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Colonic variceal bleeding is a rare cause of lower gastrointestinal (GI) bleeding, which carries a high mortality rate. Due to limited data, the optimal management of colonic variceal bleeding is not known. Coil-assisted retrograde transvenous obliteration (CARTO) has been shown to be very effective in managing non-esophageal variceal bleeding, but only a few cases demonstrate its effectiveness in treating colonic variceal bleeding. Here we present a case of colonic variceal bleeding treated with CARTO in order to expand on the limited body of evidence showing its efficacy in effectively treating this rare cause of life-threatening GI bleeding., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Hassan et al.)

Introduction: Pouchitis is the most common complication in patients with ileal pouch-anal anastomosis (IPAA), which can develop in up to 66% of patients. There is limited data on the effect of orthoptic liver transplantation (OLT) on the risk of developing pouchitis. We aimed to objectively assess whether OLT itself significantly modifies the risk of developing pouchitis in patients with overlap PSC and inflammatory bowel disease (IBD)., Method: We searched Medline, Scopus, and Embase databases from inception through September 2023 for studies that describe the outcomes of IPAA in patients with PSC and IBD who also have a history of OLT. Pooled proportions, Odds Ratio (OR), and 95% confidence intervals (CI) for data were calculated utilizing a random effects model. Using the Freeman-Turkey double arcsine transformation (FTT) method, the pooled weight-adjusted estimate of event rates for clinical outcomes in each group was also calculated. Heterogeneity between studies was assessed using the Cochrane Q statistic (I 2 )., Results: Seven studies with a total of 291 patients with a history of PSC, IBD, and OLT were identified. The pooled overall risk of pouchitis in PSC/IBD patients with a history of OLT was 65% (95% CI: 0.57-0.72), with no heterogeneity observed in the analysis (I 2 = 0%). In a subgroup analysis of patients who had IPAA followed by OLT, 3 studies with 28 patients were included; the pooled risk of pouchitis after IPAA and OLT was 83% (95% CI: 0.71-0.94; I 2  = 0%), which was significantly higher ( P  < .001) than the OLT followed by IPAA group (59%; 95 CI: 0.48-0.71; I 2  = 0%). There was no difference in the risk of pouchitis between OLT and non-OLT groups (OR = 1.36; 95% CI: 0.37-5.0)., Conclusions: Our meta-analysis revelaed that pouchitis is common in patients who underwent OLT for PSC, especially in those who had IPAA before the OLT. OLT before IPAA may reduce the risk of pouchitis. Further larger studies are warranted to reproduce this and investigate the reason behind this difference., Competing Interests: J.G.H. holds the position of clinical associate editor for Crohn’s & Colitis 360 and has been recused from reviewing or making decisions for the manuscript. F.A.F: AbbVie, Avalo Therapeutics, BMS, Braintree Labs, Fresenius Kabi, GI Reviewers, GSK, IBD Educational Group, Iterative Health, Janssen, Pharmacosmos, Pfizer, Sandoz Immunology, Sebela, Viatris. DSMB: Lilly. J.G.H: Advisory Board for BMS. Rest of authors have no conflict of interest. Disclosures: None to disclose., (© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation.)

Background: The aim of the study was to investigate the risk factors associated with the development of small bowel obstruction (SBO) in Crohn's disease (CD) after small bowel resection (SBR) that are not due to active/recurrent inflammation., Methods: We conducted a retrospective cohort study of patients who had SBR for active or complicated CD. Abstracted data included demographics, phenotype, therapies for CD, endoscopic disease recurrence, and several surgical variables. The primary outcome was the development of non-inflammatory SBO (NI-SBO) within 5 years after SBR., Results: A total of 335 patients were included. The cumulative rates of NI-SBO at 6 months, 1 year, and 5 years were 5 (1.5%), 8 (2.4%), and 29 (8.9%), respectively. Variables associated with the development of NI-SBO were active macroscopic or microscopic inflammation in the surgical margins (13 (56%) vs. 65 (27%), P = 0.004), open resection (vs. laparoscopic resection) (12 (41.4%) vs. 60 (19.5%), P = 0.0006) and a higher median number of previous resections (2 (interquartile range (IQR) 2 - 3) vs. 1 (IQR 1 - 2), P = 0.0002). Only 21% of patients who developed NI-SBO required surgical intervention., Conclusions: The incidence of NI-SBO after SBR in CD is low and associated with inflammation at the margins of the resected bowel, previous bowel resections, and an open laparotomy approach. Most NI-SBOs resolve with medical management., Competing Interests: M. Zulqarnain: no conflict; F. Jaber: no conflict, V. Jahagirdar: no conflict; S. Alsakarneh: no conflict; A. Stanton: no conflict; N. Patel: no conflict; J. Gomez: no conflict; P. Beniwal-Patel: no conflict; D. Stein: AbbVie: consulting, speaking and teaching; Allergan: speaking; Bristol Myers Squibb: speaking and teaching; Pfizer: speaking and teaching; Takeda: speaking and teaching; M. F. Otterson: no conflict; A. Yarur: consultant Takeda, Bristol Myers Squibb, Pfizer, Arena., (Copyright 2024, Zulqarnain et al.)

Background: Pivotal trials have shown that ustekinumab is effective in ulcerative colitis (UC). However, the population included in these trials do not represent the cohort of patients treated in the real world. In this study, we aimed to describe the effectiveness and safety of ustekinumab in a clinical cohort of patients with UC., Methods: We performed a multicenter retrospective cohort study and included patients with active UC starting ustekinumab. Variables collected included demographics, clinical data, and disease activity (measured using partial Mayo score [PMS] and endoscopic Mayo score) at follow-up. The primary outcomes were cumulative rates of steroid-free clinical and biochemical remission (SFCBR), defined as a PMS <2 while off steroids and a normal C-reactive protein and/or fecal calprotectin., Results: A total of 245 patients met inclusion criteria. The median time of follow-up was 33 (interquartile range, 17-53) weeks, and 214 (87.3%) had previous exposure to a biologic and/or tofacitinib. Rates of SFCBR, clinical remission, and endoscopic remission at 6 and 12 months were 12.0% (n = 16 of 139), 29.0% (n = 71 of 175), and 18.0% (n = 7 of 39), and 23.8% (n = 15 of 63), 54.3% (n = 57 of 105), and 31.0% (n = 9 of 29), respectively. Non-Hispanic White race, higher baseline PMS, and the use of concomitant corticosteroids were independently associated with failure to achieve SFCBR. Of the 73 that were dose escalated, 28.4% did not respond, 49.3% experienced a benefit, and 21.6% achieved remission., Conclusions: In a population enriched with refractory UC, ustekinumab was well tolerated and induced remission in a significant number of patients. Larger studies with a longer follow-up are warranted., (© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose: To compare the risks of adverse outcomes, including mortality, gastrointestinal bleeding, and venous thromboembolism, between COVID-19 patients with inflammatory bowel disease (IBD) and those without IBD., Methods: We analyzed data from the National Inpatient Sample between January and December 2020. The study included adult patients with Crohn's disease (CD) and ulcerative colitis (UC) who contracted COVID-19. Inpatient outcomes were compared between the IBD and non-IBD COVID-19 cohorts., Results: Out of 1,050,045 COVID-19 hospitalizations, 0.28% had CD (2954 patients) and 0.26% had UC (2794 patients). After adjusting for confounding factors, UC patients had a significantly higher risk of deep vein thrombosis compared to non-IBD patients, with an adjusted odds ratio (aOR) of 2.55 ( P  < 0.001). However, CD patients did not show a significant association with deep vein thrombosis (aOR 1.29, P  = 0.329). There were no significant associations between IBD patients (both UC and CD) and pulmonary embolism, nonvariceal gastrointestinal bleeding, or in-hospital mortality. UC patients had a longer average hospital stay (8.25 days) compared to non-IBD patients (adjusted mean difference 0.89, P  = 0.007). Healthcare resource utilization was similar among the three groups., Conclusion: Our national study on COVID-19 hospitalizations indicates that patients with IBD have comparable rates of gastrointestinal bleeding, pulmonary embolism, and mortality as those without IBD. However, patients with UC hospitalized with COVID-19 have a higher risk of deep vein thrombosis than COVID-19 patients hospitalized without UC. Further research is needed to better understand the relationship between COVID-19 and IBD., Competing Interests: The authors report no funding or conflicts of interest., (Copyright © 2024 Baylor University Medical Center.)

Background: The career trajectory of medical professionals, particularly in specialized fields like gastroenterology, can significantly impact healthcare and research. This study aimed to analyze career choices among gastroenterology fellows in the US and investigate the factors influencing these choices., Methods: We utilized data from the American Medical Association on internal medicine subspecialty fellows. The study examined career plans of gastroenterology fellows and compared them with those of other subspecialties. A chi-square test was performed to assess differences in career choices and practice settings., Results: Among gastroenterology fellows, 46% opted for private practice, 28% pursued further training, and 26% chose academia. Notably, gastroenterology fellows were more inclined toward private practice than their counterparts in other subspecialties (46.3% vs 38.4%) and were less likely to pursue academic careers (25.6% vs 30.7%)., Conclusion: This study highlights a concerning trend among recent gastroenterology fellowship graduates favoring private practice over academic careers or additional training. To sustain and strengthen academic medicine in gastroenterology, interventions such as scholarships, mentorship programs, and loan repayment initiatives tailored to academic pursuits could play a crucial role., Competing Interests: The authors report no funding or conflicts of interest., (Copyright © 2023 Baylor University Medical Center.)

Intercropping leguminous plant species with non-legume crops could be an effective strategy to maintain soil fertility. Additionally, the application of nano-Zn and Fe in trace amounts can substantially improve the bioavailable fraction of Zn and Fe. We studied the effect of foliar application of some nanomaterials on the agronomic, physio-biochemical attributes under a radish/pea intercropping system. The radish and pea were sprayed with different nanomaterials (Zn-Fe nanocomposite, nZnO, and nanobiochar) at 0 and 50 mg L -1 concentrations. Results indicated that the growth parameters of radish were higher in intercropping than in monocropping, while pea growth was inhibited in intercropping compared with monocropping. The shoot and root length, fresh weight, and dry matter of radish were increased by 28-50%, 60-70%, and 50-56% by intercropping than monocropping. Foliar spray of nano-materials further increased the growth traits of intercropped radish, such as shoot and root length, fresh weight, and dry matter, by 7-8%, 27-41%, and 50-60%, respectively. Similarly, pigments such as chlorophyll a, b, and carotenoids and the concentration of free amino acids, soluble sugars, flavonoids, and phenolics were differentially affected by intercropping and nanomaterials. The yield of the non-legume crop was increased by intercropping, whereas the legume crop exhibited significant growth inhibition due to competitive interactions. In conclusion, both intercropping and foliar spray of nanomaterials could be used as a combined approach to benefit plant growth and enhance the bioavailable Fe and Zn fractions of both crops., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

In today's world, stress is a major factor for various diseases in modern societies which affects the day-to-day activities of human beings. The measurement of stress is a contributing factor for governments and societies that impacts the quality of daily lives. The strategy of stress monitoring systems requires an accurate stress classification technique which is identified via the reactions of the body to regulate itself to changes within the environment through mental and emotional responses. Therefore, this research proposed a novel deep learning approach for the stress classification system. In this paper, we presented an Enhanced Long Short-Term Memory(E-LSTM) based on the feature attention mechanism that focuses on determining and categorizing the stress polarity using sequential modeling and word-feature seizing. The proposed approach integrates pre-feature attention in E-LSTM to identify the complicated relationship and extract the keywords through an attention layer for stress classification. This research has been evaluated using a selected dataset accessed from the sixth Korea National Health and Nutrition Examination Survey conducted from 2013 to 2015 (KNHANES VI) to analyze health-related stress data. Statistical performance of the developed approach was analyzed based on the nine features of stress detection, and we compared the effectiveness of the developed approach with other different stress classification approaches. The experimental results shown that the developed approach obtained accuracy, precision, recall and a F1-score of 75.54%, 74.26%, 72.99% and 74.58%, respectively. The feature attention mechanism-based E-LSTM approach demonstrated superior performance in stress detection classification when compared to other classification methods including naïve Bayesian, SVM, deep belief network, and standard LSTM. The results of this study demonstrated the efficiency of the proposed approach in accurately classifying stress detection, particularly in stress monitoring systems where it is expected to be effective for stress prediction.

Background/aims: Malignant biliary strictures (MBS) are very aggressive and cannot be diagnosed in the early stages due to their asymptomatic nature. Stenting the stricture area of the biliary tree is palliative treatment but has poor survival time. Radiofrequency ablation plus stent (RFA+S) have been recently used to improve the survival and stent patency time in patients with MBS. In this systematic review and meta-analysis, we tried to evaluate the efficacy and safety of radiofrequency ablation., Materials and Methods: Study search up to December 2021 was performed in different medical databases such as PubMed, Web of Science, and Cochrane library, etc. We selected eligible studies reporting survival time, stent patency time, and adverse events in patients with MBS. We compare the outcomes of RFA+S and stent-alone treatment groups., Results: A total of 15 studies (6 randomized controlled trials and 9 observational studies) with 1815 patients were included for meta-analysis of which 701 patients were in RFA+S group and 1114 patients in the stent-alone group. Pooled mean difference of survival time was 2.88 months (95% CI: 1.78-3.97) and pooled mean difference of stent patency time was 2.11 months (95% CI: 0.91-3.30) and clinical success risk ratio was 1.05 (95% CI: 1.01-1.09). Risk ratios for adverse events are given; Bleeding 0.84 (95% CI: 0.34-2.11), abdominal pain 1.06 (95% CI: 0.79-1.40), pancreatitis 0.93 (95% CI: 0.43-2.01), cholangitis 1.07 (95% CI: 0.72-1.59), and stent dysfunction 0.87 (95% CI: 0.70-1.07)., Conclusions: Radiofrequency ablation is involved in increased survival and stent patency time for MBS patients. With the help of better techniques, adverse events can be limited., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)

A Stock market collapse occurs when stock prices drop by more than 10% across all main indexes. Predicting a stock market crisis is difficult because of the increased volatility in the stock market. Stock price drops can be triggered by a variety of factors, including corporate results, geopolitical tensions, financial crises, and pandemic events. For scholars and investors, predicting a crisis is a difficult endeavor. We developed a model for the prediction of stock crisis using Hybridized Feature Selection (HFS) approach. Firstly, we went for the suggestion of the HFS method for the removal of stock's unnecessary financial attributes. The Naïve Bayes approach, on the other hand, is used for the classification of strong fundamental stocks. In the third step, Stochastic Relative Strength Index (StochRSI) is employed to identify a stock price bubble. In the fourth step, we identified the stock market crisis point in stock prices through moving average statistics. The fifth is the prediction of stock crises by using deep learning algorithms such as Gated Recurrent Unit (GRU) and Long-Short Term Memory (LSTM). Root Mean Square Error (RMSE), Mean Squared Error (MSE) and Mean Absolute Error (MAE) are implemented for assessing the performance of the models. The HFS-based GRU technique outperformed the HFS-based LSTM method to anticipate the stock crisis. To complete the task, the experiments used Pakistan datasets. The researchers can look at additional technical factors to forecast when a crisis would occur in the future. With a new optimizer, the GRU approach may be improved and fine-tuned even more., Competing Interests: The authors have declared that no competing interests exist.

Introduction: This systematic review aims to evaluate the incidence and predictors of pacemaker-induced cardiomyopathy (PICM) in patients undergoing right ventricular pacing., Areas Covered: A literature review was conducted using MeSH terms (Right ventricular pacing, Pacemaker-related cardiomyopathy, Pacemaker-induced cardiomyopathy) in PubMed, EMBASE, Web of science CINAHL, and the Cochrane Library until October 2021. All data reporting the incidence of PICM after implantation of right-sided pacemakers or implantable cardioverter-defibrillator (ICD) were retrieved from the eligible studies., Expert Opinion: Out of 3,625 articles, 20 studies met the inclusion criteria that included 5,381 patients. . The mean age of the patients ranged between 55.8 ± 13.5 and 77.4 ± 10.8 years. The mean incidence of PICM was 25.7%. Mean ejection fraction (EF) at baseline ranged from 48 ± 1% and 62.1 ± 11.2%, while mean EF at follow-up ranged between 33.7 ± 7.4% and 53.2 ± 8.2%. Three studies reported a decline of >20% EF at follow-up. RV pacing was associated with a considerable risk of PICM, with biological factors, such as male gender, old age, increased QRS duration, and chronic RV pacing burden playing an important role in the development of disease.

Perianal fistulas are a common complication of Crohn's disease (CD) that has, historically, been challenging to manage. Despite the strong available evidence that anti-tumor necrosis factor (anti-TNF) agents are useful in the treatment of perianal fistulizing Crohn's disease (PFCD), a significant number of these patients do not respond to therapy. The use of therapeutic drug monitoring (TDM) in patients with CD receiving biologic agents has evolved and is currently positioned as an important tool to optimize and guide biologic treatment. Considering the treatment of PFCD can represent a challenge; identifying novel tools to improve the efficacy of current treatments is an important unmet need. Given its emerging role in other phenotypes of Crohn's disease, the use of TDM could also offer an opportunity to enhance the effectiveness of available therapies and improve outcomes in the subset of patients with PFCD receiving biologics. Overall, there is mounting evidence that higher anti-TNF drug levels are associated with better rates of "fistula healing". However, studies have been limited by their use of subjective outcomes and observational designs. Ultimately, further interventional, randomized controlled trials looking into the relationship between drug exposure and fistula outcomes are needed.

Question classification is one of the essential tasks for automatic question answering implementation in natural language processing (NLP). Recently, there have been several text-mining issues such as text classification, document categorization, web mining, sentiment analysis, and spam filtering that have been successfully achieved by deep learning approaches. In this study, we illustrated and investigated our work on certain deep learning approaches for question classification tasks in an extremely inflected Turkish language. In this study, we trained and tested the deep learning architectures on the questions dataset in Turkish. In addition to this, we used three main deep learning approaches (Gated Recurrent Unit (GRU), Long Short-Term Memory (LSTM), Convolutional Neural Networks (CNN)) and we also applied two different deep learning combinations of CNN-GRU and CNN-LSTM architectures. Furthermore, we applied the Word2vec technique with both skip-gram and CBOW methods for word embedding with various vector sizes on a large corpus composed of user questions. By comparing analysis, we conducted an experiment on deep learning architectures based on test and 10-cross fold validation accuracy. Experiment results were obtained to illustrate the effectiveness of various Word2vec techniques that have a considerable impact on the accuracy rate using different deep learning approaches. We attained an accuracy of 93.7% by using these techniques on the question dataset., Competing Interests: The authors declare that they have no competing interests., (© 2021 Zulqarnain et al.)

The increasing demand of a sensitive and portable electrochemical sensing platform in pharmaceutical analysis has developed widespread interest in preparing electrode materials possessing remarkable properties for the electrochemical determination of target drug analytes. Herein, we report the synthesis, characterization and application of bimetallic cobalt-iron diselenide (FeCoSe 2 ) nanorods as electrode modifiers for the selective detection of a commonly used anti-tuberculosis drug Isoniazid (INZ). We prepared FeCoSe 2 nanorods by a simple hydrothermal route and characterized these by X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), energy dispersive X-ray spectroscopy (EDX) and temperature-programmed reduction (TPR) techniques. The electrochemical characterization of FeCoSe 2 modified GCE was performed by cyclic voltammetry (CV) and square wave anodic stripping voltammetry (SWASV). Under optimized experimental conditions, a linear current-concentration response was obtained for INZ in the range of 0.03-1.0 μM, with very low limit of detection 1.24 × 10 -10 M. The real applicability of the designed FeCoSe 2 /GCE sensing platform was adjudicated by the detection of INZ in biological samples., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

To investigate cost affordable and robust HER and OER catalysts with significant low overpotentials, we have successfully embedded FeCoSe 2 spheres on smooth surfaces of graphitic carbon nitride that demonstrated high stability and electrocatalytic activity for H 2 production. We systematically analyzed the composition and morphology of Fe x Co 1-x Se 2 /g-C 3 N 4 and attributed the remarkable electrochemical performance of the catalyst to its unique structure. Fe 0.2 Co 0.8 Se 2 /g-C 3 N 4 showed a superior HER activity, with quite low overpotential value (83 mV at -20 mA cm -2 in 0.5 M H 2 SO 4 ) and a current density of -3.24, -7.84, -14.80, -30.12 mA cm -2 at 0 V (vs RHE) in Dulbecco's Phosphate-Buffered Saline (DPBS), artificial sea water (ASW), 0.5 M H 2 SO 4 and 1 M KOH, respectively. To the best of our knowledge, these are the highest reported current densities at this low potential value, showing intrinsic catalytic activity of the synthesized material. Also, the catalyst was found to deliver a high and stable current density of -1000 mA cm -2 at an overpotential of just 317 mV. Moreover, the synthesized catalyst delivered a constant current density of -30 mA cm -2 for 24 h without any noticeable change in potential at -0.2 V. These attributes confer our synthesized catalyst to be used for renewable fuel production and applications.

Objective: To estimate the prevalence of needle-stick injuries in female nurses of a public and private hospital and compare the findings., Methods: This cross-sectional study was conducted at one public and one private tertiary care hospital in Lahore, Pakistan, from March to June 2015, and comprised female nurses who were selected using non-probability purposive sampling. A structured questionnaire was used to interview the subjects. Data analysis was done using SPSS 17., Results: Of the 386 participants, there were 193(50%) from each of the two hospitals. The prevalence of needle-stick injuries was found to be 85(44%) in public and 51(26.4%) in the private hospital. The highest proportion of injuries in both hospitals occurred while disposing or recapping needles, 36(42.4%) and 32(62.7 %) in public and private hospitals, respectively, especially in the morning shift, i.e. 42(49.4%) in public and 32(62.7%) in private hospital. Syringe needles were mostly involved, 51(60%) in public and 45(88.2%) in private hospital., Conclusions: The prevalence of needle-stick injuries was higher in public hospital.

The surface antigen 2 (SAG2) gene of the protozoan parasite, Toxoplasma gondii, was cloned and extracellularly expressed in the yeast Pichia pastoris. The effectiveness of the secreted recombinant SAG2 (rSAG2-S) as a serodiagnosis reagent was assessed by western blots and ELISA. In the western blot assay, rSAG2-S reacted with all Toxoplasma-antibody positive human serum samples but not with Toxoplasma-negative samples. In the ELISA, rSAG2-S yielded sensitivity rates ranging from 80% (IgG negative, IgM positive) to 100% (IgG positive, IgM negative). In vivo experiments showed that serum from mice immunized with rSAG2-S reacted specifically with the native SAG2 of T. gondii. These mice were protected when challenged with live cells of T. gondii.