Water exchange-assisted versus carbon dioxide-insufflated single-balloon enteroscopy: a randomized controlled trial.

BACKGROUND: Single-balloon enteroscopy (SBE) is a valuable but difficult modality for the diagnosis and treatment of small-bowel disease. The water exchange method has the advantage of facilitating intubation during colonoscopy. Here, we evaluated the effects of water exchange on procedure-related variables related to SBE. METHODS: This randomized controlled trial was conducted in a tertiary-care referral center in China. Patients due for attempted total enteroscopy were randomly allocated to undergo water exchange-assisted (water exchange group) or carbon dioxide-insufflated enteroscopy (CO2 group). All patients were planned to undergo both anterograde and retrograde procedures. The primary outcome was the total enteroscopy rate. Secondary outcomes included the maximal insertion depth, positive findings, procedural time, and adverse events. RESULTS: In total, 110 patients were enrolled, with 55 in each group. Baseline characteristics between the two groups were comparable. Total enteroscopy was achieved in 58.2 % (32/55) of the water exchange group and 36.4 % (20/55) of the control group (P = 0.02). The mean (standard deviation) estimated intubation depth was 521.2 (101.4) cm in the water exchange group and 481.6 (95.2) cm in the CO2 group (P = 0.04). The insertion time was prolonged in the water exchange group compared with the CO2 group (178.9 [45.1] minutes vs. 154.2 [27.6] minutes; P < 0.001). Endoscopic findings and adverse events were comparable between the two groups. CONCLUSIONS: The water exchange method improved the total enteroscopy rate and increased the intubation depth during SBE. The use of water exchange did not increase the complications of enteroscopy.

Hyaluronic Acid Compound Filling Plus Mesotherapy vs Botulinum Toxin A for the Treatment of Horizontal Neck Lines: A Multicenter, Randomized, Evaluator-Blinded, Prospective Study in Chinese Subjects.

BACKGROUND: Although energy devices and botulinum toxin A (BTX-A) can alleviate age-related laxity, ptosis, and platysmal bands, they have limited efficacy on horizontal neck lines. OBJECTIVES: The purpose of this study was to investigate the efficacy, safety, and subject satisfaction of a combined treatment of non-cross-linked hyaluronic acid (HA) compound filling plus mesotherapy for the correction of horizontal neck lines, in comparison with BTX-A. METHODS: This multicenter, randomized, evaluator-blinded, prospective study enrolled female patients with moderate-to-severe horizontal neck lines corrected with either 2 or 3 sessions of of non-cross-linked HA compound filling plus mesotherapy or 1 session of BTX-A injection. Improvement of the neck lines grades, Global Aesthetic Improvement Scale (GAIS), patient satisfaction, and adverse events (AEs) were evaluated and compared at 1, 3, 6, and 10 months after the final treatment. RESULTS: Twenty-five patients received HA filling plus mesotherapy and 23 received BTX-A injection. Compared with BTX-A, the HA compound filling plus mesotherapy significantly improved the horizontal neck lines grades on all follow-up visits (P = 0.000). Cases of different baseline grades (2, 2.5, and 3) demonstrated similar outcomes. The GAIS and patients' satisfaction ratings were significantly higher for the HA filling plus mesotherapy treatment group (P = 0.000). Significantly higher pain ratings, higher incidence, and longer recovery of AEs (erythema, edema, and ecchymosis) were noticed in the combined treatment group (P < 0.001). No serious AEs occurred. CONCLUSIONS: Compared with BTX-A, combined treatment with HA compound filling plus mesotherapy significantly improved moderate-to-severe horizontal neck lines and achieved a high level of patient satisfaction.

How Do Tourists' Value Perceptions of Food Experiences Influence Their Perceived Destination Image and Revisit Intention? A Moderated Mediation Model.

The food experience is an important part of the tourism experience. Although it is crucial to comprehend the significance of tourists' perception of food experiences, there is a scarcity of research investigating the impact of tasting local food on tourists' perceptions and behaviors. This study employs structural equation modeling to empirically examine the relationship between tourists' value perceptions of food experiences, their perceived destination image, and their revisit intention. In addition, the moderating effects of tourists' genders on the aforementioned relationships are also explored. A renowned restaurant brand, Nanjing Impressions, which specializes in offering the unique cuisine of the city of Nanjing, China, is chosen as the research case. A grand total of 500 questionnaires were distributed, and, out of these, 458 questionnaires were deemed legitimate and kept for further analysis. The results indicate that the functional, social, emotional, cultural, and health values of local food experienced by tourists have significant positive impacts on their perceived destination image and revisit intention. Moreover, perceived destination image partially mediates the relationships between tourists' value perceptions of food experiences and their revisit intention. Gender is found to partially moderate the relationships between the proposed constructs. The current study offers noteworthy theoretical contributions and provides valuable practical suggestions for tourism destination managers.

Recent advances in edible insect processing technologies.

Alternative foods have emerged as one of the hot research topics aiming at alleviating food shortage. Insects are one of the alternative foods due to their rich nutrients. Processing is a critical step to develop insect foods, while there is a lack of comprehensive reviews to summarize the main studies. This review aims to demonstrate different processing methods in terms of their impact on insect nutrition and their potential risks. Heat treatments such as boiling and blanching show a negative effect on insect nutrition, but essential to assure food safety. Insects treated by high-pressure hydrostatic technology (HPP) and cold atmospheric pressure plasma (CAPP) can achieve a similar sterilization effect but retain the nutritional and sensory properties. Drying is a practical processing method for industrial insect production, where oven drying serves as a cost-effective method yielding products comparable in quality to freeze-dried ones. In terms of extraction technology, supercritical carbon dioxide and ultrasound-assisted technology can improve the extraction efficiency of proteins and lipids from insects, enhance the production of composite insect-fortified foods, and thus facilitate the development of the insect food industry. To address the widespread negative perceptions and low acceptance towards insect foods among consumers, the primary development direction of the insect food industry may involve creating composite fortified foods and extracting insect-based food components.