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Softwood pulp flow in rotating and non-rotating grooves is numerically simulated in the present study to investigate the fluid flow and the forces acting on a representative surface mounted in the groove. The viscosity of softwood pulp with various consistencies is available from the measurements reported in the literature providing the opportunity to examine the effects of fiber consistency on the velocity and pressure distribution within the groove. The simulations are carried out in OpenFOAM for different values of gap thickness, angular velocity and radial positions from which the pressure coefficient and shear forces values are obtained. It is found that the shear forces within the gap increase linearly with the angular velocity for all fiber consistencies investigated and in both grooves. Also, this behavior can be successfully predicted by modeling the gap flow as a Couette flow in a two-dimensional channel. Meanwhile, a more detailed analysis of the flow kinetic energy close to the stagnation point using Bernoulli’s principle is carried out to provide a better understanding of the pressure coefficient variation with angular velocity in the non-rotating groove. A comparison of pressure coefficients obtained numerically with those calculated by considering the compression effects revealed that the comparison effects are dominating in the pulp flow within the groove. Validerad;2023;Nivå 2;2023-05-29 (joosat);Licens fulltext: CC BY License

Objective Little is known to what extent access to specialist palliative care (SPC) for cancer patients dying with coronavirus disease-2019 (COVID-19) affects the occurrence of breakthrough symptoms, symptom relief, and overall care, compared to hospital deaths. Our aim was to include patients with both COVID-19 and cancer and compare those dying in hospitals with those dying in SPC with reference to the quality of end-of-life care. Methods Patients with both cancer and COVID-19 who died in hospitals ( n = 430) and within SPC ( n = 384) were identified from the Swedish Register of Palliative Care. The hospital and SPC groups were compared regarding the quality of end-of-life care, including the occurrence of 6 breakthrough symptoms during the last week in life, symptom relief, end-of-life care decisions, information, support, and human presence at death. Results Breakthrough of breathlessness was more common in the hospital patients compared to the SPC patients (61% and 39%, respectively; p Conclusion More systematic palliative care routines may be an important factor for better symptom control and higher quality of end-of-life care in hospitals.

At the multigate sluice structure on a fluvial river, undesired sediment deposition affects the normal operation of the reservoir in question. Physical and numerical models are hybridized to help explore flow and sedimentation patterns. Field and laboratory investigations show that the deposition is attributable to the formation of large recirculation zones at low and medium discharges. As a potential countermeasure, an array of guide vanes is recommended to cope with the concern. Their attack angle with the flow is a dominant parameter that needs to be evaluated. Tests in the fixed-bed model demonstrate that the vanes bend the reservoir flow towards the sluice and suppress the circulation zones along both banks. The favorable range of attack angle is 15–20°. With the examination of sedimentation of both bed and suspended loads, the numerical modeling indicates that the sediment-removal efficiency increases with an increase in attack angle. By weighing the flushing efficiency and the risk of local scouring at the vanes, the 15° vane layout is recommended. This study is expected to provide a reference for guide-vane design in similar situations.

Objective: To compare symptom prevalence and relief in residents who died in nursing homes with residents who were acutely referred to hospitals. Design: Data on symptoms during the last week of life from the Swedish Register of Palliative Care (SRPC). Setting and Subjects: Nursing homes (n = 1903 deaths) and hospitals in Sweden (n = 202 nursing home residents who were admitted to hospital before death). Data were retrieved on August 24, 2020. Results: Residents who died in hospitals had more breakthrough symptoms of breathlessness (60% vs. 31%, p < 0.0001) and delirium (41% vs. 25%, p < 0.0001) than those who died in nursing homes. When symptoms were present, complete symptom relief was seen less often in hospitals compared with nursing homes (breathlessness, 28% vs. 47%, p < 0.001; delirium, 10% vs. 35%, p < 0.0001; respiratory secretions, 30% vs. 55%, p < 0.0001). Conclusion: Despite access to oxygen and pharmacologic/nonpharmacologic therapies in hospitals, symptom relief in dying nursing home residents acutely admitted to hospitals was lower compared with those who died in nursing homes, possibly because of differences in patient characteristics.

The effects of periodicity assumptions on the macroscopic properties of packed porous beds are evaluated using a cascaded Lattice-Boltzmann method model. The porous bed is modelled as cubic and staggered packings of mono-radii circular obstructions where the bed porosity is varied by altering the circle radii. The results for the macroscopic properties are validated using previously published results. For unsteady flows, it is found that one unit cell is not enough to represent all structures of the fluid flow which substantially impacts the permeability and dispersive properties of the porous bed. In the steady region, a single unit cell is shown to accurately represent the fluid flow across all cases studied

In recent years, wall-bounded cross-flow heat exchangers have gained significant attention for battery cooling applications. Due to similarities in geometry, these systems are often evaluated based on the heat and flow knowledge of free cross-flow heat exchangers. To determine the reliability of this assumption, this study performs a numerical comparison of the thermo-fluid behavior of wall-bounded and free cross-flow heat exchangers. Both heat exchangers have similar dimensions, with transverse and longitudinal pitch ratios of 2.074 and 1.037, respectively, and are investigated at a Reynolds number of 40000 using the Unsteady Reynolds-Averaged Navier–Stokes (URANS) method. It is observed that the transition model provides the most accurate predictions of the flow field when compared to available experimental data. The results suggest that for wall-bounded heat exchangers with an aspect ratio of 2 or larger, the flow behavior in the central flow region resembles that of a free heat exchanger, but with varying magnitudes due to the increase in velocity in the core region to counterbalance the reduction near the walls. The area-averaged mean Nusselt number from 2D and 3D models for free heat exchangers shows no significant difference compared to wall-bounded heat exchangers. However, there are considerable differences in the local Nusselt number distributions in the angular and spanwise directions. Overall, it is determined that certain conditions must be satisfied to ensure that applying the thermo-fluid characteristics of a free cross-flow heat exchanger to wall-bounded cross-flow heat exchangers in battery thermal management systems is accurate. Validerad;2023;Nivå 2;2023-03-20 (joosat);Licens fulltext: CC BY LicenseThis article has previously appeared as a manuscript in a thesis.

Large eddy simulations of turbulent flow and passive scalar transport in a channel partially filled with an array of spherical particles, mimicking a layer of deposited material over a surface, are carried out to investigate the effect of turbulence mixing on the passive scalar transfer rate from the channel wall. It is observed that large turbulence structures generated at the permeable layer-fluid interface penetrate into the porous media and enhance the scalar transport from the channel wall. The small gap between the layer of particles and the wall also induces a channeling effect that implies turbulence mixing and high velocity near the wall resulting in an enhancement in scalar transport from the channel wall. The influence from the distance between the particles in one layer, particle diameter and the gap thickness on the passive scalar transport is also investigated. It is found that the highest Stanton number is derived for the largest distance between particles since this facilitates the motion of the large turbulent structures into the porous layer. Such motions will affect the scalar transport from the channel wall into the bulk. The channeling effect is observed to be the most important parameter when the particle diameter and the gap thickness are varied, and the highest Stanton number is achieved for the cases with the most effective channeling effect.

Background Recent data propose a diagnostic and prognostic capacity for citrullinated histone H3 (H3Cit), a marker of neutrophil extracellular traps (NETs), in pathologic conditions such as cancer and thrombosis. However, current research is hampered by lack of standardized assays. Objectives We aimed to develop an assay to reliably quantify nucleosomal H3Cit in human plasma. Methods We assessed the common practice of in vitro enzymatically modified histone H3 as calibration standards and the specificity of available intrapeptidyl citrulline antibodies. Based on our findings, we developed and validated a novel assay to quantify nucleosomal H3Cit in human plasma. Results We show that enzymatically citrullinated H3 proteins are compromised by high enzyme-dependent lot variability as well as instability in plasma. We furthermore demonstrate that the majority of commercially available antibodies against intrapeptidyl citrulline display poor specificity for their reported target when tested against a panel of semi-synthetic nucleosomes containing distinct histone H3 citrullinations. Finally, we present a novel assay utilizing highly specific monoclonal antibodies and semi-synthetic nucleosomes containing citrulline in place of arginine at histone H3, arginine residues 2, 8, and 17 (H3R2,8,17Cit) as calibration standards. Rigorous validation of this assay shows its capacity to accurately and reliably quantify nucleosomal H3Cit levels in human plasma with clear elevations in cancer patients compared to healthy individuals. Conclusions Our novel approach using defined nucleosome controls enables reliable quantification of H3Cit in human plasma. This assay will be broadly applicable to study the role of histone citrullination in disease and its utility as a biomarker.

A diffluence‐confluence unit is an elementary component within a river system and presents a complex yet linked pattern of both flow and sediment transport in between. This study deals, by means of ...

Background Hospitalisation of patients with advanced dementia is generally regarded as less preferable compared to care at home or in a nursing home. For patients with other diagnoses, young age has been associated with better end-of-life care. However, studies comparing the quality of palliative care for persons with advanced dementia in hospitals and nursing homes are scarce. The aim of this study was to investigate whether quality of end-of-life care for patients with dementia depends on age, gender and place of death. Methods The Swedish Register of Palliative Care (SRPC) was used to identify patients who died from dementia in hospitals or nursing homes during a three-year period. The likelihood of death occurring at a hospital, based on age and gender differences, was calculated. Associations between 13 end-of-life care quality indicators collected from the SRPC and age, gender and place of care were examined in a logistic regression model. Results Death at a hospital was associated with poorer quality of end-of-life care for 10 of the 13 measured outcomes when compared to death at a nursing home, and with better quality according to two of the outcomes. Death at a hospital was more common for men compared to women and for younger patients compared to older. Receiving fluids intravenously or via enteral tube in the last 24 h of life was strongly associated with death at a hospital. Women were more likely to have their oral health assessed and less likely to have pressure ulcers at death. Eight of 12 end-of-life care outcomes showed better results for the age group 65 to 84 years compared to those 85 years or older. Conclusions Death in hospitals was associated with poorer quality of end-of-life care compared to death in nursing homes. Our data support the importance of advance care planning and individual assessments in nursing homes to avoid referral to hospitals during end of life. Despite established recommendations to avoid hospitalisation if possible, there were strong associations between younger age, male gender and hospitalisation in the end of life. Further studies are needed to investigate the role of socioeconomic factors in end-of-life care for this patient group.

Purpose The primary aim of the study was to develop and investigate a patient interactive digital support (an app) for patients on adjuvant endocrine breast cancer treatment. Patient’s interactive digital applications are a fast-growing area for research and development. In general, patients want more information and support with regard to their diagnosis, treatment and self-care. At the same time, the health care system has limited resources for follow-up. Our primary endpoints were usability of the app and if it added any value to the patients. Methods We designed and constructed a prototype, in dialogue with patients, containing four main modules for registration of drug compliance, performed physical exercise, self-care activities, and questions on health and quality of life. The app was then tested by patients and improved further before we completed a pilot study in which 15 patients used the app for 3 months. Results Patients perceived the app easy to use with a very high median system usability score of 88.8, range 30–100. The 15 women registered in total 4251 times, range 118 to 372. The majority of registrations concerned compliance (adherence to treatment) and physical exercise. Conclusion The app was perceived easy to use and of support in every-day life of breast cancer survivors. How to best integrate electronically collected patient reported outcome measures in clinical routine needs to be further studied, and future research will show if it will be cost-effective in terms of better health outcome and less resource use.

The flow within an industrial scroll-inlet high-efficiency cyclone separator has been studied using RSM and LES simulations. Of particular interest is the effect of the gas outlet configuration, i.e. outlet scroll and radial bend, on the flow pattern, pressure drop and cyclone efficiency. A surprising phenomenon is that the inner vortex splits into two vortices for the cyclone with a conventional outlet pipe while if the cyclone is equipped with an outlet scroll or radial bend there is no split. The outlet scroll and radial bend increase the pressure losses by 5.1% and 6.4%, respectively. These installations, moreover, significantly destabilize the pressure losses and the amplitude of instantaneous pressure drop oscillations increases from 0.65% to 16.2% and 33.96%, respectively. The investigated outlet scroll and radial bend have practically no effects on the cyclone efficiency since the flow in the main separation zone is not affected by the gas outlet configuration.

The aim of the present paper is to evaluate and compare the pore level hydrodynamic dispersion and effects of turbulence during flow in porous media. In order to compute these quantities, large eddy simulations of turbulent flow in five unit cells comprised of spherical particles are performed and the results are averaged over the cells. Visualizations of vortical structures reveal that the size of the turbulence structures is of the size of the pores. Investigations furthermore yield that volume-averaged values of the hydrodynamic dispersion are of the same order as the Reynolds stress within the pores. It is also shown that the effect of intra-pore turbulence and hydrodynamic dispersion on the redistribution of macroscopic momentum within the porous medium is negligible compared to Forchheimer term. A discussion is provided on the accuracy of the eddy viscosity hypothesis in the modeling of the volume-averaged intra-pore Reynolds stresses. Finally, the effect of variation in the pore-scale geometry on the turbulence structures and averaged values of hydrodynamic dispersion and Reynolds stress is investigated.

Recent studies have demonstrated a role of neutrophils in both venous and arterial thrombosis. A key prothrombotic feature of neutrophils is their ability to release web-like structures composed of DNA filaments coated with histones and granule proteins referred to as neutrophil extracellular traps (NETs). NETs were discovered over a decade ago as part of our first line of host defense against invading microorganisms. Although NETs have a protective role against pathogens, recent data suggest that an uncontrolled and excessive NET formation within the vasculature may contribute to pathological thrombotic disorders. In vitro studies suggest that NETs promote vessel occlusion by providing a scaffold for platelets, red blood cells, extracellular vesicles, and procoagulant molecules, such as von Willebrand factor and tissue factor. In addition, NET components enhance coagulation by both activating the intrinsic pathway and degrading an inhibitor of the extrinsic pathway (tissue factor pathway inhibitor). NET formation has, therefore, been proposed to contribute to thrombus formation and propagation in arterial, venous, and cancer-associated thrombosis. This review will describe animal and human studies suggesting a role of NETs in the pathogenesis of various thrombotic disorders. Targeting NETs may be a novel approach to reduce thrombosis without affecting hemostasis.

The association between venous thromboembolism (VTE) and occult cancer is well established. However, the benefit of cancer screening in all VTE patients remains controversial. The Registro Informatizado Enfermedad TromboEmbólica (RIETE) score is a recently proposed risk score to identify VTE patients at high risk of occult cancer. We evaluated the performance of the RIETE score in a routine clinical setting comprising patients presenting with VTE between January 1 and December 31, 2014, at Danderyd University hospital. Out of 488 VTE patients, 47 (9.6%) patients received a new cancer diagnosis during a 24-month follow-up. After exclusion of patients with cancer diagnosed at baseline (≤ 10 days after VTE, n = 16), 472 patients were considered eligible for cancer screening. Among these 472 patients, 31 (6.6%) received a cancer diagnosis during follow-up. The cumulative incidence was high after both unprovoked (8.5%) and provoked (4.8%) VTE. The RIETE score was evaluated in 467 of these patients. Interestingly, a high RIETE score was not significantly associated with cancer diagnosis during follow-up (OR 1.78; 95% CI 0.85–3.63), which was mainly due to a poor performance in women (OR 1.04; 95% CI 0.30–2.83). In summary, we observed a relatively high incidence of occult cancer in both unprovoked and provoked VTE. The RIETE score performed poorly in identifying patients at high risk of occult cancer in our VTE population. Additional risk assessment models are warranted to identify VTE patients who would benefit from extensive cancer screening. Electronic supplementary material The online version of this article (10.1007/s11239-019-01822-z) contains supplementary material, which is available to authorized users.

The impoundment of the Three Gorges Dam on the Yangtze River begins in 2003 and a full pool level is first attained in 2010. This process leads to reciprocal adjustments in flow discharge, sediment transport and morphology downstream of the dam. Based on 26-year recorded hydrologic data 1990–2015 and surveyed bathymetries 1998, 2010 and 2015, this study elucidates, before and after the commissioning of the dam, the alterations along the 500-km reach of the river. Two-dimensional numerical simulations are performed to predict future morphological changes by 2025. The analyses demonstrate that the impoundment modulates the seasonal flow discharges and traps an appreciable amount of sediment, resulting in enhanced erosion potential and coarsening of sediment. On a multi-year basis, the maximum discharge varies by a factor of 1.3 and the corresponding suspended load concentration and transport rate differ by a factor of 3.0 and 3.8, respectively. Combinations of surveyed and simulated bathymetries reveal its morphological responses to the changes. A general pattern of erosion is observed along the reach. In its upper 120 km, the process slows down towards 2025. In the middle 200 km, the erosion shifts, following the gradual impounding, to slight deposition, which then shifts back to erosion around September 2018. In the final 180 km, erosion continues without any sign of de-escalation, which is presumedly ascribed to tidal actions. The reach has not yet achieved a hydro-morphological equilibrium; the riverbed down-cutting is supposed to continue for a while. The combination of the field and numerical investigations provides, with the elapse of time, insight into the morpho-dynamics in the 500 km river reach. Validerad;2021;Nivå 2;2021-07-08 (alebob);Finansiär: Chinese Scholarship Council (CSC); Swedish STandUP for Energy project; Erasmus Programme

Abstract The 3D flow-fields in a staggered and cubic arrangement of mono-radii cylinders are investigated using tomographic-PIV. The cylinder Reynolds-number is in the range of $$\approx 10$$ ≈ 10 to $$\approx 800$$ ≈ 800 giving an almost complete overview of the transition region. Two pore-scale effects are discovered. The first, visible in the cubic packing, is a spatially alternating lateral velocity field, which has a significant impact on the pressure drop and transversal dispersion. The second effect, present in the staggered array, is an example of a disturbance propagation effect that takes place in the laminar steady region; this manifests as a peculiar and complex flow-pattern. In accordance with other studies, it is shown that Darcy’s law can, from an engineering point of view be valid far beyond the limit for Stokesian flow. Graphic abstract

Background At the time of the first wave of the COVID-19 pandemic in Sweden, little was known about how effective our regular end-of-life care strategies would be for patients dying from COVID-19 in hospitals. The aim of the study was to describe and evaluate end-of-life care for patients dying from COVID-19 in hospitals in Sweden up until up until 12 November 2020. Methods Data were collected from the Swedish Register of Palliative Care. Hospital deaths during 2020 for patients with COVID-19 were included and compared to a reference cohort of hospital patients who died during 2019. Logistic regression was used to compare the groups and to control for impact of sex, age and a diagnosis of dementia. Results The COVID-19 group (1476 individuals) had a lower proportion of women and was older compared to the reference cohort (13,158 individuals), 81.8 versus 80.6 years (p p p p = .021), pain (p = .025) and respiratory secretions (p = .037) was more often achieved in the COVID-19 group. In the COVID-19 group, 57% had someone present at the time of death compared to 77% in the reference cohort (p Conclusions The standard medical strategies for symptom relief and end-of-life care in hospitals seemed to be acceptable. Symptoms in COVID-19 deaths in hospitals were relieved as much as or even to a higher degree than in hospitals in 2019. Importantly, though, as a result of closing the hospitals to relatives and visitors, patients dying from COVID-19 more frequently died alone, and healthcare providers were not able to substitute for absent relatives.

Background Coronavirus disease 2019 (COVID-19), is a disease with diverse presentation. Several studies have shown different occurrence of symptoms for women and men, but no studies have been found examining sex differences in clinical presentation for nursing home residents dying from COVID-19. The objective of this study was to describe sex and age differences and the impact of a dementia diagnosis on symptom occurrence during the last week in life for persons dying from COVID-19 in nursing homes. Methods This is a population-based retrospective study based on data from the Swedish Register of Palliative Care. A total of 1994 residents aged 65 or older who died from COVID-19 in nursing homes were identified. The impact of sex, age and a dementia diagnosis on six different symptoms was analysed using chi2-test and multivariate logistic regression. Results Residents dying from COVID-19 were more often men (p p p Conclusions We found sex differences in symptom presentation for fatal COVID-19 in nursing home settings which remained after adjusting for age. Residents with a dementia diagnosis had fewer symptoms reported before death compared to those without dementia. Clinical presentation of fatal COVID-19 differs between women and men in nursing homes. Residents with fatal COVID-19 present with more unspecific and less prominent symptoms when also suffering from dementia.

We present numerical simulations of post-Darcy flow in thin porous medium: one consisting of staggered arrangements of circular cylinders and one random distribution of cylinders bounded between walls. The simulations span a range of Reynolds numbers, 40 to 4000, where the pressure drop varies nonlinearly with the average velocity, covering nonlinear laminar flow to the fully turbulent regime. The results are compared to those obtained by replacing the bounding walls with symmetric boundaries with the aim to reveal the effect of bounding walls on microscopic characteristics and macroscopic measures, i.e., pressure drop, hydrodynamic dispersion and Reynolds stresses. We use large eddy simulation to directly calculate the Reynolds stresses and turbulent intensity. The simulations show that vortical structures emerge at the boundary between the cylinders and the bounding walls causing a difference between the microscopic flow in the confined and non-confined porous media. This affects the averaged values of pressure drop, the hydrodynamic dispersion and the Reynolds stresses. Finally, the distance between the bounding walls is altered with the particle Reynolds number kept constant. It is observed that the difference between results calculated in confined and non-confined cases increases when the bounding walls are narrower.

Context: Although the coronavirus disease 2019 (COVID-19) pandemic might affect important clinical routines, few studies have focused on the maintenance of good quality in end-of-life care. Objectives: The objective was to examine whether adherence to clinical routines for good end-of-life care differed for deaths because of COVID-19 compared with a reference cohort from 2019 and whether they differed between nursing homes and hospitals. Methods: Data about five items reflecting clinical routines for persons who died an expected death from COVID-19 during the first three months of the pandemic (March-May 2020) were collected from the Swedish Register of Palliative Care. The items were compared between the COVID-19 group and the reference cohort and between the nursing home and hospital COVID-19 deaths. Results: About 1316 expected deaths were identified in nursing homes and 685 in hospitals. Four of the five items differed for total COVID-19 group compared with the reference cohort: fewer were examined by a physician during the last days before death, pain and oral health were less likely to be assessed, and fewer had a specialized palliative care team consultation (P < 0.0001, respectively). Assessment of symptoms other than pain did not differ significantly. The five items differed between the nursing homes and hospitals in the COVID-19 group, most notably regarding the proportion of persons examined by a physician during the last days (nursing homes: 18%; hospitals: 100%). Conclusion: This national register study shows that several clinical routines for end-of-life care did not meet the usual standards during the first three months of the COVID-19 pandemic in Sweden. Higher preparedness for and monitoring of end-of-life care quality should be integrated into future pandemic plans.

The swelling effect in hydrogel bodies or sponge-like porous bodies (SPB) used in a specific stormwater storage concept of the down-flow type is considered. A macroscopic swelling model is proposed, in which water is assumed to penetrate into the hydrogel by diffusion described by diffusion equations together with a free-moving boundary separating the interface between the water and hydrogel. Such a type of problem belongs to the certain class of problems called Stefan-problems. The main objective of this contribution is to compare how the theoretical total amount of absorbed water is modified by the inclusion of swelling, when compared to the previously studied SPB devices analyzed only for the effect of diffusion. The results can be summarized in terms of the geometrical dimensions of the storage device and the magnitude of the diffusion coefficient D. The geometrical variables influence both the maximum possible absorbed volume and the time to reach that volume. The diffusion coefficient D only influences the rate of volume growth and the time to reach the maximum volume of stored water. The initial swelling of the hydrogel SPB grows with time (Dt) until the steady state is reached and the swelling rate approaches zero. In all the cases considered, the swelling in general increases the maximum possible absorbed water volume by an amount of 14%.

Predicting survival accurately in patients with advanced cancer is important in guiding interventions and planning future care. Objective tools are therefore needed. Blood biomarkers are appealing due to their rapid measurement and objective nature. Thrombosis is a common complication in cancer. Recent data indicate that tumor-induced neutrophil extracellular traps (NETs) are pro-thrombotic. We therefore performed a comprehensive investigation of circulating markers of neutrophil activation, NET formation, coagulation and fibrinolysis in 106 patients with terminal cancer. We found that neutrophil activation and NET markers were prognostic in terminal cancer patients. Interestingly, markers of coagulation and fibrinolysis did not have a prognostic value in this patient group, and there were weak or no correlations between these markers and markers of neutrophil activation and NETs. This suggest that NETs are linked to a poor prognosis through pathways independent of coagulation. Additional studies are needed to determine the utility of circulating neutrophil activation and NET markers, alone or in concert with established clinical parameters, as objective and reliable prognostic tools in advanced cancer.

Background: Increasing numbers of people dying from COVID-19 are reported, but data are lacking on the way they die. Objective: To study symptoms and symptom relief during the last week of life, comparing nursing homes with hospitals. Design: The Swedish Register of Palliative Care with national coverage was used. Breakthrough symptoms were registered as Yes/No. Symptom relief was recorded on a 3-grade scale as complete-partial-no relief. All deaths in COVID-19 were contrasted to deaths in a reference population (deaths 2019). Deaths at nursing homes were compared with deaths in hospitals. Setting and Subjects: All deaths in hospitals or nursing homes (n = 490) were analyzed. Deaths in other settings (specialized palliative care wards [n = 11], in palliative home care [n = 2], or in their own homes [n = 8]) were excluded (n = 21). Only patients with expected deaths (n = 390) were entered in the final analysis. Results: Breathlessness as a breakthrough symptom was more common in COVID-19 patients than in the 2019 reference population (p < 0.001) and relief of breathlessness, as well as anxiety, delirium, and death rattles was less successful in COVID-19 patients (p < 0.05 to p < 0.01 in different comparisons). Patients were older in nursing homes than in hospitals (86.6 years vs. 80.9 years, p < 0.001) and more often female (48% vs. 34%, p < 0.001). Breakthrough of breathlessness was much more frequently reported in hospital settings than in nursing homes, 73% versus 35% (p < 0.0001), and complete relief was more rarely possible in hospitals, 20% versus 42% (p < 0.01). The proportion of partial relief+complete relief was comparable, 92% versus 95% (ns). Also, anxiety and pain were more often completely relieved in nursing homes (p < 0.01 in both comparisons). Conclusion: The lower symptom prevalence in nursing homes may be explained by elderly frail residents dying already in the first phase of the COVID-19 disease, before acute respiratory distress syndrome develops.

An innovative concept of dynamic stormwater storage in sponge-like porous bodies (SPBs) is presented and modelled using first principles, for down-flow and up-flow variants of SPBs. The rate of inflow driven by absorption and/or capillary action into various porous material structures was computed as a function of time and found to be critically dependent on the type of structure and the porous material used. In a case study, the rates of inflow and storage filling were modelled for various conditions and found to match, or exceed, the rates of rainwater inflow and volume accumulation associated with two types of Swedish rainfalls, of 60-min duration and a return period of 10 years. Hence, the mathematical models indicated that the SPB devices studied could capture relevant amounts of water. The theoretical study also showed that the SPB concepts could be further optimized. Such findings confirmed the potential of dynamic SPB storage to control stormwater runoff and serve as one of numerous elements contributing to restoration of pre-urban hydrology in urban catchments. Finally, the issues to be considered in bringing this theoretical concept to a higher Technological Readiness Level were discussed briefly, including operational challenges. However, it should be noted that a proper analysis of such issues requires a separate study building on the current presentation of theoretical concepts.

The study of evaporation and freezing of droplets is important in, e.g., spray cooling, surface coating, ink-jet printing, and when dealing with icing on wind turbines, airplane wings, and roads. Due to the complex nature of the flow within droplets, a wide range of temperatures, from freezing temperatures to heating temperatures, have to be taken into account in order to increase the understanding of the flow behavior. This study aimed to reveal if natural convection and/or Marangoni convection influence the flow in freezing and evaporating droplets. Droplets were released on cold and warm surfaces using similar experimental techniques and setups, and the internal flow within freezing and evaporating water droplets were then investigated and compared to one another using Particle Image Velocimetry. It was shown that, for both freezing and evaporating droplets, a shift in flow direction occurs early in the processes. For the freezing droplets, this effect could be traced to the Marangoni convection, but this could not be concluded for the evaporating droplets. For both evaporating and freezing droplets, after the shift in flow direction, natural convection dominates the flow. In the end of the freezing process, conduction seems to be the only contributing factor for the flow.

A review of the numerical modeling of the compression molding of the sheet molding compound (SMC) is presented. The focus of this review is the practical difficulties of modeling cases with high fiber content, an area in which there is relatively little documented work. In these cases, the prediction of the flows become intricate due to several reasons, mainly the complex rheology of the compound and large temperature gradients, but also the orientation of fibers and the micromechanics of the interactions between the fluid and the fibers play major roles. The details of this during moldings are discussed. Special attention is given to the impact on viscosity from the high fiber volume fraction, and the various models for this. One additional area of interest is the modeling of the fiber orientation.