ADR - Science topic

The traditional, paper-centric infrastructure public-private partnership (PPP) contracts have experienced record numbers of failures and terminations due to contract compliance issues, lack of trust and transparency, and information distortions. While studies on the adoption of blockchain and smart contracts in PPP are still growing, a quantitative...

Background and Aim Simnotrelvir/ritonavir and nirmatrelvir/ritonavir are major treatments for COVID‐19, but their comparative efficacy and safety, especially in patients with moderate to severe COVID‐19, remain unclear. Methods This was a retrospective cohort study using electronic medical record data. From May 30, 2023, to October 8, 2023, 115 pa...

Prioritizing patient safety in healthcare is crucial to mitigate adverse drug reactions (ADR) and enhance overall well-being. Despite a significant percentage of hospital admissions being attributed to drug side effects, less than 5% are reported directly by patients. This highlights the necessity for a comprehensive approach to identify, prevent,...

Background HIV/AIDS remains a global health challenge, with significant prevalence in sub-Saharan Africa. Highly active antiretroviral therapy (HAART) is the mainstay treatment for HIV, and the number of people living with HIV (PLWHIV) on HAART has considerably increased worldwide. The use of HAART has led to improved patient outcomes; however, it...

Objectives As anesthesia assisted (AA) colonoscopy becomes increasingly popular, there has been concern about its impact on the quality of colonoscopy examinations. We aimed to clarify the impact of anesthesia assistance on the adenoma detection rate (ADR) and non-adenomatous polyp detection rate (PDR) of colonoscopy. Methods We collected data fro...

El siguiente artículo se centra en presentar e implementar un programa de transferencia de la fuerza máxima a la fuerza explosiva en los deportistas de las categorías juveniles de Taekwondo que les permitan tener un mejor rendimiento durante las competencias, para que puedan realizar cada acción con la potencia necesaria, debido a que los deportist...

Objective There are three categories of drugs that treat human epidermal growth factor receptor type 2 (HER-2) positive breast cancer: monoclonal antibodies (mAbs), antibody-drug conjugates (ADCs), and tyrosine kinase inhibitors (TKIs). The purpose of this study is to analyze and compare the adverse reactions of three classes of anti-HER-2 drugs to...

Dietary restriction (DR) is a well‐established method for extending lifespan across various species, including C. elegans. Among the different DR regimens, axenic dietary restriction (ADR), in which worms are grown in a nutrient‐rich sterile liquid medium, yields the most powerful lifespan extension. However, the molecular mechanisms underlying thi...

Cilj ovog rada je analiza značaja i položaja normi koje regulišu prava titulara žigova u vezi sa registracijom naziva domena. Čitav okvir je regulisan pravilima koja samostalno donose kompanije koje pružaju usluge internet infrastrukture, imena i numeracije. S druge strane, zakonodavci ponekad moraju da intervenišu kako bi poboljšali taj okvir. UDR...

Background Real-world data on adverse drug reactions (ADRs) associated with idarucizumab and andexanet alfa are limited. Aim This study aimed to assess the frequency, the characteristics and clinical and demographic factors associated with ADRs related to their use. Methods This is a retrospective analysis of ADR reports collected in Vigibase® un...

Aims We aimed to describe suspected adverse drug reactions (ADRs) in infants resulting from medications transmitted through mothers' milk, as reported to the European ADR database, EudraVigilance. The research sought to understand the frequency, seriousness and nature of these ADRs to assess potential risks associated with maternal medication use d...

The ability to accurately determine the rotation rate and spin axis of active satellites during deployment, during phases of uncertain operations (e.g. loss of control, potential fuel leaks) and particularly for defunct satellites to assess suitability of removal of space objects by active debris removal is increasingly important. Conventional tech...

A prospective observational study was carried out to evaluate the patterns, severity, and management of chemotherapy-induced adverse drug reactions (ADRs) in cancer patients. The study included 135 patients receiving chemotherapy at a tertiary care hospital over six months. ADRs were assessed using Naranjo's causality assessment scale, Hartwig's se...

The question of the lawfulness, legality and otherwise of arrests has been a growing concern in the Nigerian criminal justice system notwithstanding the recent legislative revolution by the enactment of the Administration of Criminal Justice Act (ACJA) which provides comprehensive and innovative procedural checks on the power of arrest of the Polic...

The present study predicts effective doses of a set of phenethylamine (PEA) analogues that are frequently present in pre-workout and weight-loss food supplements, to prioritize these compounds for further risk assessment. In vitro determined EC50 values of PEA analogues for multiple human adrenergic receptor (ADR) subtypes (ADRα1A, α1B, α1D, α2A, β...

Campus conflicts, particularly school bullying, have garnered significant global attention, necessitating the exploration of effective resolution mechanisms. Peer mediation has emerged as a promising alternative dispute resolution (ADR) method, demonstrating success in various contexts, including labor disputes and community conflicts. This study e...

Drug side effect prediction is important for patient safety and drug development. Conventional approaches, such as clinical trials and post-marketing surveillance, are time-consuming, resource-intensive, and usually insufficient in detecting rare or delayed adverse effects. Current computational models, e.g., statistical and rule-based methods, are...

Pharmacovigilance plays a critical role in ensuring drug safety by identifying, assessing, and preventing adverse drug reactions (ADRs). Traditional pharmacovigilance methods rely heavily on manual reporting and retrospective analysis, leading to delays in detecting potential safety concerns. Artificial intelligence (AI) and machine learning (ML) h...

This piece examines the relationship between culture and alternative dispute resolution (ADR) and how cultural beliefs, values, biases shape human relationships, conflicts, and dispute resolution outcomes. It critically analyzes the dual-edged influence of culture on ADR practices, highlighting both the benefits and drawbacks, and explores the impl...

Antiseizure medication (ASM) induced metabolic syndrome (AIMetS) is a common adverse drug reaction (ADR) of pharmacotherapy for epilepsy and psychiatric disorders. However, the sensitivity and specificity of blood biomarkers may be insufficient due to the influence of combined pathology, concomitant diseases, and the peculiarities of the metabolism...

The main purpose of the article is to evaluate the possibility of using alternative dispute resolution (ADR) methods in resolving investment disputes in the energy sector. The basic method is the analysis of the literature on the subject, laws regarding the use of ADR methods and their interpretation presented by representatives of the doctrine. Th...

Background: Among rheumatologic diseases following therapy with immune checkpoint inhibitors (ICIs), the cases of cancer patients diagnosed as having polymyalgia rheumatica (PMR), particularly with nivolumab and pembrolizumab, has been steadily rising in published reports. Objectives: We performed a systematic review of published case reports with...

Poly(lactide) (PLA)/polyvinylidene difluoride (PVDF)/chain extender containing epoxy functional groups (ADR)/carboxylate multiwall carbon nanotubes (MWCNTs‐COOH) composites were prepared by combining solution blending and melt blending techniques. The dispersion state of MWCNTs‐COOH in the composites was controlled by the in situ reaction between c...

Background Lecanemab and Aducanumab are two novel anti-amyloid beta (Aβ) therapies for Alzheimer’s disease (AD) that have shown promise in slowing cognitive decline. However, their safety profiles remain unclear due to limited real-world evidence. This study aims to analyze and compare adverse drug reactions (ADRs) of these drugs using data from th...

Soil permeability is a critical parameter that dictates the movement of water through soil, and it impacts processes such as seepage, erosion, slope stability, foundation design, groundwater contamination, and various engineering applications. This study investigates the permeability of soil amended with waste foundry sand (WFS) at a replacement le...

Adverse Drug Reactions (ADRs) present major challenges to patient safety, necessitating timely and precise identification to enhance pharmacovigilance initiatives. Traditional ADR reporting systems suffer from underreporting and delays, prompting the need for alternative data sources such as social media. However, extracting meaningful insights fro...

Background: AYUSH systems, including Ayurveda, Siddha, Sowgarigpa Unani, Yoga, and Naturopathy, have gained significant popularity worldwide. However, there is a growing concern about adverse drug reactions (ADRs) associated with AYUSH formulations. Objective: This review aims to provide a comprehensive overview of ADRs reported in AYUSH systems, h...

The persistent farmers-herders' conflict in Adamawa State, Nigeria presents a complex challenge to manage. The conflict primarily arises from competition over scarce resources, which is further intensified by ethnic, religious, and political factors. The conflict has caused widespread devastation, claiming lives, destroying property, and displacing...

This article advocates redefining the lawyer’s role as a conflict manager, shifting from adversarial approaches to interest-based, consensual conflict resolution. Although litigation remains the norm, alternative dispute resolution (ADR), especially mediation, offers significant benefits that are often underutilized. Lawyers can act as advisors, gu...

Alla fine di questa prima edizione e del percorso sul territorio, che ha visto incontri pubblici nei comuni di Modena, Formigine, Capri-Unione delle Terre d'Argine, il 27 marzo, presso l’Aula Magna del Dipartimento di Giurisprudenza di Modena si terrà un convegno dedicato a “Risoluzione alternativa delle controversie: (ri)conciliarsi con la Pubbli...

Aims The quality of bowel preparation is crucial for the diagnostic effectiveness of colonoscopy, reducing costs associated with unnecessary repeats and discomfort for the patient. Scientific evidence shows that an "optimal" preparation defined by a Boston Bowel Preparation Scale (BBPS) score of 8 or 9 significantly increases the Adenoma Detection...

Background Adverse drug reactions (ADRs) harm patients and are costly for healthcare systems. Genetic variation contributes to variability in medication response and prospective knowledge of these variants can decrease risk of ADRs, as shown in the PREPARE trial. Reduction in ADRs would affect only those reactions to drugs contained in well-validat...

Background Androgen antagonists, including apalutamide, darolutamide, and enzalutamide, play a crucial role in the treatment of prostate cancer. This research evaluated the adverse drug reactions (ADRs) associated with the use of these androgen antagonists as reported by the World Health Organization (WHO). Additionally, it compared the adverse dru...

One of the adverse drug reactions that occur in patients who receive treatment therapy is drug side effects. Statins are the first choice in cholesterol-lowering therapy. Although statins are safe and well tolerated, they have the potential for side effects. The purpose of this study is to determine the prevalence of adverse drug reactions, the inc...

Introduction Based on the teachings of Rudolf Steiner, anthroposophic medicine (AM) is practiced in more than 80 countries around the world today. AM blends physical, mental and spiritual dimensions of life into patient care, nevertheless regarding itself as highly scientific. As a comparable systematic review (SR) of AM conducted more than two dec...

The rapid expansion of the Internet of Things (IoT) has led to the widespread adoption of sensor networks, with Long-Range Wide-Area Networks (LoRaWANs) emerging as a key technology due to their ability to support long-range communication while minimizing power consumption. However, optimizing network performance and energy efficiency in dynamic, l...

Construction disputes are prevalent because of the complexity of projects, heterogeneity of stakeholder interests, and contractual ambiguity. Although negotiation is still the preferred way to resolve these disputes, power inequalities, cognitive distortions, and adversarial behavior tend to undermine equitable and efficient solutions. This researc...

This Data Explained summarises the content and potential limitations to users of the Welsh National Database for Substance Misuse (WNDSM) dataset. This is the primary dataset relating to individuals referred to, assessed and/or provided treatment within specialist substance misuse services in Wales. This paper aims to guide researchers who are in...

In smart-city scenarios, the high density of buildings and nodes poses significant challenges to the Quality of Service (QoS) in LoRaWAN communications, resulting in frequent data loss and degraded network performance. This paper introduces the LoRa Loss Node Relay Mechanism (LLNRM), a novel solution designed to enhance the reliability of LoRaWAN n...

Pakistan faces a significant backlog of civil dispute cases, hindering the administration of justice and jeopardizing the nation's social, political, and economic stability. Mediation is an alternative dispute resolution procedure that facilitates the attainment of justice in the resolution of tax issues. The primary aim of mediation is to enhance...

Inadequate bowel preparation (BP) negatively affects the diagnostic performance of a colonoscopy. Most of the trials assessing adequacy of bowel preparation regimens excluded patients affected by chronic kidney disease (CKD), especially patients on dialysis. This study aimed to 1/ assess the impact of dialysis on BP quality and adenoma detection ra...

Background The risk factors related to the adverse drug reactions (ADRs) of anlotinib have been rarely investigated. In addition, a corresponding risk prediction model has not been established in China pertaining to anlotinib-related ADRs. Objectives To manage ADRs more efficiently and improve the prognosis of patients administered anlotinib. Des...

Objective Colorectal cancer (CRC) is the third most common cancer in Denmark, with a 5-year mortality of 40%. To reduce CRC incidence and mortality, a faecal immunochemical test (FIT)-based screening programme was introduced in 2014. Adenoma detection rate (ADR) is an established quality marker inversely associated with post-colonoscopy CRC (PCCRC)...

Adriamycin (ADR), as an anti-cancer drug in routine clinical application, is utilized to treat various cancers such as ovarian cancer, hematological malignant tumor, and endometrial carcinoma. However, its serious dose-dependent cardiotoxicity extremely limits its clinical application. Currently, there remains a dearth of therapeutic agents to miti...

This work examines how decentralised autonomous organisations (DAOs) can improve transparency, fairness, and inclusivity in community-based decision-making, using the case of research grant allocation within a university community in Switzerland. The current voting mechanism has been criticised for fostering partiality and favouring personal networ...

Corona virus disease is a most contagious disease caused by a newly discovered corona virus, initially identified in the Mainland of China(Wuhan) in late December 2019. Covid-19 has been initiated as a highly infectious disease that can spread quickly in a community population depending the number of susceptible and infected larger number of cases...

As global demographics shift toward an aging population, the urgency for innovative diagnostic tools to address Alzheimer’s and dementia-related diseases (ADR) has never been greater. Current methods often miss the opportunity to capture the nuanced interplay between cognitive decline and emotional health, leaving critical diagnostic gaps. This pap...

Background This study assessed the adverse drug reactions (ADRs) associated with HDAC inhibitors using the VigiAccess database maintained by the World Health Organization (WHO). Furthermore, it compared the ADR profiles of three different drugs to identify the one with the lowest individualized risk for patients. Materials and methods Data on adve...

Enhanced Passive Safety Surveillance was used to detect safety signals before the peak period of immunization with quadrivalent inactivated influenza vaccines (IIV4) in Finland (standard dose [SD]) and Germany (high dose [HD]) in the 2023–24 season. The primary objective was to evaluate adverse drug reactions (ADRs) occurring ≤7 days following IIV4...

Background The burden of substandard antibiotics is high in low-middle income countries including Malawi. These poor-quality antibiotics may cause deleterious effects on patients and promote drug resistance. We assessed the quality of antibiotics and the associated clinical outcomes among hospitalized patients in southern Malawi. Methods A cross-s...

Large Vision-Language Models (LVLMs) have achieved significant progress in combining visual comprehension with language generation. Despite this success, the training data of LVLMs still suffers from Long-Tail (LT) problems, where the data distribution is highly imbalanced. Previous works have mainly focused on traditional VLM architectures, i.e.,...

Rats are gregarious rodents who naturally live in diverse social groups and communicate in part through ultrasonic vocalisations (USVs). USVs encode significant information about affective state and play an important role in social behaviour. Monitoring USVs is a non-invasive method of adding richness to data in a variety of experimental paradigms....

With the emergence of data ecosystems organisations are not only analysing their own data but also utilising data outside of their boundaries. Interorganizational data exchange comes with new challenges in terms of data governance. Inspired by organisational information processing theory, this paper follows an action design research (ADR) approach...

Introduction: In recent decades, AIDS–related illnesses have declined due to the widespread use of highly active antiretroviral therapy (HAART). Despite the numerous benefits that HAART provides, it causes significant challenges for users in the form of adverse drug reactions (ADRs). Therefore, this systematic review and meta-analysis was conducted...

This paper presents a hybrid optimization methodology for parameter estimation of reactive transport systems. Using reduced-order advection-diffusion-reaction (ADR) models, the computational requirements of global optimization with dynamic PDE constraints are addressed by combining metaheuristics with gradient-based optimizers. A case study in prep...

Adiabatic demagnetization refrigeration (ADR) offers a compelling alternative to traditional ultra-low temperature technologies by eliminating the reliance on scarce ³He and gravitational constraints. The key of ADR development is to find magnetic refrigerants with exceptional magnetocaloric properties. In this study, polycrystalline CsEuCl3 and Cs...

Background Bowel preparation quality is one of the most important quality measures in colonoscopy. Sulfate-based tablets (Sodium sulfate, magnesium sulfate, potassium chloride) and sulfate-based solution (sodium, magnesium, potassium sulfate) are commonly used for bowel preparation for colonoscopy. However, there has been no comparison between thes...

This article or writing aims to find out about the ineffectiveness of settlement through arbitration according to Republic of Indonesia Law Number 30 of 1999 concerning Adr (Alternative Dispute Resolation). The problem focuses on the ineffectiveness of settlement through arbitration according to Republic of Indonesia Law Number 30 of 1999 concernin...

The hospitality industry in South Asia is influenced by regional market dynamics, with Sri Lanka and the Maldives often compared due to their geographical proximity and tourism dependence. However, a stark contrast exists in the Average Daily Rate (ADR) of hotels in Sri Lanka and luxury resorts in the Maldives. This paper explores the factors behin...

Background Hip dysplasia (HD) at skeletal maturity can result from residual developmental dysplasia of the hip (DDH) treated in childhood or from primary adolescent-onset HD (AOHD). This study aims to compare the pathomorphology of these two HD subtypes with that of a normal control group. Methods This retrospective study reviewed patients who und...

Background Intravenous (IV) therapy is a common treatment but is associated with high rates of medication errors and adverse events, especially in children. In China, most public hospitals have halted adult outpatient IV services, but pediatric IV management remains a challenge. This study evaluates the effectiveness of medication safety officer (M...

Introduction Despite expanded antiretroviral therapy (ART) in China, HIV transmission persists. Liangshan Prefecture is one of the areas in China most severely affected by HIV, with high levels of drug resistance. A deeper understanding of HIV-1 drug resistance can lead to improvements in current treatment policies. Methods We conducted an analysi...

Thermoplastic polyamide elastomers (TPAEs) with polyamide 6 (PA6) as hard segments and polyether amine as soft segments are successfully synthesized by one‐pot melt polycondensation, in which the tensile strength and elongation‐at‐break of the resulting TPAE with soft segment content of 43 wt% reached (27.54 ± 0.92) MPa and (508.10 ± 19.81)%, respe...

Conflict is undoubtedly an inevitable component of human interactions in any given society. Conflict arises from the differences and incompatibility of aims and values among individuals in a community. Throughout history, whether in ancient times or in the present day, when conflicts arise, people have always sought ways to resolve them, eithe...

Background Poor bowel preparation has been a great problem of endoscopists for a long time. Low-residue diet (LRD) is often recommended on the day before colonoscopy. However, the quality of bowel preparation with LRD alone is suboptimal. The aim of our study was to examine whether patients who consumed LRD with oral nutritional supplements (ONSs)...

This article examines the Dispute Adjudication Board (DAB) as an innovative mechanism within Georgia’s alternative dispute resolution (ADR) system. As large-scale infrastructure projects proliferate globally, effective and timely dispute resolution becomes essential. While ADR mechanisms like arbitration and mediation are well-established, the DAB...

Purpose: Dosing, safety, and outcomes of amiodarone in acute post-operative atrial arrhythmias (POAAs) after lung transplantation are not well understood. Current literature suggests amiodarone may increase mortality in lung transplant recipients (LTRs). This study described outcomes associated with amiodarone use in POAAs after lung transplantatio...

The construction industry over the years has seen changes and advancements in almost all areas such as planning, execution, etc. However, alternative dispute resolution (ADR) is an important aspect with regard to the dispute mitigation process, which still needs to be implemented in a full-fledged manner. It is, therefore, important to gather the p...

The present article delves into the theoretical considerations that underlie the current use of Alternative Dispute Resolution (ADR) within the Criminal Justice System. We argue that ADR can address the Social Causes of Crime while still honouring strong beliefs in individual accountability and societal standards by looking at it through the persp...

Artificial intelligence (AI)-assisted prediction of adverse drug reactions (ADRs) has significant potential for improving drug safety and reducing financial costs. Early studies often relied on limited dimensions such as the molecular structure of drugs or interactions with biomolecules. In contrast, integrating these characteristics provides valua...

Introduction Adverse Drug Reactions (ADRs), a widespread phenomenon in clinical drug treatment, are often associated with a high risk of morbidity and even death. Drugs and changes in gene expression are the two important factors that affect whether and how adverse reactions occur. Notably, pharmacogenomics data have recently become more available...

Purpose To evaluate the factors influencing voriconazole (VRC) administration, clinical efficacy, and safety in children with hematological malignancies (HM) and invasive fungal infection (IFD). Methods This is a single-center, retrospective real-world study conducted between July 2018 and December 2023. Univariate and multivariate logistic regres...

Introduction: Rates of drug-resistant tuberculosis (TB) are increasing worldwide. TB preventive treatment (TPT) for contacts of active TB patients is essential to halt infection progression and transmission. While newer TPT regimens for drug-sensitive strains are expanding, optimal treatment for contacts exposed to drug-resistant TB (DR-TB) remains...

Due to the development of court mediation conducted on the basis of the provisions of the Code of Civil Procedure and the lack of significant amendment to the provisions relating to the mediator’s remuneration for the services provided, the authors of the study ask whether the remuneration in question is adequate to the mediator’s experience, compe...

Mediation is the most widely used form of dispute resolution. Given its position vis-à-vis the judicial process in continental legal culture, it should be recognised as part of the administration of justice. In this context, it is legitimate to discuss the right to mediation in the context of the evolution of human rights, as another right of the i...

Treatment interruptions due to adverse drug reactions (ADRs) are common in iron deficiency anemia (IDA). We evaluated medication completion rates and quality of life (QoL) changes in patients with IDA after starting ferric citrate hydrate (FCH) treatment. This multicenter, open-label, uncontrolled, single-arm comparative study included 30 Japanese...

The emergence of tax disputes as a consequence of differences in interests between tax authorities and taxpayers is a normal thing to happen. However, if an excessive number of tax disputes occur, this has the potential to create legal uncertainty, both for taxpayers and tax authorities. In theory and practice, a dispute resolution mechanism has de...

Introduction In gliomas, various oncogenic factors can lead to an imbalance between cell proliferation and apoptosis. Lomustine inhibits tumor cell growth by disrupting DNA replication and repair mechanisms. In contrast, temozolomide, an imidazole tetrazine compound, promotes cell apoptosis through DNA alkylation. The present study aimed to systema...

Purpose This study conducted a post-marketing safety re-evaluation of placental polypeptide injections in China to support updates to drug guidelines, pharmacovigilance efforts, and rational clinical use, facilitating its inclusion in essential drug lists and medical insurance coverage. Methods A hospital-based centralized monitoring system tracke...

RESUMEN El presente trabajo versa sobre el transporte por carretera de gasolina realizado por particulares. Principalmente, particulares que no se encuentran habilitados para desarrollar esta actividad y la realizan en vehículos no fabricados para dicho fin. Con ello se genera un riesgo para la seguridad vial, el medio ambiente, la seguridad ciuda-...

Fecha de recepción: 30/12/2021. Fecha de aceptación: 14/03/2022 RESUMEN El presente artículo versa sobre la gasolina destinada a ser empleada como combustible para las "narcolanchas". Esta gasolina bautizada como "narcogasolina", ade-más de ser una herramienta fundamental y, por ende, parte vital de la logística nece-saria para el tráfico de hachís...

Purpose To explore the efficacy and safety of pyrotinib in a real-world setting in a population with HER2-positive advanced breast cancer, subgroup analysis was conducted based on different clinicopathological features to further explore the general characteristics of patients, tumor nature, and the effect of various lines of treatment before patie...

Introduction: High-quality colonoscopy is influenced by several factors, with the adenoma detection rate (ADR) being one of the most studied indicators. A strong inverse relationship exists between ADR and the risk of developing post-colonoscopy colorectal cancer (PCCRC), prompting the European Society of Gastrointestinal Endoscopy guidelines to re...

Background Hypertension presents as a modifiable risk factor for cardiovascular diseases, with approximately two-thirds of the global hypertensive population concentrated in low- and middle-income nations. Sarpagandha Mishran is an Ayurveda intervention utilized for the management of hypertension. The objective of the study is to assess the clinica...

Objectives: There is still no consensus regarding the indications of long-acting injectable antipsychotics (LAIs) in early psychosis (EP). This umbrella review synthesizes findings from systematic reviews and meta-analyses on the risk-benefit balance of LAIs in EP. Methods: Eligible systematic reviews and meta-analyses on LAIs in EP were identified...

Contract management in construction law plays a critical role in mitigating risks, ensuring performance enforcement, and facilitating dispute resolution. The increasing complexity of construction projects, coupled with evolving regulatory frameworks, necessitates robust contract management strategies to address financial, operational, and legal ris...

Background Same-day performance of esophagogastroduodenoscopy (EGD) and colonoscopy is called bidirectional endoscopy (BDE). BDE is commonly performed, but the optimal sequence for which procedure to do first is not well established. This is the first study in the US to investigate the optimal sequence for BDE. Methods We performed a cohort study...