Search results for: micro-electrical discharge machining

Authors: Prashant Neupane, Sumitra Kafle, Asmi Pandey, Laura Mitchell

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Pain following caesarean section can influence recovery, patient satisfaction, breast feeding success and mother-child bonding. Since the introduction of enhanced recovery protocols, mothers are often discharged 24 hours later. We identified concerns within our hospital with mothers tolerating poorly controlled pain in order to achieve earlier discharge and subsequently suffering significant pain at home with inadequate analgesia. Methods: We conducted a prospective audit of analgesic prescribing and post-operative pain scores after caesarean section. Mothers were seen on post-operative day one, their pain score recorded on a verbal analogue score from 0-10, and their prescription chart reviewed. A follow-up phone call was then made on post-operative day 3-7 to enquire about pain scores and analgesia use at home. Following this, a standardized proforma for prescribing after the caesarean section was introduced, including the addition of dihydrocodeine that patients can take home following discharge. There were educational update sessions for anesthetists and midwifes, and then a re-audit was conducted months later. Results: Data was collected from 50 women before and after the introduction of the change. Initial audit showed that there was considerable variation in prescribing, with four women prescribed no regular analgesia at all and inconsistency in the dose of oral morphine prescribed. Women were not given any form of analgesia to take home after discharge and were advised to take regular paracetamol and ibuprofen. However, 31/50 (62%) reported that they needed additional analgesia and eight women (16%) even sought prescription for additional analgesia from elsewhere. After the introduction of the change, prescribing was more consistent with all patients prescribed regular analgesia. 46/50 patients were given dihydrocodeine on discharge. Mean pain scores on post-operative day one improved from 5.16 to 3.9, and at home improved from 6.18 to 2.58. Use of dihydrocodeine at home significantly improved patients reporting of severe pain at home from 24% to zero. Discussion: Lack of strong analgesia out of the hospital and the increased demands on activity levels means that women are frequently in more pain at home after discharge. Introduction of a standardized prescription proforma, including the use of to-take-out dihydrocodeine, was successful in improving patient pain scores and the requirement for additional analgesia, both in hospital and at home.

Keywords: analgesia, caesarean section, post-operative pain, standardised

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Authors: Cheong Hyeon Oh, Dongho Nam, Byungsik Kim

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Due to the recent climate change, flood damage caused by local floods and typhoons has frequently occurred, the incidence rate and intensity of wildfires are greatly increased due to increased temperatures and changes in precipitation patterns. Wildfires cause primary damage, such as loss of forest resources, as well as secondary disasters, such as landslides, floods, and debris flow. In many countries around the world, damage and economic losses from secondary damage are occurring as well as the direct effects of forest fires. Therefore, in this study, the Rainfall-Runoff model(S-RAT) was used for the wildfire affected areas in Gangneung and Goseong, which occurred on April 2019, when the stability of vegetation and soil were destroyed by wildfires. Rainfall data from Typhoon Rusa were used in the S-RAT model, and flood discharge was calculated according to changes in land cover before and after wildfire damage. The results of the calculation showed that flood discharge increased significantly due to changes in land cover, as the increase in flood discharge increases the possibility of the occurrence of the debris flow and the extent of the damage, the debris flow height and range were calculated before and after forest fire using RAMMS. The analysis results showed that the height and extent of damage increased after wildfire, but the result value was underestimated due to the characteristics that using DEM and maximum flood discharge of the RAMMS model. This research was supported by a grant(2017-MOIS31-004) from Fundamental Technology Development Program for Extreme Disaster Response funded by Korean Ministry of Interior and Safety (MOIS). This paper work (or document) was financially supported by Ministry of the Interior and Safety as 'Human resoure development Project in Disaster management'.

Keywords: wildfire, debris flow, land cover, rainfall-runoff meodel S-RAT, RAMMS, height

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Authors: B. Rajesh Kamath, J. Sundara Rajan, M. K. Veeraiah, M. Z. Kurian

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Insulation performance of a gas insulated system is severely affected by particle contaminants. These metallic particles adversely affect the characteristics of insulating system. These particles can produce surface charges due to partial discharge activities. These particles which are free to move enhance the local electric fields. This paper deals with the influence of conducting particle placed in a co-axial duct on the discharge characteristics of gas mixtures. Co-axial duct placed in a high pressure chamber is used for the purpose. A gas pressure of 0.1, 0.2 and 0.3 MPa have been considered with a 10:90 SF₆ and N₂ gas mixtures. The 2D and 3D histograms of clean duct and duct with copper particle are discussed in this paper.

Keywords: coaxial duct, gas insulated system, gas mixtures, metallic particle, partial discharges, histograms

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Authors: Salah Gariani, Islam Shyha, Fawad Inam, Dehong Huo

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A controlled cutting fluid impinging supply system (CUT-LIST) was developed to deliver an accurate amount of cutting fluid into the machining zone via well-positioned coherent nozzles based on a calculation of the heat generated. The performance of the CUT-LIST was evaluated against a conventional flood cutting fluid supply system during step shoulder milling of Ti-6Al-4V using vegetable oil-based cutting fluid. In this paper, the micro-hardness of the machined surface was used as the main criterion to compare the two systems. CUT-LIST provided significant reductions in cutting fluid consumption (up to 42%). Both systems caused increased micro-hardness value at 100 µm from the machined surface, whereas a slight reduction in micro-hardness of 4.5% was measured when using CUL-LIST. It was noted that the first 50 µm is the soft sub-surface promoted by thermal softening, whereas down to 100 µm is the hard sub-surface caused by the cyclic internal work hardening and then gradually decreased until it reached the base material nominal hardness. It can be concluded that the CUT-LIST has always given lower micro-hardness values near the machined surfaces in all conditions investigated.

Keywords: impinging supply system, micro-hardness, shoulder milling, Ti-6Al-4V, vegetable oil-based cutting fluid

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Authors: Yang Liu, Mathias Agmell, Aylin Ahadi, Jan-Eric Stahl, Jinming Zhou

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Tool wear and tool geometry have significant effects on the residual stresses in the component produced by high-speed machining. In this paper, Coupled Eulerian and Lagrangian (CEL) model is adopted to investigate the residual stress in high-speed machining of Inconel718 with a CBN170 cutting tool. The result shows that the mesh with the smallest size of 5 um yields cutting forces and chip morphology in close agreement with the experimental data. The analysis of thermal loading and mechanical loading are performed to study the effect of segmented chip morphology on the machined surface topography and residual stress distribution. The effects of cutting edge radius and flank wear on residual stresses formation and distribution on the workpiece were also investigated. It is found that the temperature within 100um depth of the machined surface increases drastically due to the more friction heat generation with the contact area of tool and workpiece increasing when a larger edge radius and flank wear are used. With the depth further increasing, the temperature drops rapidly for all cases due to the low conductivity of Inconel718. Consequently, higher and deeper tensile residual stress is generated on the superficial. Furthermore, an increased depth of plastic deformation and compressive residual stress is noticed in the subsurface, which is attributed to the reduction of the yield strength under the thermal effect. Besides, the ploughing effect produced by a larger tool edge radius contributes more than flank wear. The magnitude variation of the compressive residual stress caused by various edge radius and flank wear have a totally opposite trend, which depends on the magnitude of the ploughing and friction pressure acting on the machined surface.

Keywords: Coupled Eulerian Lagrangian, segmented chip, residual stress, tool wear, edge radius, Inconel718

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Authors: Junaid N. Chauhdary, Bernard A. Engel, Allah Bakhsh

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Solar powered tubewells can be a reliable and affordable source of supplying irrigation water compared with electric or diesel operated tubewells due to frequent load shedding and soaring energy prices. A study was conducted on a solar tubewell installed at the Water Management Research Center (WMRC), University of Agriculture, Faisalabad to investigate the viability of a solar powered tubewell in terms of discharge and benefit cost ratio. The tubewell discharge was 50 m3hr-1 with a total dynamic head of 30 m. The depth of bore was 31 m (14 m blind + 17 m screen) with a casing diameter of 15.2 cm (6 inches). A 3-stage submersible pump of 10.2 cm (4 inch) diameter was lowered in the casing to a depth of 22 m. The pump was powered from 21 solar panels of 200 W capacity each. The tubewell peak discharge was observed as 6 and 7 hr day-1 in winter and summer, respectively. The breakeven analysis of the solar tubewell showed that the payback period of the solar tubewell was 1.5 years of its 10 year usable life with an IRR (internal rate of return) of 69 %. The BCR (benefit cost ratio) of the solar tubewell at 2, 4, 6, and 8 percent discount rate were 3.75, 3.45, 3.19 and 2.96, respectively. The NPV (net present value) of the solar tubewell at 2, 4, 6, and 8 % discount rates were 1.89, 1.65, 1.45 and 1.27 million rupees, respectively. These results indicated that the solar powered tubewells are a viable option as well as environmentally friendly and can be adopted by the farmers due to their affordable payback period.

Keywords: benefit cost ratio, internal rate of return (IRR), net present value (NPV), solar tubewell

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Authors: Cheryl Forchuk, Sandra Fisman, Steve Cordes, Dan Catunto, Katherine Krakowski, Melissa Jeffrey, John D’Oria

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The discharge of youth aged 16-25 from hospital into homelessness is a prevalent issue despite research indicating social, safety, health and economic detriments on both the individual and community. Lack of stable housing for youth discharged into homelessness results in long-term consequences, including exacerbation of health problems and costly health care service use and hospital readmission. People experiencing homelessness are four times more likely to be readmitted within one month of discharge and hospitals must spend $2,559 more per client. Finding safe housing for these individuals is imperative to their recovery and transition back to the community. People discharged from hospital to homelessness experience challenges, including poor health outcomes and increased hospital readmissions. Youth are the fastest-growing subgroup of people experiencing homelessness in Canada. The needs of youth are unique and include supports related to education, employment opportunities, and age-related service barriers. This study aims to identify the needs of youth at risk of homelessness by evaluating the efficacy of the “Preventing Discharge to No Fixed Address – Youth” (NFA-Y) program, which aims to prevent youth from being discharged from hospital into homelessness. The program connects youth aged 16-25 who are inpatients at London Health Sciences Centre and St. Joseph’s Health Care London to housing and financial support. Supports are offered through collaboration with community partners: Youth Opportunities Unlimited, Canadian Mental Health Association Elgin Middlesex, City of London Coordinated Access, Ontario Works, and Salvation Army’s Housing Stability Bank. This study was reviewed and approved by Western University’s Research Ethics Board. A series of interviews are being conducted with approximately ninety-three youth participants at three time points: baseline (pre-discharge), six, and twelve months post-discharge. Focus groups with participants, health care providers, and community partners are being conducted at three-time points. In addition, administrative data from service providers will be collected and analyzed. Since homelessness has a detrimental effect on recovery, client and community safety, and healthcare expenditure, locating safe housing for psychiatric patients has had a positive impact on treatment, rehabilitation, and the system as a whole. If successful, the findings of this project will offer safe policy alternatives for the prevention of homelessness for at-risk youth, help set them up for success in their future years, and mitigate the rise of the homeless youth population in Canada.

Keywords: youth homelessness, no-fixed address, mental health, homelessness prevention, hospital discharge

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Authors: Mdoe Mwajuma Bakari, Mselle Lilian Teddy, Kibusi Stephen Mathew

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Background: Due to the increase of caesarean section (CS), many women are discharge early to their home. Women should be aware on how to take care of themselves at home after CS. Evidence shows non-uniform health education on home care after CS are provided to post CS mothers because of lack of standard home care guideline on home after CS; as existing guidelines explore only care of women in hospital setting, for health care workers. There is a need to develop post CS home care guide; exploring contents of home based care education after CS provided by nurse midwives will inform the development of the guide. Objective: To explore the content of health education provided by nurse midwives to post CS mother about home care after hospital discharge in Dodoma, Tanzania. Methodology: An exploratory qualitative study using in-depth interview was conducted in this study using triangulation of data collection method; where 14 nurse midwives working in maternity unit and 11 post CS mother attending their post-natal clinic were recruited. Content analysis was used to generate themes that describe health education information provided by nurse midwives to post CS mother about home care after hospital discharge. Results: The study found that, nutrition health education, maternal and newborn hygiene care of caesarean wound at home were the component of health education provided to post CS mothers by nurse midwives. Contradicting instruction were found to be provided to post CS mothers. Conclusion: This study reported non-uniform health education provided by the nurse midwives on home care after CS. Despite of the fact that nurse midwives recognizes the need to provide health education to the post CS mothers, there is a need to develop home care guideline as a reference for their education to ensure uniform package of education is provided to post CS mothers in order to improve recovery of post CS mothers from CS.

Keywords: caesarean section, home care, discharge education, homecare after caesarean section

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Authors: Anjali Vanpariya, Priyanka Marathey, Sakshum Khanna, Roma Patel, Indrajit Mukhopadhyay

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Silicon (Si) is a promising negative electrode material for lithium-ion batteries (LiBs) due to its low cost, non-toxicity, and a high theoretical capacity of 4200 mAhg⁻¹. The primary challenge of the application of Si-based LiBs is large volume expansion (~ 300%) during the charge-discharge process. Incorporation of graphene, carbon nanotubes (CNTs), morphological control, and nanoparticles was utilized as effective strategies to tackle volume expansion issues. However, molten salt methods can resolve the issue, but high-temperature requirement limits its application. For sustainable and practical approach, room temperature (RT) based methods are essentially required. Use of ionic liquids (ILs) for electrodeposition of Si nanostructures can possibly resolve the issue of temperature as well as greener media. In this work, electrodeposition of Si nanoparticles on gold substrate was successfully carried out in the presence of ILs media, 1-butyl-3-methylimidazolium-bis (trifluoromethyl sulfonyl) imide (BMImTf₂N) at room temperature. Cyclic voltammetry (CV) suggests the sequential reduction of Si⁴⁺ to Si²⁺ and then Si nanoparticles (SiNs). The structure and morphology of the electrodeposited SiNs were investigated by FE-SEM and observed interconnected Si nanoparticles of average particle size ⁓100-200 nm. XRD and XPS data confirm the deposition of Si on Au (111). The first discharge-charge capacity of Si anode material has been found to be 1857 and 422 mAhg⁻¹, respectively, at current density 7.8 Ag⁻¹. The irreversible capacity of the first discharge-charge process can be attributed to the solid electrolyte interface (SEI) formation via electrolyte decomposition, and trapped Li⁺ inserted into the inner pores of Si. Pulverization of SiNs results in the creation of a new active site, which facilitates the formation of new SEI in the subsequent cycles leading to fading in a specific capacity. After 20 cycles, charge-discharge profiles have been stabilized, and a reversible capacity of 150 mAhg⁻¹ is retained. Electrochemical impedance spectroscopy (EIS) data shows the decrease in Rct value from 94.7 to 47.6 kΩ after 50 cycles of charge-discharge, which demonstrates the improvements of the interfacial charge transfer kinetics. The decrease in the Warburg impedance after 50 cycles of charge-discharge measurements indicates facile diffusion in fragmented and smaller Si nanoparticles. In summary, Si nanoparticles deposited on gold substrate using ILs as media and characterized well with different analytical techniques. Synthesized material was successfully utilized for LiBs application, which is well supported by CV and EIS data.

Keywords: silicon nanoparticles, ionic liquid, electrodeposition, cyclic voltammetry, Li-ion battery

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Authors: David Downey

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With the introduction of additive manufacturing (3D printing) to produce titanium (Ti6Al4V) components in the medical/aerospace and automotive industries, intricate geometries can be produced with virtually complete design freedom. However, the consideration of microstructural anisotropy resulting from the additive manufacturing process becomes necessary due to this design flexibility and the need to print a geometric shape that can consist of numerous angles, radii, and swept surfaces. A femoral knee implant serves as an example of a 3D-printed near-net-shaped product. The mechanical properties of the printed components, and consequently, their machinability, are affected by microstructural anisotropy. Currently, finish-machining operations performed on titanium printed parts using selective laser melting (SLM) utilize the same cutting tools employed for processing wrought titanium components. Cutting forces for components manufactured through SLM can be up to 70% higher than those for their wrought counterparts made of Ti6Al4V. Moreover, temperatures at the cutting interface of 3D printed material can surpass those of wrought titanium, leading to significant tool wear. Although the criteria for tool wear may be similar for both 3D printed and wrought materials, the rate of wear during the machining process may differ. The impact of these issues on the choice of cutting tool material and tool lifetimes will be discussed.

Keywords: additive manufacturing, build orientation, microstructural anisotropy, printed titanium Ti6Al4V, tool wear

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Authors: Zhihong Luo, Guangbin Zhu, Lulu Guo, Zhujun Lyu, Kun Luo

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Cycling life has become the threshold for the prospective application of Li-O₂ batteries, and the protection of Li anode has recently regarded as the key factor to the performance. Herein, a simple low rate pre-activation (20 cycles at 0.5 Ag⁻¹ and a capacity of 200 mAh g⁻¹) was employed to effectively improve the performance and cyclability of Li-O₂ batteries. The charge/discharge cycles at 1 A g⁻¹ with a capacity of 1000 mAh g⁻¹ were maintained for up to 290 times versus 55 times for the cell without pre-activation. The ultimate battery capacity and high rate discharge property were also largely enhanced. Morphology, XRD and XPS analyses reveal that the performance improvement is in close association with the formation of the smooth and compact surface layer formed on the Li anode after low rate pre-activation, which apparently alleviated the corrosion of Li anode and the passivation of cathode during battery cycling, and the corresponding mechanism was also discussed.

Keywords: lithium oxygen battery, pre-activation, cyclability, capacity

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Authors: Thirasak Panyaphirawat, Pairoj Sapsmarnwong, Teeratas Pornyungyuen

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This paper presents the findings of an experimental investigation of important machining parameters for the horizontal boring tool modified to mouth with a horizontal lathe machine to bore an overlength workpiece. In order to verify a usability of a modified tool, design of experiment based on Taguchi method is performed. The parameters investigated are spindle speed, feed rate, depth of cut and length of workpiece. Taguchi L9 orthogonal array is selected for four factors three level parameters in order to minimize surface roughness (Ra and Rz) of S45C steel tubes. Signal to noise ratio analysis and analysis of variance (ANOVA) is performed to study an effect of said parameters and to optimize the machine setting for best surface finish. The controlled factors with most effect are depth of cut, spindle speed, length of workpiece, and feed rate in order. The confirmation test is performed to test the optimal setting obtained from Taguchi method and the result is satisfactory.

Keywords: design of experiment, Taguchi design, optimization, analysis of variance, machining parameters, horizontal boring tool

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Authors: Scott Ashby, Emily Granger, Mark Connellan

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Background: In-hospital management of Out-of-Hospital Cardiac Arrest (OHCA) is complex as the aetiologies are varied. Acute coronary angiography has been shown to improve outcomes for patients with coronary occlusion as the cause; however, these patients are difficult to identify. ECG results may help identify these patients, but the accuracy of this diagnostic test is under debate, and requires further investigation. Methods: Arrest and hospital management information was collated retrospectively for OHCA patients who presented to a single clinical site between 2009 and 2013. Angiography results were then collected and checked for significance with survival to discharge. The presence of a severe lesion (>70%) was then compared to categorised ECG findings, and the accuracy of the test was calculated. Results: 104 patients were included in this study, 44 survived to discharge, 52 died and 8 were transferred to other clinical sites. Angiography appears to significantly correlate with survival to discharge. ECG showed 54.8% sensitivity for detecting the presence of a severe lesion within the group that received angiography. A combined criterion including any ECG pathology showed 100% sensitivity and negative predictive value, however, a low specificity and positive predictive value. Conclusion: In the cohort investigated, ST elevation on ECG is not a sensitive enough screening test to be used to determine whether OHCA patients have coronary stenosis as the likely cause of their arrest, and more investigation into whether screening with a combined ECG criterion, or whether all patients should receive angiography routinely following OHCA is needed.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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Authors: Zohaib Ellahi, Guolong Zhao

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Ceramic matrix composite (CMC) material possesses high strength, wear resistance and anisotropy thus machining of this material is very difficult and demands high cost. In this research, FEM simulations and physical experiments have been carried out to assess the machinability of carbon fiber reinforced silicon carbide (C/SiC) using polycrystalline diamond (PCD) tool in slot milling process. Finite element model has been generated in Abaqus/CAE software and milling operation performed by using user defined material subroutine. Effect of different milling parameters on cutting forces and stresses has been calculated through FEM simulations and compared with experimental results to validate the finite element model. Cutting forces in x and y-direction were calculated through both experiments and finite element model and found a good agreement between them. With increase in cutting speed resultant cutting forces are decreased. Resultant cutting forces are increased with increased feed per tooth and depth of cut. When machining performed along the fiber direction stresses generated near the tool edge were minimum and increases with fiber cutting angle.

Keywords: experimental & numerical investigation, C/SiC cutting performance analysis, milling of CMCs, CMC composite stress analysis

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Authors: Anh Vo Van Ha, Yun Zhao, Luat Cong Nguyen, Tan Khac Chu, Phung Hoang Nguyen, Minh Ngoc Pham, Colin W. Binns, Andy H. Lee

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This study aims to study longitudinal changes in blood pressure (BP) during the 1-year postpartum period and to evaluate the influence of parity, maternal age at delivery, prepregnancy BMI, gestational weight gain, gestational age at delivery and postpartum maternal weight. A prospective longitudinal cohort study of 883 singleton Vietnamese women was conducted in Hanoi, Haiphong, and Ho Chi Minh City, Vietnam during 2015-2017. Women diagnosed with gestational diabetes mellitus at 24-28 weeks of gestation, pre-eclampsia, and hypoglycemia was excluded from analysis. BP was repeatedly measured at discharge, 6 and 12 months postpartum using automatic blood pressure monitors. Linear mixed model with repeated measures was used to describe changes occurring during pregnancy to 1-year postpartum. Parity, self-reported prepregnancy BMI, gestational weight gain, maternal age and gestational age at delivery will be treated as time-invariant variables and measured maternal weight will be treated as a time-varying variable in models. Women with higher measured postpartum weight had higher mean systolic blood pressure (SBP), 0.20 mmHg, 95% CI [0.12, 0.28]. Similarly, women with higher measured postpartum weight had higher mean diastolic blood pressure (DBP), 0.15 mmHg, 95% CI [0.08, 0.23]. These differences were both statistically significant, P < 0.001. There were no differences in SBP and DBP depending on parity, maternal age at delivery, prepregnancy BMI, gestational weight gain and gestational age at delivery. Compared with discharge measurement, SBP was significantly higher in 6 months postpartum, 6.91 mmHg, 95% CI [6.22, 7.59], and 12 months postpartum, 6.39 mmHg, 95% CI [5.64, 7.15]. Similarly, DBP was also significantly higher in 6 and months postpartum than at discharge, 10.46 mmHg 95% CI [9.75, 11.17], and 11.33 mmHg 95% CI [10.54, 12.12]. In conclusion, BP measured repeatedly during the postpartum period (6 and 12 months postpartum) showed a statistically significant increase, compared with after discharge from the hospital. Maternal weight was a significant predictor of postpartum blood pressure over the 1-year postpartum period.

Keywords: blood pressure, maternal weight, postpartum, Vietnam

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Authors: Sarabjeet Singh Sidhu, Ajay Batish, Sanjeev Kumar

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This paper reports the optimal process conditions for machining of three different types of metal matrix composites (MMCs): 65vol%SiC/A356.2; 10vol%SiC-5vol%quartz/Al and 30vol%SiC/A359 using PMEDM process. Metal removal rate (MRR), tool wear rate (TWR), surface roughness (SR) and surface integrity (SI) were evaluated after each trial and contributing process parameters were identified. The four responses were then collectively optimized using the technique for order preference by similarity to ideal solution (TOPSIS) and optimal process conditions were identified for each type of MMCS. The density of reinforced particles shields the matrix material from spark energy hence the high MRR and SR was observed with lowest reinforced particle. TWR was highest with Cu-Gr electrode due to disintegration of the weakly bonded particles in the composite electrode. Each workpiece was examined for surface integrity and ranked as per severity of surface defects observed and their rankings were used for arriving at the most optimal process settings for each workpiece.

Keywords: metal matrix composites (MMCS), metal removal rate (MRR), surface roughness (SR), surface integrity (SI), tool wear rate (TWR), technique for order preference by similarity to ideal solution (TOPSIS)

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Authors: Xuan Hua Huang, Shu Fen Wu, Yi Ting Huang, Pi Yueh Lee

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Background: In Taiwan, the Taiwan healthcare care Indicator Series regards the rate of hospital readmission as an important indicator of healthcare quality. Unplanned readmission not only effects patient’s condition but also increase healthcare utilization rate and healthcare costs. Purpose: The purpose of this study was explored the effects of adult unplanned readmission within 14 days of discharge at a regional teaching hospital in South Taiwan. Methods: The retrospectively review design was used. A total 495 participants of unplanned readmissions and 878 of non-readmissions within 14 days recruited from a regional teaching hospital in Southern Taiwan. The instruments used included the Charlson Comorbidity Index, and demographic characteristics, and disease-related variables. Statistical analyses were performed with SPSS version 22.0. The descriptive statistics were used (means, standard deviations, and percentage) and the inferential statistics were used T-test, Chi-square test and Logistic regression. Results: The unplanned readmissions within 14 days rate was 36%. The majorities were 268 males (54.1%), aged >65 were 318 (64.2%), and mean age was 68.8±14.65 years (23-98years). The mean score for the comorbidities was 3.77±2.73. The top three diagnosed of the readmission were digestive diseases (32.7%), respiratory diseases (15.2%), and genitourinary diseases (10.5%). There were significant relationships among the gender, age, marriage, comorbidity status, and discharge planning services (χ2: 3.816-16.474, p: 0.051~0.000). Logistic regression analysis showed that old age (OR = 1.012, 95% CI: 1.003, 1.021), had the multi-morbidity (OR = 0.712~4.040, 95% CI: 0.559~8.522), had been consult with discharge planning services (OR = 1.696, 95% CI: 1.105, 2.061) have a higher risk of readmission. Conclusions: This study finds that multi-morbidity was independent risk factor for unplanned readmissions at 14 days, recommended that the interventional treatment of the medical team be provided to provide integrated care for multi-morbidity to improve the patient's self-care ability and reduce the 14-day unplanned readmission rate.

Keywords: unplanned readmission, comorbidities, Charlson comorbidity index, logistic regression

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Authors: Taposh Roy, Anna Paradowska, Ralph Abrahams, Quan Lai, Michael Law, Peter Mutton, Mehdi Soodi, Wenyi Yan

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In this investigation, a laser cladding process with a powder feeding was used to deposit stainless steel 410L (high strength, excellent resistance to abrasion and corrosion, and great laser compatibility) onto railhead (higher strength, heat treated hypereutectoid rail grade manufactured in accordance with the requirements of European standard EN 13674 Part 1 for R400HT grade), to investigate the development and controllability of process-induced residual stress in the cladding, heat-affected zone (HAZ) and substrate and to analyse their correlation with hardness profile during two different laser cladding directions (across and along the track). Residual stresses were analysed by neutron diffraction at OPAL reactor, ANSTO. Neutron diffraction was carried out on the samples in longitudinal (parallel to the rail), transverse (perpendicular to the rail) and normal (through thickness) directions with high spatial resolution through the thickness. Due to the thick rail and thin cladding, 4 mm thick reference samples were prepared from every specimen by Electric Discharge Machining (EDM). Metallography across the laser claded sample revealed four distinct zones: The clad zone, the dilution zone, HAZ and the substrate. Compressive residual stresses were found in the clad zone and tensile residual stress in the dilution zone and HAZ. Laser cladding in longitudinally cladding induced higher tensile stress in the HAZ, whereas transversely cladding rail showed lower tensile behavior.

Keywords: laser cladding, residual stress, neutron diffraction, HAZ

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Authors: Hadjadj Abdechafik, Kious Mecheri, Ameur Aissa

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The objective of this study is to develop a process of treatment of the vibratory signals generated during a horizontal high speed milling process without applying any coolant in order to establish a monitoring system able to improve the machining performance. Thus, many tests were carried out on the horizontal high speed centre (PCI Météor 10), in given cutting conditions, by using a milling cutter with only one insert and measured its frontal wear from its new state that is considered as a reference state until a worn state that is considered as unsuitable for the tool to be used. The results obtained show that the first harmonic follow well the evolution of frontal wear, on another hand a wavelet transform is used for signal processing and is found to be useful for observing the evolution of the wavelet approximations through the cutting tool life. The power and the Root Mean Square (RMS) values of the wavelet transformed signal gave the best results and can be used for tool wear estimation. All this features can constitute the suitable indicators for an effective detection of tool wear and then used for the input parameters of an online monitoring system. Although we noted the remarkable influence of the machining cycle on the quality of measurements by the introduction of a bias on the signal, this phenomenon appears in particular in horizontal milling and in the majority of studies is ignored.

Keywords: flank wear, vibration, milling, signal processing, monitoring

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Authors: Amir Mahyar Khorasani, Ian Gibson, Moshe Goldberg, Mohammad Masoud Movahedi, Guy Littlefair

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One of the important factors in manufacturing processes especially machining operations is surface quality. Improving this parameter results in improving fatigue strength, corrosion resistance, creep life and surface friction. The reliability and clearance of removable joints such as thread and nuts are highly related to the surface roughness. In this work, the effect of different cutting parameters such as cutting fluid pressure, feed rate and cutting speed on the surface quality of the crest of thread in the high-speed milling of Brass C3600 have been determined. Two popular neural networks containing MLP and RBF coupling with Taguchi L32 have been used to model surface roughness which was shown to be highly adept for such tasks. The contribution of this work is modelling surface roughness on the crest of the thread by using precise profilometer with nanoscale resolution. Experimental tests have been carried out for validation and approved suitable accuracy of the proposed model. Also analysing the interaction of parameters two by two showed that the most effective cutting parameter on the surface value is feed rate followed by cutting speed and cutting fluid pressure.

Keywords: artificial neural networks, cutting conditions, high-speed machining, surface roughness, thread milling

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Authors: N. Matveev, A. Pervov

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Local utilities often face problems of local industrial wastes, storm water disposal due to existing strict regulations. For many local industries, the problem of wastewater treatment and discharge into surface reservoirs can’t be solved through the use of conventional biological treatment techniques. Current discharge standards require very strict removal of a number of impurities such as ammonia, nitrates, phosphate, etc. To reach this level of removal, expensive reagents and sorbents are used. The modern concept of rational water resources management requires the development of new efficient techniques that provide wastewater treatment and reuse. As RO membranes simultaneously reject all dissolved impurities such as BOD, TDS, ammonia, phosphates etc., they become very attractive for the direct treatment of wastewater without biological stage. To treat wastewater, specially designed membrane "open channel" modules are used that do not possess "dead areas" that cause fouling or require pretreatment. A solution to RO concentrate disposal problem is presented that consists of reducing of initial wastewater volume by 100 times. Concentrate is withdrawn from membrane unit as sludge moisture. The efficient use of membrane RO techniques is connected with a salt balance in water system. Thus, to provide high ecological efficiency of developed techniques, all components of water supply and wastewater discharge systems should be accounted for.

Keywords: reverse osmosis, stormwater treatment, open-channel module, wastewater reuse

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Authors: Mamdouh Y. Saleh, Gaber El Enany, Medhat H. Elzahar, Mohamed Z. Elshikhipy, Rana Hamouda

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The heavy metals pollution in water, sediments and fish of Lake Manzala affected from the disposal of wastewater, industrial and agricultural drainage water into the lake on the environmental situation. A pilot plant with an industrial discharge flow of 135L/h was designed according to the activated sludge plant to simulate between the biological and chemical treatment with the addition of alum to the aeration tank with dosages of 100, 150, 200, and 250 mg/L. The industrial discharge had concentrations of Lead and BOD5 with an average range 1.22, 145mg/L, respectively. That means the average Pb was high up to 25 times than the allowed permissible concentration. The optimization of the chemical-biological process using 200mg/L alum dosage compared has improvement of Lead and BOD5 removal efficiency to 61.76% and 56%, respectively.

Keywords: industrial wastewater, activated sludge, BOD5, lead, alum salt

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Authors: Prashant Parhad, Vinayak Dakre, Ajay Likhite, Jatin Bhatt

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This work mainly focuses on machinability studies of Austempered Ductile Iron (ADI). The Ductile Iron (DI) was austempered at 250 oC for different durations and the process window for austempering was established by studying the microstructure. The microstructural characterization of the material was done using optical microscopy, SEM and XRD. The samples austempered as per the process window were then subjected to turning using a TiAlN-coated tungsten carbide insert to study the effect of cutting parameters, namely the cutting speed and the depth of cut. The effect was investigated in terms of cutting forces required as well as the surface roughness obtained. The turning was conducted on a CNC turning machine and primary (Fx), radial (Fy) and feed (Fz) cutting forces were quantified with a three-component dynamometer. It was observed that the magnitude of radial force was more than that of primary cutting force for all cutting speed and for various depths of cut studied. It has also been seen that increasing the cutting speed improves the surface quality. The observed machinability behaviour was investigated in light of the microstructure of the material obtained under the given austempering conditions and a structure-property- co-relation was established between the two. For all cutting speed and depth of cut, the best machining response in terms of cutting forces and surface quality was obtained towards the centre of process window.

Keywords: process window, cutting speed, depth of cut, surface roughness

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Authors: Najeeb Hassan, Mahmudur Rahman

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Arial Khan River is one of the main south-eastward outlets of the River Padma. This river maintains a meander channel through its course and is erosional in nature. The specific objective of the research is to study and evaluate the hydrological characteristics in the form of assessing changes of cross-sections, discharge, water level and velocity profile in different stations and to create a hydrodynamic model of the Arial Khan River. Necessary data have been collected from Bangladesh Water Development Board (BWDB) and Center for Environment and Geographic Information Services (CEGIS). Satellite images have been observed from Google earth. In this study, hydrodynamic model of Arial Khan River has been developed using well known steady open channel flow code Hydrologic Engineering Centers and River Analysis System (HEC-RAS) using field surveyed geometric data. Cross-section properties at 22 locations of River Arial Khan for the years 2011, 2013 and 2015 were also analysed. 1-D HEC-RAS model has been developed using the cross sectional data of 2015 and appropriate boundary condition is being used to run the model. This Arial Khan River model is calibrated using the pick discharge of 2015. The applicable value of Mannings roughness coefficient (n) is adjusted through the process of calibration. The value of water level which ties with the observed data to an acceptable accuracy is taken as calibrated model. The 1-D HEC-RAS model then validated by using the pick discharges from 2009-2018. Variation in observed water level in the model and collected water level data is being compared to validate the model. It is observed that due to seasonal variation, discharge of the river changes rapidly and Mannings roughness coefficient (n) also changes due to the vegetation growth along the river banks. This river model may act as a tool to measure flood area in future. By considering the past pick flow discharge, it is strongly recommended to improve the carrying capacity of Arial Khan River to protect the surrounding areas from flash flood.

Keywords: BWDB, CEGIS, HEC-RAS

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Authors: Juan C. Sanchez, Jose L. Endrino, Alejandro Toro, Hugo A. Estupinan, Glenn Leighton

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For years, the reduction of friction and wear has been a matter of interest in the engineering field. Several solutions have been proposed to address this issue, including the use of lubricants and coatings to reduce the frictional forces and to increase the surface wear resistance. Alternatively, texturing processes have been used in a wide variety of materials, in many cases inspired in natural surfaces. Nature has shown how species adapt to the environment and the engineers try to understand natural surfaces for particular applications by analyzing outstanding species such as gecko for high adhesion, lotus leaves for hydrophobicity, sharks for reduced flow resistance and snakes for optimized frictional response. Texturized surfaces have shown a superior performance in terms of the frictional response in many situations, and the control of its behavior greatly depends on the manufacturing process. The focus of this work is to evaluate the tribological behavior of AISI 52100 steel samples texturized by Photochemical Machining (PCM). The surface texture was inspired by several features of the snakeskin such as aspect ratio of fibrils and mean fibril spacing. Two coatings were applied on the texturized surface, namely Diamond-like Carbon (DLC) and Molybdenum Disulphide (MoS₂), and their tribological behavior after pin-on-disk tests were compared with that of the non-texturized and uncovered surfaces. The samples were characterised through Stereoscopic Microscope (SM), Scanning Electron Microscope (SEM), Optical Microscope (OM), Profilometer, Raman Spectrometer (RS) and X-Ray Diffractometer (XRD). The Coefficient of Friction (COF) measured in pin-on-disk tests showed correlations with the sliding direction (relative to the texture features) and the aspect ratio of the texture features. Regarding the coated surfaces, the DLC and MoS₂ coating had a good performance in terms of wear rate and coefficient of friction compared with the uncoated and non-texturized surfaces. On the other hand, for the uncoated surfaces, the texture showed an influence in the tribological performance with respect to the non-texturized surface.

Keywords: coating, coefficient of friction, deterministic surface, photochemical machining

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Authors: Po-Wen Chen, Jin-Yu Wu, Md. Manirul Ali, Yang Peng, Chen-Te Chang, Der-Jun Jan

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Dynamics of cathode spot has become a major part of vacuum arc discharge with its high academic interest and wide application potential. In this article, using a three-dimensional statistical model, we simulate the distribution of the ignition probability of a new cathode spot occurring in different magnetic pressure on old cathode spot surface and at different arcing time. This model for the ignition probability of a new cathode spot was proposed in two typical situations, one by the pure isotropic random walk in the absence of an external magnetic field, other by the retrograde motion in external magnetic field, in parallel with the cathode surface. We mainly focus on developed relationship between the ignition probability density distribution of a new cathode spot and the external magnetic field.

Keywords: cathode spot, vacuum arc discharge, transverse magnetic field, random walk

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Authors: Emil Ghiocel Ioanid, Viorica Frunză, Dorina Rusu, Ana Maria Vlad, Catalin Tanase, Simona Dunca

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The application of cold radio-frequency (RF) plasma in the conservation of cultural heritage became important in the last decades due to the positive results obtained in decontamination treatments. This paper presents an equipment especially designed for RF cold plasma application on paper documents, developed within a research project. The equipment allows the application of decontamination and cleaning treatments on any type of paper support, as well as the coating with a protective polymer. The equipment consists in a Pyrex vessel, inside which are placed two plane-parallel electrodes, capacitively coupled to a radio-frequency generator. The operating parameters of the equipment are: 1.2 MHz frequency, 50V/cm electric field intensity, current intensity in the discharge 100 mA, 40 W power in the discharge, the pressure varying from 5∙10-1 mbar to 5.5∙10-1 mbar, depending on the fragility of the material, operating in gaseous nitrogen. In order to optimize the equipment treatments in nitrogen plasma have been performed on samples infested with microorganisms, then the decontamination and the changes in surface properties (color, pH) were assessed. The analyses results presented in the table revealed only minor modifications of surface pH the colorimetric analysis showing a slight change to yellow. The equipment offers the possibility of performing decontamination, cleaning and protective coating of paper-based documents in successive stages, thus avoiding the recontamination with harmful biological agents.

Keywords: nitrogen plasma, cultural heritage, paper support, radio-frequency

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Authors: Mohammadreza Nezamirad, Sepideh Amirahmadian, Nasim Sabetpour, Azadeh Yazdi, Amirmasoud Hamedi

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Cavitation inside diesel injector nozzle is investigated using Reynolds-Stress-Navier Stokes equations. Schnerr-Sauer cavitation model is used for modeling cavitation inside diesel injector nozzle. The carrying fluid utilized in the current study is diesel fuel. The flow is verified at the beginning by comparing with the previous experimental data, and it was found that K-Epsilon turbulent model could lead to a better accuracy comparing to K-Omega turbulent model. Moreover, the mass flow rate obtained numerically is compared with the experimental value, and the discrepancy was found to be less than 5 percent which shows the accuracy of the current results. Finally, a real-size four-hole nozzle is investigated, and the flow inside it is visualized based on velocity profile, discharge coefficient, and cavitation number. It was found that the mesh density could be reduced significantly by utilizing periodic boundary conditions. Velocity contour at the mid nozzle showed that the maximum value of velocity occurs at the end of the needle before entering the orifice area. Last but not least, at the same boundary conditions, when different needle heights were utilized, it was found that as needle height increases with an increase in cavitation number, discharge coefficient increases, while the mentioned increases are more tangible at smaller values of needle heights.

Keywords: cavitation, diesel fuel, CFD, real size nozzle, mass flow rate

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Authors: T. Suleiman, C. Mchugh, H. Ranu

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Background; Asthma continues to be associated with poor patient outcomes, including mortality. An audit of the management of acute asthma admissions in our hospital in 2020 found poor compliance with National Asthma and COPD Audit Project (NACAP) standards which set out to improve inpatient asthma care. Clinical nurse specialists have been shown to improve patient care across a range of specialties. In September 2021, an asthma Nurse Specialist (ANS) was employed in our hospital. Aim; To re-audit management of acute asthma admissions using NACAP standards and assess for quality improvement post-employment of an ANS. Methodology; NACAP standards are wide-reaching; therefore, we focused on ‘specific elements of good practice’ in addition to the provision of inhaled corticosteroids (ICS) on discharge. Medical notes were retrospectively requested from the hospital coding department and selected as per NACAP inclusion criteria. Data collection and entry into the NACAP database were carried out. As this was a clinical audit, ethics approval was not required. Results; Cycle 1 (pre-ANS) and 2 (post-ANS) of the audit included 20 and 32 patients, respectively, with comparable baseline demographics. No patients had a discharge bundle completed on discharge in cycle 1 vs. 84% of cases in cycle 2. Regarding specific components of the bundle, 25% of patients in cycle 1 had their inhaler technique checked vs. 91% in cycle 2. Furthermore, 80% of patients had maintenance medications reviewed in cycle 1 vs. 97% in cycle 2. Medication adherence was addressed in 20% of cases in cycle 1 vs. 88% of cases in cycle 2. Personalized asthma action plans were not issued or reviewed in any cases in cycle 1 as compared with 84% of cases in cycle 2. Triggers were discussed in 30% of cases in cycle 1 vs. 88% of cases in cycle 2. Tobacco dependence was addressed in 44% of cases in cycle 1 vs. 100% of cases in cycle 2. No patients in cycle 1 had community follow-up requested within 2 days vs. 81% of the patients in cycle 2. Similarly, 20% of the patients in cycle 1 vs. 88% of the patients in cycle 2 had a 4-week asthma clinic follow-up requested. 75% of patients in cycle 1 were the recipient of ICS on discharge compared with 94% of patients in cycle 2. Conclusion; Our quality improvement project demonstrates the utility of an ANS in improving performance in the management of acute asthma admissions, evidenced here through concordance with NACAP standards. Asthma is a complex condition with biological, psychological, and sociological components; therefore, ANS is a suitable intervention to improve concordance with guidelines. ANS likely impacted performance directly, for example, by checking inhaler technique, and indirectly as a safety net ensuring doctors included ICS on discharge.

Keywords: asthma, nurse specialist, clinical audit, quality improvement

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Authors: Mehmet Erdi Korkmaz, Mustafa Günay

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Nowadays, grinding is frequently replaced with hard turning for reducing set up time and higher accuracy. This paper focused on mathematical modeling of average surface roughness (Ra) in hard turning of AISI L2 grade (DIN 1.2210) cold work tool steel with ceramic tools. The steel was hardened to 60±1 HRC after the heat treatment process. Cutting speed, feed rate, depth of cut and tool nose radius was chosen as the cutting conditions. The uncoated ceramic cutting tools were used in the machining experiments. The machining experiments were performed according to Taguchi L27 orthogonal array on CNC lathe. Ra values were calculated by averaging three roughness values obtained from three different points of machined surface. The influences of cutting conditions on surface roughness were evaluated as statistical and experimental. The analysis of variance (ANOVA) with 95% confidence level was applied for statistical analysis of experimental results. Finally, mathematical models were developed using the artificial neural networks (ANN). ANOVA results show that feed rate is the dominant factor affecting surface roughness, followed by tool nose radius and cutting speed.

Keywords: ANN, hard turning, DIN 1.2210, surface roughness, Taguchi method

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