North American Expert Consensus on the Post-procedural Care of Patients After Per-oral Endoscopic Myotomy Using a Delphi Process.

Background & Aims: There is significant variability in the immediate post-operative and long-term management of patients undergoing per-oral endoscopic myotomy (POEM), largely stemming from the lack of high-quality evidence. We aimed to establish a consensus on several important questions on the after care of post-POEM patients through a modified Delphi process.

Methods: A steering committee developed an initial questionnaire consisting of 5 domains (33 statements): post-POEM admission/discharge, indication for immediate post-POEM esophagram, peri-procedural medications and diet resumption, clinic follow-up recommendations, and post-POEM reflux surveillance and management.

Highly Efficient Propyne/Propylene Separation in a "Flexible-Robust" and Hydrolytically Stable Cu(II)-MOF.

Propyne/propylene separation is important in the petrochemical industry but challenging due to their similar physical properties and close molecular sizes. Metal-organic frameworks (MOFs) are a class of promising adsorbents for light hydrocarbon separations. Among them, the so-called "flexible-robust" MOFs combine the advantages of flexibility and rigidity in structure and could show enhanced gas separation selectivity as well as improved gas uptake at low pressure.

Successful Design and Implementation of a POEM Program for Achalasia in an Integrated Healthcare System.

Background: Per Oral Endoscopic Myotomy (POEM) is a minimally invasive treatment for achalasia with results comparable to laparoscopic Heller myotomy (LHM). Studies have described the development of proficiency for endoscopists learning to perform POEM, and societies have defined educational and technical objectives for advanced endoscopy fellows in training. However, there is limited guidance on the organizational strategy and educational plan necessary to develop an achalasia service with POEM expertise.

Oxalactam A, a Novel Macrolactam with Potent Anti- Activity from the Endophytic Fungus .

A novel macrolactam named oxalactam A (), three known dipeptides (-) as well as other known alkaloids (-) were obtained from the endophytic fungus , which was derived from the tuber of (Icacinaceae). All chemical structures were established based on spectroscopic data, chemical methods, ECD calculations, and C-DP4+ analysis. Among them, oxalactam A () is a 16-membered polyenic macrolactam bearing a new skeleton of 2,9-dimethyl-azacyclohexadecane core and exhibited potent anti- activity with a MIC value of 10 μg/mL in vitro.

A New C22-Quassinoid with Anti-Pancreatic Adenocarcinoma Activity from Seeds of Brucea javanica.

An undescribed C22-quassinoid named sergeolide A (1) and fifteen known quassinoids (2-16) were obtained from the seeds of Brucea javanica (Simaroubaceae). All chemical structures were established based on spectroscopic data and X-ray diffraction analysis. Sergeolide A (1) is the first example of a naturally occurring C22-quassinoid bearing a butenolide group fused the A ring of the bruceolide skeleton from Brucea genus.

Glycoproteins as diagnostic and prognostic biomarkers for neurodegenerative diseases: A glycoproteomic approach.

Neurodegenerative diseases (NDs) are incurable and can develop progressively debilitating disorders, including dementia and ataxias. Alzheimer's disease and Parkinson's disease are the most common NDs that mainly affect the elderly people. There is an urgent need to develop new diagnostic tools so that patients can be accurately stratified at an early stage.

Anti-inflammatory property and functional substances of Lonicerae Japonicae Caulis.

Ethnopharmacological Relevance: Lonicerae Japonicae Caulis, the dried stem and branch of Lonicera japonica Thunb., is a Chinese Materia Medica known as Ren Dong Teng in Chinese with long use history in the traditional Chinese medicine (TCM) prescriptions. Lonicerae Japonicae Caulis possesses heat-clearing and detoxifying functions according to the TCM theory.

Hydrophobic Metal-Organic Frameworks: Assessment, Construction, and Diverse Applications.

Tens of thousands of metal-organic frameworks (MOFs) have been developed in the past two decades, and only ≈100 of them have been demonstrated as porous and hydrophobic. These hydrophobic MOFs feature not only a rich structural variety, highly crystalline frameworks, and uniform micropores, but also a low affinity toward water and superior hydrolytic stability, which make them promising adsorbents for diverse applications, including humid CO capture, alcohol/water separation, pollutant removal from air or water, substrate-selective catalysis, energy storage, anticorrosion, and self-cleaning. Herein, the recent research advancements in hydrophobic MOFs are presented.

Copper ions suppress abscisic acid biosynthesis to enhance defence against Phytophthora infestans in potato.

Copper-based antimicrobial compounds are widely and historically used to control plant diseases, such as late blight caused by Phytophthora infestans, which seriously affects the yield and quality of potato. We previously identified that copper ion (Cu ) acts as an extremely sensitive elicitor to induce ethylene (ET)-dependent immunity in Arabidopsis. Here, we found that Cu induces the defence response to P.

Reverse Endoscopic Ultrasound-Guided Gastrojejunostomy for the Treatment of Superior Mesenteric Artery Syndrome: A New Concept.

Superior mesenteric artery syndrome (SMAS) causes compression and partial or complete obstruction of the duodenum, resulting in abdominal pain, nausea, vomiting, and weight loss. If conservative therapy fails, the patient is typically referred for enteral feeding or laparoscopic gastrojejunostomy. The last few years have seen increasing use of endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) for gastric obstruction indications.

Endoscopic Therapy for Pancreatic Fluid Collections: A Definitive Management Using a Dedicated Algorithm.

Background/aims:  Endoscopic ultrasonography (EUS)-guided drainage is the preferred approach for infected or symptomatic pancreatic fluid collections (PFCs). Here, we developed an algorithm for the management of pancreatitis complicated by PFCs and report on its effcacy and safety.

Methods: Between September 2011 and October 2017, patients were prospectively managed according to the algorithm.

O-GlcNAcylation of truncated NAC segment alters peptide-dependent effects on α-synuclein aggregation.

Numerous post-translational modifications (PTMs) of the Parkinson's disease (PD) associated α-synuclein (α-syn) protein have been recognised to play critical roles in disease aetiology. Indeed, dysregulated phosphorylation and proteolysis are thought to modulate α-syn aggregation and disease progression. Among the PTMs, enzymatic glycosylation with N-acetylglucosamine (GlcNAc) onto the protein's hydroxylated amino acid residues is reported to deliver protective effects against its pathogenic processing.

Effects of TAT-SOD at Acupoints on Essential Hypertension by Monitoring Meridians Electrical Potential.

Objectives: To investigate the effect on essential hypertension of the topical application of TAT-Cu, Zn-superoxide dismutase (TAT-SOD) at left acupoint Zusanli (ST 36), and to observe whether the change of electrical potential difference (EPD) can be related to the change of blood pressure.

Methods: Sixteen patients with essential hypertension and 16 healthy subjects were included in the study. EPD between the left acupoints of Yanglingquan (GB 34) and Qiuxu (GB 40) was firstly screened out for the EPD detection.

Advances in the development of imaging probes and aggregation inhibitors for alpha-synuclein.

Abnormal protein aggregation has been linked to many neurodegenerative diseases, including Parkinson's disease (PD). The main pathological hallmark of PD is the formation of Lewy bodies (LBs) and Lewy neurites, both of which contain the presynaptic protein alpha-synuclein (α-syn). Under normal conditions, native α-syn exists in a soluble unfolded state but undergoes misfolding and aggregation into toxic aggregates under pathological conditions.

Reaction duration-dependent formation of two Cu(ii)-MOFs with selective adsorption properties of CH over CH.

The formation of metal-organic frameworks (MOFs) under given reaction conditions depends on various factors including reaction duration, temperature, used solvent, system pH, and others. Among them, the reaction duration is relatively less investigated. In this work, based on a Cu(ii)-MOF system, the reaction duration was found to play an important role in directing the formation of two different products, (NH2(CH3)2)[Cu12(DDPN)6(H2O)10Cl] (BUT-301) on shorter reaction time and (NH2(CH3)2)2[Cu(DDPN)] (BUT-302) on longer reaction time, when CuCl2 reacted with 3,5-di(3,5-dicarboxylphenyl)nitrobenzene (H4DDPN) in a DMA/MeOH mixed solvent at 120 °C.

Constructing new metal-organic frameworks with complicated ligands from "One-Pot" reactions.

Metal-organic frameworks (MOFs) have emerged as one of the most fascinating libraries of porous materials. In spite of their myriad merits, practical application of most MOFs is restricted due to their high preparation cost because of the complicated organic ligands involved. To address this limitation, we propose to use simple and cheap organic precursors to synthesize MOFs with complicated ligands "one-pot" reactions of these precursors along with the formation of new MOFs.

POEM in Latin America: The Rise of a New Standard.

Background: Per-oral endoscopic myotomy (POEM) has become the preferred alternative treatment to standard Heller myotomy for patients with esophageal achalasia, in Latin American countries. The aim of our study was to evaluate the efficacy and safety of a POEM in the management of achalasia with and without Chagas disease in patients receiving POEM.

Methods: Patients who underwent POEM from tertiary centers in Latin America were included in a dedicated registry.

A Stable Zr(IV)-Based Metal-Organic Framework Constructed from C═C Bridged Di-isophthalate Ligand for Sensitive Detection of CrO in Water.

As the CrO anion is highly toxic, new sensors have been developing for its effective detection from water, among which metal-organic frameworks (MOFs) show distinct superiority over many other materials. Herein, a new fluorescent Zr(IV)-based MOF, [ZrO(OH)(HO)(sbtc)] (referred to as BUT-28), based on the di-isophthalate ligand with a central CH═CH moiety, trans-stilbene-3,3',5,5'-tetracarboxylate (sbtc), has been prepared and structurally determined. The MOF shows excellent stability in neutral, highly acidic, and weakly basic aqueous solutions.

Second generation optical coherence tomography: Preliminary experience in pancreatic and biliary strictures.

Introduction: Evaluation of indeterminate biliary strictures remains a diagnostic challenge. Optical coherence tomography (OCT) provides in-vivo, wide-field, cross-sectional imaging at the microstructure level. We present the first preliminary data using a second-generation OCT system using volumetric laser endomicroscopy (VLE) in biliary and pancreatic duct strictures.

EUS-directed Transgastric ERCP (EDGE) Versus Laparoscopy-assisted ERCP (LA-ERCP) for Roux-en-Y Gastric Bypass (RYGB) Anatomy: A Multicenter Early Comparative Experience of Clinical Outcomes.

Background And Aims: The standard of care for managing pancreaticobiliary disease in altered Roux-en-Y gastric bypass patients is laparoscopy-assisted endoscopic retrograde cholangiopancreatography (LA-ERCP), but is limited by cost and adverse events. Recently a minimally invasive, completely endoscopic approach using endoscopic ultrasound (EUS) directed transgastric ERCP (EDGE) has been described. We aim to compare EDGE to LA-ERCP in this study.

Gastric peroral endoscopic myotomy for the treatment of refractory gastroparesis: a multicenter international experience.

Background: Gastroparesis is a difficult-to-treat motility disorder with a poor response to medical therapy. Gastric peroral endoscopic pyloromyotomy (G-POEM) has been offered as a novel therapy in the treatment of refractory gastroparesis. We present a multicenter case series of our experience with G-POEM.

Digital Pancreaticocholangioscopy for Mapping of Pancreaticobiliary Neoplasia: Can We Alter the Surgical Resection Margin?

Introduction: In patients with pancreaticobiliary lesions anticipating surgical resection, digital pancreaticocholangioscopy can be used to identify the extent of disease. This presurgical"mapping" could change the surgical plan and optimize patient care.

Materials And Methods: Patients with pancreaticobiliary lesions anticipating surgery who underwent endoscopic retrograde cholangiopancreatography with digital pancreaticocholangioscopy from 9 international centers were included.