Effect of Cu Additions on Scale Structure and Descaling Efficiency of Low C Steel Reheated in a Combustion Gas Atmosphere

Modern EAF steelmaking employs scrap as its primary source of raw material. Different sources of scrap have varying levels of residuals, which can negatively influence product properties, performance, and surface quality. The presence of some residuals, such as Cu and Ni in controlled quantities, can also positively impact steel performance for some applications. It is also well known that interactions between residuals and alloying elements in steel can modify the structure of scale formed during slab reheating prior to hot rolling. These changes in the scale structure can influence scale removability. In this study, the effect of varying Cu concentrations in a low alloyed Mn and Si containing steel was examined to investigate its impact on scale removability. Laboratory studies were performed with simulated reheating and descaling conditions that mimic the conditions used in industrial practices. The scale structure that formed during reheating in the combustion atmosphere was investigated using SEM/EDX analysis. A special laboratory water jet descaling device was used to evaluate scale removability at three different hydraulic impact factors. The results showed that Cu at different levels significantly modified scale structure that formed, particularly the internal scale layers, which affected scale removability at different applied descaling impact factors. The effects of Cu level and descaling impact factor on scale removability is discussed

Effect of Cu Additions on Scale Structure and Descaling Efficiency of Low C Steel Reheated in a Combustion Gas Atmosphere

Modern EAF steelmaking employs scrap as its primary source of raw material. Different sources of scrap have varying levels of residuals, which can negatively influence product properties, performance, and surface quality. The presence of some residuals, such as Cu and Ni in controlled quantities, can also positively impact steel performance for some applications. It is also well known that interactions between residuals and alloying elements in steel can modify the structure of scale formed during slab reheating prior to hot rolling. These changes in the scale structure can influence scale removability. In this study, the effect of varying Cu concentrations in a low alloyed Mn and Si containing steel was examined to investigate its impact on scale removability. Laboratory studies were performed with simulated reheating and descaling conditions that mimic the conditions used in industrial practices. The scale structure that formed during reheating in the combustion atmosphere was investigated using SEM/EDX analysis. A special laboratory water jet descaling device was used to evaluate scale removability at three different hydraulic impact factors. The results showed that Cu at different levels significantly modified scale structure that formed, particularly the internal scale layers, which affected scale removability at different applied descaling impact factors. The effects of Cu level and descaling impact factor on scale removability is discussed

Safety of overlapping inpatient orthopaedic surgery: A multicenter study

BackgroundAlthough overlapping surgery is used to maximize efficiency, more empirical data are needed to guide patient safety. We conducted a retrospective cohort study to evaluate the safety of overlapping inpatient orthopaedic surgery, as judged by the occurrence of perioperative complications.MethodsAll inpatient orthopaedic surgical procedures performed at 5 academic institutions from January 1, 2015, to December 31, 2015, were included. Overlapping surgery was defined as 2 skin incisions open simultaneously for 1 surgeon. In comparing patients who underwent overlapping surgery with those who underwent non-overlapping surgery, the primary outcome was the occurrence of a perioperative complication within 30 days of the surgical procedure, and secondary outcomes included all-cause 30-day readmission, length of stay, and mortality. To determine if there was an association between overlapping surgery and a perioperative complication, we tested for non-inferiority of overlapping surgery, assuming a null hypothesis of an increased risk of 50%. We used an inverse probability of treatment weighted regression model adjusted for institution, procedure type, demographic characteristics (age, sex, race, comorbidities), admission type, admission severity of illness, and clustering by surgeon.ResultsAmong 14,135 cases, the frequency of overlapping surgery was 40%. The frequencies of perioperative complications were 1% in the overlapping surgery group and 2% in the non-overlapping surgery group. The overlapping surgery group was non-inferior to the non-overlapping surgery group (odds ratio [OR], 0.61 [90% confidence interval (CI), 0.45 to 0.83]; p < 0.001), with reduced odds of perioperative complications (OR, 0.61 [95% CI, 0.43 to 0.88]; p = 0.009). For secondary outcomes, there was a significantly lower chance of all-cause 30-day readmission in the overlapping surgery group (OR, 0.67 [95% CI, 0.52 to 0.87]; p = 0.003) and shorter length of stay (e, 0.94 [95% CI, 0.89 to 0.99]; p = 0.012). There was no difference in mortality.ConclusionsOur results suggest that overlapping inpatient orthopaedic surgery does not introduce additional perioperative risk for the complications that we evaluated. The suitability of this practice should be determined by individual surgeons on a case-by-case basis with appropriate informed consent.Level of evidenceTherapeutic Level III. See Instructions for Authors for a complete description of levels of evidence

A formal syntactic analysis of agentivity in motion predicates in Ghanaian Student Pidgin (GSP)

The paper explores the syntactic structure of Agentive motion predicates in Ghanaian Student Pidgin (GSP), an English-lexified expanded pidgin spoken by (mostly male) students (and young adults) in Ghanaian secondary and tertiary educational institutions. I argue that GSP uses Serial Verb Constructions (SVCs) to encode Agentive motion predicates and propose syntactic analyses to account for the difference in interpretation between Initial Contact Agentives and Continuous Contact Agentives – despite the apparent similarity in their surface structures. The paper argues that though (in accordance with previous studies on agentivity Kratzer, 1996; Pylkkänen, 2008; Harley, 2013) GSP introduces the agent with an agentive vP in both Initial and Continuous Contact agentives, the difference in interpretation between the two results from an embedded make-clause in the underlying structure of Initial Contact agentives which is not present in Continuous Contact agentives.  The paper explores the syntactic structure of Agentive motion predicates in Ghanaian Student Pidgin (GSP), an English-lexified expanded pidgin spoken by (mostly male) students (and young adults) in Ghanaian secondary and tertiary educational institutions. I argue that GSP uses Serial Verb Constructions (SVCs) to encode Agentive motion predicates and propose syntactic analyses to account for the difference in interpretation between Initial Contact Agentives and Continuous Contact Agentives — despite the apparent similarity in their surface structures. The paper argues that though (in accordance with previous studies on agentivity (KRATZER, 1996; PYLKKÄNEN, 2008; HARLEY, 2013)) GSP introduces the agent with an agentive vP in both Initial and Continuous Contact agentives, the difference in interpretation between the two results from an embedded make-clause in the underlying structure of Initial Contact agentives which is not present in Continuous Contact agentives

Simultaneous Quantification of Lamivudine, Zidovudine and Related Impurities in Fixed Oral Dosage Combination Using RP-HPLC with DAD detection

A simple and fast isocratic Reverse Phase High Performance Liquid Chromatography (RP-HPLC) method has been developed and validated for the simultaneous determination of Lamivudine, zidovudine and their related impurities in tablets. The method consists of a mobile phase combination of Acetonitrile (HPLC grade) and Buffer (0.0680 g of Potassium Dihydrogen Orthophosphate, 0.3 ml of Triethylamine, pH adjusted to 8.0 with Orthophosphoric acid to a final volume preparation of 100 ml) in the ratio 10:90. Phenomenex Luna 5-µm C18 (2)-250 x 4.6-mm, 5-µm) was used as the stationary phase. The column oven was set to a temperature of 30±1oC. Quantification was achieved with a DAD detector set at 270 nm. Resolution was achieved at a short run time of 25 minutes. Zidovudine related impurity C, Lamivudine, salicylic acid, Zidovudine and Zidovudine related impurity B eluted at 3.749±0.004, 4.862±0.013, 15.332±0.064, 21.201±0.076 and 23.682±0.117 respectively. Relative retention times (RRT) for lamivudine unknown related impurities with respect to Zidovudine were 0.15, 0.17, 0.30 and 0.59. RRT for Zidovudine unknown related impurities with respect to Zidovudine were 0.39 and 0.63.  The method was found to be specific, robust, accurate and precise for the estimation of Zidovudine related impurity C, Lamivudine, salicylic acid, Zidovudine and Zidovudine related impurity B in fixed oral dosage tablets over the concentration ranges of 0.0204 mg/mL-0.0088 mg/mL, 0.0962 mg/mL-0.7699 mg/mL, 0.1929 mg/mL-1.5410 mg/mL and 0.0088 mg/mL-0.024 mg/mL respectively. The Correlation Coefficient (r2) for Zidovudine related impurity C, Lamivudine, salicylic acid, Zidovudine and Zidovudine related impurity B were greater than 0.998. The LOD were found to be between 1.9x10-4 mg/mL to 2.69 x10-4 mg/mL.  The proposed method is precise, specific, accurate and robust for the simultaneous estimation of Zidovudine related impurity C, Lamivudine, salicylic acid, Zidovudine, Zidovudine related impurity B and other related impurities in dosage forms. Keywords: Zidovudine related impurity C, Lamivudine, salicylic acid, Zidovudine, Zidovudine related impurity B, Lamivudine related impurities, Zidovudine related impurities RP-HPLC, Validation.

Technical efficiency of public district hospitals and health centres in Ghana: a pilot study

BACKGROUND: The Government of Ghana has been implementing various health sector reforms (e.g. user fees in public health facilities, decentralization, sector-wide approaches to donor coordination) in a bid to improve efficiency in health care. However, to date, except for the pilot study reported in this paper, no attempt has been made to make an estimate of the efficiency of hospitals and/or health centres in Ghana. The objectives of this study, based on data collected in 2000, were: (i) to estimate the relative technical efficiency (TE) and scale efficiency (SE) of a sample of public hospitals and health centres in Ghana; and (ii) to demonstrate policy implications for health sector policy-makers. METHODS: The Data Envelopment Analysis (DEA) approach was used to estimate the efficiency of 17 district hospitals and 17 health centres. This was an exploratory study. RESULTS: Eight (47%) hospitals were technically inefficient, with an average TE score of 61% and a standard deviation (STD) of 12%. Ten (59%) hospitals were scale inefficient, manifesting an average SE of 81% (STD = 25%). Out of the 17 health centres, 3 (18%) were technically inefficient, with a mean TE score of 49% (STD = 27%). Eight health centres (47%) were scale inefficient, with an average SE score of 84% (STD = 16%). CONCLUSION: This pilot study demonstrated to policy-makers the versatility of DEA in measuring inefficiencies among individual facilities and inputs. There is a need for the Planning and Budgeting Unit of the Ghana Health Services to continually monitor the productivity growth, allocative efficiency and technical efficiency of all its health facilities (hospitals and health centres) in the course of the implementation of health sector reforms

Monoamniotic twin pregnancy discordant for body stalk anomaly: a case report

Body stalk anomaly, also known as limb-body syndrome, is a rare and lethal congenital anomaly. It presents a major abdominal wall defect and severe kyphosis with either a rudimentary or absent umbilical cord. We present a case of monoamniotic twin discordant for body stalk anomaly diagnosed at 27 weeks. Ultrasound findings demonstrated a normal Twin A, but Twin B was abnormal with a large ventral wall defect and severe kyphoscoliosis. The pregnancy was managed conservatively and concluded with an emergency caesarean section at 31 weeks on account of preterm labour. The unaffected twin survived with no significant morbidity. This case highlights some of the challenges posed to the obstetrician in managing such a rare anomaly in twin pregnancy

The Cost of Annual versus Biannual Community-Directed Treatment of Onchocerciasis with Ivermectin: Ghana as a Case Study

BACKGROUND: It has been proposed that switching from annual to biannual (twice yearly) mass community-directed treatment with ivermectin (CDTI) might improve the chances of onchocerciasis elimination in some African foci. However, historically, relatively few communities have received biannual treatments in Africa, and there are no cost data associated with increasing ivermectin treatment frequency at a large scale. Collecting cost data is essential for conducting economic evaluations of control programmes. Some countries, such as Ghana, have adopted a biannual treatment strategy in selected districts. We undertook a study to estimate the costs associated with annual and biannual CDTI in Ghana. METHODOLOGY: The study was conducted in the Brong-Ahafo and Northern regions of Ghana. Data collection was organized at the national, regional, district, sub-district and community levels, and involved interviewing key personnel and scrutinizing national records. Data were collected in four districts; one in which treatment is delivered annually, two in which it is delivered biannually, and one where treatment takes place biannually in some communities and annually in others. Both financial and economic costs were collected from the health care provider's perspective. PRINCIPAL FINDINGS: The estimated cost of treating annually was US Dollars (USD) 0.45 per person including the value of time donated by the community drug distributors (which was estimated at USD 0.05 per person per treatment round). The cost of CDTI was approximately 50–60% higher in those districts where treatment was biannual than in those where it was annual. Large-scale mass biannual treatment was reported as being well received and considered sustainable. CONCLUSIONS/SIGNIFICANCE: This study provides rigorous evidence of the different costs associated with annual and biannual CDTI in Ghana which can be used to inform an economic evaluation of the debate on the optimal treatment frequency required to control (or eliminate) onchocerciasis in Africa