Response surface and neural network based predictive models of cutting temperature in hard turning

The present study aimed to develop the predictive models of average tool-workpiece interface temperature in hard turning of AISI 1060 steels by coated carbide insert. The Response Surface Methodology (RSM) and Artificial Neural Network (ANN) were employed to predict the temperature in respect of cutting speed, feed rate and material hardness. The number and orientation of the experimental trials, conducted in both dry and high pressure coolant (HPC) environments, were planned using full factorial design. The temperature was measured by using the tool-work thermocouple. In RSM model, two quadratic equations of temperature were derived from experimental data. The analysis of variance (ANOVA) and mean absolute percentage error (MAPE) were performed to suffice the adequacy of the models. In ANN model, 80% data were used to train and 20% data were employed for testing. Like RSM, herein, the error analysis was also conducted. The accuracy of the RSM and ANN model was found to be ⩾99%. The ANN models exhibit an error of ∼5% MAE for testing data. The regression coefficient was found to be greater than 99.9% for both dry and HPC. Both these models are acceptable, although the ANN model demonstrated a higher accuracy. These models, if employed, are expected to provide a better control of cutting temperature in turning of hardened steel

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)