Background: Coronavirus Disease 2019 (COVID-19) is currently a global public health threat. Outside of China, Italy is one of the most suffering countries with the COVID-19 epidemic. It is important to predict the epidemics trend of COVID-19 epidemic in Italy to help develop public health strategies. Methods: We used time-series data of COVID-19 from Jan 22,2020 to Mar 16,2020. An infectious disease dynamic extended susceptible-infected-removed (eSIR) model, which covers the effects of different intervention measures in dissimilar periods, was applied to estimate the epidemic trend in Italy. The basic reproductive number was estimated using Markov Chain Monte Carlo methods and presented using the resulting posterior mean and 95% credible interval (CI). Hunan, with similar total number of populations in Italy, was used as a comparative item. Results: In the eSIR model, we estimated that the basic reproductive number for COVID-19 was respectively 4.10 (95% CI: 2.15–6.77) in Italy and 3.15(95% CI: 1.71–5.21) in Hunan. There would be totally 30 086 infected cases (95%CI:7920-81 869) under the current country blockade and the endpoint would be Apr 25 (95%CI: Mar 30 to Aug 07) in Italy. If the country blockade is imposed 5 day later, the total number of infected cases would expand the infection scale 1.50 times. Conclusion: Italy’s current strict measures can efficaciously prevent the further spread of COVID-19 and should be maintained. Necessary strict public health measures be implemented as soon as possible in other European countries with a high number of COVID-19 cases. The most effective strategy needs to be confirmed in further studies.

Background and Objectives: This study retrospectively evaluated the value of liquid-based cytology (LBC) alone for diagnosing pancreatic cystic neoplasms (PCNs) in a large sample and initially estimated factors that might affect LBC diagnostic ability. Methods: From April 2015 to October 2022, we prospectively enrolled 331 patients with suspected PCNs in our prospective database. Among them, 112 patients chosen to receive surgical resection were included. Only 96 patients who underwent EUS-guided cystic fluid LBC were finally studied. The diagnostic values of LBC for differentiating benign and malignant PCNs and subtypes of PCNs were evaluated. Results: There were 71 female and 25 male patients with a mean age of 47.6 ± 14.4 years. The median cyst size was 43.4 mm. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of LBC for the differentiation of benign and malignant PCNs were 96.9%, 57.1%, 100%, 100%, and 96.7%, respectively. The overall diagnostic accuracy of LBC for specific cyst types was 33.3% (32/96). Cysts located in the pancreatic body/tail or with irregular shapes were more likely to obtain a definite LBC diagnosis. At the same time, age, sex, tumor size, cystic fluid viscosity, operation time, needle type, and presence of septation were not significantly different. Conclusion: Liquid-based cytology alone is useful for differentiating benign PCNs from malignant PCNs and can successfully characterize the PCN subtypes in one-third of patients. Pancreatic cystic neoplasms located in the body/tail or exhibiting irregular shapes are more likely to obtain a definite LBC diagnosis.

Background and Aim: Current treatments for refractory benign esophageal strictures (BESs) often take several years and have poor effects. The authors propose a novel method of self-help inflatable balloon (SHIB) and evaluate its efficacy and safety. Methods: A prospective, multicenter study was conducted from January 2019 to March 2022. All enrolled patients were diagnosed with refractory BESs and received SHIB. The primary endpoint was the clinical success rate at 12 months after removing SHIB. The secondary endpoints were the number of days of placing SHIB, and changes from baseline in BMI and health-related quality of life at 1, 3, 6, and 12 months. Results: The clinical success rate was 51.2% (21/41) with the median days of placing SHIB being 104.0 days (range: 62.0–134.5 days), which was higher in the endoscopic group compared to the caustic and surgery groups (63.3 vs. 28.6% vs. 0, P=0.025). All patients (100%) showed significant improvement in dysphagia scores during placing SHIB. Although 20 patients (48.8%) experienced recurrent stricture, the median stricture length was decreased (P<0.001) and the median intervention-free interval was prolonged (P<0.001). In all patients, the mean BMI at and health-related quality of life at 1, 3, 6, and 12 months were significantly increased compared with baseline (P<0.05). On multivariate analysis, stricture etiology and wearing time were independent predictors of recurrent stricture. Conclusions: The SHIB has high efficacy and safety in treating refractory BESs of different origins, especially for endoscopic resection. Stricture etiology and wearing time were independent predictors of recurrent stricture.

Objectives: To explore the safety and efficacy of injections of 1%, 2%, or 3% lauromacrogol during EUS–guided lauromacrogol ablation (EUS-LA) for the treatment of pancreatic cystic neoplasms (PCNs) and to determine the optimal concentration of lauromacrogol for use in EUS-LA therapeutic regimens. Methods: From May 2021 to January 2023, patients who met the indications for EUS-LA were randomly divided into 3 groups: A, B, and C; the patients in these groups were injected with 1%, 2%, and 3% lauromacrogol during EUS-LA, respectively. Safety was evaluated based on the incidence of postoperative complications. Efficacy was comprehensively evaluated by assessing the ablation rate and ablation effect. Results: Forty-two patients underwent EUS-LA, and 31 patients completed at least 1 postoperative re-examination. No acute pancreatitis was observed in the 1% and 2% lauromacrogol groups, and 1 case of acute pancreatitis occurred in the 3% lauromacrogol group. The total complication rate was 2.4%. The median ablation rates of the groups were 94.1%, 82.0%, and 100.0%, respectively. There were statistically significant differences in the EUS-LA ablation rate between the 1% and 3% lauromacrogol groups and between the 2% and 3% lauromacrogol groups. There was a statistically significant difference in complete disappearance between the 1% and 3% lauromacrogol groups as well as between the 2% and 3% lauromacrogol groups. Conclusion: The short-term outcomes showed that injections of 1%, 2%, and 3% lauromacrogol were safe for use in EUS-LA, and injection of 3% lauromacrogol was the most effective for EUS-LA.

Sleep disorders represent major public health concerns with significant health consequences. While diet shows promise as a modifiable intervention, the differential effects of established dietary patterns on specific sleep phenotypes and the contributions of specific food groups remains unclear. Therefore, this study investigated how three established dietary patterns relate to distinct sleep outcomes, and further explored the contributions of specific food components. We combined four decades of data and analyzed 9040 US adults from NHANES with sampling weights. Five sleep outcomes were examined in relation to dietary pattern adherence, quantified through averaged 24‐h recall data from two consecutive days: including self‐reported sleep duration, sufficiency, OSA, daytime sleepiness, and stop breathing. For international validation, we used the Global Dietary Database (62 countries) linked to country‐level sleep apnea prevalence (191 countries). Cohort analysis employed the Chinese Longitudinal Healthy Longevity Survey ( n = 6885). Causal associations between dietary components and sleep phenotypes were investigated using two‐sample Mendelian randomization with genome‐wide association summary statistics. Our results demonstrated that greater the Mediterranean Diet (MED) adherence was associated with longer sleep duration ( β = 0.06, 95% CI: 0.03–0.10, p < 0.001) and sufficient sleep (OR = 1.10, 95% CI: 1.04–1.15, p < 0.001). Notably, dietary Approaches to Stop Hypertension (DASH) adherence offered the strongest protection against daytime sleepiness (OR = 0.89, 95% CI: 0.85–0.93, p < 0.001) and breathing cessation episodes (OR = 0.91, 95% CI: 0.85–0.96, p = 0.001). The Alternative Healthy Eating Index (AHEI) demonstrated balanced associations with improved sleep sufficiency (OR = 1.006, p < 0.05), reduced daytime sleepiness (OR = 0.995, p < 0.05), and fewer breathing episodes (OR = 0.989, p < 0.01). Furthermore, food‐component‐level analyses revealed consistent protective associations from legumes, nuts, and whole grains, while vegetables, fruits, meats, and SSBs showed variable effects—findings supported by both multi‐database analyses and Mendelian randomization. Importantly, MR further demonstrated specific causal associations for fruits and vegetables: pears and strong vegetable preferences protected against short sleep, while cabbage, grapefruit, and melon causally increased sleep disorder risk. Additionally, processed meats causally increased OSA and snoring risk, with food processing degree emerging as a critical causal determinant. In conclusion, this study makes three main contributions. First, we provide a direct comparison of multiple dietary patterns (MED, DASH, AHE) across diverse sleep phenotypes. Second, we identify specific protective food components, with genetic causal evidence supporting their effects on sleep. Third, we integrate multi‐national datasets to validate findings across diverse populations, substantially enhancing generalizability. Collectively, these findings support evidence‐based dietary interventions for sleep health improvement.