Electrical conduction and rheological behaviour of composites of poly(epsilon-caprolactone) and MWCNTs

Two mechanisms of conduction were identified from temperature dependent (120 K-340 K) DC electrical resistivity measurements of composites of poly(c-caprolactone) (PCL) and multi-walled carbon nanotubes (MWCNTs). Activation of variable range hopping (VRH) occurred at lower temperatures than that for temperature fluctuation induced tunneling (TFIT). Experimental data was in good agreement with the VRH model in contrast to the TFIT model, where broadening of tunnel junctions and increasing electrical resistivity at T > T-g is a consequence of a large difference in the coefficients of thermal expansion of PCL and MWCNTs. A numerical model was developed to explain this behavior accounting for a thermal expansion effect by supposing the large increase in electrical resistivity corresponds to the larger relative deformation due to thermal expansion associated with disintegration of the conductive MWCNT network. MWCNTs had a significant nucleating effect on PCL resulting in increased PCL crystallinity and an electrically insulating layer between MWCNTs. The onset of rheological percolation at similar to 0.18 vol% MWCNTs was clearly evident as storage modulus, G' and complex viscosity, vertical bar eta*vertical bar increased by several orders of magnitude. From Cole-Cole and Van Gurp-Palmen plots, and extraction of crossover points (G(c)) from overlaying plots of G' and G '' as a function of frequency, the onset of rheological percolation at 0.18 vol% MWCNTs was confirmed, a similar MWCNT loading to that determined for electrical percolation. 

Melt Processing and Properties of Polyamide 6/Graphene Nanoplatelet Composites

Graphene, due to its outstanding properties, has become the topic of much research activity in recent years. Much of that work has been on a laboratory scale however, if we are to introduce graphene into real product applications it is necessary to examine how the material behaves under industrial processing conditions. In this paper the melt processing of polyamide 6/graphene nanoplatelet composites via twin screw extrusion is investigated and structure–property relationships are examined for mechanical and electrical properties. Graphene nanoplatelets (GNPs) with two aspect ratios (700 and 1000) were used in order to examine the influence of particle dimensions on composite properties. It was found that the introduction of GNPs had a nucleating effect on polyamide 6 (PA6) crystallization and substantially increased crystallinity by up to 120% for a 20% loading in PA6. A small increase in crystallinity was observed when extruder screw speed increased from 50 rpm to 200 rpm which could be attributed to better dispersion and more nucleation sites for crystallization. A maximum enhancement of 412% in Young's modulus was achieved at 20 wt% loading of GNPs. This is the highest reported enhancement in modulus achieved to date for a melt mixed thermoplastic/GNPs composite. A further result of importance here is that the modulus continued to increase as the loading of GNPs increased even at 20 wt% loading and results are in excellent agreement with theoretical predictions for modulus enhancement. Electrical percolation was achieved between 10–15 wt% loading for both aspect ratios of GNPs with an increase in conductivity of approximately 6 orders of magnitude compared to the unfilled PA6.

Melt Processing and Properties of Polyamide 6/Graphene Nanoplatelet Composites

In this paper, the processing and characterization of Polyamide 6 (PA6) / graphite nanoplatelets
(GNPs) composites is reported. PA6/GNPs composites were prepared by melt-mixing using an
industrial, co-rotating, intermeshing, twin-screw extruder. A bespoke screw configuration was used
that was designed in-house to enhance nanoparticle dispersion into a polymer matrix. The effects of
GNPs type (xGnP® M-5 and xGnP® C-500), GNPs content, and extruder screw speed on the bulk
properties of the PA6/GNPs nanocomposites were investigated. Results show a considerable
improvement in the thermal and mechanical properties of PA6/GNPs composites, as compared with
the unfilled PA6 polymer. An increase in crystallinity (%Xc) with increasing GNPs content, and a
change in shape of the crystallization exotherms (broadening) and melting endotherms, both suggest a
change in the crystal type and perfection. An increase in tensile modulus of as much as 376% and
412% was observed for PA6/M-5 xGnP® and PA6/C-500 xGnP® composites, respectively, at filler
contents of 20wt%. The enhancement of Young’s modulus and yield stress can be attributed to the
reinforcing effect of GNPs and their uniform dispersion in the PA6 matrix. The rheological response
of the composite resembles that of a ‘pseudo-solid’, rather than a molten liquid, and analysis of the
rheological data indicates that a percolation threshold was reached at GNPs contents of between 10–
15wt%. The electrical conductivity of the composite also increased with increasing GNPs content,
with an addition of 15wt% GNPs resulting in a 6 order-of-magnitude increase in conductivity. The
electrical percolation thresholds of all composites were between 10–15wt%.

Characterisation of melt processed nanocomposites of Polyamide 6 subjected to uniaxial-drawing

In this paper, the processing and characterization of Polyamide 6 (PA6) nanocomposites containing graphite nanoplatelets (GNPs) is reported. PA6 nanocomposites were prepared by melt-mixing using an industrial, co-rotating, intermeshing, twin-screw extruder. A bespoke screw configuration was used that was designed in-house to enhance nanoparticle dispersion into a polymer matrix. The effects of nano-filler type (xGnPTM M-5 and xGnPTM C-500), nano-filler content, and extruder screw speed on the bulk properties of the PA6 nanocomposites were investigated. The crystalline structures of PA6 nanocomposites are related to thermal treatment, stress history and the presence of moisture and nanofillers. DSC, Raman and XRD studies show an increase in crystallinity with increasing GNP content and a phase transformation between α-form to γ-form crystals as a result of the heterophase nucleation effect. The effect of uniaxial stretching on PA6 nanocomposites was investigated by drawing specimens heated at temperatures below the melting temperature. DSC and Raman studies on the drawn samples show an increase in yield stress as the GNP content increases due to the strain induced crystallization and γ—β transition during stretching. The rheological response of the nanocomposites resemble that of a ‘pseudo-solid’, rather than a molten liquid, and analysis of the rheological data indicates that a percolation threshold was reached at GNP contents of between 10–15wt%. An increase in tensile modulus of as much as 412% was observed for PA6/C-500 xGnPTM composites, at a filler content of 20wt%. The enhancement of Young’s modulus and yield stress can be attributed to the reinforcing effect of GNPs and their uniform dispersion in the PA6 matrix. The electrical conductivity of the composite also increased with increasing GNP content, with an addition of 15wt% GNP resulting in a 6 order-of-magnitude increase in conductivity. The effects of uniaxial-drawing and the inclusion of multiple nano-filler varieties on the electrical and mechanical properties are currently under investigation.

Processability, structural evolution and properties of melt processed biaxially stretched HDPE/MWCNT nanocomposites

Biaxial stretching of melt mixed high density polyethylene (HDPE)/multiwalled carbon nanotube (MWCNT) nanocomposites was conducted in the melt state at different stretching ratios (SRs). The addition of MWCNTs leads to significant strain hardening in the HDPE, greatly improving the stability and thus processability of the stretching process. Scanning electron microscopy shows that the MWCNTs in the polymer matrix are gradually disentangled and randomly oriented in the stretching plane with increasing SRs. All the stretched samples exhibit an increase in crystallinity (about 10%) due to strain induced crystallization and a broadened distribution of crystallite size according to the XRD and DSC results. The mechanical properties of the composites improve with increasing SRs, while they drop off after a SR of 2.5 for the neat HDPE which is likely to be due to the relaxation of polymer chains prior to solidification. The presence of the MWCNTs appears to inhibit this relaxation thus helping to maintain the orientation and mechanical properties at high SRs. The modulus, yield strength and breaking strength of stretched composites with 8 wt% MWCNTs increase by approximately 54%, 85% and 193% respectively compared with the neat HDPE at a SR of 3. The electrical percolation threshold for the unstretched material occurs at 1.9 wt% MWCNTs. As SR increases, the values of critical concentration increase from 1.9 wt% to 4.9 wt% implying the destruction of conductive networks due to an increased inter-particle distance. A loading of 6 wt% MWCNTs is sufficient to ensure that the sheet conductivity is robust to changes in the SR. Decreased values of critical exponent from 1.9 to 1.1 and morphological investigation reveal a transformation of the system structure from three dimensional to two dimensional as SR increases.

Characterization and structure–property relationship of melt-mixed high density polyethylene/multi-walled carbon nanotube composites under extensional deformation

Melt-mixed high density polyethylene (HDPE)/multi-walled carbon nanotube (MWCNT) nanocomposites with 1–10 wt% MWCNTs were prepared by twin screw extrusion and compression moulded into sheet form. The compression moulded nanocomposites exhibit a 112% increase in modulus at a MWCNT loading of 4 wt%, and a low electrical percolation threshold of 1.9 wt%. Subsequently, uniaxial, sequential (seq-) biaxial and simultaneous (sim-) biaxial stretching of the virgin HDPE and nanocomposite sheets was conducted at different strain rates and stretching temperatures to investigate the processability of HDPE with the addition of nanotubes and the influence of deformation on the structure and final properties of nanocomposites. The results show that the processability of HDPE is improved under all the uniaxial and biaxial deformation conditions due to a strengthened strain hardening behaviour with the addition of MWCNTs. Extensional deformation is observed to disentangle nanotube agglomerates and the disentanglement degree is shown to depend on the stretching mode, strain rate and stretching temperatures applied. The disentanglement effectiveness is: uniaxial stretching < sim-biaxial stretching < seq-biaxial stretching, under the same deformation parameters. In sim-biaxial stretching, reducing the strain rate and stretching temperature can lead to more nanotube agglomerate breakup. Enhanced nanotube agglomerate disentanglement exhibits a positive effect on the mechanical properties and a negative effect on the electrical properties of the deformed nanocomposites. The ultimate stress of the composite containing 4 wt% MWCNTs increased by ∼492% after seq-biaxial stretching, while the resistivity increased by ∼1012 Ω cm.

Rethinking Rice Preparation for Highly Efficient Removal of Inorganic Arsenic Using Percolating Cooking Water

A novel way of cooking rice to maximize the removal of the carcinogen inorganic arsenic (Asi) is presented here. In conventional rice cooking water and grain are in continuous contact, and it is known that the larger the water:rice cooking ratio, the more Asi removed by cooking, suggesting that the Asi in the grain is mobile in water. Experiments were designed where rice is cooked in a continual stream of percolating near boiling water, either low in Asi, or Asi free. This has the advantage of not only exposing grain to large volumes of cooking water, but also physically removes any Asi leached from the grain into the water receiving vessel. The relationship between cooking water volume and Asi removal in conventional rice cooking was demonstrated for the rice types under study. At a water-to-rice cooking ratio of 12:1, 57±5% of Asi could be removed, average of 6 wholegrain and 6 polished rice samples. Two types of percolating technology were tested, one where the cooking water was recycled through condensing boiling water steam and passing the freshly distilled hot water through the grain in a laboratory setting, and one where tap water was used to cook the rice held in an off-the-shelf coffee percolator in a domestic setting. Both approaches proved highly effective in removing Asi from the cooking rice, with up to 85% of Asi removed from individual rice types. For the recycled water experiment 59±8% and 69±10% of Asi was removed, on average, compared to uncooked rice for polished (n=27) and wholegrain (n=13) rice, respectively. For coffee percolation there was no difference between wholegrain and polished rice, and the effectiveness of Asi removal was 49±7% across 6 wholegrain and 6 polished rice samples. The manuscript explores the potential applications and further optimization of this percolating cooking water, high Asi removal, discovery.

Effect of cooling rate on the properties of high density polyethylene/multi-walled carbon nanotube composites

High density polyethylene (HDPE)/multi-walled carbon nanotube (MWCNT) nanocomposites were prepared by melt mixing using twin-screw extrusion. The extruded pellets were compression moulded at 200°C for 5min followed by cooling at different cooling rates (20°C/min and 300°C/min respectively) to produce sheets for characterization. Scanning electron microscopy (SEM) shows that the MWCNTs are uniformly dispersed in the HDPE. At 4 wt% addition of MWCNTs composite modulus increased by over 110% compared with the unfilled HDPE (regardless of the cooling rate). The yield strength of both unfilled and filled HDPE decreased after rapid cooling by about 10% due to a lower crystallinity and imperfect crystallites. The electrical percolation threshold of composites, irrespective of the cooling rate, is between a MWCNT concentration of 1∼2 wt%. Interestingly, the electrical resistivity of the rapidly cooled composite with 2 wt% MWCNTs is lower than that of the slowly cooled composites with the same MWCNT loading. This may be due to the lower crystallinity and smaller crystallites facilitating the formation of conductive pathways. This result may have significant implications for both process control and the tailoring of electrical conductivity in the manufacture of conductive HDPE/MWCNT nanocomposites.

Possibility of designing catalysts beyond the traditional volcano curve: A theoretical framework for multi-phase surfaces

The current theory of catalyst activity in heterogeneous catalysis is mainly obtained from the study of catalysts with mono-phases, while most catalysts in real systems consist of multi-phases, the understanding of which is far short of chemists' expectation. Density functional theory (DFT) and micro-kinetics simulations are used to investigate the activities of six mono-phase and nine bi-phase catalysts, using CO hydrogenation that is arguably the most typical reaction in heterogeneous catalysis. Excellent activities that are beyond the activity peak of traditional mono-phase volcano curves are found on some bi-phase surfaces. By analyzing these results, a new framework to understand the unexpected activities of bi-phase surfaces is proposed. Based on the framework, several principles for the design of multi-phase catalysts are suggested. The theoretical framework extends the traditional catalysis theory to understand more complex systems.

Novel critical phenomena in optimization driven processes on networks

The work presented in this Ph.D thesis was developed in the context of complex network theory, from a statistical physics standpoint. We examine two distinct problems in this research field, taking a special interest in their respective critical properties. In both cases, the emergence of criticality is driven by a local optimization dynamics. Firstly, a recently introduced class of percolation problems that attracted a significant amount of attention from the scientific community, and was quickly followed up by an abundance of other works. Percolation transitions were believed to be continuous, until, recently, an 'explosive' percolation problem was reported to undergo a discontinuous transition, in [93]. The system's evolution is driven by a metropolis-like algorithm, apparently producing a discontinuous jump on the giant component's size at the percolation threshold. This finding was subsequently supported by number of other experimental studies [96, 97, 98, 99, 100, 101]. However, in [1] we have proved that the explosive percolation transition is actually continuous. The discontinuity which was observed in the evolution of the giant component's relative size is explained by the unusual smallness of the corresponding critical exponent, combined with the finiteness of the systems considered in experiments. Therefore, the size of the jump vanishes as the system's size goes to infinity. Additionally, we provide the complete theoretical description of the critical properties for a generalized version of the explosive percolation model [2], as well as a method [3] for a precise calculation of percolation's critical properties from numerical data (useful when exact results are not available). Secondly, we study a network flow optimization model, where the dynamics consists of consecutive mergings and splittings of currents flowing in the network. The current conservation constraint does not impose any particular criterion for the split of current among channels outgoing nodes, allowing us to introduce an asymmetrical rule, observed in several real systems. We solved analytically the dynamic equations describing this model in the high and low current regimes. The solutions found are compared with numerical results, for the two regimes, showing an excellent agreement. Surprisingly, in the low current regime, this model exhibits some features usually associated with continuous phase transitions.

Cinética da transferência de calor em materiais com mudança de fase

É extensa a bibliografia dedicada a potenciais aplicações de materiais com mudança de fase na regulação térmica e no armazenamento de calor ou de frio. No entanto, a baixa condutividade térmica impõe limitações numa grande diversidade de aplicações com exigências críticas em termos de tempo de resposta curto ou com requisitos de elevada potência em ciclos de carga/descarga de calor latente. Foram desenvolvidos códigos numéricos no sentido de obter soluções precisas para descrever a cinética da transferência de calor com mudança de fase, com base em geometrias representativas, i.e. planar e esférica. Foram igualmente propostas soluções aproximadas, sendo identificados correspondentes critérios de validação em função das propriedades dos materiais de mudança de fase e de outros parâmetros relevantes tais como as escalas de tamanho e de tempo, etc. As referidas soluções permitiram identificar com rigor os fatores determinantes daquelas limitações, quantificar os correspondentes efeitos e estabelecer critérios de qualidade adequados para diferentes tipologias de potenciais aplicações. Os referidos critérios foram sistematizados de acordo com metodologias de seleção propostas por Ashby e co-autores, tendo em vista o melhor desempenho dos materiais em aplicações representativas, designadamente com requisitos ao nível de densidade energética, tempo de resposta, potência de carga/descarga e gama de temperaturas de operação. Nesta sistematização foram incluídos alguns dos compósitos desenvolvidos durante o presente trabalho. A avaliação das limitações acima mencionadas deu origem ao desenvolvimento de materiais compósitos para acumulação de calor ou frio, com acentuada melhoria de resposta térmica, mediante incorporação de uma fase com condutividade térmica muito superior à da matriz. Para este efeito, foram desenvolvidos modelos para otimizar a distribuição espacial da fase condutora, de modo a superar os limites de percolação previstos por modelos clássicos de condução em compósitos com distribuição aleatória, visando melhorias de desempenho térmico com reduzidas frações de fase condutora e garantindo que a densidade energética não é significativamente afetada. Os modelos elaborados correspondem a compósitos de tipo core-shell, baseados em microestruturas celulares da fase de elevada condutividade térmica, impregnadas com o material de mudança de fase propriamente dito. Além de visarem a minimização da fração de fase condutora e correspondentes custos, os modelos de compósitos propostos tiveram em conta a adequação a métodos de processamento versáteis, reprodutíveis, preferencialmente com base na emulsificação de líquidos orgânicos em suspensões aquosas ou outros processos de reduzidas complexidade e com base em materiais de baixo custo (material de mudança de fase e fase condutora). O design da distribuição microestrutural também considerou a possibilidade de orientação preferencial de fases condutoras com elevada anisotropia (p.e. grafite), mediante auto-organização. Outros estágios do projeto foram subordinados a esses objetivos de desenvolvimento de compósitos com resposta térmica otimizada, em conformidade com previsões dos modelos de compósitos de tipo core-shell, acima mencionadas. Neste enquadramento, foram preparados 3 tipos de compósitos com organização celular da fase condutora, com as seguintes características e metodologias: i) compósitos celulares parafina-grafite para acumulação de calor, preparados in-situ por emulsificação de uma suspensão de grafite em parafina fundida; ii) compósitos celulares parafina-Al2O3 para acumulação de calor, preparados por impregnação de parafina em esqueleto cerâmico celular de Al2O3; iii) compósitos celulares para acumulação de frio, obtidos mediante impregnação de matrizes celulares de grafite com solução de colagénio, após preparação prévia das matrizes de grafite celular. Os compósitos com esqueleto cerâmico (ii) requereram o desenvolvimento prévio de um método para o seu processamento, baseado na emulsificação de suspensões de Al2O3 em parafina fundida, com adequados aditivos dispersantes, tensioactivos e consolidantes do esqueleto cerâmico, tornando-o auto-suportável durante as fases posteriores de eliminação da parafina, até à queima a alta temperatura, originando cerâmicos celulares com adequada resistência mecânica. Os compósitos desenvolvidos apresentam melhorias significativos de condutividade térmica, atingindo ganhos superiores a 1 ordem de grandeza com frações de fase condutora inferior a 10 % vol. (4 W m-1 K-1), em virtude da organização core-shell e com o contributo adicional da anisotropia da grafite, mediante orientação preferencial. Foram ainda preparados compósitos de armazenamento de frio (iii), com orientação aleatória da fase condutora, obtidos mediante gelificação de suspensões de partículas de grafite em solução aquosa de colagénio. Apesar da estabilidade microestrutural e de forma, conferida por gelificação, estes compósitos confirmaram a esperada limitação dos compósitos com distribuição aleatória, em confronto com os ganhos alcançados com a organização de tipo core-shell.

Laser assisted directional solidification of zirconia-based eutectics

Directionally solidified zirconia-based eutectic (DSE) fibres were obtained using the laser floating zone (LFZ) method. Two systems were investigated: zirconia-barium zirconate and zirconia-mullite. The purpose was to take advantage of zirconia properties, particularly as an ionic conductor and a mechanical rein-forcement phase. The influence of processing conditions in the structural and microstructural characteristics and their consequences on the electrical and mechanical behaviour were the focus of this thesis. The novel zirconia-barium zirconate eutectic materials were developed in order to combine oxygen ionic conduction through zirconia with protonic conduction from barium zirconate, promoting mixed ionic conduction behaviour. The mi-crostructure of the fibres comprises two alternated regions: bands having coarser zirconia-rich microstructure; and inter-band regions changing from a homogeneous coupled eutectic, at the lowest pulling rate, to columnar colony microstructure, for the faster grown fibres. The bands inter-distance increases with the growth rate and, at 300 mm/h, zirconia dendrites develop enclosed in a fine-interpenetrated network of 50 vol.% ZrO2-50 vol.% BaZrO3. Both phases display contiguity without interphase boundaries, according to impedance spec-troscopy data. Yttria-rich compositions were considered in order to promote the yttrium incorporation in both phases, as revealed by Raman spectroscopy and corroborated by the elemental chemical analysis in energy dispersive spectros-copy. This is a mandatory condition to attain simultaneous contribution to the mixed ionic conduction. Such results are supported by impedance spectrosco-py measurements, which clearly disclose an increase of total ionic conduction for lower temperatures in wet/reduction atmospheres (activation energies of 35 kJ/mol in N2+H2 and 48 kJ/mol in air, in the range of 320-500 ºC) compared to the dry/oxidizing conditions (attaining values close to 90 kJ/mol, above 500 ºC). At high temperatures, the proton incorporation into the barium zirconate is un-favourable, so oxygen ion conduction through zirconia prevails, in dry and oxi-dizing environments, reaching a maximum of 1.3x10-2 S/cm in dry air, at ~1000 ºC. The ionic conduction of zirconia was alternatively combined with another high temperature oxygen ion conductor, as mullite, in order to obtain a broad elec-trolytic domain. The growth rate has a huge influence in the amount of phases and microstructure of the directionally solidified zirconia-mullite fibres. Their microstructure changes from planar coupled eutectic to dendritic eutectic mor-phology, when the growth rate rises from 1 to 500 mm/h, along with an incre-ment of tetragonal zirconia content. Furthermore, high growth rates lead to the development of Al-Si-Y glassy phase, and thus less mullite amount, which is found to considerably reduce the total ionic conduction of as-grown fibres. The reduction of the glassy phase content after annealing (10h; 1400 ºC) promotes an increase of the total ionic conduction (≥0.01 S/cm at 1370 °C), raising the mullite and tetragonal zirconia contents and leading to microstructural differ-ences, namely the distribution and size of the zirconia constituent. This has important consequences in conductivity by improving the percolation pathways. A notable increase in hardness is observed from 11.3 GPa for the 10 mm/h pulled fibre to 21.2 GPa for the fibre grown at 500 mm/h. The ultra-fine eutectic morphology of the 500 mm/h fibres results in a maximum value of 534 MPa for room temperature bending strength, which decreases to about one-fourth of this value at high temperature testing (1400 ºC) due to the soft nature of the glassy-matrix.

Partilhar, comunicar e cooperar : a utilização de recursos digitais de apoio à disciplina de educação física

Trabalho de projeto de mestrado, Educação (Área de especialização em Educação e Tecnologias Digitais), Universidade de Lisboa, Instituto de Educação, 2014

Evaluation de la douleur chez les personnes cérébrolésées non-communicantes aux soins intensifs

La douleur est fréquente en milieu de soins intensifs et sa gestion est l'une des missions des infirmières. Son évaluation est une prémisse indispensable à son soulagement. Cependant lorsque le patient est incapable de signaler sa douleur, les infirmières doivent se baser sur des signes externes pour l'évaluer. Les guides de bonne pratique recommandent chez les personnes non communicantes l'usage d'un instrument validé pour la population donnée et basé sur l'observation des comportements. A l'heure actuelle, les instruments d'évaluation de la douleur disponibles ne sont que partiellement adaptés aux personnes cérébrolésées dans la mesure où ces personnes présentent des comportements qui leur sont spécifiques. C'est pourquoi, cette étude vise à identifier, décrire et valider des indicateurs, et des descripteurs, de la douleur chez les personnes cérébrolésées. Un devis d'étude mixte multiphase avec une dominante quantitative a été choisi pour cette étude. Une première phase consistait à identifier des indicateurs et des descripteurs de la douleur chez les personnes cérébrolésées non communicantes aux soins intensifs en combinant trois sources de données : une revue intégrative des écrits, une démarche consultative utilisant la technique du groupe nominal auprès de 18 cliniciens expérimentés (6 médecins et 12 infirmières) et les résultats d'une étude pilote observationnelle réalisée auprès de 10 traumatisés crâniens. Les résultats ont permis d'identifier 6 indicateurs et 47 descripteurs comportementaux, vocaux et physiologiques susceptibles d'être inclus dans un instrument d'évaluation de la douleur destiné aux personnes cérébrolésées non- communicantes aux soins intensifs. Une deuxième phase séquentielle vérifiait les propriétés psychométriques des indicateurs et des descripteurs préalablement identifiés. La validation de contenu a été testée auprès de 10 experts cliniques et 4 experts scientifiques à l'aide d'un questionnaire structuré qui cherchait à évaluer la pertinence et la clarté/compréhensibilité de chaque descripteur. Cette démarche a permis de sélectionner 33 des 47 descripteurs et valider 6 indicateurs. Dans un deuxième temps, les propriétés psychométriques de ces indicateurs et descripteurs ont été étudiés au repos, lors de stimulation non nociceptive et lors d'une stimulation nociceptive (la latéralisation du patient) auprès de 116 personnes cérébrolésées aux soins intensifs hospitalisées dans deux centres hospitaliers universitaires. Les résultats montrent d'importantes variations dans les descripteurs observés lors de stimulation nociceptive probablement dues à l'hétérogénéité des patients au niveau de leur état de conscience. Dix descripteurs ont été éliminés, car leur fréquence lors de la stimulation nociceptive était inférieure à 5% ou leur fiabilité insuffisante. Les descripteurs physiologiques ont tous été supprimés en raison de leur faible variabilité et d'une fiabilité inter juge problématique. Les résultats montrent que la validité concomitante, c'est-à-dire la corrélation entre l'auto- évaluation du patient et les mesures réalisées avec les descripteurs, est satisfaisante lors de stimulation nociceptive {rs=0,527, p=0,003, n=30). Par contre la validité convergente, qui vérifiait l'association entre l'évaluation de la douleur par l'infirmière en charge du patient et les mesures réalisés avec les descripteurs, ainsi que la validité divergente, qui vérifiait si les indicateurs discriminent entre la stimulation nociceptive et le repos, mettent en évidence des résultats variables en fonction de l'état de conscience des patients. Ces résultats soulignent la nécessité d'étudier les descripteurs de la douleur chez des patients cérébrolésés en fonction du niveau de conscience et de considérer l'hétérogénéité de cette population dans la conception d'un instrument d'évaluation de la douleur pour les personnes cérébrolésées non communicantes aux soins intensifs. - Pain is frequent in the intensive care unit (ICU) and its management is a major issue for nurses. The assessment of pain is a prerequisite for appropriate pain management. However, pain assessment is difficult when patients are unable to communicate about their experience and nurses have to base their evaluation on external signs. Clinical practice guidelines highlight the need to use behavioral scales that have been validated for nonverbal patients. Current behavioral pain tools for ICU patients unable to communicate may not be appropriate for nonverbal brain-injured ICU patients, as they demonstrate specific responses to pain. This study aimed to identify, describe and validate pain indicators and descriptors in brain-injured ICU patients. A mixed multiphase method design with a quantitative dominant was chosen for this study. The first phase aimed to identify indicators and descriptors of pain for nonverbal brain- injured ICU patients using data from three sources: an integrative literature review, a consultation using the nominal group technique with 18 experienced clinicians (12 nurses and 6 physicians) and the results of an observational pilot study with 10 traumatic brain injured patients. The results of this first phase identified 6 indicators and 47 behavioral, vocal and physiological descriptors of pain that could be included in a pain assessment tool for this population. The sequential phase two tested the psychometric properties of the list of previously identified indicators and descriptors. Content validity was tested with 10 clinical and 4 scientific experts for pertinence and comprehensibility using a structured questionnaire. This process resulted in 33 descriptors to be selected out of 47 previously identified, and six validated indicators. Then, the psychometric properties of the descriptors and indicators were tested at rest, during non nociceptive stimulation and nociceptive stimulation (turning) in a sample of 116 brain-injured ICLI patients who were hospitalized in two university centers. Results showed important variations in the descriptors observed during the nociceptive stimulation, probably due to the heterogeneity of patients' level of consciousness. Ten descriptors were excluded, as they were observed less than 5% of the time or their reliability was insufficient. All physiologic descriptors were deleted as they showed little variability and inter observer reliability was lacking. Concomitant validity, testing the association between patients' self report of pain and measures performed using the descriptors, was acceptable during nociceptive stimulation (rs=0,527, p=0,003, n=30). However, convergent validity ( testing for an association between the nurses' pain assessment and measures done with descriptors) and divergent validity (testing for the ability of the indicators to discriminate between rest and a nociceptive stimulation) varied according to the level of consciousness These results highlight the need to study pain descriptors in brain-injured patients with different level of consciousness and to take into account the heterogeneity of this population forthe conception of a pain assessment tool for nonverbal brain-injured ICU patients.

Ischemic heart disease in postmortem CT and CT angiography

Objective: Postmortem radiology had in recent years appeared in the field of forensic medicine and is now considered by some authors as a good replacement for conventional autopsy and by others as a complementary examination. Although postmortem CT radiological imaging is very useful in demonstrating traumatic lesions, its utility is still quite limited in the cardiovascular field. This limitation could be minimized by the introduction of postmortem angiography. At the University Center of Legal Medicine of Lausanne, CT scans and postmortem multiphase CTangiography are used in cases with a suspicion of ischemic heart disease.Method: The goal of this presentation is to demonstrate some correlations between postmortem CT, CTangiography and conventional autopsy examination in cases of ischemic heart disease.Results: We observed that the native CT scan can show only some pathological findings as cardiac tamponade and calcifications of coronary arteries. However, postmortem angiography allows a better visualization of coronary arteries and evaluation of stenosis and occlusion as well as better imaging of soft tissue.Conclusion: The interpretation of postmortem modern radiology is a new field for both forensic pathologists and radiologists who have to learn to read the postmortem modified images. The information obtained from both parties can help to further the understanding of CT and CT angiography in postmortem cases.