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The aim of this multicentric study was to assess the impacts of oxidative stress, inflammation, and the presence of small, dense, low-density lipoproteins (sdLDL) on the antioxidative function of high-density lipoprotein (HDL) subclasses and the distribution of paraoxonase-1 (PON1) activity within HDL in patients with ST-segment elevation acute myocardial infarction (STEMI). In 69 STEMI patients and 67 healthy control subjects, the lipoproteins' subclasses were separated using polyacrylamide gradient (3–31%) gel electrophoresis. The relative proportion of sdLDL and each HDL subclass was evaluated by measuring the areas under the peaks of densitometric scans. The distribution of the relative proportion of PON1 activity within the HDL subclasses (pPON1 within HDL) was estimated using the zymogram method. The STEMI patients had significantly lower proportions of HDL2a and HDL3a subclasses (p = 0.001 and p < 0.001, respectively) and lower pPON1 within HDL3b (p = 0.006), as well as higher proportions of HDL3b and HDL3c subclasses (p = 0.013 and p < 0.001, respectively) and higher pPON1 within HDL2 than the controls. Independent positive associations between sdLDL and pPON1 within HDL3a and between malondialdehyde (MDA) and pPON1 within HDL2b were shown in the STEMI group. The increased oxidative stress and increased proportion of sdLDL in STEMI are closely related to the compromised antioxidative function of small HDL3 particles and the altered pPON1 within HDL. [ABSTRACT FROM AUTHOR]

Gastrointestinal (GI) bleeding is one of the most common conditions among patients visiting emergency departments in Korea. GI bleeding is divided into upper and lower GI bleeding, according to the bleeding site. GI bleeding is also divided into overt and occult GI bleeding based on bleeding characteristics. In addition, obscure GI bleeding refers to recurrent or persistent GI bleeding from a source that cannot be identified after esophagogastroduodenoscopy or colonoscopy. The small intestine is the largest part of the alimentary tract. It extends from the pylorus to the cecum. The small intestine is difficult to access owing to its long length. Moreover, it is not fixed to the abdominal cavity. When hemorrhage occurs in the small intestine, the source cannot be found in many cases because of the characteristics of the small intestine. In practice, small-intestinal bleeding accounts for most of the obscure GI bleeding. Therefore, in this review, we introduce and describe systemic approaches and examination methods, including video capsule endoscopy and balloon enteroscopy, that can be performed in patients with suspected small bowel bleeding in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Meckels diverticulum (MD) causes a number of acute surgical pathologies and can contain ectopic tissue with the surgical aim to resect all ectopic mucosa. This has traditionally implied a small bowel resection (BR); though contemporary literature has demonstrated Meckel's diverticulectomy to be safe. The aim of this study was to determine optimal resection strategy, and assess MD histopathological features and their relationship to outcomes. Methods: A 19‐year retrospective review of patient medical records across seven hospitals was conducted with demographic, clinical and pathological data collected. Analysis was conducted using a student's t‐test for continuous variables and chi‐squared test for categorical variables. Univariate regression was performed to identify risk factors. P < 0.05 was considered statistically significant. Results: One hundred and sixty patients underwent resection of MD, 70 (44%) had Meckel's diverticulectomy and 90 (56%) had BR. No significant difference in length (P = 0.486), width (P = 0.238), or ratio (P = 0.188) of diverticulectomy compared to BR, with fewer complications in diverticulectomy. In all, 24 (15.3%) MD were perforated, of whom 5 had gastric mucosa, 2 had mixed ectopic mucosa and 1 carcinoid tissue. There were no cases of ectopic mucosa in the resection margin requiring re‐operation, or causing base perforation. MD specimen with greater length: width ratio was a risk factor for perforation OR 1.437 P = 0.042 but not for malignancy P = 0.813 or ectopic tissue P = 0.185. Conclusion: Meckel's diverticulectomy is safe via laparoscopic or open approach compared with BR. Despite higher perforation rates in MD with greater length: width ratio, no malignancy or ectopic risk was identified, supporting diverticulectomy as a safe operative approach. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Small Business & Entrepreneurship is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The current study aimed to investigate the issues in contemporary management strategies that focus on small pancreatic neuroendocrine tumors (PNETs). Data Sources and Study Selection: We searched various scientific databases using specific keywords. Results: Surveillance-only strategies were considered for selected patients. The exact cut-off value of small neuroendocrine tumors for surveillance-only strategies needs to be verified with additional high-level evidence. Conclusion: There is no consensus on the size and treatment strategy for small PNETs currently. Patients with small nonfunctioning PNETs require individualized recommendations for surgery versus active surveillance based on tumor size, radiographic characteristics, and patient characteristics, such as age and comorbidities and also patient references. [ABSTRACT FROM AUTHOR]

Drones are increasingly used for fauna monitoring and wildlife tracking; however, their application for wildlife tracking is restricted by developing such systems. Here we explore the potential of drones for wildlife tracking using an off-the-shelf system that is easy to use by non-specialists consisting of a multirotor drone, smartphones, and commercial tracking devices via Bluetooth and Ultra-Wide Band (UWB). We present the system configuration, explore the operational parameters that can affect detection capabilities, and test the effectiveness of the system for locating targets by simulating target animals in savanna and forest environments. The self-contained tracking system was built without hardware or software customization. In 40 tracking flights carried out in the Brazilian Cerrado, we obtained a detection rate of 90% in savanna and 40% in forest areas. Tests for targets in movement (N = 20), the detection rates were 90% in the savanna and 30% in the forest areas. The spatial accuracy obtained by the system was 14.61 m, being significantly more accurate in savanna ( x ¯ = 10.53) than in forest areas ( x ¯ = 13.06). This approach to wildlife tracking facilitates the use of drones by non-specialists at an affordable cost for conservation projects with limited resources. The reduced size of the tags, the long battery life, and the lower cost compared to GPS-tags open up a range of opportunities for animal tracking. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Technology Economics is the property of Chinese Society of Technology Economics and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The COVID-19 pandemic has significantly impacted the health, economy, and social sectors, and micro, small, and medium-sized enterprises (MSMEs) worldwide, including in Indonesia. This paper examines the use of social media and e-commerce with an entrepreneurial orientation to enhance the business performance of MSMEs. The study should serve as a model for improving the quality of micro, small, and medium-sized enterprises in the Jambi Province, in Indonesia. The research employs quantitative and qualitative approaches. The latter method employs in-depth interviews, focus group discussions (FGDs), and observation, whereas the former uses the partial least squares method (PLS). The findings and discussions conclude that social media adoption positively affected the performance and entrepreneurial orientation of MSMEs during the said period. Similarly, e-commerce positively affected the performance and entrepreneurial orientation of MSMEs. Entrepreneurialism and social media adoption had a significant impact on the performance of MSMEs, and due to its entrepreneurial orientation, e-commerce influenced the performance of MSMEs

Jejunoileal bypass (JIB) was an early bariatric procedure that involved bypassing most of the small bowel resulting in malabsorption and weight loss. Due to serious complications associated with the procedure, JIB was largely discontinued by the mid-1980s. We report the case of a 77-year-old woman with a history of JIB 31 years earlier. In 2022, she was hospitalized for acute abdominal pain. A computed tomography (CT) scan revealed a suspicion of internal hernia (IH) with a typical swirl sign. Due to the quick relief of symptoms an emergency surgery was not considered at the time. Nevertheless, a subsequent operation revealed a large mesenteric defect, adhesions and 100 cm of effective small bowel left. Although the procedure is no longer performed, some patients with JIB are still alive and develop late complications. To our knowledge, this is the first case report describing an IH in a patient who has undergone JIB. [ABSTRACT FROM AUTHOR]

PurposeNecrotizing enterocolitis is associated with decreased intestinal perfusion and ischemia. Paneth cells, specialized epithelial cells, have been shown to regulate the intestinal vasculature and disruption of these cells has been associated with NEC. We hypothesized that Paneth cell disruption in immature mice intestine would decrease the perfusion of the intestinal microvasculature.MethodsPaneth cells were disrupted in P14-16 mice using chemical (dithizone) and transgenic (diphtheria toxin) methodology. Six hours after Paneth cell disruption, Dylight 488 was injected directly into the left ventricle and allowed to perfuse for 5 minutes prior to intestinal harvesting. Tissue samples were evaluated with confocal fluorescence microscopy to quantify intestinal perfusion and samples were quantified by real time RT-PCR for gene expression.ResultsDithizone treatment significantly decreased intestinal perfusion compared to controls (p  0.21). Intestines from all treatment groups had similar PECAM staining, but intestines treated with dithizone had significantly decreased nNOS and iNOS gene expression compared to controls (p

Fetal exposure to chorioamnionitis can impact the outcomes of the developing fetus both at the time of birth and in the subsequent neonatal period. Infants exposed to chorioamnionitis have a higher incidence of gastrointestinal (GI) pathology, including necrotizing enterocolitis (NEC); however, the mechanism remains undefined. To simulate the fetal exposure to maternal inflammation (FEMI) induced by chorioamnionitis, pregnant mice (C57BL/6J, IL-6 -/-, RAG -/- or TNFR1 -/-) were injected intraperitoneally on embryonic day (E)15.5 with lipopolysaccharide (LPS; 100 µg/kg body weight). Pups were delivered at term, and reared to postnatal day (P)0, P7, P14, P28 or P56. Serum and intestinal tissue samples were collected to quantify growth, inflammatory markers, histological intestinal injury, and goblet and Paneth cells. To determine whether FEMI increased subsequent susceptibility to intestinal injury, a secondary dose of LPS (100 µg/kg body weight) was given on P5, prior to tissue harvesting on P7. FEMI had no effect on growth of the offspring or their small intestine. FEMI significantly decreased both goblet and Paneth cell numbers while simultaneously increasing serum levels of IL-1β, IL-10, KC/GRO (CXCL1 and CXCL2), TNF and IL-6. These alterations were IL-6 dependent and, importantly, increased susceptibility to LPS-induced intestinal injury later in life. Our data show that FEMI impairs normal intestinal development by decreasing components of innate immunity and simultaneously increasing markers of inflammation. These changes increase susceptibility to intestinal injury later in life and provide novel mechanistic data to potentially explain why preterm infants exposed to chorioamnionitis prior to birth have a higher incidence of NEC and other GI disorders.

Structural models of large and dynamic molecular complexes are appearing in increasing numbers, in large part because of recent technical advances in cryo-electron microscopy. However, the inherent complexity of such biological assemblies comprising dozens of moving parts often limits the resolution of structural models and leaves the puzzle as to how each functional configuration transitions to the next. Orthogonal biochemical information is crucial to understanding the molecular interactions that drive those rearrangements. We present a two-step method for chemical probing detected by tandem mass-spectrometry to globally assess the reactivity of lysine residues within purified macromolecular complexes. Because lysine side chains often balance the negative charge of RNA in ribonucleoprotein complexes, the method is especially useful for detecting changes in protein-RNA interactions. By probing the E. coli 30S ribosome subunit, we established that the reactivity pattern of lysine residues quantitatively reflects structure models derived from X-ray crystallography. We also used the strategy to assess differences in three conformations of purified human spliceosomes in the context of recent cryo-electron microscopy models. Our results demonstrate that the probing method yields powerful biochemical information that helps contextualize architectural rearrangements of intermediate resolution structures of macromolecular complexes, often solved in multiple conformations.

Small-bowel obstruction (SBO) is a common and important disease, for which machine learning tools have yet to be developed. Image annotation is a critical first step for development of such tools. This study assesses whether image annotation by eye tracking is sufficiently accurate and precise to serve as a first step in the development of machine learning tools for detection of SBO on CT. Seven subjects diagnosed with SBO by CT were included in the study. For each subject, an obstructed segment of bowel was chosen. Three observers annotated the centerline of the segment by manual fiducial placement and by visual fiducial placement using a Tobii 4c eye tracker. Each annotation was repeated three times. The distance between centerlines was calculated after alignment using dynamic time warping (DTW) and statistically compared to clinical thresholds for diagnosis of SBO. Intra-observer DTW distance between manual and visual centerlines was calculated as a measure of accuracy. These distances were 1.1 ± 0.2, 1.3 ± 0.4, and 1.8 ± 0.2 cm for the three observers and were less than 1.5 cm for two of three observers (P

Postnatal growth retardation (PGR) is common in piglets. Abnormal development in small intestine was casually implicated in impaired growth, but the exact mechanism is still implausible. The present study unveiled transcriptome profile of jejunal mucosa, the major site of nutrient absorption, in PGR and healthy piglets using RNA-sequencing (RNA-seq). The middle segments of jejunum and ileum, and jejunal mucosa were obtained from healthy and PGR piglets at 42 d of age. Total RNA samples extracted from jejunal mucosa of healthy and PGR piglets were submitted for RNA-seq. Lower villus height was observed in both jejunum and ileum from PGR piglets suggesting structural impairment in small intestine (P < 0.05). RNA-seq libraries were constructed and sequenced, and produced average 4.8 × 107 clean reads. Analysis revealed a total of 499 differently expressed genes (DEGs), of which 320 DEGs were downregulated in PGR piglets as compared to healthy piglets. The functional annotation based on Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) highlighted that most DEGs were involved in nutrient metabolism and immune responses. Our results further indicated decreased gene expression associated with glucose, lipid, protein, mineral, and vitamin metabolic process, detoxication ability, oxidoreductase activity, and mucosal barrier function; as well as the increased insulin resistance and inflammatory response in the jejunal mucosa of PGR piglets. These results characterized the transcriptomic profile of the jejunal mucosa in PGR piglets, and could provide valuable information with respect to better understanding the nutrition metabolism and immune responses in the small intestine of piglets.

BackgroundVideo capsule endoscopy (VCE) is a noninvasive imaging modality that can identify mucosal lesions not detected with traditional endoscopy or abdominal sonography. In people, VCE is used in diagnostic and management protocols of various gastrointestinal (GI) disorders, particularly in GI bleeding of obscure origin or unexplained iron deficiency anemia (IDA).ObjectiveTo evaluate the utility of VCE in the identification of mucosal lesions in dogs with evidence of GI hemorrhage.AnimalsSixteen client-owned dogs that underwent VCE.MethodsRetrospective case-control study. Medical records were reviewed to include dogs with microcytosis, low normal mean corpuscular volume, or clinical GI bleeding that received VCE.ResultsMedian age of dogs was 8.7 years (range, 8 months to 15 years) with a median weight of 21.7 kg (range, 6.9-62.5 kg). Abdominal ultrasound (16), abdominal radiography (4), and abdominal CT (1) did not identify a cause for GI blood loss. Gastric mucosal lesions were identified by VCE in 15 of 16 dogs and small intestinal lesions in 12 of 14 dogs, with 2 capsules remaining in the stomach. Endoscopy was performed in 2 dogs before VCE; 1 dog had additional small intestinal lesions identified through the use of VCE.Conclusions and clinical importanceVideo capsule endoscopy is a minimally invasive diagnostic tool that can identify GI lesions in dogs presenting with microcytosis with or without GI hemorrhage when ultrasonography is inconclusive; however, the majority of lesions identified would have been apparent with conventional endoscopy.

Tuft cells are rare, secretory epithelial cells that generated scant immunological interest until contemporaneous reports in 2016 linked tuft cells with type 2 immunity in the small intestine. Tuft cells have the capacity to produce an unusual spectrum of biological effector molecules, including IL-25, eicosanoids implicated in allergy (such as cysteinyl leukotrienes and prostaglandin D2) and the neurotransmitter acetylcholine. In most cases, the extracellular signals controlling tuft cell effector function are unknown, but signal transduction is thought to proceed via canonical, G protein-coupled receptor-dependent pathways involving components of the signalling pathway used by type II taste bud cells to sense sweet, bitter and umami compounds. Tuft cells are ideally positioned as chemosensory sentinels that can detect and relay information from diverse luminal substances via what appear to be stereotyped outputs to initiate both positive and aversive responses through populations of immune and neuronal cells. Despite recent insights, numerous questions remain regarding tuft cell lineage, diversity and effector mechanisms and how tuft cells interface with the immunological niche in the tissues where they reside.

Purpose of reviewThe aim of this review is to summarize the recent literature on associations of small intestinal microbial and bile acid profiles with liver cirrhosis and its complications.Recent findingsRecent studies into the duodenal microbiome of patients with cirrhosis have linked the microbiome to certain etiologies of chronic liver disease as well as complications of cirrhosis. In particular, microbial differences in the duodenum of patients with cirrhosis have been linked to the presence of hepatic encephalopathy and varices. While the fecal microbiome of patients with liver cirrhosis is well characterized, the small intestinal microbiome of cirrhotic patients is an active area of research. This review focuses on the current understanding of the small intestinal microbiome in human cirrhosis as well as future directions of the field.

ObjectiveAntimicrobial C-type lectin regenerating islet-derived 3 gamma (REG3G) is suppressed in the small intestine during chronic ethanol feeding. Our aim was to determine the mechanism that underlies REG3G suppression during experimental alcoholic liver disease.DesignInterleukin 22 (IL-22) regulates expression of REG3G. Therefore, we investigated the role of IL-22 in mice subjected to chronic-binge ethanol feeding (NIAAA model).ResultsIn a mouse model of alcoholic liver disease, we found that type 3 innate lymphoid cells produce lower levels of IL-22. Reduced IL-22 production was the result of ethanol-induced dysbiosis and lower intestinal levels of indole-3-acetic acid (IAA), a microbiota-derived ligand of the aryl hydrocarbon receptor (AHR), which regulates expression of IL-22. Importantly, faecal levels of IAA were also found to be lower in patients with alcoholic hepatitis compared with healthy controls. Supplementation to restore intestinal levels of IAA protected mice from ethanol-induced steatohepatitis by inducing intestinal expression of IL-22 and REG3G, which prevented translocation of bacteria to liver. We engineered Lactobacillus reuteri to produce IL-22 (L. reuteri/IL-22) and fed them to mice along with the ethanol diet; these mice had reduced liver damage, inflammation and bacterial translocation to the liver compared with mice fed an isogenic control strain and upregulated expression of REG3G in intestine. However, L. reuteri/IL-22 did not reduce ethanol-induced liver disease in Reg3g-/- mice.ConclusionEthanol-associated dysbiosis reduces levels of IAA and activation of the AHR to decrease expression of IL-22 in the intestine, leading to reduced expression of REG3G; this results in bacterial translocation to the liver and steatohepatitis. Bacteria engineered to produce IL-22 induce expression of REG3G to reduce ethanol-induced steatohepatitis.

ObjectiveThe main objective of this study was to evaluate the accuracy of emergency physician-performed point-of-care ultrasound (POCUS) for the diagnosis of small-bowel obstruction (SBO) compared to computed tomography (CT).MethodsWe performed a prospective, multicenter, observational study examining a convenience sample of adult patients with potential SBO presenting to the emergency department (ED) between July 2014 and May 2017. Each POCUS was interpreted at the bedside by the performing emergency physician and retrospectively by an expert reviewer. Test characteristics were calculated for POCUS, blinded expert interpretation, and specific POCUS parameters.ResultsA total of 217 subjects were included in the primary analysis with an overall SBO prevalence of 42.9%. For the diagnosis of SBO, POCUS demonstrated an overall sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of 0.88 (95% confidence interval [CI] = 0.80 to 0.94), 0.54 (95% CI = 0.45 to 0.63), 1.92 (95% CI = 1.56 to 2.35), and 0.22 (95% CI = 0.12 to 0.39), respectively. Expert review yielded a similar sensitivity (0.89 [95% CI = 0.81 to 0.95]) with a significantly higher specificity (0.82 [95% CI = 0.74 to 0.88]). The more sensitive sonographic parameters for both POC sonographers and expert reviewers were small-bowel dilation ≥ 25 mm (0.87 [95% CI = 0.79 to 0.93], 0.87 [95% CI = 0.79 to 0.93]) and abnormal peristalsis (0.82 [95% CI = 0.72 to 0.89], 0.85 [95% CI = 0.76 to 0.87]). The more specific parameters for both groups were transition point (0.82 [95% CI = 0.74 to 0.89], 0.98 [95% CI = 0.94 to 1.00]), intraperitoneal free fluid (0.82 [95% CI = 0.74 to 0.89], 0.93 [95% CI = 0.87 to 0.97]), and bowel wall edema (0.76 [95% CI = 0.67 to 0.83], 0.93 [95% CI = 0.87 to 0.97]).ConclusionPOCUS is moderately sensitive for SBO, although less specific, when performed by a diverse group of emergency physicians across multiple EDs. Interpretation of acquired POCUS images is significantly more accurate when performed by physicians with prior emergency ultrasound fellowship training and familiarity with the sonographic appearance of SBO.

ObjectiveThe aim of this study is to determine the interrater agreement in a clinical practice environment for the most commonly used magnetic resonance enterography (MRE) features of Crohn's disease (CD).MethodsCD patients with MRE's before and after treatment were retrospectively identified using search queries over a 7-year period (May 2017-September 2017). MRE features of CD comprising components of multiple CD scoring indices were scored by radiologists in the same segment of bowel. Agreement for nominal categorical and continuous variables was assessed using a κ and interclass correlation coefficients, respectively.Results80 scans comprised the study population. Moderate interrater agreement was seen in both the pre- and post-treatment MRE's for presence of diffusion restriction (к = 0.43, 0.48; pre- and post-treatment), stricturing disease (к = 0.51, 0.52), overall degree of severity (к = 0.49, 0.59). Substantial agreement was seen in pre- and post-treatment scans for length of involvement (interclass correlation coefficient = 0.67, 0.61). The presence of mucosal ulceration had no agreement (к = -0.07, -0.042).ConclusionMany MRE features of active CD comprising the major CD scoring indices are reproducible when interpreted by non-CD focused abdominal radiologists. However, the presence of mucosal ulcerations had no agreement and may need more investigation before including this feature as a driver in therapeutic decision making.Advances in knowledgeDemonstrates the unreliability of mucosal ulceration by non-CD focused abdominal radiologists, targeting a potential area for future education. Key Points The majority of MRE findings incorporated in to many CD scoring indices have fair to moderate inter-rater agreement even when read by non-MRE expert radiologists. Substantial agreement was seen in the length of involved bowel, but this feature is only incorporated in to one of the CD scoring indices. Presence of mucosal ulcerations had no interrater agreement in our study-a feature which is heavily weighted by several CD scoring indices. Research should be focused bridging those features which have poor interrater agreement.

Oral infection of C57BL/6J mice with Toxoplasma gondii results in a marked bacterial dysbiosis and the development of severe pathology in the distal small intestine that is dependent on CD4+ T cells and interferon gamma (IFN-γ). This dysbiosis and bacterial translocation contribute to the development of ileal pathology, but the factors that support the bloom of bacterial pathobionts are unclear. The use of microbial community profiling and shotgun metagenomics revealed that Toxoplasma infection induces a dysbiosis dominated by Enterobacteriaceae and an increased potential for nitrate respiration. In vivo experiments using bacterial metabolic mutants revealed that during this infection, host-derived nitrate supports the expansion of Enterobacteriaceae in the ileum via nitrate respiration. Additional experiments with infected mice indicate that the IFN-γ/STAT1/iNOS axis, while essential for parasite control, also supplies a pool of nitrate that serves as a source for anaerobic respiration and supports overgrowth of Enterobacteriaceae Together, these data reveal a trade-off in intestinal immunity after oral infection of C57BL/6J mice with T. gondii, in which inducible nitric oxide synthase (iNOS) is required for parasite control, while this host enzyme is responsible for specific modification of the composition of the microbiome that contributes to pathology.IMPORTANCEToxoplasma gondii is a protozoan parasite and a leading cause of foodborne illness. Infection is initiated when the parasite invades the intestinal epithelium, and in many host species, this leads to intense inflammation and a dramatic disruption of the normal microbial ecosystem that resides in the healthy gut (the so-called microbiome). One characteristic change in the microbiome during infection with Toxoplasma-as well as numerous other pathogens-is the overgrowth of Escherichia coli or similar bacteria and a breakdown of commensal containment leading to seeding of peripheral organs with gut bacteria and subsequent sepsis. Our findings provide one clear explanation for how this process is regulated, thereby improving our understanding of the relationship between parasite infection, inflammation, and disease. Furthermore, our results could serve as the basis for the development of novel therapeutics to reduce the potential for harmful bacteria to bloom in the gut during infection.

Men and women differ in circulating lipids and coronary artery disease (CAD). While sex hormones such as estrogens decrease CAD risk, hormone replacement therapy increases risk. Biological sex is determined by sex hormones and chromosomes, but effects of sex chromosomes on circulating lipids and atherosclerosis are unknown. Here, we use mouse models to separate effects of sex chromosomes and hormones on atherosclerosis, circulating lipids and intestinal fat metabolism. We assess atherosclerosis in multiple models and experimental paradigms that distinguish effects of sex chromosomes, and male or female gonads. Pro-atherogenic lipids and atherosclerosis are greater in XX than XY mice, indicating a primary effect of sex chromosomes. Small intestine expression of enzymes involved in lipid absorption and chylomicron assembly are greater in XX male and female mice with higher intestinal lipids. Together, our results show that an XX sex chromosome complement promotes the bioavailability of dietary fat to accelerate atherosclerosis.

Undernutrition in children is a pressing global health problem, manifested in part by impaired linear growth (stunting). Current nutritional interventions have been largely ineffective in overcoming stunting, emphasizing the need to obtain better understanding of its underlying causes. Treating Bangladeshi children with severe acute malnutrition with therapeutic foods reduced plasma levels of a biomarker of osteoclastic activity without affecting biomarkers of osteoblastic activity or improving their severe stunting. To characterize interactions among the gut microbiota, human milk oligosaccharides (HMOs), and osteoclast and osteoblast biology, young germ-free mice were colonized with cultured bacterial strains from a 6-mo-old stunted infant and fed a diet mimicking that consumed by the donor population. Adding purified bovine sialylated milk oligosaccharides (S-BMO) with structures similar to those in human milk to this diet increased femoral trabecular bone volume and cortical thickness, reduced osteoclasts and their bone marrow progenitors, and altered regulators of osteoclastogenesis and mediators of Th2 responses. Comparisons of germ-free and colonized mice revealed S-BMO-dependent and microbiota-dependent increases in cecal levels of succinate, increased numbers of small intestinal tuft cells, and evidence for activation of a succinate-induced tuft cell signaling pathway linked to Th2 immune responses. A prominent fucosylated HMO, 2'-fucosyllactose, failed to elicit these changes in bone biology, highlighting the structural specificity of the S-BMO effects. These results underscore the need to further characterize the balance between, and determinants of, osteoclastic and osteoblastic activity in stunted infants/children, and suggest that certain milk oligosaccharides may have therapeutic utility in this setting.

BackgroundHistopathology, immunohistochemistry, and molecular clonality testing are metrics frequently used to diagnose chronic enteropathy (CE) in cats. However, normal values for these metrics have been based mainly on samples from cats that were relatively young, specific pathogen-free, or both.ObjectivesTo describe results of histopathology, immunohistochemistry, and clonality testing of endoscopically-derived biopsy specimens of the upper small intestinal tract from a cohort of clinically healthy client-owned cats.AnimalsTwenty clinically healthy client-owned cats ≥3 years of age.MethodsTissue specimens were collected from the stomach and duodenum and evaluated single blinded by a board-certified pathologist. In addition, samples were evaluated by routine immunohistochemistry and clonality testing. Cats were followed after the procedure for signs of CE.ResultsIntegrated results from histopathology, immunohistochemistry, and clonality testing were interpreted as consistent with small cell lymphoma (SCL; n = 12), emerging SCL (n = 1), lymphocytic enteritis (n = 6), and pseudoclonality (n = 1). On follow-up, 3 cats eventually developed clinical signs of CE, of which 2 were euthanized 295 and 654 days post-endoscopy. The remaining 17 cats did not show clinical signs of CE after a median of 709 days (range, 219-869 days).Conclusions and clinical importanceIntestinal biopsy specimens from clinically healthy client-owned cats commonly had abnormal findings on histopathology, immunohistochemistry, clonality testing, or some combination of these without apparent clinical relevance. Current diagnostic metrics for diagnosing CE in cats may need modification to be applicable to the general population of cats.

ObjectiveExposure to lethal doses of radiation has severe effects on normal tissues. Exposed individuals experience a plethora of symptoms in different organ systems including the gastrointestinal (GI) tract, summarized as Acute Radiation Syndrome (ARS). There are currently no approved drugs for mitigating GI-ARS. A recent high-throughput screen performed at the UCLA Center for Medical Countermeasures against Radiation identified compounds containing sulfonylpiperazine groups with radiation mitigation properties to the hematopoietic system and the gut. Among these 1-[(4-Nitrophenyl)sulfonyl]-4-phenylpiperazine (Compound #5) efficiently mitigated gastrointestinal ARS. However, the mechanism of action and target cells of this drug is still unknown. In this study we examined if Compound #5 affects gut-associated lymphoid tissue (GALT) with its subepithelial domes called Peyer's patches.MethodsC3H mice were irradiated with 0 or 12 Gy total body irradiation (TBI). A single dose of Compound #5 or solvent was administered subcutaneously 24 h later. 48 h after irradiation the mice were sacrificed, and the guts examined for changes in the number of visible Peyer's patches. In some experiments the mice received 4 daily injections of treatment and were sacrificed 96 h after TBI. For immune histochemistry gut tissues were fixed in formalin and embedded in paraffin blocks. Sections were stained with H&E, anti-Ki67 or a TUNEL assay to assess the number of regenerating crypts, mitotic and apoptotic indices. Cells isolated from Peyer's patches were subjected to immune profiling using flow cytometry.ResultsCompound #5 significantly increased the number of visible Peyer's patches when compared to its control in non-irradiated and irradiated mice. Additionally, assessment of total cells per Peyer's patch isolated from these mice demonstrated an overall increase in the total number of Peyer's patch cells per mouse in Compound #5-treated mice. In non-irradiated animals the number of CD11bhigh in Peyer's patches increased significantly. These Compound #5-driven increases did not coincide with a decrease in apoptosis or an increase in proliferation in the germinal centers inside Peyer's patches 24 h after drug treatment. A single dose of Compound #5 significantly increased the number of CD45+ cells after 12 Gy TBI. Importantly, 96 h after 12 Gy TBI Compound #5 induced a significant rise in the number of visible Peyer's patches and the number of Peyer's patch-associated regenerating crypts.ConclusionIn summary, our study provides evidence that Compound #5 leads to an influx of immune cells into GALT, thereby supporting crypt regeneration preferentially in the proximity of Peyer's patches.

During homeostasis, the colonic epithelium is replenished every 3-5 days by rapidly cycling Lgr5+ stem cells. However, various insults can lead to depletion of Lgr5+ stem cells, and colonic epithelium can be regenerated from Lgr5-negative cells. While studies in the small intestine have addressed the lineage identity of the Lgr5-negative regenerative cell population, in the colon this question has remained unanswered. Here, we set out to identify which cell(s) contribute to colonic regeneration by performing genetic fate-mapping studies of progenitor populations in mice. First, using keratin-19 (Krt19) to mark a heterogeneous population of cells, we found that Lgr5-negative cells can regenerate colonic crypts and give rise to Lgr5+ stem cells. Notch1+ absorptive progenitor cells did not contribute to epithelial repair after injury, whereas Atoh1+ secretory progenitors did contribute to this process. Additionally, while colonic Atoh1+ cells contributed minimally to other lineages during homeostasis, they displayed plasticity and contributed to epithelial repair during injury, independent of Lgr5+ cells. Our findings suggest that promotion of secretory progenitor plasticity could enable gut healing in colitis.

BACKGROUND: Laparoscopic ileostomy closure with intracorporeal anastomosis offers potential advantages over open reversal with extracorporeal anastomosis, including earlier return of bowel function and reduced postoperative pain. In this study, we aim to compare the outcome and cost of laparoscopic ileostomy reversal (utilizing either intracorporeal or extracorporeal anastomosis) with open ileostomy reversal. METHODS: A retrospective review of sequential patients undergoing elective loop ileostomy reversal between 2013 and 2016 at a single, high-volume institution was performed. Patients were stratified on the basis of operative approach: open reversal, laparoscopic-assisted reversal with extracorporeal anastomosis (LE), and laparoscopic reversal with intracorporeal anastomosis (LI). Linear and logistic regressions were utilized to perform multivariate analysis and determine risk-adjusted outcomes. RESULTS: Of 132 sequential cases of loop ileostomy reversal, 50 (38%) underwent open, 49 (37%) underwent LE, and 33 (22%) underwent LI. Demographic data and preoperative comorbidities were similar between the three cohorts. Median length of stay was significantly shorter for LI (52.1 h, p

Fecal microbiota transplantation (FMT) is an effective tool for treating Clostridium difficile infection in the setting of dysbiosis of the intestinal microbiome. FMT for other forms of human disorders linked to dysbiosis have been less effective. The fecal microbiota contains a high density of virus-like particles (VLP), up to 90% of which are bacteriophages, thought to have a role in regulating gut bacterial populations. We hypothesized that transplantation of the phage-containing fecal VLP fraction may reduce bacterial density in the dysbiotic setting of small intestinal bacterial overgrowth (SIBO). In an experiment using fecal transplantation, we compared the effect of the fecal VLP fraction (bacteria removed) against Whole FMT (bacteria intact) on the ileal microbiome. Recipients were either treated with a 30-day high-fat diet (HFD) as a model of dysbiosis to induce SIBO or were on a standard diet (SD). We observed that transplantation of fecal VLPs from donors on a HFD was sufficient to alter the ileal microbiota, but the effect was dependent on diet of the recipient. In recipients on a HFD, ileal bacterial density was reduced. In recipients on a SD, the ileal microbiome transitioned toward the composition associated with a HFD. In both recipient groups, transplantation of fecal VLP fraction alone produced the same outcome as whole FMT. Neither treatment altered expression of antimicrobial peptides. These findings demonstrated a potential role of VLPs, likely phages, for modifying the gut microbiome during dysbiosis.

Fecal microbiota transplantation (FMT) is an effective tool for treating Clostridium difficile infection in the setting of dysbiosis of the intestinal microbiome. FMT for other forms of human disorders linked to dysbiosis have been less effective. The fecal microbiota contains a high density of virus-like particles (VLP), up to 90% of which are bacteriophages, thought to have a role in regulating gut bacterial populations. We hypothesized that transplantation of the phage-containing fecal VLP fraction may reduce bacterial density in the dysbiotic setting of small intestinal bacterial overgrowth (SIBO). In an experiment using fecal transplantation, we compared the effect of the fecal VLP fraction (bacteria removed) against "Whole" FMT (bacteria intact) on the ileal microbiome. Recipients were either treated with a 30-day high-fat diet (HFD) as a model of dysbiosis to induce SIBO or were on a standard diet (SD). We observed that transplantation of fecal VLPs from donors on a HFD was sufficient to alter the ileal microbiota, but the effect was dependent on diet of the recipient. In recipients on a HFD, ileal bacterial density was reduced. In recipients on a SD, the ileal microbiome transitioned toward the composition associated with a HFD. In both recipient groups, transplantation of fecal VLP fraction alone produced the same outcome as whole FMT. Neither treatment altered expression of antimicrobial peptides. These findings demonstrated a potential role of VLPs, likely phages, for modifying the gut microbiome during dysbiosis.

Levels of the ribosome, the conserved molecular machine that mediates translation, are tightly linked to cellular growth rate. In humans, ribosomopathies are diseases associated with cell-type-specific pathologies and reduced ribosomal protein (RP) levels. Because gene expression defects resulting from ribosome deficiency have not yet been experimentally defined, we systematically probed mRNA, translation, and protein signatures that were either unlinked from or linked to cellular growth rate in RP-deficient yeast cells. Ribosome deficiency was associated with altered translation of gene subclasses, and profound general secondary effects of RP loss on the spectrum of cellular mRNAs were seen. Among these effects, growth-defective 60S mutants increased synthesis of proteins involved in proteasome-mediated degradation, whereas 40S mutants accumulated mature 60S subunits and increased translation of ribosome biogenesis genes. These distinct signatures of protein synthesis suggest intriguing and currently mysterious differences in the cellular consequences of deficiency for small and large ribosomal subunits.

Adult intestinal epithelial stem cells are a promising resource for treatment of intestinal epithelial disorders that cause intestinal failure and for intestinal tissue engineering. We developed two different animal models to study the implantation of cultured murine and human intestinal epithelial cells in the less differentiated "spheroid" state and the more differentiated "enteroid" state into the denuded small intestine of mice. Engraftment of donor cells could not be achieved while the recipient intestine remained in continuity. However, we were able to demonstrate successful implantation of murine and human epithelial cells when the graft segment was in a bypassed loop of jejunum. Implantation of donor cells occurred in a random fashion in villus and crypt areas. Engraftment was observed in 75% of recipients for murine and 36% of recipients for human cells. Engrafted spheroid cells differentiated into the full complement of intestinal epithelial cells. These findings demonstrate for the first time successful engraftment into the small bowel which is optimized in a bypassed loop surgical model.

Abundant evidence from many laboratories supports the premise that α-defensin peptides secreted from Paneth cells are key mediators of host-microbe interactions in the small intestine that contribute to host defense and homeostasis. α-defensins are among the most highly expressed antimicrobial peptides at this mucosal surface in many mammals, including humans and mice; however, there is striking variation among species in the number and primary structure of α-defensin paralogs. Studies of these biomolecules in vivo are further complicated by striking variations between laboratory mouse strains. Herein, we report an experimental approach to determine with precision and specificity expression levels of α-defensin (Defa) mRNA in the small intestine of C57BL/6 mice through an optimized set of oligonucleotide primers for qRT-PCR assays and cloned cDNA plasmids corresponding to the Defa paralogs. This approach demonstrated marked differences in α-defensin expression in C57BL/6 mice with respect to proximal/distal anatomical location and developmental stage, which have not been described previously. These data underscore the importance of careful attention to method (primer choice, proximal vs. distal location, and developmental stage) in analysis of antimicrobial peptide expression and their impact.

This paper focused on the assessment of governance risks and its effects to employee retention of service-based businesses in Laguna, Philippines. The study exclusively adopted the governance risks from LaConte’s Strategic Risks Model and Job Embeddedness’ Theory for employee retention. Descriptive research and purposive sampling were employed with 360 retrieved questionnaires. The questionnaire used in this study were subjected to reliability testing with acceptable to good internal consistency. Data were evaluated using statistical tools of frequency, rank, mean, weighted mean and ANOVA. The highest governance risks experienced by business owners during the pandemic in relation to planning is the suspended implementation of goals and objectives while in terms of monitoring and control, unpreparedness on future risks was ranked first. Management support to the professional needs of its employees is significant for reduced turnover of employee retention. Moreover, for the employee productivity, involvement of the employees to the business planning got the highest mean. Planning, and monitoring and control have strong significant difference when grouped according to service sector while under employee retention, reduced turnover is significantly different when grouped according to profile factor. However, the employee productivity showed only strong significant difference in service sector. The study suggested that LGUs may develop a program for governance management and employee empowerment program to aid the recovery programs for service-based businesses.

The COVID-19 virus pandemic, which began in 2020, had a negative impact on the global and Croatian economy. Accordingly, the pandemic has globally affected the reduction in overall demand, the decline in consumption preferences, reduced the flow of people, goods, and services, disrupted supply chains, and consequently reduced production and trade in goods and services. The economic crisis encompassed even the most developed countries in the world, therefore there has been a decline in global GDP of 4.4%, and the crisis has also resulted in a GDP reduction of all major world economies (except the economy of the People’s Republic of China). The aim of this paper is to analyze the state and business performance of the enterprise sector in the County of Šibenik-Knin for two periods, ie the pre-pandemic year 2019 and the first pandemic year 2020. The following state and business performance indicators will be analyzed: realized profit/loss, number of employees, number of enterprises, total income, income per employee, income per enterprise, and market share. In addition, in order to have an insight into the state and business performance of the enterprise sector in the County of Šibenik-Knin, selected business performance indicators for enterprises of the County of Šibenik-Knin County and the Republic of Croatia will be compared. The observation of the enterprises encompasses two criteria: size and activity. The paper analyzes secondary data from the database of the Digital Chamber of the Croatian Chamber of Commerce and also provides the limitations of the study and useful recommendations for future research.

Summary: Motivation: Workplace training is an indispensable part of workforce skill development, but it is often provided irregularly and selectively in private enterprises. This is a missed opportunity given its potential to contribute to employee wellbeing and human capital development, and to boost firm performance. Purpose: We examine workplace training provision and private returns to training in Myanmar, a country with a severely constrained formal educational system and underperforming private sector. Methods and approach: We use linked employer–worker panel data from micro, small, and medium manufacturing enterprises in Myanmar. Our regression framework includes controls for production factors and other standard enterprise and owner characteristics, including employee and owner skills, and unobservable time‐invariant employee and firm heterogeneity. Findings First, we document a low prevalence of training in manufacturing enterprises. Second, we find a wage premium associated with training of about 8%. Third, we show that workplace training is offered selectively to workers and how, when this is the case, the wage gap between trained and untrained workers surpasses 10%. Fourth, we find that prior training (in other firms) or certified training do not contribute to higher wages, indicating that training is largely firm‐specific. Finally, we find that the wage returns to training are particularly high for women and among the least educated workers. Policy implications: Considering the wage return as a lower bound of productivity gains from training, our results suggest that government support of workplace training programmes in private enterprises could help increase performance of the manufacturing sector in Myanmar. High returns to training among the least educated workers indicate that training could improve the overall income distribution in the economy. [ABSTRACT FROM AUTHOR]

This research is a literature study on marketing strategies for MSME owners in Riau. This study aims to analyze what marketing strategies are used by MSME owners in an effort to maintain their business continuity. The research method used in this study is a qualitative descriptive method. The type of data used in this study is qualitative data, which is categorized into two types, namely primary data and secondary data. Sources of data obtained through library research techniques (library study) which refers to sources available both online and offline such as: scientific journals, books and news sourced from trusted sources. The results of the study conclude that the marketing strategies carried out by MSME owners in maintaining their business during the Covid-19 pandemic are; Product Strategy, during the Covid-19 pandemic, MSME owners in Riau also created innovations in their respective products. Price Strategy (Price), during the pandemic, MSME owners in Riau also carried out a price strategy in the form of discounts or price discounts to attract consumers and be able to maintain business. Promotion Strategy (Promotion), The forms of promotion used are: (1) Advertising (Advertising) (2) Personal Selling (Personal Selling) (3) Sales Promotion (4) Place Strategy (Place/Distribution). [ABSTRACT FROM AUTHOR]

The digitalization of companies and the implantation of Industry 4.0 concepts are emerging and challenging for micro and Small and Medium Enterprises (SME). The benefits are evident for the companies, as their business processes become simplified, and the internationalization and global market penetration turn out to be improved. However, information security and cybersecurity concerns have been raised on SME, as best practices and regulations compliance should be applied. The wide set of these regulations and their broad scope has put constraints on their overall direct mapping and adoption into SME. This paper describes an original methodology to map the Roadmap for Minimum Cybersecurity Capabilities (RMCSC) delivered by the Portuguese Cybersecurity Centre, into the well-adopted international information security ISO 27001:2013 standard. The proposed mapping is oriented toward the characteristics of SME and allows these companies to assess their cybersecurity risk to further mitigate potential identified flaws. The main deliverable of this paper is the developed methodology, which correlates the actions of the cybersecurity capabilities roadmap and the security controls enclosed in the ISO 27001:2013 standard. A questionnaire was developed to support the cybersecurity risk self-diagnosis, and the actions were justified and detailed in this paper. Further developments include the submission of the questionnaire to a case study of SME in the centre region of Portugal. [ABSTRACT FROM AUTHOR]

Acute mesenteric ischemia (AMI) is an uncommon yet highly lethal cause of acute abdomen in the emergency setting. Computed tomography (CT) imaging, in particular a biphasic protocol consisting of angiographic and venous phase scans, is widely used to corroborate non-specific clinical findings when suspicions of AMI are high. Techniques such as low kilovoltage peak scanning, dual energy acquisition, or a combined arterial/enteric phase can improve iodine conspicuity and evaluation of bowel enhancement. Biphasic CT with CT angiography is mandatory to directly assess for the 3 primary etiologies of AMI—arterial, venous, and non-occlusive mesenteric ischemia (NOMI), and the CT angiographic findings may be the first visible in the disease. In addition, numerous non-vascular CT findings have also been reported. Bowel wall thickening, mesenteric stranding, and ascites are common but non-specific findings that correlate poorly with disease severity. Pneumatosis intestinalis and portomesenteric venous gas, while not pathognomonic for ischemia, are highly specific in cases of high clinical suspicion. Bowel wall hypoenhancement is an early and specific sign but requires a protocol optimizing iodine conspicuity to confidently identify. Finally, intraperitoneal free air and solid organ infarcts are also highly specific ancillary findings in AMI. AMI occurs as a complication in 10% of small bowel obstruction (SBO) patients, and understanding imaging findings of ischemia in the context of SBO is necessary to aid in treatment planning and reduce over- and under-diagnosis of strangulation. Familiarity with the imaging features of ischemia by radiologists is vital to establish an early diagnosis before irreversible necrosis occurs. [ABSTRACT FROM AUTHOR]

Micro, small, and medium-sized enterprises (MSMEs) in India were hit hard by the Goods and Services Tax (GST). The goals of this tax overhaul were to simplify indirect taxation, strengthen the single market, and facilitate corporate operations. Its positive and negative effects on MSMEs reflect the complexity of the terrain in which they operate. The streamlining of taxes processes was one of the most noticeable advantages of GST for MSMEs. To make things easier for companies, GST took the role of several other state and federal taxes. As a result, tax collection efficiencies increased and tax avoidance decreased. Businesses were able to more easily report their tax payments because to the GST network's electronic filing and credit claim system. However, many SMEs had problems with the introduction of GST. Companies' resources were stretched thin as they struggled to adjust to the additional compliance demands brought on by the switch to a different tax system. The high compliance costs for small businesses were a direct result of the complexity of the tax system. GST's effect on MSMEs' competitiveness was industry specific. The tax costs on certain small and medium-sized businesses were cut while others were increased. Cost structures were affected by the possibility of receiving an input tax credit, with the greatest advantages accruing to companies involved in manufacturing and value addition. The dynamics of SMEs' supply chains were also impacted by GST. As a result, more companies began giving preference to vendors who were GST-compliant. As a result, many formerly informal businesses registered for GST. However, it also meant facing tougher competition from established powerhouses. For micro, small, and medium-sized enterprises (MSMEs), the effects of GST were complicated. While its ultimate goals were to streamline taxes and increase formalisation, its implementation first disrupted many small firms and made it difficult for them to comply. Factors include sector-specific dynamics and the adaptability of MSMEs to the new tax system will determine the long-term consequences. The effects of the changing and adapting GST on MSMEs have been the topic of continuing research and discussion. [ABSTRACT FROM AUTHOR]

Artificial Intelligence (AI) and Machine Learning (ML) represent popular topics of Industry 4.0. The use of these techniques, which are evolving rapidly in both academia and practice, can bring many benefits to production systems, such as enabling resilience and improving sustainable growth. However, given the effort needed in the implementation of AI/ML such as in terms of data quality and employee skills, the potential of AI/ML has not yet fully materialized in the context of manufacturing Micro, Small, and Medium Enterprises (MSMEs), which could improve their core processes or innovate product level to stay competitive, taking advantage of these technologies. This research work, methodologically based on a scoping literature review, presents an investigation of which are the existing applications of AI/ML in manufacturing MSMEs and discusses the limitations and challenges of these technologies. Moreover, the main emerging topics of research and future trends are summarized. [ABSTRACT FROM AUTHOR]

Background: The relative efficacy and safety of Everolimus-eluting stents versus paclitaxel-eluting stents in the small coronary vessels (<2.75mm) remains less well defined so the objective was to assess the twelve months outcome of the Everolimus --eluting stents (EES) versus the Paclitaxel- Eluting Stent (PES) in the small coronary vessels (<2.75mm) coronary intervention. Methods: .91patients referred for coronary intervention with reference vessel diameter (R.V. D.) <2.75mm were randomly assigned to either EES or PES. The primary endpoint was target vessel revascularization (TVR) at twelve months follow up. Out of the 91 patients enrolled, 53.8% were assigned to receive EES; 46.2% were assigned to receive PES. Results: a significantly lower TVR among the EES group (2% versus 14.2%), p=0.03. Likewise, instant restenosis (ISR) rate was significantly lower among the EES group (6.1% versus 21.4%), p=0. 031.On the other hand; there were no significant differences in the rates of deaths; target vessel- related myocardial infarction or stent thrombosis between the two groups. Conclusions: Both stents were similarly safe while EES is more effective. [ABSTRACT FROM AUTHOR]

The introduction of device-assisted enteroscopy (DAE) in the beginning of 21st century has revolutionized the diagnosis and treatment of diseases of the small intestine. In contrast to capsule endoscopy, the other main diagnostic modality of the small bowel diseases, DAE has the unique advantages of observing the region of interest in detail and enabling tissue acquisition and therapeutic intervention. As DAE becomes an essential procedure in daily clinical practice, there is an increasing need for correct guidelines on when and how to perform it and what technical factors should be considered. In response to these needs, the Korean Association for the Study of Intestinal Diseases developed an expert consensus statement on the performance of DAE by reviewing the current evidence. This expert consensus statement particularly focuses on the indications, choice of insertion route, therapeutic intervention, complications, and relevant technical points. [ABSTRACT FROM AUTHOR]

The incidence of small and asymptomatic pancreatic neuroendocrine neoplasms (PNENs) has increased due to the widespread use of high-resolution diagnostic imaging in screening programs. Most PNENs are slow-growing indolent neoplasms. However, a local invasion or metastasis can sometimes occur with PNENs, leading to a poor prognosis. The management of small, nonfunctioning PNENs remains under debate. The National Comprehensive Cancer Network guidelines recommend observation in selected cases of small PNENs less than 2 cm. Pancreatic surgery remains a high-risk operation with a 28–30% morbidity and 1% mortality. Therefore, the decision on how to manage small PNENs is challenging. This review focuses on the management of small nonfunctioning PNENs. We also highlight the malignant potential of small PNENs according to tumor size, tumor grade, and tumor biomarker. Endoscopic-ultrasound-guided biopsy is recommended to evaluate the potential risk of malignancy. Furthermore, we discuss the current guidelines and future directions for the management of small PNENs. [ABSTRACT FROM AUTHOR]

Micro, Small, and Medium-sized Enterprises play a vital role in driving the Nigerian economy, as they account for 96% of businesses and 84% of job creation. This study examines the corporate social responsibility (CSR) practices of micro, small, and medium-sized enterprises in the Jos metropolis, focusing on four variables: information on corporate responsibility, attitudes towards business ethics, firm reputation, and economic responsibility. The primary objective of this research is to investigate the relationship between these variables and the CSR of microbusinesses in the study area. The study findings indicate a significant positive effect of these variables on the CSR practices of microbusinesses. Therefore, the study recommends increasing awareness and integrating these determinants into the strategic planning of microbusinesses to have a positive impact on their CSR practices. This research provides insights into the factors that can enhance microenterprise engagement in CSR activities not only in the Jos metropolis but also beyond. In the same vein, the study's supports the assertion that businesses should prioritise the interests of all stakeholders, including the community, and engage in activities that will promote mutual benefits, which is consistent with both stakeholder theory and social exchange theory. [ABSTRACT FROM AUTHOR]

Çalışmanın amacı çeşitli sektörlerde faaliyet gösteren küçük, orta ve büyük ölçekli şirketlerin finansal performanslarının MOORA yöntemiyle analizidir. MOORA yöntemi şirketin finansal performansının belirlenmesi konusunda etkinlik özelliğine sahip güvenilir bilgiler sağlar. MOORA yöntemine göre, en iyi performans gösteren ilk üç sıralamasında büyük ölçekli ve orta ölçekli şirketler yer almaktadır. Bu durum, büyük ve orta ölçekli şirketlerin küçük şirketlere göre daha etkin çalıştığını gösteren bir işarettir. Büyük ve orta ölçekli şirketler küçük ölçekli şirketlere göre gerçek piyasa değerlerine daha fazla yaklaşmaktadırlar. Bu durum, yatırımcıların şirket hakkında daha fazla bilgiye sahip olduğunu gösterir. Abstract The aim of the study is to analyze the financial performances of small, medium and large companies operating in various sectors using the MOORA method. Financial analysis provides important information about the company's liquidity, long-term solvency and determination of its healthy financial structure. In this framework, financial analysis is the evaluation of the data produced by the accounting information system. As a result of the evaluation, the decision-making process starts by the company and its stakeholders. The objectivity and correctness of the decision positively affect the performance of the company. The MOORA method is recommended for analyzing the financial performance of companies. According to the results, it is seen that large and medium sized companies have better performance. When this situation is associated with the efficient market hypothesis, it shows that large and medium-sized companies operate more effectively than small companies.

Phoomjai Sornsenee,1 Krittanon Kongtragulsub,2 Kraitouch Watcharajiranich,2 Ratsak Chantanuwat,2 Awika Aungchayakul,2 Kollarat Mangkhalathat,2 Siriyakorn Laparojkit2 1Department of Family Medicine and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand; 2Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, ThailandCorrespondence: Phoomjai Sornsenee, Department of Family Medicine and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, 15 Karnjanavanich Road, Hat Yai, Songkhla, 90110, Thailand, Tel +66954204713, Fax +6674451333, Email ezipnary@gmail.comPurpose: COVID-19 has become a global pandemic. Since the Thai government announced its pandemic-related restrictions, economic indicators have inevitably been impacted. Micro, small, and medium enterprise (MSME) entrepreneurs have adapted to the unexpected changes, undoubtedly requiring government assistance. Therefore, this study assessed the prevalence of anxiety and depression in MSME restaurant entrepreneurs after the government announced its COVID-19-related restrictions.Patients and Methods: An online questionnaire was developed and distributed to MSME entrepreneurs’ restaurants in Songkhla province, southern Thailand, in November 2021. Thai Hospital Anxiety and Depression Scales (Thai HADS) were used to assess the prevalence of anxiety and depression. Multiple logistic regression was used to analyze the factors associated with depression and anxiety, and the adjusted odds ratio (OR) for both variables was reported at a P-value < 0.05 for significance.Results: In total, 181 MSME restaurant entrepreneurs responded to our online questionnaire in November 2021. The prevalence of anxiety and depression was 12.2% and 11.6%, respectively. Participants with a family history of psychological disorders (OR 34.9, P-value 0.003), an underlying disease (OR 7.14, P-value 0.032), a high debt-to-income ratio (OR 73.75, P-value 0.007), or a low education level were more likely to have anxiety. Similarly, participants who had an underlying disease (OR 14.29, P-value 0.032) and lacked access to supportive measures from the government (OR 6.94, P-value 0.009) were more likely to suffer from depression.Conclusion: The period of restrictive policies during the COVID-19 pandemic had a negative impact on MSME restaurant entrepreneurs’ mental health. The factors that were significantly associated with anxiety were debt-to-income ratio and concern about COVID-19 prevention and treatment. The factors that were significantly associated with depression included inadequate access to government aid. Hence, the government should focus on providing and allocating healthcare resources during the COVID-19 pandemic.Keywords: anxiety and depression and, micro, small, and medium enterprises, MSMEs, COVID-19, COVID-19 restrictions, entrepreneurs

Purpose This study aimed to evaluate the natural growth of subepithelial tumors of the small bowel detected on CT. Materials and Methods Consecutive patients who were suspected of having subepithelial tumors of the small bowel between January 2005 and December 2020 were reviewed. Eligible patients with suspected small (< 30 mm) subepithelial tumors on at least two CT evaluations were included in the analysis. The patients’ data on demographic characteristics, tumoral characteristics, and tumoral size changes during the follow-up were collected. Results This study included 64 patients with suspected small subepithelial tumors (n = 64) of the small bowel. After a median follow-up of 15.8 months, the diameter and volume growth rates were 0.02 mm/month and 1.5 mm3/month, respectively. A significant correlation was observed between the initial size and the growth rate of the small bowel subepithelial tumors. The group of large-sized tumors (initial diameter ≥ 10 mm) tended to show lobulated contours, heterogeneous enhancement, and necrotic changes more frequently than the group of small-sized tumors (initial diameter < 10 mm). Conclusion Small bowel subepithelial tumors measuring less than 10 mm grew more slowly than those measuring 10–30 mm.