Title: Perioperative Optimization With Nutritional Supplements in Patients Undergoing

Gastrointestinal Surgery for Cancer (PROGRESS): Protocol for a Feasibility Randomized

Controlled Trial
Author: Gunther Eysenbach
Discussion and Summary: The primary objective of our trial is to determine the proportion of
eligible patients randomized in an 18-month period. The primary feasibility outcome will be to
(1) stop, main study not feasible: estimated proportion of randomized patients <40.0% (40/100);
(2) continue with protocol modifications: estimated proportion of randomized patients 40.0%
(40/100) to 59.0% (50/100); or (3) continue without modification: estimated proportion of
randomized patients ≥60.0% (60/100). The secondary objectives are to evaluate compliance
with the nutritional supplements and to estimate differences in postoperative complications,
global health-related quality of life (QoL), and median length of hospital stay between the
groups. This is a randomized, placebo-controlled, double-blind feasibility study. Patients must
have a resectable gastrointestinal cancer for which an elective procedure is planned in order to
be eligible. Three nutritional supplements and a liquid diet are included in the intervention.
Carbohydrate loading helps to reduce the stress from surgery by decreasing insulin
resistance.The results will help to determine the feasibility of a larger randomized controlled
trial to implement a perioperative nutritional supplement program for patients undergoing
gastrointestinal surgery for cancer.

What are the significant contributions of the researches in the field of medicine and nursing?
This will help the nurses with the optimization of nutritional supplement in patients undergoing
gastrointestinal surgery for cancer. This will help in providing nursing intervention especially
taking care of the patient who has undergone surgery.

Title: Automated Diagnosis of Various Gastrointestinal Lesions Using a Deep Learning-Based

Classification and Retrieval Framework With a Large Endoscopic Database: Model Development
and Validation
Authors: Muhammad Owais, Muhammad Arsalan, Tahir Mahmood, Jin Kyu Kang, Kang Ryoung
Park.
Discussion and Summary: Early detection of different gastrointestinal illnesses can lead to
efficient treatment and lower the risk of several potentially fatal conditions.In previous studies,
various deep learning-based computer-aided diagnosis tools have been used to make a
significant contribution to the effective diagnosis and treatment of gastrointestinal diseases.
However, most of these methods were designed to detect a limited number of gastrointestinal
diseases, such as polyps, tumors, or cancers, in a specific part of the human gastrointestinal
tract. The goal of this study is to create a complete computer-aided diagnosis tool to help
doctors diagnose various gastrointestinal illnesses. A deep learning-based classification
network is followed by a retrieval approach in our proposed framework. The classification
network predicts the illness type for the current medical state in the first stage. The framework's
retrieval section then displays relevant cases (endoscopic images) from the preceding
database. These past cases help the medical expert validate the current computer prediction
subjectively, which ultimately results in better diagnosis and treatment.The ideal accuracy, F1
score, mean average precision, and mean average recall attained by our suggested method were
96.19 percent, 96.99 percent, 98.18 percent, and 95.86 percent, respectively. Our proposed
diagnostic framework outperformed state-of-the-art procedures in terms of overall
performance.

What are the significant contributions of the researches in the field of medicine and nursing?
This research establishes a complete computer-aided diagnosis system for detecting various
gastrointestinal illnesses. The results show the superiority of our proposed method over various
other recent methods and illustrate its potential for clinical diagnosis and treatment. Our
proposed network can be applicable to other classification domains in medical imaging, such as
computed tomography scans, magnetic resonance imaging, and ultrasound sequences.

Title: Perspectives of Inpatients With Cirrhosis and Caregivers on Using Health Information
Technology: Cross-sectional Multicenter Study

Authors :Chathur Acharya , Tejasav S Sehrawat , Deborah B McGuire , Jawaid Shaw , Andrew
Fagan , Sara McGeorge , Amy Olofson , Melanie B White , Edith Gavis , Patrick S Kamath , Lori
Bergstrom , Jasmohan Singh Bajaj
Discussion and Summary: The goal of this study was to find out how patient-caregiver dyads
felt about adopting or refusing health IT solutions.In Patients with cirrhosis and their caregivers
were approached to participate in a randomized health IT intervention trial requiring daily
contact with research teams via the Patient Buddy app. Regression analysis for
acceptance-related factors were conducted. A semistructured interview was conducted with
individuals who declined, with topics focusing on caregivers, protocol, transportation/logistics,
technology demands, and privacy. A total of 349 patient-caregiver dyads were approached (191
from Virginia Commonwealth University, 56 from Richmond Veterans Affairs Medical Center,
and 102 from Mayo Clinic), 87 of which (25%) agreed to participate. On regression, dyads
agreeing included a male patient (odds ratio [OR] 2.08, P=.01), gastrointestinal bleeding (OR 2.3,
P=.006), or hepatic encephalopathy admission (OR 2.0, P=.01), whereas opioid use (OR 0.46,
P=.03) and alcohol-related etiology (OR 0.54, P=.02) were associated with refusal. Race, study
site, and other admission reasons did not contribute to refusing participation. Among the 262
dyads who declined randomization, caregiver reluctance (43%), perceived burden (31%),
technology-related issues (14%), transportation/logistics (10%), and others (4%), but not privacy,
were highlighted as major concerns.
What are the significant contributions of the researches in the field of medicine and nursing?
Participation may be improved by reducing perceived patient-caregiver load and improving
communication.

Title: Comparison of Endoscopy First and Laparoscopic Cholecystectomy First Strategies for
Patients With Gallstone Disease and Intermediate Risk of Choledocholithiasis: Protocol for a
Clinical Randomized Controlled Trial
Authors : Ausra Aleknaite , Gintaras Simutis , Juozas Stanaitis , Tomas Jucaitis , Mantas
Drungilas , Jonas Valantinas , Kestutis Strupas
Discussion and Summary: For patients with symptomatic cholecystolithiasis and intermediate
risk of choledocholithiasis, this study compares the two therapeutic options of endoscopic
ultrasonography before laparoscopic cholecystectomy and intraoperative cholangiography.
Adult patients receiving laparoscopic cholecystectomy for symptomatic gallbladder stones with
intermediate risk of choledocholithiasis are enrolled in this randomized, active-controlled,
single-center clinical trial. An innovative prognostic score is used to calculate the risk of
choledocholithiasis (the Vilnius University Hospital Index). In a retrospective analysis, this
measure performed better in terms of prognosis than the score published by the American
Society for Gastrointestinal Endoscopy in 2010. A total of 106 participants will be included and
randomized into two groups. Before laparoscopic cholecystectomy, one arm will have its bile
ducts evaluated using endoscopic ultrasonography and endoscopic retrograde cholangiography
on demand ("endoscopy first"). Another arm will have intraoperative cholangiography during
laparoscopic cholecystectomy and on-demand endoscopic retrograde
cholangiopancreatography ("cholecystectomy first"). A six-month follow-up is required after
surgery. The length of hospital stay is the key outcome. The secondary endpoints are accuracy
of the different management strategies, adverse events of the interventions, duct clearance and
technical success of the interventions (intraoperative cholangiography, endoscopic ultrasound,
and endoscopic retrograde cholangiography), and cost of treatment.
What are the significant contributions of the researches in the field of medicine and nursing?
This study will assess which treatment is preferable for patients at intermediate risk of common
bile duct stones and will design a simple and safe choledocholithiasis management regimen.

Title: The influence of probiotics on gastrointestinal tract infections among children attending
childcare: A systematic review and meta-analysis
Authors :Ahmad, Hafiz H., Peck, Blake and Terry, Daniel
Discussion and Summary: There is no systematic review available with pooled analysis of the
influence of probiotics on the incidence of gastrointestinal tract infections (GITIs) in the current
literature. As a result, the goal of this systematic review was to present current information on
the overall and strain-specific effects of probiotics in avoiding GITIs in infants and children in
childcare centers. After filtering the original search results of 779 publications, the review
narrowed it down to 18 RCTs. Only 15 trials were deemed suitable for the pooled analysis since
they addressed at least one outcome. Probiotic supplementation (overall effect) was found to
reduce the risk of GITI episode by 26%, with Lacticaseibacillus paracasei, Limosilactobacillus
reuteri, and Lacticaseibacillus rhamnosus GG being particularly effective in reducing GITI
episode, duration of infection, and absence from childcare, respectively. The effect of
Bifidobacterium animalis subsp. is unknown due to a lack of evidence. Based on the outcomes
of the studies covered in this review, lactis BB-12 was developed. The supplementation of
probiotic (overall effect) showed that the risk of GITI episode can be reduced by 26% (relative
risk: 0.74, 95% CI: 0.58 to 0.95, p = 0.02). The study demonstrates that the risk can be even
further reduced to 51% (relative risk 0.49, 95% CI 0.32–0.76, p < 0.01) if a specific strain of
probiotic (Lacticaseibacillus paracasei) was used. It must be noted, not all probiotic strains
were found effective in reducing the risk for GITI episodes since, the supplementation of
Bifidobacterium animalis subsp. lactis BB-12 had no significant effect on reducing the number
of children having at least one GITI episode. Also, the two trials (Merenstein et al., 2010b, 2011)
which were not included in the pooled analysis suggests lack of efficacy of Bifidobacterium
animalis subsp. lactis BB-12 in reducing incidence of diarrheal events (p = 0.73 & p = 0.36
respectively – Table 1). These results are consistent with past meta-analyses examining
children with respiratory tract infectionsin the home and childcare environment. The review
concludes that the supplementation of probiotics (overall effect) may reduce the risk of GITI
episode by 26%. Lacticaseibacillus paracasei, Limosilactobacillus reuteri and Lacticaseibacillus
rhamnosus GG are potent probiotic strains in reducing GITI episode, duration of infection and
absenteeism from childcare respectively. There is insufficient evidence to determine the effect
of Bifidobacterium animalis subsp. lactis BB-12 based on the findings of the trials included in
this review.
What are the significant contributions of the researches in the field of medicine and nursing?
This will help determine the effectiveness of probiotics on gastrointestinal tract infections
among children. THis will help since we all know that children are prone to gastrointestinal
infections. This will also lessen the use of antibiotics since infections are usually treated with
the use of antibiotics. Since some of the children doesn't like the taste of antibiotic unlike the
probiotics which tastes good.
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Serrano, P. E., Parpia, S., Nair, S., Ruo, L., Simunovic, M., Levine, O., Duceppe, E., & Rodrigues, C.
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undergoing gastrointestinal surgery for cancer (progress): Protocol for a feasibility randomized
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Owais, M., Arsalan, M., Mahmood, T., Kang, J. K., & Park, K. R. (2020). Automated Diagnosis of
Various Gastrointestinal Lesions Using a Deep Learning–Based Classification and Retrieval
Framework With a Large Endoscopic Database: Model Development and Validation. Journal of
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