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Background: Enteral feeding tubes, used in patients who require enteral nutrition or medication, require flushing between medications and feedings to maintain patency. Various types of water can be used to flush enteral feeding tubes, which raises the question of which type of water is best supported by evidence. Purpose: The aims of this quality improvement project were to examine the evidence on the use of tap water instead of sterile water for enteral tube flushes and to implement the use of tap water as a safe, cost-effective alternative to sterile water at a multisite oncology institution. Methods: A systematic literature search of electronic databases including Scopus, PubMed, CINAHL, Google Scholar, Embase, and JBI was conducted to review current evidence and professional organization recommendations on the use of sterile water versus tap water in enteral feeding tubes. The oncology institution's policies were reviewed, and nurses were surveyed on the type of water they used for enteral tube flushes. Results: After the literature search and nurse survey results concurred that tap water was as effective as sterile water, the institution's nursing practice policy was updated to state that tap water should be used for enteral tube flushes, and that the use of sterile water for this purpose should be reserved for cases when there are concerns about tap water safety. This policy change was projected to incur annual sterile water cost savings of $15,930 to $19,872. Conclusion: The implementation of a policy recommending the use of tap water for enteral tube flushes standardized clinical practice and decreased institutional costs while maintaining patient safety. After exploring the evidence for the use of tap water versus sterile water in enteral tube flushes, especially for immunocompromised and critically ill patients, this quality improvement project implemented the use of tap water as a safe, cost-effective alternative to sterile water at a multisite oncology institution. [ABSTRACT FROM AUTHOR]

Bio inspired textured surfaces are used in diversified engineering applications namely in tribology, biomedical, antifouling, anti-icing, micro fluidics, anti-bacterial surfaces, solar cells, etc. These textured surfaces are categorized as dimpled textured surfaces (negative) or pillared (positive) textured surfaces. Presently, laser machining is used to create dimpled textured surfaces. However very limited number of micro manufacturing process are available which can fabricate positive textured surface consisting of pillars of varying cross-sectional areas. Therefore, the primary objective of this work is to explore the reverse micro EDM process (R-MEDM) to fabricate pillared (positive) textured surface even on metallic surface. Earlier studies in R-MEDM had reported challenges involved in preparation of electrode used in the process. It is very difficult to machine thousands of micro-holes on plate which act as electrode in R-MEDM process. These holes will be replicated on work surface during processing. The work presented here addressed solutions to the challenges of preparation of electrodes and improves the process by using modified bubble assisted flushing method. Detail experimental investigation has been carried out in this work to evaluate the effect of process parameters on material removal rate, explore the use of low-cost sieves as electrodes followed by contact angle measurement on a fabricated textured surface. It is found that sieves are low-cost solution to successfully fabricate hydrophobic textured surface. Passing bubble enhances the debris flushing efficiency. Improvement of material removal rate by 20–25% and contact angle by 15–18% is realized using a bubble flushing method. The array of square rods of 200 µm side and 250 µm lengths were successfully fabricated on 6 mm bulk rod of brass with a good dimensional accuracy. [ABSTRACT FROM AUTHOR]

Globally, the health of coastal water bodies continues to be threatened by climate change and mounting anthropogenic pressures related to population increase and associated development. Land use changes have increased the direct runoff of freshwater, nutrients, and other contaminants from watersheds into coastal systems. Exacerbated by increased temperatures, these changes have contributed to a worldwide decline in seagrass coverage and losses of critical habitat and ecosystem functions. For restricted estuaries and lagoons, the influx of nutrients is particularly damaging due to high water residence times and impaired flushing. The result is eutrophication and associated declines in water quality and ecosystem function. To mitigate degraded water quality, engineered ocean–estuary exchanges have been carried out and studied with examples in Australia, New Zealand, India, Denmark, the Netherlands, Portugal, and the United States of America. Based on successes including decreased nutrient concentrations, turbidity, and chlorophyll and increased faunal abundance in some past studies, this option is considered as a management tool for combatting worsening water quality in other estuaries including the Indian River Lagoon, a subtropical, lagoon-type estuary on the central east coast of Florida, USA. Decreased residence times, lower nutrients, higher dissolved oxygen (DO), higher salinity, lower temperature, and lower turbidity all combine for improved ecosystem health. In this review, the successes and failures of past projects intended to increase ocean–estuary exchanges, including biological and geochemical processes that contributed to observed outcomes, are evaluated. The primary indicators of water quality considered in this review include nutrient contents (e.g., nitrogen and phosphorus) and dissolved oxygen levels. Secondary indicators include changes in temperature and salinity pre- and post- engineering as well as turbidity, which can also impact seagrass growth and overall ecosystem health. Each of the sites investigated recorded improvements in water quality, though some were more pronounced and occurred over shorter time scales. Overall, enhanced ocean exchange in restricted, impaired water bodies resulted in system-specific response trajectories, with many experiencing a net positive outcome with respect to water quality and ecosystem health. [ABSTRACT FROM AUTHOR]

New building construction is often counted as a source of indoor air pollution because of formaldehyde and volatile organic compounds (VOCs) emitted from new building materials, such as furnishings, wood, and finishings. The high levels of formaldehyde and VOCs in the early stage of new buildings could be linked to the negative health effects on occupants. The aim of this study is to examine the impacts of flush-out air flow rate and flush period in reducing formaldehyde and VOCs produced by building materials or furnishing of newly built residential buildings. Field measurements were conducted from September 2016 to August 2018 in nineteen newly built apartments to verify the effectiveness of the flush-out procedure. The field measurements showed that after the flush-out, the indoor concentrations of formaldehyde and VOCs in the newly built samples significantly decreased. The indoor concentrations of formaldehyde and TVOCs were reduced to about 61% and 41% of the initial concentration when the samples were flushed at 0.7ACH for nine days. The results of this study showed that the flush-out for a short term of below two weeks was more effective reducing the emission potential of VOCs than of formaldehyde. When the samples were flushed for more than seven days, the air change rates of the flushing did not significantly influence the reduction of indoor pollutants.

One of the primary ways utilities prevent and address water quality concerns in distribution systems is via regular hydrant flushing, yet rigorous research to evaluate the impact of full‐scale flushing programs is limited. This study employed time‐series and correlation analyses to evaluate the efficacy of a utility's five‐month repeated conventional flushing program to reduce nitrification and improve disinfectant residual concentrations in the distribution system. Short‐term water quality improvements during flushes were common across the 16 locations flushed, but lasting improvements were inconsistent as demonstrated by continued nitrification and heterogeneous water quality changes. Flushing frequencies and flow rates may need to be tailored to individual sites, even when similar water quality challenges exist. Water quality monitoring data and related analyses helped to prioritize flush sites, maximize efficiency during and between flushes, and inform decisions to implement additional interventions. [ABSTRACT FROM AUTHOR]

BACKGROUND: Clinically, the most dangerous and serious complication of artificial joint replacement is periprosthetic infections. It is urgent to find a way to prevent periprosthetic infections after artificial joint replacement. OBJECTIVE: To study the effect of povidone-iodine on muscle, blood vessel, fat and bone of rabbits after immersion and flushing. METHODS: Forty male New Zealand rabbits aged 10 weeks were selected. The left hind leg of each rabbit served as the experimental group and the right hind leg served as the control group. After anesthesia, the hind limbs of each rabbit were cut open to expose the muscle, blood vessels, fat and bone. The control group was soaked and flushed with normal saline inside the surgical incision, while the experimental group was soaked and flushed with povidone-iodine inside the surgical incision. After being soaked in povidone-iodine for 0, 1, 3, 5 minutes, 10 rabbits were randomly selected and executed to collect wound tissue samples. The samples were made into pathological slices for hematoxylin-eosin staining observation as well as statistical analysis and comparison of cell counts. RESULTS AND CONCLUSION: Compared with the control group, the muscle, blood vessels, fat and bone after immersion and flushing with povidone-iodine showed no obvious difference in cell structure, morphology and number under microscope. The paired t-test was used to explore the difference between the control and experimental groups, and the paired data did not show any difference (P > 0.05). It is suggested that povidone-iodine shows no significant difference from normal saline after immersion and flushing of rabbit tissues such as muscle, blood vessels, fat and bone, indicating that povidone-iodine solution as an intra-incisional antiseptic is safe and effective. [ABSTRACT FROM AUTHOR]

Flushing is a widely used method for cleaning water pipes, demanding the achievement of optimal flushing velocity for effectiveness. A prior examination of flushing condition including velocity, duration, and flow rate is crucial to minimize water and economic losses while maximizing the impact of flushing. Although simulation models are commonly employed for this purpose, they often overlook potential head loss during flow through hydrants or drain valves, compromising the effectiveness of flushing. This study investigated the impact of different simulation methods on estimating flushing conditions through hydrants and drain valves. The structural layout (minor loss coefficient) and specifications (emitter coefficient) of each flushing path were incorporated into traditional models. Applying this method to a hypothetical network and the water distribution system of G-City in Gyeonggi Province of South Korea, we compared the flushing effects of four different modeling approaches. Results reveal that drain valves tend to exhibit higher velocity than hydrants under the same conditions, mainly due to their structural layout. However, both drain valves and hydrants may experience overestimation of flow rate and velocity if the minor loss coefficient is disregarded. Practitioners should exercise caution regarding potential low flushing efficiencies. The limited numbers and locations of drain valves compared to hydrants constrain their field application, emphasizing the need for comprehensive consideration of various field conditions when developing a suitable flushing plan. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the effects of short-term feed supplementation of Lemuru fish oil on the reproductive performance of 20 primiparous Garut ewes. For this purpose, the effects of four diets were compared: a control diet (C) and three diets with various oil supplements. These diets were: 6% palm oil (P1), 3% palm oil with 3% Lemuru fish oil (P2), and 6% Lemuru fish oil (P3). Experimental ewes were subjected to estrous synchronization using two injections of PGF2α 11 days apart. The hormonal profiles and blood metabolites were monitored for animals of each group. Estrous expression was observed at mating, and embryo counts were recorded individually using trans-rectal ultrasonography 20 days after mating. Results showed that plasma concentrations of cholesterol were significantly (P<0.05) higher for P2 and P3 (44.90±10.51 and 49.81±14.37 mg/dL, respectively) than control and P1 groups. Similarly, blood estradiol concentrations were significantly higher for P3 than P1 and P2 groups before estrus, while during estrus P3 had higher blood estradiol than control group (P<0.05). All treatment diets significantly enhanced the onset of estrus in comparison with control animals (P<0.05), while receptivity was higher for P3 (21.80±2.86 times) than for control group (P<0.05). The proportion of ewes pregnant after the first estrus was the highest for P3 (100%) compared to all other diets. However, there was no effect of diets on the number of embryos. In conclusion, feed supplementation of Lemuru fish oil improves reproductive performance of ewes following natural mating by stimulating onset of estrus and increasing pregnancy rates, making Lemuru oil an attractive feed supplement. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate and analyze the effects of a flushing diet containing Docosahexaenoic acid (DHA) and Eicosapentaenoic acid (EPA) from Lemuru (Sardinella sp) fish oil on the reproductive performance parameters of Garut ewes. Forty (n = 40) primiparous Garut ewes aged 12–14 months with an average body weight of 28.92 ± 4.94 kg were assigned into four experimental treatment groups. The experimental diets contained roughage: concentrate (30:70%) designated as control concentrate (CNT), flushing concentrate with 6% palm oil (PO), flushing concentrate with 3% palm oil mixed with 3% lemuru oil as DHA and EPA sources (PFO), and flushing concentrate with the addition of 6% lemuru oil (FO). Treatment animals were fed two weeks before and after conception and parturition (8 weeks of total flushing treatment). The addition of fish oil at either 3% (PFO) or 6% (FO) resulted in significantly higher reproductive performance of ewes by increasing the litter size, as reflected by the birth of multiple kids (P < 0.05) compared to CNT and PO. Adding fish oil (PFO and FO) also maintains gestation, resulting in increased lamb yield, especially in the FO treatment, which yields the highest lamb yield (0% single lamb birth). The lamb male ratio was also higher with fish oil supplementation (PFO and PO) (P < 0.05). This research revealed a positive effect of 6% Lemuru oil on decreasing embryo loss and increasing the proportion of twin births. These findings thus support the hypothesis that ration flushing with double the required DHA and EPA from 6% Lemuru fish oil (FO) resulted in significantly higher reproductive performance in Garut sheep. [ABSTRACT FROM AUTHOR]

ABSTRACTRenowned for its leaf-spice attributes, kaffir lime has economic value that is worthy of intensifying amidst environmental threats, such as drought stress. This study aimed to analyze the morpho-physiological traits of kaffir lime in response to defoliation and drought stress. Kaffir lime was subjected to drought, defoliation, and a combination of both arranged in a randomised complete block design. Concerning morphology, defoliated lime produced a new flush that grows like a crown, while drought-treated plants displayed a bent pose with withered, edge-rolled, and drooping leaves. Higher leaf drop incidences were also noticed in drought-stressed plants. A combination of defoliation and drought stress produced severe flushing disruption by reducing 61% flush number, 77% flush fresh weight, and 74% flush dry weight, compared to undefoliated plants in normal irrigated conditions. Regardless of drought stress conditions, leaf production did not show significant differences among all defoliated plants. Defoliated plants maintained their photosynthetic rate and water use efficiency, leading to the absence of bent flush and rolling leaves as morphological markers of drought-treated plants. It is implied that defoliation can be a practical strategy for adapting kaffir lime in a drought environment.

The main objective of research work to investigates the effects of various process parameters on the material removal rate, kerf width, surface roughness and the dimensional accuracy of Inconel 718 workpiece subjected to wire electrical discharge machining (WEDM). The input parameters of this study were wire speed, wire tension and flushing rate. The individual as well as interacting effect of process parameters on surface roughness, kerf width and dimensional accuracy. It was found that, in order to minimize the diameter error for circular cuts, the flushing rate, wire speed and wire tension should all be held at maximum values. The wire tension and wire speed both exhibited an insignificant effect on the surface roughness. The dimensional accuracy of the machined holes decreased with increasing wire tension and in order to achieve maximum material removal rate, wire tension and wire speed must be around 1400–1600 gf and at 8 m/min respectively. The flushing rates over 5 L/min had a negligible effect on the material removal rate. The highest kerf width and material removal rate were obtained at medium values of wire tension (1400–1600 gf) and wire speed (8 m/min). The lowest diameter error is achieved in a combination of maximum flushing rate, wire speed and wire tension. Factors such as circularity, cylindricity and hole diameter were closely examined in order to gain a deeper understanding of their influence on dimensional accuracy. [ABSTRACT FROM AUTHOR]

Background: Niacin, an established therapeutic for dyslipidemia, is hindered by its propensity to induce significant cutaneous flushing when administered orally in its unmodified state, thereby constraining its clinical utility. Objective: This study aimed to fabricate, characterize, and assess the in-vitro and in-vivo effectiveness of niacin-loaded polymeric films (NLPFs) comprised of carboxymethyl tamarind seed polysaccharide. The primary objective was to mitigate the flushing-related side effects associated with oral niacin administration. Methods: NLPFs were synthesized using the solvent casting method and subsequently subjected to characterization, including assessments of tensile strength, moisture uptake, thickness, and folding endurance. Surface characteristics were analyzed using a surface profiler and scanning electron microscopy (SEM). Potential interactions between niacin and the polysaccharide core were investigated through X-ray diffraction experiments (XRD) and Fourier transform infrared spectroscopy (FTIR). The viscoelastic properties of the films were explored using a Rheometer. In-vitro assessments included drug release studies, swelling behavior assays, and antioxidant assays. In-vivo efficacy was evaluated through skin permeation assays, skin irritation assays, and histopathological analyses. Results: NLPFs exhibited a smooth texture with favorable tensile strength and moisture absorption capabilities. Niacin demonstrated interaction with the polysaccharide core, rendering the films amorphous. The films displayed slow and sustained drug release, exceptional antioxidant properties, optimal swelling behavior, and viscoelastic characteristics. Furthermore, the films exhibited biocompatibility and non-toxicity towards skin cells. Conclusion: NLPFs emerged as promising carrier systems for the therapeutic transdermal delivery of niacin, effectively mitigating its flushing-associated adverse effects. [ABSTRACT FROM AUTHOR]

Electrical discharge drilling of blind holes has been a challenging task due to the inherent difficulties in removing debris from the discharging gap. This paper investigates the working mechanism and effects of new stepped electrodes which are used in conjunction with injection flushing in drilling deep blind holes. A series of theoretical simulations and comparative experiments were conducted using cylindrical electrodes and two types of stepped electrodes. Pulse waveforms were captured to analyse the discharge status. Surface topography and machining quality were analysed using scanning electron microscope (SEM) images. The machining performance was evaluated by studying the material removal rate (MRR) and tool wear ratio (TWR). Experiment results show that internal flushing caused the debris to circulate in the machining zone and led to abnormal discharges, disrupting the formation of the plasma channel. The MRR was increased by 75% and 82% when using cylindrical electrodes with pressures of 120 psi and 40 psi, respectively. In contrast, the MRR with injection flushing was about 80% of that without injection flushing when using stepped electrodes. Regardless of the type of electrode, the application of injection flushing resulted in the increase in the maximum effective machining depth. [ABSTRACT FROM AUTHOR]

In contrast to "frank" pathogens, like Salmonella entrocolitica, Shigella dysenteriae, and Vibrio cholerae, that always have a probability of disease, "opportunistic" pathogens are organisms that cause an infectious disease in a host with a weakened immune system and rarely in a healthy host. Historically, drinking water treatment has focused on control of frank pathogens, particularly those from human or animal sources (like Giardia lamblia, Cryptosporidium parvum, or Hepatitis A virus), but in recent years outbreaks from drinking water have increasingly been due to opportunistic pathogens. Characteristics of opportunistic pathogens that make them problematic for water treatment include: (1) they are normally present in aquatic environments, (2) they grow in biofilms that protect the bacteria from disinfectants, and (3) under appropriate conditions in drinking water systems (e.g., warm water, stagnation, low disinfectant levels, etc.), these bacteria can amplify to levels that can pose a public health risk. The three most common opportunistic pathogens in drinking water systems are Legionella pneumophila, Mycobacterium avium, and Pseudomonas aeruginosa. This report focuses on these organisms to provide information on their public health risk, occurrence in drinking water systems, susceptibility to various disinfectants, and other operational practices (like flushing and cleaning of pipes and storage tanks). In addition, information is provided on a group of nine other opportunistic pathogens that are less commonly found in drinking water systems, including Aeromonas hydrophila, Klebsiella pneumoniae, Serratia marcescens, Burkholderia pseudomallei, Acinetobacter baumannii, Stenotrophomonas maltophilia, Arcobacter butzleri, and several free-living amoebae including Naegleria fowleri and species of Acanthamoeba. The public health risk for these microbes in drinking water is still unclear, but in most cases, efforts to manage Legionella, mycobacteria, and Pseudomonas risks will also be effective for these other opportunistic pathogens. The approach to managing opportunistic pathogens in drinking water supplies focuses on controlling the growth of these organisms. Many of these microbes are normal inhabitants in biofilms in water, so the attention is less on eliminating these organisms from entering the system and more on managing their occurrence and concentrations in the pipe network. With anticipated warming trends associated with climate change, the factors that drive the growth of opportunistic pathogens in drinking water systems will likely increase. It is important, therefore, to evaluate treatment barriers and management activities for control of opportunistic pathogen risks. Controls for primary treatment, particularly for turbidity management and disinfection, should be reviewed to ensure adequacy for opportunistic pathogen control. However, the major focus for the utility's opportunistic pathogen risk reduction plan is the management of biological activity and biofilms in the distribution system. Factors that influence the growth of microbes (primarily in biofilms) in the distribution system include, temperature, disinfectant type and concentration, nutrient levels (measured as AOC or BDOC), stagnation, flushing of pipes and cleaning of storage tank sediments, and corrosion control. Pressure management and distribution system integrity are also important to the microbial quality of water but are related more to the intrusion of contaminants into the distribution system rather than directly related to microbial growth. Summarizing the identified risk from drinking water, the availability and quality of disinfection data for treatment, and guidelines or standards for control showed that adequate information is best available for management of L. pneumophila. For L. pneumophila, the risk for this organism has been clearly established from drinking water, cases have increased worldwide, and it is one of the most identified causes of drinking water outbreaks. Water management best practices (e.g., maintenance of a disinfectant residual throughout the distribution system, flushing and cleaning of sediments in pipelines and storage tanks, among others) have been shown to be effective for control of L. pneumophila in water supplies. In addition, there are well documented management guidelines available for the control of the organism in drinking water distribution systems. By comparison, management of risks for Mycobacteria from water are less clear than for L. pneumophila. Treatment of M. avium is difficult due to its resistance to disinfection, the tendency to form clumps, and attachment to surfaces in biofilms. Additionally, there are no guidelines for management of M. avium in drinking water, and one risk assessment study suggested a low risk of infection. The role of tap water in the transmission of the other opportunistic pathogens is less clear and, in many cases, actions to manage L. pneumophila (e.g., maintenance of a disinfectant residual, flushing, cleaning of storage tanks, etc.) will also be beneficial in helping to manage these organisms as well. [ABSTRACT FROM AUTHOR]

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Relevance. The article provides an overview of the problem of drilling wells for oil and gas in conditions of permafrost. When constructing wells for various purposes in conditions of permafrost rocks, special requirements are imposed on the selection of the optimal drilling fluid. Deposits in the permafrost zone have significant differences from conditions where rocks have a positive temperature. Aim. For permafrost conditions, the choice of optimal drilling technology plays an important role. The temperature of the drilling fluid during drilling should be equal to the temperature of the rocks being drilled or be slightly lower. Methods. An analysis of the types of flushing agents used for drilling permafrost has been carried out, and the main technologies used in this case have been considered. A description of the developed flushing liquid is given, and its optimal composition is determined. Results and conclusions. The objectives are solved by developing a clay-free polymer drilling fluid with antifreeze additives, which has a freezing point of minus 7°C. The paper considers the issues of reverse freezing of wells and the use of a thermal case in order to improve the thermal regulation of wells. The choice of thermal insulation equipment is outlined based on predicting temperature changes in the properties of rocks. It was shown that reverse freezing of rocks during the construction of oil and gas wells leads to leaks and collapse of casing columns, freezing of casing columns to the walls of the well, and failure of columns to reach a given design depth. The paper introduces the formula to determine the pressure, at which the stress in the casing reaches the yield point and collapse of the casing occurs. The article shows the diagram of the hydration of ions of the proposed drilling fluid with permafrost and the main causes of complications. Using the laboratory studies, the optimal composition of the drilling fluid was determined. The introduction of the proposed drilling fluid into the practice of permafrost drilling will make it possible to successfully construct oil and gas wells.

Globally, the health of coastal water bodies continues to be threatened by climate change and mounting anthropogenic pressures related to population increase and associated development. Land use changes have increased the direct runoff of freshwater, nutrients, and other contaminants from watersheds into coastal systems. Exacerbated by increased temperatures, these changes have contributed to a worldwide decline in seagrass coverage and losses of critical habitat and ecosystem functions. For restricted estuaries and lagoons, the influx of nutrients is particularly damaging due to high water residence times and impaired flushing. The result is eutrophication and associated declines in water quality and ecosystem function. To mitigate degraded water quality, engineered ocean–estuary exchanges have been carried out and studied with examples in Australia, New Zealand, India, Denmark, the Netherlands, Portugal, and the United States of America. Based on successes including decreased nutrient concentrations, turbidity, and chlorophyll and increased faunal abundance in some past studies, this option is considered as a management tool for combatting worsening water quality in other estuaries including the Indian River Lagoon, a subtropical, lagoon-type estuary on the central east coast of Florida, USA. Decreased residence times, lower nutrients, higher dissolved oxygen (DO), higher salinity, lower temperature, and lower turbidity all combine for improved ecosystem health. In this review, the successes and failures of past projects intended to increase ocean–estuary exchanges, including biological and geochemical processes that contributed to observed outcomes, are evaluated. The primary indicators of water quality considered in this review include nutrient contents (e.g., nitrogen and phosphorus) and dissolved oxygen levels. Secondary indicators include changes in temperature and salinity pre- and post- engineering as well as turbidity, which can also impact seagrass growth and overall ecosystem health. Each of the sites investigated recorded improvements in water quality, though some were more pronounced and occurred over shorter time scales. Overall, enhanced ocean exchange in restricted, impaired water bodies resulted in system-specific response trajectories, with many experiencing a net positive outcome with respect to water quality and ecosystem health.

Current study hypothesized that dietary l‐carnitine (LC) inclusion during the mating period ameliorates both metabolic status and reproductive performance of ewes. Seventy Baluchi ewes (52 ± 4.2 kg of bodyweight and 18 ± 6 months old of age) were enrolled in this study. Animals were randomly allocated into two dietary treatments, control (only basal diet) or basal diet plus supplementation with a rumen‐protected LC (Carneon 20 Rumin‐pro; 20% LC; Kaesler Nutrition GmbH) at the rate of 10 g/head/day from 21 days before until 35 days after introducing rams to the ewes (MP). Feed intake was monitored by subtracting the ort from feed offered. Blood sample collection was conducted on Days −10, +10 and +20 relative to MP. Pregnancy was confirmed on Day 30 post‐MP. Feed intake of the ewes in the LC group was higher than the control (p < 0.05). LC supplementation increased the cholesterol concentration in the ewes (p < 0.05). Blood urea concentration of animals in the LC group was significantly lower than the control (p < 0.05). The mRNA expression of toll‐like receptor 4 was evidently lower in animals supplemented with LC than the control (p < 0.05). Both lambing and fecundity rates in the LC group tended to be higher compared with the control. LC supplementation showed potential to alter certain metabolites in the ewes. A tendency for higher lambing rate may partly be driven by dams efficient energy partitioning to support foetal growth and maintaining pregnancy. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES Thoracoscopic sympathicotomy may be an effective treatment for disabling facial blushing in selected patients. Short- and mid-term results are good but very long-term results are scarce in the medical literature and there is no knowledge which extent of sympathicotomy is better long-term for isolated facial blushing. METHODS We previously randomized 100 patients between a rib-oriented R2 or R2–R3 sympathicotomy for isolated facial blushing, and reported local effects, side effects and quality of life after 12 months. In the present study, we sent identical questionnaires to all patients after a median of 16 years (interquartile range 15–17 years). RESULTS The response rate was 66%. Overall, 82% reported excellent or satisfactory results on facial blushing, with significant better local effect after R2 sympathicotomy compared with R2–R3 sympathicotomy. Patients who underwent R2 sympathicotomy were also significantly more satisfied with the operation. We found no significant difference between R2 and R2–R3 sympathicotomy in quality of life or rates of compensatory sweating (77%) and recurrence of blushing (41%) which was milder than preoperatively in most patients. CONCLUSIONS R2 sympathicotomy should be the preferred approach for isolated facial blushing because of better local effect and higher satisfaction rates. Although this was a very long-term follow-up of the only randomized trial of its kind the response rate was limited leaving a risk of undetected bias. [ABSTRACT FROM AUTHOR]

An experiment was made to compare some basic productive indexes in sheep of the Pach-head Maritsa breed when replacing barley grain with sunflower expeller in their rations during "flushing - pregnancy"- period. The obtained results indicate a trend of positive influence of feed replacement as follows: body scoring index of sheep at the end of pregnancy - 3.58 (expeller) against 3.25 (barley); percentage of ewes with twins - 28.57 vs. 20%, respectively; average live weight of lambs at birth - 4,110 vs. 3,974 kg; average live weight of lambs at 30 days - 15,060 vs. 14,720 kg. With identical prices for both forages, the authors recommend replacing barley with sunflower expeller. [ABSTRACT FROM AUTHOR]

The management of erythromelalgia is challenging and requires multidisciplinary effort. Patient education is crucial as unsafe self-administered cooling techniques can lead to significant morbidity, including acral necrosis, infection, and amputation. The goal of management is pain control, reduction of flare frequency, and prevention of complications. This text is focused on the management of erythromelalgia and several other incompletely understood and under-recognized neurovascular disorders such as red scrotum syndrome, red ear syndrome, facial flushing, and complex regional pain syndrome. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Erythematotelangiectatic rosacea (ETR) is recognized by flushing, persistent centrofacial erythema, and telangiectasia. Many lines of topical treatments have been used for ETR with variable outcomes. We aimed to evaluate the efficacy of 10% topical tranexamic acid (TXA) with and without microneedling in treating ETR. METHODS: All patients received treatment on both sides of the face, the right side was treated with microneedling combined with 10% topical TXA, and the left side was treated with 10% topical TXA only. All patients received three sessions at two weeks intervals. The final evaluation was done three months after the last treatment session. RESULTS: The study included 45 females. Their age ranged between 20 and 48 years. The duration of the disease ranged from two months to five years. Both sides of the face showed improvement after treatment. There was a clinically and dermoscopic significant improvement in the side treated with microneedling + TXA compared to the side of the face treated with TXA alone. LIMITATIONS: The small sample size and the lack of long-term follow-up. CONCLUSION: This study showed that TXA is an effective and safe treatment modality for ETR. Microneedling can enhance the delivery of TXA and lead to better outcomes regarding erythema and telangiectasia. [ABSTRACT FROM AUTHOR]

Niacin plays a significant role in the therapy and management of mixed dyslipidemia. Nevertheless, its administration in raw form is contraindicated due to potential adverse effects including hepatotoxicity and cutaneous flushing. Prostaglandin D2 (PGD2) plays a crucial role in the signaling cascade of niacin-induced flushing. To address the potential adverse reactions linked to niacin therapy, we developed a niacin-loaded lyotropic liquid crystal nanoparticle (NLCS) crafted explicitly for the oral administration of niacin. NLCSs were produced by disrupting the cubic gel of glyceryl monostearate (GMS). The nanoparticles demonstrated notable drug-loading capabilities with a size of approximately 255 ± 31.6 nm. Furthermore, NLCS displayed sustained release behavior, indicating their potential for controlled and prolonged drug delivery. Efficient encapsulation and minimal interaction between niacin and other excipients were evidenced through Fourier transform infrared and X-ray diffraction studies, establishing their high stability. In vitro studies suggested that the nanoparticles had good antioxidant activity, swelling behavior, and biocompatibility. Additionally, compared to raw niacin, NLCS showed a higher in vivo therapeutic efficacy, less hepatotoxicity, a more refined lipid profile, and an improved complete blood count (CBC) profile. In addition, it was shown that animals treated with NLCS had lower PGD2 levels than those treated with raw niacin. In conclusion, our study highlights the potential of NLCS as a promising strategy to alleviate the side effects linked to the direct ingestion of pure niacin. These nanoparticles offer a solution to flushing-like symptoms and hepatotoxicity, positioning them as a viable therapeutic option for managing dyslipidemia. [ABSTRACT FROM AUTHOR]

Background: The treatment of choice for tumors located in the parotid gland is surgery. Nevertheless, postoperative complications are not infrequent. Regardless of the type of surgical procedure, the most common complication is Frey's syndrome (FS). Traditionally, FS includes unilateral gustatory sweating and flushing of the facial skin lining the parotid compartment. Recent research describes atypical discomfort associated with FS. The aim of this study was to assess the late prevalence and severity of both usual and atypical symptoms after parotidectomy for benign tumors. Methods: We conducted a cross-sectional study involving 86 subjects who underwent superficial parotidectomy at least one year before the study. The questionnaire included the sweating–flushing–itch–paresthesia–pain (SFIPP) Frey scale supplemented by specific questions about symptoms. Results: Sixty-seven out of eighty-six (77.9%) cases reported almost one symptom. The most frequent symptom was itch (36/67—53.7%), followed by pain (35/67—52.2%), while 28/67 (41.8%) subjects complained of atypical symptoms without flushing or sweating. A desire to treat the discomfort was reported by 50/67 (74.6%) subjects. Conclusions: Late postparotidectomy local discomfort is not infrequent and includes both usual and "unusual" symptoms almost equally. Our results suggest the importance of informing patients about the occurrence of the syndrome and the available treatment options during pre- and postoperative counseling. [ABSTRACT FROM AUTHOR]

In the current work, numerical simulation and experimentation are carried out to investigate the performance of powder mixed dielectric in the electrical discharge micromachining process. Three distinct powders, namely aluminum (electrically conductive), silicon (semi-conductive), and aluminum oxide/alumina (electrically non-conductive) dispersed in the kerosene dielectric, are considered. For a constant applied voltage, a silicon powder particle inserted in the gap immersed with liquid dielectric shows an enlargement in the inter-electrode gap (∼38% and 63% with circular and elliptical powder) compared to the pure dielectric. The enlarged inter-electrode gap increases the machining yield due to improved flushing efficiency. The intensification of the electric field near the particles' surface lowers the breakdown voltage and charging time of the capacitor for the constant inter-electrode gap, resulting in a decrease in discharge energy per pulse and increased spark frequency. The influence of powder material properties and their sizes on breakdown strength is analyzed. Further, the discharge parameters acquired from the electric field numerical simulation of powder mixed dielectric have been utilized to conduct the numerical simulation of single crater formation with pure dielectric and powder mixed dielectric. The simulated single carters' dimensions are validated with the experimentally machined single craters. Numerical simulation and experimentation of powder mixed dielectric depict the effectiveness of aluminum oxide powders in addition to silicon and aluminum powders when dispersed in kerosene host dielectric. [ABSTRACT FROM AUTHOR]

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The low inflow rate of water into the dam reservoirs causes sedimentation, leading to a decrease in the service life of dam. As a result, the performance of the dam in controlling floods and generating energy through water release downstream will be affected. Additionally, sediment deposition near the bottom outlets and turbines causes their burial, leading to difficulties in their operation and utilization. Installing inclined plates in the upper of bottom outlets is suggested as a new method to increase the amount of flushed sediments in pressurized flushing. Awareness of changes in the upstream flow pattern of the orifice is of great importance. In the present study, the effect of installing inclined plates on flow pattern changes in the upstream of the orifice was investigated using the Flow3D model. In this study, a numerical model calibration was performed using the results of experiments conducted in the hydraulic laboratory of the Faculty of Water and Environmental Engineering at Shahid Chamran University of Ahvaz, and the RNG turbulence model was chosen for conducting the simulation. The considered variables include plate width, plate installation angle, and plate installation distance to the orifice. In total, 5 scenarios (including the reference test (i.e., without installing plates)) have been defined for the numerical model.The results showed that the installation of inclined plates against the orifice led to the creation of vortexes and the development of a low-pressure zone, resulting in an increase in the volume of flushed sediment. Also, reducing the width of plates, increasing the installation angle, and increasing the installation distance of the plates will lead to a decrease in the intensity of eddies and a decrease in the range of low-pressure zone, which reduces the effect of installing inclined plates to increase flushed sediment volume.Based on previous studies, the amount of sediment output in pressurized flushing is limited and confined to the vicinity of the dam body. Therefore, this method is not used to revive the dead storage capacity of the dam reservoirs. Ancillary facilities such as bottom outlets and hydro-power plant outlets are located near the dam structure, and sediment entry into these facilities can have destructive effects. Therefore, providing methods to increase sediment discharge from near the dam body can be highly beneficial. Additionally, by creating a low-pressure zone in the upstream of the outlet, a suction effect is created, which can be useful in increasing the volume of sediment discharged during turbidity current discharging from the bottom outlet.