Search

The ICD/ITKE Research Pavilion 2016/2017 is the most recent in the series of experimental building demonstrators developed by the Institute for Computational Design (ICD) and the Institute for Building Structures andStructural Design(ITKE) at the University of Stuttgart. The completed structure is a 12 m long cantilevering lattice-composite shell that was wound in one piece by a multi-machinefabrication system using coreless filament winding. To realise such a structure through thisfabrication processinvolved a negotiation betweenarchitectural design, structural requirements and fabrication constraints. The structural design process was divided into two steps. Ashell modelwas used to evaluate possible geometries in the initial negotiation between architectural design and fabrication constraints. In order to approximate the highlyanisotropicmaterial behaviouroffibre reinforced polymers, substitute material properties had to be determined in physical tests. In the second step the actual fibre layup was analysed using a detailedbeam-elementmodel. The main load bearing fibre bundles were directly analysed in cross section and position. As-built and intended geometry were constantly compared and the feedback was used to refine thefinite element analysisduring fabrication. This paper covers the aspects mentioned and gives an outlook on further possibilities of this design andfabrication approach.

An approximate analytical method for quantifying the lateral resistance offered by inclined cables to guyed towers, such as the pylons of cable-stayed bridges, is presented first. For this purpose,...

The prevalence of carbapenem-resistant pathogens (CRPs) has increased worldwide. Given the importance of CRPs for public health and the high rates of carbapenem resistance observed in Greece, the Hellenic Center for Disease Control and Prevention (HCDCP) under the auspices of the Ministry of Health has undertaken initiatives to develop an Action Plan (i) to estimate the burden of CRP infections in acute-care hospitals in Greece and (ii) to implement infection control measures to limit the intrahospital transmission of these organisms. Starting in November 2010, specific infections caused by CRPs were reported to the HCDCP weekly. Results showed that CRP infections constitute a significant public health problem in acute-care hospitals in this country, with a mean incidence of 0.48 per 1000 patient-days and a crude 28-day mortality rate of 34.4%. The second phase of the Action Plan consists of systemic evaluation for adherence to an infection control bundle including enhanced standard infection control practices, separation of carriers and infected patients from non-carriers, and strict implementation of contact precautions. Communication between hospitals and public health authorities has been established to facilitate rapid notification and feedback.

Ventilator-associated pneumonia (VAP) is one of the most common causes of morbidity and mortality in intensive care unit patients. However, the diagnosis is quite difficult. Gram stain (GS) of bronchoalveolar lavage (BAL) sample is a time-saving diagnostic method for VAP. However, its clinical significance has not been adequately investigated. The aim of this study was to determine its sensitivity and specificity for VAP diagnosis. We prospectively performed GS and quantitative bacterial cultures (QBC) of BAL samples, obtained through fiberoptic bronchoscope, in 75 consecutive postoperative and/or multiple trauma patients with suspected VAP. We considered BAL-GS as positive for VAP diagnosis when (i) polymorphonuclear neutrophils were > 25 per optic field at a magnification x 100 (p.o.f x 100); (ii) squamous epithelial cells were < 1% p.o.f x 100; and (iii) one or more microorganisms were seen p.o.f. at a magnification x 1,000 (p.o.f. x 1,000). VAP was diagnosed with criteria similar to those used in previous studies. Pneumonia was the final diagnosis in 22/75 (29%) patients. The BAL-GS was positive in 17/22 patients with VAP and in 7/53 patients without VAP. Accordingly, the sensitivity of BAL-GS for VAP diagnosis was 77%, the specificity 87%, the positive predictive value 71% and the negative predictive value 90%. Our data suggest that BAL-GS has good sensitivity and high specificity for VAP diagnosis. It could therefore constitute a useful complementary tool in the task of early diagnosis and treatment of VAP.

Systemic infection with Aspergillus fumigatus is an opportunistic disease that affects mainly immunocompromised hosts and is associated with a high mortality rate. We report a case of A. fumigatus endocarditis after an episode of thrombotic thrombocytopenic purpura. Diagnosis was established after sudden rupture of posterior papillary muscle of the normal native mitral valve. Soon after mitral valve replacement, Aspergillus endocarditis recurred, associated with multiple peripheral emboli, which necessitated a second operation.