Diagnostic Performance of Ultrasonography for Identification of Small Bowel Obstruction; a Systematic Review and Meta-analysis.

Introduction: Small bowel obstruction (SBO) is known as a common cause of acute abdominal complaints in the emergency department (ED). The modality of choice for the diagnosis of SBO has not yet been established. This systematic review and meta-analysis aimed to investigate the accuracy of ultrasonography for the diagnosis of SBO. Methods: Systematic search was performed on five electronic databases including Medline, Scopus, Web of Sciences, Embase, and Cochrane Library, and the retrieval period was from the inception of each database to November 2023. The quality of the included studies were investigated using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). The pooled values of diagnostic characteristics for ultrasonography were estimated using meta-Disc and Stata statistical software. Results: Twenty-one studies with a total of 1977 patients were included in the meta-analysis. The pooled estimate for sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary ROC curve of ultrasonography for diagnosing SBO were 0.93 (95% CI: 0.91-0.95), 0.8 (95% CI: 0.77-0.83), 5.69 (95% CI: 3.64-8.89), 0.1 (95% CI: 0.07-0.16), 83.51 (95% CI: 18.12-182.91) and 0.96, respectively. Conclusion: The findings of this meta-analysis showed that the utilization of ultrasonography holds promise as a diagnostic imaging for SBO with high accuracy. However, additional worldwide studies are essential to get more evidence on the value of ultrasonography for the diagnosis of SBO.

Cellulose/chitosan pH-responsive indicator incorporated with carrot anthocyanins for intelligent food packaging.

In this study, the possible use of anthocyanins of black carrot (ABC) as a chemo-responsive dye to fabricate a colorimetric pH indicator in a cellulose-chitosan matrix was investigated in order to the monitoring of spoilage in pasteurized milk. Cellulose paper was impregnated with a chitosan solution prepared by a sol-gel method containing ABC (total anthocyanins content of 10 mg/100 mL) and characterized. The swelling and water solubility increased by incorporation of ABC into the chitosan-cellulose film. The colorimetric pH indicator showed an obvious color variation from pink to khaki at different pH values (pH 2-11). Stability tests revealed that the indicator had acceptable color stability during one-month storage at 20 °C. The results also confirmed the immobilization of ABC into the matrix of the polymeric indicator with no significant effect on the chemical and super-molecular structure of the samples. In food trial, fresh pasteurized milk was entirely discerned through a perceptible color change from blue to violet rose color after 48 h storage at 20 °C, which was comfortably observable by the naked eye. The results proved that the fabricated indicator could be used as food grade biomaterials to monitor freshness/spoilage of milk.