Efficacité pédagogique chez des non-initiés de différentes méthodes de formation à l'usage du garrot tourniquet pour le contrôle des hémorragies disponibles dans les espaces publics

G. Bagou *, B. Cabrita , P.-F. Ceccaldi , G. Comte , M. Corbillon-Soubeiran , J.-F. Diependaele , F.-X. Duchateau , O. Dupuis , V. Hamel , A. Launoy , N. Laurenceau-Nicolle , E. Menthonnex , Y. Penverne , T. Rackelboom , A. Rozenberg , C. Telion m a Samu-69, groupement hospitalier Edouard-Herriot, 3, place d’Arsonval, 69437 Lyon cedex 03, France b Samu-21, hopital general, 3, rue du Faubourg-Raines, BP 1519, 21033 Dijon cedex, France c Service de gynecologie obstetrique, hopital Beaujon, 92110 Clichy, France d Samu-Cesu-80, hopital Nord, 80054 Amiens cedex, France e Smur pediatrique, CHRU de Lille, 59037 Lille cedex, France f Smur Beaujon, hopital Beaujon, 92110 Clichy, France g Service de gynecologie obstetrique, centre hospitalier Lyon-Sud, 69495 Pierre-Benite cedex, France h Samu-44, 8, quai Moncousu, 44093 Nantes cedex 1, France i Service de reanimation chirurgicale, hopital de Hautepierre, 67098 Strasbourg cedex, France j Cellule regionale des transferts perinatals Rhone-Alpes, groupement hospitalier Edouard-Herriot, 69437 Lyon cedex 03, France k Samu-38, CHU, BP 217, 38043 Grenoble cedex 9, France l Service d’anesthesie reanimation, groupe hospitalier Cochin St-Vincent-de-Paul, 75679 Paris cedex 14, France m Samu de Paris, hopital Necker, 75743 Paris cedex 15, France

The aim of this work is to propose a fast and efficient finite element method for studying clinch forming with respect to process parameters. The clinch process is a mechanical joining technique that has been studied for many years in the hope of achieving quality joints for dissimilar metal sheets with different surfaces and thickness. Its basic principle is to clamp together several metal sheets by an impact extrusion between a punch and a die. A dedicated finite element computer code is developed to specifically simulate this forming process. The resolution of the updated Lagrangian formulation is based on a static explicit approach. The integration of the elastic-plastic behavior law is realised with a Simo and Taylor algorithm. The contact conditions are insured by a penalty method. Furthermore, due to large mesh distortions, remeshing techniques are used in order to compute an accurate solution. After designing a new mesh, field variables are transferred by a diffuse approximation method. The results that we present are compared with experimental data and numerical results calculated with a static implicit method (ABAQUS). The influence of process parameters (tools geometry, friction, material behavior) is also shown to be accurately taken into account.

This paper presents a fast and efficient FE method for studying clinch forming with respect to process parameters. The basic principle of this mechanical joining technique is to clamp together several metal sheets by stamping and extrusion between a punch and a die.

This paper presents a fast and efficient FE method for studying clinch forming with respect to process parameters. The basic principle of this mechanical joining technique is to clamp together several metal sheets by stamping and extrusion between a punch and a die. The resolution of the updated lagrangian formulation is based on a static explicit approach. The contact conditions are insured by a penalty method. In addition, due to large mesh distortions, remeshing techniques are used in order to compute an accurate solution. After designing a new mesh, fields variables are transferred by a diffuse approximation technique. The results computed with the static explicit method are compared with experimental data and numerical results calculated with a static implicit method (ABAQUS). The influence of process parameters (tools geometry, friction, material behaviour) is in very good agreement with experimental results.

Multijoint arm movements of individuals with Huntington's disease (HD) were examined using three-dimensional kinematic analysis. Six HD patients with chorea and four healthy subjects performed pointing movements to a 2.5 cm target positioned at three distances in the sagittal plane, two of which required trunk motion. Healthy subjects moved in relatively straight hand paths to the targets. All HD patients produced curved hand paths, in which they brought their hand first upward and then outward to the target. Healthy subjects made single smooth movements, while HD patients made large initial movements followed by multiple submovements as the band honed in on the target. Lower functioning HD patients had particular difficulty moving to the farthest target, which required the greatest amount of trunk motion. Although the HD patients had longer movement times across all conditions, their initial velocity was often similar to that of the healthy subjects. This suggests that bradykinesia is related to the production of submovements, rather than a deficit in initial force production. The presence of submovements in Huntington's disease might reflect a deficit in controlling deceleration of the limb or an adaptive strategy to maximize accuracy.