Simulation of elongated bubbles in a channel using the two-fluid model

This paper investigates the capability of the two-fluid model to predict the bubble drift velocity of elongated bubbles in channels. The two-fluid model is widely used in the oil and gas industry for dynamic multiphase pipeline simulations. The bubble drift velocity is an important quantity in predicting pipeline flushing and slug flow. In this paper, it is shown that the two-fluid model in its standard form predicts a bubble drift velocit

De magic kun je niet verwoorden : Onderzoek naar hoe, dat wat humanistisch geestelijk verzorgers bieden in een contact rondom sterven en dood zich verhoudt tot dat wat Carlo Leget, Marinus van den Berg en Christine Longaker daarover schrijven.

De titel van dit onderzoeksverslag is een uitspraak van één van mijn respondenten die ik voor dit onderzoek geïnterviewd heb. De vraag die ik tijdens mijn interviews stelde was: ‘Wat bied jij als humanistisch geestelijk verzorger in een begeleidingscontact waarin het sterven en dood van de ander centraal staat?’. De antwoorden waren niet eenduidig. Bijna alle respondenten gaven aan dat het vooral van belang was aan te sluiten bij de wensen en de behoeften van de ander en dat dat wat er tussen jou en de ander gebeurt, dat het een zoeken is en dat wat je biedt, niet altijd te verwoorden is. De antwoorden van mijn respondenten heb ik in dit onderzoek vergeleken met de visies van Carlo Leget, Marinus van den Berg en Christine Longaker. De onderzoeksvraag die ik in dit onderzoek beantwoord luidt dan ook: Hoe verhoudt dat wat Christine Longakker, Carlo Leget en Marinus van den Berg schrijven over het begeleiden rondom sterven en dood zich tot dat wat humanistische geestelijk verzorgers, werkzaam in de zorg, bieden in een individueel begeleidingscontact waarin het sterven en de dood van de ander centraal staat? Vanuit de visie van de drie auteurs heb ik veertien thema’s opgesteld, dit zijn: innerlijke ruimte, innerlijke ruimte in jezelf, een gesprek, bevestigen en aanvaarden, luisteren en beluisteren, woorden van de ander, woorden vanuit persoonlijke levensbeschouwing, zin, symbolen en metaforen, bezinning, nabij zijn, onmacht delen, rituelen en humor. Uiteindelijk werd de meerderheid van de thema’s door de meerderheid van mijn respondenten benoemd. De visies van de drie auteurs komen dus in grote lijnen overeen met dat wat humanistisch geestelijk verzorgers zeggen dat zij bieden. De humanistisch geestelijk verzorgers legden hierbij wel meer de nadruk op het aansluiten bij de wensen en behoeften van de ander. Ook waren er verscheidene verschillen die te maken hadden met het levensbeschouwelijk kader van de auteurs en de geestelijk verzorgers. Daarnaast heeft iedere geestelijk verzorger een eigen stijl en dus een eigen manier van werken én blijft het zo dat je de ‘magic’ niet kunt altijd kunt verwoorden

Characteristics of Long-Stay Patients in a PICU and Healthcare Resource Utilization after Discharge

OBJECTIVES: To examine the characteristics of long-stay patients (LSPs) admitted to a PICU and to investigate discharge characteristics of medical complexity among discharged LSP. DESIGN: We performed a retrospective cohort study where clinical data were collected on all children admitted to our PICU between July 1, 2017, and January 1, 2020. SETTING: A single-center study based at Erasmus MC Sophia Children's Hospital, a level III interdisciplinary PICU in The Netherlands, providing all pediatric and surgical subspecialties. PATIENTS:LSP was defined as those admitted for at least 28 consecutive days. INTERVENTIONS: None. MEASUREMENTS: Length of PICU stay, diagnosis at admission, length of mechanical ventilation, need for extracorporeal membrane oxygenation, mortality, discharge location after PICU and hospital admission, medical technical support, medication use, and involvement of allied healthcare professionals after hospital discharge. MAIN RESULTS: LSP represented a small proportion of total PICU patients (108 patients; 3.2%) but consumed 33% of the total admission days, 47% of all days on extracorporeal membrane oxygenation, and 38% of all days on mechanical ventilation. After discharge, most LSP could be classified as children with medical complexity (CMC) (76%); all patients received discharge medications (median 5.5; range 2-19), most patients suffered from a chronic disease (89%), leaving the hospital with one or more technological devices (82%) and required allied healthcare professional involvement after discharge (93%). CONCLUSIONS: LSP consumes a considerable amount of resources in the PICU and its impact extends beyond the point of PICU discharge since the majority are CMC. This indicates complex care needs at home, high family needs, and a high burden on the healthcare system across hospital borders.</p

Low Hepatitis C Virus Prevalence among Men Who Have Sex with Men Attending Public Health Services in The Netherlands

The hepatitis C virus (HCV) prevalence is high among men who have sex with men (MSM) with HIV in the Netherlands. Large reductions in HCV incidence among MSM with HIV, however, have occurred since treatment with direct-acting antivirals. Over the years, a broader understanding of the HCV epidemic has shown that HCV infections are not solely restricted to MSM with HIV, but they also occur among HIV-negative MSM. Currently, HCV testing among HIV-negative MSM is only provided for PrEP users and is not part of routine sexually transmitted infection (STI) screening among HIV-negative MSM who are not using PrEP. In this study, we screened 1885 HIV-negative MSM who did not participate in a PrEP program, with over 1966 STI screening visits at four different public health clinic sites. Among the 1885 MSM, only one person had a new HCV infection, resulting in a 0.05% (95% confidence interval 0.0–0.3) incidence. Based on our findings, we can conclude that systematic HCV testing at STI clinics may not yield significant benefits for this particular population.</p

Resistance to Innovation in NATO

Torsten Gojowsky is a U.S. Army officer. Ben Haspels is a Royal Netherlands Army officer. Flemming Haar is a Danish Navy officer. Sebastian Koegle is a German officer. Sverre Wetteland is a Norwegian officer. All are students at the Naval Postgraduate School in Monterey, California.The article of record as published may be found at thestrategybridge.org/the-bridge/2018/8/16/resistance-to-innovation-in-nat

Dendritic cell-specific deletion of β-catenin results in fewer regulatory T-cells without exacerbating autoimmune collagen-induced arthritis

Dendritic cells (DCs) are professional antigen presenting cells that have the dual ability to stimulate immunity and maintain tolerance. However, the signalling pathways mediating tolerogenic DC function in vivo remain largely unknown. The β-catenin pathway has been suggested to promote a regulatory DC phenotype. The aim of this study was to unravel the role of β-catenin signalling to control DC function in the autoimmune collagen-induced arthritis model (CIA). Deletion of β-catenin specifically in DCs was achieved by crossing conditional knockout mice with a CD11c-Cre transgen

Urinary Tract Infection in Postmenopausal Women

Urinary tract infection (UTI) is the most common bacterial infection in women in general and in postmenopausal women in particular. Two groups of elderly women with recurrent UTI should be differentiated regarding age and general status: healthy, young postmenopausal women aged 50 to 70 years who are neither institutionalized or catheterized and elderly institutionalized women with or without a catheter. Bacteriuria occurs more often in elderly functionally impaired women, but in general it is asymptomatic. However, the risk factors associated with recurrent UTI in elderly women are not widely described. In a multivariate analysis it was found that urinary incontinence, a history of UTI before menopause, and nonsecretor status were strongly associated with recurrent UTI in young postmenopausal women. Another study described the incidence and risk factors of acute cystitis among nondiabetic and diabetic postmenopausal women. Independent predictors of infection included insulin-treated patients and a lifetime history of urinary infection. Borderline associations included a history of vaginal estrogen cream use in the past month, kidney stones, and asymptomatic bacteriuria at baseline. Another important factor in postmenopausal women is the potential role that estrogen deficiency plays in the development of bacteriuria. There are at least two studies showing a beneficial effect of estrogen in the management of recurrent bacteriuria in elderly women. One of these studies showed that vaginal estrogen cream reduced vaginal pH from 5.5±0.7 to 3.6±1.0, restored lactobacillus, and decreased new episodes of UTI. Another study reported similar results using an estriol vaginal ring. However, contradictory results are found in the literature. For example, additional studies found that the use of estriol-containing vaginal pessaries was less effective than oral nitrofurantoin macrocrystals in preventing UTI in postmenopausal women. Two other studies also did not find any benefit in the reduction of UTI by oral estrogen therapy. Unfortunately, the use of estrogen in preventing UTI in postmenopausal women remains questionable. New strategies have been researched for reducing the use of antibiotics in the prevention and treatment of UTI. Two of them are probiotics and cranberry juice or capsules. Although several studies regarding probiotics and cranberry juice or capsules have reported a reduction of episodes of UTI, there is no conclusive evidence that they are useful in the prevention of UTI in postmenopausal women. As for the optimal drug, dosage, and length of treatment for UTI in the elderly, there are no studies comparing these data with the treatment for young women

Simulation of Elongated Bubbles in a Channel Using the Two-Fluid Model

This paper investigates the capability of the two-fluid model to predict the bubble drift velocity of elongated bubbles in channels. The two-fluid model is widely used in the oil and gas industry for dynamic multiphase pipeline simulations. The bubble drift velocity is an important quantity in predicting pipeline flushing and slug flow. In this paper, it is shown that the two-fluid model in its standard form predicts a bubble drift velocity of (gH)^(1/2) (similar to the shallow water equations), instead of the exact value of 1/2(gH)^(1/2) as derived by Benjamin[1]. Modifying the two-fluid model with the commonly employed momentum correction parameter leads to a steady solution (in a moving reference frame), but still predicts an erroneous bubble drift velocity. To get the correct bubble drift velocity, it is necessary to include the pressure variation along the channel height due to both the hydrostatic component and the vertical momentum flux