Prediction of Surface Quality Using Artificial Neural Network for the Green Machining of Inconel 718

Inconel 718 is a nickel-based heat resistant super-alloy (HRSA) that is widely used in many aerospace and automotive applications. It possesses good properties like corrosion resistance, high strength, and exceptional weld-ability but it is considered as one of the most difficult alloys to cut. Recently researchers have focused on employing many machining strategies to improve machinability of Inconel 718. This research work presents the experimentation of wet milling of Inconel 718 using a carbide tool with biodegradable oil. Surface quality is the major aspect of machinability. Hence input parameters such as depth of cut, cutting speed, and feed rate are considered to study their effect on surface quality. Nine experimental runs based on an L9 orthogonal array are performed. Additionally, analysis of variance (ANOVA) is applied to identify the most significant factors among cutting speed, feed rate, and depth of cut. Moreover, this research work presents the Artificial Neural Network (ANN) model for predicting the surface roughness based on experimental results. The ANN based-decision-making model is trained by using acquired experimental values. Visual Gene Developer 2.0 software package is used to study the efficiency of ANN. The presented ANN model demonstrates a very good statistical performance with a high correlation and extremely low error ratio between the actual and predicted values of surface roughness and tool wear

Environmentally Conscious Machining of Inconel 718: Surface Roughness, Tool Wear and Material Removal Rate Assessment

Flood cooling is a typical strategy used in the machining of difficult-to-cut materials where high temperatures are produced.Several environmental and health concerns are associated with the cutting fluids employed during this technique. Vegetable oil-based fluids appear to be the best substitute to conventional mineral/synthetic oils due to their environmentally friendly, biode-gradable, renewable, and less toxic properties. Therefore, this paper attempts to establish an environmentally conscious, flood-cooling alternative through replacing conventional fluids with a synthetic vegetable ester-based (Mecagreen 450) biodegradableoil to investigate the machinability aspects of Inconel 718. In addition to the cooling environment, cutting speed (vs), feed pertooth (fz), and axial depth of cut (ap) have been used as control variables. ATaguchi L9array has been selected for the design ofexperiments (DOE). Parametric effects and microscopic analyses have been carried out to investigate the three response param-eters, i.e., surface roughness (Ra), tool wear, and material removal rate (MRR). Tool wear analysis is further supplemented withscanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS)

Plasma level of ADAMTS-13 in maintenance hemodialysis patients and its relation to arteriovenous fistula thrombosis

Background: End-stage renal disease is the final stage of chronic kidney disease in which irreversible deterioration in renal function occur and the body fails to maintain fluid and electrolyte balance, this need regular hemodialysis (HD) a process that removes accumulated solute from a patient with near-total renal function loss. Arteriovenous fistula (AVF) is the vascular access of choice for patients who require hemodialysis. AVF thrombosis is a major issue in hemodialysis  patients, which increase their morbidity and  lessen HD efficiency. Objective: To assess plasma level of ADAMTS-13 in HD patients and its association with AVF thrombosis, and to correlate the plasma level of ADAMTS-13 with age, duration of dialysis, certain hematological parameters and estimated GFR. Patients and Methods:This Cross_sectional study done on 60 patients  with ESRD on regular HD sessions, 20 healthy persons were included as a control . The patients subdivided into two subgroups with and without AVF thrombosis. Plasma samples were freezed until the test for the level of ADAMTS-13  was done. Results: The plasma ADAMTS-13 level was significantly lower in HD patients compared to control group (P < 0.001), and was a significantly lower in  patients with a history of AVF thrombosis than HD patients without a history of AVF thrombosis.  HD patients with AVF thrombosis had significantly lower eGFR compared to patients without a history of AVF thrombosis. There was a positive correlation of plasma ADAMTS-13 level with the mean of eGFR , platelet count and negative correlation with MPV. Conclusion: Significant differences  between HD patients and control regarding eGFR and hematological parameters . Plasma ADAMTS-13 level was significantly lower in patients compared to controls and significantly lower in patients group with AVF thrombosis than HD group without thrombosis

Hand Hygiene Knowledge and Perception among the Healthcare Workers during the COVID-19 Pandemic in Qassim, Saudi Arabia: A Cross-Sectional Survey

Hand hygiene is among the most important factors of infection control in healthcare settings. Healthcare workers are the primary source of hospital-acquired infection. We assessed the current state of hand hygiene knowledge, perception, and practice among the healthcare workers in Qassim, Saudi Arabia. In this cross-sectional study, we used the hand hygiene knowledge and perception questionnaire developed by the World Health Organization. Knowledge and perceptions were classified into good (80–100%), moderate (60–79%), and poor (<60% score). The majority of the healthcare workers had moderate knowledge (57.8%) and perception (73.4%) of hand hygiene. Males were less likely to have moderate/good knowledge compared to females (OR: 0.52, p < 0.05). Private healthcare workers were less likely (OR: 0.33, p < 0.01) to have moderate/good perceptions compared to the government healthcare workers. Healthcare workers who received training on hand hygiene were more likely to have good/moderate perception (OR: 3.2, p < 0.05) and to routinely use alcohol-based hand rubs (OR: 3.8, p < 0.05) than the ones without such training. Physicians are more likely (OR: 4.9, p < 0.05) to routinely use alcohol-based hand rubs than technicians. Our research highlighted gaps in hand hygiene knowledge, perception and practice among healthcare workers in Qassim, Saudi Arabia and the importance of training in this regard

Prevalence and associated factors of respiratory allergies in the Kingdom of Saudi Arabia: A cross-sectional investigation, September–December 2020

Background: Prevalence of different respiratory allergies is increasing in the Kingdom of Saudi Arabia (KSA). Environmental risk factors of respiratory allergy vary regionally, hence the prevalence. This necessitates the needs for regional studies. This article reports prevalence and symptoms of respiratory allergies in the Qassim region, and the factors associated with the prevalence. Methods: Eight hundred and fifty individuals aged ≥18 years and were living in the Qassim region filled up our structured online questionnaire between September and December 2020. We estimated the prevalence of different respiratory allergies with 95% confidence intervals. Multi-variable logistic regression analyses were performed to investigate the risk factors of respiratory allergies. Findings: The prevalence of any respiratory allergy in the Qassim region was 28.8%. Most families (58.1%) had at least one member with respiratory allergy. The prevalence of allergic rhinitis and bronchial asthma were 13.5% and 11.2% 4.1% respectively. The reported symptoms included runny nose (13.6%), red, watery, and itchy eyes (10.4%), difficulty sleeping at night (10.2%), difficulty breathing in cold weather (9.2%), noisy breathing (8.5%), sneezing (8%), repeated coughing (7.5%) and shortness of breath (6.4%). Individuals with a family history were more likely to report any respiratory allergy (OR: 7.8), bronchial asthma (OR: 4.2) and allergic rhinitis (OR: 8.1) compared to the individuals without such family history. Odds of respiratory allergies was higher among males (OR: 1.5). Saudi nationals were less likely to report allergic rhinitis than the non-Saudis (OR: 0.4). Among those who reported a respiratory allergy, most (73.5%) received treatment and majority (61.7%) demonstrated compliance to the treatment, 8.8% needed hospitalization, and 23.1% needed emergency nebulization. Conclusions: Prevalence reported in our study is different than that reported in other regions. Variability in the environmental exposures might explain this. We recommend a meta-analysis to estimate the national prevalence of respiratory allergies

Needle-Stick and Sharp Injuries among Hospital Healthcare Workers in Saudi Arabia: A Cross-Sectional Survey

Needle-stick or sharp injuries (NSIs) are critical occupational hazards for healthcare workers. Exposure to blood and body fluids through NSIs increases the risk of transmission of blood-borne pathogens among them. The objectives of this study were to estimate the annual incidence of NSIs and investigate the associated factors of NSIs among the healthcare workers in Saudi Arabia. A cross-sectional online survey was conducted between October and November 2021. A total of 361 healthcare workers participated in the survey from all over Saudi Arabia. The one-year incidence of at least one event of NSIs among the healthcare workers is estimated at 22.2% (95% CI: 18.0, 26.8). More than half of the injury events (53.8%) were not reported to the authority by the healthcare workers. Incidence of NSIs was highest among the physicians (36%) and was followed by nurses (34.8%), dentists (29.2%), and medical technologists (21.1%). The odds of NSIs was higher among the healthcare workers aged 26–30 years compared to the 20–25 years age group (OR: 2.51; 95% CI: 1.04, 6.03), as well as among the workers who directly dealt with needles or other sharp objects while working compared to those who did not (OR: 5.9; 95% CI: 2.69, 12.97). The high incidence and low rate of reporting of NSIs highlights the need of education and awareness raising programs targeting healthcare providers with higher risk of injury

Transcriptomics-based characterization of the toxicity of ZnO nanoparticles against chronic myeloid leukemia cells

Introduction: Zinc oxide nanoparticles (ZnO NPs) have recently attracted attention as potential anti-cancer agents. To the best of our knowledge, the toxicity of ZnO NPs against human chronic myeloid leukemia cells (K562 cell line) has not been studied using transcriptomics approach. Objective: The goals of this study were to evaluate the capability of ZnO NPs to induce apoptosis in human chronic myeloid leukemia cells (K562 cells) and to investigate the putative mechanisms of action. Methods: We used viability assay and flowcytometry coupled with Annexin V-FITC and propidium iodide to investigate the toxicity of ZnO NPs on K562 cells and normal peripheral blood mononuclear cells. Next we utilized a DNA microarray-based transcriptomics approach to characterize the ZnO NPs-induced changes in the transcriptome of K562 cells. Results: ZnO NPs exerted a selective toxicity (mainly by apoptosis) on the leukemic cells (p≤ 0.005) and altered their transcriptome; 429 differentially expressed genes (DEGs) with fold change (FC)≥ 4 and p≤ 0.008 with corrected p≤ 0.05 were identified in K562 cells post treatment with ZnO NPs. The over-expressed genes were implicated in “response to zinc”, “response to toxic substance” and “negative regulation of growth” (corrected p≤ 0.05). In contrast, the repressed genes positively regulated “cell proliferation”, “cell migration”, “cell adhesion”, “receptor signaling pathway via JAK-STAT” and “phosphatidylinositol 3-kinase signaling” (corrected p≤ 0.05). Lowering the FC to ≥ 1.5 with p≤ 0.05 and corrected p≤ 0.1 showed that ZnO NPs over-expressed the anti-oxidant defense system, drove K562 cells to undergo mitochondrial-dependent apoptosis, and targeted NF-κB pathway. Conclusion: Taken together, our findings support the earlier studies that reported anti-cancer activity of ZnO NPs and revealed possible molecular mechanisms employed by ZnO NPs to induce apoptosis in K562 cells

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Examining High School ELS\u27 Perceptions and Attitudes Toward Adopting Technology to Nurture English Language Mastery and Proficiency

The proportion of ESL/EFL learners across greater Kuwait is skyrocketing. Earlier scholars in the education discipline have applied insights and techniques of corpora technology to advance English learners\u27 learning and writing aptitudes. The research setting for this study is a high school in greater Kuwait. The research setting was a classroom context where the proposed Corpus-Based Program (CBP) curriculum was integrated into the mainstream learning for one term. The research identified 44 subjects who volunteered to enroll and contribute toward this accomplishment. For quantitative analysis, the project utilized a pre-and-post EFL Writing Test to examine the students\u27 mastery of the language and proficiency in writing using a rubric score to analyze individual performance. I administered a Semi-Structured Interview (SSI) during both the pre-and-post the CBP implementation to document the students\u27 performance before and after implementing CBP. Using a Questionnaire on Corpus Use (QOCU), the identification of students\u27 attitudes and perceptions concerning the corpus and whether it was essential in nurturing their mastery and proficiency of the English language was made. The Evaluative Questionnaire (EQ) was developed to investigate the respondents\u27 attitudes and views toward the CBP. The results indicate that students present positive perceptions and attitudes toward corpus use to nurture their competency in English language vocabulary