Endoscopic polidocanol foam sclerobanding for the treatment of grade Ⅱ-Ⅲ internal hemorrhoids:A prospective,multi-center,randomized study

BACKGROUND Endoscopic rubber band ligation(ERBL)is a nonsurgical technique for the treatment of symptomatic internal hemorrhoids but is limited by recurrence and post-procedural pain.AIM To evaluate satisfaction,long-term recurrence,and post-procedural pain in managing internal hemorrhoids using a combination of polidocanol foam sclerotherapy and ERBL.METHODS This was a prospective,multicenter,randomized study.A total of 195 consecutive patients diagnosed with grade II-III internal hemorrhoids were enrolled from four tertiary hospitals and randomly divided into a cap-assisted endoscopic polidocanol foam sclerobanding(EFSB)or an ERBL group.All patients were followed-up for 12 months.Symptom-based severity and post-procedural pain were assessed using a hemorrhoid severity score(HSS)and a visual analog scale(VAS).Continuous variables were reported as medians and interquartile range.RESULTS One hundred and ninety-five patients were enrolled,with 98 in the EFSB group.HSS was lower in the EFSB group than in the ERBL group at 8 weeks[4.0(3.0-5.0)vs 5.0(4.0-6.0),P=0.003]and 12-month[2.0(1.0-3.0)vs 3.0(2.0-3.0),P<0.001]of follow-up.The prolapse recurrence rate was lower in the EFSB group at 12 months(11.2%vs 21.6%,P=0.038).Multiple linear regression analysis demonstrated that EFSB treatment[B=-0.915,95%confidence interval(CI):−1.301 to−0.530,P=0.001]and rubber band number(B=0.843,95%CI:0.595-1.092,P<0.001)were negatively and independently associated with the VAS score 24 hours post-procedure.The median VAS was lower in the EFSB group than in the ERBL[2.0(1.0-3.0)vs 3.0(2.0-4.0),P<0.001].CONCLUSION Cap-assisted EFSB provided long-term satisfaction and effective relief from the recurrence of prolapse and pain 24 hours post-procedure.

Electrokinetic-mechanism of water and furfural oxidation on pulsed laser-interlaced Cu_(2)O and CoO on nickel foam

The electrocatalytic oxidation of biomass-derived furfural(FF)feedstocks into 2-furoic acid(FA)holds immense industrial potential in optics,cosmetics,polymers,and food.Herein,we fabricated Co O/Ni O/nickel foam(NF)and Cu_(2)O/Ni O/NF electrodes via in situ pulsed laser irradiation in liquids(PLIL)for the bifunctional electrocatalysis of oxygen evolution reaction(OER)and furfural oxidation reaction(FOR),respectively.Simultaneous oxidation of NF surface to NiO and deposition of CoO and/or Cu_(2)O on NF during PLIL offer distinct advantages for enhancing both the OER and FOR.CoO/NiO/NF electrocatalyst provides a consistently low overpotential of~359 m V(OER)at 10 m A/cm^(2),achieving the maximum FA yield(~16.37 m M)with 61.5%selectivity,79.5%carbon balance,and a remarkable Faradaic efficiency of~90.1%during 2 h of FOR at 1.43 V(vs.reversible hydrogen electrode).Mechanistic pathway via in situ electrochemical-Raman spectroscopy on CoO/NiO/NF reveals the involvement of phase transition intermediates(NiOOH and CoOOH)as surface-active centers during electrochemical oxidation.The carbonyl carbon in FF is attacked by hydroxyl groups to form unstable hydrates that subsequently undergo further oxidation to yield FA products.This method holds promise for large-scale applications,enabling simultaneous production of renewable building materials and fuel.

Layered Structural PBAT Composite Foams for Efficient Electromagnetic Interference Shielding

The utilization of eco-friendly,lightweight,high-efficiency and high-absorbing electromagnetic interference(EMI)shielding composites is imperative in light of the worldwide promotion of sustainable manufacturing.In this work,magnetic poly(butyleneadipate-coterephthalate)(PBAT)microspheres were firstly synthesized via phase separation method,then PBAT composite foams with layered structure was constructed through the supercritical carbon dioxide foaming and scraping techniques.The merits of integrating ferroferric oxideloaded multi-walled carbon nanotubes(Fe3O4@MWCNTs)nanoparticles,a microcellular framework,and a highly conductive silver layer have been judiciously orchestrated within this distinctive layered configuration.Microwaves are consumed throughout the process of“absorption-reflection-reabsorption”as much as possible,which greatly declines the secondary radiation pollution.The biodegradable PBAT composite foams achieved an EMI shielding effectiveness of up to 68 dB and an absorptivity of 77%,and authenticated favorable stabilization after the tape adhesion experiment.

Liquid injectivity in a SAG foam process:Effect of permeability

Foam is utilized in enhanced oil recovery and CO_(2) sequestration.Surfactant-alternating-gas(SAG)is a preferred approach for placing foam into reservoirs,due to it enhances gas injection and minimizes corrosion in facilities.Our previous studies with similar permeability cores show that during SAG injection,several banks occupy the area near the well where fluid exhibits distinct behaviour.However,underground reservoirs are heterogeneous,often layered.It is crucial to understand the effect of permeability on fluid behaviour and injectivity in a SAG process.In this work,coreflood experiments are conducted in cores with permeabilities ranging from 16 to 2300 mD.We observe the same sequence of banks in cores with different permeabilities.However,the speed at which banks propagate and their overall mobility can vary depending on permeability.At higher permeabilities,the gas-dissolution bank and the forced-imbibition bank progress more rapidly during liquid injection.The total mobilities of both banks decrease with permeability.By utilizing a bank-propagation model,we scale up our experimental findings and compare them to results obtained using the Peaceman equation.Our findings reveal that the liquid injectivity in a SAG foam process is misestimated by conventional simulators based on the Peaceman equation.The lower the formation permeability,the greater the error.

Semi-quantitative analysis of the structural evolution of mesophase pitch-based carbon foams by Raman and FTIR spectroscopy

Graphitized carbon foams(GFms)were prepared using mesophase pitch(MP)as a raw material by foaming(450℃),pre-oxidation(320℃),carbonization(1000℃)and graphitization(2800℃).The differences in structure and properties of GFms prepared from different MP precursors pretreated by ball milling or liquid phase extraction were investigated and compared,and semi-quantitative calculations were conducted on the Raman and FTIR spectra of samples at each preparation stage.Semi-quantitat-ive spectroscopic analysis provided detailed information on the structure and chemical composition changes of the MP and GFm de-rived from it.Combined with microscopic observations,the change from precursor to GFm was analyzed.The results showed that ball milling concentrated the distribution of aromatic molecules in the pitch,which contributed to uniform foaming to give a GFm with a uniform pore distribution and good properties.Liquid phase extraction helped remove light components while retaining large aromatics to form graphitic planes with the largest average size during post-treatment to produce a GFm with the highest degree of graphitization and the fewest open pores,giving the best compression resistance(2.47 MPa),the highest thermal conductivity(64.47 W/(m·K))and the lowest electrical resistance(13.02μΩ·m).Characterization combining semi-quantitative spectroscopic ana-lysis with microscopic observations allowed us to control the preparation of the MP-derived GFms.

Prospective randomized study to evaluate and compare the post-procedural sexual function in patients undergoing semi-rigid ureterorenoscopy for distal ureteric stones in three different operating room settings

Objective:To evaluate and compare the effect of semi-rigid ureterorenoscopy on post-procedural sexual function with three different operating room settings.Methods:In this prospective randomized study,consecutive sexually active patients with normal pre-operative sexual function undergoing uncomplicated semi-rigid ureterorenoscopy for distal ureteric stones were randomized into three groups,with three different operating room settings.Procedure-related anxiety and sexual function were assessed pre-operatively using Amsterdam Preoperative Anxiety and Information Scale and Brief Sexual Function Inventory(in males)and Female Sexual Function Index-6(in females),respectively.All the participants were stented following the procedure,and the stent was removed after 3 weeks.Post-procedural sexual function and general discomfort were assessed and compared between three groups at 1 week,3 weeks,and 12 weeks.The effect of surgery-related anxiety,preoperative sexual function,age,and general discomfort(including stent-related discomfort)on post-procedural sexual function were analyzed using multiple regression analysis.A p-value of less than 0.05 was considered statistically significant.Results:Totally,327 eligible patients were randomized into three groups.The group of patients who underwent the procedural with a screen separating the operating area from the patient vision,while the patient could watch the endoscopy through a separate monitor,had better post-procedural sexual function compared to those who had total vision of the operating area as well as to those whose eyes were blocked.This difference was statistically significant.This post-procedural reduction in sexual function could not be attributed to in situ stent alone.Conclusions:Our study showed that semi-rigid ureterorenoscopy can have significant negative effect on sexual function,which can be reduced with proper preoperative counseling and an ideal operating room settings.

Propagation Properties of Shock Waves in Polyurethane Foam based on Atomistic Simulations

Porous materials are widely used in the field of protection because of their excellent energy absorption characteristics.In this work,a series of polyurethane microscopic models are established and the effect of porosity on the shock waves is studied with classical molecular dynamics simulations.Firstly,shock Hugoniot relations for different porosities are obtained,which compare well with the experimental data.The pores collapse and form local stress wave,which results in the complex multi-wave structure of the shock wave.The microstructure analysis shows that the local stress increases and the local velocity decreases gradually during the process of pore collapse to complete compaction.Finally,it leads to stress relaxation and velocity homogenization.The shock stress peaks can be fitted with two exponential functions,and the amplitude of attenuation coefficient decreases with the increase of density.Besides,the pore collapse under shock or non-shock are discussed by the entropy increase rate of the system.The energy is dissipated mainly through the multiple interactions of the waves under shock.The energy is dissipated mainly by the friction between atoms under non-shock.

An efficient and mild recycling of waste melamine formaldehyde foams by alkaline hydrolysis

Melamine formaldehyde foam(MFF)generates many poisonous chemicals through the traditional recycling methods for organic resin wastes.Herein,a high MFF degradation ratio of ca.97 wt.%was achieved under the mild conditions(160℃)in a NaOH–H2O system with ammelide and ammeline as the main degradation products.The alkaline solvent had an obvious corrosion effect for MFF,as indicated by scanning electron microscopy(SEM).The reaction process and products distribution were studied by Fourier-transform infrared spectroscopy(FTIR),X-ray photoelectron spectroscopy(XPS),and ^(13)C nuclear magnetic resonance(NMR).Besides,the MFF degradation products that have the similar chemical structures and bonding performances to those of melamine can be directly used as the raw material for synthesis of melamine urea-formaldehyde resins(MUFs).Moreover,the degradation system demonstrated here showed the high degradation efficiency after reusing for 7 times.The degradation process generated few harmful pollutants and no pre-or post-treatments were required,which proves its feasibility in the safe removal or recovery of waste MFF.

High-performance thermal interface materials enabled by vertical alignment of lightweight and soft graphene foams

High-performance thermal interface materials (TIMs) are highly sought after for modern electronics. Two-dimensional (2D) materials as vertical aligned fillers can optimize the out-plane thermal conductivity (k ⊥), but their excessively high content or intrinsic rigidness deteriorate TIMs softness, leading to worsening for thermal contact resistance (R contact). In this study, 2D graphene materials are fabricated into lightweight and soft graphene foams (GFs) with high-orientation, acting as vertical filler frameworks to optimize the k ⊥ and R contact for vertical GF (VGF) TIMs. The VGF-TIM has a high k ⊥ of 47.9 W·m^(−1)·K^(−1) at a low graphene content of 15.5 wt.%. Due to the softness and low filler contents of GFs, the VGF-TIM exhibits a low compressive module (4.2 MPa), demonstrating excellent compressibility. The resulting TIM exhibit a low contact resistance of 24.4 K·mm2·W^(−1), demonstrating 185.1% higher cooling efficiency in practical heat dissipating scenario compared to commercial advanced TIMs. This work provides guidelines for the design of advanced TIMs and their applications in thermal management.

Non-dimensional analysis on blast wave propagation in foam concrete:Minimum thickness to avoid stress enhancement

Foam concrete is a prospective material in defense engineering to protect structures due to its high energy absorption capability resulted from the long plateau stage.However,stress enhancement rather than stress mitigation may happen when foam concrete is used as sacrificial claddings placed in the path of an incoming blast load.To investigate this interesting phenomenon,a one-dimensional difference model for blast wave propagation in foam concrete is firstly proposed and numerically solved by improving the second-order Godunov method.The difference model and numerical algorithm are validated against experimental results including both the stress mitigation and the stress enhancement.The difference model is then used to numerically analyze the blast wave propagation and deformation of material in which the effects of blast loads,stress-strain relation and length of foam concrete are considered.In particular,the concept of minimum thickness of foam concrete to avoid stress enhancement is proposed.Finally,non-dimensional analysis on the minimum thickness is conducted and an empirical formula is proposed by curve-fitting the numerical data,which can provide a reference for the application of foam concrete in defense engineering.

Experimental investigation of the effects of oil asphaltene content on CO_(2) foam stability in the presence of nanoparticles and sodium dodecyl sulfate

Foam stability tests were performed using sodium dodecyl sulfate(SDS)surfactant and SiO2 nanoparticles as foaming system at different asphaltene concentrations,and the half-life of CO_(2) foam was measured.The mechanism of foam stability reduction in the presence of asphaltene was analyzed by scanning electron microscope(SEM),UV adsorption spectrophotometric concentration measurement and Zeta potential measurement.When the mass ratio of synthetic oil to foam-formation suspension was 1:9 and the asphaltene mass fraction increased from 0 to 15%,the half-life of SDS-stabilized foams decreased from 751 s to 239 s,and the half-life of SDS/silica-stabilized foams decreased from 912 s to 298 s.When the mass ratio of synthetic oil to foam-formation suspension was 2:8 and the asphaltene mass fraction increased from 0 to 15%,the half-life of SDS-stabilized foams decreased from 526 s to 171 s,and the half-life of SDS/silica-stabilized foams decreased from 660 s to 205 s.In addition,due to asphaltene-SDS/silica interaction in the aqueous phase,the absolute value of Zeta potential decreases,and the surface charges of particles reduce,leading to the reduction of repulsive forces between two interfaces of thin liquid film,which in turn,damages the foam stability.

Boron nitride silicone rubber composite foam with low dielectric and high thermal conductivity

Silicone rubber(SR)is widely used in the field of electronic packaging because of its low dielectric properties.In this work,the porosity of the SR was improved,and the dielectric constant of the SR foam was reduced by adding expanded microspheres(EM).Then,the thermal conductivity of the system was improved by combining the modified boron nitride(f-BN).The results showed that after the f-BN was added,the dielectric constant and dielectric loss were much lower than those of pure SR.Micron-sized modified boron nitride(f-mBN)improved the dielectric and thermal conductivity of the SR foam better than that of nano-sized modified boron nitride(f-nBN),but f-nBN improved the volume resistivity,tensile strength,and thermal stability of the SR better than f-mBN.When the mass ratio of f-mBN and fnBN is 2:1,the thermal conductivity of the SR foam reaches the maximum value of 0.808 W·m^(-1)·K^(-1),which is 6.5 times that before the addition.The heat release rate and fire growth index are the lowest,and the improvement in flame retardancy is mainly attributed to the high thermal stability and physical barrier of f-BN.

Tamping the movement of the laser absorption cutoff position using gold foam hohlraum

In indirect-driven laser fusion experiments,the movement of the laser absorption layer will distort the radiation uniformity on the capsule.The gold foam has advantages in symmetry control and lowering wall plasma blowoff when used in an inertial confinement fusion(ICF)hohlraum.This work investigates the motion of the laser absorption cutoff position using lowdensity foam gold walls.It is found that the motion of the laser absorption cutoff position can be significantly mitigated through optimal initial low density,tailored to a specific laser shape.For a short square laser pulse,the laser absorption cutoff position remains almost stationary at an initial density of approximately 0.6 g cm^(-3).For a long-shaped laser pulse,the minimal motion of the laser absorption cutoff position is observed at an initial density of about 0.1 g cm^(-3).This approach allows for the adjustment of the symmetry of the hohlraum radiation source.The insights gained from this study serve as a crucial reference for optimizing the hohlraum wall density.

Foamed microemulsion nanodroplets loaded with chlorin e6 for epidermal-targeted treatment against psoriasis

Psoriasis is a chronic skin disease characterized by the hyperproliferation of keratinocytes and an overactive autoimmune response. Photodynamic therapy (PDT) has been established as a promising intervention for alleviating psoriasis. However, the current transdermal delivery of photosensitizers is inefficient and imprecise. In this study, we developed a foamed microemulsion nanodroplets system containing chlorin e6 (Ce6 FM), exhibiting precise epidermal targeting and retention, which targeted the aberrantly proliferating epidermal cells at psoriatic skin lesions and avoided the damage to the normal cutaneous cells. Upon application in a psoriatic mouse model, Ce6 FM efficiently induced keratinocyte apoptosis by generating reactive oxygen species under laser. Furthermore, Ce6 FM-based PDT activated the cyclooxygenase-2-induced immunosuppressive pathway in keratinocytes, resulting in the amelioration of the autoimmune microenvironment in psoriatic skin. Additionally, Ce6 FM-based PDT did not induce skin damage or atrophy associated with non-targeted halometasone treatment. Overall, Ce6 FM-based PDT holds promise as an effective, safe and compliant strategy for psoriasis treatment.

A review of the development of asphalt foaming technology

To comprehensively assess the current state-of-art in asphalt foaming technology, the following four key aspectshave been reviewed systematically: foaming principles, test methods, evaluation indicators, and influencing factors.Key findings reveal that asphalt foaming was primarily driven by the vaporization of water, with deteriorationprocesses including bubble collapse and liquid film drainage. However, the current understanding of asphaltfoaming principles remains limited, primarily due to difficulties in capturing and precisely measuring its microscopic behaviors during asphalt foaming process. Volume changes provided an intuitive means to evaluate theexpansion capacity of asphalt and its foaming stability. Bubble evolution characteristics of foamed asphalt offeredpromising insights into its foaming performance. Traditional ruler and stopwatch-based assessments were beingsuperseded by automated techniques like laser and ultrasonic ranging. Nevertheless, the current measuringequipment still lacks the capability to comprehensively evaluate the foaming effect of asphalt across various dimensions. Asphalt temperature and foaming water consumption significantly affected asphalt foaming performance, and the inclusion of foaming agents typically led to a notable increase in the half life of foamed asphalt.However, the interaction between foaming agents and asphalt, as well as the underlying mechanisms affecting thefoaming effect, are still unclear and require further exploration. Future research should primarily focus on thecorrelation between asphalt foaming effect and mixture performance, aiming to guide the practical engineeringapplication of foamed asphalt mixtures and enlarge the advantages of such low-emission and sustainable mixtures.

Experimental investigation on weak shock wave mitigation characteristics of flexible polyurethane foam and polyurea

In recent years,explosion shock wave has been considered as a signature injury of the current military conflicts.Although strong shock wave is lethal to the human body,weak shock wave can cause many more lasting consequences.To investigate the protection ability and characteristics of flexible materials and structures under weak shock wave loading,the blast wave produced by TNT explosive is loaded on the polyurethane foam with the density of 200.0 kg/m3(F-200)and 400.0 kg/m3(F-400),polyurea with the density of 1100.0 kg/m^(3)(P-1100)and structures composed of the two materials,which are intended for individual protection.Experimental results indicate that the shock wave is attenuated to weak pressure disturbance after interacting with the flexible materials which are not damaged.The shock wave protective capability of single-layer materials is dependent on their thickness,density and microscopic characteristics.The overpressure,maximum pressure rise rate and impulse of transmitted wave decrease exponentially with increase in sample thickness.For the same thickness,F-400 provides better protective capability than F-200 while P-1100 shows the best protective capability among the three materials.In this study,as the materials are not destroyed,F-200 with a thickness more than10.0 mm,F-400 with a thickness more than 4.0 mm,and P-1100 with a thickness more than 1.0 mm can attenuate the overpressure amplitude more than 90.0%.Further,multi-layer flexible composites are designed.Different layer layouts of designed structures and layer thickness of the single-layer materials can affect the protective performance.Within the research range,the structure in which polyurea is placed on the impact side shows the optimal shock wave protective performance,and the thicknesses of polyurea and polyurethane foam are 1.0 mm and 4.0 mm respectively.The overpressure attenuation rate reached maximum value of 93.3%and impulse attenuation capacity of this structure are better than those of single-layer polyurea and polyurethane foam with higher areal density.

Facile identification of fluorosurfactant category in aqueous film-forming foam concentrates via optimized^(19)F NMR

Aqueous film-forming foams(AFFFs)are the primary source of toxic perfluoroalkyl and polyfluoroalkyl substances(PFAS)in wastewater.Thus,it is urgent to develop a facile and fast method for identifying fluorosurfactants in commercially available AFFFs.In this work,fluorine nuclear magnetic resonance(^(19)F NMR)spectroscopy was optimized to measure AFFFs directly with the extra addition of 5%D_(2)O as the locking reagent,and high-quality spectra could be acquired within 4 min(0.1%fluorosurfactant content).Recovery experiments demonstrated that the use of different AFFFs had no marked influence on the quantitative analysis of fluorosurfactants.Such method works with low-field NMR spectroscopy(1.4 T)as well.Two-dimensional(2D)^(19)F COSY NMR was used to make signal assignments for different fluorosurfactant derivatives.The optimized ^(19)F NMR could quantify the commercially available fluorosurfactants in different AFFFs,identify them being in either the perfluorooctane sulfonate(PFOS)or fluorotelomer sulfonic acid(FTS)categories,and distinguish the head-group of PFOS and FTS derivatives,which exhibits great potentials in the developments of relevant commercial detections.

Endoscopic polidocanol foam sclerobanding for treatment of internal hemorrhoids:A novel outpatient procedure

In the study,we comment on the article by Qu et al.Internal hemorrhoids are the most common anorectal disorders worldwide with bleeding,prolapse,and difficulty in defecation.Endoscopic rubber band ligation(ERBL)is a safe,convenient,quick,and economical outpatient procedure.The main goal of ERBL is to alleviate prolapse,but the high incidence of recurrence and post-procedural pain are of clinical concern.Polidocanol foam as a local hemostatic and anesthetic agent could reduce the rates of post-procedural pain and bleeding.Endoscopic polidocanol foam sclerobanding(EFSB)is a novel approach that could lift the mucosa for easy ligation and promote increased scarring in the submucosal tissue which translates into long-term relief from prolapse recurrence and reduced 24-h postprocedural pain.The study by Qu et al is a novel multi-center prospective randomized study to compare ERBL and EFSB in patients with grades II and III internal hemorrhoids with one-year follow-up.Results showed that EFSB is a novel therapy for internal hemorrhoids,but future studies with a larger sample,multiple treatment sessions,and long-term follow-up are required to confirm these findings.

Endoscopic polidocanol foam sclerobanding for the treatment of Grade II-III internal hemorrhoids:The focus of clinical practice

We have read the article by Qu et al with great interest,as it presents an inte-gration of endoscopic polidocanol foam sclerotherapy with rubber band ligation in patients with Grade II-III internal hemorrhoids.The authors conducted a prospective,multicenter,randomized study to evaluate the long-term sympto-matic and endoscopic efficacy of this combined intervention.In this discussion,we focus on the procedural steps of this combined strategy and suggest potential avenues for future research.

Lightweight Dual‑Functional Segregated Nanocomposite Foams for Integrated Infrared Stealth and Absorption‑Dominant Electromagnetic Interference Shielding

Lightweight infrared stealth and absorption-dominant electromagnetic interference(EMI)shielding materials are highly desirable in areas of aerospace,weapons,military and wearable electronics.Herein,lightweight and high-efficiency dual-functional segregated nanocomposite foams with microcellular structures are developed for integrated infrared stealth and absorption-dominant EMI shielding via the efficient and scalable supercritical CO_(2)(SC-CO_(2))foaming combined with hydrogen bonding assembly and compression molding strategy.The obtained lightweight segregated nanocomposite foams exhibit superior infrared stealth performances benefitting from the synergistic effect of highly effective thermal insulation and low infrared emissivity,and outstanding absorption-dominant EMI shielding performances attributed to the synchronous construction of microcellular structures and segregated structures.Particularly,the segregated nanocomposite foams present a large radiation temperature reduction of 70.2℃ at the object temperature of 100℃,and a significantly improved EM wave absorptivity/reflectivity(A/R)ratio of 2.15 at an ultralow Ti_(3)C_(2)T_(x) content of 1.7 vol%.Moreover,the segregated nanocomposite foams exhibit outstanding working reliability and stability upon dynamic compression cycles.The results demonstrate that the lightweight and high-efficiency dual-functional segregated nanocomposite foams have excellent potentials for infrared stealth and absorption-dominant EMI shielding applications in aerospace,weapons,military and wearable electronics.