2 research outputs found

    Sustainable cooling method for machining titanium alloy

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    Hard to machine materials such as Titanium Alloy TI-6AI-4V Grade 5 are notoriously known to generate high temperatures and adverse reactions between the workpiece and the tool tip materials. These conditions all contribute to an increase in the wear mechanisms, reducing tool life. Titanium Alloy, for example always requires coolant to be used during machining. However, traditional flood cooling needs to be replaced due to environmental issues, and an alternative cooling method found that has minimum impact on the environment. For true sustainable cooling of the tool it is necessary to account for all energy used in the cooling process, including the energy involved in producing the coolant. Previous research has established that efficient cooling of the tool interface improves the tool life and cutting action. The objective of this research is to determine the most appropriate sustainable cooling method that can also reduce the rate of wear at the tool interface

    Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

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    Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)
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