Effect of electro discharge machining (EDM) on the AISI316L SS white layer microstructure and corrosion resistance

The localised corrosion resistance of austenitic stainless steels is strongly influenced by the quality of finished surface. EDM machining induces substantial changes by the high thermal gradients generated by electric sparks. Experimental techniques such as roughness measurement, scanning electron microscopy (SEM), energy dispersive microanalysis (EDX) and X-ray diffraction technique, reveal microgeometrical, microstructural, chemical and mechanical changes. These changes lead to white and heat-affected layers with a depth less than 100 μm. The white layer is a melted material characterised by dendritic structure and constituted by austenite, chromium carbide and ε-carbide. The heat-affected layer is characterised by very large grain size comparatively to the bulk material. Electrochemical test coupled with metallographic examinations using SEM reveals a weakening of the resistance to pitting and intergranular corrosion comparatively to diamond polished surface. This weakening is correlated to differences in structure and chemical composition of white layer. Susceptibility to stress corrosion cracking has been attributed to the field of tensile residual stresses resulting from thermal effects. The removal of the white layer material by polishing or wire brushing restores the corrosion resistance of the AISI316L SS

Influences of up-milling and down-milling on surface integrity and fatigue strength of X160CrMoV12 steel

This paper aims to compare the influences of the two peripheral milling modes, up-milling and down-milling, on surface integrity and fatigue strength of X160CrMoV12 high-alloy steel. The experimental investigations showed an important difference between integrity of both milled surfaces. The down-milled surface is lowly work-hardened and well finished (lower roughness), but subjected to tensile residual stresses and severely damaged by folds of metal and short micro-cracks. The up-milled surface is highly work-hardened and subjected to compressive residual stresses, but poorly finished (higher roughness) and damaged by a density of micro-cavities due to carbide extraction. The results of 3-point bending fatigue tests revealed that the fatigue limit at 2 × 106 cycles of the up-milled state is largely higher of about 26% in comparison with the down-milled state. The effects of surface integrity induced by each milling mode on fatigue strength were evaluated using a HCF behaviour predictive approach based on Dang Van’s multiaxial criterion. The predictive results estimated that the pre-existing micro-cracks play a dominant role in the fatigue strength degradation of the down-milled surface while the other surface effects seem to be lower. On the contrary, the fatigue strength of the up-milled surface is less affected by the pre-existing micro-cavities. The detrimental roughness effect (stress concentration effect) is significantly reduced by the beneficial effects of superficial hardening and compressive residual stresses. So, this study revealed that up-milling is the more appropriate mode for a better surface integrity towards fatigue strength of X160CrMoV12 steel than the down-milling mode

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

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

A contribution in EDM simulation field

International audienc

Effects of finishing processes on the fatigue life improvements of electro-machined surfaces of tool steel

International audienceMachining the EN X160CrMoV12 tool steel by electro-discharge machining (EDM) process generates significant modifications of microgeometrical, microstructural and mechanical properties of the upper layers of the machined components. In this paper, the role of these modifications in controlling the stability, under cyclic loading, of the propagation of the crack networks generated by EDM is discussed. High cycle fatigue tests (2×106 cycles) show that the presence of these cracks in brittle layers, i.e. white layer, quenched the martensitic layer, and a field of tensile residual stresses (+750 MPa) results in a loss of 34% of endurance limit comparatively with the endurance evaluated for the milled state that generates crack-free surfaces. It is shown, in this work, that the detrimental effect of these crack networks can be controlled by putting in compression the upper layers of the EDM surfaces. Indeed the application of wire brushing to EDM surfaces generates compressive residual stresses (≈-100 MPa) that stabilise the crack networks propagation and therefore restores to the EDM surfaces their endurance limit value corresponding to the milled state. Moreover, removing the crack networks by polishing generates a stabilised residual stress value of ≈-130 MPa. This results in an improvement rate of about 70% of the endurance limit comparatively with the EDM state and of 26% in comparison to the milled state. These rates could be further increased by the application of the wire brushing process to the polished surfaces that reached 75% and 30% comparatively to the EDM and milling states respectively. In this case, a stabilised surface residual stress of about ≈-150 MPa was measured on the specimen surfaces