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Gastrointestinal (GI) endoscopy is among the highest waste generator in healthcare facilities. The major reasons include production of large‐volume non‐renewable waste, use of single‐use devices, and reprocessing or decontamination processes. Single‐use endoscopic accessories have gradually replaced reusable devices over last two decades contributing to the rising impact of GI endoscopy on ecosystem. Several reports of infection outbreaks with reusable duodenoscopes raised concerns regarding the efficacy and adherence to standard disinfection protocols. Even the enhanced reprocessing techniques like double high‐level disinfection have not been found to be the perfect ways for decontamination of duodenoscopes and therefore, paved the way for the development of single‐use duodenoscopes. However, the use of single‐use endoscopes is likely to amplify the net waste generated and carbon footprint of any endoscopy unit. Moreover, single‐use devices challenge one of the major pillars of sustainability, that is, "reuse." In the era of climate change, a balanced approach is required taking into consideration patient safety as well as financial and environmental implications. The possible solutions to provide optimum care while addressing the impact on climate include selective use of disposable duodenoscopes and careful selection of accessories during a case. Other options include use of disposable endcaps and development of effective high‐level disinfection techniques. The collaboration between the healthcare professionals and the manufacturers is paramount for the development of environmental friendly devices with low carbon footprint. [ABSTRACT FROM AUTHOR]

Background: The diagnosis of intrathoracic and abdominal masses is challenging when lesions are located behind major vessels. Endoscopic ultrasound (EUS) or endobronchial ultrasound (EBUS)‐guided transvascular needle aspiration (TVNA) provides a potentially useful diagnostic tool for such lesions. Data with respect to the safety and outcome of E‐TVNA are scarce. Hence, this meta‐analysis was conducted to assess the critical role of E‐TVNA for diagnosis of various lesions. Methods and Material: A meta‐analysis was performed by pooling the data from studies obtained from comprehensive search of Medline, Embase, and Scopus from January 2000 to September 2022. The outcomes analyzed included sample adequacy, diagnostic accuracy and adverse events including bleeding. Results: A total of 17 studies (n = 411) were included in the final analysis. The pooled rate of sample adequacy was 91.5% [95% confidence interval (CI): 86.8–96.2], while the pooled rate of diagnostic accuracy was 85.0% (95% CI: 78.9–91.2). The pooled rate of bleeding with E‐TVNA was 1.4% (95% CI 0.0–3.1%). All the episodes of bleeding were mild and resolved without any further intervention. There was no significant heterogeneity with respect to various outcomes and results were comparable on sensitivity analysis. Conclusions: E‐TVNA offers a safe and accurate diagnostic modality for the diagnosis of mediastinal and abdominal lesions located on the other side of major vessels. Selection of potential candidates and close periprocedural observation are essential to improve the outcome. [ABSTRACT FROM AUTHOR]

Entecavir (ETV) and Tenofovir disoproxil fumarate (TDF) are the first‐line drugs for the treatment of chronic hepatitis B virus (HBV). However, the impact of these two antiviral agents on the outcome of HBV‐related hepatocellular carcinoma (HCC) after curative therapy remains to be explored. The purpose of the present study was to compare the effect of ETV and TDF on recurrence and mortality after curative treatment for HBV‐related HCC. A comprehensive literature search of multiple electronic databases was conducted from 2000 to January 2022 for studies comparing ETV and TDF for HBV‐related HCC patients after curative therapy. The adjusted hazard ratios (aHR) were pooled using a random‐effects model. A total of nine studies with 5298 patients were included in the final meta‐analysis. TDF was associated with a lower risk of HCC recurrence [aHR 0.73, 95% confidence interval (CI) 0.65–0.81] compared to HCC. TDF reduced the risk of late recurrence compared to ETV (aHR 0.58, 95% CI 0.45–0.76) but not early recurrence (aHR 0.88, 95% CI 0.76–1.02). The mortality risk was also lower with TDF compared to ETV (aHR 0.62, 95% CI 0.50–0.77). TDF was associated with a lower risk of recurrence and mortality than ETV after resection or ablation of HBV‐related HCC. Further prospective randomized controlled studies are warranted to validate these results. [ABSTRACT FROM AUTHOR]

Background and Aim: The COVID pandemic and countrywide lockdown has had significant impact on patients with inflammatory bowel disease (IBD), with delay in diagnosis, difficulty in access to healthcare and unavailability of drugs. We conducted a telephonic survey to assess this impact. Methods: Out of 350, 302 participated in the survey. Demographic data, disease severity at the time of survey, extent of disease, details of therapy, and adherence were noted. A validated questionnaire addressing information source, perception of COVID‐19 situation, contact with healthcare, and adherence to standard precautions was administered telephonically. Results: Out of 350 contacted patients, 302 (86.28%) patients participated in the survey. Median age of cohort was 39 years. Ulcerative colitis (UC) constituted 79%, 16% Crohn's disease (CD), and 5% IBD‐unclassified. At the time of survey, 86.98% patients with UC were in clinical remission and 75.75% of CD patients were generally well. A total of 115 (38%) cases were nonadherent to therapy due to unavailability of medicines (66.38%), financial constraints (25.21%) and inability to reach healthcare facility (3.6%). Disease flare was seen in 14.2% and correlated well with nonadherence. Existing drug therapy was switched to alternative drug in 70 (23.17%) cases due to unavailability (74%). Social media (52.3%) and television (40.4%) were the common sources of information about the pandemic. Telemedicine platforms (WhatsApp and telephone) were used by 180 (59.6%) patients for consultation with good acceptance (81.6%). 87 (28.8%) patients failed to contact healthcare. Apprehension regarding severe COVID infection was noted in 80% while 29% thought that IBD therapy could increase infection risk. Adherence to wearing mask, hand washing, and social distancing was 100%. Conclusion: Pandemic resulted in disruption of healthcare visits and medication supply. Majority were concerned about increased risk of COVID‐19 infection and adhered to standard precautions. Mobile phone‐based formats for patient care may be an alternative due to patient acceptance and convenience. [ABSTRACT FROM AUTHOR]

REFERENCES 1 Pawa R, Dorrell R, Russell G, Gilliam J, Mishra G, Pawa S. Long-term transmural drainage of pancreatic fluid collections with double pigtail stents following lumen-apposing metal stent placement improves recurrence-free survival in disconnected pancreatic duct syndrome. In a recent randomized controlled trial (RCT),3 104 patients with walled-off necrosis were randomized into stenting and no-stenting after endoscopic ultrasound-guided drainage using LAMS. We read with great interest the recent article by Pawa I et al i .1 describing the outcome of lumen-apposing metal stents (LAMS) for the management of pancreatic fluid collection (PFC) associated disconnected pancreatic duct syndrome. [Extracted from the article]

Focuses on a study concerning the premium payments received by investors for risk associated with book value to market price and beta risk. Development of dual-beta asset-pricing model; Implications for risk-return relationship; Association between dual-market betas and the size effect.

Sumi et al.2 recently published their findings of ARMS in a retrospective series of 109 patients with PPI refractory GERD. Endoscopic therapies have evolved significantly over the last decade as minimally invasive therapies for GERD.1 Antireflux mucosectomy (ARMS) was first described in 2003, however the pilot series was reported in refractory GERD in 2014. [Extracted from the article]

Studies evidence on the minimally explored topic of abnormal returns earned by stockholders of foreign bidders seeking to acquire a target firm in the United States. Four sources of influence on abnormal returns; Change in net wealth of the bidder associated with changes in exchange rates.