Effectiveness of biologics for endoscopic healing in patients with isolated proximal small bowel Crohn’s disease

BACKGROUND Endoscopic healing(EH)is a key therapeutic target in Crohn’s disease(CD).Proximal small bowel(SB)lesions in patients with CD are associated with a significant risk of strictures and bowel resection.Assessing SB in patients with CD is necessary because of its significant therapeutic implications.The advent of biologic therapies,including infliximab,ustekinumab,and vedolizumab,has significantly altered CD treatment.However,data on the efficacy of biologics in achieving EH,specifically in the proximal SB of patients with CD,remain limited.AIM To assess the effectiveness of biologics for EH in patients with jejunal and/or proximal ileal CD.METHODS Between 2017 and 2023,we retrospectively included 110 consecutive patients with isolated proximal SB CD,identified through baseline balloon-assisted enteroscopy.These patients completed 1-year of treatment with infliximab,ustekinumab,or vedolizumab,and underwent a second balloon-assisted enteroscopy at 1 year.Complete EH was defined as a modified Simple Endoscopic Score for CD(SES-CD)of<3,while EH of the jejunum and proximal ileum was defined as a segmental modified SES-CD of 0.RESULTS In total,64 patients were treated with infliximab,28 with ustekinumab,and 18 with vedolizumab.The complete EH rate at 1 year was 20.9%(23/110),with 29.6%(19/64)for infliximab,10.7%(3/28)for ustekinumab,and 5.5%(1/18)for vedolizumab.The median modified SES-CD significantly decreased compared to baseline[5(2-8)vs 8(6-9),P<0.001].The jejunal and proximal ileal EH rates at 1 year were 30.8%(12/39)and 15.5%(16/103),respectively.Multiple logistic regression analysis showed that stricturing or penetrating disease[odds ratio(OR)=0.261,95%CI:0.087-0.778,P=0.016],prior exposure to biologics(OR=0.080,95%CI:0.010-0.674,P=0.020),and moderate-tosevere endoscopic disease(OR=0.277,95%CI:0.093-0.829,P=0.022)were associated with a lower likelihood of achieving EH at 1 year.CONCLUSION Only 20.9%of patients with isolated proximal SB CD achieved complete EH after 1 year of biologic therapy.

Isolated deep convections over the Tibetan Plateau in the rainy season during 2001–2020

The Tibetan Plateau(TP)is a prevalent region for convection systems due to its unique thermodynamic forcing.This study investigated isolated deep convections(IDCs),which have a smaller spatial and temporal size than mesoscale convective systems(MCSs),over the TP in the rainy season(June-September)during 2001–2020.The authors used satellite precipitation and brightness temperature observations from the Global Precipitation Measurement mission.Results show that IDCs mainly concentrate over the southern TP.The IDC number per rainy season decreases from around 140 over the southern TP to around 10 over the northern TP,with an average 54.2.The initiation time of IDCs exhibits an obvious diurnal cycle,with the peak at 1400–1500 LST and the valley at 0900–1000 LST.Most IDCs last less than five hours and more than half appear for only one hour.IDCs generally have a cold cloud area of 7422.9 km^(2),containing a precipitation area of approximately 65%.The larger the IDC,the larger the fraction of intense precipitation it contains.IDCs contribute approximately 20%–30%to total precipitation and approximately 30%–40%to extreme precipitation over the TP,with a larger percentage in July and August than in June and September.In terms of spatial distribution,IDCs contribute more to both total precipitation and extreme precipitation over the TP compared to the surrounding plain regions.IDCs over the TP account for a larger fraction than MCSs,indicating the important role of IDCs over the region.

Seismic response of a mid-story isolated structure considering SSI in mountainous areas under long-period earthquakes

At present,there is not much research on mid-story isolated structures in mountainous areas.In this study,a model of a mid-story isolated structure considering soil-structure interaction(SSI)in mountainous areas is established along with a model that does not consider SSI.Eight long-period earthquake waves and two ordinary earthquake waves are selected as inputs for the dynamic time history analysis of the structure.The results show that the seismic response of a mid-story isolated structure considering SSI in mountainous areas can be amplified when compared with a structure that does not consider SSI.The structure response under long-period earthquakes is larger than that of ordinary earthquakes.The structure response under far-field harmonic-like earthquakes is larger than that of near-fault pulse-type earthquakes.The structure response under near-fault pulse-type earthquakes is larger than that of far-field non-harmonic earthquakes.When subjected to long-period earthquakes,the displacement of the isolated bearings exceeded the limit value,which led to instability and overturning of the structure.The structure with dampers in the isolated story could adequately control the nonlinear response of the structure,effectively reduce the displacement of the isolated bearings,and provide a convenient,efficient and economic method not only for new construction but also to retrofit existing structures.

Endoscopic ultrasound-guided treatment of isolated gastric varices entwined with arteries:A case report

BACKGROUND Interventional endoscopic ultrasound is clinically used for the treatment of isolated gastric varices(IGVs)owing to its precise visualization.CASE SUMMARY A 39-year-old man was diagnosed with a large IGV during a routine physical examination.Endoscopic ultrasonography showed gastric varices entwined with an artery,which greatly increased the difficulty of treatment.We successfully treated the patient with endoscopic ultrasonography-guided coil embolization combined with cyanoacrylate injection.CONCLUSION Endoscopic ultrasonography-guided coil embolization combined with cyanoacrylate injection was safe and effective for the treatment of an IGV entwined with an artery.

Nonlinear dynamic analysis of multi-base seismically isolated structures with uplift potentialⅡ:verification examples

The work presented in this paper serves as numerical verification of the analytical model developed in the companion paper for nonlinear dynamic analysis of multi-base seismically isolated structures. To this end, two numerical examples have been analyzed using the computational algorithm incorporated into program 3D-BASIS-ME-MB, developed on the basis of the newly-formulated analytical model. The first example concerns a seven-story model structure that was tested on the earthquake simulator at the University at Buflhlo and was also used as a verification example for program SAP2000. The second example concerns a two-tower, multi-story structure with a split-level seismic-isolation system. For purposes of verification, key results produced by 3D-BASIS-ME-MB are compared to experimental results, or results obtained from other structural/finite element programs. In both examples, the analyzed structure is excited under conditions of bearing uplift, thus yielding a case of much interest in verifying the capabilities of the developed analysis tool.

Nonlinear dynamic analysis of multi-base seismically isolated structures with uplift potential Ⅰ:formulation

The complexity of modem seismically isolated structures requires the analysis of the structural, system and the isolation system in its entirety and the ability to capture potential discontinuous phenomena such as isolator uplift and their effects on the superstructures and the isolation hardware. In this paper, an analytical model is developed and a computational algorithm is formulated to analyze complex seismically isolated superstructures even when undergoing highly-nonlinear phenomena such as uplift. The computational model has the capability of modeling various types of isolation devices with strong nonlinearities, analyzing multiple superstructures （up to five separate superstructures） on multiple bases （up to five bases）, and capturing the effects of lateral loads on bearing axial forces, including bearing uplift. The model developed herein has been utilized to form the software platform 3D-BASIS-ME-MB, which provides the practicing engineering community with a versatile tool for analysis and design of complex structures with modem isolation systems.

Identification and preliminary characterization of non-polyene antibiotics secreted by new strain of actinomycete isolated from sebkha of Kenadsa, Algeria

Objective: To study the antimicrobial activity of actinomycetes isolated from sabkha of Kenadsa and identification of the isolate interesting. Methods: Eighteen strains were isolated, using four culture media from sebkha of Kenadsa(Bechar, Southwestern Algeria). Screening of antimicrobial activity consisted of two steps: in primary screening, antibacterial activity was determined by using the agar plug method against test strains; in secondary screening, better isolate which showed a good activity in the first screening was selected to extract antimicrobial substances. The antimicrobial activities of extracts were evaluated by using Kirby-Bauer disc diffusion method. Partial characterization of antimicrobial products was performed on the basis of chemical revelations, UV-vis spectrometry and infrared spectroscopy. The identification of isolate interesting was performed through morphological, chemical, biochemical and physiological characteristics. Results: All isolates showed antimicrobial activity against at least one microorganism test. One isolate, LAM143 cG 3, was selected for its broad spectrum and high antimicrobial activity. The isolate LAM143 c G3 was identified as Spirillospora sp. The comparison between the species of this genus(Spirillospora rubra and Spirillospora albida) and our isolate indicated the existence of several physiological and biochemical differences which led us to suppose that this was a new member of this genus. Primary characterization of antimicrobial substances produced by the isolate LAM143 c G3 indicated the presence of amines and phenols. The UV–vis spectrum suggested a non-polyenic nature of substances secreted by our isolate, while infrared confirmed the presence of amine groups.Conclusions: The result of the present study revealed that sebkha of Kenadsa was rich in rare actinomycetes, that secreted interesting antimicrobial substance.

Sedimentary build-ups of pre-salt isolated carbonate platforms and formation of deep-water giant oil fields in Santos Basin,Brazil

In response to the problems of unclear distribution of deep-water pre-salt carbonate reservoirs and formation conditions of large oil fields in the Santos passive continental margin basin,based on comprehensive utilization of geological,seismic,and core data,and reconstruction of Early Cretaceous prototype basin and lithofacies paleogeography,it is proposed for the first time that the construction of pre-salt carbonate build-ups was controlled by two types of isolated platforms:inter-depression fault-uplift and intra-depression fault-high.The inter-depression fault-uplift isolated platforms are distributed on the present-day pre-salt uplifted zones between depressions,and are built on half-and fault-horst blocks that were inherited and developed in the early intra-continental and inter-continental rift stages.The late intra-continental rift coquinas of the ITP Formation and the early inter-continental rift microbial limestones of the BVE Formation are continuously constructed;intra-depression fault-high isolated platforms are distributed in the current pre-salt depression zones,built on the uplifted zones formed by volcanic rock build-ups in the early prototype stage of intra-continental rifts,and only the BVE microbial limestones are developed.Both types of limestones formed into mound-shoal bodies,that have the characteristics of large reservoir thickness and good physical properties.Based on the dissection of large pre-salt oil fields discovered in the Santos Basin,it has been found that both types of platforms could form large-scale combined structural-stratigraphic traps,surrounded by high-quality lacustrine and lagoon source rocks at the periphery,and efficiently sealed by thick high-quality evaporite rocks above,forming the optimal combination of source,reservoir and cap in the form of“lower generation,middle storage,and upper cap”,with a high degree of oil and gas enrichment.It has been found that the large oil fields are all bottom water massive oil fields with a unified pressure system,and they are all filled to the spill-point.The future exploration is recommended to focus on the inter-depression fault-uplift isolated platforms in the western uplift zone and the southern section of eastern uplift zones,as well as intra-depression fault-high isolated platforms in the central depression zone.The result not only provides an important basis for the advanced selection of potential play fairways,bidding of new blocks,and deployment of awarded exploration blocks in the Santos Basin,but also provides a reference for the global selection of deep-water exploration blocks in passive continental margin basins.

A vibration isolator with a controllable quasi-zero stiffness region based on nonlinear force design

To achieve stability optimization in low-frequency vibration control for precision instruments,this paper presents a quasi-zero stiffness(QZS)vibration isolator with adjustable nonlinear stiffness.Additionally,the stress-magnetism coupling model is established through meticulous theoretical derivation.The controllable QZS interval is constructed via parameter design and magnetic control,effectively segregating the high static stiffness bearing section from the QZS vibration isolation section.Furthermore,a displacement control scheme utilizing a magnetic force is proposed to regulate entry into the QZS working range for the vibration isolation platform.Experimental results demonstrate that the operation within this QZS region reduces the peak-to-peak acceleration signal by approximately 66.7%compared with the operation outside this region,thereby significantly improving the low frequency performance of the QZS vibration isolator.

Female zebra finches are more vulnerable to social isolation stress than males:Involvement of the nonapeptide system

In group-living animals,chronic juvenile social isolation stress(SIS)can profoundly affect behavior and neuroendocrine regulation.However,its impact on social behavior in avian species,particularly regarding sexspecific neural circuit differences,remains underexplored.This study focused on zebra finches,a species known for its social clustering and cognitive abilities,to elucidate these influences.Results indicated that SIS significantly increased plasma corticosterone levels in females but not in males,suggesting a heightened stress response and susceptibility in females.Additionally,SIS disrupted sociality and flocking behavior in both sexes,with more severe impairments in social recognition observed in females.Mesotocin(MT)levels in the lateral septum of both sexes and in the ventromedial hypothalamus of females were found to mediate the SIS effect,while vasotocin(VT)levels within the social behavior network remained unchanged.Pharmacological interventions confirmed the critical role of MT in reversing SIS-induced impairments in sociality,flocking behavior,and social recognition,particularly in females.These findings highlight unique nucleus-and sex-dependent variations in MT and VT regulation,providing novel insights into the mechanisms governing avian social behavior.This study advances our understanding of the independent evolutionary pathways of neural circuits and neuroendocrine systems that modulate social behaviors across different taxonomic groups.

Nonequilibrium work equalities in isolated quantum systems

We briefly introduce the quantum Jarzynski and Bochkov-Kuzovlev equalities .in isolated quantum Hamiltonian sys- tems, including their origin, their derivations using a quantum Feynman-Kac formula, the quantum Crooks equality, the evolution equations governing the characteristic functions of the probability density functions for the quantum work, and recent experimental verifications. Some resultsare given here for the first time. We particularly emphasize the formally structural consistence between these quantum equalities and their classical counterparts, which are useful for understanding the existing equalities and pursuing new fluctuation relations in other complex quantum systems.

Isolated right ventricular noncompaction caused recurrent pulmonary embolism

Clinically, pulmonary embolism （PE） mostly comes from the lower extremity deep vein system, but if such pa- tients have no evidence of deep venous thrombosis （DVT）, other sources of emboli should be considered. It is very rare that embolus comes from the right heart system （in situ thrombosis）, Isolated fight ventricular noncompaction （iRVNC） can cause PE, but it has not been reported so far. Ventricular noncompaction （VNC） is an unusual cause of cardiomyopathy.

Traumatic isolated bilateral gluteus minimus injuries misdiagnosed as lumbar radiculopathy:A case report

BACKGROUND The tear of the gluteus medius and minimus tendons can cause chronic buttock pain,especially in middle-aged individuals;these tears occur mostly in association with degenerative changes in the muscles and tendons.Chronic injuries are more common than acute injuries,and concurrent injuries to the gluteus medius and minimus tendons without chronic pain are rare,especially isolated injuries to both sides of the gluteus minimus;such a case has not yet been reported.CASE SUMMARY The authors present a case of bilateral acute traumatic injuries to the gluteus minimus during buttock strengthening exercises in a 75-year-old male patient.The patient completely returned to his pre-injury lifestyle after 8 weeks of injury,with no limitations,but the diagnosis was initially delayed due to misdiagnosis as lumbar radiculopathy,resulting in unnecessary socio-economic burden on the patient.CONCLUSION When treating patients who complain of hip pain,it is important to consider various causes to make a correct diagnosis.

Large isolated fibrous tumors in the upper esophagus: A case report

BACKGROUND Solitary fibrous tumors(SFT)are rare spindle cell tumors that are usually benign.A total of 10 cases of SFTs in the upper esophagus have ever been reported.Here,we report the anesthetic management of a patient with a large isolated fibrous tumor of the upper esophagus compressing the tracheal membrane.We also provide a literature review of the current research.CASE SUMMARY We report the case of a 49 year old male with“cough aggravation and wheezing after exercise”,who underwent esophagectomy for a large isolated fibrous tumor compressing the tracheal membrane in the upper esophagus.We advise the use of a single-lumen tube with a blocker in patients with difficult airways to reduce the incidence of airway injury and fibrinoscopy at all stages of the perioperative period to guide airway management.This case study is the first report of the anesthetic management of a large,isolated fibrous tumor compressing the tracheal membrane in the upper esophagus.CONCLUSION This rare case emphasizes the importance of perioperative management of anesthesia in patients with large isolated fibrous tumors of the upper esophagus that compress the tracheal membrane.The use of blocker reduce the incidence of airway injury and fibrinoscopy at the perioperative period to guide airway mana-gement.

Actuator and sensor fault isolation in a class of nonlinear dynamical systems

Fault isolation in dynamical systems is a challenging task due to modeling uncertainty and measurement noise,interactive effects of multiple faults and fault propagation.This paper proposes a unified approach for isolation of multiple actuator or sensor faults in a class of nonlinear uncertain dynamical systems.Actuator and sensor fault isolation are accomplished in two independent modules,that monitor the system and are able to isolate the potential faulty actuator(s)or sensor(s).For the sensor fault isolation(SFI)case,a module is designed which monitors the system and utilizes an adaptive isolation threshold on the output residuals computed via a nonlinear estimation scheme that allows the isolation of single/multiple faulty sensor(s).For the actuator fault isolation(AFI)case,a second module is designed,which utilizes a learning-based scheme for adaptive approximation of faulty actuator(s)and,based on a reasoning decision logic and suitably designed AFI thresholds,the faulty actuator(s)set can be determined.The effectiveness of the proposed fault isolation approach developed in this paper is demonstrated through a simulation example.

Isolated gastric variceal bleeding related to non-cirrhotic portal hypertension following oxaliplatin-based chemotherapy:A case report

BACKGROUND Sinusoidal obstruction syndrome has been reported after oxaliplatin-based chemotherapy,but liver fibrosis and non-cirrhotic portal hypertension(NCPH)are rarely reported.CASE SUMMARY Here,we describe the case of a 64-year-old woman who developed isolated gastric variceal bleeding 16 mo after completing eight cycles of oxaliplatin combined with capecitabine chemotherapy after colon cancer resection.Surprisingly,splenomegaly and thrombocytopenia were not accompanied by variceal bleeding,which has been reported to have predictive value for gastric variceal formation.However,a liver biopsy showed fibrosis in the portal area,suggesting NCPH.The patient underwent endoscopic treatment and experienced no further symptoms.CONCLUSION It is necessary to guard against long-term complications after oxaliplatin-based chemotherapy.Sometimes splenic size and platelet level may not always accurately predict the occurrence of portal hypertension.

Study on the Influence of Aspect Ratio on the Seismic Response and Overturning Resistance of a New Staggered Story Isolated Structure

The aspect ratio of the structure has a significant impact on the overall stability of the ultra high-rise building. A large aspect ratio of the structure increases the risk of overturning and reduces the lateral stiffness of the structure, leading to significant tensile and compressive stresses in the isolated bearings. To study the effect of aspect ratio on the seismic response and overturning resistance of a new staggered story isolated structure, three models with different aspect ratios were established. Nonlinear time-history analysis of the three models was conducted using ETABS finite element software. The results indicate that the overturning moment and overturning resistance moment of the superstructure in the new staggered story isolated structure increase with an increasing aspect ratio. However, the increase in the overturning moment of the superstructure is much greater than the increase in the overturning resistance moment, resulting in a decrease in the overturning resistance ratio of the superstructure with an increasing aspect ratio. The overturning moment and overturning resistance moment of the substructure in the new staggered story isolated structure decrease with an increasing aspect ratio. However, the decrease in the overturning moment of the substructure is greater than the decrease in the overturning resistance moment, leading to an increase in the overturning resistance ratio of the substructure with an increasing aspect ratio. The decrease in the overturning resistance ratio of the superstructure in the new staggered story isolated structure is much greater than the increase in the overturning resistance ratio of the substructure. Therefore, as the aspect ratio of the overall structure increases, the overturning resistance ratio of the superstructure and the entire structure decreases.

Application and optimization design of non-obstructive particle damping-phononic crystal vibration isolator in viaduct structure-borne noise reduction

The problems associated with vibrations of viaducts and low-frequency structural noise radiation caused by train excitation continue to increase in importance.A new floating-slab track vibration isolator-non-obstructive particle damping-phononic crystal vibration isolator is proposed herein,which uses the particle damping vibration absorption technology and bandgap vibration control theory.The vibration reduction performance of the NOPD-PCVI was analyzed from the perspective of vibration control.The paper explores the structure-borne noise reduction performance of the NOPD-PCVIs installed on different bridge structures under varying service conditions encountered in practical engineering applications.The load transferred to the bridge is obtained from a coupled train-FST-bridge analytical model considering the different structural parameters of bridges.The vibration responses are obtained using the finite element method,while the structural noise radiation is simulated using the frequency-domain boundary element method.Using the particle swarm optimization algorithm,the parameters of the NOPD-PCVI are optimized so that its frequency bandgap matches the dominant bridge structural noise frequency range.The noise reduction performance of the NOPD-PCVIs is compared to the steel-spring isolation under different service conditions.

Phytochemical screening and antibacterial activities of Momordica charantia and Vernonia amygdalina extracts on some selected enteric isolates

Background:This research focuses on herbal medicine,an ancient healthcare practice,exploring the antibacterial attributes of fresh and dried leaf extracts from Momordica charantia(commonly known as Bitter melon)and Vernonia amygdalina(Bitter leaf).The study specifically investigates their effects on different bacterial strains associated with gastroenteritis.Methods:Four enteric bacterial isolates-Klebsiella pneumoniae,Salmonella typhi,Escherichia coli,and Proteus mirabilis-were obtained from the Medical Laboratory Unit at Babcock University Teaching Hospital in Ilishan-Remo,Ogun State.Phytochemical screening and antibacterial testing were conducted using standard biochemical techniques and the Punch-hole agar diffusion method,respectively.Results:Qualitative phytochemical screening of the plant extracts revealed the presence of flavonoids,glycosides,and saponin in both plants,excluding terpenoids.Alkaloids were identified only in Vernonia amygdalina.Despite these phytochemicals,neither plant displayed inhibitory effects on the tested bacterial isolates(Escherichia coli,Proteus mirabilis,Klebsiella pneumoniae,and Salmonella typhi)when tested individually or in combination.Intriguingly,combining the fresh and dried leaf extracts of Momordica charantia and Vernonia amygdalina with a standard drug resulted in smaller mean zone diameters of inhibition(Escherichia coli range:14 mm–16 mm,Proteus mirabilis range:31 mm–35 mm,Klebsiella pneumoniae range:13 mm–22 mm,and Salmonella typhi range:35 mm–38 mm)compared to the drug tested alone(16 mm–45 mm).Conclusion:Despite previous indications of antibacterial properties in various extracts of V.amygdalina and M.charantia leaves,our study presents contradictory results,prompting the need for further investigation despite the presence of significant phytochemicals.

Non-enzymatic methods for isolation of stromal vascular fraction and adipose-derived stem cells:A systematic review

BACKGROUND Adipose-derived stem cells(ADSCs)and the stromal vascular fraction(SVF)have garnered substantial interest in regenerative medicine due to their potential to treat a wide range of conditions.Traditional enzymatic methods for isolating these cells face challenges such as high costs,lengthy processing time,and regulatory complexities.AIM This systematic review aimed to assess the efficacy and practicality of nonenzymatic,mechanical methods for isolating SVF and ADSCs,comparing these to conventional enzymatic approaches.METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines,a comprehensive literature search was conducted across multiple databases.Studies were selected based on inclusion criteria focused on non-enzymatic isolation methods for SVF and ADSCs from adipose tissue.The risk of bias was assessed,and a qualitative synthesis of findings was performed due to the methodological heterogeneity of the included studies.RESULTS Nineteen studies met the inclusion criteria,highlighting various mechanical techniques such as centrifugation,vortexing,and ultrasonic cavitation.The review identified significant variability in cell yield and viability,and the integrity of isolated cells across different non-enzymatic methods compared to enzymatic procedures.Despite some advantages of mechanical methods,including reduced processing time and avoidance of enzymatic reagents,the evidence suggests a need for optimization to match the cell quality and therapeutic efficacy achievable with enzymatic isolation.CONCLUSION Non-enzymatic,mechanical methods offer a promising alternative to enzymatic isolation of SVF and ADSCs,potentially simplifying the isolation process and reducing regulatory hurdles.However,further research is necessary to standardize these techniques and ensure consistent,high-quality cell yields for clinical applications.The development of efficient,safe,and reproducible non-enzymatic isolation methods could significantly advance the field of regenerative medicine.