73 research outputs found

    Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

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    Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

    Experimental evidence for diffusion creep in the superplastic 3 mol% yttria-stabilized tetragonal zirconia

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    Although there have been numerous studies on the high temperature deformation characteristics of the superplastic 3 mol% yttria stabilized tetragonal zirconia (3YTZ), the rate controlling deformation mechanism has not been identified unambiguously. In the present study, experiments were conducted on 3YTZ at high stresses and at coarser grain sizes than used conventionally for superplasticity. The experimental results reveal, for the first time, an intragranular dislocation motion controlled high stress regime that is independent of the grain size. With a decrease in stress, there is a transition to a Newtonian viscous deformation regime consistent with Coble grain boundary diffusion creep. At sufficiently low stresses, or in materials with finer grain sizes, there is a further transition to a grain size dependent interface controlled deformation regime. Analysis of the experimental data suggests strongly that superplastic flow in 3YTZ occurs by an interface controlled deformation mechanism

    Data for: Microstructure, Mechanical Properties and Strengthening Mechanisms of Friction Stir Welded Kanthal APMT Steel

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    Tensile engineering stress vs. engineering plastic strain data - Figure 11(a) and (b) were created using the Excel file data

    Microstructural Refinement and Control in Friction Stir Processed Aluminum Alloys for Superplasticity

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    Friction Stir Processing (FSP) is being developed as a potential grain refinement technique in aluminum alloys. It leads to microstructures consisting of very fine grains and high grain boundary misorientations, microstructural features that are considered necessary for enhanced superplasticity. in this paper, we review the recent observations of superplasticity in several friction stir processed commercial aluminum alloys. High strain rate superplasticity has been observed in a number of FSP aluminum alloys. a critical issue is the observation of abnormal grain growth at high temperatures. in some cases, the abnormal grain growth can limit the superplastic temperature range. New approaches are presented to minimize or eliminate this problem and realize the full potential of FSP for high strain rate superplasticity

    A Preliminary Study on the Development of La\u3csub\u3e2\u3c/sub\u3eO\u3csub\u3e3\u3c/sub\u3e-Bearing Nanostructured Ferritic Steels via High Energy Ball Milling

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    Elemental powder mixture of Fe-Cr-Ti-Mo and La2O3 were ball milled for different milling times in a high energy shaker mill. Effects of ball milling time on crystallite size, particle size and hardness were investigated using X-ray diffraction (XRD), scanning electron microscopy (SEM) and microhardness tester. After 10 hours of ball milling, the smallest crystallite size and highest hardness were ∼24 nm and ∼970 HV, respectively. Transmission electron microscopy (TEM) studies have revealed nanoscale features 2-5 nm in diameter present in the milled powder. Local atom probe tomography studies have shown that these nanoscale features were possibly nanoclusters enriched in La, TiO and O

    Mechanical Alloying of Lanthana-Bearing Nanostructured Ferritic Steels

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    A novel nanostructured ferritic steel powder with the nominal composition Fe–14Cr–1Ti–0.3Mo–0.5La2O3 (wt.%) was developed via high energy ball milling. La2O3 was added to this alloy instead of the traditionally used Y2O3. The effects of varying the ball milling parameters, such as milling time, steel ball size and ball to powder ratio, on the mechanical properties and microstructural characteristics of the as-milled powder were investigated. Nanocrystallites of a body-centered cubic ferritic solid solution matrix with a mean size of approximately 20 nm were observed by transmission electron microscopy. Nanoscale characterization of the as-milled powder by local electrode atom probe tomography revealed the formation of Cr–Ti–La–O-enriched nanoclusters during mechanical alloying. The Cr:Ti:La:O ratio is considered “non-stoichiometric”. The average size (radius) of the nanoclusters was about 1 nm, with number density of 3.7 × 1024 m−3. The mechanism for formation of nanoclusters in the as-milled powder is discussed. La2O3 appears to be a promising alternative rare earth oxide for future nanostructured ferritic steels
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