Endoscopic polidocanol foam sclerobanding for the treatment of grade Ⅱ-Ⅲ internal hemorrhoids:A prospective,multi-center,randomized study

BACKGROUND Endoscopic rubber band ligation(ERBL)is a nonsurgical technique for the treatment of symptomatic internal hemorrhoids but is limited by recurrence and post-procedural pain.AIM To evaluate satisfaction,long-term recurrence,and post-procedural pain in managing internal hemorrhoids using a combination of polidocanol foam sclerotherapy and ERBL.METHODS This was a prospective,multicenter,randomized study.A total of 195 consecutive patients diagnosed with grade II-III internal hemorrhoids were enrolled from four tertiary hospitals and randomly divided into a cap-assisted endoscopic polidocanol foam sclerobanding(EFSB)or an ERBL group.All patients were followed-up for 12 months.Symptom-based severity and post-procedural pain were assessed using a hemorrhoid severity score(HSS)and a visual analog scale(VAS).Continuous variables were reported as medians and interquartile range.RESULTS One hundred and ninety-five patients were enrolled,with 98 in the EFSB group.HSS was lower in the EFSB group than in the ERBL group at 8 weeks[4.0(3.0-5.0)vs 5.0(4.0-6.0),P=0.003]and 12-month[2.0(1.0-3.0)vs 3.0(2.0-3.0),P<0.001]of follow-up.The prolapse recurrence rate was lower in the EFSB group at 12 months(11.2%vs 21.6%,P=0.038).Multiple linear regression analysis demonstrated that EFSB treatment[B=-0.915,95%confidence interval(CI):−1.301 to−0.530,P=0.001]and rubber band number(B=0.843,95%CI:0.595-1.092,P<0.001)were negatively and independently associated with the VAS score 24 hours post-procedure.The median VAS was lower in the EFSB group than in the ERBL[2.0(1.0-3.0)vs 3.0(2.0-4.0),P<0.001].CONCLUSION Cap-assisted EFSB provided long-term satisfaction and effective relief from the recurrence of prolapse and pain 24 hours post-procedure.

Endoscopic polidocanol foam sclerobanding for the treatment of Grade II-III internal hemorrhoids:The focus of clinical practice

We have read the article by Qu et al with great interest,as it presents an inte-gration of endoscopic polidocanol foam sclerotherapy with rubber band ligation in patients with Grade II-III internal hemorrhoids.The authors conducted a prospective,multicenter,randomized study to evaluate the long-term sympto-matic and endoscopic efficacy of this combined intervention.In this discussion,we focus on the procedural steps of this combined strategy and suggest potential avenues for future research.

Redefining hemorrhoid therapy with endoscopic polidocanol foam sclerobanding

Hemorrhoids are a common and painful condition,with conventional treatments such as endoscopic rubber band ligation(ERBL)and injection sclerotherapy often falling short due to high recurrence rates and significant post-operative pain.A clinical trial by Qu et al introduces a novel approach called endoscopic polidocanol foam sclerobanding(EFSB).This multicenter randomized trial involved 195 patients with grade II and III internal hemorrhoids and demonstrated that EFSB significantly reduced recurrence rates and post-procedural pain while improving symptom relief and patient satisfaction compared to ERBL.The study's strengths include its robust design,comprehensive outcome evaluation,and patient-centered approach.Despite limitations such as the single-blind design and relatively short follow-up period,the findings suggest that EFSB could enhance clinical practice by offering a more effective and patient-friendly treatment option.Further research is needed to validate these results and explore the long-term benefits and cost-effectiveness of EFSB.

Failure transition of shear-to-dilation band of rock salt under triaxial stresses

Great potential of underground gas/energy storage in salt caverns seems to be a promising solution to support renewable energy.In the underground storage method,the operating cycle unfortunately may reach up to daily or even hourly,which generates complicated pressures on the salt cavern.Furthermore,the mechanical behavior of rock salt may change and present distinct failure characteristics under different stress states,which affects the performance of salt cavern during the time period of full service.To reproduce a similar loading condition on the cavern surrounding rock mass,the cyclic triaxial loading/unloading tests are performed on the rock salt to explore the mechanical transition behavior and failure characteristics under different confinement.Experimental results show that the rock salt samples pre-sent a diffused shear failure band with significant bulges at certain locations in low confining pressure conditions(e.g.5 MPa,10 MPa and 15 MPa),which is closely related to crystal misorientation and grain boundary sliding.Under the elevated confinement(e.g.20 MPa,30 MPa and 40 MPa),the dilation band dominates the failure mechanism,where the large-size halite crystals are crushed to be smaller size and new pores are developing.The failure transition mechanism revealed in the paper provides additional insight into the mechanical performance of salt caverns influenced by complicated stress states.

Evaluation of the efficacy and safety of endoscopic band ligation in the treatment of bleeding from mild to moderate gastric varices type 1

BACKGROUND According to practice guidelines,endoscopic band ligation(EBL)and endoscopic tissue adhesive injection(TAI)are recommended for treating bleeding from esophagogastric varices.However,EBL and TAI are known to cause serious complications,such as hemorrhage from dislodged ligature rings caused by EBL and hemorrhage from operation-related ulcers resulting from TAI.However,the optimal therapy for mild to moderate type 1 gastric variceal hemorrhage(GOV1)has not been determined.Therefore,the aim of this study was to discover an individualized treatment for mild to moderate GOV1.AIM To compare the efficacy,safety and costs of EBL and TAI for the treatment of mild and moderate GOV1.METHODS A clinical analysis of the data retrieved from patients with mild or moderate GOV1 gastric varices who were treated under endoscopy was also conducted.Patients were allocated to an EBL group or an endoscopic TAI group.The differences in the incidence of varicose relief,operative time,operation success rate,mortality rate within 6 wk,rebleeding rate,6-wk operation-related ulcer healing rate,complication rate and average operation cost were compared between the two groups of patients.RESULTS The total effective rate of the two treatments was similar,but the efficacy of EBL(66.7%)was markedly better than that of TAI(39.2%)(P<0.05).The operation success rate in both groups was 100%,and the 6-wk mortality rate in both groups was 0%.The average operative time(26 min)in the EBL group was significantly shorter than that in the TAI group(46 min)(P<0.01).The rate of delayed postoperative rebleeding in the EBL group was significantly lower than that in the TAI group(11.8%vs 45.1%)(P<0.01).At 6 wk after the operation,the healing rate of operation-related ulcers in the EBL group was 80.4%,which was significantly greater than that in the TAI group(35.3%)(P<0.01).The incidence of postoperative complications in the two groups was similar.The average cost and other related economic factors were greater for the EBL than for the TAI(P<0.01).CONCLUSION For mild to moderate GOV1,patients with EBL had a greater one-time varix eradication rate,a greater 6-wk operation-related ulcer healing rate,a lower delayed rebleeding rate and a lower cost than patients with TAI.

Experimental observation of Fermi-level flat band in novel kagome metal CeNi_(5)

Kagome materials are a class of material with a lattice structure composed of corner-sharing triangles that produce various exotic electronic phenomena,such as Dirac fermions,van Hove singularities,and flat bands.However,most of the known kagome materials have a flat band detached from the Fermi energy,which limits the investigation of the emergent flat band physics.In this work,by combining soft x-ray angle-resolved photoemission spectroscopy(ARPES)and the first-principles calculations,the electronic structure is investigated of a novel kagome metal CeNi_(5) with a clear dispersion along the kz direction and a Fermi level flat band in theΓ–K–M–Γplane.Besides,resonant ARPES experimental results indicate that the valence state of Ce ions is close to 4^(+),which is consistent with the transport measurement result.Our results demonstrate the unique electronic properties of CeNi_(5) as a new kagome metal and provide an ideal platform for exploring the flat band physics and the interactions between different types of flat bands by tuning the valence state of Ce ions.

Valence Bands Convergence in p-Type CoSb_(3) through Electronegative Fluorine Filling

Band convergence is considered to be a strategy with clear benefits for thermoelectric performance,generally favoring the co-optimization of conductivity and Seebeck coefficients,and the conventional means include elemental filling to regulate the band.However,the influence of the most electronegative fluorine on the CoSb_(3) band remains unclear.We carry out density-functional-theory calculations and show that the valence band maximum gradually shifts downward with the increase of fluorine filling,lastly the valence band maximum converges to the highly degenerated secondary valence bands in fluorine-filled skutterudites.

A Narrowband Burst from FRB 20190520B Simultaneously Observed by FAST and Parkes

Fast radio bursts(FRBs)are short-duration radio transients with mysterious origins.Since their uncertainty,there are very few FRBs observed by different instruments simultaneously.This study presents a detailed analysis of a burst from FRB 20190520B observed by FAST and Parkes at the same time.The spectrum of this individual burst ended at the upper limit of the FAST frequency band and was simultaneously detected by the Parkes telescope in the 1.5–1.8GHz range.By employing spectral energy distribution(SED)and spectral sharpness methods,we confirmed the presence of narrow-band radiation in FRB 20190520B,which is crucial for understanding its radiation mechanisms.Our findings support the narrow-band characteristics that most repeaters exhibit.This work also highlights the necessity of continued multiband observations to explore its periodicity and frequency-dependent properties,contributing to an in-depth understanding of FRB phenomena.

Behavior of exciton in direct−indirect band gap Al_(x)Ga_(1−x)As crystal lattice quantum wells

Excitons have significant impacts on the properties of semiconductors.They exhibit significantly different properties when a direct semiconductor turns in to an indirect one by doping.Huybrecht variational method is also found to influence the study of exciton ground state energy and ground state binding energy in Al_(x)Ga_(1−x)As semiconductor spherical quantum dots.The Al_(x)Ga_(1−x)As is considered to be a direct semiconductor at AI concentration below 0.45,and an indirect one at the concentration above 0.45.With regards to the former,the ground state binding energy increases and decreases with AI concentration and eigenfrequency,respectively;however,while the ground state energy increases with AI concentration,it is marginally influenced by eigenfrequency.On the other hand,considering the latter,while the ground state binding energy increases with AI concentration,it decreases with eigenfrequency;nevertheless,the ground state energy increases both with AI concentration and eigenfrequency.Hence,for the better practical performance of the semiconductors,the properties of the excitons are suggested to vary by adjusting AI concentration and eigenfrequency.

Layered kagome compound Na_(2)Ni_(3)S_(4)with topological flat band

We report structural and electronic properties of Na_(2)Ni_(3)S_(4),a quasi-two-dimensional compound composed of alternating layers of[Ni_(3)S_(4)]^(2-)and Na^(+).The compound features a remarkable Ni-based kagome lattice with a square planar configuration of four surrounding S atoms for each Ni atom.Magnetization and electrical measurements reveal a weak paramagnetic insulator with a gap of about 0.5 eV.Our band structure calculation highlights a set of topological flat bands of the kagome lattice derived from the rotated dxz-orbital with C_(3)+T symmetry in the presence of crystal-field splitting.

Observation of parabolic electron bands on superconductor LaRu_(2)As_(2)

Ru-based superconductor LaRu_(2)As_(2) has been discovered exhibiting the highest critical temperature of ~ 7.8 K among iron-free transition metal pnictides with the ThCr_(2)Si_(2)-type crystal structure. However, microscopic research on this novel superconducting material is still lacking. Here, we utilize scanning tunneling microscopy/spectroscopy to uncover the superconductivity and surface structure of LaRu_(2)As_(2). Two distinct terminating surfaces are identified on the cleaved crystals, namely, the As surface and the La surface. Atomic missing line defects are observed on the La surface. Both surfaces exhibit a superconducting gap of ~ 1.0 me V. By employing quasiparticle interference techniques, we observe standing wave patterns near the line defects on the La atomic plane. These patterns are attributed to quasiparticle scattering from two electron type parabolic bands.

Band structures of strained kagome lattices

Materials with kagome lattices have attracted significant research attention due to their nontrivial features in energy bands.We theoretically investigate the evolution of electronic band structures of kagome lattices in response to uniaxial strain using both a tight-binding model and an antidot model based on a periodic muffin-tin potential.It is found that the Dirac points move with applied strain.Furthermore,the flat band of unstrained kagome lattices is found to develop into a highly anisotropic shape under a stretching strain along y direction,forming a partially flat band with a region dispersionless along ky direction while dispersive along kx direction.Our results shed light on the possibility of engineering the electronic band structures of kagome materials by mechanical strain.

Observation of flat-band localized state in a one-dimensional diamond momentum lattice of ultracold atoms

We investigated the one-dimensional diamond ladder in the momentum lattice platform. By inducing multiple twoand four-photon Bragg scatterings among specific momentum states, we achieved a flat band system based on the diamond model, precisely controlling the coupling strength and phase between individual lattice sites. Utilizing two lattice sites couplings, we generated a compact localized state associated with the flat band, which remained localized throughout the entire time evolution. We successfully realized the continuous shift of flat bands by adjusting the corresponding nearest neighbor hopping strength, enabling us to observe the complete localization process. This opens avenues for further exploration of more complex properties within flat-band systems, including investigating the robustness of flat-band localized states in disordered flat-band systems and exploring many-body localization in interacting flat-band systems.

Atomistic Investigation of Shock-Induced Amorphization within Micro-shear Bands in Hexagonal Close-Packed Titanium

The mechanical response of a single crystal titanium sample against(0001)α surface impact was investigated using molecular dynamics simulation.Remarkably,non-uniform plastic deformation was observed in the sample.At high strain rates,amorphization occurred near the edge of the contact region where severe shear strain induced a large number of stacking faults(SFs)and dislocations.In contrast,the central part of the contact region underwent less deformation with significantly fewer dislocations.Moreover,instead of amorphization by consuming SFs and dislocations,there was a gradual increase in the density of dislocations and SFs during the process of amorphization.These local amorphous regions eventually grew into shear bands.

Ultra-wide band gap and wave attenuation mechanism of a novel star-shaped chiral metamaterial

A novel hollow star-shaped chiral metamaterial(SCM)is proposed by incorporating chiral structural properties into the standard hollow star-shaped metamaterial,exhibiting a wide band gap over 1500 Hz.To broaden the band gap,solid single-phase and two-phase SCMs are designed and simulated,which produce two ultra-wide band gaps(approximately 5116 Hz and 6027 Hz,respectively).The main reason for the formation of the ultra-wide band gap is that the rotational vibration of the concave star of two novel SCMs drains the energy of an elastic wave.The impacts of the concave angle of a single-phase SCM and the resonator radius of a two-phase SCM on the band gaps are studied.Decreasing the concave angle leads to an increase in the width of the widest band gap,and the width of the widest band gap increases as the resonator radius of the two-phase SCM increases.Additionally,the study on elastic wave propagation characteristics involves analyzing frequency dispersion surfaces,wave propagation directions,group velocities,and phase velocities.Ultimately,the analysis focuses on the transmission properties of finite periodic structures.The solid single-phase SCM achieves a maximum vibration attenuation over 800,while the width of the band gap is smaller than that of the two-phase SCM.Both metamaterials exhibit high vibration attenuation capabilities,which can be used in wideband vibration reduction to satisfy the requirement of ultra-wide frequencies.

Amniotic Band Syndrome at the Van Norman Clinic in Burundi: A Case Series

Amniotic band syndrome is an acquired embryo-fetopathy. It is rare and is characterized by malformations mainly affecting the limbs but also the skull, face and thoraco-abdominal axis. Its etiopathogenesis remains poorly understood. Its diagnosis is essentially clinical and is classically based on the existence of signs such as furrows, amputations and pseudosyndactyly. To show the importance of antenatal diagnosis in resource-limited countries, we report the case of two newborns, one premature at 31 weeks and the other at term, in whom amniotic band syndrome was discovered incidentally at birth. It involved an amputation of the right leg for both cases. The premature baby was born in a context of neonatal sepsis and will succumb to the latter while the 2nd case was released from the hospital alive. Imaging examinations to search for probable congenital malformations could only be carried out for the 2nd case and no accessible congenital malformation had been identified. And as management of the disease, only psychological support to the parents was provided for the 2 cases. The antenatal discovery of a case of amniotic band syndrome in countries with low technical capacity such as Burundi should push clinicians to think in time about treatment options.

Single crystal growth and transport properties of narrow-bandgap semiconductor RhP_(2)

We report the growth of high-quality single crystals of RhP_(2),and systematically study its structure and physical properties by transport,magnetism,and heat capacity measurements.Single-crystal x-ray diffraction reveals that RhP_(2) adopts a monoclinic structure with the cell parameters a=5.7347(10)A,b=5.7804(11)A,and c=5.8222(11)A,space group P2_(1)/c(No.14).The electrical resistivityρ(T)measurements indicate that RhP_(2) exhibits narrow-bandgap behavior with the activation energies of 223.1 meV and 27.4 meV for two distinct regions,respectively.The temperaturedependent Hall effect measurements show electron domain transport behavior with a low charge carrier concentration.We find that RhP_(2) has a high mobilityμ_(e)~210 cm^(2)·V^(-1)·s^(-1)with carrier concentrations n_(e)~3.3×10^(18)cm^(3) at 300 K with a narrow-bandgap feature.The high mobilityμ_(e) reaches the maximum of approximately 340 cm^(2)·V^(-1)·s^(-1)with carrier concentrations n_^(e)~2×10^(18)cm^(-3)at 100 K.No magnetic phase transitions are observed from the susceptibilityχ(T)and specific heat C_(p)(T)measurements of RhP_(2).Our results not only provide effective potential as a material platform for studying exotic physical properties and electron band structures but also motivate further exploration of their potential photovoltaic and optoelectronic applications.

Optimal design for rubber concrete layered periodic foundations based on the analytical approximations of band gaps and mapping relations

The seismic performance of rubber concrete-layered periodic foundations are significantly influenced by their design,in which the band gaps play a paramount role.Aiming at providing better designs for these foundations,this study first proposes and validates the analytical formulas to approximate the bounds of the first few band gaps.In addition,the mapping relations linking the frequencies of different band gaps are presented.Furthermore,an optimal design method for these foundations is developed,which is validated through an engineering example.It is demonstrated that ensuring the superstructure’s resonance zones are completely covered by the corresponding periodic foundation’s band gaps can achieve satisfactory vibration attenuation effects,which is a good strategy for the design of rubber concrete layered periodic foundations.

Reanalysis of energy band structure in the type-II quantum wells

Band structure analysis holds significant importance for understanding the optoelectronic characteristics of semiconductor structures and exploring their potential applications in practice. For quantum well structures, the energy of carriers in the well splits into discrete energy levels due to the confinement of barriers in the growth direction. However, the discrete energy levels obtained at a fixed wave vector cannot accurately reflect the actual energy band structure. In this work, the band structure of the type-II quantum wells is reanalyzed. When the wave vectors of the entire Brillouin region(corresponding to the growth direction) are taken into account, the quantized energy levels of the carriers in the well are replaced by subbands with certain energy distributions. This new understanding of the energy bands of low-dimensional structures not only helps us to have a deeper cognition of the structure, but also may overturn many viewpoints in traditional band theories and serve as supplementary to the band theory of low-dimensional systems.

The Diagnostic Value of Oligoclonal Band Detection in Viral Encephalitis

Objective: This study aims to explore the differences in cerebrospinal fluid oligoclonal band (CSF-OCB) expression among different age groups in viral encephalitis and its reference value for diagnosis. Methods: Forty-two patients with viral encephalitis were divided into two groups: 25 adults and 17 children. The presence of oligoclonal bands in the cerebrospinal fluid (CSF) was detected using polyacrylamide gel electrophoresis, and CSF routine analysis was conducted for comparative analysis. Results: The CSF-OCB positivity rate was higher in the adult group (48%) compared with the pediatric group (11.76%), with a statistically significant difference (P Conclusion: 1) The expression of CSF-OCB positivity in patients with viral encephalitis is age-related, with higher positivity rates observed in adults compared to children. 2) Although CSF oligoclonal band detection is not a specific diagnostic marker for viral encephalitis in adults, it still holds certain reference value.