Evolution of Pearlite Microstructure in Low-Carbon Cast Microalloyed Steel Due to the Addition of La and Ce

The effects of rare earth elements (RE) addition on the pearlite microstructure in low-carbon microalloyed steels have been investigated under two heat treatment conditions: (1) a normalizing treatment (as a conventional heat treatment used industrially to obtain the final mechanical properties of such steels), and (2) an isothermal treatment at 650 °C. This research reports the following effects due to the addition of RE: (i) refinement of the nodule and colony size of pearlite along with the ferrite grain size in the normalized condition, without a significant change in the volume fraction of pearlite. This microstructural refinement observed at room temperature is a consequence of the refinement of cast and austenitic microstructures formed during cooling in the presence of RE; (ii) the interlamellar spacing of pearlite isothermally transformed at 650 °C, as observed by SEM and TEM, is effectively reduced in the RE-added steel. This is likely due to two different effects combined: (i) direct influence of RE on atom carbon diffusion; and (ii) pearlite growth being boundary diffusion controlled by RE partitioning.The authors from the University of Tehran gratefully acknowledge the financial support provided by the Office of International Affairs and the Office of Research Affairs, College of Engineering, for the project number 8107009.6.34. The authors from CENIM-CSIC would like to acknowledge the financial support from Comunidad de Madrid through DIMMAT-CM_S2013/MIT-2775 Project.Peer Reviewe

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

Background Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. Methods We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). Findings In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683–0·717]). Interpretation In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. Funding British Journal of Surgery Society