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Background: The ideal combination regimen for Helicobacter pylori (HP) eradication has not yet been determined and the success rate of HP eradication has been extensively reduced worldwide due to increasing antibiotic resistance. So this multinational multi-center randomized controlled trial was designed to evaluate the efficacy of tetracycline +levofloxacin for HP eradication. Methods: During a 6-month period, all of the cases with HP infection in eight referral tertiary centers of three countries were included and randomly allocated to receive either tetracycline + levofloxacin or clarithromycin plus amoxicillin quadruple regimen for two weeks. For all of the participants, pantoprazole was continued for 4 more weeks and after one to two weeks of off-therapy, they underwent urea breath test C13 to prove eradication. Results: Overall 788 patients were included (358 male (45.4%), average age 44.2 years). They were diagnosed as having non-ulcer dyspepsia (516 cases, 65.5%), peptic ulcer disease (PUD) (234 cases, 29.69%), and intestinal metaplasia (38 cases, 4.8%). Racially 63.1% were Caucasian, 14.5% Arab, 15.6% African, and 6.1% Asian. The participants were randomly allocated to groups A and B to receive either tetracycline + levofloxacin or clarithromycin. Among groups A and B in intention to treat (ITT) and per protocol (PP) analysis, 75.2% & 82.1% (285 cases) and 67.5% & 70.1% (276 cases) of participants achieved eradication, respectively (P = 0.0001). The complete compliance rate in groups A and B were 84.4% and 83.6%, respectively. During the study, 33.5% of the participants in group A (127 cases) reported side effects while the complication rate among group B was 27.9% (114 cases, P = 0.041). The most common complaints among groups A and B were nausea and vomiting (12.6% & 9.3%) and abdominal pain (4.48% & 2.68%), respectively. The rate of severe complications that caused discontinuation of medication in groups A and B were 2.1% and 1.46%, respectively (P = 679). In subgroup analysis, the eradication rates of tetracycline+levofloxacin among patients with non-ulcer dyspepsia, PUD, and intestinal metaplasia were 79.4%, 88.1%, and 73.9%, respectively. These figures in group B (clarithromycin base) were 71.3%, 67.6%, and 61.5% respectively (P = 0.0001, 0.0001, and 0.043). Conclusion: Overall, the combination of tetracycline+levofloxacin is more efficient for HP eradication in comparison with clarithromycin+amoxicillin despite more complication rate. In areas with a high rate of resistance to clarithromycin, this therapeutic regimen could be an ideal choice for HP eradication, especially among those who were diagnosed with PUD.

The sun provides a plentiful and inexpensive source of carbon-neutral energy that has yet to be fully utilized. This is a major driving force behind the development of organic photovoltaic (OPV) materials and devices, which are expected to offer benefits such as low cost, flexibility, and widespread availability. For the photovoltaic performance enhancement of the inverted ZnO-nanorods (NR)/organic hybrid solar cells with poly(3-exylthiophene):(6,6)-phenyl-C61-butyric-acid-methylester (P3HT:PCBM) and poly (3,4-ethylenedioxythiophene):poly (styrenesulfonate) (PEDOT:PSS) active layers, gold nanoparticles (Au-NPs) were introduced into the interface between indium-thin-oxide cathode layer and ZnO cathode buffer layer, and the efficiency improvement was observed. It's worth noting that adding Au NPs had both a positive and negative impact on device performance. Au NPs were shown to be advantageous to localized surface plasmon resonance (LSPs) in the coupling of dispersed light from ZnO NRs in order to extend the light's path length in the absorbing medium. Although the light absorption in the active layer could be enhanced, Au NPs might also act as recombination centers within the active layer. To avoid this adverse effect, Au NPs are covered by the ZnO seeded layer to prevent Au NPs from direct contact with the active layer. The dominant surface plasmonic effect of Au NPs increased the photoelectric conversion efficiency from 2.4% to 3.8%.

Background: The role of dairy foods in inflammatory bowel disease (IBD) has been controversial and it is debatable if patients with IBD should avoid milk and dairy products or not, as well as the relationship between these foods and symptoms among those population. Objective: This multi centric cross-sectional study designed to evaluate if it is really necessary to deprive IBD patients from consumption of dairy foods. Methods: A multicenter study with 12 gastroenterology referral centers in four countries was designed to evaluate gastrointestinal (GI) symptoms after consumption of dairy foods from all outpatients with IBD during 6 months and to compare patients treated at the same centers without IBD (non IBD cases). Results: Overall 1888 cases included (872 IBD patients and 1016 non IBD cases). 56.6% of participants were female with average age of 40.1 years. Racially 79.8% participants were Caucasians and originally they were citizens of 10 countries. Relative prevalence of IBD was higher in Africans and Indians and the most frequent prevalence of dairy foods intolerance was seen in Asians. Among IBD patients, 571 cases diagnosed as ulcerative colitis and 189 participants as Crohn’s disease. Average duration of diagnosis as IBD was 6.8 years (from 2 months to 35 years). The most prevalent GI symptoms after consumption of all the dairy foods were bloating and abdominal pain. Totally, intolerance of dairy foods and lactase deficiency was more prevalent among IBD patients in comparison with non IBD cases (65.5% vs 46.1%, P=0.0001). But the rate of GI complains among IBD patients who had not any family history of lactase deficiency, history of food sensitivity or both were 59.91%, 52.87% & 50.33% respectively and similar to non IBD cases (P=0.68, 0.98 & 0.99 respectively). Conclusion: The rate of dairy foods intolerance among IBD patients without family history of lactase deficiency or history of food sensitivity is similar to non IBD cases and probably there is no reason to deprive them from this important source of dietary calcium, vitamin D and other nutrients.

Background/Aims: The clinical practice pattern of polypectomy is not well-investigated in Asian countries. We aimed to survey Asian endoscopists about their preferred polypectomy techniques for given conditions and images of polyps. Methods: A survey was performed using questionnaires composed of two parts: a scenariobased questionnaire using scenarios of polyps, which were adopted from the European Society of Gastrointestinal Endoscopy guidelines, and an image-based questionnaire using provided endoscopic images of polyps. Results: A total of 154 endoscopists participated in this survey. The most preferred resection techniques for diminutive (≤5 mm), small (6-9 mm), and benign-looking intermediate (10-19 mm) nonpedunculated polyps were cold forceps polypectomy, hot snare polypectomy, and endoscopic mucosal resection (EMR), respectively, in both the scenario- and image-based questionnaires. For benign-looking large (≥20 mm) nonpedunculated polyps, EMR and endoscopic submucosal dissection (ESD) were preferred in the scenario- and image-based surveys, respectively. In case of malignant nonpedunculated polyps, EMR and ESD were preferred for intermediate-sized and large lesions, respectively, according to the scenario-based survey. However, ESD was preferred in both intermediate-sized and large malignant nonpedunculated polyps according to the imagebased survey. Trainee endoscopists, endoscopists working in referral centers, and endoscopists in the colorectal cancer-prevalent countries were independently associated with preference of cold snare polypectomy for removing small polyps. Conclusions: The polypectomy practice patterns of Asian endoscopists vary, and cold snare polypectomy was not the most preferred resection method for polyps

A 67-year-old male patient was admitted to hospital with upper abdominal pain, jaundice and pale stool for 2 weeks. Laboratory investigation showed highly elevated cholestatic parameters and transaminases but no increase of serum IgG4. MRI (figure 1) and endoscopic ultrasound (EUS) demonstrated a diffuse enlargement of the pancreas. Parenchymal biopsy taken by EUS-guided fine needle aspiration (FNA) contained storiform fibrosis with increased plasma cells expressing IgG4 (>30 cells/HPF) compatible with autoimmune pancreatitis type I. A steroid pulse therapy was initiated followed by maintenance therapy (prednisolone 5 mg/kg p.o.) and the patient recovered. One year later, the patient presented again with weight loss. …

Carbon-based nanomaterials have successively remained at the forefront of different research fields and applications for years. Understanding of low-dimension carbon material family (CNT, fullerenes, graphene, and graphene quantum dots) has arrived at a certain extension. In this report, graphene quantum dots were synthesized from graphene oxide with a microwave-assisted hydrothermal method. Compared with conventional time-consuming hydrothermal routes, this novel method requires a much shorter time, around ten minutes. Successful formation of quantum dots derived from graphene sheets was verified with microscopic and spectroscopic characterization. Nanoparticles present a diameter of about 2-8 nm, blue emission under ultraviolet excitation, and good dispersion in polar solvents and can be collected in powder form. The synthesized graphene quantum dots were utilized as a hole transport layer in organic solar cells to enhance the cell quantum efficiency. Such quantum dots possess energy levels (Ec and Ev) relevant to HOMO and LUMO levels of conductive polymers. Mixing P3HT:PCBM polymer and graphene quantum dots of sufficient extent notably helps reduce potential difference at interfaces of the two materials. Overall efficiency consequently advances to 1.43%, an increase of more than 44% compared with pristine cells (0.99%).

Hereditary and autoimmune pancreatitis are two rare forms of inflammatory pancreatic disorders. Both share similarities with acute, acute recurrent, and chronic pancreatitis. Regarding their pathogenesis, the premature activation of the digestive protease trypsinogen and the infiltration of inflammatory cells such as polymorphonuclear leukocytes and macrophages into the pancreas are highly relevant and can reciprocally amplify inflammation. Neutrophil serine proteases are the main components of neutrophil granulocytes and have different pro-inflammatory effects in many diseases. However, their role in pancreatitis is still limited. This section focuses on known findings regarding the role of this group of enzymes in hereditary and autoimmune pancreatitis.

Acute pancreatitis (AP) is one of the most common gastroenterological disorders leading to hospitalization. It has long been debated whether biliary AP, about 30% to 50% of all cases, is induced by bile acids (BAs) when they reach the pancreas via reflux or via the systemic blood circulation. Besides their classical function in digestion, BAs have become an attractive research target because of their recently discovered property as signaling molecules. The underlying mechanisms of BAs have been investigated in various studies. Bile acids are internalized into acinar cells through specific G-protein–coupled BA receptor 1 and various transporters. They can further act via different receptors: the farnesoid X, ryanodine, and inositol triphosphate receptor. Bile acids induce a sustained Ca2+ influx from the endoplasmic reticulum and release of Ca2+ from acidic stores into the cytosol of acinar cells. The overload of intracellular Ca2+ results in mitochondrial depolarization and subsequent acinar cell necrosis. In addition, BAs have a biphasic effect on pancreatic ductal cells. A more detailed characterization of the mechanisms through which BAs contribute to the disease pathogenesis and severity will greatly improve our understanding of the underlying pathophysiology and may allow for the development of therapeutic and preventive strategies for gallstone-inducedAP.

Background & study aims Corona virus disease-19 (COVID-19) pandemic has markedly impacted routine medical services including gastrointestinal (GI) endoscopy. We aim to report the real-life performance in high volume GI endoscopy units during the pandemic. Patients and methods A web-based survey covering all aspects of daily performance in GI endoscopy units was sent to endoscopy units worldwide. Responses were collected and data were analyzed to reveal the effect of COVID-19 pandemic on endoscopy practice. Results Participants from 48 countries (n = 163) responded to the survey with response rate of 67.35%. The majority (85%) decreased procedure volume by over 50%, and four endoscopy units (2.45%) completely stopped. The top three indications for procedures included upper GI bleeding (89.6%), lower GI bleeding (65.6%) and cholangitis (62.6%). The majority (93.9%) triaged patients for COVID-19 prior to procedure. N95 masks were used in (57.1%), isolation gowns in (74.2%) and head covers in (78.5%). Most centers (65%) did not extend use of N95 masks, however 50.9% of centers reused N95 masks. Almost all (91.4%) centers used standard endoscopic decontamination and most (69%) had no negative pressure rooms. Forty-two centers (25.8%) reported positive cases of SARS-CoV-2 infection among patients and 50 (30.7%) centers reported positive cases of SARS-CoV-2 infection among their healthcare workers. Conclusions Most GI endoscopy centers had a significant reduction in their volume and most procedures performed were urgent. Most centers used the recommended personal protective equipment (PPE) by GI societies however there is still a possibility of transmission of SARS-CoV-2 infection in GI endoscopy units.

Background and aim Malnutrition is a frequent complication of chronic pancreatitis. Adequate nutritional support is imperative, but there is still uncertainty about the optimal nutritional treatment. This work systematically compiles evidence from randomized controlled trials investigating dietary interventions in chronic pancreatitis and, in a further step, contrasts those findings with existing dietary recommendations. Methods The literature search (PubMed and Cochrane Central Register of Controlled Trials) included English and German full-text articles, which had been published in peer-reviewed journals. Two independent reviewers identified and selected studies. For meta-analysis, forest plots with 95% confidence intervals were generated using a random-effects model. Results Eleven randomized controlled trials fulfilled all selection criteria. In these trials, the following dietary interventions were tested: antioxidant treatment (n = 6), vitamin D supplementation (n = 3), supplementation with oral nutritional supplements (n = 1), and symbiotics supplementation (n = 1). Studies were of good methodological quality (mean Jadad score of 3.6) but heterogeneous in terms of interventions and study populations. Only for vitamin D, there was convincing evidence for efficacy of supplementation. We found no effect for antioxidant treatment on pain relief (standardized mean difference = -0.12; 95% confidence interval -0.73 to 0.48) and limited generalizability for interventions with oral nutritional supplements and symbiotics. Conclusions Nutritional management in chronic pancreatitis remains challenging. As well-designed randomized controlled trials are scarce, in large part, recommendations can only be based on low-level evidence studies or expert opinion. For now, consumption of a balanced diet remains the cornerstone recommendation for prevention, whereas more goal-directed interventions are indicated for specific nutrient deficiencies.

Introduction: An outbreak of coronavirus disease 19 (COVID-19) has altered the dynamic of world’s healthcare system, including endoscopic practices. Curious about the situation in different endoscopic units across the globe, the study was designed to evaluate different aspects of practice resumption worldwide. Methods: An online questionnaire was created and distributed by national/regional representatives. Redcap® platform was used as the interface; afterwards, Microsoft Excel 2016 and Prism 5 were utilized for data analysis. Results: A total of 307 responses from 47 countries/regions was collected, from which 290 valid answers were inducted and further analyzed. Almost half (47%) were in post-peak period by August, 2020. Many units were not designated to be COVID-oriented facility. About 15.5% of centers remained unrecovered, mainly in North and South America; those were recovered, training was still withheld significantly. Nevertheless, opened centers kept safety measurement strictly. Though patient load was decreased by 37% in most centers, waiting list was increased 0-25%. Among many surveillance methods, body temperature, PCR and chest CT prevailed the be the most commonly used. 74.8% claimed to have increased post-procedural disinfection time and 68.2% also observed an increased in per-case inspection. PPE usage was implemented highly and shortage of these posed as one of the resumption barriers. Post-procedural patient surveillance was not reinforced. Conclusions: The study reflected closely the global revolution of the pandemic. Shortage in staff and PPE as well as difficulty in training resumption remained barriers worldwide. Incapacity of patient post-procedural surveillance raised concerns in disease control. Funding Statement: None to declare. Declaration of Interests: None to declare. Ethics Approval Statement: The study was approved by the Institutional Review Board of the National Liver Institute, Menoufia University, Egypt (NLI IRB 00003413) in June 2020, protocol number 00203/2020.

Stack and composite are the two ways of hybridization between gold nanoparticles (AuNPs) and reduced graphene oxide (rGO) which have been fabricated and tested the ability to detect NH3 gas at room temperature. The device based on the rGO-AuNP composite structure exhibited the highest response and the fastest response and recovery time compared to stack and bare rGO. The red shift of a resonant peak in the absorption spectra and the negative shift in the binding energy of 4f5/2 peak indicated that the remarkable NH3 gas-sensing properties of this composite are mainly attributed to a chemical bonding formed between AuNPs and rGO at the defective sites. This type of interaction facilitates the electron transfer from the defect states to the AuNP surface wherein it easily reacts with the oxygen molecules in the atmosphere to create oxygen absorbents. Consequently, NH3 not only reacts with sp3-hybridized atoms but also reacts primarily with oxygen absorbents on the surface of AuNPs, resulting in a better sensing behavior of composite samples.

In 1720 Abraham Vater (1684–1751) published the first description of the Papilla at the junction of the common bile duct and the pancreatic duct that today bares his name.1 It would remain his most clinically relevant discovery, particularly since the introduction of endoscopic papillotomy in the 1970s2 and the recognition of endoscopic retrograde cholangio-pancreatography (ERCP)-induced pancreatitis as a significant disease risk.3 The anatomy of the papilla is not uniform among mammals. The rabbit has completely separate junctions of both ducts with the intestine4 and the mouse carries no smooth muscle sphincter.5 Closest to the human anatomy is probably the American Opossum,6 which has therefore been used experimentally to study the mechanisms involved in gallstone-induced pancreatitis.7 The papilla of Vater has remained the subject of many investigations in humans,8 because its impairment …

An attempt to degrade volatile organic compounds (VOCs) and sterilize air simultaneously is highly desirable to improve indoor air quality. With the help of deep ultraviolet (UVC) lighting, harmful bacteria that exists in the air can be destroyed. Thus, a new photocatalytic substance that can break down VOCs under UVC irradiation is required. Here, we demonstrate the photocatalytic activity of &beta, Ga2O3 nanostructures, synthesized via the solvothermal method for removing formaldehyde (HCHO) under deep ultraviolet irradiation. The Raman and XRD results indicated that as-synthesized nanostructures showed &beta, crystalline phase with a monoclinic structure. The photoluminescence spectrum exhibited a broad and strong green emission peak at 510 nm, which was likely attributed to a considerable amount of oxygen and gallium vacancies formed during the calcinating process. The photocatalytic efficiency for decomposing HCHO at room temperature under deep ultraviolet irradiation (278 nm) of the synthesized &beta, Ga2O3 nanoparticles is higher than that of the &beta, Ga2O3 nanorods. Both nanoparticles and nanorods obeyed the pseudo-first-order Langmuir-Hinshelwood kinetic model with a degradation rate constant of 0.057 and 0.033 min&minus, 1, corresponding to the efficiency of 82% and 62% in the formaldehyde removal, respectively.

P-type transparent conductive oxides are one of long-persued research topics in scientific community. Substitutes for unstable p-type zinc oxide are in urgent need than ever and doped tin monoxide can be a material-of-choice. In this report, we present Ag-doped SnOx thin film produced by reactive DC magnetron sputtering from Sn + Ag alloy targets. We investigated and proved the strong influence of substrate temperatures on crystal structure, optical and electrical properties. Tin monoxide thin films showed tetragonal crystal structure and preferred diffraction peaks of (001), (101), (110), (002). As substrate temperature increased, grain size also increased, leading to reduced grain boudaries, higher hole mobility and lower resistivity. Films deposited at low (150 °C) and high (300 °C) substrate temperatures had the presence of exotic β-Sn and SnO2 phases, respectively.They acted as undesired scattering centers or induce harmful carrier recombination which decreased mobility or hole concentration. The Ag-doped SnO films fabricated at 250 °C had the best electrical properties, hole concentration 5.82 × 1018 cm−3, mobility 4.1 cm2/Vs, resistivity 2.262 × 10-1Ωcm. Current-voltage characteristics of thin film diode structures of glass/FTO/n-nc-Si:H /p-Ag:SnO/Cu and glass /FTO/n-nc-Si:H /undoped SnO/Cu were studied. They showed remarkably improved electric properties of SnO: Ag films compared to the pristine SnO counterpart.

We found that inserting silver nanoparticles (AgNPs) between two layers of reduced grapheme oxide (rGO) has an effect on tailoring the work function of rGO. The utilization of rGO/AgNPs/rGO sandwich structure as the hole extraction layer in polymer solar cells is demonstrated. Solution-processable fabrication of this sandwich structure at the ITO/active layer interface facilitates the extraction of hole from active layer into ITO anode because of lowering the barrier level alignment at the interface. It results in an improvement of the short circuit current density and the overall photovoltaic performance.

The prognosis of gastric cancer depends principally upon an early diagnosis. An early and accurate diagnosis of gastric cancer needs some basic knowledges about the endoscopic characteristics of white light endoscopy, chromoendoscopy, magnified endoscopy, FICE and NBI…A strategy of screening is also a key factor for early diagnosis. The treatment of early gastric cancer by endoscopy techniques have showed more and more advantages. Beside of EMR, the technique of ESD is now applied more widely and lead to a very good prognosis and nearly a curative treatment for the patients with early gastric cancer. Key words: gastric cancer, early gastric cancer, diagnosis, endoscopy

Crystalline structure and optoelectrical properties of silver-doped tin monoxide thin films with different dopant concentrations prepared by DC magnetron sputtering are investigated. The X-ray diffraction patterns reveal that the tetragonal SnO phase exhibits preferred orientations along (101) and (110) planes. Our results indicate that replacing Sn2+ in the SnO lattice with Ag+ ions produces smaller-sized crystallites, which may lead to enhanced carrier scattering at grain boundaries. This causes a deterioration in the carrier mobility, even though the carrier concentration improves by two orders of magnitude due to doping. In addition, the Ag-doped SnO thin films show a p-type semiconductor behavior, with a direct optical gap and decreasing transmittance with increasing Ag dopant concentration.

Chromoendoscopy is a special technique used a combination dyes with endoscopy to improve visualization of the mucosa. Early detection of malignancies within the gastrointestinal tract is essential to improve the prognosis and outcome of affected patients. However, conventional white light endoscopy has a miss rate of up to 25% for gastrointestinal pathology, specifically in the context of small and flat lesions within the colon. Chromoendoscopy and other advanced imaging techniques aim at facilitating the visualization and detection of neoplastic lesions and have been applied throughout the gastrointestinal tract. Chromoendoscopy, particularly in combination with magnifying endoscopy has significantly improved means to detect neoplastic lesions in the gastrointestinal mucosa, especially early cancer. In addition, chromoendoscopy is beneficial in the upper gastrointestinal tract, especially when evaluating Barrett's oesophagus for the presence of dysplasia. Furthermore, it also improves characterization, differentiation and diagnosis of endoscopically detected suspicious lesions, and helps to delineate the extent of neoplastic lesions that may be amenable to endoscopic resection. This review discusses the teachnique, dyes, indications, applications and advanced endoscopic imaging methods used in various chromoendoscopic techniques, and presents a critical overview of the existing evidence supporting their use in current practice.

Reduced graphene oxide (rGO) nanosheets as an over-coating layer on silver nanoparticles (rGO/AgNPs) and silver nanowires (rGO/AgNWs) have been fabricated using solution processes and tested for NH3 gas detection in nitrogen/air at room temperature (RT). When exposed to 100 ppm NH3, the rGO/AgNWs device exhibited an excellent sensitivity (15%) compared to the rGO/AgNPs, rGO, and AgNWs devices. Our results revealed that the underneath AgNWs play a role as a network for providing a carrier transfer pathway, thus the rGO/AgNWs gas sensor device showed a stable, reproducible response and full recovery in nitrogen at RT. However, an excess amount of the AgNWs resulted in the agglomeration of the AgNWs. Consequently, a defective rGO over-coating layer with appearance of the pits was formed, reducing the sensitivity due to the adsorption deficiency.

Though tin oxide (SnO) is one of the strong candidates for p-type oxide semiconductor thin film transistors (TFTs), poor properties and a narrow window of deposition condition are obstacles for implementation. An Ag-doped Sn thin film was studied for the improvement of electrical performance of TFTs. SnO and Ag-doped SnO thin films were deposited by direct current magnetron sputtering as the channel for thin film transistors. The concentration of Ag doping was controlled by the amount of Ag pellets in the sputtering target preparation. A change in oxide states was observed in an Ag-doped SnO film, which can lead to the reduction of the Sn4+ oxide phase. Ag-doped SnO showed improvement of carrier mobility and concentration and resulted in improved electrical characteristics.

It is time consuming for lecturers to manually compile, run and verify students' programming assignments. Moreover, they also need to define test cases for different programming exercises in order to assess students' code. This paper presents a swarm inspired automatic test case generation for Online Programming Assessment or Judge (UOJ) system. The UOJ is built with the purpose to assist lecturers in evaluating codes submitted from students and generate test cases for every programming problem automatically. It also helps students to practice and enhance their programming skills. In this study, the mechanism of automatic test case generation was explored using Particle Swarm Optimization (PSO) algorithm and new fitness function is proposed to determine the optimal solution for each problem. Experiments were set up to benchmark between manual and automatic PSO test case generation results to evaluate the efficiency of the proposed method. The preliminary results are satisfactory for automatic test case generation using swarm inspired PSO algorithm in C++ programming assignments.