Vossstilling1099

We systematically study the effects of liquid viscosity, liquid density, and surface tension on global microbubble coalescence using lattice Boltzmann simulation. The liquid-gas system is characterized by Ohnesorge number Oh≡η_h/sqrt[ρ_hσr_F] with η_h,ρ_h,σ, and r_F being viscosity and density of liquid, surface tension, and the radius of the larger parent bubble, respectively. This study focuses on the microbubble coalescence without oscillation in an Oh range between 0.5 and 1.0. The global coalescence time is defined as the time period from initially two parent bubbles touching to finally one child bubble when its half-vertical axis reaches above 99% of the bubble radius. Comprehensive graphics processing unit parallelization, convergence check, and validation are carried out to ensure the physical accuracy and computational efficiency. From 138 simulations of 23 cases, we derive and validate a general power-law temporal scaling T^*=A_0γ^-n, that correlates the normalized global coalescence time (T^*) with size inequality (γ) of initial parent bubbles. We found that the prefactor A_0 is linear to Oh in the full considered Oh range, whereas the power index n is linear to Oh when Oh0.66. The physical insights of the coalescence behavior are explored. Such a general temporal scaling of global microbubble coalescence on size inequality may provide useful guidance for the design, development, and optimization of microfluidic systems for various applications.BACKGROUND Overweight/obesity and poor physical fitness are two prevalent lifestyle-related problems in older adults with intellectual disabilities, which each require a different approach. To improve healthy ageing, we assessed whether fatness or fitness is more important for survival in older adults with intellectual disabilities. METHODS In the HA-ID study, we measured obesity and fitness of 874 older adults with intellectual disabilities (61.4 ± 7.8 years). Alsl-cause mortality was assessed over a 5-year follow-up period. RESULTS Fitness, but not obesity, was significantly related to survival (HR range of 0.17-0.22). People who were unfit were 3.58 (95% CI = 1.72-7.46) to 4.59 (95% CI = 1.97-10.68) times more likely to die within the follow-up period than people who were fit, regardless of obesity. CONCLUSION This was the first study to show that being fit is more important for survival than fatness in older adults with intellectual disabilities. The emphasis should, therefore, shift from weight reduction to improving physical fitness. © 2020 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.Severe stroke and neurodegenerative diseases often cause limitations in communication and willing capability. Decision processes in these conditions assume primarily a positive medical indication for any intervention. If not obtainable from an individual by itself, by a disposal or by a legal custodian, the presumed will of a patient has to be detected carefully. Evidence can be raised by an interview of relatives or an individual case discussion in a local ethical comitee. Stroke and dementia can raise the need for palliative care, especially a sufficient analgesia as well as other severe illnesses. Pain in demented persons is often underrated and undertreated. The diagnosis of dementia alone does not limit the indication for curative therapy in general. Ethical comitees or ethical visits are helpful instruments to find out an adequate decision in difficult situations. © Georg Thieme Verlag KG Stuttgart · New York.in English, German In dieser Fallserie werden 3 Patienten mit einer Dermatomyositis bzw. Polymyositis autoimmuner Genese vorgestellt, die nach Entwicklung einer rasch progredienten interstitiellen Lungenbeteiligung trotz Immunsuppressiva innerhalb von Monaten verstarben. Alle 3 Patienten hatten ein passendes Antikörperprofil – bei 2 wurden Myositis-spezifische anti-melanoma-differentiation-associated-gene (MDA5)-Antikörper und bei der dritten Myositis-assoziierte Anti-Ku-Antikörper nachgewiesen. Dermatomyositis und Polymyositis sind seltene Autoimmunerkrankungen mit unterschiedlichen klinischen Manifestationen und Antikörperkonstellationen. Insbesondere das Vorliegen von MDA5-Antikörpern ist mit einer rasch progredienten pulmonalen Beteiligung und einer schlechten Prognose assoziiert.Antibiotic stewardship (ABS) denotes structured and continuous measures to improve the quality of prescribing anti-infectives. The aim is to achieve optimal treatment results and to minimize undesirable effects, especially the emergence of antibiotic resistance. This review summarizes the most important ABS principles based on recently published studies with implications for the management of community-acquired pneumonia. Local guidelines, education and training and "prospective audit and feedback" are established strategies to improve the management of patients with community-acquired pneumonia. However, the implementation of ABS programs requires trained personnel and may be impeded by limited structural and time resources. Hence, electronic health records and computer-based interventions are useful support for ABS programs and offer potential to facilitate ABS in inpatient and outpatient care. PCR-based rapid diagnostic tests, PCT-guided algorithms and penicillin allergy testing are suitable procedures to supplement ABS programs. © Georg Thieme Verlag KG Stuttgart · New York.Nosocomial pneumonia is one of the leading entities of nosocomial infections in Germany and worldwide with invasive ventilation being one of the major risk factors. However nosocomial pneumonia without ventilator support is an underappreciated complication as demonstrated by prevalence studies of the European Centre for Disease Control in 2011 and 2016. see more Major general risk factors include old age, multi-morbidity, preexisting pulmonary disease, immunosuppression and abdominal or thoracic surgery. Evidence based prevention measures for ventilated patients include hand hygiene, aseptic handling techniques of the ventilator circuit, subglottic suctioning for patients intubated more than 72 hours, cuff pressure control, mouth and dental care, daily spontaneous breathing trials, use of sedation protocols and head of bed 30-45 degrees. For non-ventilated patients early mobilization and/or frequent position changes, correct use of feeding tubes and mouth care are key components. In preoperative patients training of a simple breathing exercise combined with mnemonic aids for its use in the postoperative period has been proven to be helpful.