), and quadruple (QP) passes of thermomechanical processing to study the influence of multi-pass thermomechanical processing on the final mechanical properties and industrial feasibility. The microstructure analysis showed a significant refinement and more uniform distribution of precipitates with an increasing number of passes, as observed through optical micrographs and the full width at half maximum (FWHM)-position relationship of XRD data. The results indicate that QP is the optimum strategy for producing the best mechanical properties in the shortest production time

    Global economic burden of unmet surgical need for appendicitis

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    Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US 92492millionusingapproach1and92 492 million using approach 1 and 73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was 95004millionusingapproach1and95 004 million using approach 1 and 75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

    Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

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    Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

    Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

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    Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

    Effect of Aging Treatment on the Damping Capacity and Mechanical Properties of Mg-6Al-1Zn Alloy

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    The damping capacity and mechanical properties of Mg-6Al-1Zn alloy after heat treatment were investigated. The damping characteristics of un-heat-treated, solution treated, and aged Mg-6Al-1Zn specimens were determined by measuring the damping ratio and the logarithmic decrement of free vibrations of a bending beam clamped at one side. The microstructural evaluations confirmed that the β-Mg17Al12 phase was reprecipitated after aging and increased with an increase in aging time. The peak level of damping ratio and logarithmic decrement was obtained after 34 hr of aging time, over which the damping capacity declined according to increasing amount of strong pining points

    Influence of Microstructure and Alloy Composition on the Machinability of α/β Titanium Alloys

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    A comparative study was conducted for the machining of two α/β titanium alloys, namely Ti-6Al-4V (Ti64) and Ti-6Al-7Nb (Ti67), using wire electric discharge machining (WEDM). The influence of cutting speed and cutting mode on the machined surfaces in terms of surface roughness (Ra), recast layer (RL), and micro-hardness have been evaluated. Rough cut (RC) mode at a cutting speed of 50 µm/s resulted in thermal damage; Ra was equal to 5.68 ± 0.44 and 4.52 ± 0.35 µm for Ti64 and Ti67, respectively. Trim-cut mode using seven cuts (TRC-VII) at the same speed decreased the Ra to 1.02 ± 0.20 µm for Ti64 and 0.92 ± 0.10 µm for Ti67. At 100 µm/s, Ra reduced from 2.34 ± 0.28 µm to 0.88 ± 0.12 µm (Ti64), and from 1.42 ± 0.15 µm to 0.90 ± 0.08µm (Ti67) upon changing from TRC-III to TRC-VII. Furthermore, a thick recast layer of 30 ± 0.93 µm for Ti64 and 14 ± 0.68 µm for Ti67 was produced using the rough mode, while TRC-III and TRC-VII modes produced layers of 12 ± 1.31 µm and 5 ± 0.72 µm for Ti64 and Ti67, respectively. Moreover, rough cut and trim cut modes of WEDM played a significant role in promoting the surface hardness of Ti64 and Ti67. By employing the Response Surface Methodology, it was found that the machining mode followed by cutting speed and the interaction between them are the most influential parameters on surface roughness. Finally, mathematical models correlating machining parameters to surface roughness were successfully developed. The results strongly promote the trim-cut mode of WEDM as a promising machining route for two-phase titanium alloys

    The Mantle Section of Neoproterozoic Ophiolites from the Pan-African Belt, Eastern Desert, Egypt: Tectonomagmatic Evolution, Metamorphism, and Mineralization

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    The Eastern Desert (ED) Neoproterozoic ophiolites are tectonically important elements of the Arabian–Nubian Shield. Although affected by various degrees of dismemberment, metamorphism, and alteration, almost all of the diagnostic Penrose-type ophiolite components can be found, namely, lower units of serpentinized peridotite tectonite and cumulate ultramafics and upper units of layered and isotropic gabbros, plagiogranites, sheeted dykes and pillow lavas. The contacts between the lower unit (mantle section) and the upper unit (crustal section) were originally magmatic, but in all cases are now disrupted by tectonism. The mantle sections of the ED ophiolites are exposed as folded thrust sheets bearing important and distinctive lithologies of serpentinized peridotites of harzburgite and dunite protoliths with occasional podiform chromitites. The ED ophiolites show a spatial and temporal association with suture zones that indicate fossil subduction zone locations. Multiple episodes of regional metamorphism mostly reached greenschist facies with less common amphibolite facies localities. CO₂-metasomatism resulted in the development of talc–carbonate, listvenite, magnesite, and other carbonate-bearing meta-ultramafic rocks. Geochemical data from the ED serpentinites, despite some confounding effects of hydration and alteration, resemble modern oceanic peridotites. The ED serpentinites show high LOI (≤20 wt%); Mg# mostly higher than 0.89; enrichment of Ni, Cr, and Co; depletion of Al₂O₃ and CaO; and nearly flat, depleted, and unfractionated chondrite-normalized REE patterns. The modal abundance of clinopyroxene is very low if it is present at all. Chromian spinel survived metamorphism and is widely used as the most reliable petrogenetic and geotectonic indicator in the ED ophiolite mantle sections. The high-Cr# (mostly ~0.7) and low-TiO₂ (mostly ≤ 0.1 wt%) characters of chromian spinel indicate a high degree of partial melt extraction (≥30%), which is commonly associated with fore-arc settings and equilibration with boninite-like or high-Mg tholeiite melts. Based on the general petrological characteristics, the ED ophiolitic chromitites are largely similar to Phanerozoic examples that have been attributed to melt–peridotite interaction and subsequent melt mixing in fore-arc settings. The comparison between the ED Neoproterozoic mantle peridotites and Phanerozoic equivalents indicates considerable similarity in tectonomagmatic processes and does not support any major changes in the geothermal regime of subduction zones on Earth since the Neoproterozoic era. The mantle sections of ED ophiolites are worthy targets for mining and exploration, hosting a variety of ores (chromite, gold, and iron/nickel laterites) and industrial minerals (talc, asbestos, and serpentine)

    Prevalence and Risk Factors of Hearing Impairment Among Primary-School Children in Shebin El-Kom District, Egypt

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