EFFECT OF MECHANICAL AND PHYSICALPROPERTIES ON BRAKE PADS PRODUCED FROM BAGASSE, BANANA PEELS AND PERIWINKLE SHELL

The study examined the effect of some mechanical and physical properties on brake pads produced from bagasse, banana peels and periwinkle shell in order to determine the materials suitability to develop new asbestos-free brake pads.These materials were sourced locally at Ede, Osun state.Samples were produced from different mix ratios of constituents using two sieve grades of 180 and 250 μm particle sizes. The percentage weights (wt%) of bagasse, banana peels and periwinkle shells were varied while those of crystalline silica, lead sulphide and epoxy resin were constant for both sieve grades. The density of each sample decreases from 2298 - 1199 Kg/m3 as the sieve grade increases. Also, the oil and water absorption rates increase from 0.007 - 0.022% and 0.012 - 0.037% respectively with an increase in sieve grade. Thehardness values of the brake pads produced range from 79.7 to 89.4 HRB and 77.1 to 84.8 HRB for both sieve grades, respectively. Likewise, the values of impact strength for the sieve grades ranged from 18.89 to 27.10J/mm and 17.97 to 24.85 J/mm, respectively.The samples B and C consisting of 15 wt% bagasse, 15 wt% banana peels, 30 wt% periwinkle shell, 10 wt% crystalline silica, 10 wt% lead sulphide, 20 wt% resin and 15 wt% bagasse, 30 wt% banana peels, 15 wt% periwinkle shell, 10 wt% crystalline silica, 10 wt% lead sulphide and 20 wt% resin for sieve grade of 180 μm, respectively, were regarded as the best among others because they gave the greatest properties. Therefore, the study concluded that the use of bagasse, banana peels and periwinkle shells as reinforced materials have properties suitable for the production of brake pads

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