Solid waste recycling is an economically sound strategy for preserving the environment,safeguarding natural resources,and diminishing the reliance on raw material consumption.Geopolymer technology offers a significant...Solid waste recycling is an economically sound strategy for preserving the environment,safeguarding natural resources,and diminishing the reliance on raw material consumption.Geopolymer technology offers a significant advantage by enabling the reuse and recycling of diverse materials.This research assesses how including silica fume and glass powder enhances the impact resistance of ultra-high-performance geopolymer concrete(UHPGC).In total,18 distinct mixtures were formulated by substituting ground granulated blast furnace slag with varying proportions of silica fume and glass powder,ranging from 10%to 40%.Similarly,for each of the mixtures above,steel fibre was added at a dosage of 1.5%to address the inherent brittleness of UHPGC.The mixtures were activated by combining sodium hydroxide and sodium silicate solution to generate geopolymer binders.The specimens were subjected to drop-weight impact testing,wherein an examination was carried out to evaluate various parameters,including flowability,density at fresh and hardened state,compressive strength,impact numbers indicative of cracking and failure occurrences,ductility index,and analysis of failure modes.Additionally,the variations in the impact test outcomes were analyzed using the Weibull distribution,and the findings corresponding to survival probability were offered.Furthermore,the microstructure of UHPGC was scrutinized through scanning electron microscopy.Findings reveal that the specimens incorporating glass powder exhibited lower cracking impact number values than those utilizing silica fume,with reductions ranging from 18.63%to 34.31%.Similarly,failure impact number values decreased from 8.26%to 28.46%across glass powder contents.The maximum compressive and impact strength was recorded in UHPGC,comprising 10%silica fume with fibres.展开更多
The development of new/different management and feeding strategies to stimulate gut development and health in newly-weaned pigs, in order to improve growth performance while minimizing the use of antimicrobial compoun...The development of new/different management and feeding strategies to stimulate gut development and health in newly-weaned pigs, in order to improve growth performance while minimizing the use of antimicrobial compounds such as antibiotic growth promotants (AGP) and heavy mineral compounds, is essential for the long-term sustainability of the pig industry. Factors including the sub-optimal intake of nutrients and energy, inappropriate microbiota biomass and (or) balance, immature and compromised immune function, and psychosomatic factors caused by weaning can compromise both the efficiency of digestion and absorption and intestinal barrier function through mucosal damage and alteration of tight junction integrity. As a consequence, pigs at weaning are highly susceptible to pathogenic enteric conditions such as post-weaning diarrhea that may be caused by serotypes of enterotoxigenic Escherichia coil Many dietary components, e.g., protein, fiber, feed additives and minerals, are known to influence microbial growth in the gastrointestinal tract that in turn can impact upon pig growth and health, although the relationships between these are sometimes not necessarily apparent or obvious. In a world climate of increased scrutiny over the use of antibiotics per se in pig production, certain feed additives are seen as alternatives/replacements to antibiotics, and have evolved in some cases to have important roles in everyday commercial pig nutrition. Nevertheless and in general, there remains inconsistency and variability in the efficacy of some feed additives and in cases of severe disease outbreaks, for example, therapeutic antibiotics and/or heavy minerals such as zinc oxide (ZnO) are generally relied upon. If feed ingredients and (or) feed additives are to be used with greater regularity and reliability, then it is necessary to better understand the mechanisms whereby antibiotics and minerals such as ZnO influence animal physiology, in conjunction with the use of appropriate challenge models and in vitro and in vivo techniques.展开更多
The widespread adoption of the Internet of Things (IoT) has transformed various sectors globally, making themmore intelligent and connected. However, this advancement comes with challenges related to the effectiveness...The widespread adoption of the Internet of Things (IoT) has transformed various sectors globally, making themmore intelligent and connected. However, this advancement comes with challenges related to the effectiveness ofIoT devices. These devices, present in offices, homes, industries, and more, need constant monitoring to ensuretheir proper functionality. The success of smart systems relies on their seamless operation and ability to handlefaults. Sensors, crucial components of these systems, gather data and contribute to their functionality. Therefore,sensor faults can compromise the system’s reliability and undermine the trustworthiness of smart environments.To address these concerns, various techniques and algorithms can be employed to enhance the performance ofIoT devices through effective fault detection. This paper conducted a thorough review of the existing literature andconducted a detailed analysis.This analysis effectively links sensor errors with a prominent fault detection techniquecapable of addressing them. This study is innovative because it paves theway for future researchers to explore errorsthat have not yet been tackled by existing fault detection methods. Significant, the paper, also highlights essentialfactors for selecting and adopting fault detection techniques, as well as the characteristics of datasets and theircorresponding recommended techniques. Additionally, the paper presents amethodical overview of fault detectiontechniques employed in smart devices, including themetrics used for evaluation. Furthermore, the paper examinesthe body of academic work related to sensor faults and fault detection techniques within the domain. This reflectsthe growing inclination and scholarly attention of researchers and academicians toward strategies for fault detectionwithin the realm of the Internet of Things.展开更多
Betula alnoides is a fast-growing hardwood species grown in large plantations in Southeast Asia and South China.Nitrogen requirements for producing robus seedlings,growth and nutrient dynamics were investigated using ...Betula alnoides is a fast-growing hardwood species grown in large plantations in Southeast Asia and South China.Nitrogen requirements for producing robus seedlings,growth and nutrient dynamics were investigated using exponential fertilization treatments.Root collar diameter,height,dry mass and nutrient contents of seedlings increased exponentially in all fertilization treatments as time progressed.Moreover,with water soluble fertilizer(Plant Products plus microelements N–P2O5–K2O:20–20–20),300 mg N seedling-1was adequate.Vector analysis revealed that P was the most responsive nutrient element followed by N and K.Dilutions of N and K were evident in the plants without N addition,which induced initial P sufficiency and then luxury consumption probably due to the antagonistic interaction between N and P.However deficiencies of N,P and K were mostly observed in al exponential regimes during the experiment because seedling growth rate exceeded nutrient uptake rate,inferring that further study on improving the nutrient uptake efficiency is needed.Analysis of relationships among nutrient supply,dry mass,N content and N concentration demonstrated that 100–400 mg N seedling-1induced sufficiency to luxury consumption of nitrogen without significant change in dry mass,and 400 mg N seedling-1is recommended to apply for nutrient loading of seedlings before outplanting.The findings will help improve seedling quality and enhance the production of robust seedlings for plantation forestry of this species.展开更多
Endoscopic submucosal dissection (ESD), an endoscopic procedure for the treatment of gastric epithelial neoplasia without lymph node metastases, spread rapidly, primarily in Japan, starting in the late 1990s. ESD enab...Endoscopic submucosal dissection (ESD), an endoscopic procedure for the treatment of gastric epithelial neoplasia without lymph node metastases, spread rapidly, primarily in Japan, starting in the late 1990s. ESD enables en bloc resection of lesions that are difficult to resect using conventional endoscopic mucosal resection (EMR). However, in comparison to EMR, ESD requires a high level of endoscopic competence and a longer resection time. Thus, ESD is associated with a higher risk of adverse events, including intraoperative and postoperative bleeding and gastrointestinal perforation. In particular, because of a higher incidence of intraoperative bleeding with mucosal incision and submucosal dissection, which are distinctive endoscopic procedures in ESD, a strategy for endoscopic hemostasis, mainly by thermo-coagulation hemostasis using hemostatic forceps, is important. In addition, because of iatrogenic artificial ulcers that always form after ESD, endoscopic hemostasis and appropriate pharma-cotherapy during the healing process are essential.展开更多
Although uncommon, sporadic nonampullary duodenal adenomas have a growing detection due to the widespread of endoscopy. Endoscopic therapy is being increasingly used for these lesions, since surgery, considered the st...Although uncommon, sporadic nonampullary duodenal adenomas have a growing detection due to the widespread of endoscopy. Endoscopic therapy is being increasingly used for these lesions, since surgery, considered the standard treatment, carries significant morbidity and mortality. However, the knowledge about its risks and benefits is limited, which contributes to the current absence of standardized recommendations. This review aims to discuss the efficacy and safety of endoscopic mucosal resection(EMR) and endoscopic submucosal dissection(ESD) in the treatment of these lesions. A literature review was performed, using the Pubmed database with the query: "(duodenum or duodenal)(endoscopy or endoscopic) adenoma resection", in the human species and in English. Of the 189 retrieved articles, and after reading their abstracts, 19 were selected due to their scientific interest. The analysis of their references, led to the inclusion of 23 more articles for their relevance in this subject. The increased use of EMR in the duodenum has shown good results with complete resection rates exceeding 80% and low complication risk(delayed bleeding in less than 12% of the procedures). Although rarely used in the duodenum, ESD achieves close to 100% complete resection rates, but is associated with perforation and bleeding risk in up to one third of the cases. Even though literature is insufficient to draw definitive conclusions, studies suggest that EMR and ESD are valid options for the treatment of nonampullary adenomas. Thus, strategies to improve these techniques, and consequently increase the effectiveness and safety of the resection of these lesions, should be developed.展开更多
Inflammatory bowel disease is a group of diseases that includes Crohn's disease (CD) and ulcerative colitis. CD is characterized as a chronic inflammatory disease of the gastrointestinal tract, ranging from the mou...Inflammatory bowel disease is a group of diseases that includes Crohn's disease (CD) and ulcerative colitis. CD is characterized as a chronic inflammatory disease of the gastrointestinal tract, ranging from the mouth to the anus. Although there are gross pathological and histological similarities between CD and Johne's dis- ease of cattle, the cause of CD remains controversial. It is vital to understand fully the cause of this disease because it affects approximately 500 000 people in North America and Europe. It ranges from 27 to 48 cases per 100 000 people. There are many theories on the cause of CD ranging from possible association with environmental factors including microorganisms to imbalance in the intestinal normal flora of the pa- tients. Regardless of the environmental trigger, there is strong evidence that a genetic disposition is a major key in acquiring CD. Many studies have proven the link between mutations in the ATG16L, NOD2/CARD15, IBDS, CTLA4, TNFSF15 and IL23R genes, and CD. The purpose of this review is to examine all genetic aspects and theories of CD, including up to date multiple popu- lation studies performed worldwide.展开更多
This paper numerically and experimentally investigates the hydrodynamic interaction between two semi-submersible type VLFS modules in the frequency domain. Model tests were conducted to investigate the relationship be...This paper numerically and experimentally investigates the hydrodynamic interaction between two semi-submersible type VLFS modules in the frequency domain. Model tests were conducted to investigate the relationship between interactions and wave headings. Numerical studies were performed by solving the radiation-diffraction problem and were validated against the experimental results. Motion Response Amplitude Operators (RAOs) were obtained from numerical and experimental studies. The dependency of the hydrodynamic interaction effect on wave headings is clarified. The influence of different wave periods on the motion responses of two-module VLFS and wave elevations in the gap is studied. The results indicate that the hydrodynamic interactions of the two modules are directly related to the wave headings and the periods of the incident wave. The shielding effect plays an important role in short wave, and the influence decreases with the increase of the incident wavelength. The numerical results based on the diffraction-radiation code can give a relatively good estimation to the responses in short wave while for long wave, it would over-predict the response.展开更多
A research project was initiated by INDOT to estimate the structural contribution and feasibility of FDR bases for pavement structure under a low-medium volume traffic loading. FWD tests were conducted and the layer m...A research project was initiated by INDOT to estimate the structural contribution and feasibility of FDR bases for pavement structure under a low-medium volume traffic loading. FWD tests were conducted and the layer moduli were back calculated on different construction phases: the surface of existing HMA pavement, the FDR base, the new HMA final surface, and the nine months' traffic opening, respectively, for a total of four times. The results indicate the promise of this recycled base material in pavement construction compared to traditional granular base. In addition, this paper discusses how the lab test results relate to the expected performance in a pavement structure by the MEPDG software and its parameter effects. Research indicated the MEPDG provided comparable thickness to the 1993 AASHTO Guide if the failure criteria are set up reasonably. Therefore, the MEPDG could be used as a design tool to estimate layer thickness for FDR pavement with a low-medium traffic volume.展开更多
Recombinant adenovirus(rAdV)is a commonly used vector system for gene transfer.Efficient initial packaging and subsequent production of rAdV remains time-consuming and labor-intensive,possibly attributable to rAdv inf...Recombinant adenovirus(rAdV)is a commonly used vector system for gene transfer.Efficient initial packaging and subsequent production of rAdV remains time-consuming and labor-intensive,possibly attributable to rAdv infection-associated oxidative stress and reactive oxygen species(ROS)production.Here,we show that exogenous GAPDH expression mitigates adenovirus-induced ROS-associated apoptosis in HEK293 cells,and expedites adenovirus production.By stably overexpressing GAPDH in HEK293(293G)and 293pTP(293GP)cells,respectively,we demonstrated that rAdV-induced RoS production and cell apoptosis were significantly suppressed in 293G and 293GP cells.Transfection of 293G cells with adenoviral plasmid pAd-G2Luc yielded much higher titers of Ad-G2Luc at day 7 than that in HEK293 cells.Similarly,Ad-G2Luc was amplified more efficiently in 293G than in HEK293 cells.We further showed that transfection of 293GP cells with pAd-G2Luc produced much higher titers of Ad-G2Luc at day 5 than that of 293pTP cells.293GP cells amplified the Ad-G2Luc much more efficiently than 293pTP cells,indicating that exogenous GAPDH can further augment pTP-enhanced adenovirus production.These results demonstrate that exogenous GAPDH can effectively suppress adenovirus-induced ROS and thus accelerate adenovirus production.Therefore,the engineered 293GP cells represent a superfast rAdV production system for adenovirus-based gene transfer and gene therapy.展开更多
AIM: To explore the anti-hepatitis B virus (HBV) effects of Boehmeria nivea (B. nivea) root extract (BNE) by using the HepG2 2.2.15 cell model system. METHODS: Hepatitis B surface antigen (HBsAg), hepatitis B virus e ...AIM: To explore the anti-hepatitis B virus (HBV) effects of Boehmeria nivea (B. nivea) root extract (BNE) by using the HepG2 2.2.15 cell model system. METHODS: Hepatitis B surface antigen (HBsAg), hepatitis B virus e antigen (HBeAg), and HBV DNA were measured by using ELISA and real-time PCR, respectively. Viral DNA replication and RNA expression were determined by using Southern and Northern blot, respectively. RESULTS: In HepG2 2.2.15 cells, HBeAg (60%, P < 0.01) and particle-associated HBV DNA (> 99%, P < 0.01) secretion into supernatant were significantly inhibited by BNE at a dose of 100 mg/L, whereas the HBsAg was not inhibited. With different doses of BNE, the reduced HBeAg was correlated with the inhibition of HBV DNA. The anti-HBV effect of BNE was not caused by its cytotoxicity to cells or inhibition of viral DNA replication and RNA expression. CONCLUSION: BNE could effectively reduce the HBV production and its anti-HBV machinery might differ from the nucleoside analogues.展开更多
Endoscopic submucosal dissection (ESD) enables direct submucosal dissection so that even large early-stage gastrointestinal tumors can be resected en bloc . ESD has recently been applied to the colorectum since it was...Endoscopic submucosal dissection (ESD) enables direct submucosal dissection so that even large early-stage gastrointestinal tumors can be resected en bloc . ESD has recently been applied to the colorectum since it was originally developed for use in the stomach. However, colorectal ESD is technically more difficult with an increased risk of perforation compared with gastric ESD. In addition, this procedure is seldom performed in Western countries. Consequently, further technical advances and the availability of a suitable clinical training system are required for the extensive use of colorectal ESD. In this topic highlight, we review the most recent developments in colorectal ESD.展开更多
Recently,several studies have reported local full-thickness resection techniques using flexible endoscopy for gastric tumors,such as gastrointestinal stromal tumors,gastric carcinoid tumors,and early gastric cancer(EG...Recently,several studies have reported local full-thickness resection techniques using flexible endoscopy for gastric tumors,such as gastrointestinal stromal tumors,gastric carcinoid tumors,and early gastric cancer(EGC). These techniques have the advantage of allowing precise resection lines to be determined using intraluminal endoscopy. Thus,it is possible to minimize the resection area and subsequent deformity. Some of these methods include:(1) classical laparoscopic and endoscopic cooperative surgery(LECS);(2) inverted LECS;(3) combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique; and(4) non-exposed endoscopic wall-inversion surgery. Furthermore,a recent prospective multicenter trial of the sentinel node navigation surgery(SNNS) for EGC has shown acceptable results in terms of sentinel node detection rate and the accuracy of nodal metastasis. Endoscopic full-thickness resection with SNNS is expected to become a treatment option that bridges the gap between endoscopic submucosal dissection and standard surgery for EGC. In the future,the indications for these procedures for gastric tumors could be expanded.展开更多
High-chromium white cast iron (HCWCI) is one of the most widely used engineering materials in the mining and cement industries. However, in some components, such as the pulverizer plates of ash mills, the poor machi...High-chromium white cast iron (HCWCI) is one of the most widely used engineering materials in the mining and cement industries. However, in some components, such as the pulverizer plates of ash mills, the poor machinability of HCWCI creates difficulties. The bimetal casting technique is a suitable method for improving the machinability of HCWCI by joining an easily machined layer of plain carbon steel (PCS) to its hard part. In this study, the possibility of PCS/HCWCI bimetal casting was investigated using sand casting. The investigation was conducted by optical and electron microscopy and non-destructive, impact toughness, and tensile tests. The hardness and chemical composition profiles on both sides of the interface were plotted in this study. The results indicated that a conventional and low-cost casting technique could be a reliable method for producing PCSYdCWCI bimetal. The interfacial microstructure comprised two distinct lay- ers: a very fine, partially spheroidized pearlite layer and a coarse full pearlite layer. Moreover, characterization of the microstructure revealed that the interface was free of defects.展开更多
BACKGROUND The ingestion of foreign bodies(FBs)and food bolus impaction(FBI)in the digestive tract are commonly encountered clinical problems.Methods to handle such problems continue to evolve offering advantages,such...BACKGROUND The ingestion of foreign bodies(FBs)and food bolus impaction(FBI)in the digestive tract are commonly encountered clinical problems.Methods to handle such problems continue to evolve offering advantages,such as the avoidance of surgery,reduced cost,improved visualization,reduced morbidity,and high removal success rate.However,to date,no studies have evaluated the endoscopic management of FBs in Japan.AIM To elucidate level of safety and efficacy in the endoscopic management of FBs and FBI.METHODS A total of 215 procedures were performed at Keio University Hospital between November 2007 and August 2018.Data were collected from medical charts,and endoscopic details were collected from an endoscopic reporting system.Procedures performed with a flexible gastrointestinal endoscope were only taken into account.Patients who underwent a technique involving FB or FBI from the digestive tract were only included.Data on patient sex,patient age,outpatient,inpatient,FB type,FB location,procedure time,procedure type,removal device type,success,and technical complications were reviewed and analyzed retrospectively.RESULTS Among the 215 procedures,136(63.3%)were performed in old adults(≥60 years),180(83.7%)procedures were performed in outpatients.The most common type of FBs were press-through-pack(PTP)medications[72(33.5%)cases],FBI[47(21.9%)],Anisakis parasite(AP)[41(19.1%)cases].Most FBs were located in the esophagus[130(60.5%)cases]followed by the stomach[68(31.6%)cases].AP was commonly found in the stomach[39(57.4%)cases],and it was removed using biopsy forceps in 97.5%of the cases.The most common FBs according to anatomical location were PTP medications(40%)and dental prostheses(DP)(40%)in the laryngopharynx,PTP(48.5%)in the esophagus,AP(57.4%)in the stomach,DP(37.5%)in the small intestine and video capsule endoscopy device(75%)in the colon.A transparent cap with grasping forceps was the most commonly used device[82(38.1%)cases].The success rate of the procedure was 100%,and complication were observed in only one case(0.5%).CONCLUSION Endoscopic management of FBs and FBI in our Hospital is extremely safe and effective.展开更多
The amino acid biosynthesis and proteolytic system of Lactobacillus bulgaricus (L.Bulgaricus ) is important for its growth in niche-specific environments, as well as for flavour formation in the food industry. Compara...The amino acid biosynthesis and proteolytic system of Lactobacillus bulgaricus (L.Bulgaricus ) is important for its growth in niche-specific environments, as well as for flavour formation in the food industry. Comparative analyses of 4 completed sequences of the L.Bulgaricus strain genome on a genomic scale revealed that genes involved in amino acids synthesis were undergoing reductive evolution. However, the selected industrial strains, namely, L.Bulgaricus 2038 and L.Bulgaricus ND02, retained more complete genes in the amino acid synthesis and proteolytic system category than the laboratory strains, and have some unique genes and pathways for obtaining amino acids that enable these bacteria to adapt to their various environmental niches.展开更多
BACKGROUND We recently developed a new endoscopic closure technique using only conventional endo-clips for colorectal lesions.Little is known about the feasibility of the endoscopic mucosa-submucosa clip closure metho...BACKGROUND We recently developed a new endoscopic closure technique using only conventional endo-clips for colorectal lesions.Little is known about the feasibility of the endoscopic mucosa-submucosa clip closure method for gastric lesions.AIM To elucidate the efficacy of the endoscopic mucosa-submucosa clip closure method after gastric endoscopic submucosal dissection(ESD).METHODS Twenty-two patients who underwent gastric ESD and mucosa-submucosa clip closure were included in this study.In this method,endo-clips are placed at the edges of a mucosal defect.Additional endo-clips are then applied in the same way to facilitate reduction of the defect size.Additional endo-clips are applied to both sides of the mucosal defect.Complete closure can be achieved.We have also developed a“location score”and“closure difficulty index”for assessment purposes.RESULTS Complete closure was achieved in 68.2%of the patients(15/22).The location score in the failure group was significantly larger than that in the complete closure group(P=0.023).The closure difficulty index in the failure group was significantly higher than that in the complete closure group(P=0.007).When the cutoff value of the closure difficulty index was set at 99,the high closure difficulty index predicted failure with a sensitivity of 57.1%,specificity of 100%,and accuracy of 86.3%.CONCLUSION The endoscopic mucosa-submucosa clip closure method was unreliable after gastric ESD,especially in cases with a high closure difficulty index.展开更多
Endoscopic submucosal dissection(ESD)has been established as a standard treatment for early stage gastric cancer(EGC)in Japan and has spread worldwide.ESD has been used not only for EGC but also for early esophageal a...Endoscopic submucosal dissection(ESD)has been established as a standard treatment for early stage gastric cancer(EGC)in Japan and has spread worldwide.ESD has been used not only for EGC but also for early esophageal and colonic cancers.However,ESD is as-sociated with several adverse events,such as bleeding and perforation,which requires more skill.Adequate tissue tension and clear visibility of the tissue to be dissected are important for effective and safe dissection.Many ESD methods using traction have been devel-oped,such as clip-with-line method,percutaneous trac-tion method,sinker-assisted method,magnetic anchor method,external forceps method,internal-traction method,double-channel-scope method,outerroute method,double-scope method,endoscopic-surgical-platform,and robot-assisted method.Each method has both advantages and disadvantages.Robotic endos-copy,enabling ESD with a traction method,will become more common due to advances in technology.In thenear future,simple,noninvasive,and effective ESD us-ing traction is expected to be developed and become established as a worldwide standard treatment for superficial gastrointestinal neoplasias.展开更多
Focal adhesion kinase(FAK) is a major integrin- dep-endent tyrosine phosphorylated protein, recently, FAK association with colorectal cancer(CRC) has gained at-tention. The various cancer-promoting mechanisms that ass...Focal adhesion kinase(FAK) is a major integrin- dep-endent tyrosine phosphorylated protein, recently, FAK association with colorectal cancer(CRC) has gained at-tention. The various cancer-promoting mechanisms that associated with FAK can be implicated in the progression of CRC. The interactions between structural features of FAK and various kinases could be closely related to growth, survival, and metastasis in CRC cells. These interactions include human epithelial growth factor re-ceptor, c-Met, platelet-derived growth factor receptor, vascular endothelial growth factor receptor, and Src. Such interactions can trigger the survival signaling of CRC cells and are also involved signaling downstream of phosphatidylinositol 3-kinase, AKT, and the extracellular regulated kinase. Based on this scientific background, many pharmaceutical companies are taking efforts to develop FAK inhibitors to treat solid cancer including CRC. Although the anti-cancer efficacies have been noted in many studies, the commercial drugs have not been deve-loped yet. Therefore, the FAK research on CRC is expec-ted to gain momentum and be highly appreciated as a potential field for developing the new drugs. Therefore, the studies on FAK that effect on the progression of human CRC s would be possible to suggest various app-roaches to CRC treatment, and FAK could be a potential target as an anticancer candidate for CRC therapies.展开更多
AIM: To elucidate the safety of percutaneous endoscopic gastrostomy(PEG) under steady pressure automatically controlled endoscopy(SPACE) using carbon dioxide(CO_2).METHODS: Nine patients underwent PEG with a modified ...AIM: To elucidate the safety of percutaneous endoscopic gastrostomy(PEG) under steady pressure automatically controlled endoscopy(SPACE) using carbon dioxide(CO_2).METHODS: Nine patients underwent PEG with a modified introducer method under conscious sedation. A T-tube was attached to the channel of an endoscope connected to an automatic surgical insufflator. The stomach was inflated under the SPACE system. The intragastric pressure was kept between 4-8 mmH g with a flow of CO_2 at 35 L/min. Median procedure time, intragastric pressure, median systolic blood pressure, partial pressure of CO_2, abdominal girth before and immediately after PEG, and free gas and small intestinal gas on abdominal X-ray before and after PEG were recorded. RESULTS: PEG was completed under stable pneumostomach in all patients, with a median procedural time of 22 min. Median intragastric pressure was 6.9 mmH g and median arterial CO_2 pressure before and after PEG was 42.1 and 45.5 Torr(NS). The median abdominal girth before and after PEG was 68.1 and 69.6 cm(NS). A mild free gas image after PEG was observed in two patients, and faint abdominal gas in the downstream bowel was documented in two patients.CONCLUSION: SPACE might enable standardized pneumostomach and modified introducer procedure of PEG.展开更多
基金SASTRA Deemed University,India for its generous research support。
文摘Solid waste recycling is an economically sound strategy for preserving the environment,safeguarding natural resources,and diminishing the reliance on raw material consumption.Geopolymer technology offers a significant advantage by enabling the reuse and recycling of diverse materials.This research assesses how including silica fume and glass powder enhances the impact resistance of ultra-high-performance geopolymer concrete(UHPGC).In total,18 distinct mixtures were formulated by substituting ground granulated blast furnace slag with varying proportions of silica fume and glass powder,ranging from 10%to 40%.Similarly,for each of the mixtures above,steel fibre was added at a dosage of 1.5%to address the inherent brittleness of UHPGC.The mixtures were activated by combining sodium hydroxide and sodium silicate solution to generate geopolymer binders.The specimens were subjected to drop-weight impact testing,wherein an examination was carried out to evaluate various parameters,including flowability,density at fresh and hardened state,compressive strength,impact numbers indicative of cracking and failure occurrences,ductility index,and analysis of failure modes.Additionally,the variations in the impact test outcomes were analyzed using the Weibull distribution,and the findings corresponding to survival probability were offered.Furthermore,the microstructure of UHPGC was scrutinized through scanning electron microscopy.Findings reveal that the specimens incorporating glass powder exhibited lower cracking impact number values than those utilizing silica fume,with reductions ranging from 18.63%to 34.31%.Similarly,failure impact number values decreased from 8.26%to 28.46%across glass powder contents.The maximum compressive and impact strength was recorded in UHPGC,comprising 10%silica fume with fibres.
文摘The development of new/different management and feeding strategies to stimulate gut development and health in newly-weaned pigs, in order to improve growth performance while minimizing the use of antimicrobial compounds such as antibiotic growth promotants (AGP) and heavy mineral compounds, is essential for the long-term sustainability of the pig industry. Factors including the sub-optimal intake of nutrients and energy, inappropriate microbiota biomass and (or) balance, immature and compromised immune function, and psychosomatic factors caused by weaning can compromise both the efficiency of digestion and absorption and intestinal barrier function through mucosal damage and alteration of tight junction integrity. As a consequence, pigs at weaning are highly susceptible to pathogenic enteric conditions such as post-weaning diarrhea that may be caused by serotypes of enterotoxigenic Escherichia coil Many dietary components, e.g., protein, fiber, feed additives and minerals, are known to influence microbial growth in the gastrointestinal tract that in turn can impact upon pig growth and health, although the relationships between these are sometimes not necessarily apparent or obvious. In a world climate of increased scrutiny over the use of antibiotics per se in pig production, certain feed additives are seen as alternatives/replacements to antibiotics, and have evolved in some cases to have important roles in everyday commercial pig nutrition. Nevertheless and in general, there remains inconsistency and variability in the efficacy of some feed additives and in cases of severe disease outbreaks, for example, therapeutic antibiotics and/or heavy minerals such as zinc oxide (ZnO) are generally relied upon. If feed ingredients and (or) feed additives are to be used with greater regularity and reliability, then it is necessary to better understand the mechanisms whereby antibiotics and minerals such as ZnO influence animal physiology, in conjunction with the use of appropriate challenge models and in vitro and in vivo techniques.
文摘The widespread adoption of the Internet of Things (IoT) has transformed various sectors globally, making themmore intelligent and connected. However, this advancement comes with challenges related to the effectiveness ofIoT devices. These devices, present in offices, homes, industries, and more, need constant monitoring to ensuretheir proper functionality. The success of smart systems relies on their seamless operation and ability to handlefaults. Sensors, crucial components of these systems, gather data and contribute to their functionality. Therefore,sensor faults can compromise the system’s reliability and undermine the trustworthiness of smart environments.To address these concerns, various techniques and algorithms can be employed to enhance the performance ofIoT devices through effective fault detection. This paper conducted a thorough review of the existing literature andconducted a detailed analysis.This analysis effectively links sensor errors with a prominent fault detection techniquecapable of addressing them. This study is innovative because it paves theway for future researchers to explore errorsthat have not yet been tackled by existing fault detection methods. Significant, the paper, also highlights essentialfactors for selecting and adopting fault detection techniques, as well as the characteristics of datasets and theircorresponding recommended techniques. Additionally, the paper presents amethodical overview of fault detectiontechniques employed in smart devices, including themetrics used for evaluation. Furthermore, the paper examinesthe body of academic work related to sensor faults and fault detection techniques within the domain. This reflectsthe growing inclination and scholarly attention of researchers and academicians toward strategies for fault detectionwithin the realm of the Internet of Things.
基金financially supported by The Ministry of Science and Technology,China(2012BAD21B0102)
文摘Betula alnoides is a fast-growing hardwood species grown in large plantations in Southeast Asia and South China.Nitrogen requirements for producing robus seedlings,growth and nutrient dynamics were investigated using exponential fertilization treatments.Root collar diameter,height,dry mass and nutrient contents of seedlings increased exponentially in all fertilization treatments as time progressed.Moreover,with water soluble fertilizer(Plant Products plus microelements N–P2O5–K2O:20–20–20),300 mg N seedling-1was adequate.Vector analysis revealed that P was the most responsive nutrient element followed by N and K.Dilutions of N and K were evident in the plants without N addition,which induced initial P sufficiency and then luxury consumption probably due to the antagonistic interaction between N and P.However deficiencies of N,P and K were mostly observed in al exponential regimes during the experiment because seedling growth rate exceeded nutrient uptake rate,inferring that further study on improving the nutrient uptake efficiency is needed.Analysis of relationships among nutrient supply,dry mass,N content and N concentration demonstrated that 100–400 mg N seedling-1induced sufficiency to luxury consumption of nitrogen without significant change in dry mass,and 400 mg N seedling-1is recommended to apply for nutrient loading of seedlings before outplanting.The findings will help improve seedling quality and enhance the production of robust seedlings for plantation forestry of this species.
基金Supported by A Grant-in-Aid for Cancer Research from the Ministry of Health, Labor and Welfare of Japan, in part
文摘Endoscopic submucosal dissection (ESD), an endoscopic procedure for the treatment of gastric epithelial neoplasia without lymph node metastases, spread rapidly, primarily in Japan, starting in the late 1990s. ESD enables en bloc resection of lesions that are difficult to resect using conventional endoscopic mucosal resection (EMR). However, in comparison to EMR, ESD requires a high level of endoscopic competence and a longer resection time. Thus, ESD is associated with a higher risk of adverse events, including intraoperative and postoperative bleeding and gastrointestinal perforation. In particular, because of a higher incidence of intraoperative bleeding with mucosal incision and submucosal dissection, which are distinctive endoscopic procedures in ESD, a strategy for endoscopic hemostasis, mainly by thermo-coagulation hemostasis using hemostatic forceps, is important. In addition, because of iatrogenic artificial ulcers that always form after ESD, endoscopic hemostasis and appropriate pharma-cotherapy during the healing process are essential.
文摘Although uncommon, sporadic nonampullary duodenal adenomas have a growing detection due to the widespread of endoscopy. Endoscopic therapy is being increasingly used for these lesions, since surgery, considered the standard treatment, carries significant morbidity and mortality. However, the knowledge about its risks and benefits is limited, which contributes to the current absence of standardized recommendations. This review aims to discuss the efficacy and safety of endoscopic mucosal resection(EMR) and endoscopic submucosal dissection(ESD) in the treatment of these lesions. A literature review was performed, using the Pubmed database with the query: "(duodenum or duodenal)(endoscopy or endoscopic) adenoma resection", in the human species and in English. Of the 189 retrieved articles, and after reading their abstracts, 19 were selected due to their scientific interest. The analysis of their references, led to the inclusion of 23 more articles for their relevance in this subject. The increased use of EMR in the duodenum has shown good results with complete resection rates exceeding 80% and low complication risk(delayed bleeding in less than 12% of the procedures). Although rarely used in the duodenum, ESD achieves close to 100% complete resection rates, but is associated with perforation and bleeding risk in up to one third of the cases. Even though literature is insufficient to draw definitive conclusions, studies suggest that EMR and ESD are valid options for the treatment of nonampullary adenomas. Thus, strategies to improve these techniques, and consequently increase the effectiveness and safety of the resection of these lesions, should be developed.
基金Supported by The Broad Foundation grant,No. IBD-0207R
文摘Inflammatory bowel disease is a group of diseases that includes Crohn's disease (CD) and ulcerative colitis. CD is characterized as a chronic inflammatory disease of the gastrointestinal tract, ranging from the mouth to the anus. Although there are gross pathological and histological similarities between CD and Johne's dis- ease of cattle, the cause of CD remains controversial. It is vital to understand fully the cause of this disease because it affects approximately 500 000 people in North America and Europe. It ranges from 27 to 48 cases per 100 000 people. There are many theories on the cause of CD ranging from possible association with environmental factors including microorganisms to imbalance in the intestinal normal flora of the pa- tients. Regardless of the environmental trigger, there is strong evidence that a genetic disposition is a major key in acquiring CD. Many studies have proven the link between mutations in the ATG16L, NOD2/CARD15, IBDS, CTLA4, TNFSF15 and IL23R genes, and CD. The purpose of this review is to examine all genetic aspects and theories of CD, including up to date multiple popu- lation studies performed worldwide.
基金financially supported by the National Natural Science Foundation of China(Grant Nos.51709170 and 51979167)the Ministry of Industry and Information Technology of China(Mooring position technology:floating support platform engineering(Ⅱ))+1 种基金the Shanghai Sailing Program(Grant No.17YF1409700)the China Scholarship Council(Grant No.201806230206)
文摘This paper numerically and experimentally investigates the hydrodynamic interaction between two semi-submersible type VLFS modules in the frequency domain. Model tests were conducted to investigate the relationship between interactions and wave headings. Numerical studies were performed by solving the radiation-diffraction problem and were validated against the experimental results. Motion Response Amplitude Operators (RAOs) were obtained from numerical and experimental studies. The dependency of the hydrodynamic interaction effect on wave headings is clarified. The influence of different wave periods on the motion responses of two-module VLFS and wave elevations in the gap is studied. The results indicate that the hydrodynamic interactions of the two modules are directly related to the wave headings and the periods of the incident wave. The shielding effect plays an important role in short wave, and the influence decreases with the increase of the incident wavelength. The numerical results based on the diffraction-radiation code can give a relatively good estimation to the responses in short wave while for long wave, it would over-predict the response.
文摘A research project was initiated by INDOT to estimate the structural contribution and feasibility of FDR bases for pavement structure under a low-medium volume traffic loading. FWD tests were conducted and the layer moduli were back calculated on different construction phases: the surface of existing HMA pavement, the FDR base, the new HMA final surface, and the nine months' traffic opening, respectively, for a total of four times. The results indicate the promise of this recycled base material in pavement construction compared to traditional granular base. In addition, this paper discusses how the lab test results relate to the expected performance in a pavement structure by the MEPDG software and its parameter effects. Research indicated the MEPDG provided comparable thickness to the 1993 AASHTO Guide if the failure criteria are set up reasonably. Therefore, the MEPDG could be used as a design tool to estimate layer thickness for FDR pavement with a low-medium traffic volume.
基金supported in part by research grants from the Natural Science Foundation of China (No.82000744 to ZT,and 82102696 to J.F.)the Chongqing Bayu Young Scholar Award (China) (to J.F.)+5 种基金the 2019 Funding for Postdoctoral Research (Chongqing Human Resources and Social Security Bureau of China) (No.298 to J.F.)the National Institutes of Health (No.CA226303 to T.C.H.,DE030480 to R.R.R.)supported by the Medical Scientist Training Program of the National Institutes of Health (USA) (No.T32 GM007281)supported in part by The University of Chicago Cancer Center Support Grant (No.P30CA014599)the National Center for Advancing Translational Sciences of the National Institutes of Health through grant number 2UL1TR002389-06 that funds the Institute for Translational Medicine (ITM)supported by the Mabel Green Myers Research Endowment Fund and The University of Chicago Orthopaedics Alumni Fund.
文摘Recombinant adenovirus(rAdV)is a commonly used vector system for gene transfer.Efficient initial packaging and subsequent production of rAdV remains time-consuming and labor-intensive,possibly attributable to rAdv infection-associated oxidative stress and reactive oxygen species(ROS)production.Here,we show that exogenous GAPDH expression mitigates adenovirus-induced ROS-associated apoptosis in HEK293 cells,and expedites adenovirus production.By stably overexpressing GAPDH in HEK293(293G)and 293pTP(293GP)cells,respectively,we demonstrated that rAdV-induced RoS production and cell apoptosis were significantly suppressed in 293G and 293GP cells.Transfection of 293G cells with adenoviral plasmid pAd-G2Luc yielded much higher titers of Ad-G2Luc at day 7 than that in HEK293 cells.Similarly,Ad-G2Luc was amplified more efficiently in 293G than in HEK293 cells.We further showed that transfection of 293GP cells with pAd-G2Luc produced much higher titers of Ad-G2Luc at day 5 than that of 293pTP cells.293GP cells amplified the Ad-G2Luc much more efficiently than 293pTP cells,indicating that exogenous GAPDH can further augment pTP-enhanced adenovirus production.These results demonstrate that exogenous GAPDH can effectively suppress adenovirus-induced ROS and thus accelerate adenovirus production.Therefore,the engineered 293GP cells represent a superfast rAdV production system for adenovirus-based gene transfer and gene therapy.
文摘AIM: To explore the anti-hepatitis B virus (HBV) effects of Boehmeria nivea (B. nivea) root extract (BNE) by using the HepG2 2.2.15 cell model system. METHODS: Hepatitis B surface antigen (HBsAg), hepatitis B virus e antigen (HBeAg), and HBV DNA were measured by using ELISA and real-time PCR, respectively. Viral DNA replication and RNA expression were determined by using Southern and Northern blot, respectively. RESULTS: In HepG2 2.2.15 cells, HBeAg (60%, P < 0.01) and particle-associated HBV DNA (> 99%, P < 0.01) secretion into supernatant were significantly inhibited by BNE at a dose of 100 mg/L, whereas the HBsAg was not inhibited. With different doses of BNE, the reduced HBeAg was correlated with the inhibition of HBV DNA. The anti-HBV effect of BNE was not caused by its cytotoxicity to cells or inhibition of viral DNA replication and RNA expression. CONCLUSION: BNE could effectively reduce the HBV production and its anti-HBV machinery might differ from the nucleoside analogues.
文摘Endoscopic submucosal dissection (ESD) enables direct submucosal dissection so that even large early-stage gastrointestinal tumors can be resected en bloc . ESD has recently been applied to the colorectum since it was originally developed for use in the stomach. However, colorectal ESD is technically more difficult with an increased risk of perforation compared with gastric ESD. In addition, this procedure is seldom performed in Western countries. Consequently, further technical advances and the availability of a suitable clinical training system are required for the extensive use of colorectal ESD. In this topic highlight, we review the most recent developments in colorectal ESD.
文摘Recently,several studies have reported local full-thickness resection techniques using flexible endoscopy for gastric tumors,such as gastrointestinal stromal tumors,gastric carcinoid tumors,and early gastric cancer(EGC). These techniques have the advantage of allowing precise resection lines to be determined using intraluminal endoscopy. Thus,it is possible to minimize the resection area and subsequent deformity. Some of these methods include:(1) classical laparoscopic and endoscopic cooperative surgery(LECS);(2) inverted LECS;(3) combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique; and(4) non-exposed endoscopic wall-inversion surgery. Furthermore,a recent prospective multicenter trial of the sentinel node navigation surgery(SNNS) for EGC has shown acceptable results in terms of sentinel node detection rate and the accuracy of nodal metastasis. Endoscopic full-thickness resection with SNNS is expected to become a treatment option that bridges the gap between endoscopic submucosal dissection and standard surgery for EGC. In the future,the indications for these procedures for gastric tumors could be expanded.
文摘High-chromium white cast iron (HCWCI) is one of the most widely used engineering materials in the mining and cement industries. However, in some components, such as the pulverizer plates of ash mills, the poor machinability of HCWCI creates difficulties. The bimetal casting technique is a suitable method for improving the machinability of HCWCI by joining an easily machined layer of plain carbon steel (PCS) to its hard part. In this study, the possibility of PCS/HCWCI bimetal casting was investigated using sand casting. The investigation was conducted by optical and electron microscopy and non-destructive, impact toughness, and tensile tests. The hardness and chemical composition profiles on both sides of the interface were plotted in this study. The results indicated that a conventional and low-cost casting technique could be a reliable method for producing PCSYdCWCI bimetal. The interfacial microstructure comprised two distinct lay- ers: a very fine, partially spheroidized pearlite layer and a coarse full pearlite layer. Moreover, characterization of the microstructure revealed that the interface was free of defects.
文摘BACKGROUND The ingestion of foreign bodies(FBs)and food bolus impaction(FBI)in the digestive tract are commonly encountered clinical problems.Methods to handle such problems continue to evolve offering advantages,such as the avoidance of surgery,reduced cost,improved visualization,reduced morbidity,and high removal success rate.However,to date,no studies have evaluated the endoscopic management of FBs in Japan.AIM To elucidate level of safety and efficacy in the endoscopic management of FBs and FBI.METHODS A total of 215 procedures were performed at Keio University Hospital between November 2007 and August 2018.Data were collected from medical charts,and endoscopic details were collected from an endoscopic reporting system.Procedures performed with a flexible gastrointestinal endoscope were only taken into account.Patients who underwent a technique involving FB or FBI from the digestive tract were only included.Data on patient sex,patient age,outpatient,inpatient,FB type,FB location,procedure time,procedure type,removal device type,success,and technical complications were reviewed and analyzed retrospectively.RESULTS Among the 215 procedures,136(63.3%)were performed in old adults(≥60 years),180(83.7%)procedures were performed in outpatients.The most common type of FBs were press-through-pack(PTP)medications[72(33.5%)cases],FBI[47(21.9%)],Anisakis parasite(AP)[41(19.1%)cases].Most FBs were located in the esophagus[130(60.5%)cases]followed by the stomach[68(31.6%)cases].AP was commonly found in the stomach[39(57.4%)cases],and it was removed using biopsy forceps in 97.5%of the cases.The most common FBs according to anatomical location were PTP medications(40%)and dental prostheses(DP)(40%)in the laryngopharynx,PTP(48.5%)in the esophagus,AP(57.4%)in the stomach,DP(37.5%)in the small intestine and video capsule endoscopy device(75%)in the colon.A transparent cap with grasping forceps was the most commonly used device[82(38.1%)cases].The success rate of the procedure was 100%,and complication were observed in only one case(0.5%).CONCLUSION Endoscopic management of FBs and FBI in our Hospital is extremely safe and effective.
文摘The amino acid biosynthesis and proteolytic system of Lactobacillus bulgaricus (L.Bulgaricus ) is important for its growth in niche-specific environments, as well as for flavour formation in the food industry. Comparative analyses of 4 completed sequences of the L.Bulgaricus strain genome on a genomic scale revealed that genes involved in amino acids synthesis were undergoing reductive evolution. However, the selected industrial strains, namely, L.Bulgaricus 2038 and L.Bulgaricus ND02, retained more complete genes in the amino acid synthesis and proteolytic system category than the laboratory strains, and have some unique genes and pathways for obtaining amino acids that enable these bacteria to adapt to their various environmental niches.
文摘BACKGROUND We recently developed a new endoscopic closure technique using only conventional endo-clips for colorectal lesions.Little is known about the feasibility of the endoscopic mucosa-submucosa clip closure method for gastric lesions.AIM To elucidate the efficacy of the endoscopic mucosa-submucosa clip closure method after gastric endoscopic submucosal dissection(ESD).METHODS Twenty-two patients who underwent gastric ESD and mucosa-submucosa clip closure were included in this study.In this method,endo-clips are placed at the edges of a mucosal defect.Additional endo-clips are then applied in the same way to facilitate reduction of the defect size.Additional endo-clips are applied to both sides of the mucosal defect.Complete closure can be achieved.We have also developed a“location score”and“closure difficulty index”for assessment purposes.RESULTS Complete closure was achieved in 68.2%of the patients(15/22).The location score in the failure group was significantly larger than that in the complete closure group(P=0.023).The closure difficulty index in the failure group was significantly higher than that in the complete closure group(P=0.007).When the cutoff value of the closure difficulty index was set at 99,the high closure difficulty index predicted failure with a sensitivity of 57.1%,specificity of 100%,and accuracy of 86.3%.CONCLUSION The endoscopic mucosa-submucosa clip closure method was unreliable after gastric ESD,especially in cases with a high closure difficulty index.
文摘Endoscopic submucosal dissection(ESD)has been established as a standard treatment for early stage gastric cancer(EGC)in Japan and has spread worldwide.ESD has been used not only for EGC but also for early esophageal and colonic cancers.However,ESD is as-sociated with several adverse events,such as bleeding and perforation,which requires more skill.Adequate tissue tension and clear visibility of the tissue to be dissected are important for effective and safe dissection.Many ESD methods using traction have been devel-oped,such as clip-with-line method,percutaneous trac-tion method,sinker-assisted method,magnetic anchor method,external forceps method,internal-traction method,double-channel-scope method,outerroute method,double-scope method,endoscopic-surgical-platform,and robot-assisted method.Each method has both advantages and disadvantages.Robotic endos-copy,enabling ESD with a traction method,will become more common due to advances in technology.In thenear future,simple,noninvasive,and effective ESD us-ing traction is expected to be developed and become established as a worldwide standard treatment for superficial gastrointestinal neoplasias.
文摘Focal adhesion kinase(FAK) is a major integrin- dep-endent tyrosine phosphorylated protein, recently, FAK association with colorectal cancer(CRC) has gained at-tention. The various cancer-promoting mechanisms that associated with FAK can be implicated in the progression of CRC. The interactions between structural features of FAK and various kinases could be closely related to growth, survival, and metastasis in CRC cells. These interactions include human epithelial growth factor re-ceptor, c-Met, platelet-derived growth factor receptor, vascular endothelial growth factor receptor, and Src. Such interactions can trigger the survival signaling of CRC cells and are also involved signaling downstream of phosphatidylinositol 3-kinase, AKT, and the extracellular regulated kinase. Based on this scientific background, many pharmaceutical companies are taking efforts to develop FAK inhibitors to treat solid cancer including CRC. Although the anti-cancer efficacies have been noted in many studies, the commercial drugs have not been deve-loped yet. Therefore, the FAK research on CRC is expec-ted to gain momentum and be highly appreciated as a potential field for developing the new drugs. Therefore, the studies on FAK that effect on the progression of human CRC s would be possible to suggest various app-roaches to CRC treatment, and FAK could be a potential target as an anticancer candidate for CRC therapies.
文摘AIM: To elucidate the safety of percutaneous endoscopic gastrostomy(PEG) under steady pressure automatically controlled endoscopy(SPACE) using carbon dioxide(CO_2).METHODS: Nine patients underwent PEG with a modified introducer method under conscious sedation. A T-tube was attached to the channel of an endoscope connected to an automatic surgical insufflator. The stomach was inflated under the SPACE system. The intragastric pressure was kept between 4-8 mmH g with a flow of CO_2 at 35 L/min. Median procedure time, intragastric pressure, median systolic blood pressure, partial pressure of CO_2, abdominal girth before and immediately after PEG, and free gas and small intestinal gas on abdominal X-ray before and after PEG were recorded. RESULTS: PEG was completed under stable pneumostomach in all patients, with a median procedural time of 22 min. Median intragastric pressure was 6.9 mmH g and median arterial CO_2 pressure before and after PEG was 42.1 and 45.5 Torr(NS). The median abdominal girth before and after PEG was 68.1 and 69.6 cm(NS). A mild free gas image after PEG was observed in two patients, and faint abdominal gas in the downstream bowel was documented in two patients.CONCLUSION: SPACE might enable standardized pneumostomach and modified introducer procedure of PEG.