Prediction of post-ESD esophageal stricture by a nomogram and risk factor analysis of ineffective oral steroids prophylaxis.

BACKGROUND AND AIMS: Several risk models for esophageal stricture after endoscopic submucosal dissection have been developed. However, some of them did not include the use of steroids in the risk analysis. Glucocorticoid sensitivity mediated by glucocorticoid receptor expression has not been discussed in this condition. METHODS: Clinical and endoscopic characteristics were included in the logistic regression model to establish a nomogram for stenosis prediction. The score for each risk factor was estimated. Risk factors of ineffective oral steroid prophylaxis were analyzed and glucocorticoid receptor expressions were detected by immunohistochemistry. RESULTS: Three hundred fourteen patients of endoscopic submucosal dissection for esophageal superficial neoplasms were included to develop the nomogram. The circumferential range(≤ 3/4, 3/4-1 or the whole circumference), longitudinal diameter reached 4 cm (yes or not) and lesion location (the cervical and upper thoracic part, the middle thoracic part or the lower thoracic part) consisted of the nomogram. Patients have a high risk of esophageal stricture if they have a total point greater than 36. In the simplified risk score model, the corresponding cutoff score was 1. 92 patients with oral steroid prophylaxis were separately analyzed and the circumferential mucosal defect involving 7/8 or more was an independent risk factor of ineffective prevention (OR 12.2, 95%CI 5.27-28.11). The expression of glucocorticoid receptor ß was higher in the stricture group (p = 0.042 for AOD; p = 0.016 for the scoring system). CONCLUSIONS: We established a nomogram for esophageal stricture prediction. Depending on the characteristics of lesions, it is possible to estimate the risk of stricture under routine post-ESD treatments (no steroids or oral steroids). Alternative treatments should be considered if the risk is extremely high, especially for patients with mucosal defects involving 7/8 or more of circumference in which oral steroid treatment tends to be ineffective. The higher glucocorticoid receptor ß may indicate potential glucocorticoid resistance.

Investigating the Potential of CO2 Nanobubble Systems for Enhanced Oil Recovery in Extra-Low-Permeability Reservoirs.

Carbon Capture, Utilization, and Storage (CCUS) stands as one of the effective means to reduce carbon emissions and serves as a crucial technical pillar for achieving experimental carbon neutrality. CO2-enhanced oil recovery (CO2-EOR) represents the foremost method for CO2 utilization. CO2-EOR represents a favorable technical means of efficiently developing extra-low-permeability reservoirs. Nevertheless, the process known as the direct injection of CO2 is highly susceptible to gas scrambling, which reduces the exposure time and contact area between CO2 and the extra-low-permeability oil matrix, making it challenging to utilize CO2 molecular diffusion effectively. In this paper, a comprehensive study involving the application of a CO2 nanobubble system in extra-low-permeability reservoirs is presented. A modified nano-SiO2 particle with pro-CO2 properties was designed using the Pickering emulsion template method and employed as a CO2 nanobubble stabilizer. The suitability of the CO2 nanobubbles for use in extra-low-permeability reservoirs was evaluated in terms of their temperature resistance, oil resistance, dimensional stability, interfacial properties, and wetting-reversal properties. The enhanced oil recovery (EOR) effect of the CO2 nanobubble system was evaluated through core experiments. The results indicate that the CO2 nanobubble system can suppress the phenomena of channeling and gravity overlap in the formation. Additionally, the system can alter the wettability, thereby improving interfacial activity. Furthermore, the system can reduce the interfacial tension, thus expanding the wave efficiency of the repellent phase fluids. The system can also improve the ability of CO2 to displace the crude oil or water in the pore space. The CO2 nanobubble system can take advantage of its size and high mass transfer efficiency, among other advantages. Injection of the gas into the extra-low-permeability reservoir can be used to block high-gas-capacity channels. The injected gas is forced to enter the low-permeability layer or matrix, with the results of core simulation experiments indicating a recovery rate of 66.28%. Nanobubble technology, the subject of this paper, has significant practical implications for enhancing the efficiency of CO2-EOR and geologic sequestration, as well as providing an environmentally friendly method as part of larger CCUS-EOR.

Time trends and endoscopic management of foreign body ingestion in the upper GI tract: a retrospective analysis of 1,152 cases in China.

OBJECTIVES: foreign body ingestions are encountered in the clinical practice and sometimes require endoscopic management. However, time trends and epidemiology of these cases have not been fully clarified. Whether seasons and festivals have an effect on the occurrence has been poorly described. METHOD: from 2009 to 2020, 1,152 consecutive foreign body ingestion cases were enrolled in our endoscopic center. Case records were reviewed for demographic data, foreign body type and location, outpatient or hospitalization, adverse events and dates. Annual time trends and seasonal variation were analyzed as well as the influence of Chinese legal festivals on the incidence. The impact of SARS-CoV-2 pandemic on the potential delay for clinical consultation of these cases was preliminarily explored. Clinical features of these cases were demonstrated. RESULTS: the overall success rate was 99.7 % and the adverse events rate was 2.4 %. There was an uptrend in the annual frequency of food foreign body ingestion endoscopic extraction from 0.65 in 2009 to 8.86 in 2020 per 1,000 esophagogastroduodenoscopy patients (r = 0.902, p < 0.001). Furthermore, the frequency of endoscopic extraction significantly increased in winter (p < 0.001) and during Chinese New Year celebratory season (p = 0.003). The duration of hospitalization may be longer in the pandemic period (p = 0.0049). CONCLUSION: considering the uptrend of the annual frequency of food related foreign body endoscopic extraction, the publicity about the danger of foreign body ingestion should be enhanced. Arrangement of endoscopic physicians and assistants during the high-incidence season should be emphasized.

A Multidimensional Topotactic Host Composite Anode Toward Transparent Flexible Potassium-Ion Microcapacitors.

Transparent flexible supercapacitors (TFSCs) are a tantalizing power supplier for future transparent flexible electronics. However, their energy density is far behind a practical level while maintaining high transparency. We report here a transparent flexible potassium-ion microcapacitor, and its high energy density (15.5 µWh cm-2) roots in the battery-supercapacitor hybrid storage mechanism and much enlarged working voltage (3 V), outperforming the state-of-the-art TFSC, which is generally based on an aqueous electrolyte and an asymmetric pseudocapacitive mechanism. From an electrode material perspective, a multidimensional topotactic host composite anode is designed in which the component not only performs energy storage by synchronous and reversible uptake of potassium ions and electrons into its host structure, but also mutually compensates individual weakness in functional and structural aspects, efficiently constructing a three-dimensional potassium-ion diffusion and electron transport system. This conceptual exhibition provides design principles at material and device levels for high-performance TFSCs.

Disseminated tuberculosis mimicking abdominal metastatic carcinoma: A case report.

RATIONALE: Extra-pulmonary tuberculosis (TB) has long been a diagnostic challenge for clinicians, often requiring extensive workup and invasive procedures, with the risk of significant complications. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a minimally invasive and highly accurate diagnostic modality for the evaluation of mediastinal and abdominal lymphadenopathy and masses. Several reports on the utility of EUS-FNA as a favorable method for diagnosing extrapulmonary TB have been published. PATIENT CONCERNS: A 54-year-old man complained of intermittent melena. DIAGNOSES: 18 fluorine-fluorodeoxyglucose positron emission tomography/computed tomography revealed suspected carcinoma metastasis. EUS-FNA did not reveal any evidence of malignancy. INTERVENTIONS AND OUTCOMES: Laparoscopy was performed, and frozen section pathology during surgery showed granulomas with focal necrosis. Mycobacterium tuberculosis polymerase chain reaction was positive, but acid-fast bacilli staining was negative. Anti-TB treatment was initiated, and the patient was advised to visit the local TB dispensary regularly. LESSONS: The presence of atypical inflammation of inadequate material or non-representative samples of extra-pulmonary TB was observed on EUS-FNA cytology. Mycobacterium tuberculosis polymerase chain reaction and acid fast bacilli should be performed to diagnose TB because of its higher sensitivity.

2D Sandwiched Nano Heterostructures Endow MoSe2 /TiO2- x /Graphene with High Rate and Durability for Sodium Ion Capacitor and Its Solid Electrolyte Interphase Dependent Sodiation/Desodiation Mechanism.

Nano heterostructures relying on their versatile construction and the breadth of combined functionality have shown great potential in energy storage fields. Herein, 2D sandwiched MoSe2 /TiO2- x /graphene nano heterostructures are designed by integrating structural and functional effects of each component, aiming to address the rate capability and cyclic stability of MoSe2 for sodium ion capacitors (SICs). These 2D nano heterostructures based on graphene platform can facilitate the interfacial electron transport, giving rise to fast reaction kinetics. Meanwhile, the 2D open structure induces a large extent of surface capacitive contribution, eventually leading to a high rate capability (415.2 mAh g-1 @ 5 A g-1 ). An ultrathin oxygen deficient TiO2- x layer sandwiched in these nano heterostructures provides a strong chemical-anchoring regarding the products generated during the sodiation/desodiation process, securing the entire cyclic stability. The associated sodiation/desodiation mechanism is revealed by operando and ex situ characterizations, which exhibits a strong solid electrolyte interphase (SEI) dependence. The simulations verify the dependent sodiation products and enhanced heterostructural chemical-anchoring. Assembled SICs based on these nano heterostructures anode exhibit high initial Coulombic efficiency, energy/power densities, and long cycle life, shedding new light on the design of nano heterostructure electrodes for high performance energy storage application.

Three-Dimensional Topotactic Host Structure-Secured Ultrastable VP-CNO Composite Anodes for Long Lifespan Lithium- and Sodium-Ion Capacitors.

Performance degradation of lithium/sodium-ion capacitors (LICs/SICs) mainly originates from anode pulverization, particularly the alloying and conversion types, and has spurred research for alternatives with an insertion mechanism. Three-dimensional (3D) topotactic host materials remain much unexplored compared to two-dimensional (2D) ones (graphite, etc.). Herein, vanadium monophosphide (VP) is designed as a 3D topotactic host anode. Ex situ electrochemical characterizations reveal that there are no phase changes during (de)intercalation, which follows the topotactic intercalation mechanism. Computational simulations also confirm the metallic feature and topotactic structure of VP with a spacious interstitial position for the accommodation of guest species. To boost the electrochemical performance, carbon nano-onions (CNOs) are coupled with 3D VP. Superior specific capacity and rate capability of VP-CNOs vs lithium/sodium can be delivered due to the fast ion diffusion nature. An exceptional capacity retention of above 86% is maintained after 20 000 cycles, benefitting from the topotactic intercalation process. The optimized LICs/SICs exhibit high energy/power densities and an ultrastable lifespan of 20 000 cycles, which outperform most of the state-of-the-art LICs and SICs, demonstrating the potential of VP-CNOs as insertion anodes. This exploration would draw attention with regard to insertion anodes with 3D topotactic host topology and provide new insights into anode selection for LICs/SICs.

Excellent Fog-Droplets Collector via Integrative Janus Membrane and Conical Spine with Micro/Nanostructures.

Inspired by a cactus spine and trichomes integrated fog collection system, a strategy is presented to design a micro/nanostructured conical spine and Janus membrane integrative system (MNCS+JM). In this strategy, the surface of conical spine can be covered with rough micro and nanostructure (MNCS), so that the tiny fog-droplets can be captured, coalesced, and transported. Janus membrane (JM) with inside hydrophobic surface and outside hydrophilic surface is further used to control the water collection in process of droplet transport when the Janus membrane is vertically placed with different positions on the MNCS, thus MNCS+JM propel the droplet continuously for transport-coalescence-transport in a circle of droplet transport and collection. It is demonstrated that a higher fog collection rate can be achieved effectively, which is attributed to a cooperation effect between the Laplace pressure in difference and the released surface energy in droplet coalescence, in addition to wettability force of superhydrophobic-hydrophilic difference in the Janus membrane. This strategy of MNCS+JM offers an insight into the surface of materials to control the droplet transport for water collection in efficiency, which is significant to be extended into the realms of applications such as high-efficiency water collection systems, microfluidics devices, and others.

High-Efficiency Fog Collector: Water Unidirectional Transport on Heterogeneous Rough Conical Wires.

An artificial periodic roughness-gradient conical copper wire (PCCW) can be fabricated by inspiration from cactus spines and wet spider silks. PCCW can harvest fog on periodic points of the conical surface from air and transports the drops for a long distance without external force, which is attributed to dynamic as-released energy generated from drop deformation in drop coalescence, in addition to both gradients of geometric curve (inducing Laplace pressure) and periodic roughness (inducing surface energy difference). It is found that the ability of fog collection can be related to various tilt-angle wires, thus a fog collector with an array system of PCCWs is further designed to achieve a continuous process of efficient water collection. As a result, the effect of water collection on PCCWs is better than previous results. These findings are significant to develop and design materials with water collection and water transport for promising application in fogwater systems to ease the water crisis.

Controlled Smart Anisotropic Unidirectional Spreading of Droplet on a Fibrous Surface.

Smart anisotropic-unidirectional spreading is displayed on a wettable-gradient-aligned fibrous surface due to a synergetic directing effect from the aligned structure and the ratio of hydrophilic components.

Dynamic Magnetic Responsive Wall Array with Droplet Shedding-off Properties.

Directional control of droplets on a surface is an important issue for tasks of long-range liquid-transport, self-cleaning and water repellency. However, it is still challenging to control the structure motions in orientations so as to control the shedding-off of droplets. Herein, we report a novel dynamic magnetic responsive wall (DMRW) array on PDMS (polydimethylsiloxane)-based surface. The walls can easily tilt through the effect of the external magnet because of the magnetic material in the DMRW. The droplets can be shed off directionally on the surface. Particularly, with the shape recovery and flexible properties, it achieves simultaneous control of the tilt angles (0-60°) of DMRW for shedding-off of droplets with different volumes (1-15 µL) under magnetic action on DMRW. The mechanism of droplet shedding-off on DMRW is elucidated by theory of interfaces. It offers an insight into design of dynamic interface for water repellency. This strategy realizes the preparation of multifunctional, tunable and directional drive functions.

Bioinspired heterostructured bead-on-string fibers via controlling the wet-assembly of nanoparticles.

A kind of bioinspired heterostructured bead-on-string fiber (BHBF), composed of poly-(methyl methacrylate) (PMMA) and titanium tetrachloride (TiCl4) hydrolyzed nanoparticles, was prepared via integrating a wet-assembly system, including PMMA electrospinning, fog of nanoparticles and water coalescence at multi-stages. The wet-assembly of BHBF was regulated by the difference in surface energy and Laplace pressure. Especially, BHBF is characteristic of a hydrophilic rough bead for excellent water collection ability.