Background Despite the high prevalence of type 2 diabetes mellitus in Gulf countries, standards of diabetes care at the primary care level have not been widely studied. Aim To compare the results of diabetes clinical indicators from the American Diabetes Association (ADA) 2017 guidelines to the reference benchmarks in the Behavioral Risk Factor Surveillance System. Materials and Methods A cross-sectional analysis of electronic medical records in 643 randomly selected adult patients with type 2 diabetes was undertaken. A checklist enabled the collection of sociodemographic, clinical, biochemical, and quality measurement data. Data were analyzed using Stata 9.0. The chi-squared test was used to compare two or more proportions. Results There were 643 patients (male = 60.3%; female = 39.7%), and the majority (71.7%) aged between 40 and 64 years. Common comorbidities were dyslipidemia (72.3%), hypertension (70%), obesity (50.1%), and preobesity (overweight) (37.9%). Over 15% were smokers. The most commonly prescribed diabetes medications were metformin (89.9%), dipeptidyl peptidase-4 inhibitors (61.1%), and sulfonylureas (49.3%). Only 35.5% (p < 0.0001) of patients met the reference glycated hemoglobin (HbA1c) cutoff level of 7.0%. The reference level for blood pressure control was met by 70.2% (p < 0.0001) and for low-density lipoprotein cholesterol, 73.8% (p < 0.0001). Albuminuria was present in 39.2%, and very low vitamin D level (<20 ng/ml) in 39.1%. Most patients had annual foot (89.6%, p < 0.0001) and eye (72.3%, p < 0.0001) examinations. Only 39.9% had referrals for dietary counseling, and there were lower rates of referrals and uptake for pneumococcal, influenza, and hepatitis B vaccines. Most (76.2%) did not have screening for depression. Conclusion The majority of the results met the ADA standards, while glycemic control, dietary counseling, and screening for depression were poor in comparison to the standards. Continuing education for clinicians, patient education for self-management, and targeted weight management are recommended.
The effect of newly developed axial feed thermoforming process (AFTF) on mechanical properties and morphology were investigated to gain a better understanding of structure-properties-process relationship. The starting material for AFTF is an oriented polypropylene tube (OPP) produced in uniaxial direction by using solid state extrusion process. Morphological changes from solid-state extrusion are briefly reported. A die-less bulge testing system was designed to bulge OPP tube at a high temperature in biaxial direction. Wide-angle X-ray diffraction, field emission scanning electron microscope, and optical microscopy were used to characterize the microstructure of the extruded and bulged samples of OPP. In addition, tensile tests were carried out at room temperature of samples machined from the extruded and bulged tubes along the axial and hoop directions. The results show that tensile strength increases with draw ratio in extruded samples as well as improvements in ductility were obtained in die-less bulge tests with an increase in axial feed.
The use of high‐strength polymer in automotive structural components is limited by insufficient understanding of microscopic aspects of deformation for accurate numerical predictions of the mechanical behavior during forming processes. One approach to meeting these critical data needs is a careful examination of the structure property relationships that directly influence formability. Different hot forming processes (solid‐state extrusion, axial feed hot oil tube forming, and biaxial ball stretching test) are utilized in this work for investigating the effect of process conditions on the molecular orientation of polypropylene (PP) tubes. White‐Spruiell representation of orientation factors based on the results form X‐ray diffraction (XRD) patterns is utilized to analyze the development of orientation under extrusion and various forming conditions. POLYM. ENG. SCI., 2011. © 2011 Society of Plastics Engineers
Axisymmetric deep drawing behavior of a polymer laminated sheet metal (PLSM) is investigated using an axisymmetric cup drawing test. PLSMs are of interest as a replacement for painted finishes for automotive applications as they have the potential to achieve good quality long lasting and aesthetically appealing surfaces on stamped parts. However, there is limited understanding of PLSMs in automotive deep drawing situations to produce complex 3-D parts.The tests are carried out using well-controlled, laboratory-based, dual-action, servo-hydraulic forming presses under blank-holder force and punch displacement control conditions. An optical strain mapping system is used to measure the surface strains (and to construct 3D strain maps) from the film side of the deformed samples for a range of forming conditions. Deep drawing characteristics such as punch load versus punch displacement traces, strain distribution along the cup profile, flange wrinkling and fracture characteristics are experimentally assessed for stainless steel-plastic film laminated sheet materials. Also the effect of lamination pressure on wrinkling and delamination is investigated for a decorative pressure sensitive adhesive film affixed to the stainless steel sheet.
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