Evidence by neutron diffraction of molecular compounds in triarylamine tris-amide organogels and in their hybrid thermoreversible gels with PVC.

We report on neutron diffraction experiments performed on organogels prepared from triarylamine tris-amide (TATA), as well as on their ternary thermoreversible gels made up with poly[vinyl chloride] (PVC). Three different solvents together with their deuterated counterparts have been used; tetrachloroethane, wherein TATA fibrils display ohmic conductivity, bromobenzene and o-dichlorobenzene. The TATA crystal structure differs in the three solvents. Most importantly, the difference in the diffraction patterns whether hydrogenous solvents or deuterated solvents are used demonstrate the occurrence of molecular compounds. Tentative unit cells are presented. These results are also discussed in the light of the current views on the solvent role in the gelation process.

Pump-probe localization technique of varying solid contacts.

A baseline-free defect localization method in thin plates is proposed and tested. In this proof-of-concept work, a steel ball pressed against an aluminum plate is used to mimic a surface contact defect. The technique takes benefit of a repetitive nonlinear pump-probe interaction with a backpropagation imaging algorithm. High-frequency probe waves are periodically emitted by a piezoelectric patch transducer glued to the plate. Propagated flexural waves are recorded using a distributed array of transducers. At the same time, a continuous low-frequency pump vibration provided by a shaker fixed to the plate modulates the contact state. By combining multiple probe signals, the contact can be successfully localized. Contrast of the localization images is finally improved by a factor of 3 to 5 by implementing a modified version based on synchronous detection of the imaging algorithm.

A micro-transducer matrix design for the detection of flexural guided waves.

In this paper, a new approach is proposed for the detection of ultrasonic guided waves using a LiNbO3 single crystal-based micro-transducer matrix. This matrix was designed, manufactured, and then used to detect Lamb and Pochhammer-Chree guided waves in plate- and cylinder-like structures. This study highlights the identification of the first flexural mode F(1,1) in cylinders at low frequencies. A network analyser and a laser Doppler vibrometer (LDV) were used to characterise and study the behaviour of the micro-transducer matrix. An experimental device was designed and used to acquire electrical measurements of the micro-transducer vibrations. Then, an original experimental device was developed to generate a selected flexural guided mode in a solid aluminium cylinder. The emitter comprised two semicircular piezoelectric transducers excited with only one phased signal thanks to the inverse position of polarisation. Finally, the results prove that the flexural mode F(1,1) is selected and generated by the emitter, then detected and identified by the micro-transducer matrix.

Monitoring cleaning cycles of fouled ducts using ultrasonic coda wave interferometry (CWI).

Fouling in heat exchangers is the buildup of deposits on the solid surfaces. These deposits reduce the eco-efficiency of the processing equipment and increase the risk of subsequent surface contamination with the formation of biofilms. In the agro-food and water supplier sectors, which are our main concern, fouling on the hot walls of processing heat exchangers is a common occurrence and requires frequent cleaning cycles to ensure hygiene requirements are met. This results in a considerable ecological footprint. Sensors and diagnostic tools for monitoring fouling are thus of utmost importance to ensure the rational validation of the cleaning end-point and to decrease the environmental impact of the cleaning cycles. In this paper, a non-destructive ultrasonic monitoring technique using coda waves and the associated signal processing was tested to monitor the evolution over time of a deposit layer on a solid wall during cleaning. To ascertain the feasibility of the method, a piece of wax of controlled thickness was deposited to simulate the initial fouling state and a cleaning cycle was launched. The decorrelation coefficient was used as an indicator to monitor fouling. This article presents the principle of this unprecedented technique for measuring the degree of fouling. The results of the experiments show that this non-destructive monitoring technology is sensitive to changes in fouling and that the decorrelation coefficient curves are in agreement with the cleaning kinetics captured using a video camera, thus ascertaining the pertinence of the diagnostic tool proposed.

Timing, diagnosis, and treatment of surgical site infections after colonic surgery: prospective surveillance of 1263 patients.

BACKGROUND: Surgical site infections (SSIs) are the most frequent complication after colorectal surgery and have a major impact on length of stay and costs. AIM: To analyse the incidence, timing, and treatment of SSIs within 30 days after colonic surgery. METHODS: This was a quality improvement project through retrospective analysis of consecutive colonic surgeries between February 2012 and October 2017 at Lausanne University Hospital (CHUV). SSIs were prospectively assessed by an independent national surveillance programme (www.swissnoso.ch) up to 30 postoperative days. Treatment strategies including drainage of infection (direct wound opening or percutaneous) and surgical management were reviewed. FINDINGS: The study cohort included 1263 patients with 532 procedures (42%) performed as emergencies. SSIs were observed in 271 patients (21%), occurring at median postoperative day (POD) 9 (interquartile range (IQR): 4-16). Specifically, 53 (4%) were superficial incisional, 65 (5%) deep incisional, and 153 (12%) organ space infections (anastomotic insufficiency included). Superficial incisional SSI occurred at a median of POD 10.5 (IQR: 7-15), deep incisional at a median of POD 10 (8-15) and organ space at a median of POD 8 (5-11). Diagnosis was performed post discharge in 64 cases (24%). Whereas 47% of organ space infections were detected by POD 7, this rate was only 26% for superficial and deep incisional infections (P = 0.003). Surgical management was necessary in 133 cases (49%), and the remaining cases were managed by drainage without general anaesthesia (138 cases, 51%). CONCLUSION: Organ space infections occurred early in the postoperative course, whereas incisional infections were mostly detected post discharge over the entire 30-day observation period, emphasizing the importance of proper follow-up using a systematic, complete and independent surveillance programme.

Patient satisfaction in an outpatient parenteral antimicrobial therapy (OPAT) unit practising predominantly self-administration of antibiotics with elastomeric pumps.

Self-administration of antibiotics using elastomeric pumps has become the most frequently used treatment modality at the outpatient parenteral antimicrobial therapy (OPAT) unit of the University Hospital of Lausanne. However, it remains unknown how comfortable patients feel using this mode of treatment. A questionnaire was offered to all patients treated at the OPAT unit between June 2014 and December 2015. The questionnaire was distributed to 188 patients and 112 questionnaires were returned. Seventy-one patients were treated by self-administration, 21 attended the OPAT unit on a daily basis, and 20 received their antibiotics from home-care nurses. Overall, 83-97% of the patients gave the highest possible scores to the four items evaluating their global satisfaction. Subjects treated by self-administration gave a significantly better rating to 6 of the 17 semi-quantitative questions than the patients treated at the OPAT unit or by home-care nurses. There was no item which was more poorly rated by patients treated by self-administered OPAT than by the other treatment groups. In conclusion satisfaction was high in all patients treated by OPAT. The particularly high satisfaction of patients treated by self-administration of antibiotics with elastomeric pumps suggests that a significant number of patients are happy to take over some responsibility for their treatment. Patients' capacity to appropriate their care themselves should not be underestimated by health care professionals.

Simultaneous outbreaks of dengue, chikungunya and Zika virus infections: diagnosis challenge in a returning traveller with nonspecific febrile illness.

Zika virus is an emerging flavivirus that is following the path of dengue and chikungunya. The three Aedes-borne viruses cause simultaneous outbreaks with similar clinical manifestations which represents a diagnostic challenge in ill returning travellers. We report the first Zika virus infection case imported to Switzerland and present a diagnostic algorithm.

[Non-HIV infectious disease outpatient consultations: a 5-year study in a Swiss University Hospital]. / Consultations infectiologiques ambutatoires non VIH: analyse d'un centre universitaire sur cinq ans.

Few studies have examined the workload or clinical spectrum of non-HIV infectious diseases outpatient consultations (IDOC). This retrospective study aims to describe IDOC referrals over the past 5 years. In total, 483 patients were referred (with an increase of 63% between 2009 and 2013). Most referrals were received from primary care clinicians (45%). Median patient age was 47 years, 57% of patients were men and 17% were immunosuppressed. Of the diagnoses retained, 74% were infectious, 20% were non-infectious and 6% were of unknown aetiology. Two community outbreaks were identified (tattoo-related mycobacterial infection and Q fever). In conclusion, the infectious diseases outpatient clinic, which has expanded progressively in the past 5 years, provides a specialised service for primary health clinicians and for public health.

Health monitoring of a composite wingbox structure.

This work was devoted to the development of a health monitoring system assigned to aerospace applications. Those applications concerned the detection of damaging impacts and debonding between stiffeners and composite skins, since they are the major causes of in-service damage of aircraft structures. The chosen health monitoring system was first based on the excitation and reception of Lamb waves along the structure by using thin piezoelectric transducers (active mode) and secondly on a continuous monitoring taking the same transducers used as acoustic emission sensors (passive mode). The composite specimen used was consistent with aircraft wingbox in terms of structure and loading. Several impacts with increasing energy increments were applied on the composite specimen. In passive mode, the study showed the ability of using the acoustic signature of an impact to detect possible damage. Moreover, the damage emergence in the case of damaging impact was confirmed in active mode. Further measurements during fatigue testing were performed. The aim was to demonstrate the ability of the system to monitor disbond growth between the stiffener and the composite skin. The sensitivity of the health monitoring system to the disbond growth was further demonstrated.

Modeling of integrated Lamb waves generation systems using a coupled finite element-normal modes expansion method

As part of the research work on Smart Materials and Structures, the development of self-monitoring materials is an emerging issue. In the case of plate-shaped structures, Lamb waves can be used for their relevant properties: long-range propagation, sensitivity to internal flaws and whole-thickness interrogation. This concept requires the use of thin piezoelectric transducers integrated to the structure. Since it is of primary importance to be able to control the generated modes, a suitable modeling technique of this kind of system has been tested on different cases of practical interest. The model uses a coupled finite element-normal modes expansion approach, which allows one to consider either the case of bonded or embedded transducers. The results presented deal with examples of multi-element transducers integrated to composite materials. The influence of parameters such as the dimensions, positions and relative excitation delays of the transducers is studied.

Modeling of lamb waves generated by integrated transducers in composite plates using a coupled finite element-normal modes expansion method

Thin piezoelectric transducers attached to or embedded within composite structures could be used for in situ structural health monitoring. For plate-shaped structures, the useful ultrasonic vibration modes are Lamb waves. Preliminary testing has already demonstrated the suitability and practical feasibility of such integrated transducers, but better control of the generation of Lamb modes seems to be necessary. Therefore, an original modeling approach has been developed, which can be used to design and optimize these "sensitive materials." This modeling technique allows the determination of the amplitude of each Lamb mode excited in a composite plate with surface-bonded or bulk-embedded piezoelectric elements. The method consists of a coupling of the finite element method (FEM) and the normal modes expansion method. The limited finite element mesh of the transducer and its vicinity enables the computation of the mechanical field created by the transducer, which is then introduced as a forcing function into the normal modes equations. The adequacy and accuracy of this modeling method have been numerically and experimentally verified.

Electron microscopic analysis of asbestos body cores from the Belgian urban population.

Typical ferruginous bodies considered as asbestos bodies (AB) were collected from the lungs of 19 asbestos-exposed and 25 non-exposed urban subjects. Of the 319 body cores analysed by energy dispersive spectrometry (EDS), 315 were asbestos. The non-asbestos cores were talc and crystalline silica. 89.2% of the asbestos cores were commercial amphiboles (amosite/crocidolite), 7% were chrysotile and 3.8% were non-commercial amphiboles (anthophyllite/tremolite). The commercial amphibole bodies were found in exposed and non-exposed subjects and chrysotile bodies mostly in exposed subjects. The non-commercial amphibole bodies were detected in non-exposed patients with low lung AB levels; this background contamination would be more difficult to detect in lungs containing large amounts of bodies due to occupational exposure. Chrysotile bodies and tremolite/anthophyllite bodies were not observed together. We suggest that in Belgium the source of non-commercial amphiboles exposure is not contamination by chrysotile.

Asbestos bodies in bronchoalveolar lavage reflect lung asbestos body concentration.

Asbestos body (AB) countings on both bronchoalveolar lavage (BAL) fluids and digested lung tissue samples were performed in one hundred consecutive subjects submitted to a thoracotomy procedure, mostly for lung carcinoma. A good correlation (r = 0.73) was found between the two groups of values for the total group of subjects. When restrictive selection criteria were taken into account, such as lavage homolateral to the analysed lung, performed by the same trained physician, this correlation improved (r = 0.82). Absence of AB's or low AB counts (less than 1 AB/ml) in BAL corresponded in about 70% of cases to concentrations of less than 1,000 AB/gm and in 100% of cases to concentrations less than 10,000 AB/gm. In subjects with BAL containing more than 1 AB/ml, the lung tissues of 85% contained more than 1,000 AB/gm and the tissues of 44% contained more than 10,000 AB/gm. Above 10 AB/ml BAL, all lung tissues contained more than 10,000 AB/gm. Since lung tissue is not readily available in patients undergoing assessment of their asbestos exposure, BAL fluid analysis seems to be a useful tool to evaluate lung AB concentrations. This technique cannot be performed, however, in patients with severe lung impairment which does not allow sufficient recovery of BAL fluid.

Diagnostic value of asbestos bodies in bronchoalveolar lavage fluid.

Asbestos bodies (AB) were counted by light microscopy in bronchoalveolar lavage (BAL) fluid obtained from 563 subjects. The presence of AB was found to reflect occupational exposure to asbestos and was rarely found in unexposed control subjects at concentrations above 1/ml of fluid (6.9% of white collar workers and 17.8% of blue collar workers). The overlap of results observed between subjects with definite exposure and those without underlines the difficulty in assessing exposure by questioning alone, which leads to underestimations or even overestimations of the risk. The highest counts (log mean, 120.5 AB/ml; range, 0 to 42,600) were found in patients with radiologic evidence of asbestosis, most likely reflecting the known association of this disease with retention of large amounts of long amphiboles, rather than in patients with pleural disease. A considerable overlap of results was also observed between groups with different diseases or without any apparent disease. Apart from uncertainties in the radiologic diagnosis, this may be explained by differences in latency since first exposure, in individual response to asbestos inhalation, or in pathogenic properties of different asbestos types. Because the presence of AB in BAL fluid appears to be a marker of exposure and not of disease, AB are more likely to be detected in patients presenting with asbestos-related diseases but in whom exposure is not confirmed by the occupational history (65 of 78 cases).