Objective:Medical expulsive therapy(MET)is a suitable option for facilitating stone expulsion in patients with distal ureteral stones.This meta-analysis was conducted to compare efficacy and safety of monotherapy and ...Objective:Medical expulsive therapy(MET)is a suitable option for facilitating stone expulsion in patients with distal ureteral stones.This meta-analysis was conducted to compare efficacy and safety of monotherapy and combination therapy with tamsulosin,silodosin,and tadalafil on stone expulsion rate(SER)and stone expulsion time(SET),as well as their comparative safety,numbers of colic pain episodes,and need for analgesics.Methods:Randomized controlled trials were retrieved by searching PubMed,Scopus,and Web of Science up to November 27,2023.Hand-searching was also conducted in Google Scholar to find additional records.Papers in English that compared the safety and efficacy of at least two of the above agents in adults with distal ureteral stones≤10 mm were included.Results:In total,27 studies were identified(six studies through database searches and 21 through checking reference lists and hand-searching in Google Scholar).More than half of them(n=15,56%)were conducted in India.The SER significantly improved with silodosin compared with tamsulosin(odds ratio[OR]2.24,p<0.001),whereas the difference in SET was non-significant.Tadalafil achieved a significantly higher SER compared with tamsulosin(OR 1.42,p=0.042)without any difference in SET.Subgroup analysis of 5-and 10-mg doses of tadalafil showed no significant difference in SER or SET.We found no significant difference in need for analgesics(mean difference(MD−53.73,p=0.2)or the mean number of colic episodes(MD−0.42,p=0.060)between tadalafil and tamsulosin.SER or SET was not significantly different between silodosin and tadalafil.Tadalafil plus tamsulosin led to a significantly higher SER(OR 1.87,p<0.001)and SET(MD−2.99,p=0.002)compared with tamsulosin,without any significant difference in adverse effects.Conclusion:Compared with tamsulosin,SER significantly improved with silodosin,tadalafil,and the combination of tadalafil plus tamsulosin.Meanwhile,the difference in SET was only significant between tadalafil plus tamsulosin versus tamsulosin.It appears that tadalafil and silodosin have similar efficacy in SET and SER.All medical expulsive therapies had comparable safety.展开更多
Foamed asphalt typically relies on water as a foaming agent because water becomes gaseous at elevated temperatures, generating numerous tiny bubbles in the asphalt and causing spontaneous foaming. In this study, ethan...Foamed asphalt typically relies on water as a foaming agent because water becomes gaseous at elevated temperatures, generating numerous tiny bubbles in the asphalt and causing spontaneous foaming. In this study, ethanol was used as a potential alternative to water as a foaming agent. Ethanol is expected to be a physical blowing agent in the same manner as water, except it requires less energy to foam due to its 78 ℃ boiling point. This study compares the performance of water and ethanol as foaming agents through the measurements of rotational viscosity, the reduction in temperature during foaming, and volatile loss. The ethanol-foamed asphalt binders were prepared at 80 ~C and 100 ~C, while the water-foamed asphalt binders were prepared at 100 ~C and 120 ~＇C. Additionally, the rolling thin film oven （RTFO） was used to generate short-term aging of the foamed asphalt binders. A rotational viscometer was used to determine the viscosity of the asphalt binders at 80 ~C, 100 ~C, 120 ~C, 140 ~C, and 160 ~C. Overall, ethanol can function in the same manner as water but requires less energy to foam. It is proven based on the smaller drop in temperature of the asphalt binder foamed using ethanol compared with that prepared with water. This is due to the lower latent heat capacity of ethanol, which requires less energy to vaporize compared with water. Through the rotational viscometer test, ethanol performs better in lowering the viscosity of asphalt binders, which is essential in allowing produc- tion processes at low temperatures, as well as a better workability and aggregate coating. Ethanol can be expelled from the foamed asphalt binders at a higher rate due to its lower boiling point and latent heat.展开更多
文摘Objective:Medical expulsive therapy(MET)is a suitable option for facilitating stone expulsion in patients with distal ureteral stones.This meta-analysis was conducted to compare efficacy and safety of monotherapy and combination therapy with tamsulosin,silodosin,and tadalafil on stone expulsion rate(SER)and stone expulsion time(SET),as well as their comparative safety,numbers of colic pain episodes,and need for analgesics.Methods:Randomized controlled trials were retrieved by searching PubMed,Scopus,and Web of Science up to November 27,2023.Hand-searching was also conducted in Google Scholar to find additional records.Papers in English that compared the safety and efficacy of at least two of the above agents in adults with distal ureteral stones≤10 mm were included.Results:In total,27 studies were identified(six studies through database searches and 21 through checking reference lists and hand-searching in Google Scholar).More than half of them(n=15,56%)were conducted in India.The SER significantly improved with silodosin compared with tamsulosin(odds ratio[OR]2.24,p<0.001),whereas the difference in SET was non-significant.Tadalafil achieved a significantly higher SER compared with tamsulosin(OR 1.42,p=0.042)without any difference in SET.Subgroup analysis of 5-and 10-mg doses of tadalafil showed no significant difference in SER or SET.We found no significant difference in need for analgesics(mean difference(MD−53.73,p=0.2)or the mean number of colic episodes(MD−0.42,p=0.060)between tadalafil and tamsulosin.SER or SET was not significantly different between silodosin and tadalafil.Tadalafil plus tamsulosin led to a significantly higher SER(OR 1.87,p<0.001)and SET(MD−2.99,p=0.002)compared with tamsulosin,without any significant difference in adverse effects.Conclusion:Compared with tamsulosin,SER significantly improved with silodosin,tadalafil,and the combination of tadalafil plus tamsulosin.Meanwhile,the difference in SET was only significant between tadalafil plus tamsulosin versus tamsulosin.It appears that tadalafil and silodosin have similar efficacy in SET and SER.All medical expulsive therapies had comparable safety.
基金the National Science Foundation(NSF),which funded a research grant through the SusChem/Collaborative Research Program(award number: 1300286)
文摘Foamed asphalt typically relies on water as a foaming agent because water becomes gaseous at elevated temperatures, generating numerous tiny bubbles in the asphalt and causing spontaneous foaming. In this study, ethanol was used as a potential alternative to water as a foaming agent. Ethanol is expected to be a physical blowing agent in the same manner as water, except it requires less energy to foam due to its 78 ℃ boiling point. This study compares the performance of water and ethanol as foaming agents through the measurements of rotational viscosity, the reduction in temperature during foaming, and volatile loss. The ethanol-foamed asphalt binders were prepared at 80 ~C and 100 ~C, while the water-foamed asphalt binders were prepared at 100 ~C and 120 ~＇C. Additionally, the rolling thin film oven （RTFO） was used to generate short-term aging of the foamed asphalt binders. A rotational viscometer was used to determine the viscosity of the asphalt binders at 80 ~C, 100 ~C, 120 ~C, 140 ~C, and 160 ~C. Overall, ethanol can function in the same manner as water but requires less energy to foam. It is proven based on the smaller drop in temperature of the asphalt binder foamed using ethanol compared with that prepared with water. This is due to the lower latent heat capacity of ethanol, which requires less energy to vaporize compared with water. Through the rotational viscometer test, ethanol performs better in lowering the viscosity of asphalt binders, which is essential in allowing produc- tion processes at low temperatures, as well as a better workability and aggregate coating. Ethanol can be expelled from the foamed asphalt binders at a higher rate due to its lower boiling point and latent heat.
