Abstract Background & aims Helicobacter pylori infection is increasingly difficult to treat. The purpose of these consensus statements is to review the literature and provide specific, updated ...recommendations for eradication therapy in adults. Methods A systematic literature search identified studies on H. pylori treatment. The quality of evidence and strength of recommendations were rated according to the Grading of Recommendation Assessment, Development, and Evaluation (GRADE) approach. Statements were developed through an online platform, finalized and voted on by an international working group of specialists chosen by the Canadian Association of Gastroenterology. Results Because of increasing failure of therapy, the consensus group strongly recommended that all H. pylori eradication regimens now be given for 14 days. Recommended first-line strategies include concomitant non-bismuth quadruple therapy (proton pump inhibitor, PPI + amoxicillin + metronidazole + clarithromycin, PAMC), and traditional bismuth quadruple therapy (PPI + bismuth + metronidazole + tetracycline, PBMT). PPI triple therapy (PPI + clarithromycin and either amoxicillin or metronidazole) was restricted to areas with known low clarithromycin resistance or high eradication success with these regimens. Recommended rescue therapies include PBMT and levofloxacin-containing therapy (PPI + amoxicillin + levofloxacin, PAL). Rifabutin regimens should be restricted to patients who fail at least 3 prior options. Conclusions Optimal treatment of H. pylori requires careful attention to local antibiotic resistance and eradication patterns. Quadruple therapies PAMC or PBMT should play a more prominent role in H. pylori eradication and all treatments should be given for 14 days.
Purpose The purpose of this study was to determine the frequency of lateral hinge fractures after opening-wedge high tibial osteotomy and investigate the patterns of fracture and their clinical ...outcome. Methods We analyzed 104 knees in 93 patients with a mean age of 68 ± 7 years. Of the knees, 74 were diagnosed as having primary osteoarthritis and 30 with osteonecrosis. The mean follow-up period was 41 months. Lateral hinge fractures were classified as follows: type I, the fracture reaches just proximal to or within the tibiofibular joint; type II, the fracture reaches the distal portion of the proximal tibiofibular joint; and type III, a lateral plateau fracture. A standard postoperative rehabilitation protocol was used for type I fractures, 3 of 5 patients with type II fractures were treated with non–weight bearing, and type III fractures were treated with non–weight bearing until visible callus formation. Results The Knee Society scores for the knee and for function showed improvement from 49 ± 11 to 91 ± 7.7 points and from 62 ± 13 to 95 ± 8.2 points, respectively. Lateral cortex fractures were observed in 26 knees (25%): 19 type I, 5 type II, and 2 type III. In the type II fracture group, 2 of 5 patients were judged to have a delayed bone union. There were 2 cases of infection (2%) and 1 case of traumatic neuroma (1%) but no instances of implant failure, nonunion, or deep vein thrombosis among our patient cohort. Conclusions High tibial osteotomy patients treated with a combination of TomoFix (Synthes, Bettlach, Switzerland) and bone substitute were able to walk with full weight bearing 2 weeks after surgery. No complications were seen in 19 patients with type I fractures. Of 5 patients with type II fractures, 2 had delayed unions with a correction loss of 3° and 7°, respectively. Level of Evidence Level IV, therapeutic case series.
Abstract
We report a proof-of-concept demonstration of the anomalous Nernst thermopile driven by solar heating and radiative cooling. The anomalous Nernst thermopile proposed here consists of a ...zigzag-shaped single magnetic material without any junction structures and black ink-coated alternately on the wires arranged in the zigzag configuration. The voltage generated from this structure increases by an order of magnitude compared to an uncoated structure under the condition with solar heating and radiative cooling, which can further be enhanced by increasing the number of wires. This device concept paves the way for outdoor thermoelectric applications based on the anomalous Nernst effect.
Probiotic formulations of single species of bacteria have not been effective in preventing the recurrence of Crohn's disease after surgery. We investigated the ability of VSL#3, a mixture of 8 ...different bacterial probiotic species, to prevent Crohn's disease recurrence after surgery in a multicenter, randomized, double-blind, placebo-controlled trial.
Within 30 days of ileocolonic resection and re-anastomosis, patients with Crohn's disease were randomly assigned to groups given 1 sachet of VSL#3 (900 billion viable bacteria, comprising 4 strains of Lactobacillus, 3 strains of Bifidobacterium, and 1 strain of Streptococcus salivarius subspecies thermophilus) (n = 59) or matching placebo (n = 60). Colonoscopy was performed at days 90 and 365 to evaluate the neoterminal ileum for disease recurrence and obtain mucosal biopsies for cytokine analysis. Patients from both groups with either no or mild endoscopic recurrence at day 90 received VSL#3 until day 365. The primary outcome was the proportion of patients with severe endoscopic recurrence at day 90.
At day 90, the proportion of patients with severe endoscopic lesions did not differ significantly between VSL#3 (9.3%) and placebo (15.7%, P = .19). The proportions of patients with non-severe lesions at day 90 who had severe endoscopic recurrence at day 365 were 10.0% in the early VSL#3 group (given VSL#3 for the entire 365 days) and 26.7% in the late VSL#3 group (given VSL#3 from days 90 through 365) (P = .09). Aggregate rates of severe recurrence (on days 90 and 365) were not statistically different, 20.5% of subjects in the early VSL#3 group and 42.1% in the late VSL#3 group. Patients receiving VSL#3 had reduced mucosal inflammatory cytokine levels compared with placebo at day 90 (P < .05). Crohn's disease activity index and inflammatory bowel disease quality of life scores were similar in the 2 groups.
There were no statistical differences in endoscopic recurrence rates at day 90 between patients who received VSL#3 and patients who received placebo. Lower mucosal levels of inflammatory cytokines and a lower rate of recurrence among patients who received early VSL#3 (for the entire 365 days) indicate that this probiotic should be further investigated for prevention of Crohn's disease recurrence. Clinical trials.gov number: NCT00175292.
Chrysanthemum stunt viroid (CSVd) is a disease agent caused by a viroid from the genus Pospiviroid. The CSVd pathogen infects chrysanthemum plants and causes severe symptoms of stunting and ...significant yield loss in cultivation. Although many studies have focussed on this issue, the mechanism of CSVd‐infection remains to be clarified. In particular, the effects of CSVd on the underground parts of infected plants are not yet fully understood in Chrysanthemum. Here, we investigated whether the effects of CSVd on the root formation of infected plants varies among cultivars and wild Chrysanthemum species, C. morifolium and C. seticuspe, using transcribed RNA and in vitro assays. Furthermore, to compare infected plants with uninoculated plants, we assessed the symptoms and measured the CSVd RNA accumulation levels in several tissues using RT‐qPCR. Our findings indicated that CSVd‐infected plants exhibited severe root formation symptoms in both C. morifolium and C. seticuspe. RT‐qPCR revealed CSVd accumulation in the root tips and similar patterns of CSVd accumulation in each organ of C. morifolium and C. seticuspe. We propose that in vitro assays are useful for determining root formation in CSVd‐infected chrysanthemum plants. Such investigations are necessary to better understand CSVd infection in Chrysanthemum species and plant defences against such diseases.
Syrphid larvae are well-known predators of aphids; however, we sometimes observed them on onion plants with thrips and without any aphids, which intercropped with barley in our previous study. ...Therefore, we hypothesized that syrphid larvae fed on thrips in the onion field in the absence of aphids, their main prey. This hypothesis was tested by analyzing the prey DNA from syrphid larvae collected from onion plants intercropped with barley. We found that they preyed on three thrips species:
Thrips tabaci
(Lindeman),
Frankliniella occidentalis
(Pergande), and
Anaphothrips obscurus
(Müller). Moreover, we observed that syrphid larvae collected from onion plants fed on larval
T. tabaci
in a laboratory setting. According to
COI
sequencing of their genomes, the syrphid species occurred from the onion plants were
Sphaerophoria macrogaster
(Thomson),
Melanostoma scalare
(Fabricius),
Melanostoma mellinum
(L.), and
Platycheirus pennipes
(Ohara); all of them were found to prey on thrips in the prey DNA analyses. These results and observations supported the hypothesis and suggested that intercropping barley as a living mulch may become an option for enhancing the potential of native syrphid species as generalist predators in the onion fields.
We demonstrated the effectiveness of the machine learning method combined with first-principles calculations for the enhancement of the anomalous Nernst effect (ANE) of multilayers. The composition ...ratio of CoNi homogeneous alloy superlattices was optimized by Bayesian optimization so as to maximize the transverse thermoelectric conductivity (αxy). The nonintuitive optimal composition with a large αxy of ∼10 A K−1 m−1 was identified through the two-step Bayesian optimization using rough and fine candidate pools. The Berry curvature and band dispersion analyses revealed that αxy is enhanced by the appearance of the flat band near the Fermi level due to the multilayer formation. The magnitude of the energy derivative of the anomalous Hall conductivity increases owing to the large Berry curvature near the flat band along the R-M high symmetry line, which emerges only in the optimized superlattice, leading to the αxy enhancement. The effective method verified here will broaden the choices of ANE materials to more complex systems and, therefore, lead to the development of transverse thermoelectric conversion technologies.
The main purpose of this article is to study the Caffarelli-Kohn-Nirenberg type inequalities (1.2) with p = 1. We show that symmetry breaking of the best constants occurs provided that a parameter ...absolute value of (gamma) is large enough. In the argument we effectively employ equivalence between the Caffarelli-Kohn-Nirenberg type inequalities with p = 1 and the isoperimetric inequalities with weights. Key words: CKN-type inequality; symmetry break; weighted Hardy-Sobolev inequality; best constant.
The purpose of this study was to clarify the aim and problems of a “club activity activation project” involving professional coaches from corporations who have been employed for extracurricular ...sports activities (ESA) at public junior high schools in Suginami City, Tokyo. The study conducted expert interviews in 2019 with three people, including an official of the city administration, as well as a staff member and an instructor at a private sports company in Tokyo. As results of this research, the study clarified the following points : Suginami City instituted this project in 2013 using its budget. Suginami City uses professional coaches for ESA that were earlier supervised by teachers with no experience in playing sports, as their expertise was in subjects other than physical education. The purpose of the “club activity activation project” is to allow students to enjoy the experience of club activities, and also to reduce the burden on teachers. However, the project is facing difficulties in finding coaches for individual sports such as soft tennis. The project to revitalize ESA was initiated so that private sector instructors could rectify the unequal situation in which club activities were not feasible.
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