Prospective switch study comparing two irrigation systems for transanal irrigation in children

Background and study aims: Transanal irrigation (TAI) is used in children to treat constipation and incontinence. Belgium has 2 systems available: Colotip® (cheaper, however not designed for TAI) or Peristeen®. Patients and methods: This patient-control switch study is the first to compare 2 TAI systems. Children regularly using Colotip® for TAI were asked to participate, after consent, a visual analogue scale (VAS) rating the system and a 2-week diary (fecal continence, self-reliance, time spent on the toilet, pain, Bristol stool scale, irrigation volume and frequency of enema) were completed. Non-parametric statistics were used. Results: Out of 26 children using Colotip®, 18 (69%) children participated and 5 refused (fear n=1, satisfaction Colotip® system n=7). Of these 18 children (interquartile range: 3-18 years, median 12.5 years, 9 girls) 5 patients stopped Peristeen® (pain n=1, fear n=1 and balloon loss n=3) and 2 were lost from follow up. Dropouts and included patients showed no statistical difference. In the 11 remaining patients, pseudo-continence (p 0.015), independence (p 0.01) and VAS score (p 0.007) were significantly better with Peristeen®, no difference was found in time spent on the toilet (p 0.288) and presence of pain (p 0.785). Conclusions: In children Peristeen® offered significantly higher pseudo-continence and independency. 30% refused participation because of satisfaction with the Colotip® and 30% spina bifida patients reported rectal balloon loss due to sphincter hypotony. To diminish Peristeen® failure, a test-catheter could be of value. Considering Colotip® satisfaction, both systems should be available. Patient selection for Peristeen® needs further research.

Holmium laser enucleation of the prostate with Virtual Basket mode: faster and better control on bleeding

Background To compare clinical intra and early postoperative outcomes between conventional Holmium laser enucleation of the prostate (HoLEP) and Holmium laser enucleation of the prostate using the Virtual Basket tool (VB-HoLEP) to treat benign prostatic hyperplasia (BPH). Methods This prospective randomized study enrolled consecutive patients with BPH, who were assigned to undergo either HoLEP (n = 100), or VB-HoLEP (n = 100). All patients were evaluated preoperatively and postoperatively, with particular attention to catheterization time, operative time, blood loss, irrigation volume and hospital stay. We also evaluated the patients at 3 and 6 months after surgery and assessed maximum flow rate (Qmax), postvoid residual urine volume (PVR), the International Prostate Symptom Score (IPSS) and the Quality of Life score (QOLS). Results No significant differences in preoperative parameters between patients in each study arm were found. Compared to HoLEP, VB-HoLEP resulted in less hemoglobin decrease (2.54 vs. 1.12 g/dl, P = 0.03) and reduced operative time (57.33 ± 29.71 vs. 42.99 ± 18.51 min, P = 0.04). HoLEP and VB-HoLEP detrmined similar catheterization time (2.2 vs. 1.9 days, P = 0.45), irrigation volume (33.3 vs. 31.7 l, P = 0.69), and hospital stay (2.8 vs. 2.7 days, P = 0.21). During the 6-month follow-up no significant differences in IPSS, Qmax, PVR, and QOLS were demonstrated. Conclusions HoLEP and VB-HoLEP are both efficient and safe procedures for relieving lower urinary tract symptoms. VB-HoLEP was statistically superior to HoLEP in blood loss and operative time. However, procedures did not differ significantly in catheterization time, hospital stay, and irrigation volume. No significant differences were demonstrated in QOLS, IPSS, Qmax and PVR throughout the 6-month follow-up. Trial Registration: Current Controlled Trials ISRCTN72879639; date of registration: June 25th, 2015. Retrospectively registred.

Influence of Mean Leaf Angles and Irrigation Volumes on Water Capture, Leaching, and Growth of Tropical Tree Seedlings

Research Highlights: The mean leaf angle and crown projection area can be used as criteria for grouping tree seedling species in different irrigation zones in tree nurseries with overhead microsprinkler systems, preventing water and fertilizer waste, and increasing growth. Background and Objectives: There are important gaps in current functional knowledge about how plant architecture, especially the mean leaf angles of tree seedlings, affect water and nutrient solution capture in overhead microsprinkler systems. These gaps contribute to water and fertilizer waste in tree nurseries. This research aimed to ascertain how mean leaf angles affect irrigation water capture, leaching, and the growth of tree seedlings given different volumes of irrigation. Materials and Methods: Nine species of tree seedlings with different mean leaf angles were submitted to four irrigation volumes (8, 10, 12, and 14 mm) applied daily by overhead microsprinklers in a split-plot design completely randomized. The variables leaching fraction, height, stem diameter, shoot, root, and total dry mass, Dickson quality index, crown projection area, root system quality, and leachate electrical conductivity were evaluated. Results: For species with mean leaf angles of −54, 31, 38, 42, 55, 57, and 58°, the 8 mm irrigation volume was sufficient to produce greater growth and less leaching. For species with angles of −56 and −14°, the 14 mm irrigation volume was required to produce greater growth. Conclusions: The tree seedling species with positive mean leaf angles facilitate irrigation water and nutrient solution capture, allowing the application of lower irrigation volume. On the other hand, some tree seedling species with negative mean leaf angles hinder irrigation water and nutrient solution capture, requiring the application of higher irrigation volume. When the tree seedling species have a negative mean leaf angle, but the crown projection area is small, the difficulty of water and nutrient solution reaches directly the substrate is attenuated.

Analisis Kebutuhan Air Irigasi Pada Jaringan Sekunder Di Kota Palopo

Tujuan khusus penelitian ini untuk menganalisis banyaknya debit air dan efesiensi kebutuhan air pada jaringan irigasi sekunder di Kelurahan Mawa Kecamatan Sendana Kota Palopo. Urgensi penelitian ini, untuk mengetahui efisiensi irigasi dalam melakukan pengukuran dan pengaturan yang tepat sasaran, volume irigasi untuk memenuhi kebutuhan pertumbuhan tanaman. Metode yang digunakan dalam pengukuran debit adalah metode pelampung (apung) dengan Cara mengambil beberapa titik koordinat geografis irigasi untuk pengambilan data, sehingga memberikan data yang akurat dalam pengembangan irigasi di Kelurahan Mawa Kecamatan Sendana kedepan.Hasil penelitian; (1). Jumlah air yang masuk di saluran sekunder hulu sebesar 0.3580 m3/det., dan tiba di titik akhir penelitian sangat kurang yaitu sebesar 0.0985m3/det, dan jika dihitung secara keseluruhan dapat diketahui total jumlah debit airyang masuk pada jaringan irigasi sekunder Mawa yaitu 2,29170436 m3/det. atau setara dengan 2.291.704,36 liter/ha. (2). Efesiensi penggunaan air irigasi jaringan sekunder Mawa sebesar 36%, dan kehilangan air disepanjang saluransebesar 64 %, hal ini menandakan bahwa saluran sekunder Mawa masih belum mencapai standar efesiensi yang diharuskan oleh direktorat jendral pengairan, departemen pekerjaan umum yang dipersyaratkan dalam standar perencanaan irigasi KP-01.The specific purpose of this research is to analyze the amount of water discharge and the efficiency of water needs in secondary irrigation networks in Mawa Village, Sendana District, Palopo City. The urgency of this research is to determine the efficiency of irrigation in measuring and setting the right target of irrigation volume to meet the needs of plant growth. The method used in measuring discharge is the buoy method by taking several geographic coordinates of irrigation as data collection, so as to provide accurate data in the development of irrigation in Mawa Village, Sendana District in the future. The results: (1) The amount of water that enters the upstream secondary channel is 0.3580 m3/s and arrives at the endpoint of the study with a very low amount of water, namely 0.0985 m3/s, and if it is calculated as a whole it can be seen the total amount of water discharge. which is included in the Mawa secondary irrigation network, namely 2.29170436 m3/s or equivalent to 2,291,704.36 liters/ha. (2) The efficiency of the use of Mawa's secondary network irrigation water is 36%, and the water loss along the canal is 64%, this indicates that the Mawa secondary channel still has not reached the efficiency standard required by the Directorate General of Irrigation, under the Ministry of Public Works which is required in irrigation planning standards KP-01

Holmium Laser Enucleation of the Prostate With Virtual Basket Mode: Faster and Better Control on Bleeding

BACKGROUND: To compare clinical intra and early postoperative outcomes between conventional Holmium laser enucleation of the prostate (HoLEP) and Holmium laser enucleation of the prostate with Virtual Basket tool (VB-HoLEP) to treat benign prostatic hyperplasia (BPH).METHODS: This prospective randomized study enrolled consecutive patients with BPH to HoLEP (n = 100) or VB-HoLEP (n =100). We evaluated all patients preoperatively with particular attention to catheterization time, operative time, blood loss, irrigation volume and hospital stay. We evaluated also the patients at 3, 6 and 12 months after surgery with the use of maximum flow rate (Qmax), postvoid residual urine volume (PVR) and International Prostate Symptom Score (IPSS).RESULTS: We didn’t see significant difference in preoperative parameters between patients in each study arm. Compared with HoLEP, VB-HoLEP resulted in less hemoglobin decrease (2.54 vs 1.12 g/dL, P = .003) and had a more rapid operative time (57.33±29.71 vs 42.99±18.51 minutes, P = 0.04). HoLEP and VB-HoLEP had same catheterization time (2.2 vs 1.9 days, P = 0.45), irrigation volume (33.3 vs 31.7 L, P = 0.69), and hospital stay (2.8 vs 2.7 days, P = 0.21). During the follow-up of subsequent 12 months, we didn’t demonstrate a significant difference in IPSS, Qmax, PVR, and QOLS.CONCLUSION: HoLEP and VB-HoLEP both are efficient a safe procedure for relieving lower urinary tract symptoms. VB-HoLEP was statistically superior to HoLEP in blood loss and to allow a faster procedure. However, procedures did not differ significantly in catheterization time, hospital stay, operation time and irrigation volume. No differences were demonstrated in QOLF, IPSS, Qmax and PVR through the post-surgery 12 months of follow-up.TRIAL REGISTRATION: Current Controlled Trials ISRCTN72879639; date of registration: June 25th, 2015. Retrospectively registred.

Farmers Try to Improve Their Irrigation Practices by Using Daily Irrigation Recommendations—The Vipava Valley Case, Slovenia

Based on the latest climate change projections for the 21st century, high exposure to climate change is expected in Vipava Valley, Slovenia’s sub-Mediterranean agricultural area. An irrigation-decision support system was developed and implemented on 35 farms in the period of 2016–2020 to increase agricultural climate-change resilience. Farmers have shifted from irrigation scheduling based on experience and assumptions to irrigation scheduling based on real-time soil-water monitoring to partially implement irrigation based on irrigation-decision support systems. Simulations show that if farmers continue to practice justified irrigation applications and gradually transition to replenishing soil water reservoir content to 85%, they will achieve a 25% reduction in total irrigation-volume consumption, a 24% reduction in energy requirements and a 24% reduction in CO2 emissions. Future agricultural innovation policies should extend actions beyond the financial to those facilitating the establishment of multidisciplinary agricultural innovation teams with corresponding infrastructures to better enable the mutual exchange of knowledge, learning and development of a transparent institutional framework.