ADI 1050-6 Mechanical Behavior at Different Strain Rates and Temperatures

An experimental characterization of the austempered ductile iron ISO 17804/JS/1050-6/S was performed carrying out tensile tests under different strain rates, temperatures and stress triaxiality levels. Then, composing a yield function surface, a hardening relation, and a damage criterion, a constitutive model was developed to describe the salient features of the observed macroscopic response. In particular, the Mohr-Coulomb yield function was selected to account for the pressure effect observed on the yield surface. A new hardening relation was proposed in order to account for both strain rate and temperature effects. The Bonora's damage model, developed in the framework of the continuum damage mechanics, was adopted to capture the failure condition under different stress triaxiality levels. The damage model was appropriately modified to account for the effect of strain rate and temperature on the failure strain

Evaluation of Microstructure Quality in Ductile Irons Based on Tensile Behaviour Analysis

Dislocation-density-related equations were proved to be promising tools to correlate tensile plastic behaviour and microstructure in ductile irons (DIs), revealing distinct relationships between equation parameters and microstructure features in austempered ductile irons (ADI) and isothermed ductile irons (IDI). These equations resulted to be successful also in the characterization of the austempering process through the plastic behaviour analysis of tensile tests of an ADI 1050 that was quenched at different times during austempering. The equation parameters could indeed be correlated to the time window for the best ausferrite, and could predict the precipitation of the deleterious ε' carbides for long austempering times. In the present work the results of the tensile plastic behaviour analysis of different DIs through dislocation-density-related equations are reported. The aim of the analysis was to test the capability of these equations to assess the microstructure quality of DIs and support their industrial production

Violence against health workers: findings from three emergency departments in the teaching hospital of Padua, Italy

Emergency departments (EDs) are high-risk places for Workplace Violence (WPV). In Italy, this phenomenon is scarcely investigated. The aim of this study is to evaluate the incidence, experiencing and perception of WPV in the general ED (GED), paediatric ED (PED) and obstetric-gynaecological ED (OGED) of the teaching hospital Azienda Ospedaliera in Padua (AOP). We led a cross-sectional study among the GED, OGED and PED staffs, submitting an anonymous questionnaire, regarding personal information, verbal and physical aggression experiences, risk factors and proposals for corrective actions. Our sample consists of 73 people from GED, 45 from OGED and 53 from PED. Aggressions are common. Verbal aggressions are almost never recorded, even in the case of physical aggressions, 41% did not signal the event. Both in GED and in OGED, most of the staff (68.9% and 75.0%, respectively) underwent aggression by neither psychiatric nor substance abuser patients (PSAPs). Physical aggressions are more common in GED than in OGED and in PED; most of professionals were assaulted by PSAPs. In all EDs, verbal or physical assault has been lived through by anger, resignation or fear, rarely by indifference. Professionals think there are structural characteristics and risk factors that could be corrected. They do not know how to manage assaults and would deem it useful training meetings with experts. Our results regarding how staff perceive and experience violence in the ED concern a local situation, that nevertheless reflect current evidence about the topic of WPV which plagues EDs across the globe

Admission criteria for a cardiovascular short stay unit: a retrospective analysis on a pilot unit

Rapid intensive observation (RIO) units have been created to guarantee high standards of care in a sustainable health-care system. Within short stay units (SSUs), which are a subgroup of RIOs, only rapidly manageable patients should be admitted. Physicians are unable to predict the length of stay (LOS) as objective criteria to make such a prediction are missing. A retrospective observational study was carried out to identify the objective criteria for admission within a cardiovascular care-oriented SSU. Over a period of 317days, 340 patients (age 69.4±14.7years) were admitted to a pilot SSU within our internal medicine department. The most frequent diagnoses were chest pain (45.9%), syncope (12.9%), and supraventricular arrhythmias (11.2%). The median LOS was 4days (quartile 1:3; quartile 3:7). Predictors of LOS≤96h were age115g/L, estimated glomerular filtration rate>45mL/min/1.73m2, Charlson Comorbidity Index40, diagnosis of chest pain, syncope, supraventricular arrhythmias, or acute heart failure. The HEART (history, ECG, age, risk factors, troponin) score was found to be excellent in risk stratification of patients admitted for chest pain. Blood tests and anamnestic variables can be used to predict the LOS and thus SSU admission. The HEART score may help in the classification of patients with chest pain admitted to an SSU

Antihypertensive treatment changes and related clinical outcomes in older hospitalized patients

Background: Hypertension management in older patients represents a challenge, particularly when hospitalized. Objective: The objective of this study is to investigate the determinants and related outcomes of antihypertensive drug prescription in a cohort of older hospitalized patients. Methods: A total of 5671 patients from REPOSI (a prospective multicentre observational register of older Italian in-patients from internal medicine or geriatric wards) were considered; 4377 (77.2%) were hypertensive. Minimum treatment (MT) for hypertension was defined according to the 2018 ESC guidelines [an angiotensin-converting-enzyme-inhibitor (ACE-I) or an angiotensin-receptor-blocker (ARB) with a calcium-channel-blocker (CCB) and/or a thiazide diuretic; if >80 years old, an ACE-I or ARB or CCB or thiazide diuretic]. Determinants of MT discontinuation at discharge were assessed. Study outcomes were any cause rehospitalization/all cause death, all-cause death, cardiovascular (CV) hospitalization/death, CV death, non-CV death, evaluated according to the presence of MT at discharge. Results: Hypertensive patients were older than normotensives, with a more impaired functional status, higher burden of comorbidity and polypharmacy. A total of 2233 patients were on MT at admission, 1766 were on MT at discharge. Discontinuation of MT was associated with the presence of comorbidities (lower odds for diabetes, higher odds for chronic kidney disease and dementia). An adjusted multivariable logistic regression analysis showed that MT for hypertension at discharge was associated with lower risk of all-cause death, all-cause death/hospitalization, CV death, CV death/hospitalization and non-CV death. Conclusions: Guidelines-suggested MT for hypertension at discharge is associated with a lower risk of adverse clinical outcomes. Nevertheless, changes in antihypertensive treatment still occur in a significant proportion of older hospitalized patients