Global geoepidemiology of gastrointestinal surgery rates in Crohn’s disease

BACKGROUND Data regarding the worldwide gastrointestinal surgery rates in patients with Crohn’s disease(CD)remains limited.AIM To systematically review the global variation in the rates of surgery in CD.METHODS A comprehensive search analysis was performed using multiple electronic databases from inception through July 1,2020,to identify all full text,randomized controlled trials and cohort studies pertaining to gastrointestinal surgery rates in adult patients with CD.Outcomes included continent based demographic data,CD surgery rates over time,as well as the geoepidemiologic variation in CD surgery rates.Statistical analyses were conducted using R.RESULTS Twenty-three studies spanning four continents were included.The median proportion of persons with CD who underwent gastrointestinal surgery in studies from North America,Europe,Asia,and Oceania were 30%(range:1.7%-62.0%),40%(range:0.6%-74.0%),17%(range:16.0%-43.0%),and 38%respectively.No clear association was found regarding the proportion of patients undergoing gastrointestinal surgery over time in North America(R^(2)=0.035)and Europe(R^(2)=0.100).A moderate,negative association was seen regarding the proportion of patients undergoing gastrointestinal surgery over time(R^(2)=0.520)in Asia.CONCLUSION There appears to be significant inter-continental variation regarding surgery rates in CD.Homogenous evidencebased guidelines accounting for the geographic differences in managing patients with CD is prudent.Moreover,as a paucity of data on surgery rates in CD exists outside the North American and European continents,future studies,particularly in less studied locales,are warranted.

In situ and operando infrared spectroscopy of battery systems:Progress and opportunities

In situ and operando infrared spectroscopies are powerful techniques to support the design of novel materials for batteries and the development of new battery systems.These techniques can support the study of batteries by identifying the formation of new species and monitoring electrochemical energy stability.However,few works have employed these techniques,which can be used to investigate various materials,including systems beyond lithium-ion technology,in the research of batteries.Therefore,this review presents a comprehensive overview focusing on the main contributions of in situ and operando infrared spectroscopy for lithium-ion batteries(LIBs)and other battery systems.These techniques can successfully identify the formation of species during the electrolyte reduction,electrode degradation,and the formation of the solid-electrolyte interphase(SEI)layer.From these outcomes,it is possible to conclude that this characterization approach should be employed as a protocol to overcome remaining issues in batteries,consequently supporting battery research.This review aims to be a guide on how infrared spectroscopy can contribute to monitoring battery systems and to lead researchers interested in applying this technique.

Endoscopic management of postcholecystectomy biliary leakage

BACKGROUND: Biliary leak is an uncommon but significant complication following cholecystectomy. Endotherapy is an established method of treatment. However, the optimal intervention is not known. METHOD: Eighty-five patients with postcholecystectomy biliary leaks from July 2000 to March 2009 were retrospectively evaluated. RESULTS: The study population was 20 males and 65 females with a mean age of 42.47 years. Patients presented with abdominal pain (46), jaundice (23), fever (23), abdominal distension (42), or bilious abdominal drain (67). Endoscopic retrograde cholangiopancreatography detected a leak at the cystic duct stump in 45 patients, stricture with middle common bile duct leak in 4, leak from the right hepatic duct in 3, and a ligated common bile duct in 32. Twelve also had bile duct stones. One had a broken T-tube with stones Endotherapy was possible in 53 patients. Three patients with stones, one with a broken T-tube with stones, and 4 with stricture of the common bile duct with a leak were managed with sphincterotomy and stenting. Eight patients with a cystic duct stump leak with stones were managed with sphincterotomy and stone extraction. Three outpatients and 12 inpatients with a cystic duct stump leak were managed with sphincterotomy and stent and sphincterotomy and nasobiliary drain, respectively. Five patients with a cystic duct stump leak were managed with stenting. Sixteen with coagulopathy were managed with only nasobiliary drain (9) or stent (7). Leak closure was achieved in 100% patients Four developed mild pancreatitis which improved with conservative treatment.CONCLUSIONS: Endoscopic intervention is a safe and effective method of treatment of postcholecystectomy biliary leaks. However, management should be individualized based on factors such as outpatients or inpatients, presence of stone, stricture, ligature, or coagulopathy.

Contrast-free air cholangiography-assisted unilateral plastic stenting in malignant hilar biliary obstruction

BACKGROUND:Endoscopic palliation in malignant hilar biliary obstruction requires endoscopic retrograde cholangiopancreatography (ERCP),whereas contrast injection leads to cholangitis.Contrast-free metal stenting with or without magnetic resonance cholangiopancreatography (MRCP) has shown encouraging results,but MRCP and metal stents are costly.There have been no reports on the use of air cholangiography.METHODS:We prospectively evaluated the role of air cholangiography-assisted unilateral plastic stenting in 10 patients with type Ⅱ malignant hilar biliary obstruction.A retrospectively analysed group of 10 patients treated with contrast-free unilateral metal stenting served as historical controls.RESULTS:Ten patients with unresectable type Ⅱ malignant hilar biliary obstruction were studied.Air cholangiography detected type Ⅱ obstruction in all patients,similar to MRCP.The patients underwent unilateral stenting.Successful endoscopic drainage was achieved in all patients.The mean patency of the stent was 95.8±17.5 days in the study group and 143.9±115.1 days in the control group (P=0.20).The mean survival was 121.8±41.6 days in the study group and 154.9±122.5 days in the control group (P=0.42).KaplanMeier analysis showed an estimated median survival of 100:95% CI (65.9,134.1) days in the study group and 98:95% CI (84.1,111.9) days in the control group (P=0.62).Cholangitis occurred in none of the patients and there were no 30-day deaths nor major complications.Air cholangiographyassisted unilateral plastic stenting was cheaper than contrastfree unilateral metal stenting.CONCLUSION:Air cholangiography-assisted unilateral plastic stenting is as safe and effective as contrast-free unilateral metal stenting in type Ⅱ malignant hilar biliary obstruction for palliating patients,but it is cheaper.

Beyond Graphene Anode Materials for Emerging Metal Ion Batteries and Supercapacitors

Intensive research effort is currently focused on the development of efficient, reliable, and environmentally safe electrochemical energy storage systems due to the ever-increasing global energy storage demand. Li ion battery systems have been used as the primary energy storage device over the last three decades. However, low abundance and uneven distribution of lithium and cobalt in the earth crust and the associated cost of these materials, have resulted in a concerted effort to develop beyond lithium electrochemical storage systems. In the case of non-Li ion rechargeable systems, the development of electrode materials is a significant challenge, considering the larger ionic size of the metal-ions and slower kinetics. Two-dimensional(2D) materials, such as graphene, transition metal dichalcogenides, MXenes and phosphorene, have garnered significant attention recently due to their multi-faceted advantageous properties: large surface areas, high electrical and thermal conductivity, mechanical strength, etc. Consequently, the study of 2D materials as negative electrodes is of notable importance as emerging non-Li battery systems continue to generate increasing attention. Among these interesting materials, graphene has already been extensively studied and reviewed, hence this report focuses on 2D materials beyond graphene for emerging non-Li systems. We provide a comparative analysis of 2D material chemistry, structure, and performance parameters as anode materials in rechargeable batteries and supercapacitors.

Natural history and outcomes of patients with liver cirrhosis complicated by hepatic hydrothorax

BACKGROUNDHepatic hydrothorax (HH) is an uncommon and difficult-to-manage complicationof cirrhosis with limited treatment options.AIMTo define the clinical outcomes of patients presenting with HH managed withcurrent standards-of-care and to identify factors associated with mortality.METHODSCirrhotic patients with HH presenting to 3 tertiary centres from 2010 to 2018 wereretrospectively identified. HH was defined as pleural effusion in the absence ofcardiopulmonary disease. The primary outcomes were overall and transplant-freesurvival at 12-mo after the index admission. Cox proportional hazards analysiswas used to determine factors associated with the primary outcomes.RESULTSOverall, 84 patients were included (mean age, 58 years) with a mean model forend-stage liver disease score of 29. Management with diuretics alone achievedlong-term resolution of HH in only 12% patients. At least one thoracocentesis wasperformed in 73.8% patients, transjugular intrahepatic portosystemic shuntinsertion in 11.9% patients and 33% patients received liver transplantation within12-mo of index admission. Overall patient survival and transplant-free survival at12 mo were 68% and 41% respectively. At multivariable analysis, current smoking [hazard ratio (HR) = 8.65, 95% confidence interval (CI): 3.43-21.9, P < 0.001) and acute kidneyinjury (AKI) (HR = 2.91, 95%CI: 1.21-6.97, P = 0.017) were associated with a significantly increasedrisk of mortality.CONCLUSIONCirrhotic patients with HH are a challenging population with a poor 12-mo survival despitecurrent treatments. Current smoking and episodes of AKI are potential modifiable factors affectingsurvival. HH is often refractory of diuretic therapy and transplant assessment should beconsidered in all cases.

Effect of Gossypol on Bovine Blastocyst Attachment and Trophoblastic outgrowth in Vitro

The presont study was carried out to investigate the effect of different amounts of gossypol on bovineblastocyst attachment and trophoblastic outgrowth in vitro. Bovine oocyte were collected from theovaries of slaughtered cows and were matured and fertilized in vitro. Cleaved oocyte were culturedin CRlaa + BOEC and TC-199 + 10% FCS combined in an 1:1 ratio. After 8 days of co-culture,the hatched blastocysts were randomly allotted to different treatment groups. All were cultured ona fetal fibroblast monolaycr (prepared from bovine fetuses) in TC-199 culture medium supplementedwith 10% fetal calf serum (TCFCS). But the groups differed from one another in the dose ofgossypol given: 0.01 μg, 0.1 μg, 1 μg, 10 μs/ml, and no gossypol as control. All cultures wereperformed in 24-well culture plates at 39℃ with 5% CO_2 in air. The results indicate that the ratesof attached and outgrowing blastocysts in the medium containing 1 μg/ml gossypol were significantlylowcr than the control group (p<0.01) and outgrowth were inhibited by gossypol in a dose-dependent manner.

Plant based metabolomics:a future prospective and versatile tool for metabolite databases of Curcuma longa

Sophisticated analytical instruments are used for quality evaluation and scientific validation to compliance the Sophisticated analytical instruments are used for quality evaluation and scientific validation to compliance the market demands.Recently,increase in demand of Curcuma longa has led to a high swing in small and medium food industry.The present review is devoted to an in-depth information on metabolite database of C.longa from different analytical techniques such as high-performance thin-layer chromatography(HPTLC),liquid chromatography-mass spectrometry,gas chromatography-mass spectrometry and nuclear magnetic resonance.This work highlights different extraction methods,phytochemistry along with structure activity relationship,nutritional profiling,market viability and pharmacology of C.longa.The bioactives of C.longa depends on various factors such as plants growth,temperature,humidity,soil type,collection,drying and extraction process.These factors can contribute in quality evaluation of the food supplements if need to be included.The introduction of omics approaches can helpful to explore the quality and identification of potential lead of C.longa.The results could play an essential role in the area of food-phyto based profiling.Further,metabolomics techniques may provide a analytical platfom by combination of different"omics"data souces for future esearch to food sand herbal based products.

Multiple-order line rogue wave,lump and its interaction,periodic,and cross-kink solutions for the generalized CHKP equation

The multiple-order line rogue wave solutions method is emp loyed for searching the multiple soliton solutions for the generalized(2+1)-dimensional Camassa-HolmKadomtsev-Petviashvili(CHKP)equation,which contains first-order,second-order,and third-order waves solutions.At the critical point,the second-order derivative and Hessian matrix for only one point will be investigated and the lump solution has one minimum value.For the case,the lump solution will be shown the bright-dark lump structure and for another case can be present the dark lump structure-two small peaks and one deep hole.Also,the interaction of lump with periodic waves and the interaction between lump and soliton can be obtained by introducing the Hirota forms.In the meanwhile,the cross-kink wave and periodic wave solutions can be gained by the Hirota operator.The physical phenomena of these gained multiple soliton solutions are analyzed and indicated in figures by selecting suitable values.We alternative offer that the determining method is general,impressive,outspoken,and powerful and can be exerted to create exact solutions of various kinds of nonlinear models originated in mathematical physics and engineering.