Gastrointestinal tuberculosis:Diagnostic approaches for this uncommon pathology

A case report entitled“Primary gastroduodenal tuberculosis presenting as gastric outlet obstruction”recently published in the World Journal of Clinical Cases presented a rare cause of gastric outlet obstruction and highlighted the atypical manner in which gastrointestinal tuberculosis(TB)can present.The literature with regards to this rare pathology is limited to case reports and case series with the largest being published using data from between 2003 and 2013.However,since then the diagnostic tools available have significantly changed with more modern and increasingly accurate tests now available.This editorial reviews the current state of the art with regards to diagnosis in gastrointestinal TB.

Enhancing perianal disease management with integrated physical and psychological approaches

This article provides a comprehensive analysis of the study by Hou et al,focusing on the complex interplay between psychological and physical factors in the postoperative recovery(POR)of patients with perianal diseases.The study sheds light on how illness perception,anxiety,and depression significantly influence recovery outcomes.Hou et al developed a predictive model that demonstrated high accuracy in identifying patients at risk of poor recovery.The article explores the critical role of pre-operative psychological assessment,highlighting the need for mental health support and personalized recovery plans in enhancing POR quality.A multidisciplinary approach,integrating mental health professionals with surgeons,anesthesiologists,and other specialists,is emphasized to ensure comprehensive care for patients.The study’s findings serve as a call to integrate psychological care into surgical practice to optimize outcomes for patients with perianal diseases.

Contemporary strategies and approaches for characterizing composition and enhancing biofilm penetration targeting bacterial extracellular polymeric substances

Extracellular polymeric substances(EPS)constitutes crucial elements within bacterial biofilms,facili-tating accelerated antimicrobial resistance and conferring defense against the host's immune cells.Developing precise and effective antibiofilm approaches and strategies,tailored to the specific charac-teristics of EPS composition,can offer valuable insights for the creation of novel antimicrobial drugs.This,in turn,holds the potential to mitigate the alarming issue of bacterial drug resistance.Current analysis of EPS compositions relies heavily on colorimetric approaches with a significant bias,which is likely due to the selection of a standard compound and the cross-interference of various EPS compounds.Considering the pivotal role of EPS in biofilm functionality,it is imperative for EPS research to delve deeper into the analysis of intricate compositions,moving beyond the current focus on polymeric materials.This ne-cessitates a shift from heavy reliance on colorimetric analytic methods to more comprehensive and nuanced analytical approaches.In this study,we have provided a comprehensive summary of existing analytical methods utilized in the characterization of EPS compositions.Additionally,novel strategies aimed at targeting EPS to enhance biofilm penetration were explored,with a specific focus on high-lighting the limitations associated with colorimetric methods.Furthermore,we have outlined the challenges faced in identifying additional components of EPS and propose a prospective research plan to address these challenges.This review has the potential to guide future researchers in the search for novel compounds capable of suppressing EPS,thereby inhibiting biofilm formation.This insight opens up a new avenue for exploration within this research domain.

Optimizing a Transportation System Using Metaheuristics Approaches (EGD/GA/ACO): A Forest Vehicle Routing Case Study

The large-scale optimization problem requires some optimization techniques, and the Metaheuristics approach is highly useful for solving difficult optimization problems in practice. The purpose of the research is to optimize the transportation system with the help of this approach. We selected forest vehicle routing data as the case study to minimize the total cost and the distance of the forest transportation system. Matlab software helps us find the best solution for this case by applying three algorithms of Metaheuristics: Genetic Algorithm (GA), Ant Colony Optimization (ACO), and Extended Great Deluge (EGD). The results show that GA, compared to ACO and EGD, provides the best solution for the cost and the length of our case study. EGD is the second preferred approach, and ACO offers the last solution.

Exploring Ester Prodrugs: A Comprehensive Review of Approaches, Applications, and Methods

The review provides an overview of the approaches, applications, and methods for ester prodrugs. Ester prodrugs are pharmacologically inactive compounds in their original form but become active drugs on biotransformation within the body, which offers advantages concerning the solubility, stability, and targeted delivery of the active drug. Several approaches of ester prodrugs have been reviewed in this review, including simple ester prodrugs, amino acid ester prodrugs, sugar ester prodrugs, lipid ester prodrugs, and polymeric ester prodrugs. This review incorporates in vitro and in vivo methods as well as the characterization of physical and chemical properties for ester prodrugs, cell culture systems, enzymatic assays, and animal models—all of these having a very important bearing on the evaluation of stability, bioavailability, and efficacy for ester prodrugs. While the benefits of using ester prodrugs are significant, there are also disadvantages like instability, poor or variable enzymatic hydrolysis, and toxicity from released promoieties or by-products. This review discusses solutions to the various limitations that include enhancing stability with ionizable promoieties and using physiologically-based pharmacokinetic modeling. The review also highlights the application of ester prodrugs in neurological disorders, such as Parkinson’s disease, and the ongoing efforts to address the critical limitations in treatment efficacy. Future prodrug strategies are poised to advance significantly by harnessing diverse transport mechanisms across the blood-brain barrier and integrating nanotechnology.

Colon cancer and their targeting approaches through nanocarriers:A review

Colon cancer is the fifth most common type of cancer in the world.Colon cancer develops when healthy cells in the lining of the colon or rectum alter and grow uncontrollably to form a mass known as a tumor.Despite major medical improvements,colon cancer is still one of the leading causes of cancer-related mortality globally.One of the main issues of chemotherapy is toxicity related to conventional medicines.The targeted delivery systems are considered the safest and most effective by increasing the concentration of a therapeutic substance at the tumor site while decreasing it at other organs.Therefore,these delivery systems required lower doses for high therapeutic value with minimum side effects.The current review focuses on targeting therapeutic substances at the desired site using nanocarriers.Additionally,the diagnostic applications of nanocarriers in colorectal cancer are also discussed.

Towards Innovative Research Approaches to Investigating the Role of Emotional Variables in Promoting Language Teachers’ and Learners’ Mental Health

The adequacy of language education largely depends on the favorable and unfavorable emotions that teachers and students experience throughout the education process.Simply said,emotional factors play a key role in improving the quality of language teaching and learning.Furthermore,these emotional factors also promote the well-being of language teachers and learners and place them in a suitable mental condition.In view of the favorable impact of emotional factors on the mental health of language teachers and learners,many educational scholars around the world have studied these factors,their background,and their pedagogical consequences.Nonetheless,the majority of previous studies have employed traditional research methods in assessing these variables and their influences on language teachers’and learners’mental health.Because of the complex and dynamic quality of emotional factors,traditional research approaches often fail to evaluate these factors and their dynamic,non-linear connections with teachers’and learners’mental health and well-being.Accordingly,some novel research approaches are required to measure the dynamicity and complexity of emotional factors in language education settings.To address this call,the current state-of-the-art conceptual article seeks to provide new insights for investigating emotional factors and their potential impact on language teachers’and learners’mental states.This study also intends to offer a comprehensive list of emerging methods that take into account the complex and dynamic nature of emotional variables.Finally,the study outlines the potential implications of this review for educational researchers.

Complication rates after direct anterior vs posterior approach for hip hemiarthroplasty in elderly individuals with femoral neck fractures

BACKGROUND Dislocation rates after hemiarthroplasty reportedly vary from 1%to 17%.This serious complication is associated with increased morbidity and mortality rates.Approaches to this surgery are still debated,with no consensus regarding the superiority of any single approach.AIM To compare early postoperative complications after implementing the direct anterior and posterior approaches(PL)for hip hemiarthroplasty after femoral neck fractures.METHODS This is a comparative,retrospective,single-center cohort study conducted at a university hospital.Between March 2008 and December 2018,273 patients(a total of 280 hips)underwent bipolar hemiarthroplasties(n=280)for displaced femoral neck fractures using either the PL(n=171)or the minimally invasive direct anterior approach(DAA)(n=109).The choice of approach was related to the surgeons’practices;the implant types were similar and unrelated to the approach.Dislocation rates and other complications were reviewed after a minimum followup of 6 mo.RESULTS Both treatment groups had similarly aged patients(mean age:82 years),sex ratios,patient body mass indexes,and patient comorbidities.Surgical data(surgery delay time,operative time,and blood loss volume)did not differ significantly between the groups.The 30 d mortality rate was higher in the PL group(9.9%)than in the DAA group(3.7%),but the difference was not statistically significant(P=0.052).Among the one-month survivors,a significantly higher rate of dislocation was observed in the PL group(14/154;9.1%)than in the DAA group(0/105;0%)(P=0.002).Of the 14 patients with dislocation,8 underwent revision surgery for recurrent instability(posterior group),and one of them had 2 additional procedures due to a deep infection.The rate of other complications(e.g.,perioperative and early postoperative periprosthetic fractures and infection-related complications)did not differ significantly between the groups.CONCLUSION These findings suggest that the DAA to bipolar hemiarthroplasty for patients with femoral neck fractures is associated with a lower dislocation rate(<1%)than the PL.

Effect of two surgical approaches on the lung function and prognosis of patients with combined esophagogastric cancer

BACKGROUND Adenocarcinoma of the esophagogastric junction has a center of origin within 5 cm of the esophagogastric junction.Surgical resection remains the main treatment.A transthoracic approach is recommended for Siewert I adenocarcinoma of the esophagogastric junction and a transabdominal approach is recommended for Siewert III adenocarcinoma of the esophagogastric junction.However,there is a need to determine the optimal surgical approach for Siewert II adenocarcinoma of the esophagogastric junction to improve lung function and the prognosis of patients.AIM To investigate and compare the surgical effects,postoperative changes in pulmonary function,and prognoses of two approaches to treating combined esophagogastric cancer.METHODS One hundred and thirty-eight patients with combined esophagogastric cancer treated by general and thoracic surgeries in our hospital were selected.They were divided into group A comprising 70 patients(transabdominal approach)and group B comprising 68 patients(transthoracic approach)based on the surgical approach.The indexes related to surgical trauma,number of removed lymph nodes,indexes of lung function before and after surgery,survival rate,and survival duration of the two groups were compared 3 years after surgery.RESULTS The duration of surgery,length of hospital stay,and postoperative drainage duration of the patients in group A were shorter than those of the patients in group B,and the volume of blood loss caused by surgery was lower for group A than for group B(P<0.05).At the one-month postoperative review,the first second,maximum ventilation volume,forceful lung volume,and lung volume values were higher for group A than for group B(P<0.05).Preoperatively,the QLQ-OES18 scale scores of the patients in group A were higher than those in group B on re-evaluation at 3 mo postoperatively(P<0.05).The surgical complication rate of the patients in group A was 10.00%,which was lower than that of patients in group B,which was 23.53%(P<0.05).CONCLUSION Transabdominal and transthoracic surgical approaches are comparable in treating combined esophagogastric cancer;however,the former results in lesser surgical trauma,milder changes in pulmonary function,and fewer complications.

Exploring an eco-friendly approach to improve soil tensile behavior and cracking resistance

Soil tensile strength is a critical parameter governing the initiation and propagation of tensile cracking.This study proposes an eco-friendly approach to improve the tensile behavior and crack resistance of clayey soils.To validate the feasibility and efficacy of the proposed approach,direct tensile tests were employed to determine the tensile strength of the compacted soil with different W-OH treatment concentrations and water contents.Desiccation tests were also performed to evaluate the effectiveness of W-OH treatment in enhancing soil tensile cracking resistance.During this period,the effects of W-OH treatment concentration and water content on tensile properties,soil suction and microstructure were investigated.The tensile tests reveal that W-OH treatment has a significant impact on the tensile strength and failure mode of the soil,which not only effectively enhances the tensile strength and failure displacement,but also changes the brittle failure behavior into a more ductile quasi-brittle failure behavior.The suction measurements and mercury intrusion porosimetry(MIP)tests show that W-OH treatment can slightly reduce soil suction by affecting skeleton structure and increasing macropores.Combined with the microstructural analysis,it becomes evident that the significant improvement in soil tensile behavior through W-OH treatment is mainly attributed to the W-OH gel's ability to provide additional binding force for bridging and encapsulating the soil particles.Moreover,desiccation tests demonstrate that W-OH treatment can significantly reduce or even inhibit the formation of soil tensile cracking.With the increase of W-OH treatment concentration,the surface crack ratio and total crack length are significantly reduced.This study enhances a fundamental understanding of eco-polymer impacts on soil mechanical properties and provides valuable insight into their potential application for improving soil crack resistance.

Asymmetric relationship between global and national factors and domestic food prices:evidence from Turkey with novel nonlinear approaches

This study investigates the asymmetric relationship between global and national fac-tors and domestic food prices in Turkey,considering the recent rapid and continuous increase in domestic food prices.In this context,six global and three national explana-tory variables were included,and monthly data for the period from January 2004 to June 2021 were used.In addition,novel nonlinear time-series econometric approaches,such as wavelet coherence,Granger causality in quantiles,and quantile-on-quantile regression,were applied for examination at different times,frequencies,and quan-tiles.Moreover,the Toda-Yamamoto(TY)causality test and quantile regression(QR)approach were used for robustness checks.The empirical results revealed that(i)there is a significant relationship between domestic food prices and explanatory variables at different times and frequencies;(ii)a causal relationship exists in most quantiles,excluding the lowest quantile,some middle quantiles,and the highest quantile for some variables;(iii)the power of the effect of the explanatory variables on domestic food prices varies according to the quantiles;and(iv)the results were validated by the TY causality test and QR,which show that the results were robust.Overall,the empiri-cal results reveal that global and national factors have an asymmetric relationship with domestic food prices,highlighting the effects of fluctuations in global and national variables on domestic food prices.Thus,the results imply that Turkish policymakers should consider the asymmetric effects of global and national factors on domestic food prices at different times,frequencies,and quantiles.

Organic cathode materials for rechargeable magnesium-ion batteries:Fundamentals, recent advances, and approaches to optimization

Rechargeable magnesium-ion batteries(MIBs) are favorable substitutes for conventional lithium-ion batteries(LIBs) because of abundant magnesium reserves, a high theoretical energy density, and great inherent safety. Organic electrode materials with excellent structural tunability,unique coordination reaction mechanisms, and environmental friendliness offer great potential to promote the electrochemical performance of MIBs. However, research on organic magnesium battery cathode materials is still preliminary with many significant challenges to be resolved including low electrical conductivity and unwanted but severe dissolution in useful electrolytes. Herein, we provide a detailed overview of reported organic cathode materials for MIBs. We begin with basic properties such as charge storage mechanisms(e.g., n-, p-, and bipolartype), moving to recent advances in various types of organic cathodes including carbonyl-, nitrogen-, and sulfur-based materials. To shed light on the diverse strategies targeting high-performance Mg-organic batteries, elaborate summaries of various approaches are presented.Generally, these strategies include molecular design, polymerization, mixing with carbon, nanosizing and electrolyte/separator optimization.This review provides insights on exploring high-performance organic cathodes in rechargeable MIBs.

A Comparison between Deductive and Inductive Approaches for Teaching EFL Grammar to High School Students

This study had the purpose of testingtwo methods for teaching grammar in Englishasa Foreign Language(EFL)class:the deductive and inductive approaches in terms of effectiveness and rapport.This research was conducted in a public high school in Ecuador.Seventy students enrolled in the second year of senior high school participated.One in-service teacher taught the EFL classes during the process of intervention(10 weeks),and two EFL teachers observed all of these classes and recorded the information by filling in observation sheets.The students were administered grammar pretests and post-tests in order to assess their grammar knowledge.The results of the tests showed a significant difference in the scores in favor of the inductive approach.After the statistical analysis of the data obtained from the tests and observation sheets,we concluded that the inductive approach is more effective for teaching grammar in the EFL classroom in terms of instruction and rapport.

Laparoscopic left hemihepatectomy guided by indocyanine green fluorescence: A cranial-dorsal approach

BACKGROUND Advancements in laparoscopic technology and a deeper understanding of intra-hepatic anatomy have led to the establishment of more precise laparoscopic hepatectomy(LH)techniques.The indocyanine green(ICG)fluorescence navi-gation technique has emerged as the most effective method for identifying hepatic regions,potentially overcoming the limitations of LH.While laparoscopic left hemihepatectomy(LLH)is a standardized procedure,there is a need for innova-tive strategies to enhance its outcomes.important anatomical markers,surgical skills,and ICG staining methods.METHODS Thirty-seven patients who underwent ICG fluorescence-guided LLH at Qujing Second People's Hospital between January 2019 and February 2022 were retrospectively analyzed.The cranial-dorsal approach was performed which involves dissecting the left hepatic vein cephalad,isolating the Arantius ligament,exposing the middle hepatic vein,and dissecting the parenchyma from the dorsal to the foot in order to complete the anatomical LLH.The surgical methods,as well as intra-and post-surgical data,were recorded and analyzed.Our hospital’s Medical Ethics Committee approved this study(Ethical review:2022-019-01).RESULTS Intraoperative blood loss during LLH was 335.68±99.869 mL and the rates of transfusion and conversion to laparotomy were 13.5%and 0%,respectively.The overall incidence of complications throughout the follow-up(median of 18 months;range 1-36 months)was 21.6%.No mortality or severe complications(level IV)were reported.CONCLUSION LLH has the potential to become a novel,standardized approach that can effectively,safely,and simply expose the middle hepatic vein and meet the requirements of precision surgery.

Direct Approaches in L2 Instruction:A Turning Point in Communicative Language Teaching?(Ⅰ)

In 1990 Richards argued that there were two major approaches to teaching speaking skills,an indirect approach,"inwhich conversational competence is seen as the product of engaging learners in conversational interaction"(p.76),and a direct approach,which"6involvesplanninga conversational programme around the specific micro skills,strategies,and processes that are involved in fluent conversation"(p.77).

Which approach of total hip arthroplasty is the best efficacy and least complication?

BACKGROUND Total hip arthroplasty is as an effective intervention to relieve pain and improve hip function.Approaches of the hip have been exhaustively explored about pros and cons.The efficacy and the complications of hip approaches remains inconclusive.This study conducted an umbrella review to systematically appraise previous meta-analysis(MAs)including conventional posterior approach(PA),and minimally invasive surgeries as the lateral approach(LA),direct anterior approach(DAA),2-incisions method,mini-lateral approach and the newest technique direct superior approach(DSA)or supercapsular percutaneouslyassisted total hip(SuperPath).AIM To compare the efficacy and complications of hip approaches that have been published in all MAs and randomized controlled trials(RCTs).METHODS MAs were identified from MEDLINE and Scopus from inception until 2023.RCTs were then updated from the latest MA to September 2023.This study included studies which compared hip approaches and reported at least one outcome such as Harris Hip Score(HHS),dislocation,intra-operative fracture,wound compliData were independently selected,extracted and assessed by two reviewers.Network MA and cluster rank and surface under the cumulative ranking curve(SUCRA)were estimated for treatment efficacy and safety.RESULTS Finally,twenty-eight MAs(40 RCTs),and 13 RCTs were retrieved.In total 47 RCTs were included for reanalysis.The results of corrected covered area showed high degree(13.80%).Among 47 RCTs,most of the studies were low risk of bias in part of random process and outcome reporting,while other domains were medium to high risk of bias.DAA significantly provided higher HHS at three months than PA[pooled unstandardized mean difference(USMD):3.49,95%confidence interval(CI):0.98,6.00 with SUCRA:85.9],followed by DSA/SuperPath(USMD:1.57,95%CI:-1.55,4.69 with SUCRA:57.6).All approaches had indifferent dislocation and intraoperative fracture rates.SUCRA comparing early functional outcome and composite complications(dislocation,intra-operative fracture,wound complication,and nerve injury)found DAA was the best approach followed by DSA/SuperPath.CONCLUSION DSA/SuperPath had better earlier functional outcome than PA,but still could not overcome the result of DAA.This technique might be the other preferred option with acceptable complications.

Interactive Approaches in ESL Teaching and Its Application

Traditionally,second language reading was considered as a simple passive decoding process.However,researchers began to study the issue from the psycholinguistic perspectives,and proposed the interactive approach to ESL reading.In this thesis,a brief review is made concerning the related theories.Some strategies are suggested to improve learners’ability in top-down and bottom-up models.Finally,it is pointed out that these two models interact in the reading process,and therefore the teaching methods should also be applied in good combination to improve reading.

Minimalistic approach to left atrial appendage occlusion guided by cardiac computed tomography angiography

OBJECTIVE To assess the feasibility and safety of the minimalistic approach to left atrial appendage occlusion(LAAO) guided by cardiac computed tomography angiography(CCTA).METHODS Ninety consecutive patients who underwent LAAO, with or without CCTA-guided, were matched(1:2). Each step of the LAAO procedure in the computed tomography(CT) guidance group(CT group) was directed by preprocedural CT planning. In the control group, LAAO was performed using the standard method. All patients were followed up for 12 months, and device surveillance was conducted using CCTA.RESULTS A total of 90 patients were included in the analysis, with 30 patients in the CT group and 60 matched patients in the control group. All patients were successfully implanted with Watchman devices. The mean ages for the CT group and the control group were 70.0 ± 9.4 years and 68.4 ± 11.9 years(P = 0.52), respectively. The procedure duration(45.6 ± 10.7 min vs. 58.8 ± 13.0 min,P < 0.001) and hospital stay(7.5 ± 2.4 day vs. 9.6 ± 2.8 day, P = 0.001) in the CT group was significantly shorter compared to the control group. However, the total radiation dose was higher in the CT group compared to the control group(904.9 ± 348.0 m Gy vs.711.9 ± 211.2 m Gy, P = 0.002). There were no significant differences in periprocedural pericardial effusion(3.3% vs. 6.3%, P = 0.8) between the two groups. The rate of postprocedural adverse events(13.3% vs. 18.3%, P = 0.55) were comparable between both groups at 12 months follow-up.CONCLUSIONS CCTA is capable of detailed LAAO procedure planning. Minimalistic LAAO with preprocedural CCTA planning was feasible and safe, with shortened procedure time and acceptable increased radiation and contras consumption. For patients with contraindications to general anesthesia and/or transesophageal echocardiography, this promising method may be an alternative to conventional LAAO.

Virtual source approach for maximizing resolution in high-penetration gamma-ray imaging

High-energy gamma-ray radiography has exceptional penetration ability and has become an indispensable nondestructive testing(NDT)tool in various fields.For high-energy photons,point projection radiography is almost the only feasible imaging method,and its spatial resolution is primarily constrained by the size of the gamma-ray source.In conventional industrial applications,gamma-ray sources are commonly based on electron beams driven by accelerators,utilizing the process of bremsstrahlung radiation.The size of the gamma-ray source is dependent on the dimensional characteristics of the electron beam.Extensive research has been conducted on various advanced accelerator technologies that have the potential to greatly improve spatial resolution in NDT.In our investigation of laser-driven gamma-ray sources,a spatial resolution of about 90μm is achieved when the areal density of the penetrated object is 120 g/cm^(2).A virtual source approach is proposed to optimize the size of the gamma-ray source used for imaging,with the aim of maximizing spatial resolution.In this virtual source approach,the gamma ray can be considered as being emitted from a virtual source within the convertor,where the equivalent gamma-ray source size in imaging is much smaller than the actual emission area.On the basis of Monte Carlo simulations,we derive a set of evaluation formulas for virtual source scale and gamma-ray emission angle.Under optimal conditions,the virtual source size can be as small as 15μm,which can significantly improve the spatial resolution of high-penetration imaging to less than 50μm.

Analysis of the Impact of Optimal Solutions to the Transportation Problems for Variations in Cost Using Two Reliable Approaches

In this paper, we have used two reliable approaches (theorems) to find the optimal solutions to transportation problems, using variations in costs. In real-life scenarios, transportation costs can fluctuate due to different factors. Finding optimal solutions to the transportation problem in the context of variations in cost is vital for ensuring cost efficiency, resource allocation, customer satisfaction, competitive advantage, environmental responsibility, risk mitigation, and operational fortitude in practical situations. This paper opens up new directions for the solution of transportation problems by introducing two key theorems. By using these theorems, we can develop an algorithm for identifying the optimal solution attributes and permitting accurate quantification of changes in overall transportation costs through the addition or subtraction of constants to specific rows or columns, as well as multiplication by constants inside the cost matrix. It is anticipated that the two reliable techniques presented in this study will provide theoretical insights and practical solutions to enhance the efficiency and cost-effectiveness of transportation systems. Finally, numerical illustrations are presented to verify the proposed approaches.