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The management of inflammatory bowel disease represents a key component of clinical practice for members of the British Society of Gastroenterology (BSG). There has been considerable progress in management strategies affecting all aspects of clinical care since the publication of previous BSG guidelines in 2004, necessitating the present revision.Key components of the present document worthy of attention as having been subject to re-assessment, and revision, and having direct impact on practice include:The data generated by the nationwide audits of inflammatory bowel disease (IBD) management in the UK in 2006, and 2008.The publication of ‘Quality Care: service standards for the healthcare of people with IBD’ in 2009.The introduction of the Montreal classification for Crohn's disease and ulcerative colitis.The revision of recommendations for the use of immunosuppressive therapy.The detailed analysis, guidelines and recommendations for the safe and appropriate use of biological therapies in Crohn's disease and ulcerative colitis.The reassessment of the role of surgery in disease management, with emphasis on the importance of multi-disciplinary decision-making in complex cases.The availablity of new data on the role of reconstructive surgery in ulcerative colitis.The cross-referencing to revised guidelines for colonoscopic surveillance, for the management of metabolic bone disease, and for the care of children with inflammatory bowel disease.Use of the BSG discussion forum available on the BSG website to enable ongoing feedback on the published document http://www.bsg.org.uk/forum (accessed Oct 2010).The present document is intended primarily for the use of clinicians in the United Kingdom, and serves to replace the previous BSG guidelines in IBD, while complementing recent consensus statements published by the European Crohn's and Colitis Organisation (ECCO) https://www.ecco-ibd.eu/index.php (accessed Oct 2010).

The Lyon Consensus provides conclusive criteria for and against the diagnosis of gastro-oesophageal reflux disease (GERD), and adjunctive metrics that consolidate or refute GERD diagnosis when primary criteria are borderline or inconclusive. An international core and working group was assembled to evaluate research since publication of the original Lyon Consensus, and to vote on statements collaboratively developed to update criteria. The Lyon Consensus 2.0 provides a modern definition of actionable GERD, where evidence from oesophageal testing supports revising, escalating or personalising GERD management for the symptomatic patient. Symptoms that have a high versus low likelihood of relationship to reflux episodes are described. Unproven versus proven GERD define diagnostic strategies and testing options. Patients with no prior GERD evidence (unproven GERD) are studied using prolonged wireless pH monitoring or catheter-based pH or pH-monitoring off antisecretory medication, while patients with conclusive GERD evidence (proven GERD) and persisting symptoms are evaluated using pH-impedance monitoring while on optimised antisecretory therapy. The major changes from the original Lyon Consensus criteria include establishment of Los Angeles grade B oesophagitis as conclusive GERD evidence, description of metrics and thresholds to be used with prolonged wireless pH monitoring, and inclusion of parameters useful in diagnosis of refractory GERD when testing is performed on antisecretory therapy in proven GERD. Criteria that have not performed well in the diagnosis of actionable GERD have been retired. Personalisation of investigation and management to each patient’s unique presentation will optimise GERD diagnosis and management.

Clinical history, questionnaire data and response to antisecretory therapy are insufficient to make a conclusive diagnosis of GERD in isolation, but are of value in determining need for further investigation. Conclusive evidence for reflux on oesophageal testing include advanced grade erosive oesophagitis (LA grades C and D), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal oesophageal acid exposure time (AET) >6% on ambulatory pH or pH-impedance monitoring. A normal endoscopy does not exclude GERD, but provides supportive evidence refuting GERD in conjunction with distal AET <4% and <40 reflux episodes on pH-impedance monitoring off proton pump inhibitors. Reflux-symptom association on ambulatory reflux monitoring provides supportive evidence for reflux triggered symptoms, and may predict a better treatment outcome when present. When endoscopy and pH or pH-impedance monitoring are inconclusive, adjunctive evidence from biopsy findings (histopathology scores, dilated intercellular spaces), motor evaluation (hypotensive lower oesophageal sphincter, hiatus hernia and oesophageal body hypomotility on high-resolution manometry) and novel impedance metrics (baseline impedance, postreflux swallow-induced peristaltic wave index) can add confidence for a GERD diagnosis; however, diagnosis cannot be based on these findings alone. An assessment of anatomy, motor function, reflux burden and symptomatic phenotype will therefore help direct management. Future GERD management strategies should focus on defining individual patient phenotypes based on the level of refluxate exposure, mechanism of reflux, efficacy of clearance, underlying anatomy of the oesophagogastric junction and psychometrics defining symptomatic presentations.

Artificial intelligence (AI) holds significant potential for enhancing quality of gastrointestinal (GI) endoscopy, but the adoption of AI in clinical practice is hampered by the lack of rigorous standardisation and development methodology ensuring generalisability. The aim of the Quality Assessment of pre-clinical AI studies in Diagnostic Endoscopy (QUAIDE) Explanation and Checklist was to develop recommendations for standardised design and reporting of preclinical AI studies in GI endoscopy.The recommendations were developed based on a formal consensus approach with an international multidisciplinary panel of 32 experts among endoscopists and computer scientists. The Delphi methodology was employed to achieve consensus on statements, with a predetermined threshold of 80% agreement. A maximum three rounds of voting were permitted.Consensus was reached on 18 key recommendations, covering 6 key domains: data acquisition and annotation (6 statements), outcome reporting (3 statements), experimental setup and algorithm architecture (4 statements) and result presentation and interpretation (5 statements). QUAIDE provides recommendations on how to properly design (1. Methods, statements 1–14), present results (2. Results, statements 15–16) and integrate and interpret the obtained results (3. Discussion, statements 17–18).The QUAIDE framework offers practical guidance for authors, readers, editors and reviewers involved in AI preclinical studies in GI endoscopy, aiming at improving design and reporting, thereby promoting research standardisation and accelerating the translation of AI innovations into clinical practice.

This study is concerned with the problem of dynamical distributed consensus for multi-agent systems with nonlinear dynamics. Following the nearest neighbour rule, an adaptive consensus protocol is designed for such systems without using any global information, where the coupling weight of an agent from its neighbours adaptively updates according to the differences from the mean activity of the agent and its neighbours. The analysis shows that, under some mild assumptions, the adaptive law can achieve local and global consensus for any network with connected communication graph. Numerical simulations, illustrated by a common second-order consensus example, are performed to demonstrate the effectiveness of the presented results.

This study presents a consensus region approach to designing distributed consensus protocols for multi-agent systems with general continuous-time linear node dynamics. The consensus region approach has a favourable decoupling feature, which decouples the design of the feedback gain matrices of the consensus protocols from the communication graph. Multi-step algorithms are presented to construct the fixed-gain consensus protocols, which requires the smallest non-zero eigenvalue of the Laplacian matrix. To remove this limitation, distributed adaptive protocols with time-varying coupling weights are designed for the cases with undirected and directed graphs, which can be implemented in a fully distributed fashion. The robustness issue of the adaptive protocols in the presence of external disturbances is also discussed. For the case where there exists a leader of bounded unknown control input, distributed discontinuous and continuous controllers are designed to solve the distributed tracking problem.

Background The Tripuri people possess a rich cultural heritage, a deep-rooted tradition, and extensive knowledge of medicinal plants. However, their medicinal knowledge remains poorly documented. Therefore, this study aims to comprehensively report their ethnomedicinal knowledge with the following objectives: (1) exploring the relationship between socio-demographics and familiarity with traditional medicinal plants using statistical analysis, (2) creating a comprehensive record of the medicinal properties and applications of plants used by the Tripuri people, (3) identifying key indicator species utilized in the fringe villages of three contiguous reserve forests using multivariate statistical analysis, (4) examining the diversity and application methods of medicinal plants in contiguous reserve forests, and (5) consensus among informants regarding the use of medicinal plants for the management of diseases prevalent in the study area. Methods From 2024 to 2025, 200 respondents ( n  = 200), comprising traditional healers, farmers, traders, housewives, and employees aged 30–99, were interviewed via snowball sampling. Data collection involved observation, a semi-structured questionnaire, and individual interviews, followed by statistical analysis. Multivariate analysis identified key indicator species used by Tripuri people, and the information consensus factor (ICF) was also evaluated. Results A total of 105 plant species belonging to 53 families were documented, with leaves being the most commonly used plant part. Poultice and infusion were the primary application methods. Moreover, a comparison with previous works on novel reports, commonalities, and their cultural interpretations revealed the highest Jaccard index (JI) value of 10.65 from Barpeta District in Assam. In contrast, the lowest JI value of 1.15 was recorded from the Gingee Hills in Tamil Nadu. Additionally, most indicator species were found in the fringe villages of the Deo Reserve Forest (DRF). Notably, the ICF of 1 was recorded for disease categories related to pregnancy and childbirth, while other categories showed ICF values ranging from 0.97 to 0.98. Conclusion The present study reflects their extensive knowledge of medicinal plants, cultural beliefs, and their deep connection with nature. Traditional healers play a crucial role in conserving these medicinal plants. However, young people are gradually shifting away from traditional medical practices.

Time-varying formation control problems for high-order linear time-invariant swarm systems with switching interaction topologies are investigated. A general formation control protocol is proposed firstly. Then using a consensus based approach, necessary and sufficient conditions for swarm systems with switching interaction topologies to achieve a given time-varying formation are presented. An explicit expression of the time-varying formation reference function is given. It is revealed that the switching interaction topologies have no effect on the formation reference function and the motion modes of the formation reference can be specified. Furthermore, necessary and sufficient conditions for formation feasibility are presented. An approach to expand the feasible formation set is given and an algorithm to design the protocol for swarm systems with switching interaction topologies to achieve time-varying formations is provided. Finally, numerical simulations are presented to demonstrate theoretical results.

This study studies the consensus problem of linear multi-agent systems via event-triggered control. Two novel event-triggered control schemes, one centralised and the other distributed, are developed. It is shown that under the proposed control protocols, consensus can be reached for all undirected connected communication graphs. An example is finally presented to illustrate the effectiveness of the proposed control methods.