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Background/Aims: Recognizing Helicobacter pylori infection during endoscopy is important because it can lead to the performance of confirmatory testing. Linked color imaging (LCI) is an image enhancement technique that can improve the detection of gastrointestinal lesions. The purpose of this study was to compare LCI to conventional white light imaging (WLI) in the endoscopic diagnosis of H. pylori infection.Methods: We conducted a comprehensive literature search using PubMed, Embase, and the Cochrane Library. All studies evaluating the diagnostic performance of LCI or WLI in the endoscopic diagnosis of H. pylori were eligible. Studies on magnifying endoscopy, chromoendoscopy, and artificial intelligence were excluded.Results: Thirty-four studies were included in this meta-analysis, of which 32 reported the performance of WLI and eight reported the performance of LCI in diagnosing H. pylori infection. The pooled sensitivity and specificity of WLI in the diagnosis of H. pylori infection were 0.528 (95% confidence interval [CI], 0.517 to 0.540) and 0.821 (95% CI, 0.811 to 0.830), respectively. The pooled sensitivity and specificity of LCI in the diagnosis of H. pylori were 0.816 (95% CI, 0.790 to 0.841) and 0.868 (95% CI, 0.850 to 0.884), respectively. The pooled diagnostic odds ratios of WLI and LCI were 15.447 (95% CI, 8.225 to 29.013) and 31.838 (95% CI, 15.576 to 65.078), respectively. The areas under the summary receiver operating characteristic curves of WLI and LCI were 0.870 and 0.911, respectively.Conclusions: LCI showed higher sensitivity in the endoscopic diagnosis of H. pylori infection than standard WLI.

In a developing nervous system, axonal arbors often undergo complex rearrangements before neural circuits attain their final innervation topology. In the lateral line sensory system of the zebrafish, developing sensory axons reorganize their terminal arborization patterns to establish precise neural microcircuits around the mechanosensory hair cells. However, a quantitative understanding of the changes in the sensory arbor morphology and the regulators behind the microcircuit assembly remain enigmatic. Here, we report that Semaphorin7A (Sema7A) acts as an important mediator of these processes. Utilizing a semi-automated three-dimensional neurite tracing methodology and computational techniques, we have identified and quantitatively analyzed distinct topological features that shape the network in wild-type and Sema7A loss-of-function mutants. In contrast to those of wild-type animals, the sensory axons in Sema7A mutants display aberrant arborizations with disorganized network topology and diminished contacts to hair cells. Moreover, ectopic expression of a secreted form of Sema7A by non-hair cells induces chemotropic guidance of sensory axons. Our findings propose that Sema7A likely functions both as a juxtracrine and as a secreted cue to pattern neural circuitry during sensory organ development.

Game theory-inspired deep learning using a generative adversarial network provides an environment to competitively interact and accomplish a goal. In the context of medical imaging, most work has focused on achieving single tasks such as improving image resolution, segmenting images, and correcting motion artifacts. We developed a dual-objective adversarial learning framework that simultaneously 1) reconstructs higher quality brain magnetic resonance images (MRIs) that 2) retain disease-specific imaging features critical for predicting progression from mild cognitive impairment (MCI) to Alzheimer’s disease (AD). We obtained 3-Tesla, T1-weighted brain MRIs of participants from the Alzheimer’s Disease Neuroimaging Initiative (ADNI, N=342) and the National Alzheimer’s Coordinating Center (NACC, N =190) datasets. We simulated MRIs with missing data by removing 50% of sagittal slices from the original scans (i.e., diced scans). The generator was trained to reconstruct brain MRIs using the diced scans as input. We introduced a classifier into the GAN architecture to discriminate between stable (i.e., sMCI) and progressive MCI (i.e., pMCI) based on the generated images to facilitate encoding of disease-related information during reconstruction. The framework was trained using ADNI data and externally validated on NACC data. In the NACC cohort, generated images had better image quality than the diced scans (Structural similarity (SSIM) index: $0.553 \pm 0.116$ versus $0.348 \pm 0.108$ ). Furthermore, a classifier utilizing the generated images distinguished pMCI from sMCI more accurately than with the diced scans (F1-score: $0.634 \pm 0.019$ versus $0.573 \pm 0.028$ ). Competitive deep learning has potential to facilitate disease-oriented image reconstruction in those at risk of developing Alzheimer’s disease.

Abstract Background Owing to its strong acid inhibition, potassium-competitive acid blocker (P-CAB) based regimens for Helicobacter pylori (H. pylori) eradication are expected to offer clinical advantages over proton pump inhibitor (PPI) based regimens. This study aims to compare the efficacy and adverse effects of a 7-day and a 14-day P-CAB-based bismuth-containing quadruple regimen (PC-BMT) with those of a 14-day PPI-based bismuth-containing quadruple regimen (P-BMT) in patients with high clarithromycin resistance. Methods This randomized multicenter controlled clinical trial will be performed at five teaching hospitals in Korea. Patients with H. pylori infection who are naive to treatment will be randomized into one of three regimens: 7-day or 14-day PC-BMT (tegoprazan 50 mg BID, bismuth subcitrate 300 mg QID, metronidazole 500 mg TID, and tetracycline 500 mg QID) or 14-day P-BMT. The eradication rate, treatment-related adverse events, and drug compliance will be evaluated and compared among the three groups. Antibiotic resistance testing by culture will be conducted during the trial, and these data will be used to interpret the results. A total of 366 patients will be randomized to receive 7-day PC-BMT (n = 122), 14-day PC-BMT (n = 122), or 14-day P-BMT (n = 122). The H. pylori eradication rates in the PC-BMT and P-BMT groups will be compared using intention-to-treat and per-protocol analyses. Discussion This study will demonstrate that the 7-day or 14-day PC-BMT is well tolerated and achieve similar eradication rates to those of 14-day P-BMT. Additionally, the 7-day PC-BMT will show fewer treatment-related adverse effects and higher drug compliance, owing to its reduced treatment duration. Trial registration Korean Clinical Research Information Service registry, KCT0007444. Registered on 28 June 2022, https://cris.nih.go.kr/cris/index/index.do .

Globally, the prevalence of obesity and its associated comorbidities is increasing. Traditionally, the primary modalities for the treatment of obesity have included lifestyle interventions, pharmacological approaches, and bariatric surgery. However, endoscopic bariatric therapy, a more recent development, is emerging as a significant tool for the management of obesity and metabolic disorders. This review seeks to elucidate the latest advancements in metabolic bariatric endoscopy, highlighting their respective merits and limitations and offering insights into potential future research directions.

Techniques for upper gastrointestinal endoscopy are advancing to facilitate lesion detection and improve prognosis. However, most early tumors in the upper gastrointestinal tract exhibit subtle color changes or morphological features that are difficult to detect using white light imaging. Linked color imaging (LCI) has been developed to overcome these shortcomings; it expands or reduces color information to clarify color differences, thereby facilitating the detection and observation of lesions. This article summarizes the characteristics of LCI and advances in LCI-related research in the upper gastrointestinal tract field.

Background/Aims: Various endoscopic submucosal dissection (ESD) methods for gastric tumors have been tried. However, no studies have yet compared results according to the ESD method for gastric body tumors using a dual knife. The objective of this study was to compare outcomes of two ESD methods for gastric body tumors: the pocket-creation method and conventional method. Methods: Patients who underwent ESD for a gastric body tumor were retrospectively reviewed. Patients were divided into two groups according to the ESD method: the conventional method (group I) and pocket-creation method (group II). Characteristics of patients and tumors, hospitalization period, incidence of complications, resection margin status, incidence of surgical operation, procedure time, and laboratory findings were investigated. Results: Of the total of 100 patients, 52 belonged to group I and 48 to group II. All tumors were successfully resected en bloc. Resection margin involvement was found in six (11.5%) of group I and six (12.5%) of group II. Complications were observed in seven (13.5%; major complication five, minor two) of group I and eight (16.7%; major two, minor six) of group II. There were no significant differences in ESD outcomes such as hospitalization period, incidence of complications, resection margin status, incidence of surgical operation, procedure time, or inflammatory response after ESD between the two groups. Conclusions: Both methods are suitable for treating gastric body tumors with adequate treatment success rates and comparable complication rates.

The botanical insecticide nanoemulsion is a pesticide having an oil phase and aqueous phase that spontaneously emulsify and range in size from 20 to 200 nm. Bio-combi extracts frequently contain intricate combinations of active ingredients that may work in concert to increase bioactivity. The goal of the study was to develop the optimal nanoformulation and investigate the physiological effects of a synergistic nanoemulsion made from Tephrosia vogelii leaves and Piper aduncum fruit extracts as a substitute pesticide for Spodoptera frugiperda larvae. Low-energy spontaneous emulsification with a magnetic stirrer was used to create nanoemulsions, which were then subjected to a toxicity and food absorption test. Malvern's Zetasizer Nano (ZN), which was used to analyze the insecticidal nano formulae for PSA, revealed that the particle sizes for the 1:1, 3:1, and 1:5 ratios were 204 nm, 4724 nm, and 97 nm, respectively. Only the 1:5 formula, which is classified as a nanoparticle, met the standards for a nanoemulsion and produced S. frugiperda mortality of 82.34% at a concentration of 0.56%, and the LC25, LC50, and LC95 values were 0.1, 0.22, and 1.59%, respectively. The analyzable results demonstrated that the mixed nanoemulsion was additive at the LC50 value was 0.95 while the LC95 value was 0.70%, meaning only marginally synergistic

Enteromyxum leei has been identified as the causative agent of emaciation disease in a wide range of marine fish hosts. In this study, we aimed to determine the effect of the parasitic infection of Enteromyxum species on starry flounder that were cultured in aquaculture farms of Jeju island in Korea. As the mortality of cultured olive flounder Paralichthys olivaceus because of E. leei infection increased, some fish farms on Jeju island attempted to culture the starry flounder Platichthys stellatus, as an alternative. Myxosporeans with a developmental stage similar to E. leei were found in the intestines of cultured starry flounders. The partial 18S rDNA of myxosporeans showed 100% similarity with E. leei. To reveal the effect of E. leei infection on starry flounder, the intensity of E. leei infection measured using quantitative polymerase chain reaction, and the condition factor (CF) of fish were measured and analyzed statistically. The results showed that high-intensity E. leei infection significantly decreased the CF of the starry flounder. However, the pathogenicity of E. leei to starry flounder is low, considering its mortality and clinical signs.

Abstract Using the enhanced symmetry in the near-horizon region of the near-extremal dyonic Kerr–Newman (KN) black hole in the (A)dS space, we find the exact solutions for dyonic charged scalar field in terms of the hypergeometric function and explicitly compute the Schwinger effect for the emission of electric and/or magnetic charges. The emission formula confirms a universal factorization of the Schwinger formula in the AdS $$_2$$ 2 and another Schwinger formula in the two-dimensional Rindler space determined by the effective temperature and the Hawking temperature with the chemical potentials of electric and/or magnetic charges and the angular momentum. The emission of the same species of charges from the KN black hole is enhanced in the AdS boundary while it is suppressed in the dS boundary. In addition, the dragging of particles in the KN black hole diminishes the emission of charges in both AdS and dS spaces. The AdS geometry of near-horizon gives the Breitenloher–Freedman (BF) bound, within which the stability of dyonic KN black holes is guaranteed against both the emission of charges and Hawking radiation.

Background/Aims There have been little research on the cancer risks of patients with Peutz-Jeghers syndrome (PJS) in Korea. We aimed to investigate the clinical features of PJS patients and their cancer incidence rate. Methods Patients with PJS from nine medical centers were enrolled. In those patients diagnosed with cancer, data obtained included the date of cancer diagnosis, the tumor location, and the cancer stage. The cumulative risks of gastrointestinal cancers and extra-gastrointestinal cancers were calculated using the Kaplan-Meier method. Results A total of 96 PJS patients were included. The median age at diagnosis of PJS was 23.4 years. Cancer developed in 21 of the 96 patients (21.9%). The age of PJS diagnosis was widely distributed (0.9 to 72.4 years). The most common cancers were gastrointestinal cancer (n = 12) followed by breast cancer (n = 6). The cumulative lifetime cancer risk was calculated to be 62.1% at age 60. The cumulative lifetime gastrointestinal cancer risk was 47.1% at age 70. The cumulative lifetime extra-gastrointestinal cancer risk was 40.3% at age 60. Conclusions PJS onset may occur at any age and the risks of gastrointestinal and extra-gastrointestinal cancer are high. Thorough surveillance of PJS patients for malignancies is vital.

Abstract Recent ultra-intense lasers of subcritical fields and proposed X-ray polarimetry for highly magnetized neutron stars of supercritical fields have attracted attention to vacuum birefringence, a unique feature of the nonlinear vacuum under strong electromagnetic fields. We propose a formulation of the vacuum birefringence in a strong magnetic field ( $${\textbf{B}}$$ B ) and a weak electric field ( $${\textbf{E}}$$ E ), including the effect of electromagnetic wrench ( $$G \equiv -{\textbf{E}}\cdot {\textbf{B}}\ne 0$$ G ≡ - E · B ≠ 0 ). To do so, we derive a closed expression of the one-loop effective Lagrangian for the combined magnetic and electric fields by using the formula of the one-loop effective Lagrangian for an arbitrarily strong magnetic field. We then employ the expression to derive the polarization and magnetization of the vacuum, from which we obtain the permittivity and permeability for a weak probe field. Specifically, we find the refractive indices and the associated polarization vectors of the probe field for the case of parallel magnetic and electric fields. The proposed formulation reproduces the known results for pure magnetic fields in the proper limit. Finally, we apply the formulation to the Goldreich–Julian pulsar model. Our formulation reveals the importance of the electromagnetic wrench in vacuum birefringence: it can reduce the difference between refractive indices and rotate polarization vectors to a significant degree. Such a quantitative understanding is crucial to the X-ray polarimetry for magnetized neutron stars or magnetars, which will demonstrate the fundamental feature of the strongly-modified quantum vacuum and estimate the extreme fields surrounding those astrophysical bodies.

Summary: Quantifying the risk of progression to Alzheimer’s disease (AD) could help identify persons who could benefit from early interventions. We used data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI, n = 544, discovery cohort) and the National Alzheimer’s Coordinating Center (NACC, n = 508, validation cohort), subdividing individuals with mild cognitive impairment (MCI) into risk groups based on cerebrospinal fluid amyloid-β levels and identifying differential gray matter patterns. We then created models that fused neural networks with survival analysis, trained using non-parcellated T1-weighted brain MRIs from ADNI data, to predict the trajectories of MCI to AD conversion within the NACC cohort (integrated Brier score: 0.192 [discovery], and 0.108 [validation]). Using modern interpretability techniques, we verified that regions important for model prediction are classically associated with AD. We confirmed AD diagnosis labels using postmortem data. We conclude that our framework provides a strategy for risk-based stratification of individuals with MCI and for identifying regions key for disease prognosis.

Background/Aims: Clarithromycin resistance is a main factor for treatment failure in the context of Helicobacter pylori infection. However, the treatment regimen for clarithromycin-resistant H. pylori infection has not yet been determined. We aimed to compare the efficacy and cost-effectiveness of 14-day bismuth-based quadruple therapy versus 14-day metronidazole-intensified triple therapy for clarithromycin-resistant H. pylori infection with genotypic resistance. Methods: This was a multicenter, randomized, controlled trial. A total of 782 patients with H. pylori infection examined using sequencing-based clarithromycin resistance point mutation tests were recruited between December 2018 and October 2020 in four institutions in Korea. Patients with significant point mutations (A2142G, A2142C, A2143G, A2143C, and A2144G) were randomly assigned to receive either 14-day bismuth-based quadruple therapy (n=102) or 14-day metronidazole-intensified triple therapy (n=99). Results: The overall genotypic clarithromycin resistance rate was 25.7% according to the sequencing method. The eradication rate of 14-day bismuth-based quadruple therapy was not significantly different in the intention-to-treat analysis (80.4% vs 69.7%, p=0.079), but was significantly higher than that of 14-day metronidazole-intensified triple therapy in the per-protocol analysis (95.1% vs 76.4%, p=0.001). There were no significant differences in the incidence of side effects. In addition, the 14-day bismuth-based quadruple therapy was more cost-effective than the 14-day metronidazole-intensified triple therapy. Conclusions: Fourteen-day bismuth-based quadruple therapy showed comparable efficacy with 14-day metronidazole-intensified triple therapy, and it was more cost-effective in the context of clarithromycin-resistant H. pylori infection.

What people see through their eyes may touch their hearts. Their reflection shows how emphatic they are about their surroundings. This study aims to identify the reflection shown in the writing of English for Foreign Language (EFL) learners on what they see and feel through the photovoice technique. Given that senses and emotions are linked and can be measured through emotioncy levels, photovoice is used to lead EFL learners to experience the world around them and then reflect on it. By taking pictures and making use of them as ways of developing a piece of descriptive writing, this study found that reflection through photovoice SHOWed could give positive results. The students’ senses and emotions are blended to enhance the level of involvement that makes them able to describe things captured by their eyes as the visual sense and involve their hearts as the core of emotion to contribute to showing the actions of caring for their surroundings.

Background Only a few studies directly compared the therapeutic efficacy and safety of two pressurized metered-dose inhalers (pMDIs) in asthma. We analyzed the asthma treatment outcomes, safety, and patient preferences using formoterol/beclomethasone (FORM/BDP), a pMDI with extra-fine particles, compared with formoterol/budesonide (FORM/BUD), another pMDI with non-extra-fine particles. Methods In this randomized, double-blind, double-dummy parallel group study, 40 adult asthmatics were randomized to FORM/BDP group (n=18; active FORM/BDP and placebo FORM/BUD) or FORM/BUD group (n=22; active FORM/BUD and placebo FORM/BDP). During the two visits (baseline and end of 8-week treatment), subjects were asked to answer questionnaires including asthma control test (ACT), asthma control questionnaires (ACQ), and Quality of Life Questionnaire for Adult Korean Asthmatics (QLQAKA). Lung function, compliance with inhaler, and inhaler-handling skills were also assessed. Results Ten subjects in the FORM/BDP group and 14 in the FORM/BUD group completed follow-up visits. ACT, ACQ, QLQAKA (a primary outcome), and adverse events did not differ between two groups. We found that the increase in forced expiratory volume in 1 second/forced vital capacity and forced expiratory flow at 25% to 75% of the pulmonary volume in the FORM/BDP group was higher than in the FORM/BUD group. Regarding preference, subjects responded that the flume velocity of FORM/BDP was higher, but more adequate than that of FORM/BUD. They also answered that FORM/BDP reached the trachea and bronchus and irritated them significantly more than FORM/BUD. Conclusion The use of pMDI with extra-fine particles may relieve small airway obstruction more than the one with non-extra-fine particles despite no significant differences in overall treatment outcomes. Some asthmatics have a misconception about the adequacy of high flume velocity of pMDIs.

Background: Component resolved diagnostics (CRD) in dog and cat allergy is not sufficiently investigated, especially regarding new components such as Can f 4, Can f 6, and Fel d 7. The purpose of this study is to evaluate the potential role of CRD with new components in predicting allergic symptoms on dog and cat exposure. Methods: Among 552 Korean adults who participated in a pet exhibition and completed questionnaires regarding exposure to dog or cat and allergic symptoms, 522 were venipunctured for measurement of IgE and IgG4 antibody concentration against dog and cat dander extract and underwent skin prick test (SPT). In 238 individuals who were sensitized for both dog and cat dander extract, the dog IgE components (Can f 1–6) and the cat components (Fel d 1/2/4/7) were analyzed. Results: An increasing number of sensitizing components was associated with the likelihood of having any allergic symptoms (P < 0.001 for dog and P

A stroke is a serious life-threatening condition and a leading cause of death and disability that happens when the blood vessels to part of the brain are blocked or burst. While major advances in the understanding of the ischemic cascade in stroke was made over several decades, limited therapeutic options and high mortality and disability have caused researchers to extend the focus toward peripheral changes beyond brain. The largest proportion of microbes in human body reside in the gut and the interaction between host and microbiota in health and disease is well known. Our study aimed to explore the gut microbiota in patients with stroke with comparison to control group. Fecal samples were obtained from 51 subjects: 25 stroke patients (18 hemorrhagic, 7 ischemic) and 26 healthy control subjects. The variable region V3–V4 of the 16S rRNA gene was sequenced using the Illumina MiSeq platform. PICRUSt2 was used for prediction of metagenomics functions. Our results show taxonomic dysbiosis in stroke patients in parallel with functional dysbiosis. Here, we show that stroke patients have (1) increased Parabacteroides and Escherichia_Shigella, but decreased Prevotella and Fecalibacterium; (2) higher transposase and peptide/nickel transport system substrate-binding protein, but lower RNA polymerase sigma-70 factor and methyl-accepting chemotaxis protein, which are suggestive of malnutrition. Nutrients are essential regulators of both host and microbial physiology and function as key coordinators of host–microbe interactions. Manipulation of nutrition is expected to alleviate gut dysbiosis and prognosis and improve disability and mortality in the management of stroke.

Background Pituitary tumor transforming gene 1 (PTTG1), paired-like homeodomain 2 (PITX2), and galectin-3 have been widely studied as predictive biomarkers for various tumors and are involved in tumorigenesis and tumor progression. We evaluated the usefulness of PTTG1, PITX2, and galectin-3 as predictive biomarkers for invasive non-functioning pituitary adenomas (NFPAs) by determining the relationship between the expressions of these three proteins and the invasiveness of the NFPAs. We also investigated whether PTTG1, E-cadherin, and Ki-67, which are known to be related to each other, show a correlation with NFPA features. Methods A retrospective study was conducted on 87 patients with NPFAs who underwent surgical removal. The NFPAs were classified into three groups based on magnetic resonance imaging findings of suprasellar extension and cavernous sinus invasion. Immunohistochemical staining for PTTG1, PITX2, galectin-3, E-cadherin, and Ki-67 was performed on tissue microarrays. Results PTTG1 expression showed a statistically significant correlation with the invasiveness of NFPAs, whereas PITX2 and galectin-3 did not have a relationship with the invasiveness of NFPAs. Moreover, there was no association among PTTG1, E-cadherin, and Ki-67 expression. Conclusions PTTG1 has the potential to serve as a predictive biomarker for invasive NFPA. Furthermore, this study may serve as a reference for the development of PTTG1-targeted therapeutic agents.

Abstract Extending the electromagnetic and gravitational radiations from binary black holes with electric and magnetic charges in circular orbits in Liu et al. (Phys. Rev. D 102:103520, 2020), we calculate the total emission rates of energy and angular momentum due to gravitational and electromagnetic radiations from dyonic binary black holes in precessing elliptical orbits. It is shown that the emission rates of energy and angular momentum due to gravitational and electromagnetic radiations have the same dependence on the conic angle for different orbits. Moreover, we obtain the evolutions of orbits and find that a circular orbit remains circular while an elliptic orbit becomes quasi-circular due to electromagnetic and gravitational radiations. Using the evolution of orbits, we derive the waveform models for dyonic binary black hole inspirals and show the amplitudes of the gravitational waves for dyonic binary black hole inspirals differ from those for Schwarzschild binary black hole inspirals, which can be used to test electric and magnetic charges of black holes.

Tempat penampungan sampah (TPS) merupakan salah satu fasilitas yang wajib disediakan oleh pemerintah dalam upaya pengelolaan sampah. Penelitian ini bertujuan untuk mengevaluasi TPS eksisting di Kota Amlapura berdasarkan aspek daya tampung, kesesuaian lokasi dan infrastruktur serta merancang peta sebaran lokasi TPS optimal. Evaluasi kesesuaian daya tampung TPS dilakukan dengan membandingkan potensi timbulan sampah dengan kapasitas TPS. Evaluasi kesesuaian lokasi dilakukan dengan skoring berdasarkan variabel kesesuaian lokasi dan wilayah layanan TPS. Evaluasi kelayakan infrastruktur dilakukan dengan observasi langsung terhadap kondisi fisik TPS. Penyususnan peta sebaran TPS optimal menggunakan SIG dengan mengidentifikasi kepadatan sampah di Kota Amlapura dan menentukan titik lokasi TPS optimal berdasarkan wilayah layanan, variabel optimal kesesuaian lokasi dan ketersediaan lahan. Hasil penelitian menunjukkan bahwa TPS eksisting di Kota Amlapura memenuhi daya tampung dan kesesuaian lokasi, namun tidak memenuhi kesesuaian wilayah layanan dan infrastruktur. Peta sebaran lokasi TPS optimal menunjukan 98unit TPS rekomendasi dengan kapasitas 1 m3 tersebar di Kota Amlapura. Temuan tersebut memperkaya metodologi alternatif dalam evaluasi serta penentuan sebaran TPS dan sebagai masukan bagi pemegang keputusan dalam menyusun kebijakan pengelolaan sampah, terutama penempatan TPS dengan merelokasi TPS agar sesuai dengan potensi timbulan sampah dan wilayah layanannya serta melakukan renovasi/ perbaikan terhadap infrastruktur TPS eksisting.

Background Fractional exhaled nitric oxide (FeNO) is a non-invasive marker for eosinophilic airway inflammation and a good predictor of response to corticosteroids. There is a need for a reliable and accurate measurement method, as FeNO measurements have been widely used in clinical practice. Our study aimed to compare two FeNO analyzers and derive a conversion equation for FeNO measurements in adults. Methods We included 99 participants who had chief complaints of chronic cough and difficulty in breathing. The participants underwent concurrent FeNO measurement using NIOX VERO (Circassia AB) and NObreath (Bedfont). We compared the values of the two devices and analyzed their correlation and agreement. We then formulated an equation to convert FeNO values measured by NObreath into those obtained by NIOX VERO. Results The mean age of the participants was 51.2±17.1 years, with a female predominance (58.6%). Approximately 60% of the participants had asthma. The FeNO level measured by NIOX VERO (median, 27; interquartile range [IQR], 15–45) was significantly lower than that measured by NObreath (median, 38; IQR, 22–58; p

Abstract Background Most previous studies used aluminum hydroxide-absorbed allergen extracts in evaluating the potential therapeutic roles of intralymphatic allergen-specific immunotherapy (ILAIT). In this study, we evaluated the therapeutic efficacy and safety of ILAIT with L-tyrosine-adsorbed allergen extracts of Dermatophagoides farinae, D. pteronyssinus, cat, dog, or mixtures thereof, in patients with allergic rhinitis induced by these allergens. Methods In this randomized, double-blind, placebo-controlled trial, study subjects received three intralymphatic injections of L-tyrosine-adsorbed allergen extracts (active group) or saline (placebo group) at 4-week intervals. Results Although ILAIT reduced daily medication use and skin reactivity to HDM and cat allergens at 4 months after treatment, overall symptom score on a visual analog scale (VAS), sinonasal outcome test-20 (SNOT-20), rhinoconjunctivitis quality of life questionnaire (RQLQ), daily symptom score (dSS), daily medication score (dMS), daily symptom medication score (dSMS), nasal reactivity to HDM allergen, and basophil activity to HDM, cat, and dog allergens at 4 months and 1 year after treatment were similar between the treatment and control groups. Intralymphatic injection was more painful than a venous puncture, and pain at the injection site was the most frequent local adverse event (12.8%); dyspnea and wheezing were the most common systemic adverse events (5.3%). Conclusions ILAIT with L-tyrosine-adsorbed allergen extracts does not exhibit profound therapeutic efficacy in allergic rhinitis and can provoke moderate-to-severe systemic reactions and cause pain at the injection site. Trial registration: clinicaltrials.gov: NCT02665754; date of registration: 28 January 2016

Background/Aims: The diagnosis of small bowel Crohn’s disease with negative ileocolonoscopic findings has been challenging. Fecal calprotectin (FC) has been used to detect colonic inflammation, but its efficacy for detecting small bowel inflammation is less established. We performed an updated meta-analysis to evaluate the diagnostic accuracy of FC to detect active small bowel inflammation observed during capsule endoscopy. Methods: We conducted a systematic literature search for studies that evaluated the correlation between small bowel inflammation and FC in patients with suspected/established Crohn’s disease. We calculated the pooled sensitivity, specificity, and diagnostic odds ratios (DORs) and constructed hierarchical summary receiver operating characteristic curves for FC cutoffs of 50, 100, and 200 μg/g. Results: Fourteen studies were eligible for the final analysis. The DORs of all FC cutoffs were significant. The highest DOR was observed at 100 μg/g (sensitivity, 0.73; specificity, 0.73; and DOR, 7.89) and was suggested as the optimal diagnostic cutoff. If we analyzed only studies that included patients with suspected Crohn’s disease, the DOR was 8.96. If we analyzed only studies that included patients with a Lewis score ≥135 as a diagnostic criterion for active disease, the DOR was 10.90. Conclusions: FC has significant diagnostic accuracy for detecting small bowel inflammation, and an FC cutoff of 100 μg/g can be used as a tool to screen for small bowel Crohn’s disease.