ESGE–ESGENA guideline: Cleaning and disinfection in gastrointestinal endoscopy

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Perfectly matched layers in transmission lines

The field distribution at the ports of the transmission line structure is computed by applying Maxwell's equations to the structure and solving an eigenvalue problem. The high dimensional sparse system matrix is complex in the presence of losses and Perfectly Matched Layer. A method is presented which preserves sparseness and delivers only the small number of interesting modes out with the smallest attenuation. The modes are found solving a sequence of eigenvalue problems of modified matrices with the aid of the invert mode of the Arnoldi iteration using shifts. A new strategy is described which allows the application of the method, first developed for microwave structures, to optoelectronic devices

Computer-aided recording of automatic endoscope washing and disinfection processes as an integral part of medical documentation for quality assurance purposes

<p>Abstract</p> <p>Background</p> <p>The reprocessing of medical endoscopes is carried out using automatic cleaning and disinfection machines. The documentation and archiving of records of properly conducted reprocessing procedures is the last and increasingly important part of the reprocessing cycle for flexible endoscopes.</p> <p>Methods</p> <p>This report describes a new computer program designed to monitor and document the automatic reprocessing of flexible endoscopes and accessories in fully automatic washer-disinfectors; it does not contain nor compensate the manual cleaning step. The program implements national standards for the monitoring of hygiene in flexible endoscopes and the guidelines for the reprocessing of medical products. No FDA approval has been obtained up to now. The advantages of this newly developed computer program are firstly that it simplifies the documentation procedures of medical endoscopes and that it could be used universally with any washer-disinfector and that it is independent of the various interfaces and software products provided by the individual suppliers of washer-disinfectors.</p> <p>Results</p> <p>The computer program presented here has been tested on a total of four washer-disinfectors in more than 6000 medical examinations within 9 months.</p> <p>Conclusions</p> <p>We present for the first time an electronic documentation system for automated washer-disinfectors for medical devices e.g. flexible endoscopes which can be used on any washer-disinfectors that documents the procedures involved in the automatic cleaning process and can be easily connected to most hospital documentation systems.</p

Diagnosis and treatment of neurogenic dysphagia - S1 guideline of the German Society of Neurology.

INTRODUCTION Neurogenic dysphagia defines swallowing disorders caused by diseases of the central and peripheral nervous system, neuromuscular transmission, or muscles. Neurogenic dysphagia is one of the most common and at the same time most dangerous symptoms of many neurological diseases. Its most important sequelae include aspiration pneumonia, malnutrition and dehydration, and affected patients more often require long-term care and are exposed to an increased mortality. Based on a systematic pubmed research of related original papers, review articles, international guidelines and surveys about the diagnostics and treatment of neurogenic dysphagia, a consensus process was initiated, which included dysphagia experts from 27 medical societies. RECOMMENDATIONS This guideline consists of 53 recommendations covering in its first part the whole diagnostic spectrum from the dysphagia specific medical history, initial dysphagia screening and clinical assessment, to more refined instrumental procedures, such as flexible endoscopic evaluation of swallowing, the videofluoroscopic swallowing study and high-resolution manometry. In addition, specific clinical scenarios are captured, among others the management of patients with nasogastric and tracheotomy tubes. The second part of this guideline is dedicated to the treatment of neurogenic dysphagia. Apart from dietary interventions and behavioral swallowing treatment, interventions to improve oral hygiene, pharmacological treatment options, different modalities of neurostimulation as well as minimally invasive and surgical therapies are dealt with. CONCLUSIONS The diagnosis and treatment of neurogenic dysphagia is challenging and requires a joined effort of different medical professions. While the evidence supporting the implementation of dysphagia screening is rather convincing, further trials are needed to improve the quality of evidence for more refined methods of dysphagia diagnostics and, in particular, the different treatment options of neurogenic dysphagia. The present article is an abridged and translated version of the guideline recently published online ( https://www.awmf.org/uploads/tx_szleitlinien/030-111l_Neurogene-Dysphagie_2020-05.pdf )

Figurationen des Porträts

Mit dem Fokus auf Figurationen des Porträts wird ein Spannungsfeld kulturellen Wissens eröffnet, anhand dessen sich der historische Bezugsraum von Artefakten diskutieren lässt. Porträt meint also nicht (nur) die kunsthistorische Gattung, sondern ein Wahrnehmungsmodell, das sich zwischen einmaliger Ausprägung und der Wiedererkennbarkeit der Form entfaltet. Die Studien zielen in einem Bogen vom frühesten (Herrscher-) Porträt aus dem Alten Mesopotamien bis in die Gegenwartskunst hinein auf historisch variable Formen, individuelles Leben als besonders darzustellen. Neben genuin bild- und skulpturorientierten Beiträgen von antiken Centauren-Porträts und Statuenbasen im kaiserzeitlichen Sagalassos über die ›Antike der Fotografie‹ bis hin zu Schwitters’ Merzbild 9b und Twomblys Selbstbildnissen behandeln textorientierte Beiträge Fragen der Lesbarkeit von Porträts, etwa in apokryphen Paulus-Texten, an der Schnittstelle von biographischem Porträt und byzantinischer Philosophie oder anhand von Poes Oval Portrait. Ein eigener Fokus gilt den kulturellen Praktiken der Bedeutungsstiftung, von Stalins Herrscherbildnissen bis hin zur anthropologischen Funktion beispielsweise von Masken

Fully Integrated PHEMT Voltage Controlled Oscillator with Very High Tuning Bandwidth

Design concepts of fully monolithically in-tegrated VCOs are presented that include special so-lutions for increasing the bandwidth of operation. Re-alised buffered VCO MMICs deliver RF power be-tween 11.2 and 15.5 dBm over the frequency range from 4.6 to 6.1 GHz. The relative bandwidth f = f m is more than 27%, which is one of the highest values ever achieved with MMIC–VCOs using diode tuning