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( Lluís Mundet ),( Laia Rofes ),( Omar Ortega ),( Christopher Cabib ),( Pere Clavé ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2021 Journal of Neurogastroenterology and Motility (JNM Vol.27 No.1
Background/Aims Fecal incontinence (FI) is a prevalent condition among community-dwelling women, and has a major impact on quality of life (QoL). Research on treatments commonly used in clinical practice―Kegel exercises, biofeedback, electrostimulation, and transcutaneous neuromodulation―give discordant results and some lack methodological rigor, making scientific evidence weak. The aim is to assess the clinical efficacy of these 4 treatments on community-dwelling women with FI and their impact on severity, QoL and anorectal physiology. Methods A randomized controlled trial was conducted on 150 females with FI assessed with anorectal manometry and endoanal ultrasonography, and pudendal nerve terminal motor latency, anal/rectal sensory-evoked-potentials, clinical severity, and QoL were determined. Patients were randomly assigned to one of the following groups: Kegel (control), biofeedback + Kegel, electrostimulation + Kegel, and neuromodulation + Kegel, treated for 3 months and re-evaluated, then followed up after 6 months. Results Mean age was 61.09 ± 12.17. Severity of FI and QoL was significantly improved in a similar way after all treatments. The effect on physiology was treatment-specific: Kegel and electrostimulation + Kegel, increased resting pressure (P < 0.05). Squeeze pressures strongly augmented with biofeedback + Kegel, electrostimulation + Kegel and neuromodulation + Kegel (P < 0.01). Endurance of squeeze increased in biofeedback + Kegel and electrostimulation + Kegel (P < 0.01). Rectal perception threshold was reduced in the biofeedback + Kegel, electrostimulation + Kegel, and neuromodulation + Kegel (P < 0.05); anal sensory-evoked-potentials latency shortened in patients with electrostimulation + Kegel (P < 0.05). Conclusions The treatments for FI assessed have a strong and similar efficacy on severity and QoL but affect specific pathophysiological mechanisms. This therapeutic specificity can help to develop more efficient multimodal algorithm treatments for FI based on pathophysiological phenotypes. (J Neurogastroenterol Motil 2021;27:108-118)
Lluís Mundet,Christopher Cabib,Omar Ortega,Laia Rofes,Noemí Tomsen,Sergio Marin,Carla Chacón,Pere Clavé 대한소화기 기능성질환∙운동학회 2019 Journal of Neurogastroenterology and Motility (JNM Vol.25 No.3
Background/AimsFecal incontinence (FI) is a prevalent condition among women. While biomechanical motor components have been thoroughlyresearched, anorectal sensory aspects are less known. We studied the pathophysiology of FI in community-dwelling women,specifically, the conduction through efferent/afferent neural pathways. MethodsA cross-sectional study was conducted on 175 women with FI and 19 healthy volunteers. The functional/structural study includedanorectal manometry/endoanal ultrasound. Neurophysiological studies including pudendal nerve terminal motor latency (PNTML) andsensory-evoked-potentials to anal/rectal stimulation (ASEP/RSEP) were conducted on all healthy volunteers and on 2 subgroups of 42and 38 patients, respectively. ResultsThe main conditions associated with FI were childbirth (79.00%) and coloproctological surgery (37.10%). Cleveland score was 11.39± 4.09. Anorectal manometry showed external anal sphincter and internal anal sphincter insufficiency in 82.85% and 44.00%,respectively. Sensitivity to rectal distension was impaired in 27.42%. Endoanal ultrasound showed tears in external anal sphincter(60.57%) and internal anal sphincter disruptions (34.80%). Abnormal anorectal sensory conduction was evidenced through ASEPand RSEP in 63.16% and 50.00% of patients, respectively, alongside reduced activation of brain cortex to anorectal stimulation. Incontrast, PNTML was delayed in only 33.30%. Stools were loose/very loose in 56.70% of patients. ConclusionsPathophysiology of FI in women is mainly associated with mechanical sphincter dysfunctions related to either muscle damage or, to alesser extent, impaired efferent conduction at pudendal nerves. Impaired conduction through afferent anorectal pathways is also veryprevalent in women with FI and may play an important role as a pathophysiological factor and as a potential therapeutic target.
Incorporation of spatial autocorrelation improves soil–landform modeling at A and B horizons
Kim, Daehyun,Š,amonil, Pavel,Jeong, Gwanyong,Tejnecký,, Vá,clav,Drá,bek, Ondř,ej,Hruš,ka, Jakub,Park, Soo Jin Catena Verlag 2019 Catena Vol.183 No.-
<P><B>Abstract</B></P> <P>Research has shown that the performance of soil–landform models would improve if the effects of spatial autocorrelation were properly accounted for; however, it remains elusive whether the level of improvement would be predictable, based on the degree of spatial autocorrelation in the model variables. We evaluated this problem using 11 soil variables acquired from the A and B horizons along a hillslope of Žofínský Prales in the Czech Republic. The results showed that, with no exception, there were increases in R<SUP>2</SUP> and decreases in the Akaike information criterion (AIC), residual autocorrelation, and root-mean-square errors (RMSEs), after incorporating the spatial filters extracted by spatial eigenvector mapping into non-spatial regression models. Furthermore, the improvement of the model was positively proportional to the degree of spatial autocorrelation, inherent in the soil variables. That is, there were strikingly linear and significant relationships, in which strongly autocorrelated soil variables (i.e., having a high Moran's <I>I</I> value) exhibited greater increases in R<SUP>2</SUP> and decreases in AIC, residual autocorrelation, and RMSEs than their more weakly autocorrelated counterparts. These findings indicate that the degree of spatial autocorrelation present in soil properties can serve as a direct indicator for how much the performance of a traditional non-spatial soil–landform model would be enhanced, by explicitly taking into consideration the presence of spatial autocorrelation. More generally, our results potentially imply that the need for and benefit from incorporating spatial effects in geopedological modeling proportionally increases as the soil property of interest is more spatially structured (i.e., landform variables alone cannot capture soil spatial variability).</P> <P><B>Highlights</B></P> <P> <UL> <LI> Soil spatial variability was modeled using landform variables in a temperate forest. </LI> <LI> In this regression, we included spatial filters as additional independent variables. </LI> <LI> This inclusion improved the performance of the original non-spatial approach. </LI> <LI> Spatial autocorrelation of soil variables predicted the degree of such improvement. </LI> </UL> </P>
One-step microwave synthesis of magnetic biochars with sorption properties
Anton Zubrik,Marek Matik,Michal Lová,s,Katarí,na Š,tefuš,ová,Zuzana Danková,Slavomí,r Hredzá,k,Miroslava Vá,claví,ková,Františ,ek Bendek,Jaroslav Brian& 한국탄소학회 2018 Carbon Letters Vol.26 No.-
Adsorption is one of the best methods for wastewater purification. The fact that water quality is continuously decreasing requires the development of novel, effective and cost available adsorbents. Herein, a simple procedure for the preparation of a magnetic adsorbent from agricultural waste biomass and ferrofluid has been introduced. Specifically, ferrofluid mixed with wheat straw was directly pyrolyzed either by microwave irradiation (900 W, 30 min) or by conventional heating (550°C, 90 min). Magnetic biochars were characterized by X-ray powder diffraction, Mössbauer spectroscopy, textural analysis and tested as adsorbents of As(V) oxyanion and cationic methylene blue, respectively. Results showed that microwave pyrolysis produced char with high adsorption capacity of As(V) (Qm= 25.6 mg g–1 at pH 4), whereas conventional pyrolysis was not so effective. In comparison to conventional pyrolysis, one-step microwave pyrolysis produced a material with expressive microporosity, having a nine times higher value of specific surface area as well as total pore volume. We assumed that sorption properties are also caused by several iron-bearing composites identified by Mössbauer spectroscopy ([super] paramagnetic Fe2O3, α-Fe, non-stoichiometric Fe3C, γ-Fe2O3, γ-Fe) transformed from nano-maghemite presented in the ferrofluid. Methylene blue was also more easily removed by magnetic biochar prepared by microwaves (Qm=144.9 mg g–1 at pH 10.9) compared to using conventional techniques.
Reliability and risk treatment centered maintenance
Martin Pexa,Tomáš Hladík,Zdeněk Aleš,Václav Legát,Vít Havlů,Miroslav Müller,Petr Valášek 대한기계학회 2014 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.28 No.10
We propose a new methodology for application of well-known tools – RCM, RBI and SIFpro – with the aim to treat risks by means ofsuitable maintenance. The basis of the new methodology is the complex application of all three methods at the same time and not separatelyas is typical today. The proposed methodology suggests having just one managing team for reliability and risk treatment centredmaintenance (RRTCM), employing existing RCM, RBI, and SIFpro tools concurrently. This approach allows for significant reduction ofengineering activities’ duration. In the proposed methodology these activities are staged into five phases and structured to eliminate allduplication resulting from separate application of the three tools. The newly proposed methodology saves 45% to 50% of the engineeringworkload and adequate significant financial savings.