Acoustic interaction force between two particles immersed in a viscoelastic fluid

The interaction acoustic radiation force in a standing plane wave applied to each small solid sphere in a two-particle system immersed in a viscoelastic fluid is studied in a framework based on perturbation theory. In this work, the first- and second-order perturbation theories are used in the governing equations with considering the upper-convected maxwell model to obtain mathematical modeling. We use the finite element method to carry out simulations and describe the behavior of the viscoelastic fluid. The mathematical development is validated from three literature case studies: a one-particle system in a viscous fluid, a two-particle system in a viscous fluid, and a one-particle system in a viscoelastic fluid. The novelty of this study is to establish the acoustic interaction force between two spherical particles immersed in a viscoelastic fluid. The results show that the acoustic interaction force between two spheres is greater in a viscous fluid in comparison with the viscoelastic fluid with the same shear viscosity. This behavior is due to the relaxation time effect. A mathematical formula is proposed for the acoustic interaction force between particles located close to each other in a viscoelastic fluid

Transition to turbulence in a heated non-Newtonian pipe flow

A simplified mono-dimensional model for investigating the transition to turbulence in nonisothermal and non-Newtonian pipe flows is proposed. The flow stability is analyzed within the framework of such a model, showing that uniformly heating the pipe wall leads to an earlier transition to turbulence, while differentially heating the pipe wall produces a stabilizing effect. For power-law fluids, we also demonstrate that an increase in the power-law index, i.e., passing from shear-thinning to shear-thickening fluids, leads to a stabilization of the system

Laminar–turbulent intermittency in pipe flow for an Herschel–Bulkley fluid: Radial receptivity to finite-amplitude perturbations

We investigate the laminar-to-turbulent transition for non-Newtonian Herschel–Bulkley fluids that exhibit either a shear-thinning or shear-thickening behavior. The reduced-order model developed in this study also includes the effect of yield-stress for the fluid. Within our model framework, we investigate how the Newtonian dynamics change when significant non-Newtonian effects are considered either via the flow index n or the yield-stress τ0 or both. We find that an increase in τ0 as well as a decrease in n lead to a delayed transition if a perturbation of the given turbulent intensity is injected at various radial locations. As the radial position of the injection for the perturbation is varied in this study, our reduced-order model allows for the investigation of the flow receptivity to the finite-amplitude perturbations and to their radial position of inception. We observe that, for a given mean flow profile, the same perturbation becomes more prone to induce turbulence the closer it approaches the wall because of its initial amplitude being relatively higher with respect to the local mean flow. An opposite trend is found when the perturbation amplitude is rescaled on the local mean flow

Propagation and rupture of elastoviscoplastic liquid plugs in airway reopening model

The propagation and rupture of mucus plugs in human lungs is investigated experimentally by injecting synthetic mucus in a pre-wetted capillary tube. The rheology of our test liquid is thoroughly characterized, and four samples of synthetic mucus are considered in order to reproduce elastoviscoplastic regimes of physiological interest for airway reopening. Our experiments demonstrate the significant impact of the viscoplasticity and viscoelasticity of mucus. In support to our experiments, we propose a one-dimensional reduced-order model that takes into account capillarity, and elastoviscoplasticity. Our model manages to capture the cross-section averaged dynamics of the liquid plug and is used to elucidate and interpret the experimental evidence. Relying on it, we show that the liquid film thickening due to non-Newtonian effects favors plug rupture, whereas the increase of the effective viscosity due to higher yield stresses hinders plug rupture. As a result of such two effects, increasing the polymeric concentration in the mucus phase leads to a net increase of the rupture time and traveling length. Hence, non-Newtonian effects hinder airway reopening

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Caractérisation expérimentale d'un isolant bio-sourcé humide : évaluation de l'isotherme d'adsorption et de la conductivité thermique

International audienc

Ecoulement de Taylor-Couette pour un fluide rhéofluidifiant : instabilités secondaires axisymétriques

International audienceLa présente communication concerne les instabilités secondaires en écoulement de Taylor Couette pour un fluide rhéofluidifiant. Le dispositif expérimental est constitué de deux cylindres coaxiaux où le cylindre intérieur est en rotation et le cylindre extérieur est fixe. Le rapport de rayons η est de 0 4. et le rapport d’aspect Γ est de32. Les fluides utilisés sont d’une part une solution aqueuse de Glycérine à 85% en masse comme fluide Newtonien de référence et d’autre part des solutions aqueuses de xanthan (polymère semi-rigide) à différentes concentrations dont le comportement rhéofluidifiant peut être décrit par le modèle de Carreau. La structure de l’écoulement est déterminée par visualisation et par mesures de vitesses par PIV. Pour la solution de Glycérine la bifurcation du régime de Couette circulaire vers le régime dit TVF (Taylor Vortex Flow) s’effectue pour un nombre de Reynolds 68 3 Re . c = et un nombre d’onde 3 2 c k . = en accord avec l’analyse linéaire de stabilité. Le nombre de Reynolds a été augmenté progressivement jusqu’à 4 Re Re = c . Le régime TVF est resté stable en accord avec les résultats numériques de Jones (1981) et l’étude expérimentale de Snyder & Lambert (1966). Pour les solutions de xanthan, les valeurs du nombre de Reynolds à partir desquelles les tourbillons de Taylor apparaissent sont en accord avec la théorie linéaire comme dans le cas Newtonien. En augmentant davantage le nombre de Reynolds, une instabilité secondaire axisymétrique est observée. Le nombre de Reynolds critique associée à cette instabilité secondaire est d’autant plus proche de Rec que le fluide est rhéofluidifiant. Ces résultats sont confirmés qualitativement par des simulations numériques 2D (axisymétrique). Une interprétation de ces résultats nouveaux est proposée