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We investigate the effect of temperature on the thermal magnetic noise signal of magnetic nanoparticle (MNP) systems as models for non-interacting macrospins. An analytical expression for the amplitude of the fluctuations in a magnetic field is derived for the Brownian and the Néel fluctuation mechanisms and compared with numerical results at different temperatures. To experimentally validate our findings, magnetic noise spectra of two commercially available polydisperse MNP systems (Ferucarbotran and Perimag) were measured at different, biomedically relevant temperatures. A distinctive effect of temperature on the power spectral noise densities is measurable already for 5 K temperature differences and, within the bandwidth of the experiment, higher noise amplitudes are found for lower temperatures. However, a crossing of the spectra at higher frequencies is revealed in simulations so that the total fluctuation amplitude is conserved. These findings contribute to a profound understanding of temperature influences on MNP fluctuation and relaxation mechanisms.

Nocturia is frequent among older patients and has been linked to cardiovascular diseases. The aim of this study was to assess the time relationship between the onset of nocturia and coronary heart disease (CHD). Specifically, this study investigated whether nocturia can be identified as a red flag de novo symptom in patients with CHD.This cross-sectional study consisted of patients with CHD-related cardiac complaints who were prospectively recruited from November 2019 till March 2020 at the cardiac catheterization laboratory of the Ghent University Hospital. An analysis was performed to determine the time relationship between nocturia and CHD and to describe the nocturia characteristics.Forty-five patients with nocturia and established CHD were included. Of these patients, 74% (31/42) developed nocturia before their cardiac symptoms occurred, with a median time gap of 57 months (IQR 19-101). Furthermore, 64% (29/45) of them had clinically significant nocturia (≥2 nocturnal voids) and there was a significant correlation between age at which nocturia and cardiac symptoms occurred (r=0.89, p0.001).This is the first study that analysed the time relationship between onset of nocturia and onset of cardiac complaints in patients with CHD. In most of the patients, nocturia had started before they were diagnosed with CHD, meaning that nocturia might precede the development of cardiac symptoms, such as angina and shortness of breath. Keeping this in mind, de novo nocturia may or even should be considered as a red flag for CHD.(cross sectional study with prospectively recruitement) Source: https://www.ciap.health.nsw.gov.au/training/ebp-learning-modules/module1/grading-levels-of-evidence.html.

OBJECTIVE: This study aimed to describe the characteristics of nocturia in older hospitalised patients and to explore knowledge, beliefs, and experiences associated with night toileting while in hospital in order to identify unmet care needs. METHODS: A multisite mixed methods cross-sectional study of older hospitalised adults who were admitted for ≥ 2 days was conducted using a standardized researcher-administered questionnaire. An additional cohort 16 older hospitalised adults with nocturia > twice per night were interviewed to understand the experience and impact of nocturia during hospitalisation. RESULTS: Nocturia was experienced by 260 out of 308 participants. In-hospital nocturia was significantly correlated with nocturia in the month preceding admission, high diurnal voiding frequency and nocturnal urinary urgency. Bother was attributed to multiple nocturia episodes. Participants had poor knowledge and understanding of nocturia and believed the symptom to be a normal occurrence; only 20% had discussed management with staff. Disrupted sleep and fear of falling were common in older immobile participants with nocturia. CONCLUSION: Nocturia is highly prevalent in hospitalised older people. Toileting multiple times at night bothers patients, disrupts sleep, heightens a fear of falling yet is rarely addressed in ward management plans. A screening process to identify, assess, provide education and intervene for nocturia has the potential to improve wellbeing, safety at night and to address risk factors.

This review highlights the current views on and differences and similarities between nocturnal enuresis (NE) in children and nocturia in adults, which might be a guidance to elucidate the missing links in our knowledge. In both conditions, a genetic factor is suspected. Reduced bladder capacity and nocturnal polyuria are the main underlying lower urinary tract-related conditions. There is a link with sleep disorders, although it is not clear whether this is a cause or consequence. Physical and mental health are comprised in both conditions, however, in different ways. In NE, constipation and attention deficit disorder are the most important comorbidities and the effect on mental health and quality of life is mainly through the negative impact on self-esteem. In nocturia, cardiovascular disease and fall injuries are important comorbidities, mainly affecting the older nocturia population; personal distress and depression are consequences of the related poor sleep quality. For both conditions, treatment is often inadequate and a more individualized approach seems to be necessary. The main difference between NE and nocturia seems to be the difference in arousal to bladder stimuli, suggesting that sleep characteristics might be a key factor in these conditions.

The first published studies concerning heat transfer between flowing gas-solid suspensions (pneumatic conveying) and pipe walls appeared in the literature in the early 1960s. More recently, experimental investigations have been extended to circulating fluidized beds. Despite the relatively large number of studies undertaken, mostly in CFB-risers of limited dimensions, the variation of the CFB heat transfer coefficient with operating gas velocity and solids' loading could not be predicted accurately. In his review paper [1], Grace summarized the situation as follows: “no existing correlations give consistent agreement with the available data.” The situation in a circulating fluidized bed is indeed a complex one, with a core/annulus flow and clusters of particulates being formed, leading to a non-uniform distribution of the solids over the cross-sectional area of the riser. Existing correlations largely ignore these flow characteristics. Experimental investigations using a FCC catalyst were carried out in a...

Whereas the PCDD/F-abatement in MSWIs is mostly achieved through entrained-phase adsorption upon activated carbon, the other thermal processes are more bending towards fixed/moving bed adsorption or catalytic destruction. The treatment of entrained-phase adsorption has been previously dealt with. The present paper focuses upon fixed/moving bed adsorption as abatement alternative. The characteristics of granular carbonaceous adsorbents are reviewed and commented upon, and stress some advantages of the fixed/moving bed operation. The equilibrium adsorption characteristics are expressed in terms of the number of active sites of the adsorbent and its saturation capacity. The breakthrough calculations for a fixed/moving bed adsorber are based upon these adsorption characteristics and expressed in terms of the relevant operating parameters of the flue gases to be treated. Although detailed literature data on these adsorbers are scarce, application of the design equations predicts meaningful results, thus demonstrating the predictive capacity of the design method.

Under certain operating conditions, polychlorinated dioxins and furans occur in the flue gases of thermal processing plants. Current EU Directives limit the concentration of these emissions to less than 0.1 ng toxicity equivalents (TEQ) per standard cubic metre of dry gas at 11 vol% O 2 . These Directives have been included in the emission regulations of most of the EU countries. Dioxins and furans are not particular to incinerators; they can also originate from metallurgical and other thermal processes when these are operated under unfavourable conditions. Adsorption methods employing non-flammable carbonaceous adsorbents (activated carbon, lignite) are particularly well suited for removing PCDD/Fs. For adsorption, which requires the sorbent to be brought in contact with the gas to be cleaned, various processes are currently available, ie classical adsorption in moving/fixed bed filters or the technique of adsorption in an entrained dust cloud with a downstream fabric filter or electrostatic precipitator to remove the spent sorbent from the waste gas (entrained process). The paper will firstly assess both adsorption concepts; it will then use results obtained from operational tests in incineration plants for municipal and industrial waste to describe the efficiency of the dioxin-sorption in an entrained bed (pneumatic transport of pulverized adsorbent) and a fixed/moving bed (granular adsorbent). Variations in the dosing rate and the use of different adsorbents, as well as the operating temperature, identify the selection criteria for determining the process-engineering optimum for flue gas cleaning. The paper will demonstrate that the PCDD/F emissions can be reduced to below 0.1 ng TEQ Nm -3 and will identify the operating conditions required to achieve this standard.

Incinerators emit chlorinated hydrocarbons, such as polychlorinated benzenes (PCBz) and phenols (PCPh), polychlorinated biphenyls (PCB) and polychlorinated dibenzodioxins and furans (PCDD/F), as very dilute streams. High temperatures (>1000°C) are required in traditional oxidizers. From an energy-saving perspective and to avoid de novo synthesis of PCDD/F, exhaust gas clean-up must be performed at low temperatures (250-350°C). Catalytic combustion can be applied in this temperature range and different reactor layouts are used (eg monoliths, honeycomb). The present investigation uses a novel catalyst-coated sintered metal fleece. Thin metal fibers are sintered (nonwoven) to fleece of various thickness, structure and porosity. V-Ti-W catalysts are examined. The paper will briefly review the catalyst coating method suitable to provide a structured fleece reactor with adequate characteristics. Experiments were carried out in the temperature range of 260-340°C with various hydrocarbons injected in a carrier air stream. The experimental investigations demonstrated: (1) that the conversion of the hydrocarbons (volatile organic compounds, VOC) is independent of the oxygen concentration, corresponding to a zero-order dependence of the reaction rate; (2) that the conversion of the hydrocarbons is a first-order reaction in the VOC; (3) that the oxidation of the VOC proceeds to a greater extent with increasing temperature, with chlorine substitution enhancing the reactivity, and (4) that the reaction rate constant follows an Arrhenius-dependence with activation energies between 37.3 and 58.4 kJ/mol. An assessment of the results leads to a model expression with kinetic reaction control. This model can be used in a scale-up strategy.

We want to report on a first case reported of a 50-year-old female with repetitive and clinical significant hypertension after each injection of onabotulinumtoxinA. This is a retrospective chart review and prospective evaluation of the natriuresis and blood pressure at baseline and after injection therapy. The aim was to explore the mechanism of action of this apparent onabotulinumtoxinA related hypertension.Retrospectively hypertension appeared after 7 days and vanished after 4-5 months following injection of 300 units of onabotulinumtoxinA in the detrusor, bladder symptoms disappeared after 2 weeks and reoccurred after 5 months. Urological, nephrological, cardiological and endocrinological evaluations were normal.In the prospective evaluation a 3-day bladder diary at baseline revealed a bladder capacity of 131 ± 57 ml and at 1 month when full effect was experienced 173 ± 50 ml. At 1 month there were no leakages with six episodes of intermittent catheterization per day. The 24-hour blood pressure registration demonstrated the onset of hypertension at day 7 together with a reversal of the urinary sodium/creatinine ratios on the renal function profile.The increasing natriuresis coinciding with the hypertension is a normal compensatory mechanism suggesting that the hypertension has a central cause rather than it is caused by haematogenous spreading.

The aim of this longitudinal study was to evaluate tubular proteinuria in rats with unilateral (UPO) and bilateral (BPO) partial ureteral obstruction with the dimercaptosuccinic acid (DMSA) scan as the gold standard for measuring renal tubular damage. We studied 70 female Wistar rats: 28 animals with UPO, 28 animals with BPO, 7 sham-operated animals, and 7 controls. All animals with obstructed ureters showed renal dilatation on the diethylenetriaminepentaacetic acid DTPA images 1 and 5 weeks postoperatively. One week following UPO and BPO, tubular proteinuria and urinary N-acetyl-beta-d-glucosaminidase (NAG) activity increased (P < 0.01) and the absolute DMSA uptake decreased (P < 0.01). Persistently (week 6) high tubular proteinuria was found in 29% of the animals and was related to severe damage on the DMSA scan (P < 0.01) and to albuminuria (P < 0.05). Renal tubular damage was demonstrated by measuring renal enzymes, tubular proteins, and DMSA uptake after UPO and BPO. Persistent elevated tubular proteinuria was related to severely damaged kidneys.

Urinary tubular proteinuria and N-acetyl-β-d-glucosaminidase (NAG) activity has not yet been studied after unilateral total ureteral obstruction (UTO). The aim of the study was (1) to evaluate in a longitudinal study (7 weeks) the behaviour and the potential clinical value of tubular proteinuria and urinary NAG activity after UTO; (2) to study the physiopathology of the non-obstructed contralateral kidney by using these two different markers of tubular damage. Methods: in 28 female, adult Wistar rats (UTO: n= 16, sham: n= 12), tubular proteinuria and urinary NAG activity were measured before and 1 and 5 weeks after surgery. Results: a significant (P < 0.01) increase in tubular proteinuria/creatinine ratio and urinary creatinine and a decrease in urinary NAG activity was found 1 week after UTO. All parameters normalized after 6 weeks. Albuminuria increased progressively (P < 0.01) during the study. Conclusion: tubular proteinuria increases during the first week following UTO in rats. The initial increase of low molecular weight proteins following UTO is not due to tubular damage as no parallel increase of urinary NAG was found. We suggest an initial tubular overperfusion with primary urine, due to an increased single nephron glomerular filtration and overruling the reabsorption capacity of the proximal tubules.

Objectives: In the absence of specific symptomatology in children and neurogenic bladder disease patients, the early diagnosis of acute pyelonephritis is a challenge. The aim of the

Objectives To determine which patients with voiding dysfunction might be suitable for treatment with neuromodulation, using urodynamics to obtain an objective measure of improvement and to illustrate the effect of neuromodulation on voiding dysfunction. Patients and methods Patients were selected for implantation of a neuroprosthesis using a urodynamic evaluation before and during subchronic stimulation; 27 such patients (four men and 23 women, mean age 33 years, sd 15) were evaluated. Results Of the 27 patients, the 17 who responded well to neuromodulation all had hypocontractile detrusors and sphincter hypertonicity; sphincter relaxation during micturition was impaired. The urodynamic evaluation showed that these patients were not obstructed. Of 10 patients with spastic pelvic floor syndrome, nine responded well to the treatment. Those not responding to neuromodulation had mainly acontractile detrusors. Conclusion The ideal candidates for neuromodulation are those patients with a spastic pelvic floor syndrome or with a hypocontractile detrusor, in combination with sphincter instability, and impaired sphincter relaxation. An increase of bladder contractility, enhancement of sphincter relaxation and decrease in bladder capacity and residual urine are the most important features of the response.

In the rehabilitation of severely brain-injured patients, solving urinary incontinence poses a therapeutic challenge. From this study it appears that incontinence does not always result from impaired neuropsychological functioning. If habituation procedures fail, an underlying organic cause (usually detrusor hyperactivity with synergic sphincter action) for persistent urinary incontinence can be demonstrated in a large number of patients. In patients with a severe pelvic fracture a pudendal nerve lesion must be ruled out.

Les premiers essais d’injections d’une pâte compressive autour de l’uretre dans l’incontinence d’effort remontent a plus de 70 ans. Toutefois, a ce jour, la substance ideale n’a pas encore ete trouvee. Les etudes sur les injections periuretrales ont ete conduites essentiellement chez la femme. Les resultats a court terme sont bons dans l’incontinence d’effort moderee, mais se degradent rapidement avec le temps. La bonne indication est le traitement de l’incontinence urinaire d’effort moderee dans un contexte de comorbidite importante. Les echecs sont observes dans l’incontinence non liee a l’effort et dans les incontinences d’effort majeures. Les complications sont fonction de la substance injectee. Elles sont le plus souvent mineures. L’injection de cellules souches (myoblastes) dans le sphincter uretral constitue un traitement prometteur dans l’incontinence urinaire d’effort, mais cela demande confirmation.

Wij rapporteren de eerste ervaringen in Nederland met betrekking tot de effectiviteit en de veiligheid van de ‘self-anchoring’ adjustable transobturator male sling (ATOMS) voor de behandeling van stress urine-incontinentie (SUI) bij mannen, ontstaan na operatie aan en/of bestraling van de prostaat.

Il differenziamento sessuale e la fertilita maschili sono il risultato di una sequenza di segnali che comprende fattori cellulari, genetici ed endocrini. Le manifestazioni cliniche delle anomalie dello sviluppo sessuale maschile sono l’ipogonadismo, l’inversione sessuale e lo stato intersessuale. Esse possono essere dovute ad anomalie nella determinazione e nella differenziazione delle gonadi, a disturbi della regolazione ipotalamo-ipofisi-gonadi e della biosintesi degli ormoni steroidei, a sindromi da insensibilita agli ormoni e ad anomalie delle vie di escrezione. Dopo l’esame clinico, e necessaria una valutazione endocrinologica per distinguere l’ipogonadismo ipergonadotropo dall’insufficienza gonadica primaria e l’ipogonadismo ipogonadotropo dai disturbi pituitari e ipotalamici. La valutazione genetica comprende l’analisi dei cromosomi e, per un numero crescente di anomalie, oggi e possibile uno screening grazie alla genetica molecolare. In molti casi, in particolare in quelli di inversione sessuale e di stato intersessuale, e necessario un approccio interdisciplinare della diagnosi e del trattamento.

The syndrome of idiopathic overactive bladder (I-OAB) impairs quality of life for the affected individuals. Conservative treatment options such as antimuscarinics are not always effective, and resulting side effects can lead the patient to stop treatment. In recently years, minimally invasive and reversible sacral neuromodulation and botulinum toxin A have become available. Currently, the approved treatment option for I-OAB that is recommended by the International Consultation on Incontinence is sacral neuromodulation by InterStim therapy. This article gives an overview of the present clinical evidence on the effectiveness and reliability of these two treatment modalities as well as the current significance of sacral neuromodulation and botulinum toxin A for the second-line treatment of adult I-OAB.

The overactive bladder syndrome (OAB) negatively affects the daily life of many people worldwide and conservative treatments, such as antimuscarinics, not always bring relief and/or are associated with considerable side effects resulting in treatment failure. Second line treatment options used to be invasive surgical procedures. However, less radical, minimally invasive and reversible alternatives, such as sacral neuromodulation and botulinum toxin A have emerged. Of these, only sacral neuromodulation with InterStim Therapy has been approved for OAB and been recommended by the International Consultation on Incontinence (ICI) in 2004. Nevertheless, depending of country rules and habits, both seem to be used by urologists in clinical practice for treating idiopathic OAB (I OAB). Therefore, this review attempts to provide an update on the available clinical evidence concerning the efficacy and safety, and the current position of sacral neuromodulation and botulinum toxin A in the second line management of adults with I OAB.

To evaluate the conduit-related complications and their treatment in Mitrofanoff continent urinary diversion and antegrade colonic enema (ACE) procedures.The files of 53 patients (18 men and 35 women) in whom 58 continent stomas were created were retrospectively reviewed. Gender, age, age at the time of surgery, underlying disease, concomitant surgery, abdominal position of the stoma, follow-up, complications and treatment were assessed. The mean (sd) age at the time of surgery was 19 (13) years; 30 patients were aged15 years and the mean follow-up was 2.8 (1.9) years. Fifty-three continent vesicostomy-type Mitrofanoff stomas were constructed and five ACE procedures performed. Forty-five stomas were in the umbilicus and 13 on the abdominal wall. For 45 conduits the appendix was used; in the other 13 a transverse tubularized ileal segment according to Monti was created.There were stoma-related complications in 19 patients (36%), with 27 in all and stomal stenosis accounting for more than half. Five patients had urinary leakage. The median time to the first complication was 9 months. Multiple regression analysis showed that gender and stoma location were the only significant determinants of the complication/follow-up ratio. Women had more complications than men and umbilical stomas fared worse than those on the abdominal wall. Age, underlying disease and type of stoma were not significantly related to the complication/follow-up ratio. The complication was treated by one procedure in 13 patients; four needed two and two needed three surgical revisions. Most complications were relatively easy to treat, i.e. dilatation in five, endoscopic incision in one, re-anastomosis in four, Y-V plasty in seven, a new channel in two, reimplantation in three, a bladder cuff in two for stomal leakage, and abdominoplasty in two. Only one stoma had to be abandoned.The complication rate for continent small-diameter stoma is high. However, most complications are relatively easy to treat. Despite these complications, patient satisfaction remains high.

The paper assesses extensive data of PCDD/F measurements on flue gas emissions from thermal processes, including, e.g. municipal solid waste incinerators (MSWIs), combustors of wood and industrial waste, coal fired powerplants and boilers, ferro and non-ferro processes. Numerous investigators have conducted laboratory experiments to assess the formation mechanisms of PCDD/F. The results, obtained from fixed-bed experiments, have been critically evaluated and indicate that de novo synthesis is the dominant mechanism in actual thermal processes where conditions that favour the precursor formation are not experienced. The analysis of PCDD/F profiles from the large scale thermal processes in general, and MSWIs in particular, supports the dominant role of the de novo synthesis, irrespective of the type of thermal process considered. The PCDF/PCDD ratio exceeds 1 and the degree of chlorination points towards the dominant presence of HpCDD and OCDD within the dioxin group, and of PeCDF, HxCDF and HpCDF within the furan group. Since real-time measurement of PCDD/F is impossible, the correlation of PCDD/F emissions with operating parameters and/or emission levels of other more easily measured pollutants could be a tool in predicting the PCDD/F formation levels. Data of Flemish MSWIs were used to statistically assess such correlations. From an evaluation of the data at a given operating temperature, misleading conclusions can be drawn. Only the effect of temperature is evident. After converting all data at a reference temperature of, e.g. 230 degrees C, PCDD/F concentrations achieve nearly constant values, irrespective of the values of other parameters, thus stressing that the major controlling parameter for the PCDD/F emission is the temperature of the ESP. The PCDD/F concentrations increase with temperature in the range up to 280 degrees C. The ESP temperature should be kept preferably between 180 degrees C and 200 degrees C, where de novo synthesis is reduced and where PCDD/Fs are increasingly adsorbed on the fly ash, in line with the standard temperature dependence of adsorption isotherms.

Neuromodulation has been used to treat voiding dysfunction in adults. Due to its invasiveness it has rarely been used in children until now with the availability of transcutaneous neurostimulation. We evaluated clinical effects of transcutaneous neuromodulation on detrusor overactivity in children with the urge syndrome.Between May 1, 1998 and February 28, 1999, 15 girls (mean age 10.2 years) and 26 boys (mean age 10.7 years) with proved detrusor hyperactivity on videourodynamic study underwent neuromodulation. All children had been given anticholinergic therapy previously. Neurostimulation only was used in children in whom anticholinergics had no effect and those who had significant side effects. Anticholinergics were continued in children in whom they had a partial effect. Stimulation of 2 Hz. was applied for 2 hours every day. Surface electrodes were placed at the level of sacral root S3. After 1 month of trial stimulation those children who responded continued the treatment for 6 months, and were evaluated every 2 months.Of the 41 children 15 boys and 13 girls responded after 1 month of trial therapy with an increase in bladder capacity, decrease in urgency, decrease in incontinence and/or better sensitivity. Of the 13 children who did not respond 9 lacked motivation and 4 had no clinical effect despite motivation. After 6 months of therapy a significant increase in bladder capacity, decrease in voiding frequency and decrease in incontinence periods were noted. Adverse effects were not observed. One year after therapy relapse was noted in 7 patients, leaving 21 of 41 children definitively cured.Although preliminary, our results indicate that transcutaneous neuromodulation can improve symptoms of detrusor overactivity, as response to stimulation was noted in 76% of our patients and 56% were cured after 1 year. This therapeutic option is attractive for children because of its noninvasiveness and absence of adverse effects.

Voiding dysfunction is defined as impaired bladder emptying, and presents with a mixture of lower urinary tract symptoms. Dysfunctional voiding is a condition in which there is a lack of coordination between the sphincter and detrusor during emptying in a patient without overt uropathy or neuropathy. Assessment of voiding dysfunction is important in women and girls in the prevention and treatment of urinary incontinence, retention, urinary tract infection and subsequent kidney damage. Accurate diagnosis is essential in order to select the correct treatment. Screening can be done by history-taking: symptom scores can help to guide the screening. More objective measures are uroflowmetry, ultrasonography and video-urodynamics. The latter is the gold standard for the diagnosis of voiding dysfunction and consists of simultaneous registration of pressure in the bladder and rectum and external sphincter behavior, either by electromyographic recording of pelvic floor activity or by pressure recording at the external sphincter, during the whole bladder cycle of filling and emptying. On fluoroscopy the bladder can be visualized throughout the filling and emptying phase. In dysfunctional voiding, hypertonicity and instability of the external urethral sphincter during filling cystometry and impaired external sphincter relaxation during emptying are pathognomonic findings. Pressure-flow analysis reveals no obstruction and the detrusor contractility is low.

Electrovibration (100 Hertz, 6000 vibrations/min.) at the frenulum was used for diagnosis and treatment of idiopathic anejaculation and anorgasm in 7 men. In 3 others it was used to obtain semen for medically assisted fertilisation. It was used also with a disabled young woman to obtain orgasm. Ejaculation and orgasm are rapidly obtained in most cases.

This is a review article about the colposacropexy and the colpopromontoriopexy in the treatment of vaginal prolapse. We reviewed the literature through the eyes of a urologist dealing with genuine stress incontinence. The treatment of genuine stress incontinence without sphincterdeficiency consists in the correction of the anterior compartment prolapse. Preoperative it is important to examen the middle and the posterior compartment of the vagina in order to achieve good postoperative results. Most urologists cure genuine stress incontinence with an abdominal approach. The combination of a colposuspension and a colpopromontoriopexy is an operation that corrects anterior, middle and posterior compartment prolapse by the same approach without significant more complications or bloodloss.