AGA Clinical Practice Guideline on the Management of Pouchitis and Inflammatory Pouch Disorders.

BACKGROUND & AIMS: Pouchitis is the most common complication after restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis. This American Gastroenterological Association (AGA) guideline is intended to support practitioners in the management of pouchitis and inflammatory pouch disorders. METHODS: A multidisciplinary panel of content experts and guideline methodologists used the Grading of Recommendations Assessment, Development and Evaluation framework to prioritize clinical questions, identify patient-centered outcomes, conduct an evidence synthesis, and develop recommendations for the prevention and treatment of pouchitis, Crohn's-like disease of the pouch, and cuffitis. RESULTS: The AGA guideline panel made 9 conditional recommendations. In patients with ulcerative colitis who have undergone ileal pouch-anal anastomosis and experience intermittent symptoms of pouchitis, the AGA suggests using antibiotics for the treatment of pouchitis. In patients who experience recurrent episodes of pouchitis that respond to antibiotics, the AGA suggests using probiotics for the prevention of recurrent pouchitis. In patients who experience recurrent pouchitis that responds to antibiotics but relapses shortly after stopping antibiotics (also known as "chronic antibiotic-dependent pouchitis"), the AGA suggests using chronic antibiotic therapy to prevent recurrent pouchitis; however, in patients who are intolerant to antibiotics or who are concerned about the risks of long-term antibiotic therapy, the AGA suggests using advanced immunosuppressive therapies (eg, biologics and/or oral small molecule drugs) approved for treatment of inflammatory bowel disease. In patients who experience recurrent pouchitis with inadequate response to antibiotics (also known as "chronic antibiotic-refractory pouchitis"), the AGA suggests using advanced immunosuppressive therapies; corticosteroids can also be considered in these patients. In patients who develop symptoms due to Crohn's-like disease of the pouch, the AGA suggests using corticosteroids and advanced immunosuppressive therapies. In patients who experience symptoms due to cuffitis, the AGA suggests using therapies that have been approved for the treatment of ulcerative colitis, starting with topical mesalamine or topical corticosteroids. The panel also proposed key implementation considerations for optimal management of pouchitis and Crohn's-like disease of the pouch and identified several knowledge gaps and areas for future research. CONCLUSIONS: This guideline provides a comprehensive, patient-centered approach to the management of patients with pouchitis and other inflammatory conditions of the pouch.

An investigation of the Excitation Wavelength-Dependent Dynamic Changes in the Mechanism of Detection of Picric Acid using Pyrene-Based Donor-Acceptor Systems.

Picric acid (PA) is an important industrial feedstock and hence the release of industrial effluents without proper remediation results in its buildup in soil and water bodies. The adverse effects of PA accumulation in living beings necessitate the development of efficient methods for its detection and quantification. Herein, we describe pyrene-based fluorescent sensors for PA, where pyrene is appended with electron-withdrawing groups, malononitrile, and 2-(3-cyano-4,5,5-trimethylfuran-2(5H)-ylidene) malononitrile (DCDHF). These molecules displayed the typical emission of pyrene monomers, as well as a broad red-shifted emission resulting from an intramolecular charge transfer (ICT) in the excited state. Both the emissions displayed a turn-off response to PA with high selectivity and sensitivity and the lowest limit of detection was estimated as 27 nM. To prove the feasibility of on-site detection, test paper strips were prepared, which could detect PA up to 4.58 picograms. Using a combination of experimental and theoretical studies the mechanism of the detection was identified as primary/secondary inner filter effect, oxidative photoinduced electron transfer, or a combination of both depending on the excitation wavelength. Interestingly, the contribution of each of these mechanisms to the total quenching process varied with a change in the excitation wavelength.

Beryllium carbonyl Be(CO)n (n = 1-4) complex: a p-orbital analogy of Dewar-Chatt-Duncanson model.

Transition metal-carbonyl bonds are rationalized by M ← CO σ donation and M → CO π back donation where the d orbital of the transition metal is involved. This bonding model provided by Dewar, Chatt and Duncanson (DCD) has rationalized many transition metal-ligand bonds. The involvement of p orbital in such a DCD model can be intriguing. Alkaline earth metals with ns2np0 configuration may appear suitable as ns0np2 excitation has been recognized in many complexes. Herein, a theoretical study is presented for the Be(CO)n (n = 1-4) complex to verify this assumption. Detailed electronic structure analyses confirmed the involvement of the p orbital of beryllium in M → CO π back donation, thereby supporting the hypothesis. EDA-NOCV results reveal that the π-back donation from the central Be atom to CO ligands significantly predominates over the σ donation from the ligands for both Be(CO)3 and Be(CO)4. Our calculations reveal that Be(CO)4 is the highest carbonyl that may be experimentally detected.

Planar Tetracoordinate Hydrogen: Pushing the Limit of Multicentre Bonding.

Among the list of planar tetracoordinate atoms, the smallest element hydrogen is missing. No experimental and theoretical evidence have ever been put forwarded. Herein, we introduce the first planar tetracoordinate hydrogen atom (ptH) in the global minimum geometry of In4 H+ cluster. Bonding analysis indicates that the central hydrogen atom is acting like a proton and significant charge transfer from the surrounding In4 framework results in a negative charge of the central hydrogen atom. The proposed global minimum geometry possesses σ-aromaticity and the central hydrogen atom forms unusual multicentre bond with more than three centres.

Reply to the Comments on Planar Tetracoordinate Hydrogen: Pushing the Limit of Multicentre Bonding.

Recently, Huo et al. has commented on our communication (Angew. Chem. Int. Ed. 2024, 63, e202317312, DOI: 10.1002/anie.202317312), regarding the multireference character (MRC) of our proposed cluster. Their argument is based on small HOMO-LUMO gap, fractional occupation density (FOD) and CASPT2(12,13) calculations. They also proposed that the singlet planar In4H+ cluster cannot be observed. We present our calculations which reveals that some of their arguments are based on wrong interpretation of data and inadequate use of methodology. While we certainly agree with the strong physical ground of FOD, CASSF and CASPT2 methodology, we believe that such analysis for clusters is not adequate.

A Neutral Planar Four-Membered Si2B2 2π-Aromatic Ring.

The synthesis of the first inorganic four-membered neutral 2π-aromatic compound 2 is reported. This unique ring has been synthesized from a simple and straightforward reaction of amidinato-silylene with dichlorophenylborane, followed by the reduction with KC8 in THF. Compound 2 has been fully characterized by single-crystal X-ray diffraction (SC-XRD), NMR spectroscopy, and mass spectrometry. The computational calculations reveal that the Si2B2 ring is a π-delocalized system resulting from the interaction of pπ orbital of B and Si-N σ* orbitals having pseudo π symmetry. Compound 2 is the first known example of a neutral planar inorganic analogue of cyclobutenyl dication.

Inorganic Bergman Cyclization: An Appeal From Theory.

The scope of Bergman cyclization is expanded computationally by exploring the cyclization in inorganic B, N substituted derivative. This substitution has introduced polarity into the transition state, which resulted in dramatic lowering of the activation barrier. Natural charge distribution throughout the reaction profile has ascertained this hypothesis. Single B and N atom substitution at 1 and 6 terminal positions lowers the activation barrier by almost half of the original value which becomes even lower in the complete B, N analogue. The parent Bergman and single B, N substituted products were characterized by significant biradical character while the complete B, N substituted analogue was characterized by significant zwitterionic character. Reduction in electron delocalization is also observed in the complete B, N substituted analogue.

Ultra-high reversible hydrogen storage capacity of the Li4B2 cluster: a quantum chemical study.

Quantum chemical calculations have been carried out to investigate the hydrogen adsorption characteristics of the Li4B2 cluster. Calculations reveal that the cluster can adsorb a maximum of thirteen H2 molecules reaching a considerably high gravimetric density of 34.66 wt%. The nature of the interaction between the H2 molecule and Li center has been investigated within the realm of quantum theory of atoms in molecules which revealed the non-covalent character. The fate of H2 absorption by the cluster has been studied in the course of a 2000 fs time evolution through Born-Oppenheimer molecular dynamics simulations at different temperatures. The outcomes reveal that the H2 molecules are strongly bound at 77 K and get slowly released at elevated temperatures.

Is a transition metal-silicon quadruple bond viable?

Quadruple bonding in heavier main group elements is not known albeit having four valence orbitals accessible for bonding. Here we report the unprecedented quadruple bonding between a silicon atom and a transition metal fragment in the 1A1 electronic ground state of C3v symmetric SiRu(CO)3 based on high level theoretical calculations. Various bonding analyses reveal the nature of the Si[quadruple bond, length as m-dash]Ru quadruple bonding interaction, which involves one usual Si-Ru σ bond, two usual Si-Ru π bonds and one additional Si → Ru dative σ bond.

Boron-boron quadruple bond in Li3B2- and Li4B2 clusters.

Homopolar quadruple bonding in first row p-block elements is expected due to the presence of four valence orbitals accessible for bonding. Although quadruple bonding in C2 has been proposed, no such proposal exists for B2. Here we report the unprecedented B-B quadruple bonding in Li3B2- and Li4B2 clusters based on high level theoretical calculations. The quadruple bonding is omnipresent in the global minimum, its nearest energy isomer and the transition states connecting them. Various bonding analyses reveal the unprecedented nature of the BB quadruple bonding interaction.

Planar Pentacoordinate Nitrogen in a Pseudo-Double-Aromatic NBe5H4+ Cluster.

High-level quantum-chemical calculations have been used to predict a cationic ternary NBe5H4+ cluster containing a planar pentacoordinate nitrogen atom. The proposed cluster has pseudo dual aromaticity and is kinetically and thermodynamically very stable.

Transition metal carbon quadruple bond: viability through single electron transmutation.

Quadruple bonding to main group elements is extremely rare although they have four valence orbitals accessible for bonding. Here we report the unprecedented quadruple bonding between a carbon atom and a transition metal fragment Fe(CO)3 based on high level theoretical calculations. Various bonding analyses reveal the unprecedented nature of the C[quadruple bond, length as m-dash]Fe quadruple bonding interaction. The validity of the single electron transmutation concept has been tested which fruitfully reproduces the structural and bonding similarities between the two neighbours in the periodic table.

Ultra-Weak Metal-Metal Bonding: Is There a Beryllium-Beryllium Triple Bond?

Metal-metal triple bonds featuring s-block element have not been reported until now. Only Be-Be double bonds between have been predicted theoretically based on the intuitive electron donation from four s1 type electron-donating ligands. Herein, we theoretically predicted a novel species featuring a Be-Be triple bond in the Li6 Be2 molecule. The molecule was found to be thermodynamically stable. The presence of the triple bond was confirmed by adaptive natural density partitioning (AdNDP), electron localization function (ELF), and atoms in molecules (AIM) analyses. Moreover, the mechanical strength of the Be-Be triple bond was analyzed by using compliance matrix, pointing towards its ultra-weak nature.

Two New Species of the Genus Coomansinema Ahmad and Jairajpuri, 1989 (Nematoda: Dorylaimida) with a Key to its Species.

Two new species of the genus Coomansinema Ahmad and Jairajpuri, 1989 are described and illustrated. C. japonicum n. sp. is characterized by having medium size body (L= 1.40 - 1.45 mm); lip region truncate with completely amalgamated lips; amphideal fovea goblet - shaped; 16 - 20 µm long odontostyle; 23 - 25 µm long odontophore; comparatively anterior position of the second pair of pharyngeal glands; amphidelphic female genital system; longitudinal vulva; males with 48 - 54 µm long spicules; 7 - 8 spaced ventromedian supplements and tail long filiform in female and short conoid in male. C. longicaudatum n. sp. is characterized by having medium size body (L= 1.1 - 1.3 mm); lip region truncate, continuous with completely amalgamated lips; amphideal fovea cup - shaped; 16 - 17 µm long odontostyle; 19 - 20 µm long odontophore; comparatively anterior position of the second pair of pharyngeal glands; amphidelphic female genital system; transverse vulva, intestinal - prerectum junction with a tongue - like structure and 210 - 269 µm long filiform tail. A key to its seven valid species is provided.

NEW ALIPHATIC ESTER, ß-SITOSTEROL DIGLUCOSIDE AND VESICARIA BIFLAVONES FROM THE SEEDS OF RUMEX VESICARIUS L.

Rumex vesicalius L. (Polygonaceae) is an annual, monoecious, glabrous, pale green herb cultivated as a leafy vegetable in south western Asia and northern Africa. Its seeds are prescribed as a refrigerant, laxa- tive, antidote for scorpion venom and to cure dysentery and liver diseases. Phytochemical investigation of a methanolic extract of the seeds of R. vesicarius resulted in the isolation of a new aliphatic ester n-heptacosanyl n-hexanoate (2), a steroidal diglucoside stigmasta-5-en-3-ol-3-O-ß-D-glucopyranosido-(4--->1")-O-ß-D-glu- copyranoside (3) and two bioflavonoids characterized as (2a,3a-trans)-3a(ß),5a,7a,3'a,4'a-pentahydroxyfla- vanolyl-(8a-2')-5,7,3'-trihydroxy-4'-methoxy-8-n-but-3"-enyl-flavanone (4) and 5,7,3',4',5'-pentahydroxy- 8-(cis-1" α,2"ß-dihydroxyhept-4"-enyl-7"-oic acid)-flavanoyl-(2'--8a)-5a,7a,3'a,5'a-tetrahydroxy-4'a- methoxyflavanone (5) together with stigmasterol (1). The structures of all the isolated phytoconstituents have been established on the basis of spectral data analysis and chemical reactions.

Trophic status and helminth infracommunities of fish populations in Kashmir Himalayan lakes.

The present study considers the influence of the trophic status of three Kashmir Himalayan lakes on the patterns of helminth infracommunities in populations of three species of fish during 2006 to 2008. Data were collected from three lakes of differing trophic status in the Kashmir Himalayas, namely Anchar, a hyper(eu)trophic lake; Dal, a eutrophic lake; and Manasbal, a meso(eu)trophic lake. Three species of fish examined included the native fish Schizothorax niger Heckel and two exotic species--Carassius carassius (Linnaeus) and Cyprinus carpio Linnaeus. The analysis of data showed a clear habitat effect on the abundance pattern of helminth species, thus revealing lake-specific differences in parasite infracommunities of both S. niger and C. carassius. Helminth infracommunity richness was the highest in host populations from the Anchar lake compared to other two lakes. Low values in the Manasbal lake emphasize the low diversity of their helminth infracommunities. On the other hand, there was no observed pattern of community structure in the case of C. carpio in the three lake sites. However due to bias in sampling there was no distinct effect of fish body size on parasite infracommunity structure, although the present results do show that fish parasite data can be meaningful in diagnosing changes in the trophic condition of eutrophic lakes.

Association of Posterior Reversible Encephalopathy Syndrome (PRES) with Preeclampsia with Severe Symptoms and Eclampsia in South East Part of Bangladesh.

Posterior reversible encephalopathy syndrome (PRES) is a pathology seen not only in precelampsia with severe symptoms and eclampsia but in a varicty of diseases/ conditions. With the availability of neuroimaging, it is possible to know the exact underlying Central nervous system (CNS) pathology in preeclampsia with severe symptoms and eclampsia and thus therapy can be targeted. Preeclampsia with severe symptoms and eclampsia remains to be an important cause of maternal morbidity and mortality in both the developing and developed world. The objective of this study was to evaluate the association of Posterior reversible encephalopathy syndrome (PRES) by MRI (Magnetic resonance imaging) with preeclampsia with severe symptoms and eclampsia in south east part of Bangladesh. This cross-sectional observational study was performed among women suffering from preeclampsia with severe symptoms and eclampsia who attended at Obstetrics & Gynaecology department of Chittagong Medical College Hospital (CMCH), Bangladesh from January 2021 to June 2021. According to inclusion/exclusion criteria 50 samples were taken by convenient sampling for this study. A detail history was taken and complete general physical and gynecological examination was performed. Required data was collected through preset questionnaire. Neuroimaging reports were reviewed by both neurologist and radiologist. Data was analyzed by using windows based computer software device, SPSS 25.0. Results obtained from this study will be used to make a statement regarding aggressive management for cerebral vasospasm in severe preeclampsia and eclamptia related PRES. PRES has been reported to be reversible but late recognition or incorrect treatment can cause irreversible brain damage. Institution of early treatment leads to resolution of symptoms without any neurologic deficit and thus reduces maternal morbidity and mortality. PRES is a cliniconeuroradiologic entity. This study can aware doctors regarding prompt diagnosis of PRES in peripartum period among patient suffering from preeclampsia with severe symptoms and eclampsia by imaging aside clinical findings. A conclusive decision can be made to improve the outcome in this potentially life threatening but reversible condition.

Visible Light-Active Ternary Heterojunction Photocatalyst for Efficient CO2 Reduction with Simultaneous Amine Oxidation and Sustainable H2O2 Production.

The present work described a unique approach for CO2 reduction to methanol along with the oxidation of various amines to the corresponding imines and photocatalytic H2O2 production from H2O and molecular O2 using a heterojunction photocatalyst made up of ZnIn2S4/Ni12P5/g-C3N4(NCZ) under visible light irradiation. The photocatalysts were synthesized via a high-temperature treatment of nickel and phosphorous precursors with g-C3N4 followed by decoration of ZnIn2S4. The synthesized photocatalysts were characterized using various spectroscopic and microscopic techniques. The density functional theory (DFT) studies suggested the participation of the valence band maximum (VBM) from Ni12P5 and the conduction band maximum (CBM) from ZnIn2S4 in the ternary NCZ heterojunction. The ternary composite exhibited superior photocatalytic activity compared to that of its individual components due to the formation of a heterojunction, thereby enhancing the transfer efficiency of electrons from the conduction band of g-C3N4 to that of ZnIn2S4 using Ni12P5 as an electron bridge. Moreover, the reduced band gap of the ternary heterojunction played a key role in its higher efficiency.

"Screen and Treat" Approach among VIA Positive Women during Cervical Cancer Screening Program: Experience at Low Resource Setting.

Cancer of the uterine cervix is one of the leading causes of mortality and morbidity among women in poor countries. It is the most common reproductive cancer among women in Bangladesh and most women are diagnosed at advanced stage when appropriate treatment is not possible. But this cancer is preventable through proper screening and simultaneous treatment of premalignant lesions. The same day "Screen and Treat" approach is an endeavour to reach the goal especially at low resource settings. Ablation of precancerous lesions by thermo-coagulation is a promising mode of complete cure as this method is easy to apply, effective and relatively cheaper than other procedures. To avoid the issue of overtreatment, an intermediate approach- colposcopy can be used. Aim of this study was to diagnose premalignant lesions of cervix during screening procedure and to treat the lesions by thermo-coagulation at the same sitting. This prospective study was carried out at Upzilla Health Complex (UHC), Rangunia, from 3rd February 2018 to 6th February 2018 in a campaign of cervical cancer screening program by visual inspection of cervix with 5.00% acetic acid (VIA). About 1000 women attending the outpatient department were enrolled in this study by consecutive sampling technique according to inclusion and exclusion criteria. Informed consent was taken after explaining the screening method, thermo-coagulation procedure and follow up schedule. VIA was found positive in 22 cases. Colposcopy was done in VIA positive cases by Gynocular colposcope. Punch biopsy was taken when colposcopy revealed positive in 12 women. Then thermo-coagulation was done. Histopathology report revealed, CIN1 (cervical intraepithelial neoplasia 1)- in 6 cases (50.00%); CIN 2 (cervical intraepithelial neoplasia 2)- in 01 case (8.33%); Chronic cervicitis with squamous metaplasia- in 05 cases (41.67%). Sensitivity and specificity of colposcopy was calculated considering colposcopy directed biopsy as gold standard, which was 100.00% and 75.00% respectively in CIN-1. While in CIN-2 it was 100.00% and 95.20% respectively. VIA is an effective screening tool for cancer cervix. Main advantage is the "screen and treat" approach can be attempted for at risk women in low resource setting by thermo-coagulation which is accepted by women while guaranteeing satisfactory cure rates. Thus, reduces loss to follow-up and have an impact on cervical cancer control.

Unsupported Donor-Acceptor Complexes of Noble Gases with Group 13 Elements.

Unsupported donor-acceptor complexes of noble gases (Ng) with group 13 elements have been theoretically studied using density functional theory. Calculations reveal that heavier noble gases form thermodynamically stable compounds. The present study reveals that no rigid framework is necessary to stabilize the donor-acceptor complexes. Rather, prepyramidalization at the Lewis acid center may be an interesting alternative to stabilize these complexes. Detailed bonding analyses reveal the formation of two-center-two-electron dative bonding, where Ng atoms act as a donor.