HIGH FLOW NASAL OXYGEN- ALL YOU SHOULD KNOW

Respiratory support is applied to maintain adequate oxygenation and ventilation and hence supplemental oxygenation is the first line of treatment for hypoxemic respiratory failure. There are multiple conventional oxygen support devices. However, in majority of these, oxygen provided is not humidified and maximum flow rate is 15l/min. However, high flow nasal oxygen (HFNO) is an alternative to conventional oxygen therapy. It is a technique that delivers heated and humidified oxygen with a controlled fraction of inspired oxygen(FiO2) at a maximum flow rate of 60L/min via (1) a specialized nasal cannula

Trigonal-Sparing vs. Trigonal-Involved OnabotulinumtoxinA Injection for the Treatment of Overactive Bladder: A Systematic Review and Meta-Analysis

Objective: Overactive bladder (OAB) is a disease characterized by the presence of urinary urgency. We carried out a meta-analysis to assess the effectiveness and safety of trigonal-involved injection of onabotulinumtoxinA (BoNT-A) in comparison with the trigonal-sparing technique in cases with OAB [neurogenic detrusor overactivity (NDO) and idiopathic detrusor overactivity (IDO)].Methods: Randomized controlled trials (RCTs) of BoNT-A injection for OAB were searched systematically by using EMBASE, MEDLINE, and the Cochrane Controlled Trials Register. The datum was calculated by RevMan version 5.3.0. The original references of relating articles were also reviewed.Results: In total, six RCTs involving 437 patients were included in our analysis. For OAB, the trigone-including group showed a different patient symptom score (p = 0.03), complete dryness rate (p = 0.002), frequency of incontinence episodes (p = 0.01), detrusor pressure at maximum flow rate (p = 0.01), and volume at the first desire to void (p = 0.0004) compared with the trigone-sparing group. Also, a trigone-including intradetrusor injection demonstrated a significant improvement in the patient symptom score (p = 0.0004), complete dryness rate (p = 0.0002), frequency of incontinence episodes (p = 0.0003), detrusor pressure at maximum flow rate (p = 0.01), and volume at the first desire to void (p = 0.00006) compared with the trigone-sparing group for treatment of NDO. The adverse events rates were similar in both groups.Conclusions: The meta-analysis has demonstrated that trigone-including BoNT-A injection was more effective compared with the trigone-sparing injection for the treatment of OAB, especially for NDO.

Urodynamic Values Role For Females With Different Types Of Urinary Incontinence

Aim — The aim of this study was to analyse how conventional urodynamic values differ between females with specific types of urinary incontinence (UI). Material and Methods — Cross-sectional study enrolled 666 females with UI. Based on patient history and questionnaires they were divided into three groups: stress (SUI), mixed (MixUI) and urgency (UUI). Physical investigation and urodynamics were performed. The continuous factors: age and urodynamic data were evaluated using Multinomial regression and ANOVA test using SUI, MixUI, UUI as outcome groups. Results — Analysing urodynamic parameters significant difference between at least two groups was shown by the cystometric capacity and maximum flow rate: both highest in the SUI group; residual urine, opening detrusor pressure, maximum urethral closure pressure at rest, functional urethral length at rest: all highest in the UUI group. Mainly all urodynamic data showed significant difference between SUI/UUI, and MixUI/UUI groups, while difference between SUI/MixUI were not significant. Conclusions — Most of urodynamic data for MixUI group patients do not differ from SUI group. UDS parameters like: maximum flow rate, residual urine, opening detrusor pressure, maximum urethral closure pressure at rest, functional urethral length at rest can help to distinguish SUI and MixUI groups from UUI group.

The characters exploration of a piezoelectric pump with fishtail-shaped bluffbody

This paper focuses on a new structure in the valveless piezoelectric pump, which has a combination structure of the conical flow channel and two fishtail-shaped bluffbodies in the chamber of the pump. The fishtail-shaped bluffbody is inspired by the shape of the swimming fish to diminish the backflow and optimize the performance of the pump. The performance is studied by changing the shape and size of the inlet and outlet, the bluff bodies’ height and the space between two bluff bodies. The results show that the 3 mm × 3 mm square inlet, 3 mm diameter round outlet, 3 mm height of bluffbodies, 6.8 mm pitch of bluffbodies has a best performance in all 10 prototypes, which implements a maximum flow rate of 87.5 ml/min at 170 V 40 Hz with a noise of 42.6 dB. This study makes a preliminary investigation and theoretical explanation for the subsequent optimization of this structure, improved the performance of the valveless piezoelectric pump, broaden the thinking of the design for the bluffbody for better performance of the valveless piezoelectric pump.

A procedure to forecast and manage water resources and to redistribute runoff water flow when passing floods

Economic losses from floods have become catastrophic due to the increase in the number and scale of their propagation. Existing procedures for passing floods and pre-preparing reservoirs for flood water acceptance are ineffective and need to be improved. Therefore, the task to devise a methodology that would eliminate these shortcomings was urgent. This paper has proposed a procedure for calculating the passage of floods based on the forecasts of water inflow, taking into consideration the characteristics of the flood wave and the mode of reservoir filling, which makes it possible to bring down (reduce) the maximum flow rate through a waterworks by accumulating floodwaters in the reservoir. The software package Mike 11 (Danish Institute, Denmark) was employed to build a hydrodynamic model of floodwater movement along the examined river section from a hydrological station to a waterworks, which makes it possible to determine the levels of water and the flow rate in a reservoir at any time in the form of free surface curves when passing floods of various range. Based on the devised methodology, recommendations have been compiled for the forced discharges of water through hydroelectric turbines (in m3/s) when passing floods of various probabilities (which is especially important for floods whose probability is 0.01 %). The constructed hydrodynamic model of floodwater movement through a reservoir has allowed the verification of the devised procedure. The procedure was devised in order to effectively pass floodwaters and bring down the maximum flow rate through a waterworks. The introduction of the methodology for calculating the passage of floods could make it possible to avoid idle water discharge through the water drains of waterworks to the lower pool and provide for the most efficient utilization of floodwater resources

Lichen sclerosis–induced long segment anterior urethral stricture: The early outcome of one-stage repair using dorsolateral onlay buccal mucosa graft

Background: Substitution urethroplasty using buccal mucosal grafts can be performed by several approaches including ventral onlay graft, dorsal onlay graft, or ventral urethrotomy with dorsal inlay graft. Our study aims to evaluate the surgical outcome of dorsolateral buccal mucosal graft for long segment anterior urethral stricture >6 cm in patients with Lichen sclerosus (LS). Methods: A retrospective study included patients who underwent repair for long segment anterior urethral stricture >6 cm due to LS between January 2013 and April 2019. All patients were followed-up at 3, 6, 9, and 12 months postoperatively and then yearly by clinical symptoms, uroflowmetry, and calculation of post-void residual urine volume. Retrograde urethrogram was requested for patients with voiding symptoms or decreased maximum flow rate. Stricture recurrence that required subsequent urethrotomy or urethroplasty was considered failure. The success rate and surgical complications were collected and analyzed. Results: Thirty patients were identified. The median age (range) was 39 (25–61) years and a median (range) stricture length was 8 (6–14) cm. Most of postoperative complications were of minor degree. The success rate at median follow-up of 15 (12–24) months was 86.5%. The median maximum flow rate increased significantly from 6 (2–11) ml/s preoperatively to 18 (range: 6–23) ml/s at the 6th month ( p value < 0.001). Conclusion: Dorsolateral buccal mucosal grafts urethroplasty for long anterior urethral stricture caused by LS has a high success rate and low risk of complications including stricture recurrence.

Production Data Analysis of Hydraulically Fractured Horizontal Wells from Different Shale Formations

A comprehensive overview and analysis of the productivity of 1216 recently abandoned multi-stage hydraulically fractured horizontal wells from five shale formations in the United States (US) is presented in this study. In this study, two decline curve analysis (DCA) methods were used to match actual production history data using least-squares fitting to find the best fit production parameters to reliably forecast production. The production history matching conducted resulted in very accurate matches (correlation coefficient of 0.99) between actual production data and the two DCA methods (Arps hyperbolic decline and stretched exponential production decline (SEPD) models). Using the outcomes from production history matching, universal averages of decline parameters for Arps hyperbolic decline and SEPD models were developed for each of the five formations. Furthermore, hindcasting was performed by matching a portion of the known production history and comparing the remaining portion of the known production history to the forecast. The Arps hyperbolic decline and SEPD methods were used to match production using only limited early production data (three months, six months, one year and two years). The main goals for fitting the DCA model to early production data was to estimate the optimum decline parameters that are then used to forecast production and estimate ultimate recovery. Production history matching using limited early production periods produced accurate production forecasts using as few as six months of production history (correlation coefficients between 0.85 and 0.94 using Arps hyperbolic decline). The main outcome of this study was a production analysis conducted on the production data of more than 1000 wells from five different shale formations to present the expected production behaviors of similar wells. Different production key performance indicators (KPIs) such as average well life, cumulative production volumes at different periods, average drop in production rate within the first year of production, average time to reach maximum flow rate, and the maximum flow rate were measured on all the wells from the five formations to provide an overview of the production performance of each formation.