Feeding tube self-management experience of patients at home after discharge following esophageal cancer surgery

BACKGROUND Esophageal cancer(EC)is an aggressive malignancy with low survival(10%-30%).Nutritional problems are present throughout the perioperative period and are key to prognosis.Home enteral nutrition appears to improve the nutritional status of patients with EC.Few studies have addressed the experience of patients administering their own nutritional fluids and managing their own feeding tubes at home.The aim of this study was to explore the real-life experience of self-management of feeding tubes in patients at home after EC surgery in the first 3 months after discharge following surgery.AIM To explore feeding tube self-management experience of patients at home 3 months after discharge following EC surgery.METHODS Face-to-face semi-structured interviews were conducted with 18 patients using a feeding tube at home after EC surgery.Thematic analysis of the recordings identified themes related to feeding tube self-management.RESULTS Patients expressed similar feelings about their tube management experiences concerning three contextualized themes:Self-management dilemmas,distressing experiences,and self-management facilitators.CONCLUSION There are many dilemmas and problems in self-managing feeding tubes in postoperative homebound patients with EC.Clinical staff should provide guidance to promote a positive change in self-management behavior.

A Review of the Applications of Nanofluids and Related Hybrid Variants in Flat Tube Car Radiators

The present review explores the promising role of nanofluids and related hybrid variants in enhancing the efficiencyof flat tube car radiators.As vehicles become more advanced and demand better thermal performance,traditional coolants are starting to fall short.Nanofluids,which involve tiny nanoparticles dispersed into standardcooling liquids,offer a new solution by significantly improving heat transfer capabilities.The article categorizesthe different types of nanofluids(ranging from those based on metals and metal oxides to carbon materials andhybrid combinations)and examines their effects on the improvement of radiator performance.General consensusexists in the literature that nanofluids can support better heat dissipation and enable accordingly the developmentof smaller and lighter radiators,which require less coolant and allow more compact vehicle designs.However,thisreview demonstrates that the use of nanofluids does not come without challenges.These include the long-termstability of these fluids and material compatibility issues.A critical discussion is therefore elaborated about thegaps to be filled and the steps to be undertaken to promote and standardize the use of these fluids in the industry.

Effect of pouring time on microstructure and mechanical properties of centrifugal cast Ti-46Al alloy tubes

The grain size of TiAl alloy castings prepared by traditional casting process is coarse,thus showing poor mechanical properties.In this study,a new type of high performance Ti-46Al alloy tube prepared by vacuum centrifugal casting technology was introduced.This research comprehensively examined the influence of pouring time on the microstructure and mechanical performance of the castings,employing both experimental approaches and ProCast simulation methodologies.The findings indicate that prolonging the pouring time facilitates a microstructural evolution from coarse columnar grains to refined equiaxed grains.Under the condition of pouring temperature of 1,600℃,rotation speed of 800 r·min^(-1) and pouring time of 6 s,the tensile strength of Ti-46Al alloy at room temperature reaches 650 MPa,and the tensile strength at 800℃ reaches 705 MPa,which is significantly higher than that of traditional as-cast Ti-Al alloy.

Experimental and Numerical Study of Bonding Capacity of Interface between Ultra-High Performance Concrete and Steel Tube

This study investigates the bond performance at the interfacial region shared by Ultra-High Performance Concrete(UHPC)and steel tubes through push-out tests.This study examines how changes in steel fiber volumetric ratio and thickness of steel tube influence the bond strength characteristics.The results show that as the enhancement of the steel tube wall thickness,the ultimate bond strength at the interface improves significantly,whereas the initial bond strength exhibits only slight variations.The influence of steel fiber volumetric ratio presents a nonlinear trend,with initial bond strength decreasing at low fiber content and increasing significantly as fiber content rises.Additionally,finite element(FE)simulations were applied to replicate the experimental conditions,and the outcomes showed strong correlation with the experimental data,confirming the exactitude of the FE model in predicting the bond behavior at the UHPC-Steel interface.These findings provide valuable insights for optimizing the design of UHPC-Filled steel tubes in high-performance structure.

Nasogastric tube syndrome induced by an indwelling long intestinal tube

The nasogastric tube(NGT) has become a frequently used device to alleviate gastrointestinal symptoms. Nasogastric tube syndrome(NTS) is an uncommon but potentially life-threatening complication of an indwelling NGT. NTS is characterized by acute upper airway obstruction due to bilateral vocal cord paralysis. We report a case of a 76-year-old man with NTS, induced by an indwelling long intestinal tube. He was admitted to our hospital for treatment of sigmoid colon cancer. He underwent sigmoidectomy to release a bowel obstruction, and had a long intestinal tube inserted to decompress the intestinal tract. He presented acute dyspnea following prolonged intestinal intubation, and bronchoscopy showed bilateral vocal cord paralysis. The NGT was removed immediately, and tracheotomy was performed. The patient was finally discharged in a fully recovered state. NTS be considered in patients complaining of acute upper airway obstruction, not only with a NGT inserted but also with a long intestinal tube.

A case of postoperative recurrent intussusception associated with indwelling bowel tube

Intussusception is quite uncommon in adults.We report a rare case of a 76-year-old man with small bowel intussusception induced by two indwelling bowel tubes,the first a jejunal feeding tube and the second an ileus tube.After complete reduction of the first intussusception caused by the jejunal feeding tube and adhesion,reintussusception occurred due to the postoperative adhesion and ileus tube inserted into the bowel after the previous operation for intussusception.Finally,the part of the jejunum with re-intussusception and adhesion,including the place where the previous reduced intussusception had occurred,was resected.This case is a reminder that when there is no mucosal lesion other than an indwelling bowel tube or a hard adhesion/ inflammation around intussusception,the patient should be operated on without delay for resection of the intussusception to prevent re-intussusception,even if the resected bowel is predicted to be long.

Application of Modified Gastric Tube Placement in Patients with Indwelling Gastric Tube

Objective:To explore the effect of modified nasogastric tube placement and Rehabilitation New Liquid Spray in patients with indwelling gastric tube.Methods:Eighty-six cases with indwelling gastric tube in our hospital from January 2020 to May 2021 were randomly selected and divided into the reference group and the research group.The reference group was treated by modified gastric tube placement,and the research group was given the Rehabilitation New Liquid Spray intervention.The effect of the interventions on two groups was observed.Results:The incidence of nasal mucosal injury in the research group was lower than that in the reference group,and the incidence of pharyngeal mucosal injury in the research group was lower than that in the reference group(P<0.05).The pain score of the study group was lower than that of the reference group at 8 h,12 h and 24 h after replacement,and the incidence of hoarseness,swallowing discomfort and dry oropharynx was lower than that of the reference group(P<0.05).Conclusion:The application of modified gastric tube placement and Rehabilitation New Liquid Spray intervention in patients with indwelling gastric tube can effectively reduce the nasopharyngeal injury and improve the pain of catheterization.

A comprehensive review of lunar lava tube base construction and field research on a potential Earth test site

The Moon,as the closest celestial body to the Earth,plays a pivotal role in the progression of deep space exploration,and the establishment of research outposts on its surface represents a crucial step in this mission.Lunar lava tubes are special underground caves formed by volcanic eruptions and are considered as ideal natural shelters and scientific laboratories for lunar base construction.This paper begins with an in-depth overview of the geological origins,exploration history,and distribution locations of lunar lava tubes.Subsequently,it delves into the presentation of four distinctive advantages and typical concepts for constructing bases within lava tubes,summarizing the ground-based attempts made thus far in lunar lava tube base construction.Field studies conducted on a lava tube in Hainan revealed rock compositions similar to those found during the Apollo missions and clear lava tube structures,making it a promising analog site.Lastly,the challenges and opportunities encountered in the field of geotechnical engineering regarding the establishment of lunar lava tube bases are discussed,encompassing cave exploration technologies,in-situ testing methods,geomechanical properties under lunar extreme environments,base design and structural stability assessment,excavation and reinforcement techniques,and simulated Earth-based lava tube base.

Study on the low mechanical anisotropy of extruded Mg-Zn-Mn-Ce-Ca alloy tube in the compression process

In this study,the extruded Mg-Zn-Mn-Ce-Ca alloy tube with a low compression anisotropy along the ED,45ED and TD was prepared.The effect of the second phases,initial texture and deformation behavior on this low mechanical anisotropy was investigated.The results revealed that the alloy tube contains the high content(Mg1-xZnx)11Ce phase and the low content of Mg12Ce phase.These second phases are respectively incoherent and coherent with the Mg matrix,and their influence can be ignored.Additionally,the alloy tube exhibited a weak basal fiber texture,where the c-axis was aligned along the 0°∼30°tilt from TD to ED.Such a texture made the initial deformation(at 1.0%∼1.6%strain)of the three samples controlled by comparable basalslip.As deformation progressed(1.6∼9.0%strain),larger amounts of ETWs nucleated and gradually approached saturation in the three samples,re-orienting the c-axis to a 0°∼±30°deviation with respect to the loading directions.Meanwhile,the prismatic and pyramidal<c+a>slips replaced the dominant deformation progressively until fracture.Eventually,the similar deformation mechanisms determined by the weak initial texture in the three samples contribute to the comparable strain hardening rates,resulting in the low compressive anisotropy of the alloy tube.

The Effect and Nursing of Indwelling Nasal Jejunal Feeding Tube for Enteral Nutrition in Acute Severe Pancreatitis

Objective:To analyze the effect of enteral nutrition and nursing intervention in patients with indwelling nasojejunal tube in acute severe pancreatitis.Methods:Sixty cases of patients with indwelt nasojejunal tubes treated in our hospital from August 2019 to August 2020 were divided into routine group and observation group as research subjects.Patients in both groups received enteral nutrition,patients in the routine group received routine care,and patients in the observation group received quality care.The recovery time of gastrointestinal function,length of hospital stay,hospitalization cost,nutritional indicators and incidence of complications in the two groups were compared.Results:The recovery time of gastrointestinal function in observation group was lower than that in routine group,P<0.05;The length and cost of hospitalization in observation group were lower than those in routine group,P<0.05;The nutritional indexes in observation group were higher than those in routine group,P<0.05;The incidence of complications in observation group was lower than that in routine group,P<0.05.Conclusion:Quality nursing service improve the effect of enteral nutrition,so as to ensure that patients get sufficient nutritional support.Its effect is remarkable and it is worthy of widespread clinical application.

A well test analysis model of generalized tube flow and seepage coupling

"Generalized mobility"is used to realize the unification of tube flow and seepage in form and the unification of commonly used linear and nonlinear flow laws in form,which makes it possible to use the same form of motion equations to construct unified governing equations for reservoirs of different scales in different regions.Firstly,by defining the generalized mobility under different flow conditions,the basic equation governing fluid flow in reservoir coupling generalized tube flow and seepage is established.Secondly,two typical well test analysis models for coupling tube flow and seepage flow are given,namely,pipe-shaped composite reservoir model and partially open cylindrical reservoir model.The log-log pressure draw-down type-curve of composite pipe-shaped reservoir model can show characteristics of two sets of linear flow.The log-log pressure drawdown plot of partially opened cylindrical reservoir model can show the characteristics of spherical flow and linear flow,as well as spherical flow and radial flow.The pressure build-up derivative curves of the two models basically coincide with their respective pressure drawdown derivative curves in the early stage,pulling down features in the late stage,and the shorter the production time is,the earlier the pulling down feature appears.Finally,the practicability and reliability of the models presented in this paper are verified by three application examples.

Sandwich structures with tapered tubes as core:A quasi-static investigation

In this article,the experimental and finite element analysis is utilized to investigate the quasi-static compression features of sandwich constructions built with tapered tubes.3D printing technology was utilized to create the hollow centers of the tapering tubes,with and without corrugations.The results demonstrate that the energy absorption(EA)and specific energy absorption(SEA)of the single corrugated tapered tube sandwich are 51.6% and 19.8% higher,respectively,than those of the conical tube sandwich.Furthermore,the results demonstrate that energy absorbers can benefit from corrugation in order to increase their efficiency.Additionally,the tapered corrugated tubes'resistance to oblique impacts was studied.Compared to a straight tube,the tapered tube is more resistant to oblique loads and has a lower initial peak crushing force(PCF),according to numerical simulations.After conducting a parametric study,it was discovered that the energy absorption performance of the sandwich construction is significantly affected by the amplitude,number of corrugations,and wall thickness.EA and SEA of DTS with corrugation number of 8 increased by 17.4%and 29.6%,respectively,while PCF decreased by 9.2% compared to DTS with corrugation number of 10.

High Density 3D Carbon Tube Nanoarray Electrode Boosting the Capacitance of Filter Capacitor

Electric double-layer capacitors(EDLCs)with fast frequency response are regarded as small-scale alternatives to the commercial bulky aluminum electrolytic capacitors.Creating carbon-based nanoarray electrodes with precise alignment and smooth ion channels is crucial for enhancing EDLCs’performance.However,controlling the density of macropore-dominated nanoarray electrodes poses challenges in boosting the capacitance of line-filtering EDLCs.Herein,a simple technique to finely adjust the vertical-pore diameter and inter-spacing in three-dimensional nanoporous anodic aluminum oxide(3D-AAO)template is achieved,and 3D compactly arranged carbon tube(3D-CACT)nanoarrays are created as electrodes for symmetrical EDLCs using nanoporous 3D-AAO template-assisted chemical vapor deposition of carbon.The 3D-CACT electrodes demonstrate a high surface area of 253.0 m^(2) g^(−1),a D/G band intensity ratio of 0.94,and a C/O atomic ratio of 8.As a result,the high-density 3D-CT nanoarray-based sandwich-type EDLCs demonstrate a record high specific areal capacitance of 3.23 mF cm^(-2) at 120 Hz and exceptional fast frequency response due to the vertically aligned and highly ordered nanoarray of closely packed CT units.The 3D-CT nanoarray electrode-based EDLCs could serve as line filters in integrated circuits,aiding power system miniaturization.

Analysis of impact pressure,rock-breaking effect,and ground vibration induced by the disposable CO_(2)fracturing tube

The technology of expansion fracturing with liquid CO_(2)(EFLCO_(2))has attracted increasing attention due to reduced vibration and damage.The disposable fracturing tube has been developed and is gradually replacing the Cardox tube.However,there is a lack of impact pressure testing of disposable tubes under real working conditions,selection of gas explosion design parameters,and systematic analysis of blasting vibration.This limitation has constrained the widespread application of disposable fracturing tubes in engineering.A joint monitoring of the pressure-time curves in the disposable tubes and boreholes was conducted.The rock-breaking effect of varying hole spacing parameters in the EFLCO_(2)design was analyzed,and a systematic study was carried out on the vibration peak value,frequency,and energy characteristics.The results show that(1)the pressure distribution characteristics,stress peak value,and duration in the disposable tubes are different from those of Cardox tubes,which show multi-peak distribution,low-pressure peak value,and short duration.The correlation between the pressure in the disposable tube,filling pressure,and liquid CO_(2)weight is established,and a theoretical calculation method for the borehole wall pressure is proposed;(2)The hole spacing in rocks of different hardness is suggested;and(3)At the same scale distance,the peak particle velocity(PPV)caused by EFLCO_(2)(PPVCO_(2))is significantly smaller than that caused by blasting(PPVexplosive).The ratio of PPVexplosive to PPVCO_(2)is a power function related to scale distance,and a distance-related zonality exist in this relationship.The frequency composition of the vibration signal caused by EFLCO_(2)is relatively simple with a narrow frequency band.Its PPV and energy are mainly concentrated in the low-frequency band.This research contributes to the optimization of disposable fracturing tubes,gas explosion design,and vibration hazard control.

Nasogastric tube syndrome:A Meta-summary of case reports

BACKGROUND Since its description in 1790 by Hunter,the nasogastric tube(NGT)is commonly used in any healthcare setting for alleviating gastrointestinal symptoms or enteral feeding.However,the risks associated with its placement are often underes-timated.Upper airway obstruction with a NGT is an uncommon but potentially life-threatening complication.NGT syndrome is characterized by the presence of an NGT,throat pain and vocal cord(VC)paralysis,usually bilateral.It is poten-tially life–threatening,and early diagnosis is the key to the prevention of fatal upper airway obstruction.However,fewer cases may have been reported than might have occurred,primarily due to the clinicians'unawareness.The lack of specific signs and symptoms and the inability to prove temporal relation with NGT insertion has made diagnosing the syndrome quite challenging.AIM To review and collate the data from the published case reports and case series to understand the possible risk factors,early warning signs and symptoms for timely detection to prevent the manifestation of the complete syndrome with life-threatening airway obstruction.METHODS We conducted a systematic search for this meta-summary from the database of PubMed,EMBASE,Reference Citation Analysis(https://www.referencecitation-analysis.com/)and Google scholar,from all the past studies till August 2023.The search terms included major MESH terms"Nasogastric tube","Intubation,Gastrointestinal","Vocal Cord Paralysis",and“Syndrome”.All the case reports and case series were evaluated,and the data were extracted for patient demographics,clinical symptomatology,diagnostic and therapeutic interventions,clinical course and outcomes.A datasheet for evaluation was further prepared.RESULTS Twenty-seven cases,from five case series and 13 case reports,of NGT syndrome were retrieved from our search.There was male predominance(17,62.96%),and age at presentation ranged from 28 to 86 years.Ten patients had diabetes mellitus(37.04%),and nine were hypertensive(33.33%).Only three(11.11%)patients were reported to be immunocompromised.The median time for developing symptoms after NGT insertion was 14.5 d(interquartile range 6.25-33.75 d).The most commonly reported reason for NGT insertion was acute stroke(10,37.01%)and the most commonly reported symptoms were stridor or wheezing 17(62.96%).In 77.78%of cases,bilateral VC were affected.The only treatment instituted in most patients(77.78%)was removing the NG tube.Most patients(62.96%)required tracheostomy for airway protection.But 8 of the 23 survivors recovered within five weeks and could be decannulated.Three patients were reported to have died.CONCLUSION NGT syndrome is an uncommon clinical complication of a very common clinical procedure.However,an under-reporting is possible because of misdiagnosis or lack of awareness among clinicians.Patients in early stages and with mild symptoms may be missed.Further,high variability in the presentation timing after NGT insertion makes diagnosis challenging.Early diagnosis and prompt removal of NGT may suffice in most patients,but a significant proportion of patients presenting with respiratory compromise may require tracheostomy for airway protection.

Crashworthiness Design and Multi-Objective Optimization of Bionic Thin-Walled Hybrid Tube Structures

Thin-walled structures are widely used in cars due to their lightweight construction and energy-absorbing properties.However,issues such as high initial stress and lowenergy-absorbing efficiency arise.This study proposes a novel energy-absorbing structure inwhich a straight tube is combinedwith a conical tube and a bamboo-inspired bulkhead structure is introduced.This configuration allows the conical tube to flip outward first and then fold together with the straight tube.This deformation mode absorbs more energy and less peak force than the conical tube sinking and flipping inward.Through finite element numerical simulation,the specific energy absorption capacity of the structure is increased by 26%compared to that of a regular circular cross-section tube.Finally,the impact resistance of the bionic straight tapered tube structure is further improved through multi-objective optimization,promoting the engineering application and lightweight design of hybrid cross-section tubes.

Hollow tubes constructed by carbon nanotubes self-assembly for CO_(2) capture

Carbon nanotubes(CNTs)have garnered significant attention in the fields of science,engineering,and medicine due to their numerous advantages.The initial step towards harnessing the potential of CNTs involves their macroscopic assembly.The present study employed a gentle and direct self-assembly technique,wherein controlled growth of CNT sheaths occurred on the metal wire’s surface,followed by etching of the remaining metal to obtain the hollow tubes composed of CNTs.By controlling the growth time and temperature,it is possible to alter the thickness of the CNTs sheath.After immersing in a solution containing 1 g/L of CNTs at 60℃ for 24 h,the resulting CNTs layer achieved a thickness of up to 60μm.These hollow CNTs tubes with varying inner diameters were prepared through surface reinforcement using polymers and sacrificing metal wires,thereby exhibiting exceptional attributes such as robustness,flexibility,air tightness,and high adsorption capacity that effectively capture CO_(2) from the gas mixture.

The robust design of PMIA braided tube reinforced PFA hollow fiber membranes with graphene doping for water-in-oil separation

In order to solve the problem of oily wastewater,the poly(m-phenyleneisophthalamide)(PMIA)braided tube reinforced(PBR)poly(tetrafluoroethylene-co-perfluoropropyl vinyl ether)(PFA)hollow fiber membrane with thermal and solvent resistant property was prepared via no-solvent green method.The membrane surface and pore structure was optimized by changing the sintering temperature and graphene(GE)content.The morphologies showed that the spherical surface with good lipophilicity was formed,and the excellent mechanical strength with a favorable interface bonding state could be obtained due to the PFA melts permeating into the supporting layer.The doping of GE produced synergistic effects with the sintering temperature owing to its good thermal conductivity and pore formation.The PBR-PFA/GE hollow fiber membrane exhibited good hydrophobicity and lipophilicity with more than 97%separation efficiency for different oil products at-0.02 MPa.With the addition of GE,the average pore size first increases and then decreases,and the porosity gradually decreases.In addition,the hollow fiber membrane showed high separation ability to the water-in-oil emulsion,and maintained a stable flux recovery rate after recycling,making it possible to apply in the field of oily wastewater treatment.

Fuzzy Control Optimization of Loading Paths for Hydroforming of Variable Diameter Tubes

The design of the loading path is one of the important research contents of the tube hydroforming process.Optimization of loading paths using optimization algorithms has received attention due to the inefficiency of only finite element optimization.In this paper,the hydroforming process of 5A02 aluminum alloy variable diameter tube was as the research object.Fuzzy control was used to optimize the loading path,and the fuzzy rule base was established based on FEM.The minimum wall thickness and wall thickness reduction rate were determined as input membership functions,and the axial feeds variable value of the next step was used as output membership functions.The results show that the optimized loading path greatly improves the uniformity of wall thickness and the forming effect compared with the linear loading path.The round corner lamination rate of the tube is 91.2%under the fuzzy control optimized loading path,which was increased by 47.1%and 22.6%compared with linear loading Path 1 and Path 2,respectively.Based on the optimized loading path in the experiment,the minimum wall thickness of the variable diameter tube was 1.32 mm and the maximum thinning rate was 12.4%.The experimental results were consistent with the simulation results,which verified the accuracy of fuzzy control.The research results provide a reference for improving the forming quality of thin-walled tubes and plates.

Heat Transfer Enhancement of the Absorber Tube in a Parabolic Trough Solar Collector through the Insertion of Novel Cylindrical Turbulators

This study includes an experimental and numerical analysis of the performances of a parabolic trough collector(PTC)with and without cylindrical turbulators.The PTC is designed with dimensions of 2.00 m in length and 1.00 m in width.The related reflector is made of lined sheets of aluminum,and the tubes are made of stainless steel used for the absorption of heat.They have an outer diameter of 0.051 m and a wall thickness of 0.002 m.Water,used as a heat transfer fluid(HTF),flows through the absorber tube at a mass flow rate of 0.7 kg/s.The dimensions of cylindrical turbulators are 0.04 m in length and 0.047 m in diameter.Simulations are performed using the ANSYS Fluent 2020 R2 software.The PTC performance is evaluated by comparing the experimental and numerical outcomes,namely,the outlet temperature,useful heat,and thermal efficiency for a modified tube(MT)(tube with novel cylindrical turbulators)and a plain tube(PT)(tube without novel cylindrical turbulators).According to the results,the experimental outlet temperatures recorded 63.2°C and 50.5°C for the MT and PT,respectively.The heat gain reaches 1137.5 Win the MT and 685.8 Win the PT.Compared to the PT collector,the PTC exhibited a(1.64 times)higher efficiency.