Gender disparities and woman-specific trends in Barrett’s esophagus in the United States:An 11-year nationwide populationbased study

BACKGROUND Barrett's esophagus(BE)is a known premalignant precursor to esophageal adenocarcinoma(EAC).The prevalence rates continue to rise in the United States,but many patients who are at risk of EAC are not screened.Current practice guidelines include male gender as a predisposing factor for BE and EAC.The population-based clinical evidence regarding female gender remains limited.AIM To study comparative trends of gender disparities in patients with BE in the United States.METHODS A nationwide retrospective study was conducted using the 2009-2019 National Inpatient Sample(NIS)database.Patients with a primary or secondary diagnosis code of BE were identified.The major outcome of interest was determining the gender disparities in patients with BE.Trend analysis for respective outcomes for females was also reported to ascertain any time-based shifts.RESULTS We identified 1204190 patients with BE for the study period.Among the included patients,717439(59.6%)were men and 486751(40.4%)were women.The mean age was higher in women than in men(67.1±0.4 vs 66.6±0.3 years,P<0.001).The rate of BE per 100000 total NIS hospitalizations for males increased from 144.6 in 2009 to 213.4 in 2019(P<0.001).The rate for females increased from 96.8 in 2009 to 148.7 in 2019(P<0.001).There was a higher frequency of obesity among women compared to men(17.4%vs 12.6%,P<0.001).Obesity prevalence among females increased from 12.3%in 2009 to 21.9%in 2019(P<0.001).A lower prevalence of smoking was noted in women than in men(20.8%vs 35.7%,P<0.001).However,trend analysis showed an increasing prevalence of smoking among women,from 12.9%in 2009 to 30.7%in 2019(P<0.001).Additionally,there was a lower prevalence of alcohol abuse,Helicobacter pylori(H.pylori),and diabetes mellitus among females than males(P<0.001).Trend analysis showed an increasing prevalence of alcohol use disorder and a decreasing prevalence of H.pylori and diabetes mellitus among women(P<0.001).CONCLUSION The prevalence of BE among women has steadily increased from 2009 to 2019.The existing knowledge concerning BE development has historically focused on men,but our findings show that the risk in women is not insignificant.

Early versus delayed necrosectomy in pancreatic necrosis:A population-based cohort study on readmission,healthcare utilization,and in-hospital mortality

BACKGROUND Acute necrotizing pancreatitis is a severe and life-threatening condition.It poses a considerable challenge for clinicians due to its complex nature and the high risk of complications.Several minimally invasive and open necrosectomy procedures have been developed.Despite advancements in treatment modalities,the optimal timing to perform necrosectomy lacks consensus.AIM To evaluate the impact of necrosectomy timing on patients with pancreatic necrosis in the United States.METHODS A national retrospective cohort study was conducted using the 2016-2019 Nationwide Readmissions Database.Patients with non-elective admissions for pancreatic necrosis were identified.The participants were divided into two groups based on the necrosectomy timing:The early group received intervention within 48 hours,whereas the delayed group underwent the procedure after 48 hours.The various intervention techniques included endoscopic,percutaneous,or surgical necrosectomy.The major outcomes of interest were 30-day readmission rates,healthcare utilization,and inpatient mortality.RESULTS A total of 1309 patients with pancreatic necrosis were included.After propensity score matching,349 cases treated with early necrosectomy were matched to 375 controls who received delayed intervention.The early cohort had a 30-day readmission rate of 8.6% compared to 4.8%in the delayed cohort(P=0.040).Early necrosectomy had lower rates of mechanical ventilation(2.9%vs 10.9%,P<0.001),septic shock(8%vs 19.5%,P<0.001),and in-hospital mortality(1.1%vs 4.3%,P=0.01).Patients in the early intervention group incurred lower healthcare costs,with median total charges of $52202 compared to$147418 in the delayed group.Participants in the early cohort also had a relatively shorter median length of stay(6 vs 16 days,P<0.001).The timing of necrosectomy did not significantly influence the risk of 30-day readmission,with a hazard ratio of 0.56(95%confidence interval:0.31-1.02,P=0.06).CONCLUSION Our findings show that early necrosectomy is associated with better clinical outcomes and lower healthcare costs.Delayed intervention does not significantly alter the risk of 30-day readmission.

Water-stable ZIF-300/Ultrason? mixed-matrix membranes for selective CO_2 capture from humid post combustion flue gas

Water stable mixed-matrix membranes(MMMs) were developed to help control the global warming by capturing and sequestrating carbon dioxide(CO_2) from post-combustion flue gas originated from burning of fossil fuels.MMMs of different compositions were prepared by doping glassy polymer Ultrason? S 6010(US) with nanocrystals of zeolitic imidazolate frameworks(ZIF-300) in varying degrees. Solution-casting technique was used to fabricate various MMMs to optimize their CO_2 capturing performance from both dry and wet gases. The prepared composite membranes indicated enhanced filler-polymer interfacial adhesion, consistent distribution of nanofiller, and thermally established matrix configuration. CO_2 permeability of the membranes was enhanced as demonstrated by gas sorption and permeation experiments performed under both dry and wet conditions. As compared to neat Ultrason? membrane, CO_2 permeability of the composite membrane doped with 40 wt% ZIF-300 nanocrystals was increased by four times without disturbing CO_2/N_2 ideal selectivity. In contrast to majority of previously reported membranes, key features of the fabricated MMMs include their structural stability under humid conditions coupled with better and unaffected gas separation performance.

On REE and EER Methods for Mining Corner Points on the Images

This paper reviews, implements and compares two corner detection algorithms for mining corner points on the generic shapes. These corner detectors detect corners by using combination of one rectangle (R) and two ellipses (EE). These algorithms have been used with different combinations: REE and EER together with different parameter settings in their descriptions. REE and EER combinations slide along the boundary of the shape and record number of boundary points in each rectangle and ellipses. REE and EER setup represent both local and global views of the image outlines and present natural corner detection methodologies to detect and mine all true corners accurately. A comparative study demonstrates the superiority of the REE and EER over some of the existing algorithms.

Genetic Algorithm Works for Vectoring Image Outlines of Generic Shapes

This work proposes a scheme which helps digitizing hand printed and electronic planar objects or vectorizing the generic shapes. An evolutionary optimization technique namely Genetic Algorithm (GA) is used to solve the problem of curve fitting with a cubic spline function. GA works well for finding the optimal values of shape parameters in the description of the proposed cubic spline. The underlying scheme comprises of various phases including data of the image outlines, detection of corner points, using GA for optimal values of shape parameters, and fitting curve using cubic spline to the detected corner points.

Intelligent Approaches for Vectorizing Image Outlines

Two computing approaches, based on linear and conic splines, are proposed here in reviewed and extended for vectorizing image outlines. Both of the approaches have various phases including extracting outlines of images, detecting corner points from the detected outlines, and curve fitting. Interpolation splines are the bases of the two approached. Linear spline approach is straight forward as it does not have a degree of freedom.in terms of some shape controller in its description. However, the idea of the soft computing approach, namely simulated annealing, has been utilized for conic splines. This idea has been incorporated to optimize the shape parameters in the description of the generalized conic spline. Both of the linear and conic approaches ultimately produce optimal results for the approximate vectorization of the digital contours obtained from the generic shapes.

Modeling of Objects Using Conic Splines

This paper contributes towards modeling for the designing of objects in the areas of Computer Graphics (CG), Computer-Aided Design (CAD), Computer-Aided Manufacturing (CAM), and Computer-Aided Engineering (CAE). It provides a modeling technique for the designing of objects. The model is based on a conic-like curve (rational quadratics) method and provides an extra degree of freedom to the user to fine tune the shape of the design to the satisfactory level. The 2D curve model has then been extended for the designing of 3D objects to produce fancy objects. The scheme has been also extended to automate the degree of freedom when a reverse engineering is required for images of the objects. A heuristic technique of genetic algorithm is applied to find optimal values of shape parameters in the description of conics.

Platinum complexes of curcumin delivered by dual-responsive polymeric nanoparticles improve chemotherapeutic efficacy based on the enhanced anti-metastasis activity and reduce side effects

Platinum-based chemotherapy is used for non-small cell lung cancer(NSCLC).However,it has side effects and minimum efficacy against lung cancer metastasis.In this study,platinum-curcumin complexes were loaded into pH and redox dual-responsive nanoparticles(denoted as Pt-CUR@PSPPN)to facilitate intracellular release and synergistic anti-cancer effects.Pt-CUR@PSPPN was prepared by a nano-precipitation method and had a diameter of^100 nm.The nanoparticles showed increased anticancer effects both in vivo and in vitro.In addition,Pt-CUR@PSPPN blocked PI3K/AKT signal transduction pathway and inhibited MMP2 and VEGFR2,resulting in enhanced anti-metastatic activity.Furthermore,reduced side effects were also observed.In conclusion,Pt-CUR@PSPPN provided a novel and attractive therapeutic strategy for NSCLC.

Neural stem cell-based in vitro bioassay for the assessment of neurotoxic potential of water samples

Intensive agriculture activities,industrialization and growing numbers of wastewater treatment plants along river banks collectively contribute to the elevated levels of neurotoxic pollutants in natural water reservoirs across Europe.We established an in vitro bioassay based upon neural stem cells isolated from the subventricular zone of the postnatal mouse to evaluate the neurotoxic potential of raw wastewater,treated sewage effluent,groundwater and drinking water.The toxic potential of water samples was evaluated employing viability,proliferation,differentiation and migration assays.We found that raw wastewater could reduce the viability and proliferation of neural stem cells,and decreased the neuronal and astrocyte differentiation,neuronal neurite growth,astrocyte growth and cell migration.Treated sewage water also showed inhibitory effects on cell proliferation and migration.Our results indicated that relatively high concentrations of nitrogenous substances,pesticides,mercuric compounds,bisphenol-A,and phthalates,along with some other pollutants in raw wastewater and treated sewage water,might be the reason for the neuroinhibitory effects of these water samples.Our model successfully predicted the neurotoxicity of water samples collected from different sources and also revealed that the incomplete removal of contaminants from wastewater can be problematic for the developing nervous system.The presented data also provides strong evidence that more effective treatments should be used to minimize the contamination of water before release into major water bodies which may be considered as water reservoirs for human usage in the future.